A Hard Choice

In a written statement, the dean said he decided "after careful consideration, that the Medical Students for Choice organization did not fall within our educational mission and could not be accommodated at the School of Medicine. As a state institution, it is crucial that the University of Maryland School of Medicine remain unbiased and balanced on this issue."

In the end, the Hopkins chapter of Students for Choice hosted the conference, which drew about 25 students from five states. Lesley was still fuming about the dean's decision as Carole Meyers, Myron Rose and experts on medical abortion and world population spoke.

"Abortion is one of the most common surgical procedures performed on women, yet nobody in medical school even talks about it," Lesley said. "If medical students don't talk about it, how will they learn?"

It was Christina, the Students for Choice chapter president, who proposed holding a papaya workshop to expose more students to abortion. She'd heard about such a workshop at a national Students for Choice gathering. It was a hands-on opportunity for second-year medical students to learn how to perform an abortion, using a papaya as a stand-in for a woman's uterus. Lesley thought it was a great idea.

The women enlisted doctors, residents and nurses from Maryland and Johns Hopkins to run the workshop and e-mailed an invitation to all second-year students. They promised dinner, a sure bet to lure medical students. This time, if the dean knew about their plans, he didn't object. Soon the workshop, which could accommodate 20 students, had a waiting list -- and the women organizing it had a small firestorm on their hands.

In her e-mail, Christina had hoped to attract participants by suggesting that they'd have fun learning the procedure: "You'll get the opportunity to be shown how to use manual vacuum aspirators using papaya models (apparently papayas bear a striking resemblance to a uterus. Who knew?)" But some of the students who received the invitation didn't see it that way. "This is a serious matter," one told Christina. Those offended by her tone demanded to be dropped from any future Medical Students for Choice e-mails. After consulting a dean, the women didn't remove any names from their list, but they decided to word future missives more carefully.

On the day of the workshop, Christina wiped out the stock of papayas at a Whole Foods store. The man behind her at the checkout wanted to know what she was using them for.

A medical procedure, she told him.

Come on, tell me, he pushed. A suture?

Something like that, she said she responded. She was not about to get into an abortion discussion in the supermarket.

Bizarre as it might seem to perform an operation on a papaya, in medical school it isn't unusual. Fruit or other food is regularly used to describe things in obstetrics. A uterus holding an 8-week-old fetus is the size of a naval orange. After 12 weeks, it is more like a grapefruit. The uterus itself is shaped like, well, a papaya.

Lesley's eyes were drooping as she, Christina and Regina set out tortillas and taco fixings in a second-floor classroom and assembled papayas and abortion instruments at stations in a lab next door. Like the others, Lesley was recovering from a big test earlier in the week, but she also had overextended herself on the treadmill. Still, in a long-sleeve, black scoop-neck top, jeans, shiny black rain boots and a tan sweater vest tied lightly at her waist, she was a picture of elegance. Her chin-length blond-streaked hair was tied into a tiny pony tail, accenting her angular features.