The real mystery of Dr. Kermit Gosnell is not his identity as a serial killer who preyed on women and children, but this question: How could this go on for so long? More specifically, How is it possible that a doctor who was intentionally killing babies and unintentionally killing women could maintain his practice for decades without inspection?
David Altrogge presses in on that gnawing question in the hour-long documentary 3801 Lancaster: American Tragedy, named after the address of Gosnell’s clinic in Philadelphia.
Last week, I screened a pre-release version of the film and found it to be a powerful contribution to our country’s ongoing debate over abortion and its regulation in America. 3801 Lancaster: American Tragedy may press the uncomfortable question (“How could this go on for so long?”), but it is more likely to make headlines for featuring phone interviews with Dr. Gosnell himself, from prison, as he explains his rationale for performing late-term abortions.
Gosnell may be a serial killer, but he comes across as the friendly doctor down the street. He sees himself as a gift from God to the minority community, a Christian who believes “the Bible is clear” that human life begins with the first breath. Altrogge introduces Gosnell’s family and friends, all of whom are shocked at the crimes he committed.
Gosnell gives off not a whiff of remorse in his explanation of his actions. He claims that “fetal demise” always took place just before the delivery, due to his injection of toxins. Because a “heartbeat” after delivery may or may not indicate the baby was still alive, Gosnell saw all of his choices as ethically mandated, a way of ensuring the abortion was complete and that there would be no further pain or suffering.
The documentary’s subject matter is sobering, to say the least, but Altrogge does not belabor the gruesomeness. Only briefly does he show several images of Dr. Gosnell’s tiny victims. In the rest of the film, he relies on the descriptions given from the officers who discovered Gosnell’s “house of horrors” – a wise move, since it allows us to experience the horror of 3801 Lancaster from the perspective of ordinary people. “I didn’t think they’d look as human as they were,” one officer says, after discovering the dismembered bodies.
3801 Lancaster succeeds in giving us insight into the mind of Dr. Gosnell. But this documentary asks a bigger question: How did we let this happen? Following that narrative thread reveals a picture of breakdown at every level of government bureaucracy.
Why did no one inspect Gosnell’s clinic from 1993-2010? The answer is more complicated than partisan politics. The failure began with the shift from a Democratic governor (Casey) who was pro-life to a Republican governor (Ridge) who was pro-choice. It was decided then that abortion clinics would not be inspected unless there were complaints.
By the late 1990’s, complaints about Gosnell were trickling in, but the health department ignored them, worried that raising standards on abortion clinics would close them down and limit women’s access. In 2002, there was no inspection, even after a 22-year-old woman died during an abortion. In 2009, when another woman died, no one investigated. Had it not been for a drug bust in 2010, Dr. Gosnell would still be killing his victims.
What went wrong?
The grand jury concluded that no one took action because “the women were poor and of color and the infants were victims without identities and because the subject was the political football of abortion.” There you have it! A political issue supposedly about “women’s health” used as an excuse to ignore basic standards of care for clinics.
Altrogge carries the “political football of abortion” carefully, choosing not to use a heavy-handed approach. We listen to the testimony of women who visited Gosnell’s clinic, and sense their agony when they feel like they have no other option but to get an abortion. Altrogge interviews pro-choice nurses who campaign for tighter regulations of abortion clinics, nurses who claim they are now marginalized by Planned Parenthood as part of an “anti-abortion conspiracy.”
Pro-life or pro-choice, the viewer of this film is likely to agree that Dr. Gosnell was guilty and his imprisonment just. Still, the pro-choice viewer may be uncomfortable with the chilling logic of late-term abortion. What does it matter, really, if we are inducing “fetal demise” with toxins while in the mother’s womb or “snipping the neck” just moments later? What is the difference? In either case, we have a dead body in front of us and blood on our hands.
The most unsettling moment of the documentary, for me, was not seeing the images of Gosnell’s victims or hearing the heartbreaking stories of how he treated the women who came to see him. It was when he quoted George Bernard Shaw: “Practical man changes to fit society. Impractical man changes society to fit his needs.” Progress only comes from the latter, Gosnell says. “I am the latter.”
This is a man who is confident of his vindication, that people will see the “mercy” behind his actions, that his conviction will be overturned, and that the day will come when his contributions will be appreciated. This is a man who believes he is on the “right side of history.” In the serenity of this “kind” doctor, we see the awful, bloody result of the Enlightenment myth of progress, shown in all its shock and horror, used as justification for atrocities that startle even the most passionate abortion advocate.
Here is a way to sign up to attend a screening or host a screening in your city. Check out 3801lancaster.com.