A good friend sent me a baby-blue bulletproof vest after Michael Griffin killed Dr. David Gunn, so that I would have something to wear to work at the clinic where I do abortions. It came in a bag stamped FEMALE, and it fits quite well. I rarely wear it, though--not because it is hot and constricting, which it is, but because when I put it on, I am keenly aware of the parts of me that aren't covered. When friends ask how come I don't wear the vest, I answer, "What's the use? They'll just shoot me in the head."

And so it happened. Dr. John Britton, sixty-nine, wearing his bulletproof vest, and his bodyguard, James Barrett, seventy-four, vest status unknown, were shot in the head and killed. June Barrett, sixtyeight, a nurse, was shot in the arm. Paul Hill, a dedicated Christian terrorist who belonged to a group advocating murder of us abortion providers, shot them while they were sitting in their truck. Since then, I have been practicing crouching on the passenger-side floor of the car. My stiff hips get in the way of a quick disappearance, but after flicking the rear view mirror, I can drive backwards. They never taught me this in medical school.

At the office, things are much the same, but on the Monday after the killings the phone is busier than it has been in months. Women are trying to make appointments before I, the doctor, am offed.

One woman asks for me in a conspiratorial voice. "I can help you," a member of the staff says confidently. "No. I was told to ask for Dr. Karlin," she continues. "Do you need to make an appointment for an abortion?" the staff member asks. The caller is shocked at hearing the word spoken in a doctor's office. Some of our patients make an appointment without even being able to say the word "abortion." That is how I know we're losing. Here it is, 1994, twenty-one years after the Roe v. Wade decision, and every day I hear from at least one patient who believes that abortion is a secret, horrible crime--a torture practiced in some filthy subcellar, away from the prying eyes of even the doctor's own staff.

Nine out of ten women who come into my office have often repeated this sentence: "I would never have an abortion." When they face me and I ask them why they're crying, my patients who are minutes away from having an abortion say, "I don't believe in abortion."

Like me, these women read all around them that abortion is bad, and murder is bad, too, and has about the same moral severity. But abortion is a symptom, not the disease. It is itself a fundamental part of poverty, of despair, of a life gone wrong, of poor education in contraception, of physicians poorly trained in avoiding it. We will never reduce the number of abortions because we are not even interested in treating the disease. My patients are bruised women who have the worst abusive relationships, are alcoholics, are physicians and lawyers, are people who believe in the diaphragm, are pill failures, and are those whose doctors took them off the pill.

They are not bad. They are women. But their marginalization will allow the most horrendous behavior outside our offices and our homes.

Since the latest murders in Pensacola, I have had no protesters at my office. When I started doing abortions four years ago, they came daily. They put on some huge demonstrations outside both my home and my office. More recently, a few people pray outside the clinic. They carry a big sign, THEY KILL BABIES HERE! They call in sweet voices, "Liz, we love you. We love you. Come here and talk to us. You don't have to go in there." And when it is clear that I am going in there, they start to scream. "You will go to hell. Get over here and talk to me now. God will make you suffer." The transformation from saint to banshee is eerie. I would not be surprised if they showed up with weapons one day.

The spinmeisters tell us that radical Christian forces have turned to violence because of their frustration at not winning the 1992 Presidential election. My protesters are more frustrated by seeing my patients and me enter the clinic than by elections. When violent and needy people get frustrated, they look for support. They have found it in other anti-abortion forces, in the clergy, in a silent medical community, and, surprisingly, in the executive branch of the Government we elected. When they find a President who sounds like Pat Robertson and a Secretary of Health and Human Services who mimics Dan Quayle, they know they are acting not only from the will of God, but the will of America. And with that support, they have the expertise to kill.

My daughter says she is checking out the medieval-armor room at the Metropolitan Museum of Art in New York. A Jewish friend who witnessed the Nazi occupation of Austria and knows a thing or two about violence suggests I wear a flak helmet as well. One provider already does.

We need to know that doctors will no longer allow the marginalization of women and the doctors who help them. We need to know that when people hear bigotry from the pulpit, they will challenge it. We need more women to come out and say, "I have had an abortion." We need to meet in Pensacola, to soak up each other's strengths, to support the medical students who are starting out on our long and dangerous road.

I hope we have arrived at a time when we will have a National Abortion Day, to salute the women who have made this difficult choice, who became mothers when they could do it best, not when they were forced to.

I have learned to do a safe abortion. I have learned to counsel the most troubled women I have ever seen. I am learning not to judge. I am learning to teach what I know to medical students and residents. What I haven't learned yet is what the hell to wear to work.

Dr. Elizabeth Karlin ran the Women's Medical Center in Madison, Wisconsin.