Reed Magazine November 2004
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A RADICAL CoNCEPTIoN

Gilbert and patient image
Photo: Diana Watters
Gilbert stresses that, despite the claims of opponents of emergency contraception, the drug most often doesn’t cause a miscarriage. “It works mostly by preventing or delaying ovulation. Because it takes the sperm several days to get to the Fallopian tubes, then the egg comes out and it gets fertilized. So even after intercourse, this pill can prevent ovulation. . . . and that’s mostly how it works, probably 66 to 86 percent of the time.”

In the remainder of the cases, Gilbert said, nobody knows exactly how the drug prevents pregnancy—possibilities include thickening of the cervical mucus to trap the sperm; changing the texture of the egg’s surface to prevent fertilization; altering the rate at which the sperm and egg move through the body; or preventing implantation. The last possibility is what has many religious conservatives seeking to restrict the drug.

Gilbert believes it will take several more years (“one or two elections”) before emergency contraception is approved for sale over the counter. In the meantime, she plans to continue her pioneering efforts to make the drug better known and more available. She balks, however, at calling herself a radical in the field of medicine.

“I wouldn’t say radical, as a physician, but I like to advocate for the leading edge [of reproductive and] public health.”

From Reed to Family Tree

The roots of her commitment stretch back to her time at Reed. More than 20 years ago, when Gilbert was a sophomore, she wrote on her dorm room door the characteristics of her ideal job. “I wanted to be a doctor at a neighborhood clinic on a street corner with a big patient education library. . . that was my dream. And I’m the medical director of just such a clinic.”

Gilbert isn’t sure exactly when she decided she wanted to work in community health. As a participant in a cervical cap study during her college years, she visited a feminist women’s health clinic in Portland, and was impressed with the staff and the premium they put on educating the patients. By the time she graduated in 1985, she’d decided what she wanted to do and set upon traveling the long, tough road typical of doctors-to-be.

She graduated in 1991 from Northwestern University Medical School in Chicago, and began her residency at the St. Paul Ramsey Medical Center in Minnesota, working 80 to 100 hours each week. “Residency’s hell,” she says. Once she awoke and had no idea if it was morning or evening. “It was half light and half dark outside,” she recalls, “and I just truly didn’t know if it was 7 a.m. or 7 p.m.”

Despite the grueling schedule, Gilbert’s determination to work in community health solidified during her residency. “It really was a marvelous program with a real emphasis on community-oriented primary care. I was exposed to healthcare in the jails and the workhouse and in the high schools.”

When one of the former residents told Gilbert to apply for the post she was about to leave—medical director of Family Tree Clinic—Gilbert jumped.

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Reed Magazine November

2004