Discover more from Listening in the Dark with Amber Tamblyn
The Explosive Story of Abuse at a Renowned Fertility Clinic
An interview with journalist Susan Burton on her groundbreaking reporting on the Yale Fertility Center scandal.
Note to readers: The following includes detailed discussions of medical malpractice, fertility treatment, and drug addiction.
The insistent disbelief of women’s experiences and stories has long been a chronic failure of our culture. I’ve listened to countless stories from other women, read many books and articles on the subject, and experienced it myself. But no story in recent memory has floored me more than the podcast, The Retrievals. From Serial Productions and the New York Times, The Retrievals is a devastating look at what happens when women’s physical pain is ignored and their experiences questioned. We’ve heard so much about reproductive health through the lens of abusive government policies working to deny bodily autonomy, the right to an abortion, and birth control access. Here now is the other side of that ugly coin: abuse within the healthcare system itself. This time taking place at one of the most respected and trusted fertility clinics in the country.
The series follows the stories of twelve women who came to a fertility clinic at Yale to receive in vitro fertilization (IVF) treatment only to suffer the most brutal pain during their egg retrieval process. The procedure for an egg retrieval is not only an invasive one, it's a most intimate one, whereby a long needle is inserted into the ovaries through the woman’s vaginal wall to extract eggs that may be ready for fertilization. Without proper anesthesia, the pain of this procedure would be unbearable and the long-lasting mental, emotional, and physical damage, life-altering. The patients would eventually come to learn the cause of their pain: a trusted fertility nurse had been stealing the anesthetic (fentanyl) and replacing it with saline solution (salt water) to feed her own drug addiction.
As the series progresses, we learn that the pain endured during the egg retrieval is only one part of the violence perpetrated against the women. After undergoing a procedure done without any pain medication whatsoever, they must learn to navigate a broken healthcare system and its equally broken promises. They are forced to come to terms with what this dangerous oversight means for their mental and physical health; and for the women whose IVF procedures did not produce viable eggs, they face the terrifying question of whether the intentional decisions or neglectful mistakes by a drug-addicted nurse and incompetent hospital staff could have had anything to do with that outcome.
Some have forever lost trust in the people that were supposed to protect them: the doctors, nurses, and employees who didn’t believe their pain was real or told them they were being dramatic. Even now, as they search for justice, these women must face Yale’s legal team and its defense of the venerable institution. They must endure intense scrutiny, their experiences and the lasting trauma of it all being downplayed and questioned now for the world to see in a court of law: How bad was the pain really? What was your sexual activity like after the procedure? Do you have any past history of drug abuse? Is it possible that you may have exaggerated because IVF pumps your body full of hormones? Are you sure the pain was as bad as you remember?
After listening to the first few episodes of this groundbreaking podcast, I reached out to my friend Ira Glass, journalist and host of This American Life, and asked him to put me in touch with his co-producer Susan Burton, also the producer, host, and journalist behind The Retrievals. I had so many burning questions to ask her, like what does this story tell us about the state of reproductive health for women beyond the central conversation of abortion rights? What do you want listeners to take away from your reporting? How can we do better when it comes to believing women?
Amber Tamblyn: Susan, thanks for taking the time to speak with us about The Retrievals. While listening to this podcast I was overcome with a number of emotions. Feelings of anger, despair, numbness, extreme disappointment. But I never felt shocked. When it comes to women's physical pain and what we're expected to tolerate, this story felt sadly familiar. Can you tell us how you first found out about what was happening at the Yale Fertility Center? What caught your eye, as a storyteller and journalist?
Susan Burton: Amber, thank you so much for your interest in The Retrievals!
One Friday night in November of 2021, I was sitting on my couch scrolling through my phone. I’d stayed late at work and hadn’t yet settled in at home. It was the kind of transitional scrolling you do when you are in between. A local Connecticut news story about the clinic appeared in my feed—in the “discover” feature of my Chrome web browser. The story said that several patients had just filed a lawsuit against Yale. There weren’t a lot of details, but I was immediately drawn to what stirred underneath the few facts given—women’s pain, addiction, motherhood, infertility. And I was drawn to the setting, too—Yale, which is where I went to college, and which, as an institution, holds so much real and symbolic power. By Saturday morning I’d already downloaded every legal document I could find and had emailed the lawyer representing the patients. I wanted to know what happened here and how it felt for all involved. For months after that there was very little “in between” time; I was so focused on this story.
Amber: While this is a series about women who had to endure severe pain without anesthesia during a particularly intimate procedure, it's also a series about how much women are expected to endure when it comes to pain in general, from being gaslit by healthcare professionals to the lack of oversight on how the distribution of pain medication is monitored at a major institution like Yale. I can't help but feel that if it had been men reporting this level of pain during vasectomies, it would have garnered a much faster and much different response. Can you tell us what it was like for you to interview these women and come to know their stories? Through their stories, what did you learn about our healthcare system that you didn't know before?
Susan: The women I spoke to were amazing. In the series, I touch on how some of them had jobs that made them experts on what happened here—an addiction researcher; a professor who teaches texts on hysteria; a nurse anesthetist. But their professional expertise was only part of what made these conversations so special. On a personal level, these women were insightful, vulnerable, smart, and generous.
The interviews were, as you might expect, often emotional. I approached each initial interview the same way, focusing on the essential unit of this story, the retrieval—on what happened before, during, and after. The procedure was a way into so much: into the feelings of inadequacy that many of the women brought to or developed during IVF; their experiences of severe, unexpected pain; the way that pain was minimized or explained away; their attempts to make sense of it; their anger and vindication in the wake of finding out what happened. I was immediately struck by the patterns in the patients’ stories—importantly, the pattern of reporting pain and nobody seeming to do anything about it. It felt kind of stunning to me. How could the clinic have missed this?
As far as what I learned about our healthcare system through the patients’ stories, I think the main thing is a simple one—I learned so much about fertility treatment, which I have not gone through myself. But the medical history I do share—that so many women share—is a history of saying, “Something feels weird here. I don’t feel comfortable with this. I don’t want this. This hurts. Is this okay? Should this be happening?” and then being dismissed or made to feel crazy. And then fearing that you might pay a price for having spoken up, and honestly at this point you’d rather go elsewhere anyway, but it’s kind of too late, you have no other option. As a patient named Laura recalled to me of her painful retrieval: “But what are you gonna do? I wanted the procedure done, I just let it happen. And nobody believed me.” The series offered me the opportunity to explore some of the structural reasons for this and to think about how these kinds of experiences reverberate throughout our lives.
Amber: In “Episode 4: The Clinic,” you talk about the “million dollar question”—how did this happen? Why did it have to happen in this way? Why wasn't more anesthesia given when the patients were clearly awake? Why weren't women's complaints of severe pain during these procedures taken more seriously? Can you tell us what the answer is for you?
Susan: There are so many layers to this answer. There’s the big overarching layer of “dismissal of women’s pain.” There are personal layers: who reported what when and who may or may not have listened. There’s the nurse and her history. But one important layer that is both practical and revealing has to do with the drugs that the Yale fertility clinic used for years to treat the pain of the retrieval. The clinic used fentanyl and midazolam, a combination that offers a relatively light level of sedation for this procedure—and they used fertility nurses to administer these drugs. What’s more typical [for an egg retrieval] is deeper sedation with propofol administered by an anesthesiologist or nurse anesthetist. With the combination that Yale was using, some pain, even extreme pain, was not unknown. All of which is to say: there’s a way in which pain had been normalized. So, how did the clinic miss that so many women were in pain? Because women were in pain already. That’s a reductive answer and it’s a lot more complex than that . . . but in a way it’s also that simple. Offering inadequate pain control is another way of dismissing pain: another way of saying, This doesn’t matter.
Amber: What has the response to this series been like? What have some of the ramifications been in telling a story like this? Have you been hearing from more women at other hospitals? Does it feel like there might be more to tell?
Susan: Within hours after a trailer for the series went online in June—before the first episode was even released—I heard from a patient who said she was shaking; that she believed this had happened to her at Yale. Other notes from former Yale patients followed and so did so many notes from women describing unacknowledged or inadequately treated pain of all kinds. Obstetric trauma, IUD insertions, HSGs. One note I just read yesterday described something incredibly upsetting where a woman—actually a girl; at the time she was still in her teens—had a cervical procedure that was so painful she was screaming. She was left alone in the room, passed out, and fell off the table. When a nurse found her on the floor, naked from the waist down, she told the patient she was being dramatic. The teenager then left the office and drove herself home. There are so many more stories to tell about why things like this happen as well as so much more to this Yale story. I could have kept going. It will be interesting to see what happens with the lawsuit and what that might open up.
Amber: In closing, what should people take away from this series, about our healthcare system but also about the power of advocating for yourself within that system? What do you want readers and listeners to walk away with, when all is said and done?
Susan: One of the patients told me that the lesson for her was “to trust my own body, my own instincts, my own experience” and also to be “almost on the offense” when it comes to advocating for herself in her own healthcare. I think finding providers who listen is incredibly important. And there are wonderful healthcare providers out there. I wish that clinic sources had been able to speak to me on the record; the clinic was not a monolith full of uncaring doctors and nurses. As far as what to walk away with, I do always think there is enormous value in knowing that you are not alone. That offers a whole range of things like comfort and a leap to action. Again, I thank the patients for speaking about what happened to them which has allowed others to locate themselves in their experiences and can spark conversation and change.