Trouble In Vicksburg
1963, Warren County Courthouse, Vicksburg, Mississippi
“Doctor McConnell, are you licensed to practice medicine in the great state of Mississippi?”
My answer, “No“, to a defendant’s lawyer in a sleepy Vicksburg courtroom proved to be a “Perry Mason moment”—a dramatic courtroom instant inspired by the 1960s TV series of the same name, when the hero attorney, Perry Mason, nails the witness with a damning question that shifts the trial in his client’s favor.
At the time I was in Mississippi for a year serving as an intern at University Hospital in Jackson, sixty miles east, after graduating from medical school in Texas the previous year, testifying as a witness for the state in the trial of a Black woman accused of performing an abortion* on a White girl I’d seen in the emergency room months earlier. The defense attorney’s question was astute: he knew the law and his audience, the all-white, all-male jury sitting to my left. I was, in fact, practicing medicine in Mississippi without a license—doctors in training are exempt from State licensing requirements, a device that avoids burdening state and student with licensing exams and paperwork each time they cross a state line for further medical training.
It was a tense time in Mississippi—National Guard troops occupied Oxford, home of Ole Miss, to ensure James Meredith’s admission and safety; civil rights marches and protests were the stuff of daily news; National Guard troops surrounded the Capitol Building, and everyone assumed everyone else was armed and dangerous. My Texas license plates drew middle finger salutes, curses, and bumper bumps at red lights. It was frightening. I was not one of the “liberal, Socialist-Communist, government-as-nanny” busybodies from Elsewhere, USA that Mississippians hated for lecturing them about how to conduct their affairs. I wanted none of it. I was there to be an intern.
Unlike the frenzy I’d experienced at Dallas’ Parkland Hospital as a medical student, the Jackson ER patient load was comparatively small and orderly, an oasis of order amid the chaos outside. The bulk of my time was spent dealing with fevers, broken bones, lacerations, and mystery pains. One evening the duty nurse told me she’d put a young woman in an exam room, saying, “She’s complaining of cramps and heavy vaginal bleeding.”
The patient looked to be in her late teens, healthy, attractive, and well-spoken—a White girl whose parents could afford orthodontists, manicures, and private schools—not the poor, mostly Black patients who populated the emergency room. The nurse’s notes indicated she was from Vicksburg, and, naif that I was, I gave no thought to the fact that she was in an emergency room 60 miles from home without her mother for something as routine as vaginal bleeding. I asked the usual questions about her menstrual cycle and so on but didn’t learn anything out of the ordinary. Her general physical exam was unremarkable.
On pelvic exam I found a stiff rubber catheter, ordinarily inserted into the bladder, skillfully placed in her vagina in a manner to mechanically irritate the uterus and stimulate contractions forceful enough to expel the conceptus. If mechanical irritation didn’t work, infection, sure to follow, would. But no matter the mechanism, the method was working—I had on my hands an illegal abortion ten years before Roe v. Wade. She was too far along to halt the process without risking more trouble. I called the Ob-Gyn resident, who admitted her for further care. While asking questions, collecting blood specimens, and establishing an intravenous line, I made detailed notes, assuming the day would come when my notes—and maybe me—would be in court.
I forgot about the case until months later when I was served a subpoena to testify in the trial of the accused abortionist. The trial was to be in Vicksburg, where the abortion was alleged to have been instigated. I arrived on the appointed day and was shown to the witness room, a small bare second floor space overlooking the street. It was a hot day, and the window was open. I leaned out to catch a breeze… and saw a liquor store across the street, never mind that Mississippi was legally dry.
It will convey a sense of the law in Mississippi in those days that Marianne and I bought our monthly three-dollar fifth of Old Crow bourbon a few miles outside Jackson at a warehouse-size building deep in the pines off a two-lane rural blacktop. Arriving customers were greeted by a faux convenience store tagged onto the back of the big building, a Potemkin nod to pretense rather than the in your face attitude in Vicksburg.
In back was a big, well-lighted parking lot. No signs identified the business at hand. A single windowless door opened into a small room and bare counter—no clock, merchandize, or cash register. There was one sign—“Cash Only.” I learned on my first visit that asking for change was considered impolite at best, an insult if repeated. Customers announced their want, an unsmiling attendant nodded, disappeared into the back, and reappeared holding a brown paper sack, which was briefly opened for the customer to verify the contents. Cash was tendered and that was it.
While trying to wrap my mind around liquor stores in a dry state and the differing lawless practices between Jackson and Vicksburg, my musings were interrupted by the Warren County sheriff, who stopped in for a visit. He was a big, barrel-chested man whose heft and growling voice suggested carnivorous power. He was outfitted in a smoothly pressed tan shirt and trousers with sharp military creases, and a tan hat with a narrow, upturned brim. Completing the picture was a heavy Sam Browne belt with shoulder strap to tote the huge pistol lashed at his waist. His questions were direct, and while not unfriendly, were not designed to put me, a guest in his courthouse, at ease. I gathered that he was used to saying what he pleased and being indulged by listeners.
He introduced himself and asked a few questions about the case. I didn’t know anything about courtroom procedure, but he seemed intent on learning what I was going to say on the witness stand. It didn’t seem right. I sought to redirect the conversation.
“Sir,” I said, pointing to the liquor store, “it’s my understanding Mississippi is a dry state. Is that true?”
“Yeah, son, that true. Mississippi is dry,” he responded easily.
“But how then can a liquor store exist across the street from the county courthouse?” I blabbed.
“Well, you see, son, another truth is that us Mississippians is like ever’body else—we like a sip now ‘n then like any normal person. No point ‘n us spending our money across the river in Louisiana. No sooner ‘n your wheels make one turn in Cajunland there’s liquor aplenty to be had. Citizens is gonna drink anyway, so it might as well be convenient—no point in us crossin’ the Big Muddy to leave money in Louisiana,” he said, smiling with satisfaction. “And besides,” he added, “them stores pays lots of taxes.”
Puzzlement compounded.
“But, sir,” I plunged on, “how can the state tax a business that is legally non-existent?”
He silently shifted his bulk, frowning. I figured I’d gone too far and ventured to make a joke by speculating about what would happen if the legally non-existent liquor store paid taxes in equally non-existent imaginary dollars. Fool that I was, I expected he would get a chuckle out of it.
“Son,” he rumbled, “we don’t have them problems here in Vicksburg,” and stalked out of the room. Only then did it dawn on me who collected the “taxes.” It was a relief when the bailiff came to get me.
The courtroom was southern classic—a somber, dim space that suggested stern justice little tempered with mercy. The floor and walls were dark and the ceiling high to accommodate a balcony, where Blacks were seated. Gauzy white drapes hung limply in tall, open windows, and ceiling fans turned slowly, barely disturbing air thick with heat and humidity.
I took the witness stand, sitting between the judge on my right and an all-white, all male jury on my left. I scanned the courtroom to identify the players. At one table sat a well-dressed middle-aged, black woman and three lawyers in good suits, with expensive briefcases and orderly stacks of papers—the alleged abortionist and her lawyers.
At the other table sat a small older man with thin, unkempt gray hair dressed in a rumpled blue and white striped seersucker suit—the prosecutor. After I was sworn in, the prosecutor stumbled around asking questions about where I grew up, where I got my education, about my job as an intern in Jackson, and so on. His questions belied ignorance of medical training, and at one point he asked if my answers indicated that I was “a real doctor.” I suspected he wasn’t sure and wanted to know. Then he led me through a recitation of the events of the evening in question and showed me my ER notes and the catheter for identification.
Finally, he said, “Your witness.” One of the defense lawyers came forward. He introduced himself and asked a single question. “Doctor McConnell,” he asked with sarcastic emphasis, “are you licensed to practice medicine in the great state of Mississippi?”
“No,” I replied. A collective gasp rose from the courtroom. In an indelible instant I had become another meddling outsider, another of the mob of civil rights workers, like Martin Luther King, like the National Guard and the FBI agents who swarmed the state to ensure, among other things, that James Meredith remained enrolled in the University of Mississippi.
“No more questions, your honor,” he said with a flourish and returned to his seat.
For what seemed an eternity, nobody said or did anything—the room seemed paralyzed by the revelation. I might as well have been unmasked as voodoo doctor who treated patients by sacrificing a black rooster while chanting incantations before hanging around the patient’s neck a gris-gris bag containing a possum snout and an alligator tooth.
I looked to the prosecutor, expecting him explore the nature of the “institutional permit” system under which interns, and residents move from one state to another for training without having to take state licensing exams. But he, too, looked dumbfounded. Searching for a way to end the agony of silence, I looked to the judge, who appeared as bemused as the prosecutor.
“Your honor,” I began helpfully, “it’s not necessary for me to have a license because…”
Recovering his balance, the judge dismissed me with a wave of his hand as if shooing away a fly. “Son,” he said, pointing to the jury, “tell yo’ story to the jury,” with emphasis on “story.” In a stroke I had been reduced to child in short pants trying to explain away some mischief.
I turned to face twelve white males whose faces suggested dynamite-blasted rock more than human flesh. Not one to be deterred in most situations, I plunged on. I owe much of my position in life to an ability to sell myself and my ideas, so I adopted my most helpful, earnest, and conciliatory manner, avoiding big words, and dropping down as far as legitimately possible into the southern vernacular. I began reciting an explanation of the process of medical education: college, medical school, internship, and institutional permits. Surely, they would understand that my motives for being in Mississippi were entirely virtuous. I had been to a fine university, had four years of medical school, graduating near the top of my class, and I was healing sick Mississippians for a pauper’s wage in their fine state university hospital.
With every word it seemed ever more lame. I knew it was over. Finally, I turned to the prosecutor, hoping he would ask some helpful questions to rescue the situation. The defense lawyers looked smug; the prosecutor just sat there. The judge told me I was dismissed, and I skulked back to Jackson, where bootleggers at least had a sense of decorum.
The jury returned a Not Guilty verdict.
* Medical and lay definitions of abortion differ.
The lay public uses the term miscarriage to describe spontaneous, involuntary early termination of pregnancy with death of the fetus; lay use of the term abortion implies deliberate termination of pregnancy. Miscarriage is not a medical term.
The medical definition of abortion is any interruption of pregnancy––incidental, accidental, or intentional––with death of the fetus before the end of 22 full weeks of gestation, or if the fetus weighs less than 500 grams (1.1 lb). A pregnancy that ends between 22 and 38 full weeks of gestation with a living infant is known as a premature birth. A pregnancy that ends after 22 weeks with death of the fetus spontaneously in the uterus or during birth is called a stillbirth.