On June 24, 2022, Aaron Campbell turned away patients at his abortion clinic for the first time.
Earlier that day, the 32-year-old doctor had received word that the Supreme Court had just handed down a consequential decision in Dobbs v. Jackson, upending the constitutional right to an abortion in the U.S. The lawyers at Campbell’s clinic, the Knoxville Center for Reproductive Health in Knoxville, Tennessee, urged him to stop performing all abortions immediately.
During a phone call that afternoon with his former girlfriend, Miranda Phillips, a Jamaican couple came to the back door of the clinic to plead for help. They had come from Sevierville, a nearby town, and were trying to convince Campbell to perform an abortion. They were desperate. “Can you do this? Can you come to our home? Can we go to your home?” Campbell remembers the man asking.
“I would like to, but I can’t,” Campbell stammered back to them that day. “I swear to you, we would do it in a second if we could, but there are police watching us. Please listen to my words. There’s no if. I cannot help you.”
His father, Morris Campbell, had been serving clients at the Knoxville clinic for decades. And it was where Campbell had planned to be the rest of his life. Now, with the opinion of six conservative justices, the dream Campbell had chased for a decade had vanished.
Campbell and his somber colleagues gathered in the waiting room and posed for a photograph. The young bearded Campbell stood in the back row, his arms crossed in front of his waist, his pale face blank, eyes glazed.
“I am a PROUD abortion provider,” he wrote that day on Facebook. “The effects of the SCOTUS ruling were quite literally immediate.”
In the aftermath of the high court’s decision to overturn Roe v. Wade, abortion doctors like Campbell have been forced to reckon with an uncertain medical landscape. In Tennessee, just two months after Roe was overturned, abortion was prohibited at all stages of pregnancy with very limited exceptions. There are no reproductive health clinics in the state anymore that offer abortions, and only five remain open for other services.
Some doctors have responded by moving for new jobs in states where abortion is still legal or have changed fields altogether. Others, like Campbell, have become traveling abortion providers, piecing together a patchwork of gigs from clinic to clinic, state to state.
Even before Dobbs, Campbell had started obtaining licensure in other states. He already had a license in Pennsylvania from his residency, and he soon secured contract work at Allegheny Reproductive Health Center, one of two freestanding abortion clinics in the western part of Pennsylvania near the Ohio border. He had also already obtained licensure in North Carolina in response to a “Texas-style” abortion ban that was introduced in the Tennessee House even before the Dobbs decision.
After the Dobbs decision, he kept adding states and clinics to his roster. He obtained state licensure and connected with Las Cruces Women’s Health Organization in New Mexico, a state with protective abortion laws. The clinic is within driving distance of El Paso, Houston, and other towns in Texas, a state where abortion is completely banned. He took on shifts at Bristol Women’s Health in Virginia and at A Woman’s Choice in Charlotte, N.C. And he allocated time on his weekly calendar to provide OB-GYN care to patients with substance use disorders at the University of Tennessee Medical Center.
A couple hundred clinicians like Campbell have been forced to lead such precarious lives in the aftermath of the high court decision, according to the National Abortion Federation, a group that also matches clinicians with jobs, including those looking to travel or move to a different state to provide care. Traveling doctors like Campbell are crucial. Clinics need skilled doctors who know how to do abortions well. Meanwhile, in states where abortion is now illegal, the OB-GYN track is uncertain. Doctors like Campbell need places to work so they can keep up their skill set.
Campbell knew from the start that traveling this much would come at a cost. He would be apart from his friends, family, and his girlfriend, with whom his relationship ultimately ended in November of this year. But doing so would allow him to continue earning a living doing a job that he was skilled at and that mattered to him. Displaced by the Supreme Court decision, he would make significant sacrifices to continue his mission.
Dobbs may have knocked him down, but Campbell still wasn’t out.
Last spring, Campbell traveled to Pennsylvania to work at Allegheny Reproductive Health Center in Pittsburgh. A poster quoting Dr. Seuss (“Be Who You Are, Say What You Feel, Because Those Who Mind Don’t Matter and Those Who Matter Don’t Mind”) is plastered on the clinic wall, while a sign reading “YOU ARE MAGICAL” greets visitors to his tiny office.
Campbell performed more than a dozen abortions during one shift. Some arrived for overnight dilations ahead of surgical abortions; most were medical or pill terminations. Some patients were from out of state. According to the clinic’s CEO, Sheila Ramgopal, within hours of the Dobbs decision patient volume tripled and nearly 80% of the patients who visited Alleghany were from Ohio — a state that had banned abortions at 22 weeks. (Ohio residents have since voted to amend the constitution to enshrine abortion rights.)
A Spotify playlist wafted through the hallway via speakers Campbell had purchased for the clinic. Employees occasionally hummed along as they darted in and out of exam rooms. In a small office, Campbell snapped open four glass vials of a solution called Digoxin, and inserted each into a long syringe. A crisp black wire hanger tattoo on his upper arm peeked out from beneath his sleeves. Sometimes people ask him what the hanger symbolizes. He offers an assortment of answers depending on who is asking. Sometimes he tells them the truth: That it’s an emblem of what he proudly does for a living. Or he will say it’s about his dad. Or simply that it’s a long story.
Sitting in the office, he remembered a recent case involving a patient who lived on the Gulf Coast of Mississippi, another state where abortions are now banned. The woman had first traveled to Bristol Women’s Health, a clinic in Virginia that does abortions up to 16 weeks of pregnancy on the days when it’s able to have a doctor onsite. But the woman was further along than that. She got bad news.
“She said we were the second ones to turn her away. And she had driven,” Campbell stressed, his voice somber.
Campbell referred the patient to Pittsburgh, and she ultimately came there — thousands of miles from her home — to receive the abortion.
That afternoon in March, Campbell sat on a stool in the exam room and faced another woman who, like him, had traveled far — all the way from West Virginia, another state that has completely banned abortions. Campbell wore black scrubs, black eyeglasses, black sneakers. The woman was dressed in a sweatshirt and jeans, visibly pregnant in her second trimester. Her hair hung long in a straight ponytail as she sat on the exam table. Her eyes were crystal blue, wide, searching.
Outside the clinic rain fell. Inside the exam room, a medical assistant announced the beginning of an end: “Today you are starting your abortion.”
Campbell handed the woman a combination of pills, ibuprofen and antibiotics. She swallowed them and choked on the water. It sprayed everywhere but Campbell smiled, lulling the room into comfort.
She lay on the exam table, a hand over her forehead, as a medical assistant dragged an ultrasound probe across her skin. Campbell used the injection of drugs he had prepared earlier in the office. The solution would induce fetal demise ahead of the surgical abortion the following day. It was a precaution that would ensure two things: first, that the fetus was demised officially in the state of Pennsylvania. Also, if the woman left Pennsylvania for any reason before her surgery, both she and Campbell were protected if the fetus passed after she returned home to West Virginia or was in a state where abortion is illegal.
A blurry gray image on the ultrasound suddenly froze, static. Campbell kept working. He inserted tiny, brown, rod-like dilators that absorb fluid and expand to help the pregnancy pass ahead of surgery. The patient’s knuckles went white in her fist above her forehead. Below Campbell on the table was a piece of gauze, soaked in crimson.
A butterfly mobile fluttered above the woman’s head. Campbell looked up.
“You did great.”
When the Knoxville clinic closed, it donated its machinery and equipment in a hurry, like a ship disposes of jetsam — except at least one object. Campbell held onto the large wooden desk in the medical director’s office, the one that belonged to his father, Morris. For a while, the younger Campbell kept the drawers to the desk locked, not wanting to open them, not yet ready to remember.
Morris graduated from medical school in 1973, the year the Supreme Court decided Roe v. Wade, eventually taking over as medical director of Knoxville Center for Reproductive Health by the early 2000s. At one time, patients came not just from Tennessee, but also neighboring states like southern Kentucky or northern Georgia, and filled those rooms.
Campbell was born in 1991. His father delivered him at Knoxville’s Fort Sanders Regional Hospital. As the young Campbell grew up, his father encouraged his desire to become a doctor, too. One Halloween, a teenage Campbell dressed up as a doctor. When asked about his costume, he deadpanned, “I’m a gynecologist.”
Campbell graduated from Farragut High School and studied hard to score well on college entrance exams. He was driven, rigorous, competitive, and never let his goal to become a doctor out of sight. As a student at the University of Tennessee, Campbell often visited his father at the Knoxville clinic. Morris was the first to show his son pregnancy tissue, and for years stressed to him that this kind of medical work mattered, especially in Tennessee, a state that had always limited abortion services, long before the Dobbs decision.
Campbell always knew that his father’s profession was controversial. Morris left his name unlisted in the phone book. The homes they lived in often were set off from the street, hidden from view, one was tucked into a corner of a tree-lined cul-de-sac. And Campbell knew he should not publicly discuss his father’s profession.
Campbell recalls a family vacation to Ormond Beach, Fla. A photo shows him as a child crouched next to his father on the beach, both in swimsuits. Morris wears sunglasses and Aaron, a Nike baseball cap, both faintly smiling at the camera. On one trip to that same beach, Morris drove all the way home just to perform abortions in Knoxville and made the trip all the way back down again. As time went on, Campbell understood how committed his father was to this job. It wasn’t just work. This was a mission.
But in 2012, as Campbell was about to enter his senior year of college, everything went dark.
The phone call was sudden, unexpected. His father’s voice sounded strange and slurred.
Campbell sped over to Morris’ house and found him on the floor. Campbell kicked in the door and broke the frame to get into the bedroom; his father had locked it out of confusion and fear. Morris had hit his head, and Campbell saw blood. His father had suffered a stroke, and paramedics rushed him to Parkwest Hospital as Campbell followed behind them in his car.
Days went by as Campbell waited for signs that his father might recover. But they never appeared. Morris died that June at the age of 64.
In grief, Campbell solidified the future he envisioned. He would become just like his father. He would carry out his mission.
Campbell finished college that year but struggled emotionally. He moved in with his father’s brother, drank too much, and took out the trash each day so no one else would see evidence of the six packs he’d gunned.
But Morris’ death crystallized Campbell’s path. After completing his undergraduate studies, he enrolled in medical school at nearby East Tennessee State University, and soon launched the first campus chapter of the national group, Medical Students for Choice.
Through that group, after his first year of medical school, Campbell attended a summer program that eventually led him to a clinic in Wichita, Kansas, called South Wind Women’s Center. It is a clinic that opened in 2013, operating from the same building where George Tiller had run his clinic Women’s Health Care Services.
Tiller, too, had been inspired by his father, a physician who in the years before Roe had provided illegal abortions to patients who might otherwise not have access to safe procedures. Tiller became nationally known at his abortion clinics. But his life was cut short when an anti-abortion extremist shot and killed him in 2009 in a church where he ushered. The clinic closed down soon after.
On his trip to Wichita, Campbell performed his very first abortion in the same building where Tiller had worked for many years.
In 2017, Campbell started his residency at his top choice: the University of Pittsburgh’s Magee-Womens Hospital, a prestigious OB-GYN training program. In his personal statement to apply for a spot, Campbell evoked his father’s memory.
“He served an essential role in helping thousands of patients embrace their autonomy and make what they believed to be the best decision for themselves,” he wrote.
Now, several years later, Campbell wishes his father were here so that they could discuss the bizarre new nature of his work. He wishes he could ask for advice. Or just hear his voice.
Sometimes, he’ll place the urn that holds Morris’ ashes near to him while he watches TV.
Campbell wondered how his father would feel about a post-Dobbs world. “I can’t imagine doing a job for 40 years and it becoming a felony,” he said.
The Old Testament’s Book of Leviticus contains a phrase that’s conventionally known as the Golden Rule: “Love your neighbor as yourself.”
It is an idea that Campbell ponders when he considers what he does for a living in the context of the Baptist faith that shaped him as a kid. He’s developed a discomfort with evangelical, contemporary Christianity and its views on abortion, and wondered aloud once if he could call himself a Christian anymore. “There is so much less of ‘love thy neighbor’ and so much more of ‘thy neighbor is going to hell if they don’t think or do what I think,’” he said one evening from his home in Pittsburgh. (Campbell also rents an apartment in Knoxville.)
Campbell believes the abortion care he provides is no different than any other routine health care. He might ask a patient where they are coming from and strike up a warm conversation, but prefers not to ask why they have come to him for an abortion. In his view, this is a service that he has mastered, a job he has studied to do for many years, that people have a right to, regardless of why they want it.
The facts, Campbell said, show there are better health outcomes when abortion is done legally and safely, and that restricting abortion leads to increased maternal death rates. But he understands why someone might oppose his chosen profession. That they might feel he is committing murder.
He defended his work this way: “I want to help this person with what they think is best for themselves, and all of us know ourselves better than anyone else.” He added, “everyone probably knows someone who’s had an abortion.”
It might be easy for him to say something like anti-abortion people don’t care about women, but he isn’t sure that’s true. “They think it’s wrong and so they fight to not have other people murdered,” he said.
He paused for a long time and stroked his beard.
“I think the way that they’re thinking about it is wrong,” he said.
The moral, philosophical question comes down to what, exactly, a person is. Campbell does not consider a fetus to yet be a person. “Then you have to consider abortion in terms of how those rights compare to the rights of the pregnant person,” he said one day in April. “I think the rights of the pregnant person supersede … the right to life of the potential person.”
In Campbell’s Knoxville apartment, next to his suitcase packed for another stint on the road, a glass, framed display rests on the living room floor. Inside it is a map of America, held together by glue and wooden cutouts of all 50 states, stuck together like a jigsaw puzzle. Tiny gold rings mark some of the cities his job has parachuted him into: Bristol, Charlotte, Las Cruces, Pittsburgh, and Wichita, where he performed his first abortion.
It was a gift made by his then-girlfriend. Over Knoxville, she placed just one gold heart: home.
Home is where Campbell desperately wants to be. But he knows he cannot do his job there anymore. Life there is segmented into hours and short visits, before he inevitably departs for another state week after week.
He remarked once that some of his colleagues were willing to perform abortions at all costs, even illegally. But it’s a threshold Campbell will not cross.
“I’d be living a very simple life in jail. Too simple. Can’t do anything,” he said.
The mechanics of his life on the road have recently become even harder to manage. In the weeks after the spring visit to the Pittsburgh clinic, Campbell moved at a quick clip.
First to Charlotte for a day. He took a Sunday and Monday off and then returned to Pittsburgh. After that, he traveled to the clinic at the University of Tennessee for high-risk OB-GYN appointments on Tuesday and Wednesday. Then he flew out to Las Cruces, N.M., traveled back home to Knoxville, took a Monday off, and was back in another clinic on Tuesday.
Campbell ate mostly takeout food while he crisscrossed the nation. He missed birthday parties back home. He stopped keeping up with certain friends. And he had less time to spend with Phillips. Little things began to bother him, like the fact that she had skipped ahead a few episodes in the first season of the television series “Severance” while he was away, a show they had started together.
And then there was the dangerous nature of the job itself. Campbell knew there were people who might target him because they wanted abortion outlawed everywhere on American soil. People who filmed him with their smartphones when he walked into clinics to begin his shifts. People like George Tiller’s assassin.
Campbell owns several firearms. Two he carries most frequently are Sig Sauers: one is a micro compact, another a compact. He carries one of them in a small satchel that looks like a fanny pack, and when driving, he keeps it next to the driver’s seat of his car in a holster, always within reach. He always carries one tucked inside the small satchel on his body, even when he is operating on patients.
In 2022, stalking of abortion providers and patients has increased by 229%, according to data published earlier this year by the National Abortion Federation. Burglary of doctors or clinics is up 231%; arson at clinics rose by 100%.
Campbell pines for the day he might leave the shades of his apartment open on a summer day. But he knows he is a walking target.
To his family, he’s faded from view. A cousin on his dad’s side mentioned that she had missed Campbell at a recent family party. What family gathering? he wondered. He felt hurt that no one had asked him to attend. Had his absence led to them forgetting him altogether? Or perhaps they disapproved of the work he was doing.
Campbell’s cousin Kristen Lilly, an OB-GYN based in Knoxville, is one of the only family members who texts Campbell to ask where he is each week. One day in August, she mentioned that his work sometimes reminds her of the Christian parable of the drowning man.
The parable tells of people sinking in a boat. A sailor comes by and asks, “Do you want us to save you?” The people say, “No, God will save me.” Two more sailors come by, and the people decline their help each time. Finally, the people end up drowning and cry out, “God, why didn’t you save us?” God replies, “I sent you a sailor.”
God sent people on Earth to help each other out, Lilly reasoned. And Campbell, she said, was a little bit like the sailors.
“I do think that God gave him this purpose and gave him these talents and he’s using them,” she said.
In his year on the road, Campbell had done so many procedures he felt like he could do them in his sleep.
This is mifepristone. This is the first pill we will be taking here today. You are doing this in a state where it is legal. Cup your hands. Today you are starting your abortion.
He felt numb.
“I don’t know that I’ve had a lot of time to think about … like who I am,” Campbell said in August while visiting the Las Cruces clinic.
The stress, he said, has become almost unbearable. He felt as if he were inventing this job on the fly week after week, determining how much he could take on, how much was too much, what level of risk was too high.
Campbell owes more than $200,000 in student loans he took out for medical school. But these days, his income varies month to month. A few months ago he left his jobs in Charlotte and his shifts as an OB-GYN for patients with substance use disorders to make more room for travel. Sometimes checks do not arrive on time before his travels, and he has to dip into his savings account to make those loan payments. He also has to pay a mortgage on the Pittsburgh home he purchased during his medical residency, rent for his Knoxville apartment, and his own health insurance.
Could he sustain this way of life? Or should he quit it all and try something else? What would his life look like without this job? And who would he be without it?
In August, Campbell sat fatigued in an office in the clinic in Las Cruces, his eyelids heavy. He sipped an energy drink, but at that moment, nothing could revive him. An entire year spent on the road hit him all at once.
He had started popping Ambien to sleep at night and spent every spare minute studying for a certifying exam exam that loomed. He was nervous. He hadn’t practiced aspects of general OB-GYN in many years, but by taking it, he’d become certified in OB-GYN by the American Board of Obstetrics and Gynecologists. What if he failed the test? He felt trapped in an insidious loop of flights, rental cars, hotel rooms, and dozens of appointments in myriad cities, and imprisoned by what he saw as a moral duty.
One day around that time, as he fought against the grip of burnout, he made a startling confession.
“Now I just don’t really want to be a doctor, sometimes.”
In early August, a day after a powerful tornado ripped through Knoxville, Campbell gunned his sports sedan as though he were late for work. He drove to his old clinic, the Knoxville Center for Reproductive Health.
Campbell pulled into the driveway and parked in a tight space closest to the back door, like he always used to. Back then, he’d text his colleague inside, who’d open the door for him so he could dash inside and lock it again. Sometimes he would catch a glimpse of the squall of furious protesters just a few feet away who believed that Campbell, like his father, was a murderer.
On this late summer day, he peered inside the former clinic’s brick walls, through a glass door fastened with a little bell. It no longer chimes but hangs silently on a string like a buoy, marking this sunken ship.
Before he got back in the car, Campbell spotted the Sotheby’s “for sale” sign near the clinic’s front steps, planted in the ground near a Japanese maple.
The storm had littered the streets with tree branches and debris. But the weather had cleared and on this scorching afternoon, the sun beamed down on the young doctor as he stood in the midst of the rubble of his past. He was no longer sure he would consummate the dreams he had as a kid, or for how much longer he would be able to follow in his father’s footsteps. To keep going, he had to leave. Because now this place was just a building.
But some of the anguish he felt in his year on the road had lifted. There was hope for the young doctor. It appeared in the form of a new destination far from home — another clinic where he was needed, this time in Omaha, Neb. He would soon board another flight, rent another car, stay in another hotel, and do this job once again. His calendar was like a map. All he could do was follow it to the next place. And as he kept living his life on the road, rather than thinking of each new clinic as taking him farther from home, perhaps the work itself would help him see the person he’s been all along.
This story is part of ongoing coverage of reproductive health care supported by a grant from the Commonwealth Fund.