"Look at Him" ​​by Anna Starobinets, summary

"Look at Him" is a 2017 nonfiction book by Anna Starobinets based on real events: in November 2012, at 16 weeks of pregnancy, the writer was diagnosed with a severe fetal malformation — bilateral multicystic dysplasia of the kidneys, incompatible with life. Written in the first person, the book recounts the author’s experiences with the Russian medical system and her radically different experience at the Charité clinic in Berlin. This is a rare text in Russian literature that openly addresses perinatal loss and the inhumanity of the Russian system of care for women in such situations.

The book received the Enlightenment Prize in 2017 as the best work of popular science literature.

First diagnoses

During a routine ultrasound at 16 weeks, the doctor discovers the fetus’s kidneys are five times larger and hyperechoic and sends Anna for further examination. At the Kulakov Obstetrics and Gynecology Center on Oparin Street, Professor Demidov confirms the diagnosis — polycystic kidney disease — and informs the medical students during the examination, while the patient lies naked. Anna inadvertently becomes a teaching aid. The phrase "children like these don’t survive" is uttered without any expression of regret.

An attempt to see another specialist, Voevodin, ends in a scandal: he yells at Anna for having previously had an ultrasound done by a "competitor" and refuses to examine her. This is the first in a series of encounters with a system that lacks not only compassion but also basic standards of patient interaction.

Hope and Expectation

The only humane medical professional at this stage is Olga Malmberg, a medical expert. She says, "I’m so sorry," calls the baby a baby, not a fetus, and explains that there’s a small chance — if at least one kidney is partially functional and the water doesn’t clear in two weeks. Anna and her husband, Sasha, decide to wait. During these two weeks, Anna finishes writing a report about a troubled family, mentally begs the child to stay hundreds of times, and explains to her eight-year-old daughter, Sasha, that she’s not to blame for anything — the girl herself decided she brought this misfortune on herself.

The waters are disappearing. There is no chance.

The system that turns away

Finding a place to have an abortion becomes a separate circle of hell. Reputable private clinics and maternity hospitals refuse one after another, saying, "We don’t do that kind of thing." At one of them, Anna is told outright that pregnant patients looking at her will be "worried." At the Khamovniki women’s clinic, a security guard refuses to let her husband in, saying, "That’s the rule, it’s a women’s facility." The gynecologist offers sympathy in her own way: "You’ll give birth to another child," "A shell doesn’t hit the same crater twice," "God only gives trials according to one’s strength."

According to Russian law, late-term termination of pregnancy for medical reasons is performed exclusively in specialized hospitals. In Moscow, this includes the gynecology department at City Hospital No. 36 in the Sokolinaya Gora district, where women with infectious diseases and those who have undergone illegal abortions are referred. This "low-cost package" includes hospitalization for 10-14 days, induced labor without pain relief, curettage, and family visits — all within strictly designated hours.

Escape to Berlin

At the same time, Anna and Sasha are raising money from friends and acquaintances for a trip to Berlin. Their friend Natasha, who lives in Germany, has made arrangements with the Charité clinic in advance. Hungarian and French clinics are refusing: foreign women without a residence permit cannot perform late-term abortions. Israel is willing to accept them, but the cost and bureaucratic complications make this option almost impossible. Charité estimates a budget of around 5,000 euros, and they’re struggling to raise the money, but they manage to do so.

In Berlin, everything is different. Doctors say, "I’m sorry." My husband is nearby — no one throws him out. The anesthesiologist, Kai, is cool but professional. The midwife, Claudia, calmly explains every step. Labor is induced gently — with vaginal misoprostol every three hours. After the first pill, mild contractions begin, and after the second, they become regular. Anna is offered an epidural, and Kai, with unexpected gentleness, helps her remain still during the injection, literally cupping her face in his hands.

Death and what comes after

Anna warns everyone in advance — Natasha, her husband, the staff — that she doesn’t want to see the baby. The staff doesn’t insist, but they say, "It’s wrong, you should see." Her husband, Sasha, watches — and isn’t afraid. Anna closes her eyes.

Later, when the autopsy report arrives, Natasha translates the cause of death as "massive cerebral hemorrhage." Anna can’t forgive herself for agreeing to do without the lethal injection — the baby died during childbirth, and this weighs on her more heavily than she expected.

Talking about loss

The second part of the book is structured as a series of interviews with German specialists from the Charité clinic: midwives, a psychologist, a geneticist, and coordinator Christine Klapp. They describe the support system for families who have experienced perinatal loss in Germany: photographs of the baby taken at the parents’ request; a special refrigerator with ventilation to give parents time; clear communication protocols; and psychotherapeutic support as the standard, not the exception.

The psychologist explains to Anna the nature of the panic attacks that began a few months later — post-traumatic stress disorder, which affects approximately 10 percent of women in such situations. She recommends giving grief a specific place in her life: for example, every 12th of the month, light a candle and think about the baby with her husband for half an hour. She says guilt is a normal reaction, but if it persists, she needs a therapist. She says it’s better to tell older children the truth — otherwise they’ll blame themselves.

At the end, the midwife who delivered Anna gives her a glass pendant and two stones — one blue, one red. She explains that sometimes it’s precisely such a small thing that helps a woman grip something in her hand without breaking. Anna takes them. "This will be your strength, and this will be your joy." From the hands of a man who works as the angel of death.