When Rachel goes to see Dr. Raven, she feels very nervous. She believes that she is pregnant and is afraid of being judged harshly for it. This is demonstrated through her image of the goats and sheep waiting in “death’s immigration office” for the “deputy angel allotted to the job of the initial sorting out” of who goes to heaven and who goes to hell, and she frets about what Dr. Raven’s verdict will be. She elevates the stakes of judgment to the highest possible level, damnation or a “visa” to heaven being the two options, and is understandably very agitated when Dr. Raven sees her. [183]
Dr. Raven is not oblivious to her agitation, and it clues him in to Rachel’s true purpose in his office that day. She tells him immediately that she has missed her period. Dr. Raven is familiar with Rachel and her situation with her mother. He has treated both her and her mother for some time, and is probably familiar enough with May’s character by now to know that Rachel being pregnant would be unacceptable, as the reader already knows by her reaction to the case of the unwed mother of twins.
Here is where Dr. Raven may start on his script for surreptitiously providing abortions to patients in this time when it was illegal. The first thing he says is that pregnancy can be ruled out “with a sensible girl” like Rachel. He immediately tells her not to worry, that “[h]alf the people who come into [his] office are worried about a malignancy” [185]. That he would suggest she has a tumor, after being told nothing more than that she has missed her period and reading her body language, is absurd for a medical doctor. He tells her not to worry about a malignant tumor before makes any attempt to confirm a pregnancy. A pregnancy is incredibly more likely to cause her to miss her period than a possible tumor, which—she needn’t worry!—is likely not malignant. It’s much more likely that he is using code to provide Rachel with what she really came for, an abortion. And he uses a convenient code: a tumor is defined, after all, as a “growth of tissue,” which is technically also what an embryo is [OED]. Only then does he examine her, and confirms his miraculous guess that it was indeed a tumor, not an embryo, that caused her to miss her period. So, he arranges an appointment with a specialist in the city.
While it may be that she was never pregnant, I find it difficult to believe that a doctor, necessarily a man of science, would disregard Occam’s razor and suggest a tumor over a pregnancy before making any examination, unless he had an ulterior motive.
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Andrew--I think this is well worth pondering, and you phrase your reservations very well (leaving aside for now the fact that Laurence herself, in interviews, talked about Rachel's tumor). Is it so unbelievable that a small-town doctor, dealing with hundreds of patients over many years, would believe that most of his patients were afraid that he'd give them bad news? Most middle-aged and older people don't look forward to their physicals, simply because the likelihood that something might be wrong increases with age. Also, up to 1969, abortion in Canada carried the penalty of life imprisonment for a doctor who performed it. --But I also think there are more powerful reasons why a tumor would make more sense: a baby would continue the "liberation" narrative that began earlier when Rachel took the initiative with Nick. But what Laurence really wanted to show us is a life that changes incrementally, in small steps, one that embraces irony, because there is no redemption. Barren Rachel doesn't suddenly become pregnant--rather she becomes "pregnant" in a bitterly ironic sense. The point is: despite all that, she, at the end of the novel gets out of Dodge (see also Atwood's afterword).
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