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As I’ve headed to work in recent days to see abortion patients in my office, I have felt bereft: All the premises of my life, work, education, and future were gone. Something very profound in the meaning of the America I know has been destroyed with the election of Donald J. Trump as president.

One of the reasons I’ve felt this way is that, for the past 45 years, I have dedicated my medical career, skills and life to the assistance of women who need my services as a physician in performing safe abortions.

It is my definition of practicing medicine: a noble art that involves helping other people at the most personal level.  There is nothing more personal, intimate and private for a woman than deciding whether to have a baby or end a pregnancy.

This lifetime dedication to helping those women means for me, among other things, that I have a home, a family, an office, a staff, deeply satisfying work, and all the connections and financial obligations that those things bring.

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But I have lived for the past 45 years under constant stress. Anti-abortion protests have targeted me personally. I have received innumerable death threats because I do this important work.

I have survived, but some of my colleagues and friends have been murdered by anti-abortion fanatics.

Donald Trump has said that women should be punished for having abortions. Trump’s running mate, Indiana Governor Mike Pence, has used attacks on abortion as the principal focus of his public career.

With Trump as president and the sworn enemies of abortion controlling both houses of Congress, I really wonder if I can leave the country for any purpose and be confident that I will be allowed to return. What if the Republicans won’t let me back into my own country?  What happens to my life then?

Read more: An abortion doctor speaks out about decades of threats and violence

It seems irrational, but the people now in charge of our national government are not rational people.   They have expressed their hatred for the work I do for women. It doesn’t matter that I am a citizen and a physician. I feel that I am subject to hostile, unrestrained arbitrary power.

In fact, one week ago I received a chilling letter from Representative Marsha Blackburn (R-Tenn.), the most ferociously anti-abortion member of Congress, who chairs the Select Investigative Panel on Infant Lives.

The letter demanded that I submit a wide variety of documents, including patient medical records in cases of gestations greater than 22 weeks. I have until Nov. 21 to comply.

The panel is looking for evidence that I am selling “baby body parts.” It has the power of subpoena and can cite me for contempt of Congress if I don’t comply by the deadline.

It is frightening. It is a witch hunt.

I am a physician helping patients, and I am being treated like a criminal.

The star chamber proceedings of the Select Investigative Panel on Infant Lives is a target identification program for the anti-abortion assassins. It is terrifying.

At a deeper level, I have no confidence that Trump and the current Republican leadership will protect my life and liberty because of the work I do to help women. Their public harassment of me increases my risk of assassination.

Trump is a man who seems to care nothing for the protections of the Constitution, including civil rights and free speech. He threatens violence against members of the press and those who disagree with him. His vile, vulgar and predatory attitudes toward women have been on lurid display from the beginning to the end of his campaign. He threatens the world with nuclear instability.   How can he be the president of a country that represents freedom and civility?

Read more: ‘I just feel terrified’: Women pour support toward Planned Parenthood after Trump’s victory

Since Roe v. Wade, federal legislation and court decisions have affected us only indirectly. There have been numerous attempts to shut me down at the state level since I began performing abortions in Colorado in 1973.  Many of these bills have been directed specifically at me and at my medical practice.  I have testified against them dozens of times, sometimes under armed guard. With the help of pro-choice community and political leaders, I’ve seen most of these bills defeated.

But Trump’s election, combined with continuing control of the Congress by anti-abortion Republicans, ratchets up the threat to what we do to help women. It’s now higher than ever before. Trump can sign the most restrictive anti-abortion legislation with impunity. After he has replaced several sitting Supreme Court justices, Roe vs. Wade will be overturned, and we will all be at the mercy of even more conservative state legislatures.

This is profoundly discouraging to me, especially since I want to bring in a young doctor or two who can continue my important work when I cannot do it.

What can I tell a young physician about the future? Every day is a struggle for survival.

During the past month, I have had conversations about my specialized abortion practice in Colorado with numerous idealistic young doctors, nurses, medical students, and other health professionals.

The young physicians, including Americans who are studying in Europe, expressed their desire to serve women by performing abortions. They bought copies of my textbook on abortion care and they said they wanted to visit my practice to learn how I safely perform late abortions for women who are terminating desired pregnancies because of catastrophic fetal abnormalities. But they also expressed concern for the intensity, violence, and power of the anti-abortion movement in the United States.

They had read about the assassinations of American physicians such as Dr. George Tiller, who specialized in abortion services. They knew about the attacks on other clinics and physicians, including the time in 1988 when the front windows of my office were shot out.

What security can I offer young physicians that they can have a fulfilling life and  medical career in this work helping women and their families?

Under an unrestrained Donald Trump and this Republican Congress, I fear for my life, I fear for my family, and I fear for my future. I fear for my staff and my patients.

Even more, I fear for my country, and I fear for the world.

Warren M. Hern, MD, MPH, PhD, is a physician and epidemiologist who directs the Boulder Abortion Clinic in Boulder, Colo.