Chapter 15: A Wise Man Listens to Those with Knowledge and Experience

July 4, 1989, Circleville, Ohio

"PAPA!" Rachel exclaimed when I walked into the house, dead tired after having been awake for over thirty-seven hours.

I scooped her up, hugged her, kissed her cheek, then carried her over to Kris.

"How are you feeling, Mike?" Kris asked after we exchanged a quick kiss.

"Beat," I said. "Dinner, then bed."

"It'll be ready in five minutes," Kris said. "Come to the kitchen with me, please."

I followed her to the kitchen with Rachel in my arms.

"Was your afternoon better than your morning?" Kris asked.

"Nobody I was caring for died, so I think the answer is yes. Middle-aged man with a torn ACL; teenage girl with a severe sunburn; four-year-old with a bee sting; and an offer to shower with a nurse."

"You'll need a trauma surgeon if you did that!" Kris declared.

"Something I understand quite well! It was Ellie."

"Does she ever quit?"

"Apparently not! But I used the surgical locker room, not the one in the Emergency Department."

"Did you get to see Clarissa at all?"

"No. Our breakfast, lunch, and dinner breaks didn't line up at all. We'll try for Thursday or Friday. Saturday is a bit easier because she can match her break to mine."

"How are your students?"

"Pretty good, but this is the first rotation for the Third Years and the first Sub-Internship for the Fourth Years, so I have to do the normal teaching plus the orientation stuff."

"But didn't they start in June?"

"Yes, but they were with Doctor Mastriano, and she's not a very good teacher. I had a run-in with her about a patient; actually, a few patients. She wrote me up, but it'll be removed from my file, and she's likely to be called on the carpet at a Morbidity & Mortality Conference because a patient gorked when she refused to allow me to call a neuro consult."

"Gorked?"

"Sorry. Suffered brain damage, which is very likely irreversible. If you're OK with it, I can explain more tomorrow after I sleep."

"Yes, of course! Let me get dinner on the table. Put Rachel in her high chair, please."

"NO!" Rachel declared forcefully. "PAPA HOLD RACHEL!"

"Her Majesty, Rachel the Great, Tsarina of All Russians, has spoken!" I chuckled. "I think I can manage the stew and bread one-handed. If she eats after we do, that's fine with me if it's OK with you."

"It is."

We ate, and I gave Rachel a piece of French bread to munch and also fed her some of the stew, though not nearly enough for a normal meal for her. As soon as we finished eating, I handed a protesting Rachel to Kris, and with Kris' blessing, I went upstairs. I made sure the blackout curtains were closed, undressed, and put on my sleeping eye mask for extra protection against light, then got into bed and instantly fell asleep.

July 5, 1989, Circleville and McKinley, Ohio

"How are you feeling?" Kris asked when I came downstairs just before 8:00am on Wednesday morning.

"Better," I replied. "Twelve hours of sleep seems to have helped. Where's Rachel?"

"She's on a playdate with Abigail. I set that up because I had no idea how long you would sleep. I'm leaving in a few minutes for class, and I'll pick Rachel up on the way home from OSU. Do you need anything before I leave?"

"Just a hug and a kiss," I replied. "What time will you be home?"

"About 4:00pm."

I walked Kris to her car, we hugged and kissed, and once she had driven away, I went back into the house. I made myself breakfast, and after I had eaten and cleaned up, I checked the menu for the evening, noted we needed a few things, and after I showered and dressed, went to Kroger to do the shopping, then headed back home.

I really had nothing to do but relax, so around 11:00am, I called Clarissa to see if she wanted to have lunch. She agreed, and just before noon, we met at Frisch's.

"I expected you to show up with toddler attached to hip!" Clarissa said when we met in front of the restaurant.

We exchanged a quick hug, then walked inside.

"Kris arranged a playdate for Rachel with Abigail because she had no idea how long I'd sleep. I woke up around 8:00am, and Rachel was already at Abigail's house, and Kris was ready to leave for her class at OSU."

The hostess seated us in a booth and when the waitress came over, we ordered right away.

"How does fasting work when you have your crazy schedule?"

"With «ekonomia». Health is always the primary concern. When I discussed it with Father Roman, we agreed I'd refrain from red meat on fasting days, but no other restrictions on what I need to eat to stay healthy. For marital harmony, Kris will follow the same rule."

"How are you handling church?"

"Just Sundays for now," I replied. "We could go Wednesdays, but we decided to entertain, and I have Father Roman's blessing on what amounts to minimal attendance, at least for the first few months. Obviously, I can't go on Saturdays, and tonight and next Wednesday, we're having guests. Anyway, how much sleep did you get?"

"About four hours in a pair of two-hour stints, which I guess is far more than you had."

"You guess correctly."

"Did you have the drowning victim?"

"Yes. He was basically DOA, but you know the drill. That was right before I headed to the lake for our gig."

"Anything else interesting?"

"I asked a seventeen-year-old girl who needed an ankle X-ray if there was a chance she could be pregnant, and she wanted to know if it was an offer."

Clarissa laughed, "And you can't be a pig in the ED!"

"Kris might have an objection as well! But you know me. I simply ignored the obvious flirting."

"Flirting? She was asking the cute young doctor to fuck!"

"Whatever," I chuckled. "Not the first and won't be the last. Did you have anything interesting?"

"Just the usual, and with the Fourth, no scheduled admissions or transfers, only the admissions from the ED. We have one interesting case where we're having trouble diagnosing. Doctor Subramani has a conference call with specialists at Mayo and Emory tomorrow. I heard you had a run-in with the new Attending."

"Several, actually. Between you and me, and not to be repeated, she's lazy, and I have strong suspicions about her ability to do the Attending job. She's going to get lit up at the M & M a week from Friday."

"Why?"

I explained what had happened with the guy who was beaten up in the bar.

"You're covered because you made her write it on the chart," Clarissa observed. "No way she can throw you under the bus on that one."

"Probably not," I replied. "And I will acknowledge during my presentation of the case that I should have listened to my nurse."

"Ellie?" Clarissa smirked.

"She's obviously still interested, but she's also dialed it way back. It wasn't her, though, it was Becky, who's been a nurse nearly as long as I've been alive!"

"And your med students?"

"Mary and Tom are great; the other four are about what you'd expect. The one downside for Mary and Tom is that they were assigned to Doctor Mastriano during the interim period before the new PGY1s started, and she's not a very good teacher."

"Sleeps, can't teach, and lazy?"

"That's my assessment. Hopefully, the M & M will be a wake-up call. If not, the next year is going to suck. I'm on with her again on Saturday. On the plus side, the end result of one of our spats was that I was allowed to do a blind pericardiocentesis in the OR."

"You're not even a week into your Intern year!" Clarissa exclaimed.

"That was Doctor Mastriano's objection, though she called me a 'fucking Intern'."

"Think about how rare it is for an Intern to do anything like that."

"And think about how DUMB that historical practice is! The advantage of the new program is that nobody has to 'do what has always been done' because it's never been done before."

Clarissa laughed, "Says the man for whom 'I have never seen it done that way before' is the ultimate reprimand for a clergyman!"

"If you think about it, we're priests and priestesses and expected to follow tradition — what has been done always, everywhere, and by all."

"You're saying medicine is Orthodox?"

"I'm saying our rituals and traditions are handled exactly the same way — anything new is viewed skeptically until accepted by the medical community at large. We have our deanery meetings every Friday, our medical conferences are like synods, and AMA meetings are, in a way, Ecumenical Councils."

"Oh, for the love of God!" Clarissa said, laughing hard. "Seriously?"

"The parallels are there," I said as the waitress brought our food.

I said the blessing, and we began eating.

"Have you heard anything about Kris' citizenship application?"

"Just that it was filed on the 3rd. I believe we provided everything they need, so the next step will be interviews, potentially as soon as next month, but it could be as much as six months."

Clarissa smirked, "That should be interesting. 'Does she swallow?'"

I chuckled, "While the attorney suggested those types of questions might be asked in the case of certain marriages, he felt that Kris having a green card and formally adopting Rachel would obviate such questions, given no sane person would risk losing custody of their kid for a sham marriage."

"We are talking about you, Petrovich, and sanity was never an option!"

"No kidding!" I chuckled. "But the government doesn't know that! In any event, he thinks the interview will be it, with no visits to the house or anything like that."

"And your «minou»'s politics?" ("pussy")

"Starting that again, are we?" I asked.

"Of course!"

"Being a socialist isn't a cause for denial of naturalization, only advocating the violent overthrow of the government. And despite flying the red and black flag on May Day, she hasn't advocated a violent overthrow of the government."

"Sorry to bring this up, but how are you handling the memorial this year?"

"Viktor arranged with Father Nicholas to have the memorial that morning, which is a Saturday. Kris, Rachel, and I will be there. I'll still be on my current schedule, so I have to be at the hospital from noon to midnight, so we'll have to figure out our family birthday celebration for Rachel, and I'm sure the Kozlovs will want to do something. Kris and Lyudmila are planning a party with Rachel's friends from daycare and church, and that will be on Saturday afternoon while I'm on shift."

"Thereby avoiding a house full of toddlers and their moms!"

"One toddler is a challenge for the two of us! I can't even imagine a dozen little girls!"

"But when they grow up..." Clarissa smirked. "I recall you enjoying graduation parties!"

"That's even MORE reason to be out of the house! But seriously, at forty-two, I'd be ancient in their minds!"

"Mostly, but I think you'll be hit on by cute teenage girls for decades!"

"That does seem to happen to doctors right up into their forties."

"Speaking of one toddler being a challenge, are you still planning on having a baby next July?"

"If I have a baby in July, it'll be in every medical journal on the planet, and I'll be famous!"

"You know what I meant, you nut!"

"That's the plan," I replied. "The timing coincides nicely with the end of the thirty-six-hour shifts and weeks longer than eighty hours, though I have a strong suspicion that's about to change."

Clarissa nodded, "Doctor Subramani said she spoke to a friend in New York who said the end result is going to be a limit of eighty hours a week and shifts no longer than twenty-four hours with at least twelve between them. Which means more Residents."

"Which requires more money, and that is a complex mess with federal, state, and local funding sources, plus patient fees and insurance receipts."

"I think we'll be bitching about lack of resources when we retire in forty years or so."

"I was thinking about that, and surgeons typically retire by sixty or at least significantly reduce their actual surgeries and teach instead. I could work longer in the ED, as I could take regular shifts instead of trauma surgeon shifts, but I think at that point, I'll hang out a shingle or work in a clinic. I just don't see retiring from medicine. Doctor Evgeni is nearly eighty and still sees some patients."

"You'd make a great teacher."

"I suspect so, but not seeing patients would frustrate me to no end. It's why I'll never take a job in administration. I'd rather be a locum tenens on contract than Medical Director."

"There's no chance you'll be an eternal Resident! You'll get the Attending slot the second you pass your boards and can put FACS behind your MD! There's no way they'll risk losing you."

I smiled, "And yet, there is one thing that could take me away."

"Rutherford, right? If they become a teaching hospital and upgrade to a Level I trauma center."

"That would be it, and they're on that path, but who knows what will happen over the next decade."

"Want to make a wager?"

"On?"

"That Doctor Michael Peter Loucks, MD, FACS, will be the Chief of Emergency Medicine at Rutherford Hospital before the end of the next decade."

"And what would the bet be?" I asked with an arched eyebrow.

Clarissa laughed, "I can't make it too interesting for you because your «minou» would object." ("pussy")

"Yeah, but if that was what I would get for winning a bet that I wasn't going to have that role, do you think I'd take the job?"

Clarissa laughed, "There is no way you would trade one night with me for your ultimate dream job!"

"Are you sure about that, Lissa?" I asked with a smirk.

"Positive!" Clarissa declared. "Mainly because you could never collect."

"Truth. Despite the tragic events around Rachel's birth, I fully expect to grow old together with Kris."

"How are things going? And I don't want a flippant answer."

"They're good. We have our areas of disagreement, but they're peripheral, not core. Kris is very different from any girl with whom I've ever been involved and is more mature than most girls her age. We're going through what is likely to be the toughest time we'll ever have to, and she's handling it well. Rachel, on the other hand, is annoyed that she can't see me and alternates between clinging and giving me looks that remind me of Elizaveta when she was unhappy with me."

"Complete with hands on the hips?"

"A couple of times," I chuckled. "It was uncanny how much she reminded me of her ... Elizaveta."

"You can say that to me, Petrovich. It won't cause any trouble."

"No, I can't," I countered. "I do not want to send mixed messages to Rachel or Kris. Yes, Elizaveta is Rachel's biological mom, but Kris is the only mom Rachel will ever know, even when she finds out about Elizaveta."

"She's almost two, and at some point, probably not too far in the future, she's going to ask about the icon and prayers. You don't display any pictures, right? I haven't been in your bedroom."

"Much to your chagrin!" I teased. "But no, no pictures. I have albums, of course, but the framed pictures were put away because I didn't want Kris to feel slighted in any way. And being Orthodox, it's the icon that truly matters."

"Theologically, sure, but you don't feel that way. Well, at least not a hundred percent."

"Yes and no," I replied. "The struggle for me is honoring Elizaveta and remembering her without making Kris feel like my, and I'll use this term with you only, second wife."

"I think you've done a good job balancing things, and Kris has a good head on her shoulders. She accepted your relationship with Angie and your relationship with me and didn't freak out over our desire to have a baby together. Any woman who can do that is a keeper!"

"And you keep your hands off, Lissa!" I said with a grin.

"I told you I think she's hot, but Tessa and I are as committed as you and Kris are."

"With one exception."

"You had your chance, Petrovich!"

"And you know that wasn't for me, and why."

"Well, if a threesome with Deb and Milena left you nonplussed, I'm not sure what would work besides a monogamous relationship."

"You, Tessa, and I did NOT leave me nonplussed!"

"Except that was all about you and me. Your pleasure with Tessa was directly related to me being there, participating and watching, not having a threesome."

"You might have a point. OK to change subjects?"

"Sure."

"I spoke with the attorney handling Angie's case, and he thinks an official reprimand is likely and that it's even possible we'll get Greenberg's license suspended."

"I hope that's the case! What happens now?"

"The complaint has to be submitted to the Medical Licensing Board. The attorney will interview me to get the details from my perspective, and I'll testify in my official capacity as a doctor to his errors."

"Risky."

"I know, and I'm going to take the risk. Well, assuming the attorney doesn't have another way. Angie deserved better, and while I can't fix what Greenberg did, I can certainly make sure he never does it again."

"Just be smart, Mike."

"Nobody in Surgery or Emergency Medicine is going to cause me trouble for doing the right thing, and I don't care what Psych says, or any other department, for that matter. My guess is that Doctor Greenberg files a nolo contendere with the board in exchange for a reprimand. I won't like it, but it's better than nothing."

"Basically a plea bargain?"

"Basically. The other thing that happened was that Melissa Bush returned my call. She seems to be doing OK, but she's completely rejected Christianity, well, her version of it."

"Do you blame her? You reject it, too!"

"Yes, of course, but she claims to no longer believe in God and to be engaging in promiscuous sex with random guys on Friday nights."

"I don't believe THAT!" Clarissa declared.

"Neither did I, but she made the point that she's not the same person she was a year ago. I let her know I'd seen her dad, and her response was such that I don't believe she has any interest in getting in touch with him."

"Again, do you blame her?"

"No. Her comment was that he'd messed up her life, as well as her mom's and her brother's, and she basically expressed no sympathy for the Gospel message that everyone is redeemable."

"You are the lone voice in the wilderness on that one with regard to Lee."

"I know, but I have to be true to myself, even when it forces conclusions and actions I don't like."

"You're going to see Frank Bush again, right?"

"Yes. On a monthly basis. Maybe at some point, I'll do some evangelism at the prison, but I need a sane schedule before I can consider that."