Good Medicine - Residency I
Copyright© 2024 by Michael Loucks
Chapter 4: It's Going to Be a Very Busy Year!
June 5, 1989, On the Road to Gatlinburg, Tennessee
"What do you think of what's going on in China?" Kris asked as she maneuvered her Tempo onto US Route 23.
"I think we may never know what really happened, though it's also possible this might be the beginning of the end of the Red Chinese government. I doubt it, but with everything else going on in the Communist world, who knows? May I ask that we not get into a political discussion, please?"
"Yes. What happens now that you've finished your time with the Fire Department?"
"Now I have a full twenty-five days off and perhaps one or two more, depending on when I have my first shift."
"It doesn't start on the 1st?"
"Not necessarily. If I needed orientation, then it would. But I get paid starting on the 1st, no matter what."
"Do you know the other new doctors? I mean, besides Kylie?"
"I know their names and where they went to medical school, but that's it. I haven't met any of them. Besides Kylie, there are four men and one woman, and one of the guys is from India but went to medical school at UCLA."
"So, including you, five men and two women?"
"I'm technically not an emergency medicine Resident," I replied. "So of the actual emergency medicine Residents, it's four to two, which is an improvement, given there is only one female Resident, Doctor Billings, and only one female Attending, Doctor Gibbs."
"And you're OK with that?"
"I'll say the same thing I did when a similar question was asked about Taft — you can only draw from the pool of applicants. My medical school class was about two-to-one male over female, which was a serious improvement, and the ones behind us were less unbalanced. The most common Match for women in my class was pediatrics, followed by OB, and then going into general practice. Surgery, cardiology, and emergency medicine combined had fewer Matches by women than pediatrics."
"Why?"
"Part history, part conditioning, part personality traits. And, yes, discrimination, especially in surgery."
"And you put up with that?"
"No, I simply acknowledge it to be true. I have spoken up when and where appropriate, just as I did at Taft. Things are changing slowly, and the medical school is doing more outreach to women and minorities. But a smallish medical school in south-central Ohio is going to be more white and more male than, say, UCLA, simply because of the demographics. We don't have many Hispanics in the area, nor many Asians, just to identify two minority groups."
"What about what you call African Americans?"
"Not represented at the same percentage as they make up the population, but as Doctor Mertens said when I asked, it's an applicant problem, not an admissions problem. They admit a higher percentage of African American applicants than make up the applicant pool. Not to defend our system, but there must be discrimination in France."
"Mostly against immigrants from Africa, especially from Algeria. I believe the main cause is that many of them are Muslim and do not agree with the absolute secularism which we maintain in French political life, called «Laïcité». It is very much like what you call 'separation of church and state'."
I shook my head, "I don't think so. In our system, the government is expressly forbidden from creating a national church, and that's it. That's been read to not allow it to favor one faith over the other, and I agree. But other than that, 'Free Exercise' means the government may not interfere with religious practice, but faith may not only be public but openly influence public policy."
"But the 'wall of separation'?"
"That was Thomas Jefferson, and he's been seriously misinterpreted. In context, Jefferson's concern was being compelled to follow a specific religious practice by law, not that religious people expressed political opinions. And remember, at the time, there were still established churches in individual states because the original Constitution did not prohibit state governments from having established churches, which some did into the 19th century."
"That makes no sense at all!"
"It does if you understand the founding concept of the United States to treat every state similar to a country, albeit with a common foreign policy, a common national currency, a free trade zone, and no border controls. It's similar to the Schengen Agreement, with regard to borders, and the recently passed Single European Act with regard to a free trade zone. And I know there are proposals for a common currency, and there is quite a bit of common foreign policy."
"But you are one country!"
"We are fifty sovereign states," I replied. "And the Constitution delegates limited powers to the federal government. The main political argument in the US since 1789 is just how much power the national government ought to have."
"And what do you think?"
"I think we ended up talking about politics anyway!" I chuckled. "Which seems par for the course!"
"I suppose it is. Would you answer? I'm OK if we discuss something else."
"I think the country is too large to be governed centrally with 'one-size-fits-all' policies. What concerns me in southern Ohio may not concern someone in southern California or in Alaska or in Texas. What we have in common is currency and foreign trade, and, in theory, the ethos of the American Dream, true or not."
"Do you believe in it?"
"My family, on my mom's side, lived it, and I'm a product of it. On my dad's side, they were well-to-do from the time they first arrived in Manhattan in the 17th century. My Russian grandparents came here with nothing except the clothes on their back, a few personal items, and a balalaika."
"The one you have, right?"
"Yes. My grandfather gave it to me about four years ago. It will be Rachel's, if she wants to learn to play, which I hope she will."
"She certainly loves sitting with you when you play!"
"Most girls did!" I said.
"Of course!" Kris said, laughing softly. "Boys who played the guitar attracted girls like bees to a flower!"
"I didn't learn to play until college."
"Poor baby," Kris said flatly. "But going back to Europe, I didn't realize you knew so much about European politics!"
"I've picked it up through reading the newspaper, mostly. Our civics classes here, at least when I was in High School, focused on the American system."
"My High School here didn't offer civics, but we did have a course in principles of government, which, of course, was so out of touch with reality that I couldn't stand it!"
"The usual American mischaracterization of socialism and a denial that we have programs which are, in their essence, socialist, by American definitions."
"Yes, of course! Not to mention treating Marx and Engels as 'class enemies' while denying 'class' theory!"
"Americans do tend to suffer cognitive dissonance on that topic. But I suppose I'm a class enemy because I believe the accumulation of capital is, overall, a good thing."
"We'll work on that!" Kris said lightly.
"And I say 'good luck to you in that endeavor'!"
"Changing subjects, we never really discussed what we'd do in Tennessee."
"I believe we should spend time with Rachel, hike, swim, and make love!"
"How do you think Rachel will respond to a brother or sister?" Kris asked.
"With a sister, I think if we make the point she's a 'big girl' and the 'big sister', she'll be fine. She's not keen on boys at the moment."
"That will change!"
"More than likely, but you know Clarissa, so you know that's not a given."
"And your response?" Kris asked.
"Will be to love my daughter," I said firmly, "no matter what."
"And speaking of Clarissa, we should probably discuss her request so we're in full agreement before we have dinner with her and Tessa."
"I think, in the end, you have the master trump and the right to play it."
"I'm not sure that's fair to you," Kris said. "To simply say 'no' without approaching it with an open mind, even if the result were to be the same, seems wrong. What is a partnership if one is a dictator? You do not want to be ruled by me any more than I want to be ruled by you, which is to say not at all!
"You know, because I've said it plainly, that there are only two absolutes — absolutely no secrets and absolute sexual fidelity. And with regard to sex, I've promised to do anything you want, with you, with no limits and no restrictions, and you've made the same promise. Everything else is open to discussion.
"I reject completely all misogynistic practices, and it would therefore be completely out of line to turn the tables, so to speak. I know you like to tease about women controlling your life, but I hope you know that's not true about me, though I do reserve the right to give you guidance."
I laughed, "Guidance from a Russian woman is FAR more than just a suggestion!"
"Good advice ought to be followed, don't you think?"
"As much as it might sound as if I complain about women controlling my life, it's really not a complaint. As Mr. Sokolov told me before I married Elizaveta, God gives us wives to make us better men. I agree, and I don't feel controlled when you suggest a course of action or a change in behavior. My mom, Jocelyn, Clarissa, and Elizaveta never steered me wrong, even if I didn't always take their advice."
"You don't feel as if I'm trying to control you, do you?"
"No, I don't. You've made your views clear, but you've always been willing to hear my side and consider my views, needs, and desires. I don't feel at all controlled or limited or restrained by our relationship, with the caveats about secrecy and fidelity, with which I wholeheartedly agree."
"I would hope so! I may not be jealous, but I do not share!"
"I learned to share in kindergarten," I replied with a silly smile.
"NOT THAT WAY!" Kris protested, though she laughed after she said it.
"Well, Jocelyn and I did hang our smocks on the same hook so they wouldn't be lonely at night!"
"You were five!"
"I grew up!"
"Allegedly!" Kris teased.
"Jocelyn and Clarissa would agree with you!"
"You know they're teasing, right?" Kris asked.
"Of course. That said, both of them were instrumental in making me the man I am today."
"So I owe them a debt of gratitude?"
"I don't know that 'owe' is the right term," I replied, "but you certainly should be grateful. There were others, too, especially Angie, who had a major impact as well, though mostly in terms of my views on the horrendous state of mental healthcare."
"That really is a focus for you."
"Some would call it an obsession," I replied. "How is it in France?"
"There are plenty of doctors and plenty of services, and they are covered by our health insurance system, but I cannot say how effective it is because I don't know. Have you decided what to do about the doctor who improperly treated her?"
"I spoke briefly to Lara at the graduation party, and she and I will speak with Angie's mom later this month. In the end, it's up to Angie's mom, as I don't want to put the Stephens through an ordeal they'd prefer to avoid. If she's OK, then we'll file a formal complaint with the Ohio Medical Licensing Board and use the malpractice settlement as proof something happened. We'll probably lose before the Licensing Board, but I think it's worth the time and effort, as does Lara."
"If he's a bad doctor, he ought to be identified as one."
"I agree. I'd prefer his license be yanked, but I've been told time and again that's not going to happen, and I'm going to tilt at that windmill despite being warned not to."
"By the psychiatrist at the hospital, right?"
"Among others. Basically, it would be Mrs. Stephens filing the complaint, and Lara bankrolling the attorney, and me providing guidance and input but doing my best to stay out of the limelight."
"I'm curious whether you would choose to protect yourself or help Angie?"
"That's a difficult question to answer without understanding the exact risks, which I won't know until they occur. I think the best answer is I won't risk my future medical license, but I would risk alienating doctors and administrators."
"But wouldn't that harm your training?"
"Perhaps in some minor ways, but in the end, the literal worst-case scenario would be that I'd obtain my license as a GP and emulate Doctor Evgeni. But I don't see that happening. The psychiatrist absolutely failed to take Angie's best interest into account and literally ignored or discounted the indications that she might have been on the road to recovery, or, perhaps, stability at a level where she could regain her autonomy."
"I don't understand why that's no longer possible," Kris said.
"In part, because she has to be medicated, but in part because the psychiatrist's actions caused a mental breakdown and pushed Angie back to the exact place she had been at her lowest point. It took literally years of concerted effort to get her off the drugs, which is a prerequisite for obtaining a driving license and applying to have her right of self-determination restored. What happened means that task, which was already difficult, will now be impossible, as they'll point to that relapse as a reason to not release her from the guardianship orders."
"As I said when we first discussed this, that doctor is evil."
"Indeed he is."
June 5, 1989, Gatlinburg, Tennessee
Kris pulled into the drive of the Greystone Lodge in Gatlinburg just after 4:00pm, after an uneventful drive from McKinley. Rachel had slept a good portion of the way, as she often did on longer car rides. Kris parked, we got out, I took Rachel from her car seat, and we went into the lobby.
"We have a reservation under 'Loucks'," I said to the Reception clerk.
She flipped through cards and selected one.
"Doctor Michael Loucks?" she asked.
That was not how I'd made the reservation, and I smelled a rat, though I didn't know which rat it was.
"Yes, along with my wife and daughter."
"Welcome Doctor Loucks! We have you in one of our family suites for nine nights, departing on the 15th. I see the room rate has been paid. I'll need a credit card imprint for incidentals, please."
I handed over my MasterCard, and the clerk took an imprint, then handed it back to me.
"Sign here, please," she said, sliding a registration card to me.
I signed and pushed the card back.
"Two keys?"
"Yes, please."
"Is your luggage in your car?"
"It is."
She tapped a bell, and the bellman came over.
"Doctor and Mrs. Loucks have luggage," she said, handing the bellman the room keys. "Doctor Loucks, we can park your car for you, if you like, and bring you the keys."
"Thank you," I replied.
"Enjoy your stay!"
I handed the car keys to the bellman, and we moved aside to wait for the bellman to retrieve our luggage.
"That American custom is annoying!" Kris said quietly. "As if I'm your property!"
"She could have said 'Doctor and Mrs. Michael Loucks' and made it sound worse," I chuckled. "But we're in the South, so you have to expect people to use traditional terms and make traditional assumptions."
"All that does is perpetuate the problem!"
"Maybe so, but we're on vacation, so just let it go and enjoy the hospitality, please."
The bellman retrieved our bags, then showed us to our suite, which had two bedrooms, one of which had a bunk bed with side rails. The bathroom had a large tub and a large shower with a bench. The main room had a 35" television and stereo system.
"We can move the trundle bed to the main bedroom if you wish," the bellman offered.
"Rachel will be fine in this room," I said.
I tipped the bellman, and he said someone would return with our car keys within ten minutes.
"Someone upgraded the room and paid?" Kris asked.
"Yes. Your parents?"
"No. They wouldn't do that without asking me. Viktor Kozlov?"
"I seriously doubt it," I replied. "If Yulia ever found out, she'd be upset."
"Lara?"
"She's one possible suspect, though, like your parents, she'd have said something. The thing is, the only people I told where we were staying were my mom and Clarissa. If I had to put money on it, either Stefan or my grandfather, or both."
"Does it upset you that they didn't tell you? I mean, whoever did it?"
"No. I'm OK with surprises and unexpected gifts. And that's why I don't think it was Lara because she knows about your distaste for secrets and surprises. May I suggest you simply accept the gift graciously and let it go? I'll find a way to work your preference into a conversation so it doesn't sound critical but makes the point."
"You don't agree with me, do you?"
"I have a somewhat different opinion, but I support your desire to not have surprises or secrets. So, in the end, we'll do it your way because it's something that's important to you but not particularly important to me."
"OK. What shall we do until dinner?"
"Well, given the Tsarina slept most of the way here, I'd say we should go to the pool."
"She'll be OK?"
"I don't plan to simply toss her in!" I chuckled. "Let me get her bathing suit on."
"What about her diaper?"
"My mom bought her something called a swimsuit diaper. It's basically plastic pants with a cotton liner and then a top."
I changed Rachel, then went to put on my bathing suit and stopped dead in my tracks as I saw Kris in a pure white bikini.
"Wow!" I exclaimed.
"Thank you, but you've seen me naked!"
"I have, but sometimes leaving a bit to the imagination is sexy!"
"You don't have to imagine!" Kris protested.
"And yet, I stand by the fact that you look sexy in that bikini!"
There was a knock at the door, and when I opened it, the bellman handed me the keys to our car. Once I put the keys with my wallet on the table in the bedroom, Kris, Rachel, and I went to the pool. Rachel didn't know what to make of the kiddie pool at first but soon was splashing and enjoying the water. We spent about thirty minutes at the pool, and, as I didn't want Rachel to burn, we went back to the room and relaxed until dinner, which we ate in the hotel dining room.
"What do you make of the elections in Poland?" Kris asked as we watched the evening news on television after dinner.
"I think the genie is out of the bottle, so to speak, or Pandora's box has been opened. The repudiation of the Communist government is a major threat to the Kremlin, and Poland is a potential powder keg. All we can do is pray it ends relatively peacefully."
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