Chapter 53: There Wolf! There Castle!

September 26, 1989, Circleville, Ohio

"There's a letter for you from the Pickaway County Clerk of Courts," Kris said after greeting me at home on Tuesday evening. "It's in the basket on the kitchen counter."

"I'll look at it after we say evening prayers, I read to Rachel, and we put her to bed."

The three of us went to our icon corner, said our evening prayers, then I sat with Rachel and read her current favorite book — Put Me In The Zoo. When I finished reading to her, I took her to her room, changed her into a fresh diaper, put on clean pyjamas, and then put her down to sleep. She was very good about going to bed and closed her eyes, so I turned off the light, left her room, and went downstairs. I went to the kitchen, retrieved the envelope, and opened it.

"A jury summons," I said aloud.

"How does that work with you being a doctor?"

"I'm not sure. Give me a minute to read this, please."

I read through the document and on the reverse were instructions on how to report, and instructions on how to request an exemption, though those were mostly vague.

"It says that exemptions are for verified medical or mental conditions..."

"Is this where Clarissa says something about you being mentally ill?" Kris interrupted with a smirk.

"Obviously," I replied, shaking my head. "And I've never denied being crazy, but I don't think I want to go on record with the state as being nuts!"

"Probably not!"

"It also states financial hardship, but I'm salaried, and the hospital is required to give time off for jury duty. There is a statement that other hardships need to be described in writing, but I can't think of any. I mean, yes, the hospital will need to find someone to cover for me, but that would be true of anyone who has a job. The other listed exceptions, including being over seventy-five or having a felony conviction, don't apply. I won't try to be excused because it's my civic duty."

"When is it? And for how long?"

"October 23rd through 27th. It says I have to serve either five days or one trial. I report each day, and if I'm selected for a jury, I serve on it; if not, then I return the next day."

"Do you think you'd be chosen?"

I shrugged, "I have no idea. I'm fairly certain I couldn't serve on a jury if the case were about medical treatment, but otherwise, I suppose it would depend on what the attorneys on both sides think about me. We'll see what happens in a month. A questionnaire is included that I need to fill out with basic information, so I'll fill that out and return it. I do have one other thing to tell you before we go to bed."

"What's that?"

"I had to give a deposition today to the medical school and hospital attorneys about Krista Sandberg. No big deal, and they talked to Shelly Lindsay as well. They'll also talk to Kellie Martin and Becky Compton."

"Why?"

"It's part of the investigation before they formally expel her, which will happen by the end of the week. It's also to know what might come up if she were to sue. There's a good chance she might, though her case is actually worse than the others who tried legal action. The same attorney has come after the medical school and hospital a dozen times in the past ten years, though he's always lost."

"And yet he keeps trying?"

"Because all he needs is one win, and that will open the floodgates. He did have one success with the negotiated agreement for Melissa Bush to repeat her Fourth Year, but that agreement created no precedent, and frankly, her expulsion was too harsh given the mitigating factors. It led the medical school to be less inclined to expel individuals for non-medical infractions. That's why Jack Strickland was given a suspension and not expelled for his boorish behavior."

"Comparing a woman to a cadaver with regard to sex is more than boorish!" Kris exclaimed.

"I don't disagree, but that is how it was classified. And you've heard me complain often enough about the way women, minorities, and homosexuals are treated in the medical community. My complaints about what amounts to sexual harassment and abuse are what got me into hot water with Doctor Northrup. He's apparently also not happy with the new rule the medical school put in place about sex in the hospital, but the more I think about it, that might be posturing."

"Posturing?"

"He wants to be Medical Director, and for that to happen, he has to overcome the institutional inertia of always appointing a surgeon to that role. By taking a position against interfering with doctors' private lives, he gains the support of doctors who are jealously protecting their privileges."

"To sleep with their students!"

"From his perspective, it's about consenting adults, and he has a point, to a point. That said, I don't see a distinction with regard to propriety between screwing in the hospital or going to a motel. I could make a distinction that in the hospital, it disrespects other staff and patients, and despite believing that, I think it's more than that. I'm no prude, and I honestly do not care who sleeps with whom until it affects medical training and patient care. Doctors are already prohibited from sleeping with their patients for ethical reasons."

"Kari?" Kris asked.

"She was no longer a patient when we began dating, and I wasn't a doctor, so not bound by the same rules. Had she come back to the hospital for any reason, I wouldn't have treated her except in extremis. If I were a psychiatrist, then dating after she was no longer a patient would generally be an ethical violation."

"I suppose that makes sense. Did you make contact with anyone who could help the prisoner who isn't receiving proper medical care?"

"I spoke to the assistant in the office of the doctor in charge of prison medical care. That person flat-out refused to do anything. I was invited to write a letter and they would review it and investigate. When I asked how long the investigation would take, they said ninety days, which is unconscionable. I'm trying an end run to see if I can have any success."

"End run?"

"From gridiron football, not what you call football!

"At least in our football, you actually use your feet to advance the ball! It's illegal in your version! So silly!"

"Whatever! In any event, it means handing the ball to a back who then attempts to run to the outside of the offensive line. In general, it means to go around some obstacle, and in this context, to try to go around the bureaucratic process."

"How so?"

"By having Kurt Bowman name me as his next of kin, which gives me the right to contact the prison about his medical care. I did that and also advised him to get aspirin from the commissary and take half a tablet a day because the main cause of TIA is blood clots or plaque in arteries. That should help until I can have him properly evaluated. The problem is, the request for care will be evaluated by the same person who insists he's faking it."

"What can you do at that point?"

"I'm not sure. I think I might need to speak to an attorney."

"Your stepdad?"

"He specializes in family law. Mr. Winston, who my mom works for, is a generalist, so he's probably my best choice, at least to start. I'd say Jocelyn, but she's a brand new attorney, similar to how I'm a brand new doctor."

"I can't believe they won't provide proper medical treatment!"

"I can believe it," I sighed. "People in prison are considered sub-human by many people, no matter why they're in prison. And a felony conviction basically screws you for life, even if you're completely rehabilitated and don't pose a risk to anyone or anything. It's made worse by ever-harsher penalties, over-criminalization, and stacking of charges. But now I'm getting way out of my area of expertise!"

"I know one area where you're an expert!" Kris declared with an inviting smile.

"Should we go upstairs and try to make a baby?"

"Yes!"

September 28, 1989, McKinley, Ohio

"Got a minute?" Bobby asked early on Thursday morning.

"Ambulance bay?" I asked, given the consultation room was being used and there were others in the lounge.

He nodded, and we walked out to the ambulance bay where his squad was parked.

"Is there anything thing I can say or do to get you to fix the situation between you and Lor?"

"To me? Or to her?"

"You are both as stubborn as mules!" Bobby growled.

"As has been said, the Borodin clan is a stubborn lot, but that said, do you know the true source of my problem with Doctor Gibbs?"

"'Doctor Gibbs'? Come on, Mike!"

"If you don't understand why I used her title and surname, that makes me suspect you don't know the true source of the problem."

"And what is that?"

"She refused, even in private and off the record, to admit that she, at one time, agreed with my position on relationships between doctors and medical students. She went from wholehearted support to refusing to admit that was ever her position. And that was after she threw me under the bus with Doctor Northrup by not backing my right to hold an opinion he doesn't like because it might interfere with his longshot chance of becoming Medical Director."

"That's not how she put it."

"Of course not. I'm positive she said I took umbrage at the double-secret probation, and while that's true, it's not the source of the problem. The double-secret probation bit was overturned by Doctor Cutter, but even after that, Doctor Gibbs refused to acknowledge that at one time, she agreed with me. She's playing politics and places more value on that than on our friendship."

"Bobby, we have a run!" Sam called out from the cab of the squad.

"I'll find you later, Mike," Bobby said.

"OK," I replied.

He hopped into the squad, and I turned and went back into the ED. I wasn't really surprised that Doctor Gibbs had focused on the 'rat fink' aspect of our interaction because that had been my first complaint. That said, I'd backed off that and simply wanted her to acknowledge something she'd said in the past. Until she could do that, I didn't see a way forward except as professional colleagues.

"Doctor Mike, do you have a minute?" Al asked when he saw me walk in.

"Sure. What's up?"

"I know it's early, but I spoke with Doctor Mertens about my schedule for next year, and she said Doctor Cutter would need to approve me for the Pathology Sub-I because of how limited they are."

"That shouldn't be a problem, given your surgical rotation is before the final choices have to be made. Do the same excellent work on that rotation, let your Resident and Attending know you want to Match for surgery, and we'll address it with Doctor Cutter once you have your evaluation. Remember, the trauma surgery Residency is officially a surgical Residency. And, worse comes to worst, not having the Pathology Sub-I won't hurt your chances at Matching here or elsewhere."

"Thanks, Doctor Mike!"

"Any patients waiting?"

"No. The waiting room is a ghost town, and I just sent up the only overnight admit."

"You know what that means!" I said.

"Always calmest before the storm!"

"Bobby and Sam just had a call, so there's at least one incoming trauma."

"I'd like to be involved in more traumas," Al said.

"Me too!" I chuckled. "But my role actually works against that, given I need to be available for surgical consults, as there isn't a pure surgical Intern assigned to the ED when I'm on shift. That actually worked in our favor with that triple MVA, where we worked on all three patients. It's also the case that trauma interns handle walk-ins to allow more experienced staff to deal with traumas."

"Does it bother you?"

"Yes and no. Like you, I want more action; but I also signed up for this, knowing what it meant. As strange as it sounds, I was directly involved in more traumas on an average day as a Fourth Year than I am as a PGY1. You haven't done a cardiology rotation, whereas as a Third Year you'll tag along for consults, while Fourth Years stay in the ward."

"I'm missing the logic."

I smiled, "I did, too, at first. Think about it this way — a Fourth Year has the necessary experience to respond to an emergency that a Third Year would not. The Fourth Year at that point, being responsible for the ward demonstrates he or she is ready to be an Intern, given that's what Interns do, besides consults."

"That makes sense. I have a question, but I won't be offended if you tell me it's none of my business — did you really tape-record your meeting with Krista?"

"I did."

"You were obviously aware of her and Bill Schmidt in the on-call room."

"I think I need to decline to discuss this further until the investigation is complete."

"Got it. Sorry."

"No need to apologize. Students are expected to ask questions of their Residents. I'd prefer you ask whatever is on your mind than fail to ask an important question. If I can't answer, I'll say so. But the only way you're going to get that spot you covet is to ask questions, learn everything you can, and be the best student you can possibly be. That might mean being pushy; I certainly was. You want to be assertive right up to the point of being obnoxious, but not cross that line; I did, a few times, and it led to counseling by my Resident or Attending."

The entire morning was eerily quiet. The only trauma was a rule-out MI that Bobby and Sam brought in and Naveen and I saw only one patient each. At 11:30, I called to see if Clarissa could take her lunch, which she could, so we met in the cafeteria.

"Guess who was chosen to be the first Medicine PGY1 to do an eight-week trauma rotation?"

"Doctor Atkins?" I asked, knowing full well that was not the right answer.

"No."

"Doctor Nelson?"

"You're being yourself, Petrovich!"

I chuckled, "Obviously. I saw the revised schedule this morning. I don't think Naveen is happy with two months in Medicine, especially given I get to skip because I'm a surgical Intern."

"But you think the rotations are a good idea, right?"

"I do. We'll also have a cardiology Resident in the ED starting next week rather than have them come down only for consults or admits. The goal there is to ensure all the ED Residents and Attendings are up to speed on reading EKGs and treating MIs and strokes. The new system should also speed up admits to Medicine and Cardiology, which is important, given we're short beds at the moment and we're still about twenty months from the new ED wing being completed."

"Have you trained any paramedics?"

"No, that's being done by the Attendings because that's a requirement for certification. Roy performed the first-ever Hayes County Paramedic field intubation the other day. As we push more and more advanced procedures to the field, which is good for patients, we diminish training opportunities. It means, for example, fewer opportunities for intubation by Fourth Years, which is a problem. It means, as I see it, that they'll need to do something like 90% of all intubations in the ED so they have the necessary experience when they're Residents."

"It's an interesting problem but a good one to have."

"I agree."

"Anything further on Krista?" Clarissa asked.

"No, but I expect her to be formally expelled no later than Friday."

"Do you think she'll appeal to the Student Ethics Board?"

"If the rumors about her speaking with Arthur Braun are true, I'd say that's a lock."

"Could the tape be used as evidence in court if she sues?"

"I recall from High School that in Ohio, you only need consent of one party to record a private conversation, and as I was in the conversation, the recording is legal. That, combined with her sworn statement, will sink her. Or should. And speaking of court, guess who was summoned for jury duty?"

"That should be interesting. When?"

"Late October. There is no guarantee I'll actually serve, though. The summons said you appear for five days, and if you aren't selected, you're done. If you are selected, you serve the length of the trial, and that could be civil or criminal."

"Is your life ever going to calm down?"

"It is calm! This is something a typical citizen does."

"OK, the jury thing, but all the other stuff at the hospital?"

"I don't think that's ever going to be calm! There are so many things that need to change, I'm never going to run out of people to piss off because I point out the flaws in the system!"

"Maybe give it a rest for a bit?"

"I think no matter how hard I try, things are going to find me. You know all the 'problem children' are assigned to me."

"I think that might change after this little fiasco because it backfired on them, even if it might turn out the way they wanted. You threw a hand grenade into their little harem scheme."

"They can still screw med students if they want; they just can't do it at the hospital without the med student being dismissed if they're found out. But that's a big win in my book."

"Changing subjects, any luck with getting treatment for that inmate with TIA?"

"No. I'm attempting an end-run, and we'll see how that goes. At a minimum, I want to get someone on the record rejecting my request."

"Then what?"

"I'll have to speak to Kurt Bowman's attorney or Public Defender at that point. I have no idea if there's any chance of success."

"Sounds almost like tilting at windmills."

"Maybe, but if there was ever a worthy cause, this is it. You know what the Gospel says about visiting prisoners."

"I do. And that is what motivates you. What's the guy in for?"

"Armed robbery. His story is that he lost his job, had no money, and was trying to care for his wife and kids. He was desperate and did something extremely foolish. He got twenty years, and he's served about half."

"Normal people don't resort to armed robbery, no matter how desperate they are."

I shrugged, "I wasn't making excuses, only relating what he told me. I'd do the same for Frank Bush. Heck, I did that, in a sense, when I helped treat him after he was assaulted in the County Jail. We took an oath, Lissa."