Good Medicine - Residency I - Cover

Good Medicine - Residency I

Copyright© 2024 by Michael Loucks

Chapter 56: A Whirlwind Trip to Chicago

October 8, 1989, Columbus, Ohio

"How are things going, Michael?" Bishop JOHN asked when we met in his office after the Divine Liturgy on Sunday.

"I think, overall, things are good. Really, the only difficulties are hospital politics, and that's mainly because two very senior physicians are battling to become the Medical Director. Several doctors, including me, have been caught in the crossfire. It's not a real risk to my position, just frustrating and annoying."

"Have you involved yourself in the contest?"

"Not intentionally," I replied. "My involvement stems from a medical student who, in order to avoid failing, used sex to gain improvement in her grades. When she was discovered, she made a false accusation against at least one doctor and was dismissed from the medical school. What got me in hot water, so to speak, was my vocal objection to doctors having sexual relationships with medical students."

"That's not a violation of any rule?"

"No. The Chief Surgeon, who is the leading candidate for the Medical Director's role, agrees with me it ought to be against the rules; the Chief of Emergency Medicine argues that everyone is an adult, and it's nobody's business so long as there is no attempt to influence grades nor any pressure applied."

"Why do I have the feeling that you were the doctor falsely accused?"

"Because you're a wise, discerning man."

"Did that cause any trouble with Kris?"

"No. Two female doctors warned me about this student, and before I confronted her about a lie she'd told, my mentor, Doctor Lindsay, suggested carrying a pocket tape recorder to record any conversations I had with the student. I did, she made a false accusation about the content of the meeting, and I was instantly absolved of any wrongdoing when I played the tape for the current Medical Director."

"I'm curious to see if you can go a full week without being involved in some kind of controversy?!"

I laughed, "There's a reason Clarissa Saunders says she can't leave me unsupervised for two minutes without me finding some way to get into trouble. And at times, she'll say 'thirty seconds' instead of 'two minutes'."

"Was there any negative fallout?"

"Only because of my outspoken objection to teachers sleeping with students. That created problems with the Chief of Emergency Medicine, but the Chief Surgeon under whom I work stood up for me. In addition, after the latest incident, the medical school has made it an ethics violation for a student to have sex at the hospital."

"I suppose it shouldn't surprise me that the hospital environment is not far from General Hospital or Days of Our Lives."

"Sadly, it's only a matter of degree. Fortunately, if the Chief Surgeon becomes Medical Director, there's a good chance he'll ban any relationship between doctors and medical students."

"Was there any negative fallout at all for you?"

"Nothing that matters, except that it harmed my relationship with one of my mentors. I think it'll all blow over by the end of the year."

"And things between you and Kristina are good?"

"Very. She, Rachel, and I are enjoying being a family."

"How is Kristina doing at Ohio State?"

"All A's so far, and I don't expect her to not have an A in anything."

"You're obviously regularly attending services; are you keeping your prayer rule?"

"Yes, Vladyka, I am. And following the fasting rule we worked out with Father Luke in consultation with Father Roman. That said, given we're trying to get pregnant, the fasting rule is somewhat relaxed."

"Given monks do not procreate, I'd say that's appropriate!" Bishop JOHN said with a twinkle in his eye. "Changing topics, how are things with your chaplaincy?"

I explained the situation with Frank Bush, and then the interactions I'd had with Kurt Bowman.

"I have two requests," I said after I'd explained. "The first is I'd like to arrange for Frank Bush to take correspondence courses from Taft, but because he has an advanced degree, the state won't pay for them. I'd like you to approve funds for that purpose."

"I have funds allocated for prison ministry that are not being used. I'll put those under your control, with supervision by Protodeacon Ivan. The budget allocates $3,000 for the ministry."

"Thank you, Vladyka."

"And your second request?"

"I'd like your blessing to wear my cassock in the prison, to clearly identify myself as an Orthodox chaplain and distinguish myself from the Protestant pastors. I'd put it on only at the prison and take it off immediately after I leave."

"How are you known there?"

"Doctor Mike," I replied. "I mention I'm a lay chaplain, but I introduce myself as a doctor."

Bishop John was quiet for a moment.

"My concern, of course, is your former position and the reaction of the laity should they see you in a cassock. That said, there is no canonical restriction, simply a question of episcopal discretion. Has Father Roman asked you to wear a cassock at the monastery since your laicization?"

"No, but we've only been there on weekends when the rules are somewhat relaxed."

"You have my blessing in both instances, and I trust you won't misrepresent your position."

"Thank you, Vladyka. I won't violate your trust."

"Is there anything I can help you with other than the prison ministry?"

"Just your prayers, Vladyka."

"You have them, always."

"And you have mine."

I received his blessing, then went to find Kris and Rachel so we could head home.

October 9, 1989, McKinley, Ohio

"Do you have a moment, Doctor Mike?" Detective Louise Rehling asked when she came into the ED late on Monday morning.

"I have a few minutes while my students are assessing a patient. What can I do for you?"

"I don't know if you've followed the case, but Charles DeJong pled 'not guilty' and is going to trial for murdering his daughter."

"I don't typically follow cases, so other than knowing he was arrested, I'm not aware. What can I do for you?"

"I want to review the incident with you."

"Let's go to the consultation room, please."

I let Nate know where I'd be, then went to the consultation room with Detective Rehling.

"Take me through her first visit from the moment you saw her until she was discharged."

I took out my diagnostic notebook, turned to the correct page, and used it to prompt my memory. I repeated what I'd observed, and Detective Rehling took notes.

"No X-rays were taken, correct?" she asked.

"Correct."

"Was there anything distinctive about the bruises?"

"They were, in my opinion, consistent with being struck repeatedly by a fist."

"No cuts? No blood?"

"No, simply the bruises and a swollen lip, but no blood. She stated, as I said, she got into a fight and had been hit four times."

"Would you say that they were from a male adult fist or a teen female fist?" Detective Rehling asked.

"That's a question for a forensic pathologist," I replied.

"Do you have an opinion?"

"No. I'm completely unqualified to even offer an opinion on that."

"Did you suspect she was pregnant before you ordered the test?"

"No. As I said, it's standard procedure to run a pregnancy test on any female between menarche and menopause before an X-ray. We assume age twelve to sixty."

"How often do you see pregnant teenagers?" Detective Rehling inquired.

"It's relatively rare here; it's more common at the Free Clinic because they offer pregnancy services."

"Did she know she was pregnant?"

"Yes."

"And you didn't think to call and report an underage girl to social services?"

"I reported it to two Attending physicians. As an Intern, I report to licensed physicians who make those decisions."

"You're required to report felonies," Detective Rehling replied.

"She claimed she was pregnant by someone her age, which would make it not a felony. That said, I report injuries of any kind to my Attending, who makes a decision as to what and how to report."

"And she admitted to using marijuana?"

"No," I replied. "She was told we detected it in her urine and that it was bad for her baby."

"What were her parents told?"

"Only that she'd been hit and that she should see her personal physician."

"She was a minor. Why were her parents not told she was pregnant?"

"That's a question for the Attending physicians or the hospital counsel. Interns do not make those decisions."

"Was she showing any signs of marijuana use?"

"Not that I discerned."

"What do you know about the man who brought her in?" Detective Rehling inquired.

"Nothing other than his name — Gary."

"OK. Tell me about the second time she came into the ER."

I took her through the trauma, as well as what I observed in surgery.

"What else can you tell me about her injuries?"

"Nothing. You should be aware that Doctor Lindsay extended one of the knife wounds in order to repair Miss DeJong's lung. But you'll need to speak to Doctor Lindsay about that."

"What did you observe?"

"Standard surgical procedures, at least as they appeared to me as an Intern. I have limited experience in the OR."

"What do you know about what happened in the ICU?"

"Nothing other than that she 'coded', which means a cardiac event. I have no details about it beyond that."

"Do you have anything else to add?"

"No."

"Still hoping you'll come by .38 Special for a drink, even if it's ginger ale," Detective Rehling said with a smile.

"Not with my current schedule, which goes through at least the end of this month. Out of curiosity, do they have live music?"

"Nah, not really room for that. It's all jukebox. I suppose you could get a guy with a guitar and an amp, but that would be it. You're in a band, right?"

"Code Blue. We play a few times a year at Stirred Not Shaken."

"When's your next gig?"

"It'll be in the Spring. We're playing in Newtown, near Cincinnati, on the 20th."

"What bar?"

"Village Tavern on Main," I replied. "8:00pm on the 20th. You should probably call to check on tickets, not just show up."

"Do you have any to hand out?"

"No. They don't comp the band tickets. It's actually not a big venue, but with outdoor seating, they get a decent crowd."

"Thanks, Doc. You might be called to testify. If you are, you'll hear from the County Prosecutor's office."

"OK."

"Doctor Mike?" Sophia said from the door. "We're ready to present."

"Perfect timing, Sophia! Have a good day, Detective."

"Louise," she said.

I nodded, got up, and left the consultation room with Sophia.

"That cop has the hots for you," Sophia observed.

Actually, she didn't because she had let on, privately, that she was lesbian. That said, her public persona was very flirtatious, which I realized might be 'cover'. In order to not let the cat out of the bag, I played along.

"She'll have to get in line behind Detective Kleist," I chuckled. "Kleist actually propositioned me by asking if I liked to be tied up."

"Kinky! Cuffs and a nightstick?"

I chuckled, "That was the joke I made about a girl I dated during the Summer after I graduated from High School who is now a Deputy Sheriff in Harding County."

"Clark's girlfriend, right?" Sophia inquired.

"Yes."

We went into the treatment room for Nicole to present the case, which was a broken wrist requiring X-rays. I approved them and asked Nicole to manage the case until the X-rays were back.

"Mike," Nate called out as I came out of the exam room. "Clarissa needs a surgical consult in Trauma 2."

"Thanks, Nate."

"Mind if I tag along?" Sophia asked.

"Not at all."

We went into Trauma 2.

"Mike Loucks, Surgery," I said with a smirk. "What do we have?"

Clarissa rolled her eyes, then gave the bullet, which indicated appendicitis, which I confirmed with an exam and an ultrasound. I signed the chart, and then Clarissa, her students, Sophia, and I went to see Ghost to have him sign the chart, which he did. Clarissa and her students returned to the trauma room, and I instructed Sophia to get another chart.

October 14, 1989, Circleville, Ohio

On Saturday morning, my in-laws brought Lyudmila to the house, where she'd stay with Rachel while Kris and I were in Chicago for Maryam's wedding. As much as I wanted to take Rachel along, and as much as Maryam wanted to see her, I felt the whirlwind trip would completely disrupt Rachel's schedule. It also allowed her to entertain Abi, her friends from daycare, and two other little girls from church, with Serafima and Lyudmila playing chaperones.

Rachel didn't seem at all upset when Kris and I left because she very much liked Lyudmila, who spoiled her, as an aunt was expected to do. We drove my Mustang to Pickaway County Memorial Airport, where I parked in the designated area. We got out, grabbed our overnight bags, and walked over to where Lara and Nathan were standing. I shook hands with Nathan, and Lara and I exchanged a chaste hug, then Kris greeted them both with quick, chaste hugs.

"Mr. Shaughnessy is filing the flight plan," Lara said. "The plane is gassed and pre-flighted. The weather is fine, and everything is set."

"Great!" I replied.

A minute later, Clarissa and Tessa arrived, and everyone greeted each other. Shortly after that, a man who looked to be about fifty but who was in fantastic physical shape came out of what Lara had called the FBO building. Lara introduced all of us to Patrick Shaughnessy, who would be our pilot for our trip to Chicago.

The boarding and takeoff procedures were dramatically simpler than for a regularly scheduled commercial flight. We simply walked across the tarmac to a twin-engine plane with a 'Global Security' logo on the fuselage and climbed aboard. Mr. Shaughnessy stowed our bags, we strapped into comfortable leather seats, and five minutes later were waiting for takeoff clearance at the end of the runway. Two minutes later, we were airborne, and the plane banked to the west for our flight to Chicago.

About twenty minutes later, Lara asked to talk to me, and with Kris' blessing, we moved to a pair of seats at the back of the aircraft.

"A bit easier than the airport in Columbus," Lara commented over the noise of the twin turboprop engines which powered the plane.

"Just a bit!" I replied. "Less than twenty minutes after we left the house, we're airborne. It took longer than that to check in for our flight to Chicago when Elizaveta and I went to Europe four years ago. Did you ever think about learning to fly?"

"No. I mean, I could have, but I'd rather ride in the back of the limo than drive it!"

"Of course you would!" I chuckled. "Who doesn't like being catered to?"

"The only downside is there's no cabin attendant!" Lara said. "But there's a fridge with soft drinks and beer."

"It's a bit early for either of those."

"There's a thermos of coffee, if you want some."

"Nah, I had coffee with breakfast."

"Nathan and I are getting married at the end of January."

"There's the least surprising thing I've heard in the last few weeks! Congrats! Are you going to be able to take a honeymoon?"

"We'll delay it until school is out, similar to what you did."

"Here, or your parents' church in Pittsburgh?"

"My life is here, and everyone I want to invite except relatives is here. So we'll have the crowning at Saint Michael the Archangel."

"Combined crowning and betrothal?"

"I'm not a stickler for the older tradition the way you are, though we will wear our rings on our right hands."

"I'm very happy for you!" I said.

"Me, too!" Lara exclaimed.

I moved back to sit with Kris and quietly let her know what Lara had told me.

October 14, 1989, Chicago, Illinois

We landed at Meigs just after 10:00am Chicago time, and, as Lara had promised, a stretch limo was waiting to take us to the InterContinental Hotel on Michigan Avenue. At the hotel, Lara spoke to the concierge, who quickly checked in our entire party and provided three sets of two keys. Five minutes later, we were in our well-appointed room on the twelfth floor of the North Tower.

We unpacked, then relaxed for a bit before we met the others to have lunch at Billy Goat Tavern, which had been parodied as the Olympia Café on Saturday Night Live when John Belushi had been on the show. The food was great and inexpensive, considering we were in the Second City.

"What's everyone doing this afternoon?" Tessa asked as we ate. "Clarissa and I are going shopping on North Michigan Avenue."

"Nathan and I are going shopping as well," Lara said.

"Kris wants to go to the Art Institute of Chicago," I said. "So that's what we'll do."

"Mike needs a dose of «haute culture»!" Kris declared with a smile.

"Me Grog! New French girl think Grog «provincial»! Make Grog see pictures!"

Everyone laughed, including Kris.

"Just don't let the new French girl turn you into a socialist!" Lara declared with a silly smile.

"No chance of that!" I replied. "So long as you don't try to turn her into a decadent capitalist!"

"As if that could ever happen!" Kris exclaimed, also smiling.

"Well, Mike did become a doctor," Clarissa smirked, "so anything is possible!"

"Hey, now!" I protested. "I usually only get that kind of abuse from my baby sister or Jocelyn!"

"I thought Clarissa teased you, too," Kris said.

"She does, but usually not about medicine."

"You're not upset, are you, Petrovich?"

"No, of course not. I beat you fair and square to graduate first in our class!"

"Who had the higher MLE score?" Clarissa asked.

"Who says being a doctor is about test-taking?" I countered.

"Behave, children!" Tessa said sternly, causing all of us to laugh.

"Are they always like this?" Nathan asked.

"For as long as I've known them," Lara said.

"They love each other," Kris said. "Like brother and sister."

"We do," Clarissa agreed.

We finished lunch and agreed to meet at The Berghoff for dinner at 6:00pm.

"You're not upset about what I said, are you?" Kris asked.

"Not at all! I am provincial, at least compared to a cultured «Parisienne»! But I do want to counter your point about culture. May I say something very direct?"

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