Chapter 12: Then I Think You Know the Way Forward

April 6, 1990, McKinley, Ohio

"Would you do something for us?" Kellie Martin asked late on Friday morning.

"What's that?"

"Go to Personnel and fill out a religious accommodation request for your beard and ponytail."

"I don't need one," I said.

"You would if you wanted to accept Wernher's offer of an emergency medicine Residency. All you have to do is say you're considering it, but he said you had to shave and cut your hair, and you can't do that."

"I'm going to guess that will help the nurses in some way?"

"It'll make his unofficial policy public and put him on the back foot. It'll be one more thing he changed unilaterally, which is the main complaint the nurses have. The policy manuals simply say our appearances need to be 'professional' and 'neat', which has always been interpreted as 'properly groomed'; no political or offensive slogans on clothing or buttons; no revealing clothing; and proper hygiene. I don't see any downside, and neither does Becky, because he made the offer. All you're doing is asking for an appropriate accommodation."

"That actually makes sense, though I'm concerned Owen Roth or Shelly Lindsay will hear about it and think I'm actually considering it."

"Doesn't that work in your favor? They don't want to lose you, and it would wreck the entire 'trauma surgery' plan. Combine that with the rumor that you and Clarissa Saunders are leaving for Chicago, and you'll light a fire under Baker and Roth, not to mention the Attendings in the ED."

"I'll go see Personnel — well, I read the memo that it's 'Human Resources' now — right away.

Kellie left, and I walked down the long corridor to the Administration wing and went into the Human Resources office, which didn't appear to have changed in any way except its name.

"Good morning, Doctor!" a very pretty young woman said. "I'm Cassidy. How may I help you?"

"Good morning, Cassidy. I need to request a religious accommodation for my beard and ponytail."

"There are no hospital policies against either, except that you have to keep them neat, so no accommodation is necessary."

"The new ED Chief, Doctor Wernher, expressly said that he requires his male doctors to be clean-shaven and to have their hair cut short. Because of changes, I'm considering his offer to switch to a pure emergency medicine Residency."

"Doctor Wernher can't make that rule."

"Well, then someone needs to explain it to him because he was adamant, and he's instructed all the ED Residents and Attendings to shave and get haircuts."

"One moment, please. Let me speak to Mrs. Cartwright."

She walked away from the counter and down a short hallway. About two minutes later, Mrs. Cartwright, the Personnel Director — now the Human Resources Director — came to the counter.

"Hi, Doctor Mike. Cassidy explained the situation. You do not need any accommodation. Doctor Wernher is new, so he may not be aware of our policy. No other Chief has said anything, have they?"

"No."

"Good. Then I'm sure it's a simple misunderstanding. I'll take care of it and let you know."

"Thank you. I appreciate it."

"Any time! If you need anything, please call Cassidy, and we'll take care of you!"

"Thanks again."

"Have a good day, Doctor."

"You, too."

I left the Human Resources office and returned to the surgical lounge. I found myself in a strange situation, wishing for a severe trauma that needed my attention. It seemed so wrong, but truth be told, I was bored out of my mind and had to seriously consider my options.

I was paged just before lunch and was perversely happy that a patient needed a chest tube and then emergency surgery to repair a punctured lung. I was permitted to scrub in and assist, and we finished just in time for the M & M Conference. I'd been dreading it because it was a formal review of the events of February 20th and our patient care in the face of a violent attack.

I joined Clarissa, Shelly, Kylie, and Sophia and sat towards the back of the packed room. I was surprised to see Loretta brought into the auditorium in a wheelchair by Bobby and got up to greet her with a light hug before returning to my seat between Shelly and Clarissa.

Doctor Cutter took the podium, and after a brief intro, Bobby wheeled Loretta next to the podium and handed her the microphone. She recounted the basic events of that day and the response to them, including the addition of armed security guards. Once she finished, she asked for comments from the assembled doctors, nurses, and medical students.

As expected, there were several objections to having armed security, even off-duty police officers, in the ED. I shook my head when Dutch Wernher stood up to speak. He hadn't been in the ED that day, and he hadn't lived in the area for even a week and hardly knew anyone in the hospital except by name. He certainly had a right to speak, but a wise man would have kept his mouth shut and listened before addressing people he barely knew in a hospital he barely knew in a community he barely knew.

"I'm sure," he began, "that many of you don't lock your cars or lock your doors at home because you believe your community is safe, despite a gun battle in the ED and at least one previous incident where a doctor foolishly attempted to disarm a patient, and was fortunately rescued by an attentive Sheriff's Deputy."

"THAT IS NOT WHAT HAPPENED!" Ghost said vehemently, springing to his feet. "You weren't there, and you are mischaracterizing the events. Contrary to your claims, the Sheriff's Department wanted to award a commendation to that doctor for preventing a patient from drawing a firearm by using a wrist lock."

"Doctor Casper," Doctor Cutter said. "Thank you, but please wait for your turn to speak."

Ghost shook his head, "Not when an interloper with zero experience here and zero knowledge makes statements every single person in this room KNOWS are false."

There was applause, most especially from the nurses.

"Your input is noted. Please have a seat, and you'll have a turn."

"As I was saying..." Doctor Wernher started.

"Sit down!" a gruff voice called out, likely Tim Baker, but I wasn't sure.

"Yes! Sit down!" Becky demanded.

Suddenly, there was a clamor from numerous voices, male and female, all saying, 'Sit down!'. I simply kept my mouth shut, as did Clarissa, Shelly, and Sophia, as there was plenty of support. I hit on a course of action that would absolutely put Wernher in his place, all the while not saying anything he could point to as insubordinate. I stood.

"Fellow doctors and nurses," I said, raising my hand to request silence. "Please."

The room quieted.

"Doctor Wernher is entitled to his opinion," I continued, "and we should at least politely hear him out. When he's spoken, I'm sure plenty of you will respond politely and one at a time. I certainly will. Doctor Wernher?"

I sat down, and Shelly leaned over,

"Nicely played," she whispered.

"Slick," Clarissa whispered.

"Thank you, Doctor Loucks," he said.

"Dutch, he goes by Doctor Mike," Doctor Cutter corrected. "Please use the name he prefers."

"Zing!" Clarissa whispered.

"My apologies, Doctor Mike. As I was saying, my experience in Chicago is such that I understand the need to provide medical care in a safe, efficient manner. The current ED is not configured for safety, though, in looking at the plans for the new ED, I see the ambulance bay doors are properly configured to require badges.

"Armed security is standard in Chicago emergency departments and does not interfere in any way with patient care. It's private security, unlike here, where it's provided by off-duty law enforcement officers. Please do not dismiss patient and staff safety so lightly. Other changes should be adopted, including badges with photos, which are color-coded by role and badge access for every door."

He sat down, and I immediately stood up.

"First, I want to welcome Doctor Wernher to his first M & M at Moore Memorial in his first week as Chief of Emergency Medicine. I do agree with his proposal for photo IDs color-coded by role, but beyond that, the events of February 20th were an anomaly in our community.

"Cook County Hospital, according to doctors who have served there, sees more gunshot wounds most days than we see in months. University of Chicago Hospital, where I know the Chief, has fewer than Cook County, but still an order of magnitude more than we have. We don't have a gang problem, and our drug problems are limited, though growing.

"What that means is that we do have to take security seriously, but it has to be in proportion to the actual threat. And, to be honest, armed citizens are the norm here in Hayes County, unlike Chicago, where handguns are largely banned, even for self-defense at home.

"If you walk into the parking lot, you'll see pickups with gun racks owned by Attending physicians, senior nurses, and just about any other role you can imagine here at Moore Memorial. Take a ride over to Hayes County High, and you'll see the same thing in both students' and teachers' pickups. We, as physicians, need to respect our community, and if we want to bring about change, we need to educate the public on the risks associated with handguns, which, in our community, are mainly suicide, not homicide.