Chapter 23: It's Too Quiet

May 18, 1990, on the road from Rutherford, Ohio, to Indianapolis, Indiana

"How did it go?" Ghost asked once we left the Rutherford Hospital parking lot.

"One explicit proposition, and some light flirting," I replied.

Ghost laughed, "That's not quite what I meant, but no surprise, really."

"All good," I nodded. "I spoke to sixty-six students, and they all asked good questions. There are about ten who expressed a true interest in medical school. I offered them tours of the hospital."

"Did that include the one who made the explicit proposition?"

"No. She's the younger sister of one of my sister's friends."

Ghost laughed, "Say no more! My little sister's friends were, well, very friendly!"

"I was also asked to come back next year, though for graduation, to give the alumnus speech. It'll be ten years since I graduated High School."

"Time flies. I had my ten-year reunion three years ago."

"I haven't heard anything about our reunion, but I'm sure it's being planned. How was yours?"

"It was interesting. People don't always turn out the way you might expect. And girls who wouldn't give me the time of day were suddenly very interested. I bet that happens to you, too."

"Perhaps, but I'll have Kris on my arm, so it'll have to be more subtle."

Ghost laughed, "As if! Just wait. Think about Ellie or that girl who chased you for years, despite you being married."

"I'd rather not think about either of them! Do you know anyone who will be at this conference?"

"Two guys from med school. You know the main presenter, right?"

"Doctor Al Barton. I also met his prize pupil, Jessica Wilton, during my interview at Indiana University. He tried very hard to get me to come to Indiana, and then tried to convince me to interview at University of Chicago. Unfortunately, I heard Jessica couldn't make the conference."

"Neither of those was ever a real option for you, were they?"

"No. Well, Indiana would have been, if I had somehow not been accepted at some of my other choices. In hindsight, it would have certainly been second because of the trauma surgery program, but I didn't know that's what I wanted at the time."

"We haven't had as much time to talk, given everything that's happened. How are things going?"

"I'd say things are going well, given everything that has happened in the past six months. How is being a dad?"

Ghost smiled, "It's more challenging than medicine, but I suspect you know that."

I nodded, "I do. And in a month, Kris and I will have another daughter. I assume you and Oksana will have another?"

"If it's up to my wife, four, at least!"

"I'm not surprised at all by that. Elizaveta wanted four; Kris thinks two is the right number. Well, two together, plus the Tsarina."

"She's going to have her little nose bent out of joint when her sister arrives."

"Not as much as if we'd had a boy!"

"Oksana suggested we arrange the marriage as soon as your daughter is born."

I chuckled, "Of course she did! And I wouldn't have a problem with that, but I suspect our kids will have minds of their own."

"I'm positive they will!"

May 18, 1990, Indianapolis, Indiana

Ghost and I checked into our rooms, then went to the registration desk to pick up our credentials for the conference. We completed all of that just in time to join the other attendees for dinner in the main ballroom. Unsurprisingly, we were at a table with Al Barton.

"Hi, Mike!" Doctor Barton said as we walked up to the table.

I shook hands with him.

"Good evening, Doctor Barton. This is Doctor Greg Casper, known as 'Ghost'. Ghost, Doctor Al Barton, Chief of Emergency Medicine at University of Chicago Hospital."

Ghost shook hands, and we sat down.

"You can call me Al," Doctor Barton said.

I chuckled, "Nice riff on Paul Simon; the singer, not your US Senator!"

Al Barton laughed, "I don't think any of us want to hear Senator Simon sing. How are you, Mike?"

"Things are going well. I'm just finishing PGY1, and it's been quite the journey."

"I was very glad to hear that both doctors survived. How are they doing?"

"Shelly Lindsay is back full-time; Loretta Gibbs is still in rehab due to her spinal cord injury. I'd guess it's at least another four months before she could attempt to return to work. How is Jessica? I had hoped to see her, but I heard she couldn't make it."

"One of her closest friends will receive her Master's tomorrow. She and her husband decided that was more important, and I couldn't reasonably object, given the situation."

Waiters and waitresses began serving dinner, and we started eating, which limited the conversation. Ghost and I introduced ourselves to the other seven doctors at the table, who were from hospitals spread across the country.

"How has your training worked?" Doctor Barton asked.

"Very well, actually. As much as it pains me, Shelly Lindsay being out meant I was able to assist with surgeries and even performed a pair of appendectomies from start to finish."

"You're joking!" Doctor Barry Commoner from Swedish Medical Center in Seattle. "No PGY1 should touch a patient in the OR!"

"He's not joking," Ghost said. "He's proficient with pericardiocenteses, thoracostomies, and central lines. His training has been accelerated because he's just that good."

"I tried to recruit him to come to Indiana, and tried to get him to Match at UofC. I think, in the end, he's in the right place because he's had opportunities nobody else could reasonably give him."

"But a PGY1?" Doctor Nick Foster, from Leonard Morse Hospital in Natick, Massachusetts, queried.

"It really is mostly due to it being a new program and the hospital being shorthanded after the shootings," I said," as well as a surgeon leaving mid-Residency."

"No," Ghost said, "it really is because you're just that good. Sure, circumstances created the opportunity, but without your skills, it would never have happened. Your choice of the pathology Preceptorship made a huge difference."

"Pathology?" Doctor Amber Sutton from Johns Hopkins in Baltimore. "Why?"

"Name any other way a medical student is able to use a scalpel in a hospital setting," Ghost said. "Mike was able to cut every day for eight weeks during Fourth Year. Our Chief Surgeon is recommending a pathology Preceptorship for his top students."

"That's contrary to every bit of advice I've ever heard," Nick Foster said. "But it makes absolute sense. That said, our Chief of Surgery would never go for it."

"Sometimes you have to buck the trend," Doctor Barton observed. "I'd really prefer my trauma surgeons were trained the way Mike is being trained, but our Chief of Surgery is conservative."

"So is ours," I replied. "But as Ghost said, circumstances created an opportunity. We'll see if my current student receives the same training when she begins her Residency on June 1st. She'll be the second Resident in trauma surgery at Moore Memorial."

"You have one of our former Residents," Doctor Tom Burns from Cook County in Chicago said.

"Perry Nielson," I replied. "He's pointed out that you see more gunshot wounds in a day than we see in a month."

"Sad but true," Tom replied.

"Al, how is Jessica doing?"

"She'll start a surgical rotation in about a month, and she and Steve have a son, who's one. I know you have a daughter from ... well, I'm not sure how you want me to refer to her."

"Neither am I," I replied. "I usually just use her name — Elizaveta. Rachel will be three in August. Kris and I will have a daughter late next month."

"It might not be my business," Doctor Sutton said, "but may I ask?"

"Elizaveta died the day she gave birth to Rachel," Ghost said. "She had an intraparenchymal bleed due to an undetected and inoperable congenital arteriovenous malformation."

"Oh, shit," Doctor Sutton said quietly. "I'm sorry, Mike."

The other doctors also offered their condolences.

"Thanks. I didn't relish raising Rachel as a single dad, so about fifteen months after Elizaveta died, I remarried. And, in one of those interesting coincidences, Ghost is married to my wife's first cousin."

"I blame Mike!" Ghost said. "He introduced us!"

I chuckled, "I'll take that blame because I know you're happy! Ghost and Oksana have a baby boy who was born about a month ago."

Everyone offered Ghost their congratulations. We continued eating, and when we finished, Doctor Barton excused himself and went to the lectern to give the opening address. It was short and followed by the social director discussing the options. Dinner on Saturday would be early enough for me to attend Vespers, but the Sunday morning sessions wouldn't allow me to go to church unless I wanted to skip two presentations — one on treating strokes in the ED and the other by a physician who was also an attorney presenting on EMTALA.

Going to Vespers on Saturday meant missing both optional social activities — a jazz concert or a tour of the Indianapolis Motor Speedway following the practice session for the Indianapolis 500. Ghost was going to the jazz concert, and had encouraged me to go, but I'd begged off. I would, on the other hand, stay for the 'social time' after dinner, as I wanted to speak with as many other emergency medicine specialists as I could to develop a network of contacts that would come in handy in the future.