Good Medicine - Residency II
Copyright© 2025 by Michael Loucks
Chapter 36: «C'est quoi ce genre de conneries?!»
July 7, 1990, Circleville, Ohio
When I arrived home just before 9:20pm on Saturday, I greeted Kris with a kiss and scooped my eldest daughter into my arms.
"Your mom called twice today," Kris said. "The first call was to say Liz was in labor; the second was to say we have a niece — Jordan Elizabeth Reynolds. Mom and baby are fine."
"That's good. We'll have to find a time to go visit in a few weeks, though, unless things are resolved at the hospital, that's going to be nigh-on-impossible."
"Has there been any movement?" Kris asked.
"Not since Ted Schmidt announced he was for the tax increase yesterday morning. That still leaves it 5–4."
"I can't believe that after his wife and daughter were treated at the hospital, the Chairman didn't change his position."
"Perversely, I think that hardened his position because, even short-staffed and with what amounts to 'old' equipment, we saved them."
"That's just ... perhaps *I* will run for County Board of Commissioners!"
"Given no Democratic candidate for President has won this county since 1948, except for LBJ in 1964, I don't think a socialist program is going to sit well with the people of the county."
"But our largest employers are all unionized! How is that even possible?"
I chuckled, "Because US politics does NOT map onto European politics, which you well know! Reagan easily won the votes of a majority of union members, and you know I voted for him."
"My husband, the Class Traitor!" Kris smirked.
"Just another example of how European politics do not map onto the American system. Class here is, at best, loosely defined by income, and the vast majority of our union workers are middle-class, or even upper-middle-class. When you have a house, two cars, air conditioning, and health insurance, and can easily afford to send your kids to a state university, socialism is, at best, a hard sell. In any event, shall we say our evening prayers, then spend some time together?"
"Yes!"
The three of us went to the icon corner to say our prayers, though, because Charlotte was sound asleep, we didn't bother her. When we finished our prayers, I read a book to Rachel, then put her to bed. Once she was tucked in, I returned to the great room to sit with Kris.
"How are you holding up?" Kris asked.
"Better than I did during those twenty-four-hour shifts when I had very little sleep. At least I'm consistently getting six hours."
"Did anything come of the grievance?"
"It was filed, and I'll have to speak to someone in Human Resources on Monday. I'm not concerned because, from a PR perspective, telling a nurse that patients were more important than a labor dispute will play very well for me, and very badly for the nurses, and worse for the hospital if they act on the grievance."
"The nurses are still acting ... unfriendly?" Kris asked.
"That's a polite way to put it. Frosty is another polite way to put it."
"How long can this go on?"
"Until the nurses run out of sick time," I replied. "That means the older, more experienced nurses will generally be able to call in sick more often. They are staggering their sick time and acting somewhat randomly. Today, there was a full complement in surgery, which makes sense because no elective surgeries are scheduled, and it wouldn't hurt the hospital for nurses to call in sick on Saturday. How are you, Rachel, and Charlotte doing without me here?"
"Rachel clearly misses you, and I do as well. Charlotte mostly sleeps or nurses, so she doesn't know any different. How are you doing, besides sleep?"
"I miss my time with all of you. Are you up for a warm bubble bath?"
"Yes!" Kris said happily.
We went up to the bedroom, and I turned on the tap for the tub. Once the water was the right temperature, I closed the drain and added bubble bath. Kris and I undressed and got into the tub, with her reclining against me.
"I wish we could make love," Kris sighed. "How long?"
"The usual guidance is six weeks, but it varies from woman to woman, and depends on how difficult the delivery was, including whether an episiotomy was performed or there was tearing. In your case, it will come down to when you feel ready, though," I slid my fingers down to her pubic hair, "orgasms are not ruled out!"
Kris laughed softly, "Not that I would object, but it's more than just feeling good."
"I totally understand. For us, it's about closeness, though we both very much enjoy the pleasure, which is enhanced by that closeness."
"May I ask a borderline question?"
"Minus names or clues to names, there are no off-limits questions."
"When you were 'playing around', was it just for fun?"
"Most of the time," I replied. "There were a few girls where the closeness was important, but there was a lot of sex just because it was available and because it was fun."
"And is that an opinion you will tolerate from your daughters?"
"Does it matter?" I asked. "They'll make their own decisions as young, independent women. We'll teach them what the Church teaches and teach them to respect themselves and the boys, but at that point, it's out of our hands. No matter what happens, I'll love my daughters, and that includes if one of them were to have an 'oops' that resulted in a premature grandchild. Do you agree?"
"Yes, though I would hope they would listen."
"Me, too, but how many of your friends listened to their parents on that topic? Most of my friends didn't. That said, our girls will have the advantage of having good role models in their mother, aunt, Serafima, and Alyssa."
"I hope you won't tell them the stories your mother told you."
"It's not my place to tell them. That would be up to my mom, and I can't imagine she'd say anything to them. Remember, our conversations were in a very specific context, and were before all the crap with Liz became known. I did fail to mention I think your sister will be a good role model as well, assuming we want our daughters torturing boys when they're her age!"
Kris laughed, "She has toned it down a bit with Ian."
"Because he's completely under her control," I chuckled. "She says, 'Jump!' and he asks, 'How high, Mistress?'"
"It's not quite that bad!"
"From your perspective!"
"Perhaps we can sit quietly and you can do what you suggested with your fingers."
"Perhaps we can!"
July 8, 1990, Circleville, Ohio
"I very much enjoyed the bath last night," Kris said when we got out of bed on Sunday morning.
"I would hope so!" I chuckled. "I enjoyed that, as well as the time after!"
"Because there is no boy on this planet who would object to «la pipe»! «Deux fois!»" ("fellatio";"Twice!")
"You're not wrong!" I chuckled. "Shower with me?"
"Yes! Charlotte is sound asleep, because she nursed about an hour ago."
"I was there, remember?"
"Yes, but you went right back to sleep! That's not a complaint, mind, you, simply an observation."
We went into the bathroom, I turned on the shower, and once the water was at the proper temperature, we got in. We showered together, but didn't wash each other, as it was Sunday morning and we were going to church. We finished our showers, and after we dressed, I woke Rachel and bathed her, then fixed her a light breakfast.
Once Kris had nursed Charlotte, the four of us headed for Saint Michael the Archangel for Matins and the Divine Liturgy. Kris sat in the cry room, Rachel went to be with her godmother, and, as I was alone, I offered to chant the Matins Psalms, which Mr. Karlov, the Head Chanter, happily invited me to do.
I sang with the choir during the Divine Liturgy, something I had not done in some time. Kris and I received the Eucharist together, though Rachel and Charlotte were taken to the chalice by their godparents, Elias and Serafima, as was the tradition. They did the same for the veneration of the cross following the service, and then brought our daughters to the parish hall for coffee hour, which replaced lunch during July and August, as there was no Sunday school.
After we had coffee, we left for home so we could spend a few hours together as a family before Kris and I had to leave for dinner with Patricia Bachmann's Bridge Club. My in-laws and Lyuda came to the house to care for the girls, and Kris and I drove to Mrs. Bachmann's house, which was about ten minutes from our house. The meal was informal, with the eight women from the Bridge Club, Kris, and me, fixing plates and all sitting together in their great room, rather than at the dining room table.
The women, all between fifty and seventy, peppered me with questions about medical school, Residency, and how the hospital worked. All of them were just as surprised as Mrs. Bachmann about the low pay and long hours, and by the end of our meal, I feared for the lives of the three recalcitrant County Commissioners who were going to get an earful from the women, all of whom promised to contact their friends as well.
"I think things will change this week," I said to Kris once we were in the car on the way home. "They were angry."
"And rightly so! Honestly, $75 is a pittance to pay compared to the taxes levied for medical care in Europe or Canada!"
"I don't disagree, but the true costs here are masked by a combination of private insurance and Medicare and Medicaid. We can't even have a healthy debate about it because all of the costs are completely opaque to nearly everyone. I doubt you could find twenty people in the County who were not either employees of the hospital or on the Hospital Board of Directors who could tell you what a procedure costs, and I bet most of the people who DO work for the hospital couldn't either."
"Do you know?"
"I have a rough idea for the ED, but even then, the 'list price', if you will, called the Charge Master, is not what anyone actually pays. Medicare and Medicaid have fixed reimbursement rates, and insurance companies negotiate reimbursement rates. And for people without insurance, the hospital will offer discounts and other accommodations so they don't pay the Charge Master price. Oh, and good luck getting a look at that, because it's not published."
"What?!" Kris exclaimed in outrage.
"Don't peg your outrage meter just yet," I said. "Not only are they not published, Moore Memorial, like most hospitals, considers it proprietary information and a trade secret, and the law backs them on that claim."
"«C'est quoi ce genre de conneries?!» Kris spluttered. ("What kind of bullshit is that?!")
"From the tone, I'm going to guess that's not something you would say in polite company," I said.
"It's not! It means 'What kind of BS is that?' but saying what 'BS' stands for. How is that even possible?"
"Welcome to America," I chuckled.
"Mike, come on, you can't think that is right!"
"I didn't say I thought it was right, I simply described how it is. I need to make two points. First, those numbers are largely fictitious and serve as the starting point for negotiations and as the absolute maximum charge for each procedure, service, or supply. Second, it is literally impossible for anyone to tell you exactly what a procedure will cost because there is no way to accurately predict what consumable supplies, procedures, tests, or services a specific patient will need. Even the most routine procedures have variations."
"But you could certainly list a typical price and state that things vary!"
"Yes, you could, but hospitals don't."
"More reason for a national healthcare plan!"
"The last serious effort was by Senator Ted Kennedy from Massachusetts during the Carter Administration. He failed to convince President Carter to support a bipartisan bill that, on the surface, appeared to offer substantial improvements. The proposed legislation aimed to abolish Medicaid and replace it with government-funded private health insurance for individuals previously covered by Medicaid. Additionally, it aimed to eliminate Medicare premiums while introducing prescription drug coverage. For everyone else, federally regulated health plans that were not limited by state boundaries or worker pools."
"Why would President Carter refuse?"
"I think you can guess."
"The insurance companies, right?"
"Yes. All of those ideas Senator Kennedy had proposed were scrapped in 1980 because there was no money due to the economic disaster brought on by the chaos of the 1970s."
"And, of course, neither Reagan nor Bush, being reactionaries, would even countenance any changes!"
"Ah, but you are wrong, «ma chérie»! In 1985, the Consolidated Omnibus Budget Reconciliation Act of 1985, known as COBRA, amended the Employee Retirement Income Security Act to provide continuation of insurance coverage after leaving employment. Reagan was President, and Republicans held a majority in the Senate." ("Sweetheart")
"Oh, boy! So much change!" Kris declared, rolling her eyes.
"You did say they wouldn't even countenance any changes," I replied.
"And you know what I meant, Michael Peter Loucks!"
"Oops," I chuckled. "All three names. I'm in deep sneakers now!"
"Careful, «mon sucre d'orge», or I may bite instead of lick!" Kris teased. ("My candy cane")
"Then we'd both be sad!"
"Will it cause any trouble if I join the Democratic Socialists of America?"
"Given I don't plan to run for office ever in my entire lifetime, I don't see how it could cause me any trouble, and even if it would cause me trouble, I would never tell you not to be politically active. I'm curious, but how big is the party?"
"I discovered, much to my surprise, that there are four members of the Democratic Socialists of America in the US Congress!"
"You're joking!" I exclaimed in surprise.
"No, I'm not! Congressmen John Conyers and David Bonior from Michigan, Congressman Major Owens from New York, and Congressman Ron Dellums from California are all party members."
"Why do I hear a capital 'P' when you say 'party', Comrade?" I asked with a smirk. "How did I not know about that?"
"They all are reported to be Democrats in the media, even on C-SPAN. It's like it's some big secret."
"I can understand why! I assume they have some international affiliation?"
"Yes, with the Socialist International, which includes the Swedish Social Democrats, the British Labour Party, and the SPD in Germany, and many others."
"So, in global terms, a mainstream socialist party."
"Yes, exactly. Of course, here, they are considered communists, which is simply not accurate. Soviet-style communism is as far removed from true socialism as is capitalism."
"I'll take your word for it, as I'm not up on the nuances of arguments surrounding dialectical materialism! Nor am I particularly well versed in Hegelian dialectics."
"Wait! How do you know those? I've yet to run into anyone here who is not a self-proclaimed Marxist who knows either of those terms! Wait! I know! Mr. Black, right?"
"Yes, of course! But as part of his class in current events, when we were discussing the rise of Marxist rebellions in Africa and Latin America. If I remember correctly, the African National Congress is part of the Socialist International."
"You do remember correctly and get a gold star!"
"I'd prefer a warm bubble bath!"
"Yes, because THEN you would get what you really want!" Kris teased.
"No, we have a few more weeks before that."
"Unfortunately. A bath after we put Rachel to bed?"
"Yes!"
July 9, 1990, McKinley, Ohio
"Good afternoon, Doctor Mike," Mrs. Cartwright, the Human Resources Director, said when she came into the conference room. "I assume, given Doctor Lindsay is with you, that she's your advocate?"
"She is," I said.
I didn't believe I needed an advocate, given I was completely in the right with regard to what I'd said to Nurse Pearson, but Clarissa and Ghost had both insisted I have Shelly by my side, just in case.
"Hello, Doctor Lindsay."
"Hi, Mrs. Cartwright."
"Doctor Mike, as you know, a grievance was filed against you by Nurse Karla Pearson. Did you receive a copy of her grievance form?"
"Yes, on Friday."
"Do you admit or deny the allegations?"
"I deny them."
"You have the right to file a written response if you choose."
"I have my response," I said.
I handed her the form I'd filled out that morning with input from Ghost, Perry Nielson, and Clarissa.
"You also have the right to make a statement, if you wish."
I had wanted to apologize for my tone of voice, but Ghost had counseled against that because Nurse Pearson hadn't referenced my apology, and it was not in my interest to raise that at this point in the process.
"I'll simply summarize what I wrote — I instructed a nurse with regard to patient care, which, per the hospital procedure manual, I am authorized to do. That is expressly written into the nursing contract, which states that 'above all, a nurse's duty is to patient care, and in exigent circumstances, nurses are to follow doctor's orders irrespective of work rules'. Therefore, as my response states, the hospital is required to dismiss this grievance per the policy manual."
"That is what the contract and policy manual indicate," Mrs. Cartwright said. "May we speak completely off the record?"
"Shelly?" I inquired.
"You should, on condition that nothing you say will be used in any way, including as an avenue to gain that information via another source."
"I'll follow Shelly's advice," I said.
"Actually, it's me that needs protecting here," Mrs. Cartwright said. "You're absolutely correct that this should be dismissed out of hand, but doing that will, in effect, throw gasoline onto a fire that's already raging. What I'd like to do is say that HR is investigating, and use the entire five-business-day period permitted by the nurses' labor contract. I'll close it out next Monday at 1:00pm, and hopefully the strike will be resolved. If not, then we'll have to deal with the consequences."
"Just so we're clear," Shelly said. "You agree that the grievance will be dismissed with no action against Doctor Mike, with no reference in his HR file, including the private section?"
"Correct."
Shelly nodded to me.
"Then I agree," I said.
"Thank you. Please don't speak about this to anyone, and if anyone asks, simply say that you cannot speak while the investigation is ongoing. I will inform Margaret Teasedale that I have your response, and I've begun investigating. Just to confirm, nobody witnessed or overheard what was said, correct?"
"Correct."
"That will make it easier. I'll ask Nurse Pearson for witnesses, but I can't imagine she'll have any."
"Me, either. I did discuss it after the fact with Dutch Wernher and Clarissa Saunders, as well as seek advice on my response from Ghost and Perry Nielson."
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