Chapter 4: Loretta, Shelly, and Angie

February 28, 1990, McKinley, Ohio

"Hi, Petrovich!" Clarissa exclaimed when she walked into the surgical lounge on Wednesday afternoon.

"Hey, Lissa! What's up?"

"I'm on a late lunch break, so I decided to slum!"

"The slums are up one floor, at the north end of the building."

That was where Psych had their ward.

Clarissa laughed, "No surprise you'd think that! Where are your toddlers?"

"Doing toddler stuff! Prepping for afternoon rounds."

"How did your call with Doctor Mercer go?"

"She admitted she made errors with regard to me and one other patient."

"Angie?"

"No, besides Angie. Dona's, Anna's, and Pia's ex."

Clarissa laughed, "The kid from Milford was seeing her?"

"Apparently, but keep that to yourself."

"Of course. What was the gist of the conversation?"

"That her approach to psychology is wrong, and she'll make mistakes with anyone who is spiritual because she's put that part of the person completely off limits, and she's not treating them holistically. In the end, it's the same argument I make about medical care in the hospital — specialization is necessary, but it's the enemy of holistic treatment."

"I think you're going to beat that dead horse for the rest of your career."

"The horse isn't dead," I said. "And I don't think I'm tilting at windmills, either. I think we can bring about change, but it'll be slow. Believe it or not, I can be patient."

"That'll be the day!"

"I did say 'can'," I retorted.

"Yeah, yeah," Clarissa said, rolling her eyes.

"How are you liking the ED?" I asked.

"It's not what I signed up to do," Clarissa replied, "but I don't think Doctor Gibbs or Doctor Lindsay signed up to be shot, either."

"Life does not deal us the cards we want; we have to play the hand we're dealt."

"True. I hear Doctor Gibbs is going to rehab in Columbus on Friday."

"She is," I confirmed. "I wanted to take her, but Doctor Roth nixed that because we're already short a surgeon."

"Another helicopter ride?"

"Actually, if it were, then I'd go because the ED can't spare a flight surgeon for a non-critical case. But she's going by private ambulance service."

"I stopped in to see her yesterday; what's your take?"

"Having feeling in her legs is a very good sign. Nerve function below the injury is a strong indicator of at least partial recovery. It's likely she'll be able to walk, but she might need some kind of assistive device. Shelly is being released on Friday, and as soon as Psych clears her, she'll be back. She wanted me to do her physical."

"Who knew?" Clarissa smirked.

"Lissa..."

"Sorry. Why?"

"Because she believes I'll give her the benefit of the doubt, and that's precisely why it won't be me."

"True. I'm not saying you'd fib, but for anything that was a judgment call, you'd see it her way. Did you hear the rumor they hired a Chief of Emergency Medicine?"

"Yes, and he's allegedly from a suburban Chicago hospital. But until they announce it, who knows? It should have been Loretta, but she's out of commission for several months, most likely."

"That sucks," Clarissa observed. "On the plus side, you know who your Chief is, and the Medical Director is the one who approved the trauma surgery program when he was Chief Surgeon."

"That's why my only concern about who filled the slot was about Loretta. Sadly, I don't think they were willing to put a woman in charge of a major department."

"Or a minor one, except the Nursing Director!" Clarissa declared. "The OB chief is a guy, for Pete's sake!"

"At least Norm Zenker isn't a complete Neanderthal like the dinosaur who ran OB at Good Samaritan. And I bet that when Zenker retires in a few years, one of the female Attendings will be hired. If leadership, except nursing, remains all male, that'll attract EEOC attention."

"As it should!"

"So long as we don't reduce standards, I have no problems. You know my mentors have mostly been female."

"Anicka, Milena, Loretta, Shelly, me..." Clarissa said.

"Among others," I replied. "In any event, I'd say Shelly is on track for Chief Surgeon."

"Can you imagine the heads that will explode if that happens?"

"Mo Rafiq is gone," I said. "I don't think any of the rest would have their gonads shrivel reporting to Shelly, especially after she literally took one for the team!"

"I know you have ice water in your veins, Petrovich, but I can't believe how calm you are about it."

"I was born to be a trauma surgeon. I'm just glad it's not in 'Hawkeye Pierce' conditions."

"True. I need to get back."

We hugged, and she left. A minute later, my students returned from prepping for afternoon rounds. The afternoon was largely uneventful, and at the end of rounds, Doctor Roth asked me to come to his office.

"How are you doing being out of the ED?"

"You know that's my natural habitat, but I knew this was part of the training. I miss the ED, but I need the skills you and the other surgeons will teach me over the next five years."

"I actually wanted to discuss with you how we'll go about training Mary Anderson."

"The biggest challenge is how she learns the procedures if she's stationed in the ED and handling consults."

"That's exactly what we identified. Bob Aniston suggested that for the first three months, you and Mary should be assigned the same shift so you can teach her procedures for central lines, chest tubes, pericardiocenteses, tracheostomies, and escharotomies. At that point, you'd switch to the alternating rotations."

"I think that makes sense; my concern is my surgical training."

"According to Bob, you were perfect on your first surgery."

"Because literally nothing went wrong!"

Doctor Roth nodded, "The length of the program is, at least in part, intended to ensure you see as many things go wrong as possible so you're able to deal with them when you're the senior surgeon in the OR. You're way ahead of the game, Mike. The next three months will, in effect, make up for the three you'll spend in the ED. Same shift as you have now, with one of the new Residents covering nights. That is, unless you have some objection."

"I think it makes sense, given that only a surgeon can teach Mary the procedures."

"Thanks for being flexible."

"You're welcome. Have you heard anything about the new Chief of Emergency Medicine?"

"Probably just the same rumors you have. Cutter hasn't said anything to me, but I'd expect an announcement in the next week."

"It should be Loretta," I said. "Northrup did it as a desk job, and given the new ED, that's what it will be for the next year."

"She'll be undergoing intensive rehab for at least two months, and there is no guarantee she'll walk again. She won't be reinstated until she finishes rehab, assuming she's able to practice emergency medicine at that point. We can't do the rehab here, and even after all the upgrades over the next five years, there are no plans for a rehab clinic here."

"All logical, but it still feels wrong."

"I'd worry if you didn't think that. Your heart's in the right place, Mike. In the end, though, we have a hospital to run, and major changes are coming down the pike."

"How long will Shelly be out?" I asked.

"She's able to come back April 1st, assuming she passes her physical and psych eval, which I expect she will."

Six weeks following severe trauma and major surgery wasn't out of line, given the strenuous nature of surgery and the need to stand for long periods of time.

"I hear you received some pushback from Psych about allowing an outside psychologist to clear me," I said.

"Cutter didn't trust Psych to give you a fair shake, given the animosity between you and them. Lawson would have used your 'cool as a cucumber' nature against you, insisting you were lying to them. Cutter, Getty, Strong, Ghost, Nielson, and I all know you to be unflappable. Shelly told me how you handled what happened with your wife.

"I've only ever known one other person who was as cool a customer as you, and that was an Attending in the ED at USC Medical Center during my Sub-I. He was a combat trauma surgeon in Vietnam. Word has it, the ramshackle building where he was performing surgery was hit by mortar shells — he didn't even blink and continued operating."

"Nurse Kellie Martin," I said. "When we lost an engine on the helicopter returning from OSU, I think her heart rate dropped while mine went through the roof."

"I'd have had what the nurses call 'code brown' at that point!" Doctor Roth declared. "So you did better than I would have!"

"When Kellie asked me how I was doing after the emergency landing, I said I'd managed not to soil my underwear, so I saw that as a plus. OK to change subjects?"

"Yes."

"Pascha, that is, Orthodox Easter, is the week following Western Easter. I'd like to take Great and Holy Friday as a day off so I can attend services."

"Comparable to Good Friday in the Catholic Church?"

"Yes, though we don't abbreviate the services, and they basically run all day."

"As a seriously lapsed Catholic who only goes occasionally to keep my wife happy, I am glad for the abbreviated services! I spoke to Ghost about the Orthodox services. No wonder you can stand for hours without even noticing! Anyway, you're entitled to religious accommodation, and Shelly should be back then. Are you going to play golf with us this year?"