Chapter 5: Because I Love You

March 5, 1990, McKinley, Ohio

"I'm honestly surprised," Fran Mercer said on Monday evening after I explained why I had called her.

"If you're surprised, then I'm concerned," I replied.

"Why?"

"Because it tells me you still have a misconception about my views on what happened."

"Given how often you read me off, don't you think I have reason to be at least mildly surprised that you'd consider it?"

"I suppose that's reasonable, though you should also consider what drives my actions."

"Angie's well-being is primary over just about everything except your own family."

"And because she asked, what was my only possible course of action?"

"Oh, stop!" Fran said, laughing. "You're using the rhetorical tricks your mom used on you!"

"Guilty as charged! I come by them honestly!"

"True," Fran agreed with a wry smile.

"I only have one question for you, Fran. Can you commit unequivocally to treating Angie holistically? That is body, mind, and soul? And spare me the reflexive 'ethical concerns'."

"You do acknowledge that they are real, right?"

"If you were trying to convert her or convince her to give up her faith, I'd have you before the licensing review board so fast your head would spin. But that is not what I'm talking about, and you know it! You and I talked about these issues years ago, and you seemed willing to discuss them with me."

"You weren't a patient, Mike. Even if we called a few of those sessions 'counseling,' they were more akin to coaching than to what practitioners would call behavioral counseling. Everything I did with you could be done by a layman, except that first evaluation."

"Fair enough," I replied. "But given how integral Angie's faith is to her well-being, it can't be ignored or even minimized. I have a thought of how we might proceed."

"What's that?"

"In the same way the hospital uses cross-disciplinary teams to treat patients with complex or unknown maladies, we should do that with Angie. A monthly meeting, which could be by conference call for convenience, with you, Father Stephen, Angie's GP and OB/GYN, her Aikidō instructor, and, if appropriate, Leslie Hoffman. You all discuss Angie's case, share what you know, and agree on a unified treatment plan that minimizes the use of pharmaceuticals."

"I'm sure you're aware that Doctor Hoffman has an approach closer to yours," Fran said.

"Yes. It's one of the reasons Marjorie and Ken named her in the petition to move Angie away from the now-disgraced Doctor Greenberg. What do you think of the idea?"

"I think it's a good one, though I'm not sure how easy it will be to coordinate everyone."

"I'll speak to everyone and get them on board, then turn it over to you. I need to stay away from that group so I can be Angie's friend; I'm absolutely not her doctor."

"But are you going to second-guess us at every turn?"

"No. That was the point of what I just said. The only person I'll regularly communicate with about Angie is Marjorie Stephens. Well, and Angie, of course. So long as Marjorie is happy, I'll be happy."

"Can you really stay hands-off?"

"Can you really treat Angie holistically?"

"One of those is more difficult than the other," Fran said.

"I know. You have the much harder challenge!"

Fran laughed, "You know that's not what I meant!"

"Yes, but I actually meant what I said. Given our past disagreements, it's a reasonable question and a legitimate concern. Remember, I am not proposing any specific course of treatment, only that the treatment deals with Angie as a complete person — body, mind, and soul. It's only in that synergy that we are who we are — our authentic selves."

"And you think all the others will buy in?"

"I do. I am positive Father Stephen and Angie's Aikidō instructor will agree immediately. I can't imagine any GP or OB/GYN worth their salt who wouldn't agree simply based on continuity of care. My interactions with Leslie Hoffman tell me she'll agree. That leaves you. Are you going to reject Angie's plea for help based on a flawed view of humanity?"

"More 'black or white' thinking?"

"No," I countered. "Infinite shades of grey. It's you who are engaging in 'black or white' thinking when it comes to dealing with matters of faith. You know what the literature says about regular church attendance and schizophrenia, even if it's anecdotal. Anecdotal, it may be, but it helps Angie. So, please tell me a better plan for this patient."

"You are, as you promised you would be, a forceful advocate for your patients or, in this case, your friend."

"Does that mean you accept?" I asked.

"On a trial basis, yes, assuming the others agree."

"I'll accept that, given we're attempting something different. That said, it does echo what we were doing before with Father Stephen. I'll get in touch with him and contact Angie's Aikidō instructor. Once they're on board, I'll speak to her GP and Leslie Hoffman."

"Do your supervising physicians find you as difficult as I do?"

"More, I suspect," I chuckled. "You don't have to deal with me twelve to fifteen hours a day, five or six days a week!"

"You take perverse pleasure in being a pain in the butt, don't you?"

"I may take pleasure in the fact that Doctor Gibbs regularly calls me a pain in the ass and, in fact, upgraded me to 'royal pain in the ass' back in November."

"How are your reviews?"

"All very positive, though I have been spoken to about being confrontational."

"Shocking," Fran said lightly. "I'll let you go. Get in touch when you've spoken to the others."

"I will."

We said 'goodbye', I hung up, then returned to the great room to spend time with Kris and Rachel before bed. A short time later, we said our family prayers, and I put Rachel to bed.

"How did it go with Doctor Mercer?" Kris asked when I joined her on the couch after Rachel's bedtime routine.

"She's willing to give it a try, which is probably the most I can expect at this point. I have to be very careful not to try to treat Angie but simply manage the process. It's a fine line, but I think I can walk it."

"Is there any chance at all that Angie will recover?"

"There have been sporadic reports of what I would call long-term remission for women in their forties or fifties, but that's almost always those with late-onset. As far as I'm aware, there are no verifiable reports of women who exhibit symptoms as teenagers entering long-term remission. Of course, I'm not an expert, and I don't read the literature because I simply don't have the time. To be honest, I also don't have the training or experience to understand the literature. I'd be in the same boat with an oncology journal."

"I always had this conception of doctors as knowing more than they actually do."

"Me, too. I struggled with the concept, but now, five years after my first Preceptorship rotation, I understand what they were trying to tell me. But enough about medicine! What can I do for you?'

"Put on some soft music and cuddle before bed."

"That I can absolutely do!"

March 6, 1990, McKinley, Ohio

"How did things go with your call with Doctor Mercer?" Clarissa asked at lunch on Tuesday.

"OK. It took some arm-twisting, but I think things will work out. This morning, I called both Father Stephen and Jonas Blane, Angie's Aikidō instructor, and both agreed to participate in what I'm calling Angie's treatment team meetings. Marjorie is contacting Angie's GP, Charles Grey, and her OB/GYN, Bridget Sullivan. Once they agree, I'll speak to Leslie Hoffman. I'll work through Marjorie Stephens to ensure they're making progress and consult with Father Stephen if they seem to be veering off course."

"Creating the 'wall of separation' you need so it doesn't appear you're treating her."

"Exactly. I'm acting as her friend, doing my best to ensure her medical team works with her spiritual advisor and her physical trainer, though Aikidō has a spiritual component, similar to Shōtōkan karate."

"You're doing a good thing, Petrovich. I know how much you love her and how upset you were at what happened."

"If I believed in specific answered prayer, the one prayer I would make would be for Angie to recover enough to live a normal life, even if she was never able to marry and have kids."

"I'm going to ask this as only Lissa could — not for Elizaveta not to die?"

"I'm talking here and now, Lissa. I didn't ask for Angie to never have been afflicted with schizophrenia. I mean, at that point, the entire universe is upended. Maybe the multiverse does exist, and there are realities where Angie is healthy, and Elizaveta doesn't die, but if those things changed, what else would change? And would I ever ask for anything that took Rachel from me?"

"Never, despite her being in full toddler mode!"

I couldn't help but laugh, "Alternating between 'Love Papa!' and 'No!' from minute to minute!"

"The first said in French, of course, thanks to your sister-in-law!"

"Yeah, yeah," I chuckled. "She has a boyfriend now, so she's torturing HIM instead, I'm sure!"

"And yet, she's still teaching Rachel to speak French!"

"She has less time, so that's a good thing!" I grinned. "How is the ED?"