Chapter 6: Match and Scrambles!

March 12, 1990, McKinley, Ohio

"Got a moment, Mike?" Doctor Roth said when he saw me late on Monday morning.

"Sure. What's up?"

"Privately, please."

I nodded, followed him to his office, and shut the door behind us.

"I received our Match list," he said. "You obviously cannot share what I'm about to say with anyone."

"Understood."

"It won't surprise you, but Mary Anderson matched here, as did Ryan Harrison; it might surprise you that Erin Jackson matched here as well."

"Interesting. For that to have happened, she had to have taken a fairly extreme risk. I'm happy about that, obviously. Before I ask you about the other three, do you know if Leticia Jefferson matched with the ED?"

"She did. Brent Williams called to let me know, as he was positive you would ask."

"Excellent. Who else did we get?"

"The married couple and Felicity Howard. We didn't get our third-ranked choice or our sixth. Obviously, Mary had already Matched for the trauma surgery slot. Thoughts?"

That meant that Felicity hadn't been Matched to any of the oncology slots she'd listed, and had Matched with her backup — surgery.

"I'm glad we got the Kennedys," I said, "and I'm positive Felicity will bust her butt. I'd have ranked her higher, but I understand why you were reluctant to do so."

"Huge red flags, even with her improvement. To be honest, without your strong support, I wouldn't have listed her."

"I believe in redemption," I replied. "Everyone screws up at one time or another. Fortunately, my major screwups have occurred in areas other than medicine."

"And I know you'll do your best to ensure it stays that way."

"I will. Did Brent share any other names?"

"No. Just that one; he said she's the cousin of a friend?"

"My roommate at Taft for the first two years. I was his first white friend, and he was my first black friend. You could have used our interactions as material for one of those goofy sitcoms."

"First black friend? In college?"

"Yes. I mostly hung out with two friends from second grade onward, and there were no black guys on the chess team and none at my dōjō. He grew up in Over-the-Rhine in Cincinnati, and the only white people he interacted with regularly were cops, and you can imagine how that went."

"Badly. Racism is a scourge."

"I agree. That is one of my concerns about Leticia Jefferson, but I know the ED docs and nurses well enough that she won't get grief from them. There are others..."

"We all know who they are, and if it were up to me, they'd be out. And I don't just mean out of the hospital; I mean no medical license. Bigotry has no place in medicine, and even if not expressed, it affects how patients are treated. Study after study shows that minorities receive substandard care, even when presenting at the exact same hospital."

"That is unconscionable," I replied. "But if you look at the details, you'll see it's actually a question of insured versus uninsured versus Medicaid. Guess which group has the worst outcomes, irrespective of race?"

"Medicaid."

"Exactly. You're better off being uninsured than having Medicaid because there is no gatekeeper of any kind. Yes, the hospital has to eat the cost, but we make those decisions purely on medical need. Our judgment of medical need, not the government's."

"Sad but true," Doctor Roth agreed.

"Anything else?"

"Not at the moment. Go have your lunch. And I'm sure you'll stop in to see Brent."

"I will!"

I left his office, let my students know I was going to lunch, then left the floor. I walked to the ED, but Brent Williams was in a trauma, so I headed down the long corridor to the cafeteria. I got my food, saw Sophia and her friends, and went to sit with them.

"The anticipation is killing me!" Sophia declared once I'd quietly prayed.

"You'll Match, I'm sure."

"But I don't find out where until Friday!"

"Been there," I said. "But for me, it was Tuesday morning that ended all the stress. I mean, sure, I was convinced I'd Match here, but knowing I'd Matched meant I was going to be a doctor. And that was the key."

"You couldn't have seriously been worried," Kelly Atkins protested. "You were first in your class, and I heard you were the best!"

The way she said 'best' was clearly meant as innuendo, but I ignored it.

"While the odds of not Matching were slim, they weren't zero."

"Only because Mike has a hate-hate relationship with computers and was sure it could find some edge case to screw him!" Sophia declared mirthfully.

"There might be some truth to that," I chuckled. "Though I have switched to tolerance of the infernal devices!"

"Not just edge cases!" Kelly smirked.

"Kelly, stop it!" Sophia ordered. "I mean it. Stop it. Now."

"Who died and made YOU Queen Bitch?" Kelly asked.

"Nobody. Mike is happily married and faithful. Deal with it and drop it."

Kelly muttered something under her breath, and I decided I was glad I didn't hear it. She was quiet for the rest of the lunch while Sophia, Jenny, Nancy, and I talked about their clinical rotations. Jenny had tried to Match with Moore for Internal Medicine, but I had no idea if she had, and I doubted Tim Baker would share the list with Clarissa in advance. When I finished my lunch, I excused myself and walked back to the ED to see if Brent Williams was available.

"Hi, Brent," I said when I saw him. "Got a sec?"

"Sure. My office?"

"Yes."

I followed him to the office and shut the door behind us.

"Owen let me know Leticia had Matched here. I'm extremely happy. OK to ask who else?"

"You know the secrecy rules, right?"

"Yes. Owen reminded me."

"He has to, as I do. Karl Schmidt, Julie Plemons, Mai Liu, and Mike Jorgensen. The last spot didn't fill. Are you available to interview Scramblers by phone?"

"Yes. How often does that occur here?"

"The last two years were fine, but before that, we nearly always had one that didn't fill. Remember, we were a smaller regional medical center at that point."

"When we hit Level I, I suspect that problem will go away."

"Me, too. I'll start receiving inquiries after 10:00am tomorrow. I'll coördinate with Owen for your time."

"Thanks. Any word on the new Emergency Medicine Chief?"

"An announcement is due tomorrow. I'm fairly certain it's Dutch Wernher from Rush-Pres in Chicago."

"Is that his given name or a nickname?"

"Nickname; his given name is Rupert."

"I think I'd go by 'Dutch'," I observed.

"Yeah, me, too."

"CV?"

"Mid-fifties. He switched from Internal Medicine to Emergency Medicine around 1972 and has a good reputation in the field. Graduated from UC Berkeley, attended Emory Medical School, Residency at Bethesda Naval Hospital, and two years at Cam Ranh Bay before leaving the service and being hired at Rush-Pres. Married with three daughters."

"Sounds like a good guy, but Loretta should have that role."

"We still don't know if she'll be able to come back," Brent said, "and that role has to be a practicing physician. That was one of Cutter's criteria — no more pure administrators."

"That I can't argue with, though I'm convinced Loretta will come back."

"Me, too, but you and I both know it's a potentially long road."

"Unfortunately. Anyway, I'll keep all of that under my hat. Let me know about the Scramblers."

"Will do, and thanks."

I left his office and returned to the surgical ward, and given things were quiet, let my students take their lunch before prepping the afternoon patient. The rest of the day was routine, with three ED consults, two of which were surgical cases, though neither was an emergency. We didn't admit them, but we scheduled surgery for them later in the week.

March 13, 1990, McKinley, Ohio

Tuesday was Match Day, and as had been the case for my friends and me, all the Fourth Years were on pins and needles until the first batch of Match letters were handed out. All of the students who had had their clinical rotations with me had Matched, though other than the names I'd been given by Owen Roth and Brent Williams, I had no idea where they might have Matched.

I took the opportunity at lunch to call Doctor Mertens and inquire how many were Scrambling.

"Six. It's a good year. I see one of the emergency medicine slots didn't fill."

"I'm expecting names from Brent Williams at some point today to begin phone interviews. Are any of the six worth talking to?"

"That's a heck of a question for the Dean of Clinical Instruction!"

"No reflection on you, Doc! There are some people who simply should not be physicians."

"Nicole Caton; middle of the pack, with average reviews. I think she might have overshot for her first choices and was unlucky with her backups."

"What programs?"

"Internal Medicine."

"Have her call Brent Williams," I said. "Well, assuming she's interested in Emergency Medicine as an alternative."

"She'll actually be in my office in about ten minutes to review the Scramble list."

"Are there any other open slots here?"

"One in psych and one in OB/GYN. That's not uncommon; surprisingly, the dermatology slot filled."