Chapter 39: On Track

April 3, 1988, Chicago, Illinois

"Al, could I speak with you privately?" I asked when he offered me a drink.

"Sure. Let me pour your bourbon, and we'll go into my study."

He poured a glass of bourbon for me and a glass of soda water with lemon for himself. We walked into his study and he shut the door behind us. He motioned toward a leather chair and I sat down. He sat in a matching chair and tipped his glass towards me to tell me to talk.

"I'm worried about Jessica's stress level," I said.

"I believe what you're seeing is typical for a Resident in the ER during their first year. What has you so concerned?"

"I suppose it's just how little sleep she gets, how little time we have together, and the lack of intimacy. I'm not talking about sex, but real intimacy. She's cranky most of the time, too, which I'm sure affects that."

"You and I had some very long talks about this," he said, giving me a hard look. "Are you trying to tell me that you can't handle it?"

"No! Far from it! I'm concerned that SHE can't handle it."

I explained the gist of the conversations that Jessica, Kara, and I'd had, as well as Jessica's concern that I might leave her. And my concern that she might want to have a baby soon, which I thought was a bad idea, but didn't feel I could really discourage without causing a rift between us.

"And you think that she has the idea that the baby will create a stronger tie between you?"

I shook my head, "I don't think so. I think the real issue is that in short order I'll have three kids, and none of them are with her."

"I'm sure that contributes to it. But, and I say this in confidence, both of my first two wives thought getting pregnant would fix our marriages. It didn't, obviously. In fact, it just created more stress and made things worse. A lot of young women have the foolish notion that a baby can save a failed marriage. It can't."

"That's just it. It's NOT a failed marriage and it never will be! And I don't think less of her for not having a baby. I do everything I can to make sure that she feels loved, and both Kara and I set our schedules around Jess as much as we can. It's the rare day that we don't both walk her to work, and one of us almost always walks her home as well. I think the stress is getting to her, and that's what has her thinking that there's a problem when there isn't. Well, at least from my perspective."

"She's insecure. You know that she never had a serious boyfriend before you, and that she was pretty much a loner who did everything for herself. All of this — marriage, sex, babies, Residency, Chicago — is new to her."

"Which I think confirms my point that she's seriously stressed out. This week off will help if she can truly relax. I think she's obsessing about her boards as well. On the plus side, she received her 'Match' letter which relieved a bit of her stress, but not much."

"How much is she studying?" Doctor Barton asked.

"A LOT! That's what she does during her downtime at work, plus most of Friday and Sunday afternoons after she naps following her shift."

He shook his head but had a wry smile on his face, "I know another overachiever who did that and almost burned out. It cost me my first wife."

"So you know exactly what I'm talking about, then," I said.

"I do. She'll never believe that she's studied enough or knows enough. For her, like me back then, the only passing grade is a perfect score. It's the same with her and treating patients. What she has to learn is that in some instances, 'good enough' is the best you can do. It took me a long time to learn that you can't get every answer right and you can't save every patient. And even longer to learn that you lose some because you weren't quite good enough to save them."

"Because they were too badly injured, for example."

He nodded grimly, "Yes. Your friend Bethany was probably my best save, and honestly, the flight doctor gets a lot of credit for managing to keep her alive until she got to me."

"You know, I never asked you about that doctor who helped save Bethany."

"And I don't know who it was, actually. He gave me Bethany's vital signs and got right back into the helicopter. We brought her in from the helipad and I got to work."

"I'm sorry, I got us off track from Jessica," I said.

"It's OK. You know that Jessica had never really had a relationship before the one with you and Kara. Everything she knows about having close friends and intimate relationships has been learned since you met her. On the one hand, that's a good thing, because she didn't come into your complicated life with a bunch of preconceived ideas about how relationships are supposed to work.

"On the other hand, she doesn't know how to deal with all the challenges that inevitably arise. That's a distinct advantage, really, because it was all those preconceived notions that wrecked my first two marriages. I was never going to be the dream husband who was home at 5:30pm, ate dinner with the family, played with the kids, and then watched TV with my wife. Or whatever it was my first two wives wanted me to be."

"You didn't talk to them about it?" I asked.

"No. Of course not. It was all about me. It took me a long time to figure out that while my patients might think I'm a god, my wives certainly didn't; and my kids definitely don't!"

"I'm learning that last one, even though Jesse is barely two!"

"Our kids have a way of keeping us humble, at least to a point!" he chuckled. "Jessica has the personality she needs to be one of the best. But that personality is what is going to drive a wedge between you if you allow it to. Love her and guide her. That's the way to be successful. Be very patient."

"Which is exactly what Kara does with me. I can be a pretty serious blockhead at times. Quite a few people have noticed over the years."

"You're driven in your own way. It's not all that different from Jessica. You just chose a career that lets you be flexible with your time and has a pretty low cost of entry, both in time and money. You didn't technically need your degree to do what you're doing, right? You had a company when you were fifteen. Right person at the right time, so to speak."

"I don't suppose there's much call for self-taught doctors!"

Doctor Barton laughed, "No. Trial and error is a pretty lousy way to learn for a physician. The sad part is, that IS how we make progress. But it's the edge cases, not the norm. In your field, you can make hundreds of mistakes and then go back and fix them later. Or do something 'rough', if you will, and clean it up later, at whatever pace you deem appropriate. That doesn't really work in medicine, though I know I've described trauma surgery as doing it fast to save a life and going back later to clean things up."

"I suppose that's true for the most part, especially given our ability to test our work to prevent devastating consequences."

"I don't know if I could swing it, but I really should have you attend an M & M session. You'll see how we respond to errors."

"M & M?" I asked.

"Morbidity and Mortality Conference. We get the doctors, pathologists, students, and others together and review cases where things went horribly wrong. It's meant as a teaching session — learn from the mistakes of others."

"Jessica lives in fear of making a mistake that kills someone," I said.

"Someday, she will. And that's when she's going to need you the most. We've lost patients while she's been on duty, but she hasn't made the decision or taken the action that caused a death. She's a PGY1, so her ability to do so is really limited. Next year, she'll be closely supervised as she does her first surgical procedures. After that, she'll be working more on her own. She'll still be supervised by Attending physicians, but as they trust her, they'll give her more freedom to act independently."

"And that's when the mistakes will come," I sighed.

"Yes. The problem is, if you're too cautious during a trauma, you lose valuable seconds. But you can't be a cowboy. It's a fine balance, as you learn over the years."

"So you don't think she's stressed to the breaking point?"

"No. If I did, I'd step in. I hate to say this, but relationship problems aren't considered abnormal for Residents. They're almost expected. You have the advantage of going into this with your eyes wide open and no misconceptions about the situation. The fact that you're here talking to me, and not laying blame on Jessica, shows me that you do understand. And I was sure when I saw you in the hospital that first time that you had your wits about you and could be a rock-steady husband for a doctor."

I laughed, "Don't tell me that you had me matched up with Jessica!"

"Not until you told me that you weren't interested in medical school. THAT would have told me you weren't the guy for her. She needed someone exactly like you, and fate brought you to her."

"You and Kara!" I chuckled.

"Kara?" Doctor Barton asked, raising an eyebrow.

"She knew Jess was the girl for me when she first met her. I was still thinking it was Bethany. It was Kara who gently pushed me to Jessica. And it's Kara who helps me when I start to veer off the straight and narrow with Jessica."

"So she's the glue that holds the relationship together?"

"Yes, I'd say that she is," I agreed.

"Jessica has the week off, and then she has just seven weeks to go before she moves to the surgical service. She'll still have ER work with surgical consults, but she'll be on a less arduous schedule. Just hang in there."

"I will. I'll do my best to have her relax this week, but she wants to study."

"Let me have a word with her about that," Doctor Barton said.

I finished the bourbon that I'd been sipping, and we went back out to join my wives, Belinda, Fawn, and Gerry.

"Steve, would you like to hear me play after dinner?" Fawn asked.

I saw her bat her eyes at me, which caused Jessica to roll her eyes and Kara to smirk.

"Sure. I'd love to hear you play," I said.

"Goody!" she giggled.

"Dinner will be in a few minutes," Belinda said, getting up from the couch where she'd been sitting, talking to my wives. "Fawn, please come help."

"Good! I'm hungry!" Gerry said.

At fourteen, he was almost as tall as I was, and I didn't think he was done growing. He'd been playing football and hockey, and there was a good chance he'd gain a scholarship in one or the other. He was a good-looking kid, and from the way he talked, he'd started attracting serious attention from girls.

"You're always hungry!" Fawn complained as she followed her mom to the kitchen. "Maybe you should learn to cook!"

"That's for girls!" he said.

Doctor Barton shook his head, "Those two are at each other like cats and dogs."

"Gerry, I do at least 90% of the cooking at my house," I said.

"And he does the laundry, helps clean, does dishes..." Kara teased.

"Don't give my ugly sister any ideas!"

"Ugly?" I asked, astonished that he'd say that. "Even YOU have to know that's not true! She's a very nice-looking young woman."

"Whatever!"

"Forget it, Steve," Doctor Barton laughed. "They're teenagers. I'm sure that you and your sister had moments like this."

"Actually, we didn't," I said. "We were very close and got along really well. Most likely because my mom was pretty much the Wicked Witch of the West."

Gerry started to say something, but his dad cut him off.

"Gerald Foster Barton, if you were about to say something like that about your mom or sister, stop right now or you'll be grounded for a week!"

Gerry sulked and slumped back in his chair.

"The old 'three name trick'!" I chuckled. "The weapon of every parent!"

"You use it, too! And not just for your kids!" Kara said, pointing out something that was quite true.

"Guilty as charged," I said with a grin.

"Dinner is ready," Fawn said, coming to the door of the living room.

We all got up and went to the dining room. The meal was excellent — roasted chicken, wild rice, peas, and a tossed salad. For dessert, there was apple pie and ice cream. When we finished, we took coffee into the living room and Fawn brought out her violin.

"Gerry, go help your mom with the dishes," Doctor Barton said.

"Aww, do I have-ta?" he whined.

"No. You could be grounded for a month instead. Your choice."

Gerry went to the kitchen muttering under his breath. I assumed it was the same thoughts I'd had for my mom when she'd assigned me chores.

"What would you like me to play?" Fawn asked, looking directly at me.

"Whatever you'd like. I love Mozart, but Vivaldi or Schubert would be great as well."

"Then how about Spring, from Vivaldi's Four Seasons?" she asked.

"Perfect," I replied with a nod.

She played wonderfully, and about ten minutes later, when she finished, we applauded. She put her violin away and then rejoined us. Doctor Barton asked Jessica to come into his study and they spent about fifteen minutes talking before they came back out and she sat down next to me, smiling and shaking her head slightly. I wasn't quite sure what that meant, but I knew that she'd tell me, eventually. We stayed until just after 9:00pm, at which point we said goodnight, and left the Barton's house. As soon as we crossed the street heading south, my wives began the expected teasing.

"Oh, Steve, do you really think I'm nice looking?" Kara simpered. "I'll show you everything if you want!"

"Oh, Steve, do you want me to play for you? I could play the skin flute!" Jessica teased in an equally simpering voice.

I laughed, "Oh, stop! There is no WAY. None!"

"She WAS making goo-goo eyes at you the entire evening!" Jessica laughed. "If you asked, she'd drop her panties for you in a heartbeat!"

"And I'm not going to ask! First of all, I would never risk my relationship with Al. Second, you would never agree to THAT dalliance in a million years! I'd have better luck asking for a threesome with Becky and Penny!"