Chapter 29: Fear and Doubting

September 14, 1981, McKinley, Ohio

On Monday, after lunch, I did as Doctor Orosco had insisted and met with a counselor from Student Health Services, who, amazingly, was available immediately. The problem was, as I'd argued, that I wasn't going to repeat what I said, even to another counselor, under any circumstances. I spent ten minutes going around in circles with Doctor Ralph Hart and made no progress.

"I'm not sure what you're doing here if you won't talk to me about what happened."

"As I said, Doctor Orosco made it very clear that she was very concerned because of what I said to her at the end of our conversation, and I promised to come here as soon as possible."

"And as I said, she's right. You can't bottle up whatever it is inside you. That's a recipe for disaster."

"Doctor, I'm sorry if I sound like a broken record, but I said it one time to Doctor Orosco, and only because I promised my mom, and only on the condition that it would never be revealed. I told her I'd never repeat it, and if she ever told anyone and they asked me about it, I'd deny it ever happened."

"Let's take a different approach. I saw your major is biochemistry. Are you pre-med or science?"

"Pre-med."

"Then here's perhaps what might be your first lesson in medicine. Let me start by asking you, as a doctor, how you would feel if a patient, who you were sure had a problem, refused to allow you to even investigate the complaint. Especially if the condition was potentially serious?"

I smiled, "I know the game, Doctor. You want me to tell you I'd do everything in my power to convince the patient to participate in his or her own treatment. But in the end, it is up to the patient."

"Always. But do you know what they would do in a hospital if a patient presented with symptoms of a potentially serious illness and refused any form of diagnosis or treatment?"

"No."

"Call for a psych consult. Can you deduce why that might be?"

"Because it's irrational," I said.

"Indeed it is. Would you care to give me an analysis of your own behavior, I mean, from my perspective?"

"Irrational."

"Now, put yourself in my position. I'm responsible for student mental health. Today, I see a young man who wants to be a doctor who is refusing treatment for a problem which could negatively affect his training and his career and, ultimately, endanger patients. What do you think I should do?"

"Don't you think you're exaggerating?"

"Am I? Let's say you keep this bottled up inside you, and you don't deal with it, and it eats away at you without you even realizing it. Do you know what might happen?"

"I don't know enough about psychology to be able to answer that."

"Do you suppose I do?"

"I would hope so, given your position."

"So..." he said, with an arched eyebrow.

I laughed because I had to.

"My mom does that when she's led me to an inescapable conclusion."

"Which means you're going to talk to me, doesn't it?"

"Yes," I sighed.

"Good. Let's begin again."

September 15, 1981, McKinley, Ohio

"Hi, Paula," I said when I walked into work. "Anything you need?"

"That list is long and detailed!" she sighed. "But I don't think you want to hear my personal problems. We need ice, and some of the candy is low."

"On it!" I declared.

I refilled the cooler with ice, restocked the candy, cleaned up a box of Tide that someone had spilled, and verified the snack and pop deliveries. Nancy came in to start her shift, and Paula left. I was busy checking in a beer delivery when the shift change happened, and I just waved 'goodbye' to Paula and 'hello' to Nancy as I counted cases of Budweiser, Michelob, Pabst Blue Ribbon, and Miller.

"Hi," I said when I had a chance to stop at the front counter and talk to Nancy.

"Hi!" Nancy replied. "How are things?"

"OK, I suppose. You asked me to open up, so I need to tell you I went to Student Health Services yesterday to talk to a counselor. I'm going to meet with him three times a week for the next few weeks."

"I think you have a lot bottled up inside you. That's what I was trying to tell you."

"I know. He, uh, suggested I be careful about relationships at the moment."

"Me specifically?"

"No, just in general. He thinks I'm fragile."

"I could sort of sense that, you know? You were acting the way my mom did right after my dad left. She pretended everything was OK until one day, she broke down. I'm sorry I tried to use sex to pressure you."

"Let's forget about that and start over. We can save the wild sex for later."

"Is that a promise?" she asked with a silly smile.

"Let's take one day at a time and see how it goes? OK?"

"OK."

September 16, 1981, McKinley, Ohio

"I'm going to ask some questions which might be uncomfortable, but I'd like you to answer them honestly, please."

I nodded, "Sure."

I was at my second counseling session with Doctor Hart, and he had said he wanted to explore my relationship with Liz.

"Do you know when she had her first period?"

"Sure, because a box of sanitary pads showed up in our shared bathroom. Why?"

"I promise I'll explain at the end if you don't understand by then. It's better if you just answer."

"OK."

"Did you ever talk to her about her period? Or anything about puberty?"

I shook my head, "No. There was never even any teasing about 'mosquito bites' or anything like some of the guys at school did in sixth and seventh grades."

"Did you ever see your sister naked? Did she ever see you?"

"I think the answer to both of those is 'no'. Obviously, I can't be completely sure about what she might have seen, but I don't know when it could have been. And with me, you said 'ever', and it's possible when we were little, but if so, I don't remember."

"I was talking about from, say, age five or six."

I shook my head, "No. That I'm sure of with regard to me."

"Did you ever play 'doctor' and anything like that?"

I shook my head, "No."

"Did you ever want to?"

I smiled, "Not with Liz, but there were plenty of OTHER girls I thought about that with."

"And?"

I shrugged, "No such luck."

Doctor Hart laughed, "The story of most teenage boys' lives. When did you see your first naked girl? And I don't mean a picture or a movie."

"August 16, 1981," I replied.

"Your first love affair?"

"Yes."

"Did you compare her to your sister in any way?"

"No way! Doc, I have no feelings like that for Liz. I never have. And I'm pretty sure I never had any hidden or subconscious feelings like that, either."

"I wasn't saying you did, Mike. I'm exploring. You have to admit it's not normal for a sister to make the request she did or for a brother to respond the way you did."

"Extreme circumstances call for extreme measures."

"And I'm sure Doctor Orosco told you just how foolishly you acted and just how dangerous what you did was?"

"She dressed me down pretty well."

"Let's talk about your relationship with your mom."

"OK, Doctor Freud!" I laughed.

"Like most great thinkers, you'll find he asked some excellent questions, but his answers to them leave something to be desired. But that doesn't mean he's completely wrong, either."

I chuckled, "Masturbation therapy for female patients?"

"Where did YOU read about THAT?" he spluttered but recovered quickly. "They don't exactly cover that in High School psychology survey courses."

"No, but we had one English teacher who loved to share all kinds of interesting tidbits. It was a class of only Seniors, so everyone was eighteen or almost eighteen. Let's just say I probably learned more in his class than any other in my thirteen years in the Harding County Schools."

"What is your earliest memory of your mom?"

"Holding me so I could kiss the icon of the Theotokos in church. That's Mary, by the way."

"How old were you?"

"I don't know, two or three, maybe?"

"Was she loving and nurturing? I know you're a teenage guy, but try to answer without the usual sarcasm."

"I don't do sarcasm," I said. "It's often lost on me."

"And you want to be a doctor? Develop a good feel for it, Mike. Sarcasm is a defense mechanism many medical professionals use. You'll get into all KINDS of trouble if you don't at least have an understanding of it. So, your mom?"

"I'd say so, yes."

"Who disciplined you?"

"Mom. My dad was something of a wimp, I guess. Like me."

"You were pretty strong with your sister."

"My dad told me I'd found my balls. He also said he found his when they checked her into the Clinic and regretted it wasn't until he was forty-three."

"Your mom is the strong foundation of the family?"

"Yes."

"She ran the household? And your dad was more passive or submissive?"

"I told Doctor Orosco that when they had disagreements, my dad would go to his workshop until he figured out my mom was right, then they'd make up."

"Your mom is ethnic Russian? The daughter of immigrants?"

"Yes. My dad's ancestors were mostly Dutch, and many of them lived in New York when it was still a Dutch colony."

"Do they have a good relationship?"

"I have no idea. I think they do, but you'd have to ask them. I mean, I never felt they had any problems, but I suspect they simply kept them from us."

"That's normal, though now they may see you as an adult and let you into their lives a bit more."

"They have. Both of them. Especially after Liz's situation became known."

"And your relationship with your dad?"

"Somewhat distant, for the most part. He's very quiet and introverted."

"Two traits I believe you've inherited from him. Along with an extreme dislike of confrontation."

I nodded, "Yes. It's funny, though, because he told me when I talk, he hears my mom."

"Most children are a mix of their parents' personalities, with varying doses of grandparents, teachers, and friends tossed into the mix. Well, and then add in mental illness."

"Is that a hint?"

"I don't think so, but you have to know that's what I was worried about. If not now, later."

I nodded, "I made that assumption on Monday."

"What kind of doctor do you want to be?"

"Trauma," I said. "Emergency medicine."

"You've chosen perhaps the most stressful specialty, though a friend of mine in pediatric oncology would probably disagree, and I totally understand his point. If you bottle up all your stress, you're going to have a meltdown of epic proportions at some point. Being calm, cool, and collected, as you described your usual demeanor, is very good for someone working trauma. But internalizing all that stress will kill you, or a patient, or both.

"From everything I've seen and heard, I think you'll make a great doctor IF you develop proper coping mechanisms and learn to deal with confrontation rather than avoid it, or as you put it, by running away. You're going to have serious conflicts during your training and even more during your career. If you can't deal with conflict, you'll be washed out, either during your clinical rotations or during your Internship. That's a long way to go to discover you aren't cut out for medicine, don't you think?"

"You're telling me I'm not ready to be a doctor? And I don't mean education-wise because that's obvious."

"That is what I'm telling you, yes. From everything I've seen, you have the necessary intelligence, the right demeanor, and the single-minded focus you need to become a superb physician. But that's not enough to actually BE a physician. Once we put these current concerns to rest, I'd like to keep working with you, off and on, during your time here at Taft. Let's see if we can help you make the adjustments you need to be the doctor you want to be."

I nodded, "I suppose that makes sense."

"Mike, you told me you've wanted this from fourth grade onwards. But if you don't commit to fixing your problems, it's going to go badly, and you are not going to come out of it well. It's not a 'suppose' or 'guess' or 'try' kind of thing. Either do it or don't. But make up your mind now so you can change your career plans, if necessary."

"I don't want to do anything except be a doctor."

"Then let me help you."

"OK."

September 17, 1981, McKinley, Ohio

My fears about lab partners and reports had borne themselves out, and not just in one, but both classes. I was carrying all four of my partners, and it was just too much. At first, I'd resolved to somehow manufacture the time, but I'd realized I was reverting to form and being a doormat for them. I'd said something to Zach and Kurtis, and they'd both promised to do better. Unfortunately, Mark and Sally seemed far more interested in private anatomy experiments than our biology experiments, and I had to ask them several times to stop necking and pay attention to the lab report we were trying to write. I really didn't want to complain, but if things didn't change, I was going to have to. I simply didn't have the extra hours to spare.

The only way I could make more hours available would be to not go home on Saturday evenings. If I stayed in, I'd have an additional four or five hours to do homework, as well as extra time on Sunday morning before and after church. But that would mean not seeing Jocelyn, and seeing her was something I didn't want to give up. That meant there was no extra time to be had, which meant I would have to complain about my lab partners if they didn't shape up.

At the end of class, we went to the library to work on our lab report for an hour, and they spent most of it playing what Carter called 'slap and tickle' instead of concentrating. I finally threw up my hands in disgust and left. I stopped by the Biology office and made an appointment to see Joe Miller for Friday at 9:15am, then ate lunch with Clark, Carter, and Larry. When I finished lunch, I headed to the Quick Mart.

"Hi, Paula," I said when I walked into work. "Anything you need?"

She laughed, "One of these times, I'm actually going to tell you my problems. But in the meantime, someone dropped a bottle of vegetable oil, and it broke. A customer just mentioned it as you were putting on your smock."

"I'm on it," I said.

It took me the best part of an hour to clean up the mess, including replacing three terribly stained carpet tiles. I finished just as the Frito-Lay man showed up to replenish the snacks, which seemed to be flying off the shelves now that school was in full swing. The same was true of soft drinks as well. Beer was only delivered once a week, and that got me thinking about where Clark, Carter, and Larry got their 'regular' beer. We could all buy 3.2 beer by the glass or pitcher at a restaurant, but they'd been drinking Michelob. Mr. Sokolov's policy was to card everyone, which led to some very interesting conversations with people my grandfather's age about having to show ID. But it did remove the judgment call, which made sense given the proximity of the university.

"Twice now, you've said something about issues," I said about fifteen minutes before Paula's shift ended.

"How old are you, Mike?"

"Eighteen. Why?"

"Too young."

"To talk to?"

She laughed softly, "No, to solve my real problem. Single mom."

"Ah, yeah, that's not exactly in the cards before I graduate medical school."

"A future doctor? Hmm. Maybe a guy three years younger isn't a bad idea after all!"

"Nothing personal, but I think I have to pass. Where's the baby's dad?"

"Wright-Patterson Air Force Base. He's a sergeant. Two years ago, I had one too many beers in the wrong place at the wrong time. Carissa was the result. He turned out to be a real jerk, but at least he's paying child support without me having to take him to court."

"Who watches your daughter while you work?"

"My mom or my grandmother. Carissa and I live with my parents like I told you the other day. It's tough to make it on your own as a single mom without a college degree. But I'm doing my best."

"I'm sure."

"So what do you say?" she laughed. "Instant family; just add ring? You get the short-term payoff, and I get the long-term."

"If you think you have a tough time making ends meet now, you have NO clue what it's going to be like for me going to medical school and being an Intern. Your 'long-term' payoff would be about fifteen years down the road!"

"That long?"

I nodded, "Yep. That long. Four years of college. Four of medical school. One as an Intern. Three as a Resident. Probably two of Fellowship. THEN, and only then, can I earn some real money. And pay back all the debt I'll have racked up getting there. What's the short-term payoff?"

Paula laughed, "You're kidding, right? THIS!" she said, waving her hand up and down.

"I didn't even think that way."

"If that's REALLY true, maybe I should quit joking and talk seriously to you about it! Mostly, the first and only thing guys see is my body."

Which was VERY nice. Nice hips, flat stomach, large breasts. And a pretty face.

I shook my head, "That's an exchange I can't even think about making at this point."

"Oh, I know. You're WAY too young to think about that. I was WAY too young to have a kid. But, here I am."

Given what just about everyone in my life said about developing a sense of humor, I decided to at least try.