Chapter 45: Sorting Out the Dilemma

September 18, 1985, McKinley, Ohio

"What did you want to speak to me about, Deacon?" Father Nicholas asked as we sat in his office on Wednesday after Vespers.

"I've encountered a situation where medical ethics and the clergy handbook have come into conflict."

"Already? It's been less than a month and you aren't permitted to do any procedures, as you've told me."

"Unfortunately, medical ethics also forbid me from speaking to you or the bishop about it, even in confession."

"Who could you speak to?"

"Another doctor, my counselor, and, to an extent, one of my fellow med students."

"Any doctor?"

"I'm not actually sure. Certainly any doctor at the hospital or any of the doctors who teach at the medical school."

"Doctor Evgeni? He has admitting privileges."

"Maybe. I'd need to ask. Why?"

"If you could speak to him, he could provide an Orthodox sounding board. None of the other doctors is Orthodox, are they?"

"Not that I'm aware of. There's one doctor at the medical school with a Greek name, but I have no idea if he's Orthodox or not. I haven't had him for class."

"Who would you ask for permission?"

"My faculty advisor. I was assigned to Doctor Nora Mertens, who is Dean of Clinical Instruction."

"Why don't you speak with her and see if the ethics rules allow you to seek input from Doctor Evgeni."

"Will that satisfy His Grace?"

"I think it would, but obviously, that's not my call. Once you find out what the limits are exactly, let me know and I can speak with the bishop. I'm sure that has come up at some point in the past, if not in our diocese, then in another. May I ask an important question?"

"You may."

"Is the situation such that you think someone is in physical danger? Or presents a danger to others?"

"No."

"Then I think we're safe in waiting to get the opinion of your advisor. Other than your dilemma, how are things going?"

"Yesterday was a difficult day all around. Besides the conundrum, there was a hit-and-run accident which killed a cyclist."

"I read that in the newspaper this morning. The police said they have two witnesses, so hopefully, they'll catch the driver. It said the cyclist died in the ER."

"Right before my eyes," I replied. "It was shocking, but the shock has mostly worn off. I called Doctor Mercer this morning, and I'm going to see her next Thursday about stress management and something else I need to talk to you about."

"Should we do this as a confession?"

"I don't think that's necessary. You heard my confession on Sunday morning."

"Then go ahead."

I explained the conversation I'd had with Elizaveta and her discomfort with the situation at the hospital.

"I obviously wasn't here at the time, but the story has it that Maria was very upset with Doctor Evgeni when he told her about doing his first gynecological exam on a pregnant woman about to give birth during his training."

"That would have been in the late 40s, right?"

"Yes, so you can imagine how that went over in an even more conservative setting than the one in which we now find ourselves. I always wonder what Maria was thinking because I don't remember knowing a single female doctor when I was growing up."

"I'd say she got over it, given the number of babies Doctor Evgeni has delivered!"

"Obviously! But this sounds like another reason for you and Elizaveta to spend time with Doctor Evgeni and Maria. I know he's a GP, but I don't think that would negatively impact their advice."

"The only difference is the types of cases I'll treat, though, to be honest, the role of the GP until very recently was much broader. When he started out, there were no trauma centers, and he delivered most of the babies at the home of the mom rather than in the hospital. According to what they taught us during our first week, most women didn't see OB/GYNs, and many didn't even bother the doctor until they were sure they were pregnant, and that was because they missed their periods and got fat!"

"He's said that the role he plays has changed, but in the end, it's still his job to manage patient care from cradle to grave."

I nodded, "Something the ER can't do. I mentioned the patient diagnosed with an inoperable brain tumor who had come to the ER repeatedly, and nobody caught it because she saw so many different doctors."

"And that's a parallel with why we leave our priests in parishes from ordination until death, except in extreme circumstances. And why, when a parishioner moves from one parish to another, the best practice is for the priests to speak to each other."

"Continuity of care," I replied. "Spiritual rather than physical."

"Exactly. Think about what would happen to someone who simply walked into random churches and wanted to confess. How much pastoral care could they really be given?"

"Not much. I hadn't considered that, actually."

"I believe you always took your car to the same mechanic until recently. Why?"

I chuckled, "Because I knew and trusted Nate, and he knew me and my car. You've made your point. Why would medicine be any different from all the other things, such as having the same advisor all four years of college, and so on."

"Yes. Shall we go back to the death?"

"I actually think I'm OK, Father. I mean, intellectually, I knew it was going to happen, and I know that it will happen many more times. I actually think the thing that really affected me was when Doctor Gibbs, my mentor, said 'time of death', everyone just stopped and basically walked out of the room. It was so abrupt. Before that, it had been almost frantic, though everyone knew exactly what to do and was doing it. Then, nothing."

"Which, foregoing the theological reasons, is why every human society has rituals around death. The medical one is cold and impersonal. You've seen how we handle it."

"Done properly, the body is never left alone before burial, though we've bowed to modern practices."

"Mostly driven by health and safety concerns, though sometimes other public policy concerns weigh in, such as the «ekonomia» granted for any Orthodox in Japan to be cremated as required by Japanese law. Did you pray, Deacon?"

I nodded, "'Lord have mercy', as I usually do."

"Good. Is there anything else?"

"Elizaveta is going to go out for ice cream with Mikayla, Oksana, and Debby next Monday during my study session."

"Very good. College is always a struggle, as you well know, though we usually lose more young men than we do young women. Men tend to follow their wives to church, rather than the other way around."

"Jocelyn's husband is going to her LCMS church. He wasn't a church-goer beforehand. That said, I brought plenty of young women to church!"

Father Nicholas rolled his eyes, "I don't think I'd recommend your 'evangelism' methods."

"No, I suppose not," I replied with a wry smile.

There was nothing else, so after receiving Father Nicholas' blessing, I left the church. Elizaveta had gone home with her parents so that I didn't have to drop her at home. I got into my car and headed to Doctor Blahnik's house, where we held our Wednesday evening study group because I was usually late. When I arrived home, Elizaveta was asleep, as usual, and didn't stir when I climbed into bed.

September 19, 1985, McKinley, Ohio

On Thursday morning I went to Doctor Mertens' office and made an appointment for 4:00pm to discuss the ethical situation and how best to deal with it. The conversation was basically a repeat of the others I'd had, though the resolution was reasonable — I could speak to my spiritual advisor in broad terms, and I could speak to a doctor in detailed terms, albeit without using names unless he or she were directly involved in the case. To me, that solved the problem, at least insofar as medical ethics was concerned.

That evening, Elizaveta and I ordered pizza so we could stay home, talk, and not have to worry about cooking or dishes. I did take time out, before the pizza was delivered, to call Father Nicholas and let him know what Doctor Mertens had said, and he promised to call the bishop to ensure we were all on the same page.

"Can you tell me what that's about?" Elizaveta asked as we sat down to eat.

"Not really. I can't even give you a hint, but I promise it's about a patient, not about anything I did. I couldn't even give Father Nicholas the details."

"Then it has it has to be about someone from church."

"Kitten, please don't speculate. I can't confirm or deny anything, and if you were to guess, and someone thought I'd told you, I could get in serious trouble, including being expelled from medical school."

"But you can talk to Doctor Evgeni?"

"Yes, because he's a doctor admitted to practice at the hospital. And he can tell Father Nicholas and Vladyka ARKADY that I'm following proper medical ethics. The rules are very, very strict; you could compare it to confession because it more or less works the same way. You know Father can't reveal anything to the bishop except in very, very limited circumstances, and even then, it's iffy. Think what would happen if people thought Father Nicholas was revealing their confessions."

"Nobody would go!"

"Exactly. If I were a priest, I couldn't share anything with you without permission from the person who confessed. This is the same."

"I understand, but I don't like secrets."

"Neither do I! I want to share as much as I'm able with you; and as much as you want to hear. There are some things you won't."

"Like about the girl who was burned?"

"Exactly. I'll tell you, but I don't think you want to know."

"And you and this female doctor?"

"Why don't you come to the hospital after school on Tuesday? I'll introduce you to Doctor Gibbs, and you can see the Emergency Department. I think once you meet her, you'll see she's completely professional, and so is everyone else."

"It just seems weird to have a co-ed locker room."

"And, to be honest, it's the LEAST weird or disconcerting thing that's happened at the hospital."

"The man who died or the teenage girl who was burned?"

"Or the young woman with the inoperable brain tumor. Or the man who had a stroke. Or the man who claimed to have a backache but was probably just trying to score some drugs. Or the thing I can't tell you about."

"You've only been there three times!" Elizaveta protested.

"And from what I gather, all three were relatively calm because the patients were kind enough to basically come in at reasonable intervals. I've yet to see it overly hectic, and from what Doctor Gibbs says, it's nothing like what I'd see at a place like a public hospital in Chicago."

"I guess with that girl, it just feels totally inappropriate to look at her. I mean, I understand, in a sense, but to have her private parts exposed so everyone could see?"

"Not everyone," I replied. "Doctors and nurses. Well, and a medical student. But what's more important? Saving her life or her modesty?"

"I know, but," she took a deep breath and let it out, "it just seems wrong."

"Have you considered a male doctor might deliver one of our babies? If your OB/GYN can't get to the hospital in time, you would get whoever is on call."

"You could do it!"

"That won't be my specialty," I replied. "And barring a dire emergency, I'll call an OB Resident to do the actual delivery if it has to be done in the ER or send the patient to maternity so they can care for her!"

"You're OK with another man looking at me?"

"I'm OK with a doctor looking at you. There's a huge difference. Think about it this way — would you let a random girl look at you the way you let your gynecologist look at you?"

"Well, no, of course not!"

"So the difference is..."

Elizaveta screwed up her face the way she always did when she knew I was right.

"That she's a doctor," Elizaveta said with a frown. "But..."

"No buts, Kitten. It's different with a doctor or a nurse. Or a med student."

"I guess."

"Come see the hospital on Tuesday, please."

"I will. What are we going to do for the rest of the evening?"

"Listen to music?" I suggested. "Watch TV?"

"Fuck?" she offered with a sultry look.

She didn't have to offer twice.

September 21, 1985, McKinley, Ohio

"Let me get you something to eat, Deacon," Tasha said at the picnic on Saturday afternoon.

I smiled, "I know that's the protocol for clergy, but I think it's better to reserve the treatment for bishops and priests. Matushka and I will serve ourselves when everyone else has."

Tasha frowned, but I saw the look Elizaveta had on her face out of the corner of my eye, which I was sure caused Tasha to drop her point.

"OK," Tasha reluctantly agreed.

She walked away from the table where Elizaveta and I were sitting with Maryam, Peter, Mark, and Alyssa.

"Deacon," Maryam asked, "why refuse Tasha's offer to do something for you?"

"Because he has a servant's heart," Alyssa interjected before I could respond. "And he certainly doesn't consider his position one of privilege."

"But if it offends Tasha..." Maryam protested.

I smiled, "On the scale of things I've done to offend Tasha since she was fourteen, I'd say this is close to the bottom!"

"They were a couple for a long time," Elizaveta said. "There's a LONG history. Once the bishop elected to ordain Mike, things changed."

"Why?"

"Tasha's view on clergy might have been shaped by her environment," Clarissa smirked, coming up to the table.

"Her father is a deacon," I said. "And Tasha was not interested in being married to a clergyman, in addition to the timing for starting a family. I know you're aware she's due in late April or early May, which is not something I could even have contemplated. Those things led us to decide not to marry."

"And Elizaveta, seeing her opportunity, seized it and proposed to Mike!" Clarissa teased.

"That may have happened," I chuckled.

Peter shook his head, "I just can't wrap my head around a fifteen-year-old girl proposing!"

"That makes two of us," Clarissa replied. "But then I got to know her!"

"Me, too!" Lara laughed from behind me. "I'm another one of those who couldn't see myself married to a clergyman."

"But why?" Maryam asked.

"A clergyman's life is under a microscope," I replied. "Even what I said to Tasha before had to take into consideration how people would react. I misjudged, obviously."

"Why?"

"Because of how you reacted," Mark said. "He realizes he made a mistake."

"A minor one," Alyssa added. "You're not upset, Maryam, are you?"

"No! Just confused, that's all."

"Think about every single thing you do or say being taken the wrong way," Lara offered. "For the entire rest of your life. And having to deal with the fallout of something you didn't ACTUALLY say or do. As much as I liked Mike, it wasn't something I could do. Nor could Tasha."

"You dated Deacon?" Maryam asked.

"Briefly, and it wasn't even really dating. We got to know each other, we talked in detail, and I yielded the playing field to Elizaveta!"

"Is it really that bad?" Alyssa asked.

"Our parish is fairly calm," I replied. "But I've heard horror stories. Tasha could tell you some mild ones."

"Shall we get some food, Deacon?" Elizaveta asked. "Most everyone has theirs."

I nodded, and we got up and walked over to the grill, where we got our hamburgers, then to the table with everything else, fixed our plates, and went back to sit. We ate, and when everyone finished, a large group decided to play volleyball. I had to demur as I couldn't take off my cassock to play due to my discipline from the bishop. But that did give me a chance to speak to Tasha. She, Elizaveta, and I walked a short way away. Nik was with Yaroslav, Sasha, and Viktoriya.

"Tasha, someone recently said that Sasha was forced to marry Yaroslav. Is there ANY truth to that?"

Tasha made a face that showed there might be.

"I think my dad made it very clear that she needed to marry, though I wouldn't call it 'forced'."

"But you'd agree he pressured her?"

"I suppose it wouldn't be wrong to say that. But she also wanted a very specific benefit of marriage!"

I laughed and shook my head, "You Antonova girls!"

"Mike!" Elizaveta reprimanded.

"It's OK, Elizaveta," Tasha laughed. "You know Mike and I were together, but what you don't know is I literally had to drag him, kicking and screaming!"

"Not literally kicking and screaming," I interrupted.

"My point is," Tasha continued, "and I can be honest with you, Elizaveta, that I demanded Mike take me to bed. My sister might have the same genes, which is what got her in trouble in the first place!"

"So, is everything OK with her and Yaroslav?" I asked.

"Between the three of us, no, they aren't. I think Sasha is tired of taking care of a baby and a husband, and of those two, taking care of the husband is the much bigger problem."

"They seem happy enough," Elizaveta said, nodding in their general direction.

"It's a front," Tasha sighed. "At least for my sister. I'm afraid Yaroslav might not realize how she feels."

"She really wasn't ready to marry, was she?" I asked.

Tasha shook her head, "Not like Elizaveta or I were."

"How serious is this problem?"

"Very, I think. I'm pretty sure Dad has an idea there's a problem, and that has to be worrying him, but he's hiding it pretty well. Sasha isn't afraid to cross him at this point, and that also has to make him very concerned."

"What do you think, Tasha?" Elizaveta asked.

"Unless I miss my guess, Sasha is going to refuse to move to the house Yaroslav is about to buy."

"Lord have mercy!" I exclaimed.

"It's worse than that," Tasha sighed. "I think she's been spending time with Timmy Aston."

"Holy sh..." I caught myself. "That is priming an epic disaster! Didn't Yaroslav adopt Viktoriya? And didn't Timmy give up his parental rights?"

"Would that change the fact that he's Viktoriya's father?" Elizaveta asked.

"No, of course not," I replied, shaking my head, "but ... I don't even know what to say! Who knows, Tasha?"

"About Timmy? Just the three of us. I was going to talk to you tomorrow afternoon to ask for your advice."

"Build a bomb shelter," I suggested.

"She's not..." Elizaveta asked.

"I have no idea," Tasha replied. "That would be, well, an even bigger nightmare."

"Have you tried to talk to her?" I asked. "Tried to reason with her?"

"I'm concerned about confronting her with nothing more than suspicion."

"I can see that," I replied. "I'm concerned about you, Natalya Vasilyevna; and I'm concerned about how this will affect your parents."

And not just that, but the parish as well. The double-whammy of my dad's adulterous relationship and the potential of one by Sasha, both of which would end in divorce, might be enough to cause Holy Transfiguration to become unglued and invite all kinds of ridiculous accusations, rumors, and innuendo. It would certainly make Father Herman's life a living hell, at least for a time.

"A nightmare, as I said," Tasha replied.

"Nightmare doesn't even begin to describe it," I said. "There's another situation which I'm sure will be made public very shortly — my mom filed for divorce against my dad, citing adultery as her reason."

"No!" Tasha gasped.

"The papers were filed a week ago. I've tried to get in touch with my dad ever since we discovered what was happening, but he won't return my calls or letters. I tried yesterday and couldn't reach him."