Chapter 49: He Deserves the Best Care We Can Provide

October 5, 1985, McKinley, Ohio

Our study group had just begun when the phone rang on Saturday afternoon. Elizaveta was out with Debby, Oksana, and Mikayla, so I excused myself and answered the phone in the kitchen.

"Deacon, it's Father Nicholas."

"Hi, Father. What can I do for you?"

"Father Deacon Vasily was taken to Rutherford Hospital this afternoon."

"Lord have mercy!" I exclaimed. "How is he?"

"I don't know beyond what Father Herman said, which is that he suffered some kind of medical emergency this afternoon at home."

"Sasha and Yaroslav?" I asked.

"It would appear so."

"I assume someone called Tasha and Nik?"

"I just got off the phone with Tasha. She and Nik are leaving for Rutherford right now."

My first instinct was to drop everything and go to Rutherford myself, but given my other obligations, that wasn't necessarily the right decision.

"Are you going?"

"No. I will, of course, go if Father Herman asks or His Grace instructs. Should that happen, I'll ask you to lead Vespers, please."

Which answered the question for me — unless I was instructed by Bishop ARKADY to go to Rutherford, I needed to be at my own parish. I wanted to be able to comfort Tasha, but that was Nik's role.

"Yes, of course, Father. Would you call me as soon as you know anything?"

"Absolutely. Father Herman promised to call as soon as he knew anything. He's at the hospital now."

"Good."

"Keep all of them in prayer, please."

"I will."

"I'll see you tonight at Vespers if we don't speak beforehand."

After we said 'goodbye', I hung up and went back to the study group.

"Everything OK, Petrovich?" Clarissa asked.

"Deacon Vasily was taken to Rutherford Hospital for what Father Nicholas called 'a medical emergency'."

"Oh, my!" Maryam gasped.

"Stroke?" Clarissa asked.

"I'd say that's a good guess, but I don't know, and neither does Father Nicholas. Hopefully, it was just his blood pressure spiking."

"Sasha?"

"Exactly."

"Mind clueing the rest of us in?" Fran asked. "If you can?"

"Tasha's little sister told her husband of less than a year that she's not going to move into the new house he just bought for them."

"Oops," Sandy said, shaking her head.

"Yeah," I sighed. "Anyway, Tasha is on her way to Rutherford. Father will call with an update."

"You're not going?" Sandy asked.

"To do what?" I asked gently. "Tasha has Nik to care for her, and your medical skills and mine combined don't let us prescribe an aspirin! And besides, if Father Nicholas needs to go to Rutherford for any reason, I need to lead Vespers tonight. Basically, Father Herman won't leave the hospital except in extremis and that means Father Nicholas would cover any pastoral concerns. Obviously, Bishop ARKADY could ask either of us to go, but for now, I just wait."

"I'm surprised you're so calm," Peter said.

"It's 'Doctor Mike' in 'Trauma' mode," Clarissa said. "He understands his role, his duties, and his obligations. And that includes this study group."

"Indeed it does," I replied. "And we have a test on Monday morning in Anatomy and one in Epidemiology on Tuesday, so let's hit the books."

Elizaveta came home about an hour before our study group ended, but I didn't have a chance to do anything other than greet her with a quick kiss before returning to our review of the history of immunology and vaccinations. The phone rang just before 5:00pm, and Elizaveta let me know Father Nicholas was calling. We ended our session, and the others left, then I went to take the call.

"Deacon Vasily was admitted for observation," Father Nicholas said. "He was hypertensive, according to Father Herman."

I suppressed a chuckle and replied, "I can imagine his blood pressure going through the roof."

"With good cause."

"Yes, of course. I was actually worried about that when Sasha first announced that she was pregnant. What do we know?"

"Not much more than that, really."

"Did Yaroslav accompany Matushka Alexandra and Sasha to the hospital?"

"I didn't ask. As I'm sure you can understand, everyone's first concern is for Deacon Vasily's health."

"Yes, of course."

"I'll see you at church for Vespers in a bit."

"Thanks for calling, Father."

We said 'goodbye', and I hung up.

"What happened?" Elizaveta asked.

"Deacon Vasily is in the hospital for hypertension — high blood pressure — after Sasha announced she wasn't moving to the new house with Yaroslav."

"Oh my! How is he?"

"He was admitted for observation, which after five weeks of medical school, I know means they're concerned, but not overly so. I suspect, but I don't know, that they gave him medication to bring down his blood pressure. He'll be allowed to go home tomorrow if there aren't any further problems."

"You said he had a bad reaction like that when Sasha revealed she was pregnant."

"He did, and I recall wondering if he might have a stroke. It's not something we've even come close to studying, but I'm pretty sure hypertension is controllable with drugs. They gave some to Sasha when she had her incident before Vika was born."

"We're not going to Rutherford?"

"No. Father actually asked me to be prepared to lead Vespers in case he had to go or had to cover something for Father Herman. I'm guessing Father Herman will have Vespers given Deacon Vasily appears to be OK, minus the fact that the source of his high blood pressure isn't going away."

"Literally!" Elizaveta said with a slight smirk. "How is Tasha?"

"She and Nik went to Rutherford, obviously, but that's all I know."

"What would happen if Father Herman couldn't celebrate the Divine Liturgy tomorrow?"

"More than likely, either Protodeacon Seraphim or I would be dispatched to lead a Typika so the faithful could receive Eucharist. Deacon Vasily did that when Father Herman took his annual vacation. I'm sure Deacon Grigory would have done the same."

"Yes. I just didn't know what happened in the case where a parish didn't have their priest or deacon."

"Besides the option of a Typika, which is the most common, Vladyka could send Father James to Holy Transfiguration, and Vladyka could celebrate a Hierarchical Divine Liturgy at the Cathedral. Anyway, how was your afternoon?"

"Very good. I think Debby will be fine. She's coming to church tonight and tomorrow."

"And Vickie?"

"Is on a pretty short leash, but her parents aren't being mean. Well, I don't think they are."

"Did she tell them who the father is?"

"She doesn't know," Elizaveta said. "Well, she only knows his first name, and it's not a guy Debby knows."

"Ouch! Do her parents know that?"

"Yes. I guess Mr. Grant is trying to find the guy. He talked to someone at Ohio State, and they're investigating."

"She's fifteen, so that makes it a serious problem."

"I don't think her dad is interested in calling the police. I think he's interested in child support."

"OK. How is Debby handling it?"

"She's feeling a bit guilty for taking Vickie to the party at OSU."

"Not surprising," I observed. "Just be there for her."

"We are. How was study group?"

"Same as always. We have two tests next week, so that's where we're focusing."

"Let me get dinner. You should play your guitar — you need to relax, and you can get some practice."

"Yes, Kitten," I replied.

She gave me a kiss and went to the kitchen while I retrieved my guitar and sheet music.

October 6, 1985, McKinley, Ohio

"How are you, Tasha?" I asked quietly on Sunday morning just before Matins was to start.

"OK. Nik and I spent the night at my parents' house. Mom stayed with Dad, so she asked us to stay with Sasha and Vika. Dad is coming home later this morning, so we'll leave right after church. That means we'll miss Sunday School."

"I'm sure one of the other teens can fill in for you as troublemaker!" I teased.

"Hmph!" Tasha grumped. "We'll also miss dinner today."

"We understand," I replied, then went to the altar to serve Matins. A little over four hours later, after Matins and the Divine Liturgy, we had a light lunch, and then I led my Sunday School class. Once class ended, Elizaveta and I headed home, and rather than changing into comfortable clothes, we simply undressed and got into bed to spend some time making love before dinner with our friends. Ninety minutes later, sated and breathing hard, we reluctantly got out of bed and went to shower.

"What do you think will happen?" Elizaveta asked.

"You mean with Sasha? I have no idea, and we really do need to keep our distance except to provide whatever support Tasha needs."

"Do you know if there was any fallout from your dad?"

"Not that I've heard," I said as we got into the tub together to shower. "I'm sure tongues are wagging."

"I like it when YOUR tongue wags!" Elizaveta giggled. "And you like it when mine does!"

"Obviously!" I agreed. "But you know I meant gossip."

We finished our shower, dried, and dressed just before Alyssa, Mark, Serafima, and Elias arrived. We had a nice time together and a good meal before they left. The study group arrived a few minutes later, and after ensuring everyone had something to drink, Elizaveta went to the small bedroom to sew while the study group cracked the books.

"Are you doing OK?" Clarissa asked after everyone else had left just past 11:00pm.

"Yes. This really doesn't affect me except insofar as Elizaveta and I need to support Tasha. Deacon Vasily was supposed to go home today, and given Tasha didn't call, I'm assuming that happened."

"And that other thing?"

"Is in the hands of the priest and the girl's parents. In the end, for me, it was a tempest in a teapot. It could have been bad, but things turned out OK."

"She's keeping the baby?"

"Yes."

Clarissa shook her head, "A bad idea."

"Maybe, but it's up to her and her parents."

"Speaking of parents..."

"I haven't spoken to my dad since we had dinner. But I'll call him later in the week to check up on him. The only silver lining is he decided not to contest the divorce."

"Is he going to go public with his relationship?"

"Apparently, given he asked for two tickets to the concert. My mom and grandparents are coming on Friday evening, so my dad and Holly will come to the Saturday matinée."

"Awkward."

I shrugged, "Only for Holly. I wonder if she'll actually come with him or not. I didn't say anything to my mom or grandparents about my dad and Holly; I just arranged their tickets. How are YOU doing?"

"Our stress levels are about the same, I think. Fran is pretty much the same as us; Maryam and Peter are a bit more stressed, but not terribly so. Sandy, on the other hand..."

"Yeah," I sighed. "Fran told me that Jason is going to talk to Pete."

"'Stress reduction' isn't working?" Clarissa asked.

"No time," I replied. "I suggested they carve out a specific time, but Sandy is so stressed about school that all she does is study, and Pete can't drag her away from her books. Fran and I made sure we carved out time to spend with our spouses, and you've done the same with Abby. Maryam has church which helps her the way it helps me, and Peter signed up for fitness instruction at the medical school gym."

"I'll see if I can talk to Sandy, though I don't want to pressure her, because that might make it worse."

"No kidding. How are you doing?"

"You and I will get through this together, Petrovich. All I need is you."

I smiled, held out my arms so we could hug. We held the hug for a good minute, then I walked Clarissa out to her car — my old Mustang. Once she'd driven off, I went back inside, locked the door, and went to my room. I quietly undressed and slipped carefully into bed so as not to disturb my sleeping wife.

October 8, 1985, McKinley, Ohio

"Hi, Mike," Doctor Gibbs said when I walked into Exam 1, where she and the two Fourth Years were examining a man of about twenty with red and purple blotches on his face. "Assume the position!"

I chuckled and went to sit on the stool in the corner to observe.

"Greg, this is Mike, a First Year medical student, he's observing."

"The more the merrier!" Greg replied. "So, what is it, Doc?"

"Let us finish the exam and see where we are. We'll also run some blood tests. Jill, tell me what you found in your exam."

"Purple papule lesions on his nose and cheek, as well as on his right calf. Small lesions on his hard palate. Otherwise, everything is grossly normal."

"What would you order?"

"CBC and cultures to start."

"That's what we'll do. Greg, I'll have the nurse draw blood. We'll put a stat order in, but it could take some time."

"I don't have any place to be," he said.

"OK. Then relax, and we'll get going."

We stepped out of the room, and Doctor Gibbs asked Nurse Felicia to draw the blood samples.

"Doc," I asked. "What about a VD test?"

"Why would you suggest that?" Doctor Gibbs asked.

"Something we ran across in anatomy last week — a man in his late twenties who had lesions on his body from syphilis."

"Did those papules look like the ones on Greg?" she asked.

"I'm not experienced enough to answer that question," I replied.

"The lesions Greg has aren't typical of syphilis. What was the cause of death of your subject?"

"Heart attack, with non-Hodgkin lymphoma as the underlying cause."

"Melissa, did you appreciate any swollen lymph nodes?" Doctor Gibbs asked.

"No, doctor."

"Neither did I," Doctor Gibbs said. "It's a good question, Mike, but let's see what the blood test shows. By the way, we need specific, written authorization for a VD test. Jill, what's your differential diagnosis based on your exam?"

"Some kind of blood or vascular disorder."

"Mike could have told me that!" Doctor Gibbs replied, sounding annoyed.

Actually, I thought, I probably couldn't, at least not beyond wild speculation.

"Uhm," she replied, pulling a book from her lab coat pocket and paging through it. "It could be pyogenic granuloma or, uhm, congenital arteriovenous malformation or some kind of cancer."

"Close the book and tell me what tests you would run."

"If the blood tests don't show anything, a tissue biopsy."

"Melissa? Do you agree?"

"I'd have to look in the differential diagnosis book."

"You're both Fourth Year! Even though the things we're talking about are somewhat rare, you shouldn't have to look them up!"

"May I ask what you suspect, Doctor Gibbs?" I inquired.

"If the blood tests come back the way I think they will, then a biopsy to confirm Kaposi's sarcoma."

"Holy crap!" Melissa gasped loudly. "GRID?!"

"Staff lounge! Now!" Doctor Gibbs ordered.

The four of us moved into the lounge.

"That was completely unprofessional!" Doctor Gibbs said to Melissa. "Do not EVER react that way. Do you hear me, young lady?"

"Yes," Melissa replied meekly.

"And if you were thinking what I suspect you were thinking, do not EVER think that in this hospital, or I'll have you bounced from the program so hard you won't know what hit you, and you'll NEVER practice medicine. Do you understand?"

"Yes, but..."

"No 'buts'!" Doctor Gibbs declared emphatically. "Jill, do YOU have a problem?"

"No, Doctor," she replied.

"Mike?"

"If I understand what was implied, you suspect Greg has what the newspapers call the 'gay disease'?"

"Gay-Related Immune Deficiency, though a much better term is Acquired Immune Deficiency Syndrome, or AIDS, so as not to stigmatize those who have it. Kaposi's sarcoma is one of the cancers which is common enough that some of the literature calls it an AIDS-defining cancer. Do you have a problem?"

I shook my head, "No. He's a patient like any other patient and deserves the best care we can provide."

"Do you hear that, Melissa?" Doctor Gibbs asked.

"Yes," Melissa replied tersely.

The door to the lounge opened and Nurse Ellie stuck her head in, "Ambulance is three minutes out. Human versus chainsaw."

"Melissa, get the blood draw from Felicia and hand-carry it to the lab. Wait for the results."

"But..."

"Do it!" Doctor Gibbs commanded. "Jill, Mike — masks, goggles, gloves, and gowns. This is likely to be bloody."

Melissa had just been assigned 'scut' and cut out of the trauma because of her reaction to Greg's potential diagnosis. I had a bunch of questions, but I wasn't sure it was the time to ask them, so I simply followed Doctor Gibbs and Jill into the trauma room, where Ellie helped us put on gowns over our scrubs.

"Wanna play doctor?" she whispered, her fingers tracing along my waist as she tied my gown.

I chuckled and held up my left hand with my ring, then put on a mask and goggles, and finally, gloves. Once we were all garbed, we hurried to the ambulance bay, where the paramedics had just pulled in.

"Male, 28, traumatic amputation of his lower right arm and significant abdominal injuries; tourniquet applied to the arm; BP 80 over 50; pulse thready; resps labored; significant blood loss; PO₂ 98% on ten litres."

There was, literally, blood everywhere — on the gurney, on the floor of the ambulance, and on the paramedics.

"Do we have the limb?" Doctor Gibbs asked as the patient was hustled to Trauma 1.

"On the gurney," one of the paramedics declared.

"Ellie, type and crossmatch; Felicia, hang a unit of plasma.

"Straight to the OR!" Doctor Carlton declared after taking one look at the patient. "We'll lose him otherwise! Felicia, grab the plasma!"

Everyone except Felicia instantly reversed course, and they moved quickly down the hallway to the elevator to go up to the OR. She caught up and as they got into the elevator, she began the process of inserting an IV needle. There wasn't enough room, so both Jill and I were told to stay in the ER.

"Did you see that?" she asked once the elevator doors closed. "A huge, gaping wound in his right side?"