Chapter 53: Mutual Admiration Society

October 22, 1985, McKinley, Ohio

"You seriously think I'd change my review of you based on what you wrote?" Doctor Gibbs asked as we sat down in a consultation room.

"I want an honest evaluation," I replied. "I'd hate for you to give me better ratings because I said you were awesome!"

Doctor Gibbs laughed, "You are quite the smart aleck! The fact that you can jest now means either you're supremely confident in a good score, or you're resigned to a very bad score."

"You tell me," I replied.

She shook her head and rolled her eyes, "Are you like this all the time?"

"Yes."

"How does your wife put up with you?"

"Who says she does?" I asked with a smirk.

"Why do I get the sense that means her revenge is something you enjoy?"

"Because it is!" I declared. "So, the review?"

"Overall, you did a very good job, especially as this was your first Preceptorship. You were attentive, accepted appropriate critiques, asked appropriate and insightful questions, and acted with proper decorum. In fact, allowing for a bit of levity, which I know you like, the only disappointment is Ellie's!"

I chuckled, "And she'll have to remain disappointed."

"All kidding aside, we need male doctors to stop treating female doctors, nurses, and med students as their personal harems. That goes double for the ones who are married."

"Won't the increase in the number of women doctors help?"

"Eventually. When you do become a Resident, and I'm sure you will, work to solve the problem."

"Now you're sure I will? What happened to having 'promise'?"

"How would it have affected you, mentally, to have me tell you after a week or two that you were absolutely going to make it?"

"Me? Not at all. I already believed that!"

"Well, you get an '11' on ego, which is pretty much a necessity for surgeons and emergency medicine specialists!"

"Spinal Tap was hilarious. I'll counter the 'ego' bit and say that without supreme self-confidence, nobody should go near an operating room or a trauma room."

"I agree that doubting oneself is a sure way to lose a patient, but overconfidence kills more. Remember that, Mike. Do what you know how to do, and don't do what you don't know how to do. Never be afraid to ask for help, because if you get in over your head, you'll kill patients.

"Sometimes there isn't a choice, but that's rare. Much more common is a young doctor thinking they can work miracles beyond their skill and training. There's a saying that covers it, though it's a bit too simplistic in my mind — 'watch one; do one; teach one'. But the principle is correct — observe and learn, then do, then teach. That said, remember, you're not here to simply learn procedures and techniques."

"Melissa?"

Doctor Gibbs nodded, "Exactly. You might get away with being a jerk as a surgeon because your patients are sedated, but even then, there are limits. And, honestly, if by Fourth Year you haven't learned that every patient must be treated to the best of your skills and abilities, you have no business being a doctor. We had a guy charged with murdering his wife and kids brought in after being shot by the police when I was a PGY1. Everyone who comes here deserves our best effort to save their lives and to repair their injuries or cure their illnesses."

"Same with my church," I replied. "Everyone needs the healing provided by God."

"Including an AIDS patient?"

"Especially an AIDS patient," I replied.

"We do need to have that beer at some point. Perhaps Bobby and I can invite you and your wife for pizza."

"I'm sure that would work, though I need to check with Elizaveta. OK to call you here?"

"Sure."

"How can I improve?" I asked.

"Just keep doing what you're doing. Honestly, given the goals of the Preceptorship, that's really all I can say. Do watch your stress levels. That's one way to fail that has nothing to do with your skills, abilities, or intelligence."

"Our study group already dropped one weekly study session because we noticed one of our friends was so stressed."

"Encourage your friend to see someone if they can't manage it, because it only gets worse from here. What's your next Preceptorship?"

"Pediatrics," I replied. "I'll receive the details tomorrow, but I'm pretty sure it's in a practice, not the hospital."

"You were actually lucky to draw this first Preceptorship where you were the only First Year. Because of some vacations and other internal matters, you ended up with basically my full attention. Starting next week, I'll have four or five students for the next eight months. When you're back for radiology and surgery, stop in and say 'hello'. And let me know about pizza and beer."

"Thanks, Doctor Gibbs."

"I'll sign the form and send it in. You scored five out of five across the board with no deficiencies. So..."

I chuckled, "I gave you a five, of course. And I checked the 'plus' box next to every quality."

"Thanks. It was a pleasure having you as my student."

"And it was a privilege to have you as my first Preceptorship," I replied.

"And thus ends the Mike and Loretta Mutual Admiration Society meeting for today!"

We stood, shook hands, and I headed to the locker room to change. Unsurprisingly, Ellie found her way into the locker room just as I was pulling my medical coat over my cassock.

"I came for a goodbye hug," she said.

I shook my head, "Even if my wife would be OK with it, which I doubt she would, no public displays of affection are permitted when clergy are wearing their cassocks."

"You could take it off!" she said, licking her lips.

"And then I'd be in trouble with both my wife and my bishop! And, speaking of my wife, I need to get home because she's expecting me for dinner."

"Not even a peck?" she pouted.

"Sorry, no," I said, zipping up my bag. "Bye!"

"Bye," she replied with a frown.

I left the locker room, went into the lounge, called Elizaveta to let her know I was done, and then walked out into the ER waiting room.

"Good luck, Mike," Nate said.

"Thanks," I replied. "Hopefully, I'll see you again."

"I hope so, too," he responded.

I left the building and headed for my car. I got in, started it, and headed for home, very happy with my results, and wondering what my next eight weeks would be like in a pediatric practice.

"How was your review?" Elizaveta asked when I arrived home.

"Extremely positive."

"Excellent! Let's sit down. It's only about twenty minutes before your study group arrives."

I sat down, and Elizaveta brought dinner to the table. I prayed, and we ate quickly. When we finished, I changed into sweatpants and a T-shirt and got out the snacks while Elizaveta cleaned up from dinner. My study group arrived on time, and we settled into the living room.

"Did everyone get their evaluations?" Fran asked.

Everyone replied that they had.

"Anyone less than a 4?" she asked.

Everyone shook their heads.

"Great!" she exclaimed. "Let's get started!"

October 23, 1985, McKinley, Ohio

At the end of our Practice of Medicine classes on Wednesday, we received our next Preceptorship assignments. True to what Doctor Gibbs had said, Maryam and Peter were both part of a group of five assigned to the ER at Moore Memorial Hospital. Clarissa was part of a group of four assigned to Surgery at Moore Memorial Hospital, Fran was part of a pair assigned to Radiology, Sandy was part of a trio assigned to an OB/GYN practice, and I had my pediatric rotation at the practice in the medical building next to the hospital as part of a group of three.

"Do you know any of those students?" I asked Clarissa when we left the lecture hall to head for our Mustangs, which were parked side-by-side as always.

She shook her head, "No. Do you?"

"Just one, but only by name."

"You really did luck out to get the one-on-one attention."

I nodded, "I did. The medical gods were looking out for me."

Clarissa laughed, "Right! Petrovich believes in a god other than the 'One, True God'!"

"A turn of phrase, Lissa! And you know I wouldn't have a problem taking the Hippocratic Oath, even the original one that mentions Apollo, Asclepius, Hygieia, Panacea, and all the other gods and goddesses, because it's the idea behind that, not those specific gods, even though they're mentioned."

"The same way you approach icons and parables."

"Yes. But you know they secularized the oath, so really, that doesn't matter."

"What about your objection to swearing 'so help me God'?"

"Given the new oath doesn't have anything like that, it's not a concern. And according to Melody and Jocelyn, courts will allow you to simply 'affirm' without any reference to God."

"But how is that different?"

"Intent. And a direct violation of Jesus' command to not make an oath to tell the truth, but rather simply tell the truth. The modified Hippocratic Oath is a set of promises, the most important of which isn't even in the Oath — «Primum non nocere»."

"First, do no harm," Clarissa translated.

"Exactly. I can't imagine anything more important. And second to that is treating every patient, no matter what."

"Are you going to warn Peter about the Fourth Year?"

"I think I have to. On one hand, if I were 'Evil Mike' with a goatee, I'd find a way to let Melissa know and react."

"You viscerally object to discrimination."

"An understatement if there ever was one! But I can't 'out' Peter against his will. That would betray a trust."

"True. I suppose I'll see you in the morning, given we canceled our Wednesday sessions."

"I'd hug you..."

"I know," Clarissa sighed. "Of all the things I miss, it's that and cuddling. But, I can get hugs when I arrive for study sessions and when I leave."

I nodded, "Yes, you can."

"You're off probation on Friday, right?"

"Yes, though not really, if you know what I mean. The discipline ends. Well, assuming Vladyka hasn't changed his mind."

"He could do that?"

"A bishop's prerogative is to change his mind! It just doesn't happen as often as it does with women!"

Clarissa laughed, "The women in your life are the least likely to be whimsical!"

"True. I'll call Vladyka when I get home to confirm."

"OK. See you tomorrow!"

We both got into our cars and left the medical school parking lot, turning in opposite directions. I arrived home about ten minutes later, parked, gathered my things, and went inside. Elizaveta and I exchanged a quick kiss, then I went to change into comfortable clothes for dinner while she continued preparing our meal. Once I'd changed, I used the phone in the bedroom to call Vladyka at the Chancery.

"Good afternoon, Father Deacon!" he exclaimed when I responded to his greeting. "The Lord bless you! How are you?"

"We're doing well, Vladyka, thank you," I replied. "And you?"

"Just fine, thank you. How may I be of service?"

"I was calling because Friday would be the day that you suggested my discipline was to be lifted, and I wanted to ensure that was still your intention."

"Before I answer, may I ask if anyone suggested that you call?"

"No, Vladyka. I assumed that discipline was imposed until lifted and that unless I heard directly from you, it would continue in force, despite the suggested end date."

"Very good, Mischa. Have you obeyed my command, both in spirit and in your actions?"

"To the best of my knowledge, I have, Your Grace. Other than at home, I've only not worn my cassock when I've been required to wear surgical scrubs, which was part of your instructions."

"And you understand why I imposed the discipline in the first place?"

"Yes, Your Grace."

"And you hold no resentment?"

"None, Your Grace. I acted without permission, assuming you would be OK with it. I was in error. It won't happen again."

"Then the discipline is lifted immediately. You may perform your concert as planned. Please let Father Nicholas know that you've spoken with me."

"I will, Your Grace. Thank you."

"Remember that I love you and Matushka, and pray for you every day."

"We love you as well, and you are in our constant prayers."

"I will see you soon, Mischa. I'll arrange with Father Nicholas for you to join us at the Cathedral."

"As you command, Vladyka," I replied.

"Then have a prayerful evening at Vespers, and I will see you when you are here. Goodbye!"

"Goodbye!"

I hung up and went to join Elizaveta in the kitchen.

"My discipline is officially lifted," I said. "Vladyka also said that he'd like me to serve at the Cathedral, and he'd arrange it with Father Nicholas. And he reminded me that he loves us."

"He's a wonderful man! Was there a reason for you to come to the Cathedral?"

"Besides me being one of his clergy? Symbolism, I suspect. I've heard that any priest or deacon who is put under discipline is invited to serve with the bishop to show that there is unity, no matter what else. Mine wasn't public, as it didn't involve not serving at the altar or a temporary ban from receiving the Eucharist, which are, in effect, the same thing, so the symbolism is private as well."

"That actually makes a lot of sense. It shows you that you are restored, as it were, and had it been public, it would have shown the congregation."

"Exactly. Our bishops don't do things on whims or without reason, and they certainly aren't arbitrary."

"Dinner is ready; would you pour the drinks?"

I did as she asked and we then sat down to a fasting meal. I prayed, and then we dug in.

"What's your next assignment?"

"McKinley Pediatrics, which is in the medical building next to the hospital. Two other students are assigned along with me, but not from my study group. Maryam and Peter are assigned together to the ER, along with three other students. I was super lucky to be the only one during my Preceptorship."

"What is Clarissa doing?"

"Surgery."

"Just watching, right?"

"No! She'll do neurosurgery and remove a tumor on her first day! Or not."

"You know what I meant, husband!"

"I did. I suspect she'll do the same kinds of things I did — observe and do things like check on labs. We're not allowed to actually do any procedures. During Third and Fourth Year, anything we do is done on the license of the Resident or Attending who is supervising us, which to me explains why students who don't have the full and complete trust of their mentor only do scut."

"You mean because the doctor could lose their license?"

"As the ultimate penalty for an error? Yes."

"That means that when you eventually teach, you'll have to be VERY careful!"

"I agree, though I can't be overcautious and not teach."

"What would you do with someone like that girl who freaked out about the gay patient?"

"The same as Doctor Gibbs, with one addition — I'd pray for her. The one thing I couldn't do would be to bring religion into it, even if she did. That could get me into a lot of trouble. It's why Doctor Gibbs asked us about joining her and Bobby for pizza and beer."

"Next Thursday is fine, if that works for you."

"It does," I replied. "I'll call her tomorrow and let her know."

October 24, 1985, McKinley, Ohio

"I'm still trying to figure out how Dean Parker became involved in this, Chancellor Evans," I said after we'd ordered.

"When Miss Simmons didn't show up for work, and then didn't arrive back at the dorms for dinner, the McKinley PD was called. A student told them that you and Grace had dated, and checking around, another student told them that you'd had some kind of bad breakup. When the police ran you through their system, they didn't find anything except that you'd been interviewed about Miss Stephens' disappearance.

"The detective on that case, Tremaine, had references in his notes to Dean Parker and her accusation. He turned her name over to the detective investigating Miss Simmons' disappearance, and that detective shared the information with the Sheriff. Both of them spoke to Dean Parker, who confirmed that she had told the police what was in Detective Tremaine's notes. What she didn't do was say that the claims were unfounded, which she was required to do."

"There aren't supposed to be any records in that regard."

"There aren't any official records, and normally, nobody would see the officer's notes. That's why you were clean in the system, minus a local notation that you'd been interviewed as a witness. It was Detective Tremaine's notes which indicated he was interested in you as perhaps having been involved. He didn't clear you, per se, because as soon as they found out that Miss Stephens had left on her own and was suffering from mental illness, he marked the case closed as 'no crime committed' and simply filed his notes without updating them beyond her having been found."

"So now what?"

"Our counsel has spoken with the City Attorney and agreed that the case notes will be sealed and will only be able to be opened under court order. Unfortunately, by law, the information can't be deleted, so sealing it is the best option. Otherwise, anyone who looked at them would see the allegations, and even if there was a statement that they were unfounded, it could be used against you."

Which was also the case of the Family Court records — the allegations were there, but the files were under seal, and could only be opened with a court order, which, according to Mr. Winston, was basically impossible to get. I didn't think I could get a better result, especially if the law prevented deleting things from the police records, which made perfect sense to me.

"And Dean Parker?"

"Has been reminded of her agreement. What I can tell you is that we sent her a letter reminding her of the terms of the agreement. Beyond that, I can't say anything, though it appears she's taking a position with a university in Chicago."

"Then I feel sorry for the students and faculty there."

"Did you speak to your attorney?"

"No. I wanted to hear what you had to say first. I think I'm satisfied, so long as this is the end of it."