Chapter 31: A Natural!

August 19, 1986, McKinley, Ohio

"Ready for your evaluation?" Doctor Collins asked when I sat down in his office on Tuesday afternoon.

I nodded, "I am. May I ask how you prepared it with so little interaction?"

"Melissa had significant input, and I spoke with Doctor Subramani and the nurses. It's pretty difficult to get poor marks in an internal medicine Preceptorship if you pay attention, take notes, and ask good questions."

"Isn't Melissa on probation?" I countered.

"She is, and what better way to find out if she has what it takes to be a Resident in a teaching hospital than to have her work with a medical student on his Preceptorship?"

"That makes sense," I allowed.

"What's your evaluation of her?"

"Do you know our history?" I asked.

He nodded, "I do. I did from the very beginning. I saw it as a test of both your characters, your ability to work with someone with whom you had significant personal problems, and your ability to learn in what might be a hostile environment. I assume you know how cut-throat surgical Residencies are."

I nodded, "We've heard the horror stories of Residents using extreme measures to get ahead and get the experience in their desired specialty."

"It won't be so bad for you, as you're basically doing a general surgery Residency, and nobody will see you as a threat. My advice, for what it's worth, is that you simply accept all the routine surgeries and let the rabid dogs tear themselves apart for the rarer or more complicated ones. Sure, those would be fun and interesting, but they aren't really necessary for you to become an emergency medicine specialist with a certification in surgery or whatever they happen to call the role.

"I've heard 'trauma surgeon'," I said. "But I've also heard it the way you just said it."

"It's all new, so as is usually the case, we're making it up as we go along!"

I laughed, "Those words would have frightened me before I started medical school, but I understand that medical advances are a result of what amounts to very controlled trial and error. We learn as much from mistakes as we do from success. But the general public would flip out if that were said in any official way."

"All science is like that, as I'm sure you know. A failed experiment is NOT a failure, but another very important data point in your investigation. That's why I prefer to call those 'results contrary to our hypothesis', which doesn't have the negative connotation of 'failure'."

"That makes sense."

"So, the question for you, Mike, is this — is Melissa a good teacher?"

"I'd say she's working on it," I replied. "At first, I had to prompt her to explain what she was doing and asked a lot of questions to get information I felt she should have volunteered instead of waiting for me to ask."

"That's actually the norm. With few exceptions, doctors don't volunteer information unless asked. The one exception is during rounds or diagnostic conferences. Otherwise, they just do their thing and assume you'll ask anything you want to know."

"There's a huge flaw in that kind of thinking," I countered. "I don't know what I don't know, and I might not know to ask."

"That's medicine in a nutshell, Mike, at least from the diagnostic side. You're fed bits and pieces of information by the patient, their family, the monitors, test results, doctors, nurses, and paramedics. You are, in effect, working with one eye blindfolded and one arm tied behind your back. Your job, especially in emergency medicine, is to synthesize a tentative diagnosis as quickly as possible and act on that diagnosis while ensuring you don't do anything to make the patient worse. That said, given the limited information you have, that's ultimately impossible in some cases."

"Doctor Gibbs has said as much."

"All I can say is ask questions and keep asking until you get satisfactory answers. Sometimes that means being a pain in the ass and bugging the doctor until he or she gives you the information you need. So, in light of all that, what's your evaluation of Melissa?"

"I think she deserves the second chance she's been given, and with the right mentoring, she'll make a fine physician. My concern, if I may express this, is that hospitals won't see that, and they'll reject her from the Match. I don't think that's fair."

"Fair or not, she made her own bed," Doctor Collins said firmly. "I suspect she'll have to Scramble and won't get a prestigious hospital or one of the sought-after specialties like cardiology or surgery. Everything will come down to her interviews."

"If she can get them," I said.

"Her grades are good enough that a second-tier program might take a look at her. And in the Scramble, the hospitals aren't as picky because they need to fill their Resident slots. How would you grade her?"

"I think a four, out of five, would be right, four-and-a-half if we could give half points."

"OK," Doctor Collins said. "As for you, fives across the board. Frankly, I was pleasantly surprised at how easily you accepted being assigned to Melissa and made it work. I want to clue you into something, but you can never say I discussed this with you."

"Go ahead."

"There are a number of doctors and administrators at the hospital who are very concerned about your, and I use this term advisedly, 'religious fanaticism'. I haven't seen it, and in fact, your willingness to dispense with your clerical garb without an argument showed, at least to me, that they're wrong. I was instructed to assign you to Melissa because some people wanted to see you both fail and thought this was the perfect way to make that happen."

I wanted to scream, 'What the fuck?', but I knew that was a bad idea. And, as what Doctor Collins had said swirled in my mind, I realized there really wasn't anything I could say or do except do my best to complete my training. I quickly decided the best course of action was a word with Vladyka JOHN. I didn't want to involve Viktor, who was on the hospital board, so I wouldn't say anything to him, at least for the moment.

"I'm not sure what to say about that," I said evenly.

"Just keep demonstrating your ability to learn, your people skills, and, as your studies progress, your diagnostic skills. You may not be able to win everyone over, but you should be able to alleviate most of the concern that might interfere with you Matching here."

"I can't be someone I'm not," I said.

"Nor should you; I'm just telling you the lay of the land. How you respond is up to you."

"Does Doctor Gibbs know about this? I ask because she's basically my mentor."

"I doubt it. It's not the kind of thing that a Senior Attending or administrator would say to a Resident."

"I guess I'm shocked because I'm at the top of my class and have had perfect scores for every Preceptorship."

"About five years ago, the student at the top of the graduating class didn't Match and wasn't hired in the Scramble."

"Why?"

"He was, and I'll deny ever saying this, blackballed because he was openly gay."

Which made Peter's decision to stay 'in the closet' even more rational, despite how idiotic it was that he had to do that.

"What happened?"

"He works for a large insurance company reviewing treatment decisions. Remember, on graduation, you're an MD and are called 'Doctor', so he's qualified for that role."

"If you'll pardon me saying this, that's nuts! And I bet it was the same group who think I'm unqualified because I'm religious who thought he was unqualified because he was gay!"

"He actually didn't try to Match here, so not directly, but your point isn't off base in terms of that kind of thinking."

"What's next? Blackballing an African American, as they're calling black people now?"

"That's happened, Mike. Here and elsewhere. We always advise minority students to make sure they apply to big programs in big cities. I, and a few other Attendings here, have argued against that kind of behavior, but some people will never change."

"I can't accept that," I replied, with a wry smile, "because as a 'religious fanatic', I believe anyone can be redeemed and turn from their sins."

Doctor Collins laughed, "I will be pleased to call you a colleague on the day that happens; just keep everything I've said in mind."

"I will," I replied. "I won't break your confidence, though I will need to discuss this with my bishop, but that's effectively under the seal of confession."

"What's your next Preceptorship?"

"Radiology, with Doctor Stephens."

"If you thought THIS was staid and boring..."

I chuckled, "Melissa told you I said that?"

"Yes. And given you want emergency medicine, that's exactly the reaction I'd expect you to have. Your job will be to keep them alive long enough for us to make sure they walk out of the hospital."

I nodded, "And I need to understand how all the parts work together, from admission to discharge."

"A good attitude to have. I think we're done, so please go find Doctor Subramani and Melissa."

"Thank you for your candor," I said.

"You're welcome."

August 20, 1986, McKinley, Ohio

"That is SO fucked up, Petrovich!" Clarissa exclaimed.

I had broken Doctor Collins' confidence on Wednesday morning, but I felt I needed to speak to Clarissa, even before I called Vladyka JOHN.

"TELL me about it! I sure see why Peter is acting the way he is."

"His advisor during his undergrad warned him. I guess the professor was also gay and had suffered for it, such that he changed graduate programs. Of course, that was in the late 50s, so things were different."

"Apparently not all that different," I groused.

"What are you going to do about your situation?" she asked.

"Seek the bishop's advice, of course. I'm torn between getting my back up and insisting on my cassock and not ever wearing it to the hospital."

"How would you manage that?"

"Change here at the medical school, and just put on my ryassa, which I could leave in the car."

"I can't believe people are like that! Did you speak to your father-in-law?"

"I thought about it but decided that, in the end, it could backfire pretty badly. He has no power over who the Attendings select for the Match, and if he were to intervene, they might decide not to select me out of spite."

"The blackball thing, do you think that might affect me?"

"Honestly? It could, but for some reason, lesbians aren't seen as a 'problem', if you'll forgive the use of that word."

"Because first, we aren't a threat to their manhood the way a gay man is; second, they're afraid homosexuality is contagious; third, they think lesbians would all go straight if only they would allow the doctor to wave his supposed magic wand over them!"

"It's not magic?" I asked, making my voice sound disappointed.

Clarissa laughed, "Your pussy cat thinks so, and that's ALL that matters!"

"True!" I agreed.

"What do you think your bishop will say?"

"I suspect we'll discuss it, and he'll leave it to me. I don't know which way I'm leaning just yet. That said, I will continue to wear it to school. You know that once I'm a Resident, I'll be in scrubs basically the entire time I'm at the hospital, so it's not like it would be a major problem to basically bring that forward. What bugs me is being forced to do it by bigots who also target blacks and gays without a care in the world for the harm they're doing."

"That's your REAL hot button, isn't it? You care less about your cassock than you do outing the racist and bigoted assholes."

"Precisely. I'm tempted to wear it MORE often and make less accommodation in the hopes that one of the idiots out themselves."

"You'd put your medical career at risk for that? What if they start giving you poor marks on your Preceptorships? Or worse, your clinical work?"

"Part of me says that I'd like to see them try because despite there being a lot of subjectivity, they would never make it stick. And it would have to be a widespread conspiracy for that to work."

"And the Match?"

"Doctor Gibbs will be an Attending by then. Think she'll put up with that nonsense? Or Doctor Roth? Or, for that matter, Doctor Forsberg? She's on the committee that assesses Residents. And given it was Doctor Collins who told me this, I can't imagine he'd put up with it. I think my case is different from the outright racism and anti-homosexual bigotry. I can, by my actions, demonstrate I'm not a 'religious fanatic' in the way they mean. Clarke couldn't not be black any more than Peter could not be gay. Or you a lesbian, for that matter, and not for lack of trying on my part!"

Clarissa laughed, "You weren't trying to make me not a lesbian; WE were trying to see if my sexuality was such that we could be a couple. Now, if you didn't have that cassock, THEN I'm sure there would be options. Tessa, for example, doesn't mind boys; she just strongly prefers girls. And now that you have THAT image in your head, my work is done!"

"Lissa, you are a ... wonderful person!"

"For definitions of 'wonderful person' which equate to 'bitch'! Enjoy the fantasy, Petrovich!"

"Gee, thanks," I groaned.

It took me until ten minutes into the lecture to get that idea into the part of my brain reserved for things I should not think about, but I knew, like a shade, it would be lurking, just waiting for an opportunity to rise.

August 22, 1986, Cincinnati, Ohio

On Friday afternoon, as soon as class let out, I hurried home to change into the blue scrubs I wore for gigs, loaded my instruments into the car, and then headed to Taft to pick up Robby and Sophia for the drive to Cincinnati for the class reunion gig Kim had booked.

When we arrived at the Netherlands Hilton, we went to the concierge, who directed us to the grand ballroom where the reunion was being held. When we walked up to the room, there was a uniformed hotel staff member standing in front of the doors.

"We're the Good Old Blues Brothers Boys Band from Chicago," Robby said with a smirk.

"Ignore him," I chuckled. "His mother dropped him on his head as a baby. We're with the band. My name is Michael Loucks."

He checked a list and stepped aside so we could go into the ballroom.

"Where did THAT come from?" I asked.

"Sophia's idea!" Robby replied. "We'll use it as part of our warm-up schtick. And speaking of coming up with lines — dropped on my head?"

I grinned, "Sophia's idea as well!"

"Greek girls are the real troublemakers!" Elizaveta said piously.

"All evidence to the contrary about Russian girls notwithstanding?" I asked.

"Careful, husband!"

"And the claws come out, right on schedule!" Robby grinned.

"Watch it, Mister! You're basically healed! That could change!"

"You'll have to go through Sophia first!" Robby said defiantly.

"There, my friend, you're wrong," I said. "Nationality takes a backseat when Orthodox women are pitted against Orthodox men! My mom conspired with Mrs. Nikatopolis ALL the time!"

"She's married to a Russian, right?" Sophia asked.

"Yes, poor guy!"

"Just wait, Bub!" Sophia smirked. "We Greeks have many ways to get even!"

"Well," I grinned, "if you use the «moutza», you WILL have to deal with Elizaveta!"

"The what?" Robby asked.

"Mike," Sophia said, "I see Kim waving to you, I'll explain about Greek curses to Robby and Elizaveta."

I almost said that I'd say nice things at her memorial service when she explained to my Kitten that the curse was meant to have my dick fall off, but with Lee's and Sandy's deaths, it would have been terribly inconsiderate to say. I left the small group and went to where Kim was standing with Sticks.

"Everything seems to be set," Kim said. "No changes to the plan. We'll play instrumental versions of our songs during cocktail hour, then play our regular two sets after dinner for dancing. They'll bring us food we can eat in the 'ready room'."

"Given what Robby said when we came in," I grinned, "you should make sure we don't have to pay for it!"

"What was that?"

"A reference to The Blues Brothers when they were performing at Bob's Country Bunker!"

"Man, you see me playing country OR western, I want you to shoot me," Sticks exclaimed.

"Then I guess the Theme to Rawhide is off the playlist!" I replied with a silly grin.

"You know," Kim said thoughtfully, "if that's something Robby and Sophia are working into the skit, maybe Mike and José could sing that."

"They are," I replied. "And if they had told us, we could have been prepared. But I don't know the chords for that or the words. But I think they're still working on their patter, so I'm not surprised or upset."

"It was just an idea riffing off of that," Kim said.

"Where's José?" I asked.

"He and Dona stopped to visit her parents just outside Milford. They should be here any second now."

True to her word, they arrived about two minutes later, and the four of us went through our usual warm-up routine, finishing just as the first attendees arrived. Ten minutes later, we kicked off with I Write the Songs, though with no vocals and our sound muted to allow for conversation.

The entire evening went according to plan, and our playlist, which was heavy on late 70s music, was clearly appreciated by the reunion attendees. What surprised all of us was that in addition to the pay, there were nearly $200 in tips, which had been placed in a jar by the bar, of which we knew nothing until they brought us the money. Split six ways, an extra $30 or so in addition to our usual fee made for a very nice paycheck for about five hours.

August 23, 1986, Columbus, Ohio

On Saturday, after band practice, Elizaveta and I drove to Columbus to see Vladyka JOHN. It didn't cause any trouble with my in-laws for missing our family dinner, as they wouldn't return from vacation until late in the evening. Elizaveta had lamented missing a chance to skinny dip, but we simply didn't have the time because we had a lunch appointment with the bishop.