Chapter 38: What's Wrong, Kitten?

November 6, 1986, McKinley, Ohio

On Thursday, I had one of my occasional lunches with Lara, which was possible because the teacher to whom she was assigned at the High School had her 'planning period' immediately following lunch.

"How is every High School boy's wet dream doing teaching math?"

Lara laughed, "Only being two or three years older than some of the kids is out of the ordinary, for sure. Heck, if I were to dress a certain way, I could be one of the narcs the Sheriff has at the school!"

"I thought they kept those secret," I said. "You know, undercover."

"They try, but if you pay any attention at all, it's easy to figure out who they are. I'm pretty sure most of the kids know, and I'm sure the stoners know! One is a hot, popular girl, who never goes on dates, never goes to dances, and her excuse is that she's pre-engaged to a US Marine who is stationed overseas. She even wears a promise ring."

"How do you know she's not actually what she says she is?"

"She claims to have moved from northern California, but she doesn't know things a kid from California would know; she claims to be a Reds fan but doesn't seem to know anything other than minimal details about the Big Red Machine. Just stuff that doesn't add up. I marked her as different from day one, and I've paid attention."

"She'd have to be, what? Early twenties at the oldest? And from somewhere far enough away that nobody would recognize her from around town or whatever."

"The dead giveaway was her accent and dialect, which is obviously Philly."

"There's a Philadelphia accent and dialect?"

"Yep. Most people here might not notice, and the fact that you didn't know shows exactly why they don't. I noticed because I live in Pennsylvania and hear it all the time. I bet you know it, though, now that I think about it."

"Oh?"

"Have you heard Joan Jett speak?"

"In a radio interview. I just thought it was her."

"Another one is Chuck Barris, the guy from The Gong Show. The way they pronounce their vowels is distinctive. And it's distinctive from New York because, in Philly, they never drop their r's, with Boston being the most extreme on that."

"I don't think I could tell you any accents except 'Southern' or 'Boston'," I said.

"Because anyone you hear on national TV basically has a typical flat Midwestern accent, except when they need the accent for a reason, like on All in the Family or Hee Haw. National TV news is absolutely like that, so even Canadians like Peter Jennings sound like they're from the Midwest."

"I suppose this is a feature of growing up in a rural area of Ohio. The only accents I really ever run into are non-native speakers with Russian, Greek, or Middle-Eastern accents. Well, and the odd Hillbilly from Kentucky. Anyway, enough about narcs. Do you like teaching so far?"

"I love it! The great thing about math is that there are no opinions, no politics, no interpretations, just plain, objective answers. No matter what happens, two plus two is always four. Even at the highest theoretical levels, it is purely objective. A proof is a proof and can be verified by anyone with sufficient knowledge of higher mathematics. Computers help in some areas by being able to test those proofs by brute force."

"I hated proofs in geometry!"

Lara laughed, "Yes, but those are the very basis for showing that math is purely objective. You can't draw a square without four equal sides and four ninety-degree angles. If it doesn't have those, then no matter how much you want it to be a square, it's not a square!"

"And imaginary numbers?" I asked.

"A concept which lets us perform otherwise undefined operations, without which some forms of higher math wouldn't be possible. The fundamental theorem of algebra asserts that every polynomial equation with real or complex coefficients has a solution which is a complex number; that is, one of the terms has the imaginary unit i. You know about i, right?"

"I know it's the square root of -1, so if you need the square root of -4, you get 2i. Beyond that, no clue."

Lara nodded, "Because you stopped at calculus, and as far as I remember, nothing in chemistry or physics, even at the undergrad level, needs anything other than basic algebra and calculus. That said, I know you would have used Euler's number, or 'e', in your stats class."

"The standard normal distribution. We also used it in calculus because it's the base of the natural logarithm. I positively hated that part of calculus. The last half of the last calc class I took would have been enough to turn me off of a career in physics or engineering!"

"You stick to fixing broken bodies; I'll stick to solving complex math problems! And we'll both end up teaching what we know."

"Deal! How are things otherwise?"

"OK. Home is fine, but I decided not to see Steve again."

"Problems?"

Lara shrugged, "I need to clone you, minus the whole obedience to the bishop thing!"

"I didn't see the 'Doctor Frankenstein' module on the list of courses offered!"

Lara laughed, "He constructed the monster, but I get your point. They have cloned animals, right?"

"A zebrafish was cloned about five years ago, and that was the first vertebrate. Nobody knows if it will work with mammals, but there are investigations being done. The most challenging problem is actually an ethical one, or ones, really. The biggest concern is that much of the research requires the use of embryonic stem cells. That's especially fraught with problems for anyone who objects to abortion, not to mention the questions raised in Brave New World."

"What's your take?"

"You know my position on abortion, obviously, but I am reluctant to cut off research in areas where it might be possible to make tremendous advancements in medicine and science. That said, ethics have to be considered, which is why, for example, nobody wants to use the medical data collected by the Nazis during their evil reign. It's scientifically rigorous, minus the whole racial purity BS, but I wouldn't touch it with a ten-foot pole. That nightmare led to the so-called Doctors' Trial and the development of the Nuremberg Code."

"I know about Nürnberg, but not that part of it."

"That wasn't actually part of the main trials, but was held later, under US jurisdiction, as opposed to international jurisdiction like the ones that tried the military and politicians. These trials focused on the doctors who conducted the experiments I mentioned. Sixteen doctors were found guilty, and seven were sentenced to death by hanging. The end result was a ten-point code of ethics about medical experimentation, which included requiring the use of truly volunteer subjects; avoiding unnecessary pain and suffering; forbidding experiments where you know, in advance, death will result; no risk should be taken that is greater than the potential benefit of the resulting treatment; and the subject has the right to drop out if they believe they are at risk of death or permanent disability. There's more, but those are the key points."

"I read last year that they finally found Josef Mengele in South America, though he was dead, so they had to exhume the body to verify."

"He was, unquestionably, one of the most evil men to ever have lived and is a disgrace to the entire medical profession. So, back to boyfriends..."

"Fundamentally, I need an Orthodox guy, but they are few and far between. There are only a couple in the right age group, and one of them is out of the question completely."

"Nik."

"Obviously. His attitude towards women is, well, 'nineteenth-century Russia', to use that phrase you came up with for Tasha's dad."

"What about the new inquirer, Terry?" I asked. "He's a Junior, but older than you. He comes to church a few times a month."

"I haven't spoken to him."

"Mark and Alyssa brought him in, and they're friends with him, so I'd say talk to Alyssa and get her take. You might be just the nudge he needs to make the commitment!"

Lara laughed, "Nice, 'Petrovich'!"

"That would be a circumstance when Clarissa would use her pet name for me!"

"She and Tessa seem to be doing great."

I nodded, "They are. She's happy, and I get along MUCH better with Tessa."

"She seems to be way more laid back than Abby ever was. And speaking of 'lying back', how goes the baby-making?"

I laughed, "It's not a 'chore' by ANY stretch of the imagination, though we won't know if we've been successful for another two weeks or so."

"I hope for your sake your Kitten 'catches' because she's going to be supremely annoyed if she doesn't."

"TELL me about it," I said, shaking my head. "But I know from my studies that three to six months is typical, and up to a year is common. My fear is that if she isn't pregnant, she'll stress about it, and our medical texts say that can cause problems with conception."

"Leading to more stress..."

"Exactly. Nobody knows the exact mechanism, but it makes sense, if you think about it, that from an evolutionary standpoint, a woman under severe stress shouldn't get pregnant, as that would lead to potential gestational problems."

"It's so strange to hear you talk about evolution while you're wearing a cassock."

"If we assume that Genesis is myth, which you know I do, there is no contradiction. One could, metaphorically, identify Adam and Eve in the Garden as the point at which humans became self-aware and understood a basic moral code. If you look at the Old Testament as a whole, you see the evolution of self-knowledge and of a moral code. All of that is upset at the point of the Incarnation and reformed into the message that God is love. Jesus summed it up in one sentence."

"Love God and love your neighbor as yourself."

"Exactly. Or, to be pithy, 'God is love'."

"Changing subjects again, how is your cardiology rotation going?"

"Good. All my hard work to be at the top of my class is paying off because Moore Memorial Hospital wants me, and so I'm getting better treatment than most medical students. And I told you what the surgical Attending said."

"That's great! Dad still thinks you're wasting your talent."

"Your dad can ... well, nothing I can say wearing this cassock."

"Take a flying fuck at a rolling doughnut?" Lara smirked.

I laughed, "That phrase will work nicely, yes."

"For me, too. I've been investigating schools and I suspect I'll try for a job in Cincinnati. That lets me stay in the general area, though I'd have a long commute either to church or to work. You know money's not a problem, so I could do something like have an apartment in Cincinnati and a house in McKinley where I stayed on weekends and during breaks. Of course, a lot would depend on the future Mr. Lara, but that's a ways off."

"I think I mentioned my assignment for my OB/GYN Clerkship, which will be in Cincinnati."

"You did. That'll be in August, right?"

"Yes."

"I'm thinking of trying to do my second student teaching gig in Cincinnati, which could start at the end of August. It's either that, or start in January. I have to talk to the schools to see what openings they have. I have a guaranteed place at Hayes County High, so there's no risk. I just need to tell them I wouldn't be there in January of '88. You'll do the rest of your clinical work here in McKinley, right?"

"Probably. There are options to do visiting student work, which my counselor is encouraging. That would let me see how things are done in other hospitals, but with a family, that would be tough to do. She also suggested a stint with «Médecins Sans Frontières», but that's even more unlikely. Can you imagine me going to Africa for six months and leaving a wife and one or two kids behind?"

"You wouldn't make it out the door alive."

"No kidding! And I wouldn't want to."

We finished our lunch, and after Lara left, I joined my study group and Sophia for the remainder of our lunch period. Sophia left to join her study group, and our group went to the lounge, where we usually met to study. Things were fairly mellow, really, though they'd ramp up in January when we had to begin reviewing for the first part of the MLE, a major milestone on our way to earning our medical degrees.

November 9, 1986, McKinley, Ohio

"I've decided on Elias to replace Tasha on the Parish Council," Father Nicholas said after we completed our entrance prayers. "I spoke to him last night, and he's agreed to serve until the elections next June."

"That's good."

"Vickie will be attending Sunday school again starting today. Now that Kristin is six months old, she can go in the playroom with the other infants and toddlers."

"Good. I was surprised to see Debby in Sunday school last week."

"Like many of our kids who go to college, she was exposed to things she'd never encountered and began questioning her faith, or really, her entire worldview."

"I certainly encountered that in spades."

"Yes, but you were much better prepared than the average teenager, though I think you're doing a good job in preparing our teens. In the end, though, it's up to them, just as it was up to you. In your case, you took it as an opportunity to refine your thinking, not discard it. You had a few moments of crisis, but when all was said and done, it was your faith that got you through them."

"A few?" I asked.

Father Nicholas nodded soberly, "An understatement. And, honestly, you're still having crises of faith, though thankfully, the past few months have been calm. And hopefully, they'll stay that way. But again, to be honest, your faith has been strengthened by the trials and tribulations."

I smiled, "'For I am persuaded that neither death nor life, nor angels nor principalities nor powers, nor things present nor things to come, nor height nor depth, nor any other created thing, shall be able to separate us from the love of God which is in Christ Jesus our Lord' and, 'I can do all things through Christ who strengthens me'. Of course, those are easy to recite but difficult to live."

"Anything you need to discuss before we vest?"

I shook my head, "You heard my confession a week ago, and let's just say my schedule limits the opportunity for sin."

"Let's keep it that way, shall we?" Father Nicholas said with a smile.

"The strange thing is, I'll have a rougher schedule as a Resident, and THAT is when the opportunities for sin will be the worst because I'll be tired and overworked, which will weaken my defenses. It's why so many doctors end up drinking, taking drugs, having illicit sex, divorced, and so on."

"Being aware of it now is a good thing, and when the time comes, we'll work on strategies with Elizaveta to help you survive what amounts to a year of torture as an indentured servant."

"Someday, somebody is going to challenge the Match as a violation of the 13th Amendment, and it's not going to be pretty."

"Is there another way?"

"In Europe, they have a system that is not nearly so punishing, not to mention two years less of classroom work. They also don't have the Match, at least not in most countries. Students apply for open positions, and the local hospital or medical council decides who to hire."

"And I take it that tuition is covered by general taxation?"

"I suspect so, though I don't know that for a fact. My Residency will be paid for, at least partially, by Medicare taxes."

"I wasn't aware of that."

"Most people aren't. I don't know the full details, but I do know some of the funding comes that way, possibly even a majority of it."

"Does that bother you?"

"No, because it's a way of ensuring that there are sufficient medical training programs and that a hospital, in say, rural Louisiana or, closer to home, Appalachia, can afford to pay their Residents and run a program. While we're technically in Appalachia, I generally mean West Virginia and Eastern Kentucky. A big hospital like either Ohio State or the University of Chicago could easily run its own program to its own benefit, but Moore Memorial Hospital here in McKinley would have a tough time, and the hospital in Rutherford probably couldn't afford to do it."

"I take it that would have been your first choice growing up?"

"They don't have a proper emergency medicine department," I said. "There are no ER Residents there, only Surgery, Internal Medicine, and Pediatrics. They transfer most cardiac and oncology patients to Cincinnati, Dayton, or Columbus, for example. They're rated as a Level III trauma center, which means they don't have twenty-four-hour availability of all specialists, and for truly critically injured patients, they'll often just stabilize them and then send them via helicopter to a Level I center."

"What is Moore Memorial Hospital?"

"Level II. They're missing a couple of key specialties, and they don't have an organized research group, but the goal is to be a Level I center within five years. To turn Rutherford into even a Level II would take millions of dollars, which Harding County simply doesn't have. I could work there once I finished my Residency, but not before. And no, I have no plans to do that!"

"Thank God!" Father Nicholas exclaimed. "Shall we vest?"

November 11, 1986, McKinley, Ohio

"I thought holidays were irrelevant to medical practice," I said to Doctor Strong when I arrived at the hospital on Tuesday.

"We're not closed, we just don't schedule procedures on most federal holidays. Doctor Getty takes off Veterans Day and spends it with his dad and uncle, who both fought in World War II. He is on call if there's some major emergency, but Doctor Newsome, the Chief Attending, is covering the hospital today for cardiology. You wouldn't see much change in the ER because people still get hurt on holidays, and some, like the Fourth of July, see an increase in ER visits. Most services don't schedule procedures for holidays so that Attendings can have their holidays."

"Leaving Residents and lowly medical students to do the routine work."

"As they say, shit rolls downhill!" Doctor Strong declared. "On the plus side, I can spend time with you to go over EKGs while Jenny and Nicole handle patient checks and basic consults. I'll go down for verification of rule-out MIs after Jenny does the initial workup."

"I'm curious, if she goes down to do the workup, does she say she's a student?"