Chapter 52: Transitions

May 9, 1987, McKinley, Ohio

"How did it go?" Elizaveta asked when I finally arrived home on Saturday evening.

"I'm confident we studied properly and that we all did well. That's Clarissa's assessment as well."

"There's a letter for you from the hospital."

I went to the basket where Elizaveta put my incoming mail and used a letter opener so I could extract the papers inside. It was, as I'd expected, the June surgical schedule.

"For the first two weeks of June, I'm on a regular rotation, which means pre-rounds begin at 5:00am," I said. "My day ends at 5:00pm."

"That's a LONG day!" Elizaveta protested.

"Longer, actually, because I'll need to arrive by 4:30am or so to gather charts and check on any pre-op procedures."

"Ugh! What happens after two weeks?"

"We're covering the ER for consults and we'll be on call. I'll have a pager, and could be called in at any hour of the day or night."

"How will you handle that in church?"

"I'll discuss it with Father Nicholas, but most likely, I won't serve when I'm on call because it would be terrible to basically walk out in the middle of the anaphora or as I'm serving the Eucharist!"

"And after that week?"

"Then one more like the first two. The July schedule will be published in early June."

"OK. I know it's what we prepared for, but you're going to be dead tired."

"I know."

"It's too late to go to Vespers tonight, so what do you want to do?"

"Relax," I replied. "Even though I'm positive I did well, it was a stressful day with only brief breaks."

Elizaveta smiled and her eyes twinkled.

"Sit down on the couch and I'll help you relax!"

"Let me take off my cassock first, please."

She nodded, and I went to the bedroom and took off my cassock, then changed into sweatpants and a long-sleeve T-shirt before going back to sit on the couch. Elizaveta knelt on the floor in front of me and hooked her fingers in my sweatpants and briefs. I lifted my butt so she could draw them down and off, which she quickly did. I chuckled to myself that I'd wasted my time putting on my sweatpants.

She began by kissing the inside of my thighs, then along my semi-flaccid shaft. The string of kisses was followed by my sexy young wife running the tip of her tongue around my glans, then from the tip to the base of my dick. That was all it took for me to come to full mast, and Elizaveta responded by taking my glans into her mouth, sucking gently, and swirling her tongue around.

I really enjoyed watching my wife perform oral sex, and watching made it more erotic than closing my eyes and leaning back. The sight of her lips closed around my shaft always caused me to become rock hard, and this evening was no exception. Elizaveta grasped my shaft with one hand, cupped my sack with the other, and began bobbing her head and stroking me. She knew exactly how to bring me off, but she always took her time, because she enjoyed giving me head as much as I enjoyed licking her pussy.

With each bob of her head, each swirl of her tongue, each suck, each stroke, and each gentle squeeze of my sack, pleasure built and stress decreased, culminating with me groaning loudly as I blasted cum into Elizaveta's mouth and she lashed my glans with her tongue while pumping my shaft with one hand and squeezing my sack with the other.

When the tremendous orgasm had passed, I leaned back and closed my eyes while Elizaveta bobbed a few more times. When she released me, she moved up into my lap, leaned against me, and touched her lips to mine. I French kissed her and discovered that my little pussy cat hadn't swallowed. Not being a complete idiot, I simply went with it until she finally broke the kiss.

"Sassy!" I chuckled.

"That kiss earned you another blowjob!" she giggled. "And they'll keep going if you keep kissing me!"

"What about you?" I asked.

"Yeast infection," she said. "I went to the drugstore this morning after you left."

"When did you discover it?"

"When I got up, I suspected it, but I didn't want to worry you. I called Doctor Forsberg and went to see her, and she suggested an over-the-counter cream. It'll clear in about a week."

"How bad?"

"Not too bad, actually. I noticed some itching yesterday, and it was worse this morning. It actually worked out better that we just went to sleep last night instead of fooling around."

"If I remember correctly, high levels of estrogen increase the risk of candidiasis, the medical term for a yeast infection. It's treated topically during pregnancy, but otherwise, with an oral medication. I'd have to look up which ones, but I remember the distinction between how to treat pregnant women versus those who aren't pregnant."

"I can't even begin to imagine how much is crammed into your head!"

I laughed, "Me either, though some of my closest female friends would insist that there is nothing there! Clarissa likes to call me a 'blockhead' in Russian."

Elizaveta laughed, "She's not wrong!"

"Hey!" I protested.

"As much as I love you, and as smart as you are, you can still be such a boy!"

"Thank you!" I declared.

Elizaveta laughed, "I suppose being a boy is a good thing at times."

She reached down and took hold of my flaccid member, kissed me, and began gently stroking. When she had me hard, she slid down and gave a repeat performance before kissing me, once again with her mouth full of cum. She gave me three more blowjobs before we finally went to bed, where we snuggled close and fell asleep.

May 12, 1987, McKinley, Ohio

My third to last Preceptorship at Medical Practice Associates followed the pattern of the first five — I watched and listened while the doctors and nurses took histories, performed exams, gave injections, and drew blood. It was truly a blessing when the day ended, as I was struggling to care. I knew the importance of annual physicals, but I was not cut out for anything like that. Even internal medicine at the hospital was, in a sense, too tame for me. I needed something like emergency medicine or surgery to challenge me and, strangely, energize me.

"Only two to go," Maryam said as we left the building. "I can see that you're struggling."

"Struggling to stay awake!" I declared.

"I'll do some of this in a cardiology practice," she said. "But I'll also do surgery, angiograms, and a host of other procedures."

"And I'll take histories in the ER or on the surgical service. I was seriously less bored in radiology!"

"My least favorite was OB/GYN because of ... well, you know."

For Maryam, it was a modesty informed by a combination of her Syrian Arab culture and traditional Orthodox teaching. For her, revealing her private parts to anyone except her husband after she married was taboo, though I knew she did have annual gynecological exams.

I nodded, "I understand. Elizaveta is uncomfortable with the idea as well."

"It's a difficult balance," Maryam said. "I understand we have to learn, but my specialty won't involve that at all."

"I know the cultural concerns, because Russians have similar ones, but medicine is not about sex. I realize it's difficult to internalize that, but you need to, at least for our OB/GYN Clerkship. We'll be delivering babies!"

Maryam smiled, "That actually will be very interesting, despite the part of the body that has to be exposed."

"There was a reason why midwives did all the deliveries," I said. "And I'd be OK with going back to that, so long as medical services were nearby and easily accessible."

"And excluding men from delivering babies?"

"No, but I'd certainly leave that up to the woman. I mean, it's her body that's on display, so it has to be up to her."

"I agree, obviously. See you in a few hours, Deacon!"

We parted, and each went to our cars, and I headed home to have dinner with Elizaveta before study group met.

"How are you feeling today?" I asked after she greeted me with a kiss.

"The itch is basically gone, but Doctor Forsberg instructed me to follow the entire seven-day course."

"That is the guideline for antibacterial and antifungal medication. Just because the symptoms clear up doesn't mean the infection has cleared."

"Go change, please. Dinner will be ready in fifteen minutes."

I did as Elizaveta asked and five minutes later, I was in the kitchen.

"What's the plan for your graduation?" I asked.

"After the ceremony on Saturday morning, we'll have a graduation party in the main house. There are other parties, but I don't think I'll attend. The important friends will come to mine."

"OK."

"Back to your surgical rotation, what time do you think we'll go to bed and get up?"

"If I have to be at the hospital at 4:30am, then I need to get up around 4:00am. I'll take a quick shower, dress, eat something, then head to the hospital. Working backwards, that means going to bed between 8:00pm and 9:00pm."

"I'll go to bed with you and get up with you," Elizaveta said. "I can make your breakfast while you shower, and if I need more sleep, I can go back to bed or nap later in the day."

"So long as you take care of yourself and Rachel Michelle!"

"And you, Mike!"

We ate our dinner, and I helped Elizaveta clean up, exchanging a kiss for each item I had to dry. We finished just before my study group arrived. Elizaveta left to spend time with some of her friends just as our study group began.

May 14, 1987, Circleville, Ohio

On Thursday Elizaveta and I went out with Jocelyn and Gene, something I wished we could do more often, but given my schedule and Jocelyn's law school schedule, it was difficult. She had a very good study group, similar to mine, and they studied nearly as many hours as we did during the course of a week. Gene's load of coursework was heavy, but nothing compared to Jocelyn's and mine.

"How are your hips?" I asked Jocelyn when we sat down at the steakhouse near Circleville.

"You ought to know!" she smirked.

"Medically, woman!" I chuckled, happy that Elizaveta had laughed, not frowned.

"About the same. My last checkup was good, and the way things are going, I'll probably need another laminectomy in about five years, which is two or three years past what they had expected. The progression of the arthritis isn't nearly as bad as they expected, either."

"That's great news, because that's the real problem."

"I do not look forward to hip replacement surgery, but it beats not being able to walk."

"For sure. And every year you can delay, the better the equipment and procedures become."

"How are things with your parents?" Jocelyn asked.

"Mom is going to marry her boyfriend," I said. "And Dad, Holly, and Peter are doing OK."

"And your sister?"

"She and Paul are doing well. I suspect we'll get a pregnancy announcement sometime in the next few months."

"She was adamant about not wanting kids too soon."

"Things change," I replied. "I think the fact that Elizaveta was pregnant at seventeen, and Tasha had her baby at nineteen, had an effect. It seems babies cause babies!"

"You know better than that!" Elizaveta said mirthfully.

"Cause and effect, Kitten. Not action!"

"Babies do NOT make me want to have sex," Gene said. "Quite the opposite!"

Jocelyn smacked his arm, but she was laughing.

"NOTHING stops you from wanting to have sex!" she declared. "Trust me! I know!"

"As if you have room to talk!" he retorted.

"I think we all like sex," Elizaveta giggled. "A lot!"

A waitress came to take our orders and brought our drinks and salads shortly thereafter.

"How was your exam, Mike?" Gene asked.

"We were well prepared. I should have the results early next week, and I'm positive I did well."

"What's 'doing well'?"

"Anything above 80th percentile is enough to guarantee a Match at Moore Memorial, and I expect to hit at least the 90th, and probably higher. It's all relative, so a lot depends on everyone else who takes it. And percentile rank is what matters, because raw scores change when the test changes. It appears more changes are coming in the next few years."

"What's next?" he asked.

"You mean for tests? The second part of the MLE, which we take at the end of Fourth Year. All you have to do is pass it to graduate. Most people don't take the exam until after they've Matched."

"What happens if you fail?"

"You can take it a second time, but that's it. If you fail twice, your Match is canceled and then you have to try to Match the following year. Most people who fail twice don't bother."

"That would be rough! What do they do?"

"According to my counselor, they usually get a PhD in biochemistry and do research. Some of them retake the test to have their MD conferred, but don't try to Match."

"Jocelyn, not that this will happen, but what happens if you fail the Bar?" Elizaveta asked.

"You can retake it until you pass, but most firms only give you two shots at it before you're dismissed. You're hired provisionally, and one of the provisions for making the position permanent is passing the bar within a certain amount of time. Because of the rules for how soon you can retake it, that mostly works out to twice, possibly three times."

"What happens then?"

"You keep trying, and then try to find a new job, or hang out your own shingle. If you can't pass the bar, you can teach law school!"

"Now THAT is crazy!" I chuckled. "At least in medical school, everyone who teaches us is a doctor! How can you teach law without being a lawyer?"

"Couldn't a PhD biochemist or someone with a PhD in, say, epidemiology teach at least some of your classes?"

"They could," I agreed. "But that's not how it works."

"OK, but the point is, being a legal scholar doesn't require you to have a law license any more than being a medical researcher requires you to have an MD in every case."

"Point taken," I said. "That old saw about those who can't do, teach?"

Jocelyn laughed, "Yes!"

We finished our salads and our main courses were brought to the table, and we all dug into our steaks, baked potatoes, and steamed vegetables.

"Mike, do you know what's happening with Cincinnati?" Jocelyn asked a few minutes later.

"I won't get any details until the end of June or early July, but Angie's mom offered Elizaveta their guest room, so I can avoid having to drive home so often. Of course, we have to balance that with Elizaveta being eight or nine months pregnant. Her friends have agreed to drive her back and forth, though I'd say that will only be for the first week, and maybe the second, because I know Doctor Forsberg will tell Elizaveta not to travel for the last couple of weeks."

"Where do you stay?" Gene asked.

"With a doctor who is on the OB/GYN service and their family."

"What about church?"

"I'll probably go to the same church Angie goes to in Loveland, but there's an OCA parish near the hospital as well. I'll have to work that out with the bishop and see what he wants."

"How is that relationship?" Jocelyn asked.

"Very good," I replied. "Vladyka JOHN is awesome and we have a very good relationship."

We continued chatting and eating, and when we finished our main courses, we had dessert, and then Elizaveta and I headed home, as we both had to be up for school the next morning.

May 18, 1987, McKinley, Ohio

My letter with my MLE scores arrived on Monday. Much to Elizaveta's annoyance, I refused to open it, as our study group had agreed to open ours together. That meant it was possible it wouldn't happen until later in the week.

"How can you not open the letter?" she groused after dinner.

"Because I'm patient," I said. "And I'm positive I passed. It's just a matter of how high my score is."

"You can be very annoying at times!"

"Only at times? I'm obviously not trying hard enough!"

"Careful, husband!"

"Or what?" I chuckled.

"I'll find something that bothers you!" Elizaveta said, trying to sound menacing.

"Good luck with that," I chuckled.

She screwed up her face but didn't respond. I held out my arms, we hugged, and then I put out the snacks we usually served for study group. The group arrived on time, as they usually did, and everyone had their scores with them.

"Who goes first?" Nadine asked.

"Petrovich," Clarissa said. "That way we can just get the best score out of the way!"

"Thanks for the vote of confidence, Lissa!"

"Go on, Mike," Fran said.

I used the letter opener to slit open the envelope, extracted the score sheet, and smiled.

"99th percentile," I said.

"Unreal," Nadine said, shaking her head.

"Lissa?" I asked, handing her the letter opener.

"98th percentile! Petrovich beat me by one again!"

Fran went next and was 96th percentile; Maryam was also 96th percentile; Nadine was 92nd percentile; and Peter was 93rd percentile.

"We nailed it," I said. "Those numbers will get all of us into any Residency program in the country."

"Wanna trade?" Nadine asked. "You don't need yours for Moore Memorial Hospital!"

"True, but 92nd means you'll get an interview at any hospital that interests you. Your class rank is improving as well, and all of us will be in the top 20 students by the end."

"That'll be tough because I'm still only 27th."

"Every year someone in the top twenty has a poor test result," Fran said. "That doesn't affect class rank directly, but they can't start their Clerkships until they pass, which puts them behind pretty quickly. And there are always a couple of top 'book learning' students who struggle with clinical work. You're getting there, so just keep it up!"

"Is there any need to meet as a group after our Clerkships begin?" Peter asked.

"Tired of us already?" I asked with a grin.

"Not at all! It's a question about group study. We'd still have Friday nights."

"Our schedules are going to be such that we won't have the same times available," Clarissa observed. "Not to mention our clerkships will be different, except for Mike and me, because we matched our schedules. We won't even all be in the same classroom sessions because of that. Everyone has Friday evening free, right?"

"I should be semi-coherent by then," Maryam said. "I have overnight shifts and I'm off at 11:00am on Friday. I'll go home and sleep so I can join the group for our usual evening together."