Good Medicine - Medical School II - Cover

Good Medicine - Medical School II

Copyright © 2015-2023 Penguintopia Productions

Chapter 6: Twins

February 13, 1986, McKinley, Ohio

"Michael Loucks to see Doctor Smith," I said to the matronly receptionist.

"He's expecting you. Do you have your completed family medical history form?"

"I do. Did you receive my medical records from Doctor Kleinman in Rutherford?"

"We did. You can go in through the door, then go to Exam Room 2. I'll buzz Doctor Smith."

I did as she'd instructed, and a minute later, Doctor Smith came into the exam room carrying a sheaf of papers in a typical medical folder.

"Hi, Mike."

"Hi, Doc. Thanks for making this special appointment for me."

"I'll probably be called up on an ethics violation for failing to make you sit in the waiting room for twenty minutes!"

I laughed, "It does seem that way!"

"We schedule based on what we expect, but one thing you'll learn is that the primary complaint might not be the reason they came in, nor is it often the first thing they say. In fact, it's often, 'Oh, by the way... '. Even taking a medical history and doing an exam doesn't reveal everything, which you'll also learn. And many patients lie."

"That's the one that floors me," I replied, shaking my head. "They taught us that in our Practice of Medicine class and every doctor I've done Preceptorships with has said the same thing. I just can't understand it."

"Ask on your psych rotation! Do you know if you have Lawson, Khan, or Raju?"

"I won't know until next week."

"OK. Anyway, I had a chance to review your files, and I see you have your medical history. Any highlights?"

I handed him the form.

"Mostly a whole lot of nothing. The usual set of childhood diseases, all the recommended vaccinations, and my last tetanus shot was two years ago."

"OK. Anything bothering you at all?"

"No physical complaints."

"Exercise?"

"I run about five kilometers five mornings a week."

"Diet?"

"Elizaveta is a superb cook, and I pack my lunch most days. Well, Elizaveta packs it, but what I meant is I don't eat cafeteria food except on Monday mornings when my study group has breakfast. Lunch is usually a sandwich and fruit, and depending on the day, carrots, celery, or other vegetables."

"Junk food? Pop?"

"The occasional candy bar plus popcorn and ice cream. I do drink a lot of soft drinks."

"You'll want to watch that. Coffee and tea?"

"Both."

"Medical student quantities?" he asked with a smirk.

"Definitely!"

"Are you getting enough sleep?"

"Yes. I've never needed a lot, and I'm a morning person; very early morning. I usually get about six hours a night, sometimes a bit more."

"Alcohol intake?"

"Very low. I've never really drunk beer, and when I do drink, it's almost always a glass of wine or two with a meal. Well, besides the vodka that is obligatory for Russians on certain occasions. I'm very careful about that, and intend to basically teetotal when my clinical rotations begin."

"A good strategy. Do you smoke?"

"No."

"Any current medications or past or present use of illegal drugs?"

"No to both."

"Do you see a dentist?"

"Not since High School."

"You'll want to do that. Even regular brushing and flossing isn't sufficient."

"OK."

"Do you see any other doctors for any reason? I mean, other than your education or socially?"

"Doctor Mercer, a clinical psychologist in Milford. Mostly, that's been about helping my friend Angie, who suffers from schizophrenia, but I've spoken to Doctor Mercer about some stressful things that happened during college, and Elizaveta and I saw her for pre-marital counseling."

"No diagnosis?"

"No."

"All your relatives are still alive back two generations?"

"All four grandparents, plus my uncles, aunts, cousins, and my sister."

"History of heart disease or diabetes?"

"My paternal grandfather needed angioplasty about a year ago. He's fully recovered?"

"Risk factors?"

"A Bible-believing Calvinist, so no smoking or drinking, and a good diet."

"I assume the details are on the form?"

"Yes."

"Are your parents still married?"

"No, they're divorced."

"When?"

"Last year. Why?"

"Stress. Being in medical school is stressful enough without other things providing stress. I know your marriage is doing OK unless something changed since we had dinner."

"Nothing has changed; everything is fine."

"You were sexually active before you married?"

"Yes."

"Ever had an STD?"

"No. My friends and I all went for tests."

"Why?"

"Two gay friends strongly encouraged us."

"OK. Anything else you think I should ask about?"

"Nothing comes to mind."

"Then go ahead and strip down to your underwear, and I'll do the exam. No need for the gown unless you want to put it on."

I stripped down to my briefs, then got onto the exam table so that Doctor Smith could do a complete physical.

"Fit as a fiddle, I'd say," he pronounced when he'd finished. "I'll draw some blood. I don't usually do it, but my nurse is at lunch. I promise not to need to try more than three or four times!"

I laughed, "I keep thinking about the poor patients when I have to do my first 'real' IV and 'real' blood draw."

"It's your fellow students you should worry about because you'll practice on them first!"

"True, but the real test is in a stressful situation."

"That's why you practice until you can do it blindfolded, though I wouldn't recommend that."

He drew two tubes of blood, getting the needle into a vein correctly on the first stick.

"That will do it unless there's something else you want to talk about or have me check. If not, you can dress."

I began dressing while we continued talking.

"Nothing comes to mind. I don't really get sick. When that bad bout of flu went around a couple of years ago, I had one of the milder cases, though it did knock me on my butt for about twenty-four hours."

"OK. I'll see you in a year. Just call the office, and we'll arrange for something that fits our mutual schedules so you can be in and out quickly."

"Thanks, Doc."

"You and Elizaveta should join us for dinner again. I'll speak to Candace about it, and one of us will call."

"Sounds good."

I finished dressing, we shook hands, and he went to his private office while I went to the front desk and paid the $10 co-payment required by the Medical School health plan. That taken care of, I drove back to campus and joined my study group, who were just gathering.

"I hope you don't mind if I eat while we study," I asked.

Nobody did.

"Everything check out OK?" Fran asked.

"Yes. Obviously, the blood work will take a few days, but nothing abnormal during the physical."

"Great! Shall we get to it?"

Four hours later, we finished, and after we gathered our books, Clarissa and I took our usual walk towards our cars, which were always parked at the far end of the lot.

"Do you know just how tempted I was to say that Elizaveta gives you thorough physicals on a regular basis?" Clarissa asked.

"Oh, I'm sure! But then you realized that it would offend Maryam, so you refrained."

"Exactly! My OTHER comment would have been it wasn't a psych exam!"

"As if I'd deny that!"

"What are you and your pussy cat doing tonight?"

"Dinner then mutual, thorough, repeated physical exams!"

"So, just another Thursday at the Loucks household?"

"She's a bit hornier than usual this week."

"Poor baby!"

February 14, 1986, McKinley, Ohio

"Happy Valentine's Day, Kitten!" I said when we woke on Friday morning.

"Happy Valentine's Day, husband!"

I reached over to the nightstand, opened the drawer, and extracted a card I'd purchased on the way home on Thursday evening. I handed it to Elizaveta and wasn't surprised when she pulled a card from the drawer of her nightstand. Both cards were equally romantic, and we shared a kiss.

"I thought we might stay in bed this morning," I suggested.

"Yes!" Elizaveta squealed happily. "I thought I wore you out last night!"

"Not even close!"

We spent the next hour screwing energetically, then took a loving shower together before going to the kitchen so Elizaveta could make breakfast for us.

"What time are we meeting tonight?"

"5:30pm at the Chinese place. Jocelyn and I discussed it, and they're cool with going there, so we can stick to our fasting rule. José and Dona are cool with pretty much anything."

"You used to have triple dates on Valentine's Day in High School, right?"

"Yes. Only during my Senior year was my date my girlfriend. Jocelyn had a steady boyfriend, and Dale had a steady girlfriend every year."

"I find it hard to believe you had such trouble finding a girlfriend in High School."

"There were no girls of appropriate age at church, something for which you should be VERY thankful!"

"Tasha?"

"Was three years behind me, and her dad wouldn't allow us to date, even had I worked up the courage to ask her!"

"You're so funny! What happened when you graduated?"

"I discovered my sister's friends were all interested! Emmy and I started dating right after graduation. And then I came to Taft and Clarissa, Sandy, and Sophia whipped me into shape with some help from some other girls. But my luck wasn't much better at first."

"Then Mrs. Sokolov matched you with Katy, right?"

"Yes. Tasha and I were allowed to see each other occasionally, and she knew I was seeing Katy, but Katy and I were never steady. I'd promised Tasha that I wouldn't make any commitments like that to anyone before she and I had our talk after her graduation. So I just dated casually, until Janey, and you know who I chose when push came to shove."

"Tasha, obviously."

"Obviously. But you know how that turned out, much to your benefit."

"Yes, but did you really have to fuck two dozen girls?"

"Have to? No. Did I? Yes. I'm not making any excuses, Kitten."

"You're not to share THAT with our children, either."

"You really disagree with how my mom acted once I graduated."

"I think she gave you the excuse to justify your inappropriate behavior. I know you think you're responsible for what you did, and you are, but what she said made it much easier for you to sin and keep on sinning."

"I thought we were past this," I said warily.

"I wasn't getting on YOUR case, Mike; I was getting on your mom's! And I think it's important we discuss how we're going to raise our kids."

"Yes, though I think we have a few years before we need to worry about the 'birds and bees' talk! I think we have to make babies, then feed them for a dozen years or so before we need to think about that talk."

"And until then, practice!"

"I think we're pretty good at it, so we can probably stop practicing."

"Do you want to DIE, husband?"

"Perhaps we can continue practicing."

"Perhaps?"

"I promise to do my best to fuck you senseless tonight after the movie!"

"I'm going to hold you to that!"

We ate breakfast, and Elizaveta left for school. I settled down on the couch with my pathology book and studied the material for the day's lecture and lab, which would involve looking at various liver sections. We weren't at the point of making diagnoses — that would come during Second Year. Our goal was to learn to identify normal and abnormal samples. Just as I was putting the book and my notes into my satchel, the phone rang.

"Loucks residence," I said when I answered the phone. "Deacon Michael Speaking."

"Good morning, Mischa," my grandfather said.

"Good morning."

"Would it be possible for you to be in Pittsburgh at any time on the weekend of the Sunday of Orthodoxy?"

"It would have to be on Saturday, which would mean missing band practice and a study session. And if I were to miss Vespers, I'd have to let Father Nicholas know why. And in doing that, I'd be admitting that I violated the instructions of both Bishop ARKADY and Bishop PAUL, and it would be very likely I'd be seriously disciplined and likely deposed from the diaconate. And if I don't ask permission, I directly violate the canons and would likely be deposed."

"There is one option you haven't considered."

"Which is?"

"That the Metropolitan invites you to a meeting directly. It would be incumbent on him to inform Bishop PAUL and Father Nicholas. You would have no responsibility in that case. I can arrange it through Viktor Ivanovich Federov in Pittsburgh and Pyotr Borisovich Krasnov in New York. Both men sit on the Archdiocesan Council. Both, obviously, have an interest in preserving not just Holy Transfiguration, but the Church, and both men abhor corruption as only we who escaped the Soviet Union can do."

It was a neat avoidance move, though it seemed awfully transparent and was unlikely to stand up to serious scrutiny. Ultimately, my fate, and that of my grandfather and his friends, would rest with the new bishop. And to add a bit more to the intrigue which was going on, my grandfather and his friends could influence the election, as could I. I sighed deeply because I was being dragged into Church politics, but I didn't see any way out except to do nothing.

But, knowing what I did, there was, in my mind, no way I could do nothing. While it wasn't directly parallel, it called to mind the situations with Dean Parker and Tim Saddler, when things had reached a point where I could no longer avoid a confrontation. And really, when it came right down to it, I wasn't really risking anything other than my ordination, and ultimately, I could be faithfully Orthodox without being a deacon, serving as a catechist, or doing anything other than worshiping and raising faithful children.

"Have you shared the details with Lara's grandfather?" I asked.

"Yes. I had to do so to enlist his assistance. I trust him and his son. Your father-in-law is friends with his son. Nobody will involve your father-in-law, because we don't want to cause any additional trouble, given his position as Parish Council President at Saint Michael. On the other hand, these sexual escapades need to stop, and that needs immediate attention and a firm hand, if Holy Transfiguration is to survive."

"As much as I hate the politics and, pardon the expression, the intrigue, I don't feel as if I have a choice. If the Metropolitan invites me, I'll meet with him."

"Good. These men with whom I'm working, they are good men to know, and they are now your friends, Mischa. You may call on them for any reason at all, and they will help in any way possible. Cultivate your friendship with them and their sons."

"Your own subversive cell?" I asked with a chuckle.

"Perhaps, but a faithful one, nonetheless. Viktor Ivanovich suggested that you meet the Metropolitan at the Monastery of the Transfiguration in Ellwood City. That will ensure no gossip or speculation."

"Cloak and dagger?"

"You know that people will talk, and that would complicate matters further and make it much more difficult for the Metropolitan because rumors would spread like wildfire and cloud the truth."

"True."

"Pyotr Borisovich will arrange with the Metropolitan to send you a personal letter of invitation. That way, you have proof."

Which might or might not help, as the Metropolitan wasn't my bishop, and while he would preside at meetings of the Holy Synod, and had the right to hear appeals, what he didn't have was the right to interfere in the diocese of a brother bishop. There was a tiny bit of wriggle room because Bishop ARKADY had been suspended and Bishop PAUL was a locum tenens appointed by the Metropolitan, but I was unsure how that might play out.

"Then I'll wait for the letter."

"Good, Mischa."

"I'm sorry, but I need to get to school."

"It's OK. We've finished our conversation for now. Thank you."

"You're welcome."

We said 'goodbye', I hung up, and headed to school wondering just what it was I was walking into.

"You're late, Petrovich! We need to hurry if we're going to get our coffee!"

"Sorry. My grandfather called. As Clark would say, shit's about to get real."

"What's going to happen?"

"My grandfather activated his network of friends and is arranging for me to meet with the Metropolitan at a monastery near Pittsburgh. I'd go early on Saturday morning, meet with the Metropolitan, then return in time for Vespers. Or maybe drive up on Friday night and stay at the monastery. Basically, I'd miss a band practice, the weekly family dinner with the Kozlovs, and, of course, our study session."

"And that keeps you out of trouble?"

"Maybe. It's not totally according to Hoyle, but in the strange circumstances we're in, it might be enough."

We had to stop our conversation because we entered the building. We bought our coffee in the cafeteria and hurried to class, where we sat down next to the other members of our study group just as the lecture began. I didn't really have a chance to talk to Clarissa for the rest of the day, and when classes finished, I had to hurry home so I could get Elizaveta and we could join Jocelyn, Gene, José, and Dona for our Valentine's Day triple date.

"My grandfather called this morning," I said after Elizaveta and I got into my Mustang to drive into town.

"And?"

"He and his friend in New York hatched a plan together with Lara's grandfather and dad for the Metropolitan to invite me to meet him at Transfiguration Monastery near Pittsburgh."

"When?"

"The Saturday before the Sunday of Orthodoxy. I'd either drive up Friday evening or very early on Saturday morning. Obviously, I'd miss band practice, our family meal, and my study group. I'll receive the invitation by letter."

"That's good, but is it enough?" Elizaveta asked, sounding concerned.

"Who knows? But I have to do it."

"I think so, too. It just stinks that doing the right thing might cost you your position."

"And if it does, then you and I will raise faithful kids while I train and then practice medicine."

"Jocelyn called earlier — she wanted to make sure that we were OK with seeing Hannah and Her Sisters. It's a romantic comedy that's rated PG-13."

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