Chapter 67: Rachel Michelle Loucks

August 22, 1987, McKinley, Ohio

"Hi, Kitten," I said when I walked into the house on Saturday afternoon.

"Hi!"

"Nothing yet?"

"No," Elizaveta groused. "I called Doctor Forsberg today, but she said to wait another five days before I go see her. Could you check my blood pressure and stuff?"

"Yes, but if I find anything, I have to call an actual doctor."

"I know," she replied.

I opened my medical bag and took out my equipment, then checked my wife's blood pressure and her pulse, and listened to her heart and lungs. In my bag, I also had a Pinard horn, which was an old-fashioned way of listening for a fetal heartbeat that Doctor Evgeni had given me, as he no longer used it. I now had a chance to use it because I didn't have access to a Doppler fetal monitor.

"What's that?" Elizaveta asked.

"A Pinard horn. It's what doctors used before ultrasound and hand-held Doppler fetal monitors. It was invented by a French obstetrician, Adolphe Pinard, in the 19th century. He was one of the first advocates for prenatal care, including fetal monitoring. It will put a bit of pressure on your stomach, but I'll be able to hear Rachel's heartbeat."

"OK."

I hadn't used the device before, but I had a good idea of the principles of how it worked, and after a bit of trial and error, I heard the clear 'whoosh-whoosh' of Rachel's heartbeat. I counted while watching the secondhand on my watch.

"120," I said. "That's perfect. You and Rachel are in great shape. She's just being stubborn, like every other Russian woman I know!"

"Husband..." Elizaveta warned.

"Tell me it's not true!" I demanded as I put away my stethoscope, blood pressure cuff, and Pinard horn.

"I'm just tired."

"Want me to lie down with you?"

"That's how I got into this condition!"

"I may not have finished medical school, but I'm pretty sure it takes more than simply lying next to you in bed!"

"Right, because being in bed together doesn't lead to OTHER things!"

"It's possible," I replied with a grin. "Let's go lie down."

We did, and after about an hour, Elizaveta woke up feeling somewhat better. I knew she was tired when she allowed me to make us something to eat. We'd just finished eating when the phone rang. I got up to answer it.

"Deacon Michael's residence; Deacon Michael speaking," I said.

"Mike, it's Mom."

"Hi, Mom."

"First, how is Elizaveta?"

"She'd like nothing more than to have the baby today, but your little namesake is being stubborn, like every other Russian woman I know!"

"Husband..." Elizaveta warned.

Mom laughed, "There might be some truth to that!"

"Rachel is doing fine with a strong heartbeat and Elizaveta's vitals are all fine."

"Good. Stefan and I met with Mrs. Abbott and we decided to apply to become foster parents."

"That's great news!" I exclaimed. "Now give me the bad news."

"It could take three months for us to be fully 'vetted', as she called it, including background checks, credit checks, reference checks, interviews, and so on."

"Do you know what happened with Elaine?" I asked.

"You don't?!" Mom asked, sounding surprised.

"No. I saw her on the Friday evening before I called you and said 'goodbye', but I don't go to the hospital on Saturdays, Sundays, or Mondays, and I could get in a bit of trouble for getting involved in a patient's life."

"You said that, but I find it difficult to believe that you would get in trouble."

"It's not anything that would create a huge problem for me, as I said, but as doctors, we're supposed to leave the social work to the social workers, and focus on medicine. Technically, I got too close to her for the guidelines, though there's no actual ethical violation because that mostly only applies to psychologists and psychiatrists."

"She's being placed with a temporary foster family with a goal of reconciliation with her parents. They're adamant that Elaine has to give April up for adoption, and she's refusing to do so under any circumstances. Family Services concluded that Elaine is intelligent, responsible, and loving, and with proper parental support, she's able to care for April."

"From my interactions with her, I agree. I take it they're opposing the placement."

"Yes, but if they don't come around and demonstrate to Family Services a true change of heart, then Family Services will place Elaine and April with a permanent foster family."

"How long do they have?"

"About the same length of time it will take for us to be approved. Family Services will petition to terminate the Webbers' parental rights. They can apply to have them reinstated, though that would require a thorough investigation by Family Services. After a time, Stefan and I could, if we chose to, formally adopt Elaine."

"So I'll have another sister? Tell me how that's a good thing?!"

"Oh, stop!" Mom said, laughing. "That's exactly what you want because you feel you failed Liz when she was in a similar situation. And you think this gives ME a chance for a do-over!"

"Maybe subconsciously," I allowed, "but I didn't think about that before you mentioned it. Have you mentioned the possibility to Liz?"

"Yes. She laughed and shook her head and said it fit your personality. But she also said she could relate."

"The circumstances are a bit different," I replied. "But I think Liz would be a good mentor for Elaine."

"I take it you're aware of the charges against the baby's father, right?"

"Yes. Did Mrs. Abbott tell you?"

"No. Stefan read the report in the Cincinnati Enquirer and then spoke to someone at the Court to get the exact charges. Stefan believes a plea bargain would result in ten years. If the guy were to go to trial, he could get thirty. According to the paper, he denied everything."

"With no baby, he might have a chance, but they can use the new DNA testing methods to confirm he's the father. They're at least 90% accurate now, with some claims of 99% accuracy. They're awfully new, and haven't been tested in court, but if there was a possible test case, I'd have to say this is it."

"You seem to have a different opinion than you did with your sister."

"Forty-five is not twenty-four, and from my understanding of what happened, it was abuse. With Liz and Paul, it's a grey area, and Dad and I came down on opposite sides. Of course, he effectively removed his 'age difference' argument by marrying a girl younger than me after getting her pregnant!"

"Ten years is still too much at fourteen," Mom said. "But I know you've accepted Liz's side of the argument."

"Only for the purposes of supporting and loving her. And you have to agree that Paul has been an exemplary husband."

"I do. But, as that proverb your grandfather uses so often says, 'Trust, but verify'."

"That has come into play in my OB/GYN rotation. Doctor Kelly, my Resident, trusts me, but she's required by one of the Attendings to verify everything I do. It makes sense, of course, because I'm still a medical student. I get to do some very basic doctor things, but I still have a ridiculous amount to learn."

"When are you heading back to Cincinnati?"

"Very early Tuesday morning, just as I did last week. I'm tempted to stay, but I don't want to waste any of the seven days I'm allowed to be away. Elizaveta agrees, because she and I want as much time together with Rachel as we can get. I'm in Cincinnati until the end of September. Fortunately, Doctor Cooper is OK with Elizaveta and Rachel staying with me. Our plan is, assuming Elizaveta is up to it, for the two of them to come with me when my seven-day leave is up."

"That sounds like a good plan. Let me know if you need anything."

"I will. And thanks for your help with Elaine."

"You're welcome."

We said 'goodbye' and hung up, and I went back to the couch where Elizaveta was sitting.

"They're going to do it?" she asked.

"They're applying. They have to go through a complete check, and I don't know how that will turn out after what happened with Liz, but what's in the Family Services files can't include any of the stuff about me. It was all deleted and the court records were sealed. No substantiated accusations were made against my parents. Obviously, I don't know Stefan's background, but he has a law license, which means he passed the checks the Bar Association does. And being a lawyer, he'll be able to navigate any obstacles."

"That's good. I have to say I was surprised you didn't ask about her at the hospital, but I guess it makes sense."

"Had I asked, and had it got back to any of the doctors, I'd have been talked to, but that would be about it. I didn't do anything unethical, and I was careful not to reveal Elaine's name to anyone until after my mom had called Mrs. Abbott. So when mom called, she didn't know anything other than there was a young girl with a baby who didn't have support at home to keep and raise her."

"I know how much Tasha relies on her mom for help with Larisa, so I can understand. Being a single mom is tough!"

"And the number-one indicator for poverty," I replied. "And for poor health outcomes for both mother and child."

"Really?"

"Yes. It affects nutrition, access to medical care, and other things. Medicaid helps, but it's very limited compared to, say, the health insurance your dad offers his employees or that I have via the medical school and will have via the hospital to which I'm assigned."

"So what would you do?"

"Well, if it were up to me, I'd spend less on nuclear missiles and more on healthcare. One of those is completely immoral. I leave it to you to work out which one!"

Elizaveta laughed, "Duh! But what about the Soviet Union?"

"Nukes kill everyone. You can't win a nuclear war. Everyone loses. And while some people claim that Mutual Assured Destruction works as a deterrent, I find it unacceptably immoral."

"So surrender?"

"Do you really think Russia is going to invade Europe? They've had their butts handed to them in Afghanistan. Can you imagine what the Germans would do to them? And do you think they could hold it if they did take it? And don't you think they know that?"

"I suppose. But our grandfathers sure think it's possible."

"Anything is possible, including me sprouting wings and flying home every night after my shift!"

"Saint Michael?"

I laughed, "Not quite what I meant, but..."

"I worship you, but that's about the limit!"

"True. Everyone knows me FAR too well! Better would be inventing a Star Trek beam transporter! Then I could simply beam home from the hospital!"

"You're planning to watch the new series that begins next month, right?"

"Yes. I'm looking forward to The Next Generation. Hopefully, it'll make it beyond the three years of the original from the 60s."

"You've enjoyed the movies with the old cast."

"I have, though the first one was pretty bad. Wrath of Khan is perhaps the best Trek ever made, including the original shows."

"I found it hilarious that it was Mr. Rourke from Fantasy Island in the lead role."

"I believe I told you at the time he was in 'Space Seed', the episode that was the source for the movie. And that episode is one of the best of the original series."

"So, not 'Spock's Brain'?" Elizaveta teased.

"No!" I chuckled, knowing she was teasing me because she knew I felt it was likely the worst episode of any show ever on television.

"Are you up to going to Vespers?" I asked.

"Yes. And I'll be fine for Liturgy in the morning. I'll just nap when we come home. The girls will make dinner, just as they have the past few Sundays, and everyone will leave by 8:00pm so we can get to bed."

"Who did the grocery shopping?" I asked.

"Lara did it this morning. She left not long before you arrived home because she knew I'd want to nap and have time alone with you."

"I'm very happy you have so much help."

"And I'll do the same when all the girls eventually have their babies. I would have done more for Tasha, but she was in Rutherford with her mom."

"Will she be here tomorrow night?"

"Yes. And Lara, too."

"Good. I'm going to change for Vespers."

"OK. I'm going to wear this tent!"

I suppressed a laugh because I wasn't sure Elizaveta would appreciate it, even though she'd made the joke. I put on a clean cassock and my dress shoes, then put on my ryassa. I helped Elizaveta up and walked her out to the car, where I helped her get in before I got into the driver's seat. I helped her buckle the seat belt and position it carefully before I started the engine, then pulled out of the driveway and headed for the church.

August 25, 1987, McKinley, Ohio

"I totally didn't expect you this morning," Nicole said when I arrived at the hospital early on Tuesday morning.

"I didn't expect to be here," I replied. "We have a visit with Elizaveta's OB on Friday, so I'll go home at lunchtime, with Doctor Cooper's blessing, for that visit."

"At that point, I think your OB will want to induce."

"Probably, but she'll check amniotic fluid levels and if they're OK, she'll probably wait a day or two."

"Deacon? You're here?" Maryam asked, surprised, as she came into the lounge so we could do pre-rounds.

"I know, right?" I replied. "When I left this morning, Elizaveta hadn't had any contractions, though there's no doubt that Rachel is in position. She's just being stubborn. What do we have today?"

"There are four women who'll be discharged," Nicole replied. "We also have one who had complications but is in good condition, and two who came in about two hours ago in labor. Best friends who married the same day and got pregnant on their honeymoons. It looks as if they'll deliver together today. There's also a planned C-section at 8:00am."

"That's pretty amazing for the best friends," I replied.

"Neither of them were induced, either. They went into labor about two hours apart. Shall we go see everyone?"

"What were the complications on that patient who won't be discharged?"

"Retained placenta. She had some bleeding, but Doctor Lane got it under control and they transfused her with a litre."

We joined Doctor Kelly, Doctor Phillips, and others on rounds, and there was nothing remarkable with any of the expectant or postpartum mothers or any of the babies. Just as we finished rounds, Doctor Kelly was paged. She made a call and waved for me to come with her.

"Teenage rape victim," she said quietly. "We need to do a 'rape kit'."

"Are you sure you don't want Maryam for this?" I asked.

"If the victim objects, I'll have a nurse help me and you can come back upstairs and shadow Nicole. But you're my student, so we at least try."

"OK."

We rode the elevator down and went to Exam 3. Doctor Kelly checked the chart to get the girl's name, Tracey, and her age, sixteen. We went into the room where Tracey was with a nurse and a uniformed female police officer, who was standing in the corner.

"Names, please?" the officer asked.

"Doctor Mary Kelly and medical student Michael Loucks."

"Thank you," she said, writing our names on her pad. "Sir, could you spell your name?"

"L-O-U-C-K-S," I said.

"Thank you."

"Hi, Tracey," Doctor Kelly said. "We need to examine you, OK?"

Tracey nodded, but bit her lip.

"That means you're going to have to disrobe. You can ask anyone to leave, if you're uncomfortable, except for the police officer."

"It's OK," she said, sounding resigned.

"You can tell us to stop at any time, and we will. OK?"

"Yes."

"Mike," Doctor Kelly said, "take my key and go to the secure cabinet and get a 'rape kit', please. Sign for it, and do not break the seal until you bring it into the room."

"Yes, Doctor."

She handed me her keys, and I went out to the nurses' station where the secure cabinet was, signed for one of the numbered 'rape kits', took it from the shelf, then locked the cabinet. I'd read about them, but they were relatively new, and I hadn't actually seen one. I went back into the room and put the kit on an instrument tray the nurse had rolled over. Everyone washed their hands and put on gloves, and after the police officer verified the seal, Doctor Kelly had me open the kit.

"Tracey, are you able to stand?" Doctor Kelly asked.

"Yes."

"Mike, unfold the white butcher paper and put it on the floor, please."

I did that, and Doctor Kelly and the nurse helped Tracey from the exam table to stand on the paper.

"Mike, open one of the brown paper bags," Doctor Kelly said. "Hold it open for me."

I did as she asked.

"Tracey, I'm going to take off your blouse, OK?" Doctor Kelly said.

"Yes," Tracey replied.

Doctor Kelly did that and handed the blouse to the police officer, who was also gloved. She looked it over, then put it into the bag I was holding.

"Seal that with one of the tapes," the police officer instructed. "And initial the tape."

I did as she instructed, then held out the next bag, which was for Tracey's shoes. The procedure was followed for her socks, bra, and panties, and her ponytail holder was placed in a small evidence envelope. One by one, I handed Doctor Kelly swabs, as she collected samples from Tracey's lips, the inside of her mouth, her labia, her vagina, her urethra, and her anus. Each swab was placed in a tube, which I sealed and initialed. Tracey's hair was combed with a special comb, and a few hairs were plucked. All of that went into an evidence bag. Then, the same was done for her pubic hair. Next, scrapings were taken from under Tracey's fingernails. Last, and in my mind most embarrassing, the police officer took Polaroid pictures of bruises on Tracey's breasts and thighs, and of abrasions on her labia.

"Jenny," Doctor Kelly said to the nurse, "please help Tracey into a gown."

"Yes. Doctor."

While the nurse helped Tracey, Doctor Kelly, the police officer, and I packed everything into a large bag, and all three of us initialed the tape that we used to seal it.

"One last thing," Doctor Kelly said, changing gloves, "I need to do an internal exam."

"Fine," Tracey said with resignation.

She lay back on the exam table, and Doctor Kelly used a speculum to examine her. Doctor Kelly documented some internal abrasions in Tracey's vagina, which, combined with those on her labia, indicated forcible penetration.

"Tracey," Doctor Kelly said when she was finished, "a doctor who specializes in helping young women who have been assaulted will come to talk to you. Do you have someone here with you?"

"My mom, I think," Tracey said.

"We brought her mother in," the police officer said. "Miss Conner was brought in by ambulance from Lower Millcrest Park."

"OK to bring her mother in?" Doctor Kelly asked.