Good Medicine - Medical School III
Copyright © 2015-2023 Penguintopia Productions
Chapter 11: A Spiritual Crisis
September 17, 1987, Greater Cincinnati, Ohio
“How are you feeling?” I asked Sheila Nixon on Thursday morning.
“Did you see Alien?” she asked.
“No. I’m really into science fiction, but I don’t like horror movies, so I passed on that one.”
“But you know about the scene with the alien emerging from the crew member’s body, right?”
“Yes.”
“That’s how I feel!”
I couldn’t help but laugh, then asked, “You’re saying baby Michael is an alien life form?”
“He is a boy, so...” Sheila said with a silly smile.
“Men, too,” Shelly added
“I think the feeling is mutual,” I replied. “Isn’t the saying ‘Men are from Mars, women are from Venus’?”
“The god of war and the goddess of sex!” Shelly declared.
“If I recall my mythology correctly, she’s the goddess of love, beauty, fertility, desire, prosperity, and victory.”
“It still fits.”
“I’m a pacifist,” I replied. “I don’t believe in using violence except as a possible last resort in self-defense or defense of the helpless.”
“Did you register for the draft?” Shelly asked.
“Yes, of course. It was required by law. At this point, if I were drafted, I’d be a corpsman or fill some other medical role. Before, I’d have sought some other non-combatant role.”
“But you’d serve?”
“That would be my duty as a citizen, yes.”
“I’m curious,” Shelly said. “Have you ever fired a gun?”
“Yes, of course. I had a .22 rifle growing up, but gave it away because Orthodox clergy aren’t allowed to handle firearms, let alone fire them.”
“What would happen in basic training?”
“I have no idea,” I replied. “But there are religious exemptions. I’ll worry about that if it happens. We’re more likely to be on the sidelines of a civil war in Russia than to go up against them in a shooting war, and that’s the only thing I think would result in a draft. Anyway, I need to do an exam to see if Sheila can be discharged. A surgical Resident will make the final decision. The chart says Michael is healthy and ready to go as soon as Sheila is.”
“If you want to play doctor,” Shelly said with an inviting smile, “you can give me a very thorough exam!”
“Shel!” Sheila growled. “He just lost his wife!”
“And perhaps he needs a bit of TLC!”
“You’re the last person on the planet who’s ‘tender’ or ‘loving’ in bed!”
“May I proceed with the exam, please?” I asked, doing my best not to react to anything Sheila or Shelly were saying.
“Yes,” Sheila replied. “I apologize for Shelly.”
I simply smiled and nodded, and checked Sheila’s vital signs, checked her incision, and checked for vaginal bleeding. Her catheter was still in, and there was no blood in the urine collection bag. Once the surgical resident approved her getting out of bed, I could remove her catheter and IV, and she’d switch to oral pain medication.
“Everything looks good so far,” I said when I completed the exam. “I’ll notify the surgical team and they’ll send someone to approve your discharge.”
“Thanks, Mike. Is there any chance I could see your daughter before I’m discharged?”
“I did promise to have her visit Doctor Kelly, so let me call Doctor Cooper’s house and see if my friend Lara is willing to bring Rachel here today.”
“Lara?” Sheila asked. “As in Doctor Zhivago?”
“Yes. I’ll see you shortly, once the surgical Resident sees you.”
I left and reported to Doctor Kelly, who gave approval for me to call the surgical Resident. I did that, and once I’d finished, I called Lara and asked her to bring Rachel to the hospital at lunchtime. She agreed, and I let Doctor Kelly know. Once I’d done that, I checked on other patients assigned to Doctor Kelly and all of them were in various stages of labor, but none of them were close to delivering.
The surgical Resident, Doctor Miller, arrived and checked Sheila’s incision.
“I think you can get out of bed,” he said. “But I want you to stay until you’ve had a proper bowel movement. Mike, you can remove the catheter and IV. I’ll have the nurse bring tablet pain killers.”
“Yes, Doctor.”
“I thought I could go home today,” Sheila said.
“You can,” Doctor Miller said. “Once you have a bowel movement, we’ll discharge you immediately. That’s normal protocol for any abdominal surgery.”
Doctor Miller left, and I moved over to the bed.
“I’ll remove your catheter,” I said. “It’s probably going to hurt, despite the pain medication you’re taking.”
“As uncomfortable as it is, a bit of pain is worth it!”
I went over to the sink, washed my hands, put on surgical gloves, then moved back to the bed. I pulled down the blanket, then lifted Sheila’s gown to expose her groin. Following the procedure, I deflated the balloon, then pulled the catheter out firmly and smoothly.
“SHIT!” Sheila exclaimed, cringing. “That stung!”
“Sorry,” I replied after using my free hand to pull the bedsheet and cover Sheila. “There really isn’t any way to avoid that. It’ll most likely sting the next few times you urinate as well, which is normal.”
“Conveniently left out of Doctor Blalock’s description of the procedure!” Sheila groused.
“Maybe Mike could kiss your booboo because I’m sure that will make it feel better!” Shelly declared.
“Shelly, go get some coffee!” Sheila ordered. “Now!”
Shelly rolled her eyes but left the room, and I unhooked the urine collection bag from the bed. I emptied the urine into the toilet, then put the bag in the ‘hazardous materials’ bin.
“I’m really sorry,” Sheila said. “Shelly has no filter when she’s hot for a guy.”
“It’s OK,” I replied. “I knew a few girls like that in college.”
“But with what happened...”
“Yes, but if Rachel has taught me one thing, it’s that life has to go on, as painful as it might be.”
“You’re handling it more calmly than I would have expected.”
“This is what my friends all used to call ‘Doctor Mode’; trust me, I am not nearly so calm and emotionless outside the hospital. But here, I have to be.”
“How bad is it?” Sheila asked.
“It’s difficult to sleep and I have random bouts of crying that seem to come out of nowhere. But, as I said, I have to basically suck it up and deal with it because of Rachel.”
“I think Rachel has a wonderful dad.”
“Thanks. Let me remove your IV.”
I did that, putting a cotton ball on the puncture wound and applying surgical tape to keep it in place.
“Do you need help getting out of bed?” I asked.
“Probably.”
“I can help you, or I can call a nurse.”
Sheila laughed, “As if I’m going to object to help from the man who has seen my private parts more often than every other guy I know combined?”
“Different context,” I replied. “But some women are just more comfortable with help from other women.”
“Just help me to the chair, please. That’s a good test.”
I moved the blanket out of the way, then helped Sheila to the recliner near the bed. I got a blanket from the shelf and spread it over her, then brought her the box with the call button.
“You OK?” I asked.
“Uncomfortable, but OK.”
The nurse came in and brought two tablets of tramadol. The downside for Sheila was that one of the possible side effects of tramadol was constipation, which might delay her release. I hoped for her sake that wasn’t the case.
“Make sure you drink plenty of water with this,” the nurse said, handing a small paper cup with the tablets to Sheila. The nurse then filled the water bottle that was on the table next to the bed and brought it to Sheila. Once Sheila had taken the tablets, the nurse left. I double-checked if she was OK, then headed back to Doctor Kelly.
“Sheila’s catheter is out, as is her IV, and I helped her move to the recliner. The nurse just gave her two tablets of tramadol.”
“OK. Mrs. Fahey is about to deliver. Shall we assist Doctor Cooper?”
“Yes.”
That delivery and Mrs. Fahey’s aftercare took the rest of the morning, and I finished just before Lara arrived with Rachel. As I’d expected, Rachel was a hit with the medical staff, especially the nurses. Unsurprisingly, Doctor Phillips frowned and shook his head. His contempt for female doctors appeared to also extend to male doctors who took too much interest in their children. He was a throwback to the 50s, and I was in complete agreement with Doctor Kelly that a change in leadership was necessary.
I managed to reclaim Rachel from the nurses, and took her to see Sheila. Shelly was back in the room, but she stayed quiet.
“She’s adorable!” Sheila declared.
“Thanks,” I replied.
“Where’s your friend?”
“She’s not really allowed on the ward,” I said. “She’s in the lounge.”
“What if I said it was OK for her to visit me, as a friend?”
“I think the nursing staff is going to see right through that ruse,” I replied.
“Would you get in trouble if, say, in two weeks, we got our kids together?”
“It’s a grey area,” I replied.
“Who’s going to object to a single mom and a widowed dad getting their newborns together?”
“Oh, Doctor Phillips, for one.”
“The old grouch who comes on rounds?”
“Doctor Phillips is in his sixties,” I replied.
“Nice deflection!” Sheila declared. “Let me give you my phone number. Call if you want; if not, I’ll understand.”
Accepting her phone number couldn’t hurt and I was actually curious to see how my namesake turned out.
“OK,” I agreed.
She wrote her name and number on the pad next to the chair where she was sitting, tore off the sheet, and handed it to me. I folded the paper and put it in my pocket.
“I’m going to have lunch,” I said. “How are you doing?”
“I don’t think I’ve ever focused on going to the bathroom this much ever in my life!”
“You know what, let me listen for bowel sounds,” I offered. “That’ll tell us that things are moving. I’ll take Rachel back to Lara, and come right back. If Shelly can help you to the bed, that would make things easier.”
I took Rachel back to the lounge and let Lara know I’d be ready for lunch in ten minutes, then went back to Sheila’s room. I listened to her abdomen and heard normal bowel sounds, which meant she could be discharged, but that would require either Doctor Blalock or Doctor Miller to approve. I wrote the information on the chart.
“It should only be a matter of time,” I said. “Everything sounds good.”
“You can tell by listening?” Shelly asked.
“Yes. If you think about it, you’ll understand, because I’m sure at times you’ve heard gurgles or other noises from your stomach after eating. There are other sounds in the gastrointestinal tract we can hear.”
“Isn’t that diagnostic?” Shelly challenged.
“No. It’s simply an observation, and one I’m allowed to make. Auscultation, as well as vitals, are simply observations, as are things like checking for blood in urine or checking for bleeding or possible infection in a wound or incision. I can’t say what they mean in terms of a diagnosis, but I can say what they are and if they are normal or abnormal. Anyway, I need to get my lunch so Lara can take Rachel back home.”
I left the room, checked with Doctor Kelly, and then Lara, Rachel, and I went down to the cafeteria to eat.
“Your last day is Tuesday, right?” Lara asked.
“Yes. Then I’ll be back in McKinley full-time.”
“How do you want to handle things during your time off?”
“I think, for the most part, I’ll be able to care for Rachel. It’ll give us some significant time together before I start in the ER. If I have trouble sleeping or I need someone to watch her, I’ll call. And you know you’re welcome to hang out as much as you want.”
“At your cottage or at Doctor Blahnik’s house?”
“I’ll probably split time,” I said. “I won’t need Tasha to stay overnight, so I intend to sleep at home. But, as always, subject to change based on Rachel’s needs.”
“What time will I need to be at the cottage when you start your ER rotation?”
“About 5:30am,” I replied. “That gives me enough time to get to the hospital fifteen minutes early so whoever is going off shift can run the board for me.”
“Sounds like a plan. When will you find out about Pediatrics?”
“I’ll speak to the Chief and to Doctor Mertens in about five weeks to see if they can accommodate me. But that’ll probably be the last one. At some point, it’s on me, not on others. And it’s not really fair to other medical students.”
“I’m at your complete disposal until next August when I start student teaching.”
“I appreciate that, and it’s a debt I can never repay.”
“It’s not a ledger where you add it up, Mike. It’s about friendship and Christian love, the very things you model for everyone else.”
“I’m not sure I’m the best role model,” I challenged.
“Save the ‘chief sinner’ line for confession, though even there I don’t think it applies. Loving deacon, top medical student, and doting father. That’s a good role model for anyone.”
“I suppose,” I replied.
“Mark and Elias look up to you, and so do all the younger teen guys.”
“And when I screw up? Because you know I will. It’s the human condition.”
“It is, and that’s why they’ll understand.”
“Let’s change the subject, please.”
“Sorry. I didn’t mean to upset you.”
“I can’t even predict what’s going to upset me,” I replied. “Well, except when I’m with patients. Then nothing bothers me.”
“I’m no psychologist, but maybe that’s part of the problem — you turn it off or bottle it up all day, storing it up like a spring stores energy, and then it’s released.”
“Even if we assume that’s true, there’s literally nothing I can do about that because I absolutely can’t show emotion when I’m seeing patients.”
“Perhaps you should discuss this with Father Nicholas.”
“My last conversation with him didn’t end well,” I replied.
“What happened?”
“At least one person has accused me of behaving improperly with Tasha, and possibly other girls who are helping me with Rachel.”
“That’s a load of bull!” Lara said fiercely. “None of us would even think about doing something like that, and you certainly haven’t done or said a single inappropriate thing!”
“I know that and you know that, but tongues are apparently wagging. I was very curt with Father Nicholas about it when he told me last weekend and said if that was what people were going to say, then I was going to ask the bishop to laicize me. He suggested to me that I go home and we haven’t really spoken since.”
“That’s not good, Mike.”
“No, it’s not, but I don’t have the energy, emotional or otherwise, to deal with it. You know why I accepted ordination and how it came about. What you probably don’t know is all the drama that’s been going on ever since, which involved me having a secret meeting with the Metropolitan.”
“You were the one who had Bishop ARKADY deposed?”
“I need you to swear secrecy on this.”
“Of course.”
“It was my grandfather and my father-in-law; I was their messenger, but I agreed with them. Tasha’s dad’s Spiritual Court hearing was a kangaroo court with a pre-determined outcome, and I was used as a dupe, or as the Communists call it, a useful idiot. The now-deposed Robert Langley, who was called ‘Seraphim’, was blackmailing Bishop ARKADY in order to embezzle funds from the diocese. The blackmail was over sexual impropriety. That was never investigated as the other charges were sufficient for Timofei Andreyevich to be deposed from the office of bishop, though he was permitted to retire, at least publicly.”
“Damn, Mike!”
“Tell me about it,” I said, shaking my head. “I was suspended by our former bishop, but appealed to the Metropolitan and had it reversed.”
“You were suspended?!” Lara gasped. “What the f...”
“Because I refused to go along with the cover-up and the kangaroo court.”
“I assume Elizaveta knew all of this?”
“Yes,” I replied. “She was spitting nails.”
Lara frowned, “I’m pretty sure you understand why I made the decision I did.”
I nodded, “I was sorely tempted to ask to be laïcized at that point, but Elizaveta insisted I not allow our former bishop to drive me from the ranks of the clergy. She had a very good point. And we now have an awesome bishop.”
“May I speak plainly?”
“I’ve already granted you that privilege!”
“I don’t see you spending the rest of your life as a single dad. Someday, you’ll want to marry again. And if that’s true, which I’m sure it is, then why put up with the crap? Do what you said and ask Vladyka JOHN to return you to the order of the laïty.”
“I am not ready to think about that part of my life just yet.”
“I understand, but I’m thinking about how you could reduce your stress and also shut up the gossipy women at church who are just jealous that the younger women have taken over what the older women wrongly think they’re entitled to.”
“That about sums it up,” I replied. “But I’m not making a decision like that right now.”
“I’ll just say this once more, then drop it, but you don’t need the grief nor do you need the drama.”
“I hear you,” I replied.
We finished our lunch and I walked Lara and Rachel out to Lara’s Corvette. I helped get Rachel situated, then Lara and I exchanged a chaste hug before she got into the driver’s seat. Once she’d driven off I went back inside, changed into clean scrubs, then went to check on Sheila.
“How are you doing?” I asked.
“I had a bowel movement,” she said happily. “About ten minutes ago.”
“OK. Let me call Doctor Miller and confirm, then I’ll prepare the discharge paperwork for Doctor Blalock’s signature.”
I updated the chart, then went to Doctor Kelly’s office and let her know. I used her phone to call Doctor Miller.
“Did you check for bowel sounds?” he asked.
“I did, this morning, after you left. They were normal.”
“Then please let Doctor Blalock know the patient is ready for discharge.”
“Yes, Doctor.”
I hung up, let Doctor Kelly know what Doctor Miller had said, then went to find Doctor Blalock, who was in the lounge.
“Go ahead and prepare the discharge paperwork,” she said. “Bring it to me and I’ll sign it.”
“Yes, Doctor,” I replied.
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