Good Medicine - Medical School III - Cover

Good Medicine - Medical School III

Copyright © 2015-2023 Penguintopia Productions

Chapter 30: Moving and Visiting

November 13, 1987, McKinley, Ohio

I dreaded leaving the hospital on Friday evening, as I knew Father Nicholas had met with Viktor over lunch to convey the bishop’s discipline for Viktor’s obviously false accusation that I had fathered Sheila’s son. Lara had taken Rachel to Anicka’s house for the day and would stay there while the guys loaded our belongings into Pete’s pickup.

As planned, I picked up Robby on the way to the cottage so that I wouldn’t have to be alone if Viktor decided to confront me.

“What do you think will happen?” Robby asked.

“I have no idea. Viktor is usually rational, but nothing about the last ten weeks has been rational. Heck, nothing about the last eighteen months has been rational. Elizaveta, Lee, Sandy, and Deacon Vasily dying, Rachel being born, and the turmoil at church.”

“And your stress from medical school, too.”

“Yes, though I was thinking more about why Viktor is acting out of character.”

“You seem to be doing a good job of handling all the stress.”

“In a sense, I don’t have a choice. If I couldn’t, I’d never make it as an emergency medicine specialist or surgeon, let alone combining the two specialties. And the stoic visage hides the inner turmoil. But that’s part of the job, so to speak.”

“I couldn’t do it,” Robby said, shaking his head.

“And I couldn’t sit in a lab all day doing research. Both of us will contribute in a way that suits our personalities.”

“Is OB/GYN less stressful?” Robby asked.

“In terms of day-to-day? I think so, yes. A good part of the job is doing routine exams and managing pregnancies. Situations such as Elizaveta’s are, thankfully, rare, though obviously not quite rare enough.”

“Sophia is certainly less stressed now than last year when she had anatomy lab.”

“That is the toughest part of the four years,” I replied. “At least from my perspective as a Third Year. She’ll have her stressful moments during her emergency medicine Clerkship, but she only has to do one rotation in emergency medicine. She’ll do three in OB/GYN and two in internal medicine, in addition to the other core units — psych, pediatrics, and surgery — and her electives. She seems to be doing OK, at least from what I’ve seen.”

“Other than spending every free second reviewing her flashcards, I think so,” Robby observed.

“Been there, done that, got the medical coat!” I chuckled. “And still do that. When I have free time in the lounge, I review my flashcards, which now include differential diagnoses and procedures, not just anatomy, physiology, and body chemistry.”

When we turned into the subdivision, I saw Jason and Pete in the pickup truck parked on the side of the street. Pete followed us to the house, and we parked in the driveway. I was surprised to see the main house dark, but that meant the confrontation I’d been concerned about wouldn’t materialize.

We went into the house, and the guys began carrying boxes to the pickup while I checked the three messages on the answering machine. The first was from Doctor Mercer’s assistant confirming my appointment; the second was from Father Nicholas saying that he had met with Viktor and requesting I call him back; the third was from Jocelyn, letting me know that she and Gene would be in McKinley and would help with the move.

“I need to call my priest,” I said to Pete.

“Go on,” he replied. “We got this. Elias and Mark just arrived, so there are five of us now. Can I get the keys to the ‘Stang so we can put your instruments and other fragile stuff in there?”

I handed the keys to him, then dialed Father Nicholas’ number.

“Hi Father, it’s Mike,” I said when he answered.

“Are you at the house?”

“Yes. The main house is dark.”

“Good. After my lunch with Viktor, I called Geno and suggested that he convince Viktor they should go out for the evening, and it appears he was successful.”

“How upset was Viktor?”

“Very. He made the comment that he should have known the fix was in.”

“May I be blunt?” I asked.

“Could I stop you now that you are no longer a deacon?”

I chuckled, “No, but then again, you couldn’t really stop me when I was a deacon!”

“True, though you did moderate things a bit.”

“I did. What Viktor should have realized is that Vladyka was deadly serious when he said he would not tolerate any further false accusations.”

“I agree, though I believe Yulia is the true source of the accusation. I also heard from Father Alexi that there were questions raised at Holy Transfiguration.”

“That isn’t a surprise,” I replied. “Nik Antipov made the accusations against Tasha and is certainly reveling in me being laïcized. How did Father Alexi handle it?”

“He circulated a copy of the bishop’s directive. I would just ignore it.”

“I have no intention of responding to any accusations nor allowing them to bother me at this point. People are going to believe what they want and there is nothing I can do to change that. As a layman, I can do that; as a clergyman, I couldn’t, nor could Bishop JOHN.”

“Will you be moved out tonight?”

“Yes. Serafima and Alyssa will clean tomorrow. I seriously doubt anyone will bother them. They’ll give the keys to Viktor or Geno.”

“OK. If Viktor or Yulia do confront them, I’d suggest they simply hand over the keys and leave. I can’t imagine the cottage is dirty.”

“I’m not nearly as fastidious as Elizaveta, but Lara has done some cleaning while she’s been watching Rachel.”

“Call me if you need anything. Father Alexi is aware that you’ll be attending the Divine Liturgy at Holy Transfiguration on Sunday morning.”

“Thanks, Father. I’ll see you on Wednesday morning for Liturgy.”

We said ‘goodbye’, I hung up, then went to help the guys load the pickup truck and the cars. It took about thirty minutes to finish, and there was nothing extremely heavy as none of the furniture belonged to me. I did a quick walkthrough to ensure nothing was left behind, then locked up, and we headed to Anicka’s house where we reversed the process, though most of the boxes went to the basement until I decided what I wanted to unpack.

We set up Rachel’s crib in my bedroom and there was still enough room for the rocking chair, though the room was a bit crowded. When we finished, we joined the rest of the gang at the Chinese restaurant, with Rachel staying with Anicka and Derek, who had offered to watch her while we were out.

We had a nice meal, and I decided to skip the movie because I wanted to get a good night’s sleep, minus having to get up with Rachel to feed her around 2:00am. When Jocelyn asked if she and Gene could spend some time with me, I agreed, and we spent an hour catching up before they headed back to Columbus.

November 14, 1987, Greater Cincinnati, Ohio

“You aren’t wearing your cassock or ryassa!” Angie exclaimed when she opened the door at her house on Saturday morning.

“Hi, Ang,” I replied with a smile.

“Sorry; Hi, Mike. Come in, please.”

I carried Rachel into the house, and we followed Angie to the living room.

“I asked the bishop to laicize me,” I said.

“You’re no longer a deacon?! Why?”

Mrs. Stephens came into the room before I could answer.

“Hi, Mike,” she said. “Can I get you some coffee?”

“Yes, please.”

She left to get the coffee, and I answered Angie.

I needed to be careful, given what Angie had implied with her hug at the concert in Goshen.

“Because I need to focus on medical school and caring for Rachel,” I replied.

My caution went for naught when Angie responded.

“That means you could get married again, right?”

“Yes,” I admitted. “But that’s not something to be done lightly or soon, though I do think Rachel needs a mom.”

“You’re thinking of getting married again?” Mrs. Stephenson asked, returning with my coffee.

“Eventually,” I replied. “I’m no longer a deacon.”

“You were, uhm, demoted?” she asked.

“Laïcized,” I replied. “It was at my own request. I’ll still teach Sunday School and lead catechism when my schedule allows.”

“I’ll be in the kitchen if you need anything,” Mrs. Stephenson said, leaving the room.

“How are you doing with your change of medication?” I asked.

“OK,” Angie said. “I can fall asleep pretty easily, but I don’t sleep deeply. Doctor Mercer says I can keep trying the reduced dosage because I have more energy in the mornings now, and don’t wake up feeling like what I think a hangover must be like. May I hold Rachel?”

I was moderately concerned that holding Rachel would reïnforce whatever ideas Angie might have, but I suspected not wearing my cassock had done more to do that than holding my daughter. Saying ‘no’ would likely devastate Angie, and I knew there was no chance for Angie to get what I suspected she wanted, for innumerable reasons. It simply meant me staying on my guard so as not to lead her on about something that was, unfortunately for her, impossible.

“Of course,” I said with a smile.

I took Rachel from her carrier and handed her to Angie, who carefully cradled her in her arms. The sight did make me think about how things might have been, but as Doctor Mercer and I had discussed, nobody could reliably predict what Angie would have been like without her illness. She was still a beautiful young woman, and had taken off the weight she’d gained while on the antidepressants and antipsychotics thanks to martial arts, and I truly felt bad for her, but there was literally nothing anyone could do unless the State of Ohio were to restore her ability to consent. And that wasn’t likely to happen without support from her psychiatrist and Doctor Mercer, something I thought was highly improbable if not outright impossible.

I stayed at Angie’s for about an hour, but then had to leave, so I wasn’t late for my appointment with Doctor Mercer. When it was time to go, I bundled Rachel into her jacket, then carried her out to the car, with Angie bringing Rachel’s carrier. I put Rachel into her car seat and buckled her in, then stowed the carrier. I closed the passenger door and walked around to the driver’s side, with Angie following close behind.

“May I have a hug?” she asked.

I once again considered what was best for Angie, and concluded that the proper course of action was to hug her, and if she repeated what she’d done at the concert, discuss it with Doctor Mercer.

“Yes,” I replied.

I held out my arms and gave Angie a light hug, but then she pressed her body against mine, put her head on my chest, and sighed deeply. Rather than create an incident, I let her hold the hug for a minute, with my arms loosely around her, then gently backed up. Angie dropped her arms, then surprised me with a kiss on the cheek.

“When can I see you and Rachel again?” she asked.

“That will depend on my schedule,” I replied. “Next month, I start a new rotation and I have a pair of twenty-four-hour shifts and an eight-hour shift. I won’t be able to attend services at church, unfortunately. That’s going to be a problem for the next four to six years, which is part of the reason Bishop JOHN didn’t challenge me very much on asking to be laïcized.”

“Call me, OK? And try to find time?”

“I will,” I replied.

I got into the car, started it, waved to Angie, then put it in reverse and backed out of the driveway. Thirty minutes later, I parked at Doctor Mercer’s office in Milford. I’d be doing a bit of retracing my steps to visit my mom in Goshen, but that was simply how the schedule had worked out. I went into the building and up the stairs to Doctor Mercer’s office. I was able to go right in and chose to sit in a comfortable chair facing Doctor Mercer’s desk with Rachel’s carrier in a matching chair next to me.

“What didn’t you tell me?” she asked, clearly referring to my lack of cassock.

“I asked the bishop to release me from the diaconate,” I replied. “And he consented. That happened last Sunday.”

“We should probably start there,” she suggested.

“Actually, I think we need to start with Angie.”

“If you’re intending to lobby to reduce her prescription, save your breath. She’s not sleeping well and was agitated during our last session.”

“I wasn’t intending to do that, but I think I might shed some light on the situation. You know my take on being a «стукач» (stukach), but I can’t help it this time.”

“Mike, telling me about Angie’s behavior or symptoms of her illness is NOT being a ‘snitch’ any more than you reporting the results of a physical exam to your Attending is being a ‘snitch’.”

“That doesn’t change how it feels,” I replied. “But you’re right, of course. My band played a concert for Halloween at Goshen High, and Angie came with her mom, which she’s done before. She took advantage of me not wearing my cassock when I perform, and asked for a hug. I consented, as she’s always given chaste hugs in the past. This one wasn’t. It was a full-body hug, with her pressed tightly against me and squeezing her arms.

“I didn’t say anything, but my belief at the time was that she saw my situation as an opportunity, if you will. You know I went to see her this morning, and I was very careful not to do anything to encourage her. She asked to hold Rachel and I had the distinct feeling she was testing the waters, so to speak. When it was time for me to leave, she gave me another full-body hug, then kissed my cheek. The implications, taken together with her desire to stop taking her medication and get her driver’s license, were pretty clear.

“Unless I’m way off base, her desire to go off her medication and get her license were kicked into overdrive because, in her mind, I was available, though as a deacon I couldn’t remarry. When she saw me today without the cassock, I could see in her eyes that she felt there was a true opportunity to have what she’s always said she wanted. In my opinion, those feelings are the source of her agitation.”

Doctor Mercer frowned, “That could very well be, but it could also be lack of sleep and the onset of a symptomatic cycle. You know what she wants can never happen.”

“I will agree that it is highly improbable and nearly impossible, but I don’t know that it can never happen. That said, I operate as if it’s impossible, even if I hold out hope for some kind of miracle. But even assuming she was suddenly cured, there’s no way to know if it’s simply remission or the real thing. In addition, I am no more in position to meet her needs now than I was four years ago.”

“Are you sure about your feelings and your thinking?”

“Positive.”

“When she pressed against you, what was your second thought.”

“Nice question,” I chuckled. “My first thought was extreme concern; my second thought was that she had a fantastic figure and her body felt really nice. BUT my third thought was that she was completely incapable of consent and likely never would be capable. I’m still a red-blooded American male, Doc, but that doesn’t mean I’ll do something that would be both foolish and detrimental to Angie, not to mention flat-out illegal. I’d never practice medicine and likely go to jail for a long time.”

“Are those the things that actually prevent you from acting on her desire?”

“No. I would never, ever do anything to hurt her. As much as she thinks she wants that kind of relationship, I can’t even imagine the harm it could do to her if things went badly, which you are convinced they will.”

“And you?” Doctor Mercer asked.

“I suspect your assessment is correct, and I have nothing to counter it, so I agree.”

“From someone else, those would sound like weasel words.”

“Doc, I believe in miracles, I just don’t expect them. And they aren’t magic or wishes, as we’ve discussed. It could be anything from some pharmaceutical company developing a drug therapy that reconfigured whatever is miswired in Angie’s brain, or some kind of surgical procedure that resolved her condition without affecting cognitive and other functions. Do I expect those? No, I don’t; but then again, many medical innovations weren’t expected. That doesn’t mean they don’t happen or that research won’t pay off.”

“That is a physician’s mentality — anything can be fixed or cured if we apply the right resources.”

“Absolutely, though, as we’ve discussed, resources are limited, and that includes our knowledge of neurological function. Someday, hopefully soon, we’ll have a better idea of how the brain works. Certainly, CAT scans combined with EEGs will give us new information. And I’m hopeful about drugs, given that investigational drugs are making great strides in other areas, AZT being a prime example for helping AIDS patients live longer. That’s not directly related, but you get my drift, I’m sure.”

“I do,” Doctor Mercer replied, “and I hope you’re right, but where we are now is that Angie’s future is not positive. Her psychiatrist wants her back on the full dosage of sleeping pills and wants her to take antidepressants. So far, I’ve talked him out of it. I think, for Angie’s sake, we need to let her go as far down this path as possible with the hopes that she’ll realize she needs the drugs. Her real problem was with the antipsychotics and I’m hopeful we can keep her off those for an extended time, though you know the statistics.”

“I know they suck,” I replied. “But so do the odds when you bet on a single number in roulette. And yet, people do win. And people win the lottery. I’m not saying that’s going to happen with Angie, but I’m not about to rule out a lottery win until it’s literally impossible. Does that mean I think there’s some kind of future for us? No. And you’ll see why when we discuss my main reason for being here today. Will you do something for me?”

“Not tell Angie what you told me?”

“I’d strongly prefer you didn’t. Perhaps try to get her to tell you about the hugs by asking what happened when we saw each other. I hope, also, that you trust me not to do anything foolish.”

“With Angie? Or overall?”

“I meant with Angie; overall is a very different thing, and part of why Father Nicholas insisted I speak with you.”

“Then let’s move on to your status,” Doctor Mercer requested.

I explained the series of events that had led to my request to the bishop, as well as the fallout, up to and including moving from the cottage and Viktor’s discipline from the bishop.

“I hope you don’t hold that accusation by your in-laws against them in a way that would interfere with Rachel’s relationship with her grandparents.”

“I’ll do everything I reasonably can do to keep that relationship intact, but there is only so much I can do.”

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