Good Medicine - Medical School III - Cover

Good Medicine - Medical School III

Copyright © 2015-2023 Penguintopia Productions

Chapter 39: A Sleepover for Rachel?

November 29, 1987, McKinley, Ohio

“I’m sorry,” I said, after laughing hard for a good thirty seconds. “That was inappropriate.”

“My comment?” Sheila asked.

“No, me laughing! I just couldn’t help myself.”

“Why?”

“Because I totally did not expect it, and you said it so matter-of-factly.”

“I’m right, aren’t I?”

“I suppose so; I just hadn’t given it any thought. Part of it is probably because you were a patient.”

“You know, I hadn’t even considered that angle. You were ‘up close and personal’ with me in a situation where you’re not even supposed to think about sex, and I’m sure you didn’t.”

“I didn’t,” I confirmed.

“And that, in effect, closed off the possibility, right?”

“There are no ethical problems with our relationship, if that’s what you mean. If you mean with regard to desire, I compartmentalize my private life from my medical training. That said, the notion of ‘playing doctor’, as it were, no longer fits into my worldview. Well, for me, if you get what I mean.”

“Rather than being exploratory and one of the first steps towards sex, it would preclude sex.”

“Exactly.”

“Shelly teased that Michael and Rachel could sleep together while their parents sleep together.”

I laughed, “That sounds like her!”

“She’d have jumped you in the hospital room if given a chance!”

“That would probably have led to me being dismissed from the program. And I think Rachel is a bit young for her first boyfriend!”

“All kidding aside, what age would you let her date?”

“Probably fifteen for a regular one-on-one date, but before then I’d be OK with school dances and going out in groups. I’m under no illusion that I can control her sexual activity. And, ultimately, each person has to make those kinds of very intimate decisions for themselves.”

“Mind if I ask how old you were?”

“Eighteen, not long after High School graduation. You?”

“Eighteen at my Senior Prom. I’d been dating the guy for about five months and he booked a room in the hotel where we had our Prom. He didn’t pressure me; when the dance ended, he just asked if I wanted to go up to his room. I liked him enough that I said ‘yes’ and we did the deed. We were both inexperienced, so it was a bit of trial and error, but we figured it out.”

“Most people do,” I replied with a grin.

“We kept at it for the rest of the Summer until he went to Texas A&M and I went to UC. I haven’t seen him since. I heard he married and stayed in Texas, but we weren’t close enough that it bugged me in any way. I dated a bit at UC and was serious with one guy, but it didn’t last. Then I ended up at the New Year’s Eve party and stupidly let Michael’s biological dad talk me out of my panties. Or, rather, one too many drinks caused me to make a poor life decision. I think I told you I was on the Pill, so I should have been safe.”

“Even taken exactly as prescribed, the Pill has a non-zero failure rate. Granted, it’s tiny compared to even ‘perfect’ condom use, something that is almost impossible.”

“Perfect?”

“The fluids released before ejaculation, commonly called ‘pre-cum’, can contain sperm, and all it takes is one! In addition, you have to properly withdraw while still fully erect and holding the condom correctly, then be very careful not to have close contact until the condom has been removed and disposed of, and hands and genitals washed. You can imagine that doesn’t happen every time.”

“I know that from experience,” she said. “My High School boyfriend and I used rubbers, and we sure didn’t follow those rules. He stayed in me until he went soft more often than not.”

“And that can result in leaks, and again, a single sperm is all it takes.”

“Things they left out in High School sex ed! Well, they made some offhand comments about following the directions on the box, but who reads the instructions on a box of rubbers?”

“And your experience is exactly why I made the comment about ‘even perfect use’. Heck, I knew about it and probably wasn’t perfect every single time. Fortunately, most of my partners were on the Pill, though I used rubbers as necessary, and there were girls who used a diaphragm.”

“I asked for an IUD because of what happened. My gynecologist said they’re extremely effective.”

I nodded, “And an IUD takes away the human element, as it were, as well as strange hormone reactions.”

“OK to tell you something?”

“After your comment about wanting to jump my bones?” I asked with an arched eyebrow. “Sure.”

“I find it weirdly disconcerting that I spread my legs wide open for you and you didn’t ‘notice’, if you know what I mean. Not that you did anything wrong, just that it seems strange when I think about it.”

“You have a female gynecologist, so the only context you have for a guy seeing you that way is sex.”

“And a female pediatrician.”

“How do you know they weren’t lesbian or bisexual?” I asked with a smirk.

Sheila rolled her eyes, “OK, Smart Guy, I get it! I was just telling you that it’s weird. I’m not saying you should have ‘noticed’. In fact, I’m not even sure what I’m saying!”

“That your desire to ‘jump my bones’, as you put it, conflicts with the fact that I already had my hands on you, but in a medical context. And that right there is one of the reasons doctors are strongly advised to avoid treating friends and relatives, and are discouraged from dating patients.”

“But now you’re OK with saying that I’m sexy?”

“Of course! Red hair in a pixie cut, freckles on your nose, green eyes, and in great shape.”

“My tits are too small.”

“I’ve observed in the past that any guy who objects to the size or shape of any breasts he has a chance of seeing or touching is an utter moron! So, unless they inhibit you feeding Michael, they’re the perfect size for you!”

“Flatterer!”

“From what you said, I don’t need flattery to get me anywhere or everywhere!”

Sheila laughed, “Which actually makes me appreciate it more!”

“Is it OK to ask when you first thought about having sex with me?”

“You remember when Shelly showed up, right? You left the room almost right away, and she said she thought you were totally hot and asked what I thought. Of course, I knew about your wife, but I said that if I met you at a party and you asked me to dance, I would have said ‘yes’. Shelly, being Shelly, said ‘Horizontally!’ and I didn’t disagree. She tried pretty hard to get your attention.”

“And you know why she could never succeed.”

“But me? Wasn’t I in the same situation? Or even more, because I was actually your patient?”

“You and I had something in common in being single parents, and you naming your baby ‘Michael’ affected my opinion. That opened the door to a friendship. And then you opened a very different door with your half-jesting comment.”

“Half-jesting?”

“You said it because it was true, but you weren’t expecting anything to happen. That said, you wouldn’t object to two friends jumping each other’s bones.”

“Pretty insightful.”

“Doctors are supposed to have an analytical mind and the ability to quickly assess what they’re told either by the patient or tests and instruments, then synthesize a plan of action.”

“And?” she asked with an arched eyebrow.

“I stopped at the analysis stage.”

“Because of your wife?”

“I know this is going to sound trite, but it’s complicated. My feelings for Elizaveta and my grieving her death certainly factor into it, but so do a number of other things, including our relationship.”

“You think it might mess up our friendship?”

“It’s possible that it might, no matter what we say beforehand. And we’d have to talk about what it meant.”

“Meaning?” Sheila asked with a soft laugh. “I just want to fuck and feel good! And you’re handsome, sweet, and interesting. You think I’m sexy. There’s no real risk because neither of us thinks the other is marriage material.”

“And what happens if one of us were to change their mind? Or one of us wants to continue longer than the other? Or, God forbid, you get pregnant?”

“With an IUD?”

“Asks the girl who took her birth control pills religiously. The failure rate for copper IUDs is about a tenth of a percent during the first year. That means one woman in a thousand will get pregnant sometime during that year. The failure rate for the Pill, in perfect situations, is about three tenths of a percent, or three women in a thousand per year. In imperfect situations, which means forgetting a pill, some kind of interactions, or timing errors, it’s as high as 9%, or nearly one in ten over their entire course of using oral contraceptives.”

“Timing errors?”

“Not starting them at the correct time, or not waiting two full cycles without missing any pills. One cycle should be enough, but my professors suggest two is better.”

“What would you do?”

“I thought we discussed this, although in a different context.”

“You object to elective abortion, so you’d encourage the girl to keep the baby, and you’d be a good father, though you would let her make the final decision.”

“I would do everything in my power to convince her to have the baby, but in the end, only she could make that decision.”

“Did you have any scares?”

“No real ones,” I replied. “The odds were heavily in my favor, and there weren’t any girls I suspected would deceive me. I wouldn’t have gone to bed with them if I had that feeling. And in most cases, I played hard to get, so to speak.”

“Like you are now?” Sheila asked with a smirk.

“I think that depends on your perspective. I think we’re having a theoretical discussion, not negotiating, as it were.”

“Are you sure about that?” Sheila asked. “Once I put it out there, it became real, not just hypothetical. We both know it’s there, we’re just choosing not to say it directly.”

“You just did, albeit with some embroidery.”

“I suppose I did.”

“I don’t think it would be wise,” I replied. “At least not today.”

“I’m sorry.”

“For what?” I replied. “A sexy girl asking me to go to bed does not offend me. It would be different if I were married, but you’d have never done that. Shelly, on the other hand, would.”

“In a heartbeat. She’s had several affairs with married men. Her view is that their vows are between them and their wives and she’s not bound by them, though she wouldn’t break any vows she’s made.”

“Logical, consistent, and yet, still wrong,” I replied.

“I agree. Is this ‘never’ or ‘wait and see’?”

“I’d call it ‘wait and see’ but if it were to happen, it would be some time down the road, not soon. I want to be your friend and don’t want to mess that up. Changing topics, have you been going to church?”

“Yes, and meeting with Father Stephen. I met your friend Angie. She seems very sweet. It’s sad, really.”

“It is. So far she’s managing very well, but I fear that it’s not going to last.”

“Her reaction to Michael made it clear she wants her own baby in the worst possible way.”

“I know, and that is, sadly, not something that can happen because she’s been declared incapable of consent by the State of Ohio.”

“That would suck,” Sheila declared.

“Tell me about it,” I agreed, shaking my head.

When we finished our lunch, Sheila and Michael headed back to Cincinnati and Rachel and I went back to Anicka’s house. I spent the rest of the afternoon with Rachel until Lara arrived, having driven back from Pittsburgh.

“How was home?” I asked.

“My biological dad is supportive and my stepdad thinks I’ve thrown away my life.”

“I think I’d go with your biological dad’s opinion on that one.”

“Me, too, obviously! How were things here?”

“Good. I have my evaluation tomorrow, and Rachel and I will be moving on Friday.”

“Do you need me to watch Rachel tomorrow?”

“In the afternoon. There’s an Ethics Board meeting I have to attend and it would be distracting if Rachel decided to pick that as a fussy time. Those are rare, but you know how it goes.”

“Obviously!”

“How about we meet for lunch and then you take Rachel while I go to the meeting?”

“Sounds good. Your schedule is the same as what you told me before I left, right? Tuesdays, during the day, then overnight on Wednesdays and Saturdays?”

“Yes. I would appreciate it if you took Rachel to church on Sunday mornings.”

I could actually attend Saturday Vespers which were at 6:00pm, unlike Wednesday Vespers which were at 7:00pm.

“Of course!” Lara agreed. “A gaggle of girls would be very disappointed not to see her!”

“Joel says Abigail is a chick magnet.”

Lara laughed softly, “I can see that! And I’d say that would be true for Rachel as well.”

“A week from tomorrow I’m going to see Father Roman at the Monastery of the Transfiguration in Ellwood City.”

“Are you taking Rachel?”

“Yes. Father Roman agreed the nuns would love to entertain her while we meet.”

“Want some company for the drive?”

“I wouldn’t mind if you want to come along.”

“I do.”

“I plan to leave early enough to get there for lunch, then drive back as soon as the meeting is over. I can’t imagine it lasting more than an hour or so.”

“Is he your new confessor?”

“Not yet. This is a ‘get acquainted’ meeting and then we both speak to Vladyka JOHN, who makes the final decision. I can’t imagine any reason I’d say ‘no’, but as I consider Father Roman to be a «старец» (staretz), he might elect not to accept me for some spiritual reason only he can discern.” (“Spiritual Director”)

“You used Russian!” Lara exclaimed.

“Tell me a good word in English that fits? ‘Elder’ is the best translation, but that has a different connotation in English, especially in the way it’s used by so-called Bible churches. And it’s not as if I don’t use what amounts to Russian when I say ‘Vladyka’, though it’s Slavonic and improperly declined.”

“Changing subjects, who all will be here tonight?”

“Mark, Alyssa, Elias, Serafima, Tasha, Clarissa, and you. Tasha will bring Lara tonight.”

“How are things with your in-laws?”

“Yulia had a breakdown on Friday and is on a seventy-two-hour psych hold at the hospital. Viktor found her with photo albums from Elizaveta growing up and our wedding thrown around the room.”

“Is she going to finally get counseling?” Lara asked.

“I hope so. I don’t know how she’s responding to the psychiatrists at the hospital because she’s not allowed visitors and it would be a violation of hospital rules for me to try to see her chart. And if I ask, I’ll be told, correctly, to mind my own business. I’ll speak to Viktor tomorrow to find out if she was released and what the plan for her treatment might be.”

“Care to speculate?”

“Remember,” I said carefully, “all I’ve had is a couple of psych classes and a psych Preceptorship, and I focused on Angie’s condition for my studies and papers. Yulia doesn’t fit those criteria at all, so most of my studying simply doesn’t apply. If I had to hazard a guess, it’s what they’re calling post-traumatic stress disorder, and the root cause is Elizaveta’s death. If I had to go out on a limb, I’d say it was the fact that Elizaveta died from a congenital defect and Yulia blames herself.”

“That would make sense. Do you blame anyone? God?”

“If I affix blame, it’s the medical and scientific community for not being able to discover, diagnose, and treat the type of defect that caused Elizaveta’s death. But that’s only ephemeral blame, if you understand what I’m saying.”

“I do.”

“As for blaming God, what happened was a result of our mortality and the imperfect state of nature which resulted from the Fall. And that works either with a literal Fall or a mythical one which represents man’s separation from God because we follow our own will. Think about the description of Lucifer’s fall from grace - he followed his own will, rather than God’s.”

“But you don’t think it’s a product of sin, do you?”

“You mean Elizaveta committed some specific sin? No, of course not. Mortality is part of what it means to be human, and that’s true no matter how you view Genesis. God allows the natural processes to work, which is why we can do science and practice medicine. It’s similar to my view on miracles — if they worked the way most people think, the world would be too unpredictable to conduct any kind of scientific inquiry.

“The universe is ordered, in the sense that it operates according to observable and measurable principles, such as Newton’s laws; it is also disordered because it is not subject to God’s will. Well, it is, but only insofar as individuals accept God’s grace, and even then, the operation of the universe conforms to observable scientific principles. It is only in the direct presence of God in what is called heaven that there is complete order in the universe, where our eternal spirit communes with God’s energies.”

“Which sounds like a long form of ‘shit happens’.”

“I agree, though I don’t think I’d get away with saying that in Sunday School!”

“That might give a few people heartburn, but then again, so would some of your private theology.”

“Which I can now speak more freely about. Nobody can legitimately complain about a layman giving a private opinion on anything!”

“You know my take on that, of course.”

“I do. You felt I made a mistake in accepting ordination.”

“Not a mistake, per se, just a choice with which I disagreed. Clarissa felt you made a mistake. And one which, through a terrible sequence of events, you rectified.”

“The thing is, without accepting ordination, I’d never have married Elizaveta and wouldn’t have Rachel. And I have no regrets at all about either of those decisions. It didn’t turn out the way I expected or wanted, but I still wouldn’t go back and change it, even if I could.”

“Changing topics again, did you line up help for moving on Friday?”

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