Chapter 42: Bedside Manner

November 30, 1987, McKinley, Ohio

After I changed Rachel and fed her, I spent time rocking her, then put her down while I showered. After my shower, I dressed, then bundled Rachel against the cool November evening. Once I had her dressed, I put on my jacket, grabbed my hat, and carried her out to my car. Less than ten minutes later, we walked into the Lobby of Rickenbacker Dorm.

Not much had changed in the two-and-a-half years since graduation, and I saw the same stains on the carpet and the same ugly couches. I didn’t need to check in as I wasn’t going up to 8, so I just sat down on one of the couches to wait. I didn’t have to wait long before I saw Kari come out of the elevator.

I stood up, and she walked over to where Rachel and I were waiting.

“Kari, this is Rachel; Rachel, this is my new friend Kari!”

“You brought your daughter on our date?” Kari asked.

“I felt the two of you should meet,” I replied. “Would you like to hold her?”

“Uhm, I don’t know! I haven’t held a baby in, well, forever, I guess.”

“If I can do it, you can do it!” I said with a smile.

“But you’re a doctor, well, training to be a doctor!”

“And I had exactly zero training in how to be a dad or care for a baby. I had expected my wife to teach me those things, so I’m kind of just winging it. Just cradle her in your arms and make sure you support her head.”

I carefully handed Rachel to Kari and was very happy she didn’t fuss. Kari was clearly nervous, and after holding Rachel for a minute, handed her back.

“Ready to go?”

“Sure.”

We left the dorm lobby and walked to my Mustang, which was parked in a ‘Visitor’ spot in the parking lot.

“Nice Mustang!” she declared.

“Thanks.”

I got Rachel settled into her car seat, then Kari and I got into the car. After we buckled in, I started the car, and pulled out of the parking spot.

“Can I say this is already the weirdest date I’ve ever had?” Kari asked.

“You may,” I replied lightly. “I know it’s overwhelming, but this is my life, and hiding it does me no good. This is all new to me, too. You’re my first date since Elizaveta died.”

I could, technically, count Annette’s visit as a ‘date’, but it hadn’t felt that way, despite having pizza together and her spending the night. It reminded me, in some ways, of the encounters with my sister’s friends, though I hadn’t really discussed the future with any of them other than Maggie and Emmy, and Emmy’s situation at home had quickly put an end to that.

“I’m sorry if this is overwhelming,” I said. “But I don’t want to give any false impressions or create any illusions. If, after tonight, you want to go out again, I’ll arrange for someone to watch Rachel if you prefer a one-on-one date.”

Kari laughed softly, “Well, having a chaperone, even one who is about three months old, would make my dad happy!”

“Dads are like that, especially with daughters. How is your dad doing?”

“He was allowed to go home today, but he’s stuck in a wheelchair for another two weeks or so. That’s tough on him, obviously.”

“Does he have help?”

“Yes. My uncle and his wife took him to their house, which is a ranch, and they have a spare bedroom because my cousins both graduated college already.”

“What about your dad’s girlfriend?”

“They said Friday. She’s regained all her memory except from the time she got into the car until the day after the accident. They’re not sure she’ll ever remember it.”

“That is one common symptom of traumatic brain injury. If that’s the only cognitive deficit, then they’ll consider that full recovery.”

“How does that work?”

I shrugged, “I haven’t studied enough neurology to know more than the basics, and I most likely never will. You’d need to ask a neurologist. One of the things most people don’t realize about doctors is that they are either very generalized or very specialized. The generalized ones are people like your family doctor, who knows everything he needs to know to manage your care and treat basic illnesses. If it’s beyond that, he’d send you to a specialist, like a cardiologist or neurologist.”

“And your specialty will be the emergency room?”

“Emergency medicine combined with general surgery, to be what’s called a ‘trauma surgeon’. There are very few of those now, but they’ll be more common in the future. Did you ever watch M✶A✶S✶H?”

“Sure.”

“It is, in effect, what ‘Hawkeye’ Pierce, ‘Trapper John’ McIntyre, and B.J. Hunnicutt were doing on the show, though I’ll do less ‘meatball’ surgery and do things other than surgery. Emergency medicine actually grew out of the experiences in World War II, Korea, and Viet Nam. President Reagan, when he was governor, approved the first fireman-paramedic program after he was shown statistics that a soldier wounded in combat in Viet Nam had a better chance of survival than someone injured in an automobile accident on a California freeway.”

“Wow! That’s really true?”

“In Korea, for example, and you see this on M✶A✶S✶H, they had corpsmen, who were similar to paramedics, at the front lines, in what they called ‘aid stations’ and then used helicopters to transport those who were critically wounded, and ambulances with corpsmen, to transport those whose injuries weren’t immediately life-threatening.

“In civilian life, ambulance attendants couldn’t do more than toss the patient on a gurney, give them oxygen, and drive them to a hospital where surgeons or doctors from Internal Medicine staffed what was literally an exam room, which they called the ‘Emergency Room’. Now, we have an Emergency Department, staffed by doctors and nurses with special training in emergency medicine, or ‘trauma’. You probably don’t know it, but the first true Emergency Department, staffed by emergency medicine specialists, wasn’t created until the late 1960s in Chicago. If you’ve seen Emergency or Medical Center, you know what I’m talking about.”

“How long will you have to train?”

“Overall? About sixteen years. Four years of undergraduate work in biochemistry; four years of medical school, of which two are classroom and two are practical; then about eight years of Residency, three in the Emergency Department and five in surgery, though that’s kind of mix and match, and could change, as I’ll be in a brand new program.”

“And they pay you enough now to raise a family?”

“There is no pay until I become a Resident. In fact, I pay the medical school for the privilege of working in the hospital or a doctor’s office.”

“How does that work? I mean, you obviously have to get money from someplace.”

“I saved a significant amount of money during High School, and had help from my parents for college, in addition to earning scholarships and being an RA. My maternal grandfather, having a strong desire to have great-grandchildren, provided some money to ‘start a family’, and then after Elizaveta and I married, we moved into a cottage on her parents’ property. After she died, a group of men from church arranged to rent a house for Rachel and me, and we’ll move on Friday.”

“Your wife’s parents kicked you out?”

“No, but the situation was untenable because my mother-in-law was so grief-stricken. She’s undergoing medical care, and all things considered, including for my own mental health, it was better to move out.”

“Your life is very complicated.”

“I know. And there isn’t much I can do to change that because of the demands of my training.”

“You sound like you’re trying to discourage me rather than encourage me.”

“I’m sure it seems that way, but it’s my reality. There is no fairy tale about the cute college Freshman and handsome young doctor here, just the harsh reality of a single dad being trained as a physician specializing an emergency medicine.”

I pulled into the parking lot of the steakhouse, and after I parked, we got out, I retrieved Rachel from her car seat, put her in her carrier, and we went into the restaurant. We were seated right away, in a booth towards the back of the restaurant near the kitchen, which I was sure was the hostess’ way of trying to minimize any disruption from Rachel, should she become fussy.

“I’m not sure I can deal with this,” Kari said after we ordered our Cokes.

“I totally understand,” I replied. “And it’s better to know that now, rather than six months from now if we became involved.”

“I know I asked this before, but are you really interested, or are you just being polite, and hitting me with both barrels so I don’t feel bad?”

“If I wasn’t interested, I wouldn’t have accepted your invitation to take you on a date. You’re intelligent, pretty, and we have some common interests.”

“Music?”

“That was the main one I was thinking about. My band will be playing at Taft in a few weeks.”

“Code Blue?”

“Yes. I’m the lead singer and play backing guitar for most songs, though I play lead on a few.”

“Some of the upperclassmen have said you guys are really good. You’re a cover band, right?”

“Yes. None of us are composers. You said you wanted to study under Anicka, sorry, Doctor Blahnik. What’s your goal?”

Kari laughed softly, “Good question! Piano is my principal instrument, though I learned to play the violin as well. Doctor Blahnik is an accomplished concert pianist and maybe that’s what I’ll try to do, but I also compose music.”

“What style?”

“A mix, really. Mostly what you would call chamber music, but I’ve tried my hand at folk music and popular music.”

“When did you start playing?”

“I had my first piano lessons when I was five, and violin when I was eight. I wrote my first piece for piano and violin when I was thirteen.”

“Wow! I hope you don’t mind me asking a question similar to one I’ve been asked many times, but why Taft? It sounds as if you could have gone to the Cincinnati Conservatory, or whatever it is UC calls its music school, or even Juilliard.”

“I tried for Juilliard, but there are so many pianists that the competition is insane. I also applied to Taft, and Doctor Blahnik arranged for a full music scholarship once she heard me play, and I decided to come here rather than go to Boston, where I was also accepted. Where did people think you should go?”

“Stanford, Yale, Emory, or any of the other top medical schools. I want to stay here and serve the community where I grew up, so I decided on McKinley Medical School. I only applied to other schools in the Midwest.”

“You grew up here?”

“In West Monroe, which is near Rutherford. There’s no medical school there, and the hospital there isn’t a full teaching hospital. When I apply for the Match, I’ll put Moore Memorial Hospital at the top of my list.”

“Match?” she asked as the waitress brought our Cokes.

We interrupted our conversation to order and resumed it once the waitress left.

“The Match is how you get your first job as a doctor,” I said. “Basically, you interview at hospitals, then you make a list of where you want to work and what specialty you want and the hospitals make a list of the students they want and for what program. A big computer then makes the best Matches based on those lists, and that’s where you’re assigned.”

“You don’t get to pick?”

“No. You make a list, and you have to take whatever the computer decides. You can try to limit where you’ll be assigned, but the fewer hospitals and programs you list, the more likely you are to not Match, which would mean participating in what’s called the Scramble, where you try to find a program that wasn’t chosen by anyone so you have a chance of being a doctor. If you don’t Match or Scramble, you can’t be a doctor.”

“Whoa! Then what happens?”

“Well, you get your MD, but you can’t see patients. You can try the following year’s Match, look for a program that has lost Residents, or work for an insurance company or do research. Or find a new career.”

“So you can’t be sure you’ll be at Moore Memorial Hospital?”

“I’m ranked first in my class, and scored in the 99th percentile on my comprehensive exam, so I’ll Match with my first choice, even if it were someplace like Mayo Clinic, Johns Hopkins, Stanford, Emory, or Vanderbilt. Moore Memorial Hospital wants me, so they’ll list me first, and I’ll list them first, and I’ll Match there. The rest of my list will be irrelevant. If that weren’t the case, I’d carefully select a dozen programs and rank them in the order I felt would give me the best chance of matching, then list another dozen less desirable programs to ensure that I did Match somewhere.”

“You’re first in your class? That’s impressive.”

“And irrelevant, except for getting interviews. What truly matters are the evaluations of my clinical work. I’ve done three rotations so far — surgery, OB/GYN, and emergency medicine. All of those evaluations have been perfect. I start pediatrics tomorrow, followed by psychiatry and internal medicine. Each of those three rotations is two months long, and that takes me to the end of my third year. During Fourth Year, I have electives — emergency medicine, surgery, psychiatry, cardiology, internal medicine, and finally emergency medicine again.”

“You repeat some?”

“Yes. That’s the way you show you’re qualified for the program for which you want to Match. I’m going for a trauma surgery Residency, so I focus on emergency medicine and surgery. The repeat on internal medicine is valuable for diagnostic and patient care skills, and the psych repeat is a personal thing. I have a close friend who suffers from schizophrenia who I help care for.”

“You have like no spare time!”

“I know, and I only see her once every few months, but I speak to her by telephone and also work with the priest at her parish and her psychologist.”

“How do you see dating working if you have no time?”

“We’d have to work around my schedule, and yours, obviously. For example, and I think I mentioned this, my pediatrics rotation has me in a clinic on Tuesdays, during normal hours. Then I have two twenty-four-hour shifts, one starting Wednesday evening and the other starting Saturday evening. That would give me Mondays and Fridays free, along with Tuesday evenings, plus Saturday morning and afternoon. I think we could work it out, if you want to try.”

“Now that you’ve hit me with all the bad stuff, do you have any good points?”

“I did mention that I sing and play guitar! And hopefully you’ve deduced I’m a doting father who loves his daughter.”

“Sorry,” Kari said. “That was kind of mean to say. You haven’t done anything wrong, it’s just overwhelming, as I said earlier.”

“Not what you expected when you flirted with the handsome young medical student in the ER.”

“Not even close! I’ve only had one boyfriend, and as I said, it wasn’t all that serious, and I’ve gone on dates both in High School and at Taft, but none of that prepared me for this!”

“Not to discount that, but do you think anything prepared me for being a single dad at twenty-four while in medical school?”

“No.”

The waitress brought our food and after I said the blessing, we began to eat. I wasn’t surprised that Kari was quiet while we ate, as I really had hit her right between the eyes with my complicated life. Her reactions, at least so far, didn’t portend well for not just her, but for any girl who wasn’t already Orthodox. It would be a struggle not just because of church, but church combined with all the other challenges my life presented to a future mom for Rachel.

That made me wonder, once again, if I shouldn’t just ask Lara to marry me right away. I was reasonably certain she’d say ‘yes’, as the sole impediment in the past had been ordination. I was hesitant, at least in part, because such a short time had passed since Elizaveta’s death, but I knew I had time because, if I were to ask her, the worst-case scenario was that she would act as Rachel’s nanny and surrogate mom for at least another nine months.

One concern I had, and it would be true of Lara, Kari, Annette, and other young women in college or with careers, is that it would leave Rachel in daycare more than I wished, but also likely delay having more children. Elizaveta’s desire to be a wife and mother meshed perfectly with my medical training, and I wondered if I could replicate it, or if I should even try.

There were several eligible girls in the right age group at Saint Michael, Holy Transfiguration, and the Cathedral in Columbus, even if I excluded the girls who weren’t at least Seniors, preferably over eighteen, which I felt I had to do. I hadn’t really considered any of them, which was the same exact behavior that had led Elizaveta to accost me outside the church, and, in effect, demand I stop seeing girls who weren’t Orthodox and marry her.

We finished our meal and ordered dessert, Rachel having slept through our meal, which was what I had hoped would happen. We finished our dessert, and after I paid, we left the restaurant. I got Rachel settled, then Kari and I got in, and I headed back towards Taft.

“I’m sorry I haven’t been very good company,” she said. “I kind of ruined the date by clamming up.”

“You were thinking about the situation and trying to decide what you wanted to do. Given how unconventional the situation is, I don’t see that as a problem. The only question is whether you want to go out with me again.”

“You want to?” she asked in disbelief.

“Next time I’ll arrange for someone to watch Rachel and we can have a conventional date.”

“Why?”

“For the same reasons I gave before — you’re intelligent, pretty, and we have some common interests. In my mind, that’s absolutely worth a second date, at least.”

“I kind of figured that once I stopped talking, you’d no longer be interested.”

“I’ve been the quiet one in enough situations in the past that I can relate. The question I have, given what you just said, was if you stopped talking because you wanted me to lose interest or because you simply needed time to think? You don’t have to answer right now, and you don’t have to accept a second date right now. I can call you in a few days, or I can just wait for you to call me.”

Kari was quiet for a bit before she answered.

“This might sound strange, but would you mind if I spoke to Doctor Blahnik about you?”