Chapter 44: Skulduggery

December 2, 1987, McKinley, Ohio

On Wednesday, Rachel and I went to the morning Liturgy which Father had scheduled on my behalf, and when we finished our worship, I drove to the rental house so I could plug in the answering machine. Because of the way things had worked out, I’d have a new phone number. I could have the old one, which was currently forwarded to Anicka’s house, forwarded to the new number, but for some reason it couldn’t be transferred. I thought it might have to do with the fact that the utilities were registered in Mr. Sokolov’s name, but it wasn’t important enough for me to try to do anything about it.

Once the machine was hooked up, Rachel and I went to the medical school, where I changed my phone number and address with the Registrar, then stopped by Doctor Mertens office and gave them to her assistant, as Doctor Mertens was in a meeting. I left the medical school campus and made my next stop, which was the BMV, to change the address on my driver’s license, then went to the Post Office to put in a Change of Address form. My final stop was the bank, and then I headed to Frisch’s to have lunch with Father Nicholas.

“You’ll be able to attend the Divine Liturgy on Nativity, correct?” he asked once we’d ordered.

“Yes. I won’t be able to make it to Vespers because I don’t come off shift until 8:00pm, but I’ll be able to get a full night of sleep before Liturgy.”

“Good. Is it safe to assume Lara will bring Rachel to church?”

“Serafima is going to coördinate to ensure Rachel is in church on Wednesday evenings, Sunday mornings, and for any festal services. Between Rachel’s godparents and Lara, somebody will make sure she’s in church.”

“That’s good. How are things otherwise?”

“I’m having dinner with Viktor before my shift starts tonight. I assume he’s kept you completely up to date on the situation with Yulia?”

“He has. As a volunteer chaplain, I had a chance to see her, but she’s pretty much out of it due to the antipsychotic drugs they’ve administered. They hope to find a balance where she’s relatively calm and coherent.”

“It’s tricky,” I replied. “With Angie it was a constant struggle to get them just right, though in Angie’s case, compliance was part of the problem.”

“Doctor Baxter is confident that this is just what we non-doctors call a ‘nervous breakdown’, not signs of mental illness.”

“I’d say that’s probably the case, though obviously I’m no expert. It has all the signs of post-traumatic stress disorder, or what was commonly called ‘combat fatigue’ in soldiers. Did Viktor mention my theory?”

“Yes. Doctor Baxter said it’s not only plausible, but likely. And it makes complete sense to me, as I’ve seen situations similar to this in the past when a parent has lost a child. Fortunately, that doesn’t happen very often. The last one was a newborn about twelve years ago.”

“I don’t recall hearing about that,” I replied. “Of course, I was only about twelve, so that’s not surprising. What happened?”

“A heart defect that wasn’t repairable. I don’t recall if I ever knew the exact details. The family ended up moving to Los Angeles about a year later. May I ask your opinion of how Viktor is doing?”

“I’d say he and I are in a similar place, though his struggles are exacerbated by Yulia’s condition. He and I are on good terms, and he confirmed his intention to pay for my final year of medical school, based on his promise from three years ago.”

“That’s good to hear. Have you spoken to His Grace recently?”

“Not in the past two weeks. I had planned to call him after I meet with Father Roman next Monday. I plan to drive out early, have lunch with him, then drive back. Lara is coming along to help with Rachel, though I’m sure the nuns will dote on her.”

“Should I read anything into you and Lara spending so much time together and her caring for Rachel?”

“I promised you, as well as Doctor Mercer, not to rush into anything. I think the safest thing to say is that both of us know the potential destination but neither of us are in a rush to get there.”

“You may, of course, tell me to mind my own business, but is there anything which gives you pause?”

“Being married to Elizaveta opened my eyes to the benefit of a full-time, stay-at-home mom. I haven’t changed my philosophical position on that, but I do think it would be beneficial for Rachel not to be in daycare. Obviously, with Lara’s plans to teach, daycare would be necessary for Rachel and any other children we might have.”

“Would that cause you to decide Lara isn’t right for you and Rachel?”

“On its own? Probably not. But I think Spring is the time to actually sit down and evaluate where we are. I’m reasonably certain Lara expects me to talk to her about it once I feel emotionally ready.”

“I’ll be curious to hear what Father Roman has to say, if he agrees to become your confessor.”

“As am I!”

Rachel fussed a bit, so I took her from her carrier and cradled her. It wasn’t time for her to eat, so I gave her a couple of ounces of apple juice, as Doctor O’Neill had suggested.

The waitress brought our food, and I cradled Rachel and ate with one hand, a skill I’d developed since she’d been born. We finished our lunch, and I headed home where I changed and fed Rachel, then put her in her swing while I played my guitar. Rachel was staying awake longer during the day, and that boded well for her sleeping long enough at night that I likely wouldn’t need to be up in the middle of the night by the end of my pedes rotation.

When Rachel eventually fell asleep, I moved her from the swing to her crib and took a brief nap, knowing I might not get any sleep overnight. Lara arrived as planned, and we sat in the great room to talk.

“You should just sleep in my bed tonight,” I said.

“I’m so tempted to tease you, but I’m not sure the time is right.”

“Teasing is OK,” I replied.

“Did you have your talk with Clarissa?”

“Yes. She acknowledged that she mostly only saw me during rotations or when we were out on Friday nights with the group where things are a bit more reserved.”

“Good. I think you’re doing fine, Mike, but I know you’re still struggling to make sense of what happened.”

I shook my head, “It’ll never make sense, though I understand your point. I think my real struggle is how to proceed, and ensuring I’m not acting precipitously. I think, based on how I feel, and taking everything into account, I’ll be in a position to move forward about the time my pediatrics rotation ends in February. Six months will have passed, and I’ll hopefully have had a chance to meet with Father Roman on a few occasions to help me ensure my head is screwed on straight.”

“This is where Clarissa or Jocelyn would say ‘Yeah, good luck with that!’,” Lara said mirthfully.

“And they’d be right more often than not! That’s part of the reason I’m hoping Father Roman agrees to be my confessor. I’ll likely go see Doctor Mercer sometime in the next two months, but the timing could be difficult because of my schedule. I want to see Angie as well. I spoke to her on the phone and she seems to be doing OK, but that could change at any minute.”

“Just make sure you look out for yourself, Mike.”

I nodded, “A few people have made that point, but you know I have to put Rachel first, before anything except medical school, and even then, if push came to shove, she’d win. If there is one thing I am most grateful for, it’s all the help.”

“Speaking of that, Serafima got in touch with me to check on bringing Rachel to church. You plan to go on Saturday nights, correct?”

“Yes. I was thinking the best approach is for you to take Rachel from me at church and I’ll just go straight to the hospital after Vespers.”

“That sounds good. What time do you want me at the house on Monday morning?”

“I figure if we leave at 7:00am, we’ll be fine. It’s a four-hour drive, and my lunch with Father Roman is at noon. We should leave there around 2:00pm, I would guess.”

“Sounds like a plan.”

“I do need to leave for my dinner with Viktor. I’ll see you tomorrow around 8:30pm.”

We hugged, I went upstairs to confirm Rachel was OK and to dress for my shift. I remembered Doctor Sumner’s preference for how male doctors ought to dress, so I put on black slacks, a royal blue Oxford shirt, and a blue-and-white striped tie, along with black loafers. Once I was dressed, I put on my Winter coat and gloves, then left the house carrying my medical coat and bag. Fifteen minutes later, I pulled into the parking lot at the golf club and parked in a guest spot. I confirmed with the attendant I was meeting Viktor, then went into the building and was shown to the small private dining room we’d used before.

“Did you get an update on Yulia today?” I asked after we had ordered.

“Doctor Baxter thinks they’ve found the right balance of medications, and she was able to talk to Yulia late this afternoon. If Yulia stays stable for the next two days, she can come home on Saturday.”

“The key is going to be ensuring she stays compliant with her medications and counseling. Have you spoken to Anna?”

“Geno spoke to her in no uncertain terms about not interfering and not being negative about counseling.”

“Good. If there’s one thing to watch out for, it’s anyone who might compare counseling and treatment to «психу́шки» (psihúški) in the Soviet Union. That could undo all the hard work Doctor Baxter and Doctor Lawson have done to get Yulia to this point. Father Nicholas plans to teach a Sunday School lesson on the value of combined spiritual and secular counseling sometime in January. I certainly can testify to the benefits I’ve received from it. Have you been seeing your counselor?”

“Yes. Once every two weeks now. And I’ve been seeking guidance from Father Nicholas as well.”

“Good. If Yulia does come home, would you like me to bring Rachel to visit on Monday evening? I’m going out with a friend and instead of asking one of the girls to watch her, she could stay with Viktor Gennadyevich.”

“You’d do that?”

“You’re Rachel’s grandparents, Viktor, and I trust you completely to keep her safe. It was never my intent to deny you a relationship with Rachel, but you know I couldn’t accept Yulia basically taking her from me, which is what she wanted.”

“Yes, and Doctor Baxter thinks that was as some kind of substitute or replacement for Elizaveta.”

“That makes sense,” I replied. “A surrogate daughter, if you will. If I have a chance tomorrow morning, I’ll stop in and see Doctor Baxter or Doctor Lawson and tell them what I told you so they can reässure Yulia that she’ll be able to see her granddaughter regularly.”

“I appreciate that, Mike. I really wish that we’d all wake up from what turned out to be a nightmare, but alas, that’s not going to happen.”

“No,” I sighed, “it’s not.”

We had a nice meal, and when we finished, I headed to the hospital. I parked in the staff lot, then went into the hospital via the main doors and took the stairs up to the second floor where Pediatrics was located.

“Hi, Peggy,” I said when I walked up to the nurses’ station. “I start my rotation in about twenty minutes.”

“Hi, Mike! I have your badge and your pager, and you’ve been assigned locker J. Put your things away and I’ll call Doctor Olson. You’re assigned to him, along with Heather Pratt, a Fourth Year.”

“Sounds good,” I replied, accepting the badge and pager from her.

“Remember to change the batteries every week,” Peggy reminded me.

“Without fail,” I replied.

“Did you decide not to wear your robes?” she asked.

“I actually stepped down from my position because of the demands of my training combined with being a single father.”

“We were all shocked, Mike. If there’s anything you need, just let me know and I’ll do my best to help.”

“Thanks. I’ll go put my things in my locker and come right back.”

I walked down the hall to the lounge/locker room and found locker J. I hung up my jacket, put my hat and gloves on the shelf, put on my medical coat, slung my stethoscope around my neck, put my bag in the locker, and attached my combination lock. I spun the dial three times, clipped on my badge and pager, then headed back to the nurses’ station where Doctor Olson was waiting.

“Hi, Mike!” he said. “My condolences for your loss.”

“Thank you. What do we have?”

“Eight on the ward and one in the ED who’ll be sent up for overnight observation. It’s you, me, and Heather on tonight, along with Peggy, Eileen, and Stephanie, a nursing student. Doctor O’Neill takes over at 10:00am tomorrow. Heather leaves at 7:00am and Jerry Royce takes over. The nurses change on their own schedule, and I don’t pay close attention to that.”

“That’s about the only thing about nurses you don’t pay close attention to!” I said with a grin.

Doctor Olson laughed, “Not my fault I’m single, handsome, ripped, and popular!”

“And an ego bigger than your...” Nurse Peggy teased.

“ANYWAY,” Doctor Olson said with a grin, “as I was about to say before I was so rudely interrupted, the on-call Attending is Doctor Rosenbaum, but he’s at home, ten minutes away. His shift starts with rounds at 7:00am.”

“The Attending doesn’t have to be in the hospital?”

“No. The only reason we’d need him is if we needed to make a change to medication, which usually doesn’t happen overnight, and in many cases, there are standing orders I can follow without disturbing an Attending. If that were to be necessary, I would call him to confirm my orders.”

“And if a kid goes south?”

“That’s almost always going to mean emergency surgery or the code team. You’ll be paged or woken up if there’s a code, just as I will, because we’re on duty. Heather is on the code team.”

“What’s the protocol for sleeping?”

“That’s up to you. We’ll do our evening rounds around 10:00pm. After that, you sleep if you want. There is a bunk in the on-call room configured like the berths on Navy subs — a blackout curtain you can pull around so you aren’t disturbed.”

“Two beds for three of us?”

“Hot bunking. You and Heather can work out a schedule, unless you want to share.”

“Probably not the best idea given the expulsion that occurred earlier in the week, among other reasons!”

“Ignore Matt!” Peggy exclaimed. “He uses the couch in the Attending’s office! He’s giving you grief.”

“Doctor O’Neill did say he was the class clown!”

“I’ll go put on my floppy shoes and rubber nose!” Doctor Olson grinned. “Mike, let’s go over our current patients.”

We walked to the end of the corridor and did what amounted to mini rounds, stopping at the door to each room so Doctor Olson could give me a brief description of each patient’s condition. Just as we arrived at the last room, Nelson Farmer, whom I knew from the Ethics Board, came out of the elevator with an orderly pushing a gurney.

“Hi, Mike!” Nelson said.

“Hi, Nelson,” I replied. “Who’s this?”

“Krissy Lindstrom, thirteen, fell and hit her head on a coffee table while fighting with her little brother for the remote control. Overnight observation for a concussion.”

“You do realize you’re supposed to report to ME, right?” Doctor Olson inquired, sounding bemused.

“Sorry, Doctor O,” Nelson replied with a grin. “Krissy Lindstrom; thirteen; stable vitals; fourteen sutures for a forehead lac sustained from a fall where she struck a wooden coffee table; overnight concussion protocol.”

“OK. You and Mike get her settled, then come see me.”

“Got it, Doctor O!”

Doctor Olson walked away, and I followed Nelson and the orderly to the room she’d share with an eight-year-old girl on a cardiac monitor. Krissy was able to scoot from the gurney into the bed, and Nelson and I got her settled just as Nurse Eileen and her student, Stephanie came in.

“Orders from the ER are for ibuprofen and concussion protocol,” Nelson said. “No IV; no monitors. Eileen, Stephanie, this is Mike. Mike, Eileen and Stephanie.”

“Hi,” I said.

“Krissy, do you need anything?” Nurse Eileen asked.

“I didn’t get any dinner. They said you could get me something to eat.”

“We can do that! Let me call down. How are you feeling?”

“My head hurts, but otherwise I’m OK.”

“Stephanie, get her some water and some crackers, please, to tide her over.”

“Right away!” Stephanie, a cute girl with long black hair, replied.

“Let’s go see Doctor O,” Nelson said.

We left the room and walked to the Attending’s office where Doctor Olson was sitting behind the desk.

“She’s settled and the nurses are on the case,” Nelson said. “She asked for something to eat.”

“That’s good. Did you personally check her vitals before you left the ED?”

“No.”

“Then go do that now. Do not assume that the ER docs are anything other than bald-faced liars!”

“Seriously?” I asked.

“What is the primary goal of every ER doctor?” Doctor Olson asked.

I smiled, “Treat ‘em and street ‘em. And if you can’t street ‘em, admit ‘em.”

“And, of course, nobody in the ED would ever fudge things to get someone out of one of their treatment rooms, would they?”

“No comment,” I grinned, remembering debates between Residents when the ED docs wanted to admit someone and the service didn’t want to take them.

“Not going to sell out your own discipline?” Doctor Olson asked.

“I have no knowledge about this patient other than what Nelson said, so I have no comment!”

“Go with Nelson to check her vitals and come back. He’s off in about an hour, and then she’s yours and Heather’s.”

“Yes, Doctor,” I said.

Nelson and I left the office and walked back towards Krissy’s room.

“What rotation did you do before Pedes?” I asked.

“Internal Medicine. You were in the ER, right?”

“Yes.”