Chapter 67: Sleep Deprived

January 2, 1988, McKinley, Ohio

“No!” Clarissa whined softly when I disentangled myself from her on Saturday morning so I could care for Rachel.

I put on a robe, went to Rachel’s room, changed her, then took her downstairs with me to make her morning bottle. She’d slept until almost 6:00am, and that meant she was able to sleep through the night, which would help her other caregivers, especially during January. When the bottle was ready, I took her to the study and rocked her as she drank.

As I rocked, I savored the memories from the previous night and looked forward to our plans for the day — a joint bubble bath, Tessa and Clarissa making love, Tessa and I fucking, and, finally, Clarissa and I making love then cuddling naked until it was time to make dinner. All that would, of course, be interspersed with caring for Rachel, talking, and cuddling.

There was a slight interruption when Milena and Joel brought my instruments and sheet music, but it was at lunchtime, so it didn’t really impact our plans. We invited them to stay for lunch and put Abigail and Rachel down together on the rug by the fireplace. Rachel couldn’t really play, but Abigail hugged her and talked to her, and they seemed to enjoy themselves. When Milena, Joel, and Abigail left, I put Rachel down for her nap and Clarissa and I had our final, joyous lovemaking session, then cuddled together while Tessa lay next to us in the bed.

“This was a wonderful time, Petrovich,” Clarissa sighed, her head on my chest. “I know it’s not likely, but this is how I’d like to make our baby.”

“You, me, and Tessa?” I teased.

“Actually, yes,” Clarissa replied. “He or she is going to have two moms, so why not have both there when he or she is created? Most likely, though, you’ll be married and I doubt any girl you marry would tolerate you having sex with Tessa and me to make a baby!”

“Highly unlikely,” I chuckled. “Though someone told me about a guy in Chicago who has a three-way marriage that occurred after he got his lesbian friend in the family way!”

“You need to get in touch and find out how he made that work!” Clarissa exclaimed.

“Remember why we agreed it wouldn’t work.”

“You enjoyed watching that!” she said, laughing softly.

“Yes, but it took every ounce of love you have for me to make love with me twice, didn’t it?”

“Yes,” Clarissa sighed. “I wish ... sorry, no.”

“You can say it, Clarissa,” Tessa said. “We all know it’s true. It doesn’t bother me because I have you and you actually prefer to be with me!”

“And that’s why I love you,” Clarissa replied. “And why I want to be with you, together for life.”

“I do!” Tessa declared.

“I pronounce you wife and wife!” I chuckled.

“Do you think they’ll ever allow that?” Tessa asked.

“Society would need to change radically,” I replied. “But we’ve made similar radical transformations with regard to women’s rights and race relations. Neither is complete, but the new way is the norm and the old way is disparaged. I think that’ll happen for gays and lesbians, eventually, though it’s likely decades of struggle away. It took the Civil Rights movement a hundred years after the Civil War to achieve significant change. I don’t think it’ll take quite that long from Stonewall.”

“Tessa,” Clarissa asked, “Do you mind if I occasionally spend time cuddling with Mike?”

“No,” Tessa replied. “I’m not threatened, and I know it makes you happy. Now, if he had a pussy instead of a dick, THEN it would worry me!”

“I have enough trouble as it is,” I chuckled. “Bleeding five or six days a month is NOT on my agenda!”

“Men are such fucking wimps!” Tessa declared mirthfully.

“I won’t argue that point with you at all,” I replied. “I watched dozens of women give birth. I couldn’t do it.”

“Did you do internal exams?” Tessa asked.

“Yes. And it was disconcerting at first, but then it was just a medical procedure like any other one.”

“Seriously?”

“Ask your girlfriend! She likes pussy as much as I do!”

Both girls laughed.

“Petrovich is correct, for once,” Clarissa teased.

“Thanks, Lissa,” I said flatly. “I love you, too!”

“Oh, stop!” she replied. “Tess, it really is like that. It was weird the first few times, but then it’s just another medical procedure, like inserting a catheter or an IV. If you can’t turn off the idea that touching genitals equates to sex, you can’t be a doctor. Well, I suppose you could do psych or pathology, but not anything that involves exams. Even Maryam, who’s going into cardiology, will occasionally do exams that involve genitals. That’s rare, but it’ll certainly happen during her ER rotations and when she’s covering the ER for consults. Docs in a trauma room do everything, not just their specialty.”

“And it applies to people like radiology techs,” I added. “They do mammograms, and it’s just a breast, not a plaything. But I learned that when I saw my friend April nurse her daughter when I was eighteen. Suddenly I had a completely different context from the usual one teenage guys have. It was awe-inspiring and was something I had looked forward to seeing.”

I sighed deeply at the thought, but didn’t feel as if I was going to cry.

“You OK, Petrovich?”

“Yes. Just sometimes those really strong feelings overwhelm me. The key is not having that happen in the hospital.”

“No, just other feelings!” Clarissa teased. “Tess, I didn’t tell you about the High School Freshman who wanted to get a very special injection from a hot medical student!”

Tessa laughed, “That sounds dangerous! Fun, but dangerous!”

“Just a crush or a bit of puppy love,” I said. “It happens a lot to doctors with young female patients.”

“Or the single moms of young boys who are looking for a new dad!” Clarissa declared.

“I wonder how his search for a new dad is going,” I mused. “But that’s one of those things we’ll never know, just as I often won’t know ultimate outcomes. Clarissa will, but I won’t. And, I hate to say this, but we need to get up and make dinner.”

“Two minutes, Petrovich,” Clarissa requested, snuggling closer, pressing her sexy naked body against mine.

I pulled her tightly against me, looking forward to cuddling her from time to time, at least until I found my future life partner. When the two minutes passed, Clarissa sighed deeply, and we reluctantly got out of bed.

January 3, 1988, McKinley, Ohio

“I’m going to crash for two hours in the on-call room,” I said to Nurse Peggy on Sunday evening. “Will you wake me at 10:00pm for my next shift?”

“Call you or nudge you?” she teased.

“Either one, so long as you’re not in bed with me!”

“Spoilsport!” she said lightly. “I’ll call you in two hours.”

“Thanks.”

I went to the on-call room, took off my medical coat and stethoscope, climbed into the lower bunk, and put on soft eyeshades I’d purchased. I was exhausted from being with Clarissa and Tessa, and then having a twenty-four-hour shift when I’d had only a little sleep because we’d had three consults overnight, two of which had resulted in admissions. I thankfully fell asleep as soon as my head hit the pillow.

“Mike?” Peggy called out after what seemed like about two minutes, but had actually been about two hours. “Five minutes until your shift.”

“Thanks,” I said groggily.

I got out of bed, took off the eyeshades, put on my medical coat, and draped my stethoscope around my neck. I went to the nurses’ station, tossed a buck in the jar and poured myself coffee into an oversized mug, then went to do the handover with Doctor Toomey.

“Hi, Mike,” he said. “I hope you got some sleep.”

“A couple of hours,” I replied. “I’ll be fine.”

We met with Doctor Olson and Heather, who were going off shift. The Fourth Year who was supposed to be on overnight, Ken, had called in sick, which meant we’d be shorthanded and likely meant no sleep for me. It also meant we’d have to seriously juggle if we had multiple consults in the ER as we’d had the previous night.

Doctor Olson ran through the status of all nine patients, and Heather went over the pre-op labs, which had been ordered for three surgeries in the morning. I wouldn’t need to worry about those patients until they were in recovery, but made notes, so I knew what to expect should anything come up in the morning.

Once we finished the handover, Doctor Toomey sent me to check on the kids in the ward and ensure they’d had their meds, and that any ordered tests had been completed and any necessary blood draws had been done. I was also asked to check vitals. That meant updating charts and signing off that nurses had administered injections or given pills as directed.

I found that both amusing and, to be honest, silly, as I was a Third Year medical student signing off that nurses with twenty or more years’ experience had done their jobs. The chances I’d correct one of their mistakes was minuscule compared to the other way around, but hospital procedures required a physician to sign off, which Doctor Toomey would do virtually through me.

As I expected, the nurses had expertly and competently done their jobs in a timely fashion, and an hour after I started, I signed the last chart on a five-year-old who’d had an emergency surgical procedure to remove a marble from his nose. I’d been part of that consult the previous evening, but there was literally nothing we could do, so he’d been handed over to the on-call surgical team.

“All set,” I said to Doctor Toomey from the door to the Attending’s office.

“Any labs to collect?”

“There is one set of labs missing on the kid who is post-op marble in the nose, but the note on the chart says the test equipment is down, waiting for a repair tech. I don’t know the ETA.”

“His vitals are good, right?”

“Yes, including urine output. No post-op fever.”

“Good. Then I won’t worry too much about it. Do me a favor and call down. I want to know if we’ll have lab tests available overnight.”

“Will do.”

I went to the nurses’ station and placed the call. The tech said the backup unit was available, but it was reserved for trauma and pre-op labs. They expected the primary machine to be repaired by 9:00am. I returned to Doctor Toomey and reported what I’d been told.

“OK. Good. At least we’ll have trauma labs if we need them. I hope to God the powers that be are expanding the lab when they expand the surgical and emergency departments. If patient counts go up the way we’re expecting, we’ll need double capacity.”

“EMTALA?” I asked.

“Nice to see a med student actually paying attention to the ramifications of regulations! Don’t get me wrong, I agree with the concept, but as soon as people realize they can use the Emergency Department as a no-cost substitute for primary care, we’re going to be in deep sneakers. And that will happen. It won’t be as bad for us as say, Los Angeles, Chicago, or Detroit, but we have plenty of uninsured people in the county, not to mention the adjoining counties with Tier III trauma centers who’ll send us patients under the transfer rules.”

“What would you do?”

“Pay for healthcare with taxes like civilized countries do! In the end, all the money comes from the citizens, either through insurance schemes or taxes, so why not cut out the middlemen? Even if it only saves 5%, that’s 5% more to spend on actual healthcare! Not to mention the reduction in paperwork.”

I laughed, hard, “In your dreams, Doc! Every bureaucracy in the history of the world has run on paperwork and your scheme would be no different! I’ve seen the Medicare and Medicaid forms! Those won’t go away, and the insurance forms will be replaced by HHS forms! Talk to anyone in the military about the paperwork they do!”

“OK, so maybe not less paperwork, but less BS!”

“Seriously? Again, have you looked at Medicare and Medicaid decisions?”

“Stop ruining my perfectly good fantasy future!” Doctor Toomey demanded.

“I actually don’t disagree with you that insurance companies are a net drain on the system. I just don’t believe eliminating them will solve all the problems, and might create all kinds of unintended consequences. I’m also not sure I want to be a government employee.”

Doctor Toomey laughed, “Says the medical student who wants to Match at a public hospital run by the county!”

“Stop ruining my perfectly good fantasy future!” I chuckled. “But seriously, I could hang out my own shingle, or I could try to Match at the University of Chicago, which is a private hospital, and interested in me.”

“All kidding aside, please don’t do that. The people of Hayes County need excellent physicians, too.”

“I agree, which is my main reason for wanting to stay here and serve my community.”

“I doubt we’re going to solve the problem of providing good healthcare at reasonable costs tonight, so feel free to get some shuteye. If tonight is anything like last night, even forty winks now will help.”

“Thanks, Doc, but I just drank a large coffee. I’ll chill in the lounge until the caffeine wears off.”

He nodded, and I went to the lounge and sat down with a pediatric journal. Five minutes later, Lena Habib, a Fourth Year who was on the Student Ethics Board, came into the lounge.

“Hi, Mike,” she said.

“Hi, Lena, what’s up?”

“They called me in to cover for Ken. I’m planning to Match in pediatrics, but I’m on an internal medicine rotation and don’t have a shift tomorrow.”

“OK to ask a personal question?”

“Sure.”

“You’re Lebanese, right?”

“Yes.”

“Druze?”

“We call ourselves «Ahl al-Tawhid», but yes. How did you know?”

“Well,” I replied, “If you were an Orthodox Christian, you’d have approached me when I showed up dressed in my clerical robes, and likely showed up at church. I was positive you weren’t Muslim, given I’ve seen you drinking and you don’t dress overly conservatively. That left Maronite or Druze, and I guessed Druze because as a Maronite, you’d have recognized the diaconal robes and likely at least said ‘hello’. Are you from Detroit?”

“Also correct!”

“A large Arab population, and there are a number of Antiochian Orthodox churches there.”

“Can I ask what happened?”

“You know what happened with my wife, right?”

“Everyone does; it’s probably the saddest thing I’ve heard in my life.”

“Our clergy aren’t permitted to marry, and I couldn’t see a chaste life, nor a life where my daughter didn’t have a mother.”

“So you resigned?”

“Yes. Where do you plan to Match?”

“Someplace in the Detroit area, or Michigan in general, though there are decent Arab communities in Toledo and Cleveland. Another option would be Southern California, where there is a large group of fellow believers.”

I nodded, “Jamie Farr, the actor, is Antiochian and a member of a parish in Toledo.”

“I bet him wearing drag didn’t go over well culturally!”

“I have no idea. I’ve never visited that parish, nor met him, though some friends of mine have. Do you speak Arabic?”

“That’s open to debate,” she replied. “I speak what is often called Lebanese Arabic, but many people simply call it Lebanese, because there are significant differences with Classical Arabic and modern forms of Arabic. I also speak Syrian Arabic, French, and English, obviously. Do you speak Russian?”

“Like a mentally challenged toddler,” I chuckled. “I learned when I was little, but rarely use it. What’s your ultimate goal?”

“To open a pediatric practice in the Arab community, but without regard to religion. It’s an underserved community, especially for recent immigrants. My family came over when I was six, with most of the rest of the people who lived in our village.”

“My friend Maryam is from Syria, and her family fled the internal strife.”

“It’s a mess, and we can lay the blame squarely at the feet of the British and French who divided the Ottoman Empire as if it were spoils!”

“My Russian grandparents fled the Revolution and Civil War. My Dutch ancestors came here in the 17th century for the usual Dutch reason — to make money and spread Calvinism!”

Lena laughed, “Nice. Manhattan?”

“Yes.”

“Are you going to try to sleep?”

“Probably around midnight, if I can. I have the bottom bunk.”

“You’re OK with sleeping in the on-call room with a female?”

“Yes. You thought I might not be?”

“We religious people have a different view on appropriate decorum than most of our fellow medical students, even the Catholic ones.”

“I don’t disagree, and I discussed that with my priest before my very first rotation, along with the co-ed locker rooms.”

“That was quite the surprise for me!” Lena declared. “But now I just change and don’t worry about it. I’m much more careful about the showers.”

“Same here,” I replied. “Maryam only changes in a private area.”

“That’s how I started out, but then I realized nobody even cared or was paying attention, and it’s not like underthings are even as revealing as bathing suits girls often wear!”

“True. I’m curious how you feel about procedures involving private areas.”

“I was super uncomfortable at first, but I’ve become used to it. You know the usual cultural modesty from the Middle East, I’m sure.”

“I do. And that will be one of your challenges.”

“It will, though being a female pediatrician will make mothers more comfortable bringing their daughters to see me than if I were male. And that’s an important point, too. Your fellow faithful, the ones who are Arabic, plus mine and the Muslims, all have the same taboos.”

“I think what you’re doing is awesome!”

Lena smiled, “And the top student in the medical school insisting he wants to practice in his home community is commendable! May I ask who is caring for your daughter?”

“Tonight, her godmother and godfather. I also have a close friend who is her main caregiver, and then my in-laws and other friends all pitch in. My parents live too far away.”

“It must be difficult,” Lena observed.