Chapter 75: Welcome to the New World

January 30, 1988, McKinley, Ohio

On Saturday morning, I completed my last stint in the pediatric practice, then drove to my in-laws to get Rachel. I chatted with Viktor for about ten minutes, then headed home where I knew Sara would be waiting, with Serafima having let her in around 9:00am.

“Hi, Mike!” Sara exclaimed when I walked in.

“Hi, Sara!”

“I’ll take Rachel so you can change. Lunch in five minutes.”

“Thanks,” I replied.

I handed Rachel to Sara, then headed upstairs to change into comfortable clothes. Three minutes later, I was downstairs again, and went to the kitchen where Sara had put Rachel in her high chair and lunch on the table. I said the blessing, and we began to eat the soup and sandwiches she’d prepared.

“It’s been a month since I was here,” Sara said. “How has Rachel’s schedule changed?”

“She’s sleeping more at night and less during the day. She reliably takes two naps, from around 10:00am to noon, then from around 4:00pm to 6:00pm. Her evening nap is slowly disappearing, and her bedtime is shifting closer to 10:30pm with her waking up around 6:00am. It varies, obviously.”

“I heard from Serafima that your new schedule is both good and bad.”

“From her perspective, I can see that, but I think it’s good. I don’t mind going to bed early and getting up early, especially when I have no overnight shifts and don’t have any weekend shifts. It does create a bit of havoc for Rachel’s caregivers, but Lara, Serafima, and Alyssa worked out a schedule.”

“I’d love to help, but with school, I don’t think it will work. You’re home by 4:30pm, right?”

“That’s the idea, yes.”

“And because of school, the earliest I could be here would probably be about 3:00pm. But I have an idea! I want to see you more often, but I don’t think my parents would approve of us going out. What if I cook dinner for you some nights? I could do my homework while I’m cooking, or after dinner.”

I wondered what her parents would think of her plan if they were aware of it, which I suspected they weren’t. What she was suggesting would actually be very helpful, given I’d be coming off a twelve-hour shift and would want to spend time with Rachel. Two Mondays in February, Maryam would cook, and the other two we’d have an early dinner at the hospital. I was positive Lara would cook on Wednesdays, and Kari and I would likely simply have Chinese on Thursdays.

I was very happy with all the help I was getting, even if Sara had a very specific motive, which was not at all ulterior!

“I’d like that,” I replied. “Let’s start with one night a week. I’m having dinner with Maryam Khouri on Mondays, either here or at the hospital, and on Thursdays, Kari and I are having dinner.”

Sara smiled, “You’re going to marry an Orthodox girl, so she’s not a concern! Are you and Maryam dating?”

I shook my head, “No. It’s two friends who are medical students and who were part of the same study group and who attend the same church.”

“What about church? I haven’t seen you there since before Nativity.”

“I’m going to the Cathedral for Divine Liturgy on Sundays for the next few weeks. I’ll most likely be back at Saint Michael for Cheesefare. There’s no way I could attend all the Lenten services in Columbus. Holy Week is going to be tough, because I can’t take time off, and my schedule might even make it impossible to be at Pascha, though I might be able to trade a shift.

“There’s a good chance I could do that because I’ll be in Internal Medicine, and it’s the last rotation of Third Year, which means any other Third Year student could fill in. I’d just have to take a shift of theirs in trade, and again, I could do anything because I’ve already done them all. But I can’t plan just yet, as I won’t know that schedule until mid-March.”

“How about Tuesdays?” Sara asked.

“That would work great! Just remember, my schedule might change for March, so for now, just plan for February.”

“Cool!”

We finished our lunch, I helped Sara clean up, then picked up Rachel. The three of us went to the great room and sat on the floor, with Rachel practicing her crawling.

“What toys does she have?” Sara asked.

“There are a few things upstairs that were either gifts or which Elizaveta bought. A rattle, a telephone on wheels, and a combination toy that has a mirror, things to move, and things that make sounds. She also has a plush kitten, which you might have seen on the small shelf above her crib. But she’s really been content without needing the toys. That’ll change, of course.”

“No pacifier?”

“No. Those are thought to be bad overall and the idea of using it as a plug, the way some parents do, to keep her quiet, just seems wrong. I will get her teething rings, though she’s right at the earliest age where teeth appear. It’s more typical at six or seven months. I do have some books for little kids that I’ll start reading to her soon.

“PA!” Rachel exclaimed.

I picked her up to cradle her, and she cooed and gurgled contentedly.

“She’s advanced a lot in the last month! Crawling, saying her first words, and sitting up by herself.”

“It’s not clear if she is using that to refer to me, or just demand attention. She found that making that sound insistently gets her picked up and cuddled. That sound ‘da’, is in the second tier of easy sounds to make. The easiest are the ones that just use lips — ‘ma’, ‘pa’, ‘ba’, ‘fa’. Then come sounds like ‘da’, and finally ‘t’ sounds, which are the most difficult, especially ‘th’. Vowels are easier, of course, because you don’t really use your lips or tongue to make them.”

“Speaking of lips,” Sara said, turning her face towards me.

I smiled and kissed her softly.

“PA!” Rachel exclaimed.

“She approves!” Sara declared happily.

“You don’t think she was objecting because she wants my undivided attention?” I asked with a silly grin.

“We girls understand each other!” Sara replied.

“Uh-huh,” I chuckled.

“Try again?” Sara asked.

“And how do we know if she’s approving or objecting?” I asked.

“You’re just being difficult!”

“Something young women have said to me time and time again!”

“And you still haven’t learned to just do what we say!”

I laughed, “There is only one young woman on the planet who can command me with no chance of any pushback, and that’s the one in my arms! Her complaints will start around puberty when that no longer works!”

“How strict will you be?”

“I figure I have twelve years to instill Orthodox values, teach her how to make good decisions, and provide all the necessary information about puberty and adolescence. At that point, she’s the only one who can decide what to do. That doesn’t mean license to do anything, but I will teach her that freedom and responsibility go hand in hand, and that there are always consequences for her actions.”

“What about curfews?”

“Age appropriate, while taking into account how responsible she is. Privileges need to be earned, and being irresponsible means fewer privileges.”

“I wish my parents were that enlightened!”

I chuckled, “We’ll see if I maintain my philosophy when she’s thirteen! Reality has a way of crushing idealism! As we’re on this topic, how many kids and when?”

“As many as you want! And if you follow my eminently reasonable plan, we could start on our honeymoon!”

“May I point out that the first point I’ll have the chance to take an actual vacation is around June 1990? I may, or may not, have time off between graduation and Residency.”

“Our wedding night, then!” she exclaimed, then asked, “You really don’t have any time off?”

“I really don’t. First Year we had some time off, but none since. I arranged special permission to be with Elizaveta after Rachel was born, and then extended it because of what happened, but I hit the absolute limit of how much I could miss without failing the rotation.”

“What would have happened?”

“I’d have had to give up an elective to repeat my OB/GYN rotation, and I’d have had a black mark on my record, though one that had an explanation, so it wouldn’t really have hurt my chances. The thing is, you want to avoid that, because if you got really sick, say with mono, and failed a second one, then you’d have no choice except to go for an additional year of medical school. It sounds harsh, but if you think about what we’re training to do, skipping class or missing shifts is simply not possible.”

“You have to work all those crazy hours Elizaveta told us about with no time off?”

“Yes.”

“Yikes!”

“Does that change your view?”

“Only that I should make sure not to go to the hospital at the end of a doctor’s thirty-six-hour shift!”

“The doctors who work those kinds of hours are at the very beginning of their training, so they’re closely supervised. Those hours are a way to ensure a doctor can function under extreme conditions of stress, hunger, and exhaustion. Maybe there’s a better way, but this one works, even if it’s brutal for Residents.”

“Elizaveta always said it was even worse than it sounded, and you haven’t even reached the worst point.”

“In terms of relationship stress? Very true. That’s something you have to be prepared for. Is marriage to the handsome, successful doctor worth dealing with the long hours, the stress, and all the other stuff that comes along with medical training?”

“If I didn’t think so, I wouldn’t be here! Last time I said I didn’t expect anything like this to happen, but with, well, what happened, I had a choice, and as I said, applied the philosophy of carpe diem.”

“Actually,” I said with a smile, “as I learned in Latin class, the entire phrase is carpe diem, quam minimum credula postero, which translates to ’seize the day, put little trust into tomorrow’. Or, in scriptural terms, ’Do not worry about tomorrow; each day has enough troubles of its own’. So, rather than meaning ‘seize an opportunity if you have it’, it’s actually cautionary, warning that the future is unknown and you shouldn’t leave things to chance. You should, as Jesus also teaches, do everything you can each day to make your future better.”

“I didn’t know that, but isn’t that what I’m doing? I mean, even though I meant I was grabbing an opportunity that won’t likely occur ever again, I’m also thinking about doing the best thing today to improve my future. Honestly, and contrary to what most people would think, I believe I would have more opportunities, more freedom, and more success by marrying you than if I didn’t.”

“Not going to college?”

“I’ve spoken to the guidance counselor at school and discussed how business treats women who interrupt their careers to have kids, and it makes WAY more sense to me to marry, have kids, then go to college and work when the kids are old enough. That way, you don’t suffer what my guidance counselor called the ‘mommy penalty’ where anything you did before you had kids simply doesn’t count in the minds of what she called ‘troglodytes’ who do the hiring and who are managers.”

“I know quite a few medical students who would agree with you!”

Rachel squirmed, so I put her down and she crawled over to Sara who picked her up.

“That’s new,” I observed.

“I TOLD YOU!” Sara declared triumphantly. “Miss Rachel and I get along just fine, don’t we?”

Rachel cooed and gurgled, and I had to admit she was showing approval for Sara in a way she’d never done with Kari, further confirming Kari’s decision.

“She does like you,” I said.

“The saying is that the key to a man’s heart is through his stomach, but I think in your case, it’s through your daughter!”

“That may well be the case,” I agreed.

Sara’s thinking was in stark contrast to Natalie’s, even though Sara had used the word ‘freedom’ as one of the things she’d gain. I understood it, at least in context, to mean to be who she wanted to be and to do what she wanted to do, rather than as escaping from the figurative gulag Natalie sought to escape.

“How late can I stay?” Sara asked.

“As late as you like, though not so late as to make your parents concerned. We usually say evening prayers after Rachel has her 10:00pm bottle, so if you wanted to stay for those, it’s OK.”

“Dad won’t flip out so long as I’m home before midnight. I’ll get a bit of grief about missing Vespers, but it won’t cause any trouble because I can say I was with you and helping out.”

“OK. Just be smart, please.”

“Always!”

The phone rang, and I got up to answer it.

“Hi, Mike, it’s Doctor Warren.”

“Hi,” I replied. “What has you calling on a Saturday afternoon?”

“Hoping to find you at home so you didn’t have to come to the school to tell me ‘no’.”

“To what?” I asked.

“Dropping your second psych rotation. None of us here, nor Doctor Gibbs, nor Doctor Roth, nor Doctor Getty, think it’s a wise use of your time. I spoke to Doctor Lawson, and he agrees, and promised you’ll have plenty of opportunities to interview and assess patients on this rotation.”

“And what consensus did you reach on which elective I should take?” I asked.

Doctor Warren laughed, “There was a lively debate, given you’ve already tripled on emergency medicine and doubled on internal medicine. The top suggestion is an ICU Sub-Internship. Next was anesthesiology, and then endocrinology. And one that was rejected by everyone except the doctor who suggested it, pathology.”

“I doubt anyone consulted Doctor McKnight,” I said. “Which means it had to be Doctor Roth, so I have an opportunity to cut something before my surgical Residency starts.”

“Good intuition, Mike,” he said. “I see the logic, but your goal will be saving lives, not research or analysis. That’s why I support the ICU Sub-Internship, because it involves critical care and will help you hone your trauma skills.”

“Out of curiosity, why you, and not Doctor Mertens?”

“You’ve told her ‘no’ three or four times, so we decided to pinch-hit for her here in the ninth inning with the game on the line!”

“Do you need an answer on this call?”

“No. If it were that critical, I’d have called sooner. We know you well enough to know you’ll want to think about it and get Clarissa’s blessing.”

I laughed, “Nice!”

“It’s true, isn’t it?”

“Maybe,” I replied using a tone of voice which clearly indicated that I meant ‘yes’.

“You can change anything right now, but in about three weeks, we’ll need to formalize everyone’s schedules and let people know an elective isn’t available if something is over-subscribed.”

“I’ll have an answer for you by Friday.”

“Perfect. Thank you for not reflexively saying ‘no’.”

“You’re welcome.”

“How is your daughter?”

“Already teaching me how to obediently do what she asks!”

Doctor Warren laughed, “I have two girls and a boy, so I know that of what you speak!”

“No health or developmental trouble. She’s started crawling and in about a month she’ll start on solid food.”

“Bring her by the school sometime; everyone would love to see her.”

“I’ll do that. Thanks for calling.”

“You’re welcome.”

We said ‘goodbye’ and I hung up, then went back to the great room where Rachel was crawling towards the gate I had to step over to get in.

“She’s been looking for you,” Sara said. “She heard your voice and was trying to figure out where you were.”

“PA!” Rachel exclaimed, so I picked her up.

“Sorry, Rachel,” I said. “That was the dean at the medical school Papa attends, so I had to speak to him.

“Trouble?” Sara asked.

“No. It’s about scheduling my Sub-Internships. That’s the Fourth Year rotations. The Third Year rotations are called Clerkships.”

“What are you taking?”

“That’s the $64,000 question,” I replied. “I had planned on a second psych rotation, but every advisor at the medical school and all my mentors think it’s a waste.”

“Why?”

“Because I’m not going into psychiatry, and it won’t really impact my role as a trauma surgeon. I had planned it because of a friend who suffers from schizophrenia.”

“But if it won’t help, why not take a class, or whatever you want to call it, that will?”

“The best word to use is ‘rotation’ because it covers everything from what First Year students do all the way until the end of Residency. The answer, to be honest, is that I’m stubborn, and once I make up my mind, it’s hard to change it short of overwhelming evidence or some catastrophic event.”

“You would do something everyone is telling you not to do simply because you want to? Even if they all agree it won’t help?”

“Pretty much.”

“Only a guy would think that way!” Sara exclaimed. “I know the stereotype about women being fickle, but that’s not true. It’s men are stubborn and set in their ways and that makes them think we’re fickle! Just look at the old men in the parish!”

“You might have a point,” I chuckled.

“Might? Seriously, Mike! Don’t be an idiot just to get your way!”

“My new motto for life — Do no harm and don’t be an idiot!”

Sara smiled, “This is where I should say you’d be an idiot not to marry me!”

“You are just as stubborn as I am!” I chuckled. “At least on that topic! And what you just said might well be true, but we need to get past Rachel’s birthday before I make any decisions.”

Sara nodded, “Because of what else happened that day.”

“Exactly.”

“I may not understand what you’re going to say, but what are your choices?”

“Wide open, really. The primary suggestion is the ICU — the Intensive Care Unit. That would let me work with critically ill patients and gain skills I could use directly in trauma cases. The second suggestion was anesthesiology, which would give me experience in surgery, but also in other areas where anesthetics are used, such as OB. The other option is endocrinology, which would help with diagnostic skills, which would be helpful, but not as important as the first two. And the wildcard is pathology, which is doing autopsies and biopsies.”

“How would that help?”

“It’s the only way I could have a scalpel in my hand in the next three years. That was suggested by the Surgical Attending who’s basically overseeing my training program at the hospital.”