Chapter 8: In Rachel’s Best Interests

September 10, 1987, Greater Cincinnati, Ohio

“Hi, Petrovich,” Clarissa said when I called her on Thursday evening after dinner.

“Hi, Lissa.”

“How are you?”

“Today was an OK day,” I replied. “No crying, just an ache in my heart that won’t go away.”

“How did you sleep last night?”

“Fitfully,” I replied.

“What do you do before bed?”

“Took care of Rachel and read.”

“And you get up with her during the night.”

“She needs to be fed and have her diapers changed,” I replied. “It’ll be some time before she sleeps through the night, though I’m hoping she goes down to waking twice. It’s trending that way, and if I feed her at the right times, I think in another couple of weeks it’ll be better, though it’ll be months before she sleeps completely through the night.”

“Is there anything I can do to help?”

“Just be there for me to talk to,” I replied.

“Always, Petrovich! How are things at the hospital?”

“Fine. Doctor Kelly is allowing me to do all the usual procedures again. And working is the only way I can keep my mind off what happened, at least for a time. How about you?”

“All babies, all the time!” Clarissa declared. “Doctor Forsberg asked about you. You should try to see her and Doctor Smith when you’re home. Are you staying at the cottage?”

“Yes, except for our Sunday meal, which we’ll have at Anicka’s. Will you and Tessa be there?”

“Yes, of course. I planned to come over on Saturday evening, after Vespers, if that’s OK.”

“It is. In fact, invite the study group, please. I’ll let Maryam know tomorrow.”

“OK. I’ll see you on Saturday at Vespers, then.”

“Thanks, Lissa.”

I hung up, then dialed my mom’s house and asked for Stefan. Mom seemed surprised, but didn’t ask what I wanted and put him on the phone. I explained the situation to him and asked for his advice.

“What she’s asking for is difficult, and if her psychiatrist and psychologist both object, and her parents object, it’ll take a miracle for her request to be granted. Is there anyone who would speak on her behalf? You, perhaps?”

“I have to be very careful, because the law expressly prohibits me from giving a medical opinion except to my supervising doctors.”

“You wouldn’t be giving a medical opinion, just the observations of a friend. Do you, in your private, non-medical opinion, believe that she’s capable of caring for herself and managing her finances?”

“I think the best way for me to answer that question is that she’s how she was when I first met her during my Freshman year of college, which was in 1981. She did well in her classes, just as she’s doing now; she was taking karate, and now she’s practicing martial arts. All in all, she was quirky, but was perfectly capable of caring for herself until she had her breakdown.”

“And there’s the stumbling block for her.”

“She told me her real goal is her driving license,” I said.

“That might be possible without complete autonomy.”

“How much could she have?”

“Are her parents her guardians?”

“Yes.”

“Then I think her best possible chance lies in simply removing the incompetency finding.”

“How does that change things?”

“If they approved, she could get her driver’s license, so long as she’s not on any psychoactive drugs. She wouldn’t be able to sign contracts, but she would get access to at least part of her disability payments, which she’d be free to spend. But there’s another risk — her disability payments might be affected by a finding of competence, and that could affect her insurance and access to state services. If her doctors agreed to this, and she could work full-time and support herself, it would be much easier.”

“That’s unlikely to happen,” I replied. “The statistics weigh heavily against this being a permanent recovery.”

“If it’s just the driving license, then we could try a petition to have a finding that she’s competent to drive so long as she’s not taking any psychoactive medications. But, practically, will that matter if her parents don’t allow her to drive? Does she have a car?”

“No, but I think Angie’s goal is to get a full-time job that pays better than her current position as a data entry clerk.”

“That might be possible, despite her situation, because if she doesn’t need any accommodations and her condition is not a risk to others, she wouldn’t have to disclose it to a prospective employer. Again, though, you need to think about how this would affect her disability. I believe her current work is considered rehabilitative, but a full-time job probably would not be.”

“It sounds to me as if you don’t think this is a good idea.”

“It’s not a bad idea, Mike, it’s just exceedingly difficult in the best of circumstances with the doctors on board. Fundamentally, once you have a ruling such as this, then the burden of proving competency falls on the person making the petition, not the State of Ohio. They’ve already satisfied the court that she’s not capable of caring for herself, so now she has to prove she is.”

“What do you suggest?”

“Get her doctors on board, if you can.”

“Unlikely,” I replied. “And she forbade me from speaking to anyone other than you about this.”

“Then I don’t believe there are any options that have a realistic chance of success. I’m sorry, Mike.”

“It’s OK,” I replied. “I didn’t expect there was much chance of anything changing.”

“If anything does change with her doctors, let me know.”

“I will. Thanks, Stefan.”

“You’re welcome. Come see us soon, please. Your mom is concerned about you.”

“Thanks. I’ll stop in on the way home on Saturday for about an hour.”

“We’ll see you then.”

We said ‘goodbye’ and I hung up, then fed and changed Rachel, put her down, and went to bed.

September 11, 1987, Greater Cincinnati, Ohio

“You look tired again,” Doctor Kelly said when I saw her on Friday morning.

“It was a rough night,” I replied. “Rachel was fine, and was up her usual three times, but I had trouble getting to sleep when I went to bed and trouble staying asleep and falling back asleep.”

“Will you have help again this weekend?”

“I wasn’t planning on it,” I replied.

“Think about it, Mike,” Doctor Kelly urged. “You need sleep.”

“I know, Doc,” I replied, stifling a sigh which would not go over well. “I know.”

“Go do the admission exam for Mrs. Douglas, please.”

“Will do,” I replied.

I went to Mrs. Douglas’ room, introduced myself, and checked the admissions paperwork. Everything was in order, so I checked her vitals, ran a fetal monitor strip, and then reported to Doctor Kelly. She returned with me to do an internal exam, and once the chart was updated, I went to perform discharge exams with Nicole for five women who had given birth the previous day.

I had lunch with Maryam, and the afternoon was busy, with four deliveries and two new admissions. I was thoroughly beat by the time I arrived at Doctor Cooper’s house and Lara noticed right away.

“You need to stay at Doctor Blahnik’s house again this weekend,” she said firmly. “I’m going to call Tasha and make sure she’s available. If not, one of the other girls will help take care of Rachel.”

“You do the «бабушка» (babushka) thing really well.” (“Grandmother”)

“It’s in the blood! And what’s with you using Russian?”

“I’m just too tired to even think straight about anything other than medicine and Rachel.”

“Then it’s settled. I’ll arrange it.”

“Thanks, Lara.”

“You’re welcome. You might want to ask for a mild sedative to help you sleep.”

“The problem with that is, I have to be able to wake up for Rachel.”

“Something has to give, Mike, or you’re going to have some kind of breakdown — mental, physical, or spiritual; most likely all three.”

“I don’t know what to tell you,” I replied.

“Talk to your advisor at the medical school and see if there’s any way you can take the rest of the month off.”

“I don’t think that’s possible.”

“You said they were willing to make an accommodation, and from what you’ve told me, you’ve basically done more than a normal rotation for your level because of the way they do things at McKinley Medical School. Ask.”

“I’ll think about it,” I replied. “I’m too tired to argue with you right now. I’m going to eat, feed Rachel, then go to bed. Thanks, and I’ll see you tomorrow in McKinley.”

We hugged and she left. I had dinner with Doctor Cooper and Neil, and just as they had the previous Friday, Doctor Cooper and Neil went to watch Alan’s football game, and Annette was out on a date. As soon as I finished eating, I said ‘good night’ and collapsed into bed.

I awoke with a start to Rachel crying, unsure how long I’d taken before I was roused from sleep. I got out of bed, changed Rachel’s diaper, then put her in her baby carrier and took her with me to the kitchen to prepare her bottle. Nobody else was home, so I took her to the den where Doctor Cooper had a rocking chair, and I sat in it while Rachel contentedly sucked from the bottle.

When I finished feeding Rachel, I rocked until she fell asleep, then took her back to our room and put her in the bassinet. I lay back down and tried to fall back asleep. The two hours of sleep I’d had before Rachel woke me had taken just enough edge off my exhaustion that I had difficulty falling asleep and slept restlessly the rest of the night, getting up twice more to care for Rachel.

September 12, 1987, Goshen, Ohio

“I suspect you’re tired of people asking you how you’re doing,” Mom said.

We were in the kitchen drinking my grandfather’s special blend of tea, and Mom was holding a sleeping Rachel.

“You suspect correctly, but I don’t think I can prevent it.”

“Tasha I understand,” Mom said, “but I was somewhat surprised about Lara’s offer.”

“Me, too,” I replied. “But of all my friends, she’s actually the only one who is in a position to do it.”

“How is Yulia?”

“She’s clinically depressed and refusing treatment,” I replied. “But even if that weren’t the case, Elizaveta would never have agreed to have her mom care for Rachel full-time, and, to be honest, I agreed with her.”

“Let’s just say that the mother-daughter relationship there wasn’t out of the ordinary.”

“No kidding,” I replied, thinking about Liz and Mom.

“How are things with Viktor?” Mom asked.

“They’re fine,” I replied.

“I can help more with your finances if something changes,” Mom said.

“Thank you, but I can’t imagine Viktor would renege on our agreement. And you know I have enough savings from what I earned, from Grandpa’s gift, and from our wedding gifts, to cover all my needs until Residency. It’s less than two years away now, and even if I had to pay rent, I’d be OK. And I do have options.”

“May I be a mom for a moment?”

“Can anyone stop a Russian woman from being a mom or grandmother?” I asked with a wry smile.

Mom laughed softly, “No!”

“That was rhetorical!” I declared.

“Obviously!” Mom agreed.

“Go on,” I prompted.

“Are you eating right? Sleeping? Exercising?”

“Eating, yes; sleeping, poorly; exercising, no.”

“They make these strollers designed to push when you’re running,” Mom said. “Stefan and I would buy you one if you would use it.”

“Maybe when I move back to McKinley,” I replied. “There really isn’t a place to use one in Indian Hill.”

“Does Good Samaritan have a gym for staff?” Mom asked.

“Yes, though I really don’t have time to use it because of my obligations to Rachel and my training.”

“I’m concerned about your health, Mike.”

“So is the cabal of wanna-be «бабушки» (babushki),” I replied with a wan smile. (“Grandmothers”)

“Russian?” Mom asked in surprise. “When did you start using it again?”

“Yesterday, I think. As I said to Lara, I’m just too tired to even think straight about anything other than medicine and Rachel.”

“Are you seeing your counselor?”

“Yes.

“What does she have to say?”

“What can anyone say?” I asked.

“Not much, I suppose,” Mom admitted. “Has anyone said anything about the ‘cabal’ as you called them?”

“Father Nicholas expressed a concern, which is why I make sure one of the guys is around — Peter, Robby, Mark, or Elias. Have you heard any gossip?”

“No, I haven’t, but then again, I’m not at Saint Michael regularly.”

“Speaking of which, Rachel’s baptism is scheduled for October 4th. His Grace will be in town to ordain Mark Larson as a subdeacon, so we’ll do it that Sunday, even though it’s not precisely forty days.”

“Have you spoken to Liz?”

“Not since last week,” I replied. “Is there a concern?”

“No, I was just curious. Your grandfather would like to have dinner again on Monday, if that works for you. He’ll invite Liz and Paul as well.”

“It does,” I replied. “I’ll stop in and see Dad, Holly, and Peter before dinner.”

“How is your father doing?”

“OK, I guess. Dad isn’t any more open about things than he was before, and both he and Holly seem a bit uncomfortable with the situation.”

“Still?”

“Given what happened with Liz and Dad’s objections to my marriage, that shouldn’t surprise you.”

“I suppose so,” Mom replied. “Rachel seems like a content baby.”

“That’s fortunate,” I said. “It’s difficult enough as it is, and if she were fussy or colicky, I’m not sure I could handle it.”

“How does it feel to be a dad?”

“Scary,” I replied. “It’s one thing to take care of myself, or even myself and my wife; it’s a whole other thing to be responsible for someone who is utterly dependent on me.”

“Aren’t you planning to be an ER doctor?” Mom asked with a sly smile.

“Yes, and while I understand your point, I get to go home at the end of a shift and the patients are another doctor’s responsibility. It doesn’t work that way with kids!”

“No kidding!” Mom replied.

We finished our tea, I changed Rachel’s diaper, and then we headed for home.

September 12, 1987, McKinley, Ohio

When I arrived in McKinley, I made my weekly call to the bishop, then Rachel and I went to the main house to have our mid-afternoon meal with Viktor, Yulia, Geno, Anna, and Viktor Gennadyevich. Yulia still seemed seriously depressed to me, and it appeared she was simply going through the motions. I allowed her to feed Rachel, though made sure Anna was close by at all times, while I spent some time privately with Viktor in his study.

“I can’t make an official diagnosis,” I said. “But I believe Yulia is clinically depressed. She really needs to see someone.”

“I’ve tried to convince her,” Viktor replied, “and so has Father Nicholas, but she’s adamant that it won’t help.”

“Perhaps Mrs. Sokolov or Mrs. Malenkov could help?” I suggested. “Let me speak with Father Nicholas about it. The other thing you could do is convince her to see her physician. If she’s reluctant, perhaps Doctor Evgeni or Maria could convince her. I’ll mention that to Father tonight at Vespers as well.”

“How are things going in Cincinnati?” Viktor asked. “Your answer at dinner was a bit vague.”

“I didn’t want to set Yulia off,” I replied. “It’s a struggle. Fortunately, I have help from Lara Federov Bragg, as well as Doctor Cooper’s daughter, Annette. Tasha Antonov is a huge help here as well. Babies do need a feminine touch.”

“They do. And your training? How is that progressing?”

“It’s going well, even though I’m not getting enough sleep. Hopefully, one of the nighttime feedings will drop away in the next couple of weeks, though I don’t sleep well when I do sleep.”

“You’re seeing your counselor, right?”

“Yes. How are you doing?”

“I’m struggling to make sense of it all,” Viktor replied, “just as you are. Father Nicholas has been very supportive, and my dad and I have spent some time together, which has helped. Going to work helps similar to how your training helps you.”

“Something to stop our minds from racing,” I replied. “What about church?”

“I don’t think it helps me the way it helps you,” Viktor said.

“It’s always been my refuge,” I replied. “From the time I was little, being in the nave was a place I always felt safe and at peace. It’s also the place I’ve always gone during times of crisis.”

“Have you been angry with God?”

I shook my head, “No. Just as I’m not angry at the doctors because what happened was neither something we could detect nor fix.”

“Yulia is livid at Doctor Forsberg, and others, for not diagnosing the problem and not being able to save Elizaveta. And she blames you, too.”

“I suspected that was the case,” I replied. “I have one regret, and that was that I was in Cincinnati. It wouldn’t have changed the outcome, but I would have had more time with Elizaveta. I didn’t realize how short our time together would be.”

“Nobody did, Mike. You don’t blame yourself, do you?”

“No. There’s literally nobody to blame. But I have the advantage of having studied anatomy and physiology, so I know the science, and I understand the limitations of medicine. Someday, it might be possible to detect and repair the type of defect Elizaveta had, but right now? We can’t.”

“You said that you aren’t sleeping well.”

“I’m not, because Elizaveta is on my mind, not because I’m trying to think of something I could have done differently. Fundamentally, Elizaveta’s desire to be a mother meant eventually this problem would manifest itself, it was, if you’ll excuse the cliché, a ticking time bomb. How are you sleeping?”

“Not very well, either. Partly because of Elizaveta, but partly because of Yulia. I spoke with Doctor Evgeni and he offered a mild sleeping tablet, but I’m concerned about waking up if Yulia needs me.”

“One of the reasons I’ve resisted medication as well; well, because of Rachel.”

“Thanks for coming to dinner and allowing Yulia to spend time with Rachel.”

“You’re welcome. I’m going to get Rachel and go back to the cottage so we can get ready for Vespers.”

We left his study, I retrieved Rachel from Yulia who was reluctant to give her up, then went back to the cottage. I changed Rachel’s diaper, put her in a clean ‘onesie’, then put her in her baby carrier so I could take a quick shower. I showered, dressed, and then chose to drive Elizaveta’s car to church, because it had basically been sitting unused for more than two weeks. I transferred the car seat, got Rachel situated, then headed to Saint Michael the Archangel.

When I arrived, I made a brief stop by Elizaveta’s grave, then headed into the building. I let Father Nicholas know I needed to speak to him after Vespers, and he agreed. I elected not to serve, desiring to simply stand in the nave and worship. Rachel was, as always, the center of attention of all the younger girls, despite the fact that she slept through the service.