Good Medicine - Medical School IV
Copyright © 2015-2023 Penguintopia Productions
Chapter 10: Meet the Parents
May 30, 1988, McKinley, Ohio
"Dad," Danika said, "this is Michael Loucks, Third Year Medical Student; Mike, this is my dad, Doctor Thomas Kurian."
"Good morning, Doctor Kurian," I said, extending my hand.
"Good morning, Mike," he said, shaking hands with a light grip common to surgeons. "This is my wife, Accama, my mother Aneeta, and my daughter, Lusiya."
"Good morning," I said.
They all greeted me, though only Lusiya shook my hand.
"You'll forgive Rachel," I said, "She's napping in her car seat."
"Of course!" Mrs. Kurian replied.
"May I suggest lunch at an Indian restaurant in Columbus owned by the family of a doctor I know?" Doctor Kurian inquired.
"Yes, of course," I agreed.
"I've arranged for a car," Doctor Kurian said. "Unfortunately, we can't ride together, as it would be impossible with six adults and your daughter in a car seat. Lusiya knows the way and can ride with you."
I nodded, and we walked towards the operations building where I saw a black Lincoln Town Car which, to my surprise, had a sticker from Viktor's Ford dealership. Doctor Kurian went into the building and returned with the keys. Five minutes later, with Rachel, Danika, and Lusiya in my Mustang and Doctor Kurian, his wife, and mother in the Town Car, we set out for Columbus.
A few minutes into the drive, Lusiya spoke to Danika in what I had to assume was Malayalam, and I understood how Jocelyn had felt when I'd spoke Russian around her, and it drove home why Clarissa had put in the effort to learn enough Russian to get by in a basic conversation. That said, it didn't bug me because I was used to it, having been around Greeks, Ukrainians, Bulgarians, and Arabs, all of whom naturally conversed in their ancestral languages.
Lusiya occasionally stopped speaking Malayalam to give me directions, but the two sisters spoke for most of the twenty-five-minute drive to the restaurant. When we arrived, Lusiya took Rachel from her car seat and got out of the car. I took Rachel, who was stirring, from Lusiya and put her in her carrier, then slung her bag over my shoulder. She'd wake up completely soon enough and want to eat, which meant I'd likely be juggling my meal while feeding her.
"Sorry about that," Danika said quietly when Lusiya walked over to her parents. "Lusiya was asking a million questions about you."
"It's OK," I replied. "I'm used to that kind of thing happening. I know some people consider it rude, but with the various ethnicities in the OCA, I hear four or five languages regularly, and oftentimes at a table where I'm sitting. It's never bothered me because it's just the way things were growing up. Care to share?"
"She thinks you're handsome and was doing her best to get me to admit I'd been with you."
"We haven't even kissed," I replied.
"Obviously! I think I'd remember if we had! I promise on the drive back if she tries to keep the conversation in Malayalam, I'll just answer in English and insist she do the same."
"Clarissa took Russian lessons from one of our professors at Taft out of self-defense! Shall we go in?"
We did, and after we sat down, I asked for a suggestion of what to try. After being given a few options, I chose «Murgh Tandoori», or Tandoori chicken, which was prepared by roasting chicken marinated in yogurt and spices in a tandoor, a cylindrical clay oven, and «Jeera Pulao» a rice dish flavored with cumin.
After we ordered, Doctor Kurian related his family's story, from the time his dad had left India after medical school for a Residency at Stanford. One of the things that Doctor Kurian mentioned was a significant expansion of the hospital at Stanford which sounded similar to the plans for Moore Memorial, though Stanford would complete their expansion in about a year, whereas the completion of the expansion in McKinley was set for completion in the year 2000, though fundraising had run ahead of plan and it now looked as if ground would be broken by 1990, rather than 1995, which would lead to completion around 1995, the original ground-breaking date, and possibly even sooner.
The impression I had of Doctor Kurian was that he was very much like Doctor Getty, the Chief of Cardiology at Moore Memorial, though a bit more reserved. I chalked that up to a combination of culture and the hospital environment, as Moore Memorial was very much a public hospital, while Cleveland Clinic was private. All things being equal, from what I had seen so far, I preferred the model of public finance of hospitals, though funding challenges were a constant theme, whereas the private hospitals had far more resources.
As I'd predicted to myself, I ended up juggling feeding Rachel and my meal, though Danika offered to feed Rachel her carrots and tapioca, to which I agreed, and Rachel tolerated. As she ate, I noticed Rachel was fussier than usual, and after she finished eating, I looked into her mouth and saw red swelling on her gums, indicating her first teeth were about to come in.
"They make gel-filled rings that you can put in the refrigerator that will help," Accama offered. "My daughter Thresia used them with her first and it helped."
"I think I actually have one of those in the things that we were given either at the baby shower or the things Rachel's godmother has bought."
"You do a good job caring for her," Danika's grandmother said.
"For a guy?" I asked lightly, understanding the implication from her tone.
"It is uncommon," she said. "But I meant no disrespect."
"And I didn't take it as disrespect," I replied. "I'm continually amazed at my ability to care for an infant, though I do get quite a bit of help from her godmother and her grandmother and aunt."
"Extended families are extremely valuable," Doctor Kurian said. "That's something that is lost on many people here, though not on you."
"My grandmother helped care for us so my mom could go back to work," I said.
Our food arrived and Doctor Kurian asked me to say the blessing, which I did.
"I understand you were a deacon," Doctor Kurian said.
I nodded and explained how that had come about, how Elizaveta had approached me with the observation that I was 'in need of a wife', and the angst I had about asking to be laicized.
"I agree with you that a little girl needs a mother," Danika's grandmother said.
And I was sure she, as with Dani's grandmother, felt her granddaughter fit the bill. I wasn't so sure, as there were similar considerations to the situation with Maryam. That said, it was seven years before Danika would begin her Residency. In seven years, I'd be PGY6, and have completed six of my eight years, with two years of surgical Residency to go, having split the first six equally between trauma and surgery.
Danika would have clinical rotations, of course, but those were nothing like PGY1. When Danika was a PGY1, Rachel would be in school, and the two children we had discussed would be at least five, if not six, something far different from trying to care for a baby with both parents as Residents.
We finished our meal, and after a brief discussion, decided to drive back to McKinley so Danika's family could see the house. I was grateful for the thorough cleaning Irina and Susana had done, as that would make a good impression on my prospective in-laws.
When we arrived, I gave them a tour, then made tea and coffee, and cut some of a fresh loaf of artoklasia Irina had brought with her on Saturday. Danika offered to take Rachel, and when Rachel didn't object, Doctor Kurian and I took our tea and bread into my study and sat facing each other in a pair of comfortable chairs.
"Tell me what you think," Doctor Kurian said, without any preliminaries.
"With all due respect, Doctor Kurian, I believe what you think is more important at the moment."
"Why is that?" he inquired, then sipped his tea.
"Because if you don't approve, there's nothing to discuss, as Danika won't go against your wishes and marry someone you felt was unworthy. She might refuse to marry someone you chose, but she would never marry someone if you objected."
"Does that concern you?"
"Elizaveta sought her dad's approval before she approached me with her proposal. A young woman I dated before Elizaveta also needed her father's approval. I also have experience with how things go when the girl's father doesn't approve. In other words, this isn't new. As I said, I'd like to hear your thoughts."
"I was, I will admit, somewhat surprised when Danika called and let us know she had met you and you had invited her to church. I asked her many questions, and she hinted very strongly at what she was thinking. I was concerned, of course, because I don't know you or your family, but she said you scored in the 99th percentile on the MCAT and MLE step 1, and are top in your class. My first question was why you weren't at a top-tier medical school?"
"As I said to Danika earlier, I plan to serve my community, and McKinley Medical School and Moore Memorial Hospital are training me to do just that. I plan to practice here, and honestly don't see moving away because my church, family, and friends are here. My hometown is actually about forty-five minutes west, but the hospital there isn't a teaching hospital."
"I understand you helped draft a proposal for a combined emergency medicine/surgery Residency, and it was approved."
"I got the idea from Doctor Albert Barton, who's Chief of Emergency Medicine at University of Chicago Hospital. I met him when I interviewed at Indiana University Medical School."
"Do you know Doctor Malik Washington? He used to practice here before he was hired as Chief of Cardiology at the University of Chicago."
"I met him when he treated Deacon Grigory from our parish."
"I called Ron Getty to ask about you, and he gave you a glowing review."
I wasn't surprised that he'd called the Chief of Cardiology to ask about me.
"What is it that gives you pause?" I asked. "Besides not knowing my family?"
"Our Indian heritage is very important to us, and I would want my grandchildren to honor it."
"Just as I honor my Russian heritage," I replied. "But I am not defined by it. Your daughter and I were both born in the US and are Americans, and you've been here since High School. Rachel is an American. Do we keep some Russian traditions? Absolutely, though mostly to do with Church, holidays, and how we name our children. I speak Russian, but have no plans to teach Rachel to speak Russian.
"One of the most important tenets of the Orthodox Church in America is that we are not ethnic, but American, and everyone — Russians, Greeks, Arabs, Serbs, Bulgarians, Indians, Japanese, or whatever nationality can worship side-by-side as can people of any skin color. We receive converts of all races, creeds, colors, and national origins, and welcome them all.
"It's no different, in that way, from the ideals of medicine where we treat every single patient with the same care, respect, and Christian love, no matter what. The atheist receives the same quality of care as does the Orthodox Christian; the perpetrator of a crime receives the same quality of care as their victim.
"Ultimately, and with respect, Doctor Kurian, my family will be American, speak English at home, and worship together in a parish where English is the liturgical language. Will we honor our heritage? Absolutely. Will we be bound by it? Absolutely not."
"Doctor Getty said you had very strong opinions, and you weren't afraid to express them."
I nodded, "I was told many times that my job, even as a medical student, is to be a forceful advocate for my patients. I learned the lesson and applied it to other aspects of my life as well. There are many things on which I can compromise, but patient care, my faith, and my views on race and ethnicity are not among them.
"Have I noticed your daughter's skin is a lovely shade of brown compared to my pasty-white northern European complexion? Absolutely. Do I see Danika as anything other than a beautiful young woman of Indian heritage who lives in Ohio and was born in California to a father who had lived in California from the beginning of High School? No, I don't. Will I honor her Indian heritage? Of course. But I won't be bound by it."
"Medical students do not usually speak this way to senior Attendings."
"I'm not a usual medical student," I replied lightly. "I am positive Doctor Getty made that clear. When I spoke to Doctor Subramani, her advice was to set aside my usual approach and be deferential and respectful. This is me being deferential and respectful because being a doormat is not how one forcefully advocates for their patients, nor is it how one learns. That said, I will not stoop to underhanded tricks to gain procedures, but I will argue my case forcefully."
"And you think that is the best way to achieve your goal?"
I smiled, "Yes, I do. I expect to manage my family, together with my wife. We'll listen to advice, but in the end, how we conduct our marriage and raise our children is our business."
"Would you tell me about your finances, please?"
I explained how I'd worked in High School and college, how my parents had helped, and about the grants I'd received to get through Taft with no debt. For medical school, I simply said that I had received sufficient grants and scholarships to cover the cost, as I didn't want to bring Viktor into the conversation. I covered housing, both living in the cottage and the help that my grandfather and his friends were providing so Rachel and I could live in the house. I concluded by saying that the money my parents contributed towards medical school went towards expenses, as did the money I was earning from Code Blue.
"No debt at all?" Doctor Kurian asked.
"Correct. I have one credit card which I use for emergencies or travel, but it's paid in full every month when I do use it."
"Do you cook?"
"Yes, though the women from the parish have helped with meals since Elizaveta reposed, and they also help by cleaning the house and caring for Rachel when I'm on shift. Her godmother coördinates everything, and of course, my in-laws help with Rachel as well. In addition, I prepare fresh food for Rachel from raw ingredients, rather than giving her prepared baby food. Well, I use formula for obvious reasons."
"Do you know your starting salary for next year?"
"$27,800," I replied. "I'll be paid as a surgical Resident even though I'll spend the first two years in the Emergency Department as an Emergency Medicine Resident. After two years, I'll begin the surgical Residency, covering ED consults while I train, and eventually, be assigned to the Emergency Department, but as a member of the surgical staff. It's a bit convoluted because surgeons need to be supervised by surgeons, even though I'll be assigned to the ED."
"New Residencies are often complicated," Doctor Kurian acknowledged. "I'm sure there is other oversight as well."
"Yes. There are required reports and evaluations, not just of my performance, but also about the effectiveness of the training. If all goes well, then two years after I start, there will be two additional Residency slots for trauma surgeons with the goal being to cover the service. That's about the time they'll break ground on the new emergency medicine wing."
"Changing subjects, how many children do you want?"
"I never had a fixed number," I replied. "Elizaveta and I had agreed on two, but that was the minimum, not a limit. I would say, based on what I've observed, that two more would be practical, given Danika's situation."
"Do you plan to stay in this house once there is no further assistance from your grandfather and his friends?"
"As of right now, yes. I'll be able to afford the rent and utilities with the salary I'll be paid, and I have sufficient emergency reserves. Part of my savings will also go towards buying a home when the time is right."
"Assuming we were to reach an agreement, when would you propose to marry?"
"September," I replied. "That's after the canonical one-year mourning period. A secular engagement before then is fine, but the betrothal and crowning ceremonies would need to be after August 26th."
"Where?"
"Either at my parish or the cathedral. You do realize Danika would need to affirm the dogmatic declarations of the Seven Ecumenical Councils, including Chalcedon?"
"Other than receiving the Eucharist in each other's parishes, is there any practical difference?"
"No. His Grace, Bishop JOHN, the OCA bishop for Ohio, has said privately that it's a semantic disagreement that could easily be resolved if the two sides were amenable. But that's an issue for our bishops to discuss, and I consider you Orthodox, as I hope you consider me to be Orthodox."
"Let's say I wouldn't be sitting here if I did not."
"More tea?" I asked.
"Yes, please. And the bread is very good."
"Baked by Irina Gromova from our parish," I replied as I poured tea into both our cups. "As I said, the women take very good care of us."
"Out of curiosity, are there no young women in your parish in whom you are interested and who are interested in you?"
"Several, between the two parishes and the Cathedral, but most of the young women are not ready to be wives and mothers, or are away at college, or have some other impediment. There is one young woman my grandmother arranged for me to see before Danika and I met whom I see once a week, but I've made no commitments to her, her parents, or perhaps more importantly, to my grandmother."
Doctor Kurian laughed, "So what I hear about Russian grandmothers is true, then?"
"Very much so! One crosses them only at grave risk, and that's true of the bishop as well!"
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