Good Medicine - Medical School IV - Cover

Good Medicine - Medical School IV

Copyright © 2015-2023 Penguintopia Productions

Chapter 19: Answers

July 4, 1988, McKinley, Ohio

"The answer to your question from Saturday really made me think," Nadiya said, "and I realized that you're the first guy I've met who both acted like an adult and treated me like an adult. That's what intrigued me, and why I decided to give you my phone number."

"Out of curiosity, when did you tell your dad about me?"

"After you called. If you hadn't called, there wouldn't have been a point."

"And that's when he voiced his objection?" I asked.

"Yes," Nadiya confirmed. "He told me I should cancel because of what I said about you being a 'grown man' and me being a 'teenager'. I discussed it with my mom afterwards, and while she was concerned because you had a daughter, she didn't object the way my dad did. At that point, my choices were to keep our date or cancel. It was just dinner, and I really did want a chance to talk to you, so I kept the date.

"I enjoyed having dinner with you and talking with you, and when I drove home that evening, I was positive I'd made the right decision to get to know you better, and I was positive I wanted to see you again. I guess, in the end, that is what made me decide to ignore my dad's view. He totally wasn't happy with me coming here and had a fit about me spending the night, even though it's at your professor's house. I decided that you were right about being an adult, and deciding for myself, and so here I am."

"Did your dad make any threats?"

"No. He just went off about how 'perverted' it was that a twenty-five-year-old was interested in an eighteen-year-old. Mom made the point that his own mom was nineteen when she married his dad, who was twenty-eight. He said 'times were different' and went into his den and shut the door and didn't come out before I went to bed. I really think you're right that he doesn't see me as an adult, or even a young adult."

"What would his reaction to a marriage be?" I asked.

"I don't know. Does it really matter?"

"In one sense, no, it doesn't. In another sense, it does because I'd want to have good relationships with my kids' grandparents. There are going to be four sets, at least — my mom and her husband, my dad and his wife, Elizaveta's parents, and my future wife's parents. If they're divorced, it could be five sets.

"And add in the complications of great-grandparents, and strained relationships are a problem. I had that with my dad's parents because they objected to him converting to Orthodox Christianity and that created a rift. That said, it wouldn't stop me from marrying someone, but it is something to take into account, along with everything else."

"I think that makes sense," Nadiya said. "I've been thinking about everything, and it's a combination of exhilarating, confusing, frightening, and overwhelming. It's like somebody pushed me into the deep end of the pool and said 'swim' without me having had any lessons."

"Life is often like that," I replied. "What we know about marriage, we learn from our parents, at least for the most part. The same is true about parenting, though we compare our parents with our friends' parents. One of the values of dating in High School is that it gives you a chance to learn about relationships first-hand.

"In this case, though, there are the complications that I was married before, I have a daughter, and I have a career which is demanding on my time and attention beyond what's true for most people. My mom and dad could both forget about work as soon as they left their offices. That's not true for medicine, especially during medical school and the first years of Residency. Even after that, there are journals to read, charts to review, conferences to attend, and being on call.

"Ultimately, there is a lot for you to handle right off the bat — marriage, motherhood, a husband in medical school, and college. And that's why I asked the question I did just as we reached the house. It's a lot to lay on someone, no matter how old they are or how much life experience they have. In your case, it's even tougher, because, in effect, you don't have much life experience."

"You mean dating?" Nadiya asked.

"I mean dating, college, living on your own, the whole nine yards. You do have some work experience, which is something, but, to be honest, you haven't experienced being an adult."

"Are you saying now that you aren't interested?" Nadiya asked.

"Not at all! You need to have more confidence in yourself. I strongly suspect that you've never had conversations like the ones we've had."

"I haven't."

"Which is why you lack self-confidence," I said gently. "And I'm reasonably certain that it's a matter of being unsure, not viewing yourself as lacking anything."

"Your wife was even younger than I am when you married."

"Yes, she was. She was supremely confident in her ability to be a wife and mom because she'd been taught how to do that by her mom and her grandmothers. She also had the advantage that during my first two years of medical school, it was studying that occupied my time and that allowed for some flexibility. And, of course, we didn't have Rachel."

"Had she dated?"

"No. But again, her upbringing was such that she understood how a successful, traditional marriage worked and that perfectly fit her personality. Of course, being raised the way she had been, it might be that her personality was a reflection of her upbringing, though I think it really was her true nature. What she wanted out of life, what would fulfill her, was to be a wife and mother, and eventually a grandmother. I know that goes against feminist theory, but it's what Elizaveta wanted, and it was her right to want that."

"Is that what you wanted?"

"The girls I dated while I was in college, before Elizaveta and I became engaged, all had career plans. Even my friend Angie, who wanted to be a wife and mom, also wanted to teach elementary school. The girl I dated the longest, Sandy, planned to go to medical school."

"Planned?"

"While we were dating. She did go to medical school, but she took her own life."

"That was after you stopped dating, right?"

"Yes. I married right before medical school started. Sandy and I ended our relationship amicably, which I think is demonstrated by the fact that she and her boyfriend went to Europe for five weeks with Elizaveta and me and two other friends. Sandy had trouble dealing with stress, and, in the end, the stress of medical school was too much for her to bear. We all knew she was stressed, but nobody in our study group, or her boyfriend, thought she'd swallow enough pills of the correct type to kill herself."

"The stress was that bad?"

"It was, and it is. But I kind of thrive on it, as do my friends Clarissa, Maryam, and Peter. My friend Fran has coping mechanisms which involve a loving husband and chocolate. It used to include Jack Daniel's, but given the rules for blood alcohol content, we all pretty much have to be teetotal at this point. The other member of our study group, Nadine, is more private and I'm not sure how she copes, but she does. And the stress will be worse for me starting next June when I'm actually a doctor and working shifts that could last thirty-six hours."

"That's crazy!"

"TELL me about it," I chuckled. "Everyone agrees, but nothing is going to change because, in effect, that's how it's done, and for one training program to change, all training programs would have to change. I suspect that some day something bad will happen, bad enough to get attention, and then modest changes will be made. Until then? Unlikely."

"I'm not sure how I can know for sure if I can handle it or not."

"It's more about being willing to commit to doing whatever it takes to make it work. In one sense, that's true about marriage as well. You have to go into it determined to make it work, not with the idea that you can simply bail out if things become difficult."

"Why did your parents divorce?"

"My dad violated his vows," I replied. "And there was no coming back from that."

"If I'm prying, please say so, but I feel that there has to be more to it."

"There were strains in my parents' marriage because of things going on in the family, and it revealed deeper concerns which had been lurking under the surface. In the end, my dad elected to end the marriage, and he did so by having an affair. It's way more complicated, but there are simply some things I can't discuss because they would violate the privacy of other members of my family. The straw that broke the camel's back, if you will, was when my sister married a man who was more than ten years older."

"But your dad's wife is way younger, right?"

"Yes. It's seriously complicated, and there is way more to it, but I really can't talk about it."

"Sorry, I didn't mean to pry."

"You had legitimate questions, and I could answer them partially. Anyway, the next question is what you want to do."

"I still want to see you on Sunday and go to church. One step at a time, right?"

"That is the best way. We should probably get to the park. I'll need to meet the band in about forty minutes."

I changed Rachel's diaper, we packed her bag, and I carried it and my instruments to the car, while Nadiya carried Rachel. Twenty minutes later, after introducing Nadiya to Clarissa and Lara, I left Rachel with Lara, then headed to meet the members of Code Blue so we could prepare for our hour-long performance, while Nadiya stayed with my friends.

The performance, which included three songs where Kari participated, was well received as all of our performances had been, and when we finished, we packed up and joined the large group of our friends, which now included some doctors, nurses, and firemen. It didn't include Sara, as she and her family went to Columbus to spend the day with family friends.

It did include Oksana and Doctor Casper, which made it abundantly clear that her suggestion that we 'play house' for a week while her parents were away wasn't going to happen. As much as it would have been enjoyable, I was happy for her. Doctor Casper would be an Attending in June, and that would give him a much more reasonable schedule, one which would allow him to give Oksana the attention she clearly needed.

"I like her," Clarissa said, coming up to me as I got a Sprite from the cooler. "But that skin! Could it be any whiter?"

"I doubt it," I replied. "How is she getting along with everyone?"

"She and Lara hit it off pretty well," Clarissa replied. "We can talk more later."

I nodded and took my can of Sprite to where Nadiya was sitting with Lara, Rachel, Maryam, Tessa, and Milena.

"PAPA!" Rachel exclaimed, so I took her from Lara.

"Where's Abigail?" I asked.

"With Mom," Milena said. "She, Derek, and Joel took Abigail for a walk."

"BA!" Rachel demanded.

"Nadiya, would you get the apple juice from the bag next to you, please?"

She did and handed it to me and I offered it to Rachel, who happily held the bottle and sucked.

"Demanding little thing!" Tessa declared with a silly smile.

"Like all women," I replied deadpan.

"If men would actually concern themselves with our needs, we wouldn't need to be demanding!" she retorted.

"Elizaveta had no complaints," I replied smugly.

"Because you basically did what she wanted all the time!" Tessa teased.

"Not even close!" Milena said, laughing. "Mike frustrated her as he did every girl he dated in one way or another!"

"I'm just that good," I grinned.

"He certainly has the ego of a wannabe surgeon!" Lara declared.

I realized, in the midst of all the teasing, I'd been intimate with all my female friends in the small group, but hadn't even kissed Nadiya. But it had been my choice not to try, though I felt I should at least offer a hug when I walked her to Doctor Blahnik's house later in the day.

"Hi, Mike!" Doctor Gibbs said. "Great performance!"

"Thanks. You should come to Stirred Not Shaken in August. We have two gigs, one on the 5th and one on the 19th, and we have some new songs to play."

"I'll get us tickets, Lor," Bobby said.

"Mike?" Pete called out. "You up for volleyball?"

"Sure," I replied.

"Anyone else who wants to play, come join us," Pete said.

"I'll take Rachel," Nadiya said.

Rachel's bottle was empty, so I took it from her and handed her to Nadiya, thankful that Rachel didn't say 'MAMA!' which would have been difficult to explain. Tessa and Bobby both joined us to play volleyball, giving each side seven players. We played three games, with the other team winning two while we won one, before Jason, Pete, and Bobby went to man the grill and I went to sit with Nadiya and Rachel.

"How is she going to react to fireworks?" Nadiya asked.

"Good question! I have no idea, but I brought her earmuffs to muffle the sounds to protect her little ears. She'll still hear them, but it won't be too loud."

"Those aerial bombs can really shake you," Tessa observed.

"More than the average Ohio road?" I asked with a grin.

"You want bad roads?" Maryam asked. "Go to Illinois! They're the worst."

"I think she's right," Lara said. "I've been to a lot of places, and Illinois has some of the worst roads anywhere."

The food was ready, and we all helped ourselves, though I had brought Rachel's food with me, as she wasn't ready to eat anything that was being served except perhaps a hot dog bun which I did give her to gnaw on, though I watched carefully to ensure she didn't bite off too big a piece and choke on it. Clarissa left as soon as we finished eating, as she had to be on shift at 10:00pm, which was about the time the fireworks display would start.

Rachel did well during the fireworks, and the earmuffs worked as I'd intended. She wasn't really paying attention, even though I was holding her and pointing to the sky. I suspected next year might be different. When the fireworks display ended, we packed up, and Nadiya and I carried our things to the car. Because Rachel was falling asleep, I drove to Doctor Blahnik's house, rather than follow my original plan of driving home and walking with Nadiya and Rachel.

"What time do you get up in the morning?" Nadiya asked when I walked her to the door.

"5:15am," I replied. "That gives me time to shower, eat, collect Rachel's things, and get to the hospital early enough to drop her off so I can start my shift at 6:00am."

"Then I guess I'll see you next Sunday, as it seems like you don't have any extra time in the morning."

"That's true," I replied. "I'll pick you up at 9:00am so we can be at the church at 10:00am for Divine Liturgy."

"That sounds good!" Nadiya exclaimed, then leaned forward and planted a quick kiss on my cheek.

"Good night," I said.

"Good night."

Once she'd let herself into the house, I went back to the car where Rachel was sound asleep and headed south to my house.

July 5, 1988, McKinley, Ohio

"What brought you in today?" I asked a young man about my age who was pale and diaphoretic.

"I'm throwing up constantly," he groaned. "Can't keep anything down."

"I bet it was the potato salad!" a young woman about the same age said reprovingly. "I told you not to eat it after it had been out in the sun!"

"Have a seat, let me get some basic information and we'll get you to a treatment room."

I filled out the triage form and based on my questions and his symptoms, I was fairly certain Jim's girlfriend, Nickie, was correct and he had a case of food poisoning.

"I told him the mayo sitting out for hours would make him sick!" Nickie declared.

"It's actually not the mayo," I replied. "Commercial mayonnaise is perfectly safe. The bacteria usually come from the eggs, the potatoes, the surface used to chop things, or the hands of the person making it. And even a cooler won't help unless it has plenty of ice, because bacteria thrive between 40°F and 140°F."

I'd been exceedingly careful with the cole slaw I'd made, ensuring there was sufficient ice in the cooler, and bringing a larger bowl to fill with ice in which I set the bowl of cole slaw to keep it cool.

"Everyone knows it's the mayo!" Nickie protested.

"And 'everyone' is wrong," I replied. "But either way, we'll get him checked out, give him some IV fluids, and possibly medication for nausea."

I escorted them to a treatment room, wrote Jim's name and 'Food Poisoning' on the board on the line next to Exam 2, assembled a chart, and put it in the rack, then went back to my spot next to Nate.

"OK, I thought it was the mayo!" he said.

I chuckled, "Me, too, until I had my epidemiology course. I suspect we'll see a few more cases today."

"Not this one," Nate nodded towards the door. "It's too much sun!"

I saw a parent walking in a child of about ten who had terrible sunburn, to the point where I thought there might even be blisters.

"He's going right into a trauma room," I said. "What's open?"

"3."

I got up and escorted the woman and her son to Trauma 3, got basic information, then went straight to Doctor Gabriel.

"Nine-year-old fell asleep in the sun yesterday at Milton Lake. Sunburn over sixty percent of his body, with several blisters. He'll need IV fluids and a full set of labs. He's in Trauma 3."

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