Chapter 20: The Borodins Are a Stubborn Lot

July 10, 1988, Greater Cincinnati, Ohio

"Good morning!" Nadiya said when she opened the door of her house. "I'm ready to go."

"And to think some people don't believe in miracles!" I teased.

"I don't fit that particular stereotype! I'm always ready on time."

We walked to the car, I opened the passenger door for her, she got in, and I closed the door. I walked around to the driver's side, got in, buckled up, and started the car. I backed out of the driveway and headed for Saint Athanasius in Norwood.

"The basic pattern of the service will be similar to a Lutheran service," I said. "Though there is an icon screen rather than a chancel rail separating the altar from the nave."

"Nave?" Nadiya asked, interrupting me.

"That word has the same root as the word 'navy' and symbolizes the ark that carried Noah's family during the Flood. Continuing the thought, the main difference between the iconostasis and the chancel rail is that the icon screen is floor to ceiling with central doors which are opened at various times, as opposed to a low rail with a gate.

"Both serve the same purpose, and that is to limit access to the altar or sanctuary to clergy or other authorized individuals. Another commonality is that Orthodox priests hear confessions in front of the icon screen, just as Lutheran pastors traditionally heard confessions at the chancel rail. I'm not sure if your LCMS church follows that practice."

"No. Confession is done in the pastor's office, though not too many people confess."

"Confession is more common in the Orthodox Church. Both traditions developed from public confession in front of the congregation which, though once non-members were permitted into the churches during services, that practice morphed into private confession with a priest or pastor.

"In addition, we practice 'closed communion' similar to LCMS, in that only baptized and confirmed, or in our theology, chrismated, members may receive the Eucharist. Those who are not 'in communion', that is, in theological agreement with the local bishop, may receive a blessing, and also may share in the antidoron, which is blessed, but not consecrated bread."

"You seem to know a lot about my church."

"I believe I mentioned I was an authorized catechist, and our bishops require that we study the theology of other Christian groups, as well as Islam and Buddhism."

"Your services are all in English, right?"

"In most parishes, yes, though there are a few traditional responses and hymns in Church Slavonic or Greek, but those are generally only used on special occasions. It's not likely you'll hear anything other than English today, except perhaps «Господи, помилуй» (Gospodi, pomiluy) or Kyrie eleison, Slavonic and Greek for 'Lord have mercy'."

"Your church never used Latin, right?"

"Correct. Greek was the common language of the Roman Empire, and the language of the Orthodox Patriarchates in the East. The language of the liturgy was adapted to the local population, which is how Cyrillic script originated — the hymns, prayers, and text of the Divine Liturgy were translated into early Slavic languages which became in modern times Serbian, Russian, Ukrainian, Polish, and so on."

"What language did you take in High School?" Nadiya asked.

"Latin. I also took it at Taft. So many medical words are derived from Latin and Greek, that I felt it made sense. I taught myself Biblical Greek in High School. I can't really speak either of them, but I can read them."

"I think you're the smartest person I've ever met."

"I have a good memory," I replied. "That's just one sign of intelligence. I also have a Y chromosome, which my female friends insist is a contraindication of intelligence!"

Nadiya laughed, "Boys can be pretty dumb! But you're not a boy!"

"One of my friends has said that men are simply boys in bigger bodies with more disposable income!"

"I couldn't say because I don't really interact with anyone much older than me except teachers and relatives."

"Not at church?"

"No."

"In our church, the young men and boys spend time with the grandfathers. It's mostly positive, though the one time in my life I've been drunk was thanks to my grandfather and his friends. I was fourteen, and it was at Pascha, which is what we call Easter. One of the men from the parish had to carry me into the house. My mom was not amused. But other than that incident, and learning words in Russian of which my mom didn't approve, it was positive, even from her perspective. That said, my threat to her is that if she's not careful, I'll turn into my grandfather!"

"I have no clue what you're talking about!"

"A joke between my mom and me about the way Russian men act when they become grandfathers, mostly due to the behavior of Russian women."

"I feel like I'm missing quite a bit of information," Nadiya said.

"Our life experiences are fairly different, even though we're both Americans from Southern Ohio."

"And you have seven years on me."

"That's less relevant than the milieu in which we each grew up. But we have the same basic values, our faiths are compatible, if somewhat different, and we're both interested in each other. The extra years I have were mostly spent in school. Yes, I have more experience than you, but it's not so great that we can't have a successful relationship, no matter what your dad might think."

"Mom got him off the ledge, but he's totally unhappy."

"Because he still thinks of you as a little girl," I replied. "I suspect that might not change until you have a baby and become a mom."

"Except with you, the order would be reversed from normal."

"Yes, it would. Is it safe to assume you're OK with that idea from the fact that you've decided to continue seeing me over your dad's objections?"

"Conceptually? Yes. If you're asking if I'm ready to say 'yes' to a marriage proposal right now, no."

"I'm not asking that question just yet, though if you decide your answer is 'no' or that you want to wait years, I'd like you to tell me."

"Your plan, I guess you would call it, is to be married soon, right?"

"I'd say before graduation, which is next May."

"But you won't ask before the anniversary of your wife's ... what was the word you used?"

"'Repose'. And yes, that's correct."

We arrived at the church and found a spot in a pew toward the back of the nave. That would allow me to leave if Rachel needed a clean diaper or wanted a drink. I made sure Nadiya had a copy of the service book so she could follow along, and about ten minutes after we arrived, the Divine Liturgy began. About three hours later, we left the church, electing to go to lunch at Skyline rather than join the congregation.

"Can I ask why you didn't receive communion but Rachel did?"

"Like many things in my life, it's complicated. The root cause is a spiritual struggle, one which I've had from the time I was a teen, but which was exacerbated by the events of last August. I'll work through it, but until I do, I need to refrain from the Eucharist. I'm curious what you think about the service."

"I saw the pattern of the order of the service, as you suggested, though obviously way more complex than ours. And a LOT longer!"

"And that was just the Divine Liturgy," I replied. "Typically, there is a Matins service before the Divine Liturgy, and on Wednesday and Saturday evenings, Vespers. And, of course, liturgies for Feast Days. Until recently, I've gone to basically every service, every year, but with my medical training and the events of the past year, I've missed some. But it's my intent to attend all the services in the future, or at least as many as my shifts allow. I also say morning and evening prayers every day, usually with Rachel."

"That's hardcore."

"It is, and it's something you have to consider, along with fasting."

"That's even more hardcore, if I understand it correctly."

"Yes, and it has two important effects. First, to teach us to discipline ourselves, for if we can control our desire for food, we can control our other desires. Secondly, to remind us on a daily basis that we are Christians and everything we do should reflect that fact."

"That kind of takes things to a whole new level for me."

"It, along with everything else, has to factor into your decision to proceed or not."

"I definitely want to proceed to Skyline!"

I chuckled, "Me, too!"

We had a nice lunch, then I drove Nadiya home, where I walked her to the door.

"I'm busy next weekend," I said. "So, shall we plan a week from next Saturday?"

"Absolutely!"

She kissed my cheek, then went into the house, and Rachel and I headed home to McKinley.

July 11, 1988, McKinley, Ohio

"Michael, please meet Matta Monsour," Maryam said when Lauren and I joined her in the cafeteria for lunch. "Matta, Michael Loucks."

We shook hands and exchanged greetings.

"My condolences on the loss of your «khouria»," Matta said, using the Arabic word for a clergyman's wife.

"Thank you. This is Lauren Nichols, a fellow medical student."

They also exchanged greetings, then the four of us got in line to get our lunches. Once we had them, we went to a table to eat together.

"What kind of engineer are you?" I asked.

"Electrical," he replied. "I work for DP Engineering in Naperville, designing and building test equipment."

"Test equipment?" I asked.

"For automotive and manufacturing systems. Basically, the equipment is designed to test electrical circuits and logic boards for proper operation."

"Where did you go to school?"

"UofI in Champaign, Illinois. You went to college here in McKinley, right?"

"Yes. William Howard Taft."

We had a good chat, and I had a very good feeling about him by the end of lunch.

"He seems like a nice guy," Lauren said as she and I walked back to the Emergency Department.

"I agree. Maryam plans to Match in Chicago, so there's a potential future for them. Have you given more thought to your electives? I mean, besides the trauma Sub-I?"

"I spoke to Doctor Mertens, who is my advisor, but I haven't made any final decisions. I'm thinking cardiology, medicine, and surgery. Combined with emergency medicine, that would give me a broad set of choices for the Match. I'll figure out the other two before Christmas."

"Kentucky?"

"I think we discussed the challenge there, so if I do end up in Harlan County, it'll be after my Residency. But who knows? A lot depends on what happens in my personal life."

"You actually haven't mentioned anything in that regard."

"There's not much to talk about! Who has time? And I'm in no rush. You know how tough it is for women in medicine, especially when they decide to have a baby."

"Which is wrong on every level, and something we need to work to change, but unlikely to change before you begin your Residency."

"I'd need a boyfriend first!" Lauren said with a soft laugh. "Not worth the time and effort right now. Most guys won't put up with the schedules we have."

"There are quite a few girls who won't, either," I replied. "I've commented before that medicine is a harsh, demanding, jealous mistress, and she does not brook anyone or anything interfering with her demands."

"I'd say that's an accurate assessment, if a bit chauvinist."

"Sorry. Substitute 'master' and it still works!"

"You're actually not part of the problem, Mike. I'm just a bit sensitive because in High School even my guidance counselor tried to discourage me from going into medicine."

"That kind of thing makes no sense to me."

"To me, either, obviously. But it's something I've had to deal with, including at UK, where several of my professors played favorites with guys over girls in honors courses."

"Top to bottom, the treatment of girls and women in schools needs to change, and they need to be given equal opportunity. To fix that, we have to fix things starting in grade school. Yes, there are things which can be done in High School, college, medical school, and Residency, but unless girls are treated equally with regard to math and science in grade school, they're at a disadvantage, even if it's simply psychological."

"You're a feminist?" Lauren asked.

"That's been said, but I'm more interested in equality, along the same lines as Doctor King's vision of not seeing people for the color of their skin. There are differences between men and women, but I don't think the ability to learn math or science is one of them, nor the ability to be a physician. And allowances should be made for having kids, instead of disparaging the concept."

We arrived in the ED and Lauren was immediately called by Doctor Foulks to assist. I checked the board and saw there were no changes while I was at lunch, so I went into the lounge to wait for the next ambulance to arrive, which happened just six minutes later.

"Jake Brown," the paramedic called out, "twenty-nine; crush injury to right leg; BP 90/60; tachy at 110; PO₂ 98% on five litres; no distal pulse right leg; 5mg morphine; saline IV TKO."

"Trauma 1!" Doctor Casper ordered. "Bill, page Ortho!"

Bill, a Third Year, sprinted to the phone while the paramedics, Doctor Casper, Nurse Ellie, and I rushed the patient to the trauma room.

"Mike, EKG," Doctor Gabriel said, then he turned to the paramedic and asked, "What happened?"

"A pallet of bricks fell off a forklift at a construction site," the paramedic replied.

I cut Mr. Brown's work shirt and saw a contusion.

"Bad contusion on his abdomen," I said to Doctor Casper as I began attaching leads.

"OK. Leg first, because if we don't get blood flow restored, he'll lose it."

"Ortho is on their way," Bill announced.

"Trauma panel, please," Doctor Casper said to him.

"Normal sinus rhythm," I said as Bill prepared to draw the blood. "Tachy at 120; PO₂ 98%."

I checked the patient's BP and reported it, "BP 100/60."

"Trauma exam, please, Mike," Doctor Casper said as he continued to examine the patient's leg.

I performed the exam and reported the results, "Pupils equal and reactive; ears and nose clear; no apparent head injuries. Breathing is labored but clear. Heart sounds are clear but rapid."

"Miller, Ortho," Doctor Tim Miller said as he came in with a student trailing behind. "What do we have?"

"Crush injury to the right leg," Doctor Casper said. "No distal pulse."

"Stable enough to move to surgery?"

"His BP has come up since initial assessment, so I'd say yes."

"Then let's go!"

I helped disconnect the monitors and switch to a portable oxygen bottle, then the student whom I knew by sight, and I quickly moved the gurney out of the room and towards the elevator. Five minutes later, I was back in the ED. The rest of the afternoon was a series of cases which resulted in admissions, and no deaths, which, all-in-all, made for a good day.

"No Maryam?" Irina asked when she arrived with my dinner on Monday evening.

"She has a guy friend visiting from Chicago," I replied.

"Interesting!" Irina declared. "Want some company for dinner? I don't have anyplace I need to be."

"I'd like that," I said. "Let me just finish feeding Rachel so we can eat without too much interruption."

"I need fifteen minutes to get everything ready, so that works."

"OK."

I fed Rachel while Irina put what amounted to finishing touches on the meal, which included putting the bread in the oven to ensure it was warm, and just about fifteen minutes later, we sat down to eat chicken, mashed potatoes with gravy, corn, and bread.

"Awesome as always," I said a few minutes later.

"Thanks! I'm glad you like it! I have something sweet for dessert, too!"

She smirked, making it clear she wasn't referring to a pastry, ice cream, or baked goods.

"And what might that be?" I asked innocently.

"Well, if you play your cards right, it'll be cream-filled!"

I laughed, "That's supposed to entice me?"

"You get to add the cream filling! And besides, you've kissed me afterwards, and you've put your tongue in me afterwards!"

"All true, but that's not an enticement!"

"Providing the cream filling isn't an enticement?"

"I suppose," I replied evenly.

Irina laughed, "Elizaveta always said you were frustrating at times and I can see why!"

"I do my best!" I replied.

"Well, once Rachel is in bed, I want you to do your best!"

"I'll give it the old college try!"

July 15, 1988, McKinley, Ohio

The rest of the week had been uneventful, with evenings spent with Lara or Kari, and more or less routine cases in the Emergency Department. When my shift ended on Friday, I went to daycare to get Rachel, and rather than take her to my in-laws' house, I headed home so that she could spend the full weekend with Danika and me.

I'd prepared everything the previous evening, so all I needed to do was cook a shrimp and vegetable stir-fry, along with rice, which I planned to be ready for 7:30pm. I fed Rachel her dinner, and Danika arrived at 7:00pm as she'd promised, driving her BMW, which she'd received as a graduation gift. She greeted me with a quick hug, and I invited her into the house. We went to the kitchen, and she sat at the table with Rachel while I prepared our meal.

"Anything interesting happen since I last saw you?" she asked.

"Not really," I replied. "ER shifts, caring for Rachel, and spending some time with my friends. The concert at the lake for July Fourth went well, but we only played two short sets because each band only had an hour. How about you?"

"Spending time with my family and friends," she replied. "A usual Summer for me when we don't take a trip to India, which we do every three years or so. Dad has to make special arrangements to have an entire month off, and can't do that every year."