Chapter 27: I Don\'t Know What I\'m Saying

August 4, 1988, McKinley, Ohio

"Mr. Loucks, you need a LOT of practice!" Doctor Lindsay said after we completed the first two holes and I shot triple bogeys on both of them.

"No kidding," I replied. "And it's going to be tough next year with the usual thirty-six-hour PGY1 shifts in the ED."

"You will have days off."

"And I'll spend time with Rachel, sleep, run errands, and practice guitar. My band is FAR more successful than I expect my golf game to ever be!"

"When's your next gig?" Doctor Taylor asked.

"Tomorrow night at Stirred Not Shaken. We have a second gig on the 19th. Tomorrow night is sold out. Tickets for the next gig go on sale on Saturday. I can get tickets for you if you want them."

"Sold out?" Doctor Strong asked.

"We're the most popular cover band to play at the club, and their bar income was higher than for any other act in the past four years. And their tips were through the roof, too."

"You guys are that good?"

I shrugged, "People like us, but if we go cold, tickets won't be sold, and we don't have any albums to put in the discount rack!"

"Is that song in your repertoire?"

"Yes. Several Billy Joel songs, and our lead guitarist plays harmonica on that one."

"You play backing?"

"Yes. I'm lead singer, but on most songs I play backing, mainly because when we started I couldn't devote enough time to play lead. I play lead on several songs, including The Entertainer, Piano Man, Born to Run, and I play the balalaika for Lara's Theme."

"That's the Russian lute, right?" Doctor Roth asked. "The one the girl has in Doctor Zhivago?"

"Yes. I have my grandfather's instrument, which is one of the few things he brought with him from Russia when he and my grandma managed to get permission to travel to Paris in the late 30s and didn't return. They emigrated to the US from Paris and ended up in Rutherford with some other Russian émigrés."

"He taught you to play?" Doctor Lindsay asked.

"No, a music professor at Taft taught me. She's the same one who taught me to play guitar."

"She's Russian?"

"Czechoslovak," I replied. "She was an accomplished concert pianist who defected in the early 70s with help from some American benefactors who supported artists who wished to defect from the East Bloc."

"What's your opinion of Gorbachev?" Doctor Strong asked as he stepped up to the third tee.

I waited for him to drive his ball before answering.

"I think the best possible thing to say is the Russian proverb President Reagan has used many times — «Доверяй, но проверяй» — 'Trust, but verify'. My grandfather thinks the entire house of cards will collapse in the next year or two. His concern, of course, is that a second Russian Civil War could create a conflagration which ends in nuclear war. I hope when the «Коммунистическая партия Советского Союза», the Communist Party of the Soviet Union, realizes that it's 'game over' they go reasonably quietly, rather than electing to destroy the world instead of giving up their power."

"I wouldn't hold my breath on that one," Doctor Roth observed.

"Me, neither," I replied. "That said, they did agree to give up some amount of non-political economic power. But political power? No chance."

"I agree."

We finished our round, and my score was terrible, but I took solace in the fact that the relationships were far more important than how many strokes over par I shot. As we had during my Clerkship, we went to the clubhouse and Doctor Roth bought me a Coke, while buying beers for the other three.

"Still teetotaling?" Doctor Strong asked.

I nodded, "I just feel it's better, at least for now. I know one beer or one glass of wine more than four hours before a shift is no problem at all, but I want to err on the side of caution."

"Wise," Doctor Roth declared. "Why risk anyone asking questions, especially when you're this close to the brass ring? It would be foolish to toss away seven years of work to have a few drinks."

"Or miss a code call because you didn't change the batteries in your pager and were having sex in an on-call room."

"Those kinds of shenanigans simply need to stop," Doctor Roth said. "I won't tolerate it from my Residents or medical students, and no doctor should, nor should any nursing supervisor. We could end it tomorrow if we simply said we'd apply severe discipline in every case, even for Attendings."

"Good luck with THAT!" Doctor Lindsay groused. "I'd settle for making it an ethics violation for doctors to have sex with students!"

"That's beyond the pale in my book," I agreed. "I won't even date someone who I might supervise. The risk is simply too great, and the last thing I'd want is for someone to think I was receiving or granting favors because of an intimate relationship. My entire study group is of the same opinion, and we mean to make it stick when we're Attendings, at least with regard to medical and nursing students."

"People have tilted at that windmill for years," Doctor Roth said. "But attitudes are changing in society, so you might have some success."

"I'd be happy to end the discrimination against female doctors," I replied. "It's time for medicine to stop treating them as second-class citizens."

"Hear, hear!" Doctor Lindsay declared.

"Feel free to tell the truth, Mike," Doctor Roth said, "but do you think I do that?"

"You, personally? No. But the system is rigged against Doctor Lindsay and she has to decide how badly she wants to hurt her career to have kids. That's just wrong on every possible level."

"Hear, hear!" Doctor Lindsay declared again.

"You know the problem, right?" Doctor Roth asked.

I nodded, "It disrupts the normal flow of medical school or Residency, but there are literally no reasons other than pigheaded thinking which prevent reasonable solutions. I don't know exactly how it would work, but there must be some kind of reasonable accommodation that can be made that doesn't require completely sacrificing motherhood for medicine."

"Or fatherhood," Doctor Lindsay added.

"Point taken," I replied. "But not having to carry a child for nine months and then go through labor and delivery, along with social views on fatherhood, make it less of a burden for men."

"Your daughter is in daycare, right?" Doctor Strong asked.

"Yes. And that's OK with me. Would I have preferred she were with her mom? Of course. But had Elizaveta chosen to have a career, that would have happened anyway, and it was truly her decision. Her plan had been to go to college once the kids were in school. And she'd have made use of the parish daycare, which also doubles as what amounts to a playgroup for older kids."

"Can I ask something that might be out of line?" Doctor Lindsay inquired.

"How can someone who attends such a conservative church which only ordains men be so 'enlightened'?" I asked.

Doctor Lindsay laughed, "I'm going to guess you've heard that question before."

"Many times. There are theological reasons for having male clergy. That said, I actually believe there is support in the ancient church and in the Scriptures for female deacons, though their duties would be slightly different from those of male deacons. But, as I've pointed out, in many parishes a woman is parish council president, and I've yet to see a parish without near parity of men and women on the parish council. Women support and run the church, even if the bishops are nominally in charge. As the saying goes, our bishops fear no man, but every woman!"

The three doctors laughed.

"So, 'Russian woman, strong like tractor'?" Doctor Strong asked in a faux Russian accent.

"I dare you to say that around any of the grandmothers at church. I'll say nice things at your funeral if you take that dare!"

The three doctors laughed.

"And," I continued, "on that note, I need to go pick up my future «бабушка» from daycare!"

I left the country club and headed back to the hospital to get Rachel, and then headed home to have dinner with Lara.

August 5, 1988, McKinley, Ohio

"I've been thinking all week about a question Lara asked, and I'm stumped," I said to Clarissa as we sat in the lounge following lunch on Friday.

"Which question?" Clarissa asked.

"Why I hadn't discussed my praxis with regard to fasting and prayer with Nadiya, nor suggested she read one of the books by Bishop KALLISTOS."

"That is totally out of character for you," Clarissa observed. "So Lara was right to ask those questions. That's especially true given how you shut down Marcie on Monday."

"I know," I replied. "And I can make neither heads nor tails out of it."

"Were you afraid it might deter her?" Clarissa asked.

"If so, it was subconsciously."

"I wonder if it's not your struggles with the Church, and by that, I mean the human organization, not the spiritual concept. You're pretty down on the whole 'organized religion' thing at the moment."

I smiled, "I'm not a member of an organized religion! I'm Orthodox!"

Clarissa laughed, "OK, yes, but you know what I mean! 'Disorganized' is not the antonym of 'organized' in that phrase any more than 'disoriented' means 'not facing East' except in your Orthodox lexicon. You haven't changed your personal practice at all, have you?"

"If anything, I'm even more fastidious about my prayer rule, though I've been more lax with regard to fasting."

"That second part tells me there's something else going on, something deeper. I know you were told not to engage in the severe fasting practices, but if you're comfortable being lax, I'd say that's a sign of something serious going on with your interior life. Is it a matter of questioning your faith? And could that explain why you basically went off on Marcie?"

I shrugged, "Maybe. But you know how much I identify with Didymus — Doubting Thomas, as he's called — or with the young man possessed by the demon whose father declared, 'I do believe; help my unbelief'. Or maybe a better parallel is Jonah, and this last year has been me in the belly of the whale."

"Out of curiosity..."

"In church, yes, it literally happened. Out here, it's a metaphor for being swallowed up by the world and allowing it to deter you from your ministry."

"Your ability to hold those dual beliefs is confusing, though I suppose I'm used to it by now."

"It's the 'literally true' versus 'expressing truth' dichotomy. And I could, in a homily, say that Jonah is a metaphor for being consumed by the world without getting into trouble, so long as I didn't openly deny the statement in the Scriptures. In other words, I can have it both ways, so to speak, without any contradiction. And there are plenty of Church Fathers who criticized the concept of word-for-word inerrancy and overly literal understandings. That said, being overly allegorical is what caused a number of works by Origen to be anathematized and caused his status to be diminished following his death."

"Perhaps that's the root cause," Clarissa suggested. "You've been swallowed whole by medicine, and when you add in all the bullshit that happened with regard to Tasha's dad and the bullshit accusations against you, it drew you away from the Church, as an organization, and that affected your views."

"OK, that makes sense, but why did I give Marcie both barrels and soft pedal Nadiya? That's what I can't quite figure out."

"The fact that she was Sasha's friend?"

"I'm sure that's part of it," I replied, "but I think it's a small part, not the main reason. But even if we set Marcie aside, there's still the way I've handled things with Nadiya. I've never, ever done that before. I've religiously, if you'll pardon the pun, made those things clear to every non-Orthodox girl I've dated just as I made clear to every girl just how insane medical school and Residency would be. Except Nadiya."

"You told her about Residency, though, right?"

"Yes. I made that very clear."

"I think I have to agree with Lara — you're risking a potentially serious conflict in the future if you don't get that out in the open, and right away, before you move further with her. Or, take my advice and ask Danika or Danijela. Given your current struggles, and your desire to reconcile with the Church, I feel having a wife who is fully in tune with the Orthodox milieu is critical. I honestly believe that if you ever have a real crisis of faith, you'll melt down worse than the day you sat on that bench in the snowstorm without a coat."

"I guess I need to have a serious conversation with Nadiya tomorrow."

"You are stubborn that way, Petrovich!"

"I've never denied it, and I come by it honestly from my mom and grandfather!"

"Just out of curiosity, which of the girls do you think is prettier?"

"That's difficult to say," I replied. "They're very different. Danika is exotic, in the way Kimiko was, while Nadiya has creamy white skin. I'd be hard pressed to say which one was prettier."

"No disrespect to Lizochka," Clarissa said, "but Angie?"

"Red hair and green eyes are the sweet spot," I replied, "but being in love with her trumped everything else, and makes my judgment in that area suspect."

"I think, actually, that Kimiko was prettier than Angie, and both of them prettier than Tasha, but you had such a thing for Tasha that your judgment there was even MORE suspect!"

I laughed, then said, "Tasha was the prettiest girl I knew growing up, and she's still gorgeous. But we both know the prettiest girl we've ever seen was the one we saw in Doctor Mercer's office years ago."

"True! She'd shame ANY Miss Universe!"

"My decision has nothing to do with looks," I said.

"Neither of them has dated much, have they?"

"No. Neither had Danijela nor Kari, nor Lara, nor Kimiko, nor..."

Clarissa laughed, and interrupted me, "The girls you like are 'untouched by human hands'! Male, anyway!"

"You know that's not a specific criterion," I replied. "It's just worked out that way. Annette and I are extremely compatible, except for the whole Vanderbilt thing."

"You know, another thing comes to mind," Clarissa said. "Have you discussed with Nadiya the 'no diamond engagement ring' tradition? And the lack of vows in the wedding ceremony?"

"No."

"Jesus, Petrovich! Lara was right! You were at a freaking wedding last weekend and you didn't raise that? What's going on inside that head of yours? It's totally out of character for you not to bring up stuff like that."

"And if I could tell you what it is, I would," I replied. "But I've been wracking my brain all week and I can't put my finger on it."

"It's church," Clarissa said. "It's the only thing that makes sense. You should never have let the bishop come within fifty feet of you!"

"My ordination, in hindsight, does appear to have been a grave error on the part of Bishop ARKADY."

"One which you will not repeat, fortunately. The canons forbid it, and even if Bishop JOHN were to grant extreme «ekonomia», you'd turn him down."

I nodded, "I would."

"If I may be honest..."

I interrupted her, "Always, Lissa."

"Your former bishop did you grave spiritual harm, and you can lay ALL of this at his feet."

"You do recall that my father-in-law made the request, and my grandfather lobbied for it, right?"

"Yes, and where exactly was Bishop ARKADY's spiritual discernment? I'll tell you where! Lost between the legs of a twenty-something girl, that's where! And look what that led to."

"Disaster on many levels."

"I maintain my view that you need someone to shore up your spiritual side. Your Kitten did a great job at that, despite being young."

"She was the perfect wife," I replied.

"Is there something about Nadiya that reminds you of Elizaveta?" Clarissa asked.

"Again, not consciously."

"Mike? Clarissa?" Doctor Lindsay called out. "Time for Grand Rounds."

We got up and joined her, and when the entire surgical service had completed Grand Rounds, we went to the main auditorium for a lecture on laparoscopy, something which I'd heard about in medical school, but which, until 1985, had only been used for minor gynecological procedures. Today's lecture was about laparoscopic cholecystectomies, something which Moore Memorial would be switching to once the surgeons were trained. That would happen through a mix of visiting other hospitals and experienced surgeons visiting Moore Memorial.

"That's totally cool," Debbie, who was sitting to my right, whispered, as we watched a videotape of a laparoscopic procedure.

I nodded, totally engaged by the presentation, which would allow the removal of a gall bladder through a small incision, rather than an open procedure. It was an amazing advancement, and would reduce the risks associated with open procedures. I was really looking forward to it, and was pleased to hear that Doctor Lindsay would be trained at Ohio State, and that we'd have a visiting attending teach the procedure here before my surgery Sub-I ended.

When the lecture ended, I made a beeline to the locker room to change, and then to daycare to get Rachel so I could take her to my in-laws' for their usual Friday night. I couldn't stay long as I was meeting Sara for dinner before the concert at Stirred Not Shaken.

"Is there any way to get me into the club?" Sara asked as we headed to Frisch's for our usual Friday dinner.

"Not really," I replied. "They card hard at the door, and nobody under twenty-one is allowed. They had some trouble years ago, and to keep the local cops and prosecutors happy, they verify IDs for every single person. We get Kari in because she's part of the band, but she's not allowed anywhere except on the small stage or in the break room they have for performers."

"I can't believe they raised the drinking age to twenty-one!"

"If the states weren't addicted to Federal highway funds, Congress would have no power to change the drinking age, the speed limit, or a host of other things they wouldn't otherwise be permitted to do."

"So they are allowed to make an end-run on the Constitution?"

"So it would seem. The courts have said that because the states are free to forego Federal funding, it's cool for the Feds to tie specific behavior to accepting the funds."

"So they could make the driving age twenty-one?"

"In theory," I replied. "But I think you'd see serious pushback from the public on that one. Imagine all the parents who would suddenly have to be chauffeurs for school, work, dates, and so on. I think you'd see the public force states to forego the highway funds, if such a bill could even get through Congress."

"That's not how it's supposed to work!" Sara protested. "At least not according to my government teacher."