Chapter 28: A Lover, Not a Fighter

August 6, 1988, Greater Cincinnati, Ohio

Nadiya was quiet for several minutes, and I simply listened to Q102, the Cincinnati 'Top 40' station as I drove towards Route 50, which would take us into Cincinnati. We'd just crossed the Milford Bridge over the Little Miami River when she spoke.

"Can you really make a decision about the future with all the trials and tribulations in your life?"

"Honestly, I believe it would help, not hinder," I replied. "In my mind, marriage would bring stability to my life. I'd have a life partner and Rachel would have a mom. Would it add a bit of turmoil at first while we set up a new household? Yes, but I think things would quickly settle into a routine, which would be good for both Rachel and me. I know it sounds as if I'm focusing purely on our side of the relationship, but that's because I'm addressing what you said. In addition, you have to decide if it meets your needs."

"I'm honestly concerned that something might change about you in a negative way, or at least negative from my perspective."

"Isn't that always a risk?" I asked. "Nobody can know what's going to happen in the future, and I think what happened to Elizaveta proves that point. We don't use vows in our wedding ceremonies, but 'for better or worse' and 'in good times and bad' are key promises, even if they aren't stated aloud in the actual wedding ceremony."

"No vows?" Nadiya asked, sounding doubtful.

"They're assumed," I replied. "An Orthodox marriage ceremony has two components — Betrothal and Crowning. Often, they're done together, but traditionally, the Betrothal service is done at the time of engagement, and the Crowning is done as what you would call the marriage ceremony. The couple exchange rings at the Betrothal, and traditionally, there is no engagement ring. Both wear their wedding bands from the time of the betrothal service."

"No engagement ring?"

"Not traditionally. Some Orthodox do follow the Western custom, but I prefer the Orthodox custom, which Elizaveta and I followed. The same is true with vows — some couples exchange them, but they're done at the wedding reception, not as part of the ceremony in the temple."

"I have to ask — when were you going to tell me all of this? After I said I was ready to move forward?"

"To be honest, I hadn't even thought about it, and as I said, I can't even tell you why because it's not my normal modus operandi.

"I'm not sure if that's a good thing or a bad thing."

"How so?"

"Either that you were confident I wouldn't object or you were afraid I would and hoped that we'd moved too far down the path, so to speak."

"And I don't think either of those is true because it wasn't a conscious decision. Are you reconsidering your decision?"

"You assume I've reached a decision?"

"You did promise an answer this weekend," I replied. "I won't hold you to it if you aren't ready."

"Let's have dinner and see the game," Nadiya said. "I want some time to think about everything you just said."

We had pizza at LaRosa's for dinner, then headed to Riverfront where I purchased two tickets in section 342 in the Upper Deck, which was almost straight down the left-field foul line from home plate, and afforded a good view of the entire field, except the left-field corner.

Nadiya and I chatted throughout the game, though we avoided discussing church or any specifics about the future. The game didn't go well for the Reds, as they could only manage a single run in the fifth inning on a pair of singles and a ground ball, which turned into a double play but allowed the run to score.

That run had actually tied the game, but things went downhill from there, with the Padres scoring a run in the sixth and two in the eighth, giving them a 4–1 lead. The Reds managed to get a pair of runners on base in the bottom of the ninth, but with two outs, Bo Diaz lined out to third base, and the game ended.

"I don't think they'll catch the Dodgers," I said as we made our way from the ballpark. "They're not playing badly, but they are no Big Red Machine."

"Give them another year or two and I think they'll have a shot," Nadiya said. "The turmoil with Pete Rose messed them up this year."

"A terrible end to an amazing career for one of the greatest pure hitters of all-time. Not to mention being the only player to start the All Star Game at five positions — second baseman, left fielder, right fielder, third baseman, and first baseman. He should be an automatic election to the Hall of Fame, even with the ban."

"I agree, obviously. Want to stop at Graeter's for ice cream?"

"Sounds good to me!"

I actually splurged with a double scoop of chocolate in a sugar cone, while Nadiya had a double scoop of strawberry in a cake cone. When we finished, we walked back to the car for the drive back to her house.

"Do you still want me to pick you up for church in the morning?" I asked as I headed east on Route 50.

"Why are you so convinced I'm going to say 'no'?" Nadiya asked.

"I'm not. I just ... well, OK, I understand why it seems that way. I'm being overly cautious, and that comes across as an expectation of rejection. Please don't take it that way. I trust you to decide based on your own needs and desires, after proper consideration. I dumped a bunch of new information on you today, information I should have shared before. And that makes me question myself."

"As in, you're not sure I'm who you want?"

"That's not it at all," I protested.

"So you are sure I'm the one you want?" Nadiya asked lightly.

"Nice," I chuckled. "I suppose the correct answer is, so far, so good."

"What does that mean?"

"That we're moving forward and we're trying to decide together if this will work, and if it will, is it the right thing for both of us and Rachel?"

"I have to ask how you'll know Rachel's opinion?"

"Well, she has said 'mama' to you and nobody else!"

"You know she's babbling!" Nadiya declared.

"Probably, but she obviously likes you and she's very content when she's around you."

"You think it will work, right?"

"Yes, or I would have told you otherwise. If you believe that, and that I'm the right person for you, that the time is right, that you can accept how my life has to be because of medicine, and that you can embrace the Orthodox faith, then it's up to me to ask."

"So a 'yes' before you ask?"

"Isn't that more or less how it works? I mean, don't you think the guy knows the answer before he asks? If he thinks the girl will say 'no', he won't ask!"

"I suppose that's true," Nadiya agreed. "There probably aren't nearly as many surprise proposals as TV and movies would have us believe."

"I think anyone who takes their clues from daytime soaps, Prime Time dramas, or movies will have a very warped view of life and the world."

"I wouldn't call our relationship 'normal'!"

"I would prefer 'atypical', but in the end, same difference!"

"Why the different word?"

"Because 'normal' implies an expectation that's how everyone should be. Think about what 'abnormal' implies versus 'atypical'."

"I see your point, I guess. Why is it important?"

"One word has seriously negative connotations, while the other doesn't. Orthodox Christians are atypical for Christians in America, but we're not abnormal."

"When did you start making that distinction?"

"Around the time Angie's illness began to manifest itself."

"Ah, OK, now I totally get it. She was, and is, special to you."

"Yes, she is."

"She really was the one, wasn't she?"

"Probably," I replied. "But it was never to be. She was already showing symptoms when she arrived at Taft. She was functioning, so nobody thought she was anything but a little quirky until she had her first breakdown. And as someone who has his own quirks, I didn't think anything of it.

"Even after her first breakdown, the doctors didn't think it was schizophrenia. That diagnosis came after her second breakdown. At first, I thought I'd caused them, but I hadn't, it was her illness. I was the trigger, not the cause, if that makes sense. And if not me, then it would have been someone or something else. It took a bit of work to stop feeling guilty, but after I studied her illness and spoke to a psychologist, I realized nothing could have prevented it."

"I think you're a sensitive guy, Mike. I see how you are with Rachel, and I can understand why you would feel the way you did about Angie."

"I'm also single-minded and focused on medicine, which interferes with being sensitive."

"You keep bringing up the negatives," Nadiya observed. "Why not focus on the positives?"

"The last thing I want to do is give someone a rosy picture of the future when the future I have to offer will be challenging."

"Mike, I want you to tell me why I should marry you."

"That's difficult for me to do," I replied.

"If all you see are the negatives, how can anyone see the positives?"

"I don't know," I sighed. "It's not something I typically do."

"I don't believe that for one second! Is that how you are at the hospital? Down on yourself?"

"No, it's not."

"I've never seen that side of you. I've seen the father, but never the doctor. I've seen some aspects of the boyfriend, but I know it's not the complete story."

"I'm not sure how I can show you the doctor side of me," I replied.

"Is this where I make some kind of joke about playing doctor?"

"You could," I replied, "but, well, may I give the doctor's answer?"

"Of course."

"Our training, and the point is made repeatedly, that physical exams and procedures which involve intimate contact, are absolutely never about sex and can't be about sex. A breast exam, the insertion of a catheter, or a pelvic exam are purely about medicine. That gives 'playing doctor' a very different spin for me than it would for someone who isn't a medical student or doctor."

"You've done pelvic exams on female patients?"

"Yes, during my OB Clerkship. I've also inserted catheters into female patients. It's just a procedure, nothing more."

"How did that, uhm, affect how you view your wife?"

I smiled, "It didn't. That's the entire point of the dichotomy — to keep the two things completely separate in the mind of the physician."

"Is there any way I could see you at the hospital? You know, see you work?"

"Only if you need surgery," I replied. "Our team doesn't operate in the one OR with a viewing gallery. When the new surgical wing is built, all the ORs will have viewing galleries, but that's not the case now."

"Did your wife ever see you being a doctor?"

"No. I only started my clinical rotations in June and she reposed at the end of August. She was six months pregnant when I had my surgical rotation, and I was working under the same Attending, which meant no gallery. In August, I started OB, and having babies isn't a spectator sport the way surgery can be."

Nadiya laughed, "Yeah, I'm not sure how many women would be OK with an audience staring at that part of their bodies!"

"Strangely, it was mostly the husbands who objected to me performing exams, not the wives."

"I don't see that as strange," Nadiya said. "My gynecologist is male, so I wouldn't find that strange, but I could see a husband objecting because he doesn't understand what you explained before."

"A good point," I replied.

"Have you run into a patient who objected?"

"I had one this week who objected to me putting in the catheter, so I called a nurse to do it. It didn't bother me at all, because a patient always has the right to choose their doctors and nurses, except in emergency situations."

"So a patient could refuse a black doctor?"

"Yes, though not vice versa. We're required to treat any patient who presents with no discrimination of any kind. One of the cardiologists who is from Chicago told me about a patient who refused treatment from a doctor, but wouldn't articulate why, so they sent another black doctor. The patient objected again, so then they sent an Indian doctor. The patient became very upset, but I think they did the right thing, because it wasn't an emergent case."

"I love it! Who treated him?"

"In the end, the Indian doctor. The head of Cardiology at the University of Chicago is a black doctor who used to work in McKinley. I met him when he treated the deacon from our parish for a heart attack. It was his repose that led to me being ordained."

"It sounds like being a deacon in your church is dangerous! Two died, one was fired, and you quit!"

"You might have a point," I agreed. "But back to seeing my 'doctor' persona, I'm not sure how we could accomplish that."

"I guess what I'm really asking is to see the confident, aggressive side that I'm not seeing. You became very passive and seem to lack self-confidence once I gave you my phone number."

"That side of me is almost completely reserved for medicine," I declared, my voice growing stronger with each word I spoke. "With the exception of medicine and Rachel, I'm basically submissive and do my best to avoid conflict. I've been said, by my closest friends, to have a strongly feminine side, and I'd say they're right. As Michael Jackson sings, I'm a lover, not a fighter. Or, to put it another way, I believe in strength of character, and I try to model my life on the Beatitudes —

"You won't find me violating those very often, and when I do, it's nearly always when I've been pushed to the point where a strong response is necessary. Even practicing medicine, where I am aggressive, confident, and forceful, empathy for my patient is always the primary concern. The one consistent criticism I've heard is that I am too empathetic, but I think that's because medicine historically has been a men's club. That's changing, and I think my style of medicine will become prevalent. It's holistic, treating the patient physically, emotionally, psychologically, and when appropriate, spiritually."

"Don't look now," Nadiya said with a smile I saw out of the corner of my eye as I drove, "but you just became forceful and confident."

"Yes, but as is usually the case, it was in response to a challenge that I couldn't allow to pass and follow another important dictum, this time from Shakespeare — 'To thine own self be true'. Our modern understanding of that is to follow our own nature, but I mean it as Shakespeare did — part of an instruction on how to be virtuous, where you must truthfully examine yourself so that you can be truthful to all men. The entire quote is:

"In context, it's referring back to borrowing money, lending money, carousing with women of dubious character, and other intemperate pursuits. That behavior is 'false' in the sense that it's detrimental. In other words, Polonius is trying to instruct Laertes on how to be virtuous. Or, to put it succinctly, to not sin."

"Didn't Jesus take forceful action?"

I smiled, "I do confront Pharisees when appropriate; I'll save fashioning a whip from cords for when I'm sinless!"

"Didn't Jesus say he came to bring the sword?" Nadiya countered.

"Jesus does tell the Apostles not to assume he came to bring peace, but a sword, but in context he is saying that his message will cause dissension, in that he has come to 'set a man against his father, a daughter against her mother, and a daughter-in-law against her mother-in-law'; and 'a man's enemies will be those of his own household'.

"That points to another exchange, where Jesus is discussing the things they need for a journey and one of the Apostles says they have two swords and Jesus gives an ironic answer saying 'It is enough'. Two swords in a large traveling party might have provided defense against a wild animal, but not against a band of thieves or brigands, or in context, against the Romans who Jesus knew were coming to arrest him. And recall what happened when Simon Peter actually used one of those swords."

"Jesus healed the man's ear."

"His name was Malchus, according to Saint Luke, and he was a servant of the High Priest Caiaphas. Jesus told Peter to cease and desist, then healed the servant's ear. And that was after he had been betrayed by Judas with a kiss. The ultimate answer is found in something else Jesus said — 'Greater love has no one than this, than to lay down one's life for his friends'. That can be literal or figurative. Riffing on that, the role of a physician is one of giving up his own life for his neighbor. And I'm sure you know who your neighbor is."

"From the parable of the Good Samaritan."

"Exactly. Remember, too, the instructions Jesus gave when he sent out the Twelve — 'as you go, preach, saying, 'The kingdom of heaven is at hand.' Heal the sick, cleanse the lepers, raise the dead, cast out demons'."

"You cast out demons? Really?"

"If we avoid the idea of word-for-word inerrancy and understand the context, what does this sound like to you? 'immediately the spirit convulsed him, and he fell on the ground and wallowed, foaming at the mouth ... and often he has thrown him both into the fire and into the water to destroy him'."

"Epilepsy?"

"Exactly. Or some other disease which caused seizures, or perhaps even mental illness. We can treat those things. Similarly, we can treat various skin ailments or afflictions which are collectively called 'leprosy', but which aren't necessarily Hansen's disease. And I daresay using epinephrine, lidocaine, and a defibrillator or CPR would look like 'raising the dead' to someone from Jesus' time. Do you know Clarke's Third Law?"