Good Medicine - Medical School IV
Copyright © 2015-2023 Penguintopia Productions
Chapter 34: Dénouement
August 20, 1988, McKinley, Ohio
I picked up Sara at her house as planned, and then headed to Frisch's, our usual place for dinner. It being a Saturday, neither of us had to worry about fasting, which expanded our menu options greatly. I hadn't been strict about it, but had paid more attention since being restored to the Eucharist by Father Alexi. That said, I had basically ignored the Dormition Fast, though the meals the ladies from the church had delivered between the 1st and 15th of August had been meatless.
"Ready for School to start a week from Monday?" I asked.
"Yes," Sara replied. "I can't believe I'm finally a Senior!"
"Which colleges are you applying to?"
"Taft, obviously, and I should get in, but also Ohio State. The University of Dayton is my backup. My grades and my SAT and ACT scores are good enough to get into any of them. But Taft is my first choice for what should be obvious reasons. When do you find out which hospital you're assigned to?"
"The third week of March. I requested my application packets last week, and I'll send them in by the end of September and begin scheduling my interviews."
"And there's nothing you can do if you aren't assigned to Moore Memorial?"
"Correct. You sign a binding agreement when you enter the Match process. If you refuse your assignment, you are ineligible to apply for any other Residency during the Scramble. It might be possible to find a Residency later that Summer, but that would be a huge risk, and it's not clear any program would accept you based on your refusal to accept your assignment. And there's a good chance you wouldn't be allowed to participate in the Match the following year, which you could do if you didn't Match."
"That almost sounds like indentured servitude! I thought the Constitution banned that when it banned slavery."
"It did, and yes, it does seem like it, but the main difference is you can quit. Granted, you can't become a doctor, but indentured servants had a legal obligation to stay in the job and had no freedom to quit. I'm no lawyer, but it seems to me that's enough of a difference. And remember, nothing requires me to sign up for the Match.
"I could try to find a Residency outside the Match, but hospitals are also bound until the Scramble is complete. There are always Residency slots which go unfilled, but they tend to be less desirable specialties in less desirable locations. The other option is to try for a Match with the military, which happens before the main Match. If you Match with the military, you have to take it; if you don't Match, you go into the regular Match."
"So you can't even guarantee that you'll get to be what you want?"
"Correct."
"What would you do?"
"In the worst-case scenario, Scramble to anything, serve long enough to get a medical license, and become a GP like Doctor Evgeni. Anyone can do that in Ohio with just two years in Residency. In Illinois, and some other states, it only takes one year."
"That seems short."
"It's not, because it's really three years, if you think about it. I've been doing clinical work for over a year now, have about nine months to go, and then I'll be an Intern for a year. That's plenty of training to be a GP. Heck, I could do that job now, if I could get a license."
"Seriously?"
"Yes. I know how to take a history and perform a physical, know how to interpret the results of the physical, know how to interpret the results of blood tests and urinalysis, and how to diagnose common conditions. I could even deliver babies in a pinch, but that's not something GPs do these days. For anything that required specialized treatment, I'd refer the patient to another doctor or hospital."
"And you know which drugs to prescribe?"
"For most common ailments? Yes. But I could also look up which drug to use in the Physicians' Desk Reference. That happens even with very senior doctors. Mostly we know the fifty or so drugs that are commonly used in our specialty, and everything else is either determined by a consultation from a specialist, from the book or written treatment protocols, or a combination of those."
"What happens if you can't find a Residency?"
"Then you still have an MD, and are called 'Doctor', you just can't get a license. Some people work for insurance companies reviewing medical treatment, some go into research, and some get their PhD and teach or do research. As strange as it sounds, you don't need a medical license to teach medical school. The license is simply about the legal authority to practice medicine."
"Are all your teachers licensed?"
"No. There are a pair of PhDs who are researchers. One teaches epidemiology and one teaches pharmacology. If you think about it, that makes sense, given a researcher is likely to know more about the spread of disease than a doctor working in a hospital. In some ways, a pharmacist with a graduate degree would be a better choice to teach pharmacology than a doctor. The pharmacist actually is required to know far more about drugs than a typical doctor who specializes in, say, surgery or trauma."
"I hadn't really thought about it. When we first started seeing each other, I thought all doctors were doctors, and just had different jobs. I didn't realize how specialized they were. I mean, sure, surgeons are special, but otherwise, I had no idea."
"Surgeons certainly think they're special! Do you know the difference between God and a surgeon?"
"No."
"God doesn't think he's a surgeon!"
Sara laughed, "Is it that bad?"
"All doctors have something of an ego and it's really easy to develop a 'god complex' when you save lives on a daily basis."
"You?"
"It's something we all have to watch out for," I replied. "Arrogance kills."
"What do you mean?"
"If I believe I'm a 'god', I may take chances I shouldn't because I believe my skills are better than they actually are."
We arrived at the restaurant and were seated quickly by the hostess. We ordered our food as soon as the waitress came to our table, and she brought our salads right away. I said the blessing prayer, and we began to eat. We had a nice meal, and I carefully avoided any discussion of relationships, as I wanted to wait until we were in a place that wasn't quite as public.
That opportunity came when we went to get ice cream, and Sara broached the topic while we were sitting on the grass near the dorms on the Taft campus.
"Are you still seeing the girl from Goshen?" she asked.
"No," I replied.
"And you aren't seeing Danijela, right?"
"Correct."
"So it's just the Indian girl and me?"
"I had dinner with Oksana's cousin on Wednesday evening."
"Oksana's cousin? I didn't know she had one!"
"They just moved from France at the beginning of the year. Oksana introduced us."
Sara made a face of disapproval, as I was sure in her mind, Oksana had betrayed some code.
"And?" Sara asked.
"And I'm seeing her tomorrow in Columbus."
Sara frowned, "You're looking for new girls because you don't think I'm trustworthy."
"Trust is part of it," I said. "But maturity is part of it as well."
"You're saying I'm immature?! I'm more than two years older than Elizaveta was when she proposed to you!"
"Age is not an indicator of maturity," I replied.
"I think you should take me home," Sara said flatly.
I considered trying to discuss things further with Sara, but in the end, I didn't think it was a good idea. There was little I could say, and even less I could do, to make her feel better. In the end, the incident at the party wasn't about cheating or trust, but about her unwillingness to talk to me afterwards. To me, that was proof of immaturity, and didn't bode well for a future for us.
"OK," I agreed.
We walked back to the car, and I drove her home in silence. When we arrived, she got out of the car as soon as I stopped and walked quickly to the front door. I saw no value in getting out of the car, so once she'd gone inside, I backed out of the driveway and headed to my in-laws' house to get Rachel.
"PAPA!" she exclaimed when I walked into the room where she was with my sister-in-law, Viktor Gennadyevich, and Viktoria Elizaveta.
"She's had her dinner, has a clean diaper, and was an angel during Vespers," Anna said.
"Thanks for watching her today."
"You're welcome!"
"Hi, Mike," Yulia said, coming into the room.
"Hi, Yulia," I replied.
"Will you be in church soon?"
"Tomorrow I'll be at the Cathedral," I replied. "I'm not sure after that."
"But you've been attending regularly?"
"Yes. Either at Holy Transfiguration, Saint George in Loveland, Saint Athanasius in Norwood, or the Cathedral."
"Good."
"I need to get this young lady home and in bed," I said.
We all said 'good night' and Rachel and I headed home where I read One Fish, Two Fish to her, before we said our evening prayers. Once those were completed, I put her to bed and went downstairs to wait for Clarissa, who arrived about fifteen minutes later.
"How did things go with Sara?" she asked after we greeted each other with a hug.
"She didn't become emotional, but insisted I take her home when I pointed out the main problem was her lack of maturity."
"Based on her not talking to you for quite some time after her, well, I suppose faux pas is the right term."
"I'd say that's a good way to put it. Fundamentally, if she'd told me about it and had been willing to discuss it, I'd have been able to 'forgive and forget' as the saying goes. But, in effect, running away and refusing to even discuss it did not bode well for the future."
"I don't disagree with that assessment. Have you told Danika?"
"No. I figure I'll do that tomorrow evening if Kristina and I agree to move forward."
"How do you think she'll react?"
"Maturely," I replied. "And she'll end up going to Stanford for medical school and she'll try to Match there. That is really what she wants, though she's willing to compromise that for a good marriage match."
"You don't agree with that, do you?"
"She's acting based on her hierarchy of values and is acting in what she sees as her best interests. It's not my place to second guess her freely made choices."
"Except she's no more free than you are, Petrovich!"
"You've lost me."
Clarissa smiled, "You are bound by your worldview and your philosophy, just as she is. Neither of you can act in contradiction to your true nature. Oh, sure, you toyed with the idea of marrying a girl who wasn't already Orthodox, but with the exception of Angie, nothing ever really came of that because you can't compromise one iota. Well, there was Kimiko, but she had to be true to her nature. I think the proof of my point is your response to Marcie."
I nodded, "Which is, in effect, what Lara has been saying all along — the leopard cannot change his spots."
"Exactly. So how free are you, in reality?"
"I see your point, but I'm free to make decisions consistent with my nature, which is true for everyone, including God. Being human, it's possible to make decisions inconsistent with that nature, but that's asking for trouble, at least in my mind. And that's why you can't accept my proposal, no matter how much we both want that."
"You finally admit it?" Clarissa asked with an arched eyebrow.
"I've always been willing to admit that, it's accepting it that's the challenge! I can't marry my soulmate because she's a lesbian; I can't marry my true love because the State of Ohio says so. I freely admit those things, even if I don't accept them. Does that make sense?"
"Yes, so long as by 'accept' you mean 'agree'."
"More or less, yes. They are things which I do not like but which I am unable to change."
"Except you had a glimmer of hope about Angie, which is why you're so pissed at her psychiatrist and why you are unhappy with Doctor Mercer."
"That's true. The Stephens are receiving a big payout which will go into a trust to care for Angie, but that does not mean this is over by a longshot. Sadly, though, the idiot psychiatrist will most likely be able to keep his license."
"I thought Doctor Forth and Doctor Lawson had talked you off that ledge."
"I'm not the one who will file the complaint," I replied. "Angie's guardian will."
"That's her mom, right?"
"Yes. I'm her backup guardian, should anything happen to her parents."
"When did that happen?"
"Mrs. Stephens asked my stepdad to change the guardianship papers as part of this whole process. Angie's parents are in good health and are in their early fifties, so I don't expect to have to fulfill that role for twenty-five years or more. I'll be involved, of course, but not legally responsible."
"Back to things which are in the realm of possibility, would you follow your previous pattern of separating betrothal and crowning, or do them together?"
"I think that would be up to Kristina," I replied. "There's no problem with betrothal before her birthday, so I'd be OK with that, but it would have to be before November 15th when the Nativity Fast begins."
"Christmas is on a Sunday, and I can't imagine you'd have a wedding that day. That means the following Sunday, which is New Year's Day."
"Which would make it possible for Dale to be at the wedding without a whirlwind here and back trip."
"And Mikayla will be home, too, right?" Clarissa smirked.
"Last I heard, she was engaged, not to mention that Dale is married to Pam as of last December!"
"I guess he doesn't need a date, then!"
"If he does, I don't need to know about it!"
"So you and Kris are a 'done deal'?"
"I expect her to say she wants to move forward. If she does, we'll sit down with Vladyka JOHN and get his input and, hopefully, his blessing."
"And if not? I mean the bishop not giving his blessing?"
"That's unlikely. He might counsel against it, but next Friday the year is up, so there aren't any canonical restrictions."
"Isn't objecting the same thing as not giving a blessing?"
"I didn't say 'objecting', I said 'advise against', which are two different things. He may think it's a bad idea, but he wouldn't withhold his blessing for us to marry without good canonical cause."
"Ah, OK, you aren't referring to his blessing as in saying he agrees it's a good idea."
"No, I was using the word 'blessing' to mean 'permission', which is technically necessary for any marriage. Usually a priest would send a letter requesting permission to perform a betrothal and crowning and would receive it barring some canonical problem, such as lack of an ecclesiastical divorce."
"Which is why your mom needed that."
"Yes. My dad couldn't have his marriage solemnized as he married without an ecclesiastical divorce."
"Even though it was outside the Church?"
"Yes. I don't think he cares, and I doubt he'd ever seek it, so it really makes no difference in his life, or mine, for that matter."
"Are we going to say evening prayers?" Clarissa asked.
"Rachel and I did that before I put her down in her crib. I assumed you'd want my undivided attention!"
"You assumed correctly, but I totally understand your responsibility to your daughter! Would a bubble bath be in the cards?"
"So long as Tessa doesn't object, and by that, I mean you tell her it happened."
"She won't object, and yes, of course, I'll tell her."
"Then a bubble bath is just fine," I said.
I took Clarissa's hand and led her up to the master bedroom, then into the bathroom. I turned on the tap, adjusted the temperature, then closed the drain. I added cherry blossom bubble bath, and then Clarissa and I undressed and got into the tub. She sat between my legs and leaned back against me. I wrapped my arms around her, and she sighed deeply.
"You have no idea how much I love you, Petrovich."
"Actually, I think I do," I replied. "You've been by my side for the past seven years, no matter what's happened. When I had my meltdown over Jocelyn, when Angie had her meltdown, and when Elizaveta reposed. But that's only three of the major events, there were so many others, including Sandy's suicide, my parents' divorce, and well, we'd be here all night if I tried to list them all."
"I could say the same thing about you," Clarissa replied. "I came out to you, and you stood side-by-side with me when I came out to my parents, and consoled me when Glenda dumped me. You know, if I could change..."
"Don't," I counseled, interrupting. "We both know that's not possible, and would only lead to disaster if we tried. Don't dwell on what can't be, but on what is."
"Angie?"
"Yes, and Elizaveta, of course."
"Of course," Clarissa replied. "I didn't mean to disrespect her, but I meant things that are possible, but not, if that makes sense."
"This ever-changing world in which we're livin' has often made me want to give up and cry, and you've been there for me."
"Your heart is an open book to me, Petrovich," Clarissa said, completing the McCartney reference.
"So, what do you think? Honestly?"
"That you could marry literally any faithful, traditional Orthodox girl and be happy. Your view of marriage is like everything else in your life — logical and practical. That's why you said, from the start, it was about a mom for Rachel. It really was simply a matter of finding a girl who could accept the BS that comes with our medical training."
"Not quite any," I countered.
"OK, yes, mature, independent, and self-confident. Having a tight «пизда» (pizda) is a bonus!" ("pussy")
I laughed, "I have no idea, given I haven't slept with any of the true candidates."
"Well, given you're much bigger than average, they'll all be tight!"
"You know it's not about that," I replied.
"Except it is, in a sense. I don't mean that sex is your primary motivator, but your emotional and mental stability depend on the closeness that comes with marriage. In the interim, you've substituted Lara and Kari for a wife, and that has helped, but in the end, you need a wife as much as Rachel needs a mom. Your needs are simple, really, and I'm positive Kristina can meet them, even never having met her."
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