Good Medicine - Medical School IV - Cover

Good Medicine - Medical School IV

Copyright © 2015-2023 Penguintopia Productions

Chapter 38: Cruel and Unusual Punishment and Indentured Servitude

August 26, 1988, McKinley, Ohio

"Doctor Anicka Blahnik, please meet Kristina Ignatievna Korolyov; Kris, my friend and former professor, Doctor Anicka Blahnik."

They exchanged a Russian-style greeting.

"Kris, come with me," Anicka suggested. "Mike will be busy for the next two hours!"

They left, and I joined the other band members.

"I couldn't help but notice the cute blonde I've seen you with at the memorial service and today," José observed.

"Anicka is very pretty!" I agreed.

"Who knew Mike Loucks was into MILFs?" he teased. "But the other cute blonde!"

"Kris," I replied. "We'll be betrothed a week from Sunday and married on January 1st."

"What the fuck?" Kim asked. "How have we not heard about her?"

"Mike found a girl who met his criteria and wasted no time," Sophia declared. "Similar to Elizaveta's approach."

"You white guys are nuts!" Sticks declared.

"Right there with you on that one, Sticks!" Kim exclaimed.

"I don't believe anyone has even once accused Mike of being sane!" Robby exclaimed.

"Ain't THAT the truth," I chuckled.

"Let's get set up," José suggested.

He and I went to our places on the curtained stage and unpacked our instruments, then checked they were in tune. We ran through a pair of songs, using just the monitors, and then rejoined the others to wait for our published start time.

The concert went off without a hitch, and was well received, especially my duet with Milena, which was done during the second set, rather than as our final encore. After we took our final bows, I joined Kris and Anicka, and we went to mingle with Kris on my arm as a defense against the usual flirtatious students. José, on the other hand, took full advantage, and quickly had several girls competing for his attention.

"You sing wonderfully, Mike," Mr. Korolyov said.

"You do!" Lyudmila said dreamily.

"Thanks," I replied. "I'm happy you could attend."

"Did you play while you were a deacon?" Mr. Korolyov asked.

"Yes. I had the blessings of both our former bishop, ARKADY, and of Vladyka JOHN. Their rule was that I shouldn't play in any venue which served alcohol, and they did review our playlists."

"Who is the young woman you sang the duet with?" Mrs. Korolyov asked.

"My professor's daughter, who is now a professor in her own right here at Taft. She and I sang together while I was an undergrad and was taking guitar and balalaika lessons from her mom. Kris, I haven't asked, but do you play any instruments?

"No, but I sing in the choir. Did you sing in the choir before you were ordained?"

"No, though I did chant during Matins quite often before I was tonsured a Reader, at which point I did more, until I was ordained a subdeacon."

"Those must have happened quickly, though, given you were married only two years," Mr. Korolyov observed.

"Bishop ARKADY granted me «ekonomia» to marry when he selected me for the subdiaconate. It's not uncommon in the main US jurisdictions for someone to be granted «ekonomia» to marry after ordination to a minor order. Of course, I had to marry before being ordained a deacon."

"One cannot argue with the bishop," Mr. Korolyov said.

I almost laughed because I'd done that repeatedly, though I understood what he meant — once the bishop had made a decision, that was the end of the matter. I generally agreed, but there were times when that wasn't the case, as with the situation with Tasha's father.

"Kris, are you still planning to stay the night?" Mrs. Korolyov asked.

"Yes. I want to go to the party Doctor Blahnik is hosting, and then join Mike for Rachel's checkup in the morning. He'll bring me to Ashville tomorrow afternoon."

"OK. Then we'll be going now, and we'll see you both tomorrow."

They said 'goodbye', and after hugging Kris, they left with Lyudmila, while Kris and I went back to the stage so I could pack up my instruments and music. Once I had gathered everything, we walked back to the house where I left the instruments and music, then Kris and I walked to Anicka's house for the party. About twenty minutes after we arrived, most of the guests were there, and I asked for everyone's attention.

"I'd like everyone to meet Kris Korolyov," I said. "She and I will marry on January 1st at Dormition of the Mother of God Cathedral in Columbus."

There were quite a few gasps and astonished looks, but those were immediately replaced by applause and most everyone offering their congratulations. Clarissa, Lara, Fran, Sophia, and other female friends clustered around Kris, while the guys mostly spoke with me. Anicka did pull us both aside and confirm a night for dinner, and we agreed on Saturday, September 17th.

We had an enjoyable time at the party, and about 11:30pm, I drove Kris to Oksana's house, then went home, said an abbreviated set of evening prayers, and went to bed.

August 27, 1988, McKinley, Ohio

"No medical student today?" I asked Doctor O'Neill when she came into the exam room.

"Out sick. Any cough or runny nose, and we don't want them around kids, who are little germ factories!"

"So the literature says! Doctor O'Neill, this is Kris, my soon-to-be fiancée. Kris, Doctor O'Neill."

"Congratulations! Soon to be?"

"She is, but not officially until a week from tomorrow, when we have a betrothal ceremony at church."

"Nice to meet you, Kris!" Doctor O'Neill said.

"And you, Doctor," Kris replied.

"French or Canadian?" Doctor O'Neill asked.

"«Mon Dieu! Je suis Parisiene!» I speak proper French!" ("Heavens! I'm Parisienne!")

I laughed, "I forgot all about the French opinion of Québec!"

"The people are fine, you know, like cousins you see from time to time, but the language? «Quelle horreur!»" ("Horrible!")

"Wow!" I exclaimed. "Of course, that's similar to things I've heard from people who speak British English about American English."

"I spent a semester in Paris in college," Doctor O'Neill said. "But now I think I won't try out my French! How is our one-year-old?"

"She's wonderful," I replied, "and wore more of her cake than she ate yesterday."

"That's par for the course for a first birthday! How's her appetite otherwise?"

"Good. She gets her formula, plus tapioca, carrots, beets, applesauce, peaches, pears, and bread. She munches on mini Ritz crackers, Cheerios, and bagels, and drinks apple juice or white grape juice. She flat out refuses to eat peas."

"I can relate!" Doctor O'Neill replied. "Peas are way down on my list. Let's add oatmeal, mashed potatoes, bananas, strawberries, and rice. You can try scrambled eggs, if she'll eat them, along with puréed chicken or turkey. You can also try squash, some soft cheeses, cut small, and quartered grapes. Stay away from citrus for now. Have you tried sippy cups yet?"

"No," I replied as I made notes in the small notebook I always carried with me.

I'd need a shopping trip to supplement her diet. And I'd need to buy some sippy cups. Kris and I could do that at the mall when we visited the jewelry store once Rachel's checkup was completed.

"Let's give her juice in a sippy cup from now on, if she'll tolerate it. Keep the formula in a bottle until she's weaned from it. Does she drink water at all?"

"No. Juices and formula."

"She may object, but try substituting one cup of water for one of the juice servings."

"OK."

"If she refuses, don't sweat it, just try again."

"Got it."

"Has she been sick at all? Runny nose? Sniffle?"

"She's perfectly healthy," I replied.

"Sleep?"

"About eleven hours at night, and a ninety-minute nap in the early afternoon. She does not like napping, though, because she very much wants to be active."

"That's pretty typical at her age," Doctor O'Neill observed. "How is she doing with walking?"

"She's reasonably steady for about ten steps, but has trouble with momentum. It reminds me of when I learned to ice-skate, where stopping was the real problem."

"Motor skills?"

"Good. She can grab things she wants and get them into her mouth every time!"

Doctor O'Neill laughed, "That is completely normal for this age. If it can be grabbed, it goes in the mouth! How about language?"

"She says 'dada' and 'baba' with intent, uses 'mama' generically, and has a few other one-syllable sounds. She babbles, and it's clear she's trying to communicate, but I don't grok toddler."

"Grok?" Doctor O'Neill asked.

"Heinlein!" Kris interjected. "It's from «En terre étrangère» — Stranger in a Strange Land. In the French translation, it's «gnoquer», but 'grok' means 'to comprehend fully'."

"You really should read it," I said to Doctor O'Neill. "Though I suggest English rather than French!"

"I'll consider it. In any event, in the next few months, she'll likely have a dozen or more words. Does she tell you when she needs a diaper?"

"My olfactory nerve is completely tuned to that need!" I chuckled.

"I was asking because when she does that, it's an indication you can think about potty training. Girls usually train earlier than boys. The key indicators she's ready is when she tells you she has a dirty diaper, and when she regularly and correctly uses 'no'."

"What?!" I asked.

"Correlation, not causation," Doctor O'Neil said. "Fundamentally, it shows she's engaging in reasoning and taking control of her life."

"I don't call her 'Tsarina' for nothing!"

"They do tend to rule our lives! Anything else before we do the exam?"

"Not that I can think of."

"You can weigh and measure her, if you'd like."

"Sure."

I undressed Rachel, leaving her diaper on until I had her on the scale, then removing it. I noted my daughter's weight, then measured her. I looked at the chart for weight and length, and found the correct block on the grid.

"10.72kg, 80.2cm," I reported. "About 60th percentile on the chart."

"You use metric?" Kris asked.

"In medicine, yes," I replied. "In science, as well. Everything else, as I'm sure you've seen, is in Imperial measurements except plastic soft drink bottles and liquor."

"Mike, you can do a tympanic temp, please," Doctor O'Neill offered.

I put a probe cover on the tympanic thermometer and put it in Rachel's ear, then pressed the button to register her temperature.

"38.3°C," I announced.

"Then let's get her on the exam table, please."

I put her on the exam table and Doctor O'Neill took over and performed the usual exams.

"Pulse 110, which is fine at her age; respirations 32, again normal for her age; heart strong with no murmurs; lungs clear; eyes, ears, nose, and throat clear; good distal pulses; genitalia grossly normal; height and weight proportionate; well nourished; good development; no signs of injury or abuse. Mike, you can put Rachel's diaper on her."

I did that while Doctor O'Neill updated Rachel's chart.

"She's due for her third dose of polio vaccine," Doctor O'Neill said, "but her DPT isn't due until fifteen months. She won't need a checkup then, so you can just bring her in at any time and the nurse will administer the vaccination. You could also just have it done at the hospital. She's in daycare, right?"

"Yes, she's in daycare. I'll take her up to Pediatrics, because that'll be easier."

"Do you feel any need for any blood work?" Doctor O'Neill asked. "I can just do a glucose stick test unless you want a full panel for some reason."

"With no signs of any abnormalities, I'm OK with just the glucose test."

"She had her normal meal this morning?"

"Yes, about two hours ago."

Doctor O'Neill got the test kit and drew blood from Rachel's heel, which Rachel absolutely did not appreciate.

"128," Doctor O'Neill said. "That's perfect for two hours after a meal. I pronounce Miss Rachel a healthy toddler. Any questions, Dad? Or soon-to-be-Mom?"

"None from me," I replied. "Kris?"

"I have a lot to learn!" she declared. "But no questions for now."

"I'll send the nurse in to administer the polio vaccine, and we'll see Rachel in six months. Make a note about the DPT."

"I already wrote it in my notebook," I replied. "Thanks."

"You're welcome!"

Doctor O'Neill left and about two minutes later, Nurse Nickie came in to administer the vaccine, which made Rachel cry. Once Nurse Nickie was done, I dressed Rachel and then Kris and I took her to reception, where I booked an appointment for February 25. I paid the co-pay, and then the three of us went out to the car.

"In addition to our rings, I need to get some sippy cups for Rachel, and then make a trip to the grocery store. We can have lunch at Steak 'n Shake."

"That sounds good!"

We got into the car and I headed for the mall, where we went to the same jewelry store where I'd bought the rings Elizaveta and I had worn. We selected two simple bands, one gold and one silver, with brushed finishes. I was happy because they were different from the ones Elizaveta and I'd purchased. I still wore hers on a necklace, but I'd hang it next to her icon in the icon corner before my betrothal ceremony with Kris.

We left the jewelry store with the rings, then went to Sears, where I bought three sippy cups. Our purchases complete, we left the mall and headed to Steak 'n Shake, which was at the far end of the mall parking lot.

"Right or left hand?" I asked.

"For the rings? Right, of course."

"You know that's opposite the US, right?"

"Not the only thing you do the wrong way!" Kris said with a smile. "Is that a big deal?"

"Not to me," I replied. "Right hand it is."

The waitress came and took our orders.

"Can Rachel have a French fry?" Kris asked after our food was brought to our table.

"I don't see why not," I replied.

Kris handed Rachel a French fry, and Rachel immediately stuck it into her mouth.

"Mmmmm!" Rachel declared.

I laughed, "Well, that answers that question!"

"I don't know anyone who doesn't like «frites»!" Kris declared. ("fries")

"Before I forget, I arranged with my father-in-law to purchase a Ford Tempo. He'll sell it to us for just above their cost and ensure I can get good financing. The only question is the color."

"Red! «Absolument!»" ("Of course!")

"Is there a reason you're using more French?"

"Because I know you are comfortable with it. Many Americans are not, when I first meet them, I try very hard to use only English."

"You have a wonderful accent," I replied.

"And you basically have none!"

"True. Midwestern speech tends to be relatively flat and unaccented compared to the South and East Coast."

"PAPA!" Rachel exclaimed, holding out her hand.

I chuckled, "Well, 'Mama', you've created a monster!"

Kris laughed softly, "OK to give her one more?"

"So long as you deal with the cross young lady when she can't have a third one!"

"Do you have something else for her?"

"Yes. There are Cheerios in a small Tupperware container in her bag."

Kris gave Rachel another fry, much to Rachel's delight. As predicted, two minutes later, Rachel demanded another one and when Kris gave her Cheerios instead, my lovely daughter proceeded to drop them on the floor!

"Oops!" Kris exclaimed.

"That was no 'oops'," I chuckled. "That was intentional."

"She's one!"

"And she's developing a personality and a mind of her own! You heard Doctor O'Neill mention saying 'no', and that it would start fairly soon."

"This is going to be a serious learning experience."

"It certainly has been for me," I replied. "I had counted on Elizaveta to teach me and help me through it, and it's been a real challenge to do it on my own."

"PAPA!" Rachel said, sounding cross.

"You may have Cheerios and juice," I said.

I gave her a bottle of juice and put some more Cheerios on the tray of her high chair, and she proceeded to drop the bottle on the floor.

"Wow!" Kris exclaimed. "She's in a mood!"

"She certainly is," I agreed. "She's decided she wants «frites» and is not going to accept anything else. It's fairly standard toddler behavior according to the child development materials I've read." ("fries")

"PAPA!" Rachel exclaimed, furrowing her little brow.

"No more French fries," I said.

Rachel frowned, then started fussing. Had we been at home, I'd have let her fuss, but in the restaurant, I felt I had to pick her up. I did so and held her against my chest with one arm and ate with my free hand.

"I should make you do this," I chuckled. "But I'm afraid she'll only get fussier!"

"How much did you learn about babies in medical school?"

"Almost nothing. Pediatrics, especially for infants and toddlers, is highly specialized. Undergraduate studies and the first two years of medical school are very much generalized study — biochemistry, anatomy, physiology, epidemiology, and so on. Then you have two years of clinical rotations. One of the required rotations during the third year is pediatrics, but it only lasts two months and is mostly about doing what we call 'scut'. That's basic patient care, drawing blood, and so on.

"Two months is enough to learn that kids aren't just 'small adults' when it comes to medicine, but not enough to learn what I'd need to know to be a pediatrician. The next step would be an elective Sub-Internship, which is another two months during the fourth year. I don't have time for that, given the other electives I need to do. But even those two months aren't much. Three years of Residency is where the real training would happen, and even then, you would have to focus on neonatal pediatrics for infants. For the specialty I've chosen, my electives are surgery, cardiology, pathology, the ICU, and a double in emergency medicine."

"You have surgery now, yes?"

"Yes. I completed one emergency medicine Sub-I, which is what we use as shorthand for 'Sub-Internship'. Following surgery, I have pathology, then cardiology, then the ICU, and finally my second emergency medicine rotation. My advisor encouraged me to think about doing that last Sub-I at a different hospital, but I don't really see much point. The only reasonable place would be Columbus, and the only advantage would be different Residents and Attendings. If I could do it in a large urban hospital in Chicago or New York, I'd see more gunshot and stabbing victims and more drug overdoses than we do here in Hayes County."

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