Good Medicine - Medical School IV - Cover

Good Medicine - Medical School IV

Copyright © 2015-2023 Penguintopia Productions

Chapter 4: Addressing the Core Problem

April 18, 1988, McKinley, Ohio

"You were harsh," Danika observed after the rest of the study group had left.

"Better to have the wake-up call now than during medical school," I replied.

"Sorry, I wasn't saying it was unwarranted, just that you were, hmm, more forceful than I would have expected from our previous interactions."

"I'm passionate when it's appropriate," I replied. "One of the things my confessor and my mentors are helping me with is knowing when it's appropriate to apply that passion."

"Have you gotten into trouble?"

"No, which is the point of the guidance; it's about keeping me out of trouble with regard to things I am passionate about. Most recently, it's about mental health. A close friend of mine is suffering from schizophrenia and her doctors made a grave error in her treatment, causing her to need hospitalization and extensive counseling to recover from their error."

"I suspect that's a longish story."

"It is, and I'll tell you at some point. Did you speak to your dad?"

"Yes. He suggested Memorial Day, because he'll have no scheduled surgeries and he's not on call. You don't work on Mondays, so that should work for you, right?"

"Yes."

"Then they'll fly down in the morning, we'll have lunch, then you and my dad will have a private conversation."

"I think you should be part of that conversation," I said.

"That's not how it's done. I trust both you and my dad, and besides, I can always say 'no'! Or, I can also say 'yes' even if he objects."

"But you won't, will you?"

"Go against my dad? Most likely not."

"And the end of this conversation is a, well, contract of marriage?"

"In effect, yes. Assuming you come to an agreement."

"This is just weird!"

Danika smiled, "And yet, you're intrigued, as you said."

"I am," I agreed, marveling at how crazy my life could be at times.

April 21, 1988, McKinley, Ohio

"Did you bring Rachel?" Milena asked when I walked up to her outside the music room.

"No. I decided it was best if she stay with her grandparents tonight and tomorrow night. I don't want to mess up her schedule, and she's happy spending time with her cousin. And it keeps her grandma happy."

"Elizaveta had a real problem with that, but you seem to have moderated."

"I have to play the cards I've been dealt, my relationship with my in-laws has improved because of it, and it gives Lara a break, too."

"How were you yesterday?"

It had been, or rather, would have been, Elizaveta's nineteenth birthday.

"OK," I replied. "For some reason, it didn't have the impact I feared it would. I was a bit sad, but no crying."

"OK. Are you ready to practice helping horny teenage boys who last five seconds get laid?" Milena asked with a silly smile.

"Absolutely!"

"Tomorrow night, I want you to sing as if you desperately want to make love to me while looking into my eyes."

"You're dangerous!" I exclaimed.

Milena laughed, "Neither of us would even consider cheating! But nobody at Hayes County High has to know we aren't going to rip each other's clothes off backstage when we finish the song!"

"What did I miss?" José asked with a grin, having walked up behind me.

"Just Milena plotting to put on a show at the Prom!"

"They'll arrest you for that, Professor Greene!" José chuckled.

"The divorce would be the bigger problem," Milena countered.

The three of us went into the music room and about ten minutes later, kicked off our last practice before the Prom. When we finished, Kari asked about Rachel, and after I said she was at my in-laws, Kari asked if I wanted to get ice cream. I agreed, but we needed to walk to my house to return my instruments. Having done that, we retraced our steps to Taft, then walked across campus, past Rickenbacker, and down the street to Verner's. I ordered my usual single scoop of chocolate in a sugar cone and Kari ordered two scoops of strawberry in a cake cone.

"How are things going?" I asked as we sat outside on a bench in the comfortable Spring evening air.

"Good," Kari replied. "Will your schedule allow us to meet occasionally to talk?"

"Yes. Next week, Tuesday, Wednesday, or Thursday evenings would be good for dinner. That's mostly true until the end of the month. Was there anything specific?"

"No. Talking to you always made me think, and I believe you have a lot more to teach me about life, the universe, and everything."

"'42' is the answer to the Ultimate Question of Life, the Universe, and Everything!"

"And here I thought it was '69'!" Kari smirked.

I laughed, "That does answer one question, though if you know the origin story, you can't know both the question and the answer in the same universe. If they were both known, they'd cancel each other out and take the universe with them."

"I've only read the first book. I take it that's in a later book?"

"The third one — Life, the Universe and Everything. You should read The Restaurant at the End of the Universe first, though. There's a fourth one, So Long, and Thanks for All the Fish, but I felt it was only so-so compared to the other three."

"How is your training going?"

"I'm in Internal Medicine, which is routine patient care, and have a regular schedule, Tuesday through Saturday, 5:00am to 5:00pm."

"What time do you get up?"

"Around 4:00am."

"And you're eating ice cream with me at almost 10:00pm?"

"Yes," I replied. "I can get by on four hours of sleep."

"But you have the Prom tomorrow and have to work Saturday, right?"

"Yes."

"That's crazy!" Kari declared.

"That's medical training. I'll get plenty of sleep on Sunday night."

"Back in February, you said you were close to deciding."

"That may have been a bit premature," I replied.

"Oh?"

"I'm still struggling spiritually. I'm working on it, but I won't decide anything before I see Father Roman Braga, a well-respected monk, on May 3rd, and probably not for some time after that."

"I don't mean to be a bitch, but how could talking to a monk possibly help you? I mean, it's not like he has relationship experience."

"It's more about my interior life and fixing my spiritual foundation."

"I'm no expert, obviously, but I think you're still bottling up your emotions over your wife's death. And that's the real source of whatever is wrong with your 'interior life'."

"You know I have to do that at the hospital, right? And that I have to be strong for Rachel."

"What good will it do to be strong now and have some kind of emotional breakdown later? If you don't find some way to let it out, something really bad is going to happen. And I think you know it, too. And you know when."

I took a deep breath and let it out.

"Rachel's birthday."

"That answer tells me I'm exactly right. I know you need to get home to bed, but may I say something that might start a long conversation?"

"Sure."

"You felt, rightly, that I was concerned about being a mom at nineteen, and that was absolutely true. But I was also concerned with being in a relationship with someone who was both emotionless and fragile. I mean, I'm only nineteen, but it's pretty obvious to me."

"May I ask a question?"

"Yes."

"Did Anicka put you up to this?"

Kari smiled, "We discussed it. You don't want to know her solution!"

I laughed, "I can guess. But I'm not sure how that helps."

"Actually, what you're thinking is only part of it. She said you need someone who is not too close to you to pour your heart out to, and who isn't, forgive me, blinded by religious beliefs. And, in her mind, you can only do that after a very specific kind of lovemaking."

Kari was actually saying what Lara and Clarissa had said, although each of them had a different take. The one difference was that Kari had expressly stated that I needed to pour out my emotions, or, as the Church Fathers would put it, unburden my heart. As for the 'specific kind of lovemaking', that was, I was sure, a reference to Milena and me, and our deep talks which had helped her restore her relationship with Joel.

"And you're volunteering for that duty?" I asked with a wry smile.

"I could make the sacrifice," Kari replied with a soft laugh. "I believe Anicka's opinion, which she expressed to you, was that we needed each other. I think this might be why."

"At risk of having you hit me over the head with the nearest heavy item, are you thinking relationship?"

Kari rolled her eyes, "That is also part of your problem! You are so focused on finding a mom for your daughter that it's preventing you from dealing with your feelings and your loss."

"I need to think about this," I said carefully. "I also need sleep."

"Walk me back to my dorm, and we'll talk when you're ready."

"Thanks," I replied.

I walked Kari to her dorm, we exchanged a chaste hug, and I headed home for evening prayers and bed.

April 22, 1988, McKinley, Ohio

"Do you think I'm holding in my emotions?" I asked Clarissa after we had lunch with Antonne on Friday.

"Of course you are," Clarissa replied. "But that's kind of ingrained into your personality, and I'm not sure it'll change without some kind of fundamental reset, and I'm not sure that's possible given the combination of medical school and being a single dad."

"Someone suggested that it's building towards an explosion, or maybe implosion is a better word."

"I'd say the fuse is lit for August 26th," Clarissa observed. "The question is only how bad it's going to be. You think, and you may well be right, that being involved in a committed relationship, even if you aren't married, will help. On the other hand, you might completely blow it apart, and end up in a worse position.

"I also think you're still struggling with contradictions between what I consider a healthy libido and your faith. You had struggles before you married Elizaveta, but mostly you came to terms with it. Let me ask you this question — have you gone to confession recently?"

"On Holy Saturday for the first time in months. I think the previous time was before Annette."

"Why didn't you go?"

"I'd say mostly because I was upset with Father Nicholas over how he was handling my relationship with you, Lara, Tasha, and others, when I actually wasn't having sex with anyone. That was the genesis of me staying away from church, and except for Lent and Holy Week, attending church at the Cathedral."

"If you recall, I gave you advice last Fall to ask to be laicized and to take time away from church. You took the advice, at least with regard to asking to be laicized. I honestly think going to church is interfering with your recovery, not helping it. I know you believe, Mike, that was never a question. But that belief, at least as you're expressing it now, is not helping."

"Not going to services at the Cathedral would create problems with Dani," I countered.

"Elizaveta, version two?" Clarissa asked.

I took a deep breath and let it out, "That is what creates the fundamental question in my mind."

"And in mine, really. Maybe that is exactly what you need. Maybe that's exactly what you don't need. But until you sort out what you call your 'interior life', there is no way for you to properly judge. And that means dealing with your emotions, not locking them away in the hopes that, to use a medical analogy, the inflamed appendix never bursts. How often does THAT happen?"

"Not often enough to even consider any alternative to an appendectomy."

"And if you let it burst, the patient is at grave risk. Coming back from the analogy, think about the grave risk to your medical career and to your daughter if you have an emotional breakdown."

"It wouldn't be good."

"No, it wouldn't. What are your feelings towards Doctor Mercer at this point?"

"I'm angry with her, but Doctor Forth and Doctor Lawson made some very good points."

"Do you think she can help?"

"Not really. Her advice has been almost universally wrong. She objected to you and me, to Elizaveta and me, and to how I was encouraging Angie. Not to mention a few other situations to which you aren't privy. She got things right in Liz's situation, but otherwise? No. I suspect she's very good with rape and incest victims. Anything else is an open question."

"What about Mrs. Wilders here at the hospital?"

"The social worker?"

"She's a licensed clinical psychologist. She sees medical students and nursing students on the side. Could it hurt to talk to her?"

"Probably not," I admitted.

"Consider it, Petrovich. Getting back to my point about church, I'd say go with Dani, if you feel you need to do that to keep the relationship, but limit yourself to that. Say your prayers at home with Rachel and whomever, but nothing else. I know that runs counter to your inclinations, but I think you'll actually do yourself more harm than good at this point if you see the monk. Truly deal with Elizaveta's death from an emotional standpoint, THEN work on your spirituality."

"I'm not sure those things can be split," I replied. "When I speak of my 'interior life' it's my whole self, minus the body — «nous», mind, soul, psyche, conscience, or whatever words you want to use for it. I really can't separate them. That is who I am, and all the pieces interact — intellect, emotions, and «nous»."

"Do you know how frustrating you are?" Clarissa asked, sounding somewhat exasperated. "You're basically saying your 'interior life' is a mess and you can't fix it unless you fix everything at once. Is that how you'll handle trauma cases? If you can't fix everything at once, you'll fix nothing? Or will you risk a patient's survival in some vain attempt to fix everything rather than focusing on the life-threatening problem?"

"When you put it that way..."

"So, deal with your emotions, THEN worry about your spirituality. I think you'll discover that the true source of your struggles is not properly dealing with your grief. I don't disagree with you on psychological resilience as a concept; I disagree that you're as resilient as you believe you are."

"You might have a point," I admitted.

"Then make an appointment to see Mrs. Wilders. Don't think about it, just do it."

I almost said 'Let me think about it' but that might have resulted in severe bodily harm, as Clarissa tried to beat sense into me.

"I'll call her," I said.

"Good."

When we returned to Internal Medicine, I placed a call and made an appointment to see Mrs. Wilders on Tuesday, then cleared it with Doctor Vega, the Attending who would be on duty on Tuesday.

"All set," I said to Clarissa when I returned from speaking with Doctor Vega.

"Good. I'm curious about the girl from Antonne's study group, Danika."

"So am I," I chuckled. "Talk about out of left field or a bolt from the blue!"

"Is this just a cute Indian girl, or is there possibly more to it?"

"I'm meeting her parents on Memorial Day," I replied. "According to her, it's to negotiate a dowry and contract for marriage."

"You're a nut, Petrovich! Do they even do those things in India these days?"

"Apparently, though some of the abusive practices have been outlawed. It's true I'm meeting her parents, and it's true her dad is going to size me up, but beyond that, it's up to Danika and me. And I have no freaking clue."

"You wouldn't want to rank the girls, would you?"

"Not really, no."

"Want to hear my thinking?"

"Oh, sure," I chuckled. "Why not?"

"I think when push comes to shove, you'd choose Dani over Sara. Comparing Dani and Maryam is complicated because they offer two very different futures. I think, based on what I know about you, you'd choose Dani, but I'm not sure. That said, if Maryam were a choice over Dani, then Danika and Maryam compete very favorably, though I think Maryam being in love with you would influence the choice. Of course, I could be completely out to lunch, but that's how I see it."

"I think the choice between Sara and Dani is a closer thing than you do, and hinges on the ethnic thing. Between Maryam and Danika, it might hinge on kids. Danika suggested having two while she's an undergrad, which would be tricky, but doable. And she wouldn't have to delay Residency."

"Is having more than one more kid that important?"

"I don't know. And you know this is all highly speculative, especially about Danika."

"What about Samantha?"

"She's as needy as Tasha," I replied.

"The kiss of death because you aren't signing up for the nightmare of a wife who is constantly battling your one true love and who would be unhappy for most of the next decade."

"Exactly. I suppose the bottom line is that I don't know, and as you said earlier, I need to deal with my emotions before I make any permanent decisions."

"Yes, you need to do that."

When my shift ended at 5:00pm, I hurried home, ate a quick dinner of leftovers, changed clothes, then gathered my instruments and music and headed for Taft to pick up Kari as we'd agreed.

"Pretty convenient to have the Prom at the Holiday Inn," Kari observed after she got into the car.

"I was just thinking about how many rooms might have been rented by guys in the hopes of getting laid."

"I was actually surprised that they moved the Prom from the cafeteria and gym at the High School. One of my friends who's a Senior said that the Prom committee debated for a long time because the ticket price had to more than double, and some people might not be able to afford it. They decided to have a fund-raiser to limit the price increase, and it worked pretty well, as the price only went up ten bucks per couple, instead of going up by forty-five."

"I always wondered about that. In Harding County, we had ours at a banquet hall, but the owner gave the Prom committee a very, very good price, and some of the local businesses contributed. Even so, it was still $40 per couple in 1981."

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