Chapter 40: Papa Needs a Translator

September 4, 1988, Columbus, Ohio

On Sunday morning, after I fed Rachel, we said our abbreviated morning prayers for Sundays, as we'd attend Matins at the Cathedral, then packed her bag. Once she was set, I showered, put on my suit, and then we headed out to the car for the drive to pick up Kris.

"Today is the first step to you having a mommy," I said to Rachel.

"PAPA!" she exclaimed in reply.

"And 'Mama', I replied.

"GA! ZA! LA! NA! SA!" Rachel exclaimed.

"Papa needs a translator for 'toddler'," I chuckled. "I hope you like Kris as your mommy. And I hope your little nose won't be bent out of shape by a little brother or sister or two!"

"GA!" Rachel replied.

"I also hope when you learn more words, you can tell me what you've been saying!"

"NO!" Rachel declared, causing me to laugh.

"I never say that to you!" I countered.

I suspected daycare, though it wouldn't surprise me if it was Yulia or Anna. Both of them were very strict with Viktor Gennadyevich, and being a boy who was a bit older, he got up to more mischief than Rachel did by a fair amount. I felt he took after Joe more than Geno, at least in terms of personality, but he was in what was called the 'Terrible Twos', which explained part of it. Viktoria Elizaveta was still too young to get up to mischief, and I wondered who she would take after.

Rachel was content to listen to music the rest of the way to Kris' house, though once Kris was in the car, Rachel began babbling. She clearly had something on her little mind, and as a Russian woman, was going to make it known, even if 'Dada' couldn't understand a word that was being said.

"Any idea what she's saying? Kris asked.

"Not a clue!" I chuckled. "But she certainly has something on her mind! And given she wants to talk, we should start teaching her that you're 'Mama'."

"It's so very strange, but I agree."

"Not something you expected at age seventeen?"

"No! But it's fine, of course. Just strange."

"It was strange to become a father," I replied. "And I had much more time to prepare for it!"

"I also didn't expect my daughter to be at my crowning!"

"Neither did I! Has your mom said anything about the reception?"

"Just that the plans are coming together. She did say you gave your guest list to your mom."

"I did. It was a bit long, but I tried to keep it reasonable. Are your grandparents coming?"

"Yes. All four of them! I saw you invited your grandparents, including the ones who live in Chicago. Will they come?"

"I doubt it. My grandfather has heart trouble, but the bigger concern is his opinion of the Orthodox Church. He's a zealous Calvinist and thinks we're all reprobate and that we teach 'works righteousness'."

"He can't see past that for your wedding?"

"It's an open question. He and my dad tangled when my dad converted to Orthodoxy. My grandfather and my dad still don't get along, which will influence my grandfather's decision."

"Does that upset you?"

"It bothers me, but I hold no animosity. I love my grandfather despite his opinion of my faith, and I'll be gracious. I do my best to avoid discussing our differences on the occasions we see each other, and focus on the family relationship."

"And he doesn't?"

"His worldview only has two types of people — the elect and the reprobate — and he sorts everyone into one of those two categories and treats them accordingly."

"That just seems wrong to me," Kris said.

"To me, as well, but I've had run-ins with a number of Calvinists, and their worldview seems to generate similar behavior towards Orthodox Christians, whom they mostly lump in with Roman Catholics."

"Well, hopefully he will see his way clear to attend."

"Hopefully."

We arrived at the Cathedral about ten minutes before Matins started and took our place in the nave. Just over three hours later, Kris, Rachel, and I went to lunch with her parents, my mom, and Stefan. After lunch, we returned to the church for the betrothal ceremony. Mr. and Mrs. Sokolov arrived, as did my parents, grandparents, Liz and Paul, Clarissa and Tessa, Lara, Subdeacon Mark and Alyssa, Sofia and Robby, Elias and Serafima, Jocelyn and Gene, Anicka and Derek, Joel and Milena, Oksana and Doctor Casper, Doctors Smith and Forsberg, and Doctor Gibbs and Bobby. I introduced each of the people who hadn't met Kris, which included my grandparents, and then several of Kris' friends arrived, and she introduced them to me. I was pleasantly surprised to see José arrive just as the service was about to begin.

As was the tradition, everyone gathered in the narthex, and Kris and I took our positions at the doors to the nave. Father Luke was assisted by the new deacon, James, as well as the Cathedral choir. Deacon James was a traditional second-vocation deacon, having retired from a job with P&G the previous year. Once everyone was in place, Father Luke began the service

"O God eternal, who bringest them that are divided unto unity, and who hast appointed for them an indissoluble bond of love, Who didst bless Isaac and Rebekah, and show them to be heirs of Thy promise: Do Thou also bless these Thy servants, Mikhail and Kristina, guiding them unto every good work. For Thou art a merciful God, and unto Thee do we send up glory: to the Father, and to the Son, and to the Holy Spirit, now and ever, and unto ages of ages."

The choir responded with "Amen," and Father Luke continued.

"Peace be to all!" he sang, with the choir responding, "And to Thy Spirit."

"Bow your heads unto the Lord," he continued, with the choir responding, "To Thee, O Lord!"

Father Luke continued praying.

"O Lord our God, who hast espoused the Church as a pure virgin from amongst the nations: Do Thou bless this betrothal, and unite and keep these thy servants in peace and oneness of mind. For unto Thee is due all glory, honor, and worship: to the Father, and to the Son, and to the Holy Spirit, now and ever, and unto ages of ages. Amen."

The choir responded with "Amen," and then he took Kris' silver ring, held it over my head, and prayed three times:

"The servant of God, Mikhail Petrovich, is betrothed to the handmaid of God, Kristina Ignatievna, in the Name of the Father, and of the Son, and of the Holy Spirit. Amen."

He then placed the ring on my right ring finger, retrieved the gold ring from the table, held it over Kris' head, and prayed three times:

"The handmaid of God, Kristina Ignatievna, is betrothed to the servant of God, Mikhail Petrovich, in the Name of the Father, and of the Son, and of the Holy Spirit. Amen."

I was wearing Kris' ring, and she mine, and Father stepped back so that Mr. and Mrs. Sokolov could stand before us. They each removed our rings and transferred them to the other three times, such that in the end, I had on the gold ring and Kris the silver ring, then they moved to stand behind us once more. Father Luke then said the final prayer:

The choir responded with "Amen," and Father Luke prayed the prayers of dismissal. Once that was completed, everyone moved to the church hall for a reception with cake, cookies, coffee, and punch. After Father Luke blessed the food, everyone helped themselves.

"Congratulations, Mike," my grandfather said, coming up to me while Kris was speaking with Clarissa, Lara, and Jocelyn.

"Thanks. How is Grandma handling this?"

"She's fine. It's Mrs. Dimitrijevic who is on the warpath!"

"Well, I called Danijela before I arranged to come to Columbus to see Kristina, so if Mrs. Dimitrijevic has a beef, she can take it up with Danijela, who turned me down."

"I suspect there's a difference of opinion on that matter!" my grandfather said with a sly smile.

"Given it was Danijela's decision, that doesn't worry me much."

My grandfather smiled, "I wasn't suggesting you should be worried! I just find it amusing!"

I laughed, "I bet Grandma doesn't know that!"

"You would win that bet, Mischa! Your father and Holly didn't come today?"

"No, but they'll be at the wedding."

"I see you left the rings on your right hands."

"That was Kris' choice," I replied. "It's the Orthodox tradition, as well as the norm in France."

"Congrats, Mike," Doctor Casper said, coming over to us while Oksana was with Kris and other women.

"Thanks. This is my grandfather, Mikhail Ivanovich Borodin; Grandpa, this is Doctor Greg Casper."

They shook hands.

"After witnessing the ceremony, I know what I have to look forward to!" Doctor Casper said to me.

"Something you want to share?" I asked with a grin.

"That I'm dating a Russian girl! You do the math!"

I laughed hard.

"I received A's in math for my entire education, but I think it's the fact that my mom is Russian, and I was married to a Russian girl, is sufficient to understand!"

"You'll have fifty years or more to consider your situation," my grandfather said. "I wish you the best!"

"«Дедушка» (dedushka)," I said. "«Пожалуйста, не делайте этого!» (Pozhaluysta, ne delayte etogo)"

My grandfather smiled at my request to please not do what he was doing.

"Doctor," my grandfather said, "I'm sorry for trying to make a joke."

Doctor Casper smiled, "It's OK. I've met Oksana's mother and grandmother!"

My grandfather and I both exchanged a knowing look, and I excused myself. I chatted with several others before Rachel, Kris, and I left, heading to her house to have dinner with her parents before Rachel and I headed back to McKinley.

September 5, 1988, McKinley, Ohio

"What's with the new ring on your right hand?" Debbie inquired when we met in the lounge on Monday morning.

I held up my right hand. "This is a betrothal ring, and both men and women wear them from the time of the betrothal. They're worn on the right hand, which is the Orthodox tradition. Many Orthodox Christians in the US wear them on their left hands in deference to the US tradition of the left hand, so as to avoid any confusion."

"Betrothal?"

"Consider it as a formal engagement," I replied. "We had a betrothal ceremony yesterday where we became officially engaged."

"It's cool that the guy wears a ring, too," Debbie observed. "It takes him 'off the market'. Well, on the left hand, I guess."

"In theory," I chuckled. "I'll get hit on by more nurses and patients with the ring on than I did in the last six months of not wearing it."

"Seriously?"

"Seriously."

"What's wrong with people?!"

I chuckled, "There's a long list, though I have a shorter one, but you probably don't want to hear that answer!"

"Sin, right?"

"Yes. Though the root cause is our mortality."

Doctor Rafiq came in, and it was time to start our pre-round checks. He was thoroughly annoyed that he had to accompany us on these checks, but Doctor Lindsay had ordered him to do so. I wasn't privy to her thinking, though I was sure it was a mix of penance and punishment for the way he was handling his PGY1 responsibilities. He wanted to assist with surgeries, but instead was what Doctor Gibbs referred to as a 'scut monkey' — a Resident or medical student who was receiving extra 'scut' because of some failing, real or perceived.

In Doctor Rafiq's case, it wasn't about perception. Well, it was, in a sense, as perception matched reality with regard to his behavior and his methods. He was an object lesson in how not to have a successful Residency in a similar way to how Melissa Bush had been an object lesson in how not to succeed in medical school. I wondered if he was actually going to make it to the end of June, let alone have his Residency renewed.

We only had one surgery for the day, and that was a triple coronary bypass, which would be done by Doctor Roth and Doctor Getty, despite the fact it was Labor Day. It would take at least five hours, possibly six, and they would be assisted by Doctor Lindsay and Doctor Strong. With two Attendings and two senior Residents, there would be nothing for Debbie or me to do in the OR, as Doctors Rafiq and Pace would do the tasks normally assigned to us. Or so I assumed.

"Mike, intubate and hook up the monitor," Doctor Roth instructed, to my surprise.

Doctor Rafiq glowered, and as I thought about it, I was sure the instruction was a continuation of Doctor Lindsay's 'remedial action' against Doctor Rafiq. He was going to be sidelined until his attitude and behavior improved. I wasn't sure he was up to the challenge, but that wasn't for me to decide, though I would be asked my opinion of him as a teacher at the end of my surgical rotation.

I quickly completed the tasks, then moved to a spot further away from the table than usual, given we had twice the number of doctors in the OR as usual. The surgery, which involved taking grafts from the patient's legs, was grueling but straightforward, and five hours and twenty-three minutes after we started, Debbie, Doctor Rafiq, Doctor Pace, and I escorted the fifty-nine-year-old man to Recovery.

About an hour later, Debbie and I took a late lunch in the cafeteria.

"Doctor Rafiq looked as if he was going to strangle you," Debbie observed.

"I saw. Fortunately, there isn't much he can do about it, because if he sidelined me, he would have to do even more scut! His options are limited to doing scut or supervising scut, and his personality pretty much dictates he can't do it."

"I just don't get it," Debbie said. "I went into medicine to help people, the same as you did."

I nodded, "And I've run into people, as I suspect you have, who are focused on prestige or money, though if it's money they want, they won't stay in McKinley. They'll go to a big city, and they'll specialize in cardiac surgery, neurosurgery, plastic surgery, or, believe it or not, dermatology."

"Nobody wants that!" Debbie declared.

"It's the least prestigious field, except perhaps pathology, but it also has the easiest hours, the least incidence of emergent cases, and the highest pay for hours worked, except plastic surgery. Pathology, followed by internal medicine, has the lowest paid by hours worked, though emergency medicine comes close."

"Surgeons have the best deal, overall, right?"

"It depends on what parameters you use, but they are the highest paid, even for general surgery, and their hours aren't anything like emergency medicine. I'd say that the doctors earned their day's pay in that five-and-half hour surgery we just completed."

"Doctors Pace and Rafiq basically stood and watched! No different from me."

"That's true, but that is what a PGY1 does, and they aren't paid big bucks, even using the local scale. The money comes around PGY5 for surgeons, which is why they start with a salary that's a bit higher than most Residents. That said, their earning potential goes up significantly at that point compared to most other specialties."

"I think I should have paid more attention in the Practice of Medicine class."

"The only reason I paid attention to salaries was because I was developing the proposal for a trauma surgery Residency and needed to look at comparable salary schedules. Otherwise, I wouldn't have cared all that much. I'm not in it for the money, though like a good capitalist, I'll take it, pay my taxes, and feel very fortunate!"

"I thought you were a Democrat!"

I chuckled, "I'm an independent, but you can be a capitalist and be a Democrat, Walter Mondale to the contrary notwithstanding! My fiancée is a socialist, and I guarantee she thinks I'm right of center, and not just by a bit!"

"Why is that?"

"Our Democrats are to the right of most centrist parties in Europe. Kris is a true socialist."

"So, like everything owned by the government?"

"Not everything, but core services, such as healthcare, energy, and so on, and taxes, which make an attempt to level incomes. The thing is, if you define socialism properly, we have quite a few 'socialist' programs here — Medicare, Medicaid, Social Security, and so on. It really is a matter of degree, and the 'welfare state' has plenty of features that Kris would accept as good policy."

"And you?"

"Again, I'm a centrist, and I think it calls for a balance between public and private action, leaning towards private for most things, but believing regulation is necessary to protect the public. That said, we screw that up regularly with regard to the S&L crisis, breaking up AT&T, and a host of other regulatory failures. I'd rather change the subject, though, because I detest politics!"

"But don't you have to take a position on things? I mean, within medicine, at least?"

"Yes, of course, but once it becomes political, it's almost impossible to find a compromise because both sides stake out positions with non-negotiable features that contradict each other. Think about how the M & M sessions are conducted — everyone gives their input, and the group synthesizes a response that fits the facts, the needs of the patients, the needs of the hospital, and the needs of the community as a whole.

"It's not perfect, but good policies and practices come from those sessions, as opposed to the BS we have to deal with when political solutions are imposed, such as EMTALA. The main problem there is that the solution is imposed externally and has no room for adjustment or modification for local conditions. Our system, at least according to my civics teachers, is meant to have local control to provide flexibility and to allow adaptation to local circumstances. EMTALA, like many Federal programs, doesn't allow for that."