Good Medicine - Medical School IV - Cover

Good Medicine - Medical School IV

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Chapter 7: A Source of Conflict

May 7, 1988, McKinley, Ohio

On Thursday morning, I met with Jeanne Wilders, having spent several hours on Tuesday and Wednesday evenings composing the letter to Elizaveta. Kari had actually helped, as I'd been able to have a deep conversation with her, unlike the previous week when I'd simply cried. I'd stayed up later than usual to write, and I'd done the same thing on Wednesday, albeit without Kari's assistance.

"I actually don't want to see them," Jeannie said when I went to hand them to her. "I want you to tell me how you feel."

"The letter to Rachel was something I had planned to do verbally when she's older, but putting it down in writing will make that easier when the time comes. The letter to Elizaveta was cathartic, and I was able to express things I hadn't been able to express before. A friend actually helped with that, not in the writing, but in listening to me basically dump my jumble of feelings on her. The letter helped me order those feelings and, I think, better understand them."

"Which was, of course, the point," Jeannie said with a soft smile. "Do you visit Elizaveta's grave?"

"I did for a time, but I haven't recently. There will be a graveside memorial service on August 26th, but I have seriously mixed emotions about that because it's Rachel's birthday, and I need to figure out a balance between two conflicting needs."

"I'm not at all versed in Russian Orthodox Christianity, but could you do the memorial service on a different day?"

"It's certainly possible, but I have to consider not just my own feelings, but those of her closest friends and family. Of course, it's entirely possible that I'll be on call at the hospital, and have to miss both the memorial service and Rachel's birthday, but I won't know for sure until mid-July."

"You're permitted, even as a medical student, to take bereavement days, and the policy doesn't specifically require they be contemporaneous with death or burial, to accommodate the various different practices, as well as the inevitable delays that can occur. What service will you be on?"

"Surgery. I'll discuss it with Doctor Roth and Doctor Cutter."

"I know I'm telling you something you already know, but you're going to need to find a way to strike a proper balance so that your daughter doesn't feel guilty about being born."

"Which is where my main struggle arises. I'll also have one in the future of how to properly honor Elizaveta without my wife, who will be the only mother Rachel will actually know, feeling she's playing second fiddle to a, if you'll pardon the expression, ghost."

"The fact that you understand that is a strong indication that you'll be cognizant of that, and work out a balance that honors both your marriages and your daughter."

"Not an easy task."

"No, and it will involve discussing it with whomever you marry, and you'll need to take into account children you might have with your future wife. Your bond with Rachel will always be special, but you have to be careful not to neglect your other children because of the circumstances of her birth. I have a new assignment for you."

"OK."

"Visit Elizaveta's grave and talk to her. I gather from everything you've said, you believe that she can, in some way, hear you."

"Yes, though how that happens is a mystery, that is, hidden from us, not as in a 'whodunit?' like Agatha Christie's mysteries."

"Then visit her gravesite, and we'll meet once more. You're far better off if you open your heart to a friend than to a counselor. I've set you on the right path, you just need to follow it. That means not bottling up your emotions, but also not obsessing. As with most things in life, it's about balance.

"If you encounter any obstacles, I'm here to help, but I'm sure you're aware that this is a journey you have to make, and your companions on this journey are your daughter, friends, family, and pastor, not your counselor. You know what you need to do, so just do it."

"I'll make some time to see Elizaveta and come see you next week."

"Good."

"Thanks, Jeannie."

"You're welcome."

May 7, 1988, McKinley, Ohio

On Saturday evening, I joined my in-laws for dinner. I still hadn't heard from Sara and was resigned to the fact that our relationship was over. I certainly could forgive whatever transgression had occurred, but not without her admission and an explanation. But forgiveness was only one step, and as I'd said to Serafima and Lara, rebuilding trust was a different thing altogether.

"I understand you've been seeing the daughter of Miroslav Dimitrijevic," Viktor said when we met privately in his study before dinner.

"I have," I replied. "My grandmother and her grandmother suggested we get to know each other. I attend the Divine Liturgy at the Cathedral on Sunday mornings so Danijela and I can have lunch together. Nothing has been decided, and I'm not ready to make any decisions. Rest assured, nothing will interfere with Rachel's relationship with you and Yulia."

"As I'm sure you suspect, Yulia is nervous, but I've reassured her."

"The biggest challenge will come from multiple sets of grandparents," I replied. "For Rachel, there are three sets because of my parents' divorce. We'll add a fourth set no matter who I marry, and we'll all need to be flexible so as not to cause familial rifts. And when you add in the demands of my medical training, holidays become a complete mess."

"Yulia is not the most flexible person in the world," Viktor observed with a wry smile.

"And Elizaveta was more like Yulia than she would have cared to admit! Of course, I have the genetic stubbornness of the Borodin clan, so I don't have much room to talk! And speaking of Elizaveta, Serafima broached the topic of the memorial service on August 26th. We need to do that, of course, but in a way that doesn't detract from Rachel's birthday."

"What day of the week is August 26th this year?"

"A Friday. I was thinking of a simple memorial service at Elizaveta's grave on Friday morning. We could do the corporate memorial service in the temple the previous evening, which is traditional in our parish, but I'll need to confirm with Father Nicholas. Then Rachel's birthday could be celebrated on Friday evening. I'll need to get the day off, but there is a provision for that, which I'm sure you know, being on the Board of Directors."

"Thursday evening and Friday morning make sense. That way, anyone who can't take off work can attend the Thursday evening service."

"I plan to invite Bishop JOHN, though I'm not sure if he'll attend."

"I'm sure he will, if his schedule allows. How are you doing otherwise?"

"I'm doing OK. Lara is a huge help, as are Anna and Yulia. It'll be a bit of a struggle come August when Lara resumes her student teaching, but between Serafima, Anna, Yulia, and the daycare at the hospital, I think I have it covered."

"Good. And something which will be good news for you, is Resident salaries are being boosted by just over ten percent across the board, half this June, and half next June. The starting salary for surgical Residents will be increased to $27,800, which is about a twenty percent boost. This is all part of the restructuring and planning for the new surgical wings and new trauma wing."

"I'm not going to object!"

"I didn't think you would. The official announcement will go out on Monday morning. Please don't say anything before then."

"Of course not," I replied.

"Shall we join the others?"

"Yes."

May 9, 1988, McKinley, Ohio

After breakfast on Monday morning, Rachel and I went to the church cemetery. I cradled Rachel in my arms, read the prayers for the departed, then sat down. I began talking and poured my heart out to Elizaveta with tears streaming down my face. As with the letter, it was cathartic, and I felt a strange mix of sadness, emptiness, and relief. I hadn't realized how tense I'd been, and concluded that I had been self-medicating with sex, as it acted as just enough of a pressure relief valve to keep me from what would likely have been a tremendous breakdown.

"Michael?" I heard from behind me.

I turned my head to see Father Nicholas standing at the entrance to the churchyard.

"I'm fine, Father," I said. "My counselor suggested I needed to talk to Elizaveta, and that's what we're doing."

"Mrs. Sokolov saw you and was concerned, but if you're OK, I'll leave you."

"We're actually finished," I said. "Do you have a moment to talk about a memorial service in August?"

"Yes, of course. Do you want to go inside?"

"How about we sit on the bench where Elizaveta accosted me?" I asked with a slight smile.

Father Nicholas nodded, and I got up, cradled Rachel in one arm, slung her diaper bag over my other shoulder, then picked up her carrier. We walked to the bench near the parking lot where an extremely determined young woman had nearly four years in the past, demanded I marry her.

"What were you thinking?" Father Nicholas asked.

"To hold the panikhída on Thursday evening, August 25th, then a graveside service on Friday morning. That way, anyone who is unable to attend a Friday morning service could attend on Thursday evening. Of course, some of us will attend both."

"That will work," Father Nicholas said. "I'll add it to the parish calendar."

"Thank you."

"Mike, is it OK to ask about Sara Wright?"

"It's OK to ask, but I don't think I have any answers other than she's very upset and won't talk to me. Serafima and Irina have both tried, but to no avail. And before you ask, it's not anything that I did, as far as any of us can tell. Anything more I say would be pure speculation or third-hand information.

"Sara knew I had been on dates with other girls, and that I was seeing Danijela Dimitrijevic in Columbus, but was absolutely convinced that when the time came, I'd choose her. I'd say there was a very good chance she was correct in her assessment, though I need to continue working through my grief and restore my spiritual state before I make any life-changing decisions."

"Very wise," Father Nicholas said. "I haven't spoken to Sara as she wasn't in church these past two weeks and hasn't returned my calls. Her parents are quite concerned, and you can imagine what went through their minds."

"Obviously, but I can safely say Sara is not pregnant."

I could, because she'd had her period and we hadn't had intercourse between her period and the Prom. Even if she hadn't been careful with her birth control pills, I could be sure based on pure physiology that she was not pregnant.

Father Nicholas let out a sigh of relief, "That's good. And please know that I seriously doubted it, but Mrs. Wright did raise the possibility, given the way Sara is reacting."

"That would be my first thought as a parent, given what happened with Sasha and Vickie. I think the only thing you could do is ask Irina or Serafima and see if they can provide further insight."

"OK. The teen years are always toughest, as I'm sure you know. Have you made your plans to see Father Roman?"

"Yes. I'll visit him in Michigan two weeks from today."

"Will we see you back at church soon?"

"For now, the only time I can see Danijela is on Sunday, so it makes sense to worship at the Cathedral. I'll receive my schedule for my trauma Sub-I a week from today."

"Remind me what a 'Sub-I' is, please."

"A Sub-Internship. It's what Fourth Year clinical rotations are called because they're intended to prepare you for your Intern year. I'll learn to do more, specifically intubation, subclavian IVs, nasogastric tubes, and other procedures I'll be expected to know how to do and be able to perform in just over a year when I'm officially a doctor."

"Time has really flown by. It seems almost as if it were yesterday when you transferred your membership to Saint Michael the Archangel from Holy Transfiguration."

"Tell me about it! I find it hard to believe Rachel is almost nine months old and that I graduate in just over a year."

"I say the same kind of thing about my boys. My eldest will be going to Rutgers in the Fall."

"Football, right?"

"What else? The kid is built like a tank! That's from my father-in-law, not me! We're all beanpoles on my side of the family. May I return to you seeing Danijela and ask a question to which you may respond that I should mind my own business?"

"Ask," I replied.

"Are you considering anyone else?"

"Maryam and I are having dinner once a week, and we've discussed a possible future together, but we both understand the extreme difficulties involved. And the girl from the Malankara Church has indicated an interest, though culturally she would never marry without her father's approval. She wants me to meet him."

Father Nicholas smiled and shook his head, "As usual, you don't do anything the easy way. May I ask what it is, if there is anything, that gives you pause about Danijela? I understand the challenges with Maryam, as you'll both be undergoing the same difficult training for another decade, but Danijela seems a perfect match for you, if I'm correctly interpreting what Father Luke has said."

"In a sense, perhaps too perfect," I replied. "My concern is that she is so much like Elizaveta that I'm interested in her for that reason. She's not Elizaveta, but if I go into a marriage expecting it to be identical to how things were with Elizaveta, you know what will happen."

"Nothing good, that's for sure. Well, you might work through it, but it would create problems which might even dwarf the challenges you'd face when you and Maryam were both working those hellish ninety-hour weeks."

"Until I can say for sure I want to marry Danijela because she's Danijela, I can't ask. That's not a problem for her, either, as she fully expects me to honor the usual one-year mourning period, and you saw clear evidence of my emotional state a few minutes ago. Because of that, I'm not ready to make any commitments to anyone."

"I'm going to assume a wedding to Danijela would be celebrated in Columbus?"

"Would you want to tell her grandmother otherwise?"

"I don't have a death wish!"

"Exactly. So, if that were to happen, then yes. As for Maryam, if that were to happen, it would be here, though I suspect she'd ask Vladyka for his blessing to have her priest from her Antiochian parish in Fort Wayne concelebrate. And for completeness, I have no idea what would happen with Danika, and that would likely require conversations way above both our pay grades between the two bishops."

"Do you know which parish her family attends?"

"I'm not sure, actually, but they live in the Cleveland area, where they moved from California. I know her bishop is Metropolitan Thomas Mar Makarios, because he's responsible for the Malankara parishes in North America. But don't worry too much about that because it was kind of out of left field."

Father Nicholas laughed, "And Elizaveta Kozlov marching up to you at age fifteen and demanding you marry her wasn't?"

"Point taken," I replied with a smile. "And speaking of Danika, I need to get home so I can have a mentoring lunch with her."

"Have a good day, Mike."

"Thanks, Father."

May 13, 1988, Cincinnati, Ohio

Kari and I made it to the Holiday Inn near Eastgate Mall, where the Goshen Prom was being held, just in time to warm up.

"Cutting it close!" Kim said.

"I couldn't leave the hospital until 7:00pm," I replied. "And there was a wreck on Route 50 which had things backed up just east of Milford before we got to I-275. But we're here and we're ready to rock!"

We warmed up, then went to the small anteroom to wait until we were announced. Ten minutes later, Robby and Sophia kicked off their schtick, and we played our usual Blues Brothers songs, then followed the same playlist we had followed for Hayes County High's Prom.

Unlike the setup at the High School for the Goshen High Harvest Ball, there was no separation between the band and the attendees, and several girls spent almost the entire first set standing as close as they could to José and me without interfering with our playing.

"This could be a fun evening," José chuckled when we took our break after the first set.

"Those two blondes are practically drooling," Sticks said. "I feel sorry for their dates!"

"Remember, we want this gig next year," Kim said.

"Spoilsport!" José exclaimed.

He went out to play Piel Canela, and I stepped out to watch and listen. Three girls, including the two blondes, were practically swooning as he played and sang, really emphasizing his accent, which he normally played down while singing. I shook my head when one of the girls slipped him a piece of paper as he got up from his stool, following raucous applause.

"I think this is illegal in fourteen states," José said, winking and holding up the paper.

I laughed, "And?"

"And I have no place to be after the gig!"

I shook my head and took my place to play my balalaika. I didn't give the dedication, as nobody at the Prom would know Elizaveta except perhaps Mrs. Kane. I began playing Lara's Theme, and a group of students, mostly girls, but also some guys, gathered around. By the time I finished the first song, there were over a dozen students standing close. More gathered as I played Evening Bells, Along the Petersburg Road, and Cossack Lullaby, receiving a loud ovation.

When I finished, I quickly made my way back to the door to the anteroom, where Kari and José were standing.

"Those two redheads are yours if you want them," Kari observed.

"Trouble I do not need!" I replied.

We went into the anteroom so I could get some water and relax before our second set. About ten minutes later, after a quick trip to the men's room, we played our second set, concluding with I Melt with You. We took quick bows, then played our encore songs — Keep on Loving You and Your Wildest Dreams, after which Milena joined me, and we stood close, facing each other, mics in hand, and sang our duet.

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