Chapter 88: Rank Hath Its Privileges

May 7, 1989, Circleville, Ohio

"You look unhappy, Mike," Kris said when I walked out of Father Nicholas' office.

"Later, please," I said. "Let's go home."

I took Rachel from Kris and the three of us walked quickly out to my Mustang, I settled Rachel in her car seat in the back seat, then Kris and I got in. I started the car, pulled out of the parking spot, and headed towards home.

"What happened?" she asked.

"The short version is that we're transferring our membership to the Cathedral," I replied.

"You didn't think to consult me on that?" Kris asked.

"I assumed you would be OK with that because your parents are there, along with most of your friends."

"I am, of course, but you should have discussed it with me rather than make a unilateral decision."

"You're right, though I will claim my rights as expressed by the Holy Apostle Paul in his First Letter to the Corinthians! I love my wife, and considered what was best for her, even if I failed to expressly ask her. I concluded that 'best' in our context is a spiritually healthy husband."

"You're not wrong, but please discuss important things such as this with me first."

"I'm sorry," I replied.

"What was said?"

"I was basically accused of being a serial troublemaker," I replied. "Which tells me that in his mind, Father Nicholas still blames me for the uproar that began with the situation with our former bishop."

"Because of Oksana and Greg? I mean Doctor Casper?"

"It's OK to call him 'Greg' or 'Ghost', because that's what he's instructed me to call him as of July 1st. And yes, because I truthfully told him that he isn't required to be chrismated."

"And you were called a troublemaker for saying something that is completely correct?"

"Welcome to my world," I sighed. "I've seen this before with priests failing to mention that chrismation is optional in such circumstances. In one sense, I get it, because it appears, on the surface, to ensure the family is Orthodox, but in practice, if cradle Orthodox leave the church, anyone could. No amount of oil and water is going to prevent that."

"You're very irreverent at times," Kris observed.

"And yet, what I said is true in those cases! Chrism and rose water are not magical, and are efficacious only for those who love God. The same is true for the Eucharist — the 'medicine of immortality' for those who love God and deadly poison for those who do not. Metaphorically, of course. We don't believe in magic, so being chrismated or receiving the Eucharist does nothing in a vacuum, and to be efficacious, both require the believer to act in synergy with Christ. Without that union, baptism is a simple bath, and the Eucharist is a meal that does not nourish the soul."

"That wasn't a criticism, Mike, simply an observation."

"Sorry," I replied. "The conversation with Father Nicholas has put me in a mood."

"Please get out of it before our guests arrive for dinner."

"I'll be fine, I promise," I replied.

"What will Vladyka JOHN say?"

"He'll be glad we're at the cathedral, but not happy about the circumstances. That said, as I pointed out to Father Nicholas, I'm not clergy, so I have no duty to obey His Grace, only a duty to respect his office. That said, I strive to do what the bishop asks, if it is possible, and won't harm my family or my role as a physician. And he won't ask me to do anything which would do that, so we're on the same page. I'm positive he'll ask me to apologize to Father Nicholas, which I will consider once I've had time to cool down."

"Did you do anything that warrants an apology?"

"I was curt with Father Nicholas, but respectful. I also asked for his blessing before I left, despite announcing we were transferring our membership."

"And he gave it?"

"Had he not, he'd have some 'splainin' to do!"

"I'm sorry, but I don't understand what you mean."

"It's from the 1960s TV show I Love Lucy. Whenever Lucy did something that her husband didn't like, he'd say that to her."

"Ah, OK. I've seen that program, but it was dubbed in French."

"I hate dubbed movies and TV shows," I replied. "I prefer to hear the original language and read subtitles."

"The Swedes do that regularly. France and Germany dub most everything. Do you need to speak to Father Roman?"

"I should call and let him know, but parish membership is a decision of each member of the laity, unless they're trying to escape discipline, and even then, it would be permitted and the new priest informed of the situation. Clergy, on the other hand, as I'm sure you know, are not free to choose."

"Yes, of course; I was just wondering if your relationship with Father Roman as your «старец» made a difference."

"I need to apologize to you. I have a tendency to cite the canons and theological support for what I say even when someone knows it. I've done that to Father Nicholas, Bishop ARKADY, and Vladyka JOHN."

Kris laughed, "Of course you have! It's who you are!"

When we arrived home, I placed a call to the monastery and spoke briefly to Father Roman, who asked a few questions, but offered no specific suggestions, other than to say we would discuss it in detail when I visited him in late June. Once I completed the call, Kris and I worked to prepare for our guests — Oksana and Doctor Casper, Lara and Nathan, Clarissa and Tessa, and Jocelyn and Gene. I'd invited Doctor Gibbs and Bobby, but she was eight months pregnant and constantly tired, as she was still working normal shifts, and would for another two weeks.

Oksana and Doctor Casper were first to arrive, as Oksana had offered to help us with the meal. I was amused when she basically chased me out of the kitchen, but appreciated the opportunity to speak to Doctor Casper outside the hospital.

"It won't surprise you that Doctor Collins rejected Tim's appeal of his evaluation," Doctor Casper said.

"When did you hear that?"

"Before I left on Friday. Doctor Collins came to speak to Doctor Northrup while we were in that last trauma, and you left when we finished, and Doctor Northrup filled me in."

"And Tim is going to fail his trauma rotation, right?"

"That's up to Doctor Northrup, but even if not, a second sub-par evaluation with a failure means referral to Doctor Mertens as Dean of Clinical Instruction. She'll recommend an action to the other members of the Academic Committee. You know the options, I'm sure."

"He could be dismissed, required to repeat Third Year, required to restart completely, or placed on probation. Probation isn't likely, as he failed a core rotation."

"I'm curious as to what you would do?" Doctor Casper asked.

"Honestly, at this point, he's tainted so badly at Moore Memorial that I don't think it's possible for him to succeed. If he's to have any real chance, he'd need to transfer to another medical school and repeat Third Year, but that's extremely difficult to arrange, especially given his poor performance. The time to fix this, if it was fixable, was partway through the year when he received the first sub-par evaluation."

"You blame the system?"

"For that, and many other ills," I replied. "I'm not saying that Tim would ever make it, but that doesn't absolve the system."

"As I'm sure you were told, there are many, many things that can trip you up, and the system, for all its warts, does a good job of weeding out the students who should never be admitted to the profession. Between academics, clinical rotations, and interviews, I'd say we do a credible job of identifying good candidates. What was the washout rate for your class?"

"Overall, just over twenty percent, if you include the students who didn't Match."

"And that's after the medical school weeded out the academically weak or otherwise disqualified candidates. Could things be tweaked? Sure. And do we make errors in judgment? Yes. Those tend to be rectified by the students who wash out during Residency, whether for clinical reasons or inability to handle the stress or realizing that the actual practice of medicine isn't for them. But most of us are like you — there is literally nothing else we could do and be true to ourselves."

"I'm not actually arguing specifically for Tim, but I would say that there are Residents who are very poor teachers. That's something the medical school has decided to add to evaluations for Fourth Years, and I think that's the key to improving medical training. Of course, if I had my way, medical school would be five or six years with no prerequisite of an undergraduate degree, and I'd double the Preceptorships to eight hours a week."

"To get something like that done, you'd need the AMA to sign off, and it's going to be a tough sell."

"So was handwashing," I replied. "To the point that the fight even has a name assigned to it in psychology!"

"Which should be instructive."

I laughed, "You mean that one way and I mean it a different way!"

"For me," Doctor Casper said with a smile, "it's a lesson in the futility of fighting the system, at least in the short term, for you, proof that the gadfly can win, even if it takes a century!"

The doorbell rang, and I went to answer it and let Jocelyn and Gene in. I was just about to shut the door when I saw Lara pull into the driveway in her Corvette, and right behind her, Clarissa, driving my old Mustang. I waited to let them all in, then joined everyone in the great room.

May 8, 1989, Circleville, Ohio

"That was fun yesterday," Clarissa declared when she arrived at the house on Monday morning, bringing bagels and doughnuts as she'd promised.

"It was! I do need to tell you something — Kris and I will be worshiping at the Cathedral from now on."

"What did you do THIS time?" Clarissa asked.

"Explained to Doctor Casper that there was no canonical requirement that he be chrismated before his wedding to Oksana. Father Nicholas had conveniently left out that detail and was annoyed that I 'interfered' when all I did was respond to a concern by Doctor Casper about being pressured. When I defended myself, Father Nicholas called me a troublemaker and said my attitude was 'tiring'. That was the last straw."

"Did you speak to Father Roman?"

"Yes. He confirmed that as a member of the laity, I was free to transfer my membership and that we'd discuss what happened in detail when I see him next month. I'm sure I'll hear from Bishop JOHN, but he won't be disappointed to have us at the Cathedral."

"What can he do?"

"In reality? Nothing. I'm no longer clergy, so I'm completely free to give my opinion on literally anything anyone would ask. I'm sure Bishop JOHN will ask me to apologize for being curt with Father Nicholas and I'll consider that request, but he cannot order me to do it."

"Hello!" Fran called out, coming in the front door.

"In the great room!" I called back.

She came in, and over the next five minutes, Peter, Maryam, Nadine, and Kylie arrived.

"Bagels, cream cheese, and doughnuts are on the kitchen table," I said. "There's a pot of coffee and hot water for tea, and OJ and grapefruit juice in the fridge."

Everyone trooped to the kitchen to help themselves and we returned to the great room.

"Where is Rachel?" Maryam asked.

"At Milena's house with Abigail. Kris dropped her off on the way to school and will pick her up on the way home, though she's going to hang out at her parents' house with Lyudmila, so we aren't disturbed."

"We're medical students!" Fran exclaimed. "That's the very definition of 'disturbed'!"

Once we all had our food and drinks, we went to the dining room so we could spread materials on the dining room table.

"We'll have a long day on Friday," Fran said. "Eight one-hour sessions with up to forty questions per session, with a total of 318 questions, a five minute break between sessions, with twenty minutes for lunch. On the plus side, we don't have to take the Clinical Skills portion of the exam because none of us are foreign medical students."

"No, we just have to do that for our boards!" Peter declared. "But that's years from now for all of us!"

"Where are we starting?" Kylie asked.

"Anatomy," I replied. "I separated my flashcards by color, and we'll simply go around the table after shuffling the deck. We have no way of knowing the exact questions, so we'll just go through the entire deck. When we finish, we'll take a break, and then Fran has sample blocks of questions and a key to score them. That should give us an idea of where to focus after lunch today."

I split the deck seven ways, and we spent nearly two hours going around the table using the more than eight hundred cards from my anatomy deck.

"UGH!" Nadine groaned. "I didn't realize how much I'd forgotten."

"Me, either," Kylie agreed. "Neither Mike nor Clarissa missed a single one of their questions."

"It's the flashcards," Fran said. "They both went completely overboard on them!"

"Did we?" I asked with a smile.

"Don't be an ass!" Fran said, though she was smiling.

We took a fifteen minute break, then Fran handed out copies of a sample test. I set a timer for sixty minutes, and we began. The questions on this sample test were diagnostic in nature, and when the timer went off, I felt I'd done well enough to pass. We scored the exams, and to the delight of all of us, we all scored what the exam prep document indicated would be a passing grade.

"The pizzas will be here in about thirty minutes," I said. "I talked the owner into delivering them each day by offering a bit extra for delivery."

"Let's go over the items we missed," Fran said. "We'll start with Peter, and the rest of you mark off anything he brings up, and we'll go around until we cover every missed question."

That took the entire thirty minutes, as there was only some overlap in missed questions, and unsurprisingly, mine were about chronic, not acute conditions, and Clarissa's were basically the opposite.

"What's the plan after lunch?" I asked, as I ate a delicious slice of pepperoni pizza.

"I have three more sets of study questions," Fran replied, "but we'll simply discuss them instead of taking it as a sample test. Tomorrow we'll spend most of the day on flashcards. You have the biggest deck, so we'll use yours."

Clarissa started laughing uncontrollably, and it dawned me what she'd heard, as opposed to what Fran had said. I managed not to laugh, but Fran looked confused. A few seconds later, realization spread over her face.

"I think this is where I show myself out!" Fran said, shaking her head.

"Do I even want to know?" Nadine asked.

"No," I replied. "I think the Taft contingent is just having a moment. Ignore us."

We finished our pizza and spent the afternoon working through three sets of sample questions, and just before 5:00pm, called it a day. Everyone gathered their things to head out, but Maryam lingered just a bit and was the last to leave.

"You do, you know?" she said with a twinkle in her eye, then walked quickly out the door.

I couldn't help but laugh at Maryam's risqué comment, though I was positive it was teasing, even if not innocent. Maryam was far more complex than I'd initially believed, and I was very glad for the relationship we'd developed and would continue.

About five minutes after Maryam had left, Kris and Rachel arrived home. I took Rachel from her and spent a bit of time playing before Kris and I made dinner.

May 9, 1989, Circleville, Ohio

"I'm sorry," Clarissa said when she arrived at the house on Tuesday morning.

"It's OK," I said with a smile.

"You do, you know!" Clarissa declared mirthfully.

"Believe it or not, Maryam lingered and said the exact same thing before she left!"

"NO WAY!" Clarissa exclaimed.

"She puts on a very good front, but she is more like you and me than anyone knows except for me. Remember when she met me, I was a married deacon, but you noticed she'd fallen in love with me at first sight. What could she do about it at that point?"

"Nothing, which dictated being very, very careful around you. And once you asked to be laicized, she could let her hair down, so to speak, along with her panties!"

"You, too!" I replied.

"I suspect we appreciated different aspects of being in bed with you."

"It always was cuddling and sleeping together for you, not the other stuff."

"'Other stuff'? Seriously Petrovich?!"

"I effectively communicated 'fucking', 'sucking', and 'licking' without saying the words!"

"I have to say I like the laid back, mellow, fun Mike way better! Not that I didn't love you before, but you have really changed in the past eight years, and you're going to make a great doctor. You know I was worried about that when we first met."

"And you've been a big part of reinventing 'Doctor Mike', and I appreciate it."

"No disrespect to your Kitten intended, but you're way more mellow married to Kris than you were Elizaveta."

"I was a deacon almost the entire time I was married to Elizaveta! And I had to be careful given my history and her difficulty in dealing with it."

"How much does Kris know?"

"Nothing and everything! She knows I had many lovers, but she has no clue who they were except the three obvious ones."

"Jocelyn, Tasha, and Elizaveta."

"Yes. She's never asked, but I have shared basically everything with her, including all the crap that went down with Liz, Dean Wormer, and Bishop Arkady."

Clarissa laughed, "I think the fictional Dean Wormer was a saint compared to the real life Dean Parker! You shouldn't denigrate him that way!"

"Hello!" Peter called out, coming into the house.

The rest of the gang arrived over the next five minutes and we spent another full day studying.

May 12, 1989, MLE Exam Day, Columbus, Ohio

"Are you ready for this?" Clarissa asked as we headed for the testing center in Columbus.

"I don't know what more we could have done to prepare," I replied. "We're all going to ace this test."

"I want to introduce Freshman Mike to Fourth Year Mike!" Clarissa declared. "I think Freshman Mike would be downright shocked to meet Fourth Year Mike!"