Good Medicine - Medical School IV - Cover

Good Medicine - Medical School IV

Copyright © 2015-2023 Penguintopia Productions

Chapter 9: A Disturbance in the Force!

May 29, 1988, McKinley, Ohio

The week at the hospital was routine, and I continued my habit of speaking to patients when I had the opportunity. Thursday had been a melancholy day, as it would have been the day Elizaveta and I would have celebrated our third anniversary. I'd made a special trip to the church to speak to her and had spent some time crying before heading home.

On Friday, Antonne joined Clarissa and me for lunch. He had a Summer job on campus, courtesy of Doctor Stanton, so he'd be staying in McKinley, and he'd be moving into the subsidized housing that the county provided, and his mom, brother, and sister would join him in late June.

"You're not going to the afterparty tonight, are you?" Clarissa asked as she and I walked back to Internal Medicine after lunch.

"No, because I have to be up at 4:00am for my Saturday shift, and I won't get home from the concert until sometime after 10:00pm. If I go to Anicka's I won't get enough sleep. I'm going to Columbus on Sunday and the spending the day with Danika's family on Monday. And Wednesday is huge with our first day of Fourth Year."

"Your groupies will be disappointed!"

"They'll live," I chuckled.

"How are you doing otherwise?"

"OK. It's really helped to talk to Kari and focus on the positive. I'm going to see Elizaveta on Tuesday, and that helps by letting out the negative emotions which I suppress most of the time, out of necessity for caring for Rachel and completing medical school."

"The letter you wrote to Lizochka was heart-wrenching and really expressed how deeply you loved her."

"I was fortunate to have the time I did with her, and to have created a life with her. I think, honestly, the hardest thing for me to accept is that Elizaveta won't be part of Rachel's life and Rachel will never know Elizaveta. Well, in this life, at least."

"It's good you're letting the emotions out, Petrovich."

"Yes, it is."

The afternoon was routine with rounds, drawing blood, chasing labs, and spending time with patients, and at 5:00pm I left the hospital and headed home. Rachel was staying with Yulia and Anna, and I'd pick her up on Saturday evening on my way home.

At home, I ate a light dinner, then took a brief nap before gathering my instruments and music and heading to Taft for the concert. My plan was to leave as soon as possible after we took our final bows, and I'd let Anicka know I wouldn't be at the party.

"Hi, Mike!" Irina called out when I walked into the main auditorium.

She and Susana hurried over.

"What are you doing after the concert?" Irina asked.

"I have a shift at 5:00am tomorrow," I said. "So I'll be sleeping."

"So much for celebrating my graduation tonight!"

"Sorry," I replied, meaning it.

"Your shift is over at 5:00pm tomorrow, right?" Irina asked.

"Yes."

"Do you have plans?"

"No."

"How about I clean and make dinner for you tomorrow?"

"That sounds like a great plan! You can get the spare key from Serafima."

"OK!" she agreed. "She's here."

"Great!"

I headed to the stage to set up. The concert was as well received as our concerts at Taft regularly were, and when it ended, I quickly packed my instruments and left the stage, taking the corridor to the alternate exit so I wouldn't run into as many people.

"Mike?" Kari called out just as I reached the exit door.

She hurried to catch up to me.

"Why are you rushing off?" she asked.

"I want to get enough sleep before my shift," I replied.

"Want some company? I'm OK if we just sleep. You can drop me at the dorm on your way to the hospital."

"Come along," I replied.

May 28, 1988, McKinley, Ohio

"Are we sticking with Wednesdays with your new schedule?" Kari asked as we showered together on Saturday morning.

"Yes, and I won't have to go to bed quite so early, but I will have to encourage Rachel to shift her schedule, because she'll need to be up at 5:00am rather than between 6:00am and 9:00am. But if I can get her to cooperate, she'll nap for a two or three hours around noon and get around ten hours of sleep overnight."

"And if she doesn't cooperate?"

"Then I'm going to have a cranky toddler, at least for a time."

"You really do need someone full time," Kari observed.

"And given I can't afford to hire a full-time nanny and given Lara starts her student teaching in August, the only way that's going to happen is if I marry."

"That kind of narrows your choice, doesn't it?" Kari inquired. "I mean, only Dani really qualifies."

"Danika suggested a solution that involves an extended family, which is OK with me, though I'm not sure her family is OK with me."

"Why? You're a 'catch', if she's ready to marry and be a mom."

"Danika suggested her parents might be unhappy with how American I am, and my desire to raise my kids as Americans."

"Cultural divide?" Kari asked.

"That's a reasonable way to describe it. You know I play around at being Russian, and I have that identity when it suits me, but take away the Orthodox trappings, and how Russian am I?"

"Not very, really. Sure, you use the occasional Russian word, but mostly that's for Church stuff. I take it they're more like how you described your friend Tasha's dad?"

"That is the impression I have, yes. I'll know if it's a serious problem after I meet them on Monday."

"You'd allow that to influence your decision?" Kari asked as we got out of the shower.

"Influence, yes; decide, no. I think having a good relationship with any extended family is important, which was one point of conflict between Elizaveta and me. Mainly that had to do with my mother-in-law, and I constantly encouraged Elizaveta to find a modus vivendi with her mom. I had conflicts with Yulia when Rachel was born, but we've mostly worked things out at this point. Starting off a marriage where my wife's parents didn't like me strikes me as a sub-optimal life plan."

"Your in-laws liked you, right?"

"Enough to agree to sign the documents allowing their sixteen-year-old daughter to marry me!"

Kari laughed, "OK, so that was a silly question."

We dried ourselves, dressed, and went downstairs to have breakfast. Once we'd eaten, we said morning prayers, then left the house. I dropped Kari at her dorm, then headed to the hospital for my last Saturday shift in Internal Medicine.

"Morning Beth, charts please," I said when I stopped at the nurses' station.

"Right away, Mike!" she said brightly. "I'll miss seeing you on Saturdays! You always brighten my day!"

"And I appreciate your cheerful attitude!"

"Thanks!"

She brought the charts to me just as I locked my locker, and I sat down to prepare summaries for rounds. I completed the summaries, returned the charts, then filled out my evaluation for Internal Medicine, which I'd drop off at the medical school on Monday morning before Danika's family arrived.

"Chart summaries, please," Clarissa requested when she walked into the room.

"You enjoy not saying 'good morning'," I chuckled. "Practicing to be an a-hole Attending?"

"You know I do that because you commented on it the first time when I was being silly."

"If you're trying to annoy me, it won't work! My sister spent fifteen years perfecting that skill and helped me build up immunity!"

"Just give me the chart summaries, Petrovich!" she said, holding out her hand and tapping her foot on the floor.

I laughed and handed her the notebook, and she sat down next to me to review them.

"What do you plan to do starting Wednesday?" I asked. "I mean, without me to write the summaries for you?"

"Write them myself, of course!" Clarissa declared.

"So you aren't actually a slacker?"

"Only an idiot repeats work someone else has already done! Now, be quiet and let me memorize these for rounds!"

"Yes, Dear," I deadpanned.

The morning was routine, but after lunch, I asked Doctor Subramani if I could speak with her. She agreed, and we went to the Resident's office for some privacy.

"What can you tell me about Indian culture?" I asked.

"Why?" Doctor Subramani inquired.

I explained the situation with Danika, and when I finished, Doctor Subramani smiled.

"Asking me, a Hindu from Gujarat State, to describe Indian culture for Christians living in Kerala is like asking a Roman Catholic in Boston to tell you about American culture as it applies to a Pentecostal in Georgia or an atheist in San Francisco. Even the things they might list in common will have subtle differences that can be very important."

"I apologize for my ignorance," I replied.

Doctor Subramani smiled, "It's not ignorant to ask a question! You, as with most people, are a product of your culture. You see India as monolithic, even if you know it has religious and ethnic diversity, but it's no more monolithic than the US or Europe. Scandinavian culture is quite far removed from Turkish culture, just as the culture of Southern Ohio is from that of San Francisco or New York.

"My point is not to disparage you. You realized you didn't know enough about a subject that was important to you and you approached someone you felt was likely to be able to provide you with guidance. Compare it to medicine — while you could ask me about oncology or surgery, I'm only going to be able to give you the perspective of what amounts to an outsider. You'd go, for example, to Doctor Gibbs for questions about Trauma or Doctor Strong for questions about Cardiology, and come to me for questions about Medicine.

"Granted, I could answer some of those questions, but to get a thorough, complete, and accurate answer, you'd go to someone who knew that subject because they lived it every day. In the case of the young woman, you also have the added experience of her dad and grandfather living in the US for decades, which would alter, sometimes obviously, sometimes subtly, their cultural outlook. You've probably experienced that with your own grandfather and parents, and your grandfather's friends and their descendants."

"I have," I replied. "And there is a wide variation."

"And we're talking all people with Russian ancestry and a common religion."

I nodded, "Point taken."

"I'm curious," she said with a smile, "but an arranged marriage is not the norm for Americans. My cousin Anala, who you met, went to a matchmaker, but I would never do so."

"She married the match?"

"Yes, though I still say she should have set aside her insistence on a Hindu husband and married the man she was practically living with in Chicago."

"He wasn't Hindu?"

"He wasn't really anything. I suppose you could say he practiced what is called 'civil religion' in that he gave a nod to the Christian faith as most Americans do, but practically speaking, he was an agnostic with no adherence to any specific faith. Anala felt that wasn't enough for her."

"I can relate," I replied. "But going back to your implied question, I'm OK with what amounts to an arranged marriage, so long as both prospective spouses have a say in the union. And I mean a say that matters, not just acquiescence. My wife more or less arranged our marriage by approaching me, making a pragmatic case, and securing my agreement."

"That sounds very much like an Indian marriage, though it would be the fathers of the bride and groom who made the arrangements, at least in the past. More common now is for the girl to suggest a potential match to her father for his approval. It sounds as if that's what happened in this case."

"Yes. And my grandmother and one of her friends introduced me to a young woman they feel is a good match."

Doctor Subramani laughed softly, "Interesting dilemma! How will you decide?"

"Beats the heck out of me!" I chuckled. "But first I need to meet my friend's parents."

"Treat him as you would any senior Attending — be deferential, polite, and respectful."

"We're talking about me here," I chuckled. "I'm known for NOT doing those things with Attendings!"

"OK, as a normal medical student would!"

"'Normal' is not a word anyone has ever applied to me, except by adding 'ab' before it!"

"I can see that!" Doctor Subramani agreed. "It's been a pleasure to have you on the service for two months."

"Thanks. I appreciate the guidance you've provided."

"You're welcome."

I left her office and went about my usual afternoon routine, and at 5:00pm, I left the hospital, picked up Rachel from my in-laws, and headed home.

"Hi, Mike!" Irina gushed when I walked into the house.

"Hi!"

"I'll take Rachel from you," she said. "Dinner is at 6:00pm. Susana is here, and she helped cook, clean, and do laundry."

"I appreciate it!" I replied. "I'm going to go change. I'll take Rachel's diaper bag up to her room. She'll want to eat in about thirty minutes. She's eating solid food after she has her formula. You'll find tapioca, puréed carrots, and applesauce in the fridge. The carrots should be warmed."

"Got it!" Irina declared. "Go change."

I went upstairs, dropped Rachel's bag in her room, went to my room to change, then returned downstairs.

"Hi, Mike!" Susana exclaimed, coming out of the kitchen. "OK if I stay for dinner?"

"Yes, of course," I replied.

"Mike, is it strange that Rachel doesn't have teeth yet?" Irina asked.

"No. Some babies start at two or three months, some not until nine months. She's been fussier lately, according to Anna, so I think it's starting. I asked my mom and neither my sister nor I had our first tooth until we were nine or ten months old. Developmentally, she's ahead of the curve in everything except teething. She's so close to actually being able to take a step or two that it'll happen any day now."

"DADA!" Rachel exclaimed.

"See?" I chuckled, holding out my arms so I could take Rachel from Irina.

"SO cute!" Susana gushed. "What other words does she have?"

"'BA' when she wants to eat, and I think you can figure out why. And then 'GA', which seems to be a general purpose response to anything I ask her. She'll have probably a dozen words by age one, which is fairly typical, though some kids take a lot longer. And, of course, some prodigies are speaking in short sentences at age one. Those kids are rare, but it does happen."

"Do you plan to teach her any Russian?" Irina asked.

"How much do either of you speak?"

"ZERO!" Susana declared. "My family gave up Russian in the 19th century when they moved to New York. I don't think I ever heard my grandparents use it, and my parents sure didn't."

"Similar for me," Irina said, "though my dad's parents still speak Russian to each other and their close friends."

"In ten to fifteen years, you won't hear any Russian, most likely," I observed. "And Church Slavonic will be limited to a few liturgical words and responses, similar to how we use the occasional Greek. The OCA is doing its best to not be ethnically Russian, and I think that's a good thing.

"The Antiochians are moving away from Arabic because of the huge influx of parishes from the Evangelical Orthodox Church. The Greeks are still stuck in their ethnic mode, but eventually that will change as the kids reject the idea of being 'Greek-American' and become just 'American'. It happened to other ethnic groups such as the Italians, Irish, and Poles. The great melting pot eventually makes us all American, even if we can take pride in our heritage."

"You're half Dutch, right?" Susana asked. "You don't seem to view it the same as you do your Russian heritage."

"I think you're seeing the influence of my Grandpa Borodin, because we lived so far away from my Grandpa Loucks, plus being Orthodox reinforced the 'otherness' that being Dutch Reformed, or some other kind of Calvinist, would not have. Well, ethnically, anyway. Not to mention my dad's ancestors were here before the US was even a thought."

"What's Danijela Dimitrijevic's view?" Irina asked.

"Similar. She plays in a group that performs Serbian folk music, but otherwise, she's much like me. She speaks Serbo-Croatian, though not very well, and views herself as Serbian, but everything else is typically American with an Orthodox overlay. Much like the two of you, Oksana, and Sara. And the same was true of Elizaveta, of course."

"We need to finish preparing dinner," Irina said.

"Then I'll read to Rachel while you do that."

I read a pair of books by Mercer Mayer, Just Me and My Dad and Just Me and My Babysitter which my mom had bought and sent to me. Rachel seemed to be paying more attention, and actually touched the pages, usually on 'Little Critter' himself, who was some kind of anthropomorphized small, unspecified animal like a hedgehog.

"BA!" Rachel exclaimed as I was about two pages from the end of the book.

"I heard!" Irina called from the kitchen. "I'll get her bottle ready."

"Thanks," I called back, then finished reading before taking Rachel to the kitchen.

She drank her bottle, and I fed her carrots and tapioca, then Irina and Susana put dinner on the table while I got a handful of Cheerios for Rachel, along with applesauce for her dessert, which I fed her while alternating eating my meal. When we finished eating, I took Rachel to the great room while the girls cleaned up the kitchen, and fifteen minutes later, they joined us.

"Mike," Irina asked, "would you be OK with me spending the night?"

"So long as it isn't going to cause trouble with your parents."

"It won't. I don't have a curfew, remember?"

"You did say that, but won't they know you're here?"

"I said I was spending the weekend with Susana!"

"And so that she's telling the truth, I'll stay, too!" Susana declared.

I couldn't help but laugh and shake my head at the image which appeared.

"Told you!" Susana said mirthfully. "You know what image just went through HIS head!"

"One that will never happen," Irina declared firmly, but with a smile. "But we can take turns, and then sleep together, one on either side of you!"

"You're just no fun, Irina," Susana teased.

"Oh, please!" Irina protested mirthfully. "YOU said there was no chance you'd even consider it!"

"And yet," I chuckled, "by having the conversation, you both considered it. You rejected it, mind you, but you did consider it!"

"Elizaveta was right about THAT, too!" Irina groused good-naturedly. "You're difficult!"

"Obviously," I chuckled. "But only when it's funny!"

"There is one major advantage," Susana said with a sly smile. "One of us can watch Rachel while the other one is with you! Interested?"

I laughed, then said, "I may be an idiot at times, but I'm not a complete idiot!"

"Cool!" both girls exclaimed.

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