Good Medicine - Medical School III - Cover

Good Medicine - Medical School III

Copyright © 2015-2023 Penguintopia Productions

Chapter 5: Life Goes On

September 1, 1987, McKinley, Ohio

I had just hung up the phone late on Tuesday afternoon after inviting Elias and Serafima for breakfast the next day, when I heard a knock at the door.

“Hi, Petrovich,” Clarissa said, hugging me.

She had arrived a bit early for dinner with our study group, which didn’t surprise me at all.

“Hi, Lissa.”

“How’s my pseudo niece?”

“Asleep,” I replied. “But it’s about time for a diaper and bottle.”

“I wish our schedules lined up better,” she said. “I’m sorry I haven’t been as available as I would have liked.”

“I understand,” I replied. “It’s a challenge we’ll have for years to come. But we’ll both be in the ER next month.”

“Is there anything I can do for you?”

“You’re doing it by being my friend,” I replied. “Nobody can fix what’s broken, and I just need time to adjust to the new, frightening reality.”

“You didn’t pick up the report from Doctor McKnight, so he gave it to me.”

“With everything else going on, I completely forgot about it. It’s been overwhelming.”

She took a sealed envelope from her bag and handed it to me. I put it on the coffee table to read later.

“Thanks,” I said. “Mr. Winston gave me a list of things to do that I started doing today.”

“Guardians for your daughter?”

“That’s on the list,” I replied. “Along with the bank, which I took care of, and the BMV which I’ll do in the morning. I also went to the medical school and added Rachel to my insurance and made her the beneficiary of my small life insurance policy.”

“Who did you decide on for her guardians?”

“I’m going to ask Elias and Serafima to serve as godparents, so they’re the logical choice. I’ll name Mark and Alyssa as backup guardians, because the last thing I want is Family Services involved in a decision like that.”

“No kidding, How will your in-laws take that?”

“I can’t imagine either couple doing anything to interfere with a healthy relationship with grandparents, so I don’t think there will be any conflict. And it should never happen. Of course, I say that, even with what happened.”

“It’s crazy,” Clarissa said, shaking her head. “Who is your executor?”

“My grandfather, with Jocelyn as backup, mainly because she’ll be an attorney in two years.”

“I hope none of us ever have to deal with that,” she said. “Three times is too many.”

“TELL me about it,” I sighed. “Sandy, Lee, and now Elizaveta. And that doesn’t include two deacons — Vasily and Grigory.”

There was a knock at the door just as Rachel fussed, so Clarissa went to the door while I went to get Rachel. She needed a clean diaper, and she was going through them at what seemed to me to be an alarming rate, but I knew it was normal. Once I’d changed her diaper, I brought her out to the living room where Peter greeted me. I handed Rachel to Clarissa, then I went to the kitchen to make the bottle. As I was coming back into the living room, there was a knock and Peter went to open the door.

“Hi,” Fran said, offering a hug which I accepted.

“Hi, Deacon,” Maryam said.

She didn’t offer a hug, which was to be expected, even though I wasn’t in my cassock.

“Hi,” I said to both of them.

I retrieved Rachel from Clarissa and offered Rachel her bottle, then sat down on the couch. A knock at the door signaled Nadine’s arrival, and Peter let her in and we all greeted her.

“Clarissa says you’re going back to your rotation on Thursday,” Fran said.

“You know how it works,” I replied.

“I’m finding more reasons every day why medical training needs a complete overhaul,” Peter observed.

“If you think about it,” I replied, “doctors can’t allow their personal lives to interfere with treating patients, so it makes sense, even if it doesn’t make sense. If that makes sense.”

“That’s even more convoluted than your normal thought process, Petrovich!” Clarissa declared.

“But he’s right,” Nadine said. “It only makes sense from the very skewed perspective where you focus only on patient care, while ignoring the doctor’s mental and emotional health. It’s no wonder there’s a higher incidence of alcoholism, drug abuse, divorce, and suicide for physicians.”

“And THAT harms patient care,” Peter said. “It’s foolish in the extreme. Compound it with thirty-six-hour shifts with no sleep and ninety-hour weeks, and it’s actually harming both patients and doctors.”

“And we’re stuck with it,” I replied. “We want into the club, and the only way to get in is to follow the rules established by the club. When we’re actually in the club, we can change things.”

“But you already have changed some things, Deacon,” Maryam stated. “We have the chance to do procedures and assist in ways most Third Years do not because you insisted.”

“I’m not denying that we can cause change, just that the biggest challenges can only be addressed by Attendings, and there’s no will to do that at this point. Not to mention that some of the training guidelines are actually legally required to get your medical license, and I do not relish the idea of getting involved in politics.”

Our conversation was interrupted by three women from the church bringing food, supervised by Mrs. Sokolov. She asked if I’d be returning to Cincinnati the following day, and I confirmed that was the case. She asked about future meals, and I explained that I’d be having dinner with my in-laws on Saturdays, and that on Sundays I had meals being provided by Serafima, Alyssa, and Sophia. I thanked them profusely, and after they left, I put Rachel down to sleep. Maryam and Clarissa set out plates and flatware, and everyone sat down to eat a pot roast with carrots and potatoes, along with homemade bread, with a blueberry pie for dessert.

“They’re feeding you well,” Maryam observed.

I nodded, “They are, and I’m grateful. It felt almost oppressive at first, but I understand the meaning behind it.”

“Petrovich has real trouble allowing anyone to take care of him,” Clarissa observed.

“Don’t you think that’s normal for people our age?” Peter asked.

“It is,” I replied. “But what Father Nicholas pointed out was that bringing the meals means as much for them as it does for me, and perhaps even more. It allows them to feel as if they’re doing something, even though there really isn’t anything they can do.”

“Can the confirmed atheist in the room ask a question?” Peter inquired.

“Peter, you shouldn’t,” Maryam quickly interjected.

“It’s OK, Maryam,” I said. “Peter, the answer to your unasked question is that nobody can explain it. Do I want to shake my fist at God? Of course I do! That’s a normal human response. But, as a monk once said, ’Only the Christian Faith, which holds fast to the word of the resurrection, offers a certain, a secure, and a sure hope for victory over death. And this hope is a gift of God.’ And, as we sing every year during the Paschal season, ’Christ is Risen from the dead, trampling down death by death, and upon those in the tombs bestowing life’.

“The most important phrase of that Paschal troparion in Greek, is «θανάτῳ θάνατον» — literally, ‘killing death’. Or, as the Holy Apostle Paul writes to the Corinthians -

But now Christ is risen from the dead, and has become the firstfruits of those who have fallen asleep. For since by man came death, by Man also came the resurrection of the dead. For as in Adam all die, even so in Christ all shall be made alive. But each one in his own order: Christ the firstfruits, afterward those who are Christ’s at His coming. Then comes the end, when He delivers the kingdom to God the Father, when He puts an end to all rule and all authority and power. For He must reign till He has put all enemies under His feet. The last enemy that will be destroyed is death.

“He then goes on to say -

Behold, I tell you a mystery: We shall not all sleep, but we shall all be changed — in a moment, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, and the dead will be raised incorruptible, and we shall be changed. For this corruptible must put on incorruption, and this mortal must put on immortality. So when this corruptible has put on incorruption, and this mortal has put on immortality, then shall be brought to pass the saying that is written: ‘Death is swallowed up in victory’.

“So it’s the belief in heaven?” Peter asked.

“It’s the belief in the resurrection of the dead,” I replied. “The Creed says nothing about believers ‘going to heaven’, though it references ‘heaven’ with regard to Christ. What it says for the believer, is simply that ‘we acknowledge one baptism for the remission of sins’ and that ‘we look for the resurrection of the dead, and the life of the world to come’. I don’t personally believe heaven is a place, but a state of being in proper union with Christ.

“In fact, privately, I’d assert that the eternal place of ALL human beings is the direct presence of God, and I believe that’s supported by the icon of the Last Judgment, where the river of fire represents God’s love which is refining for those who love God, and torment for those who do not. But that state of being is completely up to the individual.”

“Why do you say that’s a private teaching, Deacon?” Maryam asked.

“Because it’s not an authoritative teaching, even if it’s the most common understanding. I try to be careful to differentiate between theologoumenon and dogmatic teaching. Basically, it’s probably true, but the Church has not spoken absolutely authoritatively, via an Ecumenical Council. To complete my earlier thought, the last thought I had before Elizaveta’s coffin was closed was that I would see her again at the Resurrection.”

“I thought you were a teacher,” Peter said.

I nodded, “I’m a catechist, and I’m careful when I teach catechism and Sunday School to state what is dogma and what is not.”

“So how do you make sense of what happened?”

“I don’t,” I replied. “It makes no sense, whether one is faithful or not. The only difference between you and me is that I have faith in the resurrection of the dead. But that doesn’t mean it makes sense that Elizaveta reposed and that I’m a single dad.”

“About that...” Peter began.

“Let it be, Peter,” Clarissa counseled. “It’s not time to ask that question.”

Without even finishing the question, Peter had forced me to think about something I’d so far avoided considering — lifetime celibacy. I pushed that thought aside because I couldn’t even contemplate the results of either possible answer to that question.

September 2, 1987, McKinley, Ohio

Elias and Serafima joined me for breakfast on Wednesday morning as we’d agreed.

“I’d like you two to serve as Rachel’s godparents,” I said once we’d finished eating.

They exchanged a look, then Serafima spoke.

“Of course we will!” she said. “Have you spoken to Father Nicholas?”

“Yes; and to His Grace. Rachel’s baptism will be the same day that Mark is ordained a subdeacon, which means His Grace will only need to make one trip.”

“October 4th, then, right?” Elias asked.

“Yes. And there’s one more thing. I’d like you two to act as guardians for Rachel if, God forbid, something were to happen to me.”

“We’d be honored,” Elias replied.

“OK. I’ll have the attorney draw up the documents to go along with my will. Thank you both very much.”

“You’re welcome,” Serafima said.

“I hate to eat and run,” Elias said, “but I have to be at the job site in twenty minutes and it’s fifteen minutes away.”

I walked them to the door, received hugs from both of them, then went back to the kitchen to clean up. Once I finished that, I took Rachel to see Yulia, who was still in a very emotional state. Not that I wasn’t, but I had responsibility for Rachel, and that meant my mourning could not interfere with anything I needed to do for her. We spent about twenty minutes with Yulia, then we went back to the house so I could pack my things, and gather everything I needed for Rachel.

A knock at the door signaled Lara’s arrival, as I’d arranged with her to watch Rachel while I went to the BMV. After making sure there was nothing special Lara needed, I headed to the BMV. I ended up waiting in line for nearly thirty minutes before it was my turn to speak to a clerk, who had no idea how to process my request, and had to call a supervisor, which took another ten minutes before the correct codes were entered into the computer.

“Pay the cashier, please,” he said, handing me a form. “The new titles and registration will be mailed to you. Your current title and registration are valid until the new ones arrive.”

“Thank you,” I said, accepting the form.

“And my condolences for your loss,” he said.

“Thank you.”

I went to the cashier’s line, where I waited about five minutes to pay the fee, then, receipt in hand, I headed back to my car. For the first time, it dawned on me that I wouldn’t need Elizaveta’s car, and didn’t know what to do, as it had been a gift from Viktor. But that was another thing to worry about in the future, probably when I was back in McKinley full-time. I would have to remember to drive her car occasionally so as not to let it sit for a month without being used.

“Any trouble?” Lara asked when I arrived home.

“No. Just the usual wait, though it took a supervisor to push the right keys on the computer.”

“Good. I plan to arrive at Doctor Cooper’s house at 5:15am.”

“That’s perfect.”

“Is there anything else you need?”

“Not that I can think of,” I said. “Shall we eat lunch? I need to get on the road in about forty minutes so I can be at Doctor Mercer’s office in time for my appointment.”

We went to the kitchen so we could make our lunches.

September 2, 1987, Greater Cincinnati, Ohio

“Come in, Mike,” Doctor Mercer said. “And bring Rachel with you.”

“As if I’d leave her in the waiting room?” I asked with a silly smile.

“No, of course not!”

“Where should we sit?”

“Your choice — the chair across from me, one of the side-by-side chairs, or the couch?”

“I think the side-by-side chairs,” I said, putting the baby carrier on the floor next to the chair I was going to sit in, and setting the shoulder bag of supplies next to it.

I sat down and Doctor Mercer came to sit next to me.

“Tell me how you’re feeling,” she said.

“Untethered,” I replied, “or adrift. Elizaveta was my rock, my anchor, and...”

Tears welled up in my eyes, so I took some tissues from the box on the small table between us and dabbed my eyes then blew my nose.

“ ... sorry.”

“No need to apologize, Mike,” Doctor Mercer said gently. “Have you cried? And I don’t mean just teary-eyed.”

“Yes, quite a bit, actually, and at random, inexplicable times. Well, and when I have certain thoughts. But, I have to snap out of it, because I have obligations and I have to keep them, most of all to Rachel.”

“How do you feel about that?” Doctor Mercer asked.

“What do you mean?”

“Are you angry? Depressed? Resigned? Frightened?”

“None of those, really. I think ‘empty’ fits best, but I can’t really describe it. It’s like somebody hollowed me out.”

“Have you been eating and sleeping?”

“Yes, though Rachel wakes me up every two hours or so. Tasha took her for one night so I could get a good night’s sleep.”

“How are you handling things here?”

“My friend Lara will watch Rachel when I’m at the hospital, and Doctor Cooper’s daughter will watch her on Saturdays during office hours.”

“But you’ll do the overnight feedings?”

“Yes, and I’ll get more sleep than I will during my first year of Residency. In a week or two, she’ll probably only wake up twice, instead of three times. And it’ll get better than that, at least according to my textbook.”

“That’s about right, based on my experience with my daughters. You need to watch yourself so you don’t burn out. Do you have someone you can call to help if you need a break some night?”

“I’m positive I can find someone. My mom lives in Goshen now, with her new husband, and at home there are friends. And I’m sure I could get help from people at church, both here and at home.”

Rachel fussed, which I’d expected, as I’d fed her right before leaving home.

“She’ll need a diaper and bottle,” I said.

“Go ahead,” Doctor Mercer said. “I don’t have anyone scheduled after you, so we can take as long as we need.”

I changed Rachel, sealing the soiled diaper in a Ziploc bag, along with the used wipes. I used Doctor Mercer’s microwave oven to very carefully warm water for Rachel’s formula, ensuring it wasn’t too warm.

“You’re a pro!” Doctor Mercer declared once Rachel was hungrily sucking from the bottle.

“Tasha is a good teacher.”

“What challenge do you think is your biggest?”

“Balancing time between being a dad and training to be a doctor. Elizaveta and I had a plan, but that’s obviously gone out the window now. I did speak with my mentor in the ER and asked to have a regular shift for my next rotation, and she agreed. That will help, because it means I can have a set schedule for two months while I sort things out. I’m kind of making this up as I go along because I was counting on Elizaveta to both know what to do, and to handle getting up during the night.”

“The two things to watch out for are depression and frustration. I’m going to assume you’re receiving spiritual counseling.”

“You assume correctly,” I replied. “I’ll speak to my bishop at least once a week, and see my priest every weekend.”

“One important thing to consider is having ‘me time’, as it’s often called. I know it might be difficult, but leaving Rachel with a relative or friend for a few hours and doing something just for yourself, or with your friends, is very important.”

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