Chapter 18 — I Have A Friend

_April 20, 1990, McKinley, Ohio_

{psc} The consultation room was occupied, so I walked with Jenny Leonard to the ambulance bay, as the weather was sufficiently warm to stand outside to talk. Fortunately, neither of the two smokers on duty were outside, giving us some privacy.

"How is school going?"

"Great! All A's. I'm really glad you weren't hurt in the gunfight."

"Me, too."

"How are the two doctors?"

"Doctor Lindsay, my surgical mentor, is working again. Doctor Gibbs, my mentor in the Emergency Department, is undergoing rehab and probably won't be back to work for at least six months, possibly longer."

"That's terrible!"

"It is, but she's alive, and she's recovering, unlike the Sheriff's Deputy."

"That was so sad."

"It was. What's up?"

"I know how this will sound, but it's really true. I have a friend who had sex with her boyfriend, and they didn't use protection. I would have suggested she go to the Free Clinic, but they're closed. What should I tell her?"

I believed Jenny, as she didn't strike me as irresponsible, though I also knew that teenage hormones were one of the strongest forces in the universe.

"Unfortunately, the closest clinics are in Cincinnati, Columbus, or Dayton. Does she have a driver's license?

"No. She's fifteen."

"You have yours, right?"

"Yes, but I don't have my own car; I borrowed Mom's to come see you. There's no way I could drive to one of those other cities without her knowing and asking questions."

"And your friend doesn't want to say anything to her parents?"

"No. They're pretty strict, and they'll lose their minds because they don't like the guy."

"Is he at Hayes County High?" I asked.

"No, he goes to the Catholic school; he's a Senior."

"And she's a Sophomore? Or a Freshman?"

"Sophomore. Her birthday is next month."

"Has she taken a home pregnancy test?"

"No. She's afraid her parents would find out 'cause you're supposed to use them first thing in the morning."

I considered what to do, and I couldn't reasonably have her bring her friend to the ED for a pregnancy test without a valid medical complaint of some kind. On the other hand, I could probably ask Candace Forsberg to see her as a favor.

"The rules won't let me care for your friend," I replied. "Let me speak to a friend who is an OB/GYN at the hospital and has offices in the medical building. If I can arrange for her to see your friend, that would be her first step to deciding what to do."

"When can you ask?"

"Right away, though, I want to ask you some questions first, OK?"

Jenny laughed, "I know what you want to ask! No chance. I have a boyfriend, but only kissing. I am not even close to being ready to do that with him or anyone, for that matter."

"Is he a good student?"

"Yes. He's a Senior and is interested in doing research. He'll start at Taft in the Fall uncommitted, but some kind of science."

"When the time comes, you need to be very careful, both about birth control and sexually transmitted diseases."

"I promise!" Jenny declared. "But as I said, not even close!"

"Hormones have a way of changing teenage minds. Adult minds, too!"

Jenny laughed, "I totally get that, but I have a goal, and I'm not going to do anything to mess it up!"

"Good. How do I get in touch with you?"

"You can call the house. Mom and Dad know I talk to you, and Mom knows I'm here right now. I just said I needed advice about school."

"Science, math, and computers, plus psychology and philosophy, besides the requirements for English. What foreign language did you choose?"

"French."

"God help us all!" I chuckled.

"Why? You're married to a French girl!"

"It's not her; it's her annoying sixteen-year-old sister who revels in teaching my daughter to speak French to annoy me!"

"Too funny! I'd like to meet your wife and daughter."

"I'll speak to Kris, and we'll have your family over for dinner soon."

"Great!"

We walked back inside and I walked her to the door to the waiting room. She gave me a quick hug and left, and I went to the nurses' station to use the phone.

"What's with the jailbait?" Nurse Amy asked with a smirk.

Jenny was sixteen, so she wasn't 'jailbait', but I wasn't going to get into a debate with Nurse Amy, and I wasn't going to stand for rumors or innuendo about _Days of Our Lives_ or _General Hospital_ shenanigans.

"Do not say that again," I said firmly. "There is nothing untoward going on, and I won't stand for rumors. Got it?"

"Er, uhm, sorry, Doctor."

"Don't let it happen again."

She frowned, but I didn't care if she was upset. I picked up the phone and dialed OB to discover that Candace was in her office. I ended the call, then dialed Candace's office. She was between patients, so she took my call, and I explained what Jenny had said to me,

"You're sure it's really a friend?" Candace asked.

"I've known her for about two-and-a-half years, and I don't believe she's lying to me. I did counsel her about birth control and safe sex, and she made the point that she has a boyfriend, but all they've done is kiss."

"Is this girl a relative?"

"No. Her brother died in a rollover MVA on the way to school in October of 1987. She had a fight with him just before he left. Otherwise, she'd have been in the truck with him. I helped Psych calm her down and she expressed interest in being a doctor."

"How old was she?"

"Thirteen. I've seen her about half a dozen times, always in the hospital, to give her advice or encouragement. She's a smart kid, and is making straight A's. I know that's no guarantee against risky behavior, but I trust that it really is a friend."

"OK. Have her call my office, and I'll see her friend. Something has to be done about the lack of family planning resources in McKinley."

"I'm open to ideas, but per Gale Turner, their budget was about $1.3 million, of which $1.1 million came from grant money."

"I heard they offered him a plea deal for simple battery."

"And he told them to pound sand. His attorney expects the charges to be dropped. It appears to have been about forcing the Free Clinic to close."

"Well, we aren't going to solve that problem today. Have your young friend call me, and I'll see her friend."

"Thanks, Candace. I owe you one."

I ended the call, and Mary came over to me.

"There are three in the waiting room now," she said.

"Sorry for the interruption. I was helping out a friend."

"Pregnant?" she asked quietly.

"No, she was here about a friend who might be pregnant. She came to me for help because the Free Clinic closed. Unfortunately, there wasn't anything I could do except connect her friend with Doctor Forsberg."

"The effects of that disaster are multiplying daily."

"And I don't see a remedy anytime soon because who would risk it?"

"That sucks. How do you know her?"

I explained my history with Jenny Leonard, then asked Mary to get a chart. After we treated the first patient, I called Jenny to provide her with Doctor Forsberg's phone number. Mary and I treated five more walk-ins before dinner, and after dinner, there were two EMS runs that resulted in admissions but not emergency surgery.

_April 21, 1990, Southern Ohio Correctional Facility, Lucasville, Ohio_

"Is there anything I can do for you?" I asked Frank Bush as we sat down in the visitor's room.

"Other than reading material, no, unless you know some way to legally get me out of here."

"That's a question for an attorney. I assume you've exhausted your appeals?"

"The worthwhile ones, anyway. I'd need a pardon or parole, and parole is off the table."

"I daresay a pardon is likely off the table as well."

"There's no chance of that."

"Then, short of a time machine to go back and make a different choice on February 22, 1986, I don't know of a solution.

"I probably should have just let them kill me. I can't handle another twenty or thirty years of this mind-numbing routine."

"I can't provide a complete answer, but I do know where it begins — repentance."

"To what end? The state won't care, and you know the Scriptures: _'Do you not know that the unrighteous will not inherit the kingdom of God? Do not be deceived. Neither fornicators, nor idolaters, nor adulterers, nor homosexuals, nor sodomites, nor thieves, nor covetous, nor drunkards, nor revilers, nor extortioners will inherit the kingdom of God'_."

"Neatly stopping before Paul gives the Corinthians hope: _'And such were some of you. But you were washed, but you were sanctified, but you were justified in the name of the Lord Jesus and by the Spirit of our God.'_."

"I did it after I was baptized."

"Well, given you don't believe baptism is efficacious, my response is — so what? If the water does nothing except make you wet and is merely a symbol devoid of any substantive meaning, then it means nothing. You can't, in effect, have it both ways. The Christian West erred gravely when it resorted to academics over mystery and abandoned the historical faith in favor of modernism."

"You think Jesus and the apostles went around in fancy robes?"

"No, they didn't. They went around in plain street clothing, similar to what I'm wearing, though mine has 'modern' wooden toggles and buttons. I can trace a direct line from the early days to now. And that's the key to understanding the Scriptures — tracing a clear line from the early Church to today. Let me put it this way — there was never a time when the New Testament existed, and the Church did not."

"That sounds like sophistry."

"Well, unless you can show me where the list of Scriptures was handed down on tablets or revealed to Martin Luther or John Calvin, you have a significant problem. You only know what the Scriptures are because the Church told you."

"How about we just play chess?"

"That's fine," I replied.

We played our usual three games, and when we parted, I felt that I'd made some progress, but I wasn't going to push or belabor the point. He returned to the day room while I went to the chapel to lead a prayer service and met with the men. There were two new men, and after I had spoken with Kurt, Nick, John, Sean, Nate, Mark, and Clifton, Nick introduced the others.

"Doctor Mike, these two men are Vasily Drugov and Glen Rodgers. Vasily was chrismated as a baby but hasn't been to church since he was five."

"Nice to meet both of you. Vasily, you should attend the Typika next Saturday when Protodeacon Ivan is here."

"I plan to."

I sat down with him to speak privately and discovered he'd been involved with organized crime in Cleveland and was serving life without parole for three 'hits' committed in the '70s. Unlike Frank Bush, he seemed to have adapted to prison life and was in reasonably good spirits, all things considered. Nick had been working on him to return to the faith and was having some success. I verified he had no significant health concerns. Unlike some of the others, he had regular visits from his younger brother and his nieces and nephews, all of whom were in the Cleveland area.

After I spoke with him, Glen Rodgers sat down with me.

"Are you religious at all?" I asked.

"I went to church on Easter while I was married, not much after that."

"Which church?"

"High church Episcopal, you know, smells and bells. Not all that dissimilar to your church, I think."

"There's a lot of common ground, for sure. What did you do before you were incarcerated?"

"I taught High School math and science in Ohio and Illinois."

"How long are you in for?"

"Twenty-five years. I was too friendly with teenage girls."

That fit the general pattern of the men — young girls or murder.

"When were you convicted?"

"1984. I served five years of federal time on _Fugitive Felon Act_ and _Mann Act_ charges, but the sentences weren't concurrent."

"Did they charge you with statutory or the new sexual assault statute?"

"Statutory, because it was before the new law passed."

"Twenty-five years is a long sentence for statutory rape. How many girls?"

"Six. One of the girls became pregnant, and I took her for an abortion. That made things far worse."

"Students?"

"Yes."

"All under sixteen, right?"

"Fourteen or fifteen, except for the mother of my daughter, who was seventeen."

He was not just foolish, he was reckless and careless if two of the girls had become pregnant.

"Do you see the young woman or your daughter at all?"

"It's a complicated mess, and, well, I haven't really spoken about it with anyone. I think, for now, I'll just say that my parental rights were terminated because of the sex charges, but also because I tried to flee to Canada with the child's mom, and they ruled that was putting her in extreme danger."

"Why did you come to the prayer service today?"

"Curiosity and encouragement from Kurt Bowman. He said you were a sympathetic ear and were the only one who helped him."

"If you're curious about the Orthodox Church, there are books in the prison library. Nick can show you."

"I think I'll just attend the services for now."

"That is our best form of evangelism — 'Come and see'. Is there anything I can do for you?"

"Find out how my daughter is doing. I obviously can't contact her, but maybe you could."

"I'd have to check with Family Services about that," I said.

"Actually, you could go through a secretary at Goshen High who was a neighbor and would probably know how she's doing."

"If you give me her name, I'll speak to my stepfather, who's an attorney in Cincinnati, and make sure there isn't a problem. He's actually an expert in child custody cases — one of the best in the city — so he'll know. What's your contact's name?"

"A woman I dated briefly — Linda Kane."'

"I know her," I replied. "She's the contact for a band I'm in that plays for some Proms and Harvest Balls. What's your daughter's name?"

"Heather Newton. What's your stepfather's name, if it's OK to ask."

"Stefan Chojnicki."

"He was Bev's attorney and later the attorney for the Newtons. I'm not sure he's a good choice, given the circumstances."

I considered what to do and decided it was safe to ask Linda Kane.

"Let me think about the best course of action," I said. "You just want to know how she's doing, right? No correspondence or anything like that?"

"I'd be in violation of the court order Family Services obtained if I did that before she turns eighteen."

"No promises," I said.

"I understand."

We shook hands, and as he was the last person in the group, I made my way out of the prison and headed home to Kris and Rachel.

_April 22, 1990, Circleville, Ohio_

On Sunday morning, Kris, Rachel, and I attended Matins and the Divine Liturgy at the Cathedral, then headed home to prepare for a dinner we were hosting for Subdeacon Mark, Alyssa, Elias, Serafima, John Elias, Nathan, and Lara. Once we had everything in the oven or in a pot, Kris and Rachel went to take a nap and used the time to see if I could reach Linda Kane.

"Directory Assistance. What city, please?" the operator inquired.

"Goshen. A Mrs. Linda Kane."

"I have no listing for a Linda Kane in Goshen."

"What about any listing for Kane in Goshen."

"There are no listings for anyone with the surname Kane in Goshen."

"OK. Thanks."

I hung up and considered my next step. I decided to call Kim and ask her.

"I have her home number," Kim said. "You didn't find it because it's in her husband's name."

"She didn't change her name when she married," I said. "Just like Kris."

"Not quite. Her story is more interesting. What do you need to ask her?"

"Someone asked me to speak to her but didn't have her number."

Kim read it out to me and I repeated it back. Once I had it, I flashed the switchhook and dialed the number.

"Judge Pierce," a man's voice said.

"Good afternoon. My name is Mike Loucks. I'm the lead singer for Code Blue. May I speak with Linda, please?"

"One moment."

She came to the phone about thirty seconds later.

"Hello?"

"Hi, Mrs. Kane; this is Mike Loucks from Code Blue."

"Hi, Mike! Is there a problem with the Prom?"

"No. In addition to being a doctor, I'm a prison chaplain. Do you know a Glen Rodgers?"

"I do," she said flatly.

"I believe your tone of voice answers the question I was about to ask," I said.

"Probably, but I'd like to know the question."

"Glen asked me to find out how his daughter Heather Nicole is doing. He doesn't want to contact her, just to know about her."

"That is a very, very, very bad idea," Mrs. Kane said. "Jim and Julie Newton would absolutely lose their minds, and I don't see how any good could come from it."

"OK. I only promised to ask; I didn't promise any results. I'll drop it. On a related note, I believe you might know my stepdad — Stefan Chojnicki."

"I do. He handled the case, first for Bev, then for her parents."

"I'll tell Glen that I was unable to get any information. I won't mention I spoke to you."

"I'm not concerned about him for me; I'm concerned about him for Heather. You know his crime, right?"

"He provided the basic details."

"Actually, tell him you spoke with me, and I told him to stay away and never try this again. If he does, I'll ensure a restraining order is issued immediately."

Given she was apparently married to a judge, that would be simple, even if he had to ask a fellow judge to issue the order.

"I'll relay that message. I won't take any more of your time, and I'll see you on the 11th."

We said 'goodbye' and ended the call. I wasn't really surprised at that outcome and decided I should mention the contact to my stepdad out of an abundance of caution. I picked up the phone again and dialed my mom's house. Elaine answered and after a brief chat, she called Stefan to the phone. I explained what had transpired.

"Linda Kane is absolutely correct," he said. "And your response should be precisely as you proposed — you spoke to Mrs. Kane, and she stated clearly that we'd seek a restraining order if he makes any further attempts to contact or even inquire about Heather. All his parental rights were terminated, and he was ordered to not see her."

"Understood."

"You know I can't reveal any details of a client situation, and both Heather's mother and her grandparents were my clients."

"I completely understand," I replied. "Medical confidentiality is similar, as we've discussed. While I have you, are you still planning to stay the night when you play at Goshen?"

"Yes. Rachel will stay with you, and Kris and I will come back to the house after we play. We'll drive home on Saturday morning after breakfast. We have a gig for Hayes County High on Saturday."

"Then we'll see you on the 11th."

We said 'goodbye', and I ended the call. Kris and Rachel were still sleeping, so I went to the kitchen to check on the food, then sat down on the couch with _JEM_. I read for about an hour before Kris came down the stairs.

"Did you reach Mrs. Kane?"

"I did, and she was clear that no contact, including even asking about the little girl, was welcome and suggested she'd obtain a restraining order against Glen Rodgers. Stefan basically confirmed that."

"Are you surprised?"

"Not at all. I just wonder what they've told the little girl about her dad. I do sympathize with him about not being able to see his daughter or even know anything about her, but I understand why that is."

"Forgiveness comes very easy to you, Mike, and you're always looking for a solution founded in love. Sadly, that's a rare thing. If everyone behaved the way you do, we wouldn't need socialism; it would be just like the Book of Acts!"

I chuckled, "Leave it to my wife to find a way to inject politics!"

"Am I wrong?"

"In an ideal world, no, but the lesson of Ananias and Sapphira makes it clear that there will always be those who claim to follow the community agreement but cheat for their own profit. And, now you'll tell me that's why government is needed to ensure everyone coöperates. But my visit to the prison confirms that passing laws does not prevent crime, it only punishes it. So, while the answer is 'no', the premise is flawed. Therefore, given both socialism and capitalism are flawed, I prefer social democracy, which attempts to incorporate the best features of both. Does that satisfy the family «замполит» (_zampolit_)?" {green}("Political Officer"){/green}

"No!" Kris said with a goofy smile. "But we have our entire lives ahead of us!"

"Wonderful," I said deadpan.

Kris laughed, "I believe the benefits outweigh the negatives!"

"They do! And you know I'm teasing."

"And you know I'm teasing!"

The doorbell rang, indicating that our first guests were arriving, so I got up to let them in.

_April 23, 1990, McKinley, Ohio_

"Mike, Doctor Wernher would like to see you," Ellie said just after 7:00am on Monday when Mary and I left Exam 2 after she'd sutured an arm lac.

"I'll go see him right away," I said. "Mary, take a break, please."

I left Mary and walked to Doctor Wernher's office.

"You wanted to see me?" I asked.

"Come in, Mike, and close the door."

I did as he had requested, then waited for him to tell me to sit.

"What can you tell me about the Match process here?"

"I was assigned to conduct interviews for both surgery and the ED," I replied. "I can discuss that or the conversations I had with Doctor Gibbs, but with regard to surgery, you should speak to Owen Roth."

"I was concerned about the ED. Were the candidates all ones you wanted or would have chosen?"

"I agreed with Doctor Gibbs on the order we listed the students. The only surprising thing was that the last position didn't fill and had to be filled with a Scrambler. I have to surmise that none of the students in what I called 'the field' listed us or listed us so far down they matched elsewhere."

"Do you have evaluations of each student in one of your notebooks?"

"I do."

"Would you be willing to share? I realize I can't do anything about the list at this point, and I'm not saying I would, but with no input, I'd like to know what I'm getting. What surprised me the most was that the first choice wasn't a local student."

"What I'm going to say next has to be received and noted, but no action taken because of it."

"Why did the hairs on the back of my neck suddenly stand up?"

"Because I'm in the room," I chuckled.

Doctor Wernher laughed, "You do have that reputation. But you also back it up. What?"

"Leticia Jefferson is here because of me," I replied. "Her cousin, Clark, was my roommate for the first two years at Taft. I was his first white friend, and he and I learned a lot from each other. He's also a bigger troublemaker than I am."

"I find that hard to believe!" Doctor Wernher declared.

"Ask Doctor Saunders from Medicine; she'll tell you. Clark's idea of troublemaking was to send his cousin here to interview for the Match because we have exactly zero black female Residents or Attendings and very few black Residents. That said, she was also head and shoulders above everyone except Jake Green, Callie Newsom, and Karl Schmidt.

"Jake chose not to apply here because his girlfriend wanted to Match in Virginia, so he did the same, and they both Matched at Alexandria Hospital. Callie Matched at The Christ Hospital in Cincinnati. Karl Schmidt is local and a very good candidate. Julie Plemons is from UC. Mai Liu is from OSU, Mike Jorgensen is from Indiana, and Nicole Caton is the Scrambler; she's local."

"It sounds as if we lost some good local talent."

"We did. I've argued that every hospital should have two 'local talent' draft choices who don't have to Match. It would save time and effort in a case like Mary Anderson, where we knew she'd list trauma surgery first, and she was convinced we'd list her as our first choice. But she had to interview elsewhere just in case."

"So did you, right?"

"Yes. I knew I would put Moore first and was positive I'd be the choice for the trauma surgery slot. The only risk was a married couple, but that didn't happen."

"What happened with the Scrambler?"

"She was middle of the pack and wanted Medicine. She overshot on her first choice and was unlucky with her backups. She didn't do an emergency medicine Sub-I, which was an error on her part, but I also hold the medical school responsible for not giving her good advice."

"Who was her advisor?"

"Doctor Crane. She took a pediatric Sub-I instead of emergency medicine, and he was OK with that. The problem Nicole had was that most Medicine programs wanted to see that emergency medicine Sub-I, and with very good reason. That said, I did have two committees look askance at my pathology Sub-I despite it making perfect sense. They couldn't see it as anything other than two wasted months."

"I lean in that direction, but it appears to have worked for you."

"It did. And it's why I've been able to perform procedures as a PGY1 that most PGY3s in surgery aren't able to do."

"That's Owen's problem, not mine. Messing with standard training plans is fraught with all manner of danger."

"I don't disagree, but this is a new program and gives us a chance to test changes without affecting the overall program. Mary is every bit my equal, only a year behind."

"Again, that's Owen's concern, at least for now."

"May I give you some advice?"

"Could I stop you?" Doctor Wernher asked.

I laughed, "Loretta has asked that same question many times! And yes, you can."

"Go on."

"To win the battle you want to win, you're going to need the entire trauma surgery team on your side. Privately, I will say that I do not agree that only a surgeon can supervise surgeons, though they do need to be trained by them. If you want to be Medical Director, you're going to need someone to tell the Hospital Administrator that it will work. If you want us to do that, you have to show us that it works, which was my point when we negotiated our truce. An alliance is in the cards, but that's more on you than it's on me, Mary, or Al Baker."

"Al Baker?"

"He's intending to apply for the trauma surgery slot next year. He's similar caliber."

"You surgeons are a cocky lot."

"Would you want a tentative, unconfident surgeon cutting into you? Or working in the ED when lives are on the line without split-second action?"

"I understand the point, Doctor, but you surgeons put your pants on one leg at a time like the rest of us."

"I'm positive surgical services screen for ego and eliminate candidates without a strong one. I don't think you could survive the training without it. Bedside manner isn't all that important when your patients are all unconscious."

"And yet your evaluations spoke of spending too much time bedside."

"I'm an emergency medicine specialist at heart and always have been. That's what I would have done without the trauma surgery Residency. That's why an alliance is possible. I want the ED to be the best in the country, and will do whatever it takes to make that happen."

"Will you leave your notes with me?"

"That notebook is at home. I'll bring it tomorrow. It's only evaluations, so you'll see every student I've taught, plus the interviews."

"That should make interesting reading."

"Anything else? My student is cooling her heels and there are charts in the walk-in rack."

"Dismissed,"

I got up, left his office, and went to the lounge to find Mary.

"Sorry. Get the next chart, please."

"I could have had at least one patient ready for you."

"I know. Stick to the program for now. In nine weeks, you'll have some autonomy. Wernher's program is not poor; it was just poorly presented. Go."

She left, and I got a drink of water, then met her in the corridor with the patient. The three of us went into Exam 2, and Mary completed the H&P.

"I propose the usual procedure for a dog bite," she said. "Irrigate, topical antibiotic, and update tetanus, then dress."

"Proceed," I instructed.

That was the first of a dozen routine walk-ins, after which I took my lunch break to meet Clarissa and Sophia in the cafeteria.

"How did apartment hunting go?" I asked Sophia.

"We found a place about equidistant from Stanford and the hospital," Sophia said. "Rents are pretty insane in the Bay Area, but we can swing it. Fortunately, both the hospital and Stanford offer a housing subsidy via grants."

"That's good," I said. "Are you psyched?"

"We're both psyched about our jobs but not about leaving you guys. The Proms will be our last gigs, and that's bittersweet."

"We're going to miss you guys. We'll need to find a way to get everyone together in the future, but I know that's a tall order, at least for another year."

"We'll come home to see our families, so maybe we can work around that," Sophia said.

"Let us know," I said, "and I'll move heaven and earth to get everyone together, including Maryam and Peter."

"How's he doing?" Sophia asked.

"Good, last time I spoke to him. I'll give him a call this week and call Maryam, too."

And Melissa Bush, I thought, just to check on her.

"What day do you actually leave, Sophia?"

"June 2nd. We're driving our cars which is kind of a downer, but my sister is riding with me, and Robby's cousin is riding with him. They'll fly back."

"So let the cousin or your sister drive part of the way," Clarissa suggested. "That allows you and Robby to ride together."

Sophia laughed, "I think I need to refuse my medical degree! I didn't even think of that!"

Clarissa and I both laughed as well. When we finished our meals, we each headed back to our respective services.

_April 26, 1990, McKinley, Ohio_

On Thursday, Antonne and the study group joined me for lunch. Kris had brought Rachel to the hospital at 8:00am, and the Kozlovs would pick her up right after lunch so that Conchita could have her 'Rachel time'. I stopped at daycare to get Rachel on my way to the cafeteria and saw the study group waiting for me.

"Hi, «amorcita»! Conchita said when I helped Rachel into a booster seat in a chair next to Conchita.

"Hi!" Rachel exclaimed. "Papa? Hot dog?"

I laughed because it was a repeat of exactly what had happened the previous time I'd met with the study group.

"Yes," I replied. "And French fries."

I got our lunches and sat down with the group.

"How is Doctor Gibbs?" Antonne asked.

"Slowly improving with rehab. It's probably going to be close to the end of the year before she has enough leg strength and muscle tone to be able to work. She might need leg braces for the rest of her life."

"The other doctor is fine, right?" Jordan asked.

"Doctor Lindsay, and yes, she's back to work and has no lasting physical effects. How are classes going for everyone?"

Everyone was making A's in all subjects, and none of them were struggling with anything. Of course, they were only finishing their Sophomore year, and it would become more difficult in the Fall. I didn't expect any of them to falter, as they were all very serious students.

"How is your training going?" Danika asked.

"I've done additional appendectomies, start to finish."

"That's just crazy for an Intern!" she declared.

"I resemble that remark!" I declared, causing the six students to laugh.

"When do you usually start doing those things?" Julius asked.

"PGY3 is the usual point where surgeons are allowed to begin performing surgeries," I replied. "The trauma surgery program is an experiment, and the changes may or may not spread to other programs. Fundamentally, it requires a student who has the skills, mentality, discipline, and confidence to do it without crossing lines."

"So, you're just that good?" Jordan asked with a smirk.

I chuckled, "You'll need to ask Kris _that_ question!"

"Ask Mama what?" Rachel inquired.

All the others laughed.

"If Papa is good at kissing," I replied.

"Papa and Mama kiss lots!" Rachel declared.

"Obviously," Jordan agreed with a smirk.

"She's due in June, right?" Conchita asked.

"Yes. Rachel will have a little sister in late June."

"Yay!" Rachel exclaimed. "Boys are noisy!"

"Her cousin is a bit too rambunctious for her taste," I clarified. "Back on topic, is there anything any of the six of you need from me at this point?"

None of them did, so we finished our lunches, and I took Rachel back to daycare before returning to the ED.

_April 27, 1990, McKinley, Ohio_

On Friday afternoon, just before 3:00pm, Mary and I went to the M & M for the patient who had coded on the table following the successful removal of his ruptured appendix. Surgical consults would be covered by the on-duty PGY1s and PGY2s, as both Mary and I might be called to discuss the case.

"What do you think?" she asked.

"In the end? Just one of those things. The one area of concern was drugs, but the post-mortem tox screen was negative. There were metabolites for acetaminophen, but we knew that from your H&P. The only other things in his blood work were the anesthesia drugs. My only quibble was Paul not calling a surgical consult, but that was a judgment call. Tell me why."

"His Alvarado score was 1, and any score below 5 is indicative of it not being appendicitis."

"So, what are your options?"

"Ex-lap, ultrasound, monitor, or street."

"Spoken like a surgeon," I chuckled. "Cut first!"

Mary rolled her eyes, "You're a surgeon! I went from most aggressive to least!"

"I know, but I could give you a hard time, so I did! Do you feel ready to speak on our behalf?"

"Yes, so long as you're there to back me up."

"Remember the goal of these proceedings."

"To improve medical care."

"Exactly. If someone starts giving you a hard time, just respond calmly and clearly, explain why you made the decisions, and point out that you were directly supervised during the entire process."

"Suddenly, I'm thankful for Doctor Wernher's rule."

"One benefit to us is that it moves any responsibility from you to me and from me to my supervising Attending, which in this case would be Doctor Roth because it was an emergency surgical admission."

"I'm ready."

"Good!"

We entered the auditorium and took seats towards the front of the room, as we'd be called to present on the admission and prep of the patient.