Chapter 46 — A Tireless Advocate

_September 10, 1989, Monastery of the Dormition of the Mother of God, Rives Junction, Michigan_

{psc} "Good morning, Michael," Father Roman said to me just before Matins on Sunday morning.

"Father, bless!" I replied.

He made the sign of the cross over my upturned palms and I kissed his hand.

"What time did you arrive?" he asked.

"Just after midnight," I replied. "I had a shift at the hospital until 5:00pm."

"Did you travel alone?"

"Reluctantly, but Kris and I agreed it made no sense to disrupt Rachel's schedule so badly. And it allows me to focus on the reason I'm here."

"We'll speak after Matins and Liturgy."

"I'd like you to hear my confession, please."

"Let's do that this afternoon, unless there is something so heavy on your heart that you need to confess before you receive the Eucharist."

"There is not."

"Good. Then worship in peace, and we'll have a private lunch after Liturgy."

"Yes, Father."

I moved to a spot just in front of the choir, cleared my mind, and for three hours and forty minutes, I allowed sights, sounds, and smells of Orthodox worship to draw me near to the Throne Room of God. As it had for my entire life, with very few exceptions, it created a sense of internal peace. I received the Eucharist, and once the Liturgy had ended, I joined Father Roman in a small private room for lunch.

"How have things been, Michael?" he asked after he gave the blessing.

"Overall, they are good," I replied. "I don't have enough time with Rachel, but that's a result of decisions I made long before she was born."

"Do you feel guilty?"

"I've thought quite a bit about it during the past week," I replied, "but I'm not sure that's the right word. I feel bad for Rachel, but I can't say I regret the course of action I chose when I was ten. Fundamentally, if Elizaveta hadn't reposed, I wouldn't have spent as much time with Rachel, and she wouldn't have been used to it. That said, the time I did have with her was amazing, and I'm not sure I'd be willing to give it up."

"You were feeling guilty?"

"I expressed to Kris that I felt guilty and she suggested that I needed to forgive myself the way I forgive others. I accepted that, though the more I think about it, I don't feel guilty, but I'm unhappy with how things worked out. The problem is, it's all because of my conscious decisions."

"So, is it, or is it not, weighing on your conscience?"

"Yes," I replied with a grin. "In another context, I made the point that the situation with Rachel is undesirable, but because I chose my course of action freely, the consequences aren't actually undesirable, because I knew about them and accepted them as a direct result of my own choice, a price, if you will. Kantian logic. What I didn't count on was Elizaveta's repose."

"And your marriage to Kris?"

"Is very different from my marriage to Elizaveta. Elizaveta planned to be a stay-at-home mom, at least until the kids started school. Kris is at Ohio State and has career plans."

"Do you have regrets?"

I shook my head, "No. Again, I signed up for this, and so did Kris. Rachel didn't."

"In layman's terms, you're beating yourself up for something over which you had no control — the situation which occurred after Elizaveta's repose. In spiritual terms, you counted the cost at each stage and made a conscious decision. There's no sin here, Michael. Is your daughter healthy, fed, clothed, bathed, and loved?"

"Obviously," I replied.

"Not so obvious, Michael. I'm sure you've seen abused or battered children, or those who are malnourished or ill. Is Rachel any of those things?"

"No," I admitted.

"And are you doing the best you are able to do, given your circumstances?"

"I believe so."

"And are you a good father?"

"My friends and my wife seem to think so."

Father Roman smiled, "Well, as I see it, you've made logical decisions, none of which you regret or would change, your daughter is well cared for, your marriage is stable and successful, you appear to have the respect of your friends and colleagues, and you're serving God and your community as a physician. What advice would you give to someone in your situation if you were me?"

"When you put it that way…" I replied. "But it simply feels as if my daughter is suffering from my choices."

"How so? Because she wants more time with you?"

"Yes."

"Had Elizaveta not reposed, would you have had more time for Rachel?"

"Obviously not."

"Then I'm missing the problem, except for what appears to be a guilty conscience that seems to have no basis in fact. May I use a secular phrase?"

"Yes."

"Get over it!"

I laughed, because there was nothing else to do. He had a point, and I was beating myself up for things over which I had ceded control at age ten, and there was no going back.

"You do appear to have a propensity to obsess," Father Roman continued. "I suppose that trait is key to your success as a physician in the ER, but not in other areas of your life. The Scriptures, as I'm sure you know, contain admonitions about obsessing, and I would propose that such thinking is what leads to destructive behavior — drinking, drug abuse, infidelity, and so on."

"I suspect you're right," I replied. "On that last one, for accountability, I should tell you that before I was betrothed to Elizaveta, and after I was returned to the order of the laity, but before I became betrothed to Kris, I was not chaste."

"That was confessed, and you received absolution?"

"Yes."

"And there was no infidelity, even emotional?"

"No. I do have a close female colleague, but Kris is fully aware, and the young woman and her partner are often guests in our home."

"You do realize that is how it starts, right?"

I nodded, "And both Clarissa and I are aware. I met her during my Freshman year at Taft, and she is one of the main people responsible for me being a doctor and a better man. It's similar to a relationship I had with a young woman from kindergarten until the summer after I graduated from High School."

"What happened there?"

"Our relationship didn't survive a terrible automobile accident she was in, mainly because we were both too immature to handle what happened."

"Would you explain?"

I recounted Jocelyn's store from meeting her in kindergarten through the accident and her suicide attempt, as well as my bout of depression, our eventual reconciliation, and her marriage to Gene.

"Have you had a truly close male friend besides Dale?"

"During medical school, a fellow student, Peter, but he's in Georgia for his Residency, and Robby, whose the emcee for our band, but he and his wife are likely moving to San Francisco when she finishes medical school. I do have male doctors who are mentors and colleagues, but not close friends. My best friend has, as I've said, always been female."

"I won't belabor the point, as I'm sure you understand, but you need to be very, very careful, and should develop close male friends. Is there anything else specific on your heart?"

"Impatience with the medical establishment and their intransigence on making fundamental changes."

"Arrogance, too, if you think after such a short time as a physician that you know better than those who have practiced for decades," Father Roman countered.

"Actually, my mentors, some of them very experienced, agree with me on those things, but inertia prevents needed changes from occurring in a timely fashion. A perfect example is Resident training hours, and the Libby Zion case."

"You'll have to explain."

I explained, concluding with, "If things don't change, then lawmakers will change them, and that's the last thing we need."

"I have no expertise in the area, but I believe your correct course of action is patience, which, I believe you know."

"I do."

"Is there anything else?"

"No."

"Are you keeping your prayer rule?"

"Religiously!"

"And you're using the Jesus Prayer to maintain internal quiet?"

"To the best that's possible in a busy Emergency Department. And I pray silently for every patient."

"Are you able to attend services?"

"When my schedule allows, which for the next two months is Vespers on Wednesdays and Saturdays, and Matins and the Divine Liturgy on Sundays."

"Fasting?"

"The basic relatively lax rule you assigned. We're trying to get pregnant, so, after discussing it with Kris, we think the rule about no red meat is probably the best."

"I would agree. Fish or chicken are acceptable for both of you. We'll revisit fasting after your baby is churched. How else can I help you?"

"For now, pray for me," I replied. "I'm sure I'll hit some kind of spiritual or secular brick wall and need spiritual surgery to correct it. That seems to be the pattern of my life."

"All our lives, Michael. I'm sure you know the saying — we fall down, we get up, we love God, that is the Christian life. Continue to pray, fast, attend services, and love your family. I'm positive I don't have to remind you to care for your patients in a loving Christian manner."

"It never hurts to be reminded."

"Let's finish our lunch, and then you can be on your way home."

_September 10, 1989, McKinley, Ohio_

"DADDY!" Rachel squealed when I walked in the door.

I held out my arms, and she hurried to me so I could pick her up. She gave me a kiss on the cheek and I kissed her forehead.

"How's my big girl?"

"Good! I help mommy with dinner!"

"About fifteen minutes, Mike," Kris said, coming into the room. "I just put the spaghetti noodles in the pot."

She greeted me with a kiss.

"How was your day?" I asked.

"We spent the afternoon with my parents and sister, as we'd planned. How was your visit with Father Roman?"

"Mainly we discussed my discontent about the time I can spend with Rachel."

"And did Father Roman kick your butt and set you straight?" Kris asked with a smile.

"We had a good chat, and it's a work in progress. I need to stop obsessing over things long ago decided and which cannot be solved except by the passage of time."

"So long as you accept that."

"I do," I replied.

We sat down to dinner about ten minutes later, with Rachel in her chair, but close to me so I could help her with her spaghetti, which, as usual, left her hands and face painted red with tomato sauce.

"She's so insistent on feeding herself," Kris observed. "But what a mess!"

"How about I bathe her while you clean up?"

"I think she'll appreciate that."

Kris' observation was correct, as Rachel did appreciate me bathing her, and enjoyed splashing in the bubble bath. When I finished bathing her, we returned to the great room where I read her two books, and then we said our evening prayers together. Once Rachel was in bed, Kris and I went to bed to work on a sibling for Rachel.

_September 11, 1989, McKinley, Ohio_

"Do you have five minutes?" Krista asked when I arrived in the ED just before 5:00am on Monday morning.

"Let me finish do the handover with Ron, then I do."

There was only a single patient waiting on admission, and he was being handled by Al, so I got a cup of coffee in the lounge, and Krista and I went to stand in the ambulance bay as the consultation room was occupied.

"What's up?" I asked.

"Everyone except you has decided I should fail this rotation and they don't think I should be a doctor. It's totally unfair because I wasn't even given a chance to succeed."

I actually didn't completely disagree with her, as I didn't believe she was being given a proper chance. The challenge was what I could do about it. I didn't believe approaching Doctor Northrup would be successful, nor did I think going back to Doctor Gibbs would bear any fruit. The only thing I could think of was to speak with Doctor Mertens, who was Dean of Clinical Instruction.

"I know how this is going to sound, but I have to ask two questions. First, do you want to be a physician more than anything else?"

"Yes."

"Second, and I'm sorry for asking, and you need to be completely honest, but there are rumors you've slept with Attendings. Is that true?"

"Yes. There are no rules against it."

That made her situation much more difficult, and not only might a conversation not help, it might cause trouble for me.

"The rumor goes further, to say that you did that to pass a rotation."

"That never happened!" she protested. "Both times were doctors on different services from my rotation, and I wasn't assigned to them before or after."

"Just so we're clear, I believe there should be a firm rule against doctors sleeping with medical students, for what I think are obvious reasons. And now you can see why the rumors spread."

"Oh, please! I know girls who slept with their Attendings or Residents! I never did that."

"I understand, but people make all manner of inferences. That creates a serious potential problem, because it calls every rotation into question. I'm not saying there was ever an instance when you behaved improperly, but even the suggestion of impropriety is problematic. That's why I think there needs to be a rule."

"You think that's the problem?"

"I have no idea," I replied. "But had you not done that, then I could say definitively it wasn't. But what's done is done."

"Is there any way you can help?

"I have serious reservations, but if what you're saying is true, you didn't break any rules. All I can do is have a word with Doctor Mertens. I'll call her later this morning and see if she can come here to discuss the situation. That's all I can promise, given it's the Attendings and Doctor Northrup who have the final say."

"I know. You're basically my only hope."

"Is Doctor Lincoln giving you procedures?"

"Some, but not enough, and I honestly don't think it matters given everyone except you has concluded I don't belong here."

"You realize I'm neutral on that, right?"

"Yes, but you think I _could_ make it; the others don't."

"OK. Let me see what Doctor Mertens has to say."

"Thanks, Doctor Mike."

"You're welcome."

About ninety minutes later, after handling two walk-ins, I placed a call to Doctor Mertens who, when I told her the reason, reluctantly agreed to meet me at 10:00am. I cleared that with Doctor Gibbs without mentioning the reason, and she agreed I could move my lunch break to 10:00am. I'd eat an apple and a granola bar in the ED, which would tide me over until my dinner break.

Doctor Mertens arrived as planned, and we went to a small conference room in the administrative wing.

"I think I want to approach this differently from how I first intended when I called you."

"Go on," Doctor Mertens said.

"I think it's high time for there to be a firm rule against doctors sleeping with medical students. I only have circumstantial evidence, but I have the feeling that someone is blackballing Krista because she slept with two different doctors, but never one who was on the same service or to whom she was ever assigned."

"Based on?"

"Nothing else makes sense," I replied. "The rumor is that she slept with an Attending for a grade, but she denies that, and I'm inclined to believe her. I don't condone that behavior, obviously, but it isn't against the rules."

"You don't appear to have all the relevant information," Doctor Mertens countered. "I have a specific report of an incident with an Attending from the service to which she was assigned."

"From whom, if I might ask? Position only, as I'm sure you cannot name names."

"A fellow medical student."

"As an eyewitness?" I asked.

"You're joking, right?"

"Well, with the pager incident, we actually DID have an eyewitness, so no, I'm not joking. May I ask what was said?"

"Simply that she was having an inappropriate relationship with her Attending."

"And did you verify that?"

"I asked and there was a flat denial."

"While I know that an Attending in that position has an incentive to lie, this smells more and more like someone blackballing Krista. The reason I'm saying that is because I was warned never to be alone with her AND to never leave her alone with a patient. Whatever the basis for those warnings might have been, I haven't seen a single thing that would indicate that either warning was prescient.

"Krista is not a rock star, but she's also not Tim Burg. She's competent, and, frankly, the world needs competent physicians. Is she a trauma physician? No way. But then again, neither are you, Doctor Forsberg, Doctor Baker, or Doctor Saunders. And no, I'm not saying they aren't very good, simply that not everyone is cut out for trauma. That said, she's competent at it, and she's not being graded appropriately, not being given the procedures an average student would be given. And I think it's because someone is blackballing her."

"Tell me your theory."

"There are a few possibilities — first, it's innuendo and rumor, with no substance; second, it's retaliation either from a doctor she slept with or one she didn't sleep with; third, Krista and the Attending are both lying to cover up a _quid pro quo_. I honestly think that the last one is the least likely, unless you're prepared to name that Attending and bring them up on ethics charges.

"If _that_ happens, Krista is just as likely the victim as she is the perpetrator. And that creates a massive problem because her complaint would be completely legitimate and easy for her to defend — the Attending threatened to fail her if she didn't sleep with him. How could he, accused of sleeping with a medical student, defend against that claim? And that right there is exactly why we need a rule."

"Are you suggesting you'd advise her to say that?"

"No, but she's not an idiot, Nora! She had top marks in college, scored well on the MCAT, and scored well during her first two years. And I checked, her first rotation, Pedes, she received a grade of 4. Something happened, and evidence suggests that other than exercising poor judgment by sleeping with two Attendings, Krista didn't do anything wrong, and is, in my opinion, being held to a different standard than the doctors she's accused of screwing for a grade."

"This is going to sound bad, but I have to ask — what would you say in an inquiry?"

"I would tell the truth about what I know and refuse to speculate about anything I don't know or can't deduce."

"And if asked for your opinion?"

"I'd point out the apparent double standard, and also point out that the entire thing would never have happened if the rule I'm proposing had been in place. I've made this point from the first time I set foot in the hospital. By not having the rule, medical students get…well, screwed. In various meanings of that term.

"I also want to point out that the _next_ case might well involve a gay doctor being outed against his will. And that is going to cause, pardon the expression, a shitstorm. Nobody says much about Doctor Saunders, but the two gay doctors who are out are talked about behind their backs and with some of the worst slurs imaginable."

"You know I agree with you on the topic of sex between doctors and medical students."

"Then fix it. Make a rule. Will some doctors squeal like stuck pigs? Too bad for them. I'd also make it a student ethics violation to engage in sex during clinical rotation hours. Period. End of discussion."

"Morality police?"

"No. It's a concern about professionalism, period."

"I seriously doubt the administration is going to make that rule."

"Propose it anyway, and when this, or another incident, comes back to bite them, you point to the proposed rule and say it would have saved them the grief. And maybe you accept a half-measure. Propose the rule, and if there is pushback, which we know there will be, suggest that it apply to students on their current, previous, and next rotation. Everyone knows the schedule."

"I'll discuss it with Doctor Warren and Doctor Worth."

"What are you going to do about Krista?"

"I'm going to turn that around and ask, assuming what you've inferred is true, what _you_ would do?"

"Is out of the box thinking OK?"

"Whatever it is would have to pass muster with Match committees."

"Assign her to me for the rest of the month, matching my schedule, all eighty hours, and I determine her grade."

"An Attending has to sign off."

"Doctor Casper," I replied. "I'll speak to Ghost and he'll give her a fair shot."

"What about your other students?"

"That's the tricky part, as Jake flat-out rejected switching shifts with Krista because he wants to work with me. I could handle two fourth years, which would allow me to see more patients, and give them both enough work, especially given Naveen and I are mostly doing walk-ins with the occasional EMS transport."

"Quite a few people would have to sign off on that — Doctor Northrup, Doctor Gibbs, Doctor Gabriel, and Doctor Warren. And Doctor Turner at the Free Clinic."

"Gale won't be a problem," I replied. "That would free a nurse, and you know they're terribly short-staffed. And I can convince Doctor Gibbs and Doctor Gabriel. I'll leave the muckety-mucks to you!"

"And you'll evaluate her fairly and honestly?"

"Did you seriously just ask me if I'd lie or fudge a student grade?" I asked indignantly.

"I had to ask, Mike, because I'll be asked."

"And you didn't know the answer to that question before you asked it such that you didn't _actually_ need to ask it?"

"I honestly didn't mean to offend you."

"Then please do not question my integrity."

"Others may, given her reputation."

"I'll double-dog dare them to accuse me to my face. They won't, of course, because they'll know it's BS. There was a reason you asked me to serve on the ethics committee."

"Yes, there was. Let me talk to Doctor Warren and get his take before I stir up a hornet's nest."

"One is being stirred," I replied. "Maybe this isn't the one that stings, but eventually one will, and just as the medical establishment ceded control to the legislature in New York because they didn't respond to Libby Zion, they'll cede it to the legislature or courts because of situations such as this."

"We always win," Doctor Mertens replied.

"Until you don't. That's the lesson of Libby Zion."

"An interesting point."

"That's the question, Nora — do we police ourselves or do we invite the legislature and courts to do it? I think medical professionals are best suited to make those decisions, not politicians."

"Let me see what I can do," Doctor Mertens replied. "I'm not sure I agree completely with you on your plan, but it's not unreasonable."

"I'm only unreasonable when someone is acting in a way that is not in the best interest of my patient or of medicine."

"Please do not say anything to Krista."

"Mum's the word. But we need an answer «tout de suite» as my wife would say, or 'toot sweet' as we provincials here in Ohio would say!"

"Does she really look down on typical Midwesterners?"

"You have no idea," I chuckled. "Parisian cultural arrogance knows no bounds! Nor does French socialism!"

"That must make for some interesting pillow talk!"

I chuckled, "We have had some lively debates."

"Is she teaching Rachel French?"

"No. Her trouble-making fifteen-year-old sister is doing that! Rachel is enamored with her «tante préférée»."

"Is anyone teaching her Russian?"

"No, My mother-in-law, that is Elizaveta's mom, did at first, but she more or less gave up."

"I'll let you go, and try to get back to you by the end of the day with Doctor Warren's views."

"She's salvageable," I said. "I'm positive she won't Match here because the well is poisoned, but there's no reason she can't be successful elsewhere. I'd also like to be the one to tell her, so I can lay down the law about how I expect her to perform."

"That makes sense. Thanks, Mike."

"Thank you, Nora."

We left, with Doctor Mertens returning to the medical school and with me returning to the ED. Fortunately, Krista's shift had ended at 6:00am, so she wasn't around and I didn't have to evade answering her questions. The same couldn't be said for Doctor Gibbs, who called me into her office.

"I promised Nora Mertens I'd refrain from discussing the topic of the meeting until she has a chance to discuss it with some other people."

"Krista Sandberg," Doctor Gibbs said, disgustedly.

"I promised I wouldn't reveal anything," I said. "And you know I keep my word. I will discuss the topic with you as soon as I hear from Nora that it's OK."

"Could we please have one day, just one, where you don't do or say something controversial?"

"According to Clarissa, she can't leave me unattended for two minutes without me getting into some kind of trouble."

"She's not wrong," Doctor Gibbs said flatly.

"I love you both," I replied.

"Go heal the sick, Mike."

"Right away, Doctor!"

Doctor Gibbs rolled her eyes, and I left the office.

Jake, Heather and I handled eight walk-in cases during the late morning and early afternoon, and I took a five-minute break to eat my apple and granola bar just after 11:00am. None of the cases were remarkable, so it was all routine. Just before 4:00pm, Nate let me know I had a call from Doctor Mertens. I went into the consultation room and closed the door for privacy.

"Mike," I said into the phone.

"Hi, Mike, it's Nora. Doctor Warren will sign off on your plan, assuming the medical staff at the hospital will agree. The rule change about doctors and students is likely a non-starter, at least in his opinion."

"As I said, we'll get away with it until we don't, and the results could be ugly. What about the sex while on shift ethics rule?"

"That one will be considered for the revised ethics rules for next year. I will push hard for it, and may bring you in if there is significant pushback."

"I'll speak to Doctor Gibbs now, and Doctor Gabriel first thing in the morning. Doctor Gibbs is not going to be happy."

"Doctor Warren wasn't happy, either, but he acknowledged your point about not wanting to cede control to the courts or the legislature."

"OK. Who will speak to Doctor Northrup?"

"I will, once you confirm that Doctor Gibbs and Doctor Gabriel are on board."

"Thanks. Let me go into the lion's den."

"Good luck, Dan!"

I chuckled, "I'd much rather be the Archangel Michael, wielding a sword than Daniel in the Lions' Den!"

We said 'goodbye' and I replaced the handset in the cradle, then went to find Doctor Gibbs, who was in a trauma. I let Nate know I needed to see her before she went home, then had Jake bring in another patient from the waiting room. I had just instructed Jake to begin suturing the small laceration on the six-year-old's temple when Doctor Gibbs came to the door of Exam 5.

"You needed to see me, Mike?"

"Yes. I can leave Jake to finish this. Jake, I won't be too long."

He acknowledged me and I left the exam room and followed Doctor Gibbs to her office, closing the door behind me.

"After a discussion with Nora Mertens and a review of the salient facts, I proposed a plan for Krista Sandberg. Doctor Mertens and Doctor Warren approved, but I also would need your agreement as Chief Attending and Doctor Gabriel's as Chief Resident."

"And Doctor Northrup's."

"Yes, but Doctor Mertens will speak to him if you and Pete agree."

"Tell me," Doctor Gibbs said impatiently.

"For the remainder of the month, Krista is assigned to me, according to my shift schedule, including at the Free Clinic, and I write her evaluation at the end of the month. It'll be fair and honest."

"Implying I'm not."

"No, saying that I won't write a review that extols her skills and abilities to simply prove that I'm right. I am neutral, as I've said from the beginning. I _think_ she can be salvaged, but in the end, it's up to her."

"Why, Mike?"

"Honestly? Somebody is blackballing her. It could be one of the Attendings she allegedly slept with for some reason. It could be an Attending who disapproved or is a jilted lover. It could be an Attending who wanted to sleep with her but was rebuffed. Or some other reason. But nothing I was told has been borne out — she is not dangerous to patients nor has she come on to me even in the slightest.

"I made the point with Nora that we need a rule against inappropriate relationships between doctors and students, and I am convinced if we don't make that rule, a rule will be imposed on us by the courts or the legislature. I know you agree with me. I also asked for having sex at the hospital while on a clinical rotation be made an ethics violation. Again, we need to act before something really bad happens and rules are imposed on us.

"But all that aside, whoever is out to get Krista is doing a damned good job, because they convinced Leila Javadi that Krista is some kind of seductress or succubus. I haven't spoken to her again, but I will, at some point. The thing is, Nora looked into the claim that Krista used sex to get her grade and the Attending denied it. Krista denied having sex with any Attending on the service to which she was assigned, or with any Attending who supervised her at any time."

"And you believe it?"

"If the Attending, and I don't know who it is, is lying, then somebody should do something about it. If he's telling the truth, then the scurrilous rumors should be quashed. Unless someone can prove it, she has to have the benefit of the doubt. And it appears I'm the only one willing to do so."

"Excuse me?!" Doctor Gibbs exclaimed, sounding just as indignant as I had with Doctor Mertens.

"You told me she was unqualified to be a physician, based on reports from other departments, and at odds with what I was reporting. It turns out that going to Leila was a mistake, because in the end it only confirmed in your mind that Krista didn't belong here. Something is, as they say, rotten in Denmark."

"I don't appreciate the accusation," Doctor Gibbs said.

"The source of this problem is we listened to what other people said. The difference is, I observed directly, day to day, you didn't. I changed my opinion based on that observation, an advantage you didn't have. If I have any complaint about you, it's that you dismissed what I was saying about Krista because of what had been said to you by other Attendings outside of the ED."

"What is this girl to you?"

"Someone who is not being treated fairly," I replied. "I think ALL of us were misled, including Doctor Javadi. Someone, somewhere, is out to get her for no good reason. She asked for my help because I am literally the only person who will take her seriously. Heck, I'm the only one who will actually listen to her. Even you have been dismissive, Lor."

"Will you admit that some people are simply not cut out to be doctors?"

"Yes. Show me _any_ proof that applies to Krista. I don't believe you can because it's become a self-perpetuating thing. Someone decided they didn't want her in the program and systematically ruined her reputation and ensured she didn't learn. From what I can see, nobody tried to help her. And think about what would have happened had you, and a few others, not tried to help me. Or Felicity. Or countless others."

"And if we don't agree, you're going to back her if she files a formal complaint, aren't you?"

"Why the heck is EVERYONE so worried about that? Don't answer! I'll tell you — you know the complaint is legitimate! You know if asked, I'll answer honestly and completely, and she might actually win. I'm going to repeat what I said to Nora — we have to fix this ourselves or someone outside the medical profession is going to fix it for us, and we won't like the results.

"This isn't a slam dunk like Melissa Bush or Tim Burg, or like Jack Strickland or Gerald Kirby. Quite the opposite, this is a loser case, even if we win in court. Think about the bad press and the investigation that will follow. We can't point to a single thing — not clownish behavior, not discrimination against patients, not missing a code, or being too arrogant. I thought that last one was the thing, but it's not. She wasn't taught and NOBODY intervened.

"We implemented the Resident hours limits with defined sleeping periods because of the Libby Zion case. We could, as most hospitals have done, ignore it, but that would have invited intervention by the legislature. Instead, we're out in front and we can define the best practices. And following best practices means not sleeping with your students. Would _you_ sleep with a student?"

"I'm married."

"That doesn't appear to matter to many doctors," I replied. "I can name three who regularly cheat on their wives. That's their business, and their wives' business, not mine, but being married doesn't create the barrier you and I believe it does. But we also wouldn't do it because of the potential ethical problem. I bet you had opportunities as a student and Resident."

"I did," Doctor Gibbs confirmed, "and I turned them all down."

"Exactly. My challenge has been nurses who don't think wedding vows mean anything, mostly because there are very few female Attending physicians at the hospital. That's changing, quickly, as it should, and we're likely to see a situation with reversed roles blow up in our faces. Imagine, too, if Krista were a minority. Think how THAT would play out with a public complaint."

"You've made your point," Doctor Gibbs said flatly.

"It's your call as Chief Attending," I said. "What's it going to be?"

"You're still a pain in the ass, Loucks."

"It's who I am," I replied. "A tireless advocate for my patients, but also for the weak, the downtrodden, and the mistreated. And if that makes me a pain in the ass, I'm in very good company."

"Your personal hero, Martin Luther King, for one."

"A modern-day prophet, who, like many of those, if not most, who speak truth to power, was imprisoned and killed for it. I hope to escape that fate."

"Jesus and Socrates, right?"

"Among others. I still have to make my case to Pete, but I think I can. And if you sic Ghost on me, he'll get both barrels, too."

"Would I do that?"

"In a heartbeat!"

"Get out of here! Go heal the sick!"

I nodded and left her office. I'd put my butt on the line for Krista, and I could be burned by that, but I didn't think I would be. That said, I was absolutely going to lay down the law with her as I'd said to Doctor Mertens I would.