Chapter 47 — The Woodshed

_September 11, 1989, McKinley, Ohio_

{psc} "Jesus, Petrovich!" Clarissa exclaimed while we were having just after 1:00pm on Monday afternoon.

"Tell me I'm wrong, or that anything I said to Doctor Mertens, Doctor Gibbs, and Doctor Gabriel was wrong."

"You probably aren't wrong, but you _know_ people are going to assume you're sleeping with her."

"Let 'em," I replied. "I know it's not true, you know it's not true, and most importantly, Kris will know it's not true. If someone says it to me, I'll demand proof, and if teaching a student, even remedially, is 'proof', I'll get the new rule implemented before you can say 'Jack Robinson'."

"Where did that phrase come from?"

"No clue. It wasn't one of the ones Mr. Black took time to explain, which, I suspect, means there is no origin story of which we're aware."

"Back to your Quixotic quest — what now?"

"Nora Mertens has a meeting with Doctor Northrup in about an hour. I don't see how he can reject the request without risking outside intervention. Krista isn't an idiot, and all she has to do is say that the doctors demanded she sleep with them or they'd blackball her, and someone she turned down _is_ blackballing her."

"That's true?"

"Does it matter? It wins because it _could_ be true. Think about a jury, told about doctors banging medical students, about the fact that she's being held accountable but the doctors aren't, and that she believes she's being punished for not having sex, or for having sex, or both, while the doctors all skate."

"Ugly."

"Exactly. This isn't an issue of medical training, and you know how I'll testify."

"That she's an average, but competent, clinician who appears to have been treated unfairly."

"And that I have no knowledge about her relationship with any other doctor except for me. What do you think happens if someone accuses me of sleeping with her at that point?"

"Scorched earth. But you'll screw yourself."

"Will I? What's Doctor Roth's position? And Doctor Strong's? And Doctor Gibbs'?"

"And if you're wrong about her?"

"Then I give her a substandard grade or fail her, and neither she nor anyone else can legitimately say a thing about it. Similarly, if I give her a passing grade, who could legitimately argue with it? Think about why they assigned Felicity and Tim to me. And, honestly, why they assigned Krista to me."

"There has to be some potential downside."

"Yes, if I'm wrong, it will harm my reputation and create impediments in the future. That said, I can mostly mitigate it by admitting I was wrong. The challenge would be if I'm wrong and then there's a future student who needs my help. It would harm them more than me. But you know I can't sit idly by and allow an injustice to occur."

"No, you couldn't. Isn't Jake going to be upset?"

"I'll have two Fourth Years. I'll simply see more patients, because I can have each of them do a workup, then see the patients in turn."

"You actually might be onto something to speed up how quickly patients are seen."

"Possibly, but that's not the main point."

"Obviously, but it might be part of the solution. Of course, there are a limited number of Fourth Years, though I know there are some who would like to have multiple trauma Sub-Is but who can't because of limited slots."

"The challenge, of course, is Residents who want to teach and are able to teach multiple students at a time. But we'll worry about that in the future."

We finished our coffee, and I returned to the ED while Clarissa returned to Internal Medicine. Jake, Heather, and I saw four patients and just after 3:00pm, Nate let me know that Doctor Northrup wanted to see me. I checked with Doctor Gibbs, then went to the administration wing.

"He's expecting you," Mrs. Andrews said.

I went into the office and saw Doctor Mertens and Doctor Warren as well. I greeted them, then sat down at a nod from Doctor Northrup.

"This entire situation is very irregular," Doctor Northrup said. "I'm concerned about significant disagreements amongst my Attending and Residents over a medical student, and the dissension it seems to be causing. I'm also concerned about the claims of unfair treatment and double standards. And I'm also concerned about the rumors that are flying. Doctor Loucks, you've put me, and the medical school, in a very tricky situation.

"I'm sure you're aware that the training program for medical students is far from perfect, but it does work. Can it be improved? Yes, of course. And you benefitted greatly from one of those improvements — Preceptorships. That said, what we cannot have is a specialized training program targeted for a single medical student. That's simply not sustainable. In addition, it's also not practical or reasonable to assign two Fourth Year students to a Resident.

"I've listened to what everyone has to say, and off the record, I believe we've handled this situation poorly, and it reflects badly on the hospital. That said, there is no easy solution to the problem before us. I'm reluctant to support any plan which does not conform to our standard practices, because I do not want to set a precedent that either allows students to pick their Residents, or Residents to pick their students. That is a recipe for trouble similar to the issue at hand.

"Doctor Loucks, if we were to accept your proposed solution for Miss Sandberg, it would, of necessity, mean swapping her shifts with Mr. Green, something he expressly rejected. I don't believe it wise to, in effect, punish him to benefit the wishes of another student, or even of a Resident. What that means is, despite the agreement of Doctor Gibbs and Doctor Casper, I have to reject the proposed solution.

"Doctor Warren, Doctor Mertens, and I had a lengthy discussion on how to address the specific complaint. Doctor Mertens proposed a solution on which the three of us agree. Miss Sandberg will repeat her trauma rotation, starting in December, and her grade for that second rotation will be her grade for both rotations. No record of that specific grading standard will appear in her transcripts.

"Her next rotation is Internal Medicine, and I spoke with Tim Baker right before I called you upstairs, and he will instruct his Residents to treat her as they would any other Fourth Year. He's confident that will happen. This change would cause her to give up her rotation in Pedes, but that's the price she'll have to pay if she wants to attempt to improve what would be a sub-par or failing grade.

"As for assignment, I will ask, but not require, Doctor Gabriel to match Miss Sandberg's schedule to yours as best he can, provided it fits within the normal scheduling guidelines. Scheduling of student hours has always been delegated to the Chief Resident, and I'm not of a mind to change that, nor to undermine their final authority on the matter. We'll inform Miss Sandberg of her options, and Doctor Mertens will modify her schedule for December and January if Miss Sandberg agrees."

"OK," I replied, absolutely positive Doctor Northrup was not interested in a debate.

"Now, to you, Doctor Loucks. Everyone here believes you are an excellent clinician, but you are irreverent with regard to policies, intemperate with regard to demanding change, and impatient with the process. If you do not get control of those tendencies, you won't make it to an Attending position. We all see things that ought to change, and we all get frustrated from time to time, but that is not license to disrupt the operation of the Emergency Department. I'm going to ask Doctor Gibbs to closely mentor you on that, and your evaluation as a Resident will depend on it."

I was tempted to simply say 'bullshit' but held my tongue and silently repeated the Jesus Prayer forty times.

"OK," I said evenly.

"Go back to work, Doctor," Doctor Northrup said. "Doctor Mertens will speak to Miss Sandberg."

"Yes, Doctor," I replied.

I got up and left the office, more frustrated than I'd been in a long, long time. I decided to take advantage of being excused from the meeting to go to Internal Medicine to see Clarissa.

"Uh oh," she said as soon as she saw me. "18 is empty, so let's go there."

I nodded and followed her into the empty patient room.

"What happened?"

"I said the Jesus Prayer forty times to prevent me from saying 'bullshit' to Doctor Northrup when he basically told me to shut up and do my job and not rock the boat."

"I think before we discuss that, I need to ask what happened with regard to Krista Sandberg?"

"Swapping a pedes rotation for a second trauma rotation, with her grade on the second rotation being her grade for both rotations, and nothing in her record about that grading system. That'll be in December, but no guarantee she'll be assigned to me. Her next rotation is Internal Medicine, and Doctor Northrup said he'd call Doctor Baker and ensure Krista is treated the same as any other Fourth Year. I hope you'll keep an eye on that and let me know if that doesn't happen."

"Sure. Now, tell me how much trouble you're in."

"He said that I'm 'irreverent with regard to policies, intemperate with regard to demanding change, and impatient with the process'."

"He's not wrong."

"No, he's not. But it's what he said next that's the concern — he said my frustration isn't license to disrupt the operation of the ED, and that he's instructed Doctor Gibbs to monitor me and my evaluation will depend on not doing that. It's, in effect, an order to shut up and do as I'm told."

"Or a request to back off in the only way you, who needs to occasionally be whacked on the nose with a rolled up newspaper, would understand and take to heart."

"Maybe," I admitted.

"There's no 'maybe' about it, Petrovich. You'd accept a reprimand or rebuke such as that from your bishop if it was accurate, and Doctor Northrup's description of you is accurate."

"Except what he's saying is that nothing is going to change. It's exactly the problem with the OB chief at Good Samaritan that Doctor Kelly and others identified — an unwillingness to accept necessary changes for the overall benefit of the practice of medicine. In effect, he's saying he's OK with doctors sleeping with medical students AND is OK with sex in on-call rooms."

"I think you might be reading a bit too much into it."

I shook my head, "Why rebuke me as irreverent, intemperate, and impatient about policy and changes if that's _not_ the case. Think about the things I asked for, and apply the response to those."

"We did say we would have to wait until we're Attendings to make real change. You pushing now would qualify as impatience."

"So we just ignore it? And what happens when the sexual harassment complaints are made, because you know they will be."

"The hospital quietly settles to keep it out of court."

"And doesn't change policy to avoid looking guilty."

"You're in one of your moods, Petrovich. What did you say?"

"Four words. I said 'OK' twice, then 'Yes, Doctor' when I was dismissed."

"What are you going to do?"

"Practice medicine. But this is going to blow up, and you know it. And someone is going to come to me, take a deposition, and all hell is going to break loose because I won't lie to cover their sorry butts. That said, I _am_ going to push Doctor Mertens to make having sex in the hospital while on duty an ethics violation with dismissal recommended. She was receptive to that idea."

"Neatly cutting the Gordian knot."

"And I'll get grief for it, but Lissa, it has to stop before something really bad happens and courts or the legislature impose rules on us that are not conducive to good patient care. No judge and no politician has a freaking clue about it, unless they're medical doctors, and those are few and far between."

"Don't you think they got it right in New York?"

"Do you think a hard and fast rule, with potential civil and criminal liability, is in the best interest of patients? Or is flexibility a necessary component of good medical care? And what happens when they get it wrong, but the change _sounds_ good to the public, yet needlessly makes medical care more difficult or more expensive? I'll answer — the politicians blame the doctors and hospitals, and get zero blame for the problem they created.

"It's the same problem with shifting away from insurance to government programs — there is no actual accountability. Yes, you could argue that insurance companies avoid accountability, but that only proves my point — they use the courts and the regulations to escape responsibility and liability. A bureaucrat is going to be even MORE insulated from the public, because, as was made clear in Civics class, you can only sue the government with its permission, and the remedies, if there are any, are generally weaker than against a private company."

"You must be pissed! You're discussing politics and political theory."

"You're a safe ear," I replied. "I can rant to you without worrying that someone will rat me out. And Doctor Gibbs has been assigned to be Chief Rat, in addition to Chief Attending."

"Jesus, Petrovich."

"That was made clear by Doctor Northrup. Which means her butt will be in a sling if she _doesn't_ rat on me. And that means I can no longer be honest and speak my mind to my first mentor. What was left unsaid is what Doctor Northrup is going to say to Doctor Cutter."

"Because you're officially on the Surgical Service. What about Doctor Lindsay? She seems sympathetic and I believe she agrees with you. And she's Doctor Roth's star pupil."

"I don't want to drag anyone else into this mess at the moment."

"Besides me?"

"You signed up for this when you decided to take me in as a stray and began whacking me on the nose with a rolled-up newspaper! Little did you know you were boarding a high-speed train to Crazy Town."

"I suppose that's better than a highway to hell!"

"Actually, I retract that, because of the implications with regard to mental health. Make it a 'highway to the danger zone'. Anyway, I need to get back to the ED."

"Dinner?"

"I'll call you when I'm free. If you don't hear by 7:00pm, assume I can't get away."

"OK."

We hugged, I left the room, and headed back to the ED. I found Jake and Heather, and we began seeing walk-in patients. I knew, at some point, before the end of the day, Doctor Gibbs would ask to see me, and that happened about 4:00pm.

"I warned you," she said firmly. "And so did Pete and Ghost."

"I just want you to answer one question with complete honesty," I said. "Off the record, do you, or do you not, think it's inappropriate for doctors to sleep with medical students?"

"That's neither here nor there," she countered.

"I'd like an answer, Doctor Gibbs," I said formally.

"Mike…"

"The only thing I have to say is that I'm happy this isn't the Soviet Union, where I'd be shot for pointing out the flaws of the Party."

"You're being overly dramatic."

"Answer the question, then, Doctor."

"I'm not the enemy," Doctor Gibbs replied.

"No? Doctor Northrup made it clear that you're his «стукач»." ('stukach')

"Translation?"

"Stool pigeon or snitch. I was told to shut up and desist, and you were going to monitor me and base my evaluation on my fidelity to the Party."

"Mike, please…"

"Please what? Keep quiet when an injustice is being perpetrated? Look the other way when someone is blackballed either for taking advantage of the policy or for refusing to? I don't know which, but either one is wrong. And the Old Boys Club is closing ranks. Every single department head is male. You're the only female Chief Attending. Tell me how it looks to a neutral observer."

"Mike, I don't want to fight with you."

"Answer my question, please, Doctor, or allow me to go back to work."

"That's it? We're no longer friends?"

"Beyond this conversation, I can no longer speak my mind to you without risking it getting back to Doctor Northrup and ruining my career. We can discuss clinical issues, but that's it."

"What do you expect me to do?"

"Stand up for your Residents," I replied. "Look, let's be clear. I will follow the directive, and I won't cause trouble. But, you know as well as I do, at some point, this will blow up and someone will come to me and ask difficult questions, and I'll answer them truthfully. And if anyone instructs me or advises me to lie, obfuscate, or dissimulate, I'll make sure that's known publicly. Anyone who expects different doesn't know me."

"You realize you're putting your Residency at risk, don't you?"

"That's the same thing Doctor Lawson said when I backed my friend Angie against her psychiatrist. I was not only justified, but proven right when he accepted a suspension without putting up any real fight."

"You're putting me in the same category as _him_?!"

"If the shoe fits…"

"Go back to work, Mike. We'll discuss this when you calm down."

"I'm the very picture of serenity," I countered. "I'm calm, cool, and collected."

"Exterior? Yes. Interior? No."

"Believe what you will, Doctor," I said. "Unless you have some clinical matter to discuss, I'm going back to work."

"Shit," she swore under her breath.

I wasn't sure what that meant, but in the end, I was going to do my job, to the best of my ability, and within the guidelines. That was, in the end, the only way to not be dismissed from the program, which was the clear threat Doctor Northrup had made.

"Mike?" Nate called out. "Paramedics three minutes out with an MI. Trauma 2 is free."

"Thanks, Nate."

I gathered Jake, Heather, and Kellie, and the four of us went to the ambulance bay to wait for EMS to deliver the patient, which they did two minutes after we had entered the ambulance bay. The patient was having a non-STEMI, so after evaluation and a cardiology consult, he was admitted.

The rest of the early evening was routine, and I managed to get my meal break around 6:45pm, and Clarissa could join me, given her more relaxed routine in Medicine.

"Doctor Gibbs spoke to me," I said after Clarissa and I sat down away from other Residents.

"And?"

"I called her a «стукач». It went downhill from there."

"That is not good. Is she really the enemy?"

"I asked her to give me an honest, off-the-record answer to the question about the propriety of sex between doctors and medical students, and she avoided answering. That makes her part of the problem, not part of the solution."

"And if you cut off every doctor who doesn't accept your views, you're going to find yourself alone."

"It's worse, Lissa. She _agreed_ with me on the topic until Doctor Northrup spoke to her this afternoon. Now she's basically quoting the party line like a good «аппаратчики» and doing the will of the Party." ('apparatchiki')

"You're back to Russian," Clarissa observed. "That tells me you are extremely upset."

"Shouldn't I be? Should I just 'follow orders' even when I know they're wrong?"

"No, but you have to be wise in how you do it."

"I _was_," I replied. "I wasn't overly strident, I simply pointed out something glaringly obvious that is impacting the situation I'm trying to remedy. The more I think about it, the closing ranks tells me I'm actually onto something."

"Coverup?"

"To protect someone, I suspect. I just don't know who."

"I know what you're thinking, Petrovich; don't do it."

"There's something more to this, Lissa."

"And if you try to find out, you'll risk being dismissed from the program."

"Doing nothing simply perpetuates the problem," I protested.

"Do you remember when we agreed we'd have to wait until we're Attendings to change things?" Clarissa asked.

"Nine years for me. When that time comes, I'll be an Attending who has no moral ground on which to stand after having kept my mouth shut for nearly a decade. Which is _exactly_ what they want."

"They who?"

"The doctors who perpetuate the system and refuse to implement necessary changes."

"As you see them," Clarissa countered.

"Oh, for Pete's sake, Lissa! You agree. So did Doctor Gibbs, until Doctor Northrup turned her into a snitch! She's protecting her position, and THAT is how they protect themselves."

"So you'll throw away eight years of work just like that?"

"No. But I also won't simply ignore the problem. I _will_ find a way."

"Even if it costs you everything? And leaves you in a position to not be able to care for your wife and daughter? It's not only your fate you're putting at risk."

"As I said, I _will_ find a way."

"Don't do anything rash, Petrovich."

I simply nodded and ate, and about five minutes later, Doctor Lindsay came to the table.

"Hi, Mike," she said.

"Hi, Shelly. I assume Doctor Gibbs called you and you came back?"

"Yes. Doctor Saunders, would you excuse us, please?"

"I'll move to the table with the other Residents," Clarissa offered.

She got up and Shelly sat down.

"Doctor Gibbs is worried about you," she said. "She's afraid you might quit."

"Then she doesn't really know me," I replied. "Nobody who knows me would think I would quit."

"As pedantic as you are, that might well mean you won't quit, but you might well orchestrate a situation where you were dismissed."

"Then you don't know me, either," I replied. "Or did Doctor Gibbs put that thought in your head?"

"She suggested it."

"What else did she say?" I inquired.

"That you were extremely upset with how Doctor Northrup handled things."

"Again, she's missing the point, or purposefully avoiding it. I'm completely neutral on how Krista Sandberg's complaint about her training is addressed, so long as it's actually addressed. On the other hand, I am not neutral about the fact that she's been accused of sleeping with a doctor to get a grade, and literally nothing is being done about it."

"_Did_ she sleep with a doctor to get a grade?"

"Both she and the doctor deny it; her to me, the doctor to Doctor Mertens. I was, in effect, told to shut up about it, and to not question any policies or procedures, and threatened with a negative evaluation if I don't toe the line exactly as Doctor Northrup demands."

"Doctor Roth is the one who'll sign your review."

"But not in a vacuum. And Doctor Northrup made Doctor Gibbs his…snitch."

"Why did you pause?"

"I was going to use a Russian word."

"You've decided she's the enemy?"

"Before I answer, will you, off the record, tell me if you think it's OK for doctors to sleep with medical students?"

"Is that your litmus test for friends now?"

"Before I respond to that question in response to my question, would you answer my question?"

"You know my answer," Doctor Lindsay said. "I think it's wrong, period, and I'm not afraid to say so."

"That isn't the litmus test," I replied. "Well, it is for allies, but for friends and mentors, the litmus test is not changing your position, or not speaking up when asked. Doctor Gibbs refused to speak up, despite having made unequivocal statements to me in the past. I'm positive she was told by Doctor Northrup not to agree with me, and she wouldn't, even off the record. Things might have been different had she, as Chief Attending, simply stated her opinion privately to Doctor Northrup."

"Ross and Cutter agree with you on that, and on the point about sex in on-call rooms."

"That, fortunately, is up to the medical school, not doctors. They can, as I suggested to Nora Mertens, make it a student ethics violation."

"They certainly could, and I hope they do."

"But that's a minor problem compared to sex between doctors and students, which I believe is behind the blackballing of Kista Sandberg."

"A bad breakup?" Shelly suggested.

"Or a refusal. I'm convinced Doctor Northrup knows more and is refusing to deal with it because of the Old Boys' Network that is Moore Memorial. You are the most senior female Resident, and Doctor Gibbs is the only female Chief Attending, there are no female Chief Residents, and no female Department heads. I daresay if there were more women in those positions, this topic would not be given short shrift."

"You don't think female doctors sleep with male medical students?"

"I'm sure they do, but I'm not aware of it happening, and don't care to know. All I know is of the female doctors I've worked for, not one has hit on me, either to try for an enticement to cheat, or when I was single. I can't say the same for nurses."

Shelly laughed, "Ellie still hasn't given up?"

"Ellie will _never_ give up!" I chuckled. "But she also keeps it subtle and doesn't do anything that would give me cause to complain. I know it's available, I'm just not interested."

"You don't have to answer this, but after your wife passed, were you involved with any nurses or medical students?"

"A brief relationship with a nursing student, and two with medical students, both relatively brief, and both Fourth Years, so there was no teaching or supervisory relationship. I did my utmost to keep nurses who were on the same service at bay. I know you're single…"

"Now that I'm PGY5, I finally have enough time and a regular enough schedule to have a relationship. Doctors are out, for a host of reasons, and medical students are a non-starter."

"Out of curiosity…" I asked with a smirk and a raised eyebrow.

"You're high if you think I'll answer THAT question!" she declared mirthfully. "Even though I know you're just giving me a hard time. Or maybe wanted to!"

I chuckled, "Touché. The thought never crossed my mind because of my feelings on the matter, and I suspect that's true for you, too."

"Yes, it is," Doctor Lindsay confirmed.

"While not on the exact same topic, I suspect you and I agree on the improper treatment of women who choose the 'mommy track'. I bring that up because it's a function of the same male-centered Old Boys Network that defends and protects doctors who sleep with medical students."

"What do you intend to do?"

"Practice medicine to the best of my ability in the best interest of my patients. On the other matter, I'm going to keep my own counsel, but I won't sit idly by."

"Will you promise me one thing?" Shelly asked.

"What's that?"

"That before you do _anything_ you'll speak to me? Please?"

"Before I do anything overt, I will."

"Implying you're going to do something covert."

"No, simply saying I won't act without speaking to you."

"What are you going to do about Doctor Gibbs?" Shelly inquired.

"Follow her directions on clinical matters. On anything else, I have no time for turncoats or cowards. It would be one thing if she was a Resident, but she's Chief Attending. Someone in that role has the duty to train and support their Residents, not agree to act as a stool pigeon on a topic on which she agreed with me before she was called into Doctor Northup's office. I certainly won't share any personal thoughts with her, because they might well be used against me."

"I think you might be overreacting."

"I don't think so," I replied, shaking my head. "Doctor Northrup was clear that I'm to shut up, toe the line, and follow orders, and Doctor Gibbs has to report me if I don't toe the line."

"Let me speak to Vince Taylor and Doctor Roth, please," Doctor Lindsay requested. "At least give me a day."

"OK," I agreed.

"Thanks."

We got up and left the cafeteria, but Clarissa came after me.

"Petrovich, wait up!" she called out.

I stopped to wait for Clarissa while Shelly continued towards the hospital lobby.

"Did she talk you off the ledge?" Clarissa asked.

"I wasn't on the ledge. I am suitably outraged, but I'm going to do my job. As for being quiet, well, Doctor Northrup does not have the last word."

"You're going to start an inter-service war?"

"I believe Doctor Northrup slapped me on the face with his glove, initiating the war."

"I'm not sure he'd see it that way."

"And yet, he's the one who threw down the gauntlet."

"Turn the other cheek?"

"I could go all Tolstoy and say that the only legitimate authority is God, not any human institution, but in order to practice medicine, I have to yield to the State Medical Board and the hospital administration."

"And you'll keep your promise not to do anything rash?"

"To you and to Shelly."

"OK."

I returned to the ED, completed my shift uneventfully, then headed home to say evening prayers with my wife and daughter, and work on a sibling for Rachel.

_September 12, 1989, McKinley, Ohio_

I wasn't surprised when Krista asked to speak to me first thing on Tuesday morning. I'd had the night to sleep on what I might do and had decided on a course of action. Whether it was the right way was unclear, but it was also something I could do without involving anyone except Krista. She followed me to the consultation room, which was empty.

"I wanted to thank you for going to bat for me," Krista said. "The solution isn't perfect, but given the alternatives, I'll take it."

"You're welcome," I replied. "I do have several things I want to say, and I hope you'll listen."

"It would be foolish not to!"

"Which does not mean you'll listen," I countered.

"I will."

"And, before I begin, everything we say here has to be completely confidential and cannot be shared with anyone. I mean that. If you reveal anything that is said here, you'll be done, because you'll have literally nobody who will care about you being given a chance to succeed."

"OK," Krista replied tentatively.

"Promise me, please."

"I promise."

"Good. First, on your upcoming rotation in Internal Medicine, if you have questions, need help, or need to learn something, ask Doctor Saunders, if at all possible. She and I are very close, and she won't steer you wrong. And she won't rat you out to anyone. That said, she will talk to me about pretty much everything."

"OK. Everyone knows you two are close."

"Second, and this is only advice — stay out of relationships with anyone in the hospital."

"I have no real life outside the hospital!"

"A common lament," I replied. "But the trouble you're experiencing is, in my opinion, because someone is blackballing you."

"Seriously?"

"Seriously. I'm going to ask two questions, both of which you can refuse to answer. First, which doctors did you sleep with; second, which doctor did you _refuse_ to sleep with?"

"I think I should be offended by those questions!"

"They are offensive, but necessary. I ask because it might provide a clue as to who is blackballing you. Obviously, you can refuse to answer both questions, but the answer to the second might be instructive."

"Rosenbaum in Pedes; the one I rejected."

Suddenly, things fell into place. Given how Rosenbaum had treated me simply for daring to wear my cassock at the hospital, I could see him blackballing Krista for refusing his advances. What I really needed to do was ask Doctor Mastriano about him, but I wasn't sure I could do that. It was something I'd have to think about, and something to discuss with Shelly Lindsay.

"I have a history with him," I said. "And that history makes me very suspicious. When did that happen?"

"During my Pedes rotation, which was in December and January. What happened with you?"

"He didn't come on to me," I replied with a smirk.

Krista laughed, which was what I had hoped would happen.

"The timing works," I continued. "Did you have bad breakups with either of the other two doctors?"

"No. Both were fairly short-lived, and they were just what you'd call flings with doctors who are single. Should I say something about Rosenbaum?"

Her comment about the doctors being single might well have been her rationale for turning down Rosenbaum, who was married, but I didn't feel it necessary to ask about it.

"No, you shouldn't. Right now, it could only go badly for both of us. This is a shitstorm, and I had my ass handed to me by Doctor Northrup."

"I didn't mean to get you into trouble."

"You didn't, at least not directly. I got me into trouble by rejecting the idea that it's OK for doctors to sleep with medical students. I'm not really tuned into the rumor mill or gossip circuit, but is there a doctor who you think is abusing his position with regard to female medical students?"

"I've heard some rumors and complaints," she said. "But I don't know anything more than the gossip."

"OK. I don't want you to repeat any gossip, nor engage in spreading rumors, so let's leave it there."

"What are you going to do?"

"For now? I'll do my job, and you should focus on your training. At some point, I'll take action, but I can't do that at the moment. I have to pocket the win with regard to your training, because if I did anything now, I'd put both our positions at risk."

"Thank you for believing in me."

"You're welcome. You've been given your chance; make good use of it. If you don't, you'll never be a physician."

We left the consultation room, and I began my day. When Doctor Gibbs arrived about an hour later, she called me into her office.

"Is there some clinical matter that we need to discuss, Doctor?" I asked.

"Not even a 'good morning'?" she inquired.

"Good morning," I said flatly.

"Mike," she sighed. "Can we just talk?"

"No. I have nothing to discuss because I cannot freely speak my mind without the risk of you running upstairs and snitching to Doctor Northrup if I deviate from the Party line on anything. I'm happy to discuss clinical matters, but that's all."

"You're blowing this completely out of proportion."

"No, I don't think so. We are where we are because you betrayed me, plain and simple. You've said you agree with me, but refused to back me with Doctor Northrup. One of two things must be true — you lied to me, or you threw me under the bus."

Doctor Gibbs frowned, "I had hoped you would have calmed down."

"As I said yesterday, I'm the very picture of serenity. I'm calm, cool, and collected. My statements were carefully considered after practicing appropriate spiritual discipline so as not to be intemperate. I said exactly four words to Doctor Northrup, holding my tongue. I then went to discuss the situation with Clarissa Saunders in a calm fashion. I had a calm, reasoned conversation with Shelly Lindsay. I have no desire to continue this conversation because that will make it difficult to remain calm and peaceful and do my job."

"Can we fix this?"

"I can't because I was told in no uncertain terms I'd put my Residency at risk."

"That is not what Doctor Northrup said. If I understand correctly, he said to monitor for you being disruptive."

"Which he considers to be _anything_ that goes against his views. And I'm allowing you to drag me into a conversation that can never be profitable. May I go treat patients, please, Doctor?"

"Mike…"

"May I be dismissed?"

"Go," Doctor Gibbs replied flatly.

I left the office, went to find Jake and Heather, and began seeing walk-ins. Just after 9:00am, Nate let me know I had a phone call. The consultation room was occupied, but Exam 6 was empty, so I went there to have some privacy for the call.

"Doctor Loucks," I said.

"Mike, It's Nora Mertens. Do you have time to get together outside the hospital?"

"It's tricky with my schedule, except Wednesdays. What about lunch tomorrow? I work at the Free Clinic, and there's a deli two doors down, next to the bakery. My lunch break is at noon."

"I'll meet you there at noon on Wednesday."

We ended the call, and I went back to work.