Chapter 4 — Loretta, Shelly, and Angie

_February 28, 1990, McKinley, Ohio_

{psc} "Hi, Petrovich!" Clarissa exclaimed when she walked into the surgical lounge on Wednesday afternoon.

"Hey, Lissa! What's up?"

"I'm on a late lunch break, so I decided to slum!"

"The slums are up one floor, at the north end of the building."

That was where Psych had their ward.

Clarissa laughed, "No surprise you'd think that! Where are your toddlers?"

"Doing toddler stuff! Prepping for afternoon rounds."

"How did your call with Doctor Mercer go?"

"She admitted she made errors with regard to me and one other patient."

"Angie?"

"No, besides Angie. Dona's, Anna's, and Pia's ex."

Clarissa laughed, "The kid from Milford was seeing her?"

"Apparently, but keep that to yourself."

"Of course. What was the gist of the conversation?"

"That her approach to psychology is wrong, and she'll make mistakes with anyone who is spiritual because she's put that part of the person completely off limits, and she's not treating them holistically. In the end, it's the same argument I make about medical care in the hospital — specialization is necessary, but it's the enemy of holistic treatment."

"I think you're going to beat that dead horse for the rest of your career."

"The horse isn't dead," I said. "And I don't think I'm tilting at windmills, either. I think we can bring about change, but it'll be slow. Believe it or not, I can be patient."

"That'll be the day!"

"I did say 'can'," I retorted.

"Yeah, yeah," Clarissa said, rolling her eyes.

"How are you liking the ED?" I asked.

"It's not what I signed up to do," Clarissa replied, "but I don't think Doctor Gibbs or Doctor Lindsay signed up to be shot."

"Life does not deal us the cards we want; we have to play the hand we're dealt."

"True. I hear Doctor Gibbs is going to rehab in Columbus on Friday."

"She is," I confirmed. "I wanted to take her, but Doctor Roth nixed that because we're already short a surgeon."

"Another helicopter ride?"

"Actually, if it were, then I'd go because the ED can't spare a flight surgeon for a non-critical case. But she's going by private ambulance service."

"I stopped in to see her yesterday; what's your take?"

"Having feeling in her legs is a very good sign. Nerve function below the injury is a strong indicator of at least partial recovery. It's likely she'll be able to walk, but she might need some kind of assistive device. Shelly is being released on Friday, and as soon as Psych clears her, she'll be back. She wanted me to do her physical."

"Who knew?" Clarissa smirked.

"Lissa…"

"Sorry. Why?"

"Because she believes I'll give her the benefit of the doubt, and that's precisely why it won't be me."

"True. I'm not saying you'd fib, but for anything that was a judgment call, you'd see it her way. Did you hear the rumor they hired a Chief of Emergency Medicine?"

"Yes, and allegedly from a suburban Chicago hospital. But until they announce it, who knows? It should have been Loretta, but she's out of commission for several months, most likely."

"That sucks," Clarissa observed. "On the plus side, you know who your Chief is, and the Medical Director is the one who approved the trauma surgery program when he was Chief Surgeon."

"That's why my only concern about who filled the slot was about Loretta. Sadly, I don't think they were willing to put a woman in charge of a major department."

"Or a minor one, except the Nursing Director!" Clarissa declared. "The OB chief is a guy, for Pete's sake!"

"At least Norm Zenker isn't a complete Neanderthal like the dinosaur who ran OB at Good Samaritan. And I bet when Zenker retires in a few years, one of the women Attendings is hired. If leadership, except nursing, remains all male, that'll attract EEOC attention."

"As it should!"

"So long as we don't reduce standards, I have no problems. You know my mentors have mostly been female."

"Anicka, Milena, Loretta, Shelly, me…" Clarissa said.

"Among others," I replied. "In any event, I'd say Shelly is on track for Chief Surgeon."

"Can you imagine the heads that will explode if that happens?"

"Mo Rafiq is gone," I said. "I don't think any of the rest would have their gonads shrivel reporting to Shelly, especially after she literally took one for the team!"

"I know you have ice water in your veins, Petrovich, but I can't believe how calm you are about it."

"I was born to be a trauma surgeon. I'm just glad it's not in 'Hawkeye Pierce' conditions."

"True. I need to get back."

We hugged and she left. A minute later, my students returned from prepping for afternoon rounds. The afternoon was largely uneventful, and at the end of rounds, Doctor Roth asked me to come to his office.

"How are you doing being out of the ED?"

"You know that's my natural habitat, but I knew this was part of the training. I miss it, but I need the skills you and the other surgeons will teach me over the next five years."

"I actually wanted to discuss with you how we'll go about training Mary Anderson."

"The biggest challenge is how she learns the procedures if she's stationed in the ED and handling consults."

"That's exactly what we identified. Bob Anniston suggested that for the first three months, you and Mary should be assigned the same shift so you can teach her procedures for central lines, chest tubes, pericardiocenteses, tracheostomies, and escharotomies. At that point, you'd switch to the alternating rotations."

"I think that makes sense; my concern is my surgical training."

"According to Bob, you were perfect on your first surgery."

"Because literally nothing went wrong!"

Doctor Roth nodded, "The length of the program is, at least in part, intended to ensure you see as many things go wrong as possible so you're able to deal with them when you're the senior surgeon in the OR. You're way ahead of the game, Mike. The next three months will, in effect, make up for the three you'll spend in the ED. Same shift as you have now, and one of the new Residents will cover nights. That is unless you have some objection."

"I think it makes sense, given only a surgeon can teach Mary the procedures."

"Thanks for being flexible."

"You're welcome. Have you heard anything about the new Chief of Emergency Medicine?"

"Probably just the same rumors you have. Cutter hasn't said anything to me, but I'd expect an announcement in the next week."

"It should be Loretta," I said. "Northrup did it as a desk job, and given the new ED, that's what it will be for the next year."

"She'll be undergoing intensive rehab for at least two months, and there is no guarantee she'll walk again. She won't be reinstated until she finishes rehab, assuming she's able to practice emergency medicine at that point. We can't do the rehab here, and even after all the upgrades over the next five years, there are no plans for a rehab clinic here."

"All logical, but it still feels wrong."

"I'd worry if you didn't think that. Your heart's in the right place, Mike. In the end, though, we have a hospital to run, and there are major changes coming down the pike."

"How long will Shelly be out?" I asked.

"She's able to come back April 1st, assuming she passes her physical and psych eval, which I expect she will."

Six weeks following severe trauma and major surgery wasn't out of line, given the strenuous nature of surgery and the need to stand for long periods of time.

"I hear you received some pushback from Psych about allowing an outside psychologist to clear me," I said.

"Cutter didn't trust Psych to give you a fair shake, given the animosity between you and them. Lawson would have used your 'cool as a cucumber' nature against you, insisting you were lying to them. Cutter, Getty, Strong, Ghost, Nielson, and I all know you to be unflappable. Shelly told me how you handled what happened with your wife.

"I've only ever known one other person who was as cool a customer as you, and that was an Attending in the ED at USC Medical Center during my Sub-I. He was a combat trauma surgeon in Vietnam. Word has it, the ramshackle building where he was performing surgery was hit by mortar shells — he didn't even blink and continued operating."

"Nurse Kellie Martin," I said. "When we lost an engine on the helicopter returning from OSU, I think her heart rate _dropped_ while mine went through the roof."

"I'd have had what the nurses call 'code brown' at that point!" Doctor Roth declared. "So you did better than I would have!"

"When Kellie asked me how I was doing after the emergency landing, I said I'd managed not to soil my underwear, so I saw that as a plus. OK to change subjects?"

"Yes."

"Pascha, that is, Orthodox Easter, is the week following Western Easter. I'd like to take Great and Holy Friday as a day off so I can attend services."

"Comparable to Good Friday in the Catholic Church?"

"Yes, though we don't abbreviate the services, and they basically run all day."

"As a seriously lapsed Catholic who only goes occasionally to keep my wife happy, I am glad for the abbreviated services! I spoke to Ghost about the Orthodox services. No wonder you can stand for hours and not even notice! Anyway, you're entitled to religious accommodation, and Shelly should be back then. Are you going to play golf with us this year?"

"During the weeks I'm on a surgical team, yes. The other weeks, I obviously have to cover the ED."

"Good. Anything else?"

"No. Do you have anything else for me?"

"No. Just keep doing outstanding work."

"I will."

We shook hands, and I returned to the lounge. I had two consults, neither of which required emergency surgery, and at 5:00pm, I headed home.

_March 1, 1990, McKinley, Ohio_

On Thursday morning, after rounds and overseeing my students prep patients, I went to see Cathy and Shelly.

"How are you feeling?" I asked Cathy.

"Like one of those girls in slasher movies! You know, where the masked guy with a knife comes after the cute girl, usually either while she's having sex or just after?"

I chuckled, "I'll let Doctor Edmonds know you think he's Freddy or Jason!"

"Hey, it's true, right? A masked man with a knife did this to me!"

"Technically. Context is key!"

I checked her chart, then the Foley bag.

"Urine output looks good," I said.

"If I never see a dialysis machine again, it'll be too soon! My nephrologist said that transplanted healthy kidneys don't develop cysts. And the warden said I'll be able to go home on Monday!"

"I've been inside a prison; trust me, this is NOT anything like that!"

"As a doctor, right?"

"Primarily as a lay chaplain. Sorry, I can't hang out longer. I'll stop in and see you tomorrow."

"Anytime you want."

I smiled and stepped over to Shelly's bed.

"Roth said they decided to kick you out today," I observed. "Something about being a pain in the ass to the staff?"

Shelly laughed, "The stupid TV remote broke, and it took almost twenty-four hours for maintenance to bring a new one. I mean, seriously? What's up with that?"

"It ain't the Hilton, that's for sure! Let me guess, you pressed the call button every time you needed the channel changed?"

"Or the volume changed, or it had to be turned on or off!"

"They should have stuck one of the candy stripers in here with you."

"They're having trouble recruiting since Hayes County High dropped the community service requirement for graduation."

"A foolish change. Yes, I know they're focusing more on academics, but dropping some vocational courses and things like community service requirements was a really bad decision. While I don't object to standardized tests, tying funding to test scores, as some have suggested, is likely to lead to further disparagement of graduating well-rounded citizens."

"You know the argument — higher education is the path to upward economic mobility."

"Pardon me while I laugh at the fact that a friend of mine became an apprentice electrician three years ago, was paid during his apprenticeship, and now, as a journeyman, makes more than I do and will for at least the next four years. Not to mention overtime, collective bargaining, and a job he can go home from each day without any concerns! And compare that to my friends who are teachers who make less than he does, and probably will forever. The disparagement of trades and of manual labor is a terrible opinion and a worse policy."

"Athletes and rock or pop stars are overpaid; teachers and doctors are underpaid," Shelly observed.

"I understand your point, but if Major League Baseball generates billions in revenues, the players should share in that. The problem is not the athletes or musicians, but that the public is willing to fund those sports at those levels. Of course, because so much of it is advertising revenue, the costs are spread out in a way that people don't notice, unlike their property tax bill or income tax return!"

"Raise their taxes!" Shelly declared.

"The problem is, as Willy Sutton remarked about banks, the middle class is where the money is. That said, we shouldn't subsidize sports stadiums for billionaire NFL owners!"

"Amen to that!"

"Changing back to a more important subject, when is your psych eval?"

"Tuesday. Once they clear me, then it's a physical, and I can come back as of April 1st."

"That's what Owen projected your return date to be. Any chance it could be sooner?"

"Hospital policy is six weeks after major surgery. Something about liability insurance."

"Every single day I hate insurance companies more and more. Ditto with Medicare and Medicaid refusing to pay for tests and treatment that doctors think is appropriate."

"You're preaching to the choir! How is Loretta?"

"Unhappy, but she has a bit more feeling in her legs. Yesterday, she had a positive Babinski rather than an indifferent one. I'm no expert, obviously, but she's showing improvement each day. You should stop in and see her once they kick you."

"That's my plan," Shelly confirmed. "You up for lunch once a week in March?"

"Of course."

"Cool. How about Thursdays?"

"Works for me," I agreed.

I squeezed her hand in lieu of a hug, then headed back to the surgical ward.

_March 2, 1990, McKinley, Ohio_

"If you're OK with it, Kris, Rachel, and I will come visit you after Liturgy on Sundays," I said to Loretta on Friday morning.

"I'd like that."

"How are you feeling today?"

Loretta smirked, "OK to be gross?"

"I'm a doctor! How gross could it be?"

"Guess where I itch?" she smirked.

I laughed then said, "Sorry, I shouldn't laugh, but if you have feeling _there_, that's a VERY good sign."

"TELL me about it! Lift the sheet and uncover my feet."

I laughed hard, "OK to be a smart ass?"

"What did I just walk into?"

"In the Bible, Naomi tells Ruth to uncover Boaz's feet, then lie down next to him and do what he tells her. Seems innocent enough until you understand that urine was referred to 'the water of one's feet'. She was, euphemistically saying, 'expose his genitals and have sex with him'."

"That was NOT an invitation to sex, you goofball!"

"I know that! I said I was going to be a smart ass!"

"Just uncover my feet!"

I did as she asked and saw her wiggle her left big toe.

"Wow!" I exclaimed. "That's huge! You're going to walk, Lor!"

"You do know what rehab is like, right?"

"I've heard the horror stories, but seriously, if it's that or a wheelchair…"

"Oh, I agree; I just don't want to be tortured for months on end!"

"How long at the facility?" I asked.

"At least a month, then it's week to week. Shelly stopped in to see me yesterday after they kicked her."

"She was as annoyed as every other patient who is required to leave by wheelchair. They got her to the door, she stood up, turned, and came back into the hospital and walked up to see you."

"She told me, and you know it's about liability."

"Insurance companies are the bane of our existence, though I'm not sure the government running things is any better after seeing Medicare and Medicaid! Sorry for the rant!"

"Right there with you! Changing topics, Bobby asked me to remind you that you're expected at the firehouse for dinner at some point. He doesn't see you now that you're in the surgical ward."

"As soon as we have our trauma surgery PGY1, I'll be in the ED for three months to train her on procedures, then alternate weeks. That's the new thinking on the training. But as with everything having to do with my program, always subject to change. I'll give Bobby a call."

"Did you hear they charged the girl's father with murder?" Doctor Gibbs asked.

"Yes. And that seems right to me, given he started the confrontation and brandished his pistol. Charging her lover with murder for killing her seems right, too, given she was effectively an innocent bystander. Her brother was charged with attempted murder for firing on her lover, though he missed all eight shots."

"It had to be the guy with Special Forces training who was at the hospital," Doctor Gibbs said ruefully. "But at least he won't be a burden on the taxpayers."

"I detest violence, but in this case, I'm grateful that Kleist and Turner were both crack shots and ended things before it got worse. Did you hear that the County Board voted a full scholarship for Deputy Sommers' son to go to any State school?"

"Small consolation for losing your mom at age five."

"Agreed. Rachel didn't have to suffer through the loss of her mom, which made it easier for her. Well, besides having to put up with a clueless dad."

Doctor Gibbs laughed, "I have news for you – she's going to think you're clueless for about six years starting in about nine years!"

"I think I can wait!" I chuckled. "I need to get back. Call so I can come see you on Sunday."

"I will. And thanks, Mike, for everything."

I smiled, kissed her forehead, and left the CCU to head back to the surgical ward. When I had my next break, I went to say 'goodbye' to Cathy who was being released. She flirted lightly, as was her usual practice, and I played along, though always careful to make it clear I was teasing. When I left her room, I returned to the surgical ward.

_March 3, 1990, McKinley, Ohio_

"Why?" Rachel protested when I tried to put on her earmuffs in the music room at Taft on Saturday morning.

"Because the band is loud when we practice! If you want to listen, you have to wear your earmuffs. Or you can sit in the hallway."

"NO!" Rachel protested.

"Having fun, Mike?" Kari asked with a smirk.

"Petulance and toddlers go hand-in-hand," I chuckled. "Rachel, you need to wear your earmuffs or sit in the hall.

"NO!"

"Yes," I said firmly. "I told you that before we left home when you asked to come with me."

"DON'T WANT TO!"

I picked her up, grabbed a small chair, and walked into the corridor, setting the chair so Rachel could see the band, and I could see her, and put her in the chair. She immediately scrambled out of it, and I grabbed her and put her back. It was the ultimate test of wills, and I couldn't let my daughter win, or she'd think she could defy me simply by being, well, defiant. It took three rounds before she glared at me and crossed her arms but didn't move from the chair.

"You are SO dead," Sierra said with a smile. "Want me to watch her?"

"I'd appreciate it. She can only come into the music room if she puts on her earmuffs. She refuses to wear them."

"She's being a toddler!"

"Yep! Rachel, you stay with Sierra, please."

She glared at me but didn't refuse, so I went back into the music room, picked up my guitar, and looked to Kim.

"Let's start with _I Melt For You_," she suggested.

Two hours later, we completed our practice.

"Every Saturday now, right?" Kim asked.

"With the exception of your Easter weekend and the following one."

"OK. That gives us nine more practices, I believe. I think that should be enough for the Proms. You could do an evening or two if necessary, right?"

"Yes. Wednesdays are out, but other nights are OK. Also, remember Kris is due around the third week in June."

"Even if she's late, that shouldn't interfere with the Fourth of July."

"It won't. If she hasn't delivered by the last day of June, they'll perform a C-section."

"Where is Kris?"

"She's putting the finishing touches on a paper that's due on Monday. She'll be here next week."

I grabbed my things, then bundled an unhappy Rachel in her spring coat, and she, Kari, and I left the building together.

"How are you doing?" I asked.

"Good," Kari replied. "I started dating an attorney in the Public Defender's office. He graduated law school last year."

"I'm glad to hear that. You should have him come to band practice so we can meet him."

"Yes, Dad!" Kari said with a soft laugh. "He was busy preparing a brief this weekend and needed the time. He's helping defend one of the shooters from the domestic violence incident that ended at the hospital. Are you going to have to testify?"

"I don't think so," I replied. "I didn't actually see anything."

"José said you were in the room where the deputy was killed."

"I was, but from where I was, I could only see her, not out into the corridor. All they could ask would be medical questions, and Doctor McKnight could answer those. My chart notes would suffice for any treatment, but honestly, Deputy Sommers was dead before she hit the floor with a round through her temple. And even so, none of that would matter for the others who were charged because all that happened on their adjacent properties, not at the hospital."

"Sorry, I changed from asking about testimony to being concerned about you but didn't indicate the context switch!"

I laughed, "Why does that sound like a computer term?"

"Because it is! You're doing OK, right?"

"Yes. I met with a psychologist who cleared me to return to work right away. I only missed one full day."

We reached our cars, and once I had Rachel buckled into her car seat, Kari and I exchanged a quick, chaste hug. She and I got into our respective cars, and Rachel and I headed to McKinley Music and Movies.

"Morning, Mike!" Johnny called out when we walked in.

"Morning! Anything new and interesting?"

"_Highwayman 2_ and _Vigil in a Wilderness of Mirrors_ by Fish."

"I'm not a huge fan of country, but it's hard to pass up an album by Johnny Cash, Waylon Jennings, Willie Nelson, and Kris Kristofferson! I actually don't have the first one, so if you'll get me both of those and the Fish album, I'm good."

"CDs, right?"

"Yes."

"Were you at the hospital when that stuff went down last week?" he asked as he retrieved the three discs for me.

"Yes, but thankfully, Deputy Turner and Detective Kleist ended it before I was in any real danger."

"And how is the little one?"

"Rachel, tell Johnny how you are, please."

"Not happy!" she declared.

"We had a bit of a standoff," I said to Johnny. "I wanted her to wear ear protection while the band practiced, and she exercised her right as a toddler to object."

Johnny laughed, "I have two boys, seven and four, so you don't have to tell me!"

He rang up the purchase, and I paid him.

"See you in a few weeks," I said. "Rachel, say 'bye', please."

"NO!"

"Be polite, young lady," I instructed.

"NO!"

"Good luck," Johnny said with a grin.

"Thanks. I think I'm going to need it!"

_March 3, 1990, Cincinnati, Ohio_

"May I hold Rachel?" Angie asked when Kris, Rachel, and I arrived at the Stephens' house on Saturday evening.

"You can try," I said. "She's in a mood."

"Rachel, come to Angie?" she asked.

Rachel smiled, walked over, and reached her arms up to be picked up. Angie picked up Rachel and I thought I saw a smirk on Rachel's face.

"She's such an angel," Angie observed. "What mood?"

"She's had an attitude all day today," I chuckled. "And she's showing it by being nice to you when she was unhappy with me all day! I don't get it because she usually likes 'papa time'."

"She's two, right?" Mrs. Stephens asked.

"Yes. She'll be three at the end of August."

"It's the age where they discover a level of independence, and they let you know about it! Do you have a moment to speak privately?"

"Kris?" I asked my wife, indicating I wanted her permission.

"Yes, of course," Kris replied. "I'll stay with Angie and Rachel."

Mrs. Stephens and I stepped into the kitchen.

"Angie asked about seeing Doctor Mercer again. I'm not sure that's a good idea."

"Me, either. Did Angie give a reason?"

"She doesn't like the behavioral counselor she's been seeing, and the psychiatrist suggested we find one Angie likes and can relate to. She always liked Doctor Mercer and Doctor Mercer helped at the hearing."

"Have you spoken to Doctor Mercer?"

"No. I wanted your opinion first."

"Does Angie know that?"

"No. I said I wanted to confer with the attorney Laura Bragg hired to help us. What do you think?"

"I think I'd like to speak to Doctor Mercer. I spoke to her on Wednesday, and I need to ask her a very specific question."

"Would you mind sharing?"

"Just to confirm something we discussed — holistic treatment."

"I'm sorry, I don't know that term."

"It means, to put it simply, treating body, mind, and soul. Medicine gives the soul short shrift, even in hospitals run by religious organizations. In my mind, true healing only occurs when all aspects of a patient's being are taken into account."

"Wasn't that happening with Father Stephen?"

"The problem was, as I see it, that he and Doctor Mercer didn't discuss Angie's spiritual health. He, in obedience to Bishop JOHN, reported relevant details to Doctor Mercer, but they didn't discuss Angie in a way that I believe would have helped. For Angie, as for me, receiving the Eucharist is a necessary part of healing our bodies, minds, and souls."

"So what is it you need to ask?"

"If Doctor Mercer will treat Angie in the way I think will be most beneficial. If not, then we need to find another counselor. I think she will. She actually asked about Angie when we spoke on Wednesday, and I promised to let her know how Angie was doing. On that, Angie seems a bit more alert."

"She has good days and bad days. Doctor Hoffman has reduced the dosages to the minimum that keeps Angie on an even keel about ninety percent of the time. She's working again, but only half days. More than that, and she becomes erratic. Aikido helps, as does going to church."

"Any medical problems?"

"No. She had a complete set of lab tests, and her liver and kidney function is good, something that her doctor said they have to watch closely."

I nodded, "Long-term use of any drug can impair liver and kidney function. How's her diet?"

"Good. No processed foods, limited sugar, limited salt, and limited complex carbohydrates. Fruit, vegetables, chicken, fish, and shellfish, along with nuts as snacks."

"Not all that different from my diet," I replied. "Though I eat too many French fries."

"I think we ALL do!" Mrs. Stephens said with a smile.

"And her sleeping habits?"

"The mild sedative she takes keeps her calm and helps her sleep."

"Is Angie's friend Anna still in Chicago?"

"Yes. She's still working For Allstate at their headquarters in the Chicago suburbs. She married Gerryd, has a son who is eighteen months, and is about three months pregnant. Unfortunately, she hasn't come to visit in over a year. Angie spends quite a bit of time with the women from church, both her age and the older ladies."

"Good. I'll call Doctor Mercer on Monday and then call you."

"I know it might be asking a lot, but could you see Angie more often? She was so happy today."

"My schedule has changed and would probably allow that. Let me speak to Kris, but I think we can do that."

"Good."

"Code Blue is playing at the Goshen Prom on May 11th."

"Linda Kane let me know. Angie is looking forward to it."

"Great! Shall we go rescue Angie from my daughter?"

"That adorable little angel?" Mrs. Stephens asked mirthfully.

"That's how they trap you!" I chuckled. "Then they turn into toddlers! And later, into teenagers!"

We both laughed, then returned to the living room where Angie, Kris, Rachel, and Mr. Stephens were sitting.

_March 3, 1990, McKinley, Ohio_

After dinner at Angie's house, Kris, Rachel, and I drove home, where I read to Rachel, and we said our evening prayers. Once Rachel was in bed, Kris and I relaxed in the great room with tea.

"Is it OK to ask what you and Mrs. Stephens spoke about?" Kris inquired.

"Of course! Even without our 'no secrets' rule, I'd tell you. Angie asked about seeing Fran Mercer and Mrs. Stephens asked for my thoughts on that."

"Please don't take this the wrong way, but is Angie aware that Doctor Mercer agreed with the treatment by the psychiatrist who had his license suspended?"

"No, I don't believe so, as there was no need to tell Angie. Part of it is that I'm not sure Angie could comprehend the nuances of being required to report what Angie had told Father Stephen and where responsibility for the choice of treatment actually lay.

"Remember, too, that Fran's reaction was as much about me as it was about Angie. She felt I was ignoring the standard of care because I was too close to the matter, which is the exact reason ethical physicians do not treat loved ones or family members, except _in extremis_. It's far too easy for judgment to be clouded, even if you recognize the possibility."

"We didn't discuss it, but how do you reconcile that with the situation with Elizaveta's grandfather?"

"The problem nearly always lies in the opposite direction — making an extraordinary effort or taking significant risks to achieve an unlikely outcome. In this case, it was obvious that Nikolay Vladimirovich was not going to survive, or if he did, he would be on a ventilator in a hospital bed until he had another significant coronary event. His request for me to call Father Nicholas was made because he knew he was dying.

"Once his heart stopped, I felt resuscitation efforts would be futile. I had spoken with him quite a bit over the time Elizaveta and I were courting or married and knew the last thing he wanted was 'heroic measures', as they're called. I considered that knowledge to be the equivalent of a living will, and Viktor and Doctor Gibbs concurred with that decision."

"That's your fear as well."

I nodded, "That's why we had Stefan draw up the living wills."

"What did you say to Mrs. Stephens about Doctor Mercer?"

"That I'd speak to Fran on Monday. I actually have an idea that I think will help, assuming Fran is willing."

"What's that?"

"In cases where cross-discipline expertise is needed, the hospital will convene a working group of physicians, nurses, and other professionals who meet regularly to discuss the patient's care. That's especially true for difficult or complicated cases, or cases where there is no known cure."

"Like with schizophrenia, right?"

"Yes. I think the best approach would be to have Father Stephen, Fran, Angie's GP, her gynecologist, and her Aikido instructor meet regularly, perhaps by conference call, to discuss her treatment. We know that Angie does better when she attends church and practices martial arts and that her diet directly affects her moods and her emotional stability. All of those people have to work together to get it right."

"You didn't mention her psychiatrist."

"Sorry, yes, obviously Doctor Hoffman would be involved and would probably be the one to lead the group. But I think it has to start with Fran because everything I've read says that behavioral psychology shows better results than any other possible treatment. Remember, I have but one goal here."

"To keep Angie from being sent to an inpatient facility."

"Exactly. She's living a productive life that is fulfilling, at least so far as it can be. That should be our goal for any patient we treat. That said, there is no possible way Angie can ever achieve the things she wanted most in life — a husband and children. Greenberg threw all of that out the window when he committed malpractice."

"May I ask how much money was provided?"

"Stefan negotiated an annuity that will provide $36,000 per year for life for Angie, though it's set up so that the money goes to whoever is her primary caregiver. That's her mom, and it will be so long as her mom is capable of caring for her."

"What happens after that?"

"It gets tricky, but Stefan set things up such that Lara and I are 'next friends' and we'd have significant input into her care, with Lara directing the financial side. The State would have to decide who would have custody. If something happened soon, God forbid, her brother would have custody, and more than likely, Angie would live in a Roman Catholic group home, though there is a chance she might be able to live with one of the women from Saint George, Loveland."

"Angie's parents are in their fifties, right?"

"Her dad is fifty-two and her mom is forty-nine. I hope that means at least twenty years where Mrs. Stephens can reasonably care for Angie. We'll worry about what happens after that, after that. Mrs. Stephens did ask if we could see Angie more often, and I said I'd discuss it with you."

"Rachel certainly loves her!"

"Rachel was being a…toddler!"

Kris laughed, "I was so surprised to see YOU on the receiving end! She usually worships the ground on which you walk!"

"Hold that thought for when she's a teenager," I chuckled. "I saw how things were with Liz, Tasha, Emmy, Lara, Elizaveta, and others. Conflict is normal. That's true even for your sister, though to a lesser extent than most. The Tsarina is asserting her newly discovered independence. It's right about this age when they figure out that they can flat-out refuse to do something, and adults are, generally speaking, helpless to force them."

"I bet when 'Mama' has a new baby to care for, 'Papa' will walk on water once again!"

"We'll see!" I said. "Ready for bed?"

"With you? Always!"

I took our empty mugs to the kitchen, and then Kris and I went up to bed.

_March 4, 1990, Columbus, Ohio_

"Hi, Loretta," I said when Kris, Rachel, and I entered her room at the rehab center on Sunday after church.

"Hi, Mike!"

Bobby and Bobby Junior were there as well, and I greeted them.

"How are you doing?" I asked Doctor Gibbs.

"They ran every test they could think of on Friday, and my physical torture begins tomorrow morning."

"Therapy, Doctor," I corrected. "What did the tests show?"

"I had a contrast CAT scan, and the neurologist said the results looked 'promising'. I can wiggle both big toes."

"That's excellent news."

"What happened?" Rachel asked.

"I was hurt at the hospital," Doctor Gibbs said. "My legs don't work right, and they're going to fix them."

"Papa can fix them!" Rachel declared.

"_Back to walking on water again_," Kris said quietly.

"Papa isn't that kind of doctor," I countered. "Papa's job is to save lives. Other doctors fix this kind of problem."

"Why?" Rachel asked.

"Because a doctor needs special training to fix legs; my special training is to save people who are in accidents or who have a heart attack or things like that."

"Why?"

"Because there's just too much for any single person to know!"

"Papa knows everything!" Rachel declared.

"Do you know the difference between God and a surgeon?" Bobby asked me with a grin.

I chuckled, "I've heard that one once or twice! But I'm not the one making the claim! And I'm smart enough not to run into burning buildings!"

"Don't look at me!" Bobby declared. "I'm right with you on that one! You know paramedics rarely do that. And speaking of running into burning buildings, you haven't come to the house for dinner. We still owe you for the LT."

"LT?" Kris asked.

"Short for 'lieutenant'," Bobby said. "In this case, it's Jim Greer."

"Pick a night except Wednesday or Saturday," I said.

"A week from Tuesday," Bobby suggested. "We'll get the entire company to the house, plus the captain. It'll be crowded, but we can pull the engines out of the bay and set up tables. We've done it before. What time does your shift end?"

"5:00pm."

"Then let's call it 6:30pm in case you get shanghaied into a trauma."

"Sounds good."

We spent about thirty minutes visiting, then Kris, Rachel, and I headed home for a meal with Elias, Serafina, Subdeacon Mark, and Alyssa.