Chapter 7 — An Interview

_March 16, 1990, Circleville and McKinley, Ohio_

{psc} "Did you get the students you wanted for Residency?" Kris asked when I arrived home on Friday evening.

"We did. We actually did fairly well, landing our top picks, including the one we suggested change her Match selection order. I think everyone is happy."

"Good! Are we still meeting the gang for Chinese food?"

"Yes, and the consensus, according to Fran, is that we'll see _The Hunt for Red October_. I read the book, and I enjoyed it, even though I prefer science fiction to Tom Clancy's political thrillers."

"I've heard good reviews, and I'm OK with seeing it. We'll take Rachel to my parents' house. Oksana decided to stay home tonight."

"I'm not surprised, given she's towards the end of her eighth month. I can't imagine she'd be comfortable sitting in the theatre for two hours and fifteen minutes!"

"Not to mention at least two trips to the ladies'!"

"May I say I'm happy with the initial division of labor with regard to having children?"

"Only if you want to sleep on the couch!"

"An idle threat, and you know it! Let me get the Tsarina ready. Is the plan to pick her up tonight or tomorrow morning?"

"Tomorrow, on the way to band practice."

"And you're still planning to sing at both Proms?"

"_Russian woman! Strong like ox!_" Kris said gruffly, barely concealing a smirk.

I laughed, "If _I_ had said that, I'd be in serious trouble!"

"Yes, you would!"

"Papa!" Rachel exclaimed. "Go to grandma's?"

"In a few minutes. Please put the toys you want in your backpack."

"OK!" she agreed.

About fifteen minutes later, Rachel was safely with her maternal grandparents, and Kris and I were on our way to the Chinese restaurant to meet our friends for dinner. When we arrived, Fran and Jason were just getting out of their car.

"Did Sophia Match with UC San Fran?" Fran asked.

"She did!" I replied. "She's ecstatic."

"I bet!" Fran declared as we walked towards the entrance to the restaurant. "That's an elite program, and they're doing truly groundbreaking work. How are you holding up?"

"I miss being in the ED, but I'm drinking from the firehose as a surgeon. I'm doing PGY3 work as a PGY1."

"Well, one good thing came out of that nightmare, then," Jason said. "How are your doctor friends doing?"

"Shelly Lindsay is going stir-crazy during her enforced break. She's back in two weeks. Loretta is making progress, but it's slow. Fran, you should go see her."

"You're right, of course. I'll arrange to go on Wednesday. Has her prognosis changed?"

"No. It's still 'wait and see'. My inexpert opinion is she'll walk with braces and a cane or one of those lower-arm crutches. I think she'll be able to handle working in the ED, but it's not up to me. It'll be up to Dutch Wernher, the new Chief of Emergency Medicine."

"Where's he from?" Fran asked as we walked in and moved towards our reserved tables.

"Rush-Presbyterian in Chicago. Ex-Navy, having served in Vietnam. Moved from internal medicine to emergency medicine in '72, which means he must have been one of the first at Rush-Pres, given Cook County had only started a few years before that."

"Sounds like a good guy. I know you wanted Doctor Gibbs."

"I did, but that lowlife who shot up the ED put paid to that, at least in the near term."

We greeted others who had arrived and sat down.

"No Sophia?" Fran asked Robby, who was alone.

"On shift," he replied. "Thankfully, her final OB/GYN rotation has banker's hours!"

We all laughed because that wasn't actually true, though she would end her day at 4:00pm.

Jocelyn and Gene came in and sat down, and I saw something in her face that was quickly revealed.

"We have a baby!" she exclaimed.

"Congratulations!" several of us exclaimed.

"When?" I asked.

"The day after she delivers, which should be by the end of next week. A baby boy who'll be born to a fifteen-year-old girl. She's Lutheran and went through the Lutheran agency in Columbus. They gave her options, and she liked our biographies."

"Clearly, she's mentally challenged," I said with a smirk.

"Watch it, Mik!" Jocelyn said threateningly.

"Ignore him!" Clarissa exclaimed. "Do you get to name him?"

"Yes. We eliminated 'Michael' for what I think are obvious reasons!"

I stuck my tongue out at Jocelyn, something I hadn't done in at least fifteen years. She laughed and shook her head.

"The MD behaving like a toddler!" she exclaimed.

"I reserve the right to revert to our first days of friendship!" I said with a grin.

"Kindergarten!"

"Yep!"

"You're such a goofball, Mik!"

"You know I'm very happy for you. What names?"

"We've narrowed it down to Timothy or Sean."

"Do you have all the things you'll need?" Serafima asked.

"No, but we have a week to get them," Gene said.

"We'll have a baby shower for you," Clarissa said. "Kris, will you help organize?"

"Yes, of course!" Kris exclaimed.

"I'll help, too!" Tasha interjected. "I'm so happy for you both!"

The adoption was the topic of conversation for basically the entire meal. When we finished eating, we all went to the theatre to see the movie, which I enjoyed. It wasn't quite as good as the book, and it was a stretch to see Sean Connery with a Scots accent playing a Lithuanian Soviet submarine commander, but I enjoyed it. The others had similar reactions, including Kris, though she hadn't read the book.

"Some suspension of disbelief is necessary for movies like that," she said as we walked to my Mustang. "But overall, it was entertaining. You have the book, right?"

"Yes. It's on the shelf in my study. It's part of a series of spy dramas, though it started out as a standalone book. There are three other books in the series now — _Patriot Games_, _The Cardinal of the Kremlin_, and _Clear and Present Danger_. He also wrote a World War III alternate history titled _Red Storm Rising_."

"Have you read any of them?"

"I have _The Cardinal of the Kremlin_ on my bookshelf, but I haven't had the time to read it. Maybe I'll read it during my vacation. Hopefully, Charlotte Michelle will coöperate and be born during my vacation time, but babies are so unpredictable. I have a tiny amount of flexibility, but if our new daughter doesn't coöperate, we'll have to do some juggling."

"Fortunately, school will be out, so my sister will be able to help."

"For a definition of 'help', which means being a troublemaker!"

"Only to you!"

"In all seriousness, she's a big help and a good aunt. And, as I mentioned, she's found a new victim to torture!"

Kris laughed softly, "Did I torture you?"

"No, but you're not Lyuda!"

"But you got the best sister, right?"

"I absolutely did, Lyuda's claims to the contrary notwithstanding!"

"Do you know how many children Jocelyn and Gene want to adopt?"

"At least two," I replied. "They were fortunate to get an infant so quickly. It could be years before another baby is available for them, though they're willing to adopt a toddler. I appreciate you being willing to help Clarissa plan the baby shower."

"I'd say it was because Jocelyn was the person who knows every dark secret about you growing up, but you don't have any!"

"Neither does she! Nor Dale, either. We were all goody-two-shoes' growing up. The most trouble I got into was using a vulgar Russian phrase. I was trying to explain it to Dale, but Mom did not care."

"I think putting soap in a child's mouth is child abuse."

"I would never do it, but it certainly did work. As they say, times were different. It's a logical fallacy to hold people in the past to modern standards of which they were not aware and likely could not have conceived. Most significant change comes because of a small group of radical thinkers. That was true in France, just as it was here and in England. It took time for the ideas of «Liberté, égalité, fraternité» or the ideas expressed by…

{block}{tt} "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed {/tt}{/block}

…to be realized, even in a limited fashion. I'd say both countries are _still_ working on it. And I believe you agree, though our proposed solutions are different."

"Says the government doctor, working for a government hospital, treating many patients covered by government health insurance!"

"By _choice_, «ma chérie»!"

"And our children will attend public school, just as you did, and likely a public university, just as you did…"

"Yes, yes," I chuckled. "I'm OK with _social democracy_, not with _socialism_. They are different, the opinions of many of our countrymen to the contrary notwithstanding!"

"You know I like to tease you about it!"

"The story of my life with every woman I know, starting with my mom!"

"And you love all of us!"

"I do."

_March 19, 1990, McKinley, Ohio_

"What's bugging you?" Carl Strong asked as we ate lunch together early on Monday afternoon.

"What gives you the idea something is bugging me?"

"Just the way you're discussing your training. Even the black swan events of a PGY1 performing surgical procedures in an OR don't seem to have you as up as I would have expected."

"I'm not depressed, if that's your concern."

"No, but if you went there…"

"My mom played those rhetorical games with me from the time I was little. I'm an expert!"

Carl laughed, "OK, but you know that is a major concern for physicians."

"It is, but I think it's more that what I'm doing now doesn't provide the hits of adrenaline that working in the ED did. There's too much routine work, if you will."

"You aren't the first emergency medicine specialist to go through dopamine withdrawal! I don't mean this in a perverse way, but you derive pleasure by working at your maximum, and the more, the better. I recall you were never as enthusiastic about slower-paced medicine despite the fact that slower-paced medicine fed your _other_ need — patient interaction. I think we know which drive is stronger."

"I'd say obviously, but it wasn't obvious until I spent eight months in the ED."

"What does your training regimen look like for PGY2?"

"At least the first three months will be better because I'll be in the ED full-time to train Mary Anderson on procedures. After that, I'll alternate one week in the ED and one on a regular surgical team. That will be much better."

"Shelly is back on April 1st, right? So you'll go back to the ED?"

"Most likely, yes, but there are other considerations. I'm not sure how the contracts for the _locum tenentes_ in Medicine work."

"Only YOU would decline Latin phrases we use in English!" Doctor Strong said, shaking his head.

"I gotta be me!" I chuckled.

"I believe those contracts are almost always week-to-week, or at most for a month. You should ask Tim Baker, or maybe have Owen Roth ask Baker."

"Clarissa would be VERY happy if she went back to Medicine. She's not an adrenaline or dopamine junkie!"

"Because in our roles, if the adrenaline hits, it's because something has gone terribly wrong. The same is true for all the pure surgeons. For you, it's part of your job, and you can't wait for the next fix!"

"I'm not going to argue with you on that one! How are things going in Cardiology?"

"The beat goes on!" Carl said.

I groaned, "That was bad."

"You have no room to talk!"

"True," I agreed.

"How are you doing with regard to the incident?"

"Fine. I honestly don't think about it except in relation to Loretta. I saw her on Sunday, and she's making slow progress. If I had to guess, six to eight months, though she can probably go home at the end of April."

"She's walking, right?"

"Yes, between the parallel bars with leg braces. Her coördination is slowly coming back, along with muscle tone, but she still has numbness in parts of both extremities that might be permanent."

"We just don't have the knowledge or tech to fix that completely. Where's Oscar Goldman when you need him?"

"He was the money man! You need Doctor Rudy Wells!"

"Sorry if I'm not up on my 70s TV trivia!" Carl declared with a grin.

"Those science fiction shows were my mainstay — _Six Million Dollar Man_, _The Bionic Woman_, _Logan's Run_, _Battlestar Galactica_, _Space: 1999_, and reruns of _Star Trek_. Of course, I also watched _Emergency_ and _Medical Center_."

"I was more into the cop shows like _Adam 12_, _Dragnet_, _SWAT_, _Baretta_, and _Starsky & Hutch_."

"I never asked, but what brought you to medicine?"

"A college professor. I had enrolled in a chemical engineering program, and during my first year, my advisor more or less talked me into a biochemistry program instead, on the theory that that was the future. When the time came to look into a Master's, he suggested I apply to medical school as well. I took both the GRE and MCAT, applied to both programs and, in the end, decided on medical school because it was the greater challenge."

"Why cardiology?"

"The first time I actually saw an EKG, besides on television, I was fascinated. From TV, you don't get a true impression of just how much information is available. On TV, it's basically the 'machine that goes ping'."

"That was during your Third Year, right?"

"Yes. There were no Preceptorships at my medical school. They only started here the year before you started."

"You know my theory on that."

Carl nodded, "And there are a number of us who agree; unfortunately, the powers that be at the AMA think requiring an undergraduate degree is sacrosanct and won't even consider radical ideas like six-year medical schools straight out of High School."

"So radical that much of Europe operates that way."

"Socialism!"

"Oh, give me a fracking break!" I chuckled. "I know socialism, and that is NOT socialism!"

"No kidding!"

"My wife teases me about working for a government hospital, which she correctly deduces plenty of our fellow citizens consider 'socialist'. But that's only because they have no clue what that word actually means."

"Nobody ever went broke underestimating the intelligence of the American people."

"H. L. Mencken was not wrong," I replied. "As my friend Melody, who's now an attorney, said — we know how clueless the average person is; well, statistically speaking, half the people are more clueless than that."

Carl laughed, "I'm going to have to use that! Anyway, I believe our time is up, and we need to get back to our respective services."

He was correct, so we left the cafeteria and took the stairs up one floor, where he turned right, and I turned left. I went straight to Owen Roth's office and was happy to see him.

"Time for a quick question?"

"If it's really quick," he said. "What?"

"I wondered if you knew if the _locum tenentes_ contracts were until the end of May?"

"Pedantic to a fault," Doctor Roth declared. "Every other person would just say _locums_ or _locum tenenses_!"

"I'd say 'sorry', but I'm positive you know I wouldn't mean it."

"Correct. They're on contract until the end of March, then week to week. Let me guess, you want to be released from your bondage and go back to the ED."

"I'd love to, and Doctor Saunders would be ecstatic to go back to Medicine."

"Did she put you up to this?"

"Only in the sense of bitching about not signing up for the chaos and insanity that can be the ED."

"Let me speak to Tim Baker. Shelly is a hundred percent in my mind, so we'll be back to full staff. I'm OK with you going back to your natural habitat. I'm positive Baker will be receptive, as it'll save him some money, and that's our scarcest resource."

"Thanks."

I left his office and went to find my students to supervise our afternoon procedure.

_March 20, 1990, McKinley, Ohio_

"I'd kiss you if it wouldn't get me in trouble with your French girl!" Clarissa exclaimed. "A hug will have to do!"

We hugged.

"Did they mention what I consider the one downside?" I asked.

"That I'll still cover the Free Clinic? Yes. I know you really enjoy that, but it's PGY1s only, so it was going to end, anyway. You could always volunteer."

"Eventually. Fortunately, I get to keep my current schedule, which is 0500 to 1700 Monday through Friday."

"Who picks up the extra hours?"

"Other ED staff," I replied. "I'm on call for emergency surgery or disaster protocols."

"Pager duty?"

"Until the end of May. After that, I'll be on the usual rotation of PGY2s for pager duty once every four weeks. Because of my dual specialty, I'll be the first one called in for a disaster protocol, no matter who has the duty pager."

"You'll carry a pager full-time?"

"Yes."

"Better you than me!" Clarissa declared.

I chuckled, "Your name is on the disaster protocol list right below mine."

"What god did I piss off? I was supposed to be in medicine with time to care for my patients, not work in pit lane at a NASCAR race!"

"Poor baby," I replied. "There have only been two protocols in the last four years."

"Oh, sure! Jinx it!"

I laughed, "You have two more weeks in captivity, then you're free to go back to routine medicine."

"I _like_ routine medicine!"

"It takes all kinds, I guess!" I grinned.

"Go back to your ward, Petrovich! But thanks for the good news! Lunch?"

"If we can swing it, yes."

We hugged, and I headed back to the surgical ward. One interesting thing about going back to the ED was that both Erin and Todd would be on their emergency medicine rotations. That didn't mean they'd be assigned to me, but given Erin had matched for surgery, I could reasonably request her. That would give her a chance to see more procedures and would work to the benefit of the surgical service.

There was no second surgery for which we needed to prep, so I went to the lounge and had just sat down when Margie came to the door and let me know I had a consult in the ED. Given we weren't busy, I had both Erin and Todd accompany me.

"Are you going to write our evaluations?" Todd asked as we walked to the stairs.

"Yes, though I'll discuss them with Doctor Lindsay. Neither of you has anything to worry about. We'll see what you're really made of on your next rotation."

"You're going back to the ED?" Erin asked.

"Yes. I'll have the same schedule as I have now, so there's a chance you'll be assigned to me at least some of the next two months."

"How is Doctor Gibbs?" Erin asked.

"Slowly improving. She'll be at the rehab facility until mid-April, at least, though I expect the end of the month. I don't see her coming back to work before sometime next year."

We walked into the ED and went to Trauma 2.

"Loucks, surgery," I announced, walking in.

"Hi, Mike," Ghost said. "Miles O'Brien, two, swallowed several button batteries. Ultrasound shows them in the stomach."

"Are you a _Star Trek_ fan, Mr. O'Brien?" I asked the dad, standing near the treatment table.

"That obvious?" he asked with a smile.

"To me! Ghost, I'll evaluate, but we'll need Pete Barton to perform the procedures. I could do it if Miles was over twelve years old. Let me perform an exam, and I'll call for Pete to come down."

Ghost and I reviewed the patient's vitals, and then I verified his findings with the ultrasound. Once I'd completed the exam, I went to the phone and dialed the surgical scheduling desk.

"Hi, Jen," I said. "Is Pete Barton free?"

"He just finished a procedure. Do you need to speak to him?"

"I have a toddler who needs an endoscopy to remove two button batteries."

"OK. I'll send him right down."

I thanked her and hung up. Three minutes later, Pete Barton, a pediatric surgeon, came into the room.

"Hi, Mike. What do we have?"

"Miles O'Brien, two; ingested a pair of button batteries. They're in the stomach, so endoscopic removal is indicated."

"Let me take a look, and we'll do it together."

He checked Miles, then explained to Mr. O'Brien what we were going to do. I called for an anesthesiologist, as we needed to sedate Miles, and just under fifteen minutes later, we were ready to begin the procedure.

"Mr. Barton, you'll need to wait outside during the procedure, please," Doctor Barton said. "Nurse, please escort him out."

Kellie escorted Mr. Barton out of the room.

"Mike, you do it, and I'll guide and observe," Pete Barton said.

I moved to the end of the trauma table and prepared Miles similarly to how I would for intubation.

"First, insert the pediatric mouthguard," Pete directed.

I inserted the guard, which would keep Miles' mouth properly open and protect his teeth.

"Use your normal intubation procedure, but push the scope into the esophagus instead of the trachea," Pete instructed.

Using a laryngoscope, I passed the tube into Miles' esophagus, using the camera to guide me.

"I'm in the stomach," I announced.

"Erin, would you give us an ultrasound to give us an external view?" Pete asked.

She did so, and under direction from Pete, I guided the end of the scope to the location of the first button.

"Pass the four-pronged forceps tool down the tube."

The tool was similar to the normal four-pronged forceps, except that it was attached to a long, flexible, braided surgical steel cable.

"Carefully maneuver to grasp the battery, but be very careful not to puncture the stomach lining. Just go slow and be cautious. There is literally no need to move quickly for this procedure."

It took a bit of trial and error to move the tube and forceps into the correct position, with gentle correction and guidance from Pete, but I eventually was able to grab the first battery.

"Now, lock the tool and very carefully withdraw it," Pete instructed. "Todd, a basin, please."

I made sure the alligator teeth were properly engaged, then slowly withdrew the tool and deposited the battery in the basin.

"It's intact, so no problem there," Pete announced after inspecting it. "Let's get the second one."

I repeated the procedure, which was a bit easier than the first time, but I still felt clumsy. Just over five minutes later, I deposited the second battery into the basin. It, too, was intact.

"Those do not go in the medical waste bin," Pete instructed Todd. "They cannot be safely incinerated. Saline bath, then put them in a green pouch and set them aside for proper disposal. Mike, go ahead and remove the endoscope and mouth guard."

I did as instructed, and after we used the ultrasound unit to verify there were no further foreign bodies, Pete announced we were complete.

"Let's go speak to Mr. O'Brien," Pete said. "Ghost, he's all yours."

"Erin, come with us, please," I said as I followed Pete out of the trauma room. She went to the waiting room and brought Mr. O'Brien into the consultation room.

"The procedure was successful," Pete said. "We removed two batteries, and there does not appear to be any damage to Miles' stomach. You should follow up with your pediatrician as soon as possible. If you see any blood in Miles' stool, or he vomits in the next twenty-four hours, bring him back to the hospital immediately,"

"Thank you, Doctor! Can I see him?"

"Erin will take you back. He'll be coming out of the light anesthesia, so he'll be groggy."

"Thanks again!"

He shook both our hands, and Erin escorted him back to the trauma room.

"Good job, Mike," he said. "I'd sign off, but the rules don't allow that procedure to be done except by a pediatric surgeon or under the direct supervision of a pediatric surgeon."

I nodded, "Which is, of course, why I called you! May I ask a question?"

"Of course."

"Why is the cutoff age twelve? At that point, we'd still use a pediatric endoscope for most kids."

"That's true," Pete confirmed, "but it's about the hospital guidelines for when you need a pediatric specialist."

"First menses for girls; twelve for boys. But the requirement doesn't go both ways — someone over twelve could be seen by a pediatrician."

"Yes, of course, though I'd set the upper limit at fifteen. There are no adolescent surgical specialists, so we discuss each of those early teen cases and decide based on the condition."

"What are the rules for emergencies?" I asked.

"That's a tough call, and it would be the Chief of Emergency Medicine or Chief Surgeon who would have to make that call. Unless it was truly a life or death situation, and I mean imminent, call for a pediatric specialist."

"Got it."

"Have you performed a pediatric intubation?"

"One, besides today's endoscopy. We really do need pediatric specialists in the ED."

"We'll need to do that for Level I certification, though it can be handled the same way Cutter and Roth handled your situation. I'm not sure what Pediatrics has planned, but they have another year to work it out. Anything else?"

"No. Thanks, Pete."

"Write this in your procedure book for my signature, but remember, it's not a sign-off to perform one unsupervised."

"Understood."

He left, and I collected my medical students, and we headed back up to the surgical lounge.

"How dangerous are those button batteries?" Todd asked.

"Minimally," I replied. "And had they gone past the patient's stomach, we'd have sent him home and asked his parents to check his stools to confirm the batteries had passed. If they didn't within a few days, or there was blood in his stool or gastrointestinal distress, they'd bring him back. Unfortunately, that would require an open procedure in most instances."

"Not laparoscopic?" Todd asked.

"Erin?"

"I don't know, but I can speculate."

"Go ahead."

"A combination of lack of experience combined with a lack of space."

"Good speculations. The procedure hasn't been approved for younger children, and the current tools and equipment aren't designed for children. It's similar to the pediatric endoscope and laryngoscope I used today versus adult-sized ones. Let me turn the tables and ask you what would be done if magnets were swallowed?"

"That requires immediate surgery if they've passed through the stomach," Todd replied. "There are far too many possible complications."

"Very good. Any thoughts of what specialty you'll select?"

"I'm thinking cardiology, but I'm not settled on it; I could also go surgery or emergency medicine. I'm doing doubles in cardiology and emergency medicine and singles in internal medicine and surgery."

"Sounds like a good plan. Do you plan to Match in the area?"

"Probably in Pennsylvania, which is where I'm from."

The rest of the day was quiet, and at 5:00pm, I headed home to spend the evening with Kris and Rachel.

_March 21, 1990, McKinley, Ohio_

"Mike, there are two McKinley detectives here asking for you," Margie said from the door of the surgical lounge.

"Where?" I asked.

"I asked them to wait in the consultation room."

"OK. Be right there."

I left the lounge and walked to the consultation room, where I saw Detectives Tremaine and Kleist.

"Morning, Detectives."

"Hi, Doctor Mike," Jill Kleist said with an inviting smile and a twinkle in her eyes.

"What can I do for you?"

"We're conducting an investigation and wanted to ask you a few questions."

"OK," I said, then shut the door and sat down.

"You worked at the McKinley Free Clinic until mid-February, right?"

"Yes. One shift, on Wednesdays."

"Did you observe any inappropriate behavior of any kind?" Detective Tremaine asked.

I shook my head, "Not that I can think of. I had a few cases with girls who were obviously underage who I referred to social workers, but I suspect that's not what you're referring to."

"No," Detective Tremaine replied. "We've had four complaints about inappropriate touching against one of the doctors."

That didn't exactly narrow it down, as there were different Residents assigned each day of the week, and except for me, they had rotated every two months.

"May I ask whom?"

The two detectives exchanged a look.

"Gale Turner," Detective Kleist said.

"I honestly have no idea," I said. "I was never in a room with him when he was performing an exam, and I never assisted with abortions. His main nurse, Leslie, would be your best source."

"We've spoken to her. Did any young woman ever complain about Doctor Turner or any other member of the staff?"

"No. Other than bitching about reporting STDs to the County Health Department, I don't recall any complaints of any kind."

"What's your opinion of Doctor Turner?"

"He's a good guy, and honestly, I'd be highly skeptical of any complaints. That said, if you have four, that obviously calls my perception into question. Are you allowed to share details?"

"First, are you familiar with the procedures of an abortion?"

"Yes. I observed several D&C procedures during my training, but they were to resolve miscarriages, not abortions. The procedure is similar."

"OK. What we share with you from this point cannot be repeated. Can I trust you, Doc?"

"Yes."

"Is a patient fully sedated during an abortion?"

"Rarely," I replied. "Typically, a sedative is prescribed, but the patient is conscious throughout the procedure. The Free Clinic actually doesn't have the equipment for general anesthesia — what you would call full sedation. Normally, the procedure would be performed with moderate sedation, which we call 'conscious sedation'."

"How aware is someone during that level of sedation?" Detective Kleist asked.

"They're able to answer questions and respond to stimuli. An extended conversation would require some effort. Recovery from that level of sedation is usually quick, and it doesn't require supplemental oxygen, though a nasal cannula is often used."

"So a patient under that level of sedation would notice being touched?"

"In most cases, yes."

"What does a patient wear?"

"Usually a hospital gown. In my experience, bras stay on, but everything else comes off. That said, it's up to the physician to decide."

"Do you know Doctor Turner's usual practice?"

"No. As I said, I never was in a treatment room or procedure room with him. All of our interactions other than polite greetings were in his office."

"Does he counsel patients in his office?"

"I'm sure it has happened, but the normal practice is to counsel them in treatment rooms and always with a nurse present, no matter where the consultation is done."

"Always?" Detective Tremaine asked.

"Always," I replied firmly. "It's a rule both at the Free Clinic and here at the hospital — no male staff member is ever alone with a female patient. There is always a female doctor, female nurse, or female medical student."

"And male patients?" Detective Kleist asked.

"There are no rules about male patients. May I ask if you've spoken to any other doctors?"

"I suggested you be our first stop," Detective Kleist said. "You have a history with both of us, and you have a reputation as a straight shooter."

"I could say the same for you," I said with a smile.

"One less douchebag in the world," she said. "Taking him down cost Scott and me each three days on the bench, but it was worth it."

"Psych eval?"

"Yes, and mandatory seventy-two-hour time off or desk duty. Back to the clinic — are there any circumstances you can think of where Doctor Turner would be alone with a female patient?"

"None that I can think of, no. I mean, I suspect some emergency might require that, but if it happened more than once, I can't imagine why. The procedures are obviously very intimate and proceed similar to a gynecological exam, so if the complaint is about genital touching, it's going to be tough to prove."

"When a young woman is seeking birth control, do you perform a gynecological exam?"

"Generally speaking, no, so long as they've had one in the previous twelve months. That said, if they became sexually active since that exam, then we'd strongly recommend one."

"What else would cause you to perform a gynecological exam?"

"A full-spectrum STD test series, as it requires swabs from the genitals, in addition to the anus and throat. And, of course, there are young women who use the clinic for their annual exams. Those are usually students from Taft or women on Medicaid."

"What do you know about Doctor Turner's nurse?"

"Not much. We had a few short, casual conversations, but most of my interactions were with Trina Carlslyle, a Nurse-Practitioner who is licensed to act independently of Doctor Turner for a limited set of exams and procedures."

"Which nurse did you work with?"

"Mostly Michelle Stone, but there were others on occasion."

"Did you ever work with a nurse named Abby Norman?" Detective Tremaine asked.

I suppressed a groan because that was Clarissa's ex.

"No. She left the clinic before I had my first shift there as a medical student."

"But you know her?"

"Yes. She was part of a group that went to Europe the Summer after I graduated from Taft. She was dating Doctor Saunders at that point."

"She's a lesbian?" Detective Kleist asked.

"Yes."

"What do you think of her? Nurse Norman, I mean."

"May I ask why this is relevant?"

"There were a pair of complaints against her in the past. We're wondering if there's a pattern at the Free Clinic."

"Abby and I did not get along, but those complaints don't ring true. I assume nothing came of them?"

"Correct," Detective Tremaine said. "The prosecutor decided the complainants were unreliable and never filed charges. Did you know about that?"

"No. And our relationship was such that she would never have shared that with me. Nobody at the Free Clinic said anything."

"I think that's all I have," Detective Tremaine said. "Jill?"

"Just that Doctor Mike still hasn't come to .38 Special for drinks!"

"I think I'll leave that out of my interview notes," Detective Tremaine said with a smile, closing his notebook.

"Interns have no free time," I said. "Not to mention I have a wife and daughter who need me, and my wife is pregnant."

"Congratulations," Detective Tremaine said.

"Lucky girl," Detective Kleist said with a smile.

"I'm the lucky one! If there's nothing else…"

"The invitation is open," Detective Kleist said.

The three of us got up, and they left. I walked back towards the lounge but was stopped by Margie, who asked me to see Doctor Roth. I walked to his office, and he waved me in.

"Was that about the shooting?"

"No. It was about the Free Clinic, not the hospital, but I'm not supposed to discuss it at this point."

"Please tell me you're not involved."

"Not at all. I did have to fend off Detective Kleist again."

Doctor Roth laughed, "She's about as subtle as a hydrogen bomb! She actually asked about you when she was conducting the shooting investigation."

"I'm not surprised. In any event, it's not about me or the hospital, so nothing to worry about."

"OK. Pete Barton mentioned he supervised you performing a pediatric endoscopy."

"He did, and he confirmed I knew the rules for those procedures."

"Just so you know, it's all about liability and malpractice. I'm positive you or any other Resident could do those procedures on toddlers or pre-teens, but the insurance company does not want to defend a suit where the doctor performing the procedure isn't a pediatric specialist."

"Malpractice suits involving kids are invariably decided against doctors and hospitals, even more than regular suits."

Doctor Roth nodded, "Exactly. We have to pay those off, so we want our ducks in a row to limit our exposure."

"Absolutely. Anything else?"

"No. Keep up the good work, Doctor."

"I will."