Good Medicine - Medical School II

January 14, 1986, McKinley, Ohio

After I said 'goodbye', I hung up the phone and sagged back against the fridge. I felt faint and sick to my stomach.

"Mike?" Elizaveta asked. "What's wrong?"

I shook my head slowly, trying to clear it, "I can't tell you."

"What did your grandfather say?"

"Seriously, Kitten, I can't tell you. But I need to lie down."

"You do not look well," she said, jumping up.

"I'm not," I agreed.

Elizaveta helped me to our bed, and I climbed in, pulled the covers over me, and closed my eyes. Some unknown amount of time later, I heard a voice call my name.

"Father Deacon Michael?"

I opened my eyes and blinked to see Doctor Evgeni.

"Matushka Elizaveta called me," he continued. "She was worried. She said you had a disturbing call from your grandfather, but she wouldn't say what it was about."

"I didn't tell her," I replied. "I can't tell anyone."

"Is everything OK at home? I mean, your mom and your grandparents?"

"Yes," I replied. "It's not really about them."

"Elizaveta told me that you looked pale and unsteady, and she said you were feeling faint and nauseated."

"And my heart was racing," I replied.

"I'd like to do a quick exam, if that's OK?"

"I don't think it's necessary," I replied. "It was just adrenaline."

"An important lesson to learn, Father Deacon; no physician should ever treat or even assess himself."

I knew Elizaveta would not tolerate my refusing, and he had a point, so I acquiesced with a shrug and a nod.

"Matushka, I'll speak with you after the exam," Doctor Evgeni said.

My wife, as I expected, put her hands on her hips, gave him a hard stare, but then left the room, closing the door behind her.

"She's obviously deeply concerned," Doctor Evgeni observed.

"Obviously," I replied.

"How are you feeling now?" he asked as he opened his bag.

"Sick to my stomach, but otherwise OK."

He nodded and performed a basic exam.

"Your blood pressure is a bit high, your pulse is a bit high, but otherwise, everything sounds and looks good. I'd say you're right, that it was just a rush of adrenaline. I'd advise you to take it easy for the rest of the evening and to get to bed early."

"Not really in the cards," I replied. "My study group will be here shortly."

"I understand, but you have my advice."

"Which I'll ask you not to share with Matushka, please."

"And do you propose I lie to her?"

"No. Tell her it was adrenaline, just as you said, and leave it at that, please. I'm sure you know how important studying is for medical school."

"I also know how dangerous stress can be and how it can affect your entire life. You can't let it get out of control."

"I'm actually doing OK in all other aspects; this thing that came up today is different."

"Find someone to talk to, please. You were seeing a counselor in Milford, right?"

"Yes."

"Could you talk to her?"

I could, and I could also speak to Clarissa, though I couldn't tell him that.

"I promise to call her tomorrow."

"Do you feel well enough to get up and have something to eat? I believe Matushka warmed some soup for you."

"I think so," I replied. "The queasiness has mostly subsided."

"Good. When was your last physical?"

"When I had my interview at University Medical School."

"I'd like you to have one. Who's your doctor?"

"It was Doctor Morton in Rutherford, but I'm going to start seeing someone locally."

"Who?"

"Assuming my meeting with him next week goes OK, Doctor John Smith."

"I've met him, but don't know him well. How did you select him?"

"I'm doing my OB/GYN Preceptorship with his wife, Doctor Candace Forsberg. We're having dinner a week from Thursday so I can meet him, and Doctor Forsberg can meet Elizaveta."

"Arrange for a physical as soon as you can. There's nothing specifically concerning, but we do want to make sure your blood pressure doesn't stay elevated."

I nodded and got out of bed, then Doctor Evgeni and I went to the kitchen where Elizaveta had warmed some of her homemade chicken soup.

"How is he, Doctor Evgeni?" Elizaveta asked.

"I think he'll be fine," Doctor Evgeni replied. "The symptoms he described are all consistent with a surge of adrenaline and have mostly resolved now that the adrenaline has been metabolized."

"And you told him ALL your symptoms, Mike?"

"Yes, Kitten."

"Sit down and eat," she commanded, then turned to Doctor Evgeni, "Is it OK for him to have his study group?"

Doctor Evgeni smiled, "If he feels up to it."

"I do," I replied, trying to keep my tone neutral. "Doctor Evgeni did remind me to watch my stress levels, and studying will actually help me relax. You know how much I hate missing study sessions."

"I instructed Deacon Michael to have a complete physical, which he promised to do once he meets with Doctor Smith."

"But that's nine days away!" Elizaveta protested. "And that means his appointment wouldn't be for at least two weeks. Is that safe?"

"Deacon Michael is in excellent health, Matushka. So long as he doesn't exhibit any symptoms, waiting a few weeks is OK."

"And if he does?"

"Then you can call me unless he's having breathing difficulties, in which case you should get him to the hospital as quickly as possible."

"Thank you, Doctor," Matushka said.

I said the prayer of blessing, then began eating while Elizaveta showed Doctor Evgeni out. She returned a moment later and sat down.

"Mike, what's going on?" Elizaveta asked.

"Kitten, there is literally no way I can tell you what my grandfather said."

I realized, just then, that I had a bigger dilemma. My grandfather had made an accusation against the bishop, and I had an obligation to report the accusation, but I had no idea how to do that, and even asking the question of how to do it could create problems for whomever it was I spoke to. Normally, any accusations against clergy would go to the bishop, but in this case, it was the bishop who was being accused. I'd need to look in the clergy manual to see what my obligations were.

"It's about Bishop ARKADY, isn't it?"

"Kitten, please don't ask," I pleaded, wishing that I'd simply said 'goodbye' to my grandfather and hung up before he'd made the shocking accusation.

"How much trouble could you be in?" she asked, sounding worried.

"A lot."

"What are you going to do?"

"Tonight? Study. After that? I honestly don't know."

January 15, 1986, McKinley, Ohio

On Wednesday morning, as soon as Elizaveta left for school, I left the house so that I could meet Clarissa for coffee in town. I'd asked her, as she left the house the previous evening, to meet me, but hadn't given a reason why. She arrived at the coffee shop about a minute after I did, and after we got our coffee and a doughnut, we sat in a corner booth.

"Something is obviously seriously wrong," Clarissa observed.

"That's an understatement if there ever was one," I replied.

"What happened?"

"I'm about to violate a direct command from my bishop, but I really need to talk to someone who is completely uninvolved, so it's you or Doctor Mercer, and probably both."

"There is not a single area of your life where I'm not involved, Petrovich!"

"True," I replied, taking a sip of coffee. "But you aren't involved in this because you don't even know about it."

"What could possibly be going on in your life that I don't know about?"

"Last night, my grandfather accused the bishop of what amounts to a conspiracy to cover up sexual sins."

"Yours?"

I shook my head, "No. The bishop's."

"Holy shit!" Clarissa gasped, though I was happy she kept her voice low.

"Yeah. And he deposed Deacon Vasily and dissolved the Holy Transfiguration Parish Council because Deacon Vasily discovered that Protodeacon Seraphim was embezzling funds and blackmailing Bishop ARKADY to keep quiet, using evidence of some sexual sin the bishop committed."

"I can't believe it!" Clarissa objected.

"I scarcely believe it myself," I replied. "I don't want to believe it. But something tells me that it's true."

"What? I mean, if you know."

"Honestly, I don't, but it's the only thing that explains everything that's happened. Deacon Vasily being deposed; the Parish Council being dissolved; me being given what amounts to a gag order and told to not ask any questions; my grandfather referring to the bishop as his 'former friend'; the appeal to the Metropolitan and the Synod of Bishops."

"Jesus, Petrovich. What now?"

"That's a good question. I was told to stay out of it, and honestly, I wish my grandfather hadn't dragged me in. I consulted the clergy manual, and I probably need to call the Archdiocesan Chancery and speak to the Metropolitan."

"And then what?"

"Then it's up to the Synod of Bishops to decide what to do."

"What about your ordination?"

"Given we're not Donatists, the default is that all ordinations done by Bishop ARKADY are valid, barring some clear indication of simony or some other thing which would make the ordination canonically invalid."

"Simony? You mean like paying for your ordination?"

"Yes. I'd think the only real question would be about Protodeacon Seraphim, and if the allegations are true, he'd be deposed and reported to the police."

"And then what?"

"I suppose we get a new bishop."

"I think this is like the situation with Dean Parker; just keep your head down, do your duties at church, and focus on school. Elizaveta doesn't know?"

"I can't really tell her, or anyone from church. And that includes Father Nicholas."

"You can't speak to your own priest?"

"I'd only risk getting him in trouble if the accusations are false."

"But you believe them, right?"

I nodded, "I do. But that doesn't mean they're true, and I don't want him to get into trouble by repeating them. And I know you won't tell anyone I've repeated them to you."

"Obviously! You managed to stay focused last night."

"After I had a mini-meltdown and Elizaveta, called Doctor Evgeni. It was just an adrenaline rush -- increased blood pressure, quickened pulse, queasy and nauseated. By the time you arrived for study group, it had mostly worn off."

"How did you explain THAT?"

"By saying I couldn't repeat what was said. Doctor Evgeni encouraged me to speak with Doctor Mercer if I couldn't speak with anyone else."

"But Elizaveta?"

"She trusts me. And when it all comes to a head, she'll understand why I couldn't tell her."

"Are you sure about that?"

"Yes. It's something we discussed before I was ordained, and after, as well."

"Are you going to see Doctor Mercer?"

"I'll call her when we get to school and see if she can see me tomorrow afternoon. I really don't have any other time, and I don't want to raise suspicions with anyone."

"Jesus, Petrovich! What's next? Dead drops and cutouts? This isn't a spy novel!"

"I agree, but the last thing I need right now is anyone asking questions. Skipping study tomorrow afternoon makes the most sense."

"Does it? Maryam will know; not that I think she'd intentionally rat you out, but she does go to your church, and she is friends with Elizaveta, Serafima, and the other girls in the teen and college group."

"Maybe you're right."

"Maybe?"

"Fine. I'll see if I can do it via telephone because otherwise, I have to skip something important."

"And studying isn't?" Clarissa asked.

"It is, but you know what I mean -- class, church, band practice, or family dinner."

"What is it that you need from me?"

I smiled, "Same as always -- a sounding board."

"I don't think I can give you advice about Church politics."

"No, but you listening to me think out loud is extremely helpful. And I wanted to make sure you knew what was going on. You know everything, Lissa, and I want to keep it that way."

She smiled, "Thanks. It's obvious you still love me."

"Why would you ever think otherwise?"

"I don't! But I do miss how things were before you were ordained."

"So do I, Lissa. The only way things could be different is if we'd made a different decision, one which was impossible because of who we both are."

"I sometimes wonder what it might have been like..."

"Lissa, you could never, ever walk the path I'm walking with me. There were cradle Orthodox girls who couldn't walk it with me -- Katy and Tasha. In fact, there was only one girl besides Elizaveta who could."

"Angie."

"Yes, though even that's up for debate, given that we don't know how much of what she did was a product of her condition. Lissa, you and I are where we wanted to be -- together for the long term. We agreed this was the only possible solution."

"I know," she sighed. "I love you, Petrovich."

"I love you too, Lissa. And thanks for listening to me."

January 16, 1986, McKinley, Ohio

"I heard Doctor Forsberg called you," I said to Doctor Gibbs when Elizaveta and I arrived at her apartment for dinner with her and Bobby.

"You have to have known there were going to be people who reacted badly to you marrying a teenager."

"Teenagers marry all the time," I replied. "Granted, they're eighteen or nineteen. And yes, I knew some heads would turn. Heck, if you'd have asked me even six months before Elizaveta proposed, I'd have reacted that way. My problem is people jumping to conclusions based solely on the fact that she's sixteen."

"And you have to admit that in many, if not most, cases, they'd be right."

"I don't buy stereotypes," I replied. "It's one thing to say something is statistically likely, but another thing altogether to decide something about an individual based on those statistics."

"Aren't you just saying stereotypes are accurate?" Bobby asked.

I shook my head, "Not at all. I'm saying it's wrong to decide something about an individual based on something you know about the group of which they're a member."

"And you never, ever, make judgments about someone before you know the details?"

"Of course I do! I'm a sinner, just like everyone else! The key is being aware and not acting on those conclusions I jump to without sufficient information. And before Doctor Gibbs objects, yes, I know that differential diagnosis is based, in part, on statistical likelihood, and in the ER, we do sometimes have to act quickly, basing our decisions on those likelihoods."

"This is starting to sound like a philosophy class!" Doctor Gibbs declared. "The bottom line is, I think Doctor Forsberg has come in off the ledge. How were things on Tuesday?"

"Fine," I replied. "We're seeing them for dinner next week. And there hasn't been any fallout from Mrs. Cole, the teacher, nor from Family Services."

"She actually went to the school psychologist," Elizaveta said. "But Mrs. Barngrover apparently told her that the school can't interfere with a legal marriage."

"When did that happen?" I asked.

"Last week, but I just found out about it on Tuesday. I was going to tell you, but, well, you know."

"Is there a problem?" Doctor Gibbs asked.

"Something at church which I really can't speak about to anyone."

I had spoken with Doctor Mercer at lunch, and the conversation had been nearly identical to the one I'd had with Clarissa -- minus the declarations of mutual love -- and her advice had been to simply do my best to stay out of the line of fire, if at all possible. At some point, I'd need to speak to my mom and grandfather, but I had to be careful about those conversations.

The pizza arrived, and after getting soft drinks from the fridge, we all sat down to eat.

"Are you having any difficulties at school?" Doctor Gibbs asked.

"Everything is going really well," I replied. "Passing with honors."

"Good. What's your next Preceptorship?"

"Psychiatry."

"That'll be at the hospital because it doesn't really work for private practices. You'll follow the Psych Resident around on consults and evaluations."

"How many of those do you have on any given day?"

"Usually just one or two. We have an inpatient facility, so there are rounds and patient visits as well."

"Doctor Virginia Underwood, right?" I asked.

"Yes, how do you know her?"

"She treated a close friend of mine who was eventually diagnosed with schizophrenia, though it might be borderline personality disorder."

"I'm not sure 'close friend' describes Angie," Elizaveta said. "You two would have married if it hadn't been for her illness."

"Possibly," I replied. "But we don't know how much of Angie's personality was a product of her condition and how much was, well, healthy, for lack of a better word."

"How is she?" Doctor Gibbs asked. "I mean, if you know."

"Functioning," I replied. "Her counselor calls it a success, but I find it a bitter pill to swallow. Angie had two goals in life -- to be an elementary school teacher and to be a mom. Neither of those is possible, and that feeds her depression."

"You seem fairly involved in her life."

"I am. Elizaveta and I visit Angie every eight weeks or so, and I stay in touch with Angie's counselor. Angie attends a parish in our diocese, which is in Loveland, and I'm part of her support team."

"It sounds as if you have a leg up. Did you take psych at Taft?"

"Intro and abnormal," I replied. "I took the second one after Angie was diagnosed, and did my two research papers on schizophrenia, especially early onset in female patients, with a critical evaluation of treatment protocols."

"And your conclusion?"

"It sucks. In effect, patients are over-medicated for the convenience of the treating physicians, resulting in far poorer outcomes than a treatment regimen such as the one Angie is receiving. But Angie is only able to receive that intensive counseling because she has a support group and has parents who have decent insurance for hospitalization and sufficient income to pay for the counseling. Without that, she'd be institutionalized and drugged into a stupor simply because it's easier, and society can ignore the problem by locking people with mental conditions away so they aren't seen."

"I've never seen you this vehement or worked up about anything," Doctor Gibbs observed.

"It's really the one thing that truly bugs Mike," Elizaveta said.

"That often happens when we have personal encounters with mental illness," Doctor Gibbs replied.

"The average person on the street is frightened by mental illness," I offered. "And that leads to wanting to hide those people in institutions. The same is true for certain kinds of disabilities and birth defects. The system is basically set up to institutionalize anyone who can't conform to societal norms, or who needs care beyond a welfare or social security disability check. And the thing is, neither national health insurance nor socialized medicine or whatever you want to call it, is going to solve the problem because it's not really about money."

"I do believe those are the first political words I've heard you utter," Doctor Gibbs observed.

"Actually, that has nothing to do with politics and everything to do with changing the hearts of the public. In a way, it's not all that different from the struggles around racial and sexual equality. Handicapped, or disabled, as we're calling them now, people are discouraged from being in public if their disability is 'scary'. It's like an ex-girlfriend's dad and his buddies running the black teacher out of town because they were afraid of the 'bad influence' he'd have on the community."

"You're equating racism and sexism with the treatment of handicapped and mentally ill people?" Bobby asked.

"I'm objecting to bias and discrimination in every form, including against gays and lesbians, who we haven't mentioned. I daresay your girlfriend agrees on that one."

"Of course I do. Bobby is just a bit of Neanderthal! He's the token Republican in the room!"

Elizaveta laughed, "I'm Republican, though I can't vote yet."

"Nobody's perfect," I chuckled.

"YOU voted for Reagan!" Elizaveta protested.

"Given the alternative? Yes, I did. But I also voted for Democrats in basically every other office. Honestly, divided government means compromise, and that means moderation, and THAT is what I want. No wild changes one way or the other. Stability is key."

"Your church doesn't change much, right?" Doctor Gibbs asked.

I chuckled, "Our idea of a 'new' hymn or prayer is one that's less than a thousand years old! Our services are basically the same as those conducted in Constantinople in the 4th Century. Our choral music has developed along ethnic lines, but the words and the basic melodies are the same. I could go to a liturgy conducted in any language -- Russian, Greek, Romanian, Spanish, French, or whatever, and follow the service completely, minus the homily, which, if it weren't in English or Russian, I'd not understand."

"Did your church do the same thing as the Roman Catholics with Latin?"

"Greek was the primary language of the other four patriarchates, because that was the common language in the Roman Empire, especially after the capital was moved to Constantinople. The New Testament is originally in Greek, and the official version of the Old Testament is a Greek translation called the Septuagint. That said, from the earliest times, services were conducted in the local language. The Cyrillic alphabet results from the Church wanting to make the Scriptures and services available in the Slavic languages.

"Our churches in the US started out as mostly ethnic, with the language of the mother church being used, but over the centuries, it's mostly moved to English. That said, some larger Greek and Antiochian churches conduct services in Greek or Arabic because they are still receiving immigrants. You can imagine there aren't too many Russian immigrants these days, so we've mostly moved to English."

"Interesting," Doctor Gibbs replied. "I honestly knew nothing at all about your church when we met, other than you have a totally cool building with onion domes!"

"Which is a Slavic thing," I replied. "The Greek and Antiochian churches usually have rounded domes on any towers, and a large dome over the nave. The layout of the interior of the churches follows the same basic plan, but there are ethnic differences in the details. In a way, you could compare it to the ethnic Roman Catholic parishes with their own local traditions -- the Irish, Italian, and Polish churches, for example."

"It's ultraconservative, right?" Bobby asked.

"Theologically? Yes. Politically? No. I'd say the average Orthodox Christian is moderate to left on politics, with the obvious exception of abortion. We don't have much in common politically with the Religious Right."

"Homosexuality?"

"Is not a sin. Fornication is a sin, whether you're straight or gay. And another person's sins are not usually my business; I have more than enough of my own to worry about."

"Are you saying a gay man or a lesbian could be members of your church?"

"Of course. And they would confess their sin of fornication just as I did. What happens at that point is between them and God, with guidance from the priest."

"And public displays of affection?"

Elizaveta laughed, "Those are frowned on at church, period! Even before Mike was ordained, it would have been considered inappropriate for me to kiss him except in the Russian style used for greetings, you know, multiple times on the cheeks. And men do that, well, the older men, anyway, so who would know? My mom and dad don't kiss or hug at church! And, of course, Mike can't now that he's clergy, even if he wanted to violate the social norms."

"And that's not just at church," I replied. "In public, other than brief hugs or holding hands, we're not permitted to engage in public displays of affection."

"Who signs up for THAT?" Bobby asked.

"We did!" Elizaveta declared firmly, then smirked. "But that's in public."

Doctor Gibbs laughed, "And in private?"

"That's private," Elizaveta giggled.

"I think you can work that one out for yourself, Doc," I chuckled. "Orthodoxy teaches that sexual relations are God-ordained and are healthy when practiced in the context of marriage."

"And Lor and me?" Bobby asked.

I shrugged, "Until this second, I had no idea one way or the other, and didn't care. Now I know, but I still don't care. That's between the two of you and, ultimately, God. I'm in no position to judge."

"It sounds as if your basic philosophy is MYOB," Doctor Gibbs stated.

"Pretty much," I replied. "That would have headed off quite a few things which happened over the past several years."

"I'd say it's a good policy! Let's finish eating and play some Uno!"

"Sounds like a good plan," I replied.