Chapter 52 — Red Tape and Bureaucracy

_September 24, 1989, Southern Ohio Correctional Facility, Lucasville, Ohio_

{psc} "He's faking," the middle-aged nurse, who was surly and unfriendly, declared. "Prisoners are always trying to scam the medical staff."

"I disagree, Nurse," I replied. "As I said, in addition to being a chaplain, I'm a trauma surgeon who works in the Emergency Department of Moore Memorial in McKinley. I'm confident that Kurt Bowman is not faking his TIA symptoms. He needs to see a physician immediately."

"What year are you?"

"PGY1."

She actually laughed, "A babe in the woods. I've been doing this for twenty years."

"That's 'Doctor Loucks', _Nurse_," I said. "Are you rejecting my report?"

"He's faking. I'm positive."

"And I am positive you are wrong," I replied. "Who is your supervising physician?"

"Call the Department of Rehabilitation and Corrections in Columbus. They'll answer any questions you have. And tell you that prisoners constantly fake symptoms."

"You took an oath," I replied. "Just as I did."

"And I have far more experience than you do, _Doctor_."

I was making zero headway, so I excused myself, left the infirmary. It was Sunday afternoon, so I was positive there was nobody in administration available, but decided to verify that and followed a sign which directed me to the Warden's office. As I'd expected, it was dark, so I made my way back to the security door and a guard let me out. I went to the main desk, signed out, then left the building. After going through the system of gates, I walked into the parking lot, where I saw Kris waiting with Rachel in my Mustang.

"How was the park?" I asked when I got into the car.

"Rachel met a boy!" Kris said mirthfully. "And they played together nicely."

"And so it begins," I chuckled.

"How did your visit go?"

"About as always, though Frank asked me to evaluate a fellow prisoner who is suffering from TIA — Transient Ischemic Attack — but who the prison nurse thinks is faking. She's wrong, but she was not receptive to my diagnosis."

"What can you do?"

"Not much at the moment. I tried to see the Warden, but given it's Sunday, nobody was in his office. I'll make some phone calls tomorrow."

"How dangerous is it?"

"TIA is, as the name says, transient, so it mostly resolves itself. That's the basic problem with the nurse — it's likely she hasn't observed the symptoms. Frank Bush, who is a trained physician, and who is with his friend all the time, has observed the symptoms. That said, he has no medical license and no equipment, and would get in serious trouble if he tried to do an actual exam or tried to intervene. Strangely, someone without a medical license has more freedom than someone who has had one revoked or, or in my case, has no authority to act as a physician outside the hospital or Free Clinic where I'm supervised by an Attending."

"What else did the nurse say?"

"Not much. She was dismissive and surly. I can't imagine she enjoys her job, given her attitude. Granted, she's in a prison which is, unsurprisingly, populated by criminals, which I'm sure makes her cynical. That said, she took an oath similar to mine, and the fact that she's treating murderers, rapists, drug dealers, and so on should be irrelevant. That's the one beef the cops have with me — that I don't distinguish between the 'good guys' and the 'bad guys' in the ED. Most doctors don't."

"I'd find that very hard, especially with a rapist or murderer."

"I didn't say it was easy," I replied. "I had to assist in treating Frank Bush when he was assaulted while in the County Jail. I'd give odds that the guards turned a blind eye to the assault because they felt Frank Bush was receiving 'rough justice' from his fellow prisoners."

"That's evil!"

"Yes, it is. My biggest problem with the prison system is that it is completely dehumanizing and focused on punishment and retribution, not on rehabilitation. Are there some individuals who could never be released? Absolutely. Someone like Charles Manson is such a danger to society that nothing I could think of would justify releasing him, given what he and his followers did."

"What about the man who killed Martin Luther King?" Kris asked. "Or the one who killed Robert F. Kennedy?"

"James Earl Ray, the man who killed Doctor King, was a career criminal, who had committed armed robbery and who had escaped from prison. He wasn't apprehended, and killed Doctor King about a year later. He escaped from prison again, about ten years later, with other prisoners. They were recaptured three days later. Given he showed no remorse, recanted his confession, had a history of armed crimes, and a murder conviction, releasing him would post a grave danger to the public.

"As for Sirhan Sirhan, he confessed to plotting and planning to kill Senator Kennedy, but that was his only crime. He was sentenced, after a trial in California, to die in the gas chamber, but all death sentences in California were overturned by the California Supreme Court in 1972. That commuted his sentence to life in prison. Given he very specifically targeted Senator Kennedy, and had no previous criminal convictions, I think it might be possible for him to be released at some point.

"And to answer a more recent question - John Hinckley, who tried to assassinate President Reagan and also shot James Brady and Timothy McCarthy — is mentally ill, which changes the entire picture. You know my take on psychiatric care, but if somehow Hinckley were found to not be a danger to himself or others, he ought to be released. That said, I'm not sure Jody Foster would agree he would ever not be a threat."

"The actress?"

"He had an obsession with her and shot President Reagan to impress her. I think she has a right to be concerned."

"What do you think about insanity defenses?"

"I think if you are truly unable to tell right from wrong, then imprisonment is not warranted. That said, being committed to a psychiatric facility, as much as I dislike them, is appropriate. Many states have changed their laws about insanity defenses since then, because people were outraged that he was found 'not guilty by reason of insanity'. Fundamentally, it's a finding of _non compos mentis_ — not of sound mind, and thus, not responsible for their actions.

"All of that said, my fellow citizens have decided that lengthy prison sentences are appropriate, and that releasing felons poses a general danger to society. I can argue against that, and I will, but mostly it's a lost cause, so I won't waste much breath or effort. Where I will tirelessly advocate and work is to improve conditions for prisoners. A murderer is no less human than you or I, and deserves to be treated as such. And we have to focus on rehabilitation, not punishment. A 'penitentiary' should be!"

"I'm sorry…what?"

"A place where one goes to do penance or to repent. But the common usage has become 'prison', and the entire point of incarceration has changed. That said, we execute far fewer criminals than in the past, so the question of 'danger to society' is different from how it was for most of our history."

"Who will you call about Kurt Bowman?"

"I'll start with the Ohio Department of Rehabilitation and Corrections, and take it from there."

_September 25, 1989, McKinley, Ohio_

"I can't believe Krista accused you, of all people, of trying to extort sex from her!" Kayla Billings exclaimed on Monday morning when I arrived at the hospital.

"I can't comment on that," I replied.

"OK, but making a tape recording? Wow!"

"Again, no comment," I replied. "Let's run the board, please."

"Five still here from overnight," Doctor Billings said.

"Busy night!"

"Twenty-year-old male waiting on surgery to remove a .22 slug from his right buttock."

I couldn't help but laugh, "How did THAT happen?"

"He and a buddy were drunk and, believe it or not, he dared his friend to shoot him in the ass. You can guess what happened next."

"I'd say 'unbelievable' but I believe it! At least it was a .22 and not a larger round! Stable?"

"Yes. 5 of morphine for the literal pain in the ass, but only soft tissue damage. Surgery said they'll take him around 10:00am. Next is a sixteen-year-old girl waiting on a psych admission for cutting herself; she's sedated, but stable. Twenty-three-year-old with an ectopic, who is going up momentarily; Al is waiting for the orderly with her. Fifty-four-year-old male rule-out MI, but simply has severe indigestion. Monitor until 8:00am, then refer to his personal physician. Last but not least, twenty-two-year-old male heroin user with suspected hep-C waiting on admission to Medicine."

"I have it," I said. "See you tonight!"

Kayla left, and I went to the exam room for the ectopic.

"Morning, Al."

"Morning, Doctor Mike. This is Mary Frost; Mary, Doctor Mike."

"Good morning," I said. "I'm taking over from Doctor Billings. How are you feeling?"

"Scared," she replied.

"Our surgeons and OBs are excellent," I replied. "They'll take great care of you."

Just then a pair of orderlies entered, so I forewent an exam, and Al and I helped the orderlies move Mary to the gurney.

"Go with her, please," I said to Al. "Then come find me."

"Will do!" he declared affirmatively.

Once they'd left, I checked on the other patients, all of whom were stable, though the sixteen-year-old psych consult had been given Haldol and a sedative, as she'd been extremely combative and had tried to refuse treatment.

"Mrs. Everton, When did this begin?" I asked the girl's mom.

"I didn't know about it until I saw blood on her jeans when I gathered the laundry last night. She seemed as if she was happy, though she was moody like all teenagers."

I nodded, "That is the problem with diagnosing these kinds of problems. I'm not implying anything about the cause of your daughter's actions, but a girl I had intended to marry was diagnosed with schizophrenia when we were in college. She'd showed signs in High School, but it was attributed to adolescence because, in the end, she seemed happy, was making good grades, and had a good relationship with her parents and friends."

I didn't feel the need to reveal the emotional and psychological trauma relating to her brother, as those had been definitively ruled out as the cause of Angie's behavior, a conclusion by Doctor Henderson, with which I agreed.

"She seemed so happy," Mrs. Everton said. "I just don't understand it."

"I'm not an expert in the field, but self-harm is treatable; dialectical behavior therapy for adolescents is extremely successful. One of the main contributors to success is the entire family participating."

"I'll do whatever is necessary," Mrs. Everton said.

I was very tempted to strongly suggest she take her daughter to see a psychologist, given they couldn't prescribe drugs, but that was against protocol, and given Tracy was waiting on admission to Psych, I couldn't write discharge notes with that recommendation. And, given everything else that was going on, this was no time to pick a fight with Psych.

"Good," I said. "Someone from Psych will be down within the hour to take her upstairs. If you need anything, just press the 'call' button on the small box next to the bed."

"Thank you, Doctor."

I left the room and Kellie came up to me and motioned to the consultation room.

"It's public," she said. "Including the fact that you recorded her."

"I heard from Kayla Billings. I had hoped against hope that it would stay secret, but I knew that wasn't going to be the case."

"I heard some scuttlebutt in the locker room that Doctor Northrup is extremely pissed at you."

"Good for Doctor Northrup. And, frankly, he ought to be happy, because he got his wish — she's bounced from the program. I suspect his complaint is that the dirty laundry is likely going to be aired in public, but that's _his_ fault, not mine."

"Is it true that med students will be prohibited from fooling around in the hospital?"

"That was what Doctor Warren said, and there isn't a damned thing Northrup can do about it."

"You know he can really screw you over, right?" Kellie asked.

"If I were a trauma Resident, yes; as a surgical Resident? Not so much, because Doctor Cutter is fully behind me, and the tape recording was made at the direction of Shelly Lindsay. I don't know for a fact, but I'll lay odds that the idea came from above her, either from Doctor Roth or Doctor Cutter himself. Or, if not, then she cleared it with them first."

"Just be careful, Mike. All the nurses have your back. Ellie wishes you'd have her front!"

I chuckled, "She's made that clear! And I've successfully avoided her clutches for four years now!"

"Never tempted?"

"Not even for a second, given I didn't meet her until after I was married. And she's not my type!"

"But I am?"

"As you've said, under different circumstances…"

"Doctor Mike?" Al inquired from the door.

"Check the chart rack for a walk-in and call me after you do your workup," I said.

"On it!" he declared.

"There's one happy med student," Kellie observed. "He's going to get way more procedures and responsibility for another week."

"He'll handle it well," I replied. "He's one of the best Third Years and has the right attitude for trauma."

"I concur," Kellie replied.

"Mike?" Ellie said from the door, "Psych is ready for your cutter."

"Thanks, Ellie. She's sedated, so we'll need orderlies with a gurney, not a wheelchair. Al is handling a walk-in, so would you ask Nate to make the call?"

"Sure thing!"

The morning was busy, and by 10:00am, I had resolved all the overnight cases Kayla had handed over, and after Al left, Jake, Heather, and I had seen another six patients, with two admissions and four treated and released. Just after 10:00am, Nate let me know I had a call. The consultation room was occupied, so I picked up the phone at the clerk's desk.

"Mike Loucks."

"Doctor, this is Jason Firth. Do you have a moment?"

"I do," I replied.

"I need to take a full deposition from you with regard to a medical student, Krista Sandburg. I can do it at your convenience, even after hours."

"That's going to be tough, given my schedule," I replied. "How long will it take?"

"I'd estimate about two hours. I'm free every afternoon this week, and most evenings."

"Let me see if I can clear a block of time with Doctor Gibbs. Could you come to the hospital?"

"Yes, or to your home, if necessary."

"I'll check right away and call you back."

"Thanks, Doctor."

"Mike is OK," I replied.

"Jason," he responded.

We said 'goodbye', I hung up, and went to Doctor Gibbs' office.

"Learned your lesson?" she asked without even greeting me.

I suppressed a strong urge to roll my eyes.

"The true lesson is to give the medical student the benefit of the doubt and allow them to bounce themselves, rather than open the hospital to charges of harassment. We've been fortunate to not have been bitten in the ass by inappropriate behavior and mistreatment of medical students. Someday we _will_ lose, then we're all going to pay the price. In any event, I need two hours to provide a deposition to Jason Firth, the legal counsel for McKinley Medical School. He'll come here."

She glowered, then said, "Fine. 1:00pm, though if there's some kind of major event, we'll need to pull you out."

"Understood."

"Dismissed."

I turned and left, then went to the desk and called Jason Firth to let him know I was available at 1:00pm. That completed, I saw five more patients before taking my lunch break. Rather than eat in the cafeteria, I bought my lunch and took it to the surgical lounge so I could begin what I expected would be a difficult task of obtaining medical care for Kurt Bowman. The State of Ohio didn't disappoint, as it took two transfers and a total of eleven minutes on hold to get to the office of the Chief Physician, who was the equivalent of our Medical Director.

"Private citizens are not permitted to request medical care for inmates," the assistant said. "That is limited to immediate next of kin, and is subject to review."

"I'm a licensed chaplain and a physician," I replied. "I am not a 'private citizen' in the way you mean."

"Actually, you are, at least with regard to the prison system."

"Are you telling me that a report by a qualified physician of inappropriate care will be ignored?"

"You may write a letter reporting your findings and it will be evaluated, and if found to be accurate, action will be taken."

"And how long does that take?"

"Usually ninety days."

"That's unconscionable!"

"We comply with Ohio law in the matter. You are not next of kin, nor authorized to treat inmates."

"And a request from next of kin?"

"Would be evaluated by the prison staff."

"The same ones who incorrectly assert he's faking?"

"In your opinion, Doctor. An opinion formed with no previous relationship with the inmate and no medical exam. Is there anything else?"

"No," I replied, then gritted my teeth and added a polite, "Thank you."

"Have a good afternoon."

We ended the call, and I considered my next move, and the only thing I could think of was to try to locate Kurt Bowman's next of kin, and try that approach. I'd write a letter, but it was clear it would be ignored or given short shrift. That annoyed me, but I wasn't sure there was anything I could do about it.

I finished my lunch and returned to the ED, where I saw one patient before Jason Firth arrived. He'd arranged to use a small meeting room in the admin wing, so we walked to that room where a young woman with a steno machine was waiting, along with Doctor Warren, Doctor Worth, the Dean of Student Affairs, and Leland Crowe, the hospital legal counsel.

"This is friendly, Mike," Doctor Warren said when I stopped short walking into the room. "We're all on the same side."

"I was just surprised to see you all here," I replied.

"We want to hear what you have to say, and we may ask some off-the-record questions."

"The stenographer will only record questions and answers which are expressly on the record as part of your deposition," Jason Firth said. "And I do need to caution everyone once again that they cannot attempt to influence anything Doctor Mike says in response to my questions."

"Is there anything I shouldn't say?" I asked.

"On the record, simply answer my questions as concisely and truthfully as possible. If you are speculating, surmising, or assuming, please say so clearly. Don't go beyond the scope of the question. If I need clarification, I'll ask."

"OK."

He administered an affirmation that I would speak truthfully, then began with a series of questions about my name, training, and current role. He then asked a number of general questions about training medical students and my approach to teaching. The important questions began about forty minutes into the session.

"Doctor, have you, as a physician, engaged in any conduct that was sexual in nature, including banter, with any medical students?"

"No."

"Same question, Doctor, about physicians."

"Yes, with Doctor Clarissa Saunders."

"Would you explain, please?"

I gave a very short version of my history with Clarissa, or acknowledgment that she and I were soulmates, and her revelation about being lesbian. I mentioned her teasing about Elizaveta and Kris, and our mutual teasing about our incompatible sexuality.

"Thank you," Mr. Firth said when I finished. "Same question about nurses."

"A nurse, who I prefer not to name, flirts incessantly with me, and has since my Preceptorship. She was outrageous at first, but backed off when I asked her to, and now it's simply collegial teasing. It's been purely one-way, that is, she flirts and teases and I reject her."

Mr. Crowe asked to go off the record.

"Do you feel harassed?" he asked,

I smiled, "No. She is, in the end, harmless, and as I said, she dialed it back once I asked her to. I do have a question, and that is about the scope of Mr. Firth's question — is acknowledging a 'if things were different' situation, something I should mention on the record?"

"Would you describe it?"

I explained the situation with Kellie and was happy when he said that wouldn't need to be mentioned, as it wasn't actually sexual in nature.

"I'm going to ask you about several medical students, and I'd like you to tell me about your interactions with them. First, Tim Burg."

I described what had happened with him, then we moved on to Felicity Howard, Jack Strickland, Gerald Kirby, Hope Fletcher, Melissa Bush, and, finally, the most important one, Krista Sandberg. That back and forth took about forty minutes, as I had to explain my supposed change in attitude, which was, ultimately, in response to new information.

"So, to summarize," Jason Firth said, "you insisted that she be given the benefit of the doubt and allowed to succeed or fail based purely on merit."

"Yes. She could _still_ have succeeded after the recording, had she not chosen to make a false accusation."

"Off the record, please," Mr. Crowe said. "Mike, do you have an opinion as to why she might do that?"

"I believe she was convinced I had evidence that she had, despite denials, slept with an Attending to gain a passing grade. It fit with her pattern of lies."

"But you didn't observe her acting contrary to what she'd told you, correct?"

"Correct. I based my statement to her on reports from a trusted nurse, as well as cautionary statements about her by two other Residents. I would, if pressed, say that her response to my accusation was a tacit admission of guilt, at least in regard to lying about her ongoing relationships."

"Do you know who those physicians were?"

"I only have the report from a nurse."

"We'll need her name," Mr. Crowe said. "She is not in any trouble, I promise, and no retribution will occur. Period."

"Kellie Martin."

"And the physicians who warned you?"

"Shelly Lindsay and Leila Javadi. You should probably speak with Nurse Becky Compton, who warned Krista Sandburg not to attempt to try to entice me into an affair."

"You didn't think to mention that until now?" Jason Firth asked.

"I only have a third-hand report from Nurse Martin, who heard it from Nurse Compton."

"This is still off the record, but will come up if this goes anywhere — have you engaged in a sexual relationship with any staff members at any time?"

"No staff members," I replied.

"I get the feeling that is a technically accurate answer," Mr. Crowe said.

"When I was a medical student I was involved with other medical students who were peers, that is, Fourth Years, after my wife reposed. I also had a brief relationship with a nursing student."

"I know the answer to this," Jason Firth said, "But will you share those names?"

"No, I won't."

"You might be ordered by a court to answer."

"If so, I'll retain counsel and fight it, as it has literally no relevance to this case. I never once cheated on either of my wives, nor did I even consider it. I also did not violate my clerical vows. Given I was married before I graduated, at no time was I ever involved with anyone as a physician."

"I think we discussed this once before," Mr. Firth said, "but in a deposition you could be asked and forced to answer, and having counsel is unlikely to prevent a judge from ordering you to answer under threat of a contempt citation."

"I'll cross that bridge when we come to it," I replied. "Or maybe drive off it or blow it up. But I simply cannot reveal those relationships to anyone out of respect for the young women involved, who would suffer severe negative consequences if it were known."

"Just a warning that making that argument is not likely to exempt you from a contempt citation. That said, you absolutely should confer with personal counsel on the matter."

"Are you expecting Krista Sandberg to bring suit?"

"I think you'd agree that's par for the course in cases in which you're involved."

"Sad but true," I acknowledged. "What's Krista's status?"

"Still on suspension," Jason Firth replied, "pending the outcome of an investigation, of which this is part. You've confirmed, under affirmation, the salient facts, so I have a few more loose ends to tie up, including conversations with Doctor Javadi, Doctor Lindsay, and Doctor Saunders, as well as Nurse Martin and Nurse Compton."

"Has she retained counsel?" I asked.

"I don't know for sure, but I heard through the grapevine she had a consultation. I'm sure you can guess."

I groaned, "Of course it had to be."

"What did I miss?" Doctor Worth asked.

"Arthur Braun, of Volstead and Braun, has made something of a career of coming after both the medical school and hospital on behalf of students," Mr. Crowe said. "We've tangled with him perhaps a dozen times over the last decade. We win every time, but you know that if we ever lose one, the floodgates will open, because right now, not a single ruling has ever gone against a medical school or hospital with regard to student training, which we use as an effective club. Take away that club, and put things in front of a jury, and all bets are off."

"Have I said how much I detest lawyers, present company excepted?" he asked.

"I think we're unanimous on our opinion of plaintiff's attorneys," Mr. Crowe said. "My job is, in effect, to protect all of us from them."

"Which says you have an incentive to have them around," I observed with a goofy grin.

"And right there is a perfect example as to why Doctor Loucks has a reputation as a complete smart ass!" Doctor Warren declared.

"Go ahead and say the _next_ thing, Doctor," Mr. Firth said. "I know you want to!"

I grinned, "To quote Mario Puzo, 'A lawyer with his briefcase can steal more than a hundred men with guns'."

"And on THAT note, we're done! Thank you Doctor. We'll keep you apprised of any legal action on Miss Sandberg's part."

"If that does occur," Mr. Crowe said. "The hospital will defend you, but as always, you are free to retain your own counsel at your own cost."

"Let's hope it doesn't come to that."

I left the room and instead of going to the ED, I went to Medicine to find Clarissa. I quickly explained what had transpired and what I'd said out our relationship.

"All hell will break loose if they find out about us," she said.

"I know. And it'll be bad for Maryam, too, though only for personal reasons. Tami is no longer here, so there won't be any negative impact, but it would likely cause trouble for Kylie."

"No names, right?"

"Correct, except for you, Ellie, and Kellie, but according to the lawyers, Kellie doesn't rise to the level of 'sexual contact' or whatever they call it."

"Ellie wishes!" Clarissa teased.

"No kidding! But it also means I need to be exceedingly careful with Sophia's friend Kelly, who made it quite clear she wants to sleep with me."

"What are you going to do?"

"Not sleep with her!" I replied with a grin. "I thought that was obvious!"

"I know THAT, you dolt!"

"Be completely professional and if she does anything overt, have a stern conversation with her, with either Becky or Kellie in the room. Anyway, back to the current problem — if Krista files a lawsuit, names could come out because there is limited ability to refuse to answer deposition questions, per every attorney I've spoken to."

"Is she going to?"

"A little birdie whispered in the ear of the medical school legal counsel that she had a consultation with a certain nemesis of mine."

"Braun?"

"One and the same."

"That guy should…never mind. It would be unladylike to say he needed to have his balls cut off and be forced to eat them!"

"Which you just said!" I chuckled. "Anyway, I need to get back to the ED. I just wanted to warn you they would ask about us."

"I'll stick to the party line!"

"Just so you know, and you are the only one I can say this to, but if push comes to shove, I'll give Tami's name. I might give Kylie's, but I'll try to avoid giving Maryam's. I'll flat out omit you or lie about it. My world would explode if that ever came out."

"It would, and the choices are all bad. What about a baby?"

"Given this hospital has possession of the genetic material, and you'll have the procedures here, we have plausible deniability. Heck, that might actually be a solid defense against an accusation. I don't like lying, but it might wreck my marriage if that information came out. It's completely irrelevant and has no bearing on the case, but you know lawyers."

"Scum. Except for Jocelyn, of course."

I laughed, "If she were here, I wouldn't agree to that exception! That said, I think Melody Coates is probably a very good attorney, and Mr. Winston has never failed me, nor has Stefan."

"Usually YOU are the one with the blanket rant and I correct you!"

"Shoe's on the other foot for once, Lissa! And I need to get back to the ED."

We exchanged a quick hug, and I headed back to the ED. The rest of the afternoon was busy with two traumas and a dozen walk-ins. I ate dinner with a small group of Residents as Clarissa was not available, and when I returned to the ED, I placed a call to Kurt Bowman at the prison. It took nearly five minutes for him to come on the line.

"Kurt, this is Chaplain Mike," I said. "Who is your listed next of kin?"

"My wife," he said. "Well, ex-wife. She divorced me last year and moved to Alaska with her boyfriend."

"Is there anyone else? Your mom or dad?"

"No. They're dead. And no brothers or sisters, and my son is with his mom."

"Do you know who you can list?"

"They said anyone, including a friend."

"I'm getting the run-around from the Department of Corrections. I think I can cut through the red tape, at least a bit, if you list me. That gives me certain rights, at least as I understand it."

"What the hell," he replied. "Why not. I'll fill out the form tomorrow."

"Have you requested treatment in writing?"

"Yes. I filled out the form three times, asking to see a doctor. I think the nurse used them for TP."

"Do one other thing, please; fill out the form again and let me tell you exactly what to write."

I gave him the correct language to use, though I avoided terms only a doctor would use, substituting commonly used words instead.

"File that right after you file the form to change next of kin. Do you have access to aspirin?"

"From the commissary."

"Get some and take half a tablet each morning before breakfast. Do you have funds to do that?"

"Yeah, aspirin is cheap. And at half a tablet, I can get enough to last a week at a time, which is how often I can buy it."

"OK. I'll be in touch."

"Thanks Chaplain, or Doc."

"Either one will do," I replied. "You're welcome."

I hung up, made some notes, then went back to treating patients until it was time to turn them over to Kylie.

_September 26, 1989, McKinley, Ohio_

"Mike, your wife is on Line 3," Nate said late on Tuesday afternoon.

I picked up the handset and pressed the correct button.

"Hi," I said. "What's up?"

"I have a letter from the State Department! My application was approved!"

"Excellent!" I declared. "When is your ceremony?"

"Wednesday, November 8th at 3:00pm."

"I'll arrange to take the afternoon off from the Free Clinic."

"See you tonight!"

We said 'goodbye, and I hung up, and before I could take a step, Nate let me know the paramedics were bringing in multiple MVA victims. I called Jake and Heather, and the three of us went to the ambulance bay where Ghost and Perry were waiting. Two minutes later, the patients arrived, and I inserted a chest tube in one, and ultimately sent both up for emergency surgery. Unfortunately, because the scheduled procedures for the day were completed, I didn't get to scrub in.

Jake, Heather, and I handled two more walk-ins, then I went to meet Clarissa and Shelly Lindsay for dinner in the cafeteria.

"Kris was notified that her citizenship application was approved," I said. "She'll take the oath on November 8th."

"That's great, Petrovich!" Clarissa exclaimed.

"Congratulations, Mike, Shelly said.

"Her family can apply now, right?" Clarissa asked.

"I think so, but I'm not sure. Mr. Burge deferred answering that question when we asked."

"Will Kris be a dual citizen?" Shelly asked.

"She has no intention of surrendering her French passport, and France won't revoke it because she's a US citizen. From what I understand, she's required to use her US passport to enter or leave the US, but otherwise, there's no specific law about using her French passport, at least one of which we're aware."

"How soon does Rachel get her passport for a trip to France?" Clarissa asked.

"Kris and I have only discussed going there in a general way, with no specifics. It's likely to be a few years between my Residency and babies."

"Already?!" Shelly asked.

"We sat down, figured out the optimum plan to not interfere with Kris obtaining a Master's in Public Administration, and concluded it was best to do it while she's an undergrad. That also puts the kids closer to Rachel in age, which I think is a good thing."

"Says the man with a brother who is about twenty-five-years younger!" Clarissa teased.

"A very different thing! As it is, it'll likely be nearly four years between Rachel and her younger brother or sister, but then two years between the second and third kids."

"Changing subjects," Shelly said. "I had an interview with the medical school attorney today."

"How did it go?"

"Fine. I have nothing to hide and I'm not afraid of any repercussions about advising you to tape record your encounter with Krista Sandberg."

"Out of curiosity, was that your idea, or did it come from above? And if it was yours, did you confirm it with anyone?"

"It was mine, but I made sure Doctor Roth was on board. You know he's fully behind your campaign for equal treatment of women and to end the 'harem' idea about female medical students."

"But no problem for male medical students with female Attendings or Residents?" I asked with a grin.

Shelly laughed, "I don't think I've _ever_ heard of a complaint; I mean, not a single one!"

"Petrovich never complained about Ellie Green," Clarissa smirked. "Not that he gave her offers any consideration!"

"She's incorrigible!" Shelly declared. "I think you're the only Resident in the past four years she hasn't enticed!"

"Nah, I know at least one more," I replied. "He plays for the same team as Clarissa."

"Another thing that needs to change," Shelly said. "This idea that gays can't be doctors is insane."

"As I've said about other things, the 1950s called and they want their values back. The fact that Clarissa can be out is a positive sign."

"Only because the pigs fantasize about what she does with Tessa!" Shelly said, shaking her head.

"And think that all it would take is a good screwing to convince me to change teams," Clarissa said, shaking her head. "They're wrong."

Which I knew for a fact because we'd tried, at Clarissa's instance.

"They're wrong about a lot," Shelly replied. "I've already heard some bitching about the new policy about medical students and sex on hospital property."

"To be my usual goofy self, fuck 'em! Or, actually, don't!"

Both Clarissa and Shelly laughed,

"Doctor Roth was extremely happy with that new policy. He's been agitating for it since the Gerald Kirby incident."

"Yes, but the Old Boys Network thinks that is interfering with their personal lives," I observed.

"Same response you had — fuck 'em. And they can still bang med students, just not at the hospital. But I'll pocket that small victory."

"Me, too," I replied.

We finished our meal and left the cafeteria, each heading back to our own service.