Chapter 70 — Four Dimes

_December 25, 1989, Feast of the Nativity, Circleville, Ohio_

{psc} "How was your day?" Kris asked when I arrived home on Christmas Day evening.

"It wasn't busy, but unfortunately, three of the four MIs I had didn't make it."

"Heart attacks?"

"Yes, sorry. I try not to use medical shorthand with you."

"What happened?"

"One we stabilized and sent to the cardiac catheterization lab for insertion of a stent, which I've explained. He developed arrhythmia before they could begin the procedure. The second one died about a minute after the paramedics brought him in. The third one is resting comfortably in Cardiology. The fourth coded while the Cardiologist was examining him, we brought him back, but then he coded again about five minutes later. Oh, and there was one panic attack brought on by indigestion because the patient thought he was having a heart attack."

"It must be terrible to have a loved one die on Nativity."

"As I said at the hospital, Mr. Worf's opinion notwithstanding, today is not a good day to die. How was your day?"

"Good! We went to church with my family this morning, then Rachel and I spent the rest of the day there. We came home about forty minutes ago, so we could be here when you arrived home."

"Shall we read to Rachel, say our prayers, put Rachel to bed, then take a nice, warm bubble bath?"

"That sounds wonderful!"

Rachel chose _The Bears' Picnic_, one of her favorites, and once I'd read it to her, the three of us gathered before our icons and said our evening prayers. Once we'd completed them, Kris and I put Rachel to bed, then went to the master bathroom for our bath.

"Do you still plan to visit the prison on Sunday after church?"

"Yes. It's really the only time I can go. Protodeacon Ivan is driving so he can take the Eucharist to Nick Papadakis, and he'll have me back here in time for Rachel, you, and I to leave for my dad's house."

"You should just leave from church. I can drive your car home."

"That sounds good."

"I'm curious what we'll do about a car when we have three kids, with two of them in car seats?"

"Well, that's three years from now, so it's not an immediate need, but I don't see any option other than trading the Tempo for a minivan. We've been saving towards a new car in addition to what we're saving for the house, so we'll be in good shape. I think about fifteen months from now is the right time to start building a house. I figure five bedrooms, so that we have two spare rooms. Assuming things go the way we've discussed, I'd want the child Clarissa will conceive artificially to have a room."

"You expect him or her to live with us part time?"

"I'd like to leave things open so that he or she feels completely welcome. Are you still comfortable with the idea?"

"Yes, though I do wonder what you'll say to His Grace."

"The truth. I will take whatever paperwork is generated to show him to remove _any_ speculation that I might have violated my vows. Of course, there will be gossip, but I want Vladyka to know, so there is no doubt of any kind in his mind."

"She's a lesbian!"

"Yes, of course, but she still has the appropriate parts, as do I, and orientation doesn't preclude biological function! And that's what will cause the gossip."

"Will there be a problem baptizing that child?"

"No. First of all, the church baptizes children born out of wedlock because the circumstances of one's birth are irrelevant. And Clarissa and Tessa have both agreed to do it. They come to church at least one Sunday a month."

"I noticed that Lara and Nathan are in church more often than not."

"They pretty much have to, given they're marrying on January 28th at the Cathedral."

"What are we giving them?"

"Clarissa and I discussed it, but neither of us has any ideas. I mean, what do you get a girl who's a millionaire at twenty-two?"

"Higher taxes!" Kris declared mirthfully.

"That's a gift I don't think would be appreciated!" I chuckled. "But I have time to think about it."

"Are they taking a honeymoon?"

"During the Summer when school's out, they're going to Europe for a month. I'm looking forward to the day in the future when we can go to Europe as a family."

"This time, though, not just the tourist parts!"

"Well, that's in the future. Right now, there's another place I'd rather visit!"

"Bed?"

"Yes!"

_December 26, 1989, McKinley, Ohio_

Tuesday morning was back to normal at the hospital, though a number of Attendings, Residents, and nurses were on vacation, so shifts were jumbled and there were a number of outside physicians working in the hospital to earn extra money, as well as keep their privileges. That also meant that on Wednesday, I'd work at the hospital, rather than at the Free Clinic.

"Morning, Mike!" Doctor Gibbs said when I walked into the ED. "How was your Christmas?

"I was here!" I replied. "And it was Heart Attack City! I had four MIs myself, and there were three others; five didn't make it."

"That's out of the ordinary."

"The number or the number who died?"

"Both! Do your handover then come see me."

I spoke with Paul Lincoln, who had two patients on the board — one with food poisoning who was being admitted to Medicine and one with a broken ankle, who needed surgery. Paul left, and I went to see Doctor Gibbs.

"What's up?"

"What are you doing in May?"

"Working!" I said with a smirk. "What do you _think_ I'll be doing?"

"I meant in your personal life?"

"Kris isn't due until mid-June, so no specific plans. Why?"

"There's a regional trauma conference in Indianapolis the weekend of May 19th. When is your Easter?"

"April 21st," I replied.

"We'd like you and Ghost to go to Indy for the conference."

"I appreciate the recognition."

"I'd send you to the International Conference on Emergency Medicine in Toronto, but it runs from June 20th to June 24th, and someone might bring out the guillotine for me if I did that!"

"My response would be that if you want me to go, you have to ask Kris, and I'd say your estimate of her reaction is accurate! Who'll go?"

"Me and a Resident. I have to decide which. Any suggestions?"

"Kylie Baxter," I replied without hesitation. "Is it up to you?"

"That's the other piece of information — Northrup handed in his resignation on Christmas Eve. He's going to Swedish Covenant in Chicago as Medical Director."

"That's a fairly small hospital, if I remember correctly," I said.

"It's a stepping stone for him. Once he has the position, he can parlay it into a similar job at a larger, more prestigious hospital. But he does have one thing going for him!"

"What's that?"

"Harrison Ford was born at Swedish Covenant Hospital in July 1942!"

"Interesting! What's the scoop on the Chief's job?"

"That'll be up to Cutter, but given he's brand new in the position in January, I'd put my money on a nationwide search."

"You're going to apply, right?"

"Of course!"

"You have my vote," I replied. "Though I'm not sure what that's worth."

"I certainly wouldn't mind a good word being put in with Cutter when the time is right. You surgeons are thick as thieves!"

"Guilty as charged," I chuckled. "I do have to extract a promise from you — no turf wars about who the trauma surgeons report to."

"As if I'd want to manage you? Seriously?"

I chuckled, "I can be difficult."

"You fit right in with the rest of the red shirts!"

"Ouch! But in _TNG_ red shirts are command, or 'line' officers; gold is engineering or security; and blue is science. The 'red shirts' don't die in this series!"

"Oh, shut up!" Doctor Gibbs growled. "Stop being so pedantic and ruining a good joke!"

I was SO tempted to stick my tongue out at her, but I controlled the urge.

"Whatever!" I said instead.

"Go heal the sick! I'll get you details for the conference in January. Just block out that weekend, please."

"Will do!"

I left her office and went to check on the two patients Paul had handed over. While I was in with the food poisoning patient, Clarissa arrived to admit her to Medicine, and about five minutes later, Val Jackson from Orthopedics came into the ED to admit the broken ankle.

"May I present?" Jenny asked when I went Exam 5 to see a new patient.

"Go ahead."

"Female, twenty; jogging this morning at the Y and twisted her left ankle. Pulse 70; BP 110/60; PO₂ 99%. No appreciated injuries other than the left ankle. Moderate ecchymosis; no pain in the malleolar zone; no bone tenderness. I believe it's a Grade 2 sprain, but recommend an x-ray to rule out a fracture."

"Why?"

"It's the standard protocol," she replied.

"How sure are you of your diagnosis?"

"There is no indication of a break."

"So you'll subject the patient to a possibly needless x-ray?" I challenged.

"Er, uhm…" Jenny stammered.

"Speak your mind, please. Remember, your job is to be a forceful advocate for your patient."

"We have protocols for a reason, and unless the patient has had excessive x-rays, there's no reason to reject the protocol."

"Has the patient had x-rays recently?" I asked.

"Oops!" Jenny exclaimed with a smile. "I get it. I'll be right back!"

She went back to the treatment room and returned a minute later.

"Dental x-rays last year. That's insufficient to warrant caution. May I ask a question?"

"You may."

"I've observed you order x-rays without checking."

"Yes, I have. Tell me why?"

She thought for a moment.

"Because in the case of an ankle injury, something on the order of 90% are sprains, not breaks, which means nine out of ten x-rays are probably unnecessary. You've ordered them in cases when there wasn't really an option."

"Correct. Let's go examine your patient, get the x-rays, then if they confirm your diagnosis, you can wrap the ankle."

I confirmed Jenny's diagnosis and ordered the x-rays. Forty minutes later, I observed as Jenny wrapped the ankle with an ace bandage. I wrote out the discharge orders, had Kelly retrieve a pair of crutches, and then take the patient to the door to the hospital in a wheelchair.

The morning was relatively calm, and we saw five walk-in patients, none of whom needed admission, and one EMS run for a moderate MVA, with the patient discharged with a cervical collar on account of 'whiplash'. I had lunch with Clarissa, then had a busy afternoon with a string of walk-ins. I had dinner with Shelly Lindsay and had my first challenging case just before 7:00pm.

"What do you have, John?" I asked when he came into the lounge.

"Tommy Fields; toddler with gastrointestinal distress. No fever; tympanic membranes not bulging; no mucous; no vomiting; pulse 78; BP 120/80; PO₂ 98%. No recent injuries. No other family members are ill. No reports of any medical condition; no evidence he ingested any hazardous liquids or medicines."

"What do you want to do?"

"Have you teach me to do an abdominal exam."

I nodded, "Then let's do that. You know the procedure, right?"

"Yes. Checking for rebounding, guarding, distension, tenderness, and pain with pressure. I haven't done one, though."

"Do you know what those things feel like upon palpation?"

"No."

"Then I'll perform the exam and if I detect something, I'll have you feel it, with the parent's permission. How old is your toddler?"

"Sorry. He's three. His mom is with him. I should have said that."

"Let's go see him.

We went to Exam 3 where Tommy, his mom, and Kelly were waiting.

"Mrs. Fields, this is Doctor Mike, my supervisor," John said. "Doctor Mike, Tommy and Mrs. Fields."

"Hi, Tommy," I said. "Hi, Mrs. Fields. Is there anything more you can tell me other than what you told John and Kelly?"

"Not really, He was fine until about two hours ago, when he complained that his 'tummy hurt' really badly. He didn't have a fever and didn't throw up, but he started crying. I gave him Children's Tylenol, which seemed to help, but then he complained an hour later that it hurt worse, so I brought him here."

"John says that you're sure he didn't ingest any cleaning fluids or medication."

"Positive. Everything is in locked cabinets, out of reach. We moved everything as soon as he started crawling."

"OK. Tommy, I need to listen to your heart and your breathing, look in your eyes, ears, nose, and mouth, then feel your neck and tummy. Is that OK?"

"Yes," he replied.

I performed the exam and detected no indicia of any viral or bacterial infection, and no rigidity, guarding, or tenderness, and no swollen glands.

"Tommy," I said. "Did you eat anything other than the food an adult gave you?"

"No."

Given the time of year, there was another possibility, but I had to be careful about asking.

"Tommy, does your family celebrate Christmas?"

"Yes! I got lots of presents!"

"What kind of presents?" I asked.

"A train set," he said.

I turned to his mom, "What scale?"

"HO," she replied. "But we made sure there were no small parts on any of the trains."

"OK. Tommy, what else?"

"Simon!"

"What else?"

"Clothes and books."

"Do you have a dog or cat or fish?"

"No."

"Mrs. Fields, do you have a real or artificial tree?"

"Artificial."

"Miniature bulbs?" I asked.

"Yes. We have the big ones outside, and the tree has the small ones."

"Tommy, did you put anything in your mouth at all besides your food?"

"No," he said.

"Mrs. Fields, has he been using the bathroom regularly?"

"Yes. He had a BM earlier today."

"OK. I'm going to do an ultrasound, because I strongly suspect Tommy ingested something. If this were a virus or food poisoning, he'd have a fever, swollen glands, or be vomiting. There's an outside chance it's appendicitis, but I don't believe that's the case. That said, children do not have the same classic signs adults have. The ultrasound will help us determine what's wrong."

"What else could it be?"

"There is a range of possibilities, most of them extremely rare, so let's wait to see what we find with the ultrasound, OK?"

"Yes."

"Kelly, John, let's step out a moment. Mrs. Fields, we'll be right back with the ultrasound machine."

We left the treatment room and stopped just outside the door.

"Any thoughts?" I asked.

"What do you think he swallowed?" Kelly asked.

"No clue, and I'm not sure that's what it is, but with nothing to go on except stomach pain, it's a theory. The Ultrasound will give us an idea. You handle the transducer."

"OK. Where do I scan?"

"Sternum to pubis. Do you know your anatomy well enough to evaluate the image?"

"I think so."

"Either you do or you don't."

He was quiet for a moment, then said, "I don't."

"It's never wrong to admit you don't know," I replied. "It's _always_ wrong to say you do if you don't. I'll point out each important anatomical feature while you're moving the transducer. Kelly, get the ultrasound cart, please."

Kelly retrieved the cart and the three of us returned to the exam room. John turned on the ultrasound and made the correct settings on the console. Once that was complete, he asked Mrs. Fields to remove Tommy's shirt, then explained to Tommy what he was going to do. Tommy was reasonably coöperative and Jack began the scan.

As he slowly moved and tilted the transducer, I pointed out each organ in Tommy's internal anatomy with nothing anomalous being visible until the transducer was just above Tommy's navel.

"There," I said, pointing, then pressing the button to freeze the image.

"What are those?" Jack asked.

"Move the transducer to the right and tilt it away from us," I requested, then pressed the button to unfreeze the image, followed by the 'zoom' button.

Jack did as I asked, then said, "Coins?"

"I'd wager four dimes," I said, pressing the button to freeze the image. "From the size, but they could be pennies as well. Tommy, did you eat any money?"

"NO!" he protested.

"He ate coins?" Mrs. Fields asked.

"It certainly appears that way," I said, as I pressed the button to print the image.

"What do we do?" she asked.

"Typically, if they aren't lodged in the esophagus, we wait for them to pass, which can take anywhere from two days to two weeks, depending."

"You can't remove them?"

"I'd strongly prefer not to perform what's called an endoscopy, which would require putting Tommy under general anesthesia, something we want to avoid whenever possible, then putting a tube down his throat. I'm going to call a pediatric specialist to come down and talk to you."

"OK."

I went to the phone and dialed Pediatrics. I explained to the charge nurse what I had discovered, and she promised that Matt Olson would be down within ten minutes. I thanked her, hung up, then let Mrs. Fields know he'd be down shortly. Strictly speaking, I didn't need a pediatric consult, but in cases where the answer was 'go home and wait', I'd found parents were more comfortable hearing that from a specialist than from a doctor in the ED.

"Tommy, another doctor is going to come see you," I said. "If you look at the screen, you can see there are four pieces of money in your stomach, which is why it hurts."

"I didn't eat it!" he protested.

"Tommy, don't lie," Mrs. Fields said.

"I'm not lying! The doctor is lying!"

So much for being 'Kid Whisperer' I thought to myself.

"Tommy…" Mrs. Fields reprimanded, though she sounded more exasperated than upset. I took the opportunity to update the chart, and a few minutes later, Matt Olson walked in with his student, Nathaniel.

"Hi, Mike. What do we have?" Matt asked.

"Three-year-old male with foreign bodies in the stomach that appear to be dimes. He denies eating them, despite me showing him the picture."

Matt Olson smiled, telling me that my rep had just taken a hit, but the patient was far more important than my ego.

"Mrs. Fields, this is Doctor Olson from Pediatrics," I said. "Matt, Mrs. Fields and Tommy. Mike, complete report, please?"

"Jack?" I prompted.

He did a very good job of reporting our findings, then Matt checked Tommy and repeated the ultrasound.

"Mrs. Fields, we'll step out for a moment," Matt said.

She acknowledged him and Matt, the three medical students, and I all stepped out of the exam room.

"I take it she expressed concern about sending them home to wait for the coins to pass?"

"Yes," I replied. "I'm also a bit concerned about the stomach ache, but it could well be psychosomatic."

"That's my take. The fact that Tylenol knocked down the 'tummy ache' for a time indicates that, too. And he's not acting like he's in pain now."

"He hasn't acted in pain since I saw him. Jack?"

"No evidence of pain, but we were taught there are no physical signs."

"Exactly right," Doctor Olson said. "We observe how it manifests. That kid is not in discomfort except about sitting in an exam room."

"And he knows he's lying, too," I replied. "I have absolutely nothing to support endoscopy on a three-year-old, especially given the risks of general anesthesia compared to the coins passing through the bowel."

"Agreed. Shall we go back in together? I'll back you up."

"Perfect," I agreed.

The five of us returned to the room.

"Mrs. Fields," I said. "Doctor Olson and I agree completely that the best and safest approach is for you to take Tommy home. The coins will pass through a normal BM in the next two to fourteen days. If they haven't passed in a week, he should have an ultrasound, which could be conducted either in your pediatrician's office or in our outpatient clinic."

"That's really safe?"

I nodded, "It is much safer than administering general anesthesia. The only time we'd try to remove them is if they were larger coins, and they were caught in his esophagus. I'd suggest ensuring purses or other containers with coins are out of his reach."

"They are!" she said. "Wait! His piggy bank! He gets a dime every week to save to build the habit!"

"I suspect if you check it, it'll be light four dimes," I replied.

"That kid!" she said, shaking her head. "Just like every OTHER male on the planet, you can't keep them out of trouble!"

I chuckled, "My colleague Clarissa Saunders says she can't leave me alone for thirty seconds without me finding a way to get into trouble!"

Mrs. Fields laughed, "That sounds like Tommy!"

"I have a friend who asserts that the only difference between toddler boys and adult males is body mass and the size of their wallet!"

"She's not wrong!" Mrs. Fields declared.

"Let me fill out the discharge papers. You should probably call Tommy's pediatrician in the morning just to let him or her know."

"Thank you, Doctors."

Matt acknowledged her and left with his student while I filled out the discharge papers. Because I'd used the ultrasound, and Matt was a Resident, not an Attending, I took the chart to Ghost to sign.

"Losing your touch?" he asked when I related what Tommy had said.

"So it would appear," I chuckled. "But even Pete Rose struck out!"

"What do you think of his permanent ineligibility?"

"I think he was an idiot to bet on baseball games, even if he only bet on the Reds to win. That's inexcusable, and permanent ineligibility is appropriate. That said, he should get into the Hall of Fame as a player, no matter what else he might have done later."

"Agreed."

He signed the chart, and I discharged my patient.

"Think you could do the next one without assistance?" I asked Jack.

"I have to study my anatomy plates before I say 'yes'."

"Then do that."

_December 31, 1989, Southern Ohio Correctional Facility, Lucasville, Ohio_

On Sunday, after church, I rode with Protodeacon Ivan to Lucasville, so that he could bring Nick Eucharist, and I could visit with Frank Bush and then lead a Vespers service for him and the other prisoners. Normally, when an ordained member of the clergy was present, he would lead the services, but Vladyka JOHN had granted «ekonomia» for me to lead Vespers at the prison even though Protodeacon Ivan was with me.

After the usual security checks, we were escorted to the visitor's room, and a few minutes later, Frank Bush was brought in to see me, and Protodeacon Ivan was escorted to Nick Papadakis' cell to conduct a Deacon's _Typika_, a form of the Liturgy of the Pre-Sanctified Gifts.

"How are you doing?" I asked.

Frank shrugged, "Every day is the same, with almost no variation. It's not as if they're going to allow me a furlough for a vacation. How was your Christmas?"

"Our extended family was together, though we had our celebration on Christmas Eve because I had a shift from 5:00am to 9:00pm on Christmas Day."

"Not atypical for an Intern. How is that going?"

"It's exactly what I wanted to do with my life, and I'm very much enjoying my work. The new Residency in trauma surgery provides opportunities I would never have had as a pure emergency medicine specialist or a pure surgeon."

"Who was the other guy in robes?"

"Protodeacon Ivan," I replied. "He's visiting Nick Papadakis to bring him the Eucharist."

"You don't teach that nonsense like the Papists that it's literally the body and blood of Jesus?"

"No. It's symbolic, but not in the way modern materialists understand symbols. We have the ancient understanding of a symbol as a way to manifest the reality associated with the symbol. In other words, something is symbolic is 'real', not simply some abstraction or empty representation. So, while if we were to take the chalice down to the local lab, they'd only find bread, water, and wine, when I receive the Eucharist, it manifests the reality of Jesus' statement that unless we eat his body and drink his blood, we have no life in us."

"That sounds like meaningless mumbo-jumbo!"

"Because the true nature of the Eucharist is a mystery, though not in the sense of Sherlock Holmes or the _Sunday Mystery Movie_, but in the ancient sense of the word, which means 'hidden'. Or, as Paul says, we see through a glass, darkly, and there are many things we do not fully understand, and will not understand, until we stand in the throne room of God."

"Let's play chess," Frank said.

I nodded, and we began playing. I felt I was making progress with Frank, and I was my fervent prayer that I could at least bring him to a point where he didn't simply assume he was going to Hell with no possible chance at a reprieve. We played our usual three games, of which we each won as white, and drew the third game where I had the black pieces.

"How is your correspondence course going?" I asked.

"I finally received the books last week, so I've basically just started. I did take the class on how to use the computers."

"Good. Join us for Vespers?"

"No, thanks."

I nodded, we shook hands, and after he was escorted back to his cell, I was escorted to the chapel where Kurt, Nick, John, Sean, Nate, and Protodeacon Ivan were waiting, along with another prisoner, a black man I hadn't met before. Kurt introduced him as Clifton Rice.

As I had the previous times, I conducted the Vespers service, then chatted with each prisoner in turn, and Protodeacon Ivan chatted with each of them as well. I almost laughed when Clifton Reed, who was from Cincinnati, said that he was serving fifteen years for 'knocking over liquor stores', something Clarke Brody and I had joked about many times.

I spent more time with Kurt Bowman than the others, as I inquired about his medical care in addition to other topics. He was receiving regular checkups and his medication was working, which pleased me greatly. I did verify with the other men that they had access to the medical care they needed, but none of them had any complaints. I also heard more of Sean Casey's story.

"This is confidential, obviously, but I sense a pattern."

"I was never with a girl over fifteen," he said. "I like the nubile ones."

"How many girls?" I asked.

"You can't tell anyone?"

"No."

"Six. There were two before the first time I was busted, then three more before I was busted. Well, those are the ones from after I turned eighteen. My first time was fourteen with a girl who was my same age, and there were three more who were fourteen or fifteen before I turned eighteen. The cops talked to the other two girls, but they denied everything."

"May I suggest when you get out you stick to girls who are at least eighteen?"

"I turned eighteen in 1976, and when I was busted in '80, I got probation for 'contributing'. Then everyone got insane, and the laws became tougher, though I didn't realize until my attorney explained it when I was arrested in '85."

"Are you receiving counseling?"

"It's mandatory, and I finished last year."

"Are you earning 'good time' credit?"

"Yes. I'll have to do twelve, but if I keep my nose clean in here, I'll go to a halfway house and try to find a job. It'll be tough, though."

"Does anyone visit you?"

"My mom and my brother each visit once a month. My dad died when I was twenty. I suspect things were easier for your brother-in-law."

"If you consider his wife divorcing him and leaving the state with his kid to be 'easy', then maybe."

I was thinking more about getting a job when he got out. The stigma for statutory was possible to overcome. Criminal sexual assault, not so much. Just the name of the crime would put most people off.

"The halfway house in Rutherford is pretty good. That's where my brother-in-law was. The key for him was finding someone who was willing to take a chance on him. He's kept his nose clean, which is why he's still alive. My sister wouldn't think twice about taking him all the way out if he strayed by a millimeter. See you in three weeks?"

"Sounds good."

Our time was up, so Protodeacon Ivan and I left the prison to head back north.

_December 31, 1989, Rutherford, Ohio_

"Hi, Dad! Hi, Holly!"

"Hi, Mike," my dad replied. "Peter has really been looking forward to today."

"Then what are we waiting for? I'm sure Rachel will be happy to play with Faith."

I suppressed a sigh when Holly invited Kris and Rachel to another room, while my dad, Peter, and I sat in his den, though I was on the floor with my half-brother playing _Candy Land_. The division of men and women reminded me of what had happened when Kris and I went to Chicago when my grandfather Loucks had died.

"How are things going, Mike?" my dad asked.

"Good. I'm working a lot of hours, but it isn't as bad as I'd feared. How are things at the County?"

"Very good. Robert Barnes retired as of Friday. I applied for the Director's position."

"He was there when I was born!" I chuckled.

"He was a supervisor and hired me right out of college. He put in forty years."

"Impressive. What's he doing now?"

"He and his wife are going to Australia for a month."

"When will you hear about the position?"

"Supposedly the appointment will be made next week. It's between me and two other guys. One from near Youngstown, and one from Tennessee. I'd like to think I'm a shoo-in, but you never know."

"We have a situation like that where the Chief of Emergency Medicine is leaving, and the Chief Attending should get the role, but they're going to conduct a nationwide search. I just hope they don't pass over her because she's female."

"We hired our first female civil engineer back in July. A new graduate from OSU."

"It's about time!"

"How is your sister and my grandson?"

"They're doing great. I did encourage her to get in touch, but she's still very angry with you."

"It wasn't one-sided, Mike."

"I don't want to hear it," I said. "From my perspective, it's NO-sided. I love you both and I am not taking sides and I don't want to get into it. If you say that to Liz, or even imply it, you'll ensure you never see your grandchild. Let me keep working on her, and if you do see her, please, please do not say anything about not having seen her in a while."

"You don't think I have the right to see my grandson?"

"Not according to Ohio law, and from Liz's perspective, you gave that up when you took up with Holly. Right or wrong, she's in control. This is the same general argument that Elizaveta had with her mom, but in that situation, I had to side with Elizaveta because she was my wife, and that overrode any other consideration. What I won't do is take sides in this because I love all of you."

"I know what you think of me."

"No, actually, I don't believe you do," I said, as I drew 'Mr. Mint' and had to retreat more than halfway back the _Candy Land_ board. "May I give you a perspective?"

"What?"

"Once a month, I visit Frank Bush at Southern Ohio Correctional Facility."

"Who is that?"

"The doctor who murdered Lee and almost killed Robby."

"What's your point, Mike?"

"That being a Christian is about loving everyone. Healing the sick, caring for widows and orphans, visiting the imprisoned. That is true religion, and true faith. I leave the judging to others, and they seem to relish it. So, no, you don't know what I think of you. I've tried to tell you, but you can't see past what Grandpa Loucks' church taught you. I don't think you've ever understood me. Christianity cannot be solely about believing the right thing; it must be about _doing_ the right thing. That's the entire point of the Parable of the Sheep and the Goats."

"And you're so sure you're right?"

"Only in that I'm following the instructions Jesus provided. Beyond that, all I can say is 'Lord, have mercy'."

My dad didn't respond, and I finished my game with Peter, who then wanted to show me his toys, so I followed him to his room. I was given a personal guided tour of each and every toy, with commentary about the relative value and how much fun it was to play with. He had just finished when Holly called us for dinner.

"We have an announcement," I said once we'd sat down. "Kris is pregnant and due in late June."

"Congratulations, Mike!" my dad said. "And you, too, Kris."

"I don't want a brother!" Rachel declared. "I want a sister!"

Holly and my dad laughed, and then we began eating. Once we'd finished, I volunteered to help with the dishes, and once they were done, Kris, Rachel, and I bade my dad, Holly, and the kids 'goodbye', and headed home because I had to be at the hospital at 5:00am.

_January 1, 1990, McKinley, Ohio_

"How was last night?" I asked Susan Townsend early on Monday morning.

"Pretty bad. Four MVAs with a total of six fatalities; the three that made it were already admitted. All I have for you is two drunks sleeping it off with banana bags in Exam 2 and Exam 3, and a college student with alcohol poisoning waiting on admission to medicine."

"EtOH level?"

"0.36 upon presentation; 0.31 at last check about thirty minutes ago. I have Kelly sitting with him. He's on O₂, a banana bag, and IV dextrose because his blood sugar was 58. It's 70 now."

"OK. Full report, please."

She ran through the vitals for Craig Devlin, nineteen, a student at Taft who had been brought in by EMS. Once she'd completed the report, she left, and I went to check on the patient.

"Morning, Kelly. Any changes?"

"No. He's been in and out of consciousness for the past thirty minutes, but not lucid. PO₂ is up to 92% on O₂ by mask; He vomited once, about an hour ago, but no aspiration."

"Thanks."

I performed a quick exam, then said, "Keep him on his side and watch carefully. I'm going to check in with Doctor Nielson."

I left the trauma room and went to the Attending's office.

"Morning, Perry," I said. "Bad night I hear."

"Damned drunk drivers. I take it you stayed in?"

"We had dinner with my dad and his family, and were home by 9:00pm. We said evening prayers and then went to bed. Susan handed over the two drunks and the alcohol poisoning. Medicine will take him when his EtOH is 0.25."

"OK. Hopefully we'll have a quiet morning while everyone is sleeping it off."

"Hopefully. I did see a chart in the rack, so let me deal with that."

"Make it so," he said.

I chuckled, "You're wearing blue, which makes you 'medical'. I'm wearing red, so that puts me in command!"

Perry laughed, "If you want to run this nightmare, it's all yours!"

"No thanks! I'll leave that to Loretta!"

I left the office and went to the lounge to find Jenny, and she and I got the chart from the rack.