Nothing Ventured, Nothing Gained 3/13/03

Outdoor panorama scenes:

It's a Wednesday morning, just before spring. Crocuses are blooming and the Canada geese have been seen pilfering grass in the City's parks. Several residents, although they are wildlife activists, have posted a sign near the small flock of grass munching Canada geese in the large grassy area near Presidio's offices. The sign has a cup nailed to it.

Passersby of the grassy area have had many chuckles over the content of the sign.

The City is gearing up for spring and the natives are restless. Many have taken to the bike paths of the City, just recently cleared of melted snow. Despite the chilly air, the weather has become warmer, and like most humans who live in a wintry environment, City residents shed their winter clothes and wore their spring exercise clothes on the first above 50 degree day. But during the late afternoon, the weather turns downright cold once again and the meltwater freezes.

Panning inside the offices of Presidio Med:

As a result of the warm days and cold nights, or perhaps because a viral bug has been going around, Matt & Jules have been treating a large number of sniffles and colds, as well as setting sprains and broken arms, and doling out the tetanus shots from the inevitable falls City residents have taken on the water-slick bike pathways.

Nick has been busy in his suture room for City residents haven't been too tidy during the recent snowfall but that is not the resident's fault: there has been a strike amongst the trash collectors and trash--especially glass--has been piling up. Much of the glass has been broken and when the bicylists and rollerbladers fall, they often fall on shards of glass.

At times, Nick sends some of the patients over to Jackie, who's been busy with her new underarm laser hair removal program that has been an instant hit with the exercise crowd, especially since she's charging a mere 100 smackeroos for the procedure.

In fact, that is how Jackie advertised her new program:

just 100 smackeroos and you will be rid of your underarm hair forever!

Jackie has posted her sign on the Notices board in the waiting area so patients will see it and hopefully will make an appointment. Although David has previously spoken wth Jackie about getting her profits up, he frowns at her posting her advertisements in the offices.

Letty has been busy setting up a heart healthy program & hasn't been seen much around Presidio's offices, although her quarterly earnings are up--and David has been salivating about her financials. Letty is seen walking into Presidio's offices & is chatting with Norman.

Rae has had the usual patients, but she's still upset over Grace Rothman.

A small respite in the OB suite is welcoming to Harriet. She's been upset as of late but she doesn't know why.

Inside her office, Harriet is having quite the time with one of her patient's husbands, Steve Grubman. She's frazzled at his questions, which is highly unusual for this expeienced OB. As a result, Harriet is twirling around a pencil in her hands, a sign of her agitation.

H: "Steve, there's really nothing to worry about."

S: "It's just that I feel so useless."

H: "There are ways to be involved during labor."

S: "It's not that. She's doing so much and I'm doing nothing."

H: "Labor is like that."

S: "You don't understand. She is the one who's creating this baby and all I seem to do is rub her back and time the contractions. That's why I feel useless. I should be doing something."

H: "You are doing something--you're there for her."

S: "But all I'm really doing is saying things like "good" and then timing the contractions. I'm not contributing."

H: "That's about all you can do."

S: "And that's why I feel so useless."

H: "Birth is something that a man just can not do."

S: "I know that. In the tribal cultures I did my field studies with, birth was women's work. Women went to a separate place to give birth."

H: "Where were the fathers?"

S: (surprised) "With the other men."

H: "Weren't they with their wives?"

S: "No. In many tribal cultures, men aren't allowed in the birthing hut. Unless a shaman was needed--or a berdache."

H: "Berdache?"

S: "Native American term. Someone who is a bridge between men and women. Berdache are usually men who dress and act like women."

H: "What did the men do while their wives were giving birth?"

S: "Talk. Carve. Have competitions."

H: "But not help the wives give birth?"

S: "That's a woman's domain. The other women in the tribe helped her."

H: "So you would feel more comfortable not being in the room with her during the actual delivery?"

S: (looking guilty) "Yeah."

H: "So that's your problem. How does Sheila feel about that?"

S: "I'm not sure. I haven't asked her."

H: "There's still a few weeks. You might want to broach the subject with her."

S: "I'm not sure how she'll react."

H: "There is nothing wrong with a father who chooses to remain in the waiting room while his child is being delivered."

S: (surprised) "In tribal cultures, that would be true. But that Lamaze woman, Barbara whats-her-face, said it was the duty of fathers to be supportive of their wives during labor and delivery. She said that fathers have a duty to be a coach in western cultures."

H: (smiling) "When I was a first year med student, fathers still paced the maternity waiting room until a nurse came out and showed them their newborn. By the time I was a first year resident, fathers were encouraged to actually be in the delivery room. Many men don't like being in the delivery room."

S: "So, you don't think there's anything wrong with me not wanting to be in the delivery room, even though we're in America?"

H: "No."

S: "But I'm not thrilled about being there for the labor part either."

H: "There is nothing wrong with your views. Women will have their own opinions. Many women will want the fathers in the labor room and then later in the delivery room. Some women would prefer the fathers to be as far away as possible."

S: "I have a friend who was very upset when his wife called him all sorts of names while she was delivering their child. Ten years later, he still gets upset about how she treated him."

H: "It's not her fault. I encourage men to think about their desire to be present in the delivery room. Lamaze films don't really show the real story about deliveries. And that is the fact birthing is a brutal process. And many men just don't like it."

S: "I heard a lot of the women don't like it either."

H: (chuckling) "True."

S: "So, should I ask my wife if I can stay in the waiting room during labor and delivery?"

H: "You do need to discuss the situation with her. She may want you there in the labor room but perhaps not in the delivery room."

S: "But after what Barbara said, I feel like I'd be deserting her."

H: "Society is telling you you'd be deserting her. Perhaps the two of you could talk to a doula."

S: (brightening) "Of course! Doulas are there to help the woman during labor and delivery."

H: (nodding) "Sheila might go for having a doula there during delivery."

S: "I'll talk with her about that."

H: "Steve, don't think you're less a man for wanting to not be in the delivery room."

S: "It's not that I think I'm less a man. I merely think that giving birth is a woman's domain, and I'd be in the way."

H: "Is that what was attractive about studying birthing practices in tribal cultures? I noticed that dissertation in your lap."

S: (looking down and smiling) "Yes. I just received my master's degree with this." (Steve indicates the dissertation) "It's entitled: Birthing Practices in Sub-Saharan Africa."

H: (taking a sheet of paper out of a folder on her desk) "Here's a listing of doulas. Each of them will be willing to meet with you and Sheila to discuss what you two would like to do during labor and delivery."

Steve accepts the paper.

S: "Thanks." He stands up. "I hope you don't think me a wuss."

H: "Not at all!"

S: "I just think birth is a woman's thing and I'd be in the way."

H: "There is nothing wrong with the way you think."

Steve walks to the door; Harriet is behind him.

H: "You know, I wish some of the fathers would just stay away during labor and delivery."

S: "Why?"

The two exit Harriet's office and are walking down the hallway.

H: "They get too bossy. Always asking questions. They upset their wives. Then, during delivery, they tend to crowd too close to the pelvic region and one father actually hindered his wife in delivering their child by leaning over too far."

S: "Some men actually enjoy seeing their kid being born and cutting the cord."

H: "But you wouldn't."

S: "No."

H: "Talk to Sheila and a doula." They reach the front desk where Matt is walking past. He nods to Harriet, who nods back. "And, if Sheila really wants you in the delivery room, we have earplugs you can use."

S: "I'll think about that. Thanks, Doctor Lanning."

H: "After all these months, please call me Harriet."

S: "All right, Harriet. Thanks for the list." (Steve indicates the list of doulas with his hand).

H: "All in a day's work."

Steve leaves the offices and Harriet is handed a chart by Norman. She signs off on the chart and hands the chart back to Norman, then leaves without saying a word. Norman slips the chart into its place, then David appears.

David pauses at one of Jackie's advertisements for laser underarm hair removal, frowns, then rips the sign off the Notices board. Crumpling the paper, he tosses the advertisement into the trash can.

Norman looks at David and guesses his mood--David is on the warpath once again.

D: "Seen Matt anywhere?"

N: (thinking: he's not going to turn Matt in to David) "Ummmm, not recently. He's caught up on his patient load."

David runs his hand through his hair.

D: "When you see him, tell him I need a meeting with him."

N: "All right."

D: "Thanks. Oh, and tell Jackie not to post any more of her signs." David walks away, leaving Norman shaking his head. Norman writes a message, then leaves the desk to place the message on Matt's desk:

Matt:

David's on the warpath. Meeting in his office. Good luck! --Norman

Later, Matt comes back to his office and sees the message, crumples the message, then does a jump shot at the wastebasket--he makes the point. "Yeah!" Matt says to the trashcan.

Matt goes to David's office where David is waiting for him.

D: "Doctor Slingerland, have a seat." David indicates the chair in front of his desk.

Matt hesitates a moment, wondering why David is referring him as Doctor Slingerland. Matt has a suspicion something bad is going to happen.

M: "Thank you." Matt comes in the office and takes the seat indicated. David clears his throat, then shuffles some papers around.

M: "Anything wrong?"

D: (looking startled) "Oh. Well, quarterly reports for your practice are very healthy."

Matt smiles in response.

M: "You wouldn't have called me into your office just to tell me what you know I already know."

D: "Yeah." (he looks down at the desktop, then out the window, then back at Matt). "There's no easy way to say this, so I'll just say it: the HMO has requested you cut down on the number of tests you order for patients."

Matt's smile is frozen on his face. His look grows a bit angry.

M: "I can't promise that, David. You know I can't promise to compromise my patients' health."

D: "It's either cut down on the tests or take a cut on your salary."

Matt looks shocked, then replies icily.

M: "They expect me to either cut down on the tests or take a cut on my salary?"

D: (looks nervous) "That's about it, yeah."

M: (evenly) "I see."

D: "It's not my choice. Since you came on board, patient satisfaction in your practice has improved to near 100%."

M: "Small compensation for what you just told me."

D: "But you do tend to order too many tests. HMO's tend to work differently here."

M: "I've been stateside since I was 18. I know the differences."

D: "It's the HMO's decision, not mine."

M: (standing up) "Yeah. I know."

Angry, Matt strides out of David's office, leaving David tapping his pen on the desktop. As Matt is standing in front of the elevator, Jackie walks up.

J: "You look like you've just been handed some bad news."

M: "By the HMO."

J: "Ah. And they want you to...?"

Jackie trails off, hoping Matt will fill her in. Matt glances at Jackie sharply, wondering whether or not to tell her what David has said. Remembering how Jackie gossiped about the supposed argument between Jules and himself, he decides not to tell.

M: "They want me to..." Matt trails off and looks at Jackie.

J: (eagerly) Yes?"

M: "They want me to keep my mouth shut."

J: "Matt! I was just asking."

M: "Mmm, hmm. Now I've got a patient. Later."

The elevator doors open and Matt steps in, leaving Jackie sputtering.

J: "No need to get in a snit."

M: "I'm not in a snit. I will state there is no reason for you to know everything that goes on."

J: "Ehh!"

The elevator doors shut on Jackie. Alone inside the elevator, Matt smiles to himself--but only momentarily. His expression grows angry once again as he remembers the HMO's request. He says aloud:

M: "I won't compromise my patients health. I won't."

The elevator signals Matt's floor. The doors open and he gets off, bumping into three student nurses waiting to enter the elevator. They smile at him but he doesn't notice. One, a tall redhead, says:

Redhead: "Doctor Slingerland?"

Matt looks up. "Yes?"

The redhead giggles in response. Matt looks confused for a moment, then smiles at her, and walks towards his destination: the surgical suite. The three student nurses get into the elevator and the redhead starts to follow Matt. One of the other nurses pulls her back. The redhead says, giggling:

"That was him!"

The elevator doors ding shut.

Matt spies Letty down the hall. He hurries towards her.

M: "Letty?"

Letty turns around and waits for Matt to catch up to her.

L: "Yes?"

M: "How's the HH program going?"

L: "More work than I imagined."

M: "Need some help?"

L: "Got some time?"

The two docs chuckle as they walk towards the elevator banks.

M: "I can spare a few hours here and there."

L: "Saturday all right?"

M: "Saturday's fine."

L: "Good. You can help Tom set up at the Hebrew Home."

Someone's pager beeps. Matt & Letty both look at their pagers.

M: "It's me. Patient must have awakened from surgery."

L: "Nick's handiwork?"

M: (nodding) "Yep."

The docs reach the elevators. The door dings open and Jackie emerges.

L: "He's a bit frazzled, but he's good. Hey, see ya later...(to Jackie)...Hello Jackie."

J: "Letty. Matt."

M: "Hello and goodbye, Jackie. Patient calls."

J: "Per usual. I've patients you know!"

Matt gets into the elevator and the doors begin to close, leaving Letty and Jackie standing in front of the busy elevator banks.

L: "You mean underarm patient?"

J: "It's quite a popular program. Thanks for giving me the idea."

L: (surprised) "Me? How did I give you the idea?"

J: "That teenage heart transplant patient who complained of her underarm hair while recuperating."

L: "Oh! Melissa Ringgold!"

J: "How she doing?"

L: "A la casa yesterday.Quite the miracle patient. She was within a few hours of death."

J: "And, uh, speaking of death, I think I found out who the donor was."

L: (raises her eyebrows) "Oh? More girl detective work?"

J: "No.You remember that young thespian I did the nose job on a few months back?"

Letty nods; Jackie continues.

J: "His wife phoned to settle up the bill with Norman. She mentioned he had been killed in a motorcycle accident in Utah. He died the same day as Molly's transplant. I put two and two together."

Understanding dawns on Letty's face.

L: "The heart came from Salt Lake City from a male who died in a road accident. Damn. Tom and I saw him in his one man show, The Thespian. He was quite good."

J: "I caught the same show. Great reviews in the Bee. You gonna tell Molly and her family?"

L: "Can't. Against the rules. But if his family wants to tell Molly, that's their business. Did you give them any indication who got their heart?"

J: "No. But I think Hannah kinda knew. She'd read about Molly in the paper."

L: "She might have been looking for an oblique confirmation as to who received Mark's heart."

J: "You could be right. It's just so eerie. His play had an act called 'One Dies and One Gets to Live.' It was almost like he knew he was going to die."

L: "Yeah. Strange thing is that he was talking about a heart transplant in that scene."

The two docs are sad a moment, then Letty is paged.

L: "Duty! Hey, thanks for the information."

J: "Just thought I'd pass that along."

With a sad expression on her face, Letty walks off slowly at first, then more quickly as she realizes the living need her help. Jackie watches her retreating back a moment, then turns and goes off in the direction of her office suite.

Nicholas has been very short tempered with his surgical staff. He's been blunt and agitated. He hasn't made any mistakes but there is concern about him. Letty and Rae are in the middle of a chat about Nick. They are in the kitchen drinking coffee.

R: "I don't know what's wrong with Nick lately. I'm not his keeper. Ask him yourself."

L "What's wrong with him is that you used him to escape your unhappiness."

R: "I did no such thing!"

L: "Really? He left his home for you."

R: "He made that choice, not me."

L: (continuing as if she hasn't heard Rae) "After you led him to believe he had a chance with you."

R: (angrily) "I didn't lead him to believe in anything. It was an affair. Period."

L: "Did you make it clear to Nick that you were interested only in having an affair?"

Rae doesn't know how to respond. She looks away. Letty continues.

L: "I thought so. You didn't make it clear you only wanted to have an affair. Nick thought you wanted to leave your troubled marriage for him. Now he finds out otherwise. That's why he's been short-tempered lately."

Letty stands up and goes over to the sink. She puts her coffee cup on the side of the sink.

R: "I thought he knew."

L: "Lame excuse."

Letty goes to the door.

R: "Well? What am I supposed to do about it? He made the choice to move here."

L: "Rae?"

R: "Yes?"

L: "You're repeating yourself."

Rae's mouth dangles open as Letty leaves the kitchen. Jules walks in and goes over to the coffee pot.

J: "Don't let the flies get in there--bad for business."

Rae closes her mouth.

R: "Do you think I lead people on?"

J: (Jules is fussing with the coffee creamer) "We talking about Nick?"

R: "No."

J: "Yes."

R: "Yes?"

Jules is now pouring coffee.

J: "Yes, yes. You led Nick on. I told you before: Nick is a good catch."

R: "He's not that great."

J: "Why isn't he great? You didn't have a problem meeting up with him for a few weeks every year for some hanky panky in a tent somewhere. Word is you enjoyed it."

Jules has filled her coffee cup, added milk and sugar and is stirring the coffee.

R: (spluttering) "The sex was good."

J: "What is it you don't like about Nick?"

Rae looks confused.

J: "Thought so."

R: "Why does everyone keep repeating I thought so?"

J: "You don't know why you don't like Nick. But you like what he does for you."

R: "That is so not true!"

J: "Rae, get a grip. You need to talk with Nick, not me. Gotta go."

Before Rae can drag Jules further into her problems with Nick, Jules leaves the kitchen leaving Rae to sit at the kitchen table.

After checking up on his post-surgical patient (whom Nick has operated on), Matt has some free time.

Matt has been thinking hard about certain things these days: Jules, his partnership, the problems with his father--and now the HMO's unthinkable request. He has a long break between patients, and as usual for the organized Matt, he's all caught up on his paperwork, medical updates and requisite medical journal reading.

Not having much else to do at the moment, Matt has wandered outside in the waning winter of the Bay area. A pale sun is shining, and the weather is a near-balmy 58 degrees. Matt has wandered around the pathways of UMC, looking at the students, the winter blooming flowers, the people wandering in and out of the medical offices.

He has a pensive look on his face; wondering, perhaps, about the private lives of the passing people: why is the tall blonde woman so anguished looking? Matt might be asking himself, judging from the look on his own face.

"Did the tall blonde just get a cancer diagnosis from Rae?" he asks himself. "Or perhaps she got a positive pregnancy result from Harriet. She looks to be about 40 years old--still capable of having children."

During his mental wanderings, Matt suddenly finds himself standing in line at the outside coffee stand. Surprised, he takes a deep breath, thinking he likes the smell of the Lavazza coffee. Now he's at the front of the chattering line and he orders a hazelnut with half and half.

The smiling barista hands him his order, along with a small plate of chocolate and raspberry rugalach--a sweet he learned to enjoy from Nick. Matt is surprised at the rugalach but he pays for his treat.

Still wearing a pensive expression, Matt wanders over to an empty table towards the side and near the back--out of the way but close enough so he can people-watch. The table is in front of a large still-green bush.

He is enjoying the sunny weather, his coffee and his rugalach when he hears Nick & Rae arguing behind the bush. He freezes, starts to say something then decides to ignore the quarreling couple--it's an argument he has heard before in these last few weeks. He continues with his impromptu snack as Nick & Rae argue.

R: (forcefully) "Nick, I told you: go away."

N: "What was I to you?"

R: "You were special."

N: (sarcastically) "Special in what way?"

R: "I don't know. Special special."

N: "I came here to America to be with you. I love you, Rae. And I thought you loved me."

R: "I do love you."

N: "I hear a but in that statement."

R: "But, the truth is, I don't love you in that way."

N: (dejectedly) "You mean: you don't love me in the marrying way."

R: "That's about it."

N: "Then why did you tell me you loved me?"

R: "Do we have to go through this again?"

N: (upset as the realization dawns) "You used me as an emotional vacation from your husband!"

R: "I had an affair with you. That's all. An affair."

N: "Which you led me to believe would end in marriage."

R: "I didn't lead you to believe in anything!"

N: "Yes, you did. You had a choice: either Sean or me. You chose to leave Sean but you also chose to leave me in the lurch."

R: "What are you saying?"

N: "I'm saying that in making the choice to also leave me, you are telling me I am not what you wanted."

R: "I've got to go." Rae starts to walk off; she doesn't look back at Nick.

N: "I'm sure you do....oh, Rae?"

R: (turning to look at Nick): "Yes?"

N: "I've got a date."

R: (splutters) "A date? You're talking about me leaving you and you have a date?"

N: (shrugging his shoulders) "Yes. At the opera."

R: (parroting Nick's words) "At the OP. ER. AHHH. Doesn't that beat all."

Sneering, Rae turns her shoulder on Nick, flips her hair back, then walks with purpose around the bush. She stops short when she sees Matt sitting there, calmly sipping his coffee.

R: "Matt! I, uh, we didn't see you there."

M: "Not to worry."

R: "Uh, yeah. Well, this argument's gotten around by now."

M: "Gossip mill runs amok at the offices."

R: "Something like that." Nick comes out from around the bush. Rae continues. "Well, as I said before, I've got to run."

M: "Good day, then."

Rae walks off without saying goodbye to Matt. He frowns a bit at her as Nick starts to sit down. Nick pauses.

N: "She's a bit catty these days."

M: "I can imagine. Didn't even say good day to me."

N: "Got time for another cup? My treat?"

M: "That would be wonderful."

N: "I'll go get them."

Nick walks off to get the coffee. Matt watches his passage through the people and notices that a lot of women are looking at Nick. Matt doesn't notice that several women are giving him glances as they pass by.

Nick gets the two cups of coffee and another small plate of rugalach. He walks back to the small table, smiling at the women as he passes by.

Nick comes up to the table and sets the food and drink down. Sitting down himself, he says:

N: "Looks like you're quite popular."

M: (smiling) "They're looking at you."

Two very young co-eds pass by; one smiles hugely at Matt, the other woman smiles hugely at Nick.

M: "Seems like we're both popular." Matt smiles at the women; they giggle, wave but walk on--they are much too young for Matt and Nick.

N: "Yeah."

M: "Don't be upset about Rae. She made the choice that she did."

N: "She made me look like a fool."

M: "Second thoughts about leaving Athens?"

N: "I like the challenge of a new country. I've always liked challenges."

M: "Is that why you went after Rae although you knew she was married?"

N: "Yes."

M: "And also why you signed on with Doctors without Borders? For the challenges?"

Nick nods, sipping his coffee.

N: "Yeah. It's a good organization. You ever do anything like that?"

M: "Sure did. Went to Kenya for a summer to do a vaccination program with the World Health Organization."

N: (smiling) "In the summer?" .

M: chuckling softly. "Not the greatest time to visit Kenya. Hot as Hades and that blasted sand. Got into everything. I hate sand."

N: "It's worse when it's cold frozen sand."

M:"Tell me something." (changing the subject) "You serious about a new challenge?"

N: "That I am."

M: (leaning a bit forward; his tone goes softer). "There's been talk about starting a new clinic here at UMC."

N: (surprised) "We've got a lot of clinics: women's clinic, children's clinic, our clinic."

M: "But no men's clinic."

N: "Men's clinic?"

M: "Promoting the health care of men."

N: "What would my function be?"

M: "You could be a general practicioner. In addition to doing the surgical procedures as necessary."

N: "Kinda of like what I do now? Performing surgery on Presidio's patients?"

M: "Like that. In short, the Men's Clinic would operate the same way Presidio does, except the clinic would treat just men."

N: "I'd think about it. When does this clinic open up?"

M: "The regents are bantering the idea around. Nothing firm at the moment. I caught wind of it at the charity dinner the other night."

N: "Those dinners. I met Sean at one of those dinners."

M: "When you first came here?"

N: "Yeah. He looked lost."

M: "Didn't know his wife was cheating on him with you?"

N: "Not at that time."

M: "Rae didn't tell him it was you?"

N: "I don't think so. I suppose I got off on the wrong foot with the charity dinners. They're quite useful."

Nick's and Matt's pagers both go off at the same time. They pull out their pagers and look at them.

N: "Duty calls."

M: "Same here."

The two men gather the refuse and as they walk off in different directions, they pretend to shoot hoops with their trash: Matt is successful, Nick isn't so he stoops to pick up his cup and place it in the trash.

M: "At least think about it!"

N: "That I will. I do like a new challenge."

Matt walks away and Nick mutters to himself:

N: "Nothing ventured, nothing gained."

Nick thinks about that a moment, then smiles to himself before saying aloud:

N: "It would also get me out of Rae's daily schedule."

Jauntily, Nick walks towards Presidio's offices, whistling a happy tune. For the first time since he moved to America, Nick is feeling good about his choice to move, despite his heartbreak about being led on by Rae. He pauses a moment to read the sign someone posted in the geese's feeding area:

We're indigent Canada geese. Please give your change so we can go home!

The cup nailed to the sign has a few coins in it. Nick laughs aloud.