Sal's Reflections

It was rare in a residency program that there was any fanfare to the appointment of chief resident.The position was largely one that encompassed creating the schedule for all of the residents, but was in fact more of a nuisance than an honor. However this was not the case for Michael in his fifth year of the program.Dr Carol Gunn a much loved and respected vascular surgeon had campaigned to formally have a nominating process for the position, ,and use the person selected as a role model for the new residents. Michael was unanimously selected by his peers and the surgical staff.He had developed outstanding technical skills, but what made him extraordinary was his ability to create bonds with the entire staff as well as the patients.Along the way the story of his tragic family history had surfaced ,and even Dr Skeffington his first year nemesis had written favorable reports on his stay at Bellevue.

To formalize the new responsibilities Dr Gunn had arranged an early morning coffee where she glowingly spoke about Michael .At this event there was also the opportunity for other residents, and a few seasoned staff members to chime in. It was an hour of praise ,and to some degree a roast. At the end Michael was requested to say a few words, Dr. Gunn asked him to develop the basis for his approach to the care of patients not only in the OR but post surgery. Michael was somewhat embarrassed by the praise of the morning and wanted to keep things light before everyone would go back to the chaotic schedule of the hospital.

“I want to thank Dr.Gunn and all of you for taking time out of your day to formally honor me with you praise and pathetic attempts at humor.I find it hard to believe that so much time has passed and this will be my last year at Bellevue.Thanks to the staff and the patients I now believe more deeply in the words spoken to me in my interview for the residency program. Dr.Ron Fournier told me that even though I had the title dr. coming out of med school I was not truly a real dr. That title would have genuine meaning when I became immersed in the surgical world of Bellevue. Truer words were never more on target. I am sure that you will find through the peaks and valleys of being residents that in the end it is more than worth it.”

Before closing Michael touched on the world of pain and suffering that happens every day in the hospital . He said he had been touched by so many experiences, and that suffering can also be something that leads to personal growth for the patient and the surgeon as well. All those in attendance were aware of the personal tragic history of Michael’s family and were anticipating that he would recount what he had been through. Michael began to more deeply speak about personal suffering and said.” I must admit that I know suffering at a level that is beyond imagination. I have been a New York Jets fan for years, and no one suffers more than a Jets fan.”The gathering braced for the tearful history of Michael’s family roared with boisterous shouts and laughter at the statement.

Leaving the conference room after the gathering Michael stopped by his mail box which was filled to the brim. As he entered his office he began to drink the third cup of coffee since rising, and sat at his desk sorting through the mail. Most of it was immediately filed into the waste paper basket but one was strikingly different. It appeared to be from the United States Government. Michael opened the letter and could not believe his eyes. Michael had been drafted and ordered to report to camp Pendleton in San Diego, California.

When the alarm went off at 4 am. Michael barely rolled out of bed.He had been at Bellevue for six months in his residency, and was completely exhausted. The last twenty four hours he had six phone calls, and saw patients with various surgical complications. The most serious was a seventy year old woman whose incision was draining blood which indicated internal bleeding.Almost immediately he called the attending surgeon and she was rushed into surgery.Later in the evening the surgeon stopped by his room and said”good call tonight kid.She is stabilized and you probably saved her life.”

Washing his face he quickly shaved and began to make the rounds of the patients on his clipboard. As he entered one of the wards he proceeded to the bedside of Donald Ward a fifty eight year old man who used Bellevue as his primary hotel.Still wet from his last alcoholic binge, he was always hostile and treated every staff member with complete disdain. He was not remotely interested in a twelve step approach to sobriety, but ever the optimist Michael attempted to belief that even Donald was capable of positive change,

“Good Morning Donald are you feeling better?”Donald barely looked up at Michael and said in a hateful voice”Eat me shithead.”Michael smiled having accustomed himself to the various loving ways in which a good portion of his patients responded to ordinary civil greetings.Unmoved by the poetic use of foul language that followed Michael examined Donald and momentarily thought about addressing the consequences of continued drinking, but decided to move on to the next patient.

Walking down the hall Michael recalled the words of Dr Fornier in his initial interview. “You will be cursed at,struck, have vomit on your shoes, and treat many who may totally disrespect you.. However you will make a difference and truly will become a doctor that fills the gaps for those who have nowhere else to go.”The last part of that counsel was made vivid in the next part of his rounds.Mildred was a twenty year old woman who was dying from aggressive breast cancer. Michael had seen her two days before and spent twenty minutes chatting with her. That amount of time was a luxury but she like everyone he treated was not just a series of information on his clipboard. He had been counseled both in med school and here not to be emotionally involved with his patients ,but though he respected that wisdom h,e rejected it.Evelyn was clearly dying, and at her bedside were her parents and younger brother.They rose to greet him ,and he smiled and sat on Evelyn’s bed. Gently holding her hand he spoke to her by whispering in her ear. Hearing is the last thing that goes in the death process, and he wished to let her know that she was surrounded by loved ones.He then spent a few minutes speaking with her family before going to the cafeteria for a quick cup of coffee and a bagel.

Glancing at his watch he was unaware that one of his favorite persons in the hospital had sat down next to him.Nurse Janice Brewngton was an outstanding OR nurse who made it her task to assist the new residents into the culture and rules of Bellevue.”Good morning Doctor Michael how are you?”She was aware that he had been on call for approximately thirty hours.Michael took a long gulp of coffee hoping the caffeine would sustain him for the rest of his shift.” I am on the downside of my shift so I guess I am ok.””I noticed that you had the wonderful experience of being Dr. Skeffington’s whipping boy at conference two days ago.”Michael grimaced at the memory of his being humiliated in front of his peers.” I think that he does not believe that I belong here.”Nurse Janice smiled and said”Get that out of your head. Every year he picks out the most intelligent and caring new resident and tries to completely
embarrass him. You are this year’s winning contestant. But let me tell you something.I believe he is jealous of someone like you.He has zero bedside manner, and is a compete egotist. His idea of the perfect home would be ten thousand feet of mirror. Don’t let him get to you.” Michael burst into laughter at the last comment. ,thanked nurse Janice and went back to the next few on his clip board.

After Danny’s funeral Dr.Friedman the heade of surgery at Jefferson Hospital arranged for Michael to take a few days off. During this period Micahel was sending thank you notes for all who had written or had left Mass cards. In the pile of mail was a large manilla envelope. Michael opened it and inside was a book and a short noite that said”hope this helps” The book was Man;s Search for Meaning by Viktor Frankl a Jewish physician .Michael skimmed the book but once he started reading he could not put the book down. He was touched by the reality that the author had lost most of his family and so many other vital parts of his life. One passage seared his soul.”When a man finds that it is his destiny to suffer,he will have to accept his suffering as his task;his single and unique task.He will have to acknowledge the fact that even in suffering he is unique and alone in the universe.No one can relieve him of his suffering or suffer in his place.His unique opportunity lies in the way he bears his burden.”.This and the re3st of the book did not remove the dagger oif grief from his heart but he made him search for what meaning these losses provide in his life

The next few months were an emotional roller coaster for Michae
but in March he found out where he was accepted for a surgical residency.. Michael had been accepted to the surgical residency program at Bellevue Hospital. Within a few short weeks he would be totally immersed in his new environment. One of the key challenges for Michael and Arlene was to secure an apartment as close to the hospital as possible .Residency played a paltry sum of $100 a month and they realized that this would not adequately cover Arlene and the families’ living expenses. They had a small savings account ,but sinceDanny’s death Michael and his father had become extremely close ,and his father had pledged adegree of financial help while Michael was studying to be a surgeon

One off Michael’s professors at Jefferson Dr Rodger Friedman who was most supportive of Michaels decision to pursue surgery.He was keenly aware of the trials that Michael had experienced and had apparently shared the tragic story with his wife Two weeks before the McNallys were to move to New York Mrs Friedman called Alene and invited her to lunch.Arlene remembered how solicitous Mrs Friedman had been during Danny’s death, and gladly accepted the invitation. She was but a month away from the birth of their second child and had recently experienced a great deal of water retention. Despite the difficulty that this presented she never slowed down, and was tremendously supportive to Michael

It was a beautiful clear day and Arlene was grateful to have the opportunity to have a social event that did not require planning or financial justification. When she arrived at the Capital Grill Mrs,Friedman was already seated and rose to greet her. “Good afternoon Arlene it is so nice to see you. “Arlene responded Thank you Mrs Friedman it was so kind of you to invite me to lunch. Mrs Friedman sat and said” Please call me Phyllis ., Mrs Friedman is too formal, and I feel that I somewhat know you.”

For the next ten minutes the two women exchanged pleasantries and bits of information ,but at this point it became apparent to Arlene that there was a purpose to this luncheon invitation.
Phyllis began to delineate the reason why she had asked Arlene to join her.”have been the wife of a surgeon for over thirty years, and I can still remember Rodger’s residency years. Many of his colleagues and friends of ours were in the residency with him, and almost all were married. It is somewhat sad that most of those marriages did not survive the surgical residency. Arlene could not fathom at this time why Phyllis was sharing this history..

Phyllis continued “I tell you this Arlene because I care about what you and Michael are about to experience. In in no way do I want to be a busybody or a know it all. However, I would like to share some of the things I learned along the way. Would it be alright if I did that ?“Arlene had such a sense that Phyllis was genuine and caring, and this introduction had completely engaged her interest. Arlene said” please continue because this is a whole new challenge for us.””

“:Next it is critical that you find time together. In the immortal words of the poet”Rodger and I did not have a” pot to pee in “but we found time to have dates ,and even a yearly vacation, We made tough choices financially to do this but it created the moments for us to be truly together without all the other distractions.
Also don’t look at the whole surgical residency. It looms too long, so I suggest t that you approach it with short term goals,You will find that it is easier to not only get through the grueling times, it will give you a sense of accomplishment.”

Both Arlene and Phyllis were so engrossed in their conversation that they had barely attended to their food which was getting cold. Phyllis offered that she would come up for air and they should eat a little.
Returning to her counsel Phyllis said”Flexibility has to be something that becomes part and parcel of your lives. So many times an emergency at the hospital will take precedent over your plans and you may feel resentful ,and Michael will feel guilty. At this time reflect and share your needs and feelings with each other. I would also urge you to be inventive. I cant tell you how many time s I took the boys to see their father at the hospital. Often we would take him a sandwich or bring some of the kids drawings. They loved it ,and so did we. It truly connected us and allowed the entire family to share in the residency.
Another tip was that we refused to be boxed into the holidays of the rest of the family. It was too much pressure ,so there were times when we had a seder three weeks after the regular Passover date. It allowed us to live in the present while at the same time looking forward to the time when this phase would be over.

Arlene felt as though she had sat at the feet of a mistress of learning and and could not wait to share Phyllis counsel with Michael. At the end of the meal she embraced Phyllis and agreed to ake Phyllis up on her offer of regular phone calls and communication.

Leaving the apartment Michael made his way to breakfast. Two blocks from the hospital he stopped at a local diner.After ordering his breakfast he took out his notebook and began to practice the answers he presumed would be part of the interview process .After finishing two eggs over easy,bacon, hash browns and two cups of coffee he felt less anxious about the incident in the park.He actually began to smile envisioning the glaring headlines in the New York News and New York Times.” Physician arrested for mugging a person in central park”. The suspect of this dastardly crime has been connected to a series of attacks on the East Side The alleged perpetrator of these crimes Dr.Michael Mcnallywill be arraigned and sent to Rikers island. He could imagine his friends in Jersey City being interviewed by reporters stating that McNally had a sinister past and his penchant for violence was not a suprise.

Michael paid the bill left the diner ,and as he walked he began to collect his reasons for why he had chosen to pursue a surgical residency. There was one redeeming aspect to the experience in central park ,his nervousness had evaporated That morning he was more concerned with being arrested then not performing well in the interview Within ten minutes he had arrived at the behemoth hospital complex.. His first impression of the exterior of the buildings was that the hospital apparently had seen better days. The facade of each building. needed a good sandblasting. The harshness of the East Coast climate had clearly faded the original color of the buildings ,and there were more than a few cracked or broken windows. As he walked through the heavily stained glass front doors and made his way toward the information desk he was keenly aware of the gritty appearance of the reception area. Ceilings had large water stains ,as well as floors filled with candy and cigarette wrappers.The walls were gritty and desperately in dire need of a new paint job.The semi-darkness Indicated that some of the ceiling lights had burnt out bulbs. The waiting area was filled to capacity, and the foul language of those present resembled longshoremen at their best. Weaving his way through the clientele to what was billed as the information desk he inquired as to how he could find Dr Fournier.The person behind the desk responded as if he had insulted her family ,and with a scowl on her face said”he is on the third floor”.Her annoyance grew to complete disdain when Michael asked for the elevators. She responded “they are at the end of the hall.” As Michael left this cheerful introduction to the hospital he was aware that the hallway next to the elevators was filled with gurneys that had patients on them, but no one attending to their needs.

As he left the elevator he was unsure of whether to go left or right.,He scoured the names on the doors ,at least those that actually had names..Finally he found. a door that had most of the word surgery on it. Apparently the E had faded and all that was left was SURGY.He knocked but there was no answer, so he opened the door and walked in. At that precise moment out of the next door came a physician holding a large group of files. Michel introduced himself and said”I have a nine o’clock appointment with Dr,Fornier. Dropping some of his folders the person bent to pick them up and said”I am Dr Fornier come into my office and have a seat.

Dr. Fornier went to a large metal filing cabinet in his office ,and after a few minutes of shuffling through the files pulled out what Michael suspected was his dossier .
Seated behind his desk Dr Fornier read the file and began by asking Michael some basic questions about his life and experience at Jefferson.After this Dr.Fornier
launched into a long straight from the shoulder expose about his life at Bellevue ,and what Michael could be expect if he was accepted into the resident’s program. He began with stripping any illusion about being prepared for the experience. “Let me begin by telling you that at your graduation everyone will be praising you and calling you Doctor. However in my opinion you will not really be a Doctor. After your surgical residency you will be a doctor.Here you will see and experience things that you will find nowhere else. We are the catch basin for every person that walks the streets of the city.There are those that use this facility as a hotel, and there are many that have no other place to go. For the alcoholics, some mental patients and street people the hospital is reduced to “three hots and a cot.” You will be attacked, cursed spit on, have puke on your shoes and wonder a million times why the hell you chose this place. Your television images of performing complicated surgeries and saving lives are merely fantasies You will work for thirty six hours straight,t and then have twelve hours off. You will be the bottom of the medical totem pole and perform often routine scut work.”

Michel in the midst of this expose momentarily wished he would be accepted by his second choice of hospital. However, after sharing all that was wrong about the place Dr Fornier explained why he chose to stay at Bellevue.
“In spite of all that I have laid out this morning the experience of being a doctor and surgeon here is phenomenal. Though often completely exhausted and working with minimal resources you will make a real difference here. I am privileged to work with an outstanding team of nurses and doctors. This is really a community that serves with an unbelievable dedication to any and all that come through pour doors.”As Dr Fournier went on Michael could literally see and understand the commitment that this man had made to others. His initial fear that he would be accepted at Bellevue now was transformed into the hope that this would be the place where he would spend his surgical development.

Michael now understood that he had Arlene’s complete support so he started to fill out the necessary paper work required to apply for surgical residencies. The process was referred to as “Match Day” because the medical student filled out his preferred residencies and rated them in order of preference and the hospitals did the same thing.Michael had five hospitals on his list but his number one was Bellevue Hospital in New York City.Two months after he had submitted his paperwork he was requested to come to Bellevue for an interview.

Michael had a college friend Bert Burke that had an apartment
overlooking Central Park, and when Michael called and requested they meet in the city for dinner Bert informed Michael that he would be out of town, but invited his college buddy to stay in his apartment.Michael was thrilled to be in the city that night, but he was very anxious about the interview ,and had trouble sleeping..He rose early, and despite warnings about being in the park at night decided to go for an extended run.

Entering the park he loved the stillness of the night and the cool breeze against his face.He was running at a rapid pace, and thousands of thoughts were racing through his mind.Suddenly without warning another runner crashed in to him and both tumbled and fell to the ground on top of each other.Michael struggled to gain his composure and the other runner rose quickly and bolted into the darkness. Michael instinctively reached for his back pocket, and realized the other runner had deliberately run into him and had stolen his wallet.Prudence required that he not chase the villain who may have had a weapon, but the city kid mentality kicked in and he raced to catch the thief.In minutes he caught up with the thief and tackled him. Holding the perpetrator in a headlock he said”You know what I want”. His assailant reached into his pocket and handed Michael his wallet. Michael pushed the culprit away and said”now get out of here you son of a bitch.”After this encounter Michael realized it was time to leave the park because the next thug might have a weapon.

As he walked back to the hotel he though perhaps he should call the cops, but he feared they might detain him and he did not want to be late for his interview at Bellevue. He was feeling pride because he has refused to meekly be a victim, and had fought back against his assailant..It may have been imprudent but he was glad that he dd not merely accept the robbery.

Arriving at the apartment he took the elevator to the second floor. It was now daybreak, but he would have plenty of time for a shower and a full breakfast somewhere near the hospital.He also wanted to review the answers to the questions his professors suggested would be asked in the interview.As he opened the door and switched on the light he was aghast at what he saw.His wallet was on the side table next to the bed.He had mugged another runner in the park ,and had stolen his wallet.Panic set in as he sat on the bed and reviewed his options.It was so dark that it would be literally impossible for the other person to identify him but there was still the reality that he had the wallet in his possession.He went into the bathroom and fearing that his prints would be on the wallet scrubbed it clean with a bath towel.

Opening the door he looked both ways before entering the hallway, and took the stairs instead of the elevator.Walking briskly and constantly surveying the area he finally found a mail box. He carefully removed the wallet with his handkerchief, and pitched it into the mailbox.He hurriedly walked back to the apartment avoiding eye contact with anyone on the way.

Michael loved the fact that he lived so close to the hospital for his second rotation. Michael jr. was so energetic and he would light up when Michael walked through the door.This delightful explorer of everything in the apartment would soon be joined in six months by their second child.This news came at a time when Michael was trying to decide whether he should continue his studies and explore residency programs.He had been counseled by professors and peers that he would make an outstanding pediatrician or gastroenterologist. He concurred that these opportunities would be fulfilling but the one rotation that captivated him was surgery.The hesitation on his part was that a surgical residency would be four more years of a crazy lifestyle ,and he questioned how fair that would be for his family.

Arlene could always sense when Michael was percolating the issues involved in a major decision.In many ways she knew him better than he knew himself.One night after they had put the energetic dynamo to bed Arlene said”Mrs Pittelli knew you would be home tonight and offered to baby sit while we went out for your favorite meal,a Philly cheesesteak. Michael jumped at the offer not only for the culinary delight on South street, but also it provided an opportunity for Arlene to have some adult free time.

Michael ordered the house special and said’If any of my patients could see me eating this instant heart attack they would be scandalized”. He offered a bite to Arlene, but she chose only to order a coke.Arlene started to probe their future as Michael wiped the last trace of cheese from his lips.” I know that soon you must make a decision about whether you are going to seek a residency and wondered where you were leaning.”At this request Michael smiled and realized that Arlene had an emotional radar that was always on target regarding anything that he was pondering.Michael said” I have been meaning to talk to you about possible next steps, but there has been no opportunity.I am having difficulty with the implications for you and the children .I am barely home now, and fear that a residency program may be worse.There is also the question of Danny because I know he has had great difficulty dealing with Donny’s death”.Arlene reached across the table cupping both his hands and asked”Which was your favorite rotation?”To his surprise he immediately responded”surgery.”

Arlene followed her initial question with a series of gentle but probing inquiries.Michael apparently had thought at least at the subliminal level a great deal about surgery because he gave chapter and verse about its’ appeal.His insightful wife asked “ what is standing in the way of your following your dream?”’It is the realization of the sacrifices you and the children will have to make over the next four years.” Arleme said”I understand your concerns ,but after all you have lost I believe that your taking a surgical residency will be worthwhile for all of us.”Michael touched her cheek and said “if I was just a general practitioner we would have a more normal life.””Michael you well know there is no such thing as a normal life so I vote for a surgical residency.”

At the end of their conversation walking back hand in hand to their apartment Michael. stopped and kissed Arlene.”What would I do without you?” Don’t worry Doctor you will never have that opportunity to lose me.However, there is one request from here on out. You mist share whatever your concerns are about any important decision.” Michael agreed and felt Arlene’s support had made his future more clear

There comes a time in every profession when the study part recedes into the background, and the experiential part begins.It was rewarding to have family and friends heap praise and admiration on Michael,Catherine and Joseph, but now was the time when the rubber would meet the road. This was the reality in their third year of medical school.Michael was assigned to Lakenau Hospital in Philadelphia,Catherine stayed at Jefferson, and Joseph began his medical internship at Hunterdon Medical center.The night before internships began they had a few beers at the bar in the Billings hotel.Their laughter and teasing were thin facades that covered the anxiety of the unknown.Academically they had mastered their course work, but this was different.From tomorrow on it would not be merely responding to a professor ,it would actually be in direct care of patients. At the end of the evening they agreed to meet the following Sunday to discuss their medical adventures.

Michael as was his custom arrived at the hotel bar fifteen minutes before Catherine and Joseph showed up. He was ashen from the lack of sleep, and had adsorbed too much caffeine every day for a week.Catherine and Joseph upon arrival were no less exhausted and the evening began slowly with none of the three willing to begin recounting the weeks experiences. Finally Michael broke the ice.”I was really nervous before I saw my first patient but checking myself in the mirror and putting on what I thought to be my professional Doctor face, arrived at the door of my first patient.Sidney Bergman was a fifty five year old man that had been hospitalized with a heart condition. I entered his room and said”Good morning Mr.Bergman and before I could say another word the guy makes a grunting sound and slumps over in the bed.In sheer panic I raced to the nursing station and called the resident.Mr.Bergman had died, and I thought this is not a great way for me to begin patient care.”

Next it was Catherine’s chance to describe her initial voyage into patient care.”As you well know Professor Larkin has little affection for female medical students so I was assigned by him to change the dressing of one of his patients.Little did I know that the man had been caught by his wife in bed with another woman.Her response was to shoot his penis off.So my first moment as an intern was cleaning what was left of his private area.I thought to myself while cleansing the area that this is not what my mother had in mind for her daughter the Doctor.”

Michael and Joseph roared with laughter,and then Joseph took his turn at true confessions “My first patient was a forty year old man that needed a cast. He had fallen down a flight of stairs, and had broken his right leg.I started out pretty well but had a hell of a time getting the damn thing even on both sides.By the time I finished the cast was so heavy that the guy could barely stand. He asked me if the cast was larger than normal .I immediately told him that the reason it was so large was because his injury was the most unique one I had ever treated.”

So the first week of the “Three Musketeers” medical careers had finished ,and would be followed by months of lack of sleep,monumental challenges and the growing knowledge and confidence that this is where they would make a difference in the world.

The academic schedule of medical school was far more difficult than undergraduate work, but Michael.Catherine and Joseph continued to excel in the classroom and labs.Michael had completely adjusted to Philadelphia. He compared his new city to the one of his birth but added “it is a hell of a lot larger” Most days he was engulfed in his studies but there were moments when the losses of his mother and brother weighed heavily on his heart

Financially strapped Michael and Arlene would often drive to the airport. and watch planes take off and land.It was on one of these occasions that while chatting Arlene mentioned that one of her dreams was to board a plane with a child and go to some magical place for vacation. Michael thought that would be wonderful, and hoped that someday they would be blessed with a child..Arlene leaned over and placed her hand in his and said “Do you have any idea where I went on Thursday?” Michael said”What does that have to do with vacations and children?” Arlene tousled his hair and moving closer to him in the front seat of their car responded”It has everything to do with it silly.”Michael for all his brilliance still did not have a clue what she was talking about.””What does Thursday have to do with it?”I had a doctor’s appointment.” “For a fleeting second Michael experienced panic.”Arlene are you alright?Why did you go to the Doctor’s?”Arlene could no longer hold back her news..

I went because I had a suspicion, and it was confirmed.”Michael could barely breathe suspecting that a new tragedy was about to occur.”Michael we are going to have a baby.”
Michael sobbed with joy when he heard the news, and could not speak for minutes.He had known the ravages that death leaves in its wake,, and now he would experience the wonder of the birth of a child.

There was a new energy and vitality in Michael’s step after Arlene’s news. When the day arrived he drove Arlene to the hospital, and stayed with her until she went into the birth area..He had secured permission to be with Arlene during the entire birth process.When the baby arrived and began to cry it was joined by Michael’who was weeping in unison with his son..

Michael felt such joy and elation at the sight of his newborn son..For the next few days he would leave class and race to the hospital to spend time with Arlene and Michael Jr.He told Catherine and Joe.that holding his son in his arms was beyond description.

Michael had been accepted to medical school at Thomas Jefferson University in Philadelphia, but this was a two edged sword.It was his first choice ,but there was the consideration of what would happen to his brother Danny? Danny was a Sphinx when it came to sharing his feelings, and Michael worried that without his support he would withdraw even more than he had in the last two months.Michael’s father was truly a fine man,, and a wonderful provider financially but he was really limited in the areas of communication and emotional support.

Danny was going into his Junior year at St.Aloysius High and would be a starting guard on the varsity basketball team. Pulling him out of school for a move to Philadelphia would mean that he would have the love and presence of Arlene,e but would probably feel uprooted and isolated. The second consideration was that Michael was worried about the cost of living in Philadelphia. Any apartment within a ten minute walk of the medical school would literally be three times their monthly rent.

Arlene’s brother offered a solution to both challenges. He and his family lived in a spacious mansion on Gifford Avenue which was only three minutes from St.Aloysius High School and the manicured Lincoln Park.The home had six bedrooms and four baths and there were only four residents. Coupled with that Arlene’s brother was an avid sports fan with two young sons. He was thrilled to have Danny standing in as a big brother.The second gift was that her brother owned a very successful produce business and had personal contacts in Philadelphia. One of his regular customers ,Stefano Pittelli owned a grocery store and had a son Joseph who was also to be a first year medical student at Jefferson.In addition the Pittelli’s owned a three story apartment near the hospital, and offered one of the apartments at way below market value to Michael and Arlene.

Joseph Pittelli was an Italian clone of Michael and they instantly became best friends. They were athletic, bright and had both been valedictorians in high school and college. Both sports nuts they argued over the Philly New York teams and Michael constantly referred to Philadelphia teams as perennial losers. Joseph retaliated by stating that if it were not for Italians like Berra,DiMaggio and Rizzuto the Yankees would be worse than the Phillies.This dynamic duo soon added another colleague Catherine Salvato to their midst when they formed a study group .Her path to becoming a doctor was not as easy as her buddies, and there was still a dearth of females in medical school. She was constantly having to prove that a woman could be as qualified as any male in the class.There were even members of the faculty who were less than thrilled with the three female candidates in the new class. Catherine was as bright as her peers and possessed a winning personality complimented by a keen sense of humor.

Joe and Catherine introduced Michael to genuine Italian cuisine, and warned him that if ever a can of Italian spaghetti was seen in his apartment he would be evicted.