Up There - by Big Beautiful Dreamer (~BHM, ~MWG, Romance)

[Big Beautiful Dreamer]

~BHM, ~MWG, Romance - A medical intern finds love and work in Michigan.

Up There
by Big Beautiful Dreamer​

Author's Note: There is an extensive St. John Health System in Michigan, which operates nine hospitals in the state. None of them are in Kalamazoo, and there is no St. John’s Suomi Medical Center.


Name: James Kincaid
DeaconOne #: 2-619305
DOB: 05/17/85
Address: 613-C Hawthorne Ave., Winston-Salem, NC 27102
Residency: St. John’s Suomi Medical Center, Kalamazoo, MI.


The morning had been endless: speakers droning, pedantic and nostalgic, while we all fidgeted. The ribbon cutting by Nathan Hatch, Wake Forest University’s president. Finally, finally, the white cloth-draped table with rows of white envelopes.

It was Match Day.

I stared at the letter in my shaking hands. I’d been assigned to a hospital in ... wait ...

“M-I, is that Mississippi?” I asked a classmate.

“No, Michigan,” he said absently. “I got Houston. Sweet!”

Michigan. Michigan. Michigan?! I wasn’t even sure where Michigan was. One of those big square frostbound states bordering Canada, with hockey and permafrost.

I’d lived in the South all my life. I’d grown up outside Charlotte, North Carolina, gone to college and med school in North Carolina, and had never encountered more than five cumulative inches of snow (the one time I had, school had been closed for a week). Now I was being sent to a state that probably had ice-fishing festivals.

All around me were excited snippets of information being exchanged: “Atlanta.” “New Mexico.” “Mass General, I got Mass General!” “Omigawd, I got the Cleveland Clinic.” “Did you hear? Caitlin got Mayo.” “California, far out!” “Shipshewana, Indiana, great. I wanted to get away from Indiana, now I get to spend three years patching up Amish.”

“Jamie? What’d you get?” Penny Whicker looked over my shoulder.

“Um, Kalamazoo, Michigan.”

“Oh, boy.” Penny’s eyes danced. “Great food up there and all the snow you could ask for.”

“Great food?” I was from the South, we were born to great food, it was our raison d’etre.

“Oh yeah. Try poutine.”

“Poutine, what is that, like game hen?”

Penny laughed. “No, poutine. French fries topped with cheese curd and gravy. My brother’s wife is from up there, remember? She’s turned Jack on to that mess.” Like me, Penny was a native North Carolinian, and the last word came out as may-uss.

“Ugh, sounds awful. Cheese and gravy together? Cardiac infarct on a plate.”

“Yeah, really.” Penny patted me on the back. “Mail me a snowball. I’ll be living it up in Richmond.”

And so I began my trek northward, settled into an apartment share with another resident, and plunged into residency. It had taken an act of Congress, literally, to limit residents to 80 hours a week and on-call only every third night. You try that for a while, let alone four years. We were all exhausted, all the time. Coffee became a food group, and food was hastily gulped down in foam takeout containers from the hospital cafeteria. It was either Tuesday (blue Jell-O and white-and-green glop), Wednesday (red Jell-O and meatloaf) or Thursday (green Jell-O and brown-and-orange glop). It started snowing in September (Labor Day weekend) and there was snow on the ground until April. At least I think it was April.

Snacking saved us. We trekked between the hospital and the apartment a block away, had no concept of hours, days, weeks, months, but there was always a container of poutine in the break room to be nibbled from. Poutine was Canadian but had migrated south, and no one was complaining. Also, I was gradually being introduced to other Michigan specialties, including pasties, ground beef and onion in a pastry wrapper: quick, filling, and easy to eat at a trot. I quickly became addicted to a local snack, the Kalamazoo Kettlecorn Company’s Kzoo Krunch, and something called “B’Drizzled,” chocolate cherry cheese popcorn. It had to be tasted to be believed. My palate became discerning, distinguishing Vernor’s Ginger Ale from other, lesser, brands, and fall and winter were marked by an endless variety of apple goodies that nurses would lavish on us poor overworked residents.

I didn’t even get to come up for air for either Thanksgiving or Christmas the first year. I scarcely noticed when the snow melted and mud season began. I knew it was summer only because mosquitoes attacked me as I walked to and from the hospital, and because nurses returning from vacation would bring in fudge from Mackinac Island.

My family e-mailed and phoned, but what with one thing and another we hadn’t seen each other for a year by the time I got the July Fourth Weekend off.

It was Mom who noticed first. “Oh, sweetie! Doctor Kincaid,” she crowed. She stood back and looked me over. “Oh, you look so much healthier. Like you’re finally getting some meat on your bones. How is the food up there, they don’t even know how to make iced tea, I’ve been worried about you.”

“Food’s great, Mom.” I held up my hands, laughing. I’d missed my mother’s running-monologue style of conversation. Years ago, Southern girls had been taught, A lady never lets a silence fall, and Mom took that one to heart.

In the bathroom, after a much-needed shower to wash away travel grit, I looked myself over critically. In med school I’d lost weight, a combination of stress and lack of time to eat properly, so I’d been scarecrow-like, barely a hundred sixty on my five-ten frame. Clearly, a year’s worth of poutine, Kzoo Krunch, Mackinac Island fudge and the rest had filled me out. I even thought I could discern a little paunch developing, and my chin seemed fuller.

Shrugging, I got dressed and wandered out to the back yard. I popped a beer and hung out with Dad at the grill. We talked about residency, about Michigan, about the Packers, and I drank several cold ones in succession and got pleasantly tight, enjoying the icy beer on the humid July day. I piled my plate high with burgers, dogs topped with slaw, potato chips, baked beans, macaroni and cheese. I finished off with a large bowl of banana pudding and then a dish of Dad’s homemade peach ice cream. The South was back in my mouth. Mmmmmm.

I slumped in the lawn chair, suddenly stuffed. My body had gotten used to constant small intakes of food and it had been a long time since I’d eaten so much all at once. I rested a hand on my gorged and bloated belly, idly listening to the digestive gurgles and thinking about the biochemical processes.

My sister had finally diverted her energies from her new boyfriend, probably because he looked as full as I felt. He was half-asleep in a lawn chair of his own, cradling a beer and resting a hand on a bulging stomach. Kathy had done more talking than eating, as per usual, but now leisurely spooned peach ice cream, shrieking when a drip landed on the vee of tanned skin above her shirt. In drowsy, well-fed silence, we watched fireworks being set off in a park a few miles away. We couldn’t really hear them, but we could see them, and that was good enough.

Back at the hospital, there was an ongoing potluck my first day back to celebrate surviving the first year of residency. One of the nurses had contributed two huge cherry pies. Throughout the day, as our schedules permitted, we all snacked. My body, after that one day’s indulgence back in North Carolina, was efficiently being reset to Graze.

The second year of residency was better than the first. We now had new first-year residents to harass, and we were finally allowed out of the general stuff and into oncology proper. The second year was also when I met Marianne.

One of the night shift nurses, Colleen, was always sweet to the residents. Short, tanned, brunette, and perky, she also had a fiancé who was one of the hospital’s administrators. She had a roommate, however, and grabbed me by the sleeve one evening and asked me to please please please come along with her and her fiancé as a date for the roommate, Marianne.

Well, why not? Four years of med school and a year and change of residency and I’d forgotten what it felt like to have my arm around somebody. We went to a sports bar for beer, poutine (of course) and a preseason Packers game. Marianne and I seemed to hit it off at once. I felt obligated to give her fair warning.

“You do know I’m a resident,” I said, laughing. “Break the surface about twice a year.”

Marianne grinned. “My kind of guy.” It developed that she was in her final year of a doctoral degree in English and was deep into her dissertation, something about Christology in George Herbert. Or something. We agreed, after much juvenile and half-drunken suggestions, to call our relationship “not-dating.”

And so we not-dated, Marianne and I. E-mails to vent and let off steam, a card in the mail once in a while to make the other grin and feel good, occasional little presents (she got me a “Rocky” figurine stethoscope grabby, since I was going into cancer medicine).

The second year, by virtue of some rotational karma, I got two days off at Christmas – December 25 and 26. As a bonus, hardly anyone travels on December 25 itself, so I had little trouble booking a flight.

Mom gave me her usual line about looking not half-dead anymore and clucked over how hard they were working me. As Dad and I settled into the den with a couple of beers, he gazed at me thoughtfully.

“Puttin’ on a few pounds, champ,” he said carefully.

I raised my eyebrows. “Yeah, I know. Long hours, junk food. I still work out.”

“Good, good,” and he turned on the TV.

Kathy was less subtle. “Gawd, Jamie, porking up.” Only a Southerner can make up a two-syllable word. She poked at my belly button. “Oink, oink.” She flopped onto the sofa next to me. Dad was napping in the recliner. “What-all do Yankees eat?”

“Oh, you know. Stocking up for the long hard winter,” I said lightly. Kathy rolled her eyes.

“Whatever.” Having made her point, she didn’t press the issue. I decided to take it easy at Christmas dinner.

I hadn’t reckoned on nostalgia. Mom had a strict menu for Christmas dinner. Deviation meant certain death, no doubt.

I stuffed myself like a bear going into hibernation. Even as I piled on seconds and thirds, I could feel my stomach swelling and distending with every delicious swallow. I was already way beyond full, my sides ached, and my jeans, already embarrassingly snug, constricted my bloated gut painfully, but I had to have just another taste of everything, it was all so very good, and had I ever missed sweet tea. I was past stuffed, I was about to burst, my stomach hurt, but I couldn’t resist just a little more, just a little more.

Between me, Dad, and Kathy’s boyfriend, Brian, we put a fair-size dent into Mom’s feast and afterward kind of lumbered into the den and sank into a food-induced stupor.

“Ohhh,” I groaned. “I–hic–have missed–hic–Southern cooking.” I belched. I rested a hand on my gorged gut, which protruded considerably farther out than usual. It was taut and tender and beginning to gurgle and grumble audibly.

“Looks like you like Michigan cooking okay,” Dad said.

I rolled my eyes. Might as well get this over with. “Dad, look–hic–I’ve put on a few–hic–pounds, okay. Mrrp. Whew. I work eighty–hic–hours a week. My eating ha–hic–habits are atrocious.” I stifled another belch. “I still work out.” I pressed gently down on my bloated and aching belly to try to assuage the hiccups. “I really don’t ... mrp ... want to keep hearing about it. Hic!”

Dad was silent for a minute. “Okay, fair enough,” he said.

Brian diplomatically added, “Think we all porked up just now.” He stifled a belch. “I just put on ten pounds.”

Kathy, perched on the arm of the chair that Brian was slumped in, patted his shoulder. “What a pig,” she said affectionately.

“Hey–hic! Whose jeans are unbuttoned here,” I pointed out, staring at her waist. Her tummy was pretty rounded and pouched out just above her undone jeans button.

“Oh, like you’re not about to undo those jeans before they pop,” she retorted.

That was actually a really good idea. I fumbled the button undone and tugged the zipper down.

“Ohhhh. Urrrrp.” I felt considerable relief as my swollen and distended belly was freed of constriction. I gently massaged it, feeling no give; it was firm as a drum. I was so full I was semiconscious, logy, easy prey. Too stuffed to move and too stuffed to care that I couldn’t. My abdomen felt stretched tight like a balloon with too much air in it. With every hiccup I thought I would pop.

One by one, we drifted into a half-doze, watching the Lions, against whom I now rooted as a loyal Packers fan.

With startling rapidity, the second year of residency flew by in a blur of eighty-hour weeks. There were several ways of keeping track of passing time. The seasons were snow, mud, mosquito. Or they were Packers, Brewers. Or they were poutine-and-apple, poutine-and-Kzoo Krunch, poutine-and-fudge, poutine-and-cherry pie.

In the third year of residency, Marianne finished her dissertation, successfully defending it. We celebrated with a lavish and obscenely expensive dinner out. Figuring I might never see such good food again, I ate a disgraceful amount. After dinner, as we slowly walked out, Marianne put her left arm around my thickening waist and rested her right hand on my full and bloated stomach, which was firmly distended with four courses and several glasses of wine, topped with Irish Coffee.

“Mmm,” she murmured. “I love my doctor teddy bear.”

“Gettin’ fat,” I grunted absently.

“I like a man with something to hold on to,” she replied drowsily. Wine made her sleepy.

In return, I slid my hand up and down her waist and gave the little love handle I found there a gentle squeeze. “Don’t mind it myself.”

I made a few more visits to the parents, and Dad kept his promise and said no more about my weight. I’d long since blown past the haunted-scarecrow med student look and, at five-ten, was now hauling around close to two hundred pounds. I still worked out every day, though aerobic activity was getting harder, so most of the fat manifested itself in an undeniable second chin and a pot belly. Everyone gained weight in residency. “Intern gut,” the condition was called. It came from stress, long hours, and hastily grabbed snacks. Not to mention which, if you lived in a state that cold and socked-in, you stocked up. Approximately a quarter of Michiganders were classified as obese. I might be getting to be one of them soon.

In my fourth year, I was named chief resident, which politically was a hint that the hospital might well keep me on afterward. Marianne got a job at Western Michigan University, teaching English.

And then, suddenly, my residency was over. St. John’s Suomi Medical Center offered me a position in its oncology department. I accepted with alacrity. They even, to my shock, offered me a signing bonus. Holy crap. Flush with money for the first time in my life, I immediately betook myself to Siegel Jewelers for a 1½-carat diamond ring. First, though, I had to have a talk with Marianne.

I chose a Saturday afternoon. I’d been half-watching a Brewers game, which I turned off when Marianne came in and flopped down beside me.

“Hey,” she objected mildly.

“Can we talk?”

“Yes, Joan Rivers,” she said, laughing.

I stood up. “Marianne, I’ve put on more than fifty pounds – fifty pounds – in my four years of residency. I started at one-sixty and now I’m at two-ten. I’m pretty chubby here.” I poked at my belly. “I’ve been swearing that once I finished residency I’d send it packing.”

A look of alarm rippled across Marianne’s face. “Oh, Jamie, don’t,” she blurted. She stood up and embraced me, burying her face in my chest. “I love your body.” She stood back. “I love your big strong muscular arms and legs and I love your round cushiony cheeks that I kiss and I love your warm teddy bear tummy that I snuggle up against at night. I don’t want you a skinny little scarecrow. I love you.”

She sniffled. “I’m the one needs to lose weight.” She poked at her own tummy, which like the rest of her curvaceous body had a layer of cushioning. She stood five foot four and maybe tipped the scales at one-seventy.

“Oop, no fair, Doctor Creighton,” I scolded. I drew her in and pinched her little tummy tire. “I like your padding my own self.” I steered her back to the sofa and sat her down, then said, “Be right back.”

I went down on one knee, then ruined it by overbalancing and having to catch myself on the sofa. “Marianne, I love you. You make me the happiest man alive. Marry me.”

She nodded. I wriggled the ring onto her finger. “Promise me, though, Jamie.”

“Anything.”

“Promise me you’ll never try to lose weight.”

I fished a piece of Kzoo Krunch out of the bowl. I popped it into my mouth, then positioned myself so that my mouth was up against her ear.

Crunch.