Читать книгу A Killing Frost - Hannah Alexander - Страница 11

T yrell Mercer stood frozen as the love of his life looked up at him with tender concern, touching his arm with her warm hands. Jama’s expressive blue-green eyes were dark and troubled.

“Is it a heart attack?” he asked.

“Not exactly.” She described the morning episode, and he heard the hesitation in her voice. For the second time in three weeks, he wished he didn’t know her so well. And he wished she would look into his eyes more often instead of just past his left shoulder or at the ceiling or out the front window.

“How bad is this tear you’re talking about?”

“No way of knowing,” she said. “I’m not even sure that’s what it is. Marty mentioned a sensation of ripping in his chest, and his left leg is weaker than his right.”

“He’s had weakness since his stroke.”

She hesitated, then her gaze met his straight-on. He didn’t like the look of alarm that flashed in her eyes, and as quickly disappeared. “Monty’s never had a stroke.”

“It happened right after…” It was his turn to hesitate. “Dad had a small stroke four and a half years ago, a few weeks after Amy’s funeral.” Just saying the words brought back the horrible grief of his sister’s death. He saw it affected Jama, as well. Of course it did. Amy had been Jama’s best friend…her foster sister. The whole family knew Jama had never recovered.

“The rest of us had already returned to our homes and jobs,” he told her. “Mom and Dad decided not to burden us with it. I only found out about it this year.”

He saw Jama’s eyes darken further, and he fought down his own rush of anxiety. Calm. Stay calm. But he knew from her response that, for some reason, Dad’s stroke could somehow complicate everything. He just didn’t know how.

“Why didn’t he tell me?” she asked.

“You know Dad. Never wants anyone to worry, just like today, I’m sure. What’s the significance?”

She closed her eyes briefly.

“Jama?”

She looked up then, and he could see that she was mentally adjusting her expression for him. It was in this brief change—this infinitesimal moment—that he saw the flash of loss and longing in the depth of her eyes.

“As I said, that tear he felt in his chest is classic for dissecting aortic aneurysm.” Professional again, she looked away, speaking with calm authority. “That means there’s bleeding that could get worse with blood thinners.”

“That’s why you couldn’t treat him for a heart attack?”

“Exactly. But one symptom I was using to help me make the tentative diagnosis, since I had no capacity for any other kind of test, was the weakness of that leg. This is often a symptom of the condition I suspected. With no X-ray tech available, I couldn’t know for sure.” She sought Tyrell’s gaze again.

“Explain a little more, sweetheart.” The endearment slipped out, and he didn’t care. “All of it. You’re scaring the bejeebers out of me, so the plain truth can’t be any worse.” Jama had finished second in her med-school class. He trusted her judgment, because he admired her intelligence and her logic. But when that judgment came without complete knowledge of the facts, it could be faulty.

“This shouldn’t be happening,” she said. “Monty’s too active and healthy for heart trouble, and so that’s the knowledge on which I based my decision not to treat. I didn’t know about the stroke. If this isn’t what I’ve suspected, and if this really is an MI, then there could be further damage to his heart because of the delay in treatment.”

“So it’s up to you to decide, based strictly on your medical judgment.”

“That’s right.”

Jama shouldn’t be forced to make life-and-death decisions about someone she loved. “Where’s the other doctor?” Tyrell asked. “I thought there was a director—”

“The director isn’t here, yet.” Jama raised a hand to her eyes just long enough for Tyrell to see with relief that it was not shaking. He also saw she understood that he didn’t doubt her expertise. She knew him that well. “I have an airlift on its way that will most likely arrive before Dr. Lawrence does.”

He groaned softly. “Where do you need me right now? At Dad’s bedside, or—”

“I need the parking lot cleared at the Dancing Waters Winery for landing.”

“I’ll call now.” He pulled out his cell phone.

Throughout her internship and the early years of residency training, Jama had had doctors, nurses, fellow interns and residents looking over her shoulder as she worked with patients. By the second year of her family practice residency, however, she had gained the trust of her colleagues, and no longer had anyone looking over her shoulder and critiquing her work.

Now, as the flight crew switched Monty from the clinic equipment to their own, she was the authority who stood in the middle of the action, observing every movement. Had any member of the crew made the slightest misstep, she’d have tackled that person and completed the job herself.

As she watched and tried hard to contain her worry, a fresh layer of remorse pressed down on her shoulders like a boatload of river silt.

Monty’s stroke? Had it been caused by the black grief of Amy’s death, and not some clot in his brain?

Medical science was learning more and more about the impact of emotions on overall health.

The male flight nurse, nearly as big and intimidating as Tyrell, frowned at the display on the monitor, then scowled at Jama.

“Dr. Keith, why hasn’t this man been stabilized for transport?”

The man’s attitude startled her. She resented his questioning of her judgment. “He’s as stable as we can make him under the circumstances,” she told him.

“He hasn’t received any—”

“I have reason to believe he has a dissecting aortic aneurysm, which will need to be ruled out before medication can be given for—”

“How did you determine that?” the nurse demanded. “You have no—”

“That’s my clinical assessment,” she snapped. “I’ll take responsibility for it. Don’t stand here arguing with me while this patient needs immediate transport.”

“Excuse me.” Tyrell entered the room. “I’m this man’s son. I believe the doctor has made her diagnosis. If you have any questions, you can take them up with me after you’ve flown my father to St. Mary’s.”

The staring match lasted a few seconds. The nurse backed down. He was, after all, a professional, and it was obvious he took his job seriously.

The crew completed the switch and transferred Monty to a gurney for transport while Jama tried hard to maintain her resolute demeanor.

The nurse was knowledgeable. He knew what he was doing. Jama would not, however, change her diagnosis.

She followed the crew out the front door and across the parking lot, and she might’ve followed them all the way up the hill to the helicopter in the winery parking lot. Before she could do so, however, an ancient station wagon entered the lot and pulled next to Jama’s green Subaru.

If she wasn’t mistaken, the new director had arrived to ramp up the tension a few more notches.

Dr. Ruth Lawrence was at least four inches shorter than Jama’s five-eight. She looked to be about ten years older. She wore her dark brown hair in a braid down her back. Her angular face, free of makeup, didn’t appear to have ever exhibited a smile except for telltale laugh lines around her golden-brown eyes. Her royal-blue scrubs looked well used, as did her lab coat. She’d had the sense to dress for comfort.

Jama altered her course and stepped toward her. “Dr. Lawrence? I’m Dr. Jama Keith.”

The woman nodded without smiling or offering her hand. “I saw the helicopter arrive. Do you have a report for me?” She turned and started toward the clinic, brisk steps, economical movements, no evidence of cordiality, obviously expecting Jama to keep pace.

Once more Jama reported about Monty and her judgment call. When they reached the broken windowpane, Jama promised to pay for the damage.

“I’m sure you will.” Dr. Lawrence paused at the clinic door, which had been anchored open, then she looked at Jama as if to ask why.

Jama didn’t reply.

Dr. Lawrence stepped inside. “Under the circumstances, I believe the mayor will be magnanimous,” she said over her shoulder, “but paying might remind you next time that you aren’t Dirty Harry.”

Jama was beginning to feel a little snarly. “A key might be nice next time.”

Dr. Lawrence stepped into the comfortably spacious reception room and studied the fully equipped business office behind glass. “Would a key have kept you from making a questionable diagnosis?”

Jama pressed her lips together to keep angry words from spilling out. Definitely snarly. “Are you trying to tell me I’m not going to have my own key to the clinic?”

Dr. Lawrence wandered back toward the broad hallway that led to the treatment rooms and private offices, ignoring her.

“Don’t you think the key would have prevented the broken glass?” Jama persisted.

“Couldn’t you have decided on a less destructive way to see to the patient?” Dr. Lawrence asked over her shoulder.

“Are you questioning my diagnostic skills, or my decision to break a replaceable piece of glass for the sake of patient care?”

Dr. Lawrence paused to peer into the first treatment room, where Monty had recently been, and where Zelda was cleaning up as if she had suddenly become a member of staff.

“I did the best I could with the diagnosis,” Jama said. “I’m not a radiology tech, Dr. Lawrence, and we didn’t have one on-site, so I made the best call I could under the circumstances.”

The director turned back to her. “Let’s drop the formalities. They’re stuffy and awkward. My name is Ruth, and I expect to be called Ruth, not Dr. Lawrence, and certainly not Dr. Ruth.” There was no humor in her voice.

“I’m Jama.”

“Yes, Jama,” she said, her voice suddenly softer, as if she’d discovered where she had mislaid her manners. “I’m not saying we will be chummy—” so much for the manners “—but we need to establish some simplicity. It’s going to be a hectic few days as we hire our own staff, develop our management systems, train the team to—”

“There’s no staff? ”

Dr. Lawrence…Ruth…blinked. “Who did you expect to do the hiring? The mayor?”

“It might have been helpful.”

“I won’t have a small-town mayor hiring medical personnel. I specified this before I agreed to work here.”

“Then it might have been nice if someone had informed me, ” Jama complained. Just because she’d had no voice in the decisions and plans that had been made for the next two years didn’t mean she wanted to be treated as if she didn’t exist.

“I will make my own choices and judgments about the people with whom I will spend a huge amount of my time,” Ruth said.

“Mayor Thompson hired me. You didn’t have any choice about that.”

Ruth turned to rearrange a stack of magazines on the center table in the waiting room. “Your situation is different, but since you mentioned it, just because you have a forgivable loan from this town does not mean you may behave any way you wish. Your behavior the next two years will determine whether or not you stay on after that probationary period.”

Jama pressed the tip of her tongue against her front teeth. Why on earth would she want to stay on? “A probationary period of two years? ” That was a nasty slap in the face. She would make Tyrell Mercer suffer badly for getting her into this.

She could have paid back those school loans on her own. Eventually. But Tyrell would not hear of it. Without telling her what he was up to, he’d proposed this arrangement to the city council, and the decision was made before she had time to think about it.

Sure, she’d signed the stupid contract, but she was under duress at the time. Thinking about finances made her crazy.

“Depending on how things work out,” Ruth said, “the two-year probation could be greatly reduced.”

Jama wondered what response she’d receive if she were to share her thoughts at that moment.

“During this time,” Ruth said, “you will keep in mind that I am your supervisor…director…whatever you want to call me. You will respect my orders and do as I say when on duty. When off duty, you can say anything you want to me. You will report to work when you are scheduled, and you will do nothing to jeopardize the reputation of this clinic.”

Heat warmed Jama’s face. The mayor had obviously not remained silent about her youthful escapades. But at thirty-two, she was far removed from those days.

The sound of squeaky footsteps echoed from the corridor, where Zelda in her orange shorts and green shirt and dusty running shoes came toward them with a familiar glint in her eye.