Читать книгу A Killing Frost - Hannah Alexander - Страница 9

J ama felt for a pulse at Monty Mercer’s throat and watched the rise and fall of his chest. “Dr. Lawrence,” she said into her earpiece, “this is Dr. Jama Keith. I’ve arrived early at the clinic, and I have a patient on the front porch who just lost consciousness.”

“Call an ambulance.” The clipped voice of Dr. Ruth Lawrence had not grown warmer since the last time Jama had heard it. “We aren’t open for business.”

“I can take care of him if I can get him inside. We do have supplies, don’t we?” Jama gave what vitals she could. “Where can I get a key? And when is the staff due?”

“I’m at least thirty minutes out, and no one else is scheduled to be there. Either get a key from the mayor or get the patient to the closest facility. That would be Jefferson City or Fulton.”

“I know that,” Jama snapped.

“I highly advise transfer.” No emotion. Not irritation at Jama’s shortness. Not concern. Nothing.

“I’ll call the mayor for a key.” Jama clicked off, then spoke the mayor’s name into her Bluetooth. Why was no staff scheduled to arrive?

With one call, Jama discovered Eric Thompson was out of town for a meeting and wouldn’t be back until later in the morning. She dug her only credit card out of her purse, doubting she could jimmy the lock as easily as she had at the high-school gymnasium on her graduation night. If this failed, she’d break a window.

“Hang on, Monty. I’ll take care of you.” She placed another call as she knelt before the front door and slid the card between the door and the jamb.

A deep male voice sounded in her ear. “Jama? Are you at the clinic yet? What’s up?” Caller ID.

“Hi, Tyrell, where are you?” She was surprised by the relief she felt.

“Getting the Durango serviced down at Joe’s.”

Good. That was only a few blocks away. He could walk from there. Or run. “I need you to come to the clinic. Your dad’s been injured.”

“What happened?”

“He fell.”

“I’m on my way.”

She closed her eyes, allowing herself a few seconds of comfort…followed by regret.

By the time Jama had the clinic’s front door open—Mayor Eric Thompson was welcome to withhold the cost of the broken window from her first paycheck—a crowd of two men, a woman and two children had noticed the activity and now clamored to help. They moved Monty into the clinic and settled him on a bed in the first treatment room.

They continued to hover while Jama ran from room to room, looking through cabinets for supplies to stop the bleeding and assess the damage, slamming doors and tripping over equipment. Where was the EKG machine?

“What can we do, Dr. Keith?” Harold Kaiser, the local grocer, had known Jama since she was a toddler. Her new title sounded odd on his lips. “Just tell us and we’ll do it.”

“Sure thing,” said Carol Saffer, the town postmaster. “I had some first-aid training a couple of years ago.”

Jama grimaced. Sweethearts, both of them, but she needed somebody who really knew how to help. “Hey, guys, doesn’t Zelda Benedict still live across the street?”

“Sure does,” Harold said. He and Carol often competed over which of them knew more citizens of River Dance, and who knew them better. “She walks three miles on the Katy Trail every morning she doesn’t work, then smells up the neighborhood every night before bed when she sits on her front porch and smokes her cigar, if she doesn’t have a night shift.”

Some things never changed. “Would somebody run across the street to see if she’s back from her walk?” Jama asked. Though Zelda was retired from her job as an RN at the nursing home, she had recently told Jama she still did part-time nursing.

To Jama’s great relief, just as she found the EKG machine behind door number three in the largest treatment room, all the would-be helpers were scrambling out the clinic entrance to search for Zelda.

Monty’s eyes opened when Jama began to attach the leads from the machine to his chest. He looked around the room, grimaced and tried to sit up.

“Don’t you dare move.” She pressed him back. “I’ve got work to do, and you’re hindering me. You don’t want me to look bad my first day on the job, because I will make you pay.”

He studied her a moment, then relaxed as well as any man could relax when he’d been stripped half-naked and attached to wires by a woman who’d once been a child he’d helped raise. “Did I bleed all over that nice, clean front porch?”

“I wouldn’t know, but you can help pay for the window I broke to get you in here.”

His answering grin was more of a contortion of the face. “Did this on purpose, you know. Wanted to break you in right as soon as you arrived here.”

“So you’re saying you didn’t fall from the ladder, you jumped.”

“That’s got to be it. I’ve climbed plenty of ladders. Never fallen before.”

“So what happened this time? Did a rung break? Did the ground shift under the—” The lines on the EKG machine caught her attention.

“Monty, you said you thought you might have busted a rib or two.”

“Chest hurts.”

She swallowed and tried to keep her breathing even. “Did it hurt before you fell off the ladder?”

He paused. “I’m not sure, but it might have.”

“Think about it. This is important.”

“Why?”

“It’ll give me a better idea about the source of your pain.” She searched through the cabinets for IV supplies and fluids while she punched in the preprogrammed number on her cell phone for the airlift service for St. Mary’s Hospital in Jefferson City. She would need a blood thinner and other meds…“Where was that pain located?”

He pointed to the middle of his chest.

When the line connected, Jama requested a helicopter, explained the situation and location. The emergency personnel would have to land in the parking lot of the winery, the only large, paved surface in River Dance. The gravel on the clinic lot would spray in every direction if the chopper landed here. Jama needed help to make sure the winery lot was cleared. This early in the morning, it should be empty except for employee vehicles.

She disconnected and returned her attention to Monty. “I’ve checked you over, and can’t appreciate any obvious deformities. There was a lot of blood, but it was superficial. Since I don’t have an X-ray tech, I can’t get a film right now, but, Monty, your EKG shows classic ST elevation. I’m going to establish a large bore IV and—”

“English, Jama.” He was looking gray again.

“Sorry. It looks like you’re having a heart attack. I’ve called for an airlift, but—”

“Somebody need a seventy-six-year-old nurse?” came a screechy shout from the waiting room. Zelda Benedict.

Jama was flooded with relief. That voice, recalled from Jama’s past, brought to mind memories of strength and calm assurance. “In here,” Jama called. “Second room to the left. When’s the last time you established an IV in a patient?”

The tall, slender woman entering the room wore orange jogging shorts that matched her hair, dusty tennis shoes and a light green tank top that matched her eyes. She had a green jacket that matched her tank top, but it was tied by the sleeves around her waist. Zelda Benedict looked closer to fifty than seventy-six.

“I did one yesterday, that recent enough for you?” Zelda peered at the monitor, then clucked her tongue. “Large bore? Tell me where everything is.”

“I can’t. I just got here, myself. We aren’t exactly open for business.”

“You got that right. If you’re the one who broke that glass, the mayor’s gonna tear you a new one.”

“Tear a new one…” Monty mumbled. “That’s it, Jama. That’s how my chest felt.”

Zelda patted his hand. “We’ll get you feeling better. An aspirin, a little heparin, a little trip to the hospital, and you’ll be fixed—”

“Hold it,” Jama said. “Monty, what do you mean? You felt something tearing in your chest when you fell?”

“Felt that way. Something seemed to rip, but I didn’t think much of it—didn’t have time after the fall.”

“So you’re saying you felt this tearing pain in your chest before you fell?”

He nodded.

Jama closed her eyes. She’d heard of bad first days, but this was becoming a nightmare. “Zelda, find the sublingual nitro.”

“Where do I look?”

Jama turned, scanned the glass-doored cabinets and pointed to one. “Try there. And locate the heparin and aspirin, but don’t get them out yet.”

“Why not? If this is a heart—”

“Wait a minute, will you?” How could this be happening, today of all days? Was this punishment from God so many years after the original sins?

Jama checked Monty for neurological deficits and found a decided weakness in his left leg.

Zelda brought the nitro. “Here you go. Now, how about the—”

“Forget the heparin,” Jama said.

The nurse arched a finely drawn eyebrow that matched her hair. “An aspirin, at least?”

“Can’t risk the bleeding.”

“What bleeding?” The question was threaded with the steel of Nurse Zelda’s teacher voice, honed from her years of being nurse director of River Dance Nursing Care. “This arm isn’t bleeding enough to warrant withholding blood thinners.”

“Something about this doesn’t seem to be a simple MI,” Jama said.

“So what is it? We need a diagnosis before we can treat.”

Jama touched Monty’s arm. “The ripping in his chest could be a clue about what caused the MI.”

“Did you call Fran?” Monty asked, eyes closed. Under the harsh, bright lights, his pale, grayish skin and leathered wrinkles from years beneath the sun made him look suddenly aged.

“I called Tyrell. He’s on his way here.”

“Don’t let him bully you.” Monty’s words had begun to slur. “Tell him you’ll take good care of me.”

Jama met Zelda’s inquiring look, and all the years of training fled. She was just Jama Keith again, the girl who tagged after Zelda Benedict at the nursing home like a lost puppy, finding acceptance from the elderly patients she loved, even before she began receiving pay as an aide.

Who was Jama Keith now, standing here making life-and-death decisions for the man who had been her second father? How could she—

“Dr. Keith?” Zelda’s soft green eyes held only respect. “What are your instincts telling you?”

“Dissecting aortic aneurysm. A tear in the wall of the aorta—”

“What do you need for a positive diagnosis?”

“I need to see if he has mediastinal widening, and for that, I need a chest X-ray.”

“You’ve got no tech scheduled?”

Jama shook her head. “As I said, we’re not open yet.”

Zelda’s frown finally showed her age. “Well, folderol. I knew I should’ve taken that course at the university.”

“If we treat him for a classic MI with blood thinners of any kind, and this is a tear in the aorta—”

“I know,” Zelda said. “He could bleed to death.”

“I’ve called for airlift to St. Mary’s.”

“How long do we have?”

Jama looked at the large wall clock. “They should be here in ten minutes.”

“I’ll contact the hospital for an accepting physician.”

“I need someone to clear a landing space for—”

There was another shout from the waiting room—one Jama recognized. For as far back as she could remember, that voice had meant comfort, friendship and much, much more.

And now? Tyrell Mercer’s voice stirred conflicting emotions, but she didn’t have time to deal with anything but Monty.

“There’s our man,” Zelda said with a wink. “Just in time, as always. Go put him to work, and tell him his daddy’s being well cared for by the best doctor and nurse in River Dance.”

Jama rushed to intercept “our man” and fill him in.

Tyrell was in the middle of the large waiting room, his six-foot-three broad-shouldered bulk cutting a swath across the polished wooden floor and area rug toward the treatment rooms.

He stopped when he saw Jama, his expression apprehensive. “What happened?”

Jama felt drawn to his comforting strength. She wanted nothing more than to step into his embrace and let it engulf her. Today, however, she needed to be the strong one.

She stepped forward and placed a hand on his arm. “It’s his heart.”