Читать книгу Maverick In The Er - Jessica Matthews - Страница 8

LET this be a lesson to you, Sierra McAllaster, she told herself in her rush to meet the incoming ambulance. Never say never.

She’d worked in Emergency Services before coming to Pennsylvania three months ago, and when she’d left North Carolina, she’d vowed that daily E.R. duty wouldn’t be in her future. She’d been there, done that, and although she’d once loved her work in that hectic department, it was time to pass the torch to others who thrived on the adrenalin rush. She wanted a more sedate pace with patients who weren’t broken bodies in need of an immediate fix, and she’d found it on the fifth-floor medical unit at Pittsburgh’s Good Shepherd Hospital.

However, just when she’d finally settled in to her new duties, her career plan had taken a one-hundred-and-eighty-degree turn. At this very moment she was in the middle of the very position she’d never intended to fill again, thanks to a one-sentence clause in the fine print of her contract.

“Come on, people,” Trey Donovan, the senior emergency physician, yelled beside her. “Let’s move!”

By the time their small entourage had reached the ambulance bay, two paramedics were already tugging a stretcher out of the back of their vehicle.

A feeling of dread swamped her, but she reasoned it away. You don’t know this person. None of your friends or family could possibly be on that stretcher. This is a car accident—nothing at all like David’s situation.

She swallowed hard and forced herself to fall back into her objective professional mode.

“MVA,” one medic reported, using the shorthand Sierra recalled so vividly. Motor-vehicle accident. “Forty-five-year-old male with blunt trauma to the chest and abdomen, dislocated shoulder and sundry other injuries. BP is…”

Sierra noted the vital signs as she gazed down at the man lying on the gurney, strapped to a backboard and wearing a cervical collar. Bruises were already forming on his visible extremities and lacerations from broken glass crisscrossed his face. An oxygen mask covered his nose and mouth, but his nose was swollen and clearly broken, which meant they’d need an airway.

“Let’s go,” Trey ordered, and off they scurried to the nearest available trauma room.

“He’s wearing a MedicAlert bracelet,” the other paramedic reported. “According to the company records, he’s a diabetic and he’s currently taking Coumadin, hydrochlorothiazide and something called liraglutide.”

The blood-pressure medicine wasn’t unusual for someone his age, but the blood thinner was. “Has he had a recent heart attack or stroke?”

“We don’t know, but his left knee has a freshly healing scar. Maybe a recent joint replacement? The police are trying to locate his next of kin.”

“Any record of insulin?”

The paramedic shook his head. “None.”

“What was that last drug you’d mentioned?” Trey asked, his brow furrowed as if trying to place the medication.

“Liraglutide,” the paramedic repeated.

Trey turned to one of the nurses. “Call the Pharmacy and ask—”

“Don’t bother,” Sierra interrupted. “It’s a new drug just approved by the FDA for treating type 2 Diabetes.”

“Oh.”

Trey’s dark-eyed gaze met hers over the gurney and she read his unasked question. “I had a patient who had trouble controlling his diabetes, so we tried it. It’s not the first line of therapy and has a number of side effects, but in his case it was a last-ditch resort and it worked,” she explained.

He grinned, and the most endearing dimple appeared in the side of his cheek. “Your first official day and you’re already handy to have around.”

Strangely enough, her face warmed under his appreciative comment. Sierra McAllaster did not respond to empty flattery with a blush, she reminded herself. Thanks to her husband, who’d liberally used his charm to his own advantage, she’d eventually determined it was merely a tool to get what he wanted. The lesson had been painful to learn as her illusions had been shattered, but she’d never forget it. Never again would she fall for a fellow who troweled on charm as easily as a brickmason laid his cement. She’d become immune to men like him.

However, immunized or not, it seemed rude to refuse to return his smile so she did, even though she didn’t know why she was smiling in the first place.

A few seconds later, they’d pushed the gurney against the awaiting bed in the trauma room. Sierra locked the wheels in place with the toe of one pump, having already decided she’d overdressed for the demands of this department. She’d forgotten the frantic pace—or maybe she’d simply blocked it out of her mind—which meant a dress and heels weren’t her most practical choice of attire.

“Lift on three,” Trey ordered. “One, two, three.”

Everyone complied in one smooth, well-rehearsed motion to move their patient to his new bed. Sierra hoped any residual blush on her face could be attributed to the strain and not Trey’s flattering comment.

“Can you hear me, Mr. Klein?” Trey spoke to the fellow. “You’re in the hospital and we’re going to take care of you.”

Unable to nod because his head and neck were immobilized, he simply blinked and mouthed, “Okay.”

Sierra hung around and helped the nurses organize the patient’s tubes and swap the paramedics’ equipment for hospital-issue while Trey issued orders for X-rays and lab work, requesting the same procedures Sierra would have if she’d been in charge of this case.

His next command caught her by surprise. “Go to lunch, Sierra.”

She paused. “You don’t need help?”

He shook his head and flashed his trademark grin. “Thanks, but I’m good.”

Yes, he was, she thought as she moved out of the way, somewhat reluctant to leave just yet. Instead, she took a few minutes to observe her colleague in action.

Today might be her first official day in Emergency, but it wasn’t the first day she’d worked with Trey. In her previous position as hospitalist on the fifth-floor medical unit, she’d received several patients he’d admitted and had answered his call for a consultant on numerous occasions. His medical skills then, like now, seemed outstanding.

He spoke with a calm authority that sent staff scrambling to obey, but she could tell they did so out of a desire to please rather than a sense of fear. Then again, who wouldn’t want to do whatever he asked if it meant receiving one of his killer smiles? She’d seen how his grin had turned even the most independent, career-minded woman into the equivalent of a simpering teenager.

He was also more than just a handsomely wolfish smile. His long eyelashes were partly to blame for his appeal to women, she decided. Add dark brown hair and midnight-blue eyes, a firm jaw and an attractive dimple, and infatuation was a given.

He was a tall man, which made nearly every female, no matter her size, feel dainty and feminine. While he wore the requisite surgical green scrub suit under the protective yellow paper gown, the shapeless garments didn’t detract from his muscular shoulders or his lean physique. If he could turn heads in this ugly garb, he’d probably stop traffic when he wore street clothes that actually fit.

If the hospital ever created a doctor-of-the-month calendar featuring him as the centerfold, they’d make a fortune.

As great as his physical appearance was, he wouldn’t have earned the moniker of “the delectable Dr. Donovan” if he didn’t have the personality to match. His charisma explained how he’d managed to get whatever—and whomever—he wanted in his department. Because of his persistence and eloquent arguments that she was the one physician who could immediately fill the long-vacant position in his service, he’d persuaded several top people to transfer her into his domain. Granted, she was only covering until the heads of Emergency Services and Internal Medicine hired a physician specifically for the post but, as far as she was concerned, a day spent in the ED was one day too many.

Apparently aware of her lingering presence, he flashed her a cocky grin.

Hating that he’d caught her loitering and was obviously thinking she’d become one more member of his adoring fan club, she fled the room. After a brief stop at the staffing board, where she slapped a Lunch magnet beside her name, she hurried outside, into the warm afternoon sun.

Trey surreptitiously watched Sierra leave as if a rabid dog were nipping at her heels and hid his smile. He’d first met her three months ago when he’d called the fifth-floor medical unit to request a stat internal medicine consult and Sierra had responded, barely giving him a second glance.

Accustomed to dealing with flirty and simpering females, Trey had been taken aback by her disinterest at first but then he’d been intrigued by it. In his earlier life as a footloose, carefree bachelor, he would have responded to the challenge she presented and pursued her with everything he had. However, that had all changed when his sister-in-law, Marcy, had died. While his relationships were still of the short-term variety, he’d come to the conclusion that even those were difficult to juggle with everything else in his life. Acting as Mitch’s “big brother,” helping Mitch raise his niece and coping with the demands of his job took nearly all of his free time.

As much as he’d like to know Sierra on a more personal level, his gut told him that she wasn’t the sort who would embrace such a temporary and superficial relationship.

Instead, she was the type to make a man think about the future in terms of the next twenty or thirty years. At times, he tried looking ahead that far, but he simply wasn’t ready to let a woman get that close. Between coping with Mitch’s downward spiral after Marcy’s death and his struggle to meet all of his family obligations, he didn’t have the time or the energy to devote to anyone else.

That hard truth, however, didn’t prevent him from wishing Sierra would be happy with what he could offer, especially after today when he’d seen her face turn a beautiful shade of pink. What woman in this day and age, especially one who’d survived the rigors of medical school and residency, actually blushed? Be that as it may, that small flaw only enhanced her already attractive features.

Her fine bone structure gave her an ethereal quality, as if she didn’t belong in a field as brutal as emergency medicine, but her athletic frame suggested she wasn’t a stranger to hard work.

As lovely as he considered her face and form, her thick auburn hair was nothing short of awesome. The color reminded him of flames dancing on the hearth and without any effort at all he pictured her shaking out her braid until every strand cascaded over her beautiful shoulders.

If that wasn’t enough, her shapely legs with their miles and miles of soft skin made his throat go dry. Today, like most days, she wore low-heeled pumps and a dress that fell to just above her slim knees. Her garb wasn’t practical for the demands of working in Emergency and she’d probably switch to baggy scrub suits and tennis shoes tomorrow, but he’d enjoy the view while it lasted.

His libido and personal preferences aside, he was still glad she’d finally joined the emergency-services staff. For that reason, he found himself grinning like a loon whenever he saw her.

Actually, she hadn’t joined as much as she’d been transferred. Over the past year, he’d created a paper blizzard that had gone to every department head, vice president and hospital-board member, protesting the fact that his department’s extra medical position had never been filled. As soon as he’d learned of Sierra’s credentials and past experience in Emergency, he’d intensified his efforts. If Administration had agreed they’d needed the position, he’d argued, then it was pointless not to fill it, especially when someone already on staff was ideal for the job.

While everyone agreed with his reasoning, Sierra’s boss, Lane Keegan, hadn’t wanted to lose her from the medical unit. If not for pressure from above, they’d still be at an impasse, but finally, after weeks of negotiating details, Keegan had given in. On one point, however, he’d refused to budge.

Sierra would only fill Trey’s position until they found a replacement who met the criteria, but not for longer than sixty days. Which meant Trey still had fifty-nine to work his magic and convince her to stick around permanently. His philosophy was, Better the devil you know than the one you don’t, and he’d prefer to keep Sierra, who got along well with the staff, rather than bring in a new person who might clash with everyone.

Roma Miller, the nursing supervisor who’d just received her thirty-year service pin, strode in. “Where was Dr. McAllaster going in such a hurry?”

He shrugged. “Lunch, I guess.”

“No kidding? I’ve never seen her walk so fast.”

Interesting. “She must be hungry,” he offered, although he suspected the reason for her rush had had nothing to do with her appetite and everything to do with regaining her composure after he’d caught her studying him.

In spite of her cool attitude, in spite of her standoffish ways, Sierra McAllaster obviously wasn’t as resistant to his charm as she pretended.

Munching on an apple, Sierra strolled along the circular concrete pathway of the hospital’s favorite attraction—the Healing Garden and Labyrinth—which had been created just outside Emergency. Normally, she walked the circular concrete pathway in order to recharge her mental batteries when she had a tough patient, but today her reflections were far more personal and far more immediate.

Her ridiculous reaction to Trey’s flattering comment still bothered her. Her marriage had taught her to not fall victim to a man’s flattery and until now she hadn’t. Why today was different remained a complete mystery. In her opinion, Trey’s charm was a strike against him.

He had also earned a second strike because if it weren’t for him, she’d still be reporting to work on the fifth floor, where she belonged. Although, in all fairness, she didn’t know if she should be upset with him or with herself.

If she’d been in Trey’s position, she would have presented the same case he had, asking that the vacant position be filled with a doctor who was already on staff and who possessed ED experience. As Fate would have it, she was the one with the least seniority—the only one, in fact—who fit the criteria.

Her options had been limited—either take this assignment or end her contract.

Leaving hadn’t been a viable option. She’d finally unpacked the last box of household goods this past weekend and the idea of hunting for a new job was too tiring to contemplate.

On the other hand, she did have a third option. If she’d been honest and explained why she couldn’t work in Emergency, perhaps Dr. Keegan might have chosen someone else. Pride, however, had stopped her. She’d come to Good Shepherd with a clean slate and if she dragged out her history to use like a get-out-of-jail-free card, her past would become an open book. The doubts, the pitying glances and every emotion in between would start, and she refused to deal with that from staff and her colleagues.

Consequently, she’d decided it might be time to face her fears and put those horrors behind her. Although she didn’t want to work in Emergency, she suddenly had a desire to prove she was able to.

Fortunately, Dr. Keegan had offered her several consolation prizes. One—and the most important—she was only filling in temporarily. So what if she was back in the area where she’d sworn she’d never work again, treating everything from acid reflux to herpes zoster infections, traumas to diabetic comas? She’d endured far worse and for a far longer period. Sixty days was nothing more than a wrinkle that would iron itself out in due time.

Two, Dr. Keegan had promised she could return to her hospitalist position on the fifth floor. Knowing how the other internist, William Madison, was already complaining about covering those patients as well as his own in the cardiac ICU, he was also eager for her to shake the E.R. dust off her feet and return to where she belonged.

Three, the odds of encountering a trauma that involved a close friend or family member were nonexistent. After three months in Pittsburgh, she still hadn’t developed any serious friendships or personal relationships and as long as she was expected to staff the ED, she intended to keep it that way.

As she strolled around the labyrinth, a growing sense of acceptance and her natural can-do attitude filled her. Her transfer may have thrown her off balance, but she was slowly feeling more in control over her situation. Today’s trauma had only caused her a few moments of anticipatory dread, but after that she’d handled herself well. She’d still have some bad moments, but she’d be able to deal with them. She would deal with them.

Her next mental project was to get Trey Donovan, including his twinkling eyes and his lazy grin, out of her head. After a single morning in his presence, he’d already shattered her calm, making her wish for those happy-ever-afters she’d stopped imagining were possible.

She knew better than to respond like a schoolgirl to a man who had enough charisma for three guys, but she’d done it anyway. Maybe her reaction was due to first-day-on-a-new-job stress because she’d been dreading this day for the past week. Maybe it was because she hadn’t slept well last night and her defenses were down.

Maybe it was because her blood sugar had dropped. She’d chosen to take the late lunch break and that had been delayed because they’d been busy.

Then again, maybe it was all of the above. Yes, she decided. That was it. She’d been simply tired, stressed and hungry. This afternoon, she’d be more like her old self, able to resist his wicked grins with the logic that they meant nothing.

“Can I walk with you?”

Startled out of her private thoughts, Sierra glanced down to see a girl, about ten years old, falling into step beside her on the concrete walkway. The child wore an oversize T-shirt, bright pink leggings and well-scuffed white-and-lavender tennis shoes. Her skin was tanned and her brown hair possessed lighter streaks, which suggested she spent a great deal of time outdoors. Several strands of hair had escaped her ponytail, which wasn’t quite centered in the back of her head.

Although Sierra wanted to finish her walk through the labyrinth in contemplative quiet, she didn’t want to be rude. Instead, she glanced around the garden, carefully scanning each bench for a potential parent or an otherwise responsible adult. Surprisingly, the garden was vacant and no one else was walking the labyrinth. They were alone.

“Won’t your parents wonder where you are?” Sierra asked instead.

“My mom’s dead and when my dad’s out of town I stay with my uncle,” the girl informed her. “He says I have to keep myself busy until he finishes his shift. He has a very important job, you know.”

“Really?” she replied, amazed by how anyone could expect a child at her age to amuse herself in a hospital for hours on end. Surely a man who had this so-called “very important job” would realize that.

“He’s a doctor,” the child added meaningfully.

Sierra wasn’t as impressed as the little girl obviously expected her to be. By virtue of his profession, the man should know better than to let a child run around a busy medical center completely unsupervised.

Immediately Sierra wondered if any of the physicians she knew had a niece this age, but none came to mind. Even so, something about this child’s features seemed familiar.

“You’re a doctor, too, aren’t you?” the youngster asked, as if she already knew the answer.

“Yes, I am. Are you supposed to be outside by yourself?”

The girl drew herself up, adding an inch or so to her almost five-foot frame. “I’m almost eleven,” she said, clearly affronted by Sierra’s question. “My uncle says I can come out here if it’s not raining.” She raised her hands, palms up. “No rain today.”

“No. No rain today,” Sierra echoed. “Doesn’t he worry about you wandering all over the hospital while he’s working?”

“No, because I had to cross my hearts…” she pantomimed “…and promise to follow the rules. I can only go to certain places, like the li-berry, the coffee shop or this garden. Or his office,” she tacked on. “He trusts me.”

At least this nameless man had set a few boundaries.

“The other rule is that I don’t talk to or go with a stranger, no matter where I am.”

“I’m a stranger,” Sierra pointed out, deciding she would hunt down this irresponsible uncle and give him a piece of her mind, colleague or not! The risk was too great to leave this little girl unattended. The garden saw a lot of foot traffic and anyone who weighed more than a hundred pounds could haul this youngster off without breaking a sweat, even if she was kicking and screaming.

“No, you’re not,” she said, shaking her head. “I’ve seen you lots of times.” She scurried in front of Sierra and peered at her identification badge. “You’re Dr. McAllaster. Your name tag says so.”

“Yes, but—”

“I’m Hannah,” she answered. “Now we aren’t strangers anymore.”

Hannah’s logic was definitely lacking. “Actually, we still are strangers,” Sierra corrected her gently. “I could be a not-very-nice person.”

Hannah’s ponytail bounced with each shake of her head. “Nope, you’re not. I’ve been watching you ‘cause you come here almost as much as I do. If you were a rotten person, you wouldn’t feed the birds your leftover crackers.”

Goodness! Had she been so self-absorbed that she hadn’t noticed an unattended child before today? Or maybe she’d seen her and thought she’d been under the watchful eye of one of the many visitors who came to the garden for fresh air and sunshine. Regardless, it was still eerie to realize that someone had observed her so carefully without her knowledge. She would definitely have to pay closer attention to her surroundings in the future.

“Plus, you’re a doctor. Doctors aren’t mean people. Oh, they can do nasty things like give us a shot, but it’s for our own good,” she said confidently.

While Sierra agreed that most physicians were caring individuals, she personally knew of several who should have chosen a different profession. Even so, she wouldn’t destroy the girl’s illusions. Life would take care of those soon enough.

“A lot of people come here to walk, don’t they?” Hannah asked.

“They do.”

“My uncle says they built this because the lab-y-rinth,” she stumbled over the word, “is supposed to make people feel better. The Native Americans call it a medicine wheel.”

“Really?”

“Uh-huh. They’ve gotten really popular, he says, especially at hospitals. Walking the path helps people who have stuff like high blood pressure or who can’t relax. He says that the twists and turns are s’posed to represent the twists and turns in life.”

The child sounded like a brochure that detailed the hospital’s services. “He’s right. The labyrinth helps people put the bad things in perspective.”

“Is that why you’re here? So you can put the bad stuff in pers…pers…pective?”

Hannah’s insight surprised her. Sierra began visiting the garden during her lunch hour as part of her mental-health regimen when she’d first joined the medical staff. Walking the circular concrete pathways, which were lined with colorful petunias, helped her deal with stress, especially after she lost a patient. She also knew of several surgeons who walked the labyrinth in order to clear their heads before performing surgery.

“Yes, I do,” Sierra said. “Why do you come here? To be outdoors instead of being cooped up inside?”

Hannah shrugged. “I like this place. My mom died of cancer when I was little, and whenever I get sad, I walk until I feel better. Do you think she might have lived if there’d been a lab-y-rinth at her hospital?”

Hannah’s matter-of-fact tone didn’t minimize the compassion Sierra felt for her. Oddly enough, she almost wanted to give her nameless uncle a break. Being a single parent or, in this case, an uncle wasn’t easy, especially when one dealt with an obviously precocious child like Hannah.

“Sometimes cancer wins, no matter how hard people try to fight it.”

Hannah’s brown eyebrows drew together as she nodded. “That’s what my uncle says, too. He says she didn’t want to die, but it wasn’t her fault she couldn’t stay and watch me grow up.”

“No, it wasn’t,” Sierra agreed.

Oddly enough, her uncle seemed to have imparted good insight to his niece. Sierra added one mental point in his favor.

Suddenly, the sound of dogs barking broke the quiet. Hannah immediately pulled a hot-pink cell phone out of the matching pouch hanging around her neck and the barking stopped. Sierra chuckled at herself as she realized the noise was a ringtone instead of a pack of canines on the loose.

The youngster glanced at the display and winced. “Gotta go. ‘Bye!”

“Wait! “ Sierra called as Hannah began hurdling the flowers with an easy-limbed grace in her haste to head toward the north door. “What’s your uncle’s name?”

Hannah simply smiled and waved before she disappeared through the north door.

So much for discovering the child’s identity, Sierra thought as she watched Hannah somewhat benevolently. Knowing Hannah had a cell phone made her feel somewhat better about the situation.

To Sierra’s disappointment, her wristwatch showed her allotted break time was over, too, even though she hadn’t reached the center of the labyrinth. After taking one last look in Hannah’s direction and seeing her disappear through the glass entrance doors, Sierra carefully stepped over the petunias as she strode in the opposite direction and disposed of her apple core in the trash.

Inside the main emergency hallway, ringing telephones, whispering gurney wheels and excited voices contrasted sharply with the tranquility she’d left behind. Directly ahead, she saw two different paramedics from the ones she’d met earlier, another ED physician and a nurse escorting another gurney into a trauma room. Meanwhile, Trey was heading toward an exam room as he reviewed the form on his clipboard. As soon as he saw her, his smile widened.

“How was lunch?” he asked.

She thought of the precocious Hannah. “Interesting. Why don’t I take over for you so you can take your break?”

“Thanks, but this case shouldn’t take too long. It’s also too early to meet my lunch date in the cafeteria, so I might as well earn my pay.”

She should have known. The man probably arranged his personal schedule months ahead. “Then I won’t keep you.”

Before she turned away, he stopped her. “Save tomorrow for me, though.”

She paused. “Excuse me?”

“Lunch. Tomorrow. My treat. It’ll be my official ‘welcome to the department’ gesture.”

“Do you take every new person to lunch?” she asked.

“Everyone,” he reassured her. “Even the housekeeping staff. So don’t pack your apple.”

She stared at him in surprise. “How did you know—?”

“I’m an observant kind of guy.”

Of course he was, she thought wryly. “Okay, fine. We’ll do lunch.” Then, to make certain there would be no misunderstandings, she added, “Strictly between colleagues.”

His smile seemed as broad as his shoulders. “Fair enough.”

She turned away, but he stopped her. “Out of curiosity, are you seeing anyone?”

This time she smiled. “What does the grapevine say?”

“You’re not.”

“Correct, as usual,” she agreed lightly.

“Is there someone back home?” he pressed.

Sierra hesitated. How could she explain, and did she want to? However, if her answer prevented speculation and stopped people from pushing her towards every eligible man who came along, why not?

“There was,” she replied slowly.

“Breakups are tough,” he agreed, his expression sympathetic. “So you came to Pittsburgh to start over?”

If only it had been that simple. “I did, but the situation is a little more complicated than a mere breakup.” She met his gaze. “When I left North Carolina, I left my husband in the Fairview Cemetery.”