Читать книгу Maverick In The Er - Jessica Matthews - Страница 9

TREY didn’t know what had possessed him to broach the subject of her personal life. Perhaps he’d simply been looking for an excuse to stay away from Sierra and hearing of a fellow back home would have provided it. Perhaps he was simply a glutton for punishment and hearing of her unattached status would only provide a temptation he’d be hard-pressed to resist.

Unfortunately, her response had been completely unexpected. He’d certainly never dreamed that the man she’d left behind had been her husband, much less that he was dead.

Certainly, the information she’d shared explained so much—her long hours, her avoidance of the dating scene, and her move to a new city and work environment. She hadn’t come to Pittsburgh on some grand adventure to see the world. Like his brother, Mitch. Sierra was picking up the pieces of her life.

All of which proved his theory—the best relationships were temporary.

“I’m sorry,” he murmured.

She nodded, apparently accustomed to hearing condolences if her frozen expression was any indication. “Thanks,” she murmured. Then, with a visibly shaky hand she smoothed her hair. “Are you sure you wouldn’t like me to see your patient?”

Her abrupt change of subject couldn’t have been more plain. Their question-and-answer period had come to a close, which was good. For a man who never had trouble finding something to talk about, he was suddenly at a loss for words.

He glanced at his watch. He only had ten minutes before his cafeteria appointment and it took nearly seven to walk there. “Do you mind?”

“Not at all. Enjoy your lunch.”

Eager to get away before he asked more questions, Sierra pulled the clipboard out of his hand and headed down the hall. She’d already shared more than she’d ever planned, and if she gave him enough time, the inevitable “What happened?” would follow.

She simply didn’t want to go there. Not now. Not yet. The tragedy had occurred over a year ago and she simply refused to dredge up those old feelings of shock, despair and anger, not to mention guilt. She’d finally come to the acceptance stage, but it hadn’t been easy.

Now, however, was not the time to walk down memory lane and analyze the past. At the moment, the only person who deserved her full attention was her patient—not Trey Donovan, and certainly not David McAllaster.

By the time she’d received the results of Karen Maxwell’s strep screen—it was negative—and referred her to an ENT specialist to evaluate her chronic sinusitis, Trey had returned, looking as rested and refreshed as he had before their full morning of traumas and regular patients.

As Sierra sank onto a chair in the nurses’ station, she noticed he was chatting up one of the radiology techs. The poor girl was smiling as if he’d single-handedly hung the sun, moon and stars.

“He has quite a knack with the women, doesn’t he?” Sierra mused aloud to Roma, who was clicking away on her keyboard at a nearby terminal.

“You must be talking about our famous Dr. Donovan,” Roma answered, without glancing away from her screen.

“How did you guess?”

“He does have a way with people,” she commented. “Young, old, male, female, staff, patients, it doesn’t matter. Why, I’ve seen him talk the most recalcitrant patients into behaving. When he’s on duty, things just run more smoothly.”

Sierra understood why. By virtue of his personality, he inspired people to dig deeply and give one-hundred-and-ten percent.

Just like David.

The only question was, did Trey do it for personal gain, or was he as altruistic as everyone believed? She wasn’t quite convinced of the latter.

Roma finally glanced away from her screen to direct her gaze down the hallway. “He’s so sweet to all of us. In fact, everyone fancies themselves a bit in love with him,” she remarked.

“I’ve gotten that impression,” Sierra said wryly. “Given the way women act when he’s around, I’d bet he never spends an evening alone. I’m surprised he has the energy to come to work.”

The nurse laughed. “There’s where you’re wrong. He doesn’t date as often as you might think. Oh, there are a lot who’d give their right arm for a night with him, but he’s very careful about who he takes out. And he never sees anyone more than a handful of times.”

“Really.” Sierra wasn’t convinced, but Roma seemed to know what she was talking about. “I find that hard to believe.”

Roma shrugged. “It’s true. Dr. Donovan seems like a happy-go-lucky sort, but don’t let his winning ways fool you. There’s a lot more to our good doctor than meets the eye.”

Sierra watched as the X-ray tech walked away with a light step, her face beaming in obvious delight over her encounter with Trey. Meanwhile, he wore his own satisfied expression, which suggested he’d gotten whatever he’d wanted.

Just like David, she thought with some disgust. Everything was a game, nobody was anything more than a chess piece. Thank goodness she’d grown wise to such manipulations. She’d been a pawn once in her life. She wouldn’t be one again.

After finishing with his next patient, Trey strode back to the doctors’ office. He’d requested a CT scan for one of his patients with a debilitating headache and Lila, the X-ray tech, had promised the images would be online by two o’clock. It was five minutes till, so he didn’t expect to see them posted, but it didn’t hurt to check.

He accessed Joan Villiers’s computer file and, as he’d suspected, the CT scan was still pending. A brisk knock at the door heralded Roma’s arrival.

“I’ve been looking all over for you,” the nurse remarked as she entered.

“What’s up?”

“Frances is here.”

“What’s wrong today?”

“Stomachache. Do you want me to give her to Dr. McAllaster?”

He thought a moment. “Yeah, but I’d better introduce them first, don’t you think?”

“Probably. Although I think the introductions are more for Dr. McAllaster’s benefit than Frances’s.”

“Right as usual.” Because he was curious, he asked, “From a nursing point of view, what’s your opinion of our new doc?”

Roma didn’t hesitate. “I think she’s doing okay. She’s a little tense, especially during traumas, but other than that I don’t have any complaints.”

“It’s her first day,” he reminded her. “She’s bound to be a little tense.”

“Hey, I wasn’t finding fault,” Roma protested. “Only making an observation which, as you said, is only to be expected. Now, if she’d come in all cocky and acting like a know-it-all, then I’d worry.” She patted Trey’s shoulder. “You done good, Doc, when you convinced them to transfer her to us.”

Pleased by Roma’s praise, he smiled. “I did, didn’t I?”

“According to the nurses on the fifth floor, they’re extremely upset because we stole her away.”

“It’s only for sixty days.” More or less.

“Yeah, well, they’re afraid they won’t get her back. According to them, she knows her stuff. Better yet, and unlike some doctors who shall remain nameless, she doesn’t treat them like they’re too stupid to live.”

“We were fortunate she came to Good Shepherd,” he commented, keeping the story Sierra had shared to himself. If she wanted everyone to know she was a widow—and she obviously didn’t if the information hadn’t circulated on the grapevine—she could divulge that news herself.

“Rumor says she didn’t want to be assigned to the E.R.,” Roma pointed out. “As you’re the one responsible for her transfer, I hope you intend to turn on the charm until she settles in.”

“Hey, I only made the suggestion,” he protested. “The decision came from people above my pay grade.”

“Be that as it may, if you hadn’t pushed for her, she wouldn’t be here.”

Roma was right. If he hadn’t waged his one-man war, his department would still be suffering from the lack of a physician. “Probably not,” he agreed. “We were lucky the upper echelon saw the situation from our point of view.”

Roma sighed. “I wish she’d applied for the E.R. post in the first place. Everything would be settled. As it is, who knows what her replacement will be like? “

The same thought had crossed Trey’s mind on several occasions. “I’m hoping she’ll grow to love us and will stay.”

“Hope all you want,” Roma said darkly, “but given how other physicians feel about E.R. docs, my money says she’ll run back to the fifth floor as soon as she can.”

Not if he could help matters… “I assume you’re referring to how the rest of the physicians look down on us because of the popular belief that we only decide on whether or not to admit a patient.”

“Yeah.”

It was a common stereotype, thanks to the nature of his profession. The people who presented themselves were either bleeding or sick and it was his job to either cure them or pass them off to someone who could, doing both as fast as possible. The department wasn’t called Emergency for nothing. Being the metropolitan city that Pittsburgh was, their ED never had a dull moment.

“We may not have an official client list like a private practice does, but we definitely have our regulars,” he mentioned.

“Like Frances.”

“Like Frances,” he echoed. “A lot of people list us as their primary-care physicians.”

“Probably,” Roma agreed, “but I’ll bet Dr. McAllaster feels as if she’s taken a step down in her career. Mind you, the nurses have a saying. ‘If the doctor ain’t happy, then nobody’s happy.’”

Trey disagreed. So far, Sierra hadn’t lost her temper or raised her voice and she’d been in various situations where it wouldn’t have been inappropriate. While staying calm was a great trait to exhibit in an emergency situation, over the past few months of their quasi working relationship, from what he’d seen, the woman gave the word unflappable new meaning.

“I think you’re wrong,” he said. “Sierra is too classy a lady to take out her frustrations on the rest of us.”

“She might be classy, but redheads can have fiery tempers.”

As far as he was concerned, calling Sierra a redhead was like describing the Perseid meteor shower as a few shooting stars, or the Grand Canyon as a big hole in the ground. “I’m not sure one has anything to do with the other. I’ve known lots of hot-tempered brunettes and blondes, too.”

“Okay, so I’m stereotyping,” she admitted, “but we’ll see fireworks down here before it’s over.”

He was half-eager for Roma’s fears to come true. Sierra, with her brown eyes flashing with the same fire he saw in her hair, would be an awesome sight. “Fireworks can be beautiful.”

“Yeah, in the night sky off the Roberto Clemente Bridge. Not in the hospital and without any warning.”

“I thought you liked to live life dangerously.”

“Me? Mrs. Boring who’s married to Mr. Extremely Boring?” She shook her head, smiling. “Not a chance. As much as I like my job, it has enough inherent aggravation without me looking for trouble. Speaking of which, the sooner we take care of Frances, the better.”

“Okay, but I have to check my CT scan result first. If everything looks okay and the injection we gave Mrs. Villiers is working, we can send her home.” A few keystrokes later, he found his report and read it with satisfaction. “Sure enough. She can go.”

After sharing his news with Mrs. Villiers, Trey found Sierra at the nurses’ station, ready to grab another clipboard out of the in-box.

“Before you take that case, I have a person I want you to meet,” he told her. “Room Ten.”

“A patient?”

How could he describe Frances? “Yes and no,” he admitted.

Her answering chuckle sounded sweet. “Which is it?” she asked.

“Frances is one of our colorful regulars. She’s a twenty-five-year-old woman with a learning disability who lives about a block away. Her mother used to work here and so she understands that the Good Shepherd E.R. is where people come for help.”

“Okay, so what’s unusual?”

“When I refer to ‘help,’ I’m using an extremely broad definition.”

“How broad is broad?”

“She comes in for minor things like a sliver in her hand, a skinned knee or a broken blister. She usually goes straight to the triage nurse, who finds out what she needs. Then, the nurse sends her to me or to one of the other doctors if I’m busy. We give her a little TLC and send her on her way.”

“I assume that I’m ‘one of the other doctors’?” she said dryly.

“Do you mind? “

“Not at all.”

“Good, because if you ever do see her, her visit will go easier if I’ve introduced you.”

“Okay. What’s her complaint?”

“Stomachache.”

She glanced at his empty hands. “Where’s her paperwork?”

“We don’t create any.”

Sierra stared at Trey. “No paper trail?”

“Like I said, she comes relatively often with such minor problems that we’d waste more time filling out forms than if we’d actually deal with her situation.”

She’d been warned of Trey Donovan’s unorthodox style, but she hadn’t expected to find an example of it so quickly.

“A few administrative people might be upset by the way you’re handling this individual,” she commented cautiously, to test his response. “Treating a patient without documentation. Legal liability issues, etcetera.”

He shrugged as if he was unconcerned. “I suppose they might be unhappy if Frances sues us for not removing a splinter properly. Until then, I guess you’ll have to decide if you’ll keep our secret or not.”

Sierra ignored the challenge in his voice. “Have you encouraged her to visit the outpatient clinic instead of the E.R.?”

“Frances has come here since she was a little girl so the concept is ingrained in her. Do you want to try and change her belief system at this late date?

“Besides,” he continued, “the clinic staff doesn’t know her like we do. They won’t take time for the minor things and if they do, they certainly won’t operate out of the goodness of their hearts. She won’t understand when they turn her away or ask her to pay, and then she’ll get upset and fall apart, which I can assure you is not a pretty sight. It saves so much wear and tear on everyone if we just do what needs to be done. A regular win-win situation.”

Sierra wanted to argue that Frances’s caseworker needed to be involved, but several things stopped her.

One, she was intrigued by how the ED staff had literally taken this woman under their wing.

Two, this was Trey’s domain. As the most senior ED physician, he knew his department’s strengths and limitations far better than she did. He also had the authority to establish policies and procedures, with or without his immediate supervisor’s approval. If he wanted to handle Frances in his own way, he certainly had the clout to do so.

This also seemed to be a prime opportunity to either build a bridge or a brick wall. She could stick to the hospital rule book, which would earn her brownie points from her superiors, or she could save her energy for more important battles.

On the other hand, if she caved in on this issue, was she setting a precedent? What if ten more people like Frances decided to visit the E.R. for their scrapes and scratches? They’d never have time or space to deal with the heart attacks, the broken bones or the car wrecks.

Would turning a blind eye signal that she was a pushover for a heartwarming story or a special case? The argument could be made that every person coming through the doors had special circumstances necessitating unusual solutions.

Can’t you be flexible for once in your life?

David’s voice whispered the last question and she instinctively stiffened. Unfortunately, his concept of flexibility had been his excuse for taking advantage of every opportunity that had come his way—opportunities that had covered everything from his business activities to moral decisions.

She’d always prided herself on meeting the needs of her patients, so how was this any different? If Frances had been one of her regular clients, would she have chosen differently than Trey and his staff had?

She let out a breath and nodded. “Let’s see Frances.”

Before she could take a step forward, he stopped her.

“If it looks like she has something serious, I want you to take over.”

“Why?”

“Because if I’m busy holding her hand to keep her calm, I can’t do my doctor thing.”

She chuckled at his choice of words. “Can’t walk and chew gum at the same time, eh?”

He rolled his eyes melodramatically. “Ah, now she makes a joke.”

“Sorry,” she said, unrepentant, “I couldn’t help it. Okay, we’ll do it your way. I’ll examine her while you play nursemaid. From what I’ve seen so far, you’re pretty good at handholding and sweet-talking.”

His grin was boyishly wicked. “I’m good at other things, too.”

The sudden flare of heat in his eyes spoke of more physical activities—activities that her imagination so unhelpfully supplied in vivid, living color.

If she was going to work with the delectable Dr. D. so closely over the next few months, she really would have to get more sleep. Exhaustion didn’t give her the mental fortitude to rein in her wayward thoughts.

“I’m sure you are,” she said lightly.

Inside the room, Sierra saw the dark-haired woman curled into a fetal position on the bed. Another nurse, Billie, was taking her vital signs.

“Hi, Franny,” Trey said as he approached the bed and immediately took her pulse. “I hear you’re not feeling well today.”

Frances opened her eyes and offered a weak smile. “Hi Dr. D.,” she said in a singsong voice. “My stomach really, really hurts bad. Can you fix it? “

Her childlike question made Sierra wish for the several-hundredth time that medicine could solve the problem of a child’s mind trapped inside an adult body. Not many people could deal effectively with people with learning disabilities, and she carefully watched Trey’s demeanor. She didn’t know what she was expecting, but she was pleasantly surprised to watch him smile benevolently at Frances while he patted her arm and questioned her about her diet.

As he talked, she herself focused on his sinfully thick dark hair, dark eyes and long eyelashes. She’d never studied him up close and personal before, but she understood how he’d developed his reputation of a dreamboat.

Thank goodness she wasn’t taken in by appealing packages.

“I think I was poisoned,” Frances moaned.

“Her temp is one-oh-two,” Billie interjected.

Trey glanced at Sierra, his humor evident in his eyes. “I don’t think you have food poisoning, Frances. But you are sick, which makes me glad I brought our very best doctor to see you. This is Dr. McAllaster.”

Sierra took her cue to come forward. “Hi, Frances.”

Frances gazed at Trey. “She can’t be the best ‘cause you are.”

He chuckled. “Thanks, Franny, but stomachaches are Dr. McAllaster’s specialty. Will you let her examine you?”

Frances apparently was convinced because she slowly nodded. “If you say so.”

Sierra immediately took over, not surprised by Trey’s ability to gain Frances’s cooperation. He’d obviously been dealing with this woman for quite a while.

“Okay, Frances,” she said softly. “I need you to stretch out for me.”

“But it hurts when I do,” she wailed.

“I know, but I really need you to lie flat.” After much maneuvering and moaning, Sierra gently prodded Frances’s abdomen. It didn’t take long to decide that her problem didn’t have a simple solution.

She turned to Trey. “Do you remember the paperwork you said you didn’t initiate? You’d better start it now.”

Over the next hour, Sierra realized she couldn’t have done her job without Trey. While Frances’s problem had been fairly straightforward, it had taken longer to arrive at the diagnosis because she hadn’t been particularly cooperative. Thank goodness Trey was a salesman at heart. He explained, gave guarantees and promised her everything from watching television to an ice cream if she’d allow them to do one more test.

He saw Frances through the pain of bloodwork and he did so with patience she hadn’t expected—patience that wasn’t contrived.

Neither did he express any great relief to relinquish his task when Frances’s mother arrived. Instead, he simply changed gears from moral-support agent to physician as easily as he flashed his handsome smile.

“Appendicitis?” he asked as soon as he cornered Sierra at the nurses’ station.

“I’m impressed,” she said, amazed at how he’d pinpointed her diagnosis before they’d received any reports. “You really can walk and chew gum at the same time.”

“What can I say? I’m a man of many talents. Plus, it didn’t take too much effort to add lower-right-quadrant pain and rebound tenderness with a fever to come up with appendicitis. I assume her white count is elevated?”

“According to the report that came through a minute ago, it’s eighteen point four. I’ve already called Vijay. He said because it’s such a clear-cut case to save him a trip and send her upstairs to surgery.”

Vijay Gupta was a fourth-year surgical resident assigned to Emergency. Sierra had consulted with him on several patients prior to her current E.R. stint and thought highly of him. After he completed his training, he planned to return to his native India and Sierra would be sorry to see him go.

“Sounds good to me.”

Sierra always took pride in making accurate and timely diagnoses, but none more so than when Trey stopped her a few hours later, not long before their shift ended.

“Vijay called,” he said without preamble. “Frances’s appendix was the worst he’s seen in a long time. You’ll be pleased to know he was glad you’d sent her up when you did, otherwise there would have been dire consequences.”

Gracious, but she was blushing again. “It was a team effort,” she said lightly.

“That may be, but I think we should celebrate with a cup of coffee.”

“Coffee sounds good, but I’m not sure the occasion calls for a celebration,” she said. “I was only doing my job.”

The second those words came out of her mouth she realized how much she’d sounded like Professor “Grumpy” Gunderson. After she’d pored over a patient’s medical file for clues about his illness, she’d discovered an obscure fact which had led to a confirmatory test. Her fellow students had been impressed and she’d been proud, but “Grumpy” had raised one eyebrow and sniffed.

“You’re expected to make proper diagnoses, McAllaster,” he’d said in his most condescending voice. “Every patient deserves your best. It’s your job to provide it.”

Now, a question begged to be asked. When had she become so cynical and turned into Grumpy Gunderson?

“Working down here…” Trey interrupted her bleak thoughts as he herded her into the lounge “…we take our victories when we find them. Too many cases don’t have happy endings.”

As if she’d needed a reminder, she reflected wryly as he began pouring two mugs of the strong coffee.

“Black or white?” he asked.

“White.” She fished among the containers for a packet of sweetener and dumped in a moderate amount of powdered creamer.

He leaned against the counter, mug in hand. “Just so you know, our real partying takes place on Fridays, after work. You’ll have to join us. No excuses allowed.”

She thought about the days when she’d ended the work week with the rest of her ED team at a nearby watering hole. Their tradition had been for the most senior member to make two toasts—one to the staff for jobs well done and one to pay tribute to the people they’d lost.

Her finances could surely stretch far enough for her to resume the tradition, even if she honored it only during her temporary tenure in Emergency. While she took pride in her efforts when she’d discharged a patient from the fifth floor, drinking a glass of wine alone in her apartment didn’t generate the same emotional satisfaction as being surrounded by people who’d shared in the experience.

Until Trey had dangled the notion of a celebration in front of her, she hadn’t realized how much she missed the camaraderie associated with a group of her colleagues. Trey had inadvertently reminded her of another part of her life that David had stolen.

Well, no more. She’d come to Pittsburgh to start over, and creating a new routine was part of that. She may not be able to afford more than a glass of tea or a soft drink, but drinking wasn’t the issue. Being with friends and colleagues was.

“I didn’t realize I’d touched on such a deep subject,” he joked. “You looked like you were a hundred miles away.”

“Sorry,” she said, embarrassed at being caught woolgathering. “I was, but you’re right. We should rejoice in our success stories when we can.”

His smile nearly blinded her. “Then you’ll join us on Friday night?”

“Sure, why not?”

“Great,” he said with such enthusiasm that she knew he’d hold her to her decision, no matter what. “We’ll—”

Their pagers went off simultaneously. Sierra abandoned her mug and followed Trey out of the door.

A scuffle at the far end of the hall near the ambulance entrance doors caught her attention. Two police officers were escorting two punks in low-slung jeans and ripped T-shirts, but for every step forward they sidestepped two more in an effort to keep the two street hoods apart. Obscenities flew, along with several wild punches, but it was obvious that not long ago those punches had been landing.

One young man had a swollen, bloody nose and a bloodstained bandana wrapped around his right biceps. The other had one eye completely swollen shut as he limped forward.

Trey sighed. “Looks like the natives are restless.”

“No kidding. I thought they saved their fighting for Saturday nights,” she remarked.

“Around here, any time is a good time,” he answered. “I’ll take one and you can take the other so we can get them both out of here faster.”

“Okay.”

She started forward, but he pulled her behind him. “Stay out of the way until they’re stashed in separate corners.”

Stay out of the way? For a few seconds she stood in amazement at his high-handedness. Did he really think she couldn’t hold her own? She’d gone nose to nose with men who were far more belligerent than these two. Of course, she hadn’t been wearing a dress and heels at the time, but sometimes looking feminine gave her an advantage. Goons like these were often busy ogling her legs and forgot their reason for fighting.

She hurried to catch up, but Trey’s long-legged stride had already put him at the scene. Although she was still half a hallway away, she heard and saw everything.

“Take him…” Trey pointed to the one sporting a bloody nose “…to Trauma One and the other to Room Two.”

“Move it, buddy.” Officer Wright gave his prisoner a not-so-gentle nudge in the appropriate direction. “You heard the doc.”

“Hey, man, don’t tell me what to do.” The guy immediately began swinging.

Instinctively, Sierra knew this wasn’t going to end well. She watched in horror as the situation deteriorated, taking Trey with it.