Читать книгу Doctor's Orders - Jessica Andersen - Страница 5
ОглавлениеChapter One
“I’m sorry, Doctor, but Ms. Dulbecco died early this morning.” On the phone, the nurse’s voice softened. “Did you know her personally?”
Mandy Sparks gripped the handset tightly and turned her back on the chaos of the Emergency Services Department, so her coworkers—or one coworker in particular—wouldn’t see how badly the news had upset her. She looked down, and her long blond hair fell forward past her face, forming another barrier between her and the rest of Boston General. “I didn’t know her well. She was a patient, that’s all.”
But to Mandy there was no “that’s all” about it. As far as she was concerned, every case was special, every injury or illness a personal battle.
“She went peacefully,” the nurse offered, as though that made a difference. And in a way, it did. Mandy hadn’t been able to pinpoint the cause of Irene Dulbecco’s pain, but she’d been able to make the forty-something mother of two more comfortable. She’d gotten Irene stabilized, and had sent her upstairs to the Urgent Care Department, where her husband and kids could visit more easily. Then, Mandy had gone home and crashed for six hours of badly needed sleep.
Logically she knew the staff members in Urgent Care were the best at what they did, but now she wondered if things would’ve gone differently if she’d stayed.
“If there’s nothing else, Doctor…” the nurse said, drawing out the last word to indicate that it was time for her to move on to the next call.
It wasn’t just her, either. The prevailing motto at BoGen these days seemed to be “move ’em in and push ’em out, and don’t get emotionally attached,” which Mandy found more than a little disturbing. Or maybe she was painting everyone else with a brush that belonged strictly to the department head, Parker Radcliff.
As far as she was concerned, Radcliff pretty much embodied the word disturbing.
“That’s all,” Mandy finally said into the phone. “Thanks for—” She broke off when the nurse disconnected before she’d finished, but kept the phone pressed to her ear for a moment longer, in order to buy herself some time to regroup.
I shouldn’t have come back here, she thought, closing her eyes and pinching the bridge of her nose in an effort to delay the incipient headache. I should’ve taken the job in Michigan.
Unfortunately the smaller hospital in Ann Arbor had lacked the clout of Boston General, and Mandy needed at least another eighteen months of top-flight E.R. experience and a solid recommendation if she wanted a shot at winning next year’s Meade Fellowship. With good E.R. openings in short supply, she’d been very lucky that her previous employment at BoGen had automatically moved her ahead of the other applicants.
Now, though, barely a month into her second stint at the hospital, she was starting to think she’d made a big mistake.
“Are you going to stand there listening to the dial tone all morning, Dr. Sparks?” Radcliff’s voice said unexpectedly from directly behind her, interrupting her thoughts with the sarcasm he seemed to save just for her. “Or were you planning on seeing patients at some point today?”
Mandy stiffened, but forced herself not to stammer and retreat. Instead she took a deep breath, tossed her hair back from her face and turned toward the man she’d once—in a bout of youth and stupidity—thought she loved.
Radcliff’s wavy, dark brown hair was tipped with silver at his temples, and faint creases fanned out from his dark blue eyes. Those small signs of mortality should’ve made him seem approachable, but the square set of his jaw and the coolness in his eyes formed an impenetrable barrier. He wore a crisp white lab coat, its breast pocket embroidered not with his name or title, but with two words: The Boss.
On any other man it might’ve been a joke.
On Radcliff, it was simple fact.
Four years ago, she’d been a lowly resident and he’d been the head attending, and ten years her senior. Now he ran the entire E.R., and spent more time on paperwork than medicine, which was lucky for her, because it had allowed her to avoid him since her return to BoGen. In turn, he’d limited their contact to snippy memos about increasing her patient turnover and keeping expensive tests to a minimum. On the few instances they’d been forced to interact face-to-face, they’d both made sure they were surrounded by a crowd of other staffers.
Until now.
Mandy’s heart picked up a beat. “I was discussing a patient with Urgent Care. I saw her yesterday, and her symptoms didn’t make sense to me. She passed away last night.”
Radcliff glanced at his watch, sounding almost bored when he said, “She didn’t die on your watch, which makes her Urgent Care’s problem, not yours. And your shift started ten minutes ago.”
Mandy couldn’t believe he could be so callous about a patient’s death. Sure, she’d heard the rumors that he’d only gotten colder over the past few years, but—
But nothing, her rational self interjected. Don’t think you know him now because you had a fling.
Knowing that little voice inside her was right, darn it, she said, “Sorry. I’ll skip one of my breaks or make up the time after my shift.”
Whether she liked it or not, she needed Radcliff on her side when it came time for recommendation letters. Dr. Stewart Royal, chairman of the Meade Foundation, had warned her that the competition would be fierce. She was determined to win the all expenses paid year abroad, though. She’d dearly love to get her hands on the funding and support, which she’d use to travel to Shanghai and study traditional Chinese medicine—TCM—with the master of the art, Dr. Li Wong.
Rumor had it the foundation was getting ready to award this year’s Meade Fellowship, but she held out little hope for her application. She needed another year of solid experience in her field of E.R. medicine, and a glowing recommendation from a heavy hitter like Parker Radcliff.
Which meant no picking fights with the boss, no matter how much his policies irritated her. No matter how much he irritated her.
He stared at her for a long moment, his eyes shadowed with suspicion, as if thinking she’d forget about making up the ten minutes the moment she was out of his range. Then, apparently deciding she was sincere, he nodded sharply. “See that you do. And stop bothering Urgent Care. They have more important things to do than make you feel better about losing a patient.”
“I wasn’t bothering anyone. I—” Mandy snapped her mouth shut on the protest, but it was already too late.
“Yes, you were.” He leaned in and reached for her, and for a mad, crazy second her heart thudded against her ribs at the thought that he was going to kiss her. Instead he plucked the phone handset from her fingers and hung it up with a decisive click. “Let it go.”
She told herself to nod and scram, but the rebellious part of her, the one that constantly courted trouble even when she was trying to behave, had her muttering under her breath, “You can tell me not to call, but you can’t keep me from caring.”
The words came out far louder than she’d intended. They hung in the air between them, recalling the night four years earlier, when she’d hunted him down in the doctor’s lounge at the end of a double shift to tell him she loved him, only to find that he wasn’t just on a different relationship page from her, but he’d been reading from an entirely different book, one entitled, Ten Steps To Recovering From Divorce.
Step one, apparently, was to have a no-strings affair with someone the complete opposite of his ex-wife. Mandy, ten years younger, with California beach bunny looks and an easy, generous nature, had apparently fit the bill perfectly. Unfortunately for her, Radcliff hadn’t thought to share the plan; he’d just assumed they’d both been in it for some good times and no regrets.
He’d been wrong.
For a moment she thought he was going to say something about that time, that he was finally going to acknowledge their history, if only obliquely.
Instead he stepped away from her and his voice chilled to glacial. “I may not be able to keep you from becoming unnecessarily involved with your patients, but I can and do expect efficiency from my staff. Have you looked out in the waiting area? How about the curtains or the exam rooms? They’re all full of patients, Dr. Sparks.” He paused, then said, “Don’t you dare lecture me on caring unless you’re out there dealing with patients, and if you can’t do that, then start looking for another job. I won’t allow you to disrupt my E.R.” The words not again hovered between them, unspoken.
Temper sharpened Mandy’s tone. “Then why did you hire me? You know how I practice medicine, and how my ‘touchy-feely’—” she emphasized his long-ago sneer by sketching quote marks in the air “—methods drive you nuts. Surely you didn’t think I’d changed.” She paused. “You must’ve recognized my name when you saw the application.” Or did you forget me the moment I was gone?
And the hell of it was, the answer mattered to her when it absolutely, positively shouldn’t.
His expression flattened. “I think we both know it wasn’t my decision to hire you.” His lips twisted into a smile, though his dark blue eyes held no humor. “I guess you outgrew your vow to make it without your father’s help.”
“What does my father—” Mandy broke off when it suddenly made all too much sense. “Oh,” she grated through clenched teeth. “I see.” Damn him.
Part of her irritation redirected itself to a gut-deep frustration that hadn’t changed over the years. She wasn’t sure what piece of “stay out of my business and don’t you dare call in any favors” her father hadn’t understood, but she probably shouldn’t have been surprised. Dr. David Sparks, plastic surgeon to half of Hollywood, had always possessed very selective hearing when it came to his only daughter. More tellingly, he was occasional golf buddies with three members of Boston General’s board of directors.
He might not have any pull with the Meade Foundation, but he definitely carried some clout at BoGen.
Radcliff shrugged. “Doesn’t matter to me whether you knew about your father’s involvement or not. The bottom line is that I’m stuck with you for the next year, and then I’ll be ‘strongly encouraged’—” now it was his turn to emphasize the words with finger quotes “—to give you a glowing recommendation.” He looked down at her for a long moment before he grimaced and dropped his voice to almost a conspiratorial whisper, “Look, I know you probably hate me for what happened between us, and maybe you’re right. I could’ve—should’ve—handled things better. But you’re the one who ran.”
Because you broke my heart, you bastard, she thought, but aloud, she said simply, “I’m back.”
He accepted the nonanswer with a nod, voice turning brisk. “We’re both adults, so I’d like to think we can manage to get along for the next year. But that’s going to mean you getting something straight—I don’t care what you do in your spare time, but when you’re on my clock, you’re working, and that doesn’t mean snuggling down for a series of bedside chats, or prescribing herbs and self-reflection instead of painkillers and blood pressure meds.”
Mandy gritted her teeth. He wasn’t the first to sneer at her use of non-Western medicine in a U.S. hospital setting, but his derision cut.
Unfortunately he also had a point. They needed to find a way to get along. “What exactly do you want from me?”
“I need you to process your patients faster. Do the basics. If you think there’s something more complicated going on, come to me or one of the other senior staff members before you order a nonstandard test, or even better, turf the case to another department.” He paused. “We’re the front line of medicine, not a long-term hospice. Our motto is triage, then treat what you can and ship out the rest. Let the family members, the interns and the volunteers waste time holding hands. The doctors have more important things to do.”
Which was just crap as far as Mandy was concerned. Emergency Services was where the patients needed the most reassurance, not the least, and the doctors were exactly the ones who needed to give that comfort.
“We’ll have to agree to disagree on that one,” she said, trying to match the coolness in his voice. “But I’ll work on increasing my turnover rate.”
“Fair enough.” He gestured for her to get to work, but when she turned away and headed down the short hallway to the main desk, he called, “And, Mandy?”
Hating the shimmer that worked its way through her body at the sound of his voice saying her name, she paused and looked back. “Yes?”
“I want you to forget about Irene Dulbecco’s death. Leave it alone and move on.”
Mandy grimaced but said nothing as she turned and strode away from him, knowing she was better off retreating than arguing.
She was halfway to the front desk before she stopped dead and spun back around. “How did you know the patient’s name was—”
He was gone.
PARKER STRODE OUT of the E.R., grimly aware of staffers ducking out of the line of fire as he passed. Good call on their parts, because he was in a mood.
When he reached the Atrium at the main hospital entrance, where the lack of sensitive medical equipment and the bustle and foot traffic meant he could use his cell without being overheard, he dragged out his phone.
Ducking into an alcove filled with potted plants, he dialed Stankowski’s number. The moment the phone clicked live, he skipped the pleasantries and said, “One of my doctors is curious about the Dulbecco case.”
Granted, Mandy had only just learned of her patient’s death, but unless she’d changed drastically over the past four years—and he didn’t think she had—her next step would be to check the test results and look for similar cases, which would raise some serious red flags.
“Tell her to leave it alone,” Stankowski said in his trademark laid-back fashion, which camouflaged the fact that the young homicide detective had a hell of a sharp mind.
“I tried.” Parker grimaced. “Trust me, that won’t get very far. Mandy—Dr. Sparks is a pit bull on this sort of thing. Add in the fact that Dulbecco had a husband and two kids under the age of five—upping the sympathy factor—and she’s not going to give it up easily. Either I figure out how to distract her, or we’re going to have a problem.”
There was a pause, and a note of speculation entered Stank’s voice. “Mandy, huh? Is she cute? Maybe I could distract her.”
“She’s—” Parker broke off, surprised by the quick punch of anger that hit him in the gut at the thought of Stank getting anywhere near her. “She’s not your type.”
Actually, the long-legged, willowy California blonde was exactly the sort of type Stankowski gravitated toward—gorgeous, stacked and smart. She was also Stank’s age, both of them in their early thirties, and they’d look good together, like they’d just stepped from the cover of a magazine devoted to young, upwardly mobile professionals who played extreme sports on their days off.
There was no way in hell it was happening, though. Not over Parker’s dead body.
Four years earlier, fresh out of his divorce, he’d gotten involved with Mandy even though she’d been so wrong for him it had been laughable. He’d figured they could have some good times while it lasted, which had only proved his ex-wife’s point—he didn’t understand women, or their emotions. He hadn’t realized Mandy thought they were in love until it was far too late, and he’d dealt with the guilt by being harsher than necessary.
“I get it,” Stank said, a new note entering his voice. “She’s your type. Interesting. I was starting to wonder if you even had a type.”
“She’s nobody’s type,” Parker snapped.
“So if you’re not going to let me distract her, what do you suggest we do?” Stank asked.
Parker muttered a curse. “We need to move faster.”
“No kidding.” Stank paused, no doubt waiting for Parker to come up with a bright idea. When none were forthcoming, he sighed heavily. “Look, I think I might be onto something at this end. Just keep your doctor away from Dulbecco’s case for the next few days, and we might be able to finish this thing for good.”
“That’d be a relief,” Parker said. “Thanks.” But as he hung up, he wasn’t feeling particularly relieved because Stank was right—there was no way he could see to get around it.
In order to keep Mandy out of trouble, he was going to have to do something he’d been avoiding for the past month.
He was going to have to spend time with her.
MANDY DID HER BEST to keep her mind off Irene Dulbecco’s case during her shift. Her patients helped, providing the variety that was one of the biggest draws of E.R. medicine. Against the standard backdrop of sniffles and sexually transmitted diseases, sprains and lacerations, she dealt with one toy car-up-the-nose, two MVAs—motor vehicle accidents—that she sent straight up to surgery, and a pregnant teen whose only ailment was a serious attack of nerves.
Though she normally would have spent time with the girl, Mandy knew Radcliff was watching her turnover figures, so she handed the mother-to-be over to a social worker and sent a quick prayer that everything would work out for the best.
Finally, exhausted from a single shift that had felt like an eternity, Mandy signed herself off the board and headed for the staff lounge, which was a comfortable room with a TV, kitchenette and couches, along with a row of lockers where staff members kept their street clothes and other personal effects.
Her spirits lifted when she saw her good friend, Kim Abernathy, sprawled on one of the couches in the main room. The petite brunette was wearing street clothes, indicating that she’d finished her shift upstairs in the Neonatal ICU.
Kim had her head propped up with a pillow, and her eyes were closed, and for a moment, Mandy thought she was fast asleep. Then the corners of Kim’s mouth turned up. Without opening her eyes, she said, “Hey. You’re late.”
Mandy crossed to her locker, already shucking out of her scrubs. “Did we have plans?”
“Try checking your cell phone every now and then. The Wannabes are getting together down at Jillian’s. They’re expecting us.”
Which probably meant Kim had set up the party in the first place. She’d always been the glue holding together the dozen or so premed students who’d met in college and had stayed friends in the years since. Members of the gang had come and gone over the years as relationships and jobs changed, but the spirit had remained the same. It was a group of up-and-comers who wanted to be so many things—doctors, researchers, professors, successes…some had made it big right out of school, others hadn’t yet found their stride.
Mandy figured she fell somewhere in the middle. She’d met some of her goals, like finishing med school and separating herself—mostly, anyway—from her father’s influence. Other plans were in the works, like the fellowship. Still others, like finding love and starting a family, seemed further away each year.
At the thought of love and marriage, Radcliff’s image popped into her head, causing her to mutter a curse as she dialed the combination to her locker and pulled out her jeans and a sweater.
“Problem?” Kim asked, opening an eye to look over at her.
“No. Well, yes.” Mandy paused on her way to the changing area, her mind switching gears to the other thing that was weighing heavily. “One of my patients died last night. She had a husband, and two little kids, and yes, I know that shouldn’t make her any more or less important, but…” She trailed off, then shrugged. “Sometimes it’s just not fair.”
It didn’t take a psych specialist to point out the parallels between Irene and Mandy’s own mother—both women in their early forties, both women struck down suddenly, leaving a family behind.
But while Mandy’s mother had been murdered in a home invasion gone wrong, Irene had died of a disease. But what one? She’d been healthy aside from the pain, which had sprung up suddenly out of nowhere. Mandy’s examination had turned up little more than a few bruises and a patch of healing road burn the patient said had come from having been mugged a few days earlier. None of it had explained the debilitating pain, or her death.
“Come on,” Kim said. “I prescribe bar food and some Wannabe love. It might not fix everything, but you’ll feel better. I guarantee it.”
“You’re probably right.” Telling herself she was overtired and feeling vulnerable, that was all, Mandy changed into her street clothes and pulled on a heavy parka, hat and gloves as protection against the fierce New England winter.
She and Mandy left the E.R. together and crossed the main Atrium, with its soaring ceiling, central fountain and nearly deserted coffee shop, and then pushed through the revolving doors to Washington Street.
Outside, Mandy squinted against a sharp slice of wind, wishing she’d worn another layer. When Kim turned toward the nearby MBTA stop, though, Mandy paused. She waved for her friend to keep going. “You head on over. I’m going to take a quick detour.”
Kim narrowed her almond-shaped eyes suspiciously. “Where to? You’re not trying to get out of having fun with the Wannabes, are you?”
“No, I just—” Mandy broke off, not really sure where the impulse had come from, or what she hoped to find. “I need to check something out. You go ahead and I’ll catch up. I won’t be long. Promise.”
Kim muttered a good-natured insult under her breath, but headed for the T station while Mandy hung a right and crossed Kneeland Street, headed for Chinatown.
It was nearly 10:00 p.m. and no moon was visible in the winter sky, but she felt safe enough. There were plenty of streetlights and passing cars, and her destination was at the edge of the Patriot District, an upscale historical neighborhood that had little in the way of serious crime.
“Strange place for a mugging,” she said to herself as she crossed the main street, headed for the alley where Irene Dulbecco had said she’d been attacked.
Mandy wasn’t even sure what she was looking for—a dead rat, maybe, or a spore growth that shouldn’t have been there.
Which just goes to show you’ve been watching too many medical detective shows lately, she thought as she stopped in front of the intersection Irene had described. It wasn’t a street, so much as an alley between two tall brick buildings, creating a space of dark shadows that formed a stark contrast to the well-lit main street.
When nerves shivered down her spine, Mandy fumbled in her purse for her overloaded key ring, which held a miniature flashlight and a tiny can of pepper spray. She unclipped the pepper spray so she could hold it in one hand while using the flashlight with the other.
Feeling a little braver now that she was armed and semidangerous, she moved into the shadowed alley with only a slight quiver of fear, a faint sense that maybe this wasn’t the best idea she’d ever had.
Splashes of light reflected in from the main road, enough for her to pick out the general shapes of Dumpsters and darkened doorways on either side of the narrow space.
“Let’s see what we have here,” she said quietly, clicking on her tiny flashlight and aiming the weak beam toward one of the Dumpsters, where a puddle of something had frozen to a hard slick in the winter air.
Thinking for a second that it looked like blood, she stepped closer and crouched down to investigate. As she did so, her flashlight beam caught a glint of something caught behind the wheel of the massive Dumpster. Feeling partly foolish, partly adventurous, she wiggled the thing free and came up with a flat disk that looked like a CD only smaller.
When she shined her light on the minidisk, she saw that it was labeled “ID.”
Excitement worked its way through her. The letters could stand for Irene Dulbecco.
“Then again they might not,” she muttered under her breath. She flipped the disk over, saw that there was a long scratch on the opposite side and shrugged before she pocketed the disk and straightened away from the Dumpster. “Let’s see if there’s anything else.”
She squinted and swept the light from side to side, then focused the beam over into the far corner. The light was too weak to be much good, and she took two steps further into the alley.
A heavy blow hit her from behind without warning, driving her onto her hands and knees.
She screamed as she hit, heart locking on sudden terror. The key ring flew from her hand and skidded away as she twisted, rolling to her back just in time to see the darkened silhouette of a man leaning over her, holding something that glinted in the faint streetlights. For a second, she thought it was a gun. Then he shifted, and she saw that it wasn’t a weapon.
It was a syringe.