Читать книгу Dr Tall, Dark...and Dangerous? - Lynne Marshall - Страница 9

KASEY waved toward Vincent Clark in the clinic hallway. A baby cried in the background. “Room three,” she said. “Mrs. Gardner needs the second shot in her hepatitis B series.”

Nine in the morning and already the small clinic’s waiting room was full. A newborn needed his six-week examination; a toddler’s allergies were flaring up with spring and the coming grass season; a teenage mother needed counseling on diet; a senior citizen’s diabetes wasn’t under control. On and on went the list, making Kasey wish she had forty-eight hours in her day.

Although today she welcomed the non-stop regimen and distractions.

“I’ll get right on it,” Vincent said, grabbing his laptop, flashing his killer smile.

She forced a phony grin, since smiling was the last thing she felt like doing. He deserved no less, and she didn’t believe in dumping her foul mood on others. Charming, bright and sensitive, not to mention well groomed and fit, Vincent was everything Kasey looked for in a man, or used to, anyway. The catch was she wasn’t her RN and assistant clinic administrator’s type, because he was gay.

Besides, she’d given up on finding Mr. Right. Her last big love had told her he loved her one weekend and the next said that whatever he’d said last week he didn’t feel any more. What was a girl supposed to do with that? In reality, men had never stuck around for her or her mother. Since good old Arnie had broken her heart two years ago, her motto had been to keep it superficial all the way—no investment; no pain. It wasn’t everything she’d hoped for in life, but it would have to do.

Vincent patted her shoulder as he passed. They adored each other in a strictly platonic way, the perfect working situation, and he was a good friend, one she could depend on. Since she’d put so much time and energy into her job over the last few years, she could count her friends on two fingers, sad but factual. As an RN, she believed in facts.

Besides, she wasn’t in the market for a partner, and had given up looking, especially now, since she’d gotten the horrible news about her birth father. What would be the point of getting involved with anyone for the long haul?

She dashed to her desk to look for the notes on the toddler she’d seen last week, and found six more patient messages.

What would Vincent think if he knew her prognosis? Maybe, if things ever slowed down today, she’d tell him. No. Not here. Not quickly over a cup of coffee in the lunch room. She’d need an entire night over drinks and dinner to work up the nerve to say what frightened her more than anything on earth. But she needed to tell somebody, and soon, or she’d explode, and she needed to build her support system. She definitely needed more than two friends, especially as one lived out of state.

She let out a quiet breath and picked up a note from her receptionist and read, “Facial laceration”, then grabbed her laptop and strode toward room one. As long as she was married to the community clinic, there’d be no chance of making new friends.

Laurette Meranvil was a name she hadn’t seen before. After knocking, she opened the door and found a petite, brightly dressed woman sitting on the examination table, holding a cloth to her cheek. Kasey put her computer on the stand then reached for and shook the lady’s free hand.

“I’m Kasey McGowan, the nurse practitioner. What seems to be the problem?”

“I cut my cheek on glass,” the woman said with what Kasey had come to recognize as a Haitian accent.

Gingerly removing the cloth, Kasey discovered a jagged cut dangerously close to the woman’s eye and extending out over her cheek. Fresh blood oozed with the release of pressure. She donned gloves and checked for obvious glass slivers in the wound but didn’t find any.

“How did this happen?”

Kasey read the hesitation in the patient’s eyes before the woman glanced at the floor. So often the truth went untold at the clinic. “I fell into a glass door.”

Kasey ground her molars and hid her disbelief. Not that it couldn’t happen, but … It was more important to treat the wound, knowing she might never get to the truth.

Though she was trained to suture, this facial laceration would leave an ugly scar if not expertly handled. Kasey knew her limitations, and the woman deserved the best treatment possible.

“Ms. Meranvil, would you be able to stay at the clinic a bit longer while I have one of the plastic surgeons from the Mass General hospital stitch your wound?” She was aware that keloids could develop at the site of the scar, and because it was on the patient’s face Kasey didn’t want to take any chances of disfiguring the patient even more, so she wanted to bring in an expert.

Laurette drew her eyebrows together. “I cannot pay for special treatment.”

“This is the community clinic, remember? There won’t be an extra charge.”

After a moment’s thought, Laurette gave a serious-faced nod.

“Great. We’ll take you to the treatment room and get the RN to clean your wound while we wait.” Kasey carefully pressed the skin flap closed and put a sterile four-by-four over it to catch the slow flow of blood then discarded her gloves and entered a quick note into the computer. “The nurse will be right with you, but in the meantime keep light pressure on it,” she said, signing off and grabbing the laptop on her way out.

Once back at her desk, she found her co-worker sorting another stack of patient messages.

“Vincent, can you clean the wound in room one, give her a tetanus shot, and move her to the procedure room? I’ve got to make a call to see who’s taking plastics call this month.” As a nearby training hospital, Tufts regularly sent medical students to volunteer at the clinic, but this wound called for extra special care.

She went straight to her desk and dialed the long-memorized number of the massive teaching hospital. It supported the Everett neighborhood community clinic by supplying residents on call in various specialties as needed. After going through the usual chain of command, Kasey reached the department of surgery and was promised a second-year plastics fellowship doctor would be at the clinic within the hour. Just when she’d gotten used to last month’s doctor, a bubbly young woman, May rolled around and she’d have to readjust to yet another face and name and, most importantly, personality. But that was the name of the game when operating a community clinic with a limited budget that got scrutinized with a magnifying glass each month by the trustees. She took what she was given and smiled gratefully. Fortunately, the hospital thrived on the extra experience for their interns, residents and doctor specialists in training.

After hanging up the phone and on her way to see another patient, Kasey peeked in on Laurette, noting Vincent had done a fine job of cleaning and dressing the wound. The patient rested on the gurney, staring at the ceiling, the head of the bed partially elevated.

“Can I get you some water?” Kasey asked.

The woman nodded. “Yes, thank you.”

If only Kasey were a mind reader, a skill not taught in the Master’s in Nursing program, maybe she could find out how the accident had really happened. Once the young woman took the water and sipped, she closed her eyes, sending the message loud and clear: I’m not talking about it. So Kasey quietly left the procedure room.

As the other examination rooms filled up, Kasey became involved with patient care, physicals and treatments, and an hour and a half later she glanced at her watch and stole a moment to get back to the nursing station.

Just about to call again, a shadow covered her desk.

She glanced up to find deep blue masculine eyes staring at her from beneath brown brows, and the hair on her neck prickled. The strikingly serious eyes studied her as if she’d come from another planet. Dark brown hair swept back from a high forehead and curled just beneath his earlobes suggesting a professional haircut hadn’t found a date on his calendar in a couple of months. A day’s growth of red-tinged beard covered the man’s sharp jaw.

“You have a patient for me?” The quiet baritone voice sent more chills down her arms, throwing her off track and making her a little ticked off as he hadn’t bothered to introduce himself yet.

Needing to look away, Kasey glanced over the man’s shoulder at Vincent who, in his usual playful way, watched wide-eyed, biting his knuckle over the hunk, and she tried not to roll her eyes. Vincent was a sucker for a handsome face, and with this man Vincent’s assessment was right on target. Too bad the doctor’s impatient expression ruined the effect.

“Oh, um, yes, I do have a patient for you. That is if you’re the resident from Plastic Surgery.”

To be honest, she’d expected someone younger, more in keeping with the third—and fourth-year residents who’d normally been sent to the clinic, not a man who looked as if he’d been practicing medicine for a decade and had early signs of gray sprinkled at his temples to prove it.

He gave a slow nod, his haunting eyes as steady as a surgeon’s hands, making her feel edgy. She didn’t need any help with that edgy feeling today.

“I’m Jared Finch,” he said.

Snap out of it, girl. “Hi, I’m Kasey, and over there is my co-worker, Vincent.”

Vincent beamed, more gums than teeth showing. “Hi, thanks for coming.”

“Just doing my job,” he said, nodding hello to Vincent before turning back to Kasey. “Are you in charge?”

Unable to break away from his gaze, she fought the hitch in her breath and mentally kicked herself for falling apart. He was just a man. A doctor. She’d seen plenty of handsome men in her life, just not here in her clinic. And this man, in ten seconds flat, seemed to have absconded with her composure. She wanted to grab a rubber reflex hammer and pound some sense into her head.

“Yes. I’m the nurse practitioner and I run the clinic. Thanks so much for coming, Dr. Finch.” He reached for a quick handshake, though his felt barely alive, and she shook once then let go. Even lackluster, the fraction of a moment’s connection had left her off balance. He came for the patient, give him the information. Right. She looked through the mess on her desk, found the note, and handed it to him. Clutching the laptop that had Laurette Meranvil’s information on it tightly to her chest and feeling fortified, she stood. “Let me show you the patient.”

Jared followed the skittish NP down the hall toward the patient examination room. He’d been up all night, moonlighting, and the last thing he’d wanted to do was rush over to a satellite clinic for more work. Part of his commitment to the two-year plastic surgery certification program was volunteering at clinics such as this, all over town. During the month of May, as long as he wasn’t doing surgery with his mentors, he’d be at the beck and call of the Everett community clinic, and would be required to put in twenty hours’ service. It wasn’t a “get” to, it was a “got” to, something he’d have to endure.

The nurse practitioner flipped her dark blonde hair over her shoulder and glanced at him just before opening the door. Since beginning his plastic surgery fellowship, he’d gotten into the habit of looking at women and deciding how he could improve their features. He studied the arch of her brows and the almond-shaped green eyes, the larger-than-average nose with a bump on the bridge, and her lips, small, but nicely padded. Her loose lab coat and scrub pants hid her shape, but he guessed she was at least five feet six.

“Let me show you what we’ve got,” she said, with a polite office smile. It was nice to see she hadn’t used Botox, as he preferred expressive eyes.

The corner of his mouth twitched as he followed her inside, and that would have to suffice for a friendly smile these days.

“The patient says she fell against a glass door.”

He lifted one brow and shared a knowing look with the nurse practitioner as she opened the computer and brought up the patient’s chart. He quickly read over her shoulder, just enough to fill him in.

“Mrs. Meranvil, I’m Dr. Finch. Let’s have a look at that cut.” After he’d washed his hands and donned gloves, he removed the gauze and examined the depth of the wound and potential tissue damage. “Set up a sterile field,” he said to the NP, “and I’ll inject some anesthetic. Do you have a tendency to develop keloids?”

The quiet woman’s pinched forehead clued him to rephrase his question. “Do you get bumpy scars?”

She shook her head, and he wondered if she’d completely understood him. He glanced over her skin for any evidence of old scars to compare, but her long-sleeved, frayed-at-the-cuffs blouse didn’t reveal anything.

The nurse practitioner hustled to set up the pre-sterilized pack, and he switched to sterile gloves from the basic tray then gestured to her. “I’ll need five-zero polypropylene sutures.”

She rustled through the cupboard until she found exactly what he wanted, opened the sterile pack and dropped it onto the sterile field. He nodded his thanks.

“Let’s get started,” he said, nodding toward the anesthetic. Using sterile technique, she handed him antiseptic cleanser and the tiny-gauge needle and syringe. He swiped the rubber stopper as she held the bottle upside down, and he withdrew a couple of ccs, then discarded the first needle and switched to the next, which the nurse extended to him from within its sterile wrapper.

“You’ll feel a little pinch.” He injected into the subcutaneous fat around the laceration as gingerly as possible. Once the effect set in, he’d look more closely for glass slivers or debris in the wound, though the nurse had cleaned it well.

Since he was up close, he gave a tight-lipped, woefully out-of-practice smile. The patient barely responded.

“Are you okay?” the nurse named Kasey asked. The patient nodded.

Right, he should employ some light banter. He cleared his throat. “Need anything?” It came out sterner than he’d meant. The patient shook her head as if afraid to talk to him.

That was the limit of his bedside manner these days, a fact he was gravely aware of and which, considering the field he was going into, needed to change. In his own good time. He took the delicate-toothed forceps and a small curved needle holder and began his meticulous suturing.

Suturing was nothing new to him—he’d been a practicing general surgeon for eight years before making the decision to go into plastic surgery. He almost gave a rueful laugh out loud over that thought as he sank another stitch and tied it off. He’d been forced to go into the big money specialty field after his wife had financially cleaned him out in the divorce two years ago. After all, a doctor of his skill and experience should be able to support his children and ex-wife without going broke.

He needed to think a hell of a lot more pleasant thoughts while treating this patient. She deserved his undivided attention and surgical expertise. The one thing he was sure of these days was his ability as a surgeon. Make that plastic surgeon.

Kasey was impressed with Dr. Finch’s technique if not his bedside manner, and how he took great care with each stitch. If all went well with the healing process, Laurette would wind up with only a fine pale scar beneath her dark chocolate eye.

After the procedure was finished, she helped Laurette sit up. Vowing never to clean houses like her mother, she’d been a nurse since she was twenty-two, and four years later, when she’d become a nurse practitioner, she’d been initiated by fire when this clinic had opened. Nothing fazed her now. She’d worked with plenty of fussy doctors. Dr. Finch wasn’t fussy, just particular about how he wanted things done. Showing a serious lack of bedside manner, he obviously had no intention of sticking around to reassure the patient. Task done, he’d already shoved the surgical tray aside, ripped off his gloves and was halfway to the door without a single word. At least he’d disposed of the trash and the used needles into the sharps container on his way, she’d give him that.

“Thanks, Doc,” she said, tongue in cheek.

“Not a problem,” he said in a gruff tone. Just before closing the door, he turned toward the patient. “Ms. Meranvil, we’ll need to see you back in four to five days to take out those sutures.”

“Yes, Doctor,” she whispered. “Thank you.”

Slam, bam, thank you, ma’am?

“One more thing …” He popped his head back inside the exam room. “Has she had a tetanus booster?”

“Already taken care of,” Kasey said, organizing the dressing. Sheesh, you’d think he could at least try to fake some patient concern! “Ms. Meranvil, I think you’ll be pretty as ever after these stitches come out,” she said as she lightly bandaged the wound.

After giving an encouraging smile to her patient, Kasey glanced over her shoulder. Jared had paused at the door.

“Agreed,” he’d said.

Those unreadable steel-blue eyes almost responded to his flat, partial smile. Or maybe it was just a nod with a grimace? Talk about not putting your heart into it. At least he was a top-notch technician.

Yet those eyes …

Feeling pulled into his stare, she forced herself to look away, back to her task at hand, just as the door closed. “There. I think you’re good to go.” She patted Laurette on the arm, already planning her revenge on Dr. Finch.

Despite his lack of charm, Jared Finch’s haunting eyes reappeared in her mind. There were far too many patients to tend to, so why get swept up in a remote and mysterious doctor’s gaze?

There was just no point.

Jared sat at the corner desk in the clinic office, typing his electronic chart entry, when Kasey reappeared. Fortunately, she left him alone to go about his business while she shuffled reports and folders at the adjacent desk. There was nothing worse than being interrupted by a chatty person while trying to concentrate. He cast a furtive glance at her from across the room. Dressed in scrubs and a lab coat, there was no telling what kind of shape she had.

“Since you need to see this patient again next week,” she said, ruining his hopes of blessed silence, “why don’t we send out a flyer to the neighborhood?”

He stopped typing in mid-word. “A what?”

“A flyer. We can do a one-day surgical clinic.”

He leveled her a look similar to that he gave his his son when he got out of line. Apparently it didn’t register.

“You know, since you have to come back to follow up with Laurette’s stitches?”

His dead stare stopped her for a moment. Ah, peace. He went back to the second half of that word in the report.

She cleared her throat. He tried to ignore it.

“You said yourself she has to come back in four to five days to have the stitches removed. What if there’s a problem? Do you want to leave that woman scarred?” He hadn’t sustained a dead stare this long since the last time his kids had ganged up on him about flying to a theme park in Florida. “Why not set up an open clinic for the local residents on Tuesday as you’ll have to be here anyway?”

He slowly lifted his eyes, sending her another warning glance.

“Did you know there’s a huge need for the underserved and minimally insured population in this area?” she said, undeterred. “And also, on the brighter side, you could chip away at some of the required hours for your month-long clinic rotation.”

He didn’t give a damn how good a saleswoman she was, he just wanted her to shut up so he could finish his report and get back to the hospital. “Tell you what,” he said. “I’ll give you one whole day to see your clinic walk-in patients. There. You happy now?” May as well take up her suggestion and get this volunteer time out of the way as quickly as possible. Now maybe she’d be quiet.

She tossed him a don’t-do-us-any-favors look before she commenced rushed clicking and clacking on the keyboard.

Yeah, he’d said the words, and they had seriously lacked enthusiasm, but he’d already gathered she was a smart cookie and wasn’t about to let an opportunity like this slip by. Now maybe he could finish this consult and head out.

“I’ll print up a flyer and hire some of the local boys to distribute them to the houses and on cars in the area.”

“Great. Whatever. Now, could you let me finish my report?” That got a rise in her brows, and more speedy typing, as he’d hopelessly lost his train of thought about the wording in the report.

His concentration thrown out of the window, he recalled on his drive through the neighborhood that the boulevard was lined with red-brick and mortar storefronts, and had an eclectic assortment of businesses. Many looked rundown. The place probably could use a day-long walk-in surgery clinic, and the sooner he got his volunteer hours done the sooner he could get back to focusing fully on plastic surgery.

“Maybe you should post flyers in the local business windows, too,” he said. “Though you may want to skip all the mortuaries—don’t want to send the wrong message.”

Quick to forgive, she laughed, and it sounded nice, low and husky. Almost made him smile.

“What’s up with that anyway?”

“The overabundance of mortuaries?” she said. “I think it must have something to do with having a hospital in the area since the late eighteen hundreds and the odds of folks making it out alive.” Unlike him, she could multitask, and never missed a beat typing and staring at the computer screen. “I guess the morticians went where they were guaranteed business. Though it does seem like overkill these days, pardon the pun.”

He nodded, stretching his lips into a straight line rather than a smile, and grudgingly admitted he liked her dry wit and Boston accent. Pah-din. “Yeah, so I figure if I’m volunteering time for the month, like you said, I may as well make it worth everyone’s while.” Code for get it over with ASAP. That’s what he was all about these days—meet his obligations as quickly as possible and move on. In another year he’d get his life back and begin his own private practice back home in California. Besides, he hated it when he ran out of things to do, preferring to work until he could pass out and sleep. Then work more. Anything to keep his mind occupied.

He scratched his jaw. “So I’ll come at nine and work until seven—that way folks can stop by after they get off work,” he said.

“Then why not make it eight p.m.? Would that work? With long commutes, some people don’t get home from work until after seven.”

Sure, squeeze an extra hour out of me, lady. “Fine,” he said, staring at the last dangling sentence in his report.

Truth was, unless he moonlighted, he had nothing better to do with his time most nights. He sublet a basement bachelor apartment near Beacon Hill, with rented furniture and noisy pipes, paid through his nose for the privilege to live there, and after a year had yet to meet a single neighbor.

“That way you’d get half of your required volunteer hours out of the way in one day,” she said.

He wanted to protest, say that wasn’t the reason he’d agreed to do the all-day clinic, but she’d seen right through his tidy little plan. He cleared his throat. “Good point.”

Her fingers clacked over the keyboard again. His concentration shot, he stood, crossed the room and looked over her shoulder at the screen. Within a couple of minutes she’d produced a first-rate flyer, complete with clip art of a stethoscope and all the pertinent information, clear and concise.

“What do you think?” She glanced up, their gazes connected. Up close he was struck by how green her eyes were, and that she was a natural blonde, and he wondered why it registered.

“Looks great,” he said, leaning away while she pressed “Print” and stood.

She walked across the small and cluttered office to the antiquated printer to snag the first flyer. Holding the goldenrod paper like a picture for him to see, she smiled. “Not bad.”

He looked her up and down before looking at the flyer. Yeah, not bad. “Guess I can’t weasel out of it now.”

She rewarded his honesty with a smile, a very nice smile. “Nope. I’m going to hold you to your word. We’ll put one of these by the receptionist’s window right now and start handing them out after lunch.”

As she breezed across the room toward the connecting front office in her oversized lab coat and scrubs, he caught a scent of no frills soap and enjoyed the clean smell, then discovered there was something else he favored about her. Unlike so many of his patients—size four with forty-inch chests—she wasn’t skinny trim. She was sturdy and healthy looking, not like the lettuce-and-cilantro-eating women he saw in the plastic surgery clinics.

“Look,” he said, needing to get away before he discovered anything else he liked about her, or before she bamboozled him into working there the entire month. “I’ve got to run back to the hospital. I’ll see you next Tuesday.”

Kasey hopped off the bus on her street, the rich smell of fresh pizza from the corner ma and pa shop making her instantly hungry. She strode briskly against the chill and drizzle toward her house, eager to take off her shoes and relax. In a neighborhood lined with hundred-year-old two-story houses, most divided into two units, she lived amongst an interesting mix of people: the working class; families and seniors; immigrants; and Bostonians who could trace their American heritage back for centuries. She loved her converted first-floor apartment with hardwood floors and mustard-colored walls, and appreciated her quiet neighbors, except for that constantly squawking cockatiel next door. Skipping up her front steps to get out of the drizzle, which had now progressed to rain, she wondered if spring would ever break through the dreary weather.

After grabbing the mail from the box on the porch, she used her key to open the front door, immediately disabling the alarm system. Sadly, living alone in the city, it was a necessary expense, and one that gave her peace of mind. Well worth the cost.

She tossed her mail on the dining table on her way to the kitchen, and the corner of another letter left opened from yesterday caught her eye and brought back a wave of dread. Try as she may to put it out of her head all day, she’d failed. She needed a cool glass of water before she dared read it again. Maybe the words had changed. Maybe she’d misunderstood.

A quiet mew and furry brush against her ankle made her smile. She bent to pick up Daisy, her calico cat, who’d come out of hiding to greet her.

“What’s up, Miss Daisy? Did you watch the birds today?” She thought how her cat sat perched on the back bedroom window-sill, twitching her tail for hours on end, most likely imagining leaping into the air to catch a chickadee busy with nest-building. “You want your dinner?”

After she’d fed the cat and drunk a whole glass of water, she went back to the table and picked up the letter from the Department of Health and Welfare.

“It is with great sadness we inform you that your birth father, Jeffrey Morgan McAfee, has passed away from Huntington’s disease …”

She tossed the letter on the table, closing her eyes and taking a seat. She hadn’t misread it. With elbows planted firmly on the worn walnut surface, she dropped her head into her hands and did something she rarely allowed: she felt sorry for herself.

“We recommend you meet with a genetic counselor and set up a blood test …”

She’d never known her father, her mother had never spoken of him, and this had been one hell of an introduction. She’d called her mother to verify her father’s name last night, but had only got her message machine. Then later, Mom had called back to break the bad news. He was, in fact, her father. That’s all she’d said, but Kasey intended to get the whole story one day soon.

“Did he leave you anything in his will?” So like Mom. Always looking for a free ride and never coming close to finding one.

“Yeah, Mom, one doozy of an inheritance …”

Kasey wouldn’t wish the progressive, degenerative disease on anyone, yet with her birth father having and dying from it, she had a fifty percent chance of developing Huntington’s. And once the symptoms began, if they began, which was a mind-wrenching thought in itself, there would be a tortured journey of wasting nerve cells, decreased cognition, Parkinson’s-type rigidity and myriad other health issues until it took her life.

At least Mom had apologized, but how could a person make up for sleeping with the wrong guy, getting pregnant, and never seeing him again? Actions and consequences had never really figured into her mother’s style of living.

She couldn’t dwell on the disease. There was no point. While removing her head from her hands, her stomach protested, reminding her it had been hours since she’d eaten. She either carried the marker or she didn’t, the ticking clock had already been set or it hadn’t. Thinking how her ignorance had been bliss all these years, she had no control over anything, and now her life must go on just as it had before the letter had arrived.

She stood, losing her footing and having to grab the table for balance. Could it be an early symptom? Her throat went dry. Hadn’t she been bumping into things more recently? She shook her head, scolding herself. She’d always been clumsy, especially when she rushed, and she rushed all the time at work. There was no need to second-guess every misstep. She needed to eat, that was all.

And if she wanted peace of mind, all she needed to do was make an appointment and have a blood test and find out, once and for all, if she carried the defective gene. Be done with it or face it head on.

She’d been drawing blood from patients for years, never thought twice about having her own lab work done. Not since a kid had the thought of a laboratory test sent an icy chill of fear down her spine. Until today. What would she do if she had Huntington’s? She tightened her jaw and stood straighter. If she had the disease, she’d just have to make the most of each day … until the symptoms began, and even then, she promised to live life to the fullest for as long as she was physically able.

Though her stomach growled a second time, she’d just lost her appetite.