by Amy Ruttan
“Don’t you have to stay while your patient is in the ICU?” she asked as he helped her to her feet.
“I do, but the nicest place in town isn’t far.”
She laughed. “I hate to disappoint you, the cafeteria is not the nicest place in town.”
“Well, it will have to do until I can take you to the nicest place in town. Where is that, by the way?”
She chuckled again and shrugged as they began to walk slowly away from the OR. “I don’t know. I’ve been in Seattle for five years but I haven’t got out and done much.”
“You’re not from Seattle?” he asked.
“No, I’m from Salt Lake City and, no, before you ask, I’m not Mormon. My parents are, but I never connected with the religion or any religion, just science.”
Ryan nodded. He understood that. Science had exerted the same sort of pull on him. His mother had wanted him to farm her family’s land, but by the time he’d hit eighteen it had been apparent that he was not suited to a life of ranching. That was about the time his mother had stopped talking to him and when he’d learned to fend for himself.
“Well, asking about your religious affiliation was the furthest thing from my mind.”
“Sorry, it’s just when I tell people where I’m from, that’s the first thing I’m asked.” She glanced up at him. “Sorry I’m walking so slowly.”
“It’s fine. Take your time.” He couldn’t help but wonder why she was apologizing so much.
“It’s frustrating,” she admitted. “I would spend my time racing around this hospital. I could get from the ICU to the emergency room in five minutes and now I’m significantly slower.”
He felt like he should apologize, but he hadn’t been the only willing party the night they’d conceived their child. What he did feel bad about was missing the first six months of her pregnancy, for her doing this on her own.
He was ashamed about that and angry at himself. He might not be sure about being a father, but he’d never meant to leave her alone. If he’d only known...
“Let’s get you something to eat.”
They walked into the cafeteria and Emily sat down. Ryan went to the counter and grabbed a couple of sandwiches and some water. He brought it back to her and sat down next to her.
“Thanks for this,” Emily said. “They really do make good sandwiches.”
“Still, there’s probably somewhere better and I’m going to have to find it and take you to it.”
She raised her eyebrows. “Why?”
“Emily, we have a lot to talk about.”
“Other than work, we don’t. I meant what I said in those messages, I can raise this baby on my own. We both made a mistake—”
“I don’t walk away from my responsibilities.” He was annoyed that she was giving him an out. He didn’t want an out. Well, he did, but he didn’t either. Right now, he wasn’t sure what he wanted. But he was here now.
The last time that had happened, he’d lost a child and it had hurt. He was going to take responsibility for this one.
There wasn’t any way he was going to walk away. He was going to help Emily for as long as he could.
CHAPTER FOUR
EMILY SAT AT a desk in a quiet part of the ICU. Her shift was almost over, but she didn’t want to go home just yet. Not that there was anything to go home to and she felt bad for trying to push Ryan away. It’s just that she’d never been able to rely on anyone other than her parents She’d got to where she was by working hard to overcome what her teachers had told her would hold her back. The only time she’d foolishly relied on someone else had been when she was with Robert.
He’d belittled her and cheated on her.
Why would it be any different with Ryan?
So she’d given him an out.
And he seemed to want it but said that he didn’t.
He’d been so mad when she’d suggested that he didn’t need to be involved in his child’s life. They’d eaten their sandwiches in silence, until he’d got an urgent page about Jason and left to go to the ICU.
Emily had finished the rest of her meal and then made her way back up to the ICU floor to do the last rounds on her patients before one of her residents took over to cover the night shift. Now she looked up from her charting to see Ryan by Jason’s bed and he was recording information into a computer.
Ryan might move from hospital to hospital and never hold down a steady position, but he was passionate and caring when it came to his patients. Dr. Ruchi believed in him and wanted him to be the neurosurgeon on the conjoined twin case.
Emily turned back to her computer and pulled up the chart information that Dr. Ruchi had sent over. She opened the MRI scan to take a look at the babies. There was a good chance that these babies could be successfully separated. They shared a liver and part of the colon and there were three kidneys, which meant one twin would only get one kidney, but they had four legs, four arms and two sets of genitals. It was a matter of trying to separate the liver and colon. And then there was the spine and the nerves that controlled the legs.
The babies were partially back to back.
Where they were joined it would be hard to separate them without paralyzing them. She scrubbed a hand over her face.
You’ve done other separations. This is no different.
And all those conjoined cases had been successful. The key to success was gathering a strong team and discussing the plan of attack.
Now, if only Ryan would discuss the plans with her, instead of insisting on talking about their baby, who was healthy and fine.
She closed the files and logged off the computer. She finished her charting and handed them to the nurse in charge. Emily knew that the resident in charge would know what to do. She wouldn’t have to talk to them.
With one last look at Ryan, still by Jason’s bedside, she headed to the attendings’ lounge so that she could change before she headed for home. She needed rest if she was going to be ready to face the mother of the conjoined twins tomorrow with the OB/GYN assigned to deliver the babies.
That was the first step, settling the mother into the hospital, before, in a few weeks, once the babies were bigger and stronger, safely delivering them by C-section and hoping they survived long enough to consider doing the separation surgery.
She quickly changed and was just pulling on her coat when Ryan came into the lounge.
“There you are,” he said.
“I’m going home,” she answered, without looking at him. “I’m tired and I need rest before our patient arrives tomorrow.”
“Good.” He rubbed the back of his neck. “I’m sorry for snapping at you.”
“It’s fine. It’s a lot. I get it.” Emily wrapped her scarf around her neck. “Try and get some sleep and we’ll talk tomorrow.”
“How about we talk tonight?”
“About what, Ryan? Our baby, or what I wanted to talk about?”
“The conjoined twins case. It’s only seven and the resident on duty has my pager number. Why don’t we go and have a real meal? A sandwich is a pretty poor meal.”
Say no. Just go home.
“Fine. There’s a little bistro not far from here. That way, if you’re paged you can get back fairly fast and not get lost.”
“Sounds good.”
Emily nodded and stepped out of the lounge. It didn’t take him long before he was dressed. They walked in silence together out of the hospital. It was a cool night. It was the tail end of spring and soon it would be summer.
It was her favorite season.
She was not a fan of winter.
“It’s just over there,” Emily said, pointing to the small bistro on the corner just across the street from the hospital. “It’s a favorite haunt of the chief of surgery in the morning. So if you’re ever looking to have some one-on-one time to schmooze with him, this is th
e place he’ll be.”
Ryan chuckled. “Noted. Although I don’t have to schmooze. People are usually the ones schmoozing me.”
Emily laughed.
“What?” Ryan asked.
“Oh, just...you know when you say a word over and over again it sounds funny, like it’s lost all meaning.”
Ryan cocked an eyebrow and looked at her like she’d lost her mind, and maybe she had. She was tired and she was getting a bit silly from exhaustion.
“I can’t say that I’ve noticed that.”
“Say schmooze a few more times,” she teased. She had a sense of déjà vu and then she remembered the mojito talk during their wedding. She couldn’t help but smile.
“I think not.” He opened the door to the small bistro.
“Is it just the two of you tonight?” the maître d’ asked.
“Yes,” Ryan said.
“This way.” He lead them to the back to a corner booth that was tucked away and quiet. Emily slid in and the maître d’ set down a couple of menus. “Your waiter will be with you shortly.”
“Thank you,” Emily said, as she picked up the menu.
Ryan glanced at the menu briefly, but he didn’t look particularly interested in the food. “So, you wanted to talk about our patient.”
“I do. I like to be prepared.”
“Hi, my name is Dennis and I’ll be your waiter tonight. Can I bring you anything?” the waiter asked, interrupting.
Ryan didn’t even look at him. “I’ll have an espresso.”
“Water for me,” Emily said.
Dennis nodded and left.
“How do you know Ana Ruchi?” Emily asked.
“She’s not our patient,” Ryan teased.
Emily rolled her eyes. “I am aware, but Dr. Ruchi was my mentor when I was a surgical resident and trying to decide my path. She encouraged me to move into pediatric surgery and I was wondering how a neurosurgeon such as yourself knew her. I mean, you know I’m from Salt Lake City, but I don’t know anything about you.”
A devilish smile played at the corners of his lips, lips that she suddenly and vividly remembered kissing her. “You know a lot more about me than most.”
Heat bloomed in her cheeks. “That’s not what I’m talking about, Ryan.”
He sighed. “Fine, you want to know how I know Dr. Ruchi. I’m the one who removed a substantial aneurysm from her brain about a year ago.”
Emily’s stomach twisted in a knot. Ana had never told her anything about that. An aneurysm? She hadn’t even known that Ana had had surgery. Had she missed some cue that would have told her Ana was having a hard time? “What? When?”
“A year ago, just before we met, actually. She came to me when the aneurysm was threatening her eyesight and thus threatening her ability to care for her patients, and she had me clip it.”
“You shouldn’t be telling me this! Doctor-patient confidentiality.”
Ryan grinned and leaned forward. “Ana knew that you would question my connection to her and gave me the okay to tell you.”
Ana knew her so well.
Emily bit her lip and cursed under her breath. She was going to have several words with Ana about keeping that little bit of information from her.
You didn’t tell Ana that Ryan was the father of your baby.
“So that’s why Ana trusts you to assist with the separation of the conjoined twins.”
“I have also done several separations of twins, especially where the nerves and spinal cord are involved. I have looked at the file, Emily. I know, approximately, how many nerves are shared between the two girls. I know that this separation will be tricky and that we have to prep for it, but it’s not like we’re doing the surgery tomorrow. Those babies need to be delivered and then they need to be stable. And then they have to be older than a week before we can even attempt the surgery.”
Emily was impressed, just as impressed as she had been when she’d first heard him speak at that conference in Las Vegas. She’d forgotten this side of him and how impressive he truly was.
This is the kind of thinking that got us into trouble the last time. Remember?
She had been dazzled by him and an innocent meeting for drinks had turned into several drinks for both of them and then a trip to that shady wedding chapel on the wrong side of Vegas. It had also led to a night of passion. One that she’d tried hard to forget but couldn’t.
The waiter brought their drinks. “Are we ready to order?”
“I need a few minutes,” Emily said, clearing her throat. “I’m sorry.”
“No worries. I’ll give you both a few minutes.” The waiter left.
“I think I should figure out what I’m going to have for when he comes back.” She picked up her menu and decided on a salad. “Are you going to have something to eat?”
Ryan shook his head. “I might have another espresso, but that sandwich was good enough. I’ll have something later, but I want to stay awake to be with Jason tonight. I’m hoping we’ll be able to bring him out of a medicated coma in a couple of days.”
“And you think it’ll work?”
Ryan nodded and smiled. “You asked me that before.”
She groaned. “I did, didn’t I?”
“It’s okay, Emily. It’s been a very... I don’t even have the words. It’s been a very interesting day.”
“It has.” She took a sip of her water. “So, you saved my mentor’s life?”
“I did.”
“Now, why don’t you tell me where you’re from?”
A strange expression crossed his face. “Why?”
“I told you where I’m from.”
“And you think that knowing where I come from will help you figure me out?” he asked.
“I think so. I’d like to know the place you call home since you don’t have a practice set up or a hospital that you call home.”
He pursed his lips and his expression hardened as he fiddled with his espresso cup. “I did, but it didn’t work out.”
“You had a practice?”
“Yes,” he said tightly, and she realized she had touched a nerve. She couldn’t help but wonder what had happened. “Briefly, in New York City, but it still required a lot of travel.”
“So...”
“I’m from Wyoming. A small town and, yes, mostly Mormons there too, but my mother wasn’t.”
She blushed again. “Thanks?”
“Well, you announced your religion or lack of it to me.”
She laughed. “So I did.”
“Anything else you want to know?”
“Schooling. You’re from Wyoming, so where did you attend medical school?”
“Harvard.”
“Impressive.”
He shrugged. “Not as impressive as you. You’re one of the best pediatric surgeons on the western seaboard, but you don’t brag about that.”
Emily blushed. “Why brag?”
“Why not?”
The question made her feel uncomfortable. There was nothing to brag about. Diligent studying and hard work had got her here.
“How do you know that I’m considered one of the top pediatric surgeons?”
“I did my research about you after I woke up and all that was left of you was a marriage certificate with your name on it.” He took another sip of coffee. “Your name and Elvis’s real name, which, by the way, is George Luongo.”
Emily laughed at that and shook her head.
“Are you ready to order?” the waiter asked.
“Yes, I’ll have your house salad with chicken and he’ll have another espresso.” Emily handed the waiter the menus.
“I’ll be back shortly.” The waiter left.
“So, you looked me up online?” Emily asked.
“Don’t tell me you didn’t look me
up too?” he asked.
“I did, to find out where to get the message to you that I was pregnant. I had read your published papers before the conference. Still, I had no idea that you studied at Harvard and that you were from Wyoming.”
Ryan shrugged. “It doesn’t matter where I’m from.”
“I think it matters. Where you’re from says a lot about you. Family and places shape us.”
That strange, pained expression crossed his face again. “I have to disagree with that.”
“Why?”
He scrubbed a hand over his face. “Let’s talk about the case, why don’t we? I assume that you’ll want to run through simulations of it.”
“I will. I do so every time I do a separation of conjoined twins.”
“Have you ever lost one?” he asked.
The question was dark and caught her off guard. She didn’t like to think about the patients she’d lost, because there were always patients she lost. They were always there, in the back of her mind, and they shaped what she did the next time.
They helped her fight harder.
To save more lives, but she didn’t want to dwell on them.
“No, I actually haven’t lost a set of conjoined twins and I don’t plan to start.”
He smiled. “I’m glad, and the same with me.”
The waiter brought her food and his second cup of expresso. They didn’t say much as she ate some of her salad and he finished his drink.
She was feeling better about Dr. Ruchi’s choice of neurosurgeon to help her. And they had worked well in surgery today on Jason’s spine. It was always tricky when working with a surgeon for the first time.
You were never sure if your styles would mesh. And Emily had always been particular about the way she ran her operating room. She had been worried when she’d let Ryan take the helm, but after a few minutes of being his assistant on Jason’s surgery, she had seen that all those worries had been unfounded.
They’d worked well together and she knew that they would work well together on the conjoined twins case, if they could get over all their personal issues.
There was an ear-piercing scream which made the hair on the back of her neck stand on end. Ryan leapt to his feet and Emily stood up. They could see a woman on the floor of the bistro, trying to hold her small child as the child was having what looked like a seizure.