by Score, Lucy
Stubbornly, Mack returned her focus to the insurance appeal she was working on. Her patient needed a Tier 4 medication that the insurance company had denied twice. That was important. She finished off the letter and attached the necessary documentation. Then she copied all the files into the patient’s record and scheduled a note to follow up with the insurance company on Monday.
With all that taken care of, she was officially off duty for the day. And out of excuses to not call her mother back.
Was she being a healthy adult by avoiding unnecessary stress? Or was this an immature defense mechanism left over from a tumultuous childhood?
She picked up the phone and scrolled to her mother’s contact. Andrea. Not Mom. Andrea hadn’t earned the title.
“Mackenzie!” her mother trilled when she answered, and Mack automatically shifted into carefully listening mode for any signs of alcohol, her mother’s favorite hobby.
“Hi, Mom.”
“I’ve been trying to reach you for weeks,” Andrea complained.
It had been four hours.
“I’ve been busy. What do you need?”
“Well, as you know, my birthday is coming up next weekend, and it’s been so long since you’ve been home. I would just love it if you could come back for a little celebration.”
Mack rubbed the dull ache at the back of her neck. Despite her susceptibility to guilt, she hadn’t been “home” in two years.
“Is Wendy going to be there?” Mack asked. It was her automatic out where family gatherings were concerned.
“Don’t be silly, Mackenzie. I wouldn’t ask you if I thought your sister would be around. She moved away ages ago. It’ll be just you and me.” Her mother gave a shaky, sad sigh. “To be honest, I’m feeling just a little bit lonely these days.”
“Aren’t you seeing anyone?” Mack’s rules where her mother was concerned were simple. One, the rent money continued when Andrea was sober. Two, Mack had no responsibility to ever meet another “Uncle” Anyone or rebuild a relationship with her sister. She hadn’t met her mother’s last two husbands, holding a firm line when the wedding invitations arrived.
But she’d still sent gifts. And that irked her.
“It’s just me all by my lonesome these days.” Andrea sighed. “I’m afraid I’m starting to show my age and scaring off all the eligible bachelors.”
“Are you drinking, Mom?” Some mothers and daughters talked about work or dinner recipes or books or kids. Mack monitored her mother’s sobriety.
“Of course not. Sober as a judge, darlin’.”
She was too far removed anymore to tell lie from truth over the phone. And in Andrea’s mind, sometimes there wasn’t a difference.
“In fact, we’ve got more to celebrate than my little ol’ birthday. I got my one-year chip last week,” Andrea said, back to chipper.
“Congratulations, Mom,” Mack said, calling up the calendar on her desktop.
No new stepfather. No Wendy. And no drunken tantrums.
She could probably get away for a few days. Three max. And then she could put off the next visit for another two years. A reset on the guilt button.
“You can stay here in the guest room. And maybe you could take me out for a nice dinner?” Andrea’s voice rose hopefully.
“That sounds nice. I can probably get away.” Mack ignored the sick, cold dread that slid into her stomach. Her mother had a disease. Daughters, especially doctors, didn’t walk away from a parent because they were sick.
She heard a flurry of barking on her mother’s end of the call.
“Hush now, Gigi!”
“Did you get a dog?” Mack asked.
“I did! A couple of months ago. She’s a tiny little thing but barks like she’s a big dog. Anyway, I took a peek at flights from Philadelphia—”
“I’m not based in Philadelphia anymore,” Mack said. “I’m in Maryland.”
She’d had no idea her mother had gotten a dog, just like Andrea hadn’t known Mack moved.
“Oh, well. Isn’t that nice?”
And that was the extent of their small talk. Mack promised she’d confirm her travel dates. Andrea gleefully took responsibility for making a dinner reservation for her birthday dinner.
It would be somewhere fancy, with gold-rimmed plates, white linens, and tiny portions. If there was one thing her mother loved more than alcohol, it was appearances. In Andrea’s mind, the most important thing in the world was maintaining a certain level of respectability. She was never without makeup, false lashes, and heels. Even when she was shitfaced.
At one time, Mack had thought her mother beautiful. But the ugly truth that no lipstick or pretty dress could conceal never stayed hidden for long.
Mack disconnected, feeling the way she always did after a conversation with her mother: anxious, unsettled, and vaguely ill. She could use a strong hug and maybe a happy dog, she decided and picked up her keys.
* * *
The fire station’s bay doors were wide open as the B Shift volunteers buzzed in and out seeing to routine tasks. Bright lights, shiny trucks, and people doing what they’d promised to do. It was a balm to her irritated spirit.
She parked and got out, now feeling silly.
She should have texted first or, better yet, gone straight home. It wasn’t like she was going to tell Linc about her mother. That would open the doors to her childhood. And there was no reason to go digging into that mess. She was a survivor. Not a victim. And looking forward was healthier than looking back.
But there was a joyful bark, and Sunshine was galloping in her direction.
“Hey, buddy,” Mack said, kneeling down to give the dog a good scruff. She gave in to her need for comfort and buried her face in the soft, blonde fur.
Sunshine snuck in a kiss, and Mack laughed, wondering if her mother had found this kind of joy with her dog.
“I’d like to report a dognapping in progress,” Linc called through a bullhorn, strolling out of the garage. “Unhand the dog, lady.”
She rose, brushing dirt and dog fur off her pants. He was dressed in tactical pants and a long-sleeved BFD polo that fit him like a second skin. His ball cap was on backward, and there was a smudge of grease on his jaw. That cocky grin was exactly what she needed, as was the hard hug he gave her when she walked into his arms.
“This is a nice surprise,” he said, leaning back and lifting her off her feet to the whistles and hoots of appreciation from his crew.
“Hi,” she said, feeling the ice in her belly thaw into something molten and warm.
“How was your day, Dreamy?” he asked, setting her back on her feet and slinging an arm around her shoulders.
Before she could answer, the alarm blared.
Everyone around them jumped into action.
“What have we got?” Linc called over the noise as he dragged her inside.
“Car into a structure, possible cardiac arrest,” Brody yelled back, shrugging into his gear.
“Feel like taking a ride, doc?” Linc offered.
A trauma physician on the ground was never a bad thing. “Let’s go.”
She grabbed her med bag and loaded it into the chief’s vehicle. In seconds, Linc was climbing in behind the wheel, wearing the bottom half of his gear. Sunshine watched mournfully from the end of her leash as they pulled away.
“Be a good girl,” he called to her through his open window.
Accustomed to lights, sirens, and speed, Mack triple-checked her supplies on the drive while Linc stayed on the radio with dispatch, gathering information. The engine was behind them, and an ambulance was en route, too.
They left the town limits and made the turn toward farmland and houses with big yards.
Dusk was falling, and there was a chill in the air.
“Here we go,” he said to her. “Command arriving on-scene.”
Together they exited the vehicle and jogged toward the wreck.
It was a sedan, or what was left of it, crumpled into the front porch of a
tidy white farmhouse that sat up against the road. The driver was still behind the wheel.
“He’s not breathing, and I can’t find a pulse,” a man in jeans and flannel said from his vigil at the open driver’s side door.
“Thanks. Let’s get him out,” Mack said.
“I’m with you,” Linc said. He caught the lightweight tarp Brody threw him and spread it on the ground a few feet from the car. “Lighthorse, assume command and get the engineers inside. See if the structure’s safe.”
“On it, chief.”
The ambulance hadn’t arrived yet, and it took Mack, Linc, and another firefighter to ease the man out from behind the wheel and onto the ground. Blood covered his face from the airbag.
“Pop-Pop!” There was a boy crying in the arms of the farmer’s wife.
Mack swore ripely.
“What?” Linc asked.
“It’s Leroy Mahoney. That’s his grandson, Tyrone,” she said, cutting Leroy’s sweater down the middle. “No pulse. No breath.” His lips were already tinged blue.
“Fuck,” he hissed.
“Go,” she insisted. “Take care of the kid. He trusts you.”
“Lighthorse, take over here,” he called.
Brody appeared and dropped to his knees. “What have we got, doc?”
“Sixty-eight-year-old male. Possible STEMI. Starting CPR until we get a defibrillator from the EMTs. Check him for any other injuries.” She started compressions while Brody worked his way down Leroy’s too-still body. “Get me some light here.”
She didn’t look up when a floodlight lit up the tarp. She didn’t pay attention to the sirens as they approached or the engineer team gearing up to go inside the house. The only thing that existed in her world was Leroy Mahoney’s still heart.
She paused after the rescue breath and checked vitals. “No pulse. No breath.”
“Possible broken wrist, needs stitches on the forehead. Not sure about any neck or spine injuries,” Brody reported as she began the next round of compressions.
“Get the epi in my bag for me,” she said, counting compressions internally. “Front pocket right on top.”
There was a flurry of activity behind her.
“Ma’am, I’m gonna need you to step back.” A paramedic loomed over her.
“That’s Dr. O’Neil, not ma’am, and you’re in my light,” she snapped. “I need a line in his arm now. And one of your guys needs to check the kid. He was in the back seat.”
An EMT hurried off while the “ma’am” man knelt opposite her and shrugged off his bag. “You get any epi in him yet?”
“Nope.” Sweat coursed like a river down her back. “Third round of compressions. No breath, no pulse.”
Leroy was bagged, and the second the IV port was in, the paramedic delivered the epinephrine. Another EMT slapped EKG sensors in place.
“Charging.”
“Go.”
“Nothing,” he said, reading the portable screen.
“Shock him and call for the chopper,” she decided, swiping her forearm over her forehead. Her ankle ached from the awkward position.
She delivered another round of compressions, another shock. Another shot of epinephrine. They pushed fluids into the line. Still nothing.
“Fuck me,” she muttered.
She didn’t dare look up at Tyrone. But she could hear Linc’s soothing voice, the kid’s quiet sobs. “You are not doing this tonight, Leroy,” she growled. “Go again.”
Again and again, they repeated the process.
“Looks like internal bleeding,” the paramedic noted, spotting the violent purple bruising around Leroy’s chest.
“Chopper is eight minutes out,” Brody reported.
“We don’t have eight minutes,” Mack said. “Put him on the backboard and get me a scalpel.”
“What are you doing?” the paramedic demanded.
“We’re opening him up.”
43
Linc had practically grown up on scenes like this. Flashing lights, fast, coordinated movements by the men and women who stood between the horror and the crowds of onlookers. Faces bathed in red and blue. The tension of dozens of human beings praying, hoping together.
But he also knew when something extraordinary was happening.
With Tyrone being looked after by an EMT, Linc returned to Mack’s triage area. She was snapping orders, her gloved hands moving in a concerted blur.
“You can’t just open him up out here,” the paramedic across from her warned.
“Argue with me later. When he’s open, you treat the bleed and give me room to massage his heart.”
“We don’t know if he’s on blood thinners,” he tried again. “The guy could bleed out right here.”
“The guy’s name is Leroy, and I do know that he’s not on blood thinners because I’m his goddamn family doctor. And I’m not letting him die with his grandson watching, so get the fuck on board.”
It hit him. A wave of love and pride so tall, so fierce, it made him weak in the knees.
“On board, doctor. You ever do this procedure before?”
“Nope,” Mack said as she slipped the scalpel into Leroy Mahoney’s chest.
“Holy shit. Is she—”
“Yep,” Linc told Brody as his captain approached white-faced.
Brody picked up his radio. “Dispatch, this is Engine 231 on Mulberry Road scene. Doctor is performing open heart massage on-scene.” There was a beat of silence.
“Copy that Engine 231. I’ll tell them to fly faster,” was the unfazed reply.
A hush fell over the scene, and Linc imagined dozens of prayers were floating up past the floodlights and into the dusk.
“Get that bleeder,” Mack ordered. She was up to her wrists in a human being’s chest. Linc felt a little light-headed, and he wasn’t sure if it was from love or the impossibility of watching his girlfriend play God with a man’s life.
“Beautiful,” she said. Her face was a study in concentration under the floodlights. Linc could hear the faint approach of the helicopter.
“Bleeding’s under control,” the paramedic reported gruffly.
“Good. Hang on. I think I’ve got something,” Mack said. Everyone held their breath.
Tyrone appeared at Linc’s side, a bandage on his arm, his eyes swollen from tears.
“Pop-Pop?” he whispered brokenly.
Linc put an arm around the kid and hugged him tight.
“I’ve got a beat!” Mack’s face was triumphant.
Breaths expelled in a whoosh.
“Got a radial pulse,” an EMT called from Leroy’s feet.
“Fuck yes!” Linc whispered.
“BP is stabilizing,” the paramedic observed. “I’d high-five you if you weren’t elbows-deep inside a patient right now.”
“Rain check,” Mack whooped. “Strong beats!”
A cheer unlike any celebration Linc had heard before rang out. His guys stuck their head out of the first-floor window and hollered right along with the collection of neighbors and first responders
There were tears, audible prayers of gratitude. The celebration continued as the chopper touched down in the pasture across the field while Mack quickly stitched her patient back up.
Linc watched her lean in and down, saw Leroy’s lips barely moving.
“Tyrone is just fine, Leroy. I promise you,” she said. “You hang in there, or I’m gonna be real pissed.”
Linc had never been prouder in his entire life than when he saw the professional admiration on the flight doctor’s face while she gave him her report.
“Never seen anything like it,” he said as EMTs and firefighters transferred Leroy to the spine board.
“I’m not surprised,” the hulking flight nurse said with a grin. He offered Mack a gloved hand and helped pull her to her feet. “You’re a hell of a doctor, O’Neil.”
“Thanks, Bubba,” she said. “Take good care of my guy here.”
The flight doc glanced down at her footwear and sho
ok his head. “Who knew superheroes wore air casts?” With that, they turned and jogged with the stretcher to the waiting aircraft.
Stripping off her gloves, Mack watched them go. Stood still as the helicopter lifted off. When she turned and stumbled on her walking boot, Linc was there to steady her.
“Dreamy,” he said, wrapping her up when she sagged against him.
“I’ve never been so happy, hungry, and tired in my entire life,” she confessed.
“Dr. Mack. Is my grandpa gonna be okay?” Tyrone asked.
Mack pulled him into their hug. “He’s got a good chance, buddy. Your Pop-Pop is one tough guy.”
“I’m scared,” he whispered. “We were talking about what to pack for lunch at school tomorrow. I don’t like meatloaf. And Pop-Pop was laughing, and then bang!”
“It wasn’t your fault. You didn’t distract him or cause this. Your grandpa’s heart just picked that moment to stop working right.”
Linc gave the kid an extra squeeze. “We called your mom, Tyrone. She’s going to meet us at the hospital. So why don’t we swing by your house and pick up some things for your grandpa that he can use at the hospital?”
They bundled Tyrone into the chief’s vehicle, packed a bag of whatever a seven-year-old considered essential to a grandpa—including corduroy pants, the TV remote, and Tyrone’s favorite stuffed bear—and delivered boy and bag to the hospital.
Tyrone’s mom, Leroy’s daughter, was already there. Mascara running down her cheeks, she hugged each one of them extra hard. They waited with her for an hour.
A nurse popped down with good news from the OR. Minimal damage to the heart muscle. The surgeon was putting in a stent and confident in a full recovery. Tyrone’s mom burst into tears, and Mack assured the boy they were happy tears.
This time, it was Linc driving an exhausted, sore Mackenzie home from the hospital.
“Pizza,” she said, her eyes closed, head resting against the seat. “Beer. A hot bath.”
“TV,” Linc added.
“Dog,” they said together.
“This was a very good end to what was a questionable day,” she sighed, stretching her arms toward the dashboard.