Family Practice

by Marisa Carroll

  “You’ll both be fine.” She gave Ginger’s hand a quick squeeze. “Zach will make sure of that.”

  “Yes, he will.” Ginger’s smile was serene. They would be fine from now on because she and her stepmother would always have one thing in common—they both understood the importance of family. It meant as much to Ginger as it did to her. Her stepmother had proved that by entrusting her children to Callie’s care, and in a smaller way by letting Karen be a part of their lives.

  “Okay, kids, let’s move out. We need to go check on my mom before we go upstairs.”

  “Your mother’s with you?” J.R. asked.

  Callie paused on her way out of the cubicle. “I forgot to tell you. She’s here for a CT scan on her wrist. How’s that for multitasking? Don’t worry, Dad. I’ve got it under control.”

  “I’m sure you do.” He gave her a thumbs-up. There would always be a residual bond between Karen and J.R. because of her, but Ginger and the baby were J.R.’s future. Karen was the past. Callie could accept that now. It wasn’t a failure on her part; it was the way it should be.

  “March, you two,” she said with mock sternness. “We’re in the way.” Becca opened her mouth to object and Brandon started sniffling but they obeyed and followed Callie out to the main waiting room of the E.R. Karen was sitting in a wheelchair waiting for them.

  “Have you had your CT scan already?”

  “Yes, I’m all finished with it. They wheeled me right in. They said Dr. Assad would be down to talk to us about the results before too much longer.”

  “Then we should wait here until he comes.”

  The weariness Callie had been struggling to keep at bay pushed at the edges of her consciousness. She fought it using a visualization trick she’d learned in her early days of medical school. The technique worked well most of the time, but it had its limits. For a moment the fatigue got the best of her. How, she wondered, on top of everything else, would she get them all safely back home? She was so tired she could barely stay on her feet, let alone undertake an hour’s drive back to White Pine Lake.

  Becca went to Karen and patted her hand. “After you talk to the doctor, do you want to come upstairs and wait with us to get our new baby?”

  A momentary spasm of pain flashed across her mother’s face. Sometimes even Karen Freebeing must wonder if the price of her freedom and her vaunted self-sufficiency had been worth the cost. “Is that all right with you, Callie?”

  Callie pretended not to notice Karen’s moment of regret. She was certain her mother hadn’t intended to show it. “We’ll all be more comfortable upstairs.”

  She’d hoped to find Zach in the E.R., but she was disappointed. The empty feeling in the middle of Callie’s stomach intensified. She needed to talk to him, just for a moment, to tell him that despite what had transpired between them earlier, she had every confidence in his skill and ability. That she was certain he would bring Ginger’s baby, her brother or sister, into the world safely. But it seemed she wouldn’t get the chance.

  She peered down the long hallway. Painted stripes of different colors decorated the walls, serving as guidelines to direct visitors to the various hospital departments. The blue surgery line stretched off into the distance toward a wall where it made a sharp left turn. While she watched, a man in a white coat came out of a room with Medical Imaging above the door. Dr. Assad appeared older and more tired than he had on the computer screen just a few hours earlier. The E.R. was quiet at the moment, but it was the quiet of the eye of a hurricane—or a lull in a thunderstorm.

  “Dr. Layman. It is a pleasure to meet you in person so soon, but I’m sorry it’s because you have another medical emergency in your family. I hope the outcome is favorable for both of them.” Callie was surprised Assad knew about Ginger. Her surprise must have shown on her face. “Your mother told me about your stepmother’s complicated pregnancy as she was having her CT scan,” he explained.

  Of course, how silly of her. She really was getting too tired to function well.

  Before Callie could make a polite reply, the intercom system came to life. A woman spoke, her voice calm but with an underlying layer of suppressed alarm. “Code Yellow. All available personnel to E.R. Repeat. Code Yellow. All available personnel to E.R.” Code Yellow referred to a mass casualty event. It was a situation every hospital trained their staff for and hoped never to experience.

  “A bad accident,” Assad revealed, answering Callie’s unspoken question. “Three cars full of teenagers out far too late. The first one braked for a deer and caused a chain reaction.”

  “How terrible. Can I be of help?” The offer was automatic.

  “I appreciate the offer but we have extra personnel on the way, and your place is with your family,” he reminded her. “I’ve reviewed your mother’s CT scan. The break was clean. It should heal well. If you want me to cast it on Monday, I will, but you and Zach can do it just as well and save her yet another trip to the city. If you have any further questions, do not hesitate to give me a call.”

  “Thank you, Doctor. We can manage from here.”

  “Certainly. Now I must go.” He gave her hand one more quick shake and hurried away.

  The E.R. was filling with nurses, medical techs and doctors in wrinkled white coats. She wondered if one of them was Donnell Parsons, the neurosurgeon whose offer to join him in a high-profile practice in Ann Arbor might take Zach away from White Pine Lake, away from her. She heard the wail of sirens in the distance. Part of her longed to stay and offer her services, but she was an outsider here, out of her element, and she might do more harm than good. She was not meant to be a hospitalist, a doctor who operated only in an institutional setting. Deep down she had always understood that about herself. She was meant for family practice, for taking care of the everyday aches and pains, the long-term health and well-being of all the people of her hometown, from the very young to the very old. She had made her choice. But what of Zach? Was the White Pine Lake clinic where he wanted to be, what he wanted to be doing? She wouldn’t stand in his way, but if he wanted to leave, she wouldn’t go with him. There was no future for the two of them as partners, or as lovers, if that was his choice. It was simply the way it had to be.

  She was exactly where she’d vowed never to be, in danger of a broken heart and a broken partnership. But now she could count on her family to help her get through the misery of it all.

  She moved behind Karen’s wheelchair and started pushing her mother toward the elevators that would take them to the birthing unit on the third floor. “Are you all right, Callie?” Karen asked, twisting her neck to peer over her shoulder.

  “Yes, fine,” she said, even though she was anything but. “C’mon, kids. Follow me.”

  * * *

  IT WAS ALMOST DAWN, Zach realized as he stepped out of the operating room, catching a glimpse of gray-blue sky through one of the long, narrow windows that faced out over the lake. The adrenaline rush of helping bring a new life into the world had so far kept his fatigue at bay, but he could feel it prowling at the edges of his consciousness. He ignored it. He was good at that; he’d had a lot of practice. He focused on his current objective: finding Callie to tell her everything had gone well.

  As he’d left the room, J.R. had been holding their newborn son for Ginger’s inspection, sharing those first moments of bonding for the three of them before Ginger was transferred to the recovery room. The baby was small, an ounce or two less than six pounds, but his score on the Apgar scale was high and his lungs were well developed—always a concern in a premature birth. He and Ginger would stay in the hospital for several days so that their conditions could be closely monitored, but as of now it appeared there would be no need to transfer him to Ann Arbor or even Traverse City for more specialized care.

  J.R. had asked Zach to tell Callie and the kids the good news so he could stay with Ginger as long as po
ssible. Zach appreciated the gesture. He wanted to be there to watch Callie’s face when she learned she had a baby brother. He wanted to watch the twins’ faces, too, he realized. Brandon would be triumphant. Becca more reserved, but thrilled all the same. He would go with them to the nursery, where they could admire their little brother briefly, cleaned and warm and wearing a tiny hand-sewn blue cap on his head of dark hair. Then the baby would be taken to Ginger in the recovery room for his first feeding. And later they would all be together in Ginger’s room, and the picture taking and the oohing and aahing would begin in earnest.

  Zach smiled to himself as he pulled off the paper cap and shoe coverings he’d worn in the sterile environment of the operating room. He was getting his second wind. He did love doing this, but not enough to give up what he had found in White Pine Lake. He had made his decision to stay in family medicine with less trepidation than Callie, but it was good to have it reinforced in his own mind.

  Callie. The urgency he felt to be with her was stronger than ever. He had to make her understand why he’d kept the job offer from her. She’d just spent several hours interacting with all his old colleagues. He remembered her reaction, the dismay she’d tried so hard to hide when Assad had brought up the offer to go to Ann Arbor with Parsons. How many more chance mentions of the job offer had she been subjected to?

  The music-box rendition of “Brahms’s Lullaby” came across the loudspeakers. The hospital played the tune whenever a baby was born. Callie would hear it and know it was J.R. and Ginger’s child that had arrived. She would soon be caught up in the excitement of greeting the new arrival. The nursery and birthing suites were on the third floor at the opposite end of the hospital. It was a hike, but he had made the trip a hundred times at least over the past couple of years. He headed for the stairway.

  Suddenly he noticed the unusual amount of activity in the pre-op staging area for a Sunday morning.

  Voices were hushed, the atmosphere was tense. Something was going on, something big. Announcements weren’t broadcast into the operating rooms, so he hadn’t heard anything, but whatever event had happened in the past hour, it was evident the whole surgical floor had gone on alert. He spotted Donnell Parsons coming off the elevator. Short, bull-necked and balding at thirty-seven, the man heading toward him looked more like a linebacker than a highly trained neurosurgeon.

  But now Zach was convinced something was very wrong. Parsons never operated on Sunday unless it was an emergency. The neurosurgeon hadn’t yet spotted him. All Zach had to do was turn and walk away.

  He stayed where he was.

  * * *

  THE SOUND OF MUSIC-BOX CHIMES filled the waiting room. Callie turned away from the window. “Brahms’s Lullaby.” The baby was here. She had a brother or sister. She pressed her fingers to her lips.

  Please, let them both be well and safe. She glanced at the overstuffed leather sofa a few feet away. The twins were asleep, one at either end, their heads pillowed on their arms. It could be quite a while before anyone came to escort them to Ginger and the new baby. She would let them sleep for a few minutes longer.

  A man’s figure came toward her from the direction of the elevators. She blinked the remnant of tears from her eyes, hoping for a moment it was Zach. But it wasn’t. It was her father.

  “Dad.” She hurried forward. “How are they? Are they both okay? Is it a boy or a girl?”

  He grinned, erasing some of the tension and fatigue from around his eyes and the corner of his mouth, taking ten years off his age. “They’re both fine. It’s a boy, Callie. I have a son.”

  “Oh, Daddy. A boy. Brandon will be thrilled!”

  “He’s twenty inches long, weighs five pounds and fourteen ounces, and he was born bellowing at the top of his lungs.”

  “That’s wonderful. Strong lungs, just what we wanted.”

  “And all his fingers and toes...and—” His neck turned a dull shade of red.

  “Important accessories?” Callie said, smiling.

  “Yes.” J.R. laughed, then suddenly became serious. “I would have been just as happy with a little girl. But a son...” He wrapped his arms around her and hugged her tight. “You will always be my beautiful baby girl,” he whispered, his voice breaking slightly.

  “I know, Dad.” She hugged him. “When can we see him? I didn’t wake the twins when they played the music in case there were complications.” Her nerve endings were tingling as if her blood had suddenly turned to champagne, but beneath her delight was a tight knot of anxiety that wouldn’t go away. Zach hadn’t come with J.R. Where was he? What was keeping him from them, from her?

  J.R. glanced at the couch where the twins were sleeping. “Where’s your mother?” he asked, finally noticing Karen’s absence.

  “Rudy Koslowski offered her a ride home in the unit. She was exhausted. Rudy called me a few minutes ago. She’s safe and sound back at my place. Zach and I will cast her wrist Monday morning.”

  “I’ll help you make sure there’s someone to do her farm chores for her.”

  “Thanks, Dad.”

  “There’s not much your mother and I agree on anymore, but we do agree on how much we both love you. And she’s been good for the twins. I see that, thanks to you. I’ll do my best to be civil to her. I have a sneaking suspicion she’s going to be around more often from now on.”

  Callie flushed. “Thanks, Dad. That’s wonderful. Now, when can we meet the baby?”

  “He’s in the nursery. They’re giving us a few minutes with him and then they’ll take him to Ginger in the recovery room.” Standard procedure and another sign that her little brother was strong and healthy and required no out-of-the-ordinary care.

  “Let’s wake the twins.” They’d been talking barely above a whisper, but their voices had already done the job for her. Becca was sitting up, alert and a little apprehensive, and Brandon was all sleepy-eyed boy. But as soon as both of them saw J.R., they were wide-awake and the questions came tumbling out.

  “Is the baby here? Is it a girl or a boy? Can we see it now? Can we see our mom?”

  “Yes. Boy. Yes. And not quite yet. Your mom needs to rest a bit, but come with me and we’ll meet your brother.” J.R. held out his hands and the twins bounced off the couch.

  “A boy!” Brandon did a fist pump in the air. “Did you hear, Callie? It’s a boy. What are we going to name him, Dad?”

  “I have no clue. We’ll have to choose one soon, though.”

  “Callie, c’mon. Don’t you want to see him, too?”

  “More than anything.” But something held her back a heartbeat as they started down the corridor toward the nursery window. The stairwell door opened. A tall man in blue-gray scrubs came toward her. Zach. Her heart contracted. “Dad, I’ll be just a moment.” J.R. halted at the sound of her voice, recognized Zach and nodded but kept on walking, pulled along by the twins’ excitement.

  Zach covered the distance between them in half a dozen strides and Callie didn’t stand still, either. “I’ve only got a minute,” he said. “And I’m keeping you from the baby.”

  “I can wait one more minute,” she said and smiled. He looked tired but energized. In his element. The knot of anxiety tightened into real fear and rose into her throat, making it hard to breathe.

  “I’m going back downstairs to assist Dr. Parsons with an emergency surgery, but I had to talk to you first.”

  “One of the teenage accident victims?”

  “You heard the code called.”

  “And Dr. Assad updated me on what happened.”

  “There’s one boy that is the most seriously injured. It’s a skull fracture and spinal injury. We have to get him stabilized so the air ambulance can get him downstate.”

  “It’s lucky you were here.”

  “It’s the weekend. They’re short-staffed and I owe Don Parsons a lot,
Callie. He took a chance on me when the PTSD was so bad I didn’t know if I’d ever be able to work again. I owe this hospital a lot, too. Hiring me, they took as big a chance as Parsons did.”

  “I do understand, Zach.” But she was still afraid he would choose this opportunity over her and White Pine Lake.

  “There were eleven kids in those three cars. I don’t have a choice.”

  “I understand that, too,” she said. “I wouldn’t expect any less of you.”

  “I want to talk, Callie. To work it all out, but right now there just isn’t time.”

  Her heart was beating fast and hard against her rib cage. She didn’t want to play it safe anymore. She had to know where they stood. No more holding back, no more fear of saying or doing the wrong thing. “Do we have a future beyond your six-months option? I may not act on my instincts as quickly as you do, but when I make up my mind, I don’t change it easily. I’m staying in White Pine Lake, Zach. For now, for always.” It would break her heart to let him go, but she would.

  “I’m not going anywhere, either. I tried to convince you of that tonight at the clinic but you couldn’t quite trust me enough to believe me.”

  “But there’s so much more here for you. Dr. Assad said you should consider medical school. He’s right. Will a small-town family practice be enough for you five years from now? Ten? The cholesterol checks? The sports physicals? The premenopausal ladies with boundary issues?” She tried to smile, to keep her voice from breaking, but it wouldn’t obey her.

  “The more important question is, will it be enough for you?” He took both her hands in his warm, strong ones. The waiting room was deserted at the moment but they both knew they could be interrupted at any second.

  “Yes.”

  “That’s all I need to know. I doubt it will be all that staid and boring a practice for either of us. This has been one heck of a weekend and it’s only Sunday morning. But I’ll manage somehow. I’m still an EMT, remember. The middle-of-the-night calls will keep me sharp,” he said with a smile.