When Susan injected the needle, the patient did not so much as stiffen in response. Susan waited for the clear drip of cerebrospinal fluid from the needle’s barrel, only to get a disappointing wash of reddish liquid instead. “Damn it!” She gently removed the catheter, then held pressure over the tiny hole she had made.
Remington looked over the patient’s body. “What’s wrong?”
“Traumatic tap.” Susan realized she must have nicked a small blood vessel on the way in. It happened fairly frequently, usually with a writhing pediatric patient and inexpert restraints. “I’m going to have to send this one home and try again tomorrow.”
Remington stepped around Barack and examined Susan’s work. She removed the gauze so he could look. The wound had already stopped bleeding. “I’m sure you know if you just let it drip a bit, it probably would have cleared.”
“I’m aware of that.” Susan hoped anyone performing a lumbar puncture was. “But it’s protocol. Once we see blood, even if it’s just peripheral, we have to redo the tap. We’re not supposed to take a chance of injecting the nanorobots into the circulatory system. They’re not programmed to function in that environment, and it doesn’t help the patient, either.”
“May I look?”
Susan stepped aside. Remington expertly palpated the area while the patient remained on his side. “You went in at L4/L5.”
His words were not a question, and it was standard procedure, so Susan saw no reason to reply.
“We can still use L3/L4.”
Susan did not know that. In her experience, bloody taps occurred for two reasons: Either the patient had a brain hemorrhage or the needle caught a blood vessel on insertion. In the first case, the tap should not be repeated because of serious danger of brain herniation. In the second, the fluid usually cleared in time, as Remington had stated. The technician could simply discard the first output and wait until the fluid became clear or use the bloody fluid for culture and the rest for cell studies.
If a nonurgent tap had blood, they either tried to work around it or repeated it the next day. If an urgent tap showed blood, they took the presence of the blood into account when performing tests. She had never heard of performing a second tap on the same day. “You can do that?”
“Sure, why not? It’s upstream, so anything you might have nicked the first time shouldn’t cause a problem.”
Susan still hesitated. “And it’s safe?”
“The spinal cord ends at L1 in adults.” Remington pressed a finger into the indicated place in Barack’s back. “It comes down a bit farther in kids, but L3/L4 should be safe for anyone.” He indicated a spot one vertebral space up from Susan’s tap. “Do you want me to do it?”
When Susan had offered to allow Remington to perform Fontaina’s tap, she had not realized the irony of the situation. This time, she laughed out loud. “Isn’t that rather like paging a cardiovascular surgeon to put in an IV?”
“Not exactly.” Again, Remington examined the vial of greenish liquid, paying particular attention to the seal. “Unless you’re planning to bring in Dr. Mandar.”
Susan remembered when she had called on the neurosurgeon to reevaluate Starling Woodruff, and an involuntary shiver suffused her. “Not this time. A first-year neurosurgery resident is as expert as I’m willing to bother for a routine lumbar puncture.”
Now, Remington had to laugh. “Could you imagine? After you gained his admiration, treating him like a scut puppy? He wouldn’t know whether to jump at your command, in case you bested him again, or disarticulate your cervical vertebrae and show your body to your head.”
Susan blushed, not wanting to be reminded of her earlier successes. She felt as if her recent blunders washed those away entirely. “If I paged him for this, I’d deserve the beheading.”
Without further encouragement, or even a definitive answer, Remington set to work on the lumbar puncture. Usually, Susan enjoyed procedures. This time, she felt relieved to surrender it to Remington. He worked with a smooth and confident precision she did not have the experience to equal. In seconds, he had the stylet removed and clear fluid dripping from the barrel.
Removing the seal, Susan handed him the nanorobot vial. Using sterile technique, he attached it, manipulated the plunger, and patiently injected the fluid, a bit at a time.
Susan had done things slightly differently and wondered if Remington had a reason or simply another style. “Is there an advantage to allowing that much CSF to drip out before you start? Also, the slower injection?”
Remington continued to inject the vial slowly. “There’s an article in last month’s Oncology that suggests making a bit of space before injecting intrathecally might decrease the risk for increased intracranial pressure.”
That made sense to Susan. Emptying some air from a balloon prior to twisting it into a new shape did reduce the chances of popping it. What surprised her was discovering a neurosurgery resident who read cancer journals.
“Also, slower injections might minimize postinjection headaches.”
“When did you start reading Oncology?”
Remington injected the last bit of nanorobots and fluid. “I don’t usually. That article caught my eye.” He stepped back, tossing the vial into the biohazard can. “There.” He removed the needle and held a small piece of sterile gauze against the tiny hole it left.
“Wish I’d read it.” Susan did read a lot of articles, about twenty percent of which were outside her field. She made a mental note to further broaden her research. “Do you want to do the last one?”
Remington snapped off his gloves and tossed them as well. “Why?” he asked suspiciously. “Is it an ill-tempered kangaroo?”
Susan cocked her head and turned him a searching look. “No, it’s a paranoid schizophrenic. Why would you ask such a thing?”
Remington cleaned up his workstation, while Susan opened the door to admit the orderly who had brought Barack. The young man swept in, wheeling the patient away.
“Because that’s one of the few reasons one of my colleagues would give up a procedure. I know you’re not anticipating a call for an astrocytoma resection, so if you’re giving away a procedure, it must have the fun factor of a digital bowel disimpaction.”
Susan wrinkled her nose. “Actually, psychiatrists don’t generally fight over medical procedures. We’re more of the pensive variety.” She recalled the joke she had contemplated a few days earlier, certain he knew it. “When a duck flies overhead, we’re more interested in what it might be thinking and feeling than in blasting it out of the sky.”
“Mmm.” Remington accepted that explanation. “But then you miss out on the Muscovy à l’orange with shiitake mushrooms.”
“I’m more of a barbecued chicken fan. I prefer my meat free of buckshot.”
Remington chuckled. “Not to get technical, but you shoot big game, like deer, with buckshot; hence the name. You shoot ducks with bird-shot.”
“What’s the difference?”
“About nine hundred pellets per cartridge.”
Susan only nodded. She did not want to pursue a discussion about shotgun shells, especially with someone named after a gun. “Do you want to do the next LP, or not? Given the choice, the patients would probably prefer you.” That made a better argument for her doing the procedure. The one who had less experience needed more practice, especially since she planned to keep working on this project. She thought of another issue. “I’ll tell you what. Let’s see how big and uncooperative the patient is. If we need more muscle to hold him still, I’ll do the procedure. If he’s even half as accommodating as our last patient, you’ll do the procedure and I’ll hold.”
“Our last patient?” Remington glanced toward the door through which Barack had disappeared. “You mean, the statue?”
Susan knew he intended the words as a joke, but she did feel a flash of shame. “Hey, I managed a traumatic tap on that statue.”
Remington blew off her concern with a dismissive noise. “Hell, I’ve seen
guys get bloodier taps than that off people under anesthesia. On the surgery table, you get to see everything, move things around and out of your way, and everything’s floppy and cooperative. When you blindly stab a needle into someone, you have no way of knowing where some tiny, feeder blood vessel might be sitting.”
Susan appreciated Remington’s earnest attempt to ease her conscience. Compared to the mistakes she had made with Sharicka and Payton, this barely showed up as a molehill in a mountain range. Susan shuffled away the paperwork for Barack Balinsky, pulling out a fresh sheaf on their next patient. She read aloud. “‘Cary English, sixty-four-year-old white male. Paranoid schizophrenic, refractory to treatment. Persistent delusions and hallucinations involving space aliens. Assaultive to staff and strangers; potentially dangerous.’ ”
Remington placed a fresh, wrapped tool tray on the portable stand. “Ah, sounds like you’ll be doing this one, kitten. I’m no psychiatrist, but I have a feeling poking and prodding his body might just piss him off.”
“Good thought, snooky-ookums. I’m just betting he comes with a couple of large nursing aides and maybe a son or two to assist.”
Remington set the vial of nanorobots on the tray beside the sterile kit. “I hadn’t considered that. I get most of my patients pre-anesthetized.”
To Susan’s relief, Cary did arrive with a burly nursing aide, as well as a middle-aged son who signed the consents. The two of them did a practiced job of holding the old man still, while he thrashed and howled about aliens stealing his thoughts and emotions through his bodily fluids. To her relief, Remington managed a swift, clean tap, followed by a slow injection. She wondered if she would have had the same result and supposed she might have managed it, although she could not have done it with the same speed and assuredness. She believed she had made the right choice.
The son and the nursing aide chatted baseball statistics while Remington held the gauze in place, then wheeled Cary English from the room with barely an acknowledgment. “Thanks,” Susan said.
Remington tossed his gloves. “Thank you. It’s not often I get to participate in research, especially this cutting edge. And I really like procedures, even relatively simple ones.”
Susan smiled wanly. Whether he acknowledged it or not, she owed him. Without his assistance, she would have had to explain to Goldman and Peters why she had to come in another day and reinject Barack Balinsky. At worst, he had saved her the embarrassment and another day of work. She also would have had to find someone else to hold Ronnie Bogart. “I believe I owe you lunch and a trip to my place.”
“I believe you do.” Remington finished cleaning, put everything back in order, then took Susan’s arm.
At his touch, a thrill tingled through Susan. It occurred to her, with abrupt and stunning suddenness, that she loved this man. And, though neither of them had yet spoken the words aloud, she believed he loved her, too.
Chapter 21
Doctors Susan Calvin and Remington Hawthorn sat on a bench in the park ten stories below the Calvins’ apartment, their bellies full of John Calvin’s special chicken-eggplant recipe, cobbled from the Kentucky Roasted they brought home and lots of fresh vegetables. The afternoon sun beamed down upon a horde of squealing preschoolers racing across machine-woven mats of recycled plant material and climbing ladders, tunnels, and bridges molded from shredded rubber. The softness of the ground and structures allowed them to push, shove, and plummet to their hearts’ content. Their parents and nannies watched them from windows or benches, shouting encouragements.
Remington stretched his legs in front of him and placed an arm around Susan. Excitement flitted through her at his touch. She felt like a high schooler with her first crush. Everything he did that suggested he liked her seemed like a new and exhilarating experience. She loved the look of him: golden highlights glistening in the casual disarray of his blond curls, his physique a pleasant combination of slender and muscular, his features strong and regular, the very definition of chiseled. The natural scents of him enticed her in a way no human-created smell had before, bringing her thoughts back to childhood vacations and, inexplicably, stops for ice cream.
They had talked the entire trip and now sat in a comfortable silence Susan felt no particular drive to break. She could have sat like this all day, reveling in the warmth of his closeness, the thrill of his touch, a light breeze wafting the faint, sweet odors of toast and jam from the children. Then, her mouth opened, as if of its own volition, and words she had no chance to consider spewed forth. “Do you believe in love at first sight?”
Remington hesitated, his gaze tracking a toddler headed toward what appeared to be an older sibling, the toddler’s steps tentative and bowlegged, his arms outstretched. “If you’re asking do I believe it’s possible to glance across a crowded room, meet someone’s gaze, and instantly know you’re soul mates, then no. I don’t believe it’s possible to love someone until you know what’s in that person’s heart and mind. Some of the most outwardly attractive people in the world are vain, prejudiced, or just plain stupid.” He turned his gaze to Susan and raised his brows in quick succession. “On the other hand, I do believe in lust at first sight. You see someone exquisitely beautiful and can imagine making wild, passionate love for the rest of your born days.” He smiled crookedly. “Usually, though, she opens her mouth before you can get her into bed and spoils everything.”
Susan tried not to glare. She had asked an incredibly stupid question without giving it much thought, and he had simply responded in an appallingly forthright manner. She had always preferred people who spoke their minds.
Apparently sensing he had not given the answer Susan wanted, Remington continued floundering. “But if you mean do I think our first meeting might go down in the annals of history . . .” He paused thoughtfully, then shook his head. “I’d still have to say no. As I recall, one of us acted like a pompous ass.” He grinned at her.
Susan knew how to play that game. “And the other one like a castrating bitch. Not exactly first-sight-love material.”
To Susan’s surprise, Remington further mulled a question that now seemed beaten to death. “However, I think I can firmly say that, with you, I did experience lust at first sight. And, over a relatively short period of time, I’ve grown to” — he looked at her, as if worried his next word might queer the deal — “love you.”
The reply was startled from Susan. “You love me?” As soon as the words left her lips, Susan wanted to strangle herself. Don’t sound so surprised. You knew it. And you love him, too.
Remington laughed. “Why else would I throw my body over yours to shield you from an explosion? Why would I give up my first day off to help you stab crazy people in the spine in the same setting I spend nearly every waking hour?” He shook his head. “Does reality have to strike you with a sledgehammer, you silly woman?”
Susan stared. “Well, when you put it in such a beautiful and romantic way, how could I not know it?” She snuggled against him. “And, by the way, I love you, too.”
Remington’s arms tightened around Susan. “Should I make you prove it?”
Susan forced herself not to flinch. “Right here and now?”
Remington glanced at the playground equipment, the running children, the parents ringed around them. “I’m game, but do you really think three- and four-year-olds are ready for a sex ed class?”
Susan felt her entire face warm, and that surprised her. She sighed before she could stop herself. “Remy, I need to tell you something.”
He tensed but remained silent.
Susan got the idea he was bracing himself for whatever she might say. She looked up at him. He had his lower lip trapped between his teeth, and his eyes looked positively frantic.
Susan shook her head, laughing. The children’s calls and shouts had drowned out their conversation thus far, but she lowered her voice further. Somehow, silence seemed to appear in the most unlikely places when a person said something inappropriate. “You think I’m about to tell yo
u I’m a transvestite, don’t you?”
Remington shifted in obvious discomfort. “Actually, I was thinking about an incurable venereal disease; but thanks for giving me something else to worry about.”
“It’s neither of those.”
Remington guessed, “Lesbian?”
“Nope.”
His voice became strained. “Cancer?”
Susan let him off the hook. “I’m a virgin.”
Remington studied her face. He did not appear shocked, just more tightly braced, as if he waited for the other shoe to fall. Finally, he said in a strangely squeaky voice, “That’s it?”
“That’s it. I’m a genetic woman with all of the working parts.” Susan swiftly amended her statement. “Well, they’re working as far as cycling and all. To my knowledge, there’s only one virgin who’s ever given birth.”
Remington cleared his throat, then spoke in his normal voice. “A virgin, huh? Well, that’s nothing bad.”
“In some circles, it’s considered a major achievement. After all, I’m twenty-six years old.” Susan did not want Remington to get the wrong idea. “Not that I haven’t had opportunities, of course. I mean I started dating in high school. It’s just I’ve always felt a person should be in love before making love.”
“And,” Remington started carefully, “you love me?”
“I do,” Susan admitted, then wished she had phrased it any other way. She did not want him to think she was rushing him into marriage when they had barely even managed a second date.
Remington did not seem to notice. “And I love you?”
“Are you asking me? Or telling me?”
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