“Don’t tell me I’m imagining things! I saw her walk by the desk. Tell her I need to see her.”
It occurred to Leigh to bolt and escape—she was, after all, an accused runner—but she wasn’t about to give Sam the satisfaction. The woman might be winning the war . . . but this last skirmish is mine.
+++
Nick might not be a horse person, but he knew the moment he set eyes on the big bay gelding that the animal was in trouble.
“He’s dripping with sweat,” he said, turning to Glenna. “I didn’t think horses did that, except under their saddles. Even that white stripe on his face is soaked.”
“It’s the pain,” the woman explained, her expression anxious. “Patrice said to watch for that or pawing and turning in circles.” She grimaced as the big horse turned his head to nip at his flank. “And that. That’s a sign of colic pain too, the way he’s biting himself. I don’t like how he’s holding his head. Hanging it down like—” she glanced at Maria, then lowered her voice to a whisper—“like he’s giving up.”
Nick’s stomach sank. “No word from Leigh?”
“I’ve left several messages, but she hasn’t called back.” Glenna’s lips pressed together. “I’m sorry I didn’t call you, but Patrice said Dr. Stathos left specific instructions that only she and the vet were to be called in an emergency. I had no idea that Maria had even started to talk, let alone phoned you. It’s a day of miracles and disasters, I’m afraid.”
Nick nodded. He couldn’t argue with that.
Glenna rested her hand on the slats of the stall next to Frisco’s, now filled with the one-eyed donkey. “Maria moved Tag in there. She said they’re brothers.” She smiled. “I wasn’t going to touch that one. But I do think that donkey’s been a comfort to your horse.”
Your horse. “The vet’s on his way?”
“Dr. Hunter will be here as soon as he can. He was in surgery; a rancher’s dog was hit by a car. He said to do what we could to keep Frisco from lying down and rolling. Walk him slowly around; keep him moving without wearing him out. The stable hands have gone for the day and I’m not very experienced.” Maria appeared and peered out from under Glenna’s arm, holding a halter much too large for the donkey. “Maria wants to walk him, but I don’t think that’s wise. He’s so big, and if he tried to lie down all of a sudden—”
“I’ll do it,” Nick heard himself say. “If Maria can show me how to put that halter on Frisco and find us a rope, we’ll do it together.” He smiled at her. “Won’t we?”
“You betcha, Mr. Nick.”
+++
Sam wondered if Leigh knew there were smudges of mascara under her eyes—not enough to spoil her looks, but proof she’d been crying. I know the feeling.
“I don’t want to play games,” Leigh said, crossing her arms. “If you called me in here to rub my nose in the fact that you told Nick about the miscarriage . . .”
“I thought you’d want to know why.”
“I’m not going to bite this time, Sam. The only reason I came in here is to tell you I’m through with this. It’s a waste of time for all of us, and it’s inappropriate. I should never have engaged in personal conversation with you. You’re a patient, a fairly sick one, and I’m—”
“The woman Nick thinks he wants. Or wanted. I’m guessing that’s past tense now from the way you look.” She shivered, felt a strange wave of dizziness, and glanced toward the new IV antibiotic they’d started minutes earlier. She hoped this one would work. “Nick was upset?”
“I’m not discussing that with you.”
“I don’t blame you for hating me.” Sam scratched at her ear. “I can’t count the number of times over the past year that I’ve wished you’d break your neck on that horse or fall in love with a brain surgeon.” She was surprised by a rush of tears. “I . . . I only wanted a chance. It sounds idiotic . . . pathetically corny, but I wanted what everyone else has—a happy ending.” She thought of Elisa and her LEGO castle and her throat tightened. “Nick understands that feeling. But I don’t think someone like you can.”
“Someone like me?”
Sam cleared her throat, rubbed her tongue over the tingling roof of her mouth. “You’ve had it good all your life. Parents, great schools, nice clothes . . . people who protected you, cared about you. Nick didn’t have that. Neither did Toby and I.” She closed her eyes for moment and felt her lids scratch oddly over the surfaces, as if her eyeballs had been roughened by sandpaper. “Let me tell you how it was at my house when your father was helping you with your math, and your mother was wearing pearls to bake sugar cookies for the PTA.” She stared hard at Leigh. “No dad at the Gordons’. Plenty of men, though. And the ziplock bags hidden under the lid of our toilet weren’t filled with sugar cookies. No one helped Toby and me with our homework. But if we kept quiet while Mom thrashed around in her bedroom, we’d get a candy bar. If Toby tried to interfere, he’d get a split lip.” She narrowed her eyes, fighting a wave of nausea she thought she’d left behind two decades ago. “And if I was really nice to those men and didn’t tell anyone what they did to me after Mom passed out . . .” She saw Leigh flinch and knew she’d hit her mark.
Sam scratched her forehead and grimaced against a wave of itching. “I’m not trying to get pity. I’m tough. Tougher than that punk who shot me.” She smiled grimly. “Only not so fast on my feet anymore. All I’m trying to tell you is that I’ve only met two men in my entire life that I think are worth something. Toby was one. Nick is the other. I’m not kidding myself that your husband climbed into my bed because he loved me, but I swear I won’t give up . . . trying . . . to . . .” Her voice choked and she struggled to swallow. “Something’s . . . wrong.”
Leigh stepped to the bedside. Her eyes widened and then her gaze darted to the IV fluids. “Sam, you’ve got hives. All over you. Give me your arm.” She grasped Sam’s arm, slid the clamp on the IV closed. “Are you itching?”
“Yes . . . I’m on fire.” Sam scraped her fingernails against the side of her neck. “My throat itches, too. I think my lips are swelling.” She gasped for a breath and wheezed.
Leigh crossed to the door and shouted, “I need a nurse! Bring IV Benadryl and epinephrine. Grab the crash cart and get respiratory therapy here. We’ve got an allergic reaction. A bad one.”
Sam struggled to sit upright, felt searing pain in her incision but didn’t care. She had to get up, stop what was happening. The blood pressure cuff inflated on her arm, making the itching turn to unbearable burning. Tighter, tighter. She thrashed, tried to pull it off, tried to—
“Hold still, Sam. Let us put this oxygen mask on. The nurse is going to get your IVs pumping faster. Hold still. Don’t fight us.”
Acrid plastic covered her face and Leigh’s voice sounded farther away, like it was coming from a tunnel. “Fifty of Benadryl, IV. Pull out some Solu-Medrol. Is that the BP reading—72 over 40? Check it again. Saline wide open, pour it in. She’s anaphylactic.”
Alarms buzzed above her, persistent as bees. The stinging and itching worsened until she wanted to scratch her skin bloody. She was smothering to death.
She tried to focus, couldn’t see through the fog, then struggled again to sit up so that she could suck air, barely, past her swollen throat. Her voice emerged like the last gasp of a strangler’s victim.
“I . . . can’t . . . breathe.”
Chapter Twenty-Six
Leigh bent close, trying to reassure her—Sam was panicked.
“Sam, listen to me. The epinephrine’s making your heart race and causing your shakiness, but that’s okay. Hang in there. We’ve got to stop this reaction. You’re allergic to the antibiotic. I know this is frightening, but—”
Sam gagged and Leigh snatched the misting treatment mask away as she began vomiting, each retch followed by a shrill, whistling wheeze when she struggled to get a breath. Sam’s lips had gone gray. “Suction!” Leigh ordered. “Clear her airway!”
Leigh’s gaze darted toward the monitor displ
ay as the nurses and respiratory therapist worked: BP 78 over 38, pulse 146, oxygen saturation . . . 81 percent? She gestured to one of the nurses. “Set me up for intubation. Is that steroid on board?”
“Yes, Doctor. Plus the diphenhydramine and a second dose of epi. The saline’s running wide open, but—”
“I see the blood pressure,” Leigh interjected, her mouth going dry. And I know she’s getting worse instead of better. She leaned over the bed again, very aware of Sam’s stridor and wheezes, despite the medication infusing through the mask. There was terror in her eyes.
“I’m . . . going . . . to die.” Her hand, grasping Leigh’s, was cold, clammy with sweat—her face, lips, and eyelids were rapidly swelling.
“No. We’ve informed Dr. Bartle, but there isn’t time to wait. Your throat’s swelling inside. I need to put a tube in to help you breathe.”
“Oh . . . God, help . . . me.” Sam’s eyes swam upward and then she focused again, gripped Leigh’s hand even harder. “Elisa . . . tell Nick . . .” Tears filled her eyes, spilled over, but her gaze stayed riveted to Leigh’s. The anguish in them made Leigh’s heart ache.
Lord, please help me help her.
“I’m . . . going . . . to die,” Sam repeated as the monitor alarms shrilled.
The nurse stepped close. “Your intubation tray is ready, Doctor.”
“I’m . . . sorry . . . ,” Sam whispered. “I only . . . wanted . . .” Her eyes rolled back and her head sank against the pillow.
Leigh grasped Sam’s hand, leaned close. “I won’t let you die. Do you hear me? Nick can’t lose you too. You stay with me—fight, Sam!”
She whirled, nodded to the respiratory therapist. “Let’s hyperventilate her so I can get this tube in.”
In less than two minutes, she slid the laryngoscope blade over Sam’s swollen tongue and saw with dread that the entire back of her throat was massively edematous. It was impossible to visualize the necessary landmarks—epiglottis, vocal cords . . . “Suction!”
Leigh suctioned the saliva away and held her breath as she tried to slide the tube past . . . “Too big—give me a cuffed number five,” she ordered, seeing with dismay that her patient’s face had gone grayer. “Bag her, please!”
Heart pounding nearly as fast as her patient’s, Leigh tried again with the child-sized tube, but the swelling had progressed. “Did the OR call back? Is anesthesia—”
“The anesthesiologists are all in surgery. I could call downstairs and see if they can pull the ER doctor away, or—”
“No. No time. Bag her again,” Leigh said, pulling the tube away. “Give me a number four tube. I’ll try to insert it nasally.” It won’t work. She is going to die. Unless . . . “Never mind. Get me a number fifteen scalpel, some hemostats, and prep her neck fast. I’m doing a cricothyrotomy.”
In minutes the staff had Sam, mercifully unconscious from shock, positioned with a rolled towel under her shoulders, head lolled back and throat exposed. Leigh said a prayer under her breath and touched a gloved finger to Sam’s Adam’s apple—the thyroid cartilage. She identified the cricothyroid membrane beneath, reminding herself of the underlying anatomy location of associated blood vessels. Don’t let me hit a vessel . . . She lifted the scalpel, held her breath, and quickly made a two-centimeter vertical slice, sponged away the blood and widened the opening with the hemostat, then inserted a number six endotracheal tube.
“Inflate the cuff, please,” she whispered to the technician, relief making her weak as Sam inhaled and she heard the first sweet rush of air through the tube—like a child playing with a soda straw. “We’ll get it secured in place, bag assist her for a few minutes, then continue those albuterol treatments.”
And you’ll live, Sam. You’ll live. Thank you, God.
+++
Nick felt a tug on the rope and looked back over his shoulder to see that Frisco, flanked by Tag and Maria, had stopped walking again. He couldn’t blame the horse; forty minutes of plodding in circles around the sandy riding arena felt way too long.
“He’s resting for a minute,” Maria said, surprising him again with her voice—angelic, sweet, and confident. Why he imagined that it would be different, he wasn’t sure. Except he knew the abuse and heartache she’d survived and expected, perhaps, to hear it in her voice. “Tag won’t let him lie down and roll; don’t worry,” she assured him. The donkey, as if on cue, nudged the big horse gently with his nose.
Nick smiled. “I see that.”
He walked back to Frisco, raised a hand . . . hesitated.
“It’s okay. He won’t bite you.”
Nick stroked his fingers along the gelding’s white blaze, relieved to see that the sweat was drying. Although the look in the animal’s dark eyes . . . He’s still hurting. The order of the day. All around. He touched Frisco’s soft nose, then turned to Maria. “It was your idea to call me?”
She nodded. “I knew you’d come.”
He raised his brows.
“You’re a policeman. You help people.” She stepped close to Frisco, and the horse turned his head toward her and sighed. “Animals too. Besides, he’s part of your family. And families—” she reached up to pet Frisco’s nose and Nick caught sight of the scars on her arm—“should always, always help each other. No matter what.”
Nick struggled to answer. “I think you’re right, princess.”
She smiled. “We’d better walk.”
He clucked to Frisco and the big horse moved to follow him. Tag and Maria stepped alongside, and they started another slow circuit of the sandy arena. They passed the wooden mounting block Gary had built so that the smaller riders would have an easier time climbing onto their horses. They walked by neat rows of protective riding helmets—some as big as NFL gear, for brain-injured children—hanging on pegs by the gate. The late afternoon sunlight glinted on a cluster of chrome wheelchairs and aluminum crutches. Frisco plodded quietly behind, head hanging low, and Nick led, his thoughts tumbling.
So much had happened in the past few days, things he’d never anticipated, like being here now, leading Leigh’s horse in circles with a near-blind donkey and a little girl. A child who’d been mute until today, when she’d called him to help this horse he’d never really liked. Because “. . . he’s part of your family. And families should always, always help each other. . . .”
“No matter what.” His heart cramped at the image of Leigh’s face in the gazebo today, when she’d try to explain. “I was hurting.” She still was; he saw that in her eyes every time he looked at her. Even last night, when she’d told him she wanted them to give their marriage another chance. She was frightened and confused. Maybe she had been all along. Had he really considered that? tried to understand why? Or had he always just moved ahead with what he thought was best—get married, start a family . . . buy that table? It had seemed right, solid, secure. He’d done it all because he loved Leigh; she had to know that. But if that was true, why had things ended up the way they had?
Nick clucked to Frisco, heard Maria echo it, then walked on, waiting for the vet and thinking how strange it was that he’d prodded Leigh for the truth, when maybe a much bigger truth was waiting for him right here in this dirt arena. Prompted by a little girl with cruel scars and the voice of an angel.
I’m listening, Lord. Show me, please.
+++
Sam drew a breath, grateful for its freedom despite the fact that it was flowing through a tube emerging from a gaping hole in her neck. She groaned, but no sound came because the tube bypassed her vocal cords. It was surreal. Especially the fact that it was Leigh Stathos who’d performed the emergency procedure. And saved her life, more than one nurse had told her in the past hour. Dr. Bartle had confirmed it. If Leigh hadn’t been there at the bedside, made the split-second decision to insert the breathing tube . . . Elisa would be motherless right now. Tears filled her eyes.
She hadn’t told the nurses or Dr. Bartle that the only reason Leigh had been here was that Sam had summoned her so she cou
ld enjoy the fact that she’d ruined her chances for reconciliation with Nick. If Sam were inclined to believe such things, she’d think that God had masterminded their bedside meeting. She caught sight of Leigh in the hallway and reached for the pad and pencil the nurse had provided. They’d be taking the tube out in a few hours, but Sam couldn’t wait that long. Her heart thudded. I have to do this.
“Hello,” Leigh said, stepping through the doorway. Her gaze swept the monitor displays. “Dr. Bartle says you’re doing well.” She stepped to the bedside. “No more hives, itching?”
Sam started to speak, remembered she couldn’t, and shook her head.
“Good.” Leigh rubbed her hand across the back of her neck, looking obviously fatigued. “I think I’m going to go, then. The tube will be out in a few hours—Band-Aid, very little scar—and you’ll stay on steroids and antihistamines. You’ll be fine. I’m . . .” She cleared her throat. “I’m glad I was here.”
Sam raised her hand, beckoned to Leigh before she could leave. She lifted the clipboard and tapped the pencil against it, feeling a knot gather in her throat that had nothing to do with allergic hives.
“Question?” Leigh asked. She stepped close again as Sam wrote.
You saved my life.
Leigh started to speak and Sam shook her head, pressed the pencil to the paper again.
I was awful to you and you still helped me.
“I’m a doctor.” Leigh swallowed. “And I meant what I said; I didn’t want Nick to lose you. I wasn’t there for him when Toby died. You were. I can’t bear the thought of him losing someone else.”
Sam felt a tear slide alongside her nose as she wrote again.
He never cooked for me. I think cooking is like love for him. He loves you. Always has.
Code Triage Page 26