It Started at Christmas...

by Janice Lynn

  “Okay,” he agreed, but shook his head as if baffled. “But I’m just not sure how you’re going to do it.”

  Her momentary triumph at his Okay dissipated. She blinked. “Me?”

  Looking as cool as ever, he nodded. “Now that you know how good I am at mouth-to-mouth, how are you going to keep from pulling me behind closed doors every chance you get for a little resuscitation?”

  Yeah, there was that.

  “I’ll manage to restrain myself.” Somehow. He was very, very good at kissing, but there was that whole self-respect thing that she just as desperately clung to. “Now leave so I can work.”

  And beat herself up over how she’d just proved her parents’ blood ran through her veins.

  * * *

  McKenzie looked over Edith’s test results while she waited for Lance to come to her office. Her hemoglobin and hematocrit were both decreased but not urgently so. Her abdominal and pelvic computerized tomography scan didn’t show any evidence of a perforated bowel or a cancerous mass, although certainly there was evidence of Edith’s constipation.

  Had the woman really spit up blood? If she had, where had the blood come from? Had she just coughed too hard and had a minor bleed in her bronchus? It wasn’t likely, especially as Edith had said it hadn’t been like throwing up.

  McKenzie had ordered the gastroenterology consult. She suspected Edith would be undergoing an endoscopy to evaluate her esophagus and stomach soon. Then again, it was possible the specialist might deem that, due to her age, she wasn’t a good candidate for the procedure.

  “You look mind-boggled,” Lance said, knocking on her open office door before coming into the room. “Thinking about how much fun you’re going to have with me tonight?”

  “Not that much fun,” she assured him, refusing to pander to his ego any more than she must have done earlier. “I’m trying to figure out what’s going on with a patient.”

  “Want to talk about it?”

  “Not really.” At his look of disappointment, she relented. “One of my regulars came in today with a history of abdominal pain, constipation, and spitting up blood that she described as not a real throw-up, but spitting up.”

  “Anemic?”

  “Slightly, but not enough to indicate a major bleed. She always runs borderline low, but her numbers have definitely dipped a little. I’m rechecking labs in the morning.”

  “Have you consulted a gastroenterologist or general surgeon?”

  “The first.”

  “Any other symptoms?”

  “If you named it, Edith would say she had it.”

  “Edith Winters?”

  Her gaze met his in surprise. “You know her?”

  “Sure. I used to see her quite a bit. She’s a sweet lady.”

  “She has me a bit worried. It’s probably nothing. Maybe she drank grape juice with breakfast and that’s what she saw when she spat up. I don’t know. I just feel as if I’m missing something.”

  “You want me to have a look at her for a second opinion?”

  “Would you mind?”

  “I wouldn’t have offered if I minded. I’ll be at the hospital with you anyway.”

  “Good point.” She got her purse from a desk drawer, then stood. “You ready to go so we can get this over with?”

  “‘This’ as in the hospital or the night in general?”

  She met his gaze, lifted one shoulder in a semishrug. “We’ll see. Oh, and if you think you’re going to get away with just feeding me frozen yogurt, you’re wrong. I’m not one of those ‘forever dieting and watching her carbs’ chicks you normally date who doesn’t eat. I expect real food before frozen yogurt.”

  * * *

  Lance grinned at the woman sitting next to him in his car. Twice in less than a week she’d been in his car when he’d begun to wonder if she was ever going to admit there was something between them.

  He understood her concerns regarding them working together, but it wasn’t as if they worked side by side day in and day out. More like in the same office complex and caught glimpses of each other from time to time with occasional prolonged interaction. With other women he might be concerned about a “work romance,” but not with McKenzie. She was too professional to ever let a relationship interfere with work.

  Thinking back over the past few months, really from the time he’d first met her a couple years ago when she’d moved back to Coopersville after finishing her medical training, he’d been fascinated by McKenzie. But other than that he’d catch her watching him with a curious look in her eyes, she hadn’t seemed interested in anything more than friendship and was obviously not in a life phase where she wanted a serious relationship.

  Not that he wanted that either, but he also didn’t want to become last month’s flavor within a few weeks. She didn’t seem interested in dating anyone longer than a month. It was almost as if she marked a calendar and when thirty days hit, she moved on to the next page of her dating life.

  Although he had no plans of marriage ever, he did prefer committed relationships. Just not those where his partner expected him to march her down the aisle.

  He owed Shelby that much. More. So much more. But anything beyond keeping his vow to her was beyond his reach.

  Since his last breakup he definitely hadn’t been interested in dating anyone except McKenzie. If he was being completely honest, he hadn’t been interested in dating anyone else for quite some time.

  Oddly enough, since she dated regularly and routinely, she’d repeatedly turned him down. Which, since she was obviously as attracted to him as he was her, made no sense. Unless she truly was more a stickler for not dating coworkers than he believed.

  “Have you ever dated a coworker in the past?”

  At his question, she turned to him. “What do you mean?”

  “I was just curious as to why going on a date with me was such a big deal.”

  “I didn’t say going on a date with you was a big deal,” she immediately countered.

  “My references say that going on a date with me is a very big deal.”

  “Yeah, well, you might need to update that reference because I’m telling you Mommy Dearest doesn’t count.”

  He grinned at her quick comeback. He liked that about her, that she had an intelligence and wit that stimulated him. “Did you think about our kiss?”

  “What?”

  He grinned. He knew that one would throw her off balance. “I was just curious. Did you think about our kiss on your porch this weekend?”

  “I’m not answering that.” She turned and stared out the window.

  Lance laughed. “You don’t have to. I already know.”

  “I don’t like how you think you know everything about me.”

  “I wouldn’t presume to say I know everything about you by a long shot, but your face and eyes are very expressive so there’s some things you don’t hide well.”

  “Such as?”

  “Your feelings about me.”

  “Sorry. Loathing tends to do that to a girl.”

  There went that quick wit again. He grinned. “Keep telling yourself that and you might convince yourself, but you’re not going to convince me. I’ve kissed you, remember?”

  “How could I forget when you keep reminding me?”

  He laughed again. “I plan to keep reminding you.”

  “I have a good memory. No reminders needed.”

  “I’m sure you do, but I enjoy reminding you.”

  “Because?”

  “You normally don’t fluster easily, yet I manage to fluster you.”

  “You say that as if it’s a good thing,” she accused from the passenger seat.

  Seeing the heightened color in her cheeks, hearing the pitch-change to her voice, watching the way he
r eyes sparked to life, he smiled. “Yes, I guess I do. You need to be flustered, and flustered good.”

  “Why am I blushing?”

  “Because you have a dirty mind?” he suggested, shooting her a teasing look. “And you liked that I kissed you today in your office and Friday night on your porch.”

  “Let’s change the subject. Let’s talk about Edith and her bowel movements.”

  He burst out laughing. “You have a way with words, McKenzie.”

  “Let’s hope they include no, no and no again.”

  “Then I just have to be sure to ask the right questions, such as, do you want me to stop kissing you, McKenzie?”

  She just rolled her eyes and didn’t bother giving a verbal answer.

  There really wasn’t any need.

  They both already knew that she liked him kissing her.

  CHAPTER SIX

  EDITH DIDN’T LOOK much the worse for wear when McKenzie entered her hospital room. The elderly woman lay in her bed in the standard drab hospital gown beneath a white blanket and sheet that were pulled up to beneath her armpits. Her skin was still a pasty pale color that blended too well with her bed covering and had poor turgor, despite the intravenous fluids. Oxygen was being delivered via a nasal cannula. Edith’s short salt-and-pepper hair was sticking up every which way about her head as if she’d been restless. Or maybe she’d just run her fingers through her hair a lot.

  “Hello, Edith, how are you feeling since I last saw you at the office earlier today?”

  Pushing her glasses back on her nose, the woman shrugged her frail shoulders. “About the same.”

  Which was a better answer than feeling worse.

  “Any more blood?”

  Edith shifted, rearranging pillows. “Not that I’ve seen.”

  “Are you spitting up anything?”

  She shook her head in a slow motion, as if to continue to answer required too much effort. “I was coughing up some yellowish stuff, but haven’t since I got to the hospital.”

  “Hmm, I’m going to take a look and listen to you again, and then one of my colleagues whom you’ve met before will also be checking you. Dr. Spencer.”

  “I know him. Handsome fellow. Great smile. Happy eyes.”

  Lance did have happy eyes. He had a great smile, too. But she didn’t want thoughts of that happy-eyed handsome man with his great smile interfering with her work, so she just gave Edith a tight smile. “That would be him.”

  “He your fellow?”

  McKenzie’s heart just about stopped.

  Grateful she’d just put her stethoscope diaphragm to the woman’s chest, McKenzie hesitated in answering. Was Lance her fellow? Was that what she’d agreed to earlier?

  Essentially she had agreed to date him, but calling him her fellow seemed a far stretch from their earlier conversation.

  She made note of the slight arrhythmia present in the woman’s cardiac sounds, nothing new, just a chronic issue that sometimes flared up. Edith had a cardiologist she saw regularly. Perhaps McKenzie would consult him also. First, she’d get an EKG and cardiac enzymes, just to be on the safe side.

  “Take a deep breath for me,” she encouraged. Edith’s lung sounds were not very strong, but really weren’t any different from her usual shallow and crackly breaths. “I’m going to have to see why your chest X-ray isn’t available. They did do it?”

  The woman nodded. “They brought the machine here and did the X-ray with me in bed.”

  Interesting, as Edith could get up with assistance and had walked out of the clinic of her own free will with a nurse at her side. Plus, she’d had to go to the radiology department for the CT of her abdomen. They would have taken her by wheelchair, so why the bedside X-ray rather than doing it in Radiology?

  There might be a perfectly logical reason why they’d done a portable chest X-ray instead of just doing it while she’d been there for her CT scan, McKenzie told herself.

  “Is there something wrong?” Edith asked.

  “You’re in the hospital, so obviously everything’s not right,” McKenzie began. “It concerns me that you saw blood when you spat up earlier. I need to figure out where that blood came from. Your esophagus? Your stomach? Your lungs? Then there’s your pain. How would you rate it currently?”

  “My stomach? Maybe a two or three out of ten,” Edith answered, making McKenzie question if she should have sent the woman home and just seen her back in clinic in the morning.

  Maybe she’d overreacted when Edith had mentioned seeing the blood. No, that was a new complaint for the woman and McKenzie’s gut instinct said more was going on here than met the eye. Edith didn’t look herself. She was paler, weaker.

  “Does anywhere else hurt?”

  “Not really.”

  “Explain,” she prompted, knowing how Edith could be vague.

  “Nothing that’s worth mentioning.”

  Which could mean anything with the elderly woman.

  “Edith, if there’s anything hurting or bothering you, I need to know so I can have everything checked out before I release you from the hospital. I want to make sure that we don’t miss anything.”

  McKenzie listened to Edith’s abdomen, then palpated it, making sure nothing was grossly abnormal that hadn’t shown on Edith’s CT scan.

  “I’m fine.” The woman patted McKenzie’s hand and any moment McKenzie expected to be called dearie. She finished her examination and was beginning to decide she’d truly jumped the gun on the admission when Lance stepped into the room.

  “Hey, beautiful. What’s a classy lady like you doing in a joint like this?”

  McKenzie shook her head at Lance’s entrance. The man was a nut. One who had just put a big smile on Edith’s pale face.

  “What’s a hunky dude like you doing wearing pajamas to work?”

  McKenzie blinked. Never had she heard Edith talk in such a manner.

  Lance laughed. “They’re scrubs, not pajamas, and you and I have had this conversation in the past. Good to note your memory is intact.”

  “That your fancy way of saying I haven’t lost my marbles?”

  “Something like that.” He turned to McKenzie. “I’m a little confused about why they did a portable chest X-ray rather than do that while she was in Radiology for her CT.”

  “I wondered that myself. I’ll talk to her nurse before we leave the hospital.”

  “We?” Edith piped up.

  Before Lance could say or reveal anything that McKenzie wasn’t sure she wanted to share with the elderly woman, McKenzie cleared her throat. “I suspect Dr. Spencer will be going home at some point this evening, and I certainly plan to go home too.”

  After real food and frozen yogurt.

  And mouth-to-mouth.

  Her cheeks caught fire and she prayed Edith didn’t notice because the woman wouldn’t bother filtering her comments and obviously she had no qualms about teasing Lance.

  “After looking over everything, I’m thinking you just needed a vacation,” Lance suggested.

  To McKenzie’s surprise, Edith sighed. “You know it’s bad when your husband’s doctor says you need a vacation.”

  Edith’s husband had been gone for a few years. He’d died about the time McKenzie had returned to Coopersville and started practicing at the clinic. Edith and her husband must have been patients of Lance’s prior to his death. Had the woman changed doctors at the clinic because McKenzie hadn’t known her husband and therefore she’d make no associations when seeing her?

  No wonder he’d been so familiar with Edith.

  “What do you think is going on, Edith?” Lance asked, removing his stethoscope from his lab coat pocket.

  “I think you and my doctor are up to monkey business.”

  McKenzie’s jaw dropped.


  Lance grinned. “Monkey business, eh? Is that what practicing medicine is called these days?”

  “Practicing medicine isn’t the business I was talking about. You know what I meant,” the older woman accused, wagging her finger at him.

  “As did you when I asked what you thought was going on,” Lance countered, not fazed by her good-natured fussing.

  The woman sighed and seemed to lose some of her gusto. “I’m not sure. My stomach has been hurting, but I just figured it was my constipation. Then today I saw that blood when I spit up, so I wasn’t sure what was going on and thought I’d better let Dr. Sanders check me.”

  “I’m glad you did.”

  “Me, too,” the woman admitted, looking every one of her eighty years and then a few. “I definitely feel better now than I did earlier. I think the oxygen is helping.”

  “Were you having a hard time breathing, Edith?”

  “Not really. I just felt like air was having trouble getting into my body.”

  More symptoms Edith had failed to mention.

  “Any weight gain?”

  “She was two pounds heavier than at her last office visit a couple of weeks ago,” McKenzie answered, knowing where his mind was going. “Her feet and ankles have one plus nonpitting edema and she says her wedding band,” which Edith had never stopped wearing after her husband’s death, “isn’t tighter than normal.”

  While Lance checked her over from head to toe, McKenzie logged in to the computer system and began charting her notes.

  “Chest is noisy.” Lance had obviously heard the extra sounds in Edith’s lungs, too. They were difficult to miss. “Let’s get a CT of her chest and maybe a D-dimer, too.”

  She’d already planned to order both.

  “I’ve added the chest CT and a BNP to her labs, and recommended proceeding with the D-dimer if her BNP is elevated.” McKenzie agreed with his suggestions. “Anything else you can think of?”

  He shook his head. “Maybe a sputum culture, just in case, but otherwise I think you’ve covered everything.”

  Not everything. With the human body there were so many little intricate things that could go wrong that it was impossible to cover every contingency. Especially in someone Edith’s age when things were already not working as efficiently.