“Kate!”
Kate glanced toward the sound, then back at the girl. “I’m Kate Callison, the emergency department director. That nurse is waiting for me, but I meant what I said just now. We’re here to help. With whatever you need. Go sign in at the registration desk. Tell them you spoke with me.”
“I have to go,” the girl said, backing away.
“But . . .”
As fast as she’d appeared, she was gone. Skirting the corner of the building, heading—
“Kate?”
The nurse in melon-pink scrubs held two Starbucks cups aloft, hot brews merging with cool sunrise in a fragrant cloud. Kate smiled, her uneasiness replaced by a rush of gratitude. ICU nurse Lauren Barclay was the only real friend she’d made in the months since she’d moved to Austin. Their prework coffees had become the best part of her day. Lately, the best part of anything.
“What do you think?” Lauren asked, glancing at the vacant visitors’ tables. “Sit out here?” She raised her brows, one of them disappearing beneath the flowered surgical cap she’d tied over her hair. Another attempt to tame the thick blonde mane, as wavy and long as Kate’s was dark and wispy-short. “I realize cool mornings are nothing special to a California girl,” she teased in the familiar drawl, “but in Houston, we’d call this a flat-out miracle.”
She handed Kate her coffee and settled onto a chair. “That poor mother was out there on the boulevard again. Did you see her?”
“Yes.” Kate winced. A young woman had been stationed at a busy intersection for two days now, holding a huge poster of a bright-eyed and chubby toddler. Below the photo, in heavy and uneven strokes of marking pen, she’d printed a heart-wrenching plea: Need money for my baby’s funeral.
“One of the cafeteria ladies said she’s from out of state. They were visiting here when the baby got sick. So sad.” Lauren peered at Kate over the top of her mocha. “How’d things go yesterday with the boss?”
Kate rolled her eyes at the reference to her meeting with the chief nursing officer. “I think Evelyn’s exact words went something like ‘Your team’s morale is sinking.’ She was being polite. It’s more like I’m captain of the Titanic and instead of a band playing, there’s one endless Willie Nelson CD.” She sighed. “I never intended to be interim director of the emergency department. It’s not what I applied for. And I had no idea I’d be stepping into the shoes of a saint.”
Lauren nodded. “Sunni’s disappearance has been hard on a lot of people. And if there really is new evidence, another search, and they find conclusive remains . . . I know you’re skeptical about it, but I do think the social worker’s right to present the critical incident stress information again. There’s been more staff coming to the chapel lately. Several from your team.”
“Hmm.” Kate knew her friend was talking about an informal fellowship she led for hospital personnel, designed as a support system. Fortunately she’d figured out there was no point pressuring Kate to join in. Fellowship and hand-holding were the farthest things from her mind.
“When’s that supposed to happen—the CISM refresher?” Lauren asked.
“At the staff meeting on Friday.” Kate watched as an elderly woman made her way toward the doors to the ER. She was accompanied by a man in a faded denim jacket. Tall, with broad shoulders, dark hair, and considerable beard shadow. Wearing cowboy boots, of course—apparently a state requirement.
Kate turned her attention back to Lauren. “It’s not that I’m exactly opposed to peer counseling or debriefing after a specific traumatic incident.” For some reason, she thought of the too-pale face of the girl she’d met in the shadows. “I think it may have some benefit in isolated cases.”
“But . . . ?”
“It’s been six months since Sunni disappeared. I’d be blind not to see how respected she was. I understand that her loss left a big hole. And I don’t kid myself that the things I’ve tried to do have helped much. But in my experience, dwelling on the past—resurrecting it—doesn’t help either. At some point, you have to steel yourself and move on.”
Lauren stared at her. “You’re not quitting?”
“No,” Kate said quickly, glad her new friend couldn’t know about her recent conversation with the travel nurse recruiter in Dallas. Lauren wouldn’t understand that a fallback plan was a necessity. Thankfully she’d never asked how long Kate had worked at Alamo Grace and, before that, the Mercy Hospital in San Jose or any of the other hospitals in California and elsewhere. Places where she’d joined the staff only to find that something didn’t fit, wasn’t quite right. Plan B was a lifeline for someone like Kate. “No, I’m not planning to resign. In spite of my teasing about big trucks and bigger belt buckles, churches on every corner—” Kate smiled—“and that there are actually places you can buy Texas-shaped tortilla chips, I like it here. It doesn’t make any sense, but it’s growing on me.”
Nuts as it seemed, it was true. Kate wouldn’t say this city felt like home—nothing ever had, including home—but . . . “Maybe it’s because Austin feels a little more like California.”
“Whoa, girl. Don’t say that out loud,” Lauren warned in a stage whisper. “You’ll be run out of town.” She checked her watch and stood. “We should head in.”
“Right.” Kate followed her toward the entrance to the ER. “I’ll probably be run out regardless. Interim director is a temporary position. No guarantees. I came in on the heels of a lawsuit against the hospital that’s still being settled. Patient-satisfaction surveys are at an all-time low. And last month I had to suspend that nurse.”
“For drugs—you had no choice.”
“The rumblings are that Sunni would have handled things with far more compassion. I’m working my tail off to prove myself, Lauren.” Kate plucked at her scrubs. “I wear these instead of a suit so I can pitch in alongside the staff. All shifts, I come in to see what I can do to help. Ask Vicky who offered to give that soapsuds enema she groused about. I even baked red velvet cupcakes for the last staff meeting. But . . .”
She looked toward the doors of the department. The man in the denim jacket was standing there, using his cell phone. He glanced up as they approached.
Kate lowered her voice. “My performance review is coming up. At this point, only one of the full-time clinical coordinators supports me. I can probably count on a few of the docs to put in a good word. But if I want to stay, I’ve got to make a breakthrough with my nursing staff. Get them behind me somehow. Any way I can. Or at least prevent any more ugly PR catastrophes from happen—”
“Nurse!” A man from the waiting room forced his weight against the half-open automatic door. He gestured at them wildly. “Hurry! We need help in here!”
“I’ve got the door,” the man in denim said, hitting the button to open it fully. Kate lunged into the waiting room with Lauren following. People were on their feet, shouting.
“Let them through!” the man in the denim jacket ordered, forging past Kate to clear the way. What was going on?
“Over there,” someone pleaded, grabbing at Kate’s arm. “That janitor—something’s wrong. Please hurry.”
Lauren pointed toward the far side of the room: a hospital janitor stood against the wall, eyes wild and face as gray as his uniform shirt. In his quaking hands were wads of blood-soaked paper towels.
Laceration? Bleeding ulcer? Mind whirling, Kate wedged through the space created by the man in denim, Lauren close behind.
“It’s a baby,” the janitor moaned, staggering toward them, his face even paler. “It was on the floor . . . the hallway bathroom. Oh . . . help . . .”
Kate’s heart climbed to her throat. No . . .
“He’s gonna pass out!” A woman’s shout rose above a frenzy of panicked voices. “Somebody catch him! Don’t let him drop that poor—”
Kate lurched forward a split second too late.
The janitor’s legs gave way. In his last conscious effort, he thrust the tiny, motionless newborn into the denim cowboy’s arms.
“I’M AN EMT. Show me where to go,” Wes said, feeling the impossibly fragile weight in his hands. The look in the eyes of the dark-haired nurse confirmed his thoughts: No time for protocols or even a pass off. The only hope was to start running.
“To the code room. Follow me.”
In seconds there was an open door, a flurry of scrubs beyond, and then a doctor jogging alongside Wes down the corridor toward the ER.
Overhead, a page blared. “Code purple, ER. . . . Code purple, ER. . . .”
Beige walls, yellowed vinyl floor—Wes’s boots thudded down the hallway toward the resuscitation room, a short distance made agonizing by the stillness of the tiny body in his hands. He tried to tell himself it didn’t feel cold through the sticky and congealing paper towels; he wanted to believe there was a gurgle, a gasp, a barely discernible shudder. Please, don’t let this baby be lost.
He dove through the doorway to the code room, met immediately by lights, a hiss of oxygen, beeping machines, a chorus of voices—some giving orders, some asking questions—all of them focused on the bundle in his hands.
“Put the baby here,” the dark-haired nurse instructed, and all at once Wes’s hands were empty. He stepped back. Before a sea of multicolored scrubs filled the void, he managed to get a glimpse of the infant he’d carried into the room. A boy, achingly small. Hair and scalp still covered with membrane. Eyes closed, tiny lips parted, limbs fragile and limp, skin . . . too blue.
In an instant, a translucent resuscitation mask covered the infant’s face. The dark-haired nurse’s gloved hands slid beneath his tiny body, her thumbs over his breastbone, ready to start cardiac compressions. Wes tilted his head and caught a look at the young woman. Short hair, waiflike features, big eyes. Yet despite the fact that she’d run down the hall ahead of him, her face looked pale and her expression almost—
“Sir, this way, please.” A man in a security uniform gestured to Wes. “I’ll show you where you can wash up; then I’ll need you to return to the waiting room.”
Before Wes turned, the nurse glanced his way and their eyes met. The expression in hers was more than professionally focused and intense. It seemed . . . grief-stricken.
- + -
“Wait.” The neonatologist slid his stethoscope beneath Kate’s hands. “There’s no brachial pulse. Let me listen. He’s extremely preterm. Do we have any estimate on the time of birth?”
“No.” Kate struggled against a wave of dizziness. “The janitor found him on the bathroom floor.” She glanced at the clock. “It’s been less than five minutes since then . . .”
“Here, let me,” a NICU nurse offered, stepping close to relieve Kate. Someone else moved in with an Isolette.
Kate watched the physician’s face, her stomach sinking when he frowned.
“No heart tones.” He nodded as a nurse offered him the equipment for an umbilical line. “Start compressions. We’ll need a dose of epi. Let’s tube him, oxygenate him—get him warm. Give him a reasonable trial. I’ll always try, but . . .” He looked at Kate. “No sign of the mother?”
“No, sir,” the chief of security reported from the doorway. “We’re watching the doors, doing an in-house check, OB and all the floors. PD’s been notified.” He looked at Kate. “They’ll want to talk to the ER staff that has been here. In case they saw her. We shouldn’t let anyone go off shift.”
“Of course,” Kate agreed, her voice emerging in a thick whisper. “I need to talk with the triage nurse myself.” To see if that laboring woman was signed in as an ER patient and didn’t get care in time. Don’t let it be true.
“I’ll go do that now.” She forced herself to leave the code room, knowing the infant was receiving the best care possible. As department director, Kate’s responsibilities were elsewhere. She should check on the janitor who fainted; Lauren was with him. Make sure the other patients were still being taken care of. And then she’d talk with the registration clerks and triage. But first . . .
Kate groaned softly. First, she needed to step away from here. Only for a minute. To get some air, stop herself from shaking. And . . . oh, please. To stop thinking of that baby boy’s face, imagining his mother’s anguish as she wrapped him in a nest of paper towels. Because if Kate didn’t stop, the next step would be to start remembering the details of her own lonely moment of desperation. Merciless pain and guilt would flood back. She’d worked too hard, come too far, to risk having that shameful darkness swirl again.
- + -
“Such a shame on all counts.” Cynthia McConnell dropped a crumpled butterscotch wrapper on her desktop and looked up at Wes. The social worker’s expression said she was already weighing the emotional impact Baby Doe’s death might have on emergency department staff.
“Want to bet how long it takes the media to start swarming?” Wes knew his question sounded bitter, but the blame game would soon begin. The hospital staff would become a target. Fingers pointing like they had at that Dallas search-and-rescue team during a high-profile murder last spring. Unpaid, dedicated volunteers accused of incompetence and shredded on the witness stand by attorneys for the defense. It had left Wes more than a little wary of lawyers. “If the emergency department staff wasn’t already stressed by Sunni’s case, this could do it.”
“I’ve asked Lauren Barclay from the ICU to do some one-on-one contacts with staff. She’s been recently trained as a peer counselor.”
Wes nodded. “I co-taught that class.”
“She feels her limited involvement this morning won’t keep her from being objective.” Cynthia’s eyes showed concern. “It had to be tough when the janitor gave you that baby.”
“I’m okay.” Wes knew the social worker was taking his emotional pulse. He scraped a hand over his beard growth, remembering the weight of that tiny body in his hands. And then thought of his relief at finding Amelia Braxton alive just before dawn. Found . . . lost. Barely 9 a.m. and it had been a full day already.
“It was a shock,” he continued, knowing Cynthia needed to hear more. The “I’m okay” badge of courage was brandished too quickly by first responders and medical personnel. It led to stress and serious burnout. “There wasn’t much I could do but run him to the code room. I’m glad I could.”
“I’m glad too, Wes.” There was kindness in the social worker’s eyes. “And then?”
“I was only there a few seconds but long enough to see he was going to need all the help that team could offer.” He shifted in his chair. “We’ll go ahead with the presentation we have planned for the staff meeting?”
“Depending on Lauren’s concerns after talking with staff individually, we’ll either offer a brief review of critical stress management or do a specific debriefing of the Baby Doe incident. Either way, the goal will be to bolster these folks’ coping skills. They’ve had some problems in the past six months that have sort of . . .” She hesitated as if carefully choosing her words. “Shaken their sense of teamwork. That’s why I’m especially glad that you’ll be helping me with the presentation.” Cynthia smiled. “I happen to know that team is your middle name, Mr. Tanner.”
Wes smiled back at her, recalling what he’d said to Gabe. “For a funeral director, a latte maker, a well digger, and a dog that still smells of last month’s skunk chase, we didn’t do half-bad.” Gratitude warmed him. He was proud of his team.
“So—” Cynthia checked her watch—“I’ll give you a call after I touch base with Lauren and the emergency department director.”
“Who did they finally hire for that position?” Wes stood, reaching for a butterscotch.
“A nurse from Alamo Grace, via California. Kate Callison. You probably saw her this morning. Late twenties, petite, short brunette hair?”
“Ah, right.” And sad eyes.
- + -
Kate glanced at the trio of police cruisers in the parking lot, then shot Lauren a pained look across the pebbled visitors’ table. “If I cut and run—right now, real fast—will you cover for me?”
&nbs
p; Lauren held out a peanut butter cookie. “Eat something first.” She waited until Kate finally took it. “Rough morning.”
“Rough? Rough was finding that first scorpion in my shower or being compared to Sunni Sprague every single day. And finding that note on my car: ‘Go back, California Girl.’ Today makes rough look like a picnic.” Kate shook her head, the events of the last two hours choking like her first taste of Texas humidity. “You saw our back hallway. Crime tape across the bathroom. Police uniforms outnumbering scrubs. They dusted for prints, questioned my staff, and took the tapes from the security cameras.”
“I heard they asked for the name of every patient who sat in the waiting room during the night. To see if anyone could identify the mother of the baby.”
“Yes. As if we didn’t have privacy laws to consider.” Kate groaned under her breath, knowing she’d be talking to the Lyon firm, the hospital’s lawyers. “And—” Kate fought a shiver despite the sun on her shoulders—“as if what happened in there wasn’t completely awful enough to deal with the first time around.”
Lauren was quiet for a long moment, the distant sounds of traffic on Ben White Boulevard filling the void. She brushed cookie crumbs from her lips. “It was awful. And it happened so fast. When did you realize what the janitor was holding?”
“I saw those paper towels and how pale Albert’s face was. I thought he’d cut his hand somehow. Or was having a gastric bleed. When he said baby, I didn’t think I heard it right; then he started to faint and that man was there catching the baby.” Kate stopped, stared at Lauren. “Hold on. Are you interviewing me? Did the social worker ask you to do that?”
“No.” Lauren swiped at a wavy strand of her rebel hair. “Not specifically. I did talk to the night nurses, registration clerks, and poor Albert. I’m a peer counselor; that’s what we do.” She smiled at Kate, sincerity in her expression. “I’m here now because you’re my friend, Kate. I care how you feel.”
Kate regretted that she’d sounded so accusing. “Thank you. I know that. I guess right now I feel like I just want things back to normal. Such as that is.”
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