by Laura Iding
There was a long pause as Luke stared at her, as if he might offer to take over for Debbie. But he didn’t. He simply nodded and stepped back. “Good. That’s good.” Luke glanced down when his pager went off. “Blasted thing,” he muttered. “Sorry, I have to go, but I’ll talk to you later.”
“Sure.” She fell silent as he hurried away, trying to stifle an acute stab of disappointment. Luke wasn’t obligated to do anything he didn’t want to. She didn’t have a right to depend on him.
She squared her shoulders. She’d be much better off to remain independent and self-supporting.
If only that didn’t sound so lonely.
“Dr. Hamilton? I think you’d better come and look at this guy in room twelve. He just came back from Radiology where they placed a right subclavian central line and the right side of his face and chest is puffy.”
Luke crossed over to the bedside. His pulse skipped several beats when he saw the patient, Mr. Albert, with his face swollen like a balloon.
“Get me the largest needle you can find,” Luke ordered. “Hurry!”
“What’s going on?” Caryn entered the room.
The nurse, Anna, was haphazardly digging through the supply cabinet. “He needs a needle.”
“Use this fourteen-gauge.” Caryn plucked it from the pile and handed it to him, along with a syringe.
“Thanks.” He took a deep breath, then counted Mr. Albert’s ribs as best as he could with the air trapped underneath and then quickly inserted the needle between the fourth and fifth intercostal space. The man flinched and a loud hissing sound filled the room.
“It worked.” Caryn glanced up at the monitor over Mr. Albert’s bed. “Did anyone check if he has a pulse with that heart rhythm?”
“I didn’t think of that,” Anna said in a sheepish tone. “I just couldn’t believe how his face was growing puffy, swelling up right before my eyes.”
Luke put his fingers on the patient’s carotid artery, waiting until he felt the reassuring beat of his pulse, then nodded. “Thankfully, he has a pulse now, but you’d better check his blood pressure.”
“Still a bit on the low side, at 88 over 56.” Anna glanced at him. “He doesn’t have another line, so we can’t start any vasopressors until he has a new line placed.”
Luke clenched his jaw at the latest problem but remained calm. “First I need to put a larger chest tube in. Can you find me a chest tube insertion tray?”
“Yes, I’ll get it.” Caryn left the room.
His stomach cramped but he did his best to ignore it as he grabbed some antiseptic solution from the cart and began to prep the skin of Mr. Albert’s chest around the fourteen-gauge needle. A bead of sweat slid down the center of his back and he suspected he was running a fever. Hopefully no one would notice.
“I have the tray.” Caryn set it on a nearby table and began to unwrap the sterile drapes around the tray, while keeping the contents sterile.
“Thanks.” He pulled on a cap, mask, sterile gown and sterile gloves then reached for the sterile drapes in the tray. He carefully placed them around the planned insertion site and then reached for the needle and syringe pre-filled with lidocaine so he could numb the skin. Once he’d accomplished that, he picked up the scalpel and hesitated. There was a fine tremor in his hand, and he wanted to think it was from the fever rather than nerves.
Taking a deep breath, as much as he could through his sterile mask, he used the scalpel to incise a small area right below the needle. Sweat dampened his forehead beneath the surgical cap.
“Are you all right?” Caryn frowned. “You look flushed, as if you’re running a fever.”
“I’m fine.” He concentrated on making a one-inch opening then used the trochanter to insert the large chest tube between the ribs. Ever since the on-call resident had gotten him out of bed to help with Mrs. Webster’s delivery, his stomach had been getting progressively worse. But he didn’t have time to be sick so he did his best to ignore the cramping pain. Once he had the chest tube in place, he glanced at Caryn. “Do you have a water-seal hook-up for me?”
“Right here.” Caryn hung the chest-tube container from the end of the bed, then held out the end he’d need to connect to the chest tube.
“Why did Radiology put this line in?” he asked as he made the connection and then grabbed a suture to secure the chest tube so it wouldn’t become dislodged.
“We didn’t know how long you were going to be tied up in the delivery and his other line clotted off,” Anna responded from her position on the other side of the bed. “He needed antibiotics so the resident decided to call Radiology for help.” Anna flashed him a chagrined look. “Was that wrong?”
“No, it wasn’t wrong.” They didn’t routinely send their patients to Radiology for line placements, but there had been nothing normal about the circumstances over the past twenty-four hours. He honestly couldn’t blame the resident for making the best decision he could at the time. Better to send the patient to Radiology than to try to put the line in himself without proper supervision.
If he went home sick, the residents would have no supervision.
“You really don’t look very good.” Caryn’s brow was pulled together in a frown.
He avoided her gaze, suspecting she’d be able to tell he was lying. “Too much adrenaline from the delivery.” He finished with the chest tube then stripped off his gown and mask. “Now he needs another central line.”
“Why don’t you have one of the residents do it?” Caryn said in a low tone. “You can supervise.”
She was absolutely right, he thought in relief. “Good idea. Help him set up for the procedure, would you? I’ll be right back.”
He left the unit at what he thought was an unhurried walk, considering how badly he wanted to run. But when he returned from the bathroom, Caryn met him outside Mr. Albert’s room.
“Hold it.” She grabbed his arm. It was a sign how weak he felt when he wanted to gather her close and lean on her for support. “Look at me.”
Doing as she’d asked, he steeled himself to meet her gaze.
She sucked in a swift breath, seeing right through him to the truth. “Oh, no. You’re sick with Crypto, too, aren’t you?”
“Stay away from me,” Luke warned, trying to shake her hand off. Despite his best efforts, she only tightened her grip. Stubborn woman. “I’m contagious. I don’t want you to get sick, too.”
“You need to call someone in to cover you.” She frowned. “Actually, now that I think about it, where in the heck is Mitch? I’m surprised he’s not here with everything that’s been going on.”
“He’s sick, too.” Luke swiped his forehead with the back of his arm. “There isn’t anyone else to cover. Mitch was making phone calls yesterday but everyone he called was also sick.”
Her eyes widened. “I had no idea things were so bad.”
They weren’t that bad. Yet.
“Let me grab that chair over there for you.” Before he could stop her, she darted away then returned, dragging a chair.
“Thanks, but I won’t be able to watch the procedure if I sit.” The patient lying in the bed was at a much higher level than the seat of the chair.
She scoffed. “He’s not even close to the part you need to watch. Sit down.” She pushed him into the chair and he sat. Or maybe his knees buckled. “I’ll gown up and make sure he doesn’t contaminate anything. When we get to the part where he needs to cannulate the vein, I’ll let you know so you can watch.”
Luke wished he didn’t feel as weak as Mary Webster’s baby as he leaned back in the chair. As soon as this line was placed and Mr. Albert’s care was under control, he’d go back to see how Mary was doing.
Another cramp hit him and he realized he couldn’t keep ignoring his illness. Antibiotics weren’t normally needed for healthy patients with Crypto but as he was there alone, he thought maybe his case would be an exception. If he took several doses of antibiotics, he might be able to continue working. Struggling to his feet, he
crossed to the nearest phone, keeping his voice down as he requested medication from the pharmacy. The pharmacist didn’t argue.
“I’ll send some up, but we’re running low on supplies. We’re expecting a special shipment later today, though.”
That’s right, today was Sunday. The days were blurring together as if they were one continuous never-ending shift. He glanced at his watch—it was almost eight o’clock in the morning. “I can wait for the new shipment if you need the medication for our hospitalized patients. What time are you expecting it to arrive?”
“Not until noon.” The pharmacist sounded apologetic. “There’s a huge demand for the stuff throughout the city.”
Yeah, no joke. He swallowed hard, not sure he’d be able to wait until noon. “Are you sure you have enough to spare?”
“Yes, we should have enough.”
The pharmacist didn’t exactly sound sure, but he wasn’t going to keep arguing. “I’ll take it, then, thanks.”
He waited for the medication to arrive via the pneumatic tube system then gulped it down with filtered water. When he returned to Mr. Albert’s room, Caryn and the resident were ready for him.
“All right, show me your landmarks.” He talked the resident through the procedure and thankfully this time the line went in without difficulty.
“Get a chest X-ray to verify placement,” Luke ordered. “And clean up the mess, especially making sure you find every one of your sharps. The nurses have more important things to do than to clean up after you.”
Caryn shot him a surprised look then covered a quick grin. He stared at her, remembering how beautiful she’d looked, like Sleeping Beauty, in his arms. Despite feeling like he’d been leveled by an eighteen-wheeler, his body tightened at the mere thought of holding her again.
His smile faded. He hoped to heaven he hadn’t exposed her to Crypto during their brief time together in his call room. Because if he had, he’d never forgive himself for making her sick.
And potentially risking her unborn baby.
Caryn was exhausted by the time her second twelve-hour shift was over. Never in her whole life had she worked so hard for so long.
The entire unit had handled one crisis after another until they’d finally gotten things under control.
She glanced around the unit, looking for Luke, wondering where he’d gone. She hadn’t seen him for the past couple of hours, although she knew the poor guy had been making frequent trips to the bathroom.
“Anna, have you seen Dr. Hamilton lately?” she asked.
“Not since one of the residents took him down to the ED,” Anna said in a vague tone.
What? “He was taken to the ED? You mean like a patient?” How had she missed that?
“Yeah. I’m sure he’ll be fine after a couple of liters of fluid.” Anna shrugged and walked off.
Caryn left the unit and took the elevator straight down to the emergency department. The place looked as chaotic as the ICU had been. She waylaid one of the ED nurses before she could rush past. “Do you still have Dr. Luke Hamilton down here?”
“No, we gave him two liters of IV fluids then discharged him.”
“Thanks for letting me know.” Caryn turned and left, wondering where Luke had gone. She headed down to her assigned call room, her steps slowing as she passed his door.
Shouldn’t someone make sure he’s all right? She lifted her hand and knocked. “Luke?” she called in a low tone. “Are you in there?”
Putting her ear to the door, she listened but didn’t hear any response. She tried the doorhandle but the door was locked.
Was he even in there? Or had the ED sent him home? She knocked again, but after waiting a few minutes without a response made her way down the hall to her own room.
Maybe he had been sent home. Being sick with Crypto was no picnic. No doubt he felt awful. She couldn’t blame him for wanting nothing more than to go home.
Silly to be disappointed that he hadn’t found her to say goodbye.
CHAPTER TEN
CARYN was glad that early on Monday afternoon the hospital administration at Trinity Medical Center declared the Cryptosporidium emergency officially over. Nursing staff infected with the bug were already bouncing back from the city-wide epidemic, and the hospital had gone from a record high of 248 sick calls over three days down to 31.
The staff nurses who’d been at the hospital during the emergency were allowed to go home, although they were all asked to be on call should the need arise. Luckily, many nurses had responded to the crisis and those who lived outside Milwaukee had come in to lighten the burden on the remaining staff.
Caryn left the hospital without having seen Luke since the day before. An attending physician, Dr. Billar, had shown up to replace Mitch, quickly taking control of the residents in the unit. Twice Caryn had picked up the phone to page Luke, but had then set the phone back down, figuring he wouldn’t have his pager turned on if he was sick. She didn’t know his home phone number and was too embarrassed to ask.
Since he hadn’t made a point of talking to her before he’d left, she figured he didn’t want her interfering anyway. That fact didn’t stop her from imagining Luke lying at home in bed too sick to move. Was he able to eat? Keep fluids down?
She hoped so.
The only good thing about being stuck at the hospital during the Crypto crisis was that she’d be paid for the entire time she’d been there, even the time she’d technically been off duty. The overtime she’d racked up would come in very handy in paying off the second mortgage David had spent.
The sun was shining and the temperature was warming up nicely when she drove home. Spring had finally hit Milwaukee and she liked seeing the tiny buds opening up on the trees. The delicate scent of apple blossom was in the air and she took a deep breath then sneezed when pollen tickled her nose.
She walked into her small house, feeling as if she’d been gone for weeks instead of a few days. Everything was just as she’d left it, including the half-open bags of hand-me-down maternity clothes courtesy of Debbie and Renee.
Idly, she wondered how David was doing. No doubt Debbie expected her to show up at the neuro-rehab center to see him, but she just couldn’t do it. The reminder of David’s family made her sink into her sofa, burying her face in her hands.
How long? How much longer would she have to pretend to feel something she didn’t? How long before she could tell David’s family the truth?
David had been seriously injured and, no matter how strained their relationship had been, she surely owed the father of her child something? She’d been far more worried about Luke, who could take care of himself, or at the very least pick up a phone to call for help. David couldn’t do anything.
She should visit, if only for the sake of his family. And she would. But not yet. After being at work for over forty-eight hours straight, she deserved a little down time. At least she’d been granted three consecutive days off from work, despite being placed on call, which would give her plenty of time to relax.
To face David’s family.
To gather enough strength to keep from blurting the truth.
To think about Luke and wonder if they really teetered on the verge of a relationship or if her overactive imagination had caused her to see something that wasn’t there?
On Wednesday Dana dragged Caryn out shopping. Even though she couldn’t afford to spend any money, Caryn didn’t mind tagging along. People-watching at the mall was always fun.
“Be thankful you didn’t get Crypto,” Dana said as they walked into the Grand Avenue Mall located in downtown Milwaukee. “I can’t believe how sick Mitch and I were.”
“Has Mitch heard from Luke?” Caryn asked, keeping her tone casual. “I know he was sick, too.”
“Yeah, he’s feeling better.” Dana frowned as they stopped at a dress shop. “I have to find a dress for this weekend. Mitch wants me to go with him to a fundraiser sponsored by Trinity Medical Center.”
“So what’s wrong with th
at?” Caryn asked, trying not to be depressed while eyeing dresses she wouldn’t fit into for a long time. “Sounds like fun.”
Dana wrinkled her nose. “They’re not really. Too much mingling and chatting.”
Caryn pulled out a black dress slit down to the navel. “Bet Mitch would like this one,” she teased.
Dana rolled her eyes. “Oh, please, don’t give him any ideas.”
Grinning, she put it back on the rack. A few minutes later another woman entered the store and picked up the same risqué dress, going straight to the dressing room to try it on.
Caryn looked at Dana and they both burst out laughing.
“I have to say, Caryn, you seem so much happier without David.”
She glanced at Dana in surprise. “Really?”
Dana nodded. “I never liked him much,” she confided. “You were too good for him.”
Knowing that her friends had sensed her misery made her sigh. She should have confided in them a long time ago. “David had…a lot of problems.” The middle of a dress shop wasn’t the place to go into detail.
“I suspected as much. But it doesn’t matter now. You’re better off without him.” Dana held a royal blue dress in front of her. “What do you think?”
“I like it. Try it on,” she urged.
Dana added it to a growing pile slung over her arm.
A maternity store across the way caught Caryn’s eye and as it seemed Dana would be a while, she murmured, “I’ll be right back.”
Drawn by the display in the window, she left Dana with her armful of dresses and crossed over to the small store. She felt silly even looking, considering she didn’t need clothes. Debbie and Renee had given her more than enough things to wear.
Except the clothes in the store were beautiful, flattering in a way that emphasized a woman’s pregnancy, celebrating it. For a moment she remembered Luke telling her she was a total turn-on and she blushed, thinking that she’d feel sexy in some of these items, which were far more stylish than the older clothes that had been donated to her.