And he was watching me! His scrutiny made me uncomfortable, but I am a weak woman, and the second glance from him was as tangible as a touch.
From: [email protected]
To: [email protected]
I wouldn't fuss over the Dr. John thing. Sounds like U can use a friend. As for Dan, U need to set some boundaries, sister. Dan is changing the rules and U shouldn't put up with it. Sure, Montana is beautiful, but so is Seattle. Do U really think U'd manage to survive there? BTW I'm probably going to be moving up there. Lost my job here. Boss was a jerk, so it's all good. So U have to move back, little sis. Be like old times again.
From: [email protected]
To: [email protected]
I don't know what I want anymore, Terra. Josie, my last friend from Seattle, hasn't been returning my calls or my e-mails. I feel like I'm slowly losing my identity, my husband, my family. I'm getting confused. Dan and I have been living past each other the past few days. Judy called—said she was sorry I missed the party. I felt bad for letting her down. Gloria phoned too. Said she had forgotten to tell me about the party. Said she was sorry. I felt like hanging up on her.
Chapter Thirteen
Roberta just called. She's going to be about half an hour late. Had another emergency at home,” Arlene said, leaning against the partition that gave me some privacy from the rest of the ward.
I felt a stab of annoyance with Roberta but knew that it could as easily have been me trying to find a babysitter.
“Lucky for her, things are pretty quiet for a Friday night,” Arlene continued.
I looked up at the receptionist, horrified. “Are you asking for trouble?”
Arlene shot me a puzzled look.
“You never, never say that out loud.” I gave her a stern look, hoping that by warning her I had possibly staved off disaster. The same thought had crept around the edges of my mind, taunting it, but I knew better than to give it even a whisper of attention for fear it would create its own energy. “Every time someone says that, things go haywire.”
She laughed. “Sorry. I was just making conversation.”
I was about to reply, when I heard the roar of a car pulling up to the entrance, tires screeching and horn blasting.
“Like I said,” I muttered as she left to see what the problem was. I got up to prep a room just as the doors swooshed open and the unbridled sobbing of three teenage girls filled the entrance. I couldn't help the faint uptick of my heart, the little adrenaline rush that prepared me to face this so-far unknown.
“She's not talking. She's really sick,” I heard the girls wail.
I strode quickly out to the reception area and repressed a sigh at the typical Friday-night sight that greeted me.
A boy who didn't look old enough to drive half-carried, half-pulled a young girl whose long blonde hair hung in a stringy mat over her face. Her head hung almost to her stomach; her bare feet dragged over the floor. She wore standard-issue low-cut blue jeans and a skimpy T-shirt, her clothing almost identical to that of her two friends, who were sobbing and hugging each other.
The sour stench of regurgitated alcohol and food rolled ahead of her, and I tried not to sigh. I could handle blood a lot better than vomit.
Arlene glanced up at me. “Guess you've got work to do. I've paged Dr. John. He'll be here right away.” Arlene called one of the girls aside to get what information she could. Her next step was the unenviable job of calling the young girl's parents.
The young man turned to me, desperation in his eyes. “I don't know what happened. We were at a party.”
I glanced at the girl's stained blue jeans, the vomit streaking her T-shirt and clothes. And as I brushed her hair aside, my heart skipped its next beat.
Tabitha. Dan's niece and Gloria's pride and joy.
Her pert little face and beautiful shining hair were smeared with dirt and vomit, her head lolling to one side, like a doll with a broken neck.
“What's your name?” I asked the boy.
“Deke,” he answered.
“Help me get her on this bed, Deke.” I glanced over at the hysterical girls and chose the most lucid one. “You come with me. The rest of you go back to the reception area.”
“She's not going to die, is she?” the other girl sobbed, weaving as she stood.
“Go wait in reception,” I snapped. I didn't have time for hand-holding.
Once we got Tabitha into bed, I propped her up so she wouldn't choke, then brushed her sticky hair away from her mouth and checked her breathing.
“What happened?” I asked Deke as I pulled open both eyelids. Pupils normally dilated, thank goodness. I slipped up her sleeve to check her blood pressure. Her icy skin made my own heart rate jump. Possible hypothermia. I needed to start an IV, but I needed more information first.
To my surprise, my hands were trembling as I pressed the button to inflate the b.p. cuff. I had never had to work on someone I knew so well, and it created an extra tension.
“We were at a party and then, well… I don't know,” his voice trailed off, guilt emanating from him in waves.
“You do know. Tell me.” My don't-mess-with-me nurse voice was colored with an edge of ticked-off-auntie.
“Well, we had some liquor there.”
“How much did she have to drink?” I asked, my glance ticking from Deke to the girl. “Did she have any drugs?”
“Do you remember, Cassie?” Deke asked the girl, who steadfastly refused to look at me.
“Don't mess with me, kids,” I said sternly as the machine read off her b.p. I clipped an oxymeter to her finger and turned back to Cassie. “I don't care what you did. I'm not going to report you to the police, but I need to know exactly what happened so that I do the right thing for Tabitha. We don't have a lot of time here.”
Cassie turned wide eyes to me. “Are you going to tell my mom?”
“Right now that's not important. What else did Tabitha have to drink?”
I glanced at the monitor. Steady and normal. Heart rate slightly decreased.
“No drugs. Right, Cassie? She didn't have any drugs. And she only downed one cooler. I swear.”
“Don't swear—tell the truth,” I said as I glanced down at Tabitha, hating the way she smelled and looked.
The scenario was so cheap. So common. “She had way more than one cooler,” I said.
“Okay. Maybe it was more,” Deke relented. I started a chart, scribbled a few notes.
Standing orders in this case were to start an IV to rehydrate and dilute the alcohol, so I prepped the site and started the drip. Cassie wavered at the sight.
I checked Tabitha's oxygen levels, her heart rate, put my hand to her cheek as I double-checked her physical appearance. “How much more and how quickly did she drink it?” I pressed as soon as I got Tabitha hooked up. I caught another quick consultation between Deke and Cassie and resisted the urge to grab the young girl by the shirt and shake the information out of her. My niece lay on the bed between us, with who knows what kind of alcohol cocktail spinning through her veins, and these two were trying to protect themselves.
But if I pushed too hard, they would clam up, and if Tabitha had taken drugs, this would be a whole different scenario. I doubted it, based on her appearance, but it was too early to rule anything out.
Deke started. “She might have had a couple of coolers. I think.” Another quick “cover-for-me” glance to Cassie.
“And some Jack Daniel's,” Cassie added sullenly.
I heard Dr. John's welcome voice, then he whisked the curtain aside. He glanced at Tabitha, then at Cassie and Deke. Now that the doctor was here, the atmosphere became more serious.
“How long has she been like this?” Dr. John asked, glancing at the chart, then stepping between Deke and the bed to have a closer look at Tabitha. He took a moment to glance at me. Smile. I felt a flush of warmth, then pulled myself back. Focus.
I gave a succinct rundown of what I already knew and how Tabitha was responding, my voice cl
ipped as I struggled with my anger with these kids.
My niece reeked of alcohol and bodily fluids, and I wanted nothing more than to strip her down and wash her up. Clean away the filth that dirtied her body and my image of her. But we had procedures to follow, and we still had to get what information we could from these teenagers.
“Has Arlene contacted her parents yet?”
“I believe so.” How often had I wondered what kind of parents would let their kids go wild like this? Even after I met the parents, their protestations of their child never having done something like this before would, at times, strike me as false or naïve in the extreme.
But now I saw what kind of parents Tabitha had. I'm sure Gerrit and Gloria did their best. They probably didn't know every detail of her life.
Dr. John examined her, then scribbled some orders on the chart. “I'd like to keep her overnight. I'm concerned about her alcohol level.”
I adjusted Tabitha's shirt, pulling it up around her shoulder. Sweet, loving Tabitha who happily carted my kids around had been hanging around with a guy who reeked of alcohol himself, sporting a ring in his eyebrow and a tattoo on his neck, gravity fighting with his skinny hips for his baggy blue jeans, his T-shirt ripped and stained.
What would Gloria think?
I felt a flash of guilt and shame for her. Getting blindingly drunk with Deke and Cassie on a Friday night was hardly on Gloria's wish list for her daughter.
“You kids should go,” Dr. John said as he signed off the orders on the chart. Then he caught Deke by the shoulder. “Don't even think about driving, kiddo. You smell like you're way over the limit.”
“I only had a couple of beers…” His gaze flicked toward me, then back at Dr. John and held up his hands in surrender. “Okay, okay. I'll get a cab.”
Dr. John sighed. “Fourteen. What possesses these kids to be so incredibly dumb?”
I wanted to defend Tabitha. To explain how sweet and sensible she could be.
“We'll keep her overnight.” He stripped off his gloves and glanced at Tabitha and sighed heavily. “I'm sure Gloria is not going to be impressed.” I got a conspiratorial look and as he passed, a faint brush of his warm hand over my back, right between my shoulder blades. “Thanks, Leslie,” he said quietly, his hand coming to rest on my shoulder. “I'm beat and I'm heading home. Dr. Williams is on call the rest of the night.” He smiled at me, tightened his hand. “I'll see you tomorrow.”
I swallowed at the promise in his voice and couldn't help a quick glance over my shoulder as he left. He was looking at me as well. A flush warmed my face as I turned back to the work at hand.
I got a basin of warm water and started cleaning what I could of Tabitha's face. Other than monitoring her vital signs and keeping her hydrated to dilute the alcohol, there wasn't much else we could do. Arlene would notify one of the ward nurses to come and get her, but for now I wanted to get her clean. To remove the mess that coagulated on her face. I didn't want the ward nurses seeing my niece like this.
Normally I wouldn't know the kids who came in like this at night. Normally I would clean up and when I got home, tell Dan how incredibly stupid some kids would be.
Could I tell him about tonight?
I did what I could, then stayed by her side, doing my charting while I waited for the ward nurses. I didn't want to leave her alone, and so far no one else needed my help.
Then a sound of hurrying feet and I heard someone call out, “Where's my girl? Where's Tabitha?”
I stepped outside of the cubicle and came face-to-face with Gloria. She blanched, stared at me a moment, then rushed past me to her daughter.
I decided to give them a few moments' peace and returned to my desk. I felt surreal as I made notations I'd made countless times before. But the person I wrote the information on wasn't an unknown person I could create my own scenarios around. This was a sweet young girl who sang in church, who had a cute smile and a cheerful attitude. This was my niece.
“Leslie,” Arlene popped her head over my desk, her face flushed. “Got a lady here with chest pain.”
I ran to the reception area in time to see a young woman supporting an older woman who had her hand pressed against her chest.
“It's my mother. She's been complaining about her chest,” the younger woman said, her frantic gaze flickering from me to Arlene.
I felt an uptick of adrenaline. Possible heart attack?
“I'll need you to answer some questions,” the clerk said to the younger woman, pulling her aside to the admissions desk. I grabbed a wheelchair and put the older woman in it. I recognized her as the woman who had the auction.
“Dr. Williams is on call now. Get him right away,” I said to Arlene. “Then get the lab. I'll need an ECG stat and a cardiacworkup.” I left Arlene still asking some questions of the younger woman.
As I wheeled toward the trauma room, the usual questions came back to me like riding a bike.
“When did the pain start, Mrs.—”
“Harris. Margaret Harris. I was, well…” She hesitated as I helped her into bed.
“Were you working? Resting?”
“I was getting up to get some coffee.”
“How did it feel?”
“Like a cow landed on my chest.” She stopped. Breathed again, as if making sure she still could. “I couldn't get any air. My left arm tingled. I thought I was going to throw up.” Another grimace of pain flitted over her face.
Sounded like classic cardiac symptoms. While I went through the automatic questions about her allergies and medical and family history, my mind scrambled.
OIL—Oxygen,Intravenous,Leads. OIL. The acronym I'd memorized long ago beat an insistent rhythm in my mind as I put her in bed and elevated her to a semi-seated position. I slipped on the O2 mask, high flow, attached her to the vital-signs monitor and cardiac monitor from the crash cart. Too much to do, not enough hands, I thought as I pulled in a breath, slowing myself down. OIL. Intravenous. Where was Dr. Williams?
Nice veins.
Focus, Leslie, focus. I slipped the cannula in. Nice and smooth, taped it down and adjusted the flow. My mind ticked over my list again. Oxygen. Check. Intravenous. Check. Leads. Check and check.
I scribbled a few quick notes on a clipboard on the crash cart as a lab tech came. I turned my attention back to Mrs. Harris.
“On a scale of one to ten, ten being the worst pain you ever had and one being a little discomfort, how would you rate your pain?” I asked, my gaze flicking over the information pulsing at me from the vital-signs monitor as the lab tech worked on the other side, drawing blood.
“It's about an eight,” she gasped.
Her b.p. wasn't bad, but I gave her a shot of nitro, made a quick note, and glanced at my watch. I felt slightly outside of myself, watching myself going through the routine that so easily came back to me. In charge. In control.
A clatter of wheels announced another lab tech with the ECG machine. And right at that moment the daughter appeared by the bed. She didn't even ask, just went straight to her mother's side. It was getting crowded in here and Dr. Williams still hadn't shown up. I could use his help.
“I'm sorry, ma'am, you'll have to move,” the lab tech snapped as he pulled out the leads for the ECG machine.
“I have to be here,” she said firmly.
“You can move to the head of the bed,” I said. “You won't be in the way there.”
She gave me a thankful glance.
I checked the cardiac monitor. Classic wave form of an acute heart attack.
Arlene ran in. “I can't get ahold of Dr. Williams.”
“Then try Dr. John,” I snapped, torn between concern for this woman and pity for Dr. John being called back to the hospital after a full day on call. “He's probably still in the hospital.”
“How is your pain?” I asked Mrs. Harris again as the tech pasted the leads to her chest.
“About a seven,” she said, giving her daughter a weak smile. “It's going down, Linda.”
Linda stroked her mother's hair. “That's good, Mom. You hang in there. We still need you around.”
“Shouldn't have sold the farm.”
“If you had kept it, you might be lying on the kitchen floor all alone right now.”
“Maybe. But maybe I'd feel like I had a purpose.”
“You have a purpose, Mom. That's to be with us yet.” Their conversation registered in one part of my mind and I felt my heart tremble with yearning. I thought of my own mother and for a fleeting moment wondered where she was.
“Hello again.” Dr. John was behind me, slipping on latex gloves. He gave me a tired smile that told me he would be okay. “What do we have here?” he asked as the ECG readout rolled off the machine. He pulled the paper, glanced at the patient then at me. “Morphine.”
I drew it up and gave Mrs. Harris a small amount of morphine through the IV, my eyes constantly monitoring her blood pressure, oxygen saturation levels, and heart rate. I didn't have time to grab the chart and quickly scribbled what I could on the back of my hand.
“How is your pain, Mrs. Harris?” I asked again.
“Going down,” she said, reaching up to catch her daughter's hand.
The lab tech came back with the results. Dr. John scanned them before looking up from the paper at the patient. “Looks like you're having a heart attack, or what we call a myocardial infarction. We're going to give you a drug to break up the clot in your heart that's causing this, but before we do, we need to ask you a few more questions.”
Linda gasped. “Heart attack.”
“Thankfully we caught things in time,” Dr. John said.
As Dr. John went over the screening questions, I saw a faint track of moisture drift down Mrs. Harris's cheek. She pressed her lips together but made no move to wipe her tears away.
The words heart attack had such a deadly connotation for the average person. Such strong terminology striking at, well, the very heart of a person.
I sympathized, but as I injected the clot buster, I glanced at the clock and couldn't help but feel a flush of accomplishment. Twenty-two minutes from the time Mrs. Harris came into the hospital until we injected the clot buster. Not bad.
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