by Radclyffe
“Yes.”
Honor concentrated on charting. “Drug allergies?”
“None.”
“Medications?”
Quinn’s voice was steady. “Aspirin. Cordarone. Betapace.”
Honor wrote the names of the cardiac medications without pause. “Medical history?”
“I...” Quinn took a breath. This was not the way she had wanted to tell her. At first she hadn’t thought she would need to tell her. She wasn’t under any legal obligation to reveal her medical history, and she didn’t want that to be the first thing people learned about her. But it hadn’t taken very long for her to realize that she wanted to tell Honor everything, not just for professional reasons, but for personal ones. She just hadn’t known how. Now it was too late, and it was happening all wrong. “Honor, I wanted to tell—”
“Let’s get the information down, Quinn,” Honor said calmly. “I want to get your shoulder and chest x-rayed.”
Honor’s tone of voice was perfectly appropriate. Professional, nonjudgmental, calm and controlled. But there was nothing in her eyes when she looked at Quinn, and that was worse than worry or recrimination or even anger. At least those feelings were personal, and Quinn very much wanted what was between them to be personal. Sighing, she gave Honor the facts. The facts, however, were nowhere near the truth of what she had endured. That she tried not to think about. “Four months ago I developed viral myocarditis. It started out as a respiratory infection, I think, and within a few days the inflammation had spread to my heart.”
I almost died before I admitted anything was wrong. I was young and healthy and never sick. I didn’t want Sinclair to think I couldn’t handle the pace. She never slows down; I don’t think she ever sleeps. But then, in the middle of the case...
“Quinn?” Honor’s tone was gentle. The color had drained from Quinn’s face. “You want to lie down?”
Quinn shook her head. Hoarsely, she said, “No. I...uh...developed some scar tissue, apparently, and it created some arrhythmia problems. My heart rhythm was all over the place there for a while.”
“How severe?” Honor was pleased that her voice was steady.
“I had an episode of ventricular tachycardia and arrested in the middle of a surgery.”
Honor put the pen down and looked into Quinn’s eyes. She couldn’t even begin to pretend that thinking of what had happened didn’t affect her. The very thought of Quinn nearly dying made her physically ill. Her stomach churned, and every breath burned in her chest. She could only imagine how terrifying it must have been for Quinn to live through that. Now she not only lived with the memory of it, but she had to endure the fear of it happening again. “Oh, Quinn. I’m so sorry.”
Quinn smiled wryly. “The good news is that the area of scarring in my heart is very small. My cardiac function is excellent.” She ran her right hand through her hair and sighed. “The bad news is, they can’t seem to control the arrhythmias.”
“So you need to have the implantable defibrillator in case it happens again.” Honor knew that certain cardiac arrhythmias, or irregular heartbeats, could be treated by radiofrequency ablation, a technique in which the focus of the irregular heartbeat was actually destroyed so that it no longer acted as an irritant. It was the sporadic electrical discharge from abnormal areas of the heart muscle that caused arrhythmias. When the heart didn’t beat regularly, it didn’t pump blood normally, and there wasn’t enough blood flow to sustain consciousness. Thus, some arrhythmias posed a significant risk for sudden cardiac death. SCD...sudden cardiac death. The words sliced through Honor like a knife.
“It’s only been a few months,” Quinn said. “There’s a chance that as time goes on the cardiac irritability will lessen. I might recover enough not to need the defibrillator.”
“Of course,” Honor said with forced optimism. She picked up the pen again. “When was the defibrillator placed?”
“Two months ago.”
“How often has it discharged?”
Quinn was silent long enough that Honor looked up from the chart. Quinn’s expression was bleak.
“Four or five times.”
Honor’s stomach clenched. God, she’s not even stabilized. What are they thinking, letting her work?
“My cardiologist knows about it, and he thinks it’s probably not significant. Sometimes the defibrillators are hypersensitive, depending on the settings. He fiddles with the sensitivity thresholds, but he doesn’t seem too worried.”
“Are you having any symptoms?”
Quinn shrugged. “Every once in a while I’ll have a few palpitations. Very rarely a few seconds of dizziness. I’m not even sure it’s related.”
“Are they monitoring your rhythm by remote telemetry?”
“I’m supposed to send them random heart rhythm traces every week.”
Honor arched her brow. “Supposed to send? When was the last time your cardiologist looked at one of your rhythm strips?”
“It’s been a...few weeks...the move and the new job and all. I just put it off.”
“Jesus, Quinn,” Honor said sharply, her emotions breaking through the veneer of control for the first time. “Are you at least taking your meds?”
“I’m not crazy, Honor. Yes, I’m taking them.”
“Still, I’m admitting you to the telemetry unit for observation.”
“Honor, it’s not my heart here. My heart is fine. It’s my goddamn shoulder.” Quinn tightened her right fist in frustration. “That’s what’s killing me.”
Honor’s head jerked up, fire flashing in her eyes. Quinn stared back, her blue eyes just as hot.
“Why didn’t you tell me?” Honor demanded.
“Because I was embarrassed.”
Honor blinked. For a second, she was at a loss as to what to say. All of sudden, she wanted to touch Quinn so badly. Not just for Quinn. For her. “It’s not your fault.”
“Can you honestly say you still think of me the same as you did an hour ago?”
“That has nothing to do with anything.”
A muscle in Quinn’s jaw jumped and her whole body tensed. That has everything to do with everything.
Honor looked away, because she couldn’t lie to her, and she knew that Quinn would see the truth in her eyes. Knowing this changed everything. But she would have to deal with that later.
“Is there anything else I need to know about your medical history?”
Quinn grimaced, her heart aching. “How much more could there be?”
“I’ll take that as a no. How’s your stomach?”
“Better. My shoulder feels like someone is hitting it with a sledgehammer, though.”
“Can you do without the Compazine?”
“Yeah. But I wouldn’t mind a pain pill.”
“I’ll ask Nancy to bring you something right away, and then we’ll get you x-rayed.” Honor reached for the curtain, but before she opened it, she asked the one critical question that would determine if even friendship would be possible between them. “Does anyone here at PMC know about your medical condition?”
Quinn stared at her, confused. “Of course.”
“Who?”
“The chief of surgery. I presume the chief of medicine, because he talked to her when he got me the interview.”
But they didn’t tell me. And neither did you, Quinn. How am I ever going to trust you?
Chapter Eleven
Honor was alone in the small viewing room that was part of the ER’s auxiliary x-ray department when Linda opened the door and walked in.
“Hey,” Linda greeted her, “how’s Quinn?”
Startled, Honor pulled down the film she had been inspecting and turned to face her friend. “What are you doing here?”
“I was worried about Quinn, and I wanted to find out what was going on.” Linda joined Honor in front of the light box and regarded Honor quizzically. Her friend looked troubled—more than troubled, distraught. “Honor? What’s going on? Is it worse than you thought?”
“I don’t think so,” Honor said dully, still not able to comprehend just how bad it really was, “but I’m just getting her squared away.”
“Whose chest x-ray was that?”
“Uh...” Honor fished around for some excuse and came up short. Her expression must have answered for her.
“Oh my God, was that Quinn’s?”
Sighing, Honor put the film back up. “Since you’ve already seen it, there isn’t much point in pretending otherwise.” She returned her gaze to the x-ray, seeing what she knew she would see, but continuing to stare at it until she believed it.
A miniature battery-powered computer was housed in the small plastic case that rested just above the major muscle of Quinn’s chest. From it, electrical leads coated in silicone were threaded into the subclavian vein beneath her collarbone and directed into her heart. Sensors at the end of those leads sent information to the programmable computer inside the defibrillator, allowing an electrical discharge to regulate Quinn’s heart rhythm if it became unstable. That’s assuming that the defibrillator is functioning properly and sensing her heart rate appropriately. If it isn’t, she could develop a fatal arrhythmia and die within minutes.
“Is that a pacemaker?” Linda’s voice was tight with concern.
Honor shook her head. “Implantable defibrillator.”
“Oh, poor Quinn. God, Honor, is she all right?” Linda moved closer, resting a comforting hand on Honor’s back. Are you?
“Her clavicle and humerus look fine. She’s got a tremendous amount of soft tissue swelling around the shoulder area, which is to be expected, but—”
“What about her heart?”
Honor extended a finger, pointing to the cardiac shadow on the chest x-ray. “Heart size is normal. Rate’s good. Blood pressure’s fine. I’m waiting for an EKG trace right now. So far, there’s no evidence of any instability.”
Linda tilted her head and stared at Honor as she recited the litany of facts in a monotone. “Honor? Are you okay?”
“Fine.” Honor continued to stare at the x-ray. Quinn’s heart looked normal. But it wasn’t. She wanted to tear the x-ray down and shred it, as if destroying the evidence would mitigate the truth. She wanted that x-ray to be someone else’s, anyone else’s, as long as it wasn’t Quinn’s. Her voice was flat, the helpless fury so pervasive it blocked every other emotion. “No one told me, Linda.”
“Is she sick?” Linda felt a little sick herself. She liked Quinn. She liked her a lot. And she knew that Honor liked her, too.
“I don’t know yet.” Finally, Honor managed to drag her eyes away from the x-ray that mocked her, reminding her that despite all her training—all her skill—she couldn’t make a difference when it truly mattered. Not with Terry. Not with Quinn. She turned, edging her hip onto the counter that ran below the view boxes, and pushed a hand through her hair. For the first time, she realized she was exhausted. “I haven’t had a chance to complete my evaluation. Other than her shoulder, she seems to be all right.”
“So this isn’t so bad, right?” Linda indicated the x-ray with a tip of her chin.
“I suppose that’s a matter of definition.” Honor gave a short, mirthless laugh. “She has a potentially lethal condition which is poorly controlled at the moment, and she’s twenty-eight fucking years old. God.” She closed her eyes, and all she could see was Quinn. Those brilliant eyes, that mesmerizing grin, those incredible hands. In a whisper, she asked of no one, expecting no answer, “Why is life so unfair?”
Linda heard the anguish in Honor’s voice, appreciating that it wasn’t just about Quinn. Honor had lost her lover, and whether she knew it or not, wanted it or not, she already cared about Quinn. And right now, Honor was struggling with past pain and present fear all at once, a fight that was too much for anyone. Linda slid her arm around Honor’s waist, giving her a little shake even as she hugged her comfortingly. “Honey, you know better than to ask that. Thinking that way around here will make you crazy.”
Honor leaned her cheek against Linda’s shoulder and laughed shakily. “Yeah, I know. I’m just tired, I guess.”
“Understandable. It’s been a hell of an afternoon.” She kissed Honor’s forehead fleetingly. “So, where’s Quinn right now?”
“In three. I wanted to admit her, but she’s refusing. God, she’s stubborn.”
Linda grinned, happy to hear the irritation creep into Honor’s voice. Better. “Gee whiz, a surgeon who’s stubborn? How about that. I even know some ER chiefs who are just a little bit obstinate.”
Honor glared at Linda, but just having her there was helping. She wasn’t entirely certain what it was about Quinn’s underlying condition that had thrown her so badly. She didn’t seem to be able to sort things out clearly; all she felt was a sense of panic that was clouding her judgment. And that was totally unlike her. “Do you have something constructive to add to this situation, or do you just intend to heckle me for the rest of the day?”
Much better. “Why do you want to admit her?”
“Because she hasn’t had proper monitoring for weeks, and she told me that the defibrillator has discharged as recently as two days ago!” Honor’s voice rose as the fear threatened to re-emerge. “Do you want her to drop dead?”
“Of course not,” Linda said softly, not taking offense at Honor’s tone. She knew her friend well enough to know that this wasn’t Honor. At least not Honor when she wasn’t terrified. “You’re getting a rhythm trace, right?”
“Yes, it should be done by now.”
“Okay. Do you want her to have a sling for the shoulder?”
Honor rubbed her forehead, considering priorities. Her brain still felt sluggish, but the tightness in her chest was easing now that she had something to focus on besides the shock of seeing that scar on Quinn’s chest and what lay underneath. “For a day or two. She shouldn’t be immobilized any longer than that, because adhesions will develop around the shoulder joint. Motion is actually good for it.”
“Right. I’ll get her fixed up with the shoulder immobilizer while you review the EKG. If that looks okay, what do you say about her spending the night with Robin and me?”
“At your place?”
“Why not?” Linda shrugged. “If her heart’s okay, she really doesn’t need to be admitted, right?”
“Not for the shoulder injury, no.”
“But she lives by herself, and neither of us would feel very comfortable letting her go home alone. We’ve got room.”
“All right.” Honor smiled fondly. “I’m sorry I jumped on you. I don’t know what’s wrong with me.”
Linda squeezed her hand. I know you don’t. So let’s get Quinn squared away. That way, when you figure out what’s scaring you, you just might be able to handle it.
Quinn had managed to get her shirt back on and was sitting on the side of the exam table when the curtain parted and Linda and Honor stepped into the small room. She smiled at Linda, but her eyes were on Honor, who was holding her chart and looking at some point over Quinn’s head.
“Hi, Quinn,” Linda said affectionately. “How’s the shoulder?”
“What shoulder?”
Linda laughed. “Uh-huh. Aren’t we just all tough.”
“Yeah, that’s me.” Honor, why are you angry? Why won’t you look at me?
Linda tilted her head, studying Quinn’s face. She looks more worried than sick. She surely doesn’t look in danger of dying. If I hadn’t seen that x-ray with my own eyes...no wonder Honor is having a hard time. I can’t believe it either. “I’m going to get you a shoulder immobilizer, tough guy. I’ll be back in a few minutes.”
Alone with Honor, Quinn tried desperately to gauge what the other woman was feeling. She didn’t care about her rhythm trace or her chest x-ray or her shoulder; she cared about the distance in Honor’s eyes. She sensed disappointment and anger, and beneath that, something she wasn’t quite sure she understood. It seemed like fear. “Honor? Everything okay?”
Honor gave a small shake of
her head. “I’m not sure where to start with that one.” She blew out a breath and stepped over next to Quinn, resting her left hand on the dark red vinyl a few inches from Quinn’s hip. She might have touched her, except knowing what she needed to do, she couldn’t. “Your chest x-ray is normal. You have an occasional extra beat on your rhythm strip, but nothing that looks problematic to me. Of course, your cardiologist needs to compare it to your previous traces.”
“I’ll make sure he gets that first thing on Monday,” Quinn said quickly. Please don’t look so upset. “I promise.”
“Good.” Honor hesitated, then straightened her shoulders. “I want you to take a few days off, Quinn.”
Quinn’s stomach plummeted. “I can work, Honor. This has happened before, and my shoulder will be stiff for a few days, but—”
“It’s not about your shoulder,” Honor interrupted quietly. “It’s about your medical condition.”
“What about it?” Quinn’s throat was dry.
“Right now, I’m not certain you should be working in the emergency room.” Honor drew a shaky breath. This was harder than she had imagined, because she knew she was going to hurt Quinn. But she had a responsibility as the ER chief to see that the patients as well as the department were protected. “No one informed me of your medical status. If they had, I’m not sure I would’ve hired you.”
The panic hit Quinn hard and fast. She was going to lose everything—again. Only this time it was so much worse. It wasn’t just about her job. This time it was about everything that mattered in her life.
“Honor, please. I want to work.” Her hands were shaking, and she clenched them tightly against her thighs. The only thing that had gotten her through the last few months was Saxon Sinclair’s promise that she’d be able to work—the promise to help Quinn find the kind of position that would let her be a little bit of who she was. “I need to work.”
“And I need the patients and you to be safe. This isn’t an ordinary ER, for God’s sake. A few days ago, you were doing an open thoracotomy in the procedure room. What if you’d...arrested then?” Just saying the words made Honor nauseous.