He pushed in the Pitocin intravenously and grabbed the ephedrine syringe, but knew this wouldn’t be nearly enough. “Teri, mix me some Neo and go get blood fast! Mr. Karas, it’s time for you to leave; we’ve asked you—”
Before he could finish, a steely arm encircled his neck and squeezed tight. Bear’s hot breath beat down on Luke’s neck. “What the fuck’s going on here? I want some answers!”
The circulator ran out of the room yelling, “Red alert!”
Luke clawed at the choking arm and pulled it away enough so he could speak. “Listen, asshole! You got about ten seconds to let me go or she dies!” The arm loosened a bit. Luke pulled harder. “I’m the only hope she’s got. You can argue all you want, or put your fist through my face. Either way, she dies. Now get the hell out of here and let me do my job.”
Bear didn’t move or say anything for a second or two, then he released Luke and stepped around to face him. “Listen, Doc. Do your thing. But I ain’t going nowhere and I’m warning you”—he reached out and repeatedly poked Luke’s chest with an enormous finger—“anything happens to her and I’ll finish wringing your scrawny neck!”
CHAPTER FOUR
FRIDAY, SEPTEMBER 1, 6:15 P.M.
Luke, Teri, and an OB nurse pushed the heavy bed out of the elevator and through the narrow hallways to the Surgical Intensive Care Unit, better known as the SICU. Luke’s head was throbbing, his scrubs were covered with sweat and bloodstains, but he had never been happier to finish a case in his life. Shirley lay before him snoring peacefully in a morphine haze. Bear had left to go with the baby and was undoubtedly in the newborn nursery chatting up everyone in sight about how big his son was.
Amazingly, they had pulled Shirley through her ordeal. Though physically and emotionally drained, Luke felt buoyed by a real sense of satisfaction. Not a bad showing for the new guy, he thought. This was, after all, why he had gone into medicine—to help people and make a difference in their lives. No more standing on the sidelines, helpless.
While the SICU nurse was getting Shirley hooked up to the monitors, Teri touched his arm. “Good job, Dr. Daulton. I knew you could do it.” She flashed him a broad smile. “That central line was really slick.”
“Thanks, Teri.” He was grateful the large-bore, intravenous neck line had gone in without a hitch. “I couldn’t have done it without you.” He turned to give his report to the nurse.
He heard laughter coming from down the hallway and soon the two obstetricians, Dr. Seidle and Dr. Gentry, walked in. They were all smiles as they reviewed the highlights of the case. Although the two had removed their bloody OR gowns, Dr. Gentry’s mask still had some blood spatters on it, a reminder of the frenzied action that had taken place in the delivery room.
Seidle turned to Luke. “Nice going, Daulton—way to pump that blood.” He had reverted to his normal, self-assured state, but Luke would never forget the unmistakable panic that had glazed his eyes earlier. “How much blood did you wind up giving?”
“Five units, type specific,” Luke said.
“Amazing.” Seidle shook his head. “I didn’t think we lost that much. Listen, I gotta go check on a labor patient.” He turned to Dr. Gentry. “Thanks again for your help in there, Rob. You really pulled my ass out of a sling.” Seidle strode out of the room, whistling.
Rob Gentry looked at Luke. “Rough way to start your OB experience, huh?” He glanced over at Shirley, who was still snoring up a storm. “A central line, to boot—I’m impressed. I wondered how you got all that blood in so fast.” Rob put his hand on Luke’s shoulder. He lowered his voice. “You saved her life, you know.”
“I don’t know about that.” Luke gazed out the large window. The sun was making its way toward the horizon, lighting up the meadow just beyond the parking lot. “If you hadn’t come in and helped, I’m not sure—” Luke stopped and glanced over at Shirley to make sure she was still out. “I’m not sure Seidle would’ve been able to stop the bleeding.”
“Listen, these cases are always a struggle,” Rob said. “Abruptio placenta is one of the most dreaded OB complications, often with fatal outcomes for the baby or the mother or both.” Rob ripped off his bloody surgical mask, tossed it in the waste can, and went over to the sink to wash his hands. “Seidle would’ve done the same thing for me,” he said over his shoulder, above the splashing of the water. “Good teamwork between surgery and anesthesia is critical.” He dried his hands. “Heck, I feel lucky we were able to save her uterus.”
“That was nice work.” Luke absently scratched his head through his cap. “I feel bad about the total spinal business, though—it only made things worse.”
“Listen, Luke, you had a lot on your plate and then there was that Neanderthal guy—Butch, Bear, or whatever his name was. You did a nice job handling it all. I’ve seen others of your crew fold under lesser circumstances.”
“Well thanks, Rob. I appreciate you saying it.”
“Sure. How’s Kim doing, by the way?”
Luke practically cringed. “Great, no problems,” he got out weakly. He had no desire to mix his wife into a conversation involving obstetrical nightmares.
“The big day’s fast approaching. You all set?”
“Yep.”
“Nervous?”
“Nope.”
Rob paused. “Hey, we need to hook up for a bike ride soon.”
“Sure,” Luke said. “I called you several times, but you’re always too busy.”
“I have been really busy recently,” Rob said, and cracked a thin smile.
“Oh…hmm…” Luke had no idea where to go with this one. He knew—in fact, Teri had just reminded him—that Rob was getting awfully chummy with the anesthesia billing secretary, Gwen.
The door opened and a serious-looking Dr. Jason Katz walked in. He was large framed, at least six foot two, and still looked trim for a man approaching sixty. “Luke, I was hoping to catch you here. I need to have a word with you.” Katz quickly scanned the room, taking in Shirley and her monitors. “I was on my way up here to see what all of the commotion was about and I bumped into Dr. Seidle in the hallway. He filled me in.” Katz turned to Gentry. “I understand you assisted with the section. Thank God you were available.”
“Yes, as the fates would have it,” Rob said, a grin stealing across his face.
There was an uncomfortable silence between the two men and they traded looks before Katz said, “Sometimes, God works in mysterious ways.” Katz turned to Luke. “Listen, Luke, finish up here and meet me down in my office.” With that he wheeled around and exited the room, the tails of his long white coat fluttering behind him.
“Geez,” Luke said, and shook his head. “What was that all about? Just when I thought this day was over.” He worked on signing all his papers. “Katz didn’t look too happy, did he?” he said without looking up.
“No, I guess not,” Rob said. “Special visits from the chief are rarely a good thing.”
“I better go.” Luke closed the hospital chart and headed for the door. “See you later.”
“Call me this weekend,” Rob said. “We’ll ride.”
“Sounds good,” Luke said as he trudged out the doorway.
“Hey, Luke,” Rob called from behind him. “One more thing. Watch your step around Katz.”
Luke studied the contents of the vending machine and groaned. There was a lame assortment of items ranging from stale sandwiches to artificial tapioca pudding. He patted down his pockets for change but came up empty. He pulled out his wallet and was glad to find several dollar bills inside. He also spied the little piece of paper Kim had given him; he took it out to take a closer look. She loved to make puzzles for him, but this one was special. Ten numbers were arranged in a square.
Luke smiled as he thought back to the joyous day when Kim had given it to him, then carefully tucked the paper back into his wallet, retrieved a dollar bill, and fed it to the vending machine. He punched some buttons and a Snickers bar, aka dinner, dropped with a bang. Hi
s stomach growled as he unwrapped the bar.
Minutes later, Luke stood outside the half-open door bearing a brass plaque engraved with Chief of Anesthesia: Dr. Jason Katz and finished off his Snickers bar. Inside someone clacked away at a computer keyboard. He took a deep breath, ran a hand through his mussed hair, and knocked.
“Come in,” Katz’s deep voice called.
Luke entered the small office. Katz didn’t look up but continued working at his computer. It struck Luke that Katz’s receding hairline didn’t exactly fit with the jet-black color of his short hair. He searched the older man’s face for clues about what this little meeting was all about. On his way over, it had occurred to him that maybe Katz wanted to congratulate him, but this certainly didn’t seem to fit with his earlier tone. Luke just wanted to get it over with, whatever it was. He was tired and hungry and wanted to go home.
“Have a seat, Luke,” Katz finally said, gesturing to the only other chair in the room, across from his desk. He turned his computer off with a loud beep and worked on filing some papers. The computer fan took its time whirring down to a complete stop, then left the room awash in an awkward silence.
Luke looked around the office. There were several framed pictures of Katz on the desktop. He had obviously been sightseeing in Italy; Luke recognized the Leaning Tower of Pisa and the Coliseum in the background.
Katz looked up and broke the silence. “So you engaged in a little trial by fire today, eh?” He chuckled.
“Yeah, I guess I did,” Luke replied and shifted in his seat.
Katz wheeled back in his chair and surprised him by pulling a pack of cigarettes from the breast pocket of his coat. He lit one up slowly, deliberately, and took a long drag.
Luke glanced at his watch.
“Don’t worry, this won’t take long,” Katz said, exhaling smoke. “I’ll get right to the point. As I mentioned, Mark Seidle spoke with me about the C-section.” Katz watched the smoke slowly drift upward before refocusing on Luke. “He didn’t seem too happy with your performance.”
“What?” Luke was stunned. “Why? We saved her life.”
Katz locked eyes with him. “He said something about a total spinal causing massive blood loss and that she almost bled to death.” He paused to let that sink in. “He did say you did a nice job treating the hemorrhage—didn’t panic or anything—but if you had done the spinal right in the first place—”
“You saw how big she was, right?” Luke interrupted.
“Yes, I did.”
“I was lucky to get that spinal in.” Luke was vaguely aware of how hard his hands were squeezing the armrests of the chair. “Hey, if Rob Gentry hadn’t come in and bailed Seidle out—”
Katz held up his hand. “That may be—”
“Talk about panicking,” Luke said.
“You’re missing the point.”
Luke found Katz’s preachy tone extremely irritating and felt his own face getting hot. “Well, what is the point?”
“Listen, Luke, it’s really very simple. There are two things you must understand here. One—you can’t have any bad cases. You almost had one today.” Katz flicked some ashes into the ashtray, then took another hard drag. He slowly blew the smoke out to the side. “Two—besides keeping your nose clean clinically, you must also fit in with your colleagues. You must impress the surgeons and please them. Remember, it’s a business we’re running here and these people, no matter what you might think of them, are our customers. The customer is always right, remember? Even if he’s a pompous jackass. Do I make myself clear?”
“Yeah, crystal.” Luke felt as if he was back in high school and his dad was lecturing him again. He could see his old man’s large, puffy face redden with anger, the tortuous veins standing out on his temples. All Katz needed to add was “smart guy” and Luke would’ve screamed. He realized Katz had resumed speaking.
“—seem like a nice guy and all. Your credentials are top-notch and your recommendations are all glowing. But…” Katz stared at him again. “Let me bottom line it for you. Your first year here is probational. Nothing is guaranteed. You must demonstrate to the partners that you have what it takes to stay.”
Luke didn’t reply—he didn’t trust himself to say anything civil at this point.
CHAPTER FIVE
FRIDAY, SEPTEMBER 1, 6:30 P.M.
“This is crazy,” Rob Gentry said to himself, shaking his head as he hung up his cell phone. He tucked the phone into its case on his hip and left the hospital, walking toward the doctors’ parking lot. The low sun shone in his eyes, but the blinding light would be gone soon; the fiery ball was rapidly sinking into the gray cloud bank that hugged the ridgeline of the Appalachian Mountains.
He glanced back at Swatara Regional and saw the red-brick building positively glowing, bathed in the orange light. A nurse was drawing the blinds over a window in the second floor SICU complex, in what he believed was Shirley Karas’ room. Mrs. Karas was one lucky lady, and so was her baby. That C-section with the abruption had been a real bitch. Rob had seen several over the years that didn’t have such happy outcomes.
Luke Daulton had really done a nice job keeping her alive through all the bleeding. Seidle had panicked and had clearly been in over his head. That religious nutjob, Katz, had been right, too. “Thank God Rob was there to help,” Katz had said. Rob chuckled as he crossed the parking lot to his car. The only reason he had been at the hospital was to see Gwen on her break.
His Porsche 911 Carrera waited for him at the far end of the lot—he had indulged himself and bought it last year for his fiftieth birthday. He never tired of admiring the car’s sleek profile and aggressive stance. The aluminum mag wheels and chrome detail work gleamed in the sunlight that set the metallic red body ablaze and made the car sparkle like a precious jewel. Though physically tired, Rob felt strangely exhilarated as he jumped in and turned the key. The 480 horsepower engine throbbed to life, anxious to launch him into the night. Rob goosed the gas and the twin turbos kicked in and the engine roared its deep, throaty growl. He jammed the car into first gear and popped the clutch.
The car roared out of the parking lot and Rob headed west on Route 39 toward the mountains. The sun sank below the clouds, but the sky was still bright. He slipped on his designer sunglasses and cranked up the XM radio as a Dave Matthews song started playing.
What am I doing? he wondered again. Didn’t it matter that he had family commitments tonight? What about the promise he had made to his son, that he’d be at his concert? He made a left onto the on-ramp of Southbound 81 and nudged the accelerator; the turbocharged V-8 came to life. The car rocketed forward and he enjoyed the adrenaline rush the sudden G-force always brought on. He merged smoothly onto the interstate toward Harrisburg, the engine burbling happily as the car ate up the pavement. Traffic was beginning to lighten, as everyone had already gotten a jump on the weekend and rush hour was long past. The speedometer needle jumped effortlessly to ninety.
Soon he arrived at his destination—The Rabbit Inn, a little restaurant/bar on the western bank of the Susquehanna River, off the beaten path in Enola. Of course, Enola itself was off the beaten path. Normally Rob wouldn’t have been caught dead in such a dive, but tonight The Rabbit fit the bill perfectly.
Once inside, he was forced to stop and let his eyes adjust to the dim lighting. The noise from the jukebox was deafening and smoke hung thick in the air. Rob carefully made his way to a booth in the rear, where the high seat backs would protect them from prying eyes. Risky? Only to those who gave it a second thought.
The waitress came and he ordered a Heineken, then looked up at the oversized flat screen TV suspended above the bar. Senator Pierce was making some announcement. Rob had to smile. He used to get hot about political issues—he listened to the talk radio stations incessantly and got caught up in the nuances of conservative/liberal bickering. Now he couldn’t have cared less—Senator Pierce and the balance of power in the US Senate, Iraq, Afghanistan, war, taxes—who the hell cared?
>
His musing was short lived as Gwen made her entrance into the bar. At least half the people in the room, men and women, looked up. Conversations paused, even eating and drinking were put on hold as everyone observed the striking woman glide across the room. Shit, Rob thought, so much for subterfuge. What the hell—he didn’t think he recognized anyone.
He stared at her and their eyes locked from across the room. She broke out that dazzling smile, playful and adventurous, and quickly walked over to him. He stood up to greet her. She had on a tight white cotton shirt with a revealing V neckline, and designer jeans and calf-high boots. Her long, dark silky hair flowed down almost to her narrow waist and shimmered even in the low light, framing her pretty face. She touched him lightly on the shoulder as she slid by him into the booth. He caught a whiff of her delightful fragrance.
“You look amazing,” Rob said, sitting down opposite her.
“Thanks,” she said, still beaming.
“But, did you have to wear that shirt?” Rob asked, trying hard to look serious. “Everyone in the freakin’ bar noticed you come in.”
She cocked her head slightly.
“Remember,” Rob said, “this is supposed to be a rendezvous—you know, a secret meeting.”
“What do you suggest?”
“A burlap bag, maybe.”
“Great, I’ll keep that in mind,” Gwen said. “I think I have several in my closet.”
The waitress came over and Gwen ordered a beer.
“Do you see anyone you know?” she asked. “You keep looking around.”
“No, sorry.”
“And do you always strip the label from your beer bottle? Or is that a guy thing?”
“No, it’s nothing.” He deliberately removed his hands from the bottle.
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