He had to put the subject aside for now, Luke reflected, and concentrate on his next patient. Valerie Nuncio was twenty-nine and had had a normal checkup only a few months earlier. However, due to a family history of breast and ovarian cancer, she’d recently had tests and was discovered to have a gene mutation that predisposed her to those diseases.
He entered the consulting room and shook hands with the dark-haired young woman in a peach-colored dress. Since she didn’t require an exam, Pam hadn’t asked her to undress. “Hi. I’m Dr. Van Dam.”
“I’m Val.” She had a firm grip. “I’d like some honest answers, Doctor.”
“That’s what I’m here for.” He took a chair beside hers. “You’re concerned about your cancer risk.”
“I’m more than concerned. My sister’s battling ovarian cancer and she’s only thirty-five,” Val told him. “I want a hysterectomy.”
Luke glanced at her chart. “You haven’t had children. Would you like to?”
Tears filled her eyes. “Yes, but I’m not even married yet. I can’t run the risk that I’ll wait too long.”
“Prophylactic hysterectomies—solely for preventive purposes—aren’t recommended for women under forty who might want children.” Even as he spoke, Luke recognized how frightening her situation must be.
“What is my risk?” Val demanded.
He wished he had a conclusive answer. “It depends on a number of factors.” Earlier that morning, when he’d learned from Pam that the patient had tested positive for the gene, he’d done some research and run off the results. Now he reviewed statistics and recent studies with her.
“Using oral contraceptives seems to lower the risk of ovarian cancer, but it may increase the danger of breast cancer,” he told her as they went through the reports.
“Isn’t ovarian cancer worse?” she asked. “It seems like you hear a lot about breast-cancer survivors, but not ovarian.”
That was true. “It’s harder to diagnose because the ovaries lie deep within the body,” Luke explained. “As a result, it’s often quite advanced by the time it’s detected. The overall survival rate is between thirty-five and fifty percent.”
“For my sister, it could be zero percent,” she proclaimed. “If I have my ovaries removed, won’t that solve the problem? I want to get on with my life.”
He consulted the research. “You’d have a substantial risk reduction for both types of cancer. But at your age…”
“My sister’s not that much older,” she said.
What a terrible dilemma. Also, major surgery simply to prevent a disease might not be covered by her insurance, Luke pointed out.
“I need to find that out,” Val agreed.
“I’d like you to undergo some counseling, too. You must be sure you’ve come to terms with all the issues.” He wrote a prescription, since some insurance policies might cover the counseling. “Please don’t rush into this decision when you’re so understandably upset about your sister.”
Val clutched the piece of paper. “If there were better treatments for ovarian cancer, maybe I’d run that risk. But right now, it’s not worth it.”
“After you’ve seen a counselor, let me know what you decide,” Luke told her.
“You’ll do it?” She regarded him questioningly. “One of the patients I met at the cancer center asked her doctor ten years ago and he refused. Now she’s dying, too.”
“Doctors go into medicine to heal, not to operate on the healthy,” he told her. “But in the end, it’s your body and your risk. Once I’m sure you’ve examined all the angles, I’ll comply with your wishes. Meanwhile, is your sister enrolled in a clinical trial?”
She shook her head.
“Let me look into what’s available to see if there’s anything that might benefit her.”
Val gave him a tremulous smile. “Thank you, Dr. Van Dam.”
This, Luke reflected as he said goodbye, was why he yearned to get into research. Much as he enjoyed treating individuals, he wanted to do more.
As soon as he got a break, he put in a call to an old friend, Dr. Julius LaRouche. A former tennis partner of his, the cancer specialist had moved to Tennessee, where he was involved in research at Vanderbilt Medical Center.
After they caught up, Luke explained about his patient’s sister and asked if Julius had come across any relevant new trials.
“As a matter of fact, yes.” The man’s slightly nasal voice moved along at as fast a pace as his brilliant mind. “We’re testing a radical new procedure right here. You’ve heard of nanobots.” The microscopic devices could be propelled through the bloodstream.
“Sure.”
According to Julius, researchers had developed a way to steer nanobots using resonance imaging to carry cancer-killing drugs directly to tumors. Because no new drugs were involved, the procedure didn’t have to wait for lengthy government approvals.
“It’s too soon to issue a report, but we’re already seeing some exciting results.” He paused. “Say, there’s a position opening up here. We could use an OB with your clinical experience. How about putting in an application? I’ll give you my recommendation.”
The offer caught Luke by surprise. “I made a one-year commitment to stay here,” he said. And Nashville’s almost two thousand miles away.
“Well, I’m not sure how soon it will be filled, so keep it in mind.”
“I’ll do that. Thanks, Julius.” Luke returned to his original purpose. “Any room in your testing for one more patient?”
“Sorry, we’re full for this round.”
“Are there any similar trials in Southern California?” His patient had mentioned that her sister lived nearby.
“Not that I know of,” Julius said. “I wish there were. The more centers trying this technique, the better we can evaluate it.”
They signed off. Well, that had been a significant but ultimately unsatisfying conversation, Luke reflected.
Something Julius had said nagged at him. Before he could pinpoint it, Pam peered in, her expression tense. “The day care is trying to reach you.”
Anxiously, Luke pressed Maryam’s number and prayed that everyone was safe.
“Thanks for calling back.” The day-care provider sounded strained. “I thought you’d want to know that Zoey’s very upset. She’s been crying, and when I asked why, she said nobody wants her.”
“What?” He couldn’t imagine what would give his daughter that idea. “Was there a problem at school?”
“She was fine when I met the bus,” the sitter said. “I’ve been trying to piece together what happened since then. The children were playing in the yard and I saw her talking to the gardener working next door. Do you know Bart Ryan?”
Rage swept over Luke. If that man had done anything to hurt his child…“Yes.”
“I saw him chatting with Zoey through the fence. She came running over, asking about you giving away the baby. What’s going on?”
A cold chill replaced Luke’s anger. He hadn’t exactly made a secret of his intentions to find a new home for Tina, nor had he objected to Jane discussing the topic with Bart. Never having lived in such a small community before, he hadn’t considered that his daughter might hear about this from a third party.
He explained the situation to Maryam. “It’s for Tina’s safety, and so I can give Zoey the attention she needs. I don’t understand why she’d feel like nobody wants her.”
“Didn’t you say you were going to see Cynthia?” Maryam probed. “The sooner the better.” Dr. Cynthia Lieberman, the counselor with whom he’d made an appointment, lived in Harmony Circle and had been recommended by several people, including Maryam.
“Agreed.” He put in a quick call and, stressing the urgency of the situation, asked for a crisis consultation ahead of schedule. The receptionist checked with her boss and returned to say that the counselor would stay late. He could bring his daughter in at six o’clock.
“We’ll be there,” Luke replied. “Thank you very much.�
��
He got back on the phone and arranged for Maryam to keep Tina late. After hanging up, he suddenly remembered that this was his on-call night. What if he was needed at the hospital?
Frustrated by this latest complication, Luke put his head down on his desk. He knew he could cope—he just needed a minute. Oh, bloody hell.
He sensed Jane’s reassuring presence even before he lifted his head. “Pam mentioned a problem with the kids,” she said from the doorway. “Do you need me to cover for you tonight?”
To Luke, she seemed bathed in an angelic glow. “I don’t deserve it, but yes. I’ll cover for you next week.”
“Don’t worry about it,” she said. “Are the girls okay?”
“Basically, yes.” He didn’t want to mention Bart’s role in what had happened. After all, this wasn’t really the gardener’s fault. “I’m sorry for what I said about your maternal instincts warping your judgment. You have incredible maternal instincts and great judgment.”
She could have seized the opportunity to drive home her point about adopting Tina. To Luke’s relief, she took the high road. “We’ll discuss this when you aren’t so stressed.”
“Yes. Good.” Maybe he should reconsider insisting on a two-parent home. Maybe he should reconsider everything, Luke thought as she left.
He couldn’t let her marry Bart. He didn’t know what he had to offer instead, but his gut had clenched when Julius suggested moving to Nashville. Something held him here—and yet something also held him back from Jane. What the hell could it be?
For now, he had to focus on his daughter. As for whatever lay buried inside him, maybe Dr. Lieberman could help him sort that out, as well.
Chapter Fifteen
Jane’s anger at Luke had vanished the moment she saw him with his head on his desk. And not only because she shared his concern for the kids.
Last night, he’d haunted her dreams. There’d been a scene where Luke was in bed with her, whispering words she couldn’t quite understand, and then he’d been beckoning her from down a hallway. When she approached, he always seemed to be fading around the next corner.
Deciphering that dream didn’t require an expert. Against her better judgment, she’d been seduced by the man in medical school but managed to convince herself she’d get over him. Now she’d fallen for him again, and this time her feelings resonated much more deeply.
Jane didn’t see how she was going to recover. But she’d find a way.
When her four-thirty appointment canceled, Jane drove home early and went out into the garden. Last weekend, she’d bought tomato, eggplant, parsley and basil plants and set them in place in her garden ready for planting. Nearby patches of bare soil bore markers to show where she’d sown seeds for lettuce and onions and, in a separate area to accommodate their future sprawl, zucchini.
If she married Bart, they’d spend hours gardening. Together, they’d whip up healthy meals and, afterward, they’d relax side by side to read or watch a documentary on TV. Until they had kids, although no doubt they’d eventually incorporate the little ones into their routine.
She doubted they’d ever quarrel. Living with Bart would be practically as peaceful as living by herself. And just as dull. How unfair that she’d kept him hanging for days, when her answer had to be no.
Still, Jane hesitated, trying to figure out what to say. She’d never been in a position to break someone’s heart before. Had their situations been reversed, though, she’d prefer the plain truth, wouldn’t she?
Her side gate swung open. Since hardly anyone ventured into her backyard unannounced, Jane turned in surprise.
Bart must have heard her thinking about him, or else their minds had fallen into the same track, because here he was. Mellow light played over his familiar lean figure dressed in jeans and T-shirt, with an Angels baseball cap atop his shaggy hair.
He stood sideways as if preparing for a rapid getaway. Always before, he’d ambled in here without a care in the world.
Jane hurried over. “It’s good to see you. Listen, Bart, I meant to get back to you sooner…”
“You’re not mad?” he asked.
“About what?”
“What I said to Zoey.”
That stumped her. “I didn’t know you said anything to Zoey.”
He flushed. “I shot my big mouth off. Told her we wanted to adopt the baby. She looked like I’d slapped her.”
“Oh, my gosh.” That explained the crisis this afternoon. Apparently Luke hadn’t mentioned his plans to his daughter.
“Never occurred to me she didn’t know all about it. I figured she’d be pleased.” He dragged off the cap and twisted it in his hands. “Jane, I never meant to upset the little girl.”
“Luke’s taking her to a counselor.” Jane had confidence in Cynthia’s ability to help them through this difficulty.
“I really mucked things up.” Bart grimaced.
“Counseling’s a good idea in any event, what with her mother remarrying,” Jane told him. “It isn’t your fault she didn’t know. Luke may have been trying to protect her, but secrets have a way of getting out.”
“They sure do, thanks to me.” He appeared determined to punish himself.
“I’m the one who told you about Tina. I should have cleared that with Luke first.”
They both fell silent. Studying Bart, Jane reflected how much she cared about him. But not enough to sustain a marriage. Much as she hated to admit it, Luke had been right. You can’t marry a man you don’t love.
That, she supposed, was how Luke must feel about her. Fond and admiring, but nothing more. Pain wrenched inside her at the thought.
From Brooke and Oliver’s yard next door drifted the scent of grilling steaks, a reminder of how easily this conversation might be overheard. “Please, come inside so we can talk.”
“I’m more at home outdoors.” Bart gave the cap another twist. “I’ve been doing some soul-searching this afternoon.”
“Yes?”
“About you and me.” He paused.
It hit Jane that she wasn’t the only person with doubts. The uncharacteristic wavering of Bart’s gaze bolstered her suspicion. “You’re rethinking your proposal?”
“That’s a terrible thing for a man to do.” He cleared his throat. “Jane, you’re an amazing woman. The thing is, I’d be doing you a disservice. All this emotional turmoil doesn’t suit me. What kind of husband would I make? I thought you and I could have a happy, peaceful marriage, but that’s not realistic. People have feelings, and they fight and hurt each other. I’m not sure I’m up to it.”
It struck her that, during Bart’s proposal, he hadn’t once mentioned love. “You implied that you’d been in love once,” she said. “Is that right?”
His head bobbed in the affirmative.
“How did you feel about that other woman? Was it the same as with me?” She wasn’t sure what spurred her to ask. Call it a hunch.
“No,” Bart conceded. “I was younger. I had wild, crazy feelings for her. Maybe it was too strong, the kind of thing that’s meant to burn out. I was afraid we’d drive each other over the edge.”
“I think that’s an edge people ought to go over once in a lifetime.” Jane shuddered at the image. “I’m not sure why I said that. I’m hardly the leap-off-a-cliff type, am I?”
“You’re honest and real,” Bart told her. “That’s why you’re so great. Can we still be friends, Jane?”
“Absolutely.”
He didn’t stick around as he normally would to look over her plantings. Instead, with a relieved nod, he scurried through the gate.
How ironic that she was stuck with those wild, crazy feelings for Luke, Jane reflected as she went into the house. Now she had to figure out how to get rid of them.
And move on with the business of establishing a family.
LUKE PARKED in front of the Fullerton office building that housed Dr. Lieberman’s office. Most of the parking spaces sat empty at this hour.
“Why do I
have to see a doctor?” Zoey demanded from the passenger seat. “I’m not sick.”
While Luke had explained the situation several times, either his daughter hadn’t understood or was seeking reassurance. A thin red rim around her eyes testified to her distress.
“She’s a special kind of doctor who helps heal people’s feelings when they get hurt,” he said.
“Did I hurt your feelings?” she asked as she got out.
Luke locked the car behind them. “No, sweetie, I hurt yours. I didn’t mean to keep secrets from you. Daddies make mistakes, too.”
On the elevator ride to the third floor, Zoey chewed her lip. “Does she give shots?”
Luke took her hand. “No. She’s the kind of doctor who talks to you.”
“Oh, like a shrink.”
“Where’d you hear that term?” he asked in surprise.
“In a cartoon.” She squared her shoulders. “I guess this won’t be too bad.”
In the counselor’s reception area, the front desk stood empty. Her secretary must have left for the day.
A woman in her fifties, her gray-streaked hair worn in a neat pageboy, was sorting through mail at a side table. She set the envelopes down when she spotted them. “You must be Dr. Van Dam and Zoey. I’m Dr. Lieberman. Call me Cynthia.” She extended her hand.
“I’m Luke.” As he greeted the woman her warmth and confident manner put him at ease. He also liked the way she shook hands with Zoey, treating the child as an equal.
In her private office, bright colors enlivened the walls, while children’s books and toys lay scattered on low tables. Cynthia gestured them into the comfortable chairs. “I’d like to talk to you both for a few minutes, and then to Zoey alone. Is that all right?” She spoke directly to the girl.
Hesitantly, Zoey agreed.
In response to Cynthia’s questioning, Luke sketched the situation with his ex-wife and Tina, and his decision to find a new home for the baby in order to focus on Zoey. “I should have told her about this sooner. I’m sorry she heard it from a stranger.”
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