Temporary Doctor, Surprise Father

by Lynne Marshall

  Yvonne led the way, and Jan followed them down the hall, last in line of the double parent parade. She already knew how deeply these wonderful people loved Meghan, but seeing her bedroom cinched how well they cared for her. Meghan wanted for nothing. Maybe she was a bit spoiled, but surely the child knew she was loved.

  Beck glanced around the room and grinned. “Gee. How many shades of pink are there?”

  Meghan clucked her tongue and rolled her eyes again, then fought off a contented smile. Beck slanted a glance at Jan, as if the pink room was more evidence that Meghan was indeed her daughter.

  They both noticed a couple of paintings on the wall at the same time. One was of a horse and the other was a fairly decent attempt at a self-portrait.

  “Did you paint those?” Beck asked.

  Meghan nodded shyly.

  “They’re really good. You know, I do some painting myself,” he said.

  “Really?”

  He nodded at her with a pleased smile. “Really.”

  “Maybe some time I can see them?”

  “Maybe.”

  As they prepared to leave, the girl’s timid, sweet voice stopped them. “Thank you for everything. I was mad at first, but now I think maybe you guys did the right thing.”

  Jan glanced at Beck, who stood perfectly still, staring at the daughter who looked incredibly like him. She’d as much as told them it was OK that they’d given her up. Would it be enough?

  It would have to be. “Thank you,” Jan said, as she returned to the frilly bed, bent and kissed her birth daughter on the forehead. “That means so much to me.”

  Beck wasn’t far behind, waiting his turn to kiss her cheek.

  “Is it OK if I write to you guys?”

  Both Jan and Beck looked toward her parents before answering. Daryl gave a nod. Tears brimmed in Yvonne’s eyes, but she gave her OK, too.

  “You know what?” Beck thumbed her chin. “I’d really like that. And I’ll write back to you.”

  After exchanging addresses, without saying another word, they shook hands with the Williamses one last time, waved goodbye to Meghan and left for Los Angeles.

  On the long drive home, Jan had plenty of time to think. She’d screwed up Beck’s life, but he’d handled today like a true gentleman. For a guy who’d been defiant his whole life, he’d channeled that energy into military precision and upholding the law, and had turned into one incredible human being. Too bad she’d royally messed things up between them with her lies, because it would be impossible to find another guy anywhere near as perfect for her as Beck.

  When they arrived home that night, having promised herself never to lie to Beck again, Jan stared into his deep almond-shaped eyes when he walked her to the door. She still had feelings for him. Should she tell him?

  He pulled her into a hug and she relaxed against his firm chest and shoulder.

  “What a day.” He exhaled.

  “Yeah. Thank you for being there for me.” The warmth of his embrace lulled her. She inhaled his distinct scent, marveling how she could probably pick him out of a crowd blindfolded.

  “I know how hard it was for you,” he whispered into her ear.

  He understood.

  She sucked in a relieved breath, wanting to kiss him with gratitude and maybe ask him inside. She lifted her cheek from his shoulder to find his mouth.

  He spoke before she had a chance to kiss him. “Just as hard as it is for me to tell you that I’ve decided it’s best if we don’t see each other any more.”

  CHAPTER NINE

  JAN couldn’t argue against Beck’s decision. She’d marched him through hell and back by lying to him and had cheated him of knowing his daughter. How could she expect him to forgive and forget? Even if he did admit to their obvious and growing attraction to each other, their adopted child would stand in the way of him trusting her. Meghan would be a symbol of how Jan had betrayed him.

  She’d always thought that love was worth fighting for, but without spending more time with Beck she couldn’t know for sure if the feelings blossoming in her heart were, in fact, true love. There were so many appealing qualities about him to sweep her away. It could just be exceptionally hot lust, but deep down she didn’t think so. Even if it was love, he’d be leaving again soon. They just weren’t meant to be.

  Anyway, none of it mattered because Beck had ended everything. He never wanted to see her again, and, tough as it seemed, she’d just have to get over it.

  She deserved no better.

  One week later, true to his word, Jan still hadn’t crossed paths with Beck at the hospital.

  There had been a big rigmarole over the SWAT shootout at the bank. For the following two weeks after the attempted armed robbery the evening news featured the story every night. The loss of one innocent life had been blamed on the LAPD instead of the bank robbers for instigating the whole situation. The police department hadn’t protected the bystanders enough when they’d swarmed the bank to rescue the hostages, or so they’d been accused. Even the families of the deceased bank robbers had lawyers working on their behalf, claiming unlawful loss of life. One lawyer claimed they’d allowed his client to bleed to death while attending to the uninjured hostages.

  A whisper of hope made Jan wish that was the reason Beck hadn’t been around. That his absence had only been business related, not because of her.

  The world seemed crazily out of order, but no more than Jan’s personal life. When she was completely honest with herself, a life without Beck, the man she’d come to realize she still loved, seemed sadly lacking.

  Carmen knew something was up, and in her usual unsubtle way insisted on discussing it with Jan in the nurses’ station.

  “Are you and that medic hunk, Beck, still seeing each other?” At least she’d lowered her voice.

  Jan snorted her reply. “He doesn’t want to ever see me again.”

  “I thought something was up. What went wrong?”

  Jan gave Carmen a defeated stare. “What didn’t go wrong?”

  “Are you avoiding him?”

  “He’s avoiding me.”

  “Then take this chart and bring this patient into room one, because I just saw him head for the locker room.”

  Wide-eyed and edgy, Jan rushed toward the waiting area, hoping she could get her patient into the exam room before Beck came back to the ED.

  With her concentration shot, she called the next patient’s name and after one glance left all thoughts of Beck behind. Another teenager and what looked like a parent propped up a nearly unconscious female.

  Jan found a wheelchair and helped the other two plop the girl into it. “What’s going on?” Her first thought was a possible drug overdose.

  “Regina is my roommate and yesterday she thought she had flu. Today I could hardly wake her.”

  “Are you her mother?” Jan asked the older woman.

  “I’m her dorm mother. I’ve put a call in to her parents in Missouri and I have authority to have her treated.”

  “Let’s get her inside.” A million possibilities raced through Jan’s head, but the one thought that kept coming back because of the flu scenario was meningitis. Dorms required first-year students to get vaccinated against it, but it wasn’t one hundred percent foolproof. “Regina! Turn your head for me.”

  The girl moaned with the effort. “My head is killing me.”

  “Is your neck stiff?”

  “Uh-Huh.”

  Jan wheeled her into room one and, with the help of the other women, undressed her and put a hospital gown on her. As if things weren’t bad enough, petechiae around her lower extremities didn’t bode well for her diagnosis. She hoped it was a rash, but when she pressed her thumb over the area, the skin didn’t blanch like a normal rash would have. Worst-case scenario, this wasn’t just potential meningitis, it was possibly the most virulent form of meningitis—bacterial.

  The bacteria released endotoxin into the blood stream, making the white blood cells sticky. The “sticky” WBCs d
amaged the lining of the vessels, causing multiple tiny blood clots to form throughout the body, while disrupting the natural clotting process. The result was leakage of blood into the surrounding tissue, causing the petechiae. If left unchecked, major organ damage would soon follow from the tiny rogue clots.

  She stuck her head out the door. “Carmen, ask Dr. Riordan to come quickly.”

  Before Jan could check the moaning patient’s vital signs, Gavin appeared at the bedside. His quick assessment concurred with her worst suspicions.

  “Let’s do a lumbar puncture. Start an IV. Draw electrolytes, liver and renal panels. Get a blood count and coags.” He strode to the exam room door. “Carmen, order a stat chest X-ray and an MRI.” He looked back at Jan as she hustled around the bedside, preparing to insert the intravenous line but stopping long enough to take in his concerned expression. “Call me as soon as you’re set up for the lumbar puncture.”

  Ready to place the tourniquet around the young woman’s arm, Jan nodded. Her touch set off the previously lethargic patient. Though acting confused, the girl swiped combatively at Jan’s hand.

  “I’m going to ask you to hold her still for me while I get the IV in place,” she said to the other women. One held her arms and the other her legs, and Jan successfully inserted the IV, obtained several vials of blood for the labs and started the intravenous infusion. “Watch her for me while I send these to the lab and get the lumbar-puncture kit, please,” she said on her way out the door. “Don’t let her dislodge the IV.”

  They both nodded with anxious expressions. When she reached the nurses’ station, Gavin was already instructing Carmen to find a room in the ICU. “As soon as I get the spinal fluid, get her upstairs—she needs constant observation.”

  Jan knew one-to-one care was next to impossible in the ER with the heavy patient flow, and the sick college girl, Regina, would need all the help she could get in the next several hours.

  As she scuttled back toward the room with the prepackaged lumbar puncture tray, she nodded at Gavin, who was directing Beck toward another patient room. “Take room four. MVA with multiple lacerations.” Did Gavin know something was up, too? Had Carmen told him?

  Before heading for the room, Beck glanced at Jan long enough to make her hands get jittery and her legs to turn wobbly. A familiar pang of regret made itself known. She redirected her focus on Regina and the procedure.

  With the roommate’s help, they placed the patient in a C shape on her left side with knees tucked to her chest. The dorm mother stood on the other side of the bed, holding her hands and attempting to make eye contact.

  All the necessary equipment was arranged in the sterile kit. Gavin identified the fourth lumbar vertebra and marked the interspace with a skin-marker pen. While he washed his hands, donned sterile gloves and checked the stylet with the LP needle, Jan washed Regina’s lower back with antiseptic solution and draped the area with a sterile field.

  Gavin quickly injected local anesthetic, and rechecked the lumbar position, then expertly pushed the lumbar puncture needle through the skin. He advanced the needle until a slight “pop” could be heard, then withdrew the stylet to check for CSF flow. When the first drop appeared, he connected the manometer.

  Jan held the top of the device to steady it and enable him to make the initial CSF pressure reading. Sure enough, it was above the normal reading by twenty millimeters.

  Instead of the normally clear fluid, the CSF looked cloudy, in keeping with an abundance of white blood cells, serum protein and bacteria. Things looked grim for Regina. They collected more spinal fluid in sterile containers and Jan carefully labeled them for the necessary lab studies—a cell count, glucose, and a culture to find out exactly what bug was making her so sick.

  “Let’s get some broad-spectrum antibiotics started as fast as the inpatient pharmacy can make them up,” he said, entering the order into the computer. “Carmen?” he called over his shoulder. “Is that ICU bed ready yet?”

  “Fifteen minutes,” she called back. “I’m calling Transportation now.”

  The sooner the patient was in the ICU the better.

  Out of habit, Jan instructed the friends to make sure Regina remained flat on her back after the spinal tap to prevent an increased headache—as though her head didn’t hurt enough already. At this point Regina hardly seemed able to move by herself. After assessing the patient’s responses, according to the Glascow coma scale, Regina was drifting downward rapidly from when she’d first arrived. Though she still opened her eyes to pain, her speech was confused and she’d quit following verbal commands.

  Carmen arrived with the first antibiotic, which had been sent via a pneumatic tube system throughout the hospital, and they attached it as a piggyback to the IVAC right before the orderly arrived to transport Regina to the ICU. It couldn’t be soon enough in Jan’s opinion as she noticed the petechiae around her ankles had spread to larger areas of purple bruising known as purpura. Not a good sign. Patients had been known to lose fingers and toes and worse from the disseminated clotting.

  Beck appeared on scene and offered to accompany the patient to the ICU, allowing Jan to process the specimens and clean up the bedside.

  She nodded gratefully, avoiding his eyes.

  The last thing Jan heard as they left the department was the roommate’s comment. “What’s Jeremy going to think? They had that big fight two days ago.”

  “Call him! Tell him what’s going on.”

  “I’m trying. I haven’t been able to get a hold of him.”

  “Are we allowed to use cellphones in the ER?”

  Jan glanced at Gavin. “Here, let me show you where the nurses’ lounge is. You can call him from there.”

  Gavin had heard the conversation too. When Jan returned, he’d finished entering his doctor’s notes in the portable computer and shook his head. “Just goes to show we never know when our last chance is, do we?”

  Jan nodded in accord.

  “I almost let Bethany slip away from me, but I came to my senses before it was too late,” he added.

  Jan recalled Gavin’s close brush with anaphylaxis a year earlier and his future wife’s near loss of twins. Within two weeks he’d almost lost everything near and dear to him. He could definitely relate to Jeremy’s plight.

  “Who knows, in another day or two they may have kissed and made up but, as I see it, that guy is going to have major regrets if they can’t contact him.” Gavin stared deeply into Jan’s eyes, and she couldn’t help but think he’d suddenly changed the subject from Regina’s boyfriend to her. And Beck.

  Beck assisted the ICU nurse and the orderly with transferring the patient to the bed. Regina quietly moaned her protest. He handed the orders to the ICU nurse taking over her care, knowing that Jan would have already called in her transfer report.

  He’d told Jan he never wanted to see her again, and had done a great job of staying away from the hospital ever since. Lately, he’d been wrapped up in work with all of the crazy protests over the recent bank robbery and the SWAT team’s hand in innocent loss of life. He’d also been putting in a lot of time helping out his partner at home during his recuperation from the gunshot wound and colon surgery. Both things gave him a good excuse to avoid seeing Jan.

  He thought the police force and city officials were dead wrong and all screwed up on this new call to revamp SWAT, but nothing came close to the messed-up situation with Jan.

  Gavin had been the one to call and mention that he needed another twenty hours before he could sign him off for his official medic update. And, to be honest, he’d missed being at the ER. Though it would be best to stay out of Jan’s life, reality forced him back into her world.

  He’d found her after all of these years, his attraction to her was as strong as ever, they’d just started to find their way back to the comfort and intensity of their old relationship, then she’d dropped the bombshell about their daughter. Did everything in life have to be so complicated?

  Over the years he’d a
voided any other real relationships by keeping busy. His years in the military, continuing with the National Guard reserve and finally choosing the most demanding unit in LAPD to build his career, SWAT, had left little room or time for a significant relationship. The cynical joke circulating the unit was, “You’re not a real SWAT man until you’ve had your first divorce.”

  Divorce wasn’t an option for him. If or when he ever got married, it would be for the rest of his life. Something inside had him holding out for that one special person.

  Whenever a woman started to protest about his inaccessibility, and they always did around the two-to-three-month mark, he’d use it as an excuse to break things off. So far his system had worked out fine. But he was thirty-one now and still alone. And “alone” didn’t seem to fit as well since being around Jan.

  Even if things weren’t so messed up, the odds would be stacked against them. She’d probably be like every other woman in his life and grow tired of his work schedule and monthly reservists’ weekends. Not to mention getting called up for active duty every couple of years. What was the point of thinking about it? Yet he had been, knowing his reserve contract would be up next year. He didn’t have to sign on again.

  After working the ER for the last four weeks he’d started thinking about using his GI bill to help pay for official physician assistant training. Why not tap into the government money promised for education to all US soldiers in thanks for their service? He deserved it. He’d been so set on becoming a police officer after being discharged from the army that he’d unwisely let the opportunity to get a PA license slip between his fingers. Little did he know what the future would bring.

  He’d forgotten how good it felt to do patient care and to make a difference in people’s lives. Sure, LAPD’s promise to protect and serve was a noble cause, but now medicine seemed more basic and personally gratifying, and it would take him out of the frontline of fire, which would make Jan happy. And why was he even following this line of thought?

  Because deep down, when he blocked out all the other noise in his head and was completely honest with himself, he realized that long ago January had made a decision to protect him at all costs. And when he dug deeper into the honesty…well, he knew it had been the best decision for their baby, too. She’d sacrificed everything for him…because she’d loved him.