by Laura Iding
Her pager went off and she was grateful for the interruption. “This is the surgical ICU calling. Sorry, but I need to go.”
“Why don’t you call them first to see what they want?” he asked. “You might not need to sacrifice the rest of your meal.”
She needed to get away from him, for many reasons, but most of all her sanity. She jumped on the excuse to leave. “It’s a text page about Mr. Turkow’s blood pressure—it’s down. I need to run up and examine him.”
Jake frowned and nodded. “All right. Call me if you need me,” he said. “I’ll be by to check on him later.”
“Of course.” As if there was any other option? He was the boss, after all. She took one last bite of her chicken sandwich and then hauled her tray to the sideboard, feeling his gaze on her back as she left.
She let out a sigh of relief when she stepped into the elevator to head up to the third floor. She could do this. Work with Jake as a professional.
She had no choice but to do this.
* * *
By midnight, Hannah had lost count of the number of pages she received. Thank God for her note cards because she’d responded to some issue on almost every patient on their service and she’d never have been able to keep track of the patients without her notes.
As Jake had predicted, she didn’t even see the inside of her call room until two in the morning. She stretched out on the bed and closed her eyes. One hour. She desperately needed one hour of peace and quiet.
At two forty-five, her pager went off, announcing the arrival of a new trauma patient. Overall, the night had been quiet as far as trauma calls went. But maybe the trauma activity only started to heat up in the wee hours of the morning.
The responsibility of being a doctor seemed almost overwhelming. Yet this was something she’d dreamed about for years. Ever since she’d been hospitalized with a ruptured appendix at the age of thirteen. Her surgeon, Dr. Marilee McDaniel, had been amazing. After a week in the hospital, Hannah had vowed to be just like her.
The hardships would be worth it. Hannah rolled out of bed and splashed some water on her face in a pathetic attempt to wipe away the fatigue. Forty-five minutes was almost an hour, wasn’t it?
Of course it was.
She headed down to the trauma bay, only to find Jake already there, standing at the patient’s bedside. He didn’t look nearly as tired as she felt.
“What do we have?” she asked in a low voice.
“A young man with Ehlers-Danlos syndrome.” Jake glanced up at her. “Are you familiar with it?”
Ehlers-Danlos syndrome? She stared at him. Her mind went blank. Absolutely, completely blank.
“No?” The sharp disappointment in his tone hurt, more than it should have. “I suggest you do some research—it’s a rare genetic disorder.”
She glanced over at the patient, a very handsome young man who looked to be in his early twenties. He was moaning and grimacing, as if he was in excruciating pain.
“Start a dilaudid pain pump and get a full-body CT scan,” Jake said to the nurse. “And I want to see the results of his CT scan, stat.”
Hannah pushed the emotionally draining exhaustion away and forced herself to focus. She had read about the disease, she knew she had. As she and Jake stepped away from the bedside, she finally pulled the knowledge from the deep recesses of her brain. “Ehlers-Danlos syndrome is classified by weak tissue, primarily blood vessels, resulting in multiple aneurysms.”
“Yes.” There was a flash of approval in Jake’s gaze. But then he turned serious again. “Unfortunately, Christopher Melbourne was first diagnosed with this disease at the age of seven.”
Seven? Good heavens, she couldn’t even imagine. “It’s a miracle he’s survived this long,” she murmured.
“Yes. Although with the abdominal pain he’s currently experiencing, I’m very much afraid he has a leaking abdominal aortic aneurysm.”
Her stomach clenched. Abdominal aortic aneurysms were known to be serious, life-threatening conditions. “Can you surgically repair it?”
“No. Too risky. All his blood vessels are weak and fragile, to the point that they would never hold a new tissue graft. As it is, he’s been walking around with a large aneurysm in his axillary artery that no surgeon has been brave enough to repair.”
They couldn’t operate? “So what can we do for him?”
Jake slowly shook his head, and she caught a surprising glimpse of true anguish in his eyes.
“Nothing. Except make him as comfortable as possible until he dies.”
CHAPTER FOUR
JAKE stared at the dismal results of Christopher’s CT scan, battling a surge of helplessness. He’d never seen an abdominal aneurysm this huge, extending from the heart all the way down to the kidneys. He was amazed Christopher was still coherent. No way could he afford to operate on this poor kid. He’d die on the O.R. table for sure.
There was nothing worse than losing a young patient.
Except maybe standing by and doing nothing while watching him die.
He scrubbed a hand over his jaw and sighed. No matter how much he wished otherwise, there wasn’t a single treatment option he could offer. Except comfort measures. He walked back to Christopher’s bedside where Hannah was finishing her head-to-toe assessment. “I’ve confirmed a leaking triple A,” he said in a low tone, not meant for Christopher to hear. “We need to get him transferred up to the surgical ICU.”
“Doctor...have you...called my father?” Christopher asked Hannah, his wide eyes sunken into his thin face.
Hannah leaned over and took Christopher’s frail hand firmly in hers. As they’d worked together over the past several hours, Jake had noticed she touched patients a lot. Connecting in a way that made them trust her. If she kept up the way she was going, she’d be a great surgeon. “Yes, he’s on his way.”
“Good,” Christopher whispered, before closing his eyes on another wave of pain.
Hannah brought her tortured gaze up to meet Jake’s and he slowly shook his head at her unspoken question. If he could somehow pull off a miracle, he would. But Christopher was dying. The boy’s fate was no longer in his hands.
Just as they were about to wheel him up to the ICU, his father, Allen Melbourne, rushed in, eyes wide with fear. “Chris? Are you okay?”
“Dad,” Chris whispered, reaching out for his father. “I’m glad you’re here. The pain is bad. Really bad.”
Jake saw the question in the father’s eyes and hastened to assure him. “We have him on a pain pump, with a substantial dose of the strongest narcotic we have. He should start to feel better soon. And we’re moving him to the ICU.”
“Not to surgery?” Allen asked with a frown, glancing between Jake and Hannah.
“No. I’m afraid Chris isn’t a candidate for surgery,” Jake said, as gently as he could. At this point Chris was technically a full code, but Jake had no plans to actively resuscitate him. In fact, he shouldn’t really take him to the ICU, but he wanted Chris and his father to know he’d be closely watched.
Myriad emotions played over Allen’s face until, eventually, resigned acceptance remained. Jake noticed Hannah’s eyes glistening with tears, but then she quickly pulled herself under control.
“We’re going to take very good care of your son,” she promised.
“I know,” Allen said simply. He held his son’s hand as they wheeled him down the hall toward the elevators. The simple ride to the third floor seemed excruciatingly long.
Within ten minutes of their arrival in the ICU, however, Christopher’s monitor began to alarm, signaling dangerously low blood pressure. Seconds later, his heart slowed down.
“We’re losing him,” Hannah said urgently. “Get the crash cart!” And before he could stop her, she jumped up on the edge of the bed and began performing chest compressions.
On the third stroke downward, a large crack echoed through the room. For one horrified moment everyone froze, realizing Hannah had broken several of Christopher’s ri
bs.
“Stop!” Allen cried, as the monitor continued to beep. “No more! That’s enough.”
Hannah stumbled to the floor and backed away from the bed, her eyes revealing her acute devastation. Jake wanted to reassure her that she hadn’t done anything wrong. Surely she knew breaking ribs was a common complication of doing CPR? But it was possible she’d never experienced it herself.
Sometimes being a doctor sucked.
Allen held his son close and sobbed as Christopher’s heart rate continued to slow and then eventually stopped. The nurse, thankfully, had turned off the annoying monitor alarm.
Without warning, Hannah whirled and ran from the room. Jake wanted to go after her, but he needed to finish here first.
“Mr. Melbourne, I’m sorry for your loss,” he murmured. Losing a patient was the hardest part of being a surgeon. A surgeon’s mentality was to believe they could fix anything. And a good portion of the time, that was true. But not always. Like now. “I need to know if you want us to do an autopsy so we can confirm what caused Chris’s death.”
Allen shook his head, his eyes red-rimmed and full of tears. “You already know what caused him to die, don’t you? A ruptured aneurysm. No, I don’t want an autopsy.”
Jake didn’t blame him, but they were required to ask. And in the case of Ehlers-Danlos syndrome, there might be something they could learn from the rare hereditary disease. But he didn’t have the heart to push. “It’s your choice,” he said. “Again, I’m sorry for your loss.”
“Thank you,” Allen muttered, before bending over his son one last time. The nurse shut off the monitor and the IV pumps as Jake finished the death paperwork that would normally be the responsibility of the residents.
He left the ICU and paused outside the elevator. He was exhausted, but he knew he wouldn’t be able to rest until he’d checked on Hannah.
With a resigned sigh, he headed down to the trauma-residency call rooms.
His call room was located on the other side of the building, near the faculty offices, but he made it his business to know where the residents would be sleeping, in case he needed to drag one of them out of bed. He hesitated in front of the call room assigned to the first-year trauma resident, second-guessing his decision to come here. Half-tempted to leave her alone, he heard it. The unmistakable sound of muffled crying.
“Hannah?” He knocked sharply on the door, knowing he couldn’t leave her like that. “It’s me. Jake. Open up.”
He heard her sniffle and then blow her nose, before she finally opened the door. The sight of her tear-streaked face made him want to pull her close in spite of his determination to keep his distance.
She didn’t invite him in, didn’t say anything at all as she stood there, until he finally asked, “Are you all right?”
“I’m fine.” Her expression was brittle and he sensed she was hanging on by a thread. “I’m sorry, I know I shouldn’t have let my emotions get the better of me, leaving you alone like that. If you give me a few minutes, I’ll go back upstairs to finish the paperwork.”
“I already took care of it.” He stepped forward, forcing the issue, and she moved backward, allowing him to come in. After another long silence, he finally spoke. “It’s my fault, you know.”
That shocked her. “What do you mean?”
He sighed. “I had no intention of coding that young man. Doing CPR, giving drugs, none of that was going to work when he was literally bleeding to death. But I should have told you the plan.”
She bit her lip and her beautiful blue eyes filled again with tears. “I broke his ribs,” she murmured with an anguished cry. “I promised we’d take care of him and instead I broke his ribs!”
“Hannah, please.” He couldn’t stand watching her beat herself up for something that really was his fault. “You know it’s a risk of CPR.”
She nodded, but then her eyes filled with tears. She turned away, covering her face with her hands.
There were a lot of things he could have said. He could have assured her that it’s never easy for any doctor to lose a patient. That some deaths, like Christopher’s, were inevitable.
But he didn’t say any of those things. Instead, he reached out and pulled her firmly into his arms. At first she resisted, but he didn’t let go.
After a heartbeat, she collapsed against him, burying her face in the hollow of his shoulder. He held her and murmured nonsense in her ear, as she struggled to bring her emotions under control.
Finally, the tears stopped and the tension eased from her shoulders.
And despite the sad and unfortunate circumstances that had brought them together, all he could think about was how right Hannah felt in his arms.
And how much he didn’t want to let her go.
* * *
Hannah instantly regretted the moment of weakness. She shouldn’t have given in to her turbulent emotions, brought on, no doubt, by her bone-weary exhaustion. But the loud crack of the broken ribs kept echoing over and over in her mind. And that, coupled with how Christopher’s father had cried and held his son, had just been too much.
She hadn’t seen her own father in years. Since she was ten. And she couldn’t imagine he’d ever cried a day in his life. Especially not over the family he’d abandoned without a backward glance.
Dwelling on her family issues wouldn’t help, so she pushed them aside and tried to pull herself together. This wasn’t the first patient she’d lost. And undoubtedly wouldn’t be the last.
But with Jake’s arms holding her close, his familiar musky scent filling her senses, she couldn’t find the energy to break away.
Being with him felt right. How was it possible that she actually missed him? Missed being held by him? Totally ridiculous, considering she’d only first met him a couple of days ago.
She took a deep breath, intending to pull away. Being close to Jake wasn’t healthy. He was her boss, after all. Besides, if she wanted to be taken seriously as a surgeon she couldn’t fall apart every time she lost a patient.
But then he stroked his hand slowly, deliberately down her back, and she shivered. In a moment the embrace morphed from something nice and comforting to sizzling sexual awareness. Instinctively, she pressed more firmly against him.
He nuzzled the sensitive hollow behind her ear, an erogenous zone she hadn’t even known she possessed. She shivered again and gasped, every atom in her body longing for more.
“Hannah,” he murmured, just moments before his mouth claimed hers in an explosive kiss.
It was a replay that mirrored the first night when he’d kissed her on the elevator ride up to his condo.
And just like then, she was powerless to resist. He made love to her with his mouth, his tongue probing deep, and she urged him back against the wall, tugging his scrub shirt upward so she could rake her hands up and over his chest.
When she tugged at the knot in the ties of his scrub pants, she could feel the hard urgency of his erection straining against the thin fabric. She slowly stroked him.
Jake stiffened and thrust against her hand, but then abruptly broke off the kiss and tore himself away. She stumbled backward and for a dazed moment stared at him, struggling to breathe, trying to figure out what was wrong.
“We can’t do this,” he said in a harsh tone. His erratic breathing matched hers as he straightened his scrubs. She was somewhat glad to know his body had wanted her, even if his mind didn’t.
“But—” She stopped, as reality set in. Of course they couldn’t do this. He was her boss. And she wasn’t the person he thought she was. She’d never fit into his world.
No matter how much she wanted to. Wanted him.
“No, Hannah. This isn’t going to happen. This won’t happen ever again!” The edge of desperation in his tone made her wonder who he was trying so hard to convince. Her? Or himself? But then it didn’t matter because he wrenched open her door and stalked out, slamming it shut behind him.
She winced and collapsed on her narrow cot, threading her
fingers through her hair in a gesture of helplessness. Well. That certainly could have gone better.
And even though she knew, logically, he was right to stop before things really got out of control, she also couldn’t help resenting the hell out of him. Because he’d been the one to break off the embrace. It would have been far better if she could have been the strong one, but deep down she knew she didn’t have the strength to push him away.
Might never have the strength to push him away.
Mulling over that sobering thought, her pager went off for the zillionth time. She dialed the phone, knowing that somehow, impossible as the task seemed, she needed to figure out a way to keep her distance from Jake Holt.
* * *
The next morning, Hannah took a shower in the women’s locker room, trying to wash away the fatigue that seemed to coat her skin.
Thanks to Jake’s kiss, she’d lost the one measly hour of sleep she could have had.
Damn the man, anyway. Why had he come down to her call room? She would have pulled herself together.
Over the course of her life, she’d managed far more adversity than this. And had always found a way to get through it.
As she was tying the drawstring on a pair of clean scrubs, Andrea came into the locker room. “Well?” Andrea demanded anxiously. “How was it? Rough?”
It took a moment for Hannah to realize Andrea wasn’t asking about Jake’s kiss in the call room, but how her first night on call had gone. “It was really busy,” she answered honestly. “We lost a patient last night and transferred one of our floor patients to the ICU to be treated for septic shock.”
“You lost a patient?” Andrea said, her eyes widening in horror. “Oh, you know what that means?”
Hannah sighed as she slid her arms into the sleeves of her lab coat. “Yeah, it means a young man died despite our best efforts to save him.”
“No, it means you’ll have to present the case at M & M rounds,” Andrea corrected.
What? She stared at Andrea, the knot in her stomach tightening painfully. Andrea was right. How on earth could she have forgotten how Dr. Phillips had spoken at their orientation session about a resident’s responsibility at their weekly morbidity and mortality rounds? “Oh, no,” she whispered, as the implication sank into her brain. “I hadn’t thought of that.”