First Impressions: A Modern Retelling of Jane Austen's Pride and Prejudice (Meryton Medical Romances Book 1)

by Ruby Cruz

  This was moving way too fast and my overburdened brain was beginning to smoke at the edges. “Colin, there is no way I can move to New York. I can’t just leave Jane and Chloe behind.”

  My words just did not seem to be registering with him. It was almost as if he couldn’t conceive of me denying his offer. “Lizzy, this is a wonderful opportunity. I will give you the night to think about it before I make the general announcement tomorrow of my appointment. Once that announcement is made, I am sure most nurses will jump at the chance to engage in a clinical study of this magnitude.”

  “Colin, I have my answer now and it is no. I have no intention or interest in moving to New York and even less interest in doing clinical research. I’m sure your work will be fascinating and make wonderful strides in medicine but I don’t want to have any involvement with it whatsoever.”

  He blinked at me a full minute as if taking the time to digest what I just told him. “Well, I guess if you would refuse the offer of partaking in one of the most comprehensive and innovative clinical studies in neurovascular medicine then I shall have to take my leave of you. I just hope you know exactly what opportunity you are missing.”

  “I know what I won’t miss, that’s for sure.” I gestured to the door. “Good-bye, Colin.”

  He stared at me a moment before turning on his heel and exiting. I closed the door firmly behind him and spent a moment leaning against it, my mind reeling. I was still in the utility room when Luke walked in. He saw the look on my face and asked, “Hey, are you alright? You look like you’re about to decapitate someone.”

  “I just had a run-in with Colin, the arrogant prick. He actually offered me a job working as a clinical research nurse and couldn’t believe it when I turned down the offer.”

  “Whoa, back up. He offered you a job?”

  “He gave me some bullshit about needing my clinical skills, blah blah blah, as if I had the luxury of leaving my family behind and leaving Jane in the lurch. And then he walked away as if I’d offended him that I wouldn’t take the job, like I was out of my fucking mind. I’ll tell you what, I’d be out of my fucking mind if I actually accepted working with him, the socially inept weasel.”

  “You said ‘fucking.’ You must be mad.”

  “Argh. He just gets me so aggravated, the pompous asshole. It makes my skin crawl to think I even had a drink with him, and then that kiss? God, imagine if we’d had sex.” I shuddered.

  “Whoa, now that’s an image I don’t need, hon. Honestly, Lizzy, he’s not that bad. A little self-involved, maybe, a little verbose, but he means well.”

  “Are you actually taking his side? Are you saying I should’ve abandoned Jane and Chloe to take this job that I have absolutely no interest in taking?”

  “I didn’t say that. I’m saying that Colin is entitled to his opinions. That’s all.”

  “Well, he doesn’t need to be forcing them on me and trying to persuade me to make a life decision I don’t want to make.”

  “Okay, okay. I don’t want to argue with you about this. Look, I know that Colin isn’t your favorite person right now, but you might want to take it down a notch or two. You are colleagues in a broad sense and, in your best interests, you need to keep professional.”

  I blew out a breath, his comment mollifying me a bit. “God, I hate when you’re right. Okay, no more unprofessional cursing and name calling.”

  “Good. Are we cool?”

  I nodded and he led the way out of the clean utility room. I returned to Mrs. Clancy. I forced a smile and said, “Sorry about that interruption. How’s your back feeling?”

  Ever since she’d been admitted to the floor an hour ago, Mrs. Clancy had been complaining of mid back pain even though her chest pain had disappeared. According to the report I’d gotten from the emergency room nurse, after the EKG showed no cardiac damage, the doctor in the emergency room had suspected a UTI but the urinalysis had been clean. Other than an elevated blood pressure and slight tachycardia, she had no other symptoms. She was scheduled for a CT scan of the chest the next day and an echocardiogram along with some routine blood work. The time I’d spent arguing with Colin was normally when I’d complete the admission charting on the patient and review her medical history. I was well-behind schedule and a part of me really resented Colin for interrupting my work flow.

  “The Tylenol helped slightly,” she answered but I could tell she wasn’t being entirely truthful as she shifted in the hospital bed.

  “Are you sure? I can see if we can give you something stronger.”

  “No, don’t bother, honey. I don’t want to cause you any more trouble and I don’t want to take anything that will make me feel fuzzy. I’ll manage.” I pressed a bit more but she refused to consider taking any narcotics. I continued to use the bedside computer to complete her admission charting when she added, “That young man was in such a state to speak with you. Is he your boyfriend?”

  I turned to Mrs. Clancy and saw the twinkle in her eye. “That would be a solid no. Far from it.” I replayed my discussion with Colin in my mind and at the patient’s curious gaze I continued, “He was actually offering me a job.”

  She looked shocked. “A job? At a different hospital?”

  “No, doing research on some medical procedure. Anyway, I turned him down. Research isn’t really for me.”

  She gave an exaggerated sigh of relief. “Well, that’s the best news I’ve heard all day. You’re such a good nurse; it’d be a huge loss to the hospital to have you leave.”

  “That’s very sweet of you to say, thank you.” I was genuinely touched.

  I spent another fifteen minutes completing the admission charting and then another half hour checking on my other patients, one of whom had to use the bathroom and another whose daughter was demanding to know her mother’s latest lab results. When I went back to check on Mrs. Clancy, she was still lying quietly in her bed but she was pale with a slight sheen of perspiration marring her forehead. “How are you feeling?” I asked her with some urgency. “You look uncomfortable.”

  She attempted to force a smile but the grimace on her face spoke volumes. I took her blood pressure again, which was still elevated at 160/90 despite the anti-hypertensive medication she’d received in the emergency room. She was clammy but not feverish and her heart rate had increased to 120. “Does your back still hurt? Or your chest?” She shook her head but she was starting to seem short of breath. I listened briefly to her heart and lungs, but both sounded normal. I was about to get the EKG machine and ask someone to call the attending, Dr. Darcy, when she clutched her chest. “Oh, oh,” she called out. Then she passed out.

  Oh God. I called out of the room. “I need help in here!” I tried to feel for a pulse. I thought I could feel a very weak carotid but that could’ve just as well been my own blood thundering through my fingers. In any case, I screamed into the hallway again, “Call a code!” Just a few seconds later, Luke arrived and I could hear someone else pushing the code cart down the hall. An urgent voice sounded on the intercom, but was distant through the thunder in my ears.

  “Code blue, room 529, code blue, room 529.”

  I pulled the CPR lever on the bed, and then started compressions on Mrs. Clancy’s chest. I didn’t glance up when I heard people enter the room, when Lydia pushed the code cart to the end of the bed. Breathlessly, I began to apprise the people in the room what had happened, why she was admitted, her back pain, sudden chest pain, then loss of consciousness and pulse. The resident on-call ordered a round of epinephrine as the pads for the defibrillator were attached to obtain a heart rhythm. Asystole.

  Dr. Darcy rushed into the room and barked, “What the hell happened?”

  “The patient was admitted from the ED with complaints of intermittent chest pain with no EKG changes,” I answered.

  “Can someone who isn’t an idiot tell me what happened?” Darcy demanded as he donned surgical gloves. “I admitted her; tell me something I don’t already k
now. What were her presenting symptoms, vital signs?”

  I almost didn’t answer, I was so stunned. Did he just call me an idiot? Luke glanced at me briefly as he inserted the IV, as did Lydia who was currently prepping meds at the code cart. “Switch,” I called out and a resident took over the compressions. “Since coming to the floor, she had no chest pain but complained of persistent mid-back pain. She had been hypertensive with a systolic blood pressure in the 160s with minimal response to Labetalol in the ED.”

  “Why the hell didn’t they do the CT scan in the ED? I specifically ordered that it be done before she was sent to the floor.”

  “I don’t know. When I got report, the ED nurse never mentioned anything about a CT scan. I only saw the order when she arrived here and it wasn’t ordered STAT so it wasn’t done.”

  Darcy made a disgusted sound, something like a growl, and then dismissed me with a turn of his body towards the patient. Inwardly I seethed. It was all I could do to refrain from punching him. Who the hell did he think he was?

  The code lasted about twenty minutes. Darcy ordered multiple rounds of epinephrine and atropine, intubated the patient, even attempted a defibrillation, but Mrs. Clancy’s heart never started beating again.

  I felt sick. I didn’t know if the gnawing in the pit of my stomach was from the aftermath of adrenaline or from knowing that my patient, a sweet lady whom I’d spoken with just thirty minutes earlier, had died before my eyes. Either case, I wanted to step out of the room, keep some distance between myself and Dr. God-complex. I could feel his eyes on me as he left the room for the visitor’s lounge, could hear him begin to impart the bad news to Mrs. Clancy’s already grieving husband and daughter. I gathered things together so I could begin post-mortem care on the body.

  Luke approached me and laid a hand on my shoulder. “You okay?” He stood next to me, his eyes swimming with sympathy. “I know you liked her.”

  I turned towards him, my eyes averted from the body. “God, one minute she was talking to me, joking with me, and before I knew it her eyes rolled up in her head and she was gone.” Even though I’d been a nurse for several years, I’d never experienced anyone expiring that suddenly. The guilt began afresh. “I knew something was up when she started complaining of that back pain. I knew it was really bothering her but she refused to take anything more than Tylenol.”

  “You can’t blame yourself, Lizzy. Maybe it was just her time.”

  My eyes burned as I fought the tears that threatened to well within them. I sighed and then glanced up as Dr. Darcy stood in the doorway. Luke’s gaze flitted between Darcy and me until the doctor asked me, “May we have a word?”

  Luke said, “Let me know if you need any more help with post-mortem care,” before deserting me.

  I nodded in reply, then straightened as Darcy approached me. He stood across from me, the lifeless body between us. A moment passed before I expectantly looked him square in the eye. Whatever he had to say to me couldn’t hurt me anymore than his behavior during the code.

  “Did you know that your patient had a seven centimeter triple A?” By his tone, he obviously thought I did.

  “When I was doing her health history, she mentioned having an aneurysm but didn’t know how large it was and I didn’t get that information from my report with the ED nurse.”

  He pressed his lips together. “Mr. Clancy has consented to the autopsy. As you know, with her expiration less than twenty-four hours after admission, this becomes a medical examiner’s case. Most likely, the burst of his wife’s aneurysm caused the cardiac arrest so whatever we did would not have made a difference, but I needed to inform you so you can get the appropriate paperwork in order for the medical examiner.”

  “I’ll take care of it.”

  “Good. That’s all.” He turned from me dismissively, then grabbed the patient’s chart from the bedside table before leaving the room.

  I hesitated briefly before following him down the hallway into the dictation room. This time, I did close the door. “Dr. Darcy, do you have a problem with the care I provided Mrs. Clancy?”

  He hadn’t had enough time to sit but he did lay down the patient chart on the counter. His eyes were inscrutable as they met mine. “I beg your pardon?”

  “Ever since she coded you’ve been criticizing my every action leading up to and following time of death. If I didn’t know any better, I’d suspect you feel that she might have survived if another nurse had been caring for her.”

  Darcy paused, still inscrutable, but his expression hardened briefly. “Nurse Bennett, I believe you handled yourself capably during the code. Could you have apprised yourself of Mrs. Clancy’s complete medical history prior to caring for her? Yes. Could you have been more proactive about reporting her back pain and elevated vital signs? Yes. However, as I have said, your knowledge of her medical history probably would not have changed the outcome. Now, I suggest you stop trying to find someone to blame in this situation and continue to provide care to your patients who are currently alive.” As I gazed at him wordlessly he added, “Will that be all?”

  I felt as if I’d been slapped. His eyes bore into mine until I said lamely, “I need patient labels from the chart and your signature on the autopsy request forms.”

  Without taking his eyes from mine, he opened the chart and handed me a sheet of labels. “Find me when the forms are ready.”

  Instead of returning to the nurses’ station to complete the required forms, I headed directly to the patient room and laid the labels quietly on the bedside table. As I finished preparing the body so the grieving family would be able to say their good-byes, the tears I had fought so hard to prevent before now flowed freely. God, what was wrong with me? What possessed me to confront Darcy? He was no more to blame for this whole situation than I was, yet I was feeling mortification mingled with disgust at my behavior and his.

  I was glad I had pulled the curtain all the way around the bed because I heard the footsteps before I saw the person at the door. I hastily wiped the tears from my face with my sleeve but knew that my puffy eyes would be a sure sign of my tears.

  “Lizzy, Mr. Clancy is waiting to…” Dr. Darcy stopped when he saw me. He cleared his throat and his eyes slid from me to the body of Mrs. Clancy. She looked peaceful now, her arms resting quietly at her sides, the blood from our final efforts of resuscitation washed away. The endotracheal tube and IV catheters remained in place, the only signs that she wasn’t just slumbering in her bed. “Is she ready?” His voice was soft and, for once, not accusatory.

  “Yes,” I answered, my voice throatier and thicker than I would have liked. “I’ll get those forms for you.”

  I brushed past him, but Darcy grasped my arm to stay me. “I told you, it wasn’t your fault.”

  I allowed myself to look him in the eye. His face was impassive but free of the hardness I was used to seeing. “I know. Doesn’t make it any easier, though.”

  Darcy freed my arm and I left to get the requisite forms.

  CHAPTER TWELVE

  Apology Not Accepted

  That evening, Chloe was already sleeping when I arrived home. I knew that I would miss seeing her before her bedtime, but I longed to feel her little arms wrap around my neck even when accompanied with a sloppy kiss to the cheek. She couldn’t say Aunt Lizzy yet, sounded something more like Tee-Tee. I peeked into her room and wondered how Jane’s loser of an ex-boyfriend could choose to forsake her. Somehow seeing her sleep seemed to unravel the knot that had formed in my throat.

  Jane asked me quietly, “Are you okay? Luke called to say you had a rough day at work.”

  “I’m fine. Nothing a hot shower and a glass of wine can’t fix.” I couldn’t wait to wash away the stink of death that seemed to linger on my skin. I headed to my room, began to undress. She followed me and I could hear the hesitation in her voice.

  “If you want me to stay home, I can call Charlie and postpone.”

  “Don’t be ridiculous. I�
�ve had a bad day, that’s all. Besides, the munchkin’s already asleep so, in theory, I have all night to sulk and get over it. Go and have a good time. Have enough sex for the both of us.”

  She blushed and admonished me, “Lizzy!”

  “Go on before I go and jump him myself.”

  Jane hugged me from behind. “Lizzy Bennett, you are the best sister in the world and a wonderful nurse. I know you feel differently, but I’m sure you did whatever you could to help that patient.” When I didn’t respond, she sighed. “Thanks so much for watching Chloe tonight. I won’t be late.”

  “You’d better be late. I want to know that at least one of the Bennett sisters is getting laid tonight.”

  After she left, I stood in the shower until the hot water helped knead away the stress of the day. When I emerged, I dressed in my most broken in T-shirt and sweat pants, and then I padded into the kitchen. I considered opening a bottle of wine but that felt too indulgent, so I compromised with a cup of herbal tea with a splash of brandy. This was a drink Jane would make for me if I had a cold or sore throat, which, given my present state of mind, reflected how I felt physically.

  I crawled into bed and was about ready to enjoy my tea with a couple chapters of Patricia Cornwell, when I heard the front door open. My heart thumped with the brief notion that someone was breaking in until I heard Jane call out to me softly, “It’s just me, Lizzy.”

  Concerned, I climbed out of bed and found her sitting on the couch. “Jane? What are you doing here? Where’s Charlie?”

  She sat on the couch, unmoving, unspeaking. I was about to prod her when she answered, “Charlie had to go to the hospital.”

  “Is he okay? Is he hurt?”

  “No, no, nothing like that. Someone called out sick and he volunteered to fill in.”

  “That was nice of him, I guess.”