by Dianne Drake
“Or avoid it?”
“Has anybody ever told you how blunt you are?” he said, a hint of amusement in his voice.
She laughed. “It’s been mentioned a time or two.” She was dying to ask him about his injury, but so far he didn’t seem willing to talk about it, other than in the vaguest sense. He’d said what he’d wanted to say, and that’s all there was. “Blunt, stubborn…one of the technicians who worked for us at the clinic called me Dr Ice. She didn’t know that I was aware of the nickname, but I wasn’t bothered by it. It took me a long time to learn how to appear unaffected and, apparently, I was pretty good at it.”
“Nothing about you seems unaffected to me. In fact, if your technician had seen you go under that bus with Delroy, and stay there the way you did, she’d find something else to call you. He’s doing better, by the way. Good progress, according to his doctor.”
Behind them, the frantic pounding of feet on the deck caught her attention for a moment, as one of the organized exercise groups fast-walked their way around the deck, their heel-toe, heel-toe rhythm almost precise as they passed by where Sarah and Michael were standing. As their footsteps faded she thought about how much she liked being here with Michael this way, and how she didn’t want to leave. Which was exactly why she had to. Anything else got her involved, and she was so on the brink of doing just that she felt like the ship that five-year-old Michael Sloan had watched sailing along the edge of the world, ready to fall off. She was attracted to Michael Sloan, and it was about so much more than his ability to fill her medical longings. From that very first moment he’d caught her… No musings. No regrets. She plainly couldn’t do this. “Look, Michael, about my offer to help you… I’m leaving tomorrow instead. I’ve already sent a message to the ship’s captain telling him that when I go ashore in Aruba I won’t be returning.”
“Why?” His voice was stiff. That relaxed feeling between them was gone.
Should she tell him that she had feelings for him in a way she didn’t want to? Or tell him the same thing she told everybody else—that it was time to move on? That was always the easiest excuse. Very impersonal and precise, and no one could argue against it. But with Michael she didn’t want to be impersonal and precise. She didn’t see any other way, though. “My life is full of reasons, Michael. None of them really make any difference. I just do what I do, and moving on is part of that.”
“Avoidance?” he snapped.
“Now aren’t you the one who’s being blunt?” Sarah smiled sadly, thinking about how true that was. But it was about self-preservation. She understood that better than she understood just about anything else. If you didn’t avoid things, you opened yourself up to the possibility of being hurt, and she’d already had too much pain in her life.
He chuckled, but there was a sharp edge to it. “I’ve been called stubborn a time or two also.”
“But never unaffected. The little boy who wanted to save that ship could never be unaffected. Neither could the man he turned into.”
“Look, Sarah, if I weren’t in trouble, I wouldn’t say this, but I am. Most of my medical staff is down sick, and I need you to stay here and help me until the cruise line makes other medical arrangements. I’ve cleared you working here under emergency provisions through the ship’s captain, who cleared it with the cruise line. So, until help arrives I’m authorized to do what I have to do to take care of the passengers and crew and for starters that’s putting you to work. But I’ve got to warn you up front that we’re looking at some hard hours ahead. There’s a possibility we might have an outbreak of norovirus on our hands.”
Sarah certainly knew what that was. Back in Boston, at her immediate care clinic, she’d treated a rash of people with norovirus, all of whom had jumped a quarantined ship that had been docked a few blocks from her office. “I take it you’re confining them as they get sick?”
Michael nodded. “Both the passengers and my medical crew. If I had my way, I’d confine everybody on board, sick or not, for the next three days and let the whole damned thing run its course. Which they won’t let me do. And to be honest, if this thing plays out the way it usually does, nobody’s going to be allowed off the ship in Aruba anyway.”
“Then I don’t have much of a choice, do I?” The truth was, as much as she wanted to avoid practicing medicine, this unexpected opportunity excited her. Norovirus was simple. And she would have a little more time with Michael. That was, perhaps, the real reason she accepted. Around him she didn’t feel quite so unaffected. In fact, if she wasn’t very careful, he had the power to affect her in ways she’d thought she’d never be affected again. Only if she let that happen, of course. Which she wouldn’t. “When do we start?” she asked, the gloomy shroud that had entangled her suddenly blowing out to sea.
CHAPTER EIGHT
“THREE passengers, all with non-specific complaints,” Ina announced as Sarah followed Michael through the hospital doors. “Headaches, muscle aches, fever with unknown origin, several of them with some respiratory distress. That kind of thing. I’ve got them all in exam rooms, having their vitals taken and their medical histories assessed.” Her glance darted from Michael to Sarah then back to Michael, and a thin little grin spread over her lips, even though she didn’t break her cadence. “We’ve had calls from two more passengers who will be coming down here shortly, again non-specific complaints.”
Sarah frowned. “Noro usually starts with quite a kick rather than non-specific complaints. This seems odd.”
“But there are so many variations of it,” Michael added. “Currently, there are five known specific norovirus groups that are divided into thirty-one smaller groups. The symptoms we usually see at the onset are generally the same, to varying degrees, but who knows? Viruses mutate so quickly these days we could be looking at a variant that hasn’t been identified, or just a new version on an old theme.”
“Well, identified or not,” Ina chimed in, “the captain is on his way down to the hospital to see what we’re dealing with. He says he wants a full report.”
Michael nodded. It was premature to attach any major significance to this little rush of illnesses, but the captain should be made aware that there was a similarity, just in case it turned out to be something major. In the meantime, there were still the normal ailments to treat, and people were beginning to line up in the Emergency clinic to be seen. “Sarah, could you take over regular duty in emergency? I think that will be pretty much what you did working in an immediate care clinic. I’ll back you up if you need it, look in on the patients already staying in the hospital, and I’ll also take anyone coming in we think could be in the early stages of whatever this is. And, Ina…” He simply waved her off, as she was already on her way back to her nursing duties and needed no further instruction.
“Do I have a nurse?” Sarah asked.
“We’re stretched pretty thin there, too. Besides Ina, we have two other nurses, and I’m going to try and keep them on general duty, triage, that kind of thing, if I can. If you need a nurse to assist you, call Ina and we’ll see what we can do.” He stepped closer, and took gentle hold of her arm. “You’re going to do fine, Sarah,” he said, his voice practically a whisper. “I know this isn’t what you want to do, but I appreciate you helping me. It’s safer having two doctors available.” She looked worried, in spite of the fact that she was forcing herself to smile. But there was nothing else he could do at the moment.
Sure, it would have been nice working side by side with her, just to help boost her confidence a little. Or simply to spend a little time with her any way he could get it. That just wasn’t going to happen today, though, and he wasn’t worried about leaving Sarah on her own. She was a good doctor who, for whatever reason, didn’t trust herself. That much was evident. He trusted her, though. And for now, that had to be enough. It would have been nice knowing what had caused the fear and doubt in her, but that was a story for another time. At present there were other priorities, and trusting Sarah was one of them. She was g
ood. He was sure of it—sure enough to put the lives of his patients in her hands.
Her pace was slow at first, he noted. By the time she was ready to start her medical duty, there were half a dozen patients lined up waiting to be seen, and she took her time seeing each one. He really didn’t have time to stop and observe, not that he would have, but he did catch occasional glances of Sarah as she performed a routine procedure or simply talked with a patient. What he saw was amazing. She had such grace…something to which the patients were naturally drawn. He could see that in the easy smiles that came over their faces once they were greeted by Sarah—the smiles of a patient who truly trusted the doctor. It was nice, and he would have loved standing back and watching, but Captain Regard was waiting for him now, and it was time to have a frank discussion about what was happening. In the past half-hour another ten patients with the same non-specific complaints had wandered in. And in that same amount of time, Dr Allen, one of the first people to go down with this unknown ailment, had spiked an extreme fever and developed a suspicious heart rhythm—so much so, they’d had to put him on a monitor.
If this was norovirus, it was definitely an unknown strain, as the formerly non-specific complaints were now becoming specific, and they weren’t anything like norovirus. That had him concerned.
Captain Thomas Regard was a distinguished man. Tall, with silver-gray hair and piercing blue eyes, he carried the demeanor of ship’s captain quite well, except that when Michael set eyes on him, that demeanor was diminished. Captain Regard looked gaunt, tired, and as he approached Michael’s desk, he practically fell into the chair opposite it. “Report,” he said, his voice weak. “Tell me what’s going on here. Why are most of your medical personnel down?”
“Symptoms?” Michael asked in return. “Tell me your symptoms.”
Regard shook his head. “It’s nothing. I’m due for some holiday time after this cruise, and once I’ve had a little rest I’ll be fine.”
“I have twenty people saying the same thing right now, Tom. And you’re looking like every one of them”
“Is it norovirus?” the captain asked, his haggard face creasing into a frown. Noro was the scourge of so many cruise ships these days that it was well known to people, like Captain Thomas Regard, who had absolutely no medical knowledge whatsoever, except for Norovirus.
“Initially, that’s what I thought. But now, I don’t know. I’m inclined to think we’ve got something else going on…something in its very early stages. And based on what I’m seeing, the symptoms aren’t even close to norovirus.”
“So tell me what to do, Mike. You’re the doctor here, and it’s your call. Should we be alarmed?”
“Well, twenty’s not an alarming number, if it doesn’t go beyond that. But that’s twenty people who’ve all come down with something I haven’t been able to identify yet. I’ve got them confined to quarters but something’s telling me that I need to bring them into the hospital to watch them even more closely. Especially if it’s not norovirus, which is what I’m inclined to think right now.”
Captain Regard nodded, although it was clear by the expression on his face that he didn’t have the vaguest idea what Michael was talking about. “So, what about docking and going ashore in Aruba? Should we skip that port?”
“Yes,” Michael said, without hesitation. “I don’t know if we’re dealing with something infectious, and I don’t want to risk taking it ashore. So, at least for this port of call, we need to stay on ship.”
“You know how that’s going to go over, don’t you, keeping the whole ship away from the next destination when only a handful of the passengers are sick? People aren’t going to be happy.” He let out a sigh. “And if I didn’t feel like hell right now, I’d probably try and argue you out of this, but I do, so I won’t.” He started to stand, wobbled, and sank back down into the chair. Michael was immediately at his side, laying a hand on the captain’s forehead at first, then taking hold of his wrist to feel his pulse.
“You’re burning up with fever. And your heart rate is too fast. How long have you been sick?”
“About a day. But it’ll pass,” the captain said. “I’m going back to my quarters for a short nap now, and I’ll be fine.”
“You’re off duty, Tom, and I’m admitting you to the hospital,” Michael said emphatically, helping the man up from the chair.
“I need to—”
“There’s nothing you need to do right now except rest and let me be the doctor.” He expected an argument. The man had an exceptionally robust personality, but at this moment he had no fight left in him as he practically slumped against Michael, without uttering another word. Five minutes later, Captain Thomas Regard was the twenty-first patient on the charts for whatever this outbreak was. And there was no denying it. This was definitely an outbreak of some sort. As much as he hated admitting it, Michael was admitting it now.
“Your blood sugar is three times the normal value,” Sarah said to the woman on the exam table. Mrs Margesson was the fifth over-indulger she’d seen that morning. Too much good food, too little willpower, and the result for a diabetic could be devastating. “Your blood sugar is registering at three hundred, and you need to be closer to one hundred.”
The woman grinned sheepishly. “I ate a few sweets last night and had a pastry or two for breakfast this morning,” she admitted. “I didn’t think it would hurt me.”
Sarah patted her patient’s hand. “It’s not much fun to come on a cruise and not be able to eat everything they have available, is it?”
Mrs Margesson shook her head. “The food is so…good.”
Wasn’t this the same lecture Michael had given her, only in reverse? Eat more, Sarah. Don’t let your blood sugar go so low. And hadn’t she argued with him? Maybe this was some kind of retribution, being confronted with, well…herself. Patience, Sarah, she cautioned herself as she prepared to argue logic with a woman who was clearly more interested in a chocolate-covered éclair than she was a medical lecture.
“It’s hard to resist,” Gertie Margesson continued.
Sarah smiled, thinking back to the way Michael had handled her little blood-sugar situation. He really was an excellent doctor. She admired that in him. Wanted to emulate it right now. “Here’s what I’d like to do, Gertie. First, I want to get your blood sugar back down to a normal level with some insulin. You’re not so high that you’re in any danger, but I really don’t want you getting any higher because you do risk having a stroke in the short term, and I’m sure your own doctor has advised you of all the long-term side effects.” Blindness, kidney failure, nerve damage, heart disease, circulatory problems leading to possible amputation…
Amputation! Was Michael a severe diabetic? That certainly was a consideration, and something she needed to watch him for since in the next little while he was going to be working more hours than he normally did. His blood sugar could go out of whack with extreme fatigue. “So, here’s what you need to do after we’ve got your blood-sugar level back in order. I want you to watch your diet more closely, stay away from the sweets on a regular basis, restrict your carbohydrates overall. But just so you won’t deprive yourself, I want you to go ahead and have a little indulgence every other day. Keep it moderate, though, and balance it out with a better choice of foods all the way around. In fact, I could have the ship’s dietitian sit down and have a chat with you, maybe draw up your own special menu if you’d like. Also, you need to keep a record of your blood sugar. Test yourself three times a day and bring me the results every morning. If you’re good, I’ll give you the go-ahead for that little treat. If your results aren’t so good, we’ll hold off until they are. Can you do that?” She looked Mrs Margesson straight in the eye.
“That’s asking an awful lot of me,” Gertie replied, none too happy with any of this. She wanted more, but she needed less, and Sarah had a hunch that this wouldn’t be the woman’s last trip to the ship’s hospital with a diabetic-related crisis.
“But you’ll try,” Sa
rah said.
“I’ll try, but don’t expect too much. I’m here on a holiday, and that includes my diet, so I’ll be good when I get home.”
Ah, yes. Put it off until tomorrow. She’d heard that excuse hundreds of times over the years. Deny the obvious now, promise to do better next time, and in the meantime hope the side-effects of what you’re doing now don’t do you in.
Wasn’t that the way she was living, though? Didn’t she put everything off until tomorrow, then the tomorrow after that? Didn’t she keep promising herself that she’d make a decision about her life? Well, she understood Gertie Margesson’s circumstances because, in a way, they were just like hers. Only Gertie did it with food, while she was doing it with avoidance. Yes, that old bugaboo she and Michael had already talked about. “I’m sure you do much better when you’re home, Gertie, but if you don’t do better here you might not make it home. Diabetes has serious consequences if you don’t manage it properly. So, it’s your choice. I can’t control how you eat. Can’t watch every bite you take. All I can do is try and fix you up if you hurt yourself, and hope it’s enough.”
Gertie looked like she’d been slapped in the face. Maybe it was a harsh pronouncement, but it was a true one. And for someone who had a history of missing the obvious, the way Sarah did, one thing she wasn’t missing here was the fact that she had an uncooperative patient who truly believed that her actions today didn’t have a significant bearing on her life tomorrow.
If only that were the case. But Sarah knew better, and all she had to do was remind herself of Kerry, and of Cameron.
After Gertie departed, not at all convinced by Sarah’s little admonition to do better or else, there was no one left to see, so she wandered off in the direction of the clinic where Michael was working, ready to offer assistance. On her way, she glanced into one of the private patient rooms in time to see the man in the bed go completely rigid, then begin to thrash about so hard the bed rattled.