by Laura Iding
Without warning, the three-year-old’s face turned a dusky shade of blue. Greta grabbed an ambu-bag with an oxygen mask attached, placing it securely over the child’s face.
“Dr Howe! She’s having a laryngospasm. She can’t breathe!”
CHAPTER THREE
“BE CAREFUL, try to avoid the sutures I just put in. If the skin flap goes bad, I’ll need to do the entire operation over again.”
Moriah peered into Anita’s throat with the laryngoscope, trying to visualize the tracheal opening through the swollen tissue. She had no intention of ruining Blake’s handiwork—Anita wouldn’t tolerate further surgery. But the newly placed split-thickness skin graft on Anita’s face was the least of her concerns just now. Maintaining an airway was one of the more important parts of an anesthesiologist’s job. If she didn’t get this endotracheal tube into the child soon, she’d die.
“Come on,” she muttered under her breath as she tried to slide the tube into Anita’s tiny throat. The spasms were so bad, the tube wouldn’t go in.
Moriah tossed the useless endotracheal tube aside and grabbed the face mask and ambu-bag to give the girl some oxygen. She tried to hyperventilate her. The dusky color faded but not by much.
“Do you want me to try?” Blake offered.
“No.” Moriah shook her head. Blake would certainly know how to intubate a patient but, as a surgeon, it wasn’t his area of expertise. “There isn’t time. I need to trach her.” Moriah strove to remain calm, although she had never done a tracheostomy on a child this young. “Find me a scalpel, splinter forceps and a size-three trach.”
“Here.” Greta quickly handed her the requested supplies.
“Get her strapped onto the gurney so she doesn’t move,” Moriah instructed as she prepped the child’s throat with antimicrobial solution.
Greta did as she’d been asked while Blake stepped off to the side, giving them plenty of room to work. She appreciated his sensitivity. As a surgeon, it couldn’t be easy for him to relinquish control. Taking a deep, calming breath, Moriah used the scalpel to make a small incision in the child’s throat. With tiny forceps, she opened the tissue enough to thread the tracheostomy tube into the opening in Anita’s airway.
“Greta, can you help me secure this?” Holding the trach in place with one hand, Moriah quickly connected the ambu-bag directly to the tracheostomy tube so she could give the child several deep breaths. Anita’s color instantly returned to normal and Moriah breathed a sigh of relief.
“She’s fine now.” Greta’s voice held admiration as she tied the tracheostomy tube in place. “Thank heavens. I was worried there for a moment.”
“Me, too,” Moriah admitted. “That was too close for comfort. We could have lost her.” Doubt gnawed at her. Had she made the wrong choice in extubating Anita so soon after surgery?
“You did the right thing, Moriah.” Blake’s gentle tone caused her to glance across at him in surprise. He must have read the uncertainty on her face. “You were having trouble oxygenating her during the case with the endotracheal tube in place. You didn’t know about her asthma. Any patient can have a laryngospasm, it’s a common risk of anesthesia.”
“I know.” His blue eyes were calm, steady. Logically, her brain knew Blake was right: any patient could have a laryngospasm. But the memory of Anita’s dusky blue face was difficult to forget. A few minutes longer and the results could have been catastrophic.
Shaking off her self-doubt, she squared her shoulders. There wasn’t time to dwell on her decision, not when there were other patients waiting for surgery. “All right, Greta, we’re going to start the next case. Keep a close eye on this little girl for me.”
“I will,” Greta promised. The PACU nurse reached into her bag of stuffed toys and chose a floppy-eared dog for Anita, placing the animal on the bed for the girl to see when she woke up.
Moriah smiled at Anita’s peaceful face. The last time they’d been here, the animals had been a huge hit with the children. The kids held their stuffed toys as if they were gold, smiling in spite of what must have been agonizing post-operative pain. Sometimes the silliest gifts were appreciated the most.
“Wait a minute.” Blake caught her arm as she tried to walk past him to return to the OR suites. His brows were pulled together in a concerned frown. “Are you sure you’re all right? Maybe you should take a break before we start the next case.”
“No, I don’t want to fall behind schedule.” Moriah was hyperaware of the sizzling electric shock that tingled along her nerves at Blake’s warm hand on her arm. His touch made the heavy blanket of exhaustion cloaking her shoulders dissipate. How did he manage to make her feel special with a single touch, when other men left her cold?
Irritated with herself, she pulled away and tried to concentrate on what needed to be done. “I can’t bear the thought of not getting to all the patients on the list.”
“We won’t fall behind.” Blake steered her toward the physicians’ lounge. “Five minutes with your feet up will do wonders.”
Actually, Moriah knew his feet probably ached more than hers did. He had to stand to do surgery, while she could sit. Giving in, she headed for the lounge.
“Ah-h.” Blake smiled in pure ecstasy as he propped his feet on the table. “Feels wonderful.”
“I bet.” She couldn’t begrudge him a few minutes of rest, even if being here like this with him was akin to torture. She was supposed to be purging him from her system, not longing for something she couldn’t have.
“Tell me, how is your postpartum mom doing?”
She was surprised he’d remembered, although she shouldn’t have been. Blake had a great memory for detail—it was one of the things made him such a good surgeon. She shrugged. “I’m not sure. I went to visit her last night, but the nurses wouldn’t let me in while she was trying to breast-feed. I plan to go back later today.”
“Sounds like she’s doing fine, then.”
“Maybe I’ll go take another peek at Anita.” Moriah needed to reassure herself the girl was all right.
“Greta would come and find you if something was wrong,” Blake pointed out.
“I know.” The real truth was, sitting here and chatting with him was nowhere near relaxing. Being on a different continent might have helped. “I’ll meet you in the operating room in a few minutes.”
“All right. Moriah?” he said before she could leave.
She paused in the doorway. “Yes?”
“It’s great working with you again.”
It was on the tip of her tongue to agree, except she didn’t want to lie. She, too, missed the closeness they’d once shared in the operating room.
But she missed the closeness they’d shared in and out of the bedroom far more.
“I know what you mean,” she hedged. “You were great with Anita.” Offering him a fleeting smile, she quickly ducked out of the lounge and headed to the PACU.
Anita was doing wonderfully, clutching her floppy-eared dog, her olive-toned skin pink and healthy.
“She’s fine, Dr Howe.” Greta sensed her distress. “I promise I’ll let you know if anything changes.”
“I know you will.” Moriah turned away, and went to the OR suite she shared with Blake to find her next patient, Pedro Rodriguez. She didn’t have to scrub, but she did put on a new sterile gown, gloves, face mask and bonnet before entering the suite and approaching his bedside. “Hi, Pedro. How are you?”
“Good.”
“I’m glad. My name is Dr Howe and I’m going to make sure you are asleep for the surgery.” She reviewed his medical record, familiarizing herself with his case. “You’re going to feel a pinprick here when I place your IV.” She placed the line, then connected fluids to keep the vein open.
A glance at the clock confirmed they were halfway through their day. She’d arrived early, intent on following Blake’s wishes of working with one of the other plastic surgeons. But she’d found George Litmann had already assigned her with Blake, probably because they�
�d worked together in the past. She’d tracked George down, but in the end had been too embarrassed to request a different room assignment. George would have asked why, and she hadn’t wanted to delve into her personal history with Blake.
None of that mattered anyway, seeing that Blake had said he liked working with her. She hated to admit it, but she enjoyed working with him as well. Maybe too much. Because every hour they spent together reminded her of the amazing night they’d spent together, followed by a very painful parting.
She tried to tell herself personal feelings weren’t the issue here. Professionally, it was far easier to work with someone you knew than with someone you didn’t know, especially in less than optimal conditions. Anita’s asthma and resulting laryngospasm was a perfect case in point.
For a moment she stared at the dripping IV fluids. Ironically, in spite of the way he’d hurt her, she found his calm presence in the OR reassuring.
Blake was an excellent surgeon. Working with him was easy. Never once had he pulled any of the theatrics some other surgeons were known for. Teaming up with him in an OR suite reminded her not just of their night together but of the closeness they’d once shared—a friendship she sorely missed.
Could they try their hand at friendship again? She didn’t see how, not when the intimacy they’d shared loomed between them like a rocky Peruvian cliff.
Pushing the disturbing, conflicting emotions aside, Moriah smiled down at a drowsy Pedro. Work would help her get over the past. The boy was here for contracture releases of both arms. Burns were common in Peru because of the highly flammable kerosene they used for cooking. Right now Pedro didn’t have even gross motor movement of his arms. Once Blake was finished with him, he’d be able to lift and carry objects once again.
“Relax now, Pedro. When you wake up, your surgery will be all finished.” She gave him a little more medication until his eyes fluttered shut. “Sleep well, niño,” she said softly, setting up the necessary equipment to intubate him.
The rest of the OR team entered the room, setting up for the case. One tech doused Pedro’s surgical sites with antiseptic solution, then placed sterile drapes around each arm. Moriah concentrated on placing Pedro’s endotracheal tube, then setting the proper dose of anesthesia to give him.
She sensed Blake’s presence when he entered the OR suite. He wasn’t arrogant, but he was clearly in control of the team. She listened to his voice as he spoke to the scrub techs and nurses, directing them to move several trays, positioning them so he could maximize the room he needed to operate. Since each procedure was different, the room set-up always had to be adjusted accordingly.
There was something right about being here with him, even though she knew this was all they’d ever have. Bittersweet nostalgia filled her heart. They’d fitted together so well professionally.
But not personally, she chided herself. Blake was too much like Ryan, interested in the next female conquest, not caring how many broken hearts he left scattered in his wake.
His husky voice surrounded her as he began to operate, asking for instruments. He had the most amazing hands. Sensitive surgeon’s hands. She remembered all too well how his hands had stroked every inch of her body.
Swallowing hard, she glanced at his pensive face and forced herself to admit the truth. No matter what her future held, she still harbored feelings for Blake. They might be twisted, contradictory feelings, but they wouldn’t be denied.
If she wanted to succeed in her quest to get over him, she’d better figure out a way to get the mystic allure of Blake Powers out of her system, once and for all.
Moriah took off her gloves and face mask, tossing them aside. They’d spent long hours in the OR, but her day wasn’t over yet.
“Do you know Anita’s room number?” she asked Greta in the post-anesthesia recovery unit.
“I believe she’s in room 201 on the second floor,” Greta responded.
“I’d like to check on her before I go home.” The little girl she’d performed the tracheostomy on earlier that day had haunted her all day. Normally, she’d make rounds on the post-op patients first thing in the morning, but she couldn’t bear to leave without checking on Anita.
Greta smiled, then stifled a yawn. “I’m heading back to the hotel, I just sent my last patient to his room. I can’t believe how stoic these people are. Your patient didn’t take a single milligram of morphine. And you should have seen his face light up when I gave him the stuffed ostrich.” Greta shook her head in amazement.
“I’m surprised Pedro took one of the toys,” Moriah commented.
“He said he wanted to take it home for his little brother,” Greta explained. “But I suspect he liked the attention, too.”
“He’s a great kid. Take care, Greta. See you in the morning.” Moriah headed down the hall, choosing to take the stairwell to the second floor rather than trust the ancient elevator. She found Anita’s room without difficulty. Her mother was sleeping in the chair beside her bed.
“Hola, Anita,” Moriah whispered, trying not to awaken Anita’s mother. “How are you?” She repeated the question in Spanish.
The little girl couldn’t smile because of the recent surgery to her face, but she lifted her hand and showed Moriah the floppy-eared dog she held.
“Oh, I see you still have Floppy.” Moriah was pleased to note Anita’s skin was pink and warm, indicating she was oxygenating much better and seemingly having no trouble breathing through her tracheostomy tube. “He’s adorable, and so are you.”
Anita nodded her head and played with the dog, making him jump through the air with her hand, her eyes smiling when his ears flopped up and down.
“I’ll come back in the morning to take that tube out of your throat,” Moriah told the girl in Spanish. Anita nodded again as if she understood, and Moriah turned to leave.
Nearly bumping face first into Blake, who was lounging in the doorway.
“It’s a little late for you to be here, isn’t it?” he said by way of greeting.
“For you, too.” Working with him throughout the day had stretched her nerves to breaking point. Although she’d focused her energy on her patients, she’d been aware of his constant presence on a deeper level all day. “Excuse me.” She made as if to duck around him.
“Wait for me, I’ll walk back to the hotel with you.” Blake entered Anita’s room and bent over to examine the skin flap he’d placed during surgery.
He spoke to Anita and her mother in a deep reassuring tone. Moriah lingered, listening to what he had to say, then realized she was playing right into his hands. There was no reason to wait, not when she had things to do.
Instead of going straight to the hotel, she had planned to stop by and see Rasha. The maternity ward was located on the other side of the hospital, so she headed in that direction, finding Rasha’s room without difficulty.
Conscious of possibly invading her privacy, Moriah knocked hesitantly on the door. Rasha bade her enter, so she pushed the door open, and was surprised to find a handsome young man holding the baby.
“Hola, Moriah.” Rasha greeted her with a smile.
“I hope I’m not interrupting.” Moriah edged closer, wanting to get a good look at Rasha’s daughter.
“This is my husband, Manuel. He was working out in the fishing boats when the labor pains started. He is happy to see his daughter, but not so happy he missed her birth. He also wasn’t happy my mother’s car ran out of gas.”
Moriah grinned at the way Rasha rolled her eyes. “But at least everything is fine, right, Manuel?”
The dark-haired man flashed her a bright smile and nodded. “Yes, and thank you for being there for Rasha. I know she was more calm because you were there to help.”
“I didn’t do anything. Rasha is the one who did all the work.” Moriah gazed at the infant in his arms. “Your daughter is beautiful. What did you name her?”
“Margarita,” Manuel answered, his deep voice filled with awe. “And, yes, she is the most beautiful baby
in the world.”
Since she’d heard exactly the same sentiment from a few of her siblings about their own children, Moriah had to laugh. “I agree. Well, I won’t intrude, I only wanted to stop in to say hi.”
“Would you like to hold her?” Rasha asked.
You bet I would. Moriah quickly nodded. Manuel stepped forward and very carefully placed the infant in her arms.
Moriah gazed down at Margarita’s perfect, tiny face. A flicker of doubt stabbed her heart. What if she never fell in love with a man who wanted a family like she did? She had learned the hard way with Blake that logic and love didn’t necessarily go hand in hand.
When the baby’s face scrunched up as if she might cry, Moriah forced the negative thoughts from her mind. “Shh, there now, it’s all right,” she crooned.
The baby relaxed and, all too soon, she regretfully handed the infant back to her daddy. “I’d better get going.”
“Oh, please, come back to visit again tomorrow,” Rasha begged. “Soon I’ll be discharged home.”
“All right, I’ll come back soon, I promise.” Moriah eased back out of the room, struck by how cozy the three of them were together, the start of their very own family.
A flicker of envy invaded her heart. That closeness was exactly what she’d longed for. What she’d thought she’d discovered with Blake.
Moriah knew her relationship with Ryan had been missing a key element even before he’d broken things off. She hadn’t loved Ryan, not the way a woman should love the man she was about to marry. But she should have known better than to think things would be different with his bachelor buddy Blake. Love couldn’t surmount all obstacles, and he was as much the antithesis of a family man as Ryan had been.
Stepping outside, she noted darkness had fallen. Blake would already be at the hotel by now. Why had he asked her to wait for him? Hadn’t they pretty much agreed to stay out of each other’s hair? Maybe Blake thought they could remain friends, despite everything that happened between them.