She shook her head, remembering her plan B. Superficial. Keep all future male-female relationships superficial. But that had been before she’d found out about her father and Huntington’s. Should she think about any relationships at all until she knew her results?
Jared’s handsome face popped into her thoughts again. He was a man who seemed like he could use some unattached companionship just as much as she could. Too bad she wasn’t in the mood for an affair.
CHAPTER THREE
TUESDAY morning, Kasey arrived at the free clinic a half-hour early to find a line of people halfway down the block waiting out front.
“Good morning, everyone,” she called out. “Please be patient today.” She hoped everyone at the end of the line heard her. “We’ll work as quickly as we can.” She let herself in the door, locking it behind her. The clinic wasn’t due to open until nine a.m.
She went to her desk, booted up the computer and went about her morning chores. Dr. Finch hadn’t called on Monday as he’d said he would. So much for getting swept up in his promises and dreamy looks. She should have known better since men had a long record of letting her down, beginning with her absent father, her mother’s long list of deadbeat boyfriends, and ending with her own string of sour relationships.
With the special clinic today, she’d be too busy to do research on labs that would be able to do special genetic studies, but she promised herself she’d tackle it first thing tomorrow.
What if Dr. Finch didn’t show up today? It hadn’t exactly been his idea, but he’d agreed. Her stomach tightened at the thought of having to explain to all of the patients their clinic would have to be cancelled because the future plastic surgeon hadn’t kept his promise.
She snapped her fingers. If he did show up, they’d be short a computer unless he brought his laptop. Why hadn’t she remembered to tell him that? Was it too late to call him? A sudden blast of nerves had her flitting all over the nurses’ station, searching for his phone number, not even sure she had it.
Vincent arrived through the back door in powder-blue scrubs, his lab jacket over his arm and hair sculpted in several directions. “Wow, we’ll be here until tomorrow, seeing all of those patients.”
“I know,” she said, distracted with checking supplies. “Good thing we set up all the rooms last night. Is Angie here yet?” Angie, the ready-to-retire receptionist and medical assistant, was notorious for being late to work.
“She was parking when I got here.” Vincent headed straight for the coffee pot, found a filter and held up the can of coffee, shaking it to emphasize it was almost empty as the back door opened. “Do we have a grocery list going? We need coffee and powdered creamer.”
“What we need,” she said, “is that doctor to show up.”
“Got it, and present,” said a familiar masculine voice.
Kasey glanced up to find Jared standing with a takeout tray of steaming coffees in one hand and a brown bag in the other. A mini-cringe made her cheeks warm. He wore a tan suede jacket over a button-down pinstriped yellow shirt, pressed denim jeans and brown loafers. Who pressed their jeans? He hadn’t forgotten to bring his laptop either, as a stylish computer case hung from his shoulder.
“Oh, hi,” she said, glancing at his face then her desk, feeling embarrassed. Even from this distance, his freakishly blue eyes did things to her she wasn’t prepared for.
“You’re a god,” Vincent said, rushing to his aid. “Good morning, and I’ll take these, thank you very much.”
“Don’t thank me, thank Angie.”
Vincent grabbed the coffees and passed them out to Kasey and Angie, who’d entered behind Jared. “Thank you, Ms. Angie, and here’s one for you.” He handed Jared his coffee. “And one for me.”
“Yes, thank you, Angie,” Kasey said, wondering what had prevented Jared from getting back to her yesterday about the lab appointment.
He handed the brown bag back to Angie.
She held it up. “These bagels were fresh from the oven when I picked them up at the bakery forty minutes ago,” Angie said.
“From that line I saw circling around the block, we’re going to need carbs and lots of them, so thanks,” Jared said, being the first to be offered a bagel.
“How sweet,” Vincent said, finding a blueberry bagel and taking a huge bite.
When the cream cheese made an appearance, Kasey sauntered over, though not wanting to get too close to Jared, leery that his sexual gravity might snag her like a magnet. She took a sesame bagel, smearing it with strawberry flavored soft cheese, then savored the fresh-bread smell as she gobbled it down. A simple pleasure on what promised to be a hellishly busy day. From the corner of her eye she noticed Jared watching her as she licked away the cream cheese at the corner of her mouth.
For distraction, Kasey ticked off a list of items for Angie to stock in the patient rooms then sipped her hot, rich coffee. She’d keep today’s visit from Dr. Finch strictly business, which it was. Though it had been her idea to run this clinic, he’d be expected to take charge of the lion’s share of the patients. At least he’d showed up, that was a start. If all went well, after today she wouldn’t have to see him again for the rest of the month.
Grabbing a stack of insurance forms with plans to take them to the receptionist’s desk for those in line who might possibly have some additional medical coverage, she turned and almost bumped into Jared. Her pulse, darn it, responded with a quick gallop. She’d remember that citrusy scent in the future, but only so he couldn’t sneak up on her again.
He reached into his shirt pocket and pulled out a folded piece of paper. “I was in surgery all day yesterday, so I didn’t have a chance to call you. Sorry, but I didn’t think you’d appreciate a call after bedtime.”
“How do you know my bedtime?”
The corner of his mouth twitched into a reserved smile. “I guessed.”
She didn’t smile back, refusing to look away. He didn’t have a clue how important the test was to her, but why should he? It wasn’t his problem. It was just some casual offer he’d made to give the illusion of being nice.
“Again, my apologies.”
She saw something there, in his eyes, an earnest appeal? Give the guy a break, she told herself, it’s only eight forty-five in the morning. She gave a quick nod.
“Anyway, here you go.” He handed her the paper.
Forcing her gaze away, she unfolded it and found a date and time for a genetic marker study at a Massachusetts General hospital. She really needed to quit writing off people so quickly. “Thank you,” she said, a little warm bubble rising in her chest. “I’ll be there this Saturday.”
“Good. Under ideal circumstances you could get the results in a week to ten days, but there’s such a demand for this specialty they can’t guarantee results that soon. Sorry.”
“I understand.” Her throat tightened at the thought of having the test done, and her pulse sped up, thinking about the potential results. With a shaky hand she took another sip of coffee. “How much will it cost, do you know?”
“It’s all taken care of,” he said.
“What do you mean?”
“Professional courtesy.”
“Wait. What?”
“The lab extended the courtesy.” He gave her a pointed look, and a little voice in the back of her head counseled her to shut up about it and be gracious. Though she didn’t believe his explanation for a minute and really wanted to know who’d actually paid for the test, she nodded.
“Well, I guess we better get you signed into our computer system,” she said, slipping the paper into her lab-coat pocket. “That line of patients is probably twice as long by now.”
Ten minutes later they opened the doors and began processing the ever-expanding crowd. It appeared their little neighborhood had people crawling out of the crevices in need of care. Vincent acted as the triage nurse. Kasey saw the more general-needs patients, such as pap smears, breast exams, flu and vague complaints, and Jared took anyone who needed a su
rgical consult or onsite care.
Within an hour Jared approached her desk and asked for her assistance. She jotted down a few quick notes on the breast exam she’d just completed then gave him her complete attention.
“I’ve got a patient who came in for a cyst removal on his shoulder, which I’ve already done, but I want you to see this.” She followed him into exam room two, where she saw a middle-aged man with a bright red complexion and one of his front teeth missing.
“This is Franklin O’Leary,” Jared said. “Mr. O’Leary, this is Kasey McGowan, the nurse practitioner who runs this place, and I wanted to have her take a look at your stomach.”
The man looked eight months pregnant with a rounded, bulging symmetrical contour. “If you don’t mind,” Kasey said, warming her hands while he lay flat on the examination table. “I’m going to do a little poking around.”
“It’s been a while since a lady’s poked me anywhere. Go right ahead.”
She smiled, then palpated the tightly distended skin and performed percussion, noting tympany over and around the navel, with dullness at his flanks.
“How long has your stomach been distended?” Jared asked.
“Dis—what?”
“Has your stomach been big like this for a while?” Kasey spoke up.
“A few months, I think. Just my beer gut.”
Jared marked the level of dullness on the skin with a magic marker.
“Could use a new tattoo.” The man glanced at the straight lines. “That’s not what I had in mind, but what do you expect for free?”
Kasey smiled again, appreciating his New England humor.
“Lie on your side for a minute or so,” Jared said, and waited for the patient to shift his position. The curly-headed man cooperated, though it was awkward to move with his big belly. Kasey helped him, hoping Jared would get the point.
As predicted, the dullness shifted. Kasey knew that meant textbook-wise there was at least five hundred cc of abdominal fluid and, judging from the size of the otherwise malnourished man’s abdomen, she suspected a lot more.
“How much beer do you drink?” Jared asked.
“I’m known to have a pint or two whenever I can. Doesn’t always work out, though.”
Most people underestimated their drinking, and in Franklin’s case the “whenever I can” could mean morning, noon and night.
“Roll on your back,” Jared said, this time helping him. “Kasey, will you press here for me?”
She placed her hand firmly against the patient’s abdomen in the navel area while Jared put the flat of his hand on the left side and tapped with his other hand. Sure enough, this generated a pressure wave indicating ascites.
“Do you have a history of cancer?”
“Not that I’m aware of, Doc. Should I get scared now?”
“I’m just asking questions. No need to worry.” Jared gave her a decisive look. “We need to drain him,” he said.
She nodded. Normally this procedure was done in an ER, but under the circumstances Franklin needed immediate medical attention. Suspecting he wouldn’t follow through on his own if sent to the ER, and the cost of ordering an ambulance to transport him was off the budget, they’d go ahead and do what they could for him right here, right now.
“How would you like to lose a little weight and get your trim waist back?” Jared broached the subject.
“What do you mean?” Franklin said.
Jared explained, though in a rushed manner, that Franklin’s liver wasn’t functioning as it should, and how the fluid could be removed here in the clinic with an easy procedure, then it would be sent away to a laboratory for studies.
The man licked his lips and stared at the floor for a moment while he thought, then gave the okay. Jared’s bedside manner could have been ten times better, but he didn’t seem nearly as bad as she’d thought last week. He’d gotten Franklin to agree to an important test. The guy had arranged for the clinic and then shown up. Plus, he’d come through on the lab appointment for her. That said something about his character. A man of his word meant a lot to her these days, so she’d cut him some slack on his under-par bedside manner.
Kasey had Vincent bring in a consent form and she went hunting in the supply closet for an abdominal paracentesis kit. She asked Vincent to assist Dr. Finch, since the waiting room was packed with patients, and all the examination rooms were full.
She entered the next room and found a senior citizen with a swollen cheek and a nasty tooth abscess. In a perfect world this woman would go to her dentist, but from the look of her poorly cared-for teeth, she hadn’t seen one in years. All Kasey could do was ask if she was allergic to any medicine and write her a prescription for generic antibiotics, point her to the local discount pharmacist and hope the patient followed her orders about taking the meds until they were finished, instead of stockpiling them for future use.
“Once the infection has calmed down a bit, you’ll need to see a dentist.”
“Ack, would rather have my cousin pull it.”
Before lunch, Laurette Meranvil waited in room one to have her stitches removed. Jared tended to her and, as timing would have it, and admittedly because Kasey was curious, she ran into the patient on the way out. The laceration under Laurette’s eye was a thin pink line.
The young woman smiled at Kasey.
“It’s healing beautifully,” Kasey said.
“I put special ointment from home on it.”
“I may have to find out the name of your miracle ointment for our other patients.”
“It’s Haitian vetiver oil.”
“Let me jot that down,” Kasey said, making a note to Google it later. The woman walked with her head held high out the door, so different from last week when she’d come in covering her face.
Kasey took a moment to appreciate the much-needed help the clinic brought to the community. She glanced up and found Jared watching her. The usual tension had left his eyes, and she suspected he felt the same sense of pride she did, and wondered if he got that feeling doing cosmetic surgery. He nodded at her then slipped into the next exam room. Kasey might not be sure about the magical powers of Haitian vetiver oil, but she sure as heck knew there was some special voodoo in that man’s stare.
And the day continued.
By late afternoon, Kasey couldn’t keep track of how many patients she’d seen. Angie approached wearing her usual expression, as if she was in pain, brows knitted, world-weary. Kasey had gotten so used to the expression over the years she hardly took note.
“You’ve got to see this,” Angie said. “It’ll break your heart.” At second glance, Angie did look more disturbed than usual, shaking her head, first clucking her tongue then pursing her lips.
Kasey followed the medical assistant into exam room three, where a mother and her toddler sat quietly. Angie was right, the pudgy little boy’s cleft lip did break her heart. Did the mother think they could sew the lip together in the clinic and all would be well? She tried not to let her sadness show. The child probably had to endure sympathetic glances and an overabundance of pity every day. She didn’t want to add to his pain or shame or whatever a two-year-old felt when people looked at him and treated him differently from everyone else.
“Hey, little fella,” she said, with a big smile.
She fought an urge to pick him up and hug him tight, and tell him she had a magic pill that would make his sweet little mouth look like all the other children’s. Then his big brown eyes would be the feature everyone first noticed, not his lip.
Offering her hand to the mother, Kasey maintained a professional manner. “What can we do for you today?”
The mother explained her son had been born with the problem, which, of course, Kasey already knew. He’d been born in another state, and the family couldn’t afford surgery. They’d moved to Massachusetts partially because of the health insurance system. She examined the little boy’s mouth and discovered that his palate was intact, and that the congenital deformity was l
imited to his lip. A good thing. Healthy and round, she realized he had no problem eating. She decided to let Jared take over on this consultation, and excused herself.
“Can you take a look at the toddler in room one?” she said, approaching Jared in the hallway and handing him the intake message. He glanced at Angie’s notation then slowly back to Kasey. She hoped the boy’s situation would touch his heart as much as it had hers.
“Sure,” was all he said as he disappeared behind the exam-room door.
Kasey rubbed her eyes and took a moment to sit down and rest, wishing she had another cup of coffee for false energy.
Pressed for space, and between his triage duties, Vincent had set up a makeshift immunization station in the clean supply closet with no less than fifteen people standing patiently in line. She’d guess they’d seen over sixty patients already, and knew there were at least forty more waiting. At some point, if they wanted to get out of here before midnight, they’d have to cut off the line, and she really didn’t want to be the person assigned to do that.
Angie brought another load of messages. Kasey picked the one off the top and before she headed for the next exam room noticed Jared come out from the other room and get on the phone. She overheard him talk to someone just before she entered the other exam room.
“I’ve got a little boy I’d like to refer for pro bono plastic surgery,” he said, and her heart did a little extra pitty-pat of joy. The guy wasn’t nearly as uncompassionate as he’d made himself out to be.
At some point, Vincent sent out for burgers and they ate on the run, having turned the day into a medical marathon. By ten o’clock the last patient left the clinic.
Exhausted yet exhilarated, Kasey grinned, hugged Vincent and high fived Angie. “We did it!”
“I think I’m numb,” Vincent said.
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