by Radclyffe
Glenn laughed. “No problem—we’ll still feed you, but it is a requirement that you come and cheer us on.”
“And when and where would this cheering take place?”
“Usually Wednesdays, Fridays, and Sundays. I’ll take you over to the field the first time.”
“You’re kidding. You play that many games?”
“Only during the spring and summer,” Glenn said seriously.
“That has to be, like, dozens of games.”
“Well, sure. And then there are the playoffs and the finals and the championship game. That winds up by late August.”
“Okay, I can see this is a really big deal around here.”
“Don’t you have sports where you come from?”
“I suppose we do,” Mari said, “but I’ve never paid much attention to it. The professional sports you see on television are so commercialized.”
“What about those five brothers of yours, didn’t they play sports?”
“In high school, sure, and I did go to most of their games. Basketball and soccer. No baseball, though.”
Glenn shook her head. “Philistines.”
Mari smiled. “I hereby promise to be a devoted champion of your team.”
“Your support will be greatly appreciated.” Glenn glanced at her watch. “And I guess it’s time for us to get to it.”
“Thanks again for taking the lecture this morning,” Mari said as she gathered up her things. “I really would’ve been beat if I’d had to stay up much longer.”
“Not a problem.” Glenn searched her face. “You’re okay for a full shift? Over the jet lag?”
“I’m absolutely fine,” Mari said, certain from the glimpse of worry in Glenn’s gaze she’d been right to keep some things to herself. “Let’s go clear the board.”
*
Abby tapped on Presley’s door at a little before eight. She knew Presley would be in, since she kept longer hours than most of the staff. She was behind her desk with her laptop open, her cell phone by her right hand, an iPad propped up against a stack of folders, and a supersize coffee in her left hand. She looked, as always, impeccable in a navy silk blazer and open-collared white silk shirt. A multistrand gold necklace rested just below her collarbone and a square-cut diamond glittered on the ring finger of her left hand. Her blond hair was swept back from her face and fell to just above her shoulders in thick easy waves. She smiled when she saw Abby peer in the doorway. “Hey, come on in.”
“Busy? Of course you are busy.” Abby made for the chair across from Presley. “How many worlds have you conquered this morning already?”
“Only a few,” Presley said, laughing. “What’s going on? Problem in the unit?”
“No, the ER’s fine. Well, we could always use more money, more personnel, more space—” Abby grimaced. “Really, we’re full most of the time and believe me, I’m glad for it, but if we increase our trauma call, we are badly going to need more rooms. Plus the MRI…”
“I’m working on it.”
“Believe me, I know that and I’m appreciative,” Abby said. “This is something personal. It won’t take long.”
Presley immediately sat forward, pushing aside her computer as if whatever major undertaking she’d just been involved in was completely unimportant to her. Her gaze fixed on Abby. “Is something wrong between you and Flann?”
“No, God no. Everything’s fine.” She blushed. “Ridiculous, I know, but perfect is the word I use in my head.”
“Blake is okay?”
“Blake is thriving. Somehow”—she shook her head—“he’s talked me into letting him and Margie volunteer in the ER this summer. If you and Harper agree.”
“I’ll discuss it with Harper and legal, but I don’t see a problem there.” Presley grinned. “The two of them are scary when they get their heads together.”
“Thank God it’s good scary.”
“Amen. So—what do you need?”
Abby didn’t have much time and she knew Presley didn’t either. “Flann wants to get married.”
“Of course she does, she’s more of a nester than Harper and doesn’t have a clue,” Presley said. “She took one look at you and Blake and knew where she belonged.”
Abby’s heart lurched. She hadn’t ever expected to need anyone the way she needed Flann, the way she loved her—body and soul. “She has been using the M-word from day one.”
“And is there a problem?” Presley’s question was gentle. “I know we lost touch for a while, but I think I can read happy all over you.”
“Oh no—I mean, yes, I couldn’t be happier. It’s just that you know Flann—her idea of a proposal is let’s get married and today would be time enough.”
Presley laughed. “Yeah, that’s Flann.”
“I’ve managed to hold her off for a month or so, but I don’t want this to interfere with what you and Harper have planned. After all, you got there first, so to speak.”
“Abby,” Presley said with a shake of her head, “I think it’s great. Harper will be beside herself. And so will Edward and Ida. Besides, I can’t wait to help plan your wedding.”
“Oh, please, anything you can do. Everything.” Abby pushed a hand through her hair, relief pouring through her. “I don’t know anything about weddings.”
“We’ll be old hands at it by the time Harper and I get around to it in—God, is it really only two weeks? We’ve got so much to do, we need another meeting.”
“Brunch this weekend?”
“At the latest.”
“I’ll gather the troops and let everyone know where and when.” Abby stood. “Thank you, thank you.”
Presley came around her desk and gave Abby a quick hug. “I am so happy for you. Flann is fabulous.”
“I really love her,” Abby said quietly. “And so does Blake.”
“Well, Flann is lucky to have you both. Is it a secret?”
“I don’t think Flann has told her parents yet, and we haven’t told Blake, so I’d keep it quiet for a while.”
Carrie said from the doorway, “Keep what quiet?”
Abby looked over her shoulder. “Flann and I are getting married.”
Carrie gave a little victory wiggle. “Good for you. Congratulations. Oh boy, another wedding!”
Abby thought about all she had to do in the ER, and her son who still had to find his way emotionally, physically, and in the community, and stemmed the rising panic. “Oh boy, indeed.”
Chapter Eleven
The board was full all morning and Mari ran from cubicle to cubicle seeing patients, checking on the students, and tracking down Abby or another ER doc for final sign-off on her own and the students’ cases. They were good students, responsible and caring, but they were still students. They had no idea what they didn’t know and were flush with coming out of the classroom where they thought they had learned everything there was to know. She’d felt the same way her first few days on her clinical rotations. Around eleven thirty, a quick wave of dizziness when she stood up after spending a precious fifteen minutes at a table in the little break room with a cup of tea while charting her last discharge notes reminded her she hadn’t had anything to eat since the croissant and coffee at six in the morning. She really did need to pay more attention to eating. She couldn’t do much about fretful sleeping or her frenetic pace in the ER—that was the job, after all—but she could at least try to eat. Her appetite still was nothing like it used to be, and some flavors and smells had gone off for her completely. Thank God, she still loved pizza.
Thinking about pizza made her think of Glenn, and she got that odd little twinge of heat in the center of her chest that seemed to be happening every time she thought of her or heard her voice in the hall outside a curtained room or caught a glance of her, leaning a shoulder casually against the wall while conferring with Abby or one of the students. She always looked so confident, so focused, so…sexy. Oh, hell. She had no time for out-of-the-blue thoughts like that, and no place for what they might lead to. Not for
a long, long time.
Lunch. Then back to work. Just as she dropped the chart into the outbox at the nurses’ station, Antonelli stormed around the corner as if leading an assault on some enemy encampment, his usual pace, and flagged her down. She wasn’t actually assigned to him as a supervisor, but for whatever reason, he’d decided she was his go-to person. She didn’t mind, she liked teaching.
He loomed over her, two hundred twenty pounds of barely constrained muscle and testosterone to her one twenty. “Hey, Mari, I’ve got a hot appy that needs to go up to the OR. I’m going to call the surgeon, okay?”
“Whoa, take five there, soldier.”
“Marine.” His tone suggested high insult.
“Okay, marine.” Mari gestured to an out-of-the-way corner where they could talk without patients overhearing them. “Run it down for me.”
He looked annoyed, his dark brows lowering for an instant, but he followed her out of the way of hall traffic. Although he was impatient and cocky, he respected the chain of command, and she respected him for that. He was smart, maybe the smartest of the bunch, but he was quick on the draw, a result undoubtedly of his military experience. She refrained from reminding him this wasn’t the battlefield, and every decision didn’t have to be made between one heartbeat and the next. She didn’t discount his field experience and what he had learned from it, but a civilian ER was a different kind of battlefield, and sometimes, careful surveillance and planning was just as important as the ability to rapidly assess and respond.
“It’s textbook,” Antonelli said in his usual confident and moderately dismissive voice as soon as they were alone. “Twenty-five-year-old female, twelve hours of progressively increasing right lower-quadrant pain, nausea, low-grade temp.”
“White count?” Mari asked.
“Ten point five.”
“Just mildly elevated,” Mari pointed out.
He lifted a shoulder. “It’ll be a lot higher in a few hours if she doesn’t get that out.”
“Pregnancy test?”
“Pending.”
“Heterosexual, sexually active?”
“Yeah. Straight, no chance she can be pregnant.”
“Not sexually active, then?”
“No…I mean, yeah, she is,” Antonelli said, his tone suggesting this line of questioning was annoying at best, “but she had a period a month ago, and they always use a happy hat…condom.”
“Normal?”
“Huh?”
Mari almost smiled. One thing the military didn’t teach medics particularly well was female healthcare. Female troops on the front lines lived with men, fought with men, and were considered one of guys in almost all ways—but they were still biologically unique. “Was her period typical for her—timing, duration, amount? Did you ask?”
“No, she said—”
“Come on, let’s go ask her.”
“Listen, can’t we call surgery and at least get them down—”
“Why don’t we make sure we have the full story so we get the right person down here.”
As Mari walked back to the cubicle with Antonelli dogging her heels, she scanned the chart and didn’t find anything else that teased her antennae. Antonelli was probably right. The most obvious diagnosis was usually the correct one. She smiled when she thought of the old adage, When you hear hoofbeats in the hall, don’t think of zebras. All the same, the difference between a good diagnostician and an excellent one was both curiosity and suspicion. Probably a little OCD as well. The time to be certain was before you acted, because once you began a course of treatment, uncertainty was the enemy, especially if the treatment happened to be surgical.
She pulled back the curtain and introduced herself to the pale young Asian woman who waited alone in the cubicle. She briefly ran down the history Antonelli had already taken and noted one thing he hadn’t.
“So your last period was a little late and shorter than usual?”
“Only a day and not much of that,” the patient said. “But I was right in the middle of some pretty intense rehearsals, and a lot of times when I’m really stressed that happens.”
“What do you do?” Mari asked.
“I’m a dancer. Modern, mostly.”
“Where do you perform?” Mari couldn’t imagine a local art house in this rural area, and even if there was one, she doubted it could support a dance troupe, but maybe the company was located in Albany.
Kuni Yamaguchi smiled. “We’re performing at the Saratoga Performing Arts Center this summer. I’m with the New York Dance Company, but my grandmother lives here. I stay with her whenever I can.”
“Wow, that’s incredible. I’ll have to check out the events calendar.” Mari drew the sheet down and gently palpated Kuni’s abdomen. When she reached the lower right quadrant, the young woman tensed and caught her breath. “So tell me about this pain.”
“I didn’t really pay any attention to it until last night, and then it just wouldn’t go away.”
Mari recalled Antonelli’s history and physical. Twelve-hour history of pain. “It didn’t actually start last night?”
“Well, it didn’t really start bothering me until last night. I noticed it just a time or two over the last few days. Not enough to slow me down. I didn’t miss rehearsal.”
“Aha. I know how that is.” From what Mari knew of dancers, most women in competitive fields, really, they’d have to be dead to miss a rehearsal or class or meeting. She glanced over at Antonelli, whose impatient expression had turned to a frown.
“What do you say we get an ultrasound in here,” Mari suggested casually.
“Yeah, I copy that.”
Turning back to Kuni, she said, “I want to do a quick ultrasound scan, that’s a test—”
“I know what it is, but why? The other doctor thought it was my appendix.”
“And he might very well be right. But sometimes two different things can look a lot alike at first. I just want to be sure that we’re not talking about something to do with your ovaries. We can do it while we’re waiting for the results of your pregnancy test.”
“Oh.” For an instant, Kuni looked panicked. “I can’t possibly be pregnant. I don’t have any time to be pregnant, and besides that, we’re always really careful.”
“You take the Pill?”
“I did, but it makes me bloat so I stopped. But I use a diaphragm and we use a condom.” She laughed. “Really, nothing could get through all that.”
“Uh-huh,” Mari said, seeing no point in citing the statistics.
A second later Antonelli pushed the curtain aside and trundled in with the portable ultrasound machine. He set it up beside the bed and glanced at Mari.
“Have you done one before?” Mari asked.
“A couple of times.”
“Good. Let’s see what we see.”
He squeezed the cold blue gel onto Kuni’s stomach and she stiffened at the first contact, then relaxed as Antonelli, with surprisingly sensitive hands, gently guided the probe in ever increasing circles from a spot in the right lower quadrant outward. At one point he paused, backed up, and circled again. He stopped and looked over at Mari. She had been following the images on the screen, and the mass in the right lower quadrant was pretty hard to miss.
“Let’s get GYN down here,” Mari said, looking directly into Antonelli’s eyes to make sure they were on the same wavelength. The bright snap in his dark gaze told her they were and he would make sure to request a consult stat.
Mari covered Kuni with the sheet as Antonelli stepped out to call GYN. “Did someone come with you today?”
“No, I didn’t want to worry my grandmother until I knew what was going on.”
“What about your boyfriend?”
For the first time, the young woman, who had to be in considerable pain, looked distressed. “He, uh, no. I’d rather not…”
“You might want to call him or a family member,” Mari said. “We’re going to get one of the GYN surgeons down here, but I’m pretty sure
you have what we call an ectopic pregnancy. That’s a situation where a fertilized egg doesn’t make it into the uterus but lodges somewhere else—often on a fallopian tube.”
“Pregnant? That’s not possible.” Kuni’s strident tone suggested she didn’t want to believe it, but a note of uncertainty flashed across her face.
“There isn’t a contraceptive in the world that’s a hundred percent, although some are obviously better than others. And if there was a time that maybe the condom slipped off or he didn’t get it on until later than usual…?”
“I don’t know, maybe that could have happened.” Kuni passed a trembling hand over her face. “God, what a mess. If it’s what you think, will I need surgery?”
“Yes, and the gynecologist will discuss all those details with you. Is there someone I can call for you?”
“My grandmother, I guess, but can you try not to worry her? She’s tough as nails, but she’s still eighty.”
“Of course. And you’re sure no one else?”
“He’s…our relationship isn’t public.”
Mari nodded. As long as she could find someone to be there to support the patient, the nature of her personal relationship was not her business. “All right. If you change your mind and want me to call him, I can. Do we have your grandmother’s number?”
“Yes, I gave that to the receptionist as next of kin.”
“I’ll be right back.” Mari squeezed the young woman’s hand and left to make the call.
By the time she was finished and assured Kuni’s grandmother she had enough time to arrange for someone to get over to the house to look after her animals, the GYN attending, of all people, was in the cubicle. She’d expected a resident, as had been the norm at the LA medical center where she’d trained, but then she remembered that most of the departments here didn’t have a residency program. Yet. Many of the doctors worked with nurse practitioners or physician assistants instead, but the staff physicians often answered their own ER calls out of necessity and expediency.
The gynecologist, a rugged middle-aged man with thick brown hair, a lantern jaw, and an incongruously soft, melodious voice, was in the midst of repeating the ultrasound when Mari walked back in.