by Kennedy Fox
Evan stays calm, and every move he makes is calculated. Within minutes, two ambulances pull up, and I make eye contact with one of the paramedics as she speaks with Missy, one of the triage nurses. By the look on her face, I know this isn’t good. As they’re unloaded, it takes Missy less than thirty seconds before she’s calling red tags for each family member, which means they can’t survive without immediate assistance. Gurneys are swiftly pushed through the hallway, and Evan is directing nurses and interns to trauma rooms. The ER is in calm chaos, running like a fine-tuned machine, but I can’t deny the worry I feel when I take one look at the father. I’ve barely dealt with burn victims. We had a renowned burn center in Houston where patients with severe burns went. I’m so out of my element that I start to internally panic as I understand the severity of their condition.
“We’re going to need advanced life support; he’s having trouble breathing. Massive swelling. Intubation is needed, or his airway will close,” Evan demands as the gurney is wheeled into a trauma room. The nurses move in place, taking his direction. I open my mouth and close it, not able to find my words after witnessing how charred and melted the man’s skin is. Sure, I did case studies on burn victims in med school but never witnessed anything of this magnitude. His legs are covered in blood, soaking the fabric of what’s left of his jeans. The sounds that rip from his throat are ear-piercing. I’m sure it hurts him more than anything, but that’s the body’s natural response.
“Dr. Bell. Get your head out of your ass! You need to move,” he snaps, and I pick up my pace and follow closely behind him.
Once inside the room, one nurse hooks up an IV to give massive amounts of fluids to help save his kidneys. Pain medication is administered to keep him comfortable. Seconds later, Evan is standing over the patient and gently places the tube down his throat. The ventilator kicks on and helps him breathe. Oxygen levels rise almost immediately.
Nurses move around Evan and begin measuring the percentage of burns on the body. I stand to the side, not wanting to interrupt their flow, but I feel so useless.
“Dr. Bell, get over here,” Evan demands. It feels like all hell is breaking loose around me, and I have to remind my feet to move.
I walk closer, really getting a look at the skin and how bad the burns are. As I look down his body, I see the lower half of his leg’s severed. The heat of the fire burned right through his skin.
“There’s nasal singeing,” Veronica adds. “Sixty-five percent burns, lower half of the body is the worst. Epidermis and dermis are badly damaged. Severe blistering. We actually have both second and third degree.”
“Page Dr. Dursley and get trauma surgery down here,” Evan tells another nurse. Everything happens so fast, yet it all feels like we’re moving in slow motion. The patient is sedated, but his legs worry me the most. The way they’re bleeding and exposed places him at a higher risk of infection and amputation.
“You should page the orthopedic surgeon,” I suggest, looking up at Evan’s hard stare. The patient’s leg is in bad shape, and without a doubt, he’ll need surgery.
“I need sterile sheets, saline bottles, and blankets NOW!” Evan yells, ignoring my words completely. Within minutes, all the items he requested are being handed over.
“He’s going into shock. Blood pressure is dropping,” Evan explains in a rushed tone.
“Hypovolemic shock?” I question. He just rolls his eyes at me and continues giving orders. “We have to get started on a transfusion right away. He’s lost too much already. I need O negative blood stat!”
Claire rushes out of the room to retrieve the blood.
After he’s finished giving instructions, I add my suggestion. “We need a dopamine drip.” This time, he nods in agreement, and Fiona rushes around to grab the supplies just as Claire returns. Another line is started for the blood transfusion, and once that’s inserted, Fiona begins administering the medicine while Dr. Dursley, the burn victim specialist, enters and starts assessing his burns. Dr. Vance, the trauma surgeon, enters next to help. The burns are extensive, and once all the supplies are in place, they begin debriding the burnt skin tissue. I swallow hard as I watch him peel layers off his body like shaved meat. I’ve never seen anything like it, but I swallow down the bile that threatens to surface and try to get my head back in the game.
The patient’s heartrate begins to increase steadily and so does his blood pressure. I consider it a small win, but there’s so much more that still needs to be done for his recovery.
Lines and tubes are all over the place. The man is hanging on by a thread, but at least he’s more stable now.
“His right foot is ghost white,” Dr. Dursley says softly to Evan, but since I’m standing next to him, I hear the sadness in his tone.
“No blood flow,” Evan confirms, shaking his head. “Shit.”
“I’m concerned about his exposure to infection if we don’t get the blood flowing. The longer his foot goes without it, the higher the chance an infection will get into his blood,” Dr. Vance adds.
“He might already have an infection,” Evan states. “Still waiting on the blood test results.”
“My guess you could be right. After assessing how bad his burns are and how much skin is gone, I wouldn’t be surprised if he’d need an amputation of this leg. The damage is so extensive. Even if we could repair it, he’d have lifelong pain. The nerves are all shot, and he’d continue to struggle to walk. At least with an amputation, he could wear a prosthesis and learn to walk again with therapy,” Dr. Vance says.
“I’d recommend an above-the-knee amputation to avoid further complications of needing skin grafts, but I’ll let the orthopedic surgeon make the final call,” Dr. Dursley adds.
My heart sinks, and I release a loud gasp without meaning to.
“You have something to add, Dr. Bell?” Evan asks, but not in his normal condescending tone. “I’d love to hear about your expertise on the matter.”
Oh, there it is. Asshole.
Chapter Thirteen
EVAN
“An above-the-knee amputation makes it harder to walk with a prosthesis since there’s no knee to stabilize the prosthetic and hip,” Emily says.
“That’s correct,” Dr. Dursley clips.
Emily is testing my patience, and with all the commotion, I’m not sure I have much left before I snap at her insubordination.
“Dr. Bell.” I shoot her a warning glare, but she barely flinches, which pisses me off even more. She’s wasting our time arguing about this when I know Dr. Dursley is highly proficient in burn cases.
“He’s a father and only thirty-five. At least consider a below-the-knee amputation, so he has a better chance of walking again and playing with his kids,” she continues.
I glare and give her a silent warning to stop arguing, but of course, she ignores me.
“He can get a skin graft from his butt to cover the burn once it heals, and then he can at least work toward getting a prosthesis if he has his knee.” Emily’s bottom lip is trembling, which makes me think she’s running on pure adrenaline and needs to calm the hell down before she makes a scene.
“Dr. Bell,” I warn, my voice growing louder.
“Ultimately, it’s up to Dr. Wood, the ortho surgeon. I’ll give him my notes, and he’ll examine Mr. Brauer before making any decisions,” Dr. Dursley explains.
“But you can encourage him to at least do a BKA instead,” Emily insists.
“A below-the-knee amputation won’t be as successful since he has a lot of burns below his knee,” I interrupt, needing to end this back and forth bickering. “Going above the knee gives him the best chance at healing.”
“At least consider it, Dr. Dursley. I’ve done a lot of work with amputations in my residency,” Emily continues, dismissing my words completely.
“Is that so?” He arches a brow but continues to debride the patient’s wounds.
Emily visibly swallows at the tension filling the room. Veronica and Fiona are still in the room, an
d by the way they’re acting, I know they can feel the uneasiness brewing. I’m tempted to haul Emily over my shoulder and carry her ass out of here.
“That hardly makes you an expert,” I snap, turning to Dr. Dursley. “I apologize. She’s new and still learning her place.” I narrow my eyes to her, hoping she understands my final warning.
“Learn my place?” Her voice goes up an octave. “Just because I didn’t train in a trauma hospital doesn’t mean I’m a clueless twit. If you’d asked about my work history at all instead of making assumptions, you’d know that I’ve worked side by side with some of the top-rated orthopedic surgeons in the country. I’ve seen predicted amputations of every limb that were deemed damaged and unrepairable end up getting saved. I’ve witnessed a man’s severed ankle hanging on, literally by a thread of a blood vessel. The surgeon reattached it after sixteen hours of surgery, and the man ran a 5k a year later. A motorcycle crash victim almost seven feet tall was hit at fifty miles an hour, and when his leg got tangled in the wheel tire of the other driver’s truck, the surgeon did everything he could to only amputate halfway up his calf and saved his knee. His long legs made it nearly impossible since the nerves were shot from the knee down, but he made it possible and salvaged everything he possibly could. The man has his knee and walks flawlessly with a prosthetic, so he can work and play with his three young children. So with all due respect, doctors, I think you should consider leaving this man’s knee, so he doesn’t have to depend on a wheelchair before he even hits middle age.” Her breathing is rapid, and her face is turning red at the long-winded speech she just spewed. She swallows, her chest rising and falling as she awaits a response.
“You make some great points, Dr. Bell.” Dr. Dursley finally speaks but doesn’t get to continue before I interrupt.
“Every doctor has to evaluate their risk tolerance and if that risk is worth the potential of losing the patient or not. Mr. Bauer isn’t old, but he’s not young and athletic either. His body has taken its toll from working construction the past twenty years. His blood pressure is naturally high, which is why his doctor has him on medication. His medical history states heart disease runs in his family. These are all factors in deciding his care. As a physician, you have to look at the whole story, not just what’s happening on one page.” My words come out fast and harsh, but I don’t care.
“I understand that, Dr. Bishop,” she says my name with exaggerated expression. “But the facts also attest that people with amputations or become wheelchair bound are more susceptible to mental health diseases and sometimes even become suicidal.”
I stand with my arms crossed over my chest, slowly shaking my head at her. She’s brought me to an unnecessary level of anger. “Those factors can occur in any form of illness, Dr. Bell, whether or not the patient can walk. A man who once ran his own company and supervised hundreds of employees has a stroke one day and is now dependent on being fed by his wife. His life changed in a second and oftentimes that brings depression, anxiety, and even suicidal thoughts.”
Veronica clears her throat, dismissing the heated argument that’s unfolding in front of everyone. “Dr. Wood is on his way,” Veronica announces.
“Please Dr. Dursley,” she starts begging. “He needs his knee.”
“I appreciate you voicing your concern, truly,” Dr. Dursley begins, but Emily’s face drops when she realizes she’s not going to get her way.
“I’ve learned lots of things in my life, a lot of life lessons and a lot of lessons passed down to me from my father. Something he’s always told me is that when I’m passionate about something, I do everything in my power to voice that. Regardless of titles or years served, I won’t allow anyone to make me feel inferior because I truly believe this is the right thing to do, especially in this instance,” she states matter-of-factly. “Mr. Brauer is stable for now, and he might not make it through surgery, but he also might survive all of this and continue to live another forty years. Doesn’t he deserve to live the best possible life? If down the road the leg causes problems, he can have revision surgery and then go above the knee, so why not try to give him the best possible outcome first?”
I’m grinding my teeth so hard, the pain is shooting through my head.
“Dr. Wood,” I hear Fiona greet. The silence grows between us when he walks up to Mr. Brauer.
“Hello.” He gives a small smile. “Someone want to brief me?”
“Dr. Dursley will,” I blurt out before anyone else can speak up. “Excuse us.” I grab Emily’s arm and turn us toward the door. “We’ll be right back.”
“What are you doing?” she asks between gritted teeth the moment we’re out of the room.
“What the fuck do you think you’re doing? You cannot undermine me,” I whisper-hiss, my anger about to boil over.
“Let me go,” she scoffs, trying to jerk her arm away, but I hold her firmly as I lead us down the hall to the on-call rooms. “What the hell is your problem?”
Checking for an open room, I shove her inside before closing and locking the door behind me. “You have pushed me far enough, Emily.” I get in her face. “You do not call the shots on my patients. You might’ve gotten away with that at your other job, but here we have boundaries, and I’m getting really pissed off that you keep crossing them.”
“I was voicing other options!” she shouts in my face, her cheeks burning red. We’re both still running on the adrenaline from the scene that unfolded today. “Boundaries or not, a patient’s quality of life will always come first in my book.”
“You will listen to your superior’s instructions, or you’ll end up killing a patient! What don’t you understand about that? We have protocols for a reason, but you need to fucking follow them, or everything goes to shit.” She backs up, and I step right into her space.
“Not when your protocols aren’t the only way to do things!” She pushes a finger into my chest for emphasis. “I’m sick of your macho bullshit and never taking my suggestions because God forbid mine actually might be better than yours!” She shouts louder this time, and I know the nurses down the hall can probably hear her. The last thing I need is them in our business, considering our history.
“Keep your voice down, Dr. Bell,” I hiss between my teeth.
“Oh screw off,” she shouts, her neck pulsing with anger. She’s red in the face, and I can tell she’s past the point of pissed. This discussion needs to end so I can get back to my fucking job.
“You do what you’re told, and you do your job. You don’t argue with specialists who have years of experience on you and know the right procedures. Do you understand?”
“I am doing my damn job. Hell, I’m the only one doing anything out there while you stand around and bark out orders. Then when I actually give an alternate option and speak up for a patient who can’t speak for himself, you get your caveman panties in a bundle because it wasn’t your way!”
“I told you to keep your fucking voice down,” I warn. I don’t let anyone get away with talking to me like this, especially at work where I’m a respected doctor, and people are expected to take orders from me.
“Fuck you, Evan,” she spits out loudly. “I’m so sick of—”
Cupping her face, I push her until her back hits the wall then cover her mouth with mine and immediately silence her. She won’t lower her voice, which leaves me no damn option. She’s hesitant for only a second before sinking into it as we battle for control. Her arms wrap around my waist and pull me closer as I slip my tongue between her lips and seek out her taste.
“You want to defy me, Emily?” I whisper against her lips as she pants. “You do it outside of work. Do you hear me?” I kiss along her jawline and neck until my mouth is over her ear. “Do we have an understanding?” Sliding my hand around her body, I cup her ass in my palm and squeeze.
“You can’t use kissing to distract me, Dr. Bishop,” she states boldly, making me smile against her skin.
“Are you sure about that?” I push my groin against her
stomach, so she can feel how hard I am.
“I think you like it when I defy you,” she taunts, wrapping her fingers around my shaft through my scrubs. “In fact, I think you like it a lot. I think it makes you hard as fuck.”
Fucking hell.
“Emily…” I warn, nipping her bottom lip between my teeth. “You’re playing with fire.”
“What? Afraid to put your money where your mouth is?” She lifts up her head, and I catch her mouth with mine. Goddamn, she tastes so fucking good.
“I hope you know what you’re doing.” I release a frustrated moan when she starts stroking me faster. “I’m not going to play these games with you.”
“Who says I’m playing?” she whispers against my lips. “I’m so fucking wet right now.”
I release a deep growl, and I shut my eyes trying to regain control, but it’s fucking useless.
“See for yourself, Dr. Bishop,” she taunts in a low, seductive tone.
Taking my hand, she slides it into her panties where I feel how soaked her aching pussy is. “Jesus Christ,” I mutter, pressing my forehead to hers as I slide the pad of my finger along her slit, and her wetness coats my skin. “Shit.”
I’m battling with walking away—knowing how bad this is for our professional relationship—and taking what she’s offering. She gets me so goddamn worked up, I can’t even think straight.
“Fuck it,” I mutter, going against my better judgment. Hungrily, I take her mouth and kiss the fuck out of her. Hands and lips roam each other as heavy breathing fills the small room. I cup her breast and eagerly untie her bottoms. Once her shoes and scrubs are removed, her fingers fly to my pants, and she releases my throbbing cock in her palm. I reach a hand behind my neck and pull my shirts off, tossing them to the floor.
She kneels, pulling my scrubs down with her as she wraps her luscious lips around the crown of my cock. My head falls back as she licks from the base all the way to the tip and sucks it urgently into her mouth.