Becky’s heart raced. “Can you get it? Now?” If the boy had what she suspected, they needed a clear picture before they proceeded with any plans. With his fever as high as it was, there was no way in hell antibiotics would work fast enough.
Slate’s worried blue eyes flitted between Becky, the mother, and Mac. One curt nod and he bolted from the room. Becky had never seen a cowboy move so fast.
The mother’s morose stare bit at Becky’s conscious. Safe topics didn’t come to mind and Becky finally allowed herself to focus on Mac. Everything in her head came back to the boy, including the man she’d arrived with. Nothing better to offer the mother, Becky said the first thing that came to mind. “I’m sorry about this. I can’t imagine what you’re going through. How did you come up with the name Mac?”
A soft smile curved the corners of the mother’s mouth. “His whole name is MacAllister Lee James. Big name for a three and a half year old, so we just call him Mac.”
“MacAllister? Like Slate’s last name?” Curious. Becky hadn’t thought to ask about their relationship. Not that it was any of her business. But still, human curiosity usually won over professional stoicism. And it seemed like a smart thing to consider since she couldn’t seem to decide if she was hot or cold for him.
“Yeah. Named for his father. My last name is James.” She picked at the sleeve of her shirt.
Becky didn’t have a reply. She dug into the metal bucket full of melting ice. Wrapping a cloth around a handful of rounded chunks, she tied off the cold packet and pushed it between Mac’s ankles at his pulse point. “I’m Becky O’Donald. What’s your first name?”
“I’m sorry. I’m Amelia James.” She smiled with more exhaustion in her expression than Becky had ever seen on any medical student.
“Very nice to meet you, Amelia.” Becky packed another ice wrap and tucked it under Mac’s arm into the crook of the left axilla. She pressed the last one into the small curve where his shoulder met his neck.
“What are those for? Why don’t you just put the ice on his forehead?” His mother’s question sounded rote, like she was grateful someone else had arrived to decide how to care for her child.
“Well, his fever is in his whole body. If we can reduce the temperature of the blood, I’m hoping we can cool everything down, not just his head. I happen to believe the controversial statement that your son won’t actually ‘burn’ his own brain with his fever. The body develops heat to rid itself of something else. Something foreign.” She held in her sigh. No need to worry the woman more than necessary. “But there’s no reason we can’t try to make him more comfortable.”
Slate rushed through the door, weighted down by the large box in his arms. He set the container on the island and pulled out cords, a monitor, and paddles.
Becky joined him. He bent his head toward her as if he knew she needed to speak. Her words flowed in hushed tones. “I think he has appendicitis. If he does, his best bet would be to get to Sacred Heart in Spokane. Second, the hospital in Missoula. Third, Sandpoint in northern Idaho or even Kootenai Medical Center in Coeur d’Alene. But if he’s too far along, then the only option we’d have is…” Becky bit her lip.
He stilled his hands and turned the ice blue of his gaze on her. Up close, the difference in thickness and shades of black of his individual whiskers sharpened.
She didn’t want to say it. As if keeping the option locked inside would make the moment freeze. But every second Mac went undiagnosed was wasted time. She held her words but unfroze the moment. “Can you bring him over here and lay him on the table? I’ll have Amelia get a blanket.”
Noticing the intricacies of his facial hair and the angle of his jaw seemed to steady her. Not only was the situation a life-or-death matter, but the woman he had a child with was feet away. His son. The whole affair was inappropriate.
Becky stifled the desire his nearness had stirred. Behave, Becky. She needed cold water splashed on her.
Slate joined Amelia, abandoning the assembled machine. He ever-so-gently lifted the child into his arms. Their heads tilted close. The similarity of their coloring enhanced by their nearness. Like looking between a past and future version of the same person – identical black hair, long black lashes, black eyebrows and the suggestion of a hard jaw line under the rounded curve of Mac’s cheeks. Slate murmured to Amelia. She grabbed a large comforter from a stack inside the trunk-coffee table and followed the pair to the kitchen.
Father and son.
Well, didn’t that just suck?
Chapter 4
Other option? What other option could She-Doc think would work? His helicopter was in storage for the winter, so even the short two hour ride to Missoula was too far in the blizzard. Sandpoint could be across town and there’d be no reaching it at that point.
Slate winced as he lifted Mac into his arms. His sturdy buddy seemed so slight compared to the wrestling-Spiderman-loving-eat-all-the-chocolate-in-sight little tike he’d been days ago. Sunken shadows under his eyes aged him. His flushed face framed bright, cracked lips.
No child should have to suffer like Mac did. The situation angered Slate. Hurt him. And he had no way to stop it.
Appendicitis killed if left untreated. He didn’t have human antibiotics and Mac might be too far gone for them to work anyway. If he’d known, Slate might have used the ketamine he kept on hand for the animals outside. Dosing would be an issue, but there were calculations for that kind of thing.
Amelia laid the folded comforter on the center of the island and stepped back, twisting her fingers. Poor girl. When it came to her son, everything else paled in comparison. Even her own welfare.
“Slate, go ahead and lay him down. I need him flat on his back.” Becky ordered him like a nurse, but Slate didn’t care. He’d be a nurse for the little guy, if that’d help.
She-Doc twisted her hair into a short ponytail and pointed at Mac while looking at Amelia. “Mom, I need you to hold Mac’s hand. I need to press into his abdomen with the paddle and, I’m going to warn you, it will most likely hurt. Slate, we need his ice packs back, please. They fell when you brought him over.”
If possible, Amelia’s face paled further but she nodded. Slate hoped she didn’t pass out. The girl wasn’t the strongest when it came to the little boy and pain. She’d actually vomited after Mac’s screams had carried on for the first two hours and Amelia couldn’t console him. Too much stress affected her easily.
Slate had wanted the release throwing up would bring from the nausea he’d had, too.
Becky glanced at him and then at Amelia. Her green eyes guarded. Something had shifted in the way she regarded him. But what?
She grabbed the tube of gel.
He retrieved the ice packs and handed them to Becky to replace.
Becky took a deep breath. Seriously, how long had she been a doctor? Had he made a mistake in bringing her? His options hadn’t been plentiful. He could have brought the PA, if he’d really needed to. The PA was a bit older and had been around more than just a couple months. Except the PA was at Ronan’s house… and the more he thought of it, the more appealing the option with the doctor seemed.
The monitor clicked on with the flip of a switch. Slate watched the screen. Mac’s moan indicated the doctor had placed the sonogram tube below his belly button. A black and white moving picture appeared.
Rather adeptly, She-Doc located the lower quadrant and angled and pushed, ignoring the child’s unconscious cries. She pointed to the white mass protruding like a bulbous finger into the varying shades of gray. “Right there. I was right. Appendicitis. Dang it.” She pulled the device from his skin and gently wiped the lubricant away. “Amelia, I’m going to palpate the abdomen. You may need to hold him down.”
Becky closed her eyes and pressed her fingers above the indent of Mac’s hip. She pressed harder. And harder. Mac screamed. Amelia gasped with the pull he exerted on her visibly straining arms. Becky stepped back, releasing him from the pressure. Mac quieted after a few whimpers.
Slate’s anger cascaded down his spine. How dare she? Was that really necessary? “Why did you have to do that? You already diagnosed it. You hurt him for no reason.”
Becky raised her troubled eyes to his. The pain in her voice stopped his next words from forming. “I had to find out exactly where it is.”
Slate’s contagious exasperation cut into Amelia and her cry bit through the air. “Why?”
She-Doc faced Amelia. Her expression told Slate to consider what the other option might be. What would happen if they had the time to get him to the hospital? What would the hospital staff do? In time for what?
Slate cut through the tension separating the two women. “You’re not…”
“I need to give him an appendectomy, Amelia. He’s too far gone. If we don’t do it within, I’d guess, the next hour or two, he’ll be… it’ll be too late.” Becky didn’t flinch when she made her report.
“Here? In the house? No. He needs an OR. He needs sterility.” Amelia’s voice raised an octave with each word. She shook her head and wrapped her arms around her stomach.
Slate froze. He had nothing to offer. His exam room in the barn was filthier than the kitchen. But he’d heard of the dangers of appendicitis. He’d had to put a foal down once a long time ago because of it.
Becky stepped closer and leaned her head toward Amelia. “What choice do we have? Do you want him to die?”
Smack.
A bright red mark appeared instantly on Becky’s cheek.
Amelia cried into her offending hand. “How dare you? Why would you say such a thing?”
Slate stepped between them. “Amelia. She’s here to help. You can’t do that.” He tried to understand what was happening. Amelia had attacked Becky, the woman trying to protect her son. He’d never thought Amelia could be violent.
Not for the first time, he wished his brother would show up and offer support. He reached out for Becky and touched her arm. “Are you okay? I’m sorry. She didn’t mean to do that. Did you, Amelia?” Slate looked sharply at Mac’s mom.
Becky didn’t move. Her breathing had shallowed and the hand print staining her cheek faded to a dull, flat flush.
Amelia had frozen.
Slate needed to gain control of the situation. He held out his hands toward the women centered in the tense room. “Right, Amelia? It’s okay. We just need to think this through.” To Becky, he asked, “Have you ever done this? How do you know?”
The doctor focused on him, her eyes bright with adrenaline and barely controlled emotion. “In the medical field the rule is learn one, see one, do one, teach one. I’ve learned it. I’ve seen it. I guess this is my time to do it.” She took in Amelia’s stricken face. “No, I know it isn’t very comforting. I can’t imagine any of this would be. Here are the risks.” She glanced at Slate. “Are you listening?”
Attention gained, she held up her fingers as she ticked off possible complications and risks. “Let’s forget for the moment we’re not in a hospital where the operating room is sterile and they have an anesthesiologist and nurses. Let’s forget that I’ve never done this procedure in controlled circumstances or the fact that we haven’t got traditional drugs. The weather has made travel implausible for the small child, at least for the speed we’d need to reach.
“Pure and simple, the risks are… I could cut into him to do the procedure and he could die. With all the variables, I don’t know what the statistics are. More risk for infection, irritation, indiscriminate cutting…” she sighed, “…all kinds of errors.
“But if we don’t try, the appendix will burst and shoot infected intestinal contents into the abdomen – where it’s not supposed to be and he will die. Do you understand that? I’m more scared than you are to do this. But the cons are worse than not doing anything.” She-Doc’s lip quivered from adrenaline? Or fear? Or indignation?
The impassioned speech drove the tears down Amelia’s cheeks. She crossed to Slate and grasped his hands, her fingers icy and trembling. “I can’t. Be. In. Here.” Her brown eyes begged him for help. “You need… I nee… you to… be here for him.” She turned to Mac and rested her fingers against his cheek. She leaned down and whispered, “I’m sorry, my little man. I love you so much. Try to stay with Mommy, okay? Try. I’m right outside the doors.” She stroked his skin, once, twice, kissed his forehead and then faced Becky across the island holding her son’s body. “Please. Don’t… let him die.”
Slate met Becky’s gaze with his own as Amelia ran from the room. The soft tick-tock of the grandfather clock on the wall marked time in the sudden silence.
She-Doc’s face had paled, giving her the alabaster skin of a ceramic Irish doll. Eyes wide, she nodded at him. “Are you ready?”
Slate’s stomach sank. He had to be.
Chapter 5
No way was she cutting into the toddler without some form of anesthesia. But what? Becky stared at the granite countertop. Alcohol? He’d have to drink it and he wasn’t awake to do that, plus what could it do? Not much for his little body except make him sick. No, she was just grasping. No way would she give a child alcohol.
Outside of the illegal issues associated with carrying around narcotics, Becky had never considered knocking anyone out before on her own. Even with her schooling on surgery in the most base of circumstances, she’d never been taught how to proceed without an anesthesiologist at the helm.
What did she use? Well, Slate had mentioned something about being a veterinarian. Or had he said vegetarian? “Did you say you’re a vet?”
He twisted his head toward her. The sound of her voice boomed through the virgin operating room. Why was he standing in front of the knives? He didn’t actually think she’d use kitchen utensils, did he? He shrugged. “Yeah, but animals are too different from children. I don’t know how I can help. I wouldn’t know the first thing about what to do.”
Becky waved her hand. “No. I can do it if you just hand me stuff. What I’m wondering is if you have anything we could use for anesthesia. He may have slept through the pain from palpation but what I’m about to do will wake him for sure.” Mindful of the passing time, her brain spun through possibilities.
After a long pause, Slate’s rough voice answered. “I have ether in the barn.”
And the stress dropped away. “Ether? That’s great. Can you get it? Things just got a lot easier.” Old-school anesthesia, but she could use it. Fortunately, she’d taken extra courses on rural medicine to prepare for work in the boonies. The classes didn’t cover the experience Roylance would have, but she’d take the education over nothing. Heck, even some animal medicines had been discussed for possible use during a human emergency.
While Slate retrieved the drug, Becky set up the makeshift surgical area. Diamond cut stainless steel surgical tools in a leather hard-board case, organized and sterile, comforted her with their weight. Her skill lay in maneuvering the small pieces.
Blue surgical cloths, gauze, a blood pressure cuff, syringes, bulbs, gloves, antiseptic, and other odds and ends followed the case onto the table in an obsessive fashion.
The bag couldn’t have been packed tighter. Becky welcomed the last item from the bag with a warm smile. A tiger, the size and shape of a golf ball, rested in her palm. She’d forgotten about Spike. Her lucky charm. She had taken him into every surgery during her residency. She shrugged and tucked him into her pocket. Couldn’t hurt.
Her ponytail needed to be tighter. She pulled it down and wrapped it up again.
The small boy moaned in his sleep, his hand reaching for his tummy. Becky held his fingers and rubbed the back of his wrist with her thumb. “Shh. It’s okay. You’re gonna be just fine.” She hadn’t had the nerve to tell the worried parents her surgery experience lay with adults. Pediatrics was an entirely different ballgame – smaller parts in different stages of growth, crammed into an even smaller body. Tiny and hard to work with.
That fact she’d keep to herself until after, hoping everything went smoothly. Crap, was she suppo
sed to have them sign something in case things didn’t go well? Too many things to think about.
The earthy smell and sharp poignant cologne preceded Slate into the kitchen. His stubble had darkened or his face had paled, even with the slight ruddy shade from exposure to the brisk cold. He handed her the plastic brown bottle marked with big black letters on a white label. “I brought the gauze I use and – oh, you brought supplies. How did you bring all this with you?”
Becky set the ether on the counter and fingered the lamb leather case. “I always pack for the chance anything will happen, even modified surgery. Dr. Roylance said I wouldn’t need to do any procedures away from the clinic and he always laughed at my bag.” She offered a short guffaw. “I’m glad I didn’t give in to peer pressure now.” She breathed in slow, her heart pounding like it wanted to break free. “Sorry. I ramble when I’m nervous. Or scared. Or upset.” She knocked the capped bottle over with her clumsy grasp and shot a quick glance to the witness of her nerves. “I’m not like this when I operate, just when I’m preparing. I don’t know why.”
Slate stepped close and rested his hip against the table. He reached for her hands and held them between their bodies. The points where his skin touched hers held a distinct heat, calming her. Slow, like he spoke to a person with minimal capabilities, he said, “I don’t know you. I haven’t heard of you and I’m not sure how much you know. But if you don’t think you can do this, you won’t be able to. You have to believe in yourself. Can you?” He ducked his head and his blue eyes stole her concentration.
At the moment, she didn’t care if he was married or otherwise involved. She didn’t care about anything but the heat of his hands and the intensity of his gaze.
She nodded.
He squeezed. “If nothing else, at least fake it… for me. I don’t know what we’re doing.”
The man was right. She could do it. Why was she always a victim to her insecurity? She always second-guessed herself. And with people more experienced than her around, she’d been safe to do so. Now, the responsibility and answers lie with her.
Spurs and Lace (Lonely Lace Series Book 1) Page 3