The Baby Rescue

by Jessica Matthews

  To her relief…and sorrow…she left St Luke’s with Galen’s good luck wishes ringing in her ears.

  Now they were together again.

  The pager in her pocket bleeped with a message summoning her to the ER. She wondered if this was Galen’s way of reminding her about lunch, but as soon as she crossed the threshold and saw the activity, she knew this wasn’t a social call.

  She headed for the trauma room that Fern had indicated with a curt “Room Two.” Before she could enter, a pretty paramedic—A. McCall, according to her name tag—stopped her.

  “Could I talk to you before you go in?” she asked Nikki in a low voice. “It’s important.”

  Curious, Nikki nodded. As soon as they were out of earshot of the man waiting for attention, who probably couldn’t have heard them anyway because of his demands for a painkiller, the young woman spoke.

  “I just thought I’d warn you,” she said. “This guy is a druggie, looking for a fix.”

  Nikki heard the man’s demands grow louder. “You’re sure?”

  “Positive. I learned the hard way,” she said ruefully. “He has a number of aliases and the last time I brought him in, as soon as my injection took hold he disappeared. Jared…” she colored slightly “…er, Dr Tremaine wasn’t happy with me.”

  Nikki smiled. “I can imagine. But you’re sure this is the same fellow?”

  “Absolutely, right down to the birthmark on the side of his neck. Mr Johnson, or at least that’s the name he’s using today, can dislocate his shoulder at will. He’s quite good at it.”

  Nikki had run across these people before. They tried their tricks until the staff caught onto their game, then skipped town to scam the unsuspecting staff at the next clinic or hospital.

  “Thanks for the tip.” Nikki eyed her nametag. “Ms McCall.”

  “Annie,” the woman corrected as she shook Nikki’s hand.

  “Thanks, Annie. But if you gave him a shot before, how did you avoid giving him one this time?”

  Annie smiled. “I didn’t. I used saline. It worked until we drove up and then he started complaining because it hadn’t kicked in yet. I told him that I didn’t dare administer anything stronger because he’d already received the maximum dose.”

  “Did he believe you?”

  She shrugged. “There wasn’t much he could do.”

  “Well, thanks again. I’ll take it from here.”

  Nikki walked into the exam room and greeted the blond twenty-five-year-old who was cradling his right arm. “So you dislocated your shoulder, Mr Johnson,” she said calmly.

  “Yes, and it’s killing me.”

  “I’ll be happy to give you something,” she said, “but first we need X-rays.”

  He frowned. “X-rays?”

  “Oh, yes. That doesn’t appear to be a simple dislocation.” She felt for the pulse in his wrist. It was steady and strong, but he didn’t need to know that.

  “I can tell from your pulse that you’re losing circulation. We may have to call in an orthopedic consult.” Nikki wrote a note and handed it to Ravi Kedar. “Would you please make the arrangements?”

  The nurse accepted the note with a puzzled frown, read it, then slowly nodded. “Right away, Doctor.”

  “Good.” Nikki turned back to her patient. “Now, let’s hear the real story.”

  “I already told the ambulance people what happened.”

  “What time did you fall off the ladder?”

  “I dunno. An hour ago.”

  “I don’t think so.” She straightened to her full five-foot four-inch height. “I might look like I’m naïve, but I’m not. Your injury didn’t occur an hour ago. Your name is on our list, buddy.”

  “I don’t know what you’re talking about.”

  “Bluster all you want,” she said bluntly. “You’re addicted and you need help. I can get you in a drug rehab program within two hours—”

  He jumped off the bed, his face twisted with fury. “Forget it.”

  “You need help.”

  “Yeah. I got plenty of help from you guys,” he sneered. “It was one of you who got me hooked in the first place. If he’d fixed my shoulder the first time, I wouldn’t have had to rely on medication.”

  “It started with a prescription?” Unfortunately, it did happen and for various reasons, but situations like Johnson’s were sloppy mistakes on the part of uncaring physicians.

  “Yeah.” He glanced around the room. “Where did the other guy go?”

  “To call Security.”

  He didn’t waste a minute. He maneuvered his own arm until the bone slid back into place, then hopped off the bed as he stripped the pulse oximeter off one finger and the blood-pressure cuff from his arm. “Sorry, lady, but I ain’t staying for whatever party you’re planning.”

  She blocked his path, aware that her small frame didn’t stand a chance. He wasn’t that much larger, but addicts in need of a fix often found superhuman strength. “We can help you.”

  “Move outa my way,” he ordered.

  She didn’t budge. “Give us a chance. You don’t want to spend the rest of your life like this, do you? Going from place to place, trying to satisfy your craving?”

  Suddenly he shoved her away as effortlessly as he would have a fly, then dashed out of the room.

  Nikki slammed into the nearby tray table and sent everything on it crashing to the floor before she landed in the middle of the mess.

  “What in the—?” Galen rushed in, followed by a worried Ravi and a pole-thin security guard, and helped her to her feet. “Are you hurt?”

  “I’m fine,” she said, before she looked past his shoulder to Ravi and the guard. “If you hurry, you might catch him outside. About five-seven, one-sixty, and chin-length blond hair.”

  The uniformed guard took off.

  “Will someone tell me what’s going on in my own ER?” Galen roared.

  “I had a patient who decided to discharge himself AMA. Against medical advice,” she added.

  “I know what AMA means,” he said grimly. “But that doesn’t explain why you’re on the floor and Neil is chasing after him.”

  “He didn’t like my suggestion to check into a drug program. He chose to leave rather hurriedly instead.”

  “And you tried to stop him, I suppose.”

  She looked at him with affront. “Someone had to make him think about what he was doing and where his life was going. I couldn’t let him just walk out of here.”

  “So he knocked you down and still walked out of here.” A muscle in his jaw tensed.

  “No,” she corrected. “He ran.”

  “Who was he?”

  “He went by Jake Johnson, but I understand he uses several names.”

  Galen nodded grimly. “We’ve met.” He glanced at Ravi. “If he shows up ever again, notify Security immediately. No questions asked. Do I make myself clear?”

  Ravi bobbed his head, his dark eyes wide. “Yes, sir.”

  “And make sure everyone else knows, too. I won’t have this happening again.”

  “Yes, sir. I’ll let everyone know.”

  “And you, Nikki,” he faced her, “are going to file assault charges.”

  “Oh, for heaven’s sake, Galen. If I hadn’t stood in his way, he wouldn’t have touched me.”

  “And what in heaven’s name did you think you were doing?” he railed. “You’re no bigger than a minute, anyway. You’re lucky he didn’t throw you across the room. You might have broken your neck.”

  Nikki bristled. Her height was her proverbial sore spot. Not that she cared about being shorter than nearly everyone else. It was strictly because too many people associated competence with being tall. Her stature had given her six-foot-five-inch brothers all the excuse they’d needed to be over-protective of their baby sister.

  “My size doesn’t affect my job performance or my brain power. I don’t need to be over six feet tall like you and bench-press a hundred pounds in order to treat patients.”

&
nbsp; “No, but there are times when muscles come in handy.”

  “Today wasn’t one of them.”

  The guard returned. “Sorry, Dr Lawrence. Your fellow vanished.”

  “Somehow I’m not surprised,” she said wryly. She reached down to pick the clipboard off the floor and dropped it again as her wrist protested.

  “You are hurt.” Galen grabbed her arm and began running his fingers over the skin, probing, prodding, then finally soothing.

  Every nerve ending tingled under his tender touch and the rest of her body awakened from its year-long sleep. His fingertips generated sparks that swiftly flared into a bonfire. His scent completely surrounded her as the sleeve of his scrub shirt brushed against bare arm and she closed her eyes in something akin to pure joy.

  Her good sense suddenly surfaced and she stiffened. No, she told herself. He was only being kind. His concern was no different than if she’d been any other colleague or staff member. She simply couldn’t let Galen know that he still possessed the power to make her knees weak and her toes curl. He might be a great doctor and a friend who’d give her the shirt off his back if necessary, but he wasn’t the kind of man she should be interested in. His father’s abandonment and his younger sister’s disappearance had scarred him to the place where he equated commitment with a noose around his neck.

  She jerked her hand out of his grasp. “It’s fine,” she insisted sharply. “Bruised, but not broken.”

  “You should have an X-ray.”

  “Absolutely not. I refuse to get caught up in the paperwork over nothing. Now, did you come in here to be nosy or did you want to ask me a question?”

  He frowned as if he hated to let the current subject drop but knew he had no choice in the matter. “I’d like a second opinion. My patient is comatose, with no visible reason for it.”

  “There has to be a reason, Galen,” she said, realizing how easily his name had rolled off her tongue. “It isn’t normal to be unconscious.”

  “You’re not telling me anything I don’t already know,” he said dryly as he led her to the next cubicle. “I’m afraid I’m missing something, so I want you to look at him and tell me what you think.”

  Nikki approached the bed, noting the airway and IV in the man with distinct Asian features. A quick glance showed a fairly normal heart rhythm, although the rate was depressed and his blood pressure was low.

  “What’s the story?” she asked.

  “The hotel maid found him this morning when she went to clean his room. At first she thought he was sleeping, but as the day went on she noticed he hadn’t moved a muscle. She tried to rouse him and couldn’t, so the manager called 911. At first the paramedics thought it was a drug overdose, but they couldn’t find any pills in the room.”

  “Do we have a name?”

  “He’s registered as a Michael Kwan. The EMS folks didn’t wait around for more information. The cops are supposedly going through his hotel room looking for his driver’s license. Before you ask, they didn’t find any prescription bottles lying around either.”

  By rote, she ran through the simple pneumonic for the causes of unconsciousness: AEIOU TIPS.

  “His alcohol level is zero and his glucose is normal,” Galen supplied, as if he’d read her mind.

  She mentally checked off “A” for alcohol and “I” for insulin and went back to “E”. “Epilepsy? Anything in the environment?”

  He shook his head. “No signs of seizure and it was a standard hotel room. No chemicals.”

  “And you’re positive it isn’t an overdose?”

  “Toxicology results aren’t completed yet, but we haven’t found any needle tracks and none of our antidotes, especially Narcan, have had any effect.”

  Next on the list was “U”. “Uremia?”

  He handed over the preliminary lab report. “Everything’s out of whack, but nothing that would explain being unconscious.”

  She moved on to the TIPS. “No visible signs of trauma?”

  “None.”

  “No infection either,” she mused aloud, noting the normal white-blood count.

  “I ordered a blood culture anyway,” he said. “It’ll take about six hours for a preliminary, but I doubt if it will grow any of the usual bugs.”

  “Have you thought of a psychiatric consult?”

  “If all else fails. It could be a stroke.”

  “It’s possible.” She began her own examination. “Pupils are fixed and dilated. He’s been sick for some time, I’d say. He’s pale and has poor muscle tone. And see how baggy his clothes are? He’s recently lost weight.”

  She straightened, running through her options. “I’d bet something’s going on upstairs.” She tapped her forehead. “We’d better get a CT scan.”

  “Mr Kwan is next in line,” he told her.

  “Then I’d say you’ve covered all your bases.”

  Kwan’s turn for a CT scan arrived a few minutes later. Before the radiologist reported a brain tumor near his brain stem, the lab called with the rest of the toxicology findings. Their patient had ingested a large amount of acetominophen, but whether it had been by choice or by accident to control an uncontrollable headache, no one would know. In any case, it was a moot point. He had been dying by inches and trying to counteract his overdose wouldn’t affect his outcome. All they could do was to make him comfortable.

  His breathing gradually became more depressed and Nikki knew his time was short.

  “You don’t need to stay,” Galen told her as he dashed in to check on him in between attending to his family with the intestinal complaints.

  “Yes, I do,” she said. “When the police find his family, I want to reassure them that their husband or father or son didn’t spend his final moments alone.”

  He nodded, then left as soundlessly as he’d arrived.

  Nikki watched over Mr Kwan, imagining all sorts of scenarios as to how and why he’d ended up in the town of Hope at this stage in his life. He had to have known about his tumor: its size was such that he would definitely have had signs and symptoms of its presence.

  Had he come to Hope in search of a miracle, or simply to find closure in the same way that she had?

  Her assignment to a town whose name encouraged looking to the future and not the past had appeared like a gift from heaven. She’d been weary of catching herself watching for Galen and seeing him in every tall, brown-haired man who’d crossed her path and so she’d given herself an ultimatum to stop. It had been time to fill the void in her heart with something more personal than her career.

  How ironic to find the man who’d created that void in this very place.

  Her patient interrupted her thoughts with a final shuddering gasp. The end had come quite peacefully. The knowledge would provide some consolation to his family, if he even had family.

  She shut off the monitors, closed his eyes, drew the sheet over his face, and strode from the room.

  Galen caught her before she turned down the hallway leading to her own clinic. “Are you OK?”

  “Yeah,” she answered. “It’s just a shame he was a long way from home. Have the police called?”

  “The last I heard, they’re still working on tracking down his next of kin.” He paused. “I tried to grab us a few sandwiches to eat on the run, but the cafeteria had sold out.”

  “That’s OK. I don’t usually eat lunch anyway.”

  “Then how about dinner? At eight?”

  “I’m still unpacking.”

  “All the more reason to go out.”

  “Not tonight,” she said firmly.

  “OK,” he said, as if he’d realized that she wouldn’t be persuaded. “What do you say to later in the week?”

  She was too tired to argue. “Maybe.”

  “Friday it is,” he answered as if she’d said yes. Before she could object, he added, “Thanks for your help. If I can ever repay the favor, I’m only a phone call away.”

  “I’m sure I’ll manage on my own,” she said, determin
ed not to ask for his assistance unless absolutely necessary. After working in hospitals where she saw more emergencies in a single shift than Hope would see in a week, handling a minor emergency center and walk-in medical clinic would be a breeze.

  “I’m sure you can, but technically we’re supposed to be here for each other.”

  Her heart skipped a beat as she tried not to read more into his comment than necessary.

  “Nikki…” he began.

  His tone suggested that he was going to touch on a subject that was best left forgotten. She braced herself. “Yes?”

  “Do you ever wonder what would have happened if we’d made love that night?” he asked softly, his gaze intent.

  All the time.

  She couldn’t say that, however, so she hid behind a carefree attitude. “Why would I do that?” she prevaricated.

  “Because it’s been at the back of our minds for the past year,” he said. “We need to finally get everything out in the open.”

  She waved aside his suggestion. “For heaven’s sake, Galen, why? There’s nothing to discuss. In fact, I can barely remember what happened.”

  Liar, her little voice screamed at her.

  His eyes gleamed with something she couldn’t quite identify. “Fool yourself all you want, Nikki, but you haven’t forgotten a single minute. Neither have I.”

  She broke eye contact, certain he would see more than she wanted him to. It didn’t seem fair that he could read her so easily when he hadn’t done so before.

  “Maybe not,” she admitted slowly, “but talking didn’t change the outcome back then and it won’t change it now, so let’s drop the subject, once and for all.”

  His gaze grew intent. “I can’t do that, Nik.”

  If she’d learned one thing about Galen during their residency, it had been that he was persistent when he felt strongly about something. She could either give in or wait for him to wear her down like water dripping on a stone, but in the end he would get his way. She’d prefer to have it happen on her terms and not his.

  “OK, but you said yourself that moving to a new town and learning a new routine was stressful. Can we wait a while before we take our trip down memory lane?”

  He nodded once. “OK. We’ll wait. But not for long.”