by Amy Ruttan
Face your fear and go to the Opry. What can it hurt?
It had been a long time since he’d graced those hallowed halls. The last time had been when his father was alive and he was just about to go into medical school. His father was getting out on stage to sing for the first time since Reece’s mother had died.
Reece had been so much younger then.
Maybe, just maybe, he could sneak in backstage and keep a low profile out of the spotlight. He didn’t know of many hiding spots at the Opry. Too bad Gary’s performance wasn’t at the Ryman auditorium. He knew of plenty of hiding spaces at the Ryman. It was a place he would hang out while his parents performed, but the Opry rarely performed at the Ryman anymore. Not since it moved locations.
He’d liked the Ryman.
He’d liked running around the top level. The half circle, while his father did his sound checks and his mother ordered people around.
And there were fleeting times he’d imagined himself up on the Ryman stage. Singing like his father because, even though he had issues with his father and being Ray Castille’s son, when his father walked out on stage he commanded a presence that not many people could imitate.
“Dr. Castle, Mrs. Bowen’s scans are coming up again,” the tech said, interrupting his thoughts. He hadn’t noticed the tech had returned and administered the contrast.
“Thanks.” He scrubbed a hand over his face. He had to get a control of himself, but since Vivian had walked back into his life memories were haunting him constantly.
The scans came up on the computer and Reece’s heart sank. So much had changed from Mrs. Bowen’s original MRI of just a couple of months ago. He had to start the protocol on her now or she would no longer be eligible for his trial.
Soon, whatever was left of Mrs. Bowen would be gone and it would invalidate the drug they were using.
“Where am I?” Mrs. Bowen’s voice was shaking over the intercom.
“You’re at Cumberland Mills, Mrs. Bowen. I’m Dr. Castle and we’re doing an MRI. Do you remember?”
“Oh. Oh, yes. Now I do. I’m sorry.”
“Don’t be sorry,” Reece said. He was just glad Sandra Bowen didn’t remember him from seven years ago. The first time when she’d warned him off and the second time when she’d told him Vivian was gone and it was for the best.
“Am I done?”
“Yes. You’re all done. Nurse Rose is going to take you back up to your room.”
Reece sent the scans to his office. He had to find Vivian and get her permission to start as soon as possible. She hadn’t signed the consent forms because they’d been so busy since her mother was first admitted. Now he had to track her down and get her to actually sign the forms. He wanted to start the protocol for his trial today.
As soon as he had the forms signed he would take Sandra into the OR and inject the medicine in a delicate procedure involving some nerves at the base of her skull.
He found Vivian in the cafeteria, nursing a large cup of coffee as she read a medical journal.
“Mind if I join you?”
She didn’t look up from the medical journal she was reading. “Suit yourself.”
“Is that in German?” he asked, craning his neck so he could see the words better.
“Yes, Dr. Mannheim’s latest article. I like to keep up with his research.”
“You didn’t want to leave Germany, did you?”
“Do you want the honest answer?” she asked.
“Yeah, the truth, please.”
“No, I didn’t want to come back to Nashville. I didn’t have the best childhood. Bad memories.”
Bad memories was like a slap to the face. “I find that hard to believe.”
“Why?” she asked, confused.
“I see the love between your mother and you.”
Vivian’s shoulders relaxed. “That’s not what was bad. It was all the times my mother worked night shifts and I was home alone, scared. And then when my father left...my mother checked out. So my bad memories are tied to that. Nothing else.”
Reece felt like a fool. “I’m sorry.”
Then she reached out and touched his hand gently, her soft skin causing his blood to heat. Just the simple act of her touch made him want her. She affected him so deeply.
“You were never a bad memory, Reece. Never.”
He moved his hand away, not letting her touch him. He wouldn’t let her in again. He couldn’t. Though in this moment he wanted to.
“I just got back from the MRI scan with your mother,” he said, changing the subject.
She perked up then. “Oh, yes?”
“It’s progressed since her original scan.”
Vivian shoulders slumped in defeat and he couldn’t blame her. “I figured as much. I didn’t want to believe it, but...is she still eligible for the trial?”
“She is.” Reece sat down and slid the papers toward her. “You need to sign the consent. I wasn’t in a rush. I thought we’d have more time to get her wrist healed and run some more tests, but if you want her to stay on the trial I need to get her into the OR today.”
Vivian pulled out a pen from her lab coat and signed the consent form. “How is she today?”
“The MRI was hard. I had to stop the test three times because she didn’t know where she was and didn’t seem to understand what year it was. She kept asking for her Vivi.”
Vivian groaned. “Oh, that was her special little nickname for me. I hated it.”
Reece chuckled and then took back the signed consent forms. He stood up. “Look, I’ll be at the Opry tomorrow night.”
“You will?”
He nodded. “Yeah. We have to keep an eye on Gary somehow.”
She smiled. “We do.”
He hesitated and he didn’t know why. He had what he came for; he should just turn around and head back to Vivian’s mother. Prep her for the injection.
“Do you want to come to the OR and be with your mother while I give her the protocol? It’s a blind protocol. You would have to wait until I know whether she’s getting placebo or the active medication.”
Vivian nodded and handed him back the signed papers. “Sure, I’d like that. I’d like to be able to hold her hand. As long as it doesn’t affect your trial.”
“It won’t. Not as long as you wait in the scrub room until the envelope is opened.”
“Okay, I’ll come down. When were you planning to take her down to the OR?”
“Now that I have your consent I’m going to head up to the floor and get her prepped and ready to go down. I have a small OR always on standby for my trial.”
“Wow, that’s very big of Dr. Brigham to grant you that.” There was shock in her voice.
“Why are you so surprised by that?”
“Cumberland Mills is a large hospital that does a lot of surgeries. It’s not specializing in just neurosurgery, where operating rooms can be kept on standby like that. Usually, things like trials have to wait until more emergent situations have the first go of it. I’m impressed. A lot has changed since I was here.”
He was going to tell her that he was usually bumped when there were trauma cases, but he didn’t have to because his pager went off and so did Vivian’s.
“So, about that keeping an OR on standby, I think your mother’s surgery is going to be pushed.”
“Maybe not that much has changed.” She stood. “I’ll see you down in the ER.”
Reece nodded. “Yeah, I’m going to get these consent forms up to my resident and I’ll see you in five.”
* * *
Every bone in Vivian’s body ached. She’d been on duty now for days. She hadn’t left the hospital since her mother had been admitted. And she hadn’t wanted to go home, to be honest. Her shift wasn’t over until four in the afternoon and, depending on the severity of the trauma rolling in, that could be pushed even further.
This was something she hadn’t done in a long time and she hoped that she wasn’t rusty. She stood at the edge of the ER. It was bustling as nurse
s and trauma physicians prepared for the incoming trauma. It was a multivehicle crash and there were several head and spine traumas and that was why she stood here with two other neurosurgeons, gowned and ready to take over as soon as the ambulances pulled up.
The air crackled with adrenaline. It was like standing at the edge of battlefield or, as one author had once phrased it, “The deep breath before the plunge.”
Reece came up beside her. “Gary is looking for us. We have to sign his discharge papers.”
“Did a nurse tell him we’ll be up as soon as this is over?”
“Yes, but that sometimes makes no difference to famous people.” Reece sighed. “They don’t like waiting.”
“Well, he’ll have to wait.”
“What do we know so far?” Reece asked.
“Multivehicle crash on I-65. Lots of trauma, but I guess there was a couple not wearing seat belts who were ejected and have extensive head and back injuries.”
He winced.
“We’ll do this by teams of two,” Dr. Brigham said as he walked up. “Dr. Castle and Dr. Maguire, since you’re so comfortable working together, you’ll work as a team and will take the female occupant of the vehicle.”
She didn’t really have much of a chance to argue as he moved down the line of other surgeons and began to delegate tasks.
“Whatever team is working on the female head trauma, her ambulance is pulling up,” a harried nurse shouted above the din.
“Come on,” Reece said as he took off at a jog toward the main doors. Vivian followed him. The blare of sirens was overwhelming and caused her heart to jump. When she’d been standing there and waiting for this moment she was afraid that she wouldn’t remember what to do or how to act in a trauma situation. It had been seven years since she’d worked in an emergency room. Dr. Mannheim’s clinic was for neurosurgery patients but not traumatic brain injuries right when they happened. Usually patients were brought in and they were stabilized.
Mostly, though, she removed tumors and honed her surgical skill as well as working in trials. Standing here outside of a hospital emergency room as an ambulance rolled up made her nervous. Only for a second, though. As soon as those doors opened it all came flooding back.
The paramedic jumped down and, with another paramedic, lifted the gurney.
“Patient, female, aged thirty, involved in a multivehicle crash. Was nonresponsive on the scene with a GSC score of three. Needed resuscitation at scene. Blunt trauma to the head and neck,” the paramedic shouted over the din.
Vivian peered down as they raised the gurney and she took her spot beside it as they rolled the patient into the ER.
The wound on her head was packed, but she could tell it was extensive. There were contusions over her body and glass. The woman had gone through the windshield.
Why hadn’t she been wearing a seat belt?
She let Reece guide them into a trauma pod, where they lifted her gently off the stretcher onto a hospital gurney. As the paramedics left to go back to the accident scene, Reece and Vivian began to work on the patient.
Instinct took over and she knew exactly what she was doing again as she began to cut away the bandages to reveal the damage that a plate of glass and twisted metal had caused.
“Does anyone know her name?” Reece shouted over his shoulder as he listened to her bilateral breath sounds.
“Carmen Sanchez,” someone said, but Vivian didn’t see who as she lifted Carmen’s eyelids to check her pupillary reaction.
“Carmen?” Reece asked, leaning over as Vivian flashed a light. “Can you hear me?”
Vivian saw a reaction in the right pupil, but the left was not good.
“Left pupil is blown. We need to get her to CT.” Vivian closed her eyes and checked on the laceration. “It’s deep, but if we pack it we can get her to CT.”
Reece nodded. “Breath sounds clear.”
Vivian was amazed there wasn’t more external damage. Of course that could be a totally different story when the scans came up. Having a Glasgow Coma Scale score of three wasn’t good either and Vivian strongly suspected Carmen had an intracranial bleed.
“Let’s get her down to CT,” Reece shouted above the noise as he lifted the sides of the stretcher and Vivian made sure the IV bags and lines were secure.
“Ready?” he asked.
“Yep. You don’t need to ask.” They shared a smile.
Just like old times.
She followed his lead as they moved from the trauma pod down to the CT. Once again, no words were needed as they worked seamlessly together getting their patient into the CT and then watching silently as the images loaded onto the computer screen. She was holding her breath and praying for not too much damage.
“Intracranial hematoma,” Reece remarked as the image came up. “Also bleeding in the abdomen. We need to page someone from general surgery.”
“Yes. She needs to go into the OR now.”
“I’ll go get it prepped. You stay with the patient and page the general surgeon. You’ll know the best one to work with.”
“You know where the surgical floor is?”
“Yes, I swear I won’t end up in Pathology again.”
He chuckled. “Go. We’ll be down soon.”
She nodded and headed out of the CT room. Her body protested, but she ignored the exhaustion. She had a life to save.
* * *
Reece glanced at her as they worked on Carmen in the OR. The general surgery team was waiting until the craniotomy was finished before they went and assessed the bleeders. The bleeding from the spleen wasn’t bad. The head had to be addressed first. As he watched Vivian briefly he could see the exhaustion on her face. Even though it was hidden behind a surgical mask, he knew the way she shifted her weight ever so slightly from foot to foot that she was tired.
Obviously, working in Germany had made her soft. Still, she was holding her own. He’d been worried that maybe she wouldn’t be able to hold her own in a trauma situation, especially after being up for hours. He was pleasantly surprised, but he should’ve known. Vivian had always been driven. It was what he admired most about her.
It was why he’d fallen for her seven years ago.
It’s why you still have feelings for her.
He shook those thoughts away and turned back to the craniotomy. He couldn’t be thinking like that. Vivian was off-limits. He wouldn’t ever put his heart on the line again for someone. He’d learned that lesson well.
“You okay, Dr. Castle?” It was so weird she was using the formal address. It was what he’d wanted when she’d returned and what was appropriate, given they were surrounded by nurses, other doctors and students.
It wasn’t right to be calling each other by their first names.
He still hated it. It didn’t feel right and that bothered him.
When she’d left he’d spent a year trying to forget her, to go on with his life. She had been back for a couple of days and already taking over his thoughts.
Focus.
“I’m fine, Dr. Maguire, and intracranial pressures are good.”
“That’s good. I think if she makes it through the night and through her splenectomy she’ll make it. She’s very lucky.”
Reece nodded but didn’t say anything as they worked together to evacuate the hematoma. He couldn’t enter into a level of familiarity with her again. It would just set him up for hurt. Yet being so close to her, working with her, made him forget all the reasons why she was off-limits. Being with her felt right.
“So the Opry?” she asked.
He groaned. “Why?”
“What do you mean, why?”
“I mean why are you asking about it?”
She shrugged. “I don’t know much about it.”
“What do you want to know about it?” he asked cautiously. It was a subject he didn’t like talking about. Especially not here. There was no place here in his life for a piece of his father’s world.
“Why didn’t you want to go?�
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“No reason,” Reece responded. “I really don’t want to talk about it.”
“Why?”
“It’s private,” he snapped, then sighed, annoyed with himself for getting snippy with her. “I’m focusing on the patient right now and not the Opry.”
“So am I, but we used to chat like this all the time. Suction, please.”
She was right. They did.
“That was a different time.” Reece suctioned around the bleeder. “It’s different now.”
“Fine. I’ll talk, then. It helps me focus.”
“Suit yourself.”
“To be honest, I’m not a big fan of country music.”
There was a collective gasp. He was shocked, but then he remembered her saying it before. It hadn’t bothered him back then. He had actually felt relieved. Less chance of her knowing who he was or, rather, who his father was. Reece was nobody and he liked it that way. Though his father had never been thrilled and he’d constantly reminded Reece that he was a nobody because he was just a plain old surgeon.
Even though he’d hated his parents’ lifestyle, he still loved the music. He still liked performing; he just liked medicine more.
“Not a fan of country? I’d honestly forgotten that. You know that’s sacrilegious in Nashville?”
She chuckled. “I know, I know. My mother reminds me constantly about it. I’m a native of Nashville. I was born and raised here. I was also forced to watch endless hours of Hee Haw as a child.”
Reece laughed. “Weren’t we all?”
There was some laughter from others in the OR, people who’d grown up the same way as Vivian, but not him because he was pretty darn sure no one else had had the childhood he’d had.
Yeah, he’d watched Hee Haw and listened to the Opry on the radio but, more often than not, he’d been in the audience when his father was performing, feeling entirely alone.
“I just...I’m not a fan,” Vivian said.
“That’s too bad. Gary will be so disappointed,” he teased.
She rolled her eyes. “I’ll still go. Who knows, maybe I’ll be swayed? I’ve been in Europe for a long time and maybe country music has changed.”
“It’s good, but it’s still similar. Same themes.”
“Oh. Great.”