by Loree Lough
She’d spent the equivalent of thirty hours reading up on the disorder and interviewing the cardiac specialists who’d written about Brugada in well-respected medical journals and textbooks. Armed with her thick file of facts and figures, Emily made her way to the pediatric ward and found Gabe sitting up in bed, enjoying his first meal in three days. To his right sat an elderly woman. To his left, Phillip Baker.
“A burger and fries,” Emily said, forcing a smile. “Bet that tastes good!”
“Oh, yes. I especially like the chocolate milk.”
Baker stood. “Dr. White, I’d like you to meet my mother, Sarah.”
The older woman nodded. “You have brought to us good news, I hope.”
Emily had never believed in giving false hope. But she didn’t believe in causing unnecessary worry, either. Especially with Gabe right there in earshot. She chose her words carefully and adopted her all-business façade: Stand tall. Chin up. Voice firm but friendly. “We believe we’ve identified Gabe’s problem.”
The grandmother sat up straighter. “You believe? After all this time, after starving our boy and subjecting him to needles and wires and big, noisy machines, you still are not sure?”
Gabe must have described his hospital experiences to her in great detail. He put down his burger and looked from his grandmother to Emily. She didn’t know him well, but it was clear that this bright little boy wanted answers, too.
Unfortunately, we are sure, Emily thought, tightening her grip on the folder.
Baker picked up on the seriousness of the situation. “Where can you and I discuss this, Dr. White?”
Not in front of my mother and son, his stern expression said.
“There’s a family area just down the hall. It’s quiet there.”
“Good.” And to his mother and son, he said, “We won’t be long.”
Once situated in the small, pleasantly decorated lounge, Baker helped himself to a cup of coffee. “May I pour some for you, Doctor?”
“No, thanks. I’ve had my daily quota.” In truth, she’d consumed a full pot, trying to stay awake while investigating Gabe’s illness during the wee hours.
He sat across from her, elbows on knees and big hands nervously turning the Styrofoam cup.
“Well?”
Now, looking into his expectant, worried-dad face, Emily wished she’d accepted his offer of coffee, so she could take a sip and put off the inevitable, at least for a moment.
“Gabe has Brugada syndrome.”
His well-arched brows dipped low on his forehead as he echoed the words. “Brugada syndrome. What is it?”
“It’s a condition that causes a disruption of the heart’s normal rhythm, causing irregular heartbeats . . . ventricular arrhythmia. It’s responsible for his lightheadedness, and why he passes out. It can also cause seizures, but I believe we can prevent that by implanting a cardioverter-defibrillator to monitor his heart’s rhythm and—”
“Meaning, an operation.”
“Yes.” She’d explain the details once he gave his consent.
“How rare is this . . .”
“. . . Brugada syndrome,” she finished for him. “Five people in ten thousand have it.”
“And what caused it?”
“To put it simply, gene mutations.”
“Inherited?”
“Your signature on the forms gave me permission to study your wife’s chart, and I took the liberty of doing so. Unfortunately, I found nothing in her doctors’ notes to indicate the likelihood of Brugada.”
He nodded. Slowly. Sitting back, he shook his head, stared at some unknown spot on the wall behind her. “She was always so pale. Grew tired so easily. Fainted from time to time. But they blamed it all on the MS.” Meeting her eyes, Baker said, “Is it possible she had Brugada and MS?”
“I wish I could give you a definitive answer, Mr. Baker, but since she wasn’t given the tests that are standard for diagnosing Brugada, there’s nothing in her file to answer your question.”
He sat, quiet and stone-still for several minutes, and Emily could only imagine all the questions that must be circulating in his mind.
“Will it kill him?” he ground out.
This. This was the information she most dreaded delivering. Emily held her breath, determined to get the words out in a truthful but kind manner.
“After surgery, we’ll follow the rules. Keep him out of the heat. Take his temperature often and avoid exposure to colds and flu, and other childhood illnesses that cause fevers. Make sure he’s always well hydrated. And, with the defibrillator in place, proper drug maintenance, and regular checkups, I believe Gabriel can live a long, mostly normal life.” Later, she’d explain that studies didn’t include patients under sixteen, and that Brugada, despite its rarity, was most prevalent in men over forty. Right now, Baker only needed to hear and cope with the basics.
He took a long draw of the coffee and swallowed. Hard. “Let me see if I’m understanding this correctly. My boy could die of heart failure at any time, whether or not he has surgery.”
The simple answer? Yes. But she said, “We’ll do everything we can to prevent that.”
Placing the cup on the table beside his chair, Baker scrubbed a hand over his face. “How soon will this operation take place?”
She quoted her former Johns Hopkins classmate: “The sooner, the better.”
Again, he fell silent. He didn’t seem the type to reject surgery. From what she’d heard, the majority of Pleasant Valley residents had relaxed many of the Old Order rules. Gas-powered vehicles, electricity, and plumbing were permitted. While many still held fast to the “trust God, not medicine” rules, many saw doctors on a regular basis. Perhaps his concerns were financial.
“I’m sure you’re wondering what all of this will cost. I can put you in touch with agencies that can help defray—”
“I’ll pay my own way,” he all but barked.
Again, Emily wished she had coffee, water, something to sip that would hide her discomfort.
“I’m sorry for shouting. None of this is your doing.”
“No apology necessary.”
But, as if she hadn’t spoken, Baker continued. “My hesitancy . . . You see, my parents were raised in the old ways. Decisions like this would have been easy for them.”
“They’d simply say no, and trust God’s will.”
“Exactly.”
“But Mr. Baker, you don’t speak like those who follow Old Order Amish ways. You don’t wear the clothes, or the beard and hat. You drive a pickup truck. And agreed to let me run a battery of tests on Gabe. Forgive me if I seem obtuse, but—”
His impatience was evident as he silenced her with the wave of a hand. “Before I consent to this, I’ll need more information. Lots more. About this disorder and how it progresses, if it progresses. How invasive it is. . . .” He studied her with a sidelong glance. “Will you perform the operation?”
“No, a colleague has agreed to do it. He has an excellent reputation.”
“Then I’ll want details about that reputation.” He paused, drove a hand through his hair. “Details about . . . how many patients have survived this surgery, and how many haven’t. I want to know about the operation itself. How long will Gabe be in the operating room, and what’s involved afterward, as he recovers?” Another pause as he stared at that unknown spot again. “I want to know if something . . . I mean, once he’s home, is it possible that he’ll relapse?”
Like many others in the Pleasant Valley community, he’d chosen a far more contemporary lifestyle than his parents, grandparents, and some current neighbors. Still, even if he had access to the Internet—and something told her he didn’t—it wasn’t likely he’d have time to scroll through hundreds of sites, looking for answers to his questions.
“I’ve taken the liberty of compiling some data that I think will help you better understand everything.” She held out the folder, and he accepted it. “I’m hoping you’ll agree to meet with me this evening. That�
��ll give you some time to take a look at the file, and then we can discuss Gabe’s case in detail. You can ask questions and I’ll—”
“Meet with you?”
Unless she was mistaken, he’d stopped himself from completing the question with alone?
“There’s a quiet little café about a block from here. Close enough to walk. We can talk over supper.”
She’d heard the phrase tongue-tied, but until now, hadn’t witnessed it. Emily felt a little guilty for putting him on the spot.
“I signed up for the night shift, so I’ll need a decent meal to hold me until morning. I hate to eat by myself. You’d be doing me a favor, joining me. We’ll bring back something delicious for your mom. . . .”
Baker took a moment to mull it over. He got to his feet and, after dropping the white cup into the trash can near the coffee counter, tucked the folder under one arm.
“All right. I will read this material as soon as I get to Gabe’s room. When were you planning to leave for the restaurant?”
She glanced at her watch. “It’s one thirty. I’ll stop by his room at about five, give him a quick exam, and we can leave right after.”
Emily didn’t think a man could look more uncomfortable. Was he worried that his mother wouldn’t approve of him spending time alone with a woman—a woman who wasn’t Amish?
“Tell you what,” she said. “I’ll meet you at the café instead. It’s easy to find. Turn right when you exit the hospital’s main entrance and walk a block. You can’t miss it. The sign says ‘Ella’s Café and Bakery.’”
Instantly his shoulders and taut facial features relaxed. Not much, but enough to tell her she’d guessed correctly.
For a reason she couldn’t explain, Emily was already looking forward to spending time with him, away from the hospital, away from staff, to focus on his little boy’s condition and treatment.
Oh, who are you kidding? You’re looking forward to getting to know Phillip Baker, Amishman, better!
Now Emily wished she hadn’t made the suggestion. Nothing in the Hippocratic oath forbade a personal relationship with patients’ family members, but she’d read several articles in the Code of Medical Ethics that openly disapproved of the practice. It made sense, because . . .
Talk about putting the cart before the horse, she thought. He was a loving son and father. Single-handedly ran a successful business. Had a mind of his own, as evidenced by the decisions he’d made that didn’t wholly conform to his community’s codes. Handsome, strong, soft-spoken . . . Surely one of his female Amish neighbors had captured his attention. Was she the reason Baker seemed reluctant to accept her supper invitation?
Maybe dining alone would be better, after all. She’d use the time to call Alex, firm up his surgery schedule. With a little luck, she could also remind herself of the reasons she’d decided to focus solely on work, instead of a social life.
“We can leave Gabe’s room together,” he said, surprising her. “While you’re doing his once-over exam, I’ll take my mother aside, explain that we need a quiet, private place to discuss Gabe’s case. She’ll understand. It’ll be easy.”
And if she didn’t, his tone and stance said, he’d handle it.
Well, you’ve officially crossed the line, Em.
Something told her that an hour or two alone with this charming, caring man would be a lot of things, but easy wasn’t one of them.
Chapter Four
If it had been up to Phillip, plain roller shades would hang in his shop’s windows. But Sarah wouldn’t hear of it. “As much time as you spend out there,” she’d said, “you need something nice. Something to remind you that good things, like family, are waiting for you inside!”
This afternoon, her hand-sewn curtains fluttered in the warm spring breeze. Between each lift and fall of the pale blue fabric, sunlight painted butter-yellow streaks on the small wooden mummy schtool that stood against the wall. She’d insisted he build it so that Gabe could stand beside him, reciting the names of every tool hanging from the pegboard above the workbench. Sarah had also insisted that he make one for the kitchen, because the boy enjoyed helping her by cracking eggs for cake batter or breakfast.
He missed hearing his son’s angelic voice. And the way Gabe’s eyes lit up when he figured out, all on his own, whether a job required a hammer, a wrench, or pliers. For the longest time, he believed the Phillips-head screwdriver had been named after his father. The memory still had the power to make Phillip chuckle, even now.
“It is good to see you, Phillip.”
If he hadn’t been woolgathering, he might have heard the bishop’s boots crunching up the gravel path. Might have seen the big man’s shadow stretch across the wood-planked floor.
“I’d greet you with a handshake,” he said, hands extended toward the older man, “but as you can see, I’m up to my elbows in axle grease and motor oil.”
Micah Fisher laughed, a big sound that filled the space. “Then we will shake twice when next we meet.” He removed his broad-brimmed black hat, pressed it to his suspendered chest as a somber, concerned expression darkened his eyes. “Any news on Gabriel’s condition?”
“The doctor is waiting for test results.” He delivered an abbreviated version of Brugada syndrome, adding, “Gabe might need an operation.”
Fisher stroked his beard. “Might?”
“From all I’ve gathered, it’s more likely than not.”
“And you have given your consent to this.”
A statement, he noticed, not a question. “Not yet, but if it comes to that, of course I’ll consent.”
“This means you have already asked for God’s guidance, then.”
Another statement. He saw no purpose in admitting that he hadn’t done much praying since Rebecca’s funeral. Oh, he still believed in God, but after losing her despite months and months of pleading, well, if letting a young wife and mother die was part of His will . . .
“I’m Gabe’s father, and as such, I’ll do whatever is necessary, whatever is best for him.”
“So.” Fisher tapped the brim of his hat. “You are still angry with the Almighty, are you? You realize, do you not, how futile is your mindset.”
Phillip wouldn’t describe his mindset as angry. But he’d put his faith in God when his father fell ill. When his brother struggled to live. And when prayers to God hadn’t protected Rebecca—
“Even as a small boy, you were stubborn. Always ready with an answer, even before a question was asked.” Like a disappointed father, he shook his head.
Blue eyes, magnified by the lenses of round, wire-rimmed glasses, narrowed. Unless Phillip was mistaken, the bishop was about to launch into a long-winded lecture, citing all the reasons doctors, hospitals, and operations went against the Almighty’s will.
“This doctor . . . you trust her?”
So, Phillip realized, he’d talked with Sarah before stopping by the workshop. How else could the bishop have known that Gabe’s doctor was a woman?
Her image flashed through his mind, brief as a blink . . . but more than long enough to remind him of dark, gleaming hair and thick-lashed, pale-brown eyes. He licked his lips. Swallowed. Cleared his throat. In his mind—and in his heart—such thoughts were wholly inappropriate, especially in the presence of Bishop Micah Fisher! He had just one thing in common with the doctor: Gabe. And once his boy’s health improved . . .
He concentrated on Noah Nielsen’s generator motor. Once he completed this, and two more small jobs, he’d have almost made up for the time lost while at the hospital. Amos Bontrager’s big round-baler engine could wait. On the day Amos dropped it off, he’d thanked God for keeping the old thing going until he’d harvested his largest field. “I will need it by late June, though,” he’d said, handing Phillip a crisp one-hundred-dollar bill, “when I will bring in the second crop.”
The bishop rapped on the workbench. “You are not fooling anyone, Phillip Baker. I know the look of smitten when I see it.”
That got Phillip
’s full attention. “Smitten.” He couldn’t help but chuckle. “Me?”
“Your dear mother told me of her concerns, that you are investing too much of yourself and your time in this . . . this Dr. White.”
She’d said as much to him when he’d mentioned his dinner plans, but Phillip had no intention of admitting it.
“I heartily regret the community’s decision to modernize,” Fisher said. “When we left the old ways behind, we opened the door to temptation. Too many temptations. Perhaps if things hadn’t changed, I’d still have my Esther.”
Esther. The daughter he’d shunned so many years ago for no reason other than she’d fallen in love with the wrong man.
The wrong man. It made him wonder where things could possibly go with Emily.
With Dr. White, you fool!
“You are even less Amish than the rest of us. Possibly the least Amish of us all!” Fisher pointed at his brass belt buckle. “You own suspenders. I remember well the last time you wore them to church.” He sniffed. “A place where, I might add, I have not seen you in weeks.”
He could defend himself with the truth: If he hoped to meet all his customers’ needs, it sometimes required working on Sundays.
“I know what you are thinking. That missing services is a less grievous sin than not providing for Sarah and Gabriel.”
Phillip added mind reader to the man’s numerous talents. If only people skills was among them!
“If you truly believed in His will, you would believe He will provide, even if you do not work on Sundays. And that He will heal Gabriel! Your faith in the Almighty is weak, Phillip. Weak!”
Well, the bishop had him dead to rights, there. But with good reason, he added.
“Whether you realize it or not,” Fisher continued, “you are setting an example for the boys and younger men. They look up to you. What sort of role model is a man who values money over the Word!”
Phillip put down his tools and picked up a scrap of white cloth. “You’re right, of course.”
The bishop threw back his shoulders and lifted his chin. Phillip had seen that look before, too many times to count: The older man believed his dressing-down had hit the intended target . . . and made a difference. Should he challenge the belief with one of his own, that such an opinion was, in effect, a sin of pride?