by Amy Ruttan
Women didn’t understand his devotion to his work and that was fine by him. He didn’t want to be tied down. He didn’t want a family only to have it broken.
And he was too broken himself.
The problem with Ruby was that she did understand his devotion to work. That was her passion too and that made him want her even more. She was smart, funny, strong, beautiful and independent. There was so much he loved about her.
He liked working with her and he wanted her. He’d always wanted her.
What was supposed to have been a simple kiss to break the tension had turned into something he hadn’t expected. Something he hadn’t prepared for mentally or emotionally. It had woken something inside him.
He’d thought maybe the kiss would break him of the hold she had on him, but he’d been so wrong. It had fired his blood. Made him feel alive. It had made him feel as if he was his old self again.
But he wasn’t. He would never be the same person he was before. That IED explosion had shattered him. It had broken him. And Ruby deserved so much better than the pieces of him that were left.
He’d taken a walk so that she could get some rest and be able to fly them out of Whitehead if the weather had cleared in the morning. He sincerely hoped that it would.
He went back to the room and quietly opened the door. Ruby had curled up in the middle of the bed and was sleeping soundly. A smile tugged at the corner of his mouth. She looked so peaceful.
Good.
She needed the rest. It had been a long, busy day and flying up to Whitehead from Anchorage had meant that they’d started early. Ruby had definitely clocked up over eighteen hours and she needed sleep.
He was okay. He was tired, and a bit sore, but there were many nights when he couldn’t sleep. When his PTSD was working in overdrive and the nightmares just wouldn’t stop. He could sleep later. He didn’t have to fly a plane back.
She looked so peaceful there and he wished that he could hold her.
He wished he could do more.
You need to back away.
He shut the door. The couch in the lounge room would be the perfect place to crash. If anyone asked he’d just tell them Ruby snored.
Aran chuckled silently to himself, thinking about how Ruby would react to that. He headed into the lounge and stared at the couch.
You’ve slept on worse.
“Dr. Atkinson?”
Aran spun around to see the night nurse, Joanna, standing behind him.
“Yes?”
“It’s Mitchell. He’s spiked a fever and I can’t get it to go down. I’ve given him the maximum amount of antibiotics I can.”
“I’ll be right there.”
Joanna nodded and Aran washed his hands in the lounge’s sink and took a deep breath to calm his nerves. He wasn’t a stranger to post-operative infection and fever. Especially in situations where the wounded patient was maxed out on medication and they were waiting for transport.
He just hoped that this storm would clear so they could get Mitchell down to the larger hospital which would have access to different kinds of antibiotics and a larger staff on call. He was glad that Whitehead was equipped to deal with small surgeries, but some things were better left to a hospital.
He’d learned from working on the front line that some things just couldn’t be done, and that was when you just basically did what you could to keep your patients alive until they could be shipped out. Even that was a case of throwing the dice...
He walked into the room and saw that Mitchell’s heart-rate was up. He was pale and looked as if he was having trouble breathing.
“Did you run a culture of his blood?” Aran asked as he pulled out his chart.
“I did. His white cell count isn’t elevated that high. He’s feverish, but I don’t think it’s sepsis.”
“I agree,” Aran said.
He set the chart down and examined the wound. It was healing well and there was no sign of infection there. He moved back the sheet and saw red in Mitchell’s legs. It was warm to the touch.
“Look at this, Joanna. What do you see?”
Joanna leaned in and examined it. “Deep vein thrombosis?”
Aran nodded. “Could be. Does Mitchell have a history of blood clots?”
“Not, Mitchell—but his mother did. She died of a pulmonary embolism three years ago.”
“Do you have a Doppler?” Aran asked.
“We do.”
Joanna left the room and Aran monitored Mitchell’s pulse-rate. It was high, and Aran had no doubt that what Mitchell had was thrombophlebitis. And since they didn’t have a CT scanner here the Doppler would have to do. If it was a pulmonary embolism they would have to get him back to Anchorage to do an angiogram.
Aran hoped that Whitehead stocked a supply of heparin. If he could get some heparin into Mitchell that would at least help until they got back to Seward Memorial.
Joanna returned with the Doppler.
“Here you are, Dr. Atkinson. The weather looks to be clearing. Not much snow has stayed—it’s been pretty much blown away and the temperature is rising.”
“Good—because we really need to get Mitchell down to Anchorage.”
Mitchell moaned, but he was pretty much out of it—which was good. The poor guy had been through the wringer today, and all while putting on a smile. Aran would never understand that—hiding symptoms—but then he knew there were people out there who thought every ache was cancer. Still, the pain Mitchell must have been in would have been more than just a slight ache.
“Do you have any heparin here in Whitehead?” Aran asked.
Joanna nodded. “Of course.”
“Good. Can you ready a dose, please?”
“Right away, Doctor.”
Joanna disappeared out of the room again and Aran prepped the Doppler to examine Mitchell’s leg. The more Aran thought about it the more he realized that the Medevac should be called in.
Ruby had the means to transport their patient, but with a deep vein thrombosis and a family history of pulmonary embolism the last thing Aran wanted was to take a risk flying Mitchell in Ruby’s plane.
The larger Medevac would have more staff. It was a helicopter, and it would get Mitchell where he needed to be with the right stuff on board.
Joanna returned with the dose of heparin—and it was at that moment that Aran found the clot in Mitchell’s leg.
“Thank you, Joanna. We need to get a hold of the Medevac. This can’t wait until Dr. Cloutier can fly him down. He has to get out of here now.”
“I’ll call them, Dr. Atkinson. And Mitchell’s wife too.”
“Thank you. I’ll stay with him.”
Joanna nodded and Aran administered the dose of heparin, hoping that it would help until the nearest Medevac could get in to Whitehead and take Mitchell to a hospital that would help him.
Even if it wasn’t Seward Memorial.
* * *
Ruby woke with a start.
The room was brighter, but she realized that she was sleeping in the middle of the bed and that Aran wasn’t in the bed with her. She sat up and looked on the floor, the small little laneway from the door to the bed. Thankfully he wasn’t there either.
So I didn’t knock him to the floor. That’s good.
She tied back her hair and then glanced at her watch. It was nine in the morning. She’d slept way past her alarm.
Ruby scrambled out of bed and pulled the blinds. There was melting snow, blue skies and sunshine. At least the runway would be clear and they would be able to fly back to Anchorage. She was just mad at herself for being late. She never slept in.
She cursed under her breath, annoyed, but pulled herself together, slipped on her shoes and headed out into the hall. The clinic was quiet, but it was Saturday so that wasn’t unusual. She found Aran in a waiting room chair
, his head on his hand and sleeping.
Lacey rounded the corner. “You’re awake!”
“I didn’t mean to sleep in,” Ruby said. “Sorry.”
“Aran said to let you sleep. That you needed it.”
Ruby glanced at Aran. He looked completely uncomfortable in that chair. “How long has he been there?”
“About an hour. He was up waiting for the Medevac to come and take Mitchell to Juneau.”
Ruby’s eyes widened. “Juneau? I was supposed to fly him down to Anchorage.”
Lacey sighed. “Mitchell developed a post-operative fever last night that Joanna was unable to bring down with ibuprofen or antibiotics. His pulse-rate increased and she was worried. She found Dr. Atkinson leaving your room and asked for help. He found thrombophlebitis in Mitchell’s leg and, given the family history of pulmonary embolism, he felt it would be better if the Medevac helicopter came and took him. There’s another storm rolling in—this time off the Bering Sea. It’s headed straight for Anchorage, so the Medevac decided on Juneau.”
“Oh...” Ruby glanced at Aran.
She was annoyed that Mitchell—her patient—had been sent away without her knowing and that he wasn’t going to be at Seward, where she could continue to monitor him, but she completely understood why Aran had done what he had.
Mitchell would need to be monitored in case the blood clot in his leg broke off and headed to his lungs or heart, which would be fatal. Medevac had more team members with them then she did. In the same shoes, she would have done the same thing.
“Kayla, Mitchell’s wife, couldn’t go on the Medevac so she’s hoping you can take her to Anchorage. Her sister lives there, and from there they’ll travel to Juneau.”
“Of course. Can you let her know that I’m leaving within the next hour? As soon as I get my flight plan logged.”
“I will. And thanks again.” Lacey headed back to the exam rooms.
Ruby took a deep breath and leaned against the wall.
Why hadn’t Aran woken her? How had she slept through the Medevac team coming?
She felt guilty that she’d let Mitchell down. That she hadn’t been the one to make the call. She’d known Mitchell for five years. She’d treated him for other ailments and she’d been the one to try and help his mother before the pulmonary embolism had killed her so suddenly. She felt bad that she’d slept through all this.
She hated losing control.
She hated that she hadn’t been awake.
She hated that Aran had totally thrown her world upside down.
“Hey...” she said gently, leaning over and nudging him.
Aran jumped with a start and Ruby jumped back, surprised by his response. His eyes were wild, and for one brief moment it looked as if he didn’t know where he was. As if he was on the defensive.
“Aran, it’s just me.”
It took a minute or so, but his wide eyes narrowed and his body relaxed. “Sorry,” he said and covered his face with his hand. “Sorry. I guess I was... I was sound asleep.”
There was an edge to his voice and she didn’t quite believe that she had just startled him. It was something more than being startled. There was panic, a fear just behind his eyes. As if he had post traumatic stress disorder.
She wouldn’t be surprised, given his experience with the IED explosion.
“So Mitchell was flown to Juneau?” she asked.
Aran stifled and yawn and nodded. “Yes. I’m sorry, but he had to be sent out of here to get proper help.”
“I understand. I just wish you’d woken me up.”
“Why?” he asked. “I could handle it.”
“He was my patient.”
Aran stood up. “I understand, but it’s all taken care of.”
“I know—and you did the right thing. Just next time wake me up and let me know.”
“Wait,” he said. “You’re bothered?”
“I would’ve liked to have known.”
“And what would waking you have done? He still would have had to be transferred out, with a larger team who could take him to a proper hospital. Once I gave the Medevac team an update they took over. All I did was stay up and wait for them.”
“I still would’ve liked to have known,” Ruby said sternly.
Aran shook his head. “You really don’t like relinquishing control, do you?”
“He was my patient. I am the leader of this team...”
“I did right by your patient, and now he’s off to a better facility. I don’t know why you’re picking a fight. If it’s about last night...”
“It’s not,” she said quickly, but it was. She was picking a fight because she’d been so afraid at how close he’d gotten to her. How he had affected her. How his kiss had made her forget all the rules she’d put in place when it came to relationships.
She didn’t want anything except casual, and there was no way you could do casual with someone you worked with. Getting involved with the man who was your convenient fake husband was also not casual, and she didn’t want to get involved with Aran when their marriage wasn’t even real and had a time limit.
Ruby understood the idea of sharing that kiss, but really it had been a bad idea all around and she shouldn’t have let it happen.
“We have to get back to Anchorage. The weather has cleared and we’re going to take Mitchell’s wife down so she can get a flight to Juneau.”
She didn’t wait for a response from him—just turned on her heel and left to get everything ready. She had to call in her flight plan and have someone get the plane prepared. She had to gather up what gear was left and make sure Lacey had arranged for someone to get them to the airport.
She didn’t have time to deal with the emotional crisis that Aran had stirred up in her.
She didn’t have time for any of it.
She only had time for her work.
* * *
The flight back to Anchorage was somewhat awkward. Ruby felt bad that Kayla had to be a part of it, but Kayla was mostly worried about Mitchell in Juneau and the flight down to Anchorage. Ruby knew that Kayla hated flying, and that she rarely left Whitehead, but thankfully the flight was relatively smooth.
When they landed in Anchorage, Kayla’s sister was waiting at the airport in the charter terminal, near where Ruby stored her plane. Ruby told Kayla to give Mitchell a big hug and said that she’d see them soon enough.
Then it was just her and Aran.
As they walked out to her truck she felt bad for the way she had treated him. She felt bad for trying to pick a fight with him. He’d done the right thing, and if the situations were reversed she would have done the same.
She’d just been scared.
“I’m sorry,” she said after he’d climbed into the passenger side.
“For what?” he asked.
“For snapping at you about Mitchell. You did the right thing. And you’re right—I like control. I hate losing it, and I hate when I’m not involved with my patient’s diagnosis from beginning to end. But there are some things I can’t do, and it’s hard for me to let my patient’s care fall into the hands of other competent surgeons. So I’m sorry.”
His eyebrows arched. “Thank you. Apology accepted.”
Ruby nodded. “We should get to the hospital. I was supposed to start rounds three hours ago.”
“Yes... Well, I was supposed to start in the middle of the night, but look how that turned out.”
Ruby started the truck and headed out on the highway to Seward Memorial. The weather was bad in Anchorage, but at least it wasn’t snow. Just rain.
It was a short drive to the hospital, and when they got there Jessica was waiting for them. Ruby was surprised to see her when they got off the elevators from the main entrance to the trauma floor.
“There you two are!” Jessica said impatiently.
>
Ruby could tell that she was completely agitated and she saw that Aran’s spine had stiffened, his body tensing in light of his mother’s anxious behavior.
“I sent you a message. A storm waylaid us in Whitehead,” Ruby responded calmly.
“I know,” Jessica replied. “And I completely understand that. The thing is the U.S. Citizen and Immigration Services doesn’t. Agent Bolton has been here since this morning and he’s a bit annoyed that you’re not here.”
“Agent Bolton?” Ruby asked. “I told him to send me some dates to set up a time. He didn’t.”
“This is a surprise visit,” Aran said. “I’ve heard of them before.”
“Well, he’s in the boardroom—waiting. You two need to go meet with him.”
Ruby’s stomach twisted in a knot.
Oh, Creator. How am I going to handle this?
“It’ll be okay,” Aran said calmly. “We’ll present a united front. Just don’t plaster that fake smile on your face like you did on our wedding day.”
Ruby chuckled nervously. “I’ll try not to.”
“What fake smile?” Jessica asked.
“This one.”
Ruby plastered on the smile which had been on her face the day she’d married Aran. The smile that she so often used when she was in an uncomfortable situation. Aran was laughing silently to himself and shaking his head, but Jessica looked less than impressed.
“You two have to pull it together!” Jessica snapped. “This is serious.”
“I know,” Ruby murmured.
It was a huge risk for all of them. She should never have agreed to it in the first place. She should have said no to Aran.
Only when she’d said yes she had heard her father’s voice telling her to say yes, and she’d just closed her eyes and taken the plunge into the unknown.
Jessica pursed her lips together. “Just try and keep it together.”
Ruby nodded and Jessica stormed away. “This was a bad idea,” she whispered. “I thought our marriage was a good idea at the time. I wanted to stay in the country. But I shouldn’t have said yes.”
Aran sighed. “I asked you because I wanted to do it for you. I believed in your work. I still do believe in your work. This isn’t all your fault. We both agreed to this and we’ll face this together.”