by Amy Ruttan
“You’re doing that awfully slow,” Calum teased as he was mixing something in a bowl.
“It’s got to be just right.”
“Just dump them on,” he said.
Pearl picked up a mini marshmallow and threw it at him. “Just stick to your assigned tasks.”
“I am,” he teased, continuing to mix whatever was in the bowl.
“What’re you making?” she asked, wrinkling her nose, because whatever was in the bowl smelled awful.
“I think it’s pastry, but it doesn’t smell right.” Calum frowned. “I think I did something wrong. I thought pastry was supposed to be like dough, not like...”
“It looks like wallpaper paste. You better go back to the drawing board on that one.”
He winced. “Well, you need to move faster or that sweet-potato pie will never get done.”
She tossed another marshmallow at him as he retreated to the other side of the kitchen. She wanted to make sure that everything looked okay. Jerome was outside barbecuing the turkey, or smoking it—Pearl couldn’t really tell. She continued placing marshmallows on the sweet-potato pie. She wasn’t the best cook, so she really hoped she didn’t make someone sick and that the pie tasted good.
There was a rumble and she froze. “What was that?”
“What was what?” Calum asked as he bent over a recipe book.
And then the rumble came again—this time there was clattering of dishes and then the big shake came.
“Oh, my God.” She froze, terrified.
Calum was beside her in a second and grabbed her, dragging her under a door frame. They braced themselves as the house heaved. This was more than just the tremor that they experienced when they were in the woods.
This was the real deal. She was hoping that the previous tremor was just that—a tremor—and not a prelude to what was happening now. Even though she grew up in California, she could never get used to the quakes and still remembered the big quake in San Francisco.
Calum’s arms were around her and she felt safe. She snuggled closer, holding on to him as the floor beneath them shook. She buried her head against his shoulder.
It felt like it went on for an eternity, but it ended. Her pulse was thundering and she still clung to him. It felt right to hold him and to be held by him.
“Pearl,” he whispered. “Are you okay? I didn’t mean to grab you so forcefully.”
“I’m okay and that’s fine. I’m glad you did.”
Of course, it was a bit of a fib. She wasn’t okay and she didn’t want to let go of her hold on Calum. She just clung to him as if he was her safety net and though she never really wanted to ever rely on someone, she liked being here with him. His arms were so strong and she had never felt this safe before. His arms were tight around her, holding her close, and she closed her eyes as she listened to his heart.
She could stay here forever.
“Derek!”
The blood-curdling scream from Dianne sent a chill down her spine and she was off running outside. She’d forgotten that Jerome, Dianne and Derek were outside when the earthquake hit.
Calum was behind her and they couldn’t see any of them.
The barbecue was on its side, the turkey on the ground.
Calum shut off the gas line with a wrench from the meter that ran alongside the pipe outside.
“Dianne?” Pearl shouted.
Jerome came running around the corner of the house—he was bleeding. “This way!”
Pearl and Calum followed him around to the side of the barn, and back behind the barn they found Dianne crouched beside rubble, and it looked like a piece of the barn had collapsed. Pearl’s stomach twisted in a knot as she got closer and saw it wasn’t only rubble that Dianne was crouched beside.
She saw a small arm from underneath.
It was Derek.
He was trapped.
CHAPTER NINE
THE AMBULANCE WAS on the way and Calum was thankful that Pearl had her phone on her. He helped Jerome move the rubble away as Pearl held Dianne.
As soon as they got visualization and Calum knew it was safe, he got beside Derek and assessed his ABCs without trying to disturb him. If there was a crush injury, a spinal injury, he didn’t want to move Derek, who was bent over a barrel. Calum was really worried that there was damage to Derek’s spine, as the barn collapsing had stretched him in an odd way over the side of the barrel.
A curl of dread uncoiled in the pit of his stomach and he hoped Derek would come through this. He’d known Derek the boy’s whole life. He was terrified, seeing Derek there, but he compartmentalized it and got to work. He wouldn’t let Derek die.
Jerome, even though he was a doctor, tried to take Derek’s hand, but Calum stilled him.
“Don’t move him. Not until we get a backboard. There could be damage to his spine.”
“Oh, God,” Jerome said.
“It’s okay. I’ve got this. Get the paramedics here and send Pearl over.”
Jerome nodded and left.
Pearl crouched down beside Calum.
“Derek,” she whispered, her voice shaking.
“I’m worried about his spine,” Calum said. “See how he’s bent.”
Pearl craned her neck. “Yes. We can get him on a backboard and get him to the hospital.”
“We’re going to the hospital,” Calum stated. “I’m not letting just anyone touch his spine and I need you in there with me.”
Pearl nodded and he could see that glint of determination in her eyes. He only wanted her by his side when he operated on Derek. Together, they could save Derek’s life. He was certain of that.
“Of course. I agree, we should be the only surgeons working on him.”
Pearl stood to let in the paramedics. Calum directed them with easing Derek to the backboard, not shaking Derek and protecting the spine. Once Calum felt he was secure, he let the paramedics do the rest of their work, to make sure Derek was stabilized.
“Calum,” Dianne said, tears running down her face as she clung to Jerome.
“He’s breathing. I’m going with the paramedics to the hospital and I’m going to make sure that I’m consulted if there’s a single bone broken.”
“I’m going, too,” Pearl stated.
Dianne nodded. “We’ll follow.”
Calum stood by Derek’s side and helped the paramedics wheel the stretcher back to the ambulance. Pearl was on the other side and they climbed into the back of the ambulance after Derek was loaded.
Calum’s pulse was racing. He was so worried about the little broken human in front of him, and he prayed that the spinal cord wasn’t severed; that he could save Derek from paralysis. He looked up at Pearl and she met his gaze.
She didn’t smile, but he could see the concern in her eyes, too.
He could see her worry and pain as the ambulance raced down the hill, down into town.
“It’ll be tricky,” one of the paramedics said. “There are power lines down and trees. The hospital is bombarded after the quake.”
“We’re both surgeons from San Francisco and we’ll help any way we can, but after we make sure Derek is okay.”
The paramedic nodded.
There wasn’t much to say. He’d work for days on end, straight, if it meant he could use hospital privileges and save Derek’s life. He would’ve done the same for his own child.
He would do the same for Pearl.
Once they got to the hospital, there was mass confusion in the emergency department, but he had to focus on Derek.
“What do we have here?” a trauma doctor asked, meeting them at the door.
“Male, age five, suspected break to the spine. GCS score in the field was five, but improved upon arrival to nine,” the paramedic stated.
“And who are you?” the trauma doctor asked, looking at
the both of them. “Are you the parents?”
“No. I’m Dr. Munro, orthopedic surgeon, and this is Dr. Henderson, also an orthopedic surgeon, and we’ll be leading this case.”
“This is my ER,” the trauma doctor shouted.
“And we’re specialists in spines,” Pearl snapped. “The parents will be arriving soon and have given us permission to take care of their son. This is Dr. Dianne Lopez’s child.”
The trauma surgeon nodded. “You can use trauma pod three. We’re slammed.”
“I promise, we’ll help you after we make sure that Derek is stable,” Calum offered. He hadn’t asked Pearl if she was willing to help, but he knew that she would. She might shirk other duties, but she never shirked her medical duties.
The patient always came first.
The paramedics wheeled Derek into trauma pod three and the trauma team helped Calum get into a yellow trauma gown.
“I’ll go speak with the chief of surgery,” Pearl said, tying the back of her gown.
“Okay, he may have a break in his spine. We need to move him carefully, make sure he’s stable and then I need a CT scan stat. We could be looking at crush injuries.” Calum helped the team move Derek’s backboard onto the bed so the paramedics could have back their stretcher.
Calum leaned over Derek and checked the vitals again.
There was reaction to the pupils, so he had hope that there wasn’t a head trauma and that Derek wasn’t bleeding in his brain.
Pearl returned. “Shall we get him down to the CT? We have clearance. The chief was very accommodating.”
“Yes. He’s breathing, intubated, but he’s as stable as he’s going to be and we need to find out what’s going on in there.”
Pearl nodded and they worked together to make sure that all the lines and all the bags were secured. Then they wheeled him out of the trauma pod, following one of the nurses to where the MRI was and where they jumped the line.
Together, Pearl and Calum lifted the backboard and secured Derek so that he was able to have his scans.
He had to drag Pearl away into the other room so they could do the scan. Truth be told, he had to drag himself away. It was hard to leave Derek alone and vulnerable, even though the child wasn’t aware what was going on.
The radiologist had come down so that he could interpret the scans, but Calum had seen enough scans to know what he was looking for. Pearl worried her lip, her arms crossed, and kept her eyes on Derek.
“He’s so little,” she whispered.
“I know.”
“This shouldn’t have happened to him.”
“I know.”
She glanced at him—there were tears in her eyes, and he’d never seen her like this before. So close to crying. “I can do this, it’s just...when you have a moment to feel...”
Calum sighed. “I know.”
“I’m scared, Calum. Scared for Derek.”
He took her in his arms and held her. She clung to him and he held her close while they waited for the scans to come up.
“Scans are up, Dr. Munro,” the radiologist, Dr. Redding, said.
He let go of her then.
Calum leaned over and winced when he saw that there was a fracture, but the cord appeared to be intact. Derek was going to need a fusion. There were a couple of ribs that were broken, but they were hairline fractures and didn’t appear to be infiltrating his lungs.
“There appears to be a bit of internal bleeding near the spleen, but it doesn’t appear to be excessive and is quite normal for a crush injury. We can monitor it and see if it gets any worse,” Dr. Redding said.
“Thank you, Dr. Redding.” Calum turned to Pearl. “We need to get him into the OR and we need to know where to go.”
Pearl nodded. “You stay with Derek and I’ll fill in Dianne and Jerome what’s happening and speak to the chief of surgery again. We’ll have him in the operating room as soon as possible, I’m sure.”
“Thank you.”
Pearl nodded. “Just keep our boy stable.”
It stunned him when she said that. Our boy. He wasn’t their boy, but it felt like he could’ve been. Their child would’ve been the same age.
Calum swallowed a lump that had formed in his throat. He had to be strong, he had to clear his head to be able to do this.
He was going to make sure Derek was taken care of. He wasn’t going to let down Derek, Dianne or Jerome.
* * *
Pearl looked down through her microscope at the spinal cord of her godson. Really, they shouldn’t be working on him, but there were no specialists like them in this hospital. They were Derek’s only chance.
Dianne and Jerome had given their permission and the chief of surgery graciously was assisting on Derek. They had everything they needed and it was hard to keep Dianne and Jerome out of the operating room.
Especially Dianne, who wanted to do the anesthesiology on her son, but that was against every oath they took. She couldn’t work on her son. She couldn’t be present in the operating room and Pearl couldn’t even imagine the pain of being so helpless.
Can’t you?
And just that thought made her recall in vivid detail the absolute agony of losing her baby. Of losing Calum and her baby. How she had felt so helpless and there was nothing she could do to stop it. Her medical degree had been useless in that moment when her baby passed.
It was extreme, agonizing helplessness.
“The T4 and T5 are crushed. We’re going to have fuse here and place rods,” Calum muttered.
“I agree,” Pearl said, hoping that her voice didn’t shake.
Calum glanced up at her briefly. “Pearl?”
“I’m okay,” she said. “I can do this.”
“Good, because I need you,” Calum said.
It caught her off guard. She knew that he meant he needed her for this surgery. He needed her expertise and assistance, just like he had needed her when they were working on their patient with skeletal dysplasia. They were a team. Right in this moment they needed each other.
He was staring at her, his blue eyes intense across the operating-room table.
“I need you, too,” she said. “We got this.”
The corners of his eyes crinkled and she knew that he was smiling under his mask. “Right. We do.”
Pearl nodded and went back to work. She was going to make sure that Derek wasn’t paralyzed. She was going to take care of Dianne and Jerome’s little boy.
This is why she became a surgeon.
You walked away from it, remember?
She found her work rewarding, but there was something different about being in an operating room and working on a patient’s spine after an accident compared to a busted knee or a torn rotator cuff after a sports injury.
This was saving a life. The deep-rooted part of her emotions wanted to run because she wanted to cry seeing Derek like this. She was losing control of herself seeing Derek on this table, but she couldn’t run from Derek. Derek needed her. Dianne and Jerome needed her and Calum needed her.
Right here.
Her control over her emotions had to wait and she’d lose control if it meant Derek would be saved. She’d do anything to save him.
This was what she’d been born to do as a surgeon. This was what she missed, and she was angry that she walked away from it, and she wished she could go back.
You can.
Only she wasn’t sure that she was strong enough to do that. She wasn’t sure that she could turn back the clock and walk back into her old life.
She was too terrified, but she had to try.
* * *
Pearl walked with Calum down to the small waiting room. Dianne and Jerome were there, on their own. Pearl saw that Jerome’s head had been bandaged and she was glad someone had taken care of his superficial laceration.
She felt bad for ignoring it, but their main focus was Derek.
When they walked in, Dianne’s eyes were wide, she was pale, and Jerome put his arm around her. The surgery had taken hours and when Pearl checked the clock, it was six in the morning. They’d been working all night. She was beat.
“He made it through the surgery,” Calum said. “We had to fuse his spine. He had a couple of crushed vertebrae. He has a long recovery, but I feel confident that he will walk again.”
Dianne started sobbing and then hugged Calum and then her.
“I don’t know what would’ve happened if you two weren’t there,” Dianne sobbed.
Tears were stinging Pearl’s eyes. “Well, we were, and Derek is stable. He’s going to be okay, but he’s in the intensive-care unit. He’s under the care of the paediatric surgeon on duty.”
“And that surgeon has my pager if something else happens,” Calum said. “I will be here in a heartbeat.”
Dianne hugged him. “Thank you. Thank you both. Can we go see him?”
“I don’t think the ICU doctor on duty is going to stop Dr. Lopez from seeing her son,” Pearl teased.
Dianne nodded and left with Jerome.
Pearl sighed. “So much for a relaxing weekend, huh?”
Calum chuckled and sank down in a chair, scrubbing his hand over his face. “What a day.”
“Not exactly how I thought it would go.” She sat down in the chair next to him. “I was going to take an early morning train to get back to San Francisco. I missed it.”
“I’ll take you home. I drove here and it’ll be faster than the train.”
“Thanks. I appreciate that.”
“Well, if I had known that you were coming to the ranch I could have driven you here.”
Pearl cocked an eyebrow. “Would you? Especially with how things were a bit awkward before we came?”
“Okay, maybe not when I was in that frame of mind. You’re right, but I can give you a ride back to San Francisco today. I just need some strong, strong coffee and then we can head back. I haven’t checked the extent of the damage from the quake.”