by Amy Ruttan
Although she’d never used therapeutic hypothermia on a patient, she shouldn’t have questioned his tactics. He was a brilliant surgeon. Her reaction was not keeping her emotions out of the mix. If anything, it was causing more problems.
Her plan had been to treat Ryan like any colleague and it was rare that she called out another practitioner on their methods in public like that. Especially when neurosurgery was not her specialty. And especially since it wasn’t even about that. She was angry he’d never responded to her and then he’d made her look like a fool in front of Dr. Teal. She’d hated it when Robert had done that to her.
Usually she was calm, cool and collected. She prided herself on professional behavior. Behavior she’d worked so hard to learn. What she’d just pulled was not her usual behavior and she was annoyed with herself for letting her emotions get the better of her.
The attendings’ lounge was, mercifully, empty.
“There’s an empty cubby over there.” She pointed to the one that was furthest from the door but she stayed close to the door, because it was an escape route.
“Thanks.” Ryan walked over to the cubby, slipped off his leather jacket and placed it inside. “I did get one message, by the way.”
That shocked her. “Oh?”
“The divorce papers.”
“But not news of my pregnancy. I sent you ten emails.”
“I told you the night we got married that I had to catch a flight. I was overseas and in an area where internet connection was spotty. I wasn’t trying to ignore you.”
He was unbuttoning his shirt to put on his scrubs and Emily tried not to watch. She wanted to believe him.
“I’d had a lot to drink that night. I don’t remember you telling me that.”
“I remember, sort of. I guess we’ both had a lot to drink that night because an Elvis impersonator married us? Really? That sounds tacky.” It was a joke meant to break the tension and it did.
A smile tugged at the corners of her lips and she couldn’t help but laugh just a little. “Right. Completely tacky.”
“I’m glad you decided to keep the baby,” he said softly.
“Of course I would.”
A strange expression crossed his face as he slipped off his shirt and then pulled his scrub top over his head. For a moment Emily thought that he didn’t quite believe that she would’ve kept this baby. Everyone had a choice, but she knew she’d wanted this child the moment the stick had turned blue.
Was it planned? No, but she was happy to be pregnant. She liked kids, which was why she’d become a pediatric surgeon.
“After this surgery we really need to sit down and talk,” he said.
“Right. About the conjoined twins. I have to go over the chart...”
He cocked an eyebrow. “What’re you talking about?”
“The conjoined twins case. What’re you talking about?”
“I’m talking about our marriage and the baby.”
Her heart skipped a beat and she could feel the warmth creeping up her necks into her cheeks. “Ryan, we don’t have a marriage.”
“We’re still married. We can’t get an annulment and I’m not sure about signing the divorce papers.”
Of course.
He had to make this difficult by not signing the papers. It was frustrating.
“Is that what you want to talk about? You want to talk about the divorce? It’s all laid out in the papers.”
“No, I don’t want to talk about a divorce, Emily,” he said in frustration. “I want to talk about you and me and the baby. About what we should do.”
She couldn’t help but laugh at that. “There is no you and I, Ryan. We made a silly mistake in Vegas.”
“I don’t think it was silly,” he said seriously.
“What? You can’t be serious.”
“I am serious, Emily. I want to raise our baby...” He paused and looked a bit uncertain. “I want us to raise our baby together.”
CHAPTER THREE
EMILY DIDN’T WANT to talk about it. She thought the whole idea was absurd. He wanted to talk about their relationship? He wanted to make it work? To raise a baby together? They didn’t have a relationship. They’d met, had a few drinks and had a one-night stand. And she wasn’t even sure she totally believed him about not getting her emails.
He’d acted surprised, though.
Although Robert had been a good actor too. She’d been duped before. Emily bit her lip. She wasn’t sure what to think.
Other than the work he’d published and the talks she’d listened to, she knew nothing about him and he knew nothing about her. That was not the basis for any kind of relationship. Her parents were best friends. They’d taken their time to get to know each other and they’d had a long, happy marriage.
They still had a good marriage.
Ryan and she didn’t have that.
They’d had one night together. That was the basis for nothing.
There was a tiny kick and she looked down at her belly. Well, maybe it wasn’t completely nothing, but still she didn’t want to talk about this with Ryan. They didn’t have a real marriage. Why did he seem so keen to get involved now?
“We’re not talking about this,” she said quickly. “I’ll meet you down in the OR.”
“I don’t know where the OR floor is and I don’t have access to it.”
Dammit.
“Finished getting dressed,” she said through pursed lips.
“Emily—”
“No,” she snapped. “The only thing we’re going to talk about after this surgery is the conjoined twin case. It’s a very important case and the mother is arriving tomorrow. If the babies survive the birth and make it through their first week of life, we have to talk about a plan to do the separation. That’s all I want to talk about right now. Just patients, just cases. That’s it, Ryan. That’s all I can handle.” And it was true. She was feeling overwhelmed. She hadn’t felt this way since Robert had betrayed her and she hated this feeling.
His eyes narrowed and he undid the buckle to his jeans. “Fine.”
Only she had a feeling by the way he’d said “Fine” that this wasn’t over and that this discussion was going to continue. He was persistent enough. It was something she’d admired about him. He was driven and that’s why he was the best there was in neurosurgery and why she’d striven to continue to rise in her chosen field.
There had been so many people who’d said she couldn’t be a surgeon when she struggled with Asperger’s, when she struggled with social anxieties, but she had risen above so much to get where she was. She worked longer hours. She worked hard.
To be perfect. To be the best.
Her pregnancy made her human and that had been a hard pill to swallow, but she’d never shied away from her mistakes, but to think that she and Ryan had something more than just a momentary attraction was silly.
It’s not momentary. You’re still attracted to him.
And her cheeks heated as he picked up the scrub pants. She cleared her throat and looked away. “I’ll be out in the hall and then we can head down to the OR.”
“Fine,” he said, but there was a devilish twinkle in his eyes as if he knew that he was affecting her and she hated that.
She slipped out of the attendings’ lounge and leaned against the wall, closing her eyes and trying to catch her breath. When she opened them again, she could see a few of the interns, nurses and even physicians watching her, whispering as they looked at her belly.
Dammit.
She hated being the center of attention when it came to gossip. She didn’t mind it when it was about her work, but when it involved her baby and now her supposed marriage to Ryan, it bothered her.
The door to the lounge opened up and Ryan stepped out wearing scrubs instead of his street clothes. He looked good in the dark blue o
f the SMFPC attending colors. The color brought out the intensity of his cerulean eyes.
“You okay?” he asked.
“Fine.”
Liar.
“You look a bit pale. Are you overdoing it?”
“No. I’m fine. Let’s go, they’re waiting for us in OR two and I don’t want that patient in therapeutic hypothermia any longer than he has to be.”
“Lead the way.”
Emily led Ryan down to the OR floor. They didn’t say anything to each other, but she could feel the stares as they passed through the halls. Gossip spread like wildfire in this hospital and she would have to have a word with Dr. Teal.
They stopped just outside the wide hall that led toward the many operating rooms. She pulled on her scrub cap and showed Ryan where to get a generic one. She hung up her white lab coat, changed her shoes. Ryan covered his shoes with booties. He’d have a pair of sneakers that would be just for the OR floor.
“You ready?” she asked.
“Always.” He smiled at her and it was full of confidence.
“Come on.” She punched in a code and opened the door. She always liked this walk down the hallway. It was calming. There were gurneys and equipment waiting in the wings, sometimes there would be a gurney roll by that was accompanied by a parent and a child life support person as SMFPC supported the parental presence at induction, and those cases always made her smile.
There was fear in the parents’ eyes, hidden behind their masks, but they were strong for their children and their presence really promoted the well-being and health of the children.
Then there were cases like this little boy they were attending.
Priority A, where a young life was on the line.
She ran a hand over her belly and glanced up at Ryan, whose gaze was on her belly, before he met her eyes briefly. There was pain in his eyes, but also fear.
“The scrub room is here,” she said, breaking the tension that fell between them.
He nodded and walked into the room before her. The scrub room overlooked the operating room where their young patient was lying. The rest of the operating room team was prepping him and the anesthesiologists were waiting.
Ryan was scrubbing, staring at his patient intently, as she often did herself. She would play out the surgery in her mind, like a playbook.
“Do you think you’ll be successful?” she asked, because she knew he was a great neurosurgeon but she’d never worked with him before and none of the neurosurgeons at SMFPC would ever attempt therapeutic hypothermia on a child younger than sixteen. Ryan was a bit of a maverick. Maybe that’s why she’d been so attracted to him in the first place. He was so different from Robert, who had always done things by the book.
So different from her.
“Of course.” He smiled confidently. “I’ve done this before.”
“Good, because I’ve never done this.”
“You’ve never done a spinal decompression and a repair of a fracture?”
“Yes. I’ve assisted with that, but I’ve never dealt with a child in hypothermia like this.”
“It’ll work, Emily,” Ryan said gently, before he shook off his hands and toweled them dry. “Trust me.”
Emily continued scrubbing as he headed into the operating room. He’d asked her to trust him and she wanted to do that, for their patient’s sake, but she had a hard time trusting someone she didn’t know.
She liked routine. She liked certain anesthesiologists, certain residents, certain scrub nurses in her operating room. The routine gave her a sense of calm, and she’d never worked with Ryan before.
He’s the best.
And that’s what she had to keep telling herself. She shook off her hands and then headed into the operating room. Her favorite scrub nurse, Nancy, helped her into her gown and gloves. Emily also had to remind herself that she was not lead surgeon here.
Ryan was.
She might be the head of pediatric surgery, but he was the neurosurgeon and she had to put her faith in him and what he thought was best. He’d been there when the accident had come in. He’d got all the permissions from the patient’s parents. He knew the chart best.
Emily looked up into the gallery and could see the chief of surgery watching, as well as a few of the interns and residents.
They’d come to see the show.
Ryan’s reputation preceded him.
She had to get a grip on all her self-doubt and focus on this moment, because soon there would be a set of babies on this table and it would be a team, led by her and Ryan, as they worked to separate the babies and give them a chance at life.
She approached the operating table and took the second position across from him. Dr. Sharipova was there, as well as Dr. Teal, but Dr. Teal would just be observing.
“Dr. Teal, would you read off the chart for the record?” Ryan said, totally ignoring the fact Dr. Sharipova was the resident and should be reading it out for the OR record.
Dr. Teal looked toward her and Emily nodded. “Go on, Dr. Teal.”
Amanda nodded. “Jason Klassen is a ten-year-old male patient with a break in the spine from the C7 to the T3. Patient was placed in a medicated coma and induced into therapeutic hypothermia in Portland for transfer. This surgery will reverse the hypothermia and we will attempt to repair the damage to the spine.”
“Not attempt, Dr. Teal,” Ryan said brightly. “We will.”
“Right,” Dr. Teal responded, her voice catching.
“Ready when you are, Dr. Gary,” Emily said.
Ryan nodded. “Scalpel.”
* * *
Emily might not want to admit that she was tired and hurting after hours in the operating room, but Ryan could tell that she was.
She was sitting on a bench just outside the OR and was hunched over. Her head was propped up by one arm and her eyes were closed. He could tell by the way her shoulders moved that she was taking deep breaths.
It had been a long surgery, but it had been successful. The tests on the nerves showed function in the patient’s legs. It was just a matter of time before they could bring him out of the coma and see what damage had been done to his brain, but Ryan didn’t believe that there would be any damage. Therapeutic hypothermia worked.
Right now, that wasn’t his concern. He was worried that Emily was pushing herself too hard and that she was putting herself and the baby in jeopardy.
He straddled the bench beside her. It took all his willpower not to reach out and touch her, but he thought the gesture would not be a welcome one. In fact, the moment he’d arrived he’d had the distinct feeling that his presence here was unwelcome.
And he aimed to change that. He’d give her the support she needed while he was here. He owed her that much. He was terrified about being a father and he wasn’t sure he knew how to be a good one.
His own father had abandoned him and his mother instead of ranching on his mother’s family’s land. He knew nothing about being there for a kid. He wasn’t sure he could.
Morgan never gave you the chance to decide.
Maybe that was for the best. His life was too transient. He liked it that way.
Do you?
He shook his head.
He was a fool.
“You okay?”
“Fine.” She sat up straight, but he could see that she was exhausted.
“It’s a long time on your feet.”
“I’m aware of that.”
“When did you eat last?” he asked.
Emily shook her head. “Lunch, just before I got the call from Dr. Ruchi about the conjoined twins and before you decided to grace me with your presence.”
He chuckled. “Come on, let’s get something to eat.”
“There’s no time. The patient’s parents have arrived and are in the waiting room. I think we have to go talk t
o them and take them to their son.”
“We can go talk to them, but one of the interns can take them to their son in the ICU. After we talk to them, you’re getting something to eat. Doctor’s orders.”
Emily sighed and stood up. “Fine.”
“You’re not going to argue with me?” he teased.
“No, because you’re right and I’m starving. Let’s go talk to the Klassens. Dr. Teal can take them up to see their son.” Emily stood up, but she closed her eyes and the blood drained from her face.
Ryan reached out and held her steady. “Whoa, you’re definitely not fine.”
“Just a bit dizzy. Okay, you’re right. Today I pushed it too far. I haven’t been present in a pediatric orthopedic or neurosurgery since I got pregnant.”
He helped her sit back down. “I want you to stay here. I’ll go speak with the parents and then I’ll be right back.”
She nodded. “Okay.”
“I’ll be right back. Don’t move.”
“I won’t.”
* * *
He didn’t want to leave her, but he had a duty to his patient’s parents. They were probably sick with worry. He took Dr. Teal with him so that the young intern could take Jason’s parents to the ICU, and because Dr. Teal was with him it didn’t take him long to find the waiting area.
He explained to Jason’s parents the procedure and the outcome. Jason’s family would be in Seattle for some time while Jason went through extensive physiotherapy after he healed.
At least with kids they bounced back.
After Dr. Teal had taken Jason’s parents up to the ICU, Ryan turned round and went back to the operating room floor, using Emily’s pass.
She’d stayed where he’d left her.
Only she was sitting on the floor, her back to the wall and her head between her knees. He rushed over to her and knelt down.
“Emily?”
“I really need to get something to eat.” A weak smile tugged at her lips and he couldn’t help but smile at her.
“Come on. I’ll take you to the nicest place in town.”
