Falling Again in El Salvador

by Julie Danvers

  He realized that he had just missed the perfect opportunity to tell Cassie about the accident. Except he couldn’t. What had she said? It’s about living life to the last drop.

  What would she think if she knew that coming to El Salvador wasn’t about living his life but about hiding from it? Here, he was safe from the sympathetic looks of former friends who knew everything he’d lost. He was safe from anyone who might compare him to the gifted surgeon he used to be and find he didn’t measure up. He was safe from family gatherings where everyone was a surgeon except for him, sharing a bond that he no longer had access to.

  Cassie had said that he had helped her to find her old self. How would she feel if she knew it was all a sham? That no matter how many risks he took here, no matter how many daring things he did, none of it felt more frightening to him than going back to New York and being faced with the expectations that everyone held there. He gave a short laugh. Cassie had wanted to find her old self, while Bryce wanted nothing more than to get away from the past. From Bryce Hamlin, superstar surgeon, and all of the pressure that went with living up to that reputation.

  He was glad to know that for Cassie, last night had been about more than just excitement. And he could understand that to her, being a thrill-seeker meant something more than it did to most. But what about what the two of them meant to each other?

  He couldn’t forget that he’d misread her before. He reminded himself that he couldn’t expect to form a long-term relationship with someone who didn’t feel the same way. He needed to guard his heart until he learned what Cassie wanted: an adventure or him? Or perhaps both?

  He wondered if Cassie even knew the answer.

  CHAPTER NINE

  THEY ARRIVED BACK at the camp in the late afternoon, and jumped right into work. They had no time to rest or get their bearings—the camp was in chaos. Bryce left their luggage next to the main office building, surprised that little Manny hadn’t run up to greet them or take their things back to their cabins for them.

  Medical workers were moving quickly through the camp. Bryce saw Anna, the midwife, racing toward a tent with some bandages, and he asked her how they could help.

  “Everything happened so fast,” Anna said. “At first there was a huge influx of patients all at once, but then the flow started to slow to a trickle about an hour ago. We think everyone who sustained injuries is here at the camp now. We’re trying to triage and take them one at a time. The best thing you could do would be to grab a patient and get moving.”

  Bryce moved through the camp, assisting with triage so that the worst injured patients would get help first. As he continued to work his way through the wounded, he became increasingly aware of the absence of his ten-year-old shadow. Usually the boy was the first to greet him when he got back to the camp and was constantly underfoot with questions, even during emergencies. He was helpful, too, as he could often be sent to run messages between the camp doctors. His worry began to grow, until he saw something that confirmed his worst fear: Mrs. Martinez standing outside one of the medical tents holding Rosibel, tears streaming down her face.

  He gripped her arm in reassurance as he headed into a tent, where Manny lay on a camp cot. A nasty gash was evident on the boy’s forehead, but as Bryce examined him, he became increasingly concerned about injuries he couldn’t see.

  Manny tried to sit up, and Bryce put his hand on the boy’s too-thin shoulder to keep him lying down.

  “Do you know who I am, Manny?”

  The boy seemed to be fighting to stay awake. “They told me to wait here,” he responded. “But I can’t stay. I have to look after Rosibel.” The baby gave a cry that Mrs. Martinez quickly hushed.

  As Bryce continued his examination, he was aware that Cassie had quietly entered the tent. Manny asked for his mother a few more times, but didn’t seem to hear when Mrs. Martinez tried to reassure him. After a few more moments, he didn’t respond at all as Bryce tried to rouse him.

  “Subdural hematoma,” murmured Cassie.

  “We don’t know for sure,” he said. “Not without a CT scan.”

  “And we’re not going to get a CT scan out here. A hospital in San Salvador might have one, but there’s no time to get him there. The confusion, the loss of consciousness—it all points to subdural hematoma. We need to relieve the pressure on his brain, fast.”

  He knew she was right. Manny’s symptoms indicated that he had suffered a blow to the head, possibly multiple blows. The trauma had resulted in a buildup of blood between the brain and skull. Each passing second put Manny at increased risk as the pressure on the brain from the bleeding increased. They needed to operate as quickly as possible.

  “Is my son going to die?” asked Mrs. Martinez.

  “We’ll do everything we can,” said Cassie. “There’s bleeding that is putting pressure on his brain. We need to drill a small hole into his skull, and we might have to put in something called a shunt in order to drain the pressure. I know it sounds scary, but if we don’t do it, Manny might never wake up.”

  Mrs. Martinez looked terrified, but she nodded. “Do whatever you need to do. I trust you, Doctor.”

  “The good news is that you’re in very safe hands,” Cassie said. “Bryce used to be one of the best surgeons in New York, before he got into obstetrics and started delivering babies. Manny couldn’t ask for a better doctor to do this operation than Bryce.”

  Dread settled like a block of ice into Bryce’s stomach. If they didn’t relieve the pressure on Manny’s brain quickly, he could die. But to do such a procedure here, without the benefit of modern equipment and a full staff, was daunting. Worst of all, he knew that the greatest need at this moment wasn’t for modern equipment or a staff of doctors with impressive credentials.

  What they needed most of all was a pair of steady hands.

  “Cassie,” he murmured, “can I have a word?”

  She stepped away from Mrs. Martinez. “What is it?”

  “I don’t think I can do this.”

  She put her hand on his arm. “I can understand why you’re nervous. It’s been a while since you practiced. But there’s no one else here who has more experience than you with a procedure like this, even if it’s been a few years since you performed one.”

  “It’s not that. I just don’t think I can drill into Manny’s skull.”

  “I know you care about him. The camp wouldn’t be the same without him. But you can’t let your feelings interfere with the operation. I don’t like the thought of drilling into the cranium, either. It terrifies me. But at least you’ve done it before. And even though it’s a dangerous procedure...even though he might die if you do it...”

  “He’ll definitely die if I don’t,” he finished for her. He knew the line. Her face was a mirror image of what it had been five years ago, when she’d said almost those exact words, and convinced him to perform an operation that had impacted their relationship and his career.

  But she’d said them because she was convinced that there was no alternative. And just as he had then, he agreed with her. There was certainly no alternative now. The longer they did nothing, the more likely the subdural hematoma was to increase its pressure on Manny’s brain.

  “All right,” he said. His voice was firm, decisive. “Let’s get him prepped with anesthesia.”

  Maybe his tremor wouldn’t flare up, he thought. As long as he kept calm, the chances of it flaring were small. And the procedure would be brief. He’d drill for a few seconds at most, just enough to open a hole in the cranium and relieve the pressure on the brain. As long as he stayed relaxed and focused, everything would be fine. The faster he worked, the less chance there would be of any complications.

  For a moment, as the nurses prepped Manny for surgery, Bryce almost felt like his old self again. It was just like the days of his surgical residency. Once again, he was the one expected to step up to handle a dangerous,
difficult case. And once again, Cassie was looking at him as though she relied on him. As though she trusted him.

  Ultimately, it was her look of trust that stopped him.

  Cassie had faith in him. Not to perform surgery, but to do the right thing. And he knew that he couldn’t operate on Manny just because he wanted to feel like a surgeon again. The risk of his hands trembling at the wrong moment was simply too great.

  He couldn’t put someone in danger. Especially not someone he cared about.

  He lowered the drill. “I can’t do it,” he said. He saw the surprise in her eyes above her surgical mask. He knew he needed to explain quickly, in a way that would brook no argument. Every second counted. “I have a hand tremor. I can usually control it, but I can’t always predict when it will flare up. I can’t do this operation. It’s too risky.”

  He put the drill into Cassie’s hands and closed her fingers around it.

  To her credit, Cassie didn’t hesitate, although she must have been shocked to find herself to be the one holding the drill. But if she did feel shocked, she didn’t show it. She simply took Bryce’s place at Manny’s head.

  “Show me exactly where to drill and for how long,” she said.

  Bryce was relieved that she hadn’t stopped him with any further questions. He knew that Cassie would always put her patient’s well-being above her curiosity, but he was sure that he would have questions to answer the moment the surgery was over.

  He showed Cassie where to place the drill. With luck, they would be able to suction the blood out through the hole.

  Cassie’s hands were perfectly steady as she drilled the hole, stopping exactly when Bryce gave the word. Bryce was relieved as he saw that blood immediately began to drain from the hole. There would be no need for a shunt—Cassie had performed the procedure beautifully, and they could close as soon as the blood had finished draining.

  “You’re doing great,” he said to Cassie. Her face was white as a sheet.

  “Glad to hear it,” she breathed. He could almost feel how still she was trying to be as the fluid drained from Manny’s head. “I have to say, this is a first. When you deliver babies, you typically don’t require the use of a drill.”

  “Just keep your hands steady. We’re almost there.”

  Finally, enough fluid had drained that they could close the scalp. He showed Cassie where to stitch the scalp, but she was already starting to press the edges of the incision together as he spoke. He straightened his back and went outside to where Mrs. Martinez was waiting.

  “Manny came through the procedure just fine,” he said as she cried tears of relief. “He should start coming round in a few hours. We’ll monitor him for at least seventy-two hours, but the procedure went smoothly. He’ll need to keep still for a long time, but he should be feeling better soon.”

  “Oh, thank you,” said Mrs. Martinez. She rushed inside the tent to be near her son.

  It was starting to rain. Bryce could feel a few drops at first, and then a stronger, steady patter. He couldn’t bring himself to move back inside the tent. He wanted just a moment to breathe, to feel relieved that Manny’s procedure had gone well.

  But his relief was short-lived. As Mrs. Martinez went into the tent, Cassie came out, her eyes blazing.

  “What the hell just happened, Bryce?”

  “You saved a child’s life.”

  “Bullshit! You know that’s not what I’m talking about. You hesitated. You handed the reins over to me at a crucial moment, just like you did with that complicated C-section. What’s going on? Why aren’t you doing surgical procedures?”

  “I told you why, in there.” He held up his hands. The tremor was faint, but it was visible. “Can you see it?”

  “My god, Bryce, how long has that been going on?”

  “Since a few weeks after we broke up.”

  He saw the realization dawn on her face.

  “I was in a car accident, just after you left. Hit on the expressway by a drunk driver. The physical therapy helped quite a bit afterward, but I was never able to recover the full use of my hands.”

  “So that was the reason you lost your job. That was why you changed specialties. You couldn’t be a surgeon anymore. Not with a hand tremor.” She gave a low dark laugh. “And to think that when I first got here, I was worried that it might have had something to do with me.”

  She was still slowly shaking her head. The expression on her face was incredulous. “I can’t imagine what the recovery must have been like.”

  Her continued silence was making him anxious, and he spoke nervously to fill the gap. “There’s still a lot I can do,” he said. “For a while, I thought I’d never be able to be a physician again. But then one of my mentors recommended obstetrics. There’s a lot I can do that doesn’t involve surgery. Most of the procedures that come my way are pretty low risk.”

  “How could you not tell me this?”

  “It was five years ago. Does it really matter anymore?”

  “Yes! Yes, it matters! Why didn’t you call me, why didn’t you say anything? You were in a major life-changing accident. No matter what happened between us, if you’d called me, I would have been there for you.”

  His jaw tightened. “I didn’t want your pity.”

  “I wouldn’t have offered you pity. I would have offered you support. I would have been there for you. I didn’t know. I wish you had called me. I wish you hadn’t had to go through your recovery alone.”

  “You left a note that indicated you didn’t want any calls from me.”

  “And that was a mistake. It was a stupid mistake! But I couldn’t have known you were going to be in an accident. I didn’t know you were going to lose your profession. You loved being a surgeon. It was everything to you. And you were so gifted.”

  There, he could see it in her eyes. Pity. The exact response that he didn’t want from her.

  He’d spent the past three years in El Salvador trying to escape from the shadow of Bryce Hamlin, genius surgeon. He’d tried to carve out a life for himself in New York, and it hadn’t worked. Everywhere he turned, everyone—whether they were colleagues, family or friends—wanted to talk about the doctor he used to be. The person he used to be. No one seemed to be able to talk to him without comparing him to his past, pre-accident self.

  But he wasn’t that person anymore. Even though everyone seemed to regret that that version of him was gone. Even though Cassie now stood before him, expressing her pity that he was no longer the surgeon he had been.

  He realized that she’d done the same thing she’d done when she came into his life five years ago. Back then, she opened his life to more excitement. She pushed him to take more risks. Just as she unwittingly had today. Even though she hadn’t known about his hands, she’d still pushed him to do the procedure on Manny. That was who Cassie was. She pushed him, challenged him, made him take risks he hadn’t even known were there.

  But letting her back into his heart was a risk he couldn’t take. Because along with all the memories of how she pushed him, came all the feelings of heartbreak after things had gone too far.

  He’d already survived that heartbreak once. He knew he would never be able to survive it again.

  “Cassie,” he said. “We need to end this.”

  “What do you mean?”

  “I mean us. We need to stop, the two of us. We aren’t going to be able to make it work.”

  Tears mixed with rainwater streamed down her face.

  “I don’t understand,” she said.

  “Because I’m not the rock star surgeon anymore. More than that, I’m not the person I used to be. But I think you might still need that person in your life. Everything you said today on the bus made me realize that you want an adventure. And I think that’s a wonderful thing. It’s even something I want, a lot of the time. But it’s not something I want from a re
lationship.”

  Her lips barely moved, and he had to strain to hear her against the rainfall as she said, “Is that all you think I want from a relationship?”

  He didn’t know. But he didn’t think he could handle the disappointment of finding out.

  Not again.

  “Let’s just call it what it was,” he said. “A trip down memory lane. The sooner we stop holding on to the people we used to know, the sooner we can both focus on our futures.”

  Her chin trembled, and he could hear her trying to keep her voice steady. “I’m not holding on to anyone I used to know. Because I don’t think I ever really knew you. I sure as hell don’t know you now.”

  She turned and left, leaving him standing there in the rain.

  Strange, he thought, as she walked away. Right after the breakup, he had fantasized about what it would feel like if he had been the one to initiate the breakup. He’d nursed his hurt and his anger, and he’d thought he wanted a chance to show her how it felt, to hurt her the way she’d hurt him. But as he watched her walk into the darkness, he knew that turning the tables wasn’t satisfying at all.

  * * *

  Cassie bunched her pillow into a ball. She’d tried a hundred different pillow positions and multiple corners of her mattress, but she couldn’t get comfortable enough to sleep. The rain pounded on the roof of her quarters. She was exhausted from a long day of travel and treating patients injured by the mountain rockfall. But sleep would not come. She’d been tossing and turning for hours with little success. She checked the time on the cell phone next to her bed. Three in the morning. If she was going to get any rest before her shift started in four hours, she needed to drift off soon.