“I finish taking your history, then perform a more in-depth physical exam, and probably call in a consult from an endocrinologist.”
Declan’s smile was a total bluff. Christ, how had this gotten so bad, so fast? “So, we’re about to get cozy, then.”
“Enough that you should probably call me Tess,” she said, checking his vitals on the monitor one more time as she grabbed the electronic chart the nurse had left behind.
Surprise popped through his veins, evidenced a second later on the screen beside him. “Not exactly protocol, is it?”
“Nope. But I’m not exactly a protocol kind of girl, and it’s technically not Michaelson, anyway. At least, not anymore.”
He spun that one around in his head for a second, then two, before… “Ah. Recently divorced?” Not that marriage had really ever been on Declan’s radar, especially considering the raging mess his parents’ relationship had been, but seriously—what sort of idiot would let a smart, beautiful woman like this get away from him?
“Yep.”
“I’m sorry.”
“Don’t be,” she said, her tart smile tagging him center mass before spreading a tingly path over his skin. “I’m definitely not. At any rate, since you’re tight with Connor and I’m not tight with stuffy protocol, Tess is fine.”
“What’s your new one?” Declan asked. He knew there was business at-hand, sure, and it was pretty important. But he wasn’t exactly going anywhere, and this conversation was the most personal he’d had in…hell, he didn’t even know. The modeling gig he’d fallen into after returning to civilian life two years ago was great, but most everyone in the business freelanced. He’d never been particularly close with anyone he’d worked with since the Air Force had booted his arse, and he spent the rest of his time either at the gym or with a revolving door of doctors and specialists at the VA hospital. Add his gruff, introverted nature to the mix, and none of it was exactly conducive to quality one-on-ones.
Tess paused, clearly surprised. “My new one, what?”
“Last name. The one you’re going back to, I mean.”
“Oh. Well, my maiden name is Jameson—”
“Like the whiskey,” they both said in unison. Her eyes flared, and hey, what do you know, the heat in his blood did the same damn thing.
“Exactly,” she whispered.
But before Declan could think up some way to hang on to the unexpected normalcy and pure comfort of the moment, if only for a breath, Connor appeared in the doorway of the exam room, worry etched all over his face.
“Declan? What the hell is going on? Why are you here? What’s wrong?”
And just like that, Declan was reminded that normal no longer existed.
“It’s a long story, mate, and I’m afraid there’s no happy ending.”
3
The chances of Tess’s current situation taking the handbasket route directly to Satan’s backyard were far better than she liked, which meant she had to get things under control, stat. Yes, Connor was one of her closest friends, and no, she didn’t take that lightly. But right now, her first obligation was to her patient; namely, his right to confidentiality. No matter how tight they’d been in the Air Force, if Declan didn’t want Connor to know about his health condition, Tess wasn’t going to let the big guy in on so much as a syllable.
“Are you okay with this?” she murmured to Declan, whose vitals had improved remarkably since he’d fallen into her arms in the ambulance bay.
And oh, how his body was even harder and more well-muscled than it looked.
Way to violate no less than six different sections of the ethics code, came the nagging inner voice that sounded suspiciously (but not surprisingly) like her mother. But, come on. Tess had been embarrassingly attracted to Declan—or, at least, his image—long before he’d ended up in her ED. She wasn’t about to refuse the guy care just because her hormones had gone on a walkabout months ago, when she’d first seen him on a book cover.
“Okay with what?” Connor asked, depositing Tess back to planet Don’t Be A Dumbass.
Declan looked at her, giving up a slow nod and leaning back against the pillow on his gurney, resigned. “It’s why I came. Although, I wasn’t keen on him finding out like this.”
“Finding out what?” Connor huffed in exasperation, a muscle in his jaw tightening behind his auburn beard. “I swear to God, if someone doesn’t—”
“I need a kidney transplant, mate.”
Tess fought the urge—and it was strong—to let her jaw drop.
Connor? Didn’t even come close. “You…what? What the fuck are you talking about?” He swung toward her, emotion crowding his voice. “What the fuck is he talking about?”
She released a slow exhale and forced her adrenaline to mind its manners. Not losing her cool was the one thing she could do with decent skill, and right now, both Connor and her patient needed her to deliver.
“Why don’t we all take a deep breath and start from the beginning, okay?” Reaching behind her, she dragged a chair from the corner of the exam room and slid it in Connor’s direction. “I have to take an extended health history, anyway, and that should get us all on the same page.”
Again, Declan nodded, although, he looked less than thrilled about having to trot out his health history. Tess grabbed hold of the electronic chart, along with the situation, tapping the thing to life with her index finger. “So, you were diagnosed with type 2 diabetes two years ago?”
Connor made a noise of disbelief, and Tess mentally kicked herself square in the ass. “Two years?” Connor asked. “Jesus Christ, Dec! I’m a goddamned nurse. I run an entire wellness clinic! I could’ve helped you. I could’ve—”
“Treated me like a fecking adult and not a helpless weakling?” Declan bit out, and on second thought, maybe Tess sucked at having control over this situation, too.
“That’s enough, gentlemen.” She put enough edge on the last word to remind them that they were acting like anything but. “Were you active duty when you were diagnosed?” The physical exertion required for active duty military posts was hard enough for most. Add a chronic condition like type 2 diabetes, and…
“I was honorably discharged on disability a year before my second tour was up,” Declan said quietly. “Four days before my twenty-fifth birthday.”
Tess didn’t need an abacus to figure out that put him at a not-whopping twenty-seven, just like she didn’t need a psych degree to hear the pain knotting his voice.
Thankfully, neither did Connor. “Shit. Shit.” His massive shoulders slumped back against the chair that was two sizes too small for his frame. “I’m so sorry, Dec.”
“And that would be why I didn’t tell you.” At Connor’s questioning look, Declan continued, “If things were reversed, would you want my pity?”
Connor shook his head, looking ready to protest, but Tess lifted her free hand. She might not get all the testosterone the two of them were trading like baseball cards, but pride? That she understood in motherfucking spades. “Okay. So, you’re managing your glucose levels with diet and medication?”
“Yeah. I have…I guess had an endocrinologist at the VA. Saw her on the regular. She hooked me up with a nutritionist, who hooked me up with a trainer who specializes in clients with chronic health problems.” His shoulders, which were already making his hospital gown look better than the garment ever had a right to, hitched tighter. “I wanted to be proactive about staying as fit as possible.”
“I’d say it worked.” Tess realized—too late, naturally—that her musing had been of the out-loud variety, and she cleared her throat as if it could cover her idiocy. She had the better part of a decade on him, for Chrissake. Not to mention he looked like he’d been chiseled out of the Sexy Stone, rather than born like mere mortals. “I mean, you look…very fit.”
“Just not healthy, I’m afraid,” Declan said. “About six months ago, I started having trouble sleeping and my muscles got a little jumpy. I thought it was my workouts, but my tra
iner made me go see the doc, who stuck me like a damn voodoo doll.”
“Diabetic nephropathy?” Tess asked, her heart clenching for the guy. Kidney disease wasn’t rare in type 2 diabetics, but those patients were usually a lot older and a hell of a lot less fit than Declan. Still, he was right. Fit and healthy didn’t always match up.
“Jesus,” Connor breathed as Declan’s singular nod confirmed the advanced kidney disease. "How are your blood pressure and cholesterol levels?”
“Not bad. I do the checks and keep to the dietary restrictions like I’m s’posed to, but…”
“Once your kidneys start to fail, your options become limited,” Tess finished as gently as she could. “What about stronger medication? ACE inhibitors?” Sometimes they could slow the process and keep a patient off dialysis until a donor could be located.
Declan gestured to the duffel that had gotten relegated to afterthought status once he’d passed out. One of the nurses who had met them at the doors to the ambulance bay must’ve seen it and put two and two together. “They’re all in there, along with a copy of my medical records for the past two years.”
“That’ll be really helpful,” Tess said, her brain already turning over options. Okay, so his case was a little different than most, but maybe there was an alternate treatment they could try, or a clinical study, or something that would keep him from dialysis and kidney failure.
Connor had clearly gone the same mental route, because he asked, “Can we get Rosenthal down here for a consult? He can order an MRI, or maybe even a renal scan, to better see what we’re dealing with, here.”
Calling the guy in was definitely a start. “Dr. Rosenthal is our head of endocrinology,” Tess told Declan, who looked strangely unmoved.
“Great. So I can have yet another specialist poke me and scan me within an inch of my goddamned dignity just to tell me what I already know. If it’s all the same to you, I’ll pass. Plus, I’ve already had all of that done at the VA.”
She tried—she really, really tried—to keep her empathy hat on. “Look, I’m sure you got great care at the VA, but Dr. Rosenthal is one of the most respected specialists on the East Coast. He might be able to come up with a different course of treatment than your current doctor.”
“Course of treatment? I need a transplant. There’s nothing to be done for this but the waiting,” Declan argued, and Tess’s brows shot upward without permission from the rest of her.
“Good to know you’re an M.D.”
Declan stood his ground. “I’m not wrong.”
But Tess had been doubted by far worse than a moody, broody Air Force veteran-turned-cover model, and she wasn’t afraid to wield a little attitude to prove it. “If that’s the case, then why even come here? Why not just wait out UNOS in California?”
“You wanted to know if I could help you,” Connor said after Declan’s pause.
“Aye.” His chin dropped, and Tess’s heart went along for the ride. “The doc at the VA said the meds will only do so much, and the list of people lookin’ for kidneys is long. She said it could take years. But at the rate I’m going…”
“You’ll be on dialysis by then,” Tess said, and Declan nodded in acknowledgment.
“Guess I figured I’d take the last chance I had.”
An idea welled in Tess’s mind. “I take it you don’t have any immediate relatives who might be a match.” Direct donation accounted for a decent percentage of kidney transplants.
Declan’s eyes flashed in the over-bright fluorescents overhead. “No. My mam’s gone. I never knew my da, and my sister is…no.” More pain filled his stare, to the point that not even Tess was willing to push. “I don’t have anyone”—he looked at Connor—“other than you.”
“I’ve got your back, brother.” Connor leaned forward in his chair, bracing his forearms over his scrubs-clad thighs and his forehead against his fingers, and Tess’s emotions sent a rare lump to her throat as he continued, “I’m sure you already know this, but there aren’t any ins with UNOS. Organ recipients are prioritized strictly by health conditions and match availability, so I can’t get anyone to move you up the list no matter how badly I want to.”
“I know,” Declan said. “I’m not lookin’ for special treatment or a second opinion. I know there’s no miracle cure. I just thought…”
“What about a clinical trial?”
The words bypassed Tess’s already questionable brain-to-mouth filter, halting the rest of Declan’s sentence and making Connor’s shoulders yank upward in surprise.
“Sorry?” Declan asked, and she looked at him, brows up.
“A clinical trial. No one at the VA brought that up as a possibility?” His WTF stare answered the question all on its own, so Tess didn’t pause. “Doctors and pharmaceutical companies need ways of testing new drugs and treatments before the FDA will approve them as standards of care, so they do clinical trials on qualifying patients.”
Declan thought about this for a second. “So I’d be a guinea pig.”
“The treatments are thoroughly researched before the trials are approved and funded,” Tess said, trying to keep her tone even. She wasn’t suggesting the equivalent of an eighth grade science project over here—she’d never suggest anything unsafe. “Over twenty thousand of them were registered last year alone.”
“Right.” Declan remained as unmoved as Everest. “So I would be a guinea pig.”
“You’d have to get that far,” Connor said, but he also didn’t say it was a shit idea. “There are a lot of steps involved. You’d have to find a trial you fit the criteria for, you’d have to qualify. Not to mention, you’d have to be selected, which can be difficult. Even then—”
“The treatment might not work,” Declan said, all but infusing the words with guinea pig.
“But it might,” Tess argued, her frustration threatening to flare. For fuck’s sake, she wouldn’t have put the idea out there if she didn’t think it was viable and safe.
Connor frowned. “There’s got to be a reason no one at the VA mentioned one, though.”
“They’re probably slammed.” She knew firsthand how high the need was for good medical care for veterans. The Army had paid for her degree, and even though she’d long since fulfilled her obligation in the Reserves, she remembered all too well how many veterans depended on the VA for even basic services. Something like this… “Finding the right clinical trial can take a buttload of time and energy, and if the doctors there felt like they already had a workable plan of care in place, they probably wouldn’t give a trial a second thought.”
A noise Tess couldn’t quite identify crossed Declan’s lips, caught in the no-man’s-land between a snort and a scoff. “Is buttload the technical term, then?”
Her cheeks blazed. “All I’m saying is that it can be a time-consuming process.”
“Or maybe the VA doesn’t support those…what did you call them? Clinical trials?”
“They do in some cases,” Connor said slowly. “To be honest, it might not hurt to at least look into it. Dr. Rosenthal might know of some places to start.”
Tess nodded, a plan building in her head, her pulse picking up along with it. “I have to call him for a consult, anyway. We’ll need to go over all the medical history carefully, and factor in today’s labs. Then, you and I can start looking for trials. There’s bound to be something we can at least take a swing at, or maybe even a handful of hopefuls.”
“I dunno,” Declan said, his tree-trunk arms folding over his chest and his scowl out in full force. “If whatever medicine I’d get in a trial would really make me better, don’t you think my doctor at the VA would’ve said something?”
Scorn wasn’t unfamiliar to Tess—hell, they were practically BFFs for how often her mother had paired them up like a china cup and saucer at high fucking tea. But something about the doubt on Declan’s face undid her in one hard snap.
“First of all, let me be clear. There’s no cure for diabetes. So whatever treatment you’d rec
eive as part of a trial might make you feel better, and it definitely might buy you more time before you’d need dialysis or become gravely ill while you wait for a kidney, but nothing’s going to make your disease disappear. Not even that kidney.”
She continued, even though his eyes widened and Connor’s mouth opened on what was sure to be a protest, because the rest was too important not to get out.
“There are several reasons why your doctor at the VA might not have brought up a trial. I’m not sure what hers was, but let me tell you what I do know. You passed out in my arms, in front of my ED, which—for the time being, anyway—makes you my patient. I’m giving you a sound medical option with zero risk and zero obligation.”
Her voice lowered but didn’t soften as she placed her hands on her hips and asked, “Now, are you going to stop fighting me and start trusting me enough to let me help you, or not?”
4
Declan wasn’t a sucker for much, but a woman who didn’t stand for a single ounce of bullshit?
Yeah, Dr. Michaelson was flipping all his fucking switches right now. Despite the fact that she was pissing him off, too.
Because damn it all, she might be right.
Still, his defenses weren’t about to give that little gem any airtime, regardless of what his dick thought of her bourbon-brown eyes or that lush, smart mouth. So, in the end, it was Connor who broke the standoff.
“Why don’t we take this one step at a time?” his buddy asked, intervening smoothly. Declan shouldn’t be shocked, really. Connor had always been laid back to the point that Leo and Elvis and Jonesy used to joke about checking to make sure he still had a pulse from time to time.
Declan’s own pulse jumped at the reminder of their unit-mates—the ones he’d been forced to leave behind without so much as a goodbye, thanks—and he slammed down on his unease, along with his expression, as he shrugged.
Beyond Just Us (Remington Medical Book 4): A Single Parent Marriage of Convenience Romance Page 3
