Twice Upon a Train

by K A Moll

  “Well?” she asked.

  “A bit slow,” Keegan answered quietly.

  “And what does that mean?”

  “It means I need to take your blood pressure.”

  “Our deal was pulse.”

  “Yes, it was,” Keegan answered, holding out her hand. When Nicole complied, she wrapped a cuff around her upper arm. “A bit low,” she said quietly.

  “And what does that mean?”

  “It means I need to listen to your heart. Could I get you to unbutton the top three buttons?”

  “And, if I say no?”

  “You won’t.”

  Nicole shook her head, complying. “I hope Willow’s up for a challenge, knowing how strong-willed you are.”

  “I’m sure she can handle me,” Keegan responded, slipping her hand inside Nicole’s blouse. “Okay, this might be a little cold,” she said, pressing the bell of her stethoscope under her left breast, and repositioning the instrument multiple times. “Take a deep breath...and another…and another…and we’re done with this part. Now, if I could get you to unzip your jeans.”

  Nicole squinted, meeting her gaze. “Not a snowball’s chance in hell.”

  “Alright,” Keegan responded, “so I guess we’ll talk a bit longer.” She asked for details about her symptoms, nutrition, bloodwork, and past illness. “You need to let me palpate your abdomen, Nikki.”

  “And you need to tell me what you’re worried about.”

  “I’m worried about you.”

  “I think you can be more specific, Doctor.”

  Keegan released a breath, her tone lowering. “When you consume fewer calories than you need, your body has no choice but to use its own tissue as fuel.”

  Nicole rolled her eyes. “And, here we go—”

  “So, you’ve heard this before.”

  “Multiple times.”

  “Muscles are the first to go,” Keegan continued, “and your most important muscle is your heart.”

  Nicole stiffened, her thin fingers tensing.

  “Good, I have your attention now,” Keegan responded, picking up where she left off. “When pulse and blood pressure begin to drop, it’s often a signal that the heart is beginning to fail.” She held her gaze firmly. “Purging and laxatives deplete your body of electrolytes. And, one, in particular, is what keeps your heart beating.”

  “If you’re trying to scare me, you’re doing a great job.”

  “I’m not trying to scare you; I’m trying to get your attention.”

  “I don’t purge that often, and I rarely use laxatives.”

  “Music to my ears,” Keegan responded.

  “We live in a fat-phobic society,” Nicole explained. “I have to diet, not only to be retained on big cases but to win them.”

  “No, I don’t think so,” Keegan said, her tone softening. “But regardless, it’s not worth destroying your health.” She touched her arm. “Please, Nikki, you need to let me palpate your abdomen.”

  “So, the heart issue is secondary.”

  “I can’t be sure without examining you.”

  “What are you looking for?”

  “One of several conditions, a couple potentially life-threatening. I need you to unzip your pants and let me palpate your abdomen.”

  “I’ll think about it.”

  Keegan smiled, patting her thigh. “Good enough for now,” she said, stepping off. “We’ll talk later.”

  “Keegan—”

  Keegan turned back. “Yes?”

  “Willow and I, we don’t keep secrets. She’ll want to know what’s going on. You can talk to her.”

  “I’ll bring her up to speed.”

  “Without the sugar coating.”

  “I didn’t use much.”

  “Oh, but I think you did.”

  CHAPTER EIGHTEEN

  “Did she let you do an exam?”

  “Pulse, blood pressure, and heart.”

  “So, what’d you think?”

  “I think she needs to let me palpate her abdomen.”

  “I should talk to her.”

  “Let’s let her sleep,” Keegan responded. “I’ll try again later.” She gathered her into her arms. “How about we go to the observation car for a little while? Talk, watch the scenery, maybe bring back dinner for the three of us?”

  “Good idea,” Willow responded, collecting her purse. “I could stand some good conversation and natural Utah beauty. It might even take my mind off of Nikki.”

  “That’d be good,” Keegan answered, putting her arm around her, and squeezing. “Because we can’t do more than we’re doing.”

  “I know that,” Willow said quietly, crossing paths with Humphrey as he slipped into Mrs. Pilister’s cabin. “I got such a kick out of them at lunch,” she commented, lightening the topic.

  “I did too,” Keegan answered. “And whatever comes of what they have after the trip, I think it’ll be good for them.” Her smile faded, swallowing. “It’s no fun being alone in the world.”

  Willow reached for her hand. “No, it’s not.” They walked in companionable silence through the next car, smiling at one another as they passed their special spot, and ending up in the last carriage.

  “What a view,” Keegan declared, sitting beside her on a wood-trimmed loveseat with a rounded back. “It almost makes you wish you could roll down the windows, feel the breeze on your face, and take a breath of wilderness.”

  “It does,” Willow answered, feeling a release of bodily tension.

  Keegan stretched her arm across the floral upholstery. “I’ve flown over Utah, but never stepped a foot in the state. I typically steer clear of places known for being socially conservative and highly religious. But I was reading the other day that Utah is actually quite LGBT friendly.”

  “Interesting,” Willow responded, commenting that it’d been a long time since she’d traveled anywhere. “Maybe Utah should be on your bucket list.”

  “Maybe it should,” Keegan answered, enjoying a rear window view of the scenery.

  Two passengers came in, sat, and left.

  A gate lifted, allowing a line of cars to bump across the tracks.

  The train slowed, crossing a bridge.

  “Do you think it’s weird,” Keegan asked quietly, “that I can’t stop thinking about the first time we were together?”

  “No, not at all,” Willow answered, “I mean, here we are on a train, coming together after all these years. I think it’s completely natural that you’d be thinking about it.”

  Keegan moved the end of her thumb in circles on the tip of her middle finger, her eyes lifting to meet Willow’s. “It kept me going, you know,” she said, her voice lowering, “for the longest time, well into college, the haptic memory of us—warm and wet and squishy—kept me going.”

  Butterflies took flight in Willow’s stomach.

  “When we came together,” Keegan continued, “it changed my world. For the first time in my life, I knew who I was, what I wanted, what I needed to be whole.” Her words drifted toward the sunset. “I mean, I’d read articles in my dad’s girlie magazines, looked at pictures of women, talked with the older girls. But until that day, I didn’t know—”

  Willow laid her head on her shoulder. “You didn’t know what?” she asked softly.

  “What it would really be like to be with a girl,” Keegan answered, “what it would be like to be with you.” Brown eyes closed, opening to blue ones. “Holding you in my arms, listening to your soft mews of pleasure, it set me on fire. But it wasn’t until afterward, when we were on the way to the hospital, that I realized what it was to fall for a girl so hard it hurt.”

  “Oh Keegs,” Willow murmured, brushing her cheek with her fingertips, “my sweet Keegs, I fell for you too.” Emotion broke through her words. “But I never got to tell you.”

  “I knew,” Keegan answered, her lips touching her like a whisper. “I saw it in your eyes, felt it in your touch—I knew.” She looked at her with longing. “I’ll be
t you can guess what I’m thinking,” she said, her tone low, and suggestive.

  “That we should go ahead and pick up dinner,” Willow said, her insides jangling, “settle in early.”

  “Exactly,” Keegan responded, trailing her fingertips along the neck seam of Willow’s blouse, her eyes undressing her. “God, I want you. I’ve never stopped wanting you.”

  And at that moment, Willow knew who she was and what she wanted—what she needed to be whole. “I want you too,” she murmured. They threaded their fingers together, walking to the restaurant, and back to the cabin. “Nikki didn’t touch her lunch; I just hope she eats some supper.”

  “Lunch was pretty bland,” Keegan responded. “Probably wasn’t too appetizing.” She peeked into the carryout bag. “This should be better. I just hope it’s not too rich for her stomach to handle.”

  “Well, I’ll be darned,” Willow said, opening the door, “the light’s on.”

  Keegan smiled. “That’s a good sign.”

  “Nikki,” Willow called out, “we’re back.” When she rounded the corner, she found Nicole sitting up in bed, her laptop perched on her lap.

  “You feel like eating a little something?” Keegan asked, reaching into the carryout bag for a container of Chicken Tortilla Soup.

  “Maybe a bit later,” Nicole answered, closing her laptop. “I’ve been up for a while. I think I need to lay down.”

  Willow sat on the edge of her bed. “You need to try to eat.”

  “I will. After I lay down.”

  “You promise?”

  “Yes, Willow, I promise.”

  *

  After dinner, Keegan lit candles, setting them around the edge of the Jacuzzi. Then, she poured two drinks, Pendleton, neat, setting the bottle on the floor. She smiled, preparing a saucer of chocolate covered strawberries. Willow seemed ready, said she was ready, but she wanted to start them off easy. And what could be easier than warm bubbly water, flickering lights, chocolaty fruit, and no clothes? She selected a romantic playlist, love songs from the nineties.

  “What’s this?” Willow asked, her voice lifting as she came toward her.

  “Bath time,” Keegan answered, adjusting the temperature of the water.

  “Mmmm, chocolate strawberries,” Willow said, smiling as she popped one into her mouth.

  Keegan pressed play on her iPhone.

  “Oooh, and sexy music.”

  “Uh-huh,” Keegan said, unbuttoning her shirt, and moving closer.

  Willow caught her breath. “Oh, God, this is happening.”

  “It is if you’re ready.”

  “Let’s just say my fear is fading fast.”

  “Look, if you’re not ready—”

  “I’m ready, Keegs. It’s just been a long time, a long time since you, and a long time since I got naked with anyone.”

  “I’ll go first then,” Keegan responded, kissing her as she dropped her shirt and bra to the floor, revealing sculpted abs, and breasts, perfectly small.

  With trembling fingers, Willow slipped off her blouse.

  “God, you’re beautiful,” Keegan murmured, pushing the lacy cup of her bra aside, and kissing her breast. “So incredibly beautiful.”

  Willow tilted her head, frozen—the mood gone in that split-second.

  “What?” Keegan asked, her eyebrows drawn tightly. “What’s wrong?”

  Willow snagged her blouse off the tile. “Listen, Nikki’s crying, and Nikki doesn’t cry. Hurry, Keegan, get dressed, something’s wrong.”

  CHAPTER NINETEEN

  Willow found Nicole curled in a fetal position, sobbing. Her face was ashen, and she was perspiring. She sat on the edge of her bed and rubbed her back in a gentle circular motion. “Aww, sweetie. You’re gonna be okay. Keegan’s on her way. She’ll be here in a minute.” She brushed a dampened lock of hair from her eyes. “But you gotta let her help you. Do you hear me? No more of this invincible stuff, we both know you need help.”

  “She thinks I’m really sick,” Nicole responded. “And I think I might be dying. Willow, listen to me, my will is—”

  Willow fought back tears. “I don’t want to hear about your will. And you’re not dying. If you just let her, I know Keegan can help you.”

  Nicole grimaced. “I will. But you have to listen just in case. At my bank, in a security box, forty-three-sixty. You’re executor. You get everything. In my satchel, you’ll find my Power of Attorney.” She clutched her knees, returning to the fetal position.

  “You’re not dying,” Willow choked. “Do you hear me?”

  Keegan set her medical bag on the floor beside the bed. “I’d like to examine you if you’ll let me.” When Nicole acquiesced, she checked her vitals—blood pressure, pulse, temperature, and heartbeat. “Okay, now for the hard part,” she said, unzipping Nicole’s pants, and positioning both hands on her abdomen. “I’ll be as gentle as I can.”

  Nicole nodded, wincing as firm and steady pressure was applied.

  When Keegan looked up, she was in charge. “Willow, I need you to go now, tell the engineer that we have a medical emergency.” She reached into her pocket for a business card. “Give him this so that he knows my credentials.”

  Nicole gagged, vomiting into a nearby waste container.

  “What’s wrong with her?” Willow asked.

  “I can’t be sure without tests,” Keegan answered, continuing. “Tell him I need us to stop at the nearest station with a nearby hospital.”

  “But you have an idea,” Willow persisted. “And whatever it is, it’s serious.”

  “Yes,” Keegan answered, her tone softening. “And I promise we’ll talk soon. But right now, I need you to do what I’m asking.”

  Willow nodded. “Okay, right now.”

  “And make sure you find out the name of the town and hospital. I need to call ahead, get an OR prepped, and a general surgeon on standby.”

  “No one else, just you,” Nicole interjected.

  “We’ll see how it works out,” Keegan said quietly.

  “I won’t give consent for anyone else to operate.”

  “I have to follow Utah licensure law,” Keegan responded. “Under it, I can provide emergency medical care, but in a hospital setting, I have to have privileges.”

  “Then, get them.”

  “If I can, I will.”

  “I’ll be back as soon as possible,” Willow announced. “I have my cell.”

  “We’ll be fine,” Keegan answered, her attention on Nicole. “Okay, so, I’m going to give you a couple of injections,” she said, preparing the first of two syringes, “one for pain, and the other for nausea. They’ll make you sleepy. You okay if I do that?”

  Nicole nodded, closing her eyes.

  When Willow returned, she told Keegan that they’d be stopping at a station twenty miles down the road. “The engineer thought this was our best bet,” she said, handing Keegan a slip of paper with contact information for the local hospital. “I guess there’s not much for the next hundred miles or so.”

  “Then let’s hope Afton Memorial has what we need,” Keegan responded, stepping to the window, and dialing. “Good evening,” she greeted. “Dr. Keegan Wade, Chief of Trauma Surgery at NYC General.” She explained that she was traveling, due to arrive at their train station in fifteen minutes. “I have an emergency situation, requiring an ambulance. The patient is a thirty-nine-year-old female, sudden-onset abdominal pain, abdominal swelling, and vomiting. Physical examination reveals abdominal distention and tenderness. She’ll need a CT and labs upon arrival. Please prep an OR for abdominal surgery and place a general surgeon on standby.” She blew out a breath, pacing. “How about other hospitals in your area?” She blew out another breath, raking her fingers through her hair. “How about an air medivac?” She closed her eyes and opened them. “Okay, so it appears you’re my best option. Prep your OR and free up what’s left of your surgical team. My credentials will be rolling off your fax in a matter of minutes. I need to speak with whoever can gra
nt me privileges.” When she hung up, she dialed NYC General and explained the situation.

  “That didn’t sound good,” Willow sighed.

  “It wasn’t,” Keegan responded.

  *

  “And the emergency room comes to you,” Keegan said, offering a reassuring smile as the vehicle with a high-pitched siren squealed to a halt outside Nicole’s window. Within moments, two paramedics navigated their gurney around the tight corner.

  “You Dr. Wade?” one asked.

  “I am,” Keegan answered, providing details about her patient, and following closely as they wheeled her off the train.

  “Good luck,” Humphrey called out.

  “Yes, dears,” Mrs. Pilister echoed, “good luck.”

  With a lift, the husky young men pushed Nicole’s gurney toward a decades-old Ford 350 with a box in the back, yet another indicator that the small town, publicly owned hospital to which they were headed, was financially strapped.

  “How about we have the doc ride in the back,” one paramedic suggested, turning to Willow, “and have you ride up front?”

  Willow looked to Keegan.

  “That works,” Keegan said, assuring that Willow was settled in the passenger seat before climbing in to sit beside Nicole. “We’re gonna get your IV started. Okay?”

  Nicole nodded, extending her arm. “Did you get privileges?”

  “I did,” Keegan answered. “Don’t worry; we’ll get you taken care of.”

  Nicole nodded, closing her eyes.

  *

  Afton Memorial opened its doors in the early twentieth century when other small towns were opening hospitals too. Three stories tall, its bricks were weather worn, its sidewalks were cracked, and a person with a disability would’ve been challenged to enter the building through the main entrance. There was no shiny glass, no lush landscaping, and no bluestone tiles. If cutting-edge medicine was practiced in the building, that fact would escape notice from the curb. The ambulance siren fell silent, approaching, and backing into a bay at the rear of the building. A man with fluffy silver hair and blue eyes met them at the door.