Twice Upon a Train

by K A Moll

  “No, she’s not pissed. My best guess, she’s hurt, possibly jealous.”

  Keegan shook her head, looking off. “I’ll talk to her again.” She moved to study the readout of a small machine beside Nicole’s bed. “I’m going to order a couple of new medications, see if we can get your blood pressure and heart rate where we want them. And, I think we’ll bump up your pain meds. I don’t want you uncomfortable. Sound good?”

  Nicole nodded. “Whatever you say, Doc.”

  As Keegan positioned her stethoscope, Hyrum Broderick appeared in the doorway. “Dr. Wade, if I could speak with you. We have an emergent situation, and I need your help.”

  “Be right with you,” Keegan responded, meeting Nicole’s gaze with a smile. “You’re doing great. I’ll check back in a bit.”

  *

  “Let’s talk as we walk,” Hyrum said, moving in the direction of the ER.

  Keegan fell in step, watching for Willow along the way.

  “I’m sure that I’m not telling you anything that you don’t already know,” Hyrum began, his breathing heavy as he increased their pace, “but as a hospital we’re in dire straits, unable to recruit physicians. There’s no one, absolutely no one, that I can call in to handle a surgical emergency. I have the knowledge,” he sighed, “practiced as a general surgeon for decades, but this tremor, this Parkinson’s Disease, has ripped my scalpel from my hand.”

  Keegan nodded sympathetically. “I’m happy to help as long as I’m here.”

  “I had a sense that you would,” Hyrum responded, saying that Afton Memorial’s practice was to turn surgical patients away. “But there are times when we just can’t, your case and the one that’ll be here shortly being prime examples.”

  “I understand,” Keegan responded.

  “ETA ten minutes,” the nurse called out from her station.

  “Thank you,” Hyrum called back. “Twice in one night, unbelievable,” he said, shaking his head. “And things always happen in threes.”

  “Especially in an emergency room,” Keegan responded. “Let’s hope tonight breaks the pattern. If not,” she continued, flashing a smile, “I’m at your service.”

  “And I praise the Lord for that,” Hyrum answered, bringing her up to speed on the new case—a fifty-two-year-old male who’d been struck by a train. “Intoxicated,” he added. “Partial amputation of his left lower extremity.”

  “Scrubs, I need scrubs STAT,” Keegan said, her pulse quickening, “and my scrub nurse, she’s in the suite, I need someone to call her for me.” As she gave the order, a possible explanation for Willow’s unusual behavior came to her—Naomi. She’d arrived just after she’d left Willow in the waiting room—when everything changed.

  “On it, Doctor,” the ER nurse answered. “ETA five minutes.”

  Four hours later, in the middle of the night, Keegan emerged from surgery, having completed an above knee amputation and a subdural evacuation, feeling privileged to have saved a life. And in that instant, her thoughts returned to Willow. She removed her cap, standing in the doorway of Nicole’s room, watching her breathe. She was acting as if she was asleep, but with each breath, she gave herself away. Keegan moved closer, squatting down beside the sofa. “I know you’re awake,” she said softly. “And I know you’ve been avoiding me. And I think I know why.”

  Willow rolled to her back; her eyes red from crying.

  “I think it has to do with Naomi.”

  “I wish you’d told me about her.”

  “So, it is Naomi. I’m right.”

  Willow bit her lip, tears tumbling.

  Keegan palmed her cheek, sweeping them away. “Talk to me, I’ll explain.”

  “You don’t owe me an explanation.”

  “Well, obviously, I do.”

  “Not when you’re in a relationship with her.”

  “What are you talking about?”

  “You know what I’m talking about.”

  “No, I’m afraid I don’t.”

  “Keegs, don’t lie to me.”

  “I’m not lying.”

  “I saw you,” Willow sobbed, “saw how intimate you were.”

  Keegan’s chest ached, sitting beside her, and slipping her arm around her. “Aww, sweetie, you have it all wrong.” She kissed her temple, nudging her head onto her shoulder. “I want to explain a couple of things, should’ve already explained them. Okay if I talk, and you listen for a little while?”

  Willow swallowed, nodding.

  Keegan took a soft breath, beginning. “When a surgeon barks the name of an instrument,” she said quietly, “her scrub nurse places it into her hand. When she needs a different one, she lays it down, holding her palm upward. And in that instant, her scrub nurse anticipates her need and replaces it with a new one. That’s the way it works in the surgical theatre, the way it has to work in order to assure that surgeons remain focused in critical situations. For a surgeon’s gaze to leave the surgical field, even for an instant, might cost the life of her patient.” She peered into her eyes, her voice deepening. “Naomi’s not my lover, Willow, she’s my scrub nurse, my incredibly competent scrub nurse. She’s been my right hand in the OR for years. And for the most part, the intimacy that you witnessed was the bond between a scrub nurse and her surgeon.”

  “For the most part,” Willow echoed.

  “Yes,” Keegan said, “with the remainder being the lingering consequence of a misstep.” She dropped her gaze, lifting it sheepishly. “It’s been a year since that night, that one lonely night when I allowed my primal need to rule. And still—”

  “And still she loves you, wants you.”

  Keegan nodded. “But she knows, has known since that next morning, that what happened would never happen again, that my heart would never be hers.” She brushed Willow’s cheek with her fingertips, laying her back, and kissing her. “I could never give away what’s always belonged to you.”

  CHAPTER TWENTY-TWO

  Keegan stirred, having slept on the back sliver of the sofa. She glanced at her watch, tilting it to catch a ray of early morning light from the window. Slept, she’d actually slept for three consecutive hours, a record set in terms of recent times. She’d slept well on what must’ve been the most uncomfortable bed in the world, with her hand under Willow’s shirt, cupping her breast, and her head on the corner of her pillow.

  “Good morning, Doctor,” the night nurse greeted with a twinkle in her eyes and a knowing smile. “I trust you slept well.” She hung a new IV bag and turned off the beep. “Sorry, I didn’t get in here before the alarm sounded and woke you up.” She went on to say that she’d caught all of them except that one. “Oh well, it’s probably just as well. I’m sure you’re eager to check on your patient from last night. Last word, he’s doing just fine.”

  “Good to hear,” Keegan responded.

  The nurse moved, pausing at the door. “I’ll stop by with clean towels in a few minutes.”

  “Thanks,” Keegan answered, “and thanks for keeping things quiet.”

  “Don’t mention it,” she said, stepping out.

  Willow stirred, moving her hand to top Keegan’s, and holding it tightly against her breast.

  Keegan squeezed gently, nuzzling the back of her neck, and nibbling her earlobe. “We need to get up,” she said quietly, shifting position, and kissing her lips. “Tonight, we’ll pick up where we left off.” As her sock feet touched the tile, her eyes met Nicole’s. “Good morning. How are you feeling?”

  “Better,” Nicole said. “More than ready to get these tubes out.”

  “I’m sure, but you’re not quite there yet. Tomorrow. Hopefully, by then, you’ll be able to handle clear liquids.” Keegan stepped closer, studying the monitor at her bedside. “Your heart rate and blood pressure look good.” She lifted her gown, examining her work. “and your incision does too.”

  “You think I’ll be in good enough shape to catch the train when it goes through?”

  “I do,” Keegan responded. “Barring any c
omplications, three days in the hospital, and your surgeon in the next room on the train should make the trip safe enough.”

  “Good. I am so ready to get back home.”

  “And when you do,” Keegan said, “I want you to seriously consider the referrals that we talked about.”

  Nicole sucked in a breath, breaking eye contact.

  “Look, if you don’t address this problem,” Keegan persisted, “this, or worse, will happen again.”

  “I know, I know,” Nicole said, her expression pained, “but I have to earn a living.”

  “And you will,” Keegan said. “In treatment, you’ll learn how to do that without jeopardizing your health. The two don’t have to be mutually exclusive.” And for that split second, she thought about her own situation, considering the possibility that when it came to the issue of treatment, she might be operating under the same faulty reasoning. “We have an excellent program at NYC General.”

  “I know,” Nicole responded, “an inpatient program. I’ll think about it.”

  “That’s all I can ask,” Keegan said quietly. As she collected a towel, she saw that Willow had been watching her.

  “You’re so good with her,” Willow observed, holding her gaze with a tender smile.

  “It’s not difficult,” Keegan responded, kissing her as she made her way to take a shower. When she stepped out of Nicole’s private bath, she wore navy pants, a tailored pink dress shirt, and tan loafers.

  Willow smiled, draping her stethoscope around her collar. “Handsome; that’s what you are.”

  “Why thank you,” Keegan responded, holding her, and telling her that she was beautiful. “I shouldn’t be too long,” she said, squeezing her bottom. “You want to grab breakfast when I get back; do a little sightseeing?”

  “Sounds like fun,” Willow answered, pleased when she was back in less than an hour.

  “Okay, so should we rent a car or walk somewhere?” Keegan asked.

  “I don’t see any reason for us to waste money on a rental,” Willow responded, “not when the downtown is only six blocks away.”

  “It’s not that much, fifty bucks, tops.”

  “Fifty bucks is fifty bucks.”

  “True, but on foot, we won’t see any of the parks.”

  “Right, but with only three hours, we’re not going to see much of them anyway.”

  “Good point,” Keegan said, passing a nurse’s station. “Okay, so we’ll save the money, see the downtown on foot.”

  “Looks like you’re off for a bit of sightseeing,” Naomi called out, stepping off of the elevator, a piece of lightweight luggage squeaking behind her.

  “And it looks like you’re off to catch a flight,” Keegan responded.

  Naomi nodded, saying that she didn’t look forward to the long drive through rural Utah, that it was ridiculous to have to travel that far to get to an airport. “Too much open space for me,” she added, meeting Willow’s eye, and telling her that she’d enjoyed meeting her, hoped that they’d see each other again sometime.

  “Likewise,” Willow said, apologizing for being a bit out of sorts on the day prior. “Maybe we can do lunch one of these days.”

  “I’d like that,” Naomi answered, holding Keegan’s gaze for a long moment. “I’m happy for you,” she said, a touch of sadness in her voice. She removed a key from her ring, handing it over. “Thanks for letting me use your suite. It was beautiful. I really enjoyed it.”

  “You spent more time in surgery than you did there,” Keegan said, smiling. “I appreciate you coming, helping out.”

  “It was my pleasure,” Naomi answered, moving through the main entrance. “See you when you get back,” she called out. “Safe travels.”

  “You too,” Keegan responded, turning to Willow as the doors swished shut in front of them. “Hang on,” she said, “I need to let someone know we’re going, tell them when we’ll be back, and make sure they have my number.” When she returned, she stepped out the door, down the sidewalk, threading her fingers through Willow’s as they walked.

  Willow tugged gently, bringing them to a halt. “The building,” she said, turning to look upward, “look at the detail. It was really something when it was built, wasn’t it?”

  “It was,” Keegan answered. “I guess this doctor, Hyrum’s grandfather, had this dream of opening a hospital, built it for his wife, named it for her.”

  “That’s sweet,” Willow said, taking a soft breath. “I’ll bet it breaks his heart that they can’t afford to keep it up.”

  Keegan nodded. “Yes, but he understands the business of healthcare. Without surgeons, there are no surgeries, and without surgeries, there’s simply not enough revenue. And to make matters worse, or better depending on your perspective, a small hospital like this one is as much a social welfare organization as it is a business. A small fish in a sea of whales, Afton Memorial will eventually either consolidate or close its doors.”

  “That’s sad,” Willow said, “sad for Dr. Broderick, but even more so for the community.”

  “You’re right,” Keegan responded, moving them forward. “In a town this size, a hospital like Afton Memorial, well, it’s not only the main source of health care but also the principal employer.” They walked, admiring scenery and houses.

  “Absolutely gorgeous,” Willow commented, pulling them toward a park bench, and sitting them down. Nestled in a valley, the town was surrounded by beautiful mountainous landscapes. “It’s so different here. It’s like the polar opposite of Manhattan.”

  “It is,” Keegan said, slipping her arm around her. “In a way, it reminds me of home.”

  “I can see how it does,” Willow answered quietly. “I mean, it’s not by the ocean, but it is a small fishing town. And where your hometown was known for the Gulf and shrimp, it’s known for its lakes, rivers, and rainbow trout.”

  “And the downtown,” Keegan continued, “that’s similar too.” It was quaint with red-brick buildings, antique shops, and art galleries. She’d thought more about Alabama on this walk than she had in the past year. “Oh, and religion, that’s the same too, not the Mormon part, but the fact that it’s everywhere.”

  Willow rested her head on her shoulder. “Religious or not, everyone’s been good to us, friendly.”

  “Because they’re friendly,” Keegan asked, raising an eyebrow, “or because they’re in desperate need of a surgeon, and this lesbian just happens to be one?”

  Willow met her gaze directly. “Because they’re friendly. They’re not stupid, Keegs. They know they have no hope of recruiting NYC General’s Chief of Trauma Surgery. Trust me; they do.”

  “Maybe so,” Keegan answered, with lunchtime approaching, getting them on the move. “Okay, so they have to have a restaurant somewhere.”

  Willow pointed to an establishment on the opposite side of the street. “There’s one, right over there.” She smiled, making her way to a table. “I love this place; love how homey it feels.” Her smile widened, reading the menu. “Farm to table, organic, and sustainable.”

  Keegan took a slow, easy breath, watching her. “You are so good for me.”

  Willow’s eyes sparkled. “I am, huh?”

  “Yes, you are,” Keegan responded, watching their waitress whiz by with a breakfast platter, deliver it to the man in the adjacent booth, and return. She was older and wore her hair in a bun. “What can I get you, ma’am?” she asked, looking at Willow.

  “I’ll have the turkey on a whole wheat bun,” she said, “a side salad with Ranch dressing, and an iced tea.”

  “Very good,” the waitress said, turning toward Keegan. “And for you, sir,” she asked.

  Willow looked over, concerned.

  Keegan met her gaze in an effort to assure her that she was fine. As a tall, muscular woman who’d always worn tailored clothing, she was accustomed to being mistaken for a man. “I’ll have the grilled chicken with honey mustard, mashed potatoes, no gravy, and an iced tea with lemon.”

  “Oh, God,” t
he waitress said, flush creeping down her neck, “you’re not a sir, you’re a ma’am. I must need glasses.”

  “Honest mistake,” Keegan said, smiling.

  “I’m sorry that happened,” Willow said, watching the waitress skitter off.

  “It doesn’t bother me,” Keegan responded. “Now, if she’d told me I was pretty, asked what my husband did for a living, or tried to sell me a lipstick that matched my complexion, that would bother me. Bottom line, I’m a butch, comfortable in my own skin.” She retrieved her wallet from her back pocket, paid the check, and left a generous tip for the waitress.

  “I can’t believe you left a twenty,” Willow said with an eye roll. “She called you sir, and you left her a twenty-dollar bill as a reward.”

  “In a town like this one, chances are she’s never seen a butch up close and personal,” Keegan responded, holding the door for her to step to the sidewalk. “I want her to remember our meeting fondly.” She smiled, winking. “That, and waitresses don’t earn that much. I probably should’ve left her a fifty.” When the hospital door swished open, she stood back, allowing Willow to step in front of her.

  “See you when you finish,” Willow said, turning in the direction of Nicole’s room.

  “I shouldn’t be too long,” Keegan responded, boarding the elevator, and riding to the second floor.

  “Dr. Wade, I was just about to call you,” a nurse greeted. She was in her mid-twenties and wore her hair in a ponytail.

  “Problem?” Keegan asked.

  “Your patient, he has slight swelling, warmth, and redness at the lower tip of his incision.”

  “Let’s go take a look,” Keegan said, glancing at the nurse’s ID tag, and noting that her name was Clara. She spoke with her patient, examined him, and explained why she’d be ordering an additional antibiotic. Cellulitis was a potentially life-threatening post-surgical complication but caught early; her opinion was that it would most likely respond well to treatment. “Nice catch, Clara,” she complimented as they stepped to the hallway.