[Hearts and Health 03.0] Urgent Care

by DJ Jamison

  Trent set his fork down, looking surprised. “I am a surgeon.”

  “What? So, why …”

  Trent averted his gaze. “I needed a change.”

  “So, let me get this straight. You did become a surgeon like you always planned?”

  Trent nodded.

  “And then you decided to come to Ashe and waste your talent as a clinic physician?”

  Trent frowned. “It’s not a waste to help people. I’d think you of all people would understand that.”

  “Why me of all people?” Xavier asked, feeling himself become defensive.

  Why the hell was Trent really here? He hadn’t come back just to reconnect with Xavier. He refused to believe that. Besides, he could live in Ashe and still be a surgeon. Something didn’t add up.

  Trent toyed with his food, pushing his egg around without really eating. “I just assumed this was your dream. To help people in the community, to offer better health care. To save people like your dad.”

  Trent looked like he was worried Xavier might blow up. But in truth, Xavier was surprised Trent knew him so well. In high school, his boyfriend had been focused on his own dream, and whenever Xavier spoke about better health care access for the community at large, Trent turned the conversation to how exciting and rewarding it would be to save a patient through surgery. Can you imagine? he’d said with the enthusiasm of the young and idealistic. You’re holding someone’s life in your hands!

  “It was my dream,” Xavier admitted. “I didn’t think you ever paid attention when I talked about that. You were so focused on the excitement of saving lives on the brink of death.”

  Trent looked abashed. “That’s probably true,” he said quietly. “This kind of work saves lives too, Xav. You saw that then, and I didn’t. And if we’re honest, I wanted to be a surgeon for all the wrong reasons. Maybe I thought it’d make my parents actually pay attention to me, or maybe I was just selfish and thinking about the power and prestige it would give me. Because in my head, I was going to be one of those exclusive surgeons who gets featured in medical journals for my amazing talents.” He laughed, and it sounded slightly bitter. “Fuck, I was an asshole.”

  “So, it didn’t work out like that?”

  Trent looked up from his plate, meeting Xavier’s gaze. “It almost did. I became a surgeon. I made good money. My parents were proud for a nanosecond before they were off on their next cruise, but at least I hadn’t disappointed them. My father could brag about me to his friends. But I don’t deserve any write-ups, that’s for sure.”

  “What happened? Why are you really back here?”

  Trent pushed his plate away, giving up on eating. Xavier felt slightly bad for ruining his appetite.

  “I got a wake-up call.”

  Xavier made a guess. “Like you lost a patient or made a mistake?”

  Trent shook his head. “Not exactly. A close friend died. I realized, suddenly, how short life can be. Sounds stupid coming from a surgeon, right? Truth is, we lose patients. It’s a reality of working in an OR. It doesn’t happen every day or every month, but it happens. I should be well aware of the fragility of life. But somehow, when it was Byron, it felt different. He was just gone, and my life was empty. I had the OR, but what else did I have? Not family. Not you. Not even Byron.”

  Trent’s voice grew hoarse with emotion as he talked, and Xavier felt his own eyes mist with tears. There was so much grief in his ex-boyfriend.

  “He was just a friend, this Byron?” Xavier asked tentatively.

  An ember of jealousy burned in his chest, but he resolutely ignored it. The idea Trent might have moved on and loved another man bothered him, but he had no right to be bothered. They weren’t together, hadn’t been in years.

  Trent’s lips twisted. “Does it matter?”

  There was a challenge in his eyes, one Xavier couldn’t meet. He looked away, swallowing around the lump in his throat.

  “I guess not.” Xavier pushed his own plate to the edge of the table, no longer hungry. “It still doesn’t explain why you ran away to Ashe and changed your whole career. I mean, I get that you felt like something was missing from your life, but if you gave up surgery just to be the kind of doctor I admired—”

  “It’s not all about you,” Trent interrupted, sounding pissed. “I didn’t give up surgery for you. I gave it up for me. My life was too wrapped up in it. I hit the reset button to figure out my shit. I’m not saying I’ll never go back to the OR. I might. I just … needed something.”

  “Right,” Xavier said with a nod. “It’s stupid to think you’d make such a huge change for me. I knew that.”

  “Xav …”

  Xavier stood up, done with dinner. He wasn’t sure why he was so upset. He didn’t honestly like the idea Trent would give up surgery out of some mistaken belief it would impress him. Yet, knowing that Trent returned to Ashe as a means to escape his grief, rather than a legitimate effort to reconnect with him, hurt more than he expected.

  So much for Trent’s original claim he’d returned to Ashe for Xavier.

  “I knew you didn’t come back for me.”

  ***

  Trent rushed to pay and caught up with Xavier in the parking lot. He was walking fast down the block. They’d strolled over from the community center because it was close by, so he didn’t have a lot of time to talk to Xavier before they’d be back in Marge’s presence.

  “Xav, wait,” he said, grabbing his arm.

  To his surprise, Xavier was shaking his head. A smile was on his face when he looked at Trent.

  “Who’s selfish now, right?” Xavier said. His smile turned wistful. “You’re telling me about this sad, pivotal moment in your life, and I get upset that you weren’t moved by some sort of regret about how you left me.”

  “Of course, I have regrets,” Trent said, reaching out to touch Xavier’s cheek.

  His ex-boyfriend stepped back, out of reach. Damn. He’d screwed up again.

  “You’re grieving, and you ran somewhere familiar to you. It makes sense. I’m glad you’re doing good work here, Trent. This kind of medicine was always my dream. You’re right about that.”

  Xavier turned and continued walking toward their makeshift clinic. Trent fell into step with him.

  “You were a big part of my decision, Xavier. I wanted a fresh start, and I figured returning to the last place I screwed up royally would be a good place to do it. I didn’t know if you would be here, or if you would be involved with someone. But I knew that I wanted to make things right with you, one way or another.”

  “You don’t have to placate me,” Xavier said, pausing in front of the clinic doors. “I don’t need to be the center of your world. I don’t want to be.”

  Trent trailed him inside the door, grabbing his hand to stop him in the vestibule between the outer and inner entrance.

  “I want you in my world, though, Xav. I always have. I regretted the way things ended,” he said. “This was my chance to start over, and I wanted to start over with you.”

  Xavier started to shake his head, and Trent leaned in and brushed his lips against his cheek. He wasn’t about to push for the kind of kiss he really wanted after Xavier’s many rejections, but his lips lingered on Xavier’s skin. He breathed him in and reluctantly drew back before Xavier pushed him away.

  “I messed up my life in so many ways,” Trent admitted. “I set myself up to be alone and isolated with nothing but my job to satisfy me, and it started the day I walked away from you.”

  Xavier studied his face for a long moment. “I believe you.”

  “I’m sorry.”

  “Me too.”

  “Do you think we could ever …?”

  Xavier rolled his shoulders, looking far too tense for a good answer to be forthcoming. “I don’t know.”

  Trent looked down, disappointed. He’d given it his best shot, finally gotten Xavier to listen to an apology. It wasn’t enough, it seemed.

  Xavier’s large hands cupped Trent’s face
, his fingers spanning Trent’s cheekbones and reaching into his hair and his thumbs pressing under his jaw. He tilted Trent’s head up, and their gazes connected.

  “Maybe,” he said. “Give me some time.”

  Trent attempted to nod, but Xavier’s hands held him firmly in place. He watched, held captive but not wanting to escape, as Xavier’s lips descended on his. Xavier brushed their mouths together, just a quick appetizer of a kiss that whetted his desire for more. Even that small touch lit up Trent’s insides.

  Hope and love and gut-wrenching fear all collided. His emotions threatened to burst out of his skin, and all he could do was close his eyes and endure it.

  It was a brief, sweet kiss, but one filled with promise.

  It felt like a second chance.

  Xavier pulled back. “You forgot Marge’s dinner.”

  Trent winced, the moment broken. “I better go back and get her something.”

  Xavier nodded. “I’ll get started packing up.”

  “Okay.”

  “We’re still sleeping in separate beds tonight.”

  Trent grinned. “That’s okay. I’ll be here whenever you’re ready to move beyond arguments and kisses.”

  He left before Xavier could argue with him.

  Chapter Ten

  No health outreach would be complete without some industry networking, which is why their small team was touring the hospital in Pullman when a car rolled up outside the ER doors and lurched to a stop in a no-parking zone.

  They’d had to touch base with health care professionals in each town. They didn’t want to step on any toes, but there were also practical reasons to coordinate their efforts. In some places, they had to set up in community centers or schools, but in one or two — like Pullman — they’d been given a lesser used floor of the hospital to set up their screenings. They could also handle their patients’ lab work without the hassle of transport, a big plus.

  “Help!” a guy called, tumbling from the driver’s side door and running around the car. He appeared agitated and was shaking like a leaf.

  Thank God he stayed on the road and didn’t cause an accident on the way, Trent thought. His clothes were saturated in blood, but he was moving well. Trent noticed the orange hunting vest and his heart sank.

  This wasn’t going to be pretty, was it?

  “Bill’s shot!” the driver called frantically as he flung open the passenger door. “The gun just went off!”

  Emergency room personnel were running toward the doors, bringing a gurney for the patient. But Trent and Xavier— along with the hospital liaison, Mark Adams— were closest to the car.

  “Christ, Joe!” Mark gasped. He seemed to recognize the men. “What happened? Jesus, why didn’t you call an ambulance?”

  Mark had just given Trent and Xavier a tour of the hospital and explained it was a trauma level IV hospital. Essentially, it had emergency medical staff available, but surgery and critical care was not a given. There were a few surgeons on call who served multiple hospitals, Mark said, but for the most part they relied on transfer agreements for patients who required higher levels of care. Patients in need of emergency surgery, such as victims of severe car accidents, were usually taken directly to the hospital in Hays.

  Hays was a Trauma Level III center, similar to the hospital in Ashe, with readily available surgeons and anesthesiologists.

  The gunshot victim, an older gentleman awash in blood, was so pale Trent worried he might have already lost too much blood. A flannel shirt was wadded over his chest and stomach and completely soaked through.

  Xavier lurched forward, hands outstretched as if to apply pressure to the wound, but Trent’s training — and a good dose of fear for Xavier’s well-being — took over. He wrapped an arm around Xavier’s waist and he dragged him out of the way.

  “We should help,” Xavier said shakily, though he didn’t fight Trent’s hold on him.

  He hadn’t yet done a trauma rotation during his training, and Trent suspected he was reacting on gut instinct. Seeing that much blood could shake up a trained physician, much less a student. At least Xavier’s instinct was to dive in and help rather than shy away.

  “You don’t have gloves. It’s not safe,” he murmured in Xavier’s ear, as they watched the medical staff maneuver the man out of the car and onto a gurney.

  Trent had to bite down on his desire to shout out directions. He’d never worked in the ER, outside of a rotation during medical school, but his adrenaline was pumping.

  Mark had stepped aside, speaking heatedly with the distressed looking driver.

  “We were out in a rural area. They wouldn’t have found us easily. I thought this would be faster. He slammed the butt of his shotgun on the ground, trying to break some ice, and the sucker just went off!”

  Jesus. Gun safety, anyone?

  Mark patted the driver’s arm, obviously realizing the man was distraught and criticizing his decisions wouldn’t help anyone.

  “I understand. You did your best in a crisis. Thank you for getting him here.”

  He turned, hustling inside, and Trent and Xavier followed. Marge had taken the opportunity to skip the tour in favor of a nap, so it was just the two of them.

  Mark headed straight for the flurry of activity, where doctors and nurses were shouting out instructions to each other at a rapid-fire pace.

  “He needs surgery,” the ER physician muttered, even as the thought ran through Trent’s mind. “Let’s get some fluids in him STAT! Get him typed and matched. I need as much as we can get ASAP, people!”

  “IV’s in.”

  “Trying to reach his relatives for consent.”

  The administrator spoke up. “We have this covered. Do what you have to do in order to save him. I have called Risk Management to back us.”

  They were using Type O negative blood for transfusion because time was of the essence, but the sooner they found out his actual type, the better. One of the nurses broke off and ran to check hospital records for more information.

  “Damn! There’s internal bleeding. He needs surgery now!”

  Trent itched to stepped forward, but he was also uneasy with the idea. This wasn’t his territory. He was a stranger to these physicians, and he’d sworn off surgery for a reason. If he offered his services, would he be doing it for the right reasons or did he just want to swoop in for the attention and praise it would bring him?

  They had protocols in place for these situations, after all. Perhaps he should let it play out as it would if he weren’t there.

  “Doctor, I just got off the phone with Hays. They sent their life flight helicopter out to a big highway accident. They can’t get here for well over an hour, and that’s optimistic.”

  “Call Dr. White—”

  “He’s out of the country.”

  “Damn. Call Dr. Young, then. See how long it’ll take him to drive in.”

  Xavier nudged Trent, giving him a look fraught with tension. He knew what Xavier was thinking. The longer this went on, the more difficult it was to justify not offering his help. Regardless of how he felt about surgery, if he didn’t do this, this man might very well die.

  Xavier nodded at him encouragingly, and Trent spoke up.

  “I’m a surgeon.”

  It took a minute for the medical staff to register his presence. They were continuing the battle to stabilize the victim, transfusing blood and administering meds to counter the shock his body was experiencing.

  They continued their harried movements, still talking about protocol as they searched for a solution, until Xavier put his fingers between his lips and whistled loudly.

  They faltered, looking around for the noise.

  “I’ve got a surgeon over here!” Xavier called briskly, sounding every bit as confident as the nurses bustling around the ER. “He worked at a Trauma 1 center until recently.”

  “You can do the surgery?” The lead physician asked, eyes sharp on Trent. Already Trent could see the disbelief and relief simultaneous
ly crossing the man’s face.

  “I can.”

  “You’ve got credentials?”

  “No privileges here, but I’m licensed in Kansas.”

  The doctor brought Trent up to speed on the finer details of the patient’s exact condition and needs as Trent washed his hands and gloved up. A quick examination confirmed there was damage to the large intestine and spleen.

  “We have to do a splenectomy, which means he’ll need to be monitored quite frequently as the risk for infections are greater. Consider long-term antibiotics, hmm? Also, I’m thinking we need to do a colostomy. But I won’t know for sure until I get a better look.”

  “Good enough! Someone get the paperwork figured out. Nurse Troyer, get the doctor scrubbed up and ready for the OR!”

  After that, everything moved fast. Trent found himself rattling off information to a hospital administrator while he was hustled down a hall, so they could verify his identity and medical credentials. Then he was in the OR, going through the familiar process of scrubbing hands and arms, slipping on a gown and surgical mask, and pushing through the doors.

  A quick round of brief, no-sense introductions went around, and then the patient was being wheeled in.

  Trent’s pulse tripped as the familiar scents and sounds of the OR washed over him.

  He could do this. Surgery was in his blood and his bones and his soul. His body moved on autopilot, but his mind stalled briefly, an image of Byron’s face in his mind.

  His best friend in the world, the guy he’d studied with and competed with in medical school and interning—then bonded with and loved like a brother once they were in their own posts and earning the accolades of their peers— had given everything he had to this profession.

  Surgery had gotten inside Byron, just as it had Trent, to devastating effect. It had been a cancer that ate away at his peace of mind and destroyed his sense of self.

  Trent honestly wasn’t sure if returning to the career that had killed Byron was a tribute or a betrayal of his memory. He only knew that Byron never could have stood by and watched someone die.

  And neither would he.