Career Girl in the Country / the Doctor's Reason to Stay

by Fiona Lowe

  He reached out and took both her hands into his. “That’s the last possible alternative, Edie. To save that child’s life, if that’s what it comes down to, I know you can do what you have to do. And I’ll be right there with you. But we’re going to look at other alternatives first. I’m not going to take that little girl’s arm without exhausting every other possibility. I promise you.” Ever so gently, he brushed a strand of hair back from her face. “I’ll be with you, Edie, no matter what happens.”

  His voice was so calm, so reassuring she wanted to believe him. Something in Rafe inspired her to be more than she was, to see capabilities in herself more than she had. “I know you will,” she whispered, fighting hard to keep the trembling out of her voice. “But I’m not sure if I can.”

  “My aunt trusted you with the ominous task of turning me into the father she thought I could be, and that speaks volumes. Actually, it shouts volumes.”

  “You know about that?”

  “Of course I know about that.” He tilted her face up to his. “I trust you to help me, Edie, not because my aunt trusted you but because I trust you. You can do this … we can do this. But I won’t force you to go back in there with me if you don’t want to.”

  “When you get back in there, you’ve got three minutes,” Brassard reminded them.

  This time Edie paid no attention to the fire chief. “I’m going in with you, Rafe,” she whispered, her voice still shaky. This was nothing she’d ever prepared herself to do, but Rafe gave her confidence. And that confidence grew as she felt Rafe right behind her on her way in. “Hi, April. My name is Edie, and I’ve come to help get you out of here. I know you’re scared, so I brought you a little friend to hold on to while Dr. Rafe and I take care of you.” April took hold of the bedraggled teddy with a fierceness that told Edie she was a tough little girl. “So, what I need to know first is where you hurt the most. Can you tell me?”

  April nodded. “My arm. It’s stuck. And there’s something in my tummy, on the side.”

  Edie rolled a little to her left, wedged herself back against another of the seats that had broken loose, and aimed her flashlight at April. That was when she saw it … something wedged into the child’s side, just above her waist. Maybe part of the metal bracing broken off one of the seats?

  “Two more minutes,” someone outside shouted.

  “Rafe,” Edie said calmly, trying not to alarm the child, “April has a tummyache. I think I can see the cause of it.”

  “Where?”

  “Left side, just above her waist. Metal bar of some sort, I think. Wedged in, can’t tell how deep.” She waited for his response, waited for him to tell her what to do, but what she heard instead was an utterance of profanity under his breath. So she continued to talk to April. “Can you wiggle your fingers, April? Just your fingers, nothing else.” Edie shifted the position of her flashlight so she could watch April’s reaction, and what she saw for a moment was a child putting forth every effort she had—frowning, biting down on her lip, squeezing shut her eyes to concentrate.

  “A little,” April finally said, with great effort. “My thumb a little, and I think my first two fingers. My others feel … yucky.”

  “How yucky?” Edie asked instinctively.

  “Like they’re not there.”

  Edie cringed inwardly, and Rafe gave her a supportive squeeze on her shoulder. “Are they sticky?” he asked April.

  “Some.”

  “And cold?” he continued.

  “Yes. And they hurt all the way up my arm.”

  “Pain is a good sign,” Rafe murmured into Edie’s ear, then continued, “When we get her loose, we’ve got to stabilize the metal bar in her side before we move her out. Just make sure we don’t bump it or dislodge it somehow.”

  Those words sent cold chills up Edie’s spine, almost as much as Chief Brassard’s one-minute warning did. “Let me get her BP before we do anything else, and maybe you can figure out how to take care of her arm in the meantime.” She wedged herself in a little closer to the girl. “April, I’ve got to check your blood pressure. It’s going to pinch a little, but it only lasts a few seconds. The reason we do this is so we know how well your heart is sending the blood flowing to all the places in your body it needs to go.”

  “So you can fix me up when I get my arm out?”

  Edie felt a knot catch in her throat. That was what she wanted, what she was praying for, but the two things she’d never do were offer false hope or lie. Which was why she chose her words carefully. “So we can give you the best care when we get you out of here. OK?” The knot almost choked her as she spoke, but she was going to hold on to hope … because of Rafe. He would do everything possible to help this child, and to assure the best outcome. She believed that with all her heart.

  “OK,” April agreed. “But I’m getting sleepy. I want to go home.”

  Sleepy meant shock. With her limited medical training, Edie knew that, and it worried her. “Soon, sweetheart. We’ll get you home as soon as we can. In the meantime, just try and hold as still as you can, and be very quiet, because I’ve got to listen through these.” She held up the stethoscope, then impulsively placed them in April’s ears and placed the bell on her own heart. “Can you hear it beating?”

  “Yes,” the girl said, almost mesmerized.

  “That’s what I’m going to be listening for in you, only in a different place. I’ll bet you didn’t know that there are places all over our bodies where we can either feel your heartbeat or listen to it.”

  “Will you show me?” April asked, almost timidly.

  “When we get you out of here, and after the doctors at the hospital have had a look at you, I will definitely show you. So.” She held a shushing finger to her lips then twisted slightly to look back at Rafe, who handed her the blood-pressure cuff.

  “You’re doing a good job,” he whispered, as she took it from him.

  She hoped so, hoped that wasn’t just Rafe trying to be encouraging. “How do I do this? I know how to take a reading in the arm, but not in the leg.”

  “There’s not much difference. It’s all about the positioning. What you need to do first is bend the knee of her right leg, and try keeping her foot flat, without twisting her abdomen. Actually, let me move over a little so I can work with her foot.”

  He scooted back, brushing against her, and even in his slightest touch she felt his strength rush through her. Edie hoped her shiver was imperceptible to him, even though to her it was massive, shaking her down to her very essence. “So I strap on the cuff next?” she asked.

  “Make sure the bottom is about an inch above April’s ankle then put the stethoscope on the dorsalis pedis artery. Find that by placing your finger halfway between the inner ankle bone and the Achilles tendon. Let me know when you’re there.”

  Knowing such a little thing may have seemed simple to Rafe, but to Edie his knowledge was awe-inspiring. “I feel it,” she said, when she’d finally located the pulse.

  “Good. Now listen. Most of the time you’ll be able to hear it pretty easily. Sometimes, in about two to three percent of healthy people, the sound can’t be heard in one or both legs, though. Pump up the cuff like you would in the arm, and listen.”

  Which was exactly what she did. “Ninety-four over fifty-six,” she said, then heard an audible sigh of relief from Rafe.

  “Time’s up. Everybody out!” Brassard yelled. Edie and Rafe both ignored the warning. “A little low but, all things considered, not bad,” he finally said, as he reached over Edie and took the cuff and equipment. “Now, the next thing we need to do is pack some gauze around her abdominal would to make sure nothing moves.” He handed several wads of gauze over to her. “Just be gentle. Build up enough around the metal bar so we reduce the risk of bumping it when we finally pull her out of there, then tape the gauze into place.”

  “I said, get out!” Brassard yelled.

  “I like my job a whole lot better than I like yours,” she said, placing the firs
t of the gauze. Her fingers trembled, her gut churned. She bit down on her lower lip, concentrating so hard she could taste her own blood. “How will I know if it’s good enough?”

  Rafe gave her a little squeeze on the arm. “It’ll be good enough, Edie. Trust me, you’ll do a good job.” His squeeze was a squeeze of triumph, maybe of relief … whatever it was, it caused her confidence to soar. Rafe was definitely in charge here, and one way or another, he would make things work for April.

  “Get the hell out of there!” Brassard yelled again. “Right now, or I’m sending in one of my men!”

  They both ignored him again. “Well, I think I’ve got as much gauze taped in as I can. What’s next?”

  “What’s next is that I’m going to go out and let Chief Brassard know he can’t start cutting. Not the van, not.” He nodded toward April. “I’m going to persuade him to give us more time. You going to be OK in here for a minute?”

  “We’ll be fine,” Edie said, wiggling into a more comfortable position, grateful she wasn’t spooked by cramped spaces, because this was about as cramped as she’d even been in any space. Cramped and now dark.

  “What’s it looking like in there?” Rick asked even before Rafe was all the way out.

  “Child’s stable. Talking. Scared, but Edie’s handling that. Haven’t been able to evaluate her arm yet, but she does have some kind of a rod stuck through her belly, and as there’s no significant bleeding to go with it, I’m thinking tamponade.”

  A diagnosis that caused Rick to suck in a sharp breath. “Well, I’ll get the OR ready for that one. And her arm …”

  Rafe shrugged. “Don’t know enough to give an educated guess at this point. But what I need for you to do is hold off the fire department for me. Don’t know how, don’t care, but there’s no way in hell I want them taking that van apart, not when I’ve got a kid in there with a rod through her belly. And she’s too alert to take off her arm, especially when I don’t think it needs to come off. We need to find a way to get her out without jostling her, and while I know the guys out here are doing the best they can, there’s got to be another way.”

  “Done,” Rick said. “Anything else?”

  “More light, if we can manage it.”

  “Done,” Rick repeated.

  Rafe would have asked for more space, but it didn’t matter. For now he was stuck with a good case of claustrophobia, and there was nothing he could do about it. “Oh, and while I don’t see anything to indicate it, prepare for crush syndrome, just in case. I have an idea we may get lucky with that one, but I don’t want to get everything else right and have that go wrong on us.” A smile twinkled in his eyes. “Oh, and if you have to cite crush syndrome to the fire chief as a reason why we can’t rush getting April out of there, do it.” Crush syndrome was where an extremity or other part of the body that has been trapped for a long time could start causing other problems throughout the body with the release of dangerous chemicals at high levels. Shock at the immediate release was almost always a given. Kidney failure could result, as well as death. It was a little devious using that because he was fairly certain April didn’t have it, but any excuse in a storm. And crush syndrome was a good excuse. “Also, since I have every confidence that you’re going to buy us more time, I’d like to get an IV started in April before we do anything” A tall order for a limited space. It was going to be a challenge.

  “I’ll get the supplies ready to go in. Oh, and Jess called. He hadn’t heard from you, and his phone clicked off. Said to call him when it’s over.” He started to turn away from Rafe, but turned back. “I thought about it, by the way.”

  “What?”

  “The apology, the offer.”

  “Now’s a hell of a time to bring it up,” Rafe said. “Especially if you want to negotiate something.”

  “No negotiation. Accepted. All of it.”

  In response, Rafe arched his eyebrows. “Light sedative, too,” he said, then spun round and went straight back to the van.

  “I think we need a better vantage point,” Edie called out to him. “The extra lights are good, but I think we need to have a look at her arm, and do it from somewhere between the seat and the floor?”

  “Then that’s what I’ll do,” he said, gritting his teeth, knowing that he was going to have to shove himself into an opening where he didn’t fit. “Look, Edie,” he began once he was back in the van, “there’s something I’ve got to tell you … something I hope to God doesn’t cause any problems here.” He paused a second, then continued. “I’m claustrophobic.” “A lot of people are.”

  “Not like me. I’m claustrophobic to the point of panic attacks. My old man used to lock me in a closet. Made me spend hours there. On a couple of occasions, days. Most of the time I’m OK dealing with it, but in tight spaces …”

  Edie rolled over and squeezed Rafe’s hand. “We’ll deal with it,” she said.

  And that was all she had to say, because he knew they would. Together.

  “It feels like the walls of hell are closing in on me,” Rafe panted, slithering his way into a tiny space at the back of the seat. He couldn’t see, didn’t really fit, was sweating in a way he’d never sweated before, and holding his breath in such long spurts his lungs were beginning to hurt. His lip was bleeding from biting down so hard, his muscles already aching from extreme clenching, and the panic headache pummeling him had such a loud, thumping beat to it he was surprised Edie couldn’t hear it. But after five minutes he’d cut away significant snippets of seat, and for that he was relieved. April was still doing well. Sleeping now, with an IV anchored in her leg, and a small amount of sedative to keep her relaxed.

  “You OK?” Edie asked for the hundredth time.

  “I’d rather be eating a baguette at Le Pain Merveilleux in Paris. But as that’s not an option, I’m doing fine.”

  “You’ve been to Paris?”

  He reached up to cut away another strip of seat vinyl then rose up and shone a light down into the seat’s exposed innards. “Twice. The first time was all work, no play. Medical conference. Second time I decided that all work really wasn’t the best thing to be doing in Paris, so I indulged in some of the finer things … the wine, the museums, the food …”

  “The women?” she asked.

  He chuckled. “As lovely as the women of Paris are, and they are some of the most beautiful in the world, I decided to make it an adventure for one. It’s easier that way. No one to fight with over where to go or what to do. No one to tell me when to take a nap if I wanted one, or not to drink so much wine, if that’s what I had a mind to do. Doing Paris as a single really wasn’t so bad,” he said, pulling himself into a better angle and fighting off the panic that wanted to slap him down the instant he realized he was stuck in there as tight as humanly possible, with nowhere to go, or even move, unless he wanted to back out. At this point, he was in so tight he wasn’t sure he could even do that.

  “But wouldn’t it have been wonderful to do Paris with someone you loved, someone you could share the adventure with, who didn’t care about your naps, or drinking too much wine?”

  “Maybe,” he said, feeling an increase in his heart rate, feeling the tightening of his muscles, as each and every one started clamping down on him in some kind of conspiracy. No air to breathe … He tried, sucked it in greedily. Shut his eyes, tried to focus. “If that person … existed. But she … doesn’t. At least not … for … me.”

  “So you’re an avowed bachelor?” she continued. “I mean, I understand the no-dating thing. But no nothing? Not ever?”

  “Something like that,” he forced out, sounding winded.

  “But wouldn’t an avowed bachelor still like some consistency in his life? Maybe not in the form of a wife, or even a permanent adult relationship, but what about a child? They keep you young, you know. Change your focus. Give you balance. Make you more giving, I think.”

  Why the hell was she prattling on about this now? He was in the throes of a damned panic attack, and s
he was starting up on him adopting Molly.

  “Can you even imagine the sense of accomplishment you could feel once you’ve raised that child, and she’s turned out to do something huge, like invent the drug that will cure cancer, or teach the world how to achieve global peace? I mean, one little child, in the right home situation, with the right parent, could do so much …”

  He shut his eyes for a moment, reined in his anger. She had him trapped—now she was doing the hard adoption sell. “I can’t raise Molly, if that’s what this is about. I’ve told you that. I can’t … won‘t do it.”

  “Even though you’re bound to be desperately lonely in your old age, considering the way you isolate yourself?”

  “My choice. I isolate myself because that’s what I choose to do.”

  “And who knows how you’d feel if you opened up a little, took Molly in, raised her as your daughter? She’s a wonderful little girl, Rafe. Give yourself some time to get to know her, and I promise you’ll see how fantastic she is. She’ll make you better in ways you’ve never thought could happen.”

  He glanced down into the seat parts and saw … was that April’s hand? Quickly, he shifted slightly and repositioned the flashlight for a better look. “I know she’s a wonderful little girl, and I know that adopting her is what everyone wants me to do, but.” He pressed himself tighter into the seat until the edge of it nearly cut off his breathing. “I see it,” he said. “Her hand, her arm … I can see the whole thing. And. Thank God for small miracles. Her arm is fine. It’s only her hand that’s trapped, and I think. Hand me the oil, Edie.”

  She handed him a bottle of lubricant that had come in with several other medical supplies then positioned a flashlight from her place down below. “I’ve got the IV steady, and I’m holding on to April, supporting her belly so that metal rod doesn’t move, so do what you have to do.”

  Which was what he did. He maneuvered April’s hand out of its trap. Gently released each of her fingers, one by one, then moved on down the hand until he’d finally extricated her wrist. No words spoken, no whispers, no gasps. Simply swift efficiency when it was clear what was required of him to assure that April Crowley’s life was going to go forward beautifully, after a fair amount of reconstructive surgery and rehabilitation.