by Annie O'Neil
“It’s all right, Maddie. Let’s get you up on the gurney, honey.” She looked at Michael, who had arrived back at Maddie’s other side. “On three.” They eased Maddie up and onto the gurney on her count. “Right! Let’s check you out. I’m going to have to lift up your shirt, and it’s pretty cold out here. Are you sure you don’t want to go inside?”
“No!” There was no mistaking the determination in the girl’s voice. “Where Eustace goes, I go.” She twisted suddenly, trying to get a better look at her pricked-eared pal. Her eyes tightened with pain. “It hurts to breathe.”
Fear suddenly entered the little girl’s eyes. She couldn’t be more than eleven...but Katie was sure an old soul was fueling her.
“Lie down again, hon. I think you might’ve bruised a couple of ribs. Michael, could you get me a couple of blank—?”
“Already on it, Doc.”
Katie rucked up Maddie’s shirt, relieved to see the bleeding was from a gash and nothing more. But in a dirty livestock trailer? They’d have to put a booster tetanus shot on the girl’s tick-list as well.
She tried to go for Josh-casual. “Say, it looks like you and Eustace are both going to be getting stitches tonight.”
A grin lit up the girl’s face. “Really?”
Hmm... Josh-casual obviously works.
A sting of guilt shot through her at the words she had flung at him when things had seemed too dark to continue. Reckless. Unthinking. Careless. Maybe his laissez-faire attitude had been to soothe her. To comfort her in a time of great sorrow.
She swallowed hard and continued her examination of Maddie.
“That hurts!” Maddie yelped.
“That’s your rib cage acting up. Where exactly were you when the accident happened?”
“With Eustace.”
Katie’s eyes widened, her suspicions confirmed. Well, that was just about as health and safety unconscious as things got.
“And your parents let you ride in there?”
Maddie’s eyes began to dart around the covered area. “Not exactly...”
“Who was driving the tow vehicle?”
“My bro—” She reconsidered giving the information, swallowing the rest of the word. Tears sprang into her eyes. “Am I going to get in trouble?”
“No, honey. Of course not. But riding in trailers with live—with Eustace—isn’t really legal.”
“Are my brothers going to jail?”
Katie’s eyes shot across to meet Josh’s, but he was one hundred percent focused as stitch after stitch brought the sides of the cut on Eustace’s rump neatly together. She had always loved watching Josh’s hands at work. They were large, capable hands. The intricate work they completed with skillful dexterity always surprised her.
Just as easy to picture him whipping a lasso into action as he had when he was a boy as it was to see him deftly tying a miniature knot at the end of a row of immaculate stitches as he was now.
“Probably best if you keep pneumonia out of the symptoms...”
Josh didn’t look up as he spoke, but he had always had a second sense for when Katie’s eyes were trained on him. She stiffened. It wasn’t often he had to remind her to keep her eye on the ball. The role reversal didn’t sit well.
“Maddie?” Josh raised his voice a bit. “Eustace is doing pretty good, here. Mind if I snaffle him some carrots from somewhere, then let him have a bit of a lie-down in the trailer?”
“That would be nice.” Maddie sniffled, her fear and pain visibly kicking up a notch. “There are carrots already in the trailer.”
“Michael.” Katie snapped into action. “Let’s tuck these blankets round Maddie and get her a tetanus shot before bringing her up to X-Ray, please, to check on her ribs. Maddie, honey, Michael’s going to need your parents’ phone number so we can get in touch—just to okay any treatment you’re going to need, all right?”
“You’re not going to let them arrest my brothers, are you? We just wanted to get to the nativity early!”
Tears began to pour out of Maddie’s blue eyes and Katie’s heart all but leaped to her throat. There was such love and protectiveness in her words. “Why don’t we take things one at a time? We’ll call your parents, sort you out, and then deal with everything else as and when it happens.”
“Do you think there will be an angel looking after my brothers?”
“Dr. McGann?” Jorja stuck her head through the sliding doors. “That second ambulance is incoming.”
“I sure do, Maddie,” said Katie. And she meant it. “This is Michael—Dr. Rainer. He’s going to take you up to X-Ray. We’ll see you in a little bit, all right?”
“Okay...” The young girl snuffled. Her head turned to find Josh within sight. “Thanks for looking after Eustace.”
“You bet, kiddo. It was my pleasure.” Josh flashed her one of his warm smiles and gave her arm a quick squeeze before Michael and a nurse wheeled her off to the ER.
The wail of the sirens grew louder and Katie ripped off her protective gloves, quickly wiggling her fingers into the fresh pair one of the nurses handed her. If she’d thought things had been busy earlier, they were going into full-time Christmas Eve Crazy now the sun had set.
* * *
“Teenage male, presenting with multiple leg injuries and compound fracture to the wrist.”
“Got it.” Josh helped unload the gurney along with the EMT. This was Chris, Maddie’s older brother.
Josh took in the EMT’s rattle of information as he scanned the teen’s face again. Chris couldn’t have had his first whiskers for long, let alone gained much experience behind the wheel in a snowstorm.
A nurse met him at the doors and took over as the EMT finished reeling off the treatments Chris had already received. His injuries were severe. Compound fracture to the femur. Possible compression to the ankle. Severe dislocation of the knee. And who knew what muscles and ligaments might have been torn or burst? He’d be off that leg for months. Minimum. From the looks of the blood loss and extensive damage, the boy would need to be in surgery sooner rather than later. No time to wait for parental consent.
“Right, we’d better take a look at the mess you’ve made of yourself.”
“Where’s Maddie?” The boy’s eyes were wide with panic.
“It’s all right, buddy. Maddie is up in X-Ray. Looks like you messed your leg up pretty well.”
“Where’s my brother? Have you seen Nick? Where’s Maddie? Is Eustace all right?”
A gurney went past with one of the interns at the helm. The keen one. Shannon...? Didn’t matter.
“Hey, bro!”
Another teenage boy called from a gurney as he was wheeled past. Blood was smeared all over his face and winter coat. This was obviously the one with the broken nose.
“You haven’t given them Mom and Dad’s number, have you?” he shouted, before his gurney turned the corner to one of the triage areas.
“No way—what do you think I am? An idio—? Ow!” The scream Chris emitted filled the corridor, and just as quickly as the howl of acute pain had taken over the soundscape, it disappeared as Chris lapsed into unconsciousness.
“Anyone think to check on the femoral artery?”
Josh didn’t know why he was asking. There was blood everywhere, the EMTs were long gone, and the nurse had been with him for no more than a few seconds.
“Let’s skip triage and get straight up to surgery—”
“Only for a handover.” Katie’s voice broke in.
“This guy’s going to bleed out if we don’t get him on a table fast. And who knows what sort of filth is in that leg? Time’s against us, Katie.”
“Yes, it is. And that’s why we’re going to let one of the orthopedic surgeons cover this one. They’re already prepping the room.”
Josh
nodded curtly. He thrived on make-or-break surgery, and if there was one person in the world who knew that was true of him, she was standing right there looking the picture of officiousness.
“We need you in Trauma, Josh. There are more patients incoming. The rescue crews only just opened up the car that got hit by the snowplow.”
“Understood.”
And he did. Katie did prioritizing. He did gut instinct. It was why they had always worked together so well. The yin to the other’s yang. Sure, there were fiery moments—but balance always won out in the end.
Well... He watched as she flew past him into one of the cubicles, where a patient could be heard arguing with one of the nurses. He scrubbed his jaw hard. Balance hadn’t always won out in the end.
He gave the nurse on the other side of the gurney a tight smile.
“Let’s get this whippersnapper up to surgery so we can get back for the incomings.”
“You bet, Dr. West.”
* * *
“Mrs. Wilson goes into Three and Mr. Wilson into Four.” Katie was issuing directions faster than a New York traffic cop in rush hour. She was in a fury. The Wilsons had been the hardest hit but had been the last to be brought in.
“It took the fire crew a while to dislodge their car from the snowplow.”
“One more patient incoming!”
Michael was hurtling down the corridor with a gurney. Gone was his quiet, serene demeanor. He looked near wild with panic. For an instant Katie thought the gurney was empty and that her reliable intern had all but lost the plot entirely—until she saw the tiny figure lying on the gurney. A little girl. She looked about three.
The same age her daughter would have been if she had lived. The hollow ache of grief began to creep into Katie’s heart. Josh appeared on the other side of the gurney. Great. Just what she needed. The one person in the world who could make these feelings multiply into Infinityville.
“What have we got here?”
“Three-year-old girl presenting with abdominal bruising and pain, blood in the urine, internal bleeding—suspected trauma to the left kidney.”
Michael rattled out a few more details as they raced the gurney toward the trauma unit.
“Can we get her into OR Two with Dr. Hastings?” Katie kept her eyes trained on Michael. This was a nightmare blossoming out of control.
“Nope. He’s busy with an emergency appendectomy.”
This little girl couldn’t wait. If her kidney was bleeding out, she needed surgery immediately or she would die. Her eyes flicked from Michael to Josh.
“What about Dr. Hutchins?”
“They’re all busy, Dr. McGann.” Michael churned out the information, oblivious to the emotional storm brewing between Katie and Josh. “We’ve prepped OR Four for you. Do you need me to assist?”
Katie’s eyes widened. She blinked, doing her utmost to wear her best poker face. All the other surgeons were busy. She’d have to do it—keep this child alive. She felt her hands go clammy as they clutched the side rails of the gurney. Her heart rate quickened and she knew if she looked into a mirror right now she would see her pupils were dilating.
“Are you up to doing a nephrectomy?” Josh’s voice was low. Not accusatory—the tone she would have used for someone out of their depth. Safety was paramount, particularly with lawsuits swinging like an evil pendulum above their every move these days.
“Of course!” she bit back.
Josh accompanied her, uninvited, into the lift on the way to the surgical ward, dismissing Michael from gurney duty with a smile.
“It’s a routine surgery. I did one last week.”
But not on a child...a little girl. And not with you here.
Katie didn’t dare meet his eyes. If she was going to keep it together to save this little girl’s life, a shot of Josh’s deep blue eyes was exactly what would have calmed her three years ago. That time had long passed. Even so, she could almost see her heart pumping beneath the scrubs she’d tugged on after Snow-Angel-Gate.
She couldn’t help herself. As the doors slid closed and the pair of them were left alone with their tiny patient, she lifted her eyes to meet his. They said everything she had wanted to see in them when they’d lost their little girl.
I’m here for you. You can trust in me. Let me help you.
“Don’t worry. I’ve got this.” Katie ripped her eyes away from his. “You should go back down. If anything major happens in the ER—”
“If anything major happens in the ER,” he interrupted, “they will page us. I’m staying with you.”
“What are you saying, Josh?” Katie couldn’t keep the disbelief out of her voice. “Are you saying I’m not up to this?”
“No,” he began carefully. “I’m saying you’ve had a long day, a couple of shocks, and whether you like it or not, you need me by your side. I’ll just stay for a minute or so—until you get going.”
The elevator doors opened before Katie could reply. Which was just as well. Because what could she say other than You’re right?
She had struggled over the past three years, doing operations that reminded her of her little girl and the life she might have had. Earlier on she’d deftly handed over any critical surgeries on young children to her colleagues. Just being responsible for the delicate life of a child had been too overwhelming—her own body had proved she didn’t have what it took to care for one. But in the past year she’d taught herself to close down—to behave like the clinician she was.
But with Josh here...? Game-changer. She had to prove to him she was over it. Over him. That she had moved on from the loss of their child.
Elizabeth.
Elizabeth Rose West.
A beautiful name for their darling little girl, who was nothing more than a statistic now. One out of seventy mothers give birth to a stillborn baby in America every day. The volume of that annual loss was almost too much to bear. She’d never even bothered to check the statistics on failed marriages in the wake of such a loss. Just shut it all out and moved away.
Katie gritted her teeth and gave her head a quick shake. Cobwebs and history didn’t belong in there now. This child’s life depended upon clear, swift thinking.
The anesthetist met her at the OR door for a quick handover. “A necrotomy?” He tipped his head toward the little girl.
“’Fraid so.” Katie tried to keep her tone bright.
“Well, you did a great job with the last one—no reason this should be any different.”
“Thanks, Miles. I appreciate it.”
“Well, if you’ll both excuse me, I’ll go in with the patient and get the anesthetics in order.”
“Sure thing. Oh! This is Josh. He’s—” Er...my husband, and I still love him, and...
“Dr. West.” Josh jumped in to rescue her. Again. “Locum over the holiday period. I would shake hands, but—” He gestured at the gurney he was trying to navigate into the OR.
“Miles Brand. Good to meet you.” He took over moving the gurney, along with a nurse who had materialized from the OR. “Let’s get this girl inside and on the table, shall we?”
“I’m going to scrub in while she’s prepped,” Katie said needlessly after he’d left.
“I’ll join you,” Josh offered with a soft smile.
An encouraging one. One she should graciously accept. Because what was happening right now was ticking all the I’m-Not-Ready-For-This boxes she’d systematically arranged in her brain’s no-go area.
“Thanks.”
They pushed into the scrub room together, shoulders shifting against each other’s as they had back in the day.
Josh allowed himself a millisecond of pleasure before he realigned his focus. Covert calming. It was his specialty.
“What’s the layout here?”
�
�Near enough the same as Boston,” Katie answered, pointing out the shelves that held surgical caps and masks.
Their eyes met as she tugged on a standard blue surgical cap.
“Where’s the one I got you?” It had been covered in wildflowers. What she smelled of, he’d told her when she’d unwrapped it.
“In the wash.”
Her eyes flicked away and he knew she was lying.
He tried not to notice her tying on her face mask in an effort to hide the painful thickets of emotion she was stumbling through.
Never mind, sweetheart. I feel it, too.
Stepping up to the sink, they both let muscle memory take over. The warm, steady flow of water was the predominant sound in the room as he and Katie took a good five minutes to systematically wash and scrub, first their nails, then their hands, which they held above the level of their elbows to prevent dirty water from dripping onto them.
Josh hit the taps with his elbows when they’d both finished. Katie nodded at the stack of sterile hand towels—one for each arm.
“You sure you’re good?” He handed her a towel.
“Medicine is the only thing I am sure of these days.”
Two nurses pushed into the scrub room with gowns before he could reply. There was room for hope in her response. Room to believe he was right to have sought her out. His lips parted into a smile for which he received a quick, grim nod.
Fine. He felt he’d been thrown a buoy. He could work with a nod.
* * *
She could do this, Katie silently assured herself. She’d done it before, and she would do it again.
“Arm,” instructed the surgical nurse.
Katie stuck her arm into the sterilized blue sleeve and made a one-eighty twist to fully secure the surgical gown around her, finding herself standing face-to-face with Josh while his gown was tied. He arched an inquisitive eyebrow.
Are you ready? it said.
She arched one back. Hadn’t they been through this?
“Left hand, please, Dr. McGann.”
She lifted it up and widened her eyes to a glare. Why didn’t he stop smiling?
“And the right.”
