The Nightshift Before Christmas

by Annie O'Neil

  Katie raised her hand, holding her arm taut as the nurse tugged on the glove. The other nurse was clearly pleased she had won Josh in the surgeon crapshoot.

  “Thank you, Marilyn. Merry Christmas to you.”

  “Merry Christmas to you, too, Dr. West.” The nurse giggled.

  Katie frowned. How on earth did he know Marilyn?

  She had half a mind to step across the small room and lick Josh’s gloved hands, rendering him unclean for the surgery.

  Childish? Yes. Something the head of the ER should do right before surgery? Probably not.

  There was a life to save—and she was going to be the doctor who saved it.

  CHAPTER FIVE

  “ARE YOU DOING it open or laparoscopically?” Josh kept his voice low and steady. Curious.

  “Open.”

  Katie’s eyes flicked to his as he skirted the periphery of the surgical team gathering in the OR.

  “Unusual.”

  Not for his girl, but he knew she was always at her calmest when she talked systematically through her surgery.

  Katie nodded. Blinked. His heart skipped a beat before she responded in a clear voice.

  “Not in a trauma like this. Laparoscopically is better for routine.”

  She wasn’t saying anything he didn’t know, but with a team of people in the room, communicating with a nod or a look wasn’t good enough. Everyone had to be on the same page or mistakes would be made.

  “There is potentially a lot of other damage in here, and we’re better off with a clear view of what we’re dealing with.”

  “Rib removal?” one of the surgical nurses asked, indicating that she wanted to have the correct instruments to hand.

  “Hopefully not, but one could’ve been broken on impact. We’ll have to check.”

  Katie was grateful other members of the OR team were chiming in. She knew Josh’s steady, careful breakdown of the steps in the guise of “reminding himself” was to keep her mind off the tiny body lying on the operating table. Josh could have done this surgery in his sleep. So could she. And he was just reminding her of what was true.

  “A partial nephrectomy with so much damage could lead to the need for another surgery,” Katie continued. “I don’t want that for her. I won’t know until I see the damage, but radical is the best option to keep things minimal for—”

  “Casey,” volunteered one of the nurses as the little girl’s body was stabilized for Katie to make the first incision. “Casey Wilson’s her name. The parents sent up her information when you were scrubbing in.”

  Perfect. A name. Just the way to keep it clinical.

  Her grip tightened on the scalpel. “I’m preparing to make the incision.”

  “The bruising certainly indicates massive trauma.”

  “The EMTs said the snowplow hit her side of the car. She’s lucky to have survived at all.”

  Katie shook away this new piece of information as she made an eight-inch cut from the front of the girl’s soft belly to just below her small rib cage. Her mind began to take over, and her heart beat with a steadier cadence. A clock could have marked time with her breaths.

  Massive trauma to one kidney. The other, thankfully, was untouched.

  She switched instruments and began to cut and move muscle, tiny pieces of fat and the collection of tissue that held the kidney in place. It was steady, systematic work. A glance at the stats here. A minute cut and stitch there. Updates from the nurses. Eyes fastidiously avoiding the tiny little girl’s head, just beyond the surgical drape. A vague awareness of Josh moving opposite her at the surgical table.

  As she guided her hands through the surgery, it hit her how quickly she’d lapsed into deriving comfort from Josh’s rock-solid presence across the table from her. From the moment before she’d stepped into the OR, when fear had threatened to compromise all that she worked so hard for, even the tiniest of tremors she had felt in her hands had left her. And something deep within her heart told her it was having the man she’d once believed to be the love of her life with her.

  She flicked her eyes up to meet his. Blue, pure, unwavering. He nodded before returning his eyes to the operation. There was severe bruising along Casey’s rib cage—no doubt from the seat belt—but the kidney seemed to have taken the bulk of the trauma. Katie worked her way around the tiny organ, taking particular care to properly clamp and seal the blood vessels before ultimately and successfully removing the kidney.

  Textbook.

  “You want me to close?” It was an offering, not a doubt about her ability.

  Katie shook her head. “I’m good.” She’d made it this far. She was going to see it through.

  Again, muscle memory took over as she pulled the surgical area back together, minus the small kidney, with a series of immaculately executed stitches. She ran the nurses through the aftercare before allowing herself another glance across the operating table.

  “See?”

  Josh’s blue eyes twinkled at her. Katie could tell from the crinkles round them he was smiling.

  “You did it.”

  * * *

  “You ready for Secret Santa?” Jorja, despite nearing the end of a sixteen-hour shift, seemed just as sprightly as she had when Josh had first met her.

  Was she rechargeable?

  “Sure thing.”

  “We’re all meeting down at the central desk at midnight.” Jorja’s hand shot up to cover her mouth as she stifled a yawn.

  Ah! She was human.

  Josh kept a good arm’s length between them as they walked down the corridor toward the ER. He didn’t want any more misunderstandings under the mistletoe. He’d tried dating a couple of times after he’d decided the only way forward was moving on, but had never got past ordering a drink before faking a pager call. Cheap trick, but faking affection would have been worse.

  But that didn’t mean he couldn’t be chatty.

  “This was a long shift for you. A double?”

  “No longer than yours.”

  She nodded her head in acknowledgment. “I do it every year.” She continued when Josh raised his eyebrows. “So I can be with my family on Christmas Day.”

  “Oh, right! So you’re a local?”

  “Yup.” She nodded, her voice swelling with pride. “Born and bred Copper Creeker. All six of my brothers and sisters, too.”

  “Six!” Josh couldn’t keep the surprise out of his voice.

  “Yup!” Jorja chirped again. “It means the turkey has to be absolutely ginormous—so my brothers have started deep-frying it outside to keep the oven clear for Mom.”

  “Sounds good.”

  Jorja brightened. “Want to come? You’re welcome. Everyone brings a boyfriend or a girlfriend.”

  Josh widened the gap between them. “Oh, no. No, thanks. Not for me. I’m on shift. Thanks, though.”

  Jorja’s smile faltered a bit. Josh scrubbed a hand through his hair. She was a nice enough girl, but... But he already had a girl. The girl of his dreams. And he was a little busy proving to her how indispensable he was.

  “It was a lovely invitation—it’s just...”

  “Don’t worry.” She stopped to pick a piece of errant tinsel off the floor and wove it round and round her finger, turning it pale, then pink again...pale, then pink.

  “I’m sorry, Jorja.” Josh checked an instinct to reach out and give her shoulder a comforting squeeze.

  “I saw how you looked at Dr. McGann when we were under the mistletoe.”

  This time Josh really was surprised. He didn’t know he’d been that obvious.

  “You two know each other from before, don’t you?”

  That was one way to put it.

  “We met in medical school.”

  Jorja discarded the tinse
l in a bin and gave a wistful sigh. “It’s always the good ones who are taken!”

  Responding to that might be awkward.

  “Hey!” The young woman’s features brightened again as she tugged her errant ponytail back into place. “Who’d you get for your Secret Santa?”

  “Isn’t that supposed to be secret?”

  “Yeah—but wouldn’t it be fun if you got Dr. McGann?”

  Josh considered for a moment and then lifted an eyebrow to indicate that, yes, there just might be some fun there...

  “Here!” She dug into her nurse’s smock and pulled out a crisply folded bit of paper. “I got Dr. McGann. Who’d you get?”

  “Didn’t you get her a present already?” Josh fought the urge to seem too keen.

  “Oh, I just snagged a plateful of my grandma’s Christmas cookies. She makes an amazing selection. Snickerdoodles, gingerbread men, buckeyes, peppermint crunch—you name it, she makes it.”

  “She sounds like my Gramma Jam-Jam! Never met a Christmas cookie she didn’t like.”

  Her passing had been like losing a limb. Another loss he’d had to deal with without Katie by his side. It struck him that this mission was about more than trust. He’d known the second Katie had laid eyes on him that she still loved him. What they had was chemical. No amount of spreadsheets or flowcharts or “stages of grief” steps were going to take the connection they had away.

  But this little reunion had brought more questions than answers so far. He knew in his heart that she could trust him. But when he’d needed her most she’d upped and left. Could he trust her to stick by him if things got tough again?

  “Dr. West?”

  Josh could see Jorja was talking to him, but did he have a clue about what? Not one.

  Jorja threw her hands up in the air. “Typical man! Concentration factor...nil! No wonder I can’t get a boyfriend. I can’t even get a male to listen to me, let alone like me.”

  She swatted his arm, bringing his focus back to her. Again. Oops.

  “Sorry, Jorja—I didn’t quite catch what you said.”

  “Yeah,” she deadpanned. “I got that. I was asking who your Secret Santa was so we can trade. If you still want to.”

  “Well...it sounds like—” he dug his scrap of paper out of his lab coat pocket and read “—Dr. Michael Rainer is going to be one lucky guy...having a plate of your grandmother’s cookies all to himself.”

  “Michael...” She said the intern’s name as if she were tasting it and wasn’t entirely sure what she thought of it. Then clearly a decision was made. “Michael.” She said it again, this time looking as though she’d just enjoyed a delicious bite of peppermint candy.

  Josh grinned. Michael might have to watch himself around the mistletoe. He threw an arm round the nurse’s shoulders and gave her a quick squeeze. This Secret Santa swap could be just what he needed.

  * * *

  Katie nodded at the cleared ER board with a satisfied smile. It probably wouldn’t last long—but even a few moments of clean board always lifted her heart.

  “Someone looks happy. Did the surgery go well?”

  Michael appeared at her side, giving her a little jump.

  “Yes.” Katie nodded, feeling the weight of the success lighten her heart. “Yes, it really did.”

  And it meant more than anyone will know.

  Well. One person would know.

  She heard Josh’s laugh before she saw him—and the hit of response in her belly shifted the charge of success into something more electric. It didn’t take a doctor to know it was pure unadulterated attraction. It was adrenaline from the surgery, she reasoned. It would pass.

  “Right!” Katie went into efficiency mode. “We’ve got both shift groups together. Quick reminder: Secret Santa gifts go into lockers, please—not here in the reception area.”

  A nurse guiltily tucked the foil package she’d been edging onto the counter back into her pocket.

  Katie gave her lower lip a guilty scrape with her teeth. She hated being a Scrooge, but this was a place of work.

  “Good work on clearing the board after a pretty hectic run. A couple of patients are in Recovery after surgery, but there’s no one unexpected in Intensive, thanks to you all.”

  A smattering of applause filled the area around the central desk. The staff looked tired, but triumphant. Shannon—her keenest intern—for once looked as if she’d had enough. Michael still looked doggedly studious, but she could see the fatigue in his eyes when he pulled off his glasses and gave them a rub. A few of the nurses were hiding yawns. Most of them, actually.

  They’d all been through the wringer and Katie didn’t feel any different.

  Despite her best intentions, Katie locked her eyes with Josh’s. She might not have made it through surgery without him by her side and he knew it. It made her feel vulnerable and protected at the same time. The look in his eyes made her breath catch in her throat. Pure, undiluted love.

  Saying goodbye at the end of this shift was going to be harder than she’d thought.

  Her eyes widened, still holding the pure blue magic of Josh’s gaze. She hadn’t called the agency for a replacement! And, realistically, was there going to be a locum tenens out there in the mountainscape of Copper Canyon—or anywhere in Idaho—willing to tear themselves away from whatever they’d planned to do with their family over the holidays?

  When she and Josh had had the holidays off they’d been inseparable. In more ways than one.

  She hunched her shoulders up and down. She was just going to have to suck it up. Getting a replacement for Josh at this juncture was about as likely as Santa Claus walking through the sliding doors.

  “Where is he?”

  A huge gust of wind and winter storm burst into the waiting room, along with a bearded man dressed in full Santa regalia with a rosy-cheeked Mrs. Claus following in his wake.

  “Where’s my son?” the bearded man roared again.

  Temperatures often ran high in the ER, and it looked like Santa’s temper was soaring.

  “What’s your son’s name, sir?” Josh was by his side in an instant—with a mix of concerned doctor and Watch yourself, Santa in his tone and body language. Josh was tall, and he had the confident carriage of a rodeo cowboy. Santa, however, seemed immune to what had all but buckled her knees.

  “Klausen. Check your list, Doc. Check it twice if you have to!”

  If Katie hadn’t been so taken aback by Mr. Klausen’s arrival, she would have tittered at this similarity to a certain red-suited fellow who, by all accounts, should be pretty busy shooting down chimneys about now.

  “Chris Klausen,” the man bit out.

  His tone was so sharp Katie choked on her giggles.

  “I’ve seen the trailer in the parking lot. It’s the busiest night of the year and I know they’ve got Eustace in there. The nativity was a shambles!”

  “Dad?” Maddie appeared round the corner, a bandage on her head, her arms wrapped protectively round her ribs and a slightly fearful look on her face. “Mom?”

  Katie stepped toward Maddie—ready to intervene if things grew more heated.

  “Maddie!” Mrs. Klausen rushed to her daughter’s side. “What happened? We just got the call that there was an accident.”

  The tension eased from Katie’s face as the anger obviously born of fear for their children turned into protective hugs and kisses.

  “Where are your brothers?” Her father pushed her back to arm’s length. “I’m going to wring their necks!”

  Then again...

  “Dr. McGann, I was the one who brought him up to—”

  Katie waved Michael to silence. They didn’t need to hear the gory details out here with a crowd gathering.

  “Sir, perhaps you’d like to follow me?” The last thing
the couple’s son needed, still in Recovery from surgery, was his father dressed as Santa shouting at him.

  “You all right?”

  Josh’s voice trickled along her spine as she felt him approach. He was doing it again. White Knighting it in the face of adversity. She was glad he couldn’t see her face as she pressed her lips together. Hadn’t she just proved she could hurdle her demons in the OR?

  Not without Josh by her side.

  “Would you like to come with me, Mr. and Mrs. Klausen?” Katie put her hand up in an I got it gesture to Josh and snapped a glare back at Jorja, who was busy choking down her own case of the giggles. Most likely born of nerves, but inappropriate all the same.

  “What for? Show us where the boys are, Maddie, and we’ll get on our way.”

  “I think it would be best if we had a chat before you saw your boys.” Katie was solid now—shifting her gaze from one rosy-cheeked face to the other.

  “Maddie...” Josh put a protective arm around the young girl’s shoulders. “Why don’t we see if we can track down some gingerbread?”

  “All right,” Mr. Klausen grumbled, his attention fully focused on Katie. “Let’s hear how naughty they’ve been.”

  * * *

  Katie led the way into one of the comfortably furnished family rooms the hospital had created for delivering tough news. She and Josh had been led to one like it after the postmortem on their little girl.

  No discernible evidence to indicate a problem. Just one of those things.

  The words had sat in her heart like an anvil. If there had been a reason, she could have done something. Fixed it. Not felt the living, breathing, growing terror that she had no control over what might happen if they tried again.

  “So what’ve they done? How’s Eustace?”

  “Your donkey is fine, sir.” Katie’s eyebrows lifted in surprise at the parent’s priorities—but you never knew a person’s history. Never knew how someone would respond in times of extreme stress.

  “One of our surgeons had to give him a few stitches—”

  “He was hurt?” Mrs. Klausen’s hands flew to her mouth in horror. “Eustace!” She exhaled into her cupped hands. “Eustace... We’ve had him longer than the boys! Our first baby.”