Patient Nurse

by Diana Palmer

  The owner was shocked. “Such a quiet, nice young woman,” he remarked. “Always had a kind word for everyone, and a smile. She’ll be missed. Please tell her that my wife and I wish her the best, and we’ll look after the apartment until she gets back. Anything you want from her apartment?”

  “Later, perhaps. I’ll be back to get anything she needs after I’ve spoken to her.” He’d not only have to do that, but he’d have to do something about that kitten, too. It would die if he left it. Besides, she hadn’t wanted the apartment owner to know she had it. Pets were against the rules.

  “I’ll be around, if I’m needed. You a relative?” he asked.

  “Yes,” Ramon said without explanation.

  He left, with the intention of driving himself home for dinner. But he couldn’t. Involuntarily he turned back in the direction of the hospital.

  She hadn’t regained consciousness. It wasn’t unusual, but it worried Ramon. He checked her carefully with the stethoscope, noting the steady rhythm of her brand-new metal valve, which made a soft chink-chink sound as it opened and closed. The valve would last for many years, and her quality of life would be enhanced by it. No more breathlessness at the slightest exertion, no more erratic heart rhythms, no more fatigue.

  He frowned, wondering when she’d first known about it. Surely she’d had some sort of warning and had seen a doctor when she started having trouble. Judging from the condition the valve was in, she had to have noticed that something was wrong. Her bad color alone had alerted him to a physical problem.

  That line of curiosity led him further along. He sat in the cafeteria, eating without tasting his food, and his mind continued its meandering. Why had she never told anyone of her condition? Had she had some violent episode with it? Did her aunt and uncle know anything was wrong? Did they care?

  He couldn’t help noticing the difference in the way the Kensingtons had treated Noreen since Isadora’s death. Like himself, they’d blamed her for that. None of them had ever considered anything save neglect as the cause of Isadora’s untimely passing. But Noreen’s present condition opened the whole subject up again.

  He finished his meal and got up to take his tray to the moving belt assembly in the canteen, frowning thoughtfully. He put it down and then checked his watch. It was going on eight hours since he’d operated on Noreen.

  He went back up on the staff elevator to the ICU, and moved right along past the automatic door to the cubicle where Noreen was settled.

  With a rough sigh, he went into her small cubicle and checked the many monitors to which she was connected. She seemed to be in acceptable ranges on all of them. But why hadn’t she regained consciousness?

  He leaned over her. “Noreen,” he called abruptly.

  And all at once, her eyes flew open.

  His heart jumped at the unexpected but welcome response. Her eyes followed his dark face curiously, as if she wasn’t quite conscious even now. Probably she wasn’t. The effects of anesthesia lingered.

  He checked her pupils, borrowed a stethoscope from one of the nurses and listened, nodding, to the steady rhythm of her heart. Her lungs sounded clearer.

  He lifted his head and searched her eyes, noting that they’d removed the breathing tube from her mouth.

  She tried to swallow. “So…dry.” Her voice sounded weak and shaky.

  He found one of the swabs kept for moistening the lips, drew it out of a sterile package and applied it to the inside of her mouth.

  “It’s the anesthetic we use,” he explained. “It leaves a bad taste in the mouth and some dryness. It will pass.”

  She seemed to relax. “What are…you doing here?” she managed drowsily.

  “No one knew who you were when you were brought into surgery,” he explained. “I operated.”

  She frowned. “Unethical,” she whispered.

  He shrugged. “Yes. But I didn’t see your face. I had no idea it was you.”

  She was having a hard time keeping her eyes open. “Dr. Myers will…be…upset.”

  “Myers?” he asked.

  “In…Macon. County General. He was…supposed to operate…next week.”

  She lapsed into sleep again, weary from the surgery and the exertion of talking. She was in pain, too, from the surgery. The nurses had given her the painkiller he’d already ordered.

  He moved away from the bed with a quiet sigh, pausing since he was in the unit to check on his other patient.

  She’d sleep the rest of the night; he was fairly sure of that. He went home and, on an impulse, sought a telephone number for a cardiac surgeon in Macon named Myers.

  He found the man without too much difficulty. When Dr. Myers knew to whom he was speaking, he was stunned.

  “I’ve heard of you,” he told Ramon on the telephone. “You’re quite well-known.” He paused. “Is this about a patient of mine?”

  “My late wife’s cousin, Noreen Kensington,” Ramon began.

  “Ah, Norie,” he replied, a smile in his voice. “Hard girl to get on the table, if you know what I mean. I happened to be visiting an old friend in an exclusive Atlanta apartment house two years ago when the superintendent found a young woman collapsed on the staircase and asked for my help after he’d phoned for an ambulance. I checked her over and went with her to a local hospital and conferred with the emergency room doctor about her. He ordered X-rays and we saw immediately that something was wrong. He admitted her, barely conscious and confused, and we did an echocardiogram.” He sighed. “The valve was leaking a little, and I recommended surgery, but she was lucid enough to refuse. She kept mumbling something about her cousin, who was apparently under the weather, and how she needed to get back there. I thought her own condition merited more concern, so I had her sedated and kept her overnight, until she was stabilized.”

  While Isadora died. Ramon’s eyes closed. So it hadn’t been negligence at all. Noreen had collapsed.

  “Was it a heart attack?” he asked.

  “I think it might have been a very mild one, although nothing showed up on the EKG or the echocardiogram. She recovered and refused surgery, but I insisted on keeping a watchful eye on her. I had her come to see me every three months. About a month ago, the leaking began to increase and I insisted that she arrange to have surgery before the situation became critical. She was already showing symptoms…” There was a pause, as if Ramon’s very silence communicated something to him. “How is she?”

  “She collapsed on a MARTA bus this morning. She’d locked her purse in her car and ran to catch the bus to work, but she never got there. They brought her to my hospital as a Jane Doe and I performed emergency surgery on her, without realizing her identity until the procedure was complete.”

  “Well, she had the best care, whatever the circumstances. It’s a relief to me to know that she’s in such good hands. She’s going to be all right?”

  “Her vitals are within acceptable ranges,” Ramon said, “and she’s conscious. We’ll have to wait and see how she does. I expect a complete recovery.” He took a slow breath. “I never knew she had a heart condition. I wasn’t told.”

  “Don’t feel bad. She never told anyone,” he replied. “I gather that she’s an independent young woman with no close family.”

  “She has an aunt and uncle who took her in when her parents died…”

  “Of course, but you know how it is when some relatives wind up with unexpected kids. They never quite consider them their own.”

  Ramon was still trying to get over the shock. “She told you that she was living with her cousin’s parents?”

  “Yes. She’d applied for a passport and had her birth certificate with her when she came to my office the last time. She was thinking of taking a job overseas, in some third-world country, she said. Thank God this happened before she left the States.”

  Ramon sat down. “Yes.”

  “Well, I’m happy to hear that my patient is going to survive. Please tell her that I’d like to see her when she’s back on her feet ag
ain.”

  “I’ll do that. Thank you for what you’ve done for her.”

  “I did nothing except make her come for checkups.”

  “You kept her alive. Come and see me when you’re in Atlanta next time. I’m at St. Mary’s.”

  “I’ll do that. You might, uh, return the favor if you’re ever in Macon.”

  Ramon chuckled. “I’ll make a point of it. Good evening.”

  He hung up and the smile faded. What a lot he didn’t know about Noreen. He wondered if the Kensingtons knew about her heart.

  He had to find out. He phoned their number, only to get an answering machine message that they were out of town and wouldn’t be back until the following week.

  He borrowed the passkey from the owner after he had a locksmith get Norie’s car unlocked for him. He paid the locksmith and sent him on his way. Then, with a wave to the owner of the apartment house, he took her purse inside and unlocked the door of her apartment on the second floor. The kitten came running to meet him, probably half-starved, he thought as he picked it up and tucked it under his jacket, so that no one would see him take it with him as he locked the apartment up again and left.

  He had to stop by the store on the way home to buy a few necessary items for the kitten. It was a well-mannered little thing, he thought. It laid down beside him on the front seat and just stayed there, purring happily, not bothering anything.

  When he got home again, it was company for him. He hadn’t realized how lonely his apartment was. He made himself a pot of coffee, settled into an easy chair with a steaming cup beside him on the table and opened the medical journal that he’d received that day. The kitten climbed up into his lap, curled itself comfortably and went to sleep purring.

  Before he went to bed, he telephoned ICU to check on Noreen, and found that she was continuing to make progress. When he went to bed, the kitten tagged right along. He felt it beside his head on the pillow as he drifted off to sleep.

  It was late the next day before he was able to get back into ICU to check on Noreen. His schedule had been hectic all day, and he was between surgeries when he paused by her bed, still in his surgical greens.

  Without a word, he checked her over, studied the monitors and listened to her chest.

  “I’m…all right. When can I go home?” she asked.

  He cocked an eyebrow. “Funny girl.”

  “They won’t give me anything to drink,” she accused. “And that short blond nurse ignores every question I ask her.”

  “I’ll have her shot,” he promised agreeably. “You’re being moved out of here in the morning to a private room. I’ll engage a nurse to sit with you.”

  “I don’t need—” she winced and paused to breath “—help from…you!”

  “Thank you. I like you, too.” He searched the angry pale eyes and smiled reluctantly. “Yes, you’re definitely better. I’ll be back to check on you later.”

  She blinked, still a little hungover from the anesthesia.

  “Go to sleep,” he said gently.

  She closed her eyes obediently.

  He turned to the small blond nurse and motioned her to join him by the door.

  “I know,” she said, holding up a hand, “I’m the wicked witch of ICU and I’ve been torturing her.” She smiled apologetically. “She wants cracked ice every five minutes. I have two patients who aren’t doing half as well as she is, and medications to take around, we’re shorthanded by one nurse…”

  He patted her on the shoulder. “Take two aspirins and call me in the morning,” he told her. “You’ll be fine.”

  He left before she could get her mouth closed.

  The last surgery went poorly. The patient was so far gone that all Ramon’s skill wasn’t enough to save him. He went out to tell the family, empty inside as he saw their grief and was helpless to do anything about it. One of the female chaplains appeared out of nowhere and took charge of the devastated family. Thank God for the chaplains, he thought as he went to change clothes. They were worth their weight in diamonds.

  He made one more trip to ICU that night. The shifts had changed and a bright and cheerful young African-American nurse was in charge. She gave him a big grin.

  “Your patients are going out on the floor tomorrow, aren’t they?” she asked.

  “You tell me,” he replied. “Think they’ll do?”

  She nodded. “They’re improving by leaps and bounds. We fed Miss Kensington her supper tonight and she ate all of it. Great appetite.”

  He smiled. “Good for her. No deterioration?”

  She shook her head. “Her vitals are good and getting better by the minute.”

  “Thanks.” He went to stand by Noreen’s bed. She was awake fully now, and aware of her surroundings.

  “You operated on me,” she accused.

  “I told you before, I didn’t know who you were. You had no identification on you.”

  “I locked my purse in the car and had to run to catch the bus.” She drew in a labored breath and touched her chest through the hospital gown. “Hurts.”

  “They’ll give you something for that,” he said. “Running for the bus probably precipitated this. Do you remember how you felt when you collapsed?”

  “I didn’t feel anything,” she recalled. “I saw the floor coming up toward me and I thought, I’ll break my nose. Then everything went white.”

  “No pain?”

  “Not that I remember.” She searched his drawn face. “You look so tired,” she said involuntarily.

  It surprised him that his heart jumped at her gentle concern. “Long day,” he said tersely. “And I lost a patient.”

  “I’m sorry.”

  Not one expression escaped his control. “It goes with the job. But it always hurts.” He searched her face. “Your color’s much better.”

  “When can I go back to work?”

  “When you’re well.”

  She glowered at him. “I’ll starve if I don’t work.”

  “No, you won’t. Your hospital insurance is the best in town, and it has a disability clause.”

  “How did you know?”

  “I checked. You’re already on the computer. I signed you in. By the way, I tried to call your aunt and uncle, but they’re out of town.”

  Her eyes shifted to the curtain. “There’s no need to bother them. They don’t like hospitals.”

  “You’re their niece,” he said. “They care about you.”

  She didn’t answer. She knew better, but she wasn’t going to discuss it with him. He should have expected it.

  “You’re going out to 3 East tomorrow,” he said.

  “The cardiac ward. All private rooms. There’s a nursing shortage. I’ll lie there and die and nobody will notice.”

  “Not there, you won’t. You’ll be hooked to the monitor at the desk. Someone watches constantly. And the technicians are all over the ward. You’ll be fine. All the same, I’m having a nurse special you.”

  She glared at him. “I can’t afford…!”

  “Calm down. Don’t put any stress on that new valve,” he cautioned. “And I can afford it. You’re family.”

  “No, I’m not.” She ground out the words. “No relation. None.”

  He saw the resentment and hostility in her eyes, and knew that she had every right to feel it. For two years he’d blamed her for something she hadn’t done. She’d tried to explain at first and he’d refused to listen. Probably he deserved her contempt.

  He stuck his hands into his pockets. “Have it your way. But you’ll get the private nurse, all the same. I’ll check on you in the morning.”

  She was full of things to tell him, but he didn’t stay to listen. She watched his broad back disappear out the door and her fist hit the bed furiously. The action hurt her chest and she groaned.

  “Need something for pain?”

  “Yes, please,” she answered the pretty nurse. She almost asked if they had anything for a dark-eyed pain in the neck, but considering how the s
taff adored Ramon here, she felt it was more diplomatic to keep her mouth shut.

  He hadn’t been joking about the nurse, she discovered the next day. Just after supper, a plump little tornado came in and sat down with a bag of knitting. She introduced herself as Miss Polly Plimm. She was a nurse who’d worked on special cases for Ramon before. This young woman would need some assistance for a day or two, she noted, and she was more than happy to have the work. Having retired the year before, her lack of industry was beginning to atrophy her bones. She fetched cracked ice for Noreen and checked her vital signs and the catheter bag periodically, and encouraged her young charge at every turn.

  Brad stopped by to check on his friend and was delighted to find her in such good hands. He was on day shift now and came to visit with her each evening for a few minutes before he went off duty. He noted her progress and applauded it, but he worried about what was going to happen when she had to go home. She was already talking about going back to her apartment. He hoped the surgeon wasn’t going to allow that. She really couldn’t stay by herself.

  Chapter Six

  Noreen was more aware of her surroundings after her second day on the cardiac ward, and her first totally logical thought was of the poor kitten, alone in her apartment. She and Nurse Plimm walked around the unit two times, while she brooded about the poor kitten that she’d forgotten under the effect of the surgery and the anesthetic.

  Brad came by to see her and waited while she was settled and hooked up again to the oxygen and IV and cardiac monitor.

  “My kitten,” she said plaintively. “She’s alone in my apartment. She’s been there for days with no food and no water. She’ll be dead!”

  “Ah, the kitten,” Brad mused. “Well, she’s something of a legend already, from what I hear. She’s rooming with Dr. Cortero.”

  Her heart skipped beats. She gaped at him. “With Ramon?”

  “The very same. Imagine that. I thought he hated animals.”

  “So did I.”

  “You’d never believe it, to hear him talk about that cat. He’s bought it a collar and all sorts of toys and it sleeps with him.”