by Laura Iding
David wasn’t going to wake up. Even if he did, he’d never be the same. She wasn’t pining for their relationship, she’d broken off their engagement just before his fateful dive.
Her baby would be fine without a father. She’d do everything in her power to fulfill both roles in her child’s life. A happy secure upbringing with one parent had to be a better environment than misery and arguments between two parents.
“Caryn, do you have family or friends to support you?” Luke’s blue eyes were filled with concern on her behalf. His unexpected kindness made her want to cry. Had to be the extra abundance of hormones.
“Yes, of course I do.” She sniffled and forced a smile. “David’s family is very nice.”
“So they’ll help you with the baby.” Luke sounded relieved.
“I suppose, once I tell them the news.” She couldn’t really speak with conviction because she wasn’t sure how they’d react if they knew the truth. She only wore her engagement ring for their benefit.
Secrets. Far too many secrets. They weighed heavily on her conscience.
The heart monitor from the other room set off an alarm and Caryn moved past Luke to attend to it, but he grabbed her arm. “Wait. You can’t go out there until they shut the CT scanners down.”
Chagrined, Caryn realized Luke was right. Exposure to powerful X-rays were dangerous for the baby without wearing protective lead gear. How could she have forgotten, even for a moment? Luke raised his voice to instruct the radiology technician to shut down the scanner, and as soon as the noise of it stopped, she hurried into the other room.
“Her heart rate is 166 and her blood pressure is way up, 200 over 108.” Caryn glanced at Luke, who’d followed her. “I hope this isn’t a sign of her brain herniating.”
“We need some lasix and mannitol.” He looked at the radiology tech. “Do you have any meds down here?”
“Just the emergency medications on the crash cart.” The tech looked worried.
“Get the crash cart. I’ll call Pharmacy.” Caryn headed for the nearest phone.
“Caryn, call a code blue,” Luke instructed. “We need more help down here than just the two of us.”
He was right. She dialed the emergency number to call a code blue, then the number for the pharmacy, asking for additional medications to be brought to the CT scanner.
Within minutes the room was swarming with additional medical personnel. Therese, one of the other nurses in the ICU, responded as a member of the code team.
“We need to give six milligrams of adenosine,” Luke ordered.
“I’ve got it.” Therese was on the side of the patient closest to the crash cart. Caryn didn’t care for Therese on a personal level, but she was a decent nurse—when she wanted to be. Emergency situations tended to bring out the best in people.
Caryn held out her hand. “Give it to me—I have her IV on this side.”
“OK.” Therese handed the medication over. “There’s twelve milligrams in the syringe. Give half now and the other half if we need the second dose.”
Caryn nodded in understanding as she injected the initial dose of medication into Mrs. Nowicki’s IV port.
“Her heart rate isn’t responding,” Luke observed a long minute later. “Give the second dose, Caryn. Therese, get ready to shock her.”
Since the defibrillator was on top of the crash cart next to Therese, the other nurse dialed in the controls, charging up the device in case they needed to use it.
“What did her CT scan show?” Caryn asked, after she gave the second dose of adenosine. “Is her brain injury worse?”
“Good question.” Luke glanced at the radiology tech. “How much of the scan was the radiologist able to read?”
“I’ll check.” The tech dashed from the room.
“Her rhythm looks worse, the QRS is widening, but I still feel a pulse.” Caryn glanced at Luke for direction.
“You’re right. Please, cardiovert with 25 joules.”
Therese gave Luke a private little smile as she dialed in the appropriate amount, then swept her gaze over the patient. “All clear?”
Caryn let go of the IV tubing and stepped back, making sure there was plenty of room between her stomach and the patient as Therese gave the shock. Since the heart rhythm didn’t change, Caryn stayed back as Therese deployed another shock.
“Asystole,” Caryn said, when Mrs. Nowicki’s heart rhythm went straight line, instead of converting into a normal rhythm, as they’d hoped it would.
“Start CPR.” Luke turned away when the radiologist came into the room. “Did her scan look worse?”
Caryn had to climb up to kneel on the CT table to perform CPR. After a few minutes Luke came back into the room. When he saw Caryn kneeling at the side of the bed, he frowned.
“Therese, since you’re taller than Caryn, would you take over CPR? She looks tired.”
Caryn wanted to argue, because she couldn’t be tired when she’d just started compressions, but Therese stepped up eagerly. “Of course.”
Caryn finished her round of compressions then allowed Therese to take over while she took charge of the crash cart. All too soon, the radiologist returned. He glanced at Luke and shook his head.
Luke sighed, then addressed the rest of the team. “I’m calling an end to this code. Mrs. Nowicki’s brain stem herniated and there’s nothing more we can do. It’s over.”
There was a long moment of silence. Then one by one they stopped caring for the patient. The respiratory therapist stopped giving breaths with the ambubag, Caryn turned off the IV pumps and Therese turned off the heart monitor, disconnecting the leads.
Caryn stared down at Mrs. Nowicki, feeling bad about losing her so quickly yet at the same time knowing they’d done everything possible to save her.
The entire situation reminded her sadly of David.
“Thanks for your help, Caryn,” Luke said quietly. “You, too, Therese,” he added.
Therese responded to his attention like a flower blooming in the sun. “I’m glad I was able to assist,” Therese responded coyly. “How lucky you were here to take the team leader role in the code blue, Luke.” She beamed at him as if they were the only two people in the room.
The spurt of jealousy toward Therese caught Caryn off guard. What difference did it make if Therese flirted with Luke? Hadn’t she learned her lesson with David? Hadn’t she decided she was better off alone?
Caryn prepared Mrs. Nowicki for the return trip up to the unit, although urgency was no longer necessary. Luke and Therese would make a striking couple. She turned away, reminding herself that she didn’t care. Her future was already set and it included a baby, not a man.
Especially not Luke.
A man as attractive as Luke Hamilton would be nothing but heartache and trouble.
After taking her lunch-break, Caryn stepped into her boss’s office. “Michelle? Do you have a minute?”
Michelle Granger looked away from her computer and smiled. “Sure, Caryn. Have a seat. What’s up?”
“I, uh, have something to tell you.” Caryn edged into the room, feeling inexplicably nervous. She sat in the chair next to Michelle’s desk and folded her hands in her lap. “Uh—there’s really no easy way to say this. I’m pregnant.”
“Oh, Caryn.” Michelle’s smile was bitter-sweet. Everyone in the unit knew about David’s injury. “I’m happy for you, but I’m sure this has been very difficult as well. Are you doing OK?”
She lifted one shoulder. “Yes, still very sick in the mornings for some strange reason, but otherwise fine. I have my first doctor’s appointment the day after tomorrow.”
“Do you have any idea when you’re due?”
“Early September, I think. But I’m not really sure,” Caryn confessed. It was the first of May now so if she’d fallen pregnant some time during their Mexico trip in early December, then early to mid September was probably correct.
“And you’re still having morning sickness?” Michelle sounded surprised.
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“Yes.” Caryn grimaced. “I threw up this morning right in front of Dr. Hamilton, the new critical care fellow.”
“Are you taking multivitamins on an empty stomach?” Michelle asked.
She shook her head. “I take my multivitamins with some toast each morning. I just can’t stomach a big breakfast so early.”
“Try waiting on the vitamins until lunchtime,” Michelle advised. Michelle was a single mother and her daughter had just turned five. “Maybe then you’ll feel better. And try protein in the mornings—cheese or peanut butter might work. I couldn’t take my vitamins first thing in the morning when I was pregnant with Brianna.”
Caryn had never thought about the vitamins as being the cause of her nausea, but it was definitely worth a try. “Thanks for the advice.”
“No problem.” Michelle frowned. “You also might want to go down and talk to someone in Human Resources, Caryn. Since you’ve already taken a personal leave of absence after your fiancé was injured, I’m not sure how much time they’ll allow you to take off after you deliver your baby. The federal government allows only twelve weeks total in a year.”
Twelve weeks total? Caryn stared at her boss in dismay. “But I already took six weeks off when David was injured.”
“I know.” Michelle’s gaze was sympathetic. “I’m sure the hospital will give you at least the first six weeks off work as medical leave, but after that…” She hesitated and shrugged. “I just don’t know. I’m willing to grant you personal leave but the hospital administration has to approve it first.”
Caryn swallowed hard and slowly stood. “I’ll make an appointment with them as soon as possible.”
“I’ll do whatever I can to help, Caryn,” Michelle said softly. “Let me know if you need anything.”
“Thanks.” Caryn took a deep breath and let it out slowly. “I’d better get back to work.”
“Take care.”
Caryn left Michelle’s office and returned to the unit. The news that she might not get very much time off after having her baby hit like a truckload of bricks. The balance in her savings account was already dangerously low, since the six weeks she’d taken off to be with David had been unpaid. Of course, if she’d known about her pregnancy she would have done things differently. Too bad there hadn’t been a crystal ball handy so she could have predicted her future.
She sat in the break room for a moment, so rattled about the news regarding her leave of absence she couldn’t think of anything else. Because no matter how wonderful David’s family might be, she still needed to support herself.
She needed her full-time job in order to survive.
Luke knew he had a lot to learn during his critical care fellowship and Mitch didn’t waste any time in assigning him another couple of sick patients to tend to. They were more than enough to keep him busy yet as the morning went on Caryn became a source of distraction to him. He’d be writing his progress note only to discover his gaze following her as she worked. He didn’t understand why the pretty critical care nurse and her baby kept popping into his thoughts.
Although he quickly figured out Caryn had sprung the news about her pregnancy to her boss and probably her friends, too, because the news spread through the unit faster than the speed of light. Soon he overheard bits and pieces of conversations.
“Bet she wishes she hadn’t taken that leave of absence to sit with her fiancé all those weeks.”
“His family will provide financial support, they’re too decent not to.”
“Maybe now she’ll stop waiting for him to wake up and finally move on with her own life.”
The last sentence made him pause. Caryn had emphatically claimed she wasn’t getting married, yet apparently that fact hadn’t made it through to her co-workers. Why had she kept the truth a secret? Was she worried the medical staff would think less of her for some reason? He couldn’t imagine why, given the snippets of conversation he’d overheard.
No, more likely she was simply a private person.
Luke told himself he cared about Caryn’s welfare and that of her baby, as any doctor would be concerned about a patient. Maybe Caryn was very different from most women he’d ever known, but that didn’t mean he was intrigued by her. Good thing, too, considering she was clearly impervious to his smile.
Your charm is wasted on me, Luke.
He needed to concentrate on his career, which meant keeping his relationships light and tangle-free. His parents had divorced when he’d been very young, and his father had disappeared from his life quickly thereafter. Lisa, his half-sister, had been the product of his mother’s second marriage. At last count, his mother had been married five times.
Or was it six?
He wasn’t sure why his mother bothered with the hassle of marriage since they never lasted.
A distraught man hurried into the unit and headed for Mrs. Nowicki’s room. Her son, no doubt. He’d spoken to him earlier on the phone to break the bad news. Luke watched as Caryn met him at the doorway, immediately putting her arm around his shoulder in comfort, their heads close together as they approached the bedside. After everything she’d been through, he thought it was nothing short of amazing that she was able to give comfort so selflessly to others, even though Mrs. Nowicki’s brain injury must have been a difficult reminder of her fiancé.
Struck by the depth of her compassion, he didn’t notice how hard he was staring at her until Therese came up beside him.
“Poor Caryn, pregnant and alone.”
He wondered if Therese knew how insincere she sounded. He raised a sardonic brow. “Hardly alone. She mentioned her fiancé’s family is very nice.”
“She told you that?” Therese sounded surprised. “Very interesting, since Caryn usually keeps to herself.”
Funny, he’d gotten that same impression. He was suddenly very glad Caryn had chosen him to confide in. “Are you a good friend of Caryn’s?”
“Me? Not really, but I can certainly sympathize with her plight.” Therese wrinkled her nose. “Except maybe for the pregnancy part—she should have known better than to let that happen. And from what I heard, she’s too far along to do anything but have the baby.”
Once Luke’s attitude would have been similar to Therese’s. After all, he’d always taken precautions so he wouldn’t end up in a similar predicament. His parents had only gotten married because of him, as his mother had let him know often enough. And then there was the whole situation with his sister. He clenched his jaw, thinking of Lisa’s fate.
No one should have to face raising a child all alone, without help. Without support. Without friendship. His gaze sought and found Caryn, still standing beside Mrs. Nowicki’s son, giving him all the time and attention he needed.
“Excuse me. I need to give my condolences to Mrs. Nowicki’s son.” He stepped away from Therese.
Striding toward Caryn, he wasn’t at all surprised to see her face was wet with tears she’d shed right along with Geoff Nowicki.
Struck by her caring compassion, he realized in that moment what a wonderful mother she’d make. Her determination to raise her child alone proved she possessed a deep inner strength and commitment. He admired her courage. At the same time he also experienced a strange urge to protect both Caryn and her baby from harm.
He shook off the reaction and focused on his role as a physician. “Geoff Nowicki?” he asked, stepping into the room.
“Yes.” The short bald man who was Mrs. Nowicki’s son turned toward him.
“Dr. Luke Hamilton. I’m the one who spoke to you on the phone earlier.”
“Of course.” Geoff Nowicki swiped his eyes on his sleeve and gave Luke a watery smile. “Thanks for everything you did to save her.”
“You’re welcome, although I’m sorry we couldn’t do more.” He wished things had turned out differently, but in Mrs. Nowicki’s case it simply wasn’t meant to be. “Is there something I can do for you? Is there anything else you need?”
“No, thanks. You’ve been great.
” Geoff turned and included Caryn. “Both of you. I know everyone did their best for her…” His eyes welled up again and he ducked his head. “Maybe if you’ll just give me a few minutes alone?”
“Of course. Take all the time you need.” Luke took Caryn’s arm so they could leave the room, allowing Geoff time alone with his mother. Tears continued to roll down her cheeks. When they were a few feet away, he glanced down at her in concern. “Are you all right?”
Caryn sniffled loudly but shrugged off his hand. “I’m as fine as anyone who’s just lost a patient.”
He frowned, sensing false bravado in her tone. “Caryn, you’re not just anyone. You’re pregnant. And you’re in a similar situation. I’m sure Mrs. Nowicki’s death couldn’t have been easy for you.”
Her brown eyes flashed. “You don’t know as much about me as you think. I shouldn’t have said anything to you about my relationship with David. My personal life is really none of your concern.”
She stalked off toward the nurses’ station and he let her go. Partially because what she’d said was true, her personal life wasn’t his concern. And obviously he couldn’t force her to stay.
Caryn would be fine. There was no reason for him to worry about her. She wasn’t alone. She had David’s parents to help her through this.
He had things to do so he threw his efforts into his work. After checking that all his patients had the medical care they needed and the paperwork was caught up, he prepared to leave, making sure each of the residents understood what they needed to do for the ICU patients in the unit.
When Luke was satisfied that things were under control, he headed home to his downtown condo overlooking Lake Michigan. He’d made plans to go out later with a group of residents who weren’t on call, but he was plagued by an uncharacteristic apathy. He couldn’t muster the enthusiasm needed to shower and get ready to go out.
He called and canceled his plans then settled in with the latest journal from the Society of Critical Care Medicine. He read the article on severe sepsis twice before realizing he hadn’t comprehended half of what he’d read because his thoughts had once more strayed to Caryn.
