by Laura Iding
For a moment, a very brief moment, he allowed himself to wonder what it would be like if her belly was round with his child, instead of someone else’s.
CHAPTER THREE
CARYN drove to work the next morning, feeling much better for taking Michelle’s advice. She’d nibbled cheese and crackers before leaving the house and didn’t feel the least bit nauseous now that she didn’t have a huge multivitamin pill rolling around in her stomach.
Although she felt better physically, emotionally she was still a wreck. Last night, after work, she’d gone over to the neuro-rehab center to visit David. His parents had been there, too, like they always were. She’d told them the news about the baby and at first they’d been stunned speechless, then they’d lavished her with attention, thrilled beyond belief with the news of an additional grandchild. Their constant hovering had only seemed to magnify the secrets she’d kept from them until she’d thought she might scream in frustration. In the end, she hadn’t even stayed for a full hour before begging off to go home.
She closed her eyes on a wave of guilt. She was an awful person. She’d suspected David was running a fever, but hadn’t even asked the nurses about it in her haste to leave.
Caryn pulled into her usual parking space and momentarily rested her head on her hands. She’d thought she’d feel better, telling David’s parents at least one of the secrets, but instead it seemed as if telling them about her pregnancy had only caused the other secrets to swell in size as a result.
David’s family was very close. They called each other constantly, and from all indications expected to be kept abreast of every pregnancy symptom she experienced. She wouldn’t be surprised to discover they intended to go with her to each doctor’s appointment and Lamaze class. David’s older sister, Debbie, had already volunteered to be her birthing coach.
How could she tell them the truth now?
Very simply, she couldn’t.
She had to stop worrying about David’s family and start focusing on her future. She’d already met with Human Resources and they were willing to grant her unpaid personal leave after the baby was born.
Which meant she needed to save every dime she could spare, starting now.
Today. There were so many things she needed for the baby, she wasn’t even sure where to begin. Yet the knowledge she could make whatever decisions she wanted about her child was liberating.
No more submitting to a man’s controlling nature. Ever again.
She headed into the hospital with a renewed spurt of energy. When she entered the unit things were chaotic, alarms going off and a couple of staff members scurrying from bedside to bedside. She’d barely gotten inside the door when one of the night nurses waved her over.
“Help me with this guy, Caryn,” Emily called out as she grabbed the patient’s arm to prevent him from crawling further out of bed, although his feet were almost on the floor.
She hurried over to get a grip on the patient’s other arm and between them they encouraged him to get his legs back into bed. “Wow, you guys must be having a bad night,” Caryn commented. “The place looks like a zoo.”
“We were two nurses short and it’s been like this all night,” Emily admitted.
Caryn frowned. “Is there a full moon?”
“I don’t know, but it sure feels like it. All the ICUs were short-staffed—there were eighteen sick calls last night.”
“Eighteen? For one shift?” Caryn could hardly believe it.
“Hey, you’re short-staffed, too. Two of your day shift nurses called in sick.”
“Great.” Caryn knew some nurses tended to call off sick for the smallest things, but this was ridiculous. “Is there something going around, like some wicked flu bug?”
“I don’t know, but your colleagues both called in with severe stomach cramping and diarrhea.”
“Lovely. Hope I don’t get it.” She’d just gotten through her first morning without throwing up—the last thing she needed was some horrible flu virus. Plus she didn’t want to waste her sick time, she’d need it for when she had the baby. “Is anyone making phone calls to see if someone is willing to come in and work extra?”
“Not yet. To be honest, we haven’t had time.” Emily’s gaze was apologetic. “The ED has been swamped and we’ve taken three admissions in the past two hours. I’ve barely finished the last patient’s admission assessment so the most recent admission paperwork hasn’t been started.”
“I’ll take over the new admission if you like. That way you won’t need to stay over to finish up.” Caryn figured it was a good thing she was feeling better as this was definitely going to be a long day.
“Good.” Emily’s smile was strained. “He’s in bed five. The report I was given from the ED is on the front of the clipboard. All I know is that the patient is thirty-five and received a liver transplant approximately five years ago. He’s pretty sick, and no one seems to know what’s wrong with him. The critical care fellow is in there, trying to place a pulmonary artery catheter to see if he’s septic.”
Caryn nodded. “I’ll go see if he needs help.”
Leaving the confused patient to Emily, she headed over to bed five. She didn’t find the whole team in the room, only the resident who’d been up all night and Luke. Mitch had explained how the fellowship program was designed to give additional years of study to specific specialties such as critical care. Luke was technically ranked above the residents, but was not as experienced as the attending physician, Mitch. Still, Luke appeared comfortable working in a critical care unit and was doing fine with placing the catheter.
“Hi, Caryn, you’re just in time. I think the tip of the catheter is in the pulmonary artery. Will you inflate the balloon to see if the catheter will wedge?”
“Of course.” She quickly donned a mask and gloves as she’d be close to their sterile field and quickly double checked the catheter’s connections, making sure nothing had been missed. She inflated the balloon as he’d asked and they watched the heart monitor for the reading.
“Thanks. Now, while we suture this in place, will you shoot a few cardiac outputs for us?”
She nodded. “I’m getting a cardiac output of 3.1.”
“Hmm. A little low. Do you have the rest of the readings handy?” Luke asked, dividing his attention between her and the sutures he was placing to keep the catheter from slipping out of place.
“Systemic vascular resistance is high.” Caryn gave him the rest of the hemodynamic readings. One pulmonary artery catheter could give a wealth of detailed information.
“I guess he really is septic.” Luke finished with his sutures and stepped back. “Dr. Johannes, place a sterile, transparent dressing over the catheter site, please.”
Caryn wrote down all the readings they’d obtained on her patient’s clipboard. When she’d finished, she quickly glanced at the report Emily had left for her. The patient’s name was Michael Dunn and he’d received a liver transplant five years ago after taking some prescription medication that had caused severe liver toxicity. He’d been in good health until a few days ago.
“Caryn?” Luke called. She glanced up, realizing the procedure was over and the resident, Dr. Johannes, had moved on to write his procedure note, leaving them alone in the room. Luke captured her gaze with his. “How are you feeling?”
“Fine.” When he continued to look at her intently, she fought the urge to blush. “Very good,” she amended. “Don’t worry, I’m not going to throw up on you this morning,” she teased.
“I’m not worried,” he said in a serious tone. “If you need anything, let me know.”
“Thanks.” He was sweet to offer his support, but she needed to stand on her own two feet. Literally and figuratively. She gestured to the patient. “What do you think is wrong with Mr. Dunn? Where’s the source of his infection?”
“I don’t know for sure, but I don’t dare stop his immunosuppressive medications for fear he’ll reject his liver.” Luke glanced down at her rounded stomach, b
arely visible beneath her baggy scrubs. “I wish you’d avoid taking care of transplant patients while you’re pregnant.”
She fought the urge to roll her eyes. “The Center for Disease Control clearly states there’s no clinical reason for pregnant women to avoid transplant patients.”
He frowned. “But what if you become exposed to a virus we haven’t diagnosed yet?”
Caryn knew what Luke meant. Transplant patients were immuno-suppressed, and viruses that were normally innocuous became dangerous to the patient. Pregnancy lowered a woman’s immune system, too. “I always use universal precautions.”
Luke seemed as if he wanted to argue but just then Dana stepped into the room. “Caryn, we’re short-staffed this morning. You can either start the day off with three patients instead of just two or you can be up for the first admission. Your choice.”
“I’ll take three patients, unless no one else wants to be up for the admission. It doesn’t matter. I feel great.” Caryn knew her peers were giving her the option because of her pregnancy. She appreciated their concern, but there was no reason she couldn’t carry a full load.
“Well, at this point I’ll let you be up for the first admission and I’m sure Michelle is going to be asking all of us if we’ll be willing to stay for a double. There are lots of sick calls again for second shift.”
What was with all the sick calls? “All right, I’ll see how I feel. I could probably work a double shift.”
“Wait until she’s gone through everyone else on the list first,” Dana advised. “But thanks. I’ve assigned Michael Dunn to you in bed five, along with Jerome Hartley in bed six. He’s another new admission from the night shift. He has a bleeding ulcer and the trauma team is on the way to evaluate him for possible surgery.”
Talk about a busy day. “All right. Thanks, Dana.”
“I don’t think working a double shift in your condition is a good idea.”
She glanced at Luke in surprise, having forgotten he was still there. “Why not?”
“I’m sure you’ve been under enough stress, without adding more. You need to think about your baby’s well-being.”
Caryn wasn’t going to explain how working a double shift would help get her out of debt so she could afford time off after the baby’s birth. And the longer she stood there, the more irritated she became. “I’m sure there are pregnant doctors who end up working long hours. Would you accuse them of not caring about their baby’s well-being?”
He grimaced. “I’m sorry, I didn’t mean to insinuate you didn’t care about your baby, but, Caryn, volunteering for a double shift is very different than working one out of necessity.”
“Look around, Luke.” She waved a hand at the patient lying in the bed. “These patients are sick. They deserve to have nurses taking care of them.” Caryn placed her hands on her hips. “Working a double shift is a necessity. Someone needs to do it.”
“But that someone doesn’t need to be you.”
His stubborn, misguided concern was simultaneously heart-warming and annoying. Thankfully, there wasn’t time to argue any further because just then the trauma team arrived to examine her patient with the bleeding ulcer. She quickly headed over.
So did Luke. She tried to ignore his presence as she discussed the patient’s care with the team, but she was more aware of him standing beside her than she wanted to be.
Not just because he was a good doctor, but on a personal level.
She briefly closed her eyes, wishing just for a moment that things were different. That she was free to explore these tingly feelings Luke caused.
But she wouldn’t trade her pregnancy for anything. She had to keep her priorities straight. Her baby would always come first.
A guy like Luke wasn’t even in the running.
Luke found himself keeping a close eye on Caryn, along with the rest of the ICU patients as the day progressed. Luckily, he was busy enough that he didn’t have to see Caryn much. He knew he’d made her angry, but darn it, he wished she’d take better care of herself.
“Luke?” Caryn’s voice pierced the din. “I need you to come and look at Mr. Dunn.”
He strode over to bed five. “What’s the problem?”
“His temperature has spiked to 104 degrees Fahrenheit and his blood pressure is hanging in the low nineties systolic.”
No doubt about it, Michael Dunn’s sepsis was getting worse. “Have you drawn all the cultures I ordered earlier?”
“Yes.”
“Even the special viral samples I asked for?”
“All of them. I sent dozens of blood tubes to the lab.” She placed a reassuring hand on the patient’s arm. “I’ve also placed a cooling mattress under him, too, but so far nothing has helped. His fever is sky high.”
A sick helplessness washed over him. Losing two patients in two days was a bit much to swallow on his first fellowship rotation in the ICU. “All right, let’s start a vasopressor to get his blood pressure up.”
“What medication do you want me to start with?”
“Dopamine.” He stood at Michael Dunn’s bedside and racked his brain for some way to treat his infection, as the treatments they’d started weren’t working. Caryn left to get the medication he’d ordered and a second IV pump. She was calm despite the impending medical crisis and he was secretly glad this sick patient was in her care. While she primed the IV tubing, he took the chart and wrote the orders so Caryn wouldn’t have to.
“If we need a second vasopressor, start neosynephrine.” He added more orders to the chart. “And I’d like him to start on antifungal medication, too.”
“All right.” She took the chart from his hands and her fingers lightly brushed his. The shock was electric, zapping his hand as if he’d touched a live wire. The way her gaze darted to his told him she felt it, too. Then she quickly averted her gaze, signed off the orders and tore the second ply out of the chart so she could send it to Pharmacy.
He watched her retreating figure as she left the room. The sexual awareness between them wasn’t just his overactive imagination. He’d never met a woman he was more in tune with. Yet Caryn seemed determined to ignore the sensation.
A wise move. He should be so smart. He didn’t do relationships, although reminding himself of that didn’t seem to help keep his eyes from straying to her. She was off-limits, especially considering her pregnancy, and the sooner he figured that out the better off he’d be.
He pushed the uncomfortable thought from his mind and looked back down at Michael Dunn. He didn’t know what else to do for the patient. Maybe Mitch might have a better idea.
His ideas sure didn’t seem to be getting him anywhere.
“Luke?” Caryn dashed back into the room, working quickly to hang the second vasopressor on the IV pole and priming the tubing. “My other patient is on his way back from surgery. I need you to help keep an eye on Michael Dunn.”
“I can do that.” He had to bite his tongue to keep from telling her to sit down and take it easy. The morning had gone by surprisingly fast and he’d kept the sicker of the patients for himself, leaving the residents to take over the others. Everyone had been busy, though, as all the patients seemed to be getting worse instead of better.
“I’m turning this on at a very low dose, but I’d like you to stay here for a few minutes to watch his blood pressure. Hopefully, I’ll be back soon.”
He nodded. “Do you want me to turn up the dose?”
“Only if the blood pressure doesn’t respond.” Caryn flashed him a tired smile and he was surprised to discover she didn’t look in the least bit exhausted. Like most ICU nurses, she seemed to thrive on intense activity. “I’ll be right back.” She hurried to the room next door.
Only when Michael Dunn’s condition had stabilized and she’d gotten her second patient settled in from surgery did Caryn say anything about taking a lunch-break. In fact, Luke was trying to think of a subtle way to suggest he buy her lunch when Dana came over and insisted on covering Caryn’s patients s
o she could leave.
“I won’t be long,” Caryn promised the petite brunette nurse. “I’ll grab a sandwich and eat in the back room.”
“Just make sure you have enough to eat,” Dana admonished. “I’m sure your baby is hungry.”
Caryn laughed and the way her whole face lit up kicked him in the chest, stealing his breath.
She was so beautiful.
She needed to laugh more often.
Luke toyed with the idea of joining Caryn for lunch, but couldn’t grab a sandwich for himself until he’d consulted with Mitch on what to do for Michael Dunn. Once he was done, he headed downstairs to the cafeteria to get some food and rushed back up to the small nurses’ lounge, hoping Caryn wouldn’t mind sharing a meal with him.
When he walked in he found her sitting on the sofa with her feet propped up on the table, her hand on the small swell of her abdomen and a dreamy expression on her face.
Drawn to her as if pulled by some invisible force, he approached. “Caryn?”
“Hi, Luke.” Her smile dazzled him. He set his lunch on the table and sat beside her.
“Did you feel the baby move?” he asked in a hushed tone.
“Yes,” she said in awe. “For the first time.”
Strange, but he almost asked if he could feel it, too. She must have sensed his desire because after the slightest hesitation she reached for his hand. “Here.” She placed his hand over her belly.
The simple touch shouldn’t have been a turn-on, but it was. Her skin was warm even through the thin fabric of her scrubs and he gently brushed his fingertips over the soft yet firm curve of her belly.
“Just wait, maybe it will happen again.” She covered his hand with hers and the intimate gesture sent a jagged bolt of desire streaking through him.
This was too personal. He should pull away. Except he managed to catch a whiff of her strawberry shampoo, which made him want to lean closer to inhale her scent more deeply. Caryn had run around the entire morning between her busy patients but she didn’t look like it. A tiny fluttering movement under his palm caught him off-guard.
