by Laura Iding
She stared at him for a long minute. “It’s not so much that I want to raise the baby alone, but I don’t want to be in a situation where I’m dependent on someone else.”
“Because you don’t want to get hurt?” he probed.
She shrugged, but the flash in her eyes told him he’d hit the center of the bull’s-eye. “Maybe in some ways that’s true. But it’s more than that. I may not have planned to get pregnant, but now that I am I want to make sure my child is raised in a loving home. A stable, steady environment.”
“I understand.” And he thought he did. Although he couldn’t help adding, “You’re smart enough to know that accepting a helping hand on occasion doesn’t mean giving up on that loving home or the stable, steady environment.”
She frowned a little, as if troubled by that. “Yes.”
“Caryn.” He lifted a hand to gently cup her face. “I’d like to help, if you’ll let me.”
Time hung suspended between them as she stared up at him.
Her lips parted, and, unable to help himself, he lowered his head to kiss her.
“Caryn? Is that you?”
She jerked away and he turned in time to see three women making their way through the crowd toward them. He frowned, relieved yet irritated with the interruption.
“Yes. It’s me.” Caryn’s greeting was less than enthusiastic as she turned to the women. “Luke, I’d like to introduce you to Virginia, David’s mom, Debbie, David’s sister, and Renee, David’s sister-in-law.” She eased back, putting space between them. “Ladies, this is Dr. Luke Hamilton, one of our new critical care fellows at Trinity Medical Center.”
Confused thoughts whirling around his head, he managed a smile as he greeted the women.
“What are you doing here?” Caryn asked them.
Debbie raised a brow. “I was going to ask you the same thing. We came from the theater across the street. We had tickets to see that new musical.”
“I’ve heard great things about it,” Caryn said with a smile.
When it looked like Caryn was going to be grilled about her presence at Andrea’s he quickly interrupted, offering to buy them something to drink.
“Sure, I’ll have a Chardonnay,” Debbie agreed. The other women placed similar orders so Luke put the round on his tab and then handed out the drinks as the bartender served them.
There was an awkward pause but Dana came to the rescue, joining the group as soon as she noticed the new arrivals. “Caryn, are you off work again tomorrow?”
She nodded. “Yes, but I work Sunday.”
“Well, don’t answer your phone,” Dana advised. “The sick calls have been coming in like crazy, I’ve never seen anything like it.”
“Lots of the residents have been sick, too,” Luke added. “Must be a virus going around. The ED has been jammed with patients all week. Luckily, lots of them just need to be rehydrated before being discharged.”
“How have you been feeling, Caryn?” Virginia asked with genuine concern.
“Great.” She put a hand over her stomach. “We’re both fine.”
“You look as if you’re not gaining enough weight.” Virginia’s tone was critical.
For the first time Luke noticed Caryn wore maternity clothes that seemed awfully big, dwarfing her small frame. He hoped the baby was growing the way it should. “Caryn, how was your doctor’s appointment yesterday?”
He realized his mistake when Caryn’s eyes widened in alarm. At the same time Debbie and Virginia exchanged shocked looks.
“You had your first doctor’s appointment?” Debbie exclaimed. “Why didn’t you tell me? I would have gone with you. What did he say?”
Caryn swallowed hard and Luke sent her a silent apology with his gaze. She gave him faint smile, and then seemed to gather the remnants of her courage to explain. “My doctor is Marion Kingsley, a she, not a he. And she said I’m fine, very healthy and probably due early September.”
“Are they going to do an ultrasound?” Virginia asked, her voice excited. “I just know you’re carrying David’s son.”
“She suggested an ultrasound, but I haven’t decided yet,” Caryn hedged. She quickly finished her ginger ale. “Speaking of the baby, I need to get home, I’m pretty tired.”
Luke wished very badly he could ask Caryn to stay, at least long enough for him to apologize for opening his big mouth, but within minutes Caryn said her goodbyes and walked outside, with David’s family close on her heels.
It was all he could do not to go after her.
Once Caryn was gone, he lost interest in sticking around himself. The night was young and the place was still hopping, but he didn’t care. Making his excuses to Dana and Mitch, he left.
He stood outside in the cool night air and took several deep breaths. So much for attempting to forget his attraction to Caryn. Hell, he’d almost kissed her right in front of her former fiancé’s family.
Becoming involved with Caryn was scary. Because he didn’t want to hurt her.
Yet even knowing that, he didn’t think he could stay away.
His gut clenched. Either way, it was a no-win situation.
Physically exhausted, Caryn stumbled up the few steps leading into her tiny bungalow and let herself in with her key. After she’d washed her face and climbed into bed, though, sleep eluded her.
The tiny fluttering movements were back, and she put a hand over her rounded tummy and wished she could share the wonder with someone.
With Luke.
She’d known there’d be a good chance she’d run into him at Andrea’s, it was a popular place for the hospital crowd. But seeing him in the casual atmosphere had only complicated things more. Somehow he’d made her feel like the most beautiful woman in the world, despite being five months pregnant.
And for a charged moment she’d suspected he’d been about to kiss her. Until David’s family had shown up.
Despite her best efforts, Caryn knew she’d somehow betrayed her instinctive attraction to Luke, because both Virginia and Debbie had bombarded her with ballistic missiles disguised as innocent questions once they’d gotten outside.
“How long has Luke worked in your ICU?”
“Do you work closely together?”
“Is he married?”
“How often do you see him?”
“How did he find out about your doctor’s appointment?”
Caryn suspected the last question was at the heart of the problem. Finding out how she’d told Luke about her first doctor’s appointment had rankled.
She stared blindly at the ceiling, knowing it was useless to wish things could be different. As much as she was physically attracted to Luke, she had to put the needs of her baby first. A helping hand was fine, but she suspected Luke wanted to offer more. She didn’t need anything. Hadn’t both Renee and Debbie loaned her a whole bag of maternity clothes? Maybe they were a little too big for her but at least she was saving money on that.
She closed her eyes and tried to think about practical things. But instead her mind continued to relive the moment she’d sensed Luke had been about to kiss her.
The next morning Caryn’s phone rang, as Dana had predicted. Not quite as early as she’d expected, though, the clock read eight o’clock as she grabbed the phone.
“Hello?”
“Caryn? It’s Michelle. I’m sorry to call so early, but I’m really desperate for help. Will you come in, just for a few hours? Please?”
Her body wanted to refuse but she couldn’t ignore Michelle’s plea. Plus the extra money, overtime no less, would be an added benefit. “Sure. Give me an hour and I’ll be there.”
“You got it. Thanks a million, Caryn.”
Caryn actually made it to work in less than her estimated hour, as the early morning rush-hour traffic had already thinned out. When she arrived in the unit she was surprised to see Luke. Wasn’t he supposed to be off?
She didn’t get a chance to talk to him right away, though, because the place was extremely busy. Michelle hadn’t been ly
ing. In fact, her boss was wearing a scrub jacket over her work clothes so she could pitch in to help.
After a few hours Caryn headed into the break room to gulp down a large cup of apple juice. When she turned around, she discovered Luke had followed her in.
“Hi.” She smiled, and her resolve to stay away evaporated in the secret thrill of seeing him.
“Caryn.” He stepped close and rubbed his thumb lightly beneath her eye. “You look tired. Didn’t you sleep well last night?”
“Not really.” Her cheeks went warm in response to his touch.
“Neither did I.” His smile was crooked. “Maybe we could get together for lunch later?”
Instead of refusing, she found herself nodding in agreement. “I’d like that.”
“Great.” His pager went off and he reached for it with a grimace. “There’s another potential admission in the ED. I need to go and evaluate her for myself.”
“I understand,” she murmured as he hurried off.
She didn’t exactly have time to sit around either, so she returned to her patient care. As she worked, she couldn’t help but anticipate her lunch with Luke.
Within minutes, Michelle poked her head into her patient’s room. “Caryn, I know you already have two patients, but we’re getting a new admission up from the ED. Will you help with the admission? I’ll keep an eye on your patients for you.”
“Sure.” Caryn couldn’t argue about the workload, not when she’d never seen her boss look more frazzled. “This is Michael Dunn, he’s a liver transplant from about five years ago. He’s septic, although we haven’t gotten any positive cultures on him to pinpoint the source of his sepsis.”
“Unusual for the cultures to take so long,” Michelle said with a frown.
“We just can’t figure out what’s wrong with him. Plus he’s had non-stop diarrhea since his admission. We’ve sent that for cultures, too, but haven’t found anything.” Caryn washed her hands in the sink. “What’s the new admission?”
“An elderly woman with severe dehydration and electrolyte imbalance. I think she’s having some heart trouble as a result.”
Caryn nodded and crossed over to the only empty bedside in the unit. She’d barely gotten the room ready when Luke brought up her patient.
“This is Mrs. Whalen,” he said as she connected the patient to the bedside monitor. “We’ve given her one liter of fluid in the ED so far. She needs more but we can’t give it too fast.”
“What was her latest potassium?” Caryn asked when she saw the premature beats on Mrs. Whalen’s EKG.
“Still low at 2.8. Twenty milliequivilants are hanging.”
“Only twenty?” Caryn was surprised.
“She only has a peripheral line.” Luke glanced at her. “When you’re ready, I’ll need your help to set up for a central line. Once we have that in place, we can give concentrated electrolytes.”
“Sounds good.” She finished doing her baseline set of vital signs then quickly wrote them on her flow sheet. “Do I have time to do a full admission assessment?”
Luke shook his head. “No, I’d really like to get the line in. I don’t like the looks of her rhythm.”
Caryn couldn’t blame him. She didn’t like the looks of her patient’s EKG either. The poor woman was almost ninety and looked so frail lying in the bed, hardly aware of what was going on around her.
She went out to get the necessary equipment then helped Luke set up a sterile field around the subclavian site. She donned a mask and sterile gloves herself as there wasn’t a resident around to assist.
“I can’t believe the sick calls are still coming in droves.” Caryn held up the bottle of lidocaine so that Luke could draw some into a syringe.
“Yeah, so much for our respective days off, huh?” He fell silent as he gently inserted the needle under Mrs. Whalen’s skin and injected the local anesthetic to help numb the site.
The monitor let off a triple beep and Caryn glanced up in time to see the patient go into V-tach.
“Get me a crash cart,” she yelled, shoving the tray of sterile supplies away with her foot.
“Here.” Michelle wheeled it in.
“Get ready to shock her,” Luke said. Then he frowned. “Wait a minute, doesn’t that look like Torsades?”
Caryn had already ripped open the defibrillator pads to place them on Mrs. Whalen’s chest. She stared at the monitor for a minute, seeing the way the V-tach grew larger then smaller in amplitude. “You’re right. It is Torsades de pointes.” Which changed their treatment plan significantly.
Luke nodded. “Get the pharmacist up here with two grams of magnesium,” he said to Michelle, who ran to do as he’d asked. “Caryn, we can still shock her, but without the magnesium we may not be able to convert her.”
“Do you want me to do CPR instead?” Caryn asked.
He hesitated. “Let’s try a series of shocks, just in case. Then we’ll do CPR until the pharmacist brings the magnesium.”
Caryn attached the hands-free pads then charged up the defibrillator. They’d just completed the three sets of shocks when the pharmacist arrived, short of breath but with the necessary magnesium sulfate.
Abandoning the defibrillator, Caryn quickly gave the bolus of medication. They watched for almost a full minute before the patient converted back into normal sinus rhythm.
“Whew.” Caryn took a deep breath and pushed the crash cart out of the way. “That was close.”
“You’re not kidding.” Luke frowned. “Maybe I should have given her magnesium before waiting to start the central line.”
“Don’t second-guess yourself,” Caryn cautioned. “You made the best decision with the information you had at the time. Besides, she needed additional electrolytes, other than just magnesium. The central line was critical.”
“I guess you’re right.” Luke dragged his hand over his face. “Thanks. I needed to hear that.”
She couldn’t help but smile. It was nice to be able to offer support to him after the things he’d done for her. “You’re welcome. Ready to place that catheter now?”
Once the central venous catheter was placed, she turned to Luke. “What caused her to become so dehydrated anyway?”
“The same flu bug everyone else has.”
“Not a flu bug after all,” Michelle said in a weary tone from the doorway.
Caryn looked up. “What do you mean?”
“We just got a call from the department of health and human services. Apparently the Milwaukee public water system has been contaminated. All these sick calls aren’t simply because of the flu, people are sick because they’re infected with Cryptosporidium.”
Caryn felt her jaw drop as the magnitude of what her boss was saying sank in. “You’re kidding.”
“I wish.” Michelle sighed. “It gets worse. We had a record number of sick calls today, sixty-four to be exact with possibly more still to come. Our hospital administrators have just declared a state of emergency because so many staff members have called in sick.”
Her stomach sank. “What exactly does that mean?”
“It’s just like a snow emergency. All the staff who are currently here are required to stay inhouse. Indefinitely.”
CHAPTER SIX
“CRYPTO?” Luke stared at the woman in the doorway. He didn’t know her name, but she had to be the ICU manager as she wore street clothes beneath her scrub jacket. “The Milwaukee water system is infected with Crypto?”
“Yes.” The woman raised a hand to rub her temple, as if she had a headache. “And our entire medical center uses Milwaukee water.”
“It’s not filtered?” Luke’s fingers tightened into fists at his side, unable to believe what he was hearing.
“It is in some areas, like in all the ICUs, the OR, the oncology and transplant units. But the rest…” She shrugged.
The enormity of the situation was staggering. No wonder there had been so many sick staff members and patients. His gaze swung to Caryn. “What about you? How are
you feeling?”
“So far, I’m good.” But her hand was splayed over her abdomen as if to protect her baby. “I have filtered water at home,” she confessed. “Not that I’m good about changing the filters.”
He gave a silent prayer of thanks that Caryn wasn’t infected. Her pregnancy would have made the risk much higher.
“Caryn, you need to take over your other patients, I have to make phone calls to all the nurses who live outside the Milwaukee area to see if they’re willing to come in.” The ICU manager shook her head. “This whole situation could get worse before it gets better.”
“OK.” Caryn snapped her fingers and turned to Luke. “Michael Dunn.”
“You’re right.” Luke immediately figured out what she meant. “He’s probably got Crypto, too.”
“But we sent stool cultures,” Caryn said as they both headed directly toward Michael’s room.
“They don’t routinely check cultures for Cryptosporidium.” Luke could have smacked himself for not thinking of this earlier. Diarrhea wasn’t a common symptom of sepsis, he should have asked for specific parasite cultures, too.
“Can we treat him?” Caryn asked, keeping her voice low.
“I’m not sure. There’s a new drug called nitazoxanide but it’s only been tested on patients with normal immune systems.” He hesitated then added, “I really need to call Mitch, see what he thinks.”
“I understand.” Caryn’s wide eyes betrayed her anxiety.
He reached over to take her hand in his. She didn’t pull away, but clutched him firmly as if she needed this small contact as much as he did. He gave her hand a gentle squeeze, then reluctantly let go. “I’ll let you know what Mitch wants to do.”
“I’ll be here.” Caryn smiled at him, then turned to her patient.
Getting a hold of Mitch was easier said than done. After almost ten minutes of waiting for him to answer his page, he finally discovered why. “You’re sick, too, aren’t you?”
“Oh, yeah.” Mitch’s voice sounded strained, as if he was in pain. “I heard about the Crypto outbreak on the news while I was stuck in the bathroom, experiencing the symptoms firsthand. Good timing, huh?”
Luke wanted to laugh, but didn’t think Mitch would appreciate humor at his expense. He got straight to the point of his call. “I need to treat Michael Dunn for Crypto. Any suggestions?”
