Jan nailed her with a glare. “He rides a chopper.”
Carmen rolled her eyes. “Oh, great. So here we go with another lame excuse from the queen of brush-offs. What was wrong with the last guy you went out with? Oh, yeah, his teeth were too white.” She shook her head in a slow, wide swing.
“That guy’s teeth were practically fluorescent, Carmen. I couldn’t look him in the face without needing sunglasses.”
Carmen worked to conceal the crack of a smile. She moved closer and lowered her voice. “Beck is different. You’ve got to admit, he’s a real find. A keeper,” she sang. “Why not give him a chance?”
Jan drew a deep breath and adjusted her glasses. “Look. I admit he’s a hunk, but let’s face it. He’s out of my league.” She gave a pleading puppy-dog glance. “You don’t want to be responsible for my broken heart, do you?”
Carmen slumped her shoulders. “You’re impossible. Someday you’re going to realize what you’ve missed out on and regret it.” Carmen couldn’t possibly know what a home run she’d hit with that bit of wisdom. She raised her hands in defeat. “OK. I give up. I’ll butt out.”
Knowing Carmen as she did, Jan knew the woman had no intention of butting out. At least Jan had bought herself some time to figure out a strategy of her own on how to deal with the Beck situation.
She spun around and headed toward the triage station. Thankfully tonight it was her turn to assess patients and assign their priority in order of their illness’s severity instead of at what time they showed up at the ER. If she played things right, she could possibly avoid Beck the entire shift.
Before she reached her station, Beck appeared at the front desk. Her heart rocked with an unwanted reaction. He looked clean-shaven, and if it were possible, his hair was even shorter. He wore his dark police uniform like a new-age knight, a tall, broad-shouldered, noble public servant. To protect and serve.
Not fair.
When he noticed Jan and quickly looked away, she almost wished things could be normal between them instead of strained. Then she made a beeline for the triage door.
Patients arrived in clumps. Eight different maladies rushed the front desk within five minutes of each other, and Jan worked her way through the problems in order of severity. The chest pain first, the child with the asthma attack next, the skateboard accident with a potential fracture third. The frequent-flyer migraine and the infected lip piercing would have to wait a bit longer. The rectal pain, “microscopic bugs under the skin,” and the new-onset fever and cough would most likely have a two-to three-hour wait before seeing an emergency doctor tonight.
Three hours into the busy Sunday evening shift, a car sped into the red zone directly in front of the emergency entrance. A skinny teenage boy frantically rushed inside.
“I need help,” he called to the desk clerk. “My girlfriend just had a seizure.”
Jan heard him and rushed to the wheelchair storage area, thankful their stock hadn’t been depleted, grabbed one and wheeled it to the curb. A lethargic redhaired girl drowsily lifted her head from the front seat of the car.
“You’re going to be OK. You’re at the hospital now,” Jan reassured her as she assisted the doe-eyed, freckle-faced girl into the wheelchair.
“What happened?” Jan asked as they re-entered the hospital.
The boy jumped in. “We were, like, just talking, and she got this strange look on her face and then, dude, she started shaking. She even foamed at the mouth.”
Sluggish, but coming round, the girl was able to give her name, Cassie, and answer the question of where she thought she was. She was a bit foggy on what time it was. While Jan settled her, she asked more questions. Cassie knew the day’s date and her birthday. She was only sixteen. Her parents would need to be contacted as her condition wasn’t life-threatening.
“Have you had any physical trauma lately? A fall? Bump your head?”
Cassie shook her head. Her vital signs, including her temperature, were normal, with the exception of a rapid heartbeat.
“Take any drugs recently?”
The boyfriend stepped back and got quiet.
“No,” Cassie stated.
“Any alcohol today?”
Again she shook her head. Jan hadn’t smelled anything obvious either.
“Been sick lately? Have you been getting enough sleep?”
“No and yeah.”
“Show how many fingers I’m holding up.”
The girl mimicked three digits. A quick head and face exam proved to be normal. A tap test of reflexes in all four extremities was also unremarkable.
“Tell me what happened.”
“I dunno. I, like, had this weird feeling and then I was like…here.”
“We’ll admit you to the emergency ward for a thorough neurological examination, but your parents need to consent before we can do anything.”
The attending boy’s eyebrows rose and he edged closer to the triage room door.
Cassie lazily nodded her head. “OK,” she said.
Jan didn’t want to risk putting Cassie back in the waiting room where she’d go unobserved, so she called the ED ward clerk and secured a bed. She also initiated standard protocol orders for the patient—monitor, IV and oxygen—prior to being examined by a doctor.
Jan wheeled Cassie to the ER entry, tapped in the code and waited for the doors to open.
“Look,” the boy said, with a skittish glance. “I gotta go. Cass, I’ll call you later, OK?”
For the first time during her ER visit Cassie looked alert. “Why?”
“I just gotta. Your parents are coming and all, so that’s cool. Look. I’ll call ya. OK?” He squeezed her shoulder and took off.
Cassie got sullen and slumped in the wheelchair. “Whatever,” she said under her breath.
As Jan rolled the girl past the doctor and nurses’station, Carmen indicated room five was vacant. Jan nodded and proceeded toward the room, but on her way made a stop at the linen cart for a few extra bath blankets.
When they arrived in the room, she handed Cassie a hospital gown and pulled the curtain for privacy. The tall teen turned her back to Jan and removed baggy jeans and a loose shirt. Jan padded the bedside rails with the extra blankets as part of the seizure protocol for patient safety. When Cassie had changed, she assisted her into the bed, applied oxygen, blood pressure and oxygen sat monitor and secured the bedrail.
“Was that guy your boyfriend?” Jan asked casually, pretending to be busy with putting the girl’s belongings into a large plastic ER patient bag.
Cassie harrumphed. “Used to be.” She folded her arms across her chest and stared at the ceiling.
Before starting an IV, Jan placed the personal items bag under the gurney. About to ask if Cassie was sexually active, she noticed the bed shaking. She glanced up to find Cassie rigid, staring at the ceiling with her jaw locked and hands fisted, her legs stiff and straight. The tonic phase of a seizure.
“I need help in room five,” she called out, not leaving the bedside.
Cassie had moved into the clonic phase with rhythmic jerky movements when Beck appeared.
“Help me get her on her side so she doesn’t aspirate anything.”
Beck jumped into action, protecting the girl’s head while assisting Jan in turning Cassie onto her side. The patient went back into the stiff tonic phase. Jan turned on the wall suction and hooked up a suction device. She knew not to put anything into a patient’s mouth during a seizure, but waited for a chance to suction the excess saliva from the corner of Cassie’s mouth.
“How’s her O2 sat?” Jan asked, distracted with the convulsing patient.
“It’s good,” he said, with his large hand guarding Cassie’s head as it jerked and twisted.
Having Beck near felt reassuring, though there was nothing they could do until the seizure had settled down. Within another minute Cassie stopped jerking and grinding her teeth. Her heart rate was still rapid, but her blood pressure was normal as was her oxygen level. She stared blankly into
the distance.
Jan suctioned her mouth thoroughly, which got a reaction from Cassie. She pulled in her chin and looked annoyed but didn’t utter a sound. Beck started an IV in her arm.
Gavin appeared and began issuing orders. “Get a glucose, BUN,’ lytes, drug screen. IV normal saline, TKO. Order a stat EEG and CT scan of the head.”
“Write the orders down,” Carmen called out from her nurses’ station perch. “They’re a little busy to take verbal orders, Dr. Riordan.” She’d emphasized the word “doctor”.
He followed her recommendation, grabbed a green sheet and scribbled out his orders at the nearby patient bedside table.
Beck found the proper-colored tops for the lab-test vials in the IV tray and drew the required blood before hooking up the intravenous line to fluids. Jan noticed the ease with which he worked as she labeled the specimens. She rushed the vials down to the lab to expedite the results and to get away from Beck. After last night’s kiss, she couldn’t afford to be in the same vicinity as him for any length of time. She couldn’t allow herself to fall under his spell and forget the secret that was bound to keep them apart forever.
Jan returned to the triage room, surprised to see the patients with the rectal pain and infected lip piercing still waiting to be seen. The waiting room had filled up again, and a new case needed her immediate attention. Evidently, Sunday night pot roast dinner had turned scary when the forty-six-year-old patriarch had forgotten to chew.
The wife frantically explained they’d tried the Heimlich maneuver, to no avail.
“If he’s breathing, there’s no need to use that maneuver. See the constant drooling?”
The woman nodded.
“The meat is lodged in his esophagus and he can’t swallow it. Fortunately, it’s not blocking his airway.”
“What does that mean?”
“It means we’ll have to call the on-call GI guy to come down and do an endoscopy to remove it.”
“Will he be OK?”
“They’ll sedate him first, and he should be fine, but he may need to stay overnight for further evaluation.”
The drooling man bobbed his head up and down in agreement, looking as though he’d do anything to get the lodged chunk of meat out of his throat.
An hour before the end of shift there was a lull in triage and Jan snuck back to the nurses’ lounge for a bottle of water. Gavin called out her name before she could return to her station. He motioned to her from his office to come over.
When she stepped inside, she found Beck already seated. When Dr. Riordan gestured for her to sit, she had no choice but to take the only remaining chair in the room…next to Beck.
“Tell me about Cassie,” Gavin started.
Jan leaned forward and took a breath to gather her thoughts. She’d seen so many cases that night she needed to make sure she was talking about the same patient. “The seizure patient?”
“Yeah. It wasn’t a seizure.”
“What do you mean?” Jan glanced at Beck for back-up.
“You could have fooled me,” Beck said.
“The electroencephalograph was normal. Completely normal. So was all of the lab work. The preliminary toxicology is negative for the usual suspects. No cocaine, speed, alcohol, or barbiturates.”
They all sat in silence, considering the implications of the findings.
“What about the CT?” Beck asked.
“Normal. No sign of brain lesion or injury.”
“Are you saying hers was a pseudo-seizure?” Jan asked.
Gavin shrugged. “Could be.”
“Once this soldier in my squad developed seizures and they eventually figured out they were psychogenic in nature,” Beck said. “They looked like regular convulsions and he wasn’t faking them. They were real to him, but he didn’t have any abnormal brainwave activity. Turned out he’d developed post-traumatic stress syndrome and certain sounds and smells triggered these events.”
“Cassie mentioned that the boy who brought her in had wanted to break things off today. She didn’t seem too upset about it. He couldn’t seem to get away fast enough when he heard her parents were coming in, though. I’d never in a million years have guessed that she was faking it.”
“She wasn’t necessarily faking it. In some instances personal problems can trigger seizure activity, though, like Beck said, it’s psychosocial in nature,” Gavin said. “I’m admitting her for observation and calling Psych and Neuro in for an evaluation and we’ll go from there. But what I do know is, she’s pregnant.”
Jan’s head shot up. “But she’s as thin as a waif.”
“I know. I stopped the lorazepam the minute I got the results. She may not have told her parents yet, so I’ll wait until she’s alone and more alert before I talk to her. Anyway, if you guys didn’t spot anything else while you were with her, I’d better get on,” he said, before bustling off.
Jan glanced at Beck and quickly away, before he could beat her to it. If convulsions could develop from hoarding personal and emotional trauma, or from being unwed and pregnant, hell, she should have been seizing for years now. She shook her head and rose to leave. Beck followed her outside.
He tapped her on the shoulder. She turned and found an earnest expression on his face. “I happened to hear you have tomorrow off, and was wondering if you’d meet me for breakfast.”
After a short burst of palpitations, Jan squinted and flashed a glare at Carmen, who averted her eyes rapidly. What should she do? The man should hate her for jilting him all those years ago, yet he’d been a perfect gentleman at work and had just asked her out for an innocent breakfast. Could she trust the amiable smile?
Deep groves bracketed his mouth and stretched all the way down to his chin. His eyes softened with the gesture and she fought the desire to look at him again, more thoroughly.
“Why?” she asked, staring at her feet.
He lowered his voice. “We used to be friends, January. Remember? I’d just like to do some catching up.” He lifted his palms. “But if that’s not OK with you, I’ll understand.”
Jan swallowed, guilt rolling in like a huge wave. “I guess breakfast would be OK.”
His relieved smile reminded her how easy it had been to fall for him. She couldn’t let that ever happen again.
What was his story? Why would he want to spend time with her after she’d done such a dirty trick by running away and breaking things off when he’d needed her most? When she’d needed him most?
Could she trust him with his little innocent breakfast proposal, or was she walking into some kind of trap?
CHAPTER FOUR
THE next morning, not wanting to wear anything suggestive, Jan dressed carefully in a red Mexican-styled blouse with a bright embroidered bib for her breakfast date with Beck. He’d suggested the Pancake House, and she couldn’t help but think he’d chosen their favorite teenage haunt in Glendale as a reminder. Amazingly, the place hadn’t changed much at all.
Jan entered the A-frame building to find Beck already seated in a booth near the entrance. She wrapped the sweater she’d thrown over her shoulders tighter and tied the sleeves around her neck. The old lime green vinyl seats may have been replaced with plusher patterned wine-colored upholstery, but she’d quickly realized he’d chosen their favorite booth, the one by the full-length triangular window. She’d be extra-careful not to get drawn in with nostalgia.
With unreadable eyes, Beck watched her approach and stood when she got closer. “Good morning,” he said with a nod.
“Hi.” She glanced around. “It’s amazing this place is still in business.”
He handed her a large menu. “They’ve even upgraded the food with a few ‘lite’ and healthy items.”
The mundane conversation helped her slip into her seat and deal with the unavoidable anxiety that welled up inside. Meeting Beck for a meal for the first time in thirteen years took more courage than she’d ever dreamed. She tried to ignore the tingling in her palms and twitchy oversensitive feel of her sk
in. Recalling the kiss they’d shared on Saturday night, and her rapturous response, she’d do anything to avoid touching him again.
Beck tilted his head. “You look like you’re facing a death sentence. That’s a little harsh on a guy’s ego.”
She shook her head, releasing tensed facial muscles. The truth was she didn’t think she’d be able to eat a bite around him. “I just haven’t had my morning coffee yet, that’s all.”
He studied her face, and she knew he didn’t buy one phony word she’d uttered. He waved for the waitress. “Two coffees, please.”
Jan drew a deep breath to force herself to relax, but the tactic failed miserably. Her hands twined into a ball on the table. Why in the world had she consented to meet him?
“So what’s it going to be, a short stack?” he asked with a mischievous glint in his gaze soon after the waitress had left the table.
Why did she allow herself to look into his eyes? There was no trace left of the determined boy she’d once loved. He was all man, confident and proud. She, on the other hand, had all of a sudden reverted to the shy and uncertain tenth-grader on their first date. No. She couldn’t think of this as a date. It was strictly a get-together to touch base and “check in” with an old friend after a long absence.
“A short stack sounds good,” she said.
“That’s more like it.”
“The pancakes?”
“The blouse. It looks more like the girl I remember. All bright colors and attitude.”
Her cheeks warmed and she reached for the glass of ice water. That girl had been missing since her pregnancy. “I wasn’t nearly as flashy as you paint me.”
“You were flashy, January. Trust me.” He gave a knowing grin, approval written all over his face. “That’s part of what I dug about you.”
She shook her head, a hot blush rising from her neck. Flashy or not, she had trusted him, with all of her heart, but look where that had gotten her.
“Level with me—whatever happened to the modeling career?” he continued.
Did he have to remember everything? “That was my mother’s idea,” she bluffed, and hoped he didn’t catch on.
Temporary Doctor, Surprise Father Page 5
