by Laura Iding
“I see,” she murmured, wishing she’d kept her stupid mouth shut. Her own fault, for obsessing about her personal problems.
No more lapses in concentration, she told herself sternly. As Jake had pointed out the other day, inattention to detail could kill a patient.
“Any other questions?” Jake asked.
“Nope.” Thankfully, her pager went off again. “Excuse me,” she said, moving away to find a phone.
The floor nurse on the other end of the line was clearly upset. “This guy’s going crazy! We need you here, now!”
She dropped the phone and ran.
The patient’s room was complete chaos when she arrived. The patient was a forty-year-old man who’d come in with a ruptured appendix. He was shouting obscenities and had tossed his bedside table and his dinner tray across his room.
“Get Security in here,” she ordered, suspecting that talking him down was out of the question. He was post-op day three and she suspected he might be having DTs from alcohol withdrawal. Grimly, she realized she should have given him something to sedate him earlier. “We need this guy placed in restraints.”
Four security officers arrived and assisted in wrestling the guy down, as the nurses were afraid to get anywhere near him, not that she could blame them. She knew, only too well, what it felt like to be slugged by a patient.
Her pager went off with yet another trauma call. She stifled a sigh. At the rate this night was going, she wouldn’t even get one hour of sleep.
It wasn’t until they’d gotten the rambunctious patient safely placed in four-point locking restraints that she bothered to scroll through her page. Two victims with multiple gunshot wounds. Great. Just what she needed.
“Give him two milligrams of Ativan, and if that doesn’t work to keep him calm, you can repeat it times one. I’ll be back to check on him later.”
“I’m sorry, you have to write that order before you leave,” the nurse said.
She tamped down her temper, knowing the nurse was only following the rules. Rules that had sounded logical enough during orientation but that seemed ridiculous at times like this. Grabbing the chart, she wrote the order very neatly, to prevent any errors, despite being in a hurry. Afterward she bolted down to the trauma room, taking the stairs two at a time.
There were at least a dozen people filling the room, mostly police officers. She could barely see the patients. “What happened?” she asked when Jake waved her over.
“Two young men were caught robbing a liquor store. They tried to shoot at the cops and earned multiple gunshot wounds as a result. This guy has a gunshot wound to the chest—I’m waiting for the cardiothoracic surgeons. You’d better take that one there—he’s not as badly off. His gunshot wounds are in his extremities, one in his arm and the other in his leg.”
“Okay.” Hannah walked over to her patient and sucked in a harsh breath when she saw him. Tristan? No, it couldn’t be. She leaned over, trying to see past the blood. Same facial features and brown hair, but not Tristan. Thank God. Looking at him more closely confirmed the patient was probably a year or two younger than Tristan.
As she began cleaning out the gunshot wounds to investigate the extent of the damage, she did her best to ignore the sick feeling clenching her stomach. This kid wasn’t Tristan, but it just as easily could have been. If not Tristan, one of his not-too-bright friends.
Coming face-to-face with the past she’d tried to leave behind wasn’t easy. Especially since Tristan had just gotten out of jail where he’d served the past three years for armed robbery.
CHAPTER SEVEN
HANNAH did her best to remain objective as she cared for the young gunshot victim, but it wasn’t easy. All the conflicted feelings she had toward Tristan crowded her brain. She pushed them aside, as best she could, to focus on her patient.
How he’d been injured wasn’t her issue. She had to be concerned with repairing the damage, regardless of the cause.
Her victim’s name was Devon Wallace, and his arm wound wasn’t too bad as the bullet had gone through cleanly. Some muscle damage, sure, but nothing serious.
The leg wound was another matter. He had a significant amount of bleeding from his thigh, despite the pressure dressing that had been placed by the paramedics to minimize blood loss. In addition, there was no exit wound, from what she could tell. She had a sinking suspicion that the bullet was lodged near or partially inside the artery.
The policemen hovered right behind her, practically looking over her shoulder, making it clear to the hospital staff that the two victims she and Jake were working on were their prisoners as well as patients. Their presence was rather intimidating, to say the least.
“Get me a vascular surgical tray,” Hannah said to the nurse. “I need to explore Devon’s bullet wound and possibly repair the damage.”
“Doctor, we need the bullet as evidence once you’re able to remove it,” the officer closest to her said. He was a young man, close to her own age, but the bleak expression in his eyes betrayed how he’d seen too much ugliness in his line of work.
A fact she could, unfortunately, relate to. She gave a curt nod, to show she understood his request.
During her early teenage years, cops had been an authority figure she’d been taught to avoid at all costs. But since entering medical school, she’d been forced to reassess her opinion. From the very beginning, she’d learned that cops and health-care workers had a strange sort of bond between them. Maybe because they were both public servants.
Cops were there to protect and the doctors and nurses were there to heal.
“Believe me, once I get the bleeding under control, it’s all yours,” she said.
“Here’s the vascular tray, Dr. Stewart,” the nurse announced as she placed the covered tray on the bedside table. The young officer stepped back to give her room to work. As Hannah pulled on sterile gloves, the nurse unwrapped the sterile covering over the instruments.
“Give him five milligrams of morphine and five milligrams of Versed,” she ordered. “And then help me remove the pressure dressing.”
Even though she’d given him enough sedation to knock him out, she still picked up the prefilled needle and syringe and injected Lidocaine into the edges of the wound to numb the area. The last thing she needed was for Devon to jerk away and cause more damage to the artery. Luckily, the drug combination worked, as he didn’t flinch when she made the first incision. There was a lot of blood coming from the wound as she used the scalpel to widen the entry wound to expose the length of the artery, the better to gauge the injury.
After mopping up more blood, she glanced at the nurse. “Give him two units of O-negative blood,” Hannah ordered. “And get him type and crossmatched for more.”
Jake came up beside her, and instantly her senses went on alert, in a very different way than when the young, good-looking cop had done the same thing. Why, oh, why did Jake have this affect on her? “Are you okay?” he asked in a low voice, as if they were the only two people in the trauma bay.
She nodded, determined to ignore her reaction to him. “Yes, but I’ll need your help if the artery has been nicked. There’s a lot of blood, indicating the artery has likely been damaged.”
“The CT surgeon is here to evaluate Joey, the kid with the gunshot wound to the chest, so I’ll be free to help in a few minutes,” he promised. “I’ll arrange for an O.R. team to be on stand by, in case we need to do a full graft replacement.”
“Sounds good,” she murmured. Jake moved away, and while she should have been relieved, she missed the security of having him close by as she continued to work on Devon’s wound. Exploring farther, she eventually found the bullet, lodged right near the femoral artery. From what she could tell, there was also a very slight tear in the artery.
Not too badly damaged. She was hopeful they could do the repair here in the ED.
Whether he realized it or not, Devon was extremely lucky the cop hadn’t shot a millimeter to the left, or he would probably have
lost his leg or bled to death before getting to the hospital. Even with the pressure dressing the paramedics had applied, and the tiny tear, he’d lost a lot of blood.
She’d certainly seen patients die from a femoral-artery injury. A bit ironic seeing as he’d survive long enough to serve his jail time.
Using the clamps from the tray, she did her best to isolate the area of the tear and then worked on removing the bullet. “Nurse, grab a specimen cup for the evidence,” she instructed.
The nurse opened up a sterile container and then stood waiting. Hannah gently grasped the bullet with the pickups and slowly drew it out of the wound. She dropped the mashed bullet inside.
The nurse closed it and then turned to hand the evidence over to the cop. He took it and then pulled out a slip of paper and a pen.
“I need both of your full names to verify the chain of evidence,” he said, with a hint of apology in his tone. “In case we need you to testify in court.”
Great, just what she needed. Would they look into her background, as well? She certainly hoped not. The nurse gave her name and then the officer glanced at her.
“Hannah Joy Stewart,” she said curtly, hoping he wasn’t serious about the possibility of testifying.
“Could I have your address, too?” he asked. “In case we need to send a subpoena?”
“Give him the hospital address,” Jake advised, coming up beside her, pulling on a sterile gown and gloves. “Since this is work related, he doesn’t need your personal address.”
“Trust me, I could get her personal address if I wanted to,” the officer said dryly.
There was a tense moment as the two men stared at each other, giving Hannah the distinct impression they saw her as some sort of chew-toy to fight over. It might have been funny if Devon’s artery hadn’t been clamped for almost two minutes.
Jake looked away first, turning his attention to Devon’s wound. She moved aside to give him room to work. Since the officer was still waiting, she went ahead and gave him her home address, figuring the cop was right—no doubt he could find out where she lived if he really wanted to.
And the last thing she wanted was for a cop, any cop, to start probing into her background. What if he found out about Tristan? The very idea made her stomach clench painfully.
“Thanks, Dr. Stewart,” he said, with a satisfied smile.
She nodded again, and then leaned over to watch what Jake was doing. He had the artery repaired in less than a minute.
“Release the clamp, slowly,” he instructed.
She did as he asked, releasing the clamp slowly so they could be sure the sutures at the repair site would hold. When there was no more blood loss, she breathed a tiny sigh of relief.
Now for the real test, full circulation. “Check for pulses in his feet,” she said to the nurse. There was a moment of silence as the nurse palpated the top of Devon’s foot and then slowly nodded.
“I feel a pulse. It’s weak, but it’s there.”
“Excellent,” Jake murmured. “Good save.” Why she clung pathetically to every ounce of praise he doled out, she had no clue. He stepped aside and gestured to the wound. “Because of the contamination from the bullet, you’ll need to irrigate the wound very well before you close.”
She glanced up at him in surprise. He was going to allow her to close the entire wound, muscle and all? Not that she was planning to argue. Thrilled with the chance, she nodded. “Understood.”
After only placing a couple of sutures, she was interrupted when the doors from the ambulance bay burst open and two women rushed in.
“Devon! Joey!” the older of the two women shouted. For being older, she moved fast, reaching Hannah and grabbing her arm before the cops surged forward.
“Get back!” the officer yelled, dragging the woman away from Hannah and the sterile field. “Get out of here. No visitors allowed!”
“You can’t keep me from my sons!” the woman screeched, fighting against the cops who were physically pushing her out of the way, back outside the trauma bay. “I’ll call a lawyer!”
“Go ahead—your sons are going to need a lawyer,” the cop responded grimly, “as they’re both prisoners in our custody. They’re under arrest for armed robbery and attempting to shoot a police officer, which means no visitors!”
Hannah tried to shut out the commotion, even though her heart was racing at the unexpected interruption. She knew only too well how prisoner patients didn’t get the same privileges as other patients because they were essentially in custody.
Jake glanced at her, silently asking if she was okay.
She wasn’t, but he didn’t know, couldn’t know, how this entire scenario hit too close to home.
As she finished closing Devon’s wound, she knew the woman who’d rushed into the emergency department could have been her mother trying to see her brother. Or, for that matter, she might have been the one trying to bulldoze her way into seeing her brother.
Because, no matter how badly Tristan had screwed up his life, she still loved him.
* * *
Jake went to find Hannah, once he’d assured himself that the two gunshot victims were settled in their respective beds. Joey was in the ICU after getting the bullet removed from his chest, and Devon was up on the general surgical floor.
She’d handled the femoral artery injury very well, despite her nervousness. Not that she let much of her inner turmoil show, except for near the end, when the mother of the victim had rushed in.
Hannah had looked as if she’d wanted to let the patient’s mother see her son, not that he could blame her. But the cop had stood by his rules of prisoner patients having no visitors.
He wanted to talk to Hannah, to make sure she was really doing okay, but he also had to find Richard. Twice tonight he’d needed Richard’s assistance only he hadn’t been there for him.
He needed to have a chat with Richard, and soon. Just because the attending physicians were now required to take call, it was no reason for the senior residents to slack off on their responsibilities.
Jake hesitated, knowing he should put work concerns first, but he couldn’t do it. Instead, he went to find Hannah.
When he walked onto the general-surgery floor, he frowned when he found her standing in the hallway outside Devon’s room, talking to the young officer that had been down in the trauma bay. The way they were talking in low, hushed voices grated on his nerves. What was she thinking, flirting with a cop?
The walls around his heart hardened. So much for thinking he had a certain connection with Hannah. Was he falling into the same trap as he had with Allie?
The possibility was terrifying.
“Dr. Stewart, do you have a minute to discuss patient care?” he asked in a hard, sarcastic tone.
She looked surprised to see him, but the cop didn’t. The cop glared at him, as if annoyed at the interruption. But Hannah seemed oblivious to the tension between them. “Of course. I’ll see you later, Sam.”
Sam? Sam? They were on a first-name basis? What the hell was she thinking? And why did he care?
“Flirt on your own time, not mine,” he snapped when he headed toward the ICU at such a brisk pace she needed to jog to catch up.
“Flirt? What are you talking about?” she demanded.
“You heard me. It’s obvious to me and every other person in the hospital that the cop wants to date you, a fact I couldn’t care less about except that we happen to have a critically ill patient who requires your attention.”
Hannah’s mouth dropped open in shock at his accusation. The moment the words left his mouth, he wondered if he’d crossed the line. Yet he couldn’t seem to stop.
“Don’t act so surprised,” he continued in the same sarcastic tone. “You’re too smart to be that clueless.”
“You’re crazy,” she sputtered. “He’s a nice guy, that’s all. I was trying to understand his no-visitor rule. I’m not interested in dating anyone. But if I were, the last person I’d choose is a cop.”
/> The frankness of her tone made him think she might be telling the truth. And he just barely caught himself before he could ask why a cop might be the last person she’d choose to go out with.
He leveled his tone with an effort. “Who you date isn’t my business, but Joey is. His condition is critical. I need you to keep a close eye on him for the rest of the night.” Jake tried to pretend the cozy chat between Hannah and the cop hadn’t made him see red. “Joey’s blood pressure is low, yet he can’t get too much volume through blood products because the CT surgeons had to repair the hole in his heart. You’ll need to walk a very fine line with him.”
“Understood.” Her annoyance couldn’t have been any clearer if she’d displayed it across a billboard. Had he misjudged the coziness between them? And what difference did it make one way or the other? “What would you like me to do if his blood pressure drops? Start vasopressors? Or give him more volume?”
After he finished explaining how he wanted Joey’s care managed, he turned and left the ICU, feeling like a fool.
He scrubbed a hand over his face. Why had he overreacted to seeing her talking with the young, handsome cop who had made it clear he wouldn’t have minded asking her out? It wasn’t as if he had any claim on Hannah. If she and the cop hit it off, great. Why did he care?
He needed to stop comparing everything she did to Allie. It was his own fault that he’d fallen for Allie, never once considering he’d been nothing more than a shiny prize she’d wanted to win.
So far, Hannah wasn’t tripping over herself to get his attention. She wasn’t flirting with him as if he were the greatest thing in the world.
Most of all, Hannah hadn’t gone into medicine for the selfish reasons Allie had become a nurse, to snag a rich doctor for a husband. The memory of listening to Allie laugh about it with her best friend still made him burn with humiliation.
Mentally kicking himself for allowing his emotions to get tangled over Hannah, he headed down to his call room. He threw himself onto the bed and closed his eyes but, no matter how much he tried to rest, he couldn’t sleep. Every interaction he had with Hannah seemed to mock him.
