A White Knight in ER

by Jessica Matthews

  Surprisingly enough, he wasn’t even tempted to accept. Seeing Bonnie and Megan side by side, he knew which woman he wanted and which one he didn’t.

  ‘Thanks for the offer,’ he said as he flashed Bonnie one of his killer smiles to soften the rejection. ‘I think I’ll see what luck I have on my own.’

  She squeezed his arm—a slow, lingering type of squeeze that was filled with promise and guaranteed to turn a man into a pliable mass. A few weeks ago it would have been effective on him, but not now. The only touch he wanted to experience was Megan’s, and from the disgusted look on her face it wouldn’t happen any time soon, if ever.

  ‘If you should change your mind, just give me a call.’ Bonnie winked. ‘Day or night.’

  ‘I will.’

  Louise broke into the conversation. ‘You do realize that if you’re going to give her away, the new owner will want a guarantee that she’s healthy. I’m talking vaccinations, deworming and who knows what else.’

  He’d guessed that. Paying for a trip to the vet didn’t sound bad if it helped with his ultimate goal of someone taking the retriever off his hands. ‘Not a problem.’

  ‘As a dog owner myself,’ Gene added, ‘you’d better switch to dog food. If they get used to people food, they won’t touch the stuff they’re supposed to eat.’

  ‘I have a friend who works at the grain co-op,’ Bonnie said brightly. ‘I’ll put in a good word for you. I’m sure he’ll give you a discount.’

  As Bonnie fluttered her eyelashes, Megan wondered how much longer she could tolerate the other nurse’s blatant bid for Jonas’s personal attention.

  Normally, she welcomed the opportunity for staff to mill around the central nurses’ station. It was a time for people to chat, catch up on the latest news or just talk about medical concerns on a more informal basis than in the departmental meeting. Yesterday she’d taken the initiative to mention her broken engagement and had glossed over the reasons with a hearty, ‘We decided that we wanted different things in life.’

  While she enjoyed these impromptu gatherings, she almost wished they would end. The female staff flocked around Jonas like buzzards on the scent of fresh roadkill and their interest rarely centered on hospital topics. Even Gene, the only other male on this shift, didn’t seem to mind the admiration Jonas received.

  Too disgusted by the younger nurse’s posturing to watch or listen to what would happen next, Megan rose without a word. She’d thought of a few choice comments to make, but talking required more of an effort than she could summon. Last night her stomach had started a perpetual roller-coaster ride and the OTC meds she’d taken hadn’t helped. Jonas’s warnings about the side effects of the antiretroviral medications had become fact and she could only hope her symptoms would level out before long. She didn’t know what she’d do, or how she’d manage, if they became worse.

  Intent on putting distance between herself and the crowd that had gathered around Jonas, she walked toward the supply room. Actually, she ambled, because every step seemed to aggravate the churning in her midsection. If fate was kind, Louise’s huge white board that showed the patient room assignments would remain empty long enough for her to chew another handful of antacids.

  Jonas fell into step beside her. ‘Not in the mood to be sociable this morning?’

  ‘It’s too early to watch you two drool over each other.’

  He clutched a hand to his chest melodramatically. ‘Drool? We weren’t drooling. At least, I wasn’t.’

  She raised one eyebrow as she met his gaze. ‘You could have fooled me.’

  ‘Bonnie was just being helpful.’

  ‘Yeah, right.’ She was used to her colleague’s flirtatious ways. Bonnie was known to play the field and Megan wouldn’t be surprised if every male in the county under the age of forty had sampled her well-developed charms.

  What did bother her, and it shouldn’t, was how Jonas seemed to preen under Bonnie’s attention. To think she was worried about contracting HIV from a needlestick injury when Jonas should be worrying about that and every other possible disease if he accepted what the other nurse was freely offering.

  As she popped the pink tablets in her mouth, she saw the smirk on his face. ‘Stop smiling.’

  He laughed aloud. ‘You’re jealous.’

  ‘I am not jealous. Why should I be? If you want to spend your time with Bodacious Bonnie, then—’

  ‘Bodacious Bonnie?’

  ‘Don’t tell me that you haven’t noticed her cleavage.’

  ‘It’s rather impossible not to,’ he said in a dry tone.

  Of course it was. The younger nurse always wore T-shirts that showed her curves to their best advantage. Thanks to regular exercise and Mother Nature who’d kindly made her well proportioned, Megan wasn’t unhappy with her own figure. However, compared to Bonnie, she felt positively shapeless and dowdy.

  ‘Just so you’ll know, they’re fake.’

  Curiosity gleamed in his eyes. ‘Really?’

  ‘Yeah, really. Now, if you’re through bothering me, I have to check our stock of IV sets.’

  ‘You know,’ he commented idly, ‘until this week, I thought you didn’t have a grumpy bone in your body.’

  For a woman who always tried to focus on people’s good qualities and overlook the bad, his gentle chastisement hit hard. Normally she was the most even-tempered person, but ever since Jonas had interfered in her life she’d turned into a person she didn’t like.

  He hadn’t interfered, she reminded herself. At least, not to the point where he’d affected the outcome. In all honesty, she should thank him for saving her from certain disaster.

  She rubbed the back of her neck. ‘I apologize. I just don’t…’

  ‘Feel well,’ he finished.

  Megan stared at him in surprise. ‘How did you know?’

  ‘I’m a doctor. I majored in “green around the gills” and, believe me, you have a galloping case of them. So the old stomach is on the warpath?’

  ‘Like you wouldn’t believe.’ Megan pressed a spot in her middle. ‘I’ve tried the usual over-the-counter remedies, but nothing has worked.’

  ‘I’ll prescribe something stronger,’ he said. ‘If that doesn’t help, we’ll cut down the dosage of your medications.’

  ‘But won’t they be less effective against the virus?’

  ‘Not if you take the same number of milligrams in a day’s time. You’ll just take them more often.’

  ‘Does that protocol really help the nausea?’

  He shrugged. ‘For some, yes.’

  She wasn’t totally reassured. She’d rather discontinue the offending drugs but, given the alternative, she’d take nausea any day. ‘Any word from the lab about Carl Walker’s Western blot results?’

  ‘No. I thought I’d hear something yesterday, but I didn’t, so I’ll look into it today. I promise to let you know what I find out.’

  ‘Thanks.’

  ‘Now, why don’t we go into the lounge and I’ll fix a cup of hot tea? I’ll bet I can even find a few crackers.’

  Darn it! She didn’t want him to be kind or thoughtful, but crackers and tea did sound heavenly. ‘Then you know how to boil water?’ she teased.

  ‘Two minutes in the microwave,’ he said promptly, and put actions to his words while she looked on. ‘Don’t skip lunch either. Stick to gelatin and chicken soup.’

  Jonas was definitely being far too kind for her peace of mind. Right now she had enough on her proverbial plate without adding Jonas to the mix.

  Don’t be a fool, she chided herself. He’s not adding anything to the mix. Preparing tea had been a friendly gesture, nothing more and nothing less. Her weak stomach was making her think all sorts of weird thoughts that were grounded more in fantasy than in reality.

  He passed her the steaming cup and she decided that she’d only imagined the way his hands had lingered before he’d let go. ‘Take things easy for a few minutes,’ he advised. ‘Come back when you’re ready. If we need you before
then, I’ll let you know.’

  Megan drank most of the tea and ate sufficient crackers to settle her stomach before Gene popped his head inside the room to make an announcement. ‘I’ve got a patient for you, Megan.’

  ‘Who?’

  ‘Mrs Spears. No one else will take her.’

  Today Megan didn’t want her either, but she didn’t have a choice. ‘I’ll be right there.’

  As Megan had suspected, Violet Spears’s problem hadn’t developed overnight and would take a long time to cure.

  ‘You’ve had this for quite a while, haven’t you, Mrs Spears?’ Megan asked as she gazed at the ulcer she’d uncovered on the woman’s leg. It was the size of her fist, had an angry-looking core, and from the grimaces on Mrs Spears’s face was extremely painful.

  The sixty-year-old patient with gray hair that hadn’t seen a comb for the last year nodded. ‘Don’t remember exactly when I noticed it, but it’s gotten so I cain’t get round town on my bike.’

  Violet Spears wasn’t unknown in the ER. She arrived from time to time, needing treatment for a variety of ills that ranged from pneumonia to a sliced hand. No matter what the situation, she arrived in the worst-smelling condition imaginable. Although she owned a house, she was for all intents and purposes homeless. According to the social workers, she lived without electricity or heat, except for a fireplace that they were afraid was more hazardous than helpful.

  ‘How’s your other leg?’ Megan asked as she tugged off the gray sock on Violet’s left foot and placed it beside the red one she’d already removed.

  ‘It’s fine.’

  Megan noticed an area that would probably turn into another ulcer soon if left untreated, but didn’t comment. Jonas could decide what to do for this woman who needed help but usually refused it.

  ‘I’m going to get the doctor,’ she told Mrs Spears. ‘I’ll be right back.’

  ‘I ain’t goin’ nowheres,’ the woman answered with a toothless grin.

  Megan found Jonas at the nurses’ desk, surrounded by staff members waiting for his direction. ‘He needs one pill a day for ten days,’ he instructed Gene. ‘If he isn’t better by then, he should see his family physician or visit us again.’

  ‘Will do.’

  ‘Louise,’ Jonas called. As the ward clerk turned to him, he said, ‘Let me know when Radiology has those X-rays done on the woman in room five. And if we don’t have lab results on Mr Lassiter in five minutes, call and remind them that we aren’t getting any younger.’

  ‘Sure thing, boss.’

  Jonas looked at Megan. ‘What do you have?’

  She handed over her chart. ‘Here’s one of our more colorful local characters for you.’

  He raised one eyebrow. ‘We’ve already treated a fellow who insists on wearing his clothes inside out and tinfoil on his head and a guy who caught a tender portion of his anatomy in his zipper during a lunchtime liaison with his secretary. Who’s more colorful than they are?’

  ‘Mrs Spears,’ she answered promptly. ‘Have you ever seen a little old lady riding a bicycle around town, carrying a loaded box or trash bag in her basket?’

  ‘Can’t say that I have.’

  ‘Well, you will. People have caught her sifting through dumpsters and hauling off anything and everything. This is the lady.’

  ‘Hmm.’ He glanced at her record. ‘BP is a little high, but not bad. So she has an ulcer on her leg?’

  ‘And the start of one on the other. Good luck.’

  ‘What for?’

  ‘Whenever she’s been admitted, she checks herself out AMA,’ she said, referring to the ‘against medical advice’ designation. ‘And if she doesn’t need hospitalization, unless you can cure her with a single shot, she won’t comply with your treatment.’

  ‘Then she drops in quite often?’

  ‘Surprisingly enough, we only see her a few times a year. She’s probably built up an immunity to almost every germ and virus on the planet.’

  He tucked the clipboard under his arm. ‘Then let’s see what I can do.’

  Megan followed as he entered the room and introduced himself to the woman sitting on the bed, both dirty legs stretched out on the pristine white sheets. Today was certainly the day for unusual characters. Not many people arrived in the ER wearing a pink sweater with frayed cuffs and holes in the elbows and a dingy yellow T-shirt. Greasy food stains dotted her blue-flowered skirt which, at the moment, was pulled above two dirt-encrusted knobby knees.

  Jonas tugged on a fresh pair of latex gloves as he peered at her shins. ‘You have cellulitis, Mrs Spears, and it’s going to take time to treat it properly.’

  Her cloudy gray eyes narrowed. ‘Time? How much time?’

  ‘It depends. A few days, maybe a week.’

  ‘I don’t have to stay here, do I?’ she asked as Jonas began cleaning the wound with the supplies Megan had already set on a tray.

  ‘The dressings have to be changed twice a day. Can you do that at home?’

  ‘I cain’t stay here,’ she exclaimed.

  ‘Why not? You’ll get three meals a day, a warm bed, a bath…’

  Mrs Spears shook her head violently. ‘Nope. I only gots enough money to pay for today.’ She shifted position and pulled a handful of one-dollar bills out of her pocket. ‘Ten bucks. Don’t have no more to stay longer.’

  ‘The hospital understands if you don’t have the money,’ Megan said, wondering how she could make the woman understand that they had a legal obligation to provide care regardless of the patient’s ability to pay.

  Mrs Spears folded her arms. ‘Nope. Cain’t stay. People will rob me blind if I ain’t at home.’

  Megan doubted it.

  Jonas finished his task and wrapped a dressing around the woman’s leg. ‘The best place for you to heal is here. You’ll get better so much faster if the nurses can look after you.’

  ‘I kin look after myself.’ She pointed to her leg. ‘Just finish up what yer doin’ and I’ll be on my way.’

  Jonas glanced at Megan and she shrugged. ‘What if I promise to drive by your house every evening?’ he asked slowly. ‘Just to make sure there aren’t any suspicious characters hanging around. Would you stay then?’

  Her face gradually lost its mulish set and became more speculative. ‘That is an idea.’

  Although his willingness to go the extra mile impressed Megan, his offer was fraught with difficulties. No one really knew Mrs Spears’s state of mind and if even the smallest blade of grass was disturbed, provided she had any, Jonas could find himself in a heap of trouble.

  ‘You got a good heart, Doctor,’ Mrs Spears finally said, ‘but I cain’t have you doin’ such a big thing for me. It wouldn’t be right, not when the po-lice won’t even drive through the neighborhood ’less they have to. You got enough to worry ’bout with all kinds of sick folk needin’ yer attention. I’ll just go on home so’s I can tend my own affairs.’

  ‘I could ask the police to make extra patrols in your neighborhood.’

  Mrs Spears cackled as she met Megan’s gaze. ‘He don’t give up, does he?’

  Megan grinned. ‘No, he doesn’t.’

  ‘I tell you what,’ the woman declared. ‘I’ll come back here twice a day until you tell me I don’t need to.’

  Jonas stripped off his gloves and shook her bony hand. ‘It’s a deal.’

  Megan doubted if the business office would approve of the arrangement, but if anyone could convince them it was in everyone’s best interests, Jonas could.

  ‘Now, if I’m busy or not here,’ he warned her, ‘one of the nurses will look after you.’

  ‘Fine by me.’

  ‘In the meantime, we’re going to give you a couple of shots to jump-start the healing process. You also have to promise that you’ll stay off your feet as much as possible and keep them elevated.’

  ‘I expect I can do that,’ she assured him.

  ‘Good,’ he said as he scribbled his orders on the chart before handing the clipboard over
to Megan. ‘We’ll see you early this evening.’

  Megan read his orders for a tetanus injection, antibiotic and thiamine. The woman obviously didn’t take vitamins and B1 would help maintain nervous and muscular function in her legs.

  Within fifteen minutes Mrs Spears was on her way and promised to return before dark.

  ‘How are you going to justify seeing her twice a day?’ Megan asked Jonas as soon as they were alone.

  ‘It’s cheaper to slap on a fresh dressing in the ER than to pay for hospitalization,’ he told her. ‘If we’re going to absorb the cost anyway, what will it matter?’

  ‘To me, it doesn’t. But the bean counters won’t like it. They’ll argue that she always sneaks out AMA, so why allow her to tie up ER staff’s time, space and supplies?’

  He shrugged. ‘My way will at least give her a chance at recovery. If we admit her and she walks out, she won’t get treated. Plus, I’m hoping that once she builds some trust, we may talk her into staying, at least overnight.’

  ‘I never thought of that,’ she admitted.

  ‘What choice do we have? We’re potentially looking at septicemia, gangrene and amputation, which is more costly for us in the long run. Bending the rules is worth a try.’

  Megan couldn’t argue with his logic.

  Left alone to ready the room for the next patient, she was glad she didn’t have much to do. Normally the sights and smells of the ER didn’t bother her, but they did today. Violet’s residual body odor and the pungent smell of her soiled dressings aggravated Megan’s already stressed stomach.

  The reasons for her nausea reminded her of Carl Walker’s pending test procedure. Surely she’d hear something—anything—today. When business slowed down to a steady trickle, she’d ask Jonas to call the infection control nurse. She didn’t want to take one more of these nasty pills than absolutely necessary.

  Jonas returned to his office, wishing the radiologist had given him better news. The elderly gentleman’s broken leg wasn’t due to his fall but to suspected bone cancer.

  And speaking of better news, he had one other woman who was eagerly waiting for an overdue report. He dialed the infection control office number and asked for Susan.