by Laura Iding
“Good.” He blew out a breath and bent over the surgical site. Without warning, the entire OR suite went black.
Everyone in the room froze as a strange, unnatural silence filled the air.
“What the hell?”
Moriah heard Blake’s voice in the darkness but she was already feeling for the ambu-bag so she could give manual breaths to her patient. There were no windows in the OR, so the lack of light was absolute. She couldn’t even see a shadow.
“Dammit! Where in the hell is the back-up generator?” Blake had every reason to be more than a little annoyed.
“I don’t think they have one.” Moriah gave Sebastian several deep breaths with the ambu-bag. She wished she could see Blake’s face. “The power will come back on any second, I’m sure.”
“It had better. For God’s sake, I had a scalpel in this kid’s arm.” His frustration was palpable and she could only imagine how he felt. As if the delicate surgery wasn’t difficult enough, without losing power at the worst possible moment.
“This happened last year, too, remember?” Moriah strove to remain calm. “It didn’t take long for them to get the power back on.”
Luckily, just then the lights flickered on and the familiar hum of the anesthesia machine filled the room. The clock confirmed the power had only been out for three and a half of the longest minutes of her life. Moriah sighed in relief.
Until she noticed Sebastian’s dangerously low vital signs.
“Blake, his blood pressure is down to 74 systolic and his pulse ox is only 78 per cent.” She unclamped the IV fluids, allowing them to flow wide open into the patient. “Something’s happened. We’re losing him.”
“He’s bleeding profusely. I must have nicked the artery when the power went out.” Blake’s horrified tone confirmed her worst fears. “Get me some suction, I need to see if I can repair the damage.”
“I need several units of blood—what type is he?” Moriah quickly flipped through his chart. When she found the information, her heart sank. “AB neg? Do we even have any AB negative blood available?”
“I’ll check.” The circulating nurse hurried out.
Helplessly, Moriah stared at the monitor. She’d increased his oxygen, bringing his pulse ox up to a whopping 83 per cent, but that wasn’t good enough. She pulled more IV fluids off the cart and hung them on a pressure bag to get the fluid in as fast as possible.
“I’ve repaired the artery, but he lost a good liter of blood.” Blake’s concerned gaze met hers. “If there isn’t enough blood on hand, we’ll need to start asking the staff for direct donations.”
Moriah nodded. “I’m O neg, I’ll donate a pint first.”
Blake shook his head. “I’d rather you waited. I need you here. He’s better off with blood from a direct AB negative match.”
“O neg is the universal donor,” she argued. “I know there is still a potential reaction to antibodies, but it’s worth the risk.” The odds of one of the staff being AB negative were slim, since it was the rarest blood type of all.
Blake met her gaze, then nodded. “I know.”
The circulating nurse returned with a bag in hand. “We don’t have any AB negative blood. I do have one unit of O negative blood, but that’s all.”
“That’s not enough.” As she spoke, she quickly hung the single unit of life-saving blood. “Is there anyone working out there with O negative or AB negative blood type?”
The nurse shook her head. “No, I already asked.”
“Fine. Get Terrance back in here to cover me. I’m going to donate a unit myself.”
CHAPTER EIGHT
BLAKE felt a strong sense of admiration as he watched Moriah hand over Sebastian’s care to Terrance Whitney before she left the OR suite.
He wished she didn’t have to do it, especially since the situation was his fault. He didn’t know why he was surprised at her willingness to help, though, because Moriah was the type of doctor to go all the way for her patients.
She didn’t try to kill them by slicing their arteries with a scalpel when the power went off. He shook his head. He didn’t think he’d flinched, but he must have done to slice the artery like that.
Numb with guilt, he stared down at the open incision in front of him. The repaired artery was holding well, but he still needed to finish the contracture release. When he reached for forceps, he realized his hands were shaking. With a muttered curse he dropped the instrument and resisted the urge to shove the instrument tray across the room.
“Do you have a recent set of vitals for me?” Blake couldn’t help his sharp tone. This was a crisis. Whitney should know enough to fill him in on what his patient was doing without being asked.
“Blood pressure marginal at 82 over 45. Pulse remains tachy at 121. His pulse ox is still low at 84 per cent.”
“Have you given the entire unit of O negative blood yet?” Blake wanted to know.
“Yeah.”
Damn. He’d hoped the blood would help more. He frowned. “Do we have any fresh frozen plasma we can use as a volume expander until we get more blood?”
“Look, I know my job, Powers. I’ve already given one unit of fresh frozen, with another ready to go.” Whitney’s clipped tone betrayed his annoyance.
Blake bit back a sarcastic response. There was no point in entering into a verbal sparring match with Whitney. It wasn’t the anesthesiologist’s fault he himself had panicked when Moriah hadn’t shown up that morning.
Sebastian needed help. Now.
Blake swallowed hard, opening and closing his fingers to relax his tense muscles. There wasn’t anything else he could do for his patient but wait for Moriah’s blood and finish the kid’s surgery. Taking a deep breath, he once again picked up the forceps. This time, his hands remained steady.
He focused his attention on where he’d been with the original surgery, prior to the power going off. Within moments the door to the OR suite opened and the circulating nurse stepped in. “I have the second unit of O negative blood donated by Dr Howe.”
“Great.” Whitney took the unit from the nurse’s hands and Blake watched as he proceeded to hang the unit on the IV pole. It was an odd sensation, knowing the blood was Moriah’s. Whitney opened the clamp so the blood could run in freely.
Blake tore his gaze from the blood and turned his attention to the operation at hand. He cut the tendon and released the contracture.
“His pressure is climbing, up to 93 over 50. Pulse is down to 106. He’s oxygenating better, almost 88 per cent—nope, now it’s 90 per cent.”
“All right, let’s finish this surgery.” Thankful his patient was doing better, Blake quickly maneuvered the tendon into place then began the painstaking task of re-attaching it. At least Sebastian wouldn’t die from his error.
But he very well could have.
“I’m giving him a dose of steroids, to control any possible blood transfusion reactions from receiving uncrossmatched blood.” Whitney continued to inform Blake what he was doing. Then Moriah returned to the room, using her crutches.
“How is he?” she asked in a worried tone.
“Fine, your blood helped to stabilize him. See?” Whitney handed her the patient’s clipboard, displaying the pertinent information for her to read.
“I’m so glad.”
Blake glanced at her. Moriah’s face, the part he could see above her mask, was pale. “Are you all right? You look like you’re about to faint.”
She raised a brow. “I’m fine. Don’t worry about me. Terrance, I’m ready to take over here. Thanks again for your help.”
“No problem. He’s all yours.”
Blake should have been relieved everything was going better, but as he worked he couldn’t erase the image of Sebastian’s bright red blood pooling in the incision site. If the power had stayed out a minute or two longer—no, it didn’t bear thinking about what might have happened.
There wasn’t time to wallow in self-pity. He finished the surgery on Sebastian’s arm, then wen
t to the affected leg on the same side. There was still plenty of work to do before Sebastian could be transferred out of the OR suite and into the post-anesthesia recovery area.
Blake forced himself to eat something from the hospital cafeteria, although he wasn’t hungry. He knew Sebastian was doing all right. He hadn’t left the PACU until he was reassured the boy was stable.
Shoving his half-eaten food aside, he scrubbed his hands over his face. The accidental nicking of Sebastian’s brachial artery weighed heavily on his mind. Unfortunately, it wasn’t the first time in his medical career he’d made a mistake. He would never forget the case during his residency, when the patient had taken a turn for the worse during the course of surgery and Blake hadn’t noticed.
Part of the blame rested with the anesthesiologist who hadn’t said a word, but had continued to give higher and higher doses of medication to keep the patient stable. A good portion of the blame, though, was his. He’d forgotten the number-one rule of medicine—always look at your patient first. He’d been so intent on the intricate details of performing surgery, he’d forgotten to step back and look at the patient as a whole.
Mistakes were never easy to deal with, and some would argue that this one with Sebastian wasn’t his fault. The power had gone out at the worst possible time. Still, there was no denying his fingers had been holding the scalpel that had nicked the artery. Even if the power had gone off, he shouldn’t have flinched. Holding steady was a surgeon’s responsibility, no matter what area he specialized in.
Resolutely, he stood and carried his tray to the dirty-dish line. He was finished operating for the day, but he was too restless to leave the hospital. Instead he found himself returning to the PACU.
“Where’s Sebastian?” he asked the PACU nurse, whose name escaped him.
“He’s been transferred to his room, number 224.”
“Thanks.” Blake knew Sebastian must be fine, they wouldn’t have transferred him if he wasn’t, but he headed to the second-floor patient rooms anyway.
When he poked his head into the room, he found the seventeen-year-old boy resting comfortably. There was no sign of Sebastian’s family, the ones who normally provided primary care-giving while the patient was in the hospital, so he pulled up a chair and sat down, content to watch the boy as he slept.
“Blake?”
He must have dozed because Moriah’s quiet voice startled him. A glance at his watch proved he’d been sitting at Sebastian’s bedside for almost an hour. Moriah stood in the doorway with a worried expression on her face.
“Yeah?”
“It’s late. Come back to the hotel. You need to get some sleep.” Her furrowed brow betrayed her anxiety.
She was right, but leaving Sebastian wasn’t easy. The lack of family staying at his bedside concerned him. “I don’t want to leave him alone.”
“His mother is right here. She stayed outside here because she didn’t want to wake you.”
“Oh.” Feeling foolish, he stood and reluctantly followed Moriah into the hall. A middle-aged woman was seated in a chair just outside the door.
The woman smiled and ducked her head shyly when he greeted her, then hurried into Sebastian’s room. So much for trying to be helpful. All he’d managed had been to keep the boy’s mother from visiting.
Moriah fell into step beside him as they headed down the hall, through the hospital. “Are you all right?”
“Fine.” He didn’t really want to talk about what had happened. His nerves were still raw, and not just from the incident with Sebastian. Every nerve in his body strained to be with Moriah.
She didn’t seem to notice his internal battle. “I want to ask you about the surgery schedule. I need your help to get Henri scheduled.”
“Shouldn’t be a problem. His surgery won’t take long, I’m sure we can squeeze him in between two previously scheduled cases.” He was more than willing to do Henri’s surgery whenever he could.
“Well, actually, I need you to do him on Sunday,” Moriah confessed as they stepped outside. He frowned when she noticed she’d ditched her crutches. “You see, Henri told me his mother passed away a few months ago. He’s been living in the orphanage. I managed to get consent from the sister in charge, who is his legal guardian, but there isn’t anyone to take care of him while he’s in the hospital. I’m off on Monday, so I’d like you to do his procedure tomorrow.”
“Wait a minute.” Blake tried to follow her convoluted logic. He stopped and turned to face her. “Henri’s mother died? When did he tell you this?”
“I saw him with a group from the orphanage one day.” She lifted her palms helplessly. “I’m sorry, I must have forgotten to mention it.”
“Poor kid.” Blake experienced a new kinship with the boy. He’d often felt like an orphan those first few years. At least he’d had his aunt and uncle to take care of him. Henri didn’t have anyone.
“Not according to Sister Rita. She thinks he’s the greatest thing in the world. She couldn’t say enough positive things about him.” Moriah arched her brow. “That’s where I was earlier this morning, getting in touch with her so I could officially get her consent. So will you, please, do Henri’s surgery on Sunday?”
Damn. Could this day get any worse? Moriah hadn’t skipped out that morning because of some secret desire to avoid him. No, she’d been worried about Henri. The poor kid certainly deserved the chance to regain full use of his burned hand. If he’d had doubts before, he didn’t now. “Yes. I’ll do his surgery on Sunday.”
“Thanks.” Relief was evident on her features. He’d expected that, but he wasn’t prepared for her to throw her arms around his neck and kiss him.
His first instinct was to lock her close, but then reality hit hard. This was exactly where he wanted her, and it was also exactly how he’d manage to hurt her. Again. When would he learn? With a quick movement he firmly pulled her arms away and stepped back.
“Ah…I have to go. See you later.” Gathering all his strength, he turned and left. But, damn, it wasn’t easy.
“Blake! Wait, please.”
But he kept on walking, his stomach clenching tighter and tighter with every step.
Moriah stumbled over a rock on the road, wincing at the added pressure on her ankle. She’d gotten sick and tired of using the crutches so she’d tossed them aside at the end of her last case. Walking on her foot normally didn’t hurt too badly but now she felt every injured muscle anew.
She swore and hauled herself upright. What was wrong with her that she allowed Blake to tear her apart like this? He couldn’t have made his intent any clearer. She should be glad. Maybe now she could get on with her life, once and for all.
She sniffled and swiped at her tears. OK, so perhaps getting on with her life was impossible at the moment, seeing as they were both stuck here in Peru for the duration of the mission, but afterwards she needed to do something drastic. Pack up and move far away. She’d already left Trinity Medical Center, but maybe she needed to move to another city. Wisconsin was cold in the winter: maybe she’d head south where the temperature was warm.
Except then she’d be far away from her family.
Her anger deflated like a punctured balloon. No matter how miserable she was, the last thing she’d do was move away from her family. Her family was like a rock, always there when she needed them. In fact, she wished her sister Melanie was with her now. Melanie was one of the few who knew about her brief fling with Blake. Older by two years, Melanie had understood exactly what she’d gone through.
By the time she reached her hotel room, Moriah had wrestled her emotions under control. With a sigh, she lay on her bed and stared at the ceiling.
She was better off without Blake, she knew that. Yet watching him remain alone, sidestepping emotional entanglements, even something as basic as friendship, bothered her.
Why she cared about his apparent preference for loneliness was beyond her.
The next morning, severe stomach cramps brought Moriah out of a sound
sleep. Doubled over in pain, she made her way to the bathroom in the nick of time. Why the sudden attack of nausea and diarrhea? They’d been in Peru for over a week, her body had seemingly adjusted to the food and water.
Battling painful cramps, she clutched her stomach and tried to stand. What had happened? She’d only eaten food from the hotel or the hospital cafeteria. Her mind searched back, retracing her steps the day before.
To the time she’d given blood. She remembered feeling dizzy and faint—they’d probably taken the blood too fast—but she hadn’t cared, knowing Sebastian’s life had depended on it. Still, when she’d nearly passed out, one of the Peruvian nurses had poured her a glass of water. She’d assumed it had been water from the hospital, but now that she thought about it, she remembered seeing the nurse with a large plastic bottle. Had the water been brought from the nurses’ home? She winced. If so, it would explain why she felt so sick.
After seeming to spend hours in the bathroom, Moriah crawled back to bed. She wasn’t going to make it to the hospital any time soon. She tried to grab the phone, knowing she needed to call and let someone know, but another bad cramp caught her in a vicious grip, twisting her intestines like a giant old-fashioned washing-machine wringer.
At some point someone pounded at her door, but she couldn’t drag herself out of bed to answer it. In the back of her mind she hoped the person looking for her was Blake.
The pounding stopped and another wave of nausea hit hard. She barely made it to the bathroom before she was violently ill. Sweat ran in rivulets down her back, soaking her cotton nightgown so it clung to her skin.
“Moriah? Are you all right? Dammit, answer me, or I’m coming in there.” Blake’s warning shout echoed off the bathroom walls, reverberating against her already pounding head.
“I’m sick.” The words were barely above a whisper.
He flung open the bathroom door and when he saw her he immediately dropped to her side. “My God, what happened?”
“Must have drunk non-purified water after I gave blood.” She should have been horribly embarrassed for Blake to find her like this, but she couldn’t find the energy to care. “Can’t work. Need someone to cover me.”
