This Time for Keeps (Doctors of Rittenhouse Square Book 3)

by Jill Blake

  Samantha swallowed and turned pale. “No, thanks.”

  Isabelle narrowed her eyes. “Are you okay?”

  Sam nodded and waved a finger at the coffee cup. “Would you mind moving that away?”

  Isabelle did as her friend requested. “Better?”

  “Much, thanks.”

  Isabelle watched her fiddle with her silverware. “You sure you’re okay?”

  “Yes.” Sam bit her lip and started shredding a paper napkin.

  “Sam, what’s going on?”

  Jane returned to the table just as Sam burst into tears and blurted, “I’m pregnant.”

  Isabelle pulled a few clean napkins from the metal dispenser in the middle of their table and offered them to Sam. She exchanged a glance with Jane, who shook her head and shrugged. Apparently this was news to her as well. Isabelle rubbed a gentle hand across Sam’s back, waiting for the storm to pass. “I take it this wasn’t planned?”

  “No. We had to do IVF the last time, remember? Three rounds before it finally took. And now, with all this IPO craziness, Alex is hardly around long enough to—” Sam broke off and scrubbed at her face with the napkins. “It never even occurred to me to do the test until this morning. Three weeks of vomiting. If a patient came to me this way, that’s the first thing I’d do, is a pregnancy test. I feel like an idiot.”

  “Well, it’s been known to happen,” Isabelle said.

  “Being an idiot?”

  “That too.” She handed over fresh napkins. “I’m sure you’ve heard plenty of stories yourself about women who do assisted reproduction the first time, and then boom, they’re baby-producing factories even without the drugs.”

  “Yes, but I didn’t think I’d be one of them. The twins are barely seventeen months old. I’m exhausted trying to keep up with them, and the clinic, and don’t get me started on Alex’s travel schedule.”

  “What did he say when you told him?”

  Sam shrugged.

  It was Jane who asked the question. “You did tell Alex, didn’t you?”

  “No.” She stared glumly at the wadded napkins in her hand. “Not yet.”

  “But you’re going to?” Jane persisted.

  “Yes.” She glanced up and frowned. “What? I can’t have a mini-meltdown every once in a while?”

  “Of course you can,” Isabelle assured her. “God knows, I’ve had enough of them myself.”

  Jane leaned forward as far as her belly allowed and clasped her hand over Sam’s. “We’re here for you, sweetie. And Alex will be too, once you let him know.”

  “When are you due?” Isabelle asked.

  “I don’t know. I haven’t had a period since I don’t remember when. I only weaned off breastfeeding a few months ago. I’ll need an ultrasound for dates.” She looked at Isabelle. “I don’t suppose you’d consider doing a quick scan? Unofficially. We could stop by your office after brunch…”

  “Sam, you know I don’t see patients anymore.”

  “But you still have a key to the office, don’t you? It’s not like you’ve resigned. You’re just on temporary leave. And this’ll be a quick in and out. Do the crown-to-rump measurement, check for cardiac activity, and we’re done. Please, Iz.”

  Isabelle glanced at Jane for help, but Jane refused to be drawn in. “It’s your choice, Iz.”

  Sam was right. Isabelle still had a key to the office; she hadn’t even removed it from the keychain that held the keys to her house, car, and bicycle lock. But the thought of entering an exam room again and going through the rituals that only a year ago had been so ingrained that she could do them in her sleep—washing her hands, applying the ultrasound gel, sweeping the wand over a gravid abdomen until the images came into focus—had her breaking into a cold sweat.

  She made a last-ditch effort to avoid the situation. “Isn’t Alex expecting you home soon?”

  Sam waved the concern aside. “He and Ross are babysitting. They can manage without us another few hours. I’ll text, let him know we’re running late.”

  Isabelle took a deep breath and let it out slowly. “Fine,” she said. “Let’s do it.”

  ###

  It was just as she remembered: sterile hallways with walls painted in neutral tones, aqua-green exam table with retractable stirrups, portable ultrasound machine that hummed into action at the flick of a switch.

  “Will you look at that,” Jane marveled as the grainy images on the screen coalesced into a recognizable peanut-shaped form floating in a fluid-filled sac. She slid forward on her chair and squeezed Sam’s hand.

  “Twenty-six millimeters,” Isabelle said, typing the measurements in. “You’re nine weeks, three days. Give or take.”

  Another click of the keyboard, and the whoosh-whoosh of baby’s heartbeat filled the room. “A hundred seventy beats per minute. Perfect. Want a disc?”

  Sam blinked and offered a watery smile. “Please.”

  Isabelle wiped off the gel and put away the ultrasound probe. “Give me a minute.”

  Sam stopped her with a hand on her arm. “Izzy, thank you. Really. You don’t know how much this means to me.”

  Isabelle patted her hand and forced a smile. “I’ll be right back.”

  At the nurses’ station, as she hunted up a clean disc and waited for the computer to boot, Isabelle tried to get a handle on her emotions. The sense of dread she’d felt earlier, on the drive over, was gone. Her hands were steady, her breathing calm. Granted, it was Sunday, and the office was closed, so there was none of the typical chaos that she’d come to expect and even relish during her years in practice. But the very fact that she was here, patiently waiting for Sam’s ultrasound to download, was a minor miracle.

  She’d half expected a repeat of the panic attack she’d experienced the last time she was in the office, and was relieved that it hadn’t happened.

  What she hadn’t anticipated though was the sense of familiarity, of rightness, she had felt while doing the ultrasound. Maneuvering the transducer across Samantha’s stomach, automatically adjusting the angle to get the best image, picking up the fetal heart tones on Doppler—this must have been what Dorothy felt after clicking her ruby red heels together and chanting, “There’s no place like home.”

  Isabelle had almost convinced herself that she’d be happy going for the rest of her life without doing any hands-on patient care. That she’d be content pushing papers—designing, coordinating, evaluating clinical trials, all the while keeping actual patients at a distance. Important work, certainly, and gratifying in its own way. But was it really enough?

  Jane echoed the thought on their way out of the office. “When are you going back to work?”

  Isabelle kept her eyes on the elevator display panel, watching each floor button light up as they descended. “I am working.”

  “I meant here,” Jane said. “Seeing patients.”

  Isabelle shrugged.

  “You are coming back, aren’t you?” Sam asked, clutching the paper-sleeved disc of her ultrasound.

  Isabelle lifted her left hand and brought her fingers together, struggling in vain to make the “okay” sign. “Anterior interosseus nerve weakness,” she said. “Would you want the surgeon who’s operating on you to have this?”

  Sam and Jane exchanged glances. “Could the nerve still regenerate?” Jane asked.

  The doors slid open, and Isabelle stepped out into the lobby. “The neurologist says give it another half year and see.”

  “What about non-surgical stuff?” Sam said. “Primary care for women. Gynecology, prenatal care. You don’t need to be the one doing deliveries. A lot of big hospitals have laborist programs these days. Isn’t that the new trend, to have purely hospital-based OB’s who do all the deliveries, freeing up the non-hospitalist docs to concentrate on the outpatient setting?”

  “And what about teaching, or precepting?” Jane added. “You were involved with the residency program before.”

  Isabelle listened stoically to her friends’ suggestions, t
amping down her reflexive anger and frustration. She knew they were only trying to help. And it wasn’t as if she hadn’t heard the same song and dance before. Her brother Marc, her sister Emma, both her parents, had all given her their version of the same pep talk.

  How could any of them understand what she was going through? The debilitating fear, the freezing up at a critical moment—just because it hadn’t happened today didn’t mean it wouldn’t happen again at some point in the future. And that didn’t even touch on the physical changes: the near-constant ache in her arm that radiated up to her elbow and down into her wrist, the stiffness every morning that she had to massage under a hot shower just so she could do everyday activities like fastening her bra. If she did return to clinical medicine, how long would it be before she became bitter over the limitations imposed by her injury?

  Even Luca, in his efforts to be helpful and supportive, didn’t realize that forcing her at this point to cook was like handing her a rope and pickaxe and expecting her to climb Mt. Whitney. How could she, when even opening a jar was beyond her?

  Then only person besides Jake who understood, or at least didn’t try to prod her beyond her abilities, was her therapist. She still went every week, and it was like a safety relief valve, the opportunity to pour out all her stress and rage and despair in one sitting to a person paid to listen in supportive silence.

  It hadn’t always been this way. At first, the therapist had worked with her intensely on some cognitive behavioral therapy skills—visualization, deep breathing, eye movement desensitization and reprocessing—to get her past the worst of her PTSD symptoms. It hadn’t completely gotten rid of the nightmares, or the panic attacks, but they were far less frequent than they had been, and she was no longer in a perpetual state of hypervigilance like she had been the first few months out from surgery.

  Lately, their sessions focused more on practicing mindfulness and breaking the cycle of negative thinking. For Isabelle, that posed the greatest challenge, especially since the gap between where she had been before the shooting and where she was now didn’t seem to be getting much narrower.

  Maybe she was expecting too much, too quickly. Things certainly weren’t as bleak as they had been even a few months ago. She was gaining more strength and dexterity in her wrist and hand, despite what seemed like excruciatingly slow progress—especially to someone of her impatient nature, who was used to doing everything at breakneck speed.

  She was making progress in her new job. After the submission of the current NDA paperwork, she was meeting with Jake to discuss the possibility of taking on a more permanent position as a director of clinical studies for Oncogene Technologies’ ovarian cancer trials. For someone who had, as a clinician, felt frustrated by the inability to treat ovarian cancer in practice, given that the majority of cases were diagnosed at such a late stage, being on the cutting edge of research that held out the possibility of both early detection and cure was exciting.

  Could she add some clinical work to the mix as well? She wasn’t sure, though today’s trip to the office served as a reminder of the fact that soon she would have to make a decision one way or the other.

  “Izzy?”

  Sam’s voice brought her back to the present. They had crossed the street to the parking lot where earlier they’d left both cars.

  On impulse, Isabelle hugged Samantha, and then Jane. “You’re right, both of you. I have a lot to think about.”

  Sam raised the disc. “Thank you for this.”

  Isabelle smiled. “Congratulations again. Let me know if you need anything. And you, too, Jane. Call me any time, and I’ll be there.”

  Chapter 14

  He could have spent the day rattling around his empty house, trying to concentrate on the latest home-improvement project, or putting in some quality time on the computer.

  Instead, he’d managed to convince a skeptical Bella that it made more sense for him to stay at her place for the day, rather than shuttling back and forth between Philadelphia and Princeton. He had plenty of work on his laptop to keep him busy while she enjoyed brunch with her friends.

  “Yes, I’m sure,” he said for the third time as she handed him a spare key and backed out the door.

  He took her up on the invitation—however reluctantly given—to make himself at home. Brewing a second cappuccino with the whole milk they’d purchased yesterday, he glanced through the Sunday paper that Isabelle had left on the kitchen counter. A notice regarding an afternoon performance of Don Giovanni at the Kimmel Center caught his eye. He wondered if Bella liked opera. It was an acquired taste, like Campari. He grinned, remembering her reaction to her first sip of the liqueur in Amalfi. Perhaps he’d better hold off getting opera tickets until he’d vetted her music preferences.

  He wandered through the house, peeking into rooms with open doors, browsing the shelves of her impressive book collection. His practical, no-nonsense Bella apparently had a penchant for lurid romance novels. He chose one at random from a row of paperbacks, chuckling at the cover that featured a half-naked woman caught in the embrace of a muscle-bound long-haired man in pirate costume. The flyleaf was inscribed “To my favorite niece.” Of course. Bella had mentioned having an aunt who wrote bodice-rippers; now at least he knew what she’d meant by the term. It would be interesting to meet the woman who penned such books, he thought, replacing the paperback.

  Dios, who was he kidding? The draw wasn’t the fact that the woman wrote what amounted to soft-core porn, but that she was Bella’s aunt. He was curious about everything that had to do with Bella, and her family certainly ranked high on that list. She’d described her parents, brother, and sister so vividly that he almost felt like he knew them. Not the same as getting to know them in person, but eventually, as his relationship with Bella progressed, he hoped that too would happen.

  Downstairs, in the basement, he found a well-equipped home gym and laundry room. He wasn’t big on cardio equipment and weights, preferring the variety and teamwork of outdoor sports like soccer and rowing. But he certainly admired the effect that working out had on Bella’s body. While she was thinner than she’d been in Amalfi, she also had more muscle definition, and he couldn’t deny the benefits of exercise on stamina. He definitely enjoyed Bella’s endurance in bed, the exquisite grace of her taut body as she met him stroke for stroke, the supple strength of her legs as she rode him to climax.

  Glancing at his watch, he wondered how long her brunch would last. Should he text her, find out when she’d be back? Or would she see that as too intrusive?

  Her continued skittishness around him kept him from pressing too hard. It was a delicate balance, though, to know how far he could go without sending her scurrying in the opposite direction. All he knew was that if he left it up to her, they might never get beyond the current stage, where she seemed to constantly have one foot out the door. Ruefully, Luca acknowledged that since the breakup of his marriage, he’d been the one to always keep an eye on the exit. To have the situation reversed was both novel and somewhat frustrating. But he was a patient man, and as he’d told Bella, he had perseverance in spades.

  Deciding she wouldn’t mind his use of the washer and dryer, especially if he laundered her things alongside his own, Luca dumped the last two days’ worth of clothing into the machine. He emptied the laundry hamper from the master bath, measured out some detergent, and started the wash cycle.

  For the next few hours, he worked on his laptop, reviewing yet another batch of the seemingly infinite supply of documents related to the IPO. A brief conference call with Alex and Ross followed.

  By the time his sister Teresa called him on Skype, he was ready for a break.

  “Mama is concerned about you, Luca,” she said, dispensing with the usual pleasantries. “She wants to know when you’re going to get over this nonsense with Cristina and start making bambini.”

  “Nonsense?” Luca frowned. “We’ve been divorced for five years. Berlusconi has a better chance of becoming the next pope than I d
o of getting back together with Cristina.”

  “I’m sure she’d take you back in a heartbeat—”

  “Not interested.”

  “But why?”

  “Give it a rest, Teresa.” He hadn’t confided in his family the particulars of his breakup with Cristina, and he wasn’t planning on starting with his baby sister. Even the version he’d shared with Bella wasn’t the full story. Some things were best left unsaid.

  Like the shame of walking in on your wife and her lover, together, in your own house. Six years later, and the image was still seared into his brain. His wife, the high-powered attorney, whom he’d heard described on more than one occasion as a “ball-breaker,” naked, blindfolded and bound, bent over an armchair, while the man stood behind her, pants unzipped but otherwise fully dressed, pounding into her and snarling, “Shut up, bitch. Unless you want to be punished.”

  He’d misunderstood at first, thinking his wife under attack. Charging into the room, wrestling the man to the ground, he’d felt a surge of primal rage. In the seconds it took for recognition to set it, and for Cristina’s panicked entreaties to penetrate, he’d managed to inflict enough damage to the SOB’s face to necessitate a trip to the local ER.

  In the end, Luca had been the one to walk out, Cristina’s parting words ringing in his ears. She’d been a willing participant, apparently, tired of “vanilla sex” with her husband, and looking to spice up her life.

  He’d spent five years getting over it, over the humiliation of Cristina’s rejection and ultimate act of betrayal. Finding out about the abortion—he didn’t even know if the child was his—had simply driven the message home: that the woman who’d promised before God to love and cherish him felt nothing for him but contempt.

  For five years he’d gone from bed to bed, as if driven to prove time and again that he had what it took to please a woman and make her beg for more. For five years he’d struggled to figure out where it had all gone wrong, and what he could have done differently.