From Hawaii to Forever

by Julie Danvers

  But they had barely taken their first few bites before they heard a commotion at the far end of the lawn. Kat stared, wondering what was going on, and then she heard faint cries of, “Oh, my God! Somebody call 911!” and “Is there a doctor anywhere?”

  Jack leapt into action, with Kat close behind him.

  A man was slumped over his bowl of shave ice and now he slid from the picnic table. He didn’t seem to have fainted, but Kat could see he was in danger of losing consciousness. He was slightly overweight, aged about forty. A woman who seemed to be his wife stood next to him and two children, a boy and a girl, stood nearby. The boy appeared to be trying not to cry; he had his arm around the girl, who looked to be about five and was crying profusely.

  “He was fine just a minute ago...” The woman was distraught.

  “It’s okay—I’m a doctor and he’s a paramedic,” Kat said, and motioned toward Jack, who was checking the man’s vitals as best he could without any equipment. “I need to know what happened.”

  “He...he said he was tired. We’d been hiking, and we missed lunch because of the hike,” the woman said.

  “Okay, deep breaths,” said Kat. “Does he have any medical conditions that we should know about?”

  Given the suddenness of the man’s fall, and the fact that he’d missed a meal, her money was on some form of hypoglycemic shock—possibly due to diabetes.

  Just as she was forming that thought, Jack said, “Kat, he’s on an insulin pump.” He pulled at the lower half of the man’s shirt to reveal the device.

  The pump was common for people with Type One diabetes. Small and portable, it could be worn discreetly under most clothing. It was meant to deliver small, continuous doses of insulin to the body throughout the day, rather like a portable pancreas. But insulin pumps weren’t always reliable, and the danger could be significant if a pump malfunctioned.

  “Check to see it’s functioning properly,” Kat said.

  “Doesn’t look like it,” Jack responded. “I can’t even read the screen.”

  “Did he complain of any dizziness earlier today?” Kat asked the man’s wife. “Any shakiness, sweating, rapid heart rate?”

  “It’s hard to say,” the woman responded. “We’ve just been up Diamond Head. He was a little shaky, and sweating quite a bit, but so were the children and I. We assumed it was just the result of a long hike in the heat.”

  “Could just be heatstroke,” said Jack. “Although the broken pump makes insulin shock more likely. Does he have a glucagon rescue kit?”

  The man’s wife buried her face in her hands. “He was prescribed one six months ago but we never thought we’d need it. We left it in the hotel...an hour from here.”

  “Call it in,” said Kat, but Jack was already on his phone, talking to ambulance dispatch. “What are his vitals?” she asked him.

  “Pulse is fast. He’s conscious, but just barely.”

  “Can he swallow?”

  Jack looked up to see an employee of the shave ice stand among the gathered crowd. “Can you bring us a bottle of syrup?” he said. “Any flavor. We need to get his blood sugar up now.”

  A moment later someone handed Jack a bottle of strawberry syrup and a paper cup. He poured a small amount of syrup into the cup while Kat knelt by the man’s head and tried to keep him conscious.

  If the man could stay conscious long enough to swallow the syrup, they’d be able to raise his blood sugar enough to revive him, so that he would simply need to be stabilized at the hospital. But if he fell unconscious there would be no way to raise his blood sugar until the ambulance arrived.

  Kat knew the nearest ambulance was at least twenty minutes away, and every minute counted. Every second their patient continued to suffer from insulin shock was crucial, and she desperately wanted to prevent the man from slipping into a coma and suffering all the complications that would arise from that.

  “Raise his head a little,” said Jack, and Kat supported the man by his shoulders.

  His wife knelt down to help her support the man’s weight.

  “Here, let him lean back on you while he drinks,” Kat said to her.

  Jack held the cup to the man’s lips and tipped it back slightly. The man managed one swallow, then two.

  “Easy does it,” said Jack. “We just want to give the insulin something to work with, so that your blood sugar can stabilize. Right now it’s way too low. The good news is that you’re still awake, so you can keep swallowing this syrup.”

  Kat was impressed with Jack’s calm tone. She’d heard him use the same one while bringing patients into the ER, and she knew firsthand how reassuring his confident tone could be. She knew that he wanted to try to normalize things for the family, to reassure the children that help was here for them and for their father. Sometimes talking helped everyone to stay calm.

  Jack kept on tipping the syrup into the man’s mouth, one swallow at a time, until the man was able to hold the cup himself. Kat was relieved. He was probably out of danger.

  After a few more minutes the ambulance pulled up. Kat recognized two EMTs from Oahu General, who nodded at her and Jack as they took over.

  “You’re in good hands now,” Jack said, patting the man’s shoulder and giving a reassuring glance to his wife.

  As Jack and Kat moved back from the patient to give the EMTs a chance to safely assist him into the ambulance, the manager of the shave ice stand appeared behind them. He was holding large-sized bowls of the same ices they’d ordered.

  “On the house,” he said. “I noticed you didn’t get to eat yours before they melted because you were busy saving that man’s life.”

  As they were eating, Kat said, “Jack, you really are an amazing paramedic. With skills like yours...with a family like yours...why didn’t you become a doctor?”

  He put down his spoon and gave her a grim look. “That question answers itself.”

  “I’m not sure I understand...”

  He sighed. “You have no idea what it’s like to be constantly noticed as one of those Harpers. With a family like mine you always have to wonder if people really care about you, or if it’s just about your connections and the career advancement those connections can provide. When I was in medical school I was always wondering... Does this person want to be my friend, or do they want my dad to offer them a summer internship? Does that professor really think I did a good job on that procedure, or does he want me to mention his name to my mother?”

  She thought about that. Jack was right; she didn’t have any idea what that would be like. She’d been the first in her family to graduate from college, let alone go to medical school. She’d known plenty of other students who’d come to medical school already having family and other connections in the field, and she’d often been envious of those connections, but for Jack it sounded like having a family that was so well-known in the medical community was more of a liability than anything else.

  “I bet there were times when it really sucked,” she said. “Not only would you be constantly wondering whether people liked you for you, but you’d also be dealing with some pretty high expectations.”

  “You have no idea,” he said again. “Most kids get to dream about what they want to be when they grow up. For my brothers and me it was a foregone conclusion: we were going to be doctors, whether we wanted to or not. And everyone assumed we wanted to. My brother Matt was the only person I could really talk to about it.”

  “Do you get to see him much?”

  “Not really. Have you always known you wanted to be a doctor?” he asked quickly.

  She had a feeling he wanted to change the subject, and she was happy to oblige. She was curious about him, but she didn’t want to push for more than he was ready to give.

  “It’s been a dream of mine ever since I was very young,” Kat said. “My dad passed away when I was ten. Pneumonia. Maybe things
would have been different if he’d been able to see a doctor sooner, but he was always working, and sometimes he’d put off going to the doctor to save money.”

  Jack nodded. “That’s why the idea of opening a nonprofit clinic at Chicago Grace was so important to you? That’s why you got so mad when they told you no?”

  Kat gave a terse nod. “If there’s any way I can make it so that fewer families have to go through what mine did, I’ll do it.”

  “I can’t imagine losing a parent at such a young age,” Jack said. “It must have changed everything?”

  “Pretty much everything,” she agreed. “I think that was the beginning of my Type A tendencies. I turned into a little adult. If I wasn’t the one worrying about the bills our electricity would go out. I can’t fault my mom, though. She might not have been the most organized person in the world, but she worked hard to put me through school.”

  “It doesn’t sound like you had the chance to have much of a childhood.”

  “Yes and no. My family was poor, but I never felt poor because I felt loved. And even though I had to work pretty hard—I started working part-time jobs when I was sixteen to save up to pay for school—I still feel it was all worth it in the end.” She brightened. “And it’s not as though I can’t make up for lost time. Maybe I didn’t get the chance to do anything wild or reckless when I was younger, but opportunities continue to present themselves.” She gave him a wicked smile.

  “Oh? And what kind of opportunities might those be?”

  “Well, I believe I recall one of us suggesting cliff jumping as a fun recreational pastime.”

  He laughed. “You can’t be serious.”

  Her eyes widened innocently. “Why not?”

  Truth be told, she’d been wildly curious about the idea of cliff jumping ever since he’d suggested it. And she didn’t want to wait around to see if any of their friends wanted to go. She wanted to go now—with him—before she lost her nerve.

  “I think you were right when you said that I needed some excitement, some kind of thrill. This is my chance. Besides, you said it was great for mental clarity.”

  “That’s true,” he said, his face growing thoughtful. “You’re never more certain of what you really want than when you’re hurtling through the air at top speed. Into appropriately deep water, of course.” He glared down at her. “Safety first,” he said sternly.

  “Of course,” she said. “So—are we doing this?”

  “Let’s go.”

  * * *

  Jack had been driving for about an hour. They were almost to the spot of coastline that was his destination—the perfect spot for cliff jumping. Something was still bothering him, but he wasn’t sure how to bring it up.

  Just say it, he thought. You’re about to literally jump off a cliff with this woman. If you’re not afraid of that you shouldn’t be afraid of an emotional conversation.

  He summoned his courage. “Earlier...when you were telling me about how hard you had to work to get through medical school... I couldn’t help but feel guilty,” he said.

  “Guilty? Why on earth should you feel guilty?” she asked.

  “Because I walked away from something you worked so hard for,” he said. “I left medical school at the end of my third year but I could have sailed through—because of who my parents are, and because my family have money. You had to scrimp and save and plan your whole life to get something that I gave up.”

  “It wasn’t what you wanted,” she said. “Becoming a doctor has always been my dream. But it doesn’t sound as though it was ever yours. Why feel guilty just because you decided to walk away from the path that I chose?”

  He was relieved to hear that she wasn’t appalled by his decision. But Kat wasn’t finished.

  “There is something I wonder about, though,” she said. “You said earlier that you were closest to your brother Matt, but that you don’t see him much now. Why not?”

  “My older brother and I haven’t spoken in four years,” he said.

  He wasn’t sure why he was opening up to her. Maybe because she’d been so sympathetic. His struggle was nothing, compared to hers, but she seemed to understand exactly what he was saying.

  “Oh,” said Kat. “This wouldn’t happen to be the same brother you told me about while we were in quarantine? The one who cheated with your fiancée?”

  “That’s the one,” said Jack.

  He’d always refused to talk about Matt and Sophie. He’d simply decided to leave that part of his life behind. He wasn’t sure why he felt he could talk about it now, except that there was something about Kat’s ability to understand him that seemed to make his words come tumbling out.

  “Matt was the only person in my family who I could really be myself with,” said Jack. “I looked up to him.”

  “Sounds like you were pretty close,” said Kat.

  “We were. Matt was a great older brother while we were growing up. He always stood up for me, listened to me, and he helped me out whenever I needed it.”

  “So what happened?”

  “It’s complicated,” he said. “When I left medical school to join the SEALs Sophie felt that I’d let her down. She was in medical school too, and she’d always planned for a certain kind of life. She wanted to be married to someone who was a doctor, like she was, and she wanted a big house in the same suburb my parents lived in. And then I didn’t want those things anymore.”

  Kat placed a hand on his arm. “It’s hard when people grow apart,” she said. “But if you wanted such different things maybe it’s for the best that you didn’t end up together.”

  “I can see that now,” Jack said. “But at the time I was heartbroken. It wasn’t just that she didn’t want to be with me. I could have understood that. She’d thought all along that I wanted one kind of life, and then I started trying to explain that I wanted something different... Even though I’d hoped she would understand, I would never have faulted her for still wanting a different life than the one I’d started looking for. If it had just been that I would have gotten over it in time.”

  He took a deep breath. “But then I found out that she’d been cheating on me with Matt. She left me for him the next day. I confronted Matt and told him that I couldn’t believe he would do that to me.”

  “How could he?” said Kat. “How could your family accept that from either of them?”

  He sighed, and then he said, “Sophie was pregnant.”

  Kat paused for a moment, and Jack’s heart went cold at the shocked expression on her face.

  “You have a child?” she said. But then understanding broke through. Her hand went to her mouth. “Oh, no. It wasn’t yours, was it?”

  He winced. “See? I told you I was naïve. You put it together right away.” He gave a dry laugh. “Matt knew the baby was his. He and Sophie had been cheating on me for six months. I’ve always wondered if she viewed Matt and I as somehow interchangeable. As long as she married into the Harper family she’d have the connections she needed to work at any hospital she liked for the rest of her life.”

  “But that’s not all, is it?” asked Kat.

  “What do you mean?”

  “Jack, it sounds to me like you and your brother were incredibly close. To lose that relationship, especially when you didn’t have many other people you felt you could count on...it must have been devastating.”

  He shrugged, reluctant to let her know how right she was.

  “Have you ever thought about calling him?” she asked.

  “No way,” he said. “I don’t need the complication.”

  “Jack, family isn’t a complication. It’s family. You have a niece or nephew to get to know.”

  “No,” he said. “I thought I had a family. Instead I have a group of people back in Nebraska who are interested in prestige and not much else, and who all happen to share the same last na
me.”

  He was taken aback by the bitterness in his own voice, and surprised when Kat said softly, “I can understand why you’d feel that way. It sounds like Sophie confirmed your worst fear: that people were only interested in you for your family’s prestige and connections.”

  “Exactly. And then when you came, with your incredible reputation and your plans to change all the policies at the hospital...”

  “You thought I was some bigwig who’d put my career over the people in my life.”

  He had the grace to blush. “I can see how wrong I was about that now. People come here all the time, thinking they’re going to escape their problems, or they’re going to jumpstart their careers by being a big fish in a small pond. But it’s my small pond, and I’m very protective of it.”

  She thought for a moment, and then she said, “It might surprise you to hear this, but I know how it feels to be used for your connections.”

  “Oh?”

  “When I got fired from Chicago Grace, Christopher called off the wedding right away. We’d both thought I was going to be promoted to director of the internal medicine department, and when I didn’t get the promotion, and then got fired, he broke up with me.”

  Jack shook his head. This Christopher guy was a complete idiot.

  “Anyway, this whole year I’ve been trying to figure out why I’m not grieving Christopher more. I was going to marry him. I thought he was the love of my life. But I feel like I’ve been more upset over losing my job than losing my fiancé. Ex-fiancé.”

  “Well, your job was something you worked hard for most of your life. Your career was about you and about your connection with your dad. Who never even met Christopher. So it makes sense that losing your job would have affected you much more deeply.”

  “Yes, but it’s more than that. I don’t think Christopher and I were really meant to be. I thought he loved me... But now I think he just loved the idea of being married to a department head at a top Chicago hospital. He liked the prestige. But when it came to really making a difference in the way I wanted to he didn’t care.”