Mikaela moaned as shivers ran down her back. She wiggled closer, running her hands across smooth shoulders and arching up for more. Busy fingers had her spiraling up and frantic, she pushed Sam on his back and straddled him. She took him in slowly and deeply and felt her body swell as he filled her. Pressure in just the right spot, she thought with a moan as he moved inside. The feel of his tongue on her breasts and his hands spanning her waist had her riding faster until she exploded with sensation. Sam tumbled with her and spent, gathered her in his arms and held tight.
Mikaela lay with her head on Sam’s shoulder and listened to his heartbeat as it slowed. “Thank you for letting me wear your shirt,” she said and smiled.
“Anytime, sweetheart, anytime.” Sam chuckled.
Mikaela turned her head and softly kissed Sam’s neck. Sam hardened and ran a feather light touch from her breast to the smooth curve of her thigh. She held her breath as his fingers found her core and sensation built again.
“You hungry?” he asked.
“I can wait,” she managed.
Sam chuckled. “In that case …” he started and flipped her on her back.
Two hours later, Sam and Mikaela sat at the kitchen table eating chicken wraps, listening to the fire crackle and pop in the fireplace. Mikaela pulled her terry robe closer around her and enjoying the flavor combination of hummus, avocado, and spicy chicken, eyed Sam. “That shirt looks better on me,” she said casually.
Sam grinned. “I’d have to agree. Personally, I like what you have on under that robe now.”
“I’m not wearing anything under this robe.”
“Exactly,” he smiled and was surprised to see a faint flush on her cheeks.
Charmed, he leaned in. “You take my breath away,” he said, catching her gaze and holding it. “And if there’s anything of mine you’d like to borrow, you go right ahead. I love the return policy,” he said as he bit into the wrap.
Mikaela laughed. “How was work today?”
“It was good. Busy, but there’s a good rhythm to the clinic. There’s a new young tech assigned to the eye clinic. I can see two patients for every one of hers. Eventually she’ll get up to speed, but in the meantime, it creates a bottleneck. Luckily no one seems to mind if I grab an extra chart or two. Today, however, I had the experienced tech who’s been there for years. What a difference. If something needed doing, it was done before I wrote the order. The patients were screened and waiting and I was moving at a fair clip. Just goes to show how efficient it could be.”
“Sounds more hectic, though.”
“Not really. I’d rather be busy and efficient than sitting around cooling my heels, waiting for patients to be put in the lanes.”
Mikaela nodded. “It’s a strange system at the hospital when departments don’t have control over which technicians are hired. It’s all about seniority and who can bump who.”
“I think that’s part of the problem with this new tech. I’m not sure the eye clinic is really what she wanted, but the hours and salary were better than any other option, so she’s giving it a go. And sadly, the other applicant for the job was better qualified and more interested.”
“Just not as senior,” Mikaela added.
“Exactly.”
“And the one who is better qualified and more interested will probably end up in labor and delivery,” Mikaela said sardonically.
“Probably. But the patients will get a very thorough eye exam.” Sam laughed. “Your call is crazy. Have you ever had enough? Especially when you have to go in when you’re not on call?”
Mikaela looked at him, trying to gauge what was behind the question. Was he bothered by the time she spent at work? Every man is not Elliott, she chided herself. “No,” she said slowly. “It’s part of the specialty. Babies come when they come. We can predict all we want, but Mother Nature has the upper hand. And I like the unpredictability. It’s part of what attracted me to obstetrics. It’s pretty amazing watching nature unfold.”
“With two minutes of sheer terror when that newborn pops out,” Sam shuddered.
Mikaela laughed. “This from the surgeon who operates within millimeters of the brain. I’ll take the newborn.”
“I’ll stick with the eyeball.”
Mikaela finished the last sip of wine as Sam collected the plates.
“You up for a swim?” he asked as he loaded the dishwasher.
“That sounds great. Just let me get a swimsuit on,” Mikaela said, getting up from the table.
Sam walked over to stand in front of her. He undid her belt slowly, holding her gaze and slid his hands up her sides, caressing the warm soft skin, barely brushing her breasts.
Mikaela’s skin tingled all the way to her toes.
“Can I convince you that you don’t need a swimsuit?” Sam whispered as he touched his lips softly to hers and ran kisses along her jawline.
Mikaela closed her eyes, tilted her head to expose her neck and arched her back at the tickle of the teasing lightness. Sam kept his touch barely there as he skimmed over flesh from the smooth curve of her neck to the flat planes of her belly.
Sam slipped the robe from her shoulders. Mikaela found the snap of his jeans and lowered the zipper. She pulled his T-shirt over his head and ran her hands down the rippling muscles of his abdomen lowering the jeans as she went.
When she trembled, Sam scooped her up. Mikaela wound her arms around his neck.
“The water will be warm,” he said as he carried her to the pool, “And I’ve a need to see you slick and wet.”
Much later, Mikaela was wrapped in Sam’s arms as they curled together on the bed under a warm comforter. She listened to his steady quiet breathing and tried not to worry.
Look at all the positives. The sex was a huge positive, she grinned. She loved him and she was pretty sure he had feelings for her. Coming home at night and being with him, talking, laughing, she never wanted it to end. And, the sex, well all he had to do was touch her and she melted. She really liked melting.
So why hadn’t she told him about her family? Should she worry about his comments about her work and all the time she spent there? Or was she just reading too much into everything he said? she asked herself tiredly.
Their relationship was definitely changing. Mikaela swallowed the panic at the thought of change. Change could be good. Look how it worked out for her job. Change had been the best thing. She found a job she was good at, that was challenging and stimulating. She worked with a great group of people whom she admired and respected. Change was good.
So why did it make her sad? What was it about the two of them together that created a frisson of doubt? Maybe she was more affected by what happened with Elliott than she realized. Was she really still carrying around baggage that she should let go? It wasn’t that easy.
She had loved Elliott, in a way. Well, she thought she had loved him. She definitely trusted him, and it still shocked her to have been so completely wrong about him. What if she was reading Sam wrong? What if this was all just a passing fling so he could get what he wanted? It was Elliott all over again. Mikaela silently wiped away a tear. Had she really put herself into that situation again? She sighed. She didn’t know and wasn’t even sure how to figure it out. Mikaela wished she could just live in the moment and enjoy the ride. But who was she kidding? She needed more. She loved Sam and change was happening. She just needed to decide which was scarier – if he loved her back or if he didn’t.
Chapter 25
happenstance horoscope
ARIES (March 21-April 19) Weigh the pros and cons before you make a change. Don’t feel pressured to accept something that doesn’t feel right. Let others acknowledge what you do and look for greater security.
At five-thirty the next evening, Mikaela rolled her shoulders tiredly, shrugged out of her lab coat, and hung it on the hook on the back of her office door. She still had a couple of charts to dictate, but she also had a meeting with Dr. Crispin, the chief of surgery, and didn’t
want to be late.
His secretary had contacted hers the week before to set up the meeting, and between her schedule and his, this was the first convenient time. Her three-month anniversary at Emerson was coming up, and she wondered if the meeting was a performance review. It was standard procedure, and she didn’t expect any surprises.
She made her way to his office and knocked on the door that was standing ajar.
“Come in,” he called.
She pushed open the door and saw him standing at a coffee machine. He was a tall man, with a lean face and gray hair at his temples. Mikaela had met with him twice, and had only seen his serious side. She was beginning to think that was the only side he had.
He turned to greet her. “Hello, Mikaela. Come in. I was just getting a coffee. Would you like one?”
Mikaela’s heart sank. She had hoped for a quick, perfunctory performance review, so she could head home and have dinner with Sam. If he was settling in with a coffee, it didn’t bode well. “Not for me, thanks.”
“Take a seat,” he invited. He picked up the steaming cup and took a sip as he sat behind a large desk opposite to her. The wall behind him held stacks of books and papers.
He cleared papers from the center of his desk and taking another sip, he moved a folder in front of him. He cleared his throat. “So it’s been just over three months since you started here at Emerson. How are you finding it?”
“It’s good,” she replied. “I’m enjoying the patients and the new clinic. The renovations to the maternity ward are almost complete, and I’m happy with how it’s turned out. The transition to the new space has gone smoothly. The nurses and admin staff are great, and I’m really enjoying the sense of community from Emerson.”
Dr. Crispin nodded. “Emerson has the feel of a smaller community hospital with the expertise of a bigger center. We’re very lucky that way. I think people enjoy your leadership style. You’ve managed to accomplish a lot, manage a lot of change, and keep everyone happy. I wanted to commend you for that. It’s not always easy to satisfy everyone.”
“Thank you,” Mikaela murmured, pleased and grateful for the feedback.
He shuffled papers in the folder and pulled out a sheet. “I wanted to talk to you, in particular, about the operating room time.”
Mikaela looked at him. “Is there a problem?”
“Depends where you’re sitting,” he said. “Operating time is always at a premium, and some departments are never satisfied. Well, maybe that’s too harsh,” he admitted. “But they would be happier with more and make that known with regularity. Granted, some specialties, like orthopedics, who are often operating after hours, or ophthalmology, where the demand is greatest, make the most noise. Their waiting lists are long, and the government is looking at ways to cut that back. Bonuses, incentives, penalties, any way you look at it, they want those wait lists cut. And of course, for the hospital board, the bottom line is the dollar. Utilization. Keep costs down, revenues up, maximize resources, I’m sure you’ve heard it all before.”
He adjusted the folder. “We keep track of operating room use. Your trend is approximately seventy-four percent departmental utilization. What you’ve released, other departments have picked up, so the overall utilization is there, but it’s been flagged. Ophthalmology has picked up ninety percent of the days and orthopedics the other ten percent.” He cleared his throat. “The request has been made to redistribute the time, to maximize utilization, and to make it more equitable between departments. Now that we’ve seen what you’ve used in the last three months, we can make a better projection of what is actually needed. I’m sure you understand.” He closed the folder and smiled.
“I’m not sure that I do,” Mikaela admitted. “What exactly does this mean?”
“Well, essentially, what we’re proposing is that you would keep two units and reassign the other two units to ophthalmology.”
“Reassign to ophthalmology?”
“Yes.” He shuffled more papers on his desk. “Currently their utilization is one hundred and twenty-two percent of their time. Their need for extra time is greatest,” he said, checking the figures in the piles of papers. “It’s all just a matter of numbers, really,” he said dismissively. “Of course, this would start with the next block of OR.”
“And how fluid is this? If my department’s needs increase, will the time come back to ob-gyn?”
“Well, theoretically … ” Dr. Crispin hesitated. “But again, we would have to look at the numbers in each department and see how that would work out most equitably.”
“So in a nutshell, no.”
He nodded reluctantly. “It would be unlikely, unless there was a real need shown, or the government put incentives in place to justify it.”
“And the government has put incentives in place for ophthalmology to operate more?”
“Yes, currently they are the flavor of the month, so to speak. The population is aging and cataracts need to be done. So they get the time. But it jibes with our numbers. They’ve been requesting more time for a few months now.”
I’m sure Sam has, Mikaela thought sardonically. “I don’t feel these past three months actually represent my department’s long-term pattern,” she pointed out. “There’s the potential of another obstetrician joining. I’ve approached the hospital board about it and a financial audit is underway. If it goes through, we’ll need one hundred percent of the OR time, and it will be filled. Right now, my practice is growing. The first three months don’t reflect the actual need at all.”
“Well, that may be so, but we have to look at what is happening now, not what might be needed three or six months from now.”
“You said yourself that utilization is one hundred percent. Why can’t it continue with the status quo for another six to twelve months until a more accurate pattern is established?” she asked.
“Well, it has been considered …” Dr. Crispin hesitated. “But there has been considerable pressure from ophthalmology.”
“Have other solutions been considered?” Mikaela asked. “I wasn’t even informed this was on the table and a decision being made.” She reined in her temper. “I was given the position of department head so that the department would have a voice in this type of decision – one that could have serious impact on the future growth and recruitment of an obstetrician-gynecologist to Emerson. I don’t think considerable pressure from ophthalmology is enough. I think the needs of the Department of Obstetrics and Gynecology should be heard as well.”
“Well, there is a committee. It’s made up of two members from the board of directors, myself as chief of surgery, the chief of staff, and four representatives from the various surgical specialties.”
“Including ophthalmology?”
“Yes, one of the ophthalmologists is on the committee.”
“I hope they’re abstaining from voting.”
“It hasn’t really been put to a vote,” Dr. Crispin said, leaning back in his chair. “I don’t think anyone thought you’d mind. Your utilization is low and ophthalmology’s is high. It seemed straightforward to balance things out.”
“Well, actually, I do mind. I was given two days a week of OR time when I was recruited. It’s not something I want to give away until I’ve had a chance to give it some careful consideration.”
“That’s certainly your privilege,” Dr. Crispin said. “I hope you’ll look at the bigger picture and as always, consider patient care as the number one priority.” He opened a file and wrote a short note on a page. “The next meeting of the committee will be in one week. Perhaps you could let me know by then or put something in writing, so I can present it to the committee.”
“Certainly,” said Mikaela.
He closed the file and leaned forward, looking at her intently. “As you said, one of the pleasures, indeed one of the traditions, of working at Emerson is the teamwork and collegiality among the staff.” He folded his hands into a triangle and tapped his chin thoughtfully. “Sometimes i
t involves compromise. Maybe it seems disappointing, even unfair, at the time. But then the tide turns and needs change, and that’s taken into consideration. It’s worked for us for many years, you understand, and we pride ourselves on its success. One could almost say it’s the Emerson way.” He looked over at her in silence.
Mikaela looked back without saying a word. Message sent and received, she thought bitterly.
He leaned back. “As I said, you’ve led the department well through many changes. It’s a strength of your leadership.” He stood.
Mikaela stood as well. “Thank you. I’ve enjoyed it. I’m learning that some change is necessary to move forward and grow. Would I be able to get a copy of that report?”
“Certainly. I’ll have Gillian send you a copy first thing tomorrow.”
“Thank you. And thank you for meeting with me and going over this. I’ll look it over and put something in writing for you before next week.”
Dr. Crispin nodded and came around to see her out.
“Good night,” Mikaela said.
“Good night. Drive carefully. They were forecasting snow so the roads may be slippery.”
Mikaela nodded and smiled and headed out. The smile quickly faded as she made her way back to her own office. She closed the door with a snap and sat down at her desk.
Chapter 26
Written in the Stars by Esmeralda Garnet
ARIES (March 21-April 19) The more information you gather, the more effective you will be. The situation is not what you expected it to be. Dig deeper.
That’s the Emerson tradition, she mimicked sarcastically. Just lie down and let them walk all over you, she thought, crossing her arms across her chest and sitting back. That’s the way it’s always been done, she fumed. Just because it’s always been done that way, doesn’t mean it’s the best way.
How can they look at a brand new practice pattern, one that’s barely been established, and project that to the needs of the department for the future? Mikaela shook her head and picked up a pencil and started tapping the desk. She didn’t want a title that didn’t have any authority behind it to back it up. She was the department head and to her that meant she would have a voice in decision-making. She didn’t want to be excluded and then be told what to do because everyone else got together and decided it was the best thing.
Perfectly Honest Page 14
