The Doctor's Blessing

by Patricia Davids

  Sitting at his desk, he noticed the old chart files he’d been too busy to review. He opened them and began to study them.

  The first chart he picked was the child named Knepp. As it turned out, it wasn’t one of Sophie’s children. The parents were Otto and Norma Knepp. Their child had died at eighteen months from persistent jaundice. As he read the lab reports and notes by his grandfather, he became more and more intrigued. It was as if he were reading Grace’s chart. The similarities were too close to ignore.

  There was a soft knock at his door. Amber looked in, staring at a point over his head. Each time she couldn’t bring herself to look him in the face, another piece got shaved off his heart. He had no idea how to mend it.

  She said, “I’m getting ready to leave. Do you need anything before I go?”

  A kiss, a hug, a smile. I want you back, Amber. How do I do that? Help me, God. Help me find a way through this wall she’s put up between us.

  He glanced at the chart in his hands. Medicine was her life. Somehow, the answer was in their work.

  “Amber, do you remember a child of Otto and Norma Knepp who died about eight years ago?”

  He saw the hesitation in her face, but her curiosity won out. “I do. The funeral was held the day after I arrived here. Why?”

  “I started reading this old chart and found that this Knepp child died of severe jaundice at eighteen months of age.”

  Amber stepped inside the room. He wanted to shout for joy. Instead, he kept his gaze down. She asked, “Was it liver failure?”

  Leafing though the chart, he said, “Not according to these lab reports. Do you know if Otto and Elijah are related?”

  “I believe they’re first cousins. Actually, I think Norma and Sophie are second cousins.” She came to peer over his shoulder at the papers he held.

  His heart raced at her nearness. It was a struggle to keep his voice level. “Sophie’s twins, this child and now Grace, all related. This suggests we are dealing with some kind of inherited disorder.”

  “Like what?”

  “I’m not sure. Maybe something like Dubin-Johnson or Rotor’s syndromes, maybe—” He spun around to the computer and began typing.

  Pulling a chair up, she sat beside him. “Maybe what?”

  His frustration at the slow speed of the dial-up connection was offset by Amber’s nearness. He wouldn’t care if it took an hour to get online as long as she stayed beside him.

  Nudging him with her elbow, she repeated, “Maybe what?”

  “Maybe it’s Crigler-Najjar Syndrome.”

  Her eyebrows shot up. “Why does that sound familiar?”

  “It’s a very rare recessive genetic defect. The actual incidence is less than one case per one million live births.”

  “One in a million?” she repeated. “And you think we’ve had four suspected cases in our town? That’s kind of a stretch.”

  “No, it’s not. There are only about two hundred cases of Crigler-Najjar Syndrome in the world. There are nearly forty cases in the United States. Care to guess where the majority of those are found?”

  He saw the lightbulb come on. She leaned toward him eagerly. “A recessive gene disorder would occur more frequently in a population with limited common ancestors.”

  “Bingo. Old Order Amish and Mennonite communities.” The computer finally connected. She bumped him with her elbow to gain access to his keyboard.

  Happily, he allowed it, grinning like a schoolkid. This was the woman he’d come to love, determined, smart and eager to help. She typed quickly and pulled up the Web site for the Pennsylvania Clinic for Special-Needs Children.

  Tapping the screen with her finger, she said, “This is where they’re doing wonders with genetic research among the Amish. They are working on treatments and, someday, maybe even cures.”

  “How do you know this?” He stared at her in amazement.

  “I read everything I can about my mother’s people. This is the contact information for the clinic.” She pointed to a number scrolling at the bottom of the screen.

  Leaning close to look, he inhaled the clean, citrus scent of her hair and the fragrance that was uniquely her own. It sent his head swimming. He reached for the mouse at the same time she did. His hand covered hers.

  Her gaze flew to his face, those beautiful mermaid eyes widened with wonder. He’d never wanted to kiss anyone so badly in his whole life.

  Never had Amber wanted a man to kiss her as much as she wanted to be kissed by Phillip. He knew it. She saw it in his gaze.

  He was so close. If she moved a fraction of an inch toward him it would be the impetus he needed. The temptation was so great it formed a physical ache in her chest.

  “Amber.” He breathed her name into the air with such longing.

  Turning her face away, she concentrated on keeping her wild emotions in check.

  He squeezed her hand. “Tell me you feel the way I do about you. Tell me I’m not imagining this…thing we have.”

  “Phillip, there’s no future for us.”

  Taking her chin in his hand, he tipped her face toward him. “Are you sure about that?”

  “Maybe,” she whispered, wishing for some way to keep this wonderful man in her life.

  His tender smile was her undoing. Closing her eyes, she raised her lips to his. His kiss, featherlight at first, slowly deepened as his hands cupped her face. This was how it was meant to be between two people in love.

  Pulling away at last, he drew a ragged breath. “You rock my world, Amber. We can work this out, darling. I know we can.”

  “How? Do you give up your dreams or do I give up mine? How long before one of us starts to feel cheated? To wonder if it was worth it? I won’t do that to you. I won’t do it to myself.”

  How she wanted to snatch her words out of the air and take them back. She couldn’t because they were the truth.

  “I understand.” His voice grew rough as he withdrew his hand in a soft caress. “I don’t like it, but I understand.”

  Clenching her jaw, she refused to acknowledge the stinging behind her eyes. She forced her attention back to the computer screen. “This may not be what Grace has.”

  When he didn’t say anything, she chanced a glance in his direction. He stared at her with a lost, sad look in his eyes.

  After a moment, he blinked hard, then focused on the computer and took control of the mouse. “I’ll have to do some further research on this disorder, but I think we’re on to something.”

  He clicked through to information and symptoms of the disorder. “It says high levels of unconjugated bilirubin in the presence of normal liver function is characteristic of CNS. That’s exactly what I’ve found with Grace. The cause of CNS is a missing liver enzyme. That explains a lot.”

  Amber forced herself to concentrate on the computer screen and not on her breaking heart. A child needed their help. “Grace’s liver functions normally, but without that specific enzyme, the production of bilirubin in the blood can’t be controlled by her body.”

  “Right. Nothing we’ve tested for so far could detect that.”

  One more click brought up the picture of a child resting in a crib under intense blue lights. A mirror on one side of the crib reflected the light around the sleeping infant.

  Phillip said, “The current treatment is twelve hours of phototherapy a day for their entire lives. With the type 1, which sounds like Grace’s illness, patients will die before they are two years old without these special blue lights.”

  Amber couldn’t imagine trying to sleep one night under such intense lamps, let alone a whole lifetime.

  He leaned closer to the screen. “These people are doing some fascinating work. In rural Pennsylvania, of all places. How strange is that? They’ve identified more than thirty-five different diseases that Amish children can be born with. Wow. What I wouldn’t give to tour their facility.”

  “Is there anything else that can be done for Grace?”

  “Sorry, I got off on a tangen
t for a second. It says a liver transplant provides the only known cure.”

  Sitting back, he shook his head. “A transplant exchanges one set of problems for another. Costly antirejection drugs, infections, a whole host of other potential complications.”

  “But it can save her life?”

  He looked at her. “Yes. Would the Amish consent to a liver transplant for one of their children?”

  “Harold told me they won’t accept heart transplants. I do know someone who had a kidney transplant. Yes, I believe most of them would allow it. They’re not opposed to modern medicine.”

  Rubbing his chin with one hand, he studied the screen. “She would need home phototherapy lights like the ones in the picture in order to survive until she’s old enough for a transplant.”

  Amber sat back with a sigh. “I see one big hurdle with that.”

  “What?”

  “The Amish have no electricity in their homes.”

  “That is a big problem. Would they make an exception for this?”

  “I’m not sure. What is the likelihood of matching Grace for a liver?”

  “We’re getting ahead of ourselves. First we need to confirm that this is what she has.” He picked up the phone and began dialing.

  “Who are you calling?”

  “The physicians at the Pennsylvania Clinic for Special Needs Children. I want to pick their brains.”

  Rising to her feet, she stared down at him with pride and sadness. She deeply admired his intensity, his knowledge and his desire to help patients. He was a fine doctor. She would be sorry to see him leave—for that reason and many others.

  As she headed for the door, he softly called her name. When she looked back, he said, “Thank you.”

  She gave him a half smile and a short nod. He was a good man but he wasn’t the man for her.

  The eagerness in his voice as he spoke with the genetic specialist and the questions he fired off proved to her he’d never be happy practicing small-town medicine. His vocation lay in another direction.

  Her calling was here among the Amish. Only, how could she be happy in Hope Springs without Phillip?

  Chapter Twenty-Two

  At the sound of her phone ringing, Amber laid aside her duster to answer it. Even a telemarketer would be a welcome break from her Saturday morning housecleaning. How did things get so dirty in a week?

  Snatching up the portable handset, she pressed it to her ear. “Hello?”

  “Amber, I’m glad I caught you.” The cheerful voice belonged to Jennifer Hart, the director of the county animal shelter.

  A sinking sensation hit the pit of Amber’s stomach. Crossing to her kitchen table, she parked herself on one of the chairs. “What’s up?”

  “We have room at the shelter now for the cat you are fostering.”

  Oh, no. Amber knew this day was coming, but she still wasn’t prepared. “Jennifer, I don’t mind keeping Fluffy a little longer. I’ve been thinking about adopting him myself.”

  “We’ve had an inquiry about him from our Web site. A family in Toledo believes he’s the cat they lost when they were on vacation. They’re driving down to see him tomorrow. I’m sorry, Amber. Is there any way you can bring him in today?”

  Fluffy had a family searching for him. Adopting him was out of the question now. Amber fought back sudden, unexpected tears. What was wrong with her? She should be thrilled for her pet and the unknown family. “Sure. I can bring him in.”

  Ten minutes later, Amber could barely see the front door for her tears. She didn’t want company but the persistent knocking would not stop. Setting her now-damp cat down off her lap, she wiped her swollen eyes with a paper towel and jerked open the door. “Yes?”

  It was Phillip. Why did it have to be him?

  “Amber, you’re crying. What’s wrong, honey?”

  Sympathy was the last thing she needed. She started boohooing again.

  Without another word, he stepped inside and took her in his arms. One hand cupped the back of her head and tucked her face against him. The other arm held her tight as she cried out her heartbreak. Softly, he swayed and rocked her as if she were a child. Over and over, he murmured that it would be okay.

  No, it wouldn’t.

  Her sobbing slowed to an occasional hiccup, but she didn’t move. She simply rested in the gentleness of his embrace, soaking in his masculine smell and warmth. He would be gone soon. When he was, she would remember this moment of kindness for a long, long time.

  He leaned back to look down at her. “What happened?”

  “It’s just the last straw.” She fought back a new flood of tears.

  Slipping a finger under her chin, he raised her face to his. “What was the last straw?”

  “The Humane Society wants Fluffy back. I have to take him there this afternoon.” Her lip started quivering.

  “I’m so sorry. Can’t you adopt him?”

  “He has a family already.”

  “You’re his family.”

  “No, the family that lost him wants him back. I knew I wouldn’t keep him but I didn’t know how attached I was going to get, either.”

  That, in a nutshell, was what was wrong with her whole life. The things she loved were gone or going away. Her practice, unless Harold came back, her cat, this wonderful man—it wasn’t fair.

  Moving out of his arms was the last thing she wanted to do. She forced herself to do it anyway. “What are you doing here, Phillip?”

  “I need your help.”

  Rubbing her cheeks with her palms, she cleared her throat and tried to look like a calm, reasonable woman instead of a wreck. “Sure. What do you need me to do?”

  “I’m meeting with Elijah Knepp and some of his Church elders at five o’clock tonight. I’m sorry for the short notice. We were right about Grace having Crigler-Nijjar syndrome. I got confirmation this morning.”

  “Oh, no. I hoped we were wrong.” Her heart ached for Grace and her parents. Returning Fluffy paled in comparison to such heartrending news.

  “Elijah was at the hospital this morning. Sophie has been released. Both of them came to see the baby. When I explained what Grace would need to go home, they said no. Can you believe that?”

  Putting her own troubles aside, she gestured toward the living room. “Have a seat. Let me wash my face and we can talk about this.”

  “I’m sorry to bring this to you but I didn’t know who else could help.”

  After Amber made herself presentable, she joined Phillip in the living room. Agitated, he paced back and forth in front of her bay window. Taking a seat in one of her chairs, she asked, “Can I get you something to drink? A soda? I have iced tea made.”

  He stopped pacing and turned around. “No, I’m fine. Tell me why these people won’t allow electricity in their home to save their child’s life.”

  How could she explain it to him? “Phillip, the Amish believe they are commanded to be separate from the world. Literally. Having power lines come to their home makes them connected to the world at large.”

  “Grace will die without those lights.”

  “We all die. The Amish understand that and accept it in a way that is foreign to many people. They know that Grace will be in a better place, a place without pain or want. They love their child as any parent loves their child, but they believe they will be with her in heaven. She will not be lost to them.”

  He turned to stare out the window. “You were supposed to help. How can I argue against that when it is what I believe as a Christian?”

  She rose and moved to his side. “I’m not suggesting we give up. I’m simply saying we have to work within their system.”

  Rubbing the back of his neck, he asked, “How do we do that?”

  “Do you know why my phone didn’t work the night Sophie gave birth?”

  “Why?”

  “Because Elijah slipped the battery out when I wasn’t looking and put it back in before I left.”

  Looking stunned, he pressed the fingers of o
ne hand against his temple. “Okay, two questions. Why? And how did he know how to do that?”

  “The why was because Sophie didn’t want to deliver at the hospital. He knew how because his son uses a cell phone. The cell phone operates on a battery and is not connected to landlines so some Amish are accepting them.”

  “That seems contradictory.”

  “Welcome to the Amish world. What we need is a way to provide the power for Sophie’s light without electric lines to the house.” Amber started pacing.

  “A generator?” he suggested.

  “That may not work. The Knepps belong to an ultraconservative church district that doesn’t allow the use of gas.”

  “How do the Amish feel about solar power?”

  Returning to her chair, Amber sat forward and laced her fingers together around her knees. “Solar might be okay. It’s light from God to power the world. Maybe that’s the right angle. If their Church elders don’t agree to the lights, then Sophie and Elijah will have to abide by that decision or be shunned.”

  “It doesn’t seem right.” He shook his head in frustration.

  “For the Amish, it is not about the individual. It is about the good of the whole.”

  “Then the good of the whole is the angle I need.”

  “I’d say so.”

  He sat in the armchair opposite her. “Let’s think this through.”

  Folding her jean-clad legs under her, she stared at the floor. “My mind is a blank.”

  “I’m sorry. I know you’re upset about your cat. I shouldn’t have come running to you.”

  She waved aside his concern. “I don’t have to leave for a while yet. I’m glad you came.”

  He rose and started pacing again, his brow furrowed in concentration. She didn’t envy him his task. His words today might mean the difference between life and death for little Grace.

  Turning to her, he said, “I think I’ve got an idea. Listen to this.”

  Phillip arrived at the home of Elijah Knepp at five minutes before five o’clock. On the porch, he saw eight straw hats hanging from pegs along the side of the house. He took a second to wonder how each man found his own hat when he left. They looked identical to him.