“Not the solution, perhaps,” she said as the elevator door pinged open, “but a very potent antidote.”
Propping the door with one hand, she took her bag in the other and leaned in to kiss the doorman’s cheek.
“Just so you know,” she added, “the antidote plans to make a trip to New York in the next week or so. His name’s Brennan. Michael Brennan.”
“I’ll be sure to ring the apartment the moment Mr. Brennan arrives,” Jerome replied with a twinkle in his eyes.
Strange, Zia thought as she keyed the front door and let herself into the black-and-white-tiled foyer. She still faced a wrenching decision. Yet now opting for research instead of hands-on medicine didn’t feel like such a traitorous act. The possibility of a substantial grant from GSI to underwrite that research had given it impetus. She could be part of a team that pinpointed sources of deadly infections. Reduced risks to hospital patients. Saved lives.
First, though, she had to draft the proposal Rafe Montoya had outlined. She’d get on the computer, she decided as she dropped her bag in her bedroom and went to the bathroom. Right after she’d soaked long enough to ease her aching hip and thigh and calf muscles. Mike Brennan, she acknowledged with a rueful grin, had given her a lesson in anatomy unlike any she’d taken in med school.
* * *
She was at the hospital early the next morning. Those residents who’d worked through Christmas greeted her return with relief.
“Hope you’re rested and ready to go,” Don Carter warned. Happily married and totally stressed, he couldn’t wait to shed his stethoscope for a long-anticipated New Year ski trip to Vermont. “We’ve been slammed with the usual spike in heart attacks and acute respiratory failures.”
Zia nodded. Contrary to the popular misperception that the sharp increase in holiday deaths was driven by substance abuse, family-related homicides or depression-driven suicides, she now knew other significant causes came into play. A major contributing factor was that people who felt ill simply put off a trip to the hospital, choosing instead to be with their families over Christmas or New Year’s.
Holiday staffing was also an issue, especially at Level 1 trauma centers, where seconds could mean the difference between life and death. Recognizing that fact, Mount Sinai’s various centers, schools and hospitals paid careful attention to staff levels during this critical period.
Even with the controlled staffing, however, the holidays kept everyone hopping. Zia quickly fell back into the hectic schedule of morning team meetings, patient exams, family-centered rounds, chart reviews, one-on-ones with her interns and day-end team sessions. She still had two weeks in the Pediatric Intensive Care Unit before she completed that rotation. And, as they always did, these desperately ill kids tugged at her heart. Some cried, some screamed, but others showed no reaction to the catheters and IVs and high-dosage drugs that made them groggy or nauseous or both.
This was particularly true of the five-month-old admitted the second day after Zia’s return. The infant lay listless and unmoving, his skin sallow and his eyes dull. She said nothing while one of her interns read aloud the admitting physician’s chart notations. Nor did she offer an opinion or advice while he examined the patient under his parents’ worried eyes.
When her small group had adjourned to the hall outside the nursery however, she quizzed the intern. “Did you note any anomaly in Benjamin’s penis?”
She always referred to her patients by first name to insure neither she nor her students ever forgot they were treating living, breathing humans.
“I...uh...” The intern looked from her to his fellow students and back again. “No.”
“It appeared elongated to me. Combined with his low birth weight and failure to thrive, what does that suggest to you?”
The intern bit his lip and searched his memory. “Low-renin hypertension?”
The genetic defect was rare and difficult to diagnose. She didn’t blame the intern for missing it on the first go-around.
“That’s what it looks like to me. I would suggest you have the lab measure his renin level and compare it to his aldosterone.”
“Will do.”
“If the ratio’s too low, as I suspect it may be, let’s get a consult from the Adrenal Steroid Disorders group before we discuss his condition with his parents.”
Relief and respect reverberated in the fervent reply. “I’ll take care of it.”
Jézus! Had she ever been that young? Ever that terrified of doing more harm than good?
Of course she had.
That thought stayed with her as she crossed the catwalk connecting the Kravis Children’s Hospital with the tower housing the school of medicine’s research center. As head of the world-renowned facility, Dr. Wilbanks and his staff occupied a suite of offices with a bird’s-eye view of Central Park. Zia confirmed her appointment with the receptionist, then stood at the windows to admire the landscape. From this height, the frozen reservoir, rolling fields and bare-branched trees were a symphony in gray and icy white.
The buzz of the intercom brought her around. The receptionist listened for a moment and nodded to Zia. “Dr. Wilbanks will see you now.”
Roger Wilbanks’s physical stature matched his reputation in the world of pediatric research. Tall, snowy haired and lean almost to the point of emaciation, he greeted Zia with a burning intensity that both flattered and intimidated.
“I hope you’ve come to tell me you’ve decided to join our team, Dr. St. Sebastian.”
“Yes, sir, I have.”
As soon as the words were out, a thousand-pound boulder seemed to roll off Zia’s shoulders. This was right for her. She’d known it somewhere deep inside for months but hadn’t been able to shake the feeling that she would be abandoning the youngest, most helpless patients.
That guilty sense of desertion, of turning her back on her young patients, was gone. Part of that was due to Dr. Wilbanks’s validation of her initial research. And part, she realized, was due to Mike Brennan. He’d triggered an interest in a world outside of pediatric medicine. She was light-years from expanding her research to the wider population of ships’ crews and prison populations, but Mike had opened whole new vistas that gave the sterile environment of a lab new, exciting dimensions.
The possibility GSI might contribute to her research sparked an interest on the part of Dr. Wilbanks, as well. “Global Shipping Incorporated?” he echoed, his brows soaring above his rimless half-glasses. “They suggested they might fund a study of hospital-acquired infections in newborn infants?”
“They’re interested in any research that might pinpoint sources of infection. Apparently MRSA is as much a worry in the maritime world as it is in hospitals.”
His brows remained at full mast while Zia walked him through the paper copies of the slides Rafe Montoya had printed out for her. The chart listing the studies GSI had funded or contributed to proved especially riveting. By the time she finished, she could almost see the dollar signs gleaming in her mentor’s eyes.
“When do you present your current study to the faculty?” he asked.
“The second week in January. I don’t have a specific day or time yet, but...”
“I’ll take care of that. In the meantime, you need to get to work on a proposal for an expanded study. I’ll have one of the senior research assistants work with you on that. You also need to talk to someone in the comptroller’s office. Unfortunately, requesting and acquiring grants has become a complex process. So complex we often use the services of consultants. The comptroller will help you there. In the meantime, you can count your work with us as an elective and complete your residency on schedule.”
He pushed away from his desk and came around to lay a collegial hand on her shoulder.
“I don’t need to tell you research is the heart and soul of medicine, Dr. St. Sebastian. The publ
ic may hail Albert Sabin and Jonas Salk as the heroes who conquered polio, but neither of those preeminent scientists could have developed their vaccines without the work done by John Enders at Boston’s Children’s Hospital. God willing, our research into the molecular genetics of heart disease, the pathogenesis of influenza and herpes and, yes, the increasing incidence of MRSA among newborns, will yield the same profound results.”
* * *
Zia couldn’t have asked for a more motivational speech. Or a more ringing endorsement of her shift to full-time research. Buoyed by the increasing certainty she’d made the right decision, she traded hours with another resident so she could have dinner with Natalie and Dom the evening they flew in from Texas.
They’d come back a week before the duchess and Maria were scheduled to return. The New Year celebrations were over, the slush had morphed to grime, and the city shivered under an Arctic blast. Hunched against the cold, Zia took a cab to their apartment in the venerable old 30 Beekman Place building. It was less than a block from UN Headquarters, where Dom was still trying to adjust to his mission as cultural attaché.
The tenth-floor condo boasted plenty of room for entertainment and a million-dollar view of the Manhattan skyline. More important, as far as Natalie was concerned, it was only steps from a dog run, where she and the liver-and-white-spotted Magyar Agár exercised twice a day.
Natalie and the hound were just returning from their evening constitutional when Zia climbed out of the cab. The whipcord-lean hound greeted her ecstatically, Natalie with a hug and a smile.
“I was so surprised and excited when you called and told us you were switching to pediatric research,” her sister-in-law said. “I hope you get as much fulfillment from your field as I do from mine.”
“I hope so, too.” She had to ask. “How did Dom react to the news that I won’t be practicing hands-on medicine?”
“Oh, Zia! Your brother wants whatever you want.” Her brown eyes brimmed with laughter. “You could dance naked down Broadway and Dom would flatten anyone who so much as glanced sideways at you. And speaking of dancing naked...”
She hit the elevator button and spun in a slow circle to unwind the leash wrapped around her calves.
“Mike Brennan stopped by the resort before we left.”
“Why?”
“He said he wanted to talk to Dev about a fleet of new cargo ships his company is thinking about acquiring. But he and Dom spent quite a bit of time out on the balcony, one-on-one.”
This was news to Zia. She and Mike had iMessaged each other a few times. Like most texts, they were short and only hinted at the activities cut off by her departure from Houston. Yet they also managed to convey an unsaid but unmistakable desire to pick up where they’d left off. None of Mike’s iMessages had mentioned a one-on-one with her brother, however.
“How did they get along? Was any blood spilled? Bodily harm inflicted?”
“Let’s just say your brother isn’t making any more ‘Cossack-y, I’ll carve out his liver with a saber’ noises.”
Zia had to smile. Dom talked a good game. She couldn’t count the number of dates she’d had to bring by the house so he could scope them out. Or the friends he’d subjected to intense and, to them, nerve-racking scrutiny. Yet he’d always respected Zia’s intelligence and, more important, her common sense. He’d never interfered or second-guessed her choices. Not an easy task for the older brother who’d raised her from her early teens.
“By the way,” Natalie said casually as the elevator arrived and the hound dragged her inside, “we expect you to bring Mike to dinner when he’s in New York for that conference he’s suddenly decided to attend.”
“How did you...?” Laughing, Zia followed her sister and the hound into the elevator. “Never mind.”
The two women exchanged a wry smile. Dominic St. Sebastian might have put his days as an undercover agent behind him. He kept a hand in the business, however. Or at least a finger.
* * *
Zia didn’t exactly count the days until Mike showed up in New York. She was too busy with rounds and teaching and preparing the presentation of her MRSA study to the faculty and her fellow residents. In between, she snatched what time she could to work on the proposal for the expanded study.
Per Dr. Wilbanks’s instructions, she used National Institutes of Health guidelines to draft the proposal. The first step was to describe the greatly expanded research project and what it was intended to accomplish. After that she interviewed prospective team members, detailed their credentials and ran her choices by Dr. Wilbanks for approval. Once she had the team lined up, she used their collective expertise to refine the objectives and nail down the resources required. They also put together a projected budget for the estimated life of the study. The “one million, two hundred thousand” bottom line made Zia gulp.
It caused the school’s assistant comptroller to suck a little air, too. A busy, fussy type with salt-and-pepper hair and a string of framed degrees on her office wall, the financial guru felt compelled to deliver a lecture about the acquisition and disbursement of grant monies.
“I’m sure you understand that we have to be very careful, Dr. St. Sebastian. Especially with a grant in the amount you’re requesting. We have an excellent record here at Mount Sinai, I’m very happy to say. But recent audits by the National Institutes of Health have uncovered waste and, in some cases, outright fraud at other institutes.”
“That’s why I’m here, Ms. Horton. I want to be sure we do everything by the book.”
“Good, good.” She glanced over the figures in the proposed budget again. “I doubt you’ll pull in half of what you’re requesting.”
She hesitated, her lips pursed.
“We use the services of two excellent consulting firms that specialize in searching out and securing grant monies. I’ll give you the contact information for both, but in this tight economy...”
She shook her head discouragingly. Zia debated whether to tell her about the GSI connection. She decided to wait until the expanded study had been approved and the hunt for funding actually got under way.
A few clicks of the assistant comptroller’s keyboard produced a printed list of “grant consultants.” Zia tucked it in the black Prada messenger bag Gina and Jack had given her for Christmas. It was exactly the right size to carry her iPad mini, her phone and all the paraphernalia she needed for work.
* * *
The dollars were still on her mind when she emerged from the subway at 72nd and Broadway just after seven o’clock. The Arctic cold front had finally blown itself out, but the air was still frosty enough for her to keep her head down and her shoulders hunched as she hurried the two blocks to the Dakota.
Jerome had gone off duty at six. The new night doorman, whose name Zia had to struggle to recall, intercepted her on the way to the elevators. “Excuse me, Doctor. A courier delivered this for you a short time ago.”
With a word of thanks, she examined the plain white envelope he handed her. The outside contained only her name. The inside, Zia discovered with a delighted grin, contained an IOU for one carriage ride through Central Park, redeemable tonight or anytime tomorrow. Her pulse skipping, she dialed Mike’s number.
“When did you get in?”
“A couple of hours ago.”
“Why didn’t you call me?”
“I knew you were working. So what’s the deal? Are you up for a carriage ride?”
“It’s freezing out there!”
“I’ll keep you warm.”
The husky promise sent a shiver of delight dancing down Zia’s spine. She tried to remember if she’d seen any carriages during her dash from the subway. The new mayor had vowed to ban them, citing traffic safety and animal protection issues. She didn’t think the ban had gone into effect but didn’t remember noticing any carriages on the street.
“Why don’t we decide what we’ll do when you get here?”
“Fine by me. I’ll grab a cab. See you shortly.”
“Wait! How shortly?”
Too late. He’d already disconnected. She headed for the elevator again and keyed the door of the duchess’s apartment with a fervent prayer she had time for a shower and to do something with her hair.
She didn’t. The intercom buzzed while she was soaping herself down. She almost missed it over the drum of the water. Would have if she hadn’t kept an ear tuned for it.
“Damn!”
She grabbed a towel but left a trail of wet footprints as she dripped her way from the bathroom to the hall intercom. “If that’s Mr. Brennan, send him up.”
“Yes, ma’am.”
Back in the bedroom she yanked her closet doors. She was reaching for the comfortable sweats she spent most evenings in but stopped with her hand in midair. When she answered the front door a few moments later, she was wearing only the towel and a smile.
He, on the other hand, was wearing leather gloves, a charcoal cashmere overcoat and his black Stetson. Tipping the brim back with two fingers, he gave a low whistle.
“If this is how you New York City gals answer the door,” he drawled as his gaze made a slow, approving circuit from her neck to her knees and back again, “I’ll have to make a few more executive board meetings.”
“I’m only a temporary resident,” she reminded him.
“So this is a Hungarian custom?”
“Actually, it is. Public baths have been popular in my country for several thousand years. The Romans loved to luxuriate in the bubbling hot springs in and around Budapest.”
“That so?” He waggled his brows in an exaggerated leer. “You have to hand it to those Romans.”
The Texan's Royal M.D. Page 8
