Maverick In The Er
Maverick In The Er
Jessica Matthews
The Delectable Dr Donovan ER doctor Trey Donovan is sinfully sexy, seriously good at his job, and willing to do whatever it takes for his patients. His team at Good Shepherd Hospital is second to none including new doctor Sierra McAllaster.Trey can have any (and every! ) woman he wants as long as they dont expect a fling to end in a diamond ring! But Sierra makes maverick Trey want to break his own relationship rules
He spoke with a calm authority that sent staff scrambling to obey. Then again, who wouldnt want to do whatever he asked if it meant receiving one of his killer smiles?
His long eyelashes were partly to blame for his appeal to women, she decided. Add dark brown hair and blue eyes, a firm jaw and an attractive dimple, and infatuation was a given.
While he wore the requisite surgical green scrub suit under a protective yellow paper gown, the shapeless garments didnt detract from his muscular shoulders or his lean physique. If he could turn heads in this ugly garb, hed probably stop traffic when he wore street clothes that actually fit. If the hospital ever created a doctor-of-the-month calendar featuring him as the centerfold theyd make a fortune.
As great as his physical appearance was, he wouldnt have earned the moniker of the delectable Dr. Donovan if he didnt have the personality to match. His charisma explained how hed managed to get whateverand whomeverhe wanted in his department. His persistence and eloquent arguments had persuaded several top people to transfer her into his domain.
Apparently aware of her lingering presence, he flashed her a cocky grin.
Hating that hed caught her loitering, and was obviously thinking shed become one more member of his adoring fan club, she fled the room.
About the Author
JESSICA MATTHEWSS interest in medicine began at a young age, and she nourished it with medical stories and hospital-based television programmes. After a stint as a teenage candy-striper, she pursued a career as a clinical laboratory scientist. When not writing or on duty, she fills her day with countless family and school-related activities. Jessica lives in the central United States, with her husband, daughter and son.
Recent titles by the same author:
EMERGENCY: PARENTS NEEDED
HIS BABY BOMBSHELL
THE BABY DOCTORS BRIDE
Dear Reader
One day I stumbled across an article about labyrinths and their associated healing effects. I was intrigued by how hospitals in the US are building these labyrinths on their campuses to help patients achieve spiritual health while their medical needs are addressed. I began my research and was fascinated by what I learned.
Consequently, I wanted to incorporate this concept into a story. Ive taken a few liberties for my own purposes, but I simply had to create characters who needed the emotionally healing effects of a labyrinth.
I hope you enjoy what Ive done. Happy reading!
Sincerely
Jessica Matthews
MAVERICK IN THE ER
JESSICA MATTHEWS
www.millsandboon.co.uk (http://www.millsandboon.co.uk)
To Terry, for being my hero.
CHAPTER ONE
LET this be a lesson to you, Sierra McAllaster, she told herself in her rush to meet the incoming ambulance. Never say never.
Shed worked in Emergency Services before coming to Pennsylvania three months ago, and when shed left North Carolina, shed vowed that daily E.R. duty wouldnt be in her future. Shed been there, done that, and although shed once loved her work in that hectic department, it was time to pass the torch to others who thrived on the adrenalin rush. She wanted a more sedate pace with patients who werent broken bodies in need of an immediate fix, and shed found it on the fifth-floor medical unit at Pittsburghs Good Shepherd Hospital.
However, just when shed finally settled in to her new duties, her career plan had taken a one-hundred-and-eighty-degree turn. At this very moment she was in the middle of the very position shed never intended to fill again, thanks to a one-sentence clause in the fine print of her contract.
Come on, people, Trey Donovan, the senior emergency physician, yelled beside her. Lets move!
By the time their small entourage had reached the ambulance bay, two paramedics were already tugging a stretcher out of the back of their vehicle.
A feeling of dread swamped her, but she reasoned it away. You dont know this person. None of your friendsor family could possibly be on that stretcher. This is a car accidentnothing at all like Davids situation.
She swallowed hard and forced herself to fall back into her objective professional mode.
MVA, one medic reported, using the shorthand Sierra recalled so vividly. Motor-vehicle accident. Forty-five-year-old male with blunt trauma to the chest and abdomen, dislocated shoulder and sundry other injuries. BP is
Sierra noted the vital signs as she gazed down at the man lying on the gurney, strapped to a backboard and wearing a cervical collar. Bruises were already forming on his visible extremities and lacerations from broken glass crisscrossed his face. An oxygen mask covered his nose and mouth, but his nose was swollen and clearly broken, which meant theyd need an airway.
Lets go, Trey ordered, and off they scurried to the nearest available trauma room.
Hes wearing a MedicAlert bracelet, the other paramedic reported. According to the company records, hes a diabetic and hes currently taking Coumadin, hydrochlorothiazide and something called liraglutide.
The blood-pressure medicine wasnt unusual for someone his age, but the blood thinner was. Has he had a recent heart attack or stroke?
We dont know, but his left knee has a freshly healing scar. Maybe a recent joint replacement? The police are trying to locate his next of kin.
Any record of insulin?
The paramedic shook his head. None.
What was that last drug youd mentioned? Trey asked, his brow furrowed as if trying to place the medication.
Liraglutide, the paramedic repeated.
Trey turned to one of the nurses. Call the Pharmacy and ask
Dont bother, Sierra interrupted. Its a new drug just approved by the FDA for treating type 2 Diabetes.
Oh.
Treys dark-eyed gaze met hers over the gurney and she read his unasked question. I had a patient who had trouble controlling his diabetes, so we tried it. Its not the first line of therapy and has a number of side effects, but in his case it was a last-ditch resort and it worked, she explained.
He grinned, and the most endearing dimple appeared in the side of his cheek. Your first official day and youre already handy to have around.
Strangely enough, her face warmed under his appreciative comment. Sierra McAllaster did not respond to empty flattery with a blush, she reminded herself. Thanks to her husband, whod liberally used his charm to his own advantage, shed eventually determined it was merely a tool to get what he wanted. The lesson had been painful to learn as her illusions had been shattered, but shed never forget it. Never again would she fall for a fellow who troweled on charm as easily as a brickmason laid his cement. Shed become immune to men like him.
However, immunized or not, it seemed rude to refuse to return his smile so she did, even though she didnt know why she was smiling in the first place.
A few seconds later, theyd pushed the gurney against the awaiting bed in the trauma room. Sierra locked the wheels in place with the toe of one pump, having already decided shed overdressed for the demands of this department. Shed forgotten the frantic paceor maybe shed simply blocked it out of her mindwhich meant a dress and heels werent her most practical choice of attire.
Lift on three, Trey ordered. One, two, three.
Everyone complied in one smooth, well-rehearsed motion to move their patient to his new bed. Sierra hoped any residual blush on her face could be attributed to the strain and not Treys flattering comment.
Can you hear me, Mr. Klein? Trey spoke to the fellow. Youre in the hospital and were going to take care of you.
Unable to nod because his head and neck were immobilized, he simply blinked and mouthed, Okay.
Sierra hung around and helped the nurses organize the patients tubes and swap the paramedics equipment for hospital-issue while Trey issued orders for X-rays and lab work, requesting the same procedures Sierra would have if shed been in charge of this case.
His next command caught her by surprise. Go to lunch, Sierra.
She paused. You dont need help?
He shook his head and flashed his trademark grin. Thanks, but Im good.
Yes, he was, she thought as she moved out of the way, somewhat reluctant to leave just yet. Instead, she took a few minutes to observe her colleague in action.
Today might be her first official day in Emergency, but it wasnt the first day shed worked with Trey. In her previous position as hospitalist on the fifth-floor medical unit, shed received several patients hed admitted and had answered his call for a consultant on numerous occasions. His medical skills then, like now, seemed outstanding.
He spoke with a calm authority that sent staff scrambling to obey, but she could tell they did so out of a desire to please rather than a sense of fear. Then again, who wouldnt want to do whatever he asked if it meant receiving one of his killer smiles? Shed seen how his grin had turned even the most independent, career-minded woman into the equivalent of a simpering teenager.
He was also more than just a handsomely wolfish smile. His long eyelashes were partly to blame for his appeal to women, she decided. Add dark brown hair and midnight-blue eyes, a firm jaw and an attractive dimple, and infatuation was a given.
He was a tall man, which made nearly every female, no matter her size, feel dainty and feminine. While he wore the requisite surgical green scrub suit under the protective yellow paper gown, the shapeless garments didnt detract from his muscular shoulders or his lean physique. If he could turn heads in this ugly garb, hed probably stop traffic when he wore street clothes that actually fit.
If the hospital ever created a doctor-of-the-month calendar featuring him as the centerfold, theyd make a fortune.
As great as his physical appearance was, he wouldnt have earned the moniker of the delectable Dr. Donovan if he didnt have the personality to match. His charisma explained how hed managed to get whateverand whomeverhe wanted in his department. Because of his persistence and eloquent arguments that she was the one physician who could immediately fill the long-vacant position in his service, hed persuaded several top people to transfer her into his domain. Granted, she was only covering until the heads of Emergency Services and Internal Medicine hired a physician specifically for the post but, as far as she was concerned, a day spent in the ED was one day too many.
Apparently aware of her lingering presence, he flashed her a cocky grin.
Hating that hed caught her loitering and was obviously thinking shed become one more member of his adoring fan club, she fled the room. After a brief stop at the staffing board, where she slapped a Lunch magnet beside her name, she hurried outside, into the warm afternoon sun.
Trey surreptitiously watched Sierra leave as if a rabid dog were nipping at her heels and hid his smile. Hed first met her three months ago when hed called the fifth-floor medical unit to request a stat internal medicine consult and Sierra had responded, barely giving him a second glance.
Accustomed to dealing with flirty and simpering females, Trey had been taken aback by her disinterest at first but then hed been intrigued by it. In his earlier life as a footloose, carefree bachelor, he would have responded to the challenge she presented and pursued her with everything he had. However, that had all changed when his sister-in-law, Marcy, had died. While his relationships were still of the short-term variety, hed come to the conclusion that even those were difficult to juggle with everything else in his life. Acting as Mitchs big brother, helping Mitch raise his niece and coping with the demands of his job took nearly all of his free time.
As much as hed like to know Sierra on a more personal level, his gut told him that she wasnt the sort who would embrace such a temporary and superficial relationship.
Instead, she was the type to make a man think about the future in terms of the next twenty or thirty years. At times, he tried looking ahead that far, but he simply wasnt ready to let a woman get that close. Between coping with Mitchs downward spiral after Marcys death and his struggle to meet all of his family obligations, he didnt have the time or the energy to devote to anyone else.
That hard truth, however, didnt prevent him from wishing Sierra would be happy with what he could offer, especially after today when hed seen her face turn a beautiful shade of pink. What woman in this day and age, especially one whod survived the rigors of medical school and residency, actually blushed? Be that as it may, that small flaw only enhanced her already attractive features.
Her fine bone structure gave her an ethereal quality, as if she didnt belong in a field as brutal as emergency medicine, but her athletic frame suggested she wasnt a stranger to hard work.
As lovely as he considered her face and form, her thick auburn hair was nothing short of awesome. The color reminded him of flames dancing on the hearth and without any effort at all he pictured her shaking out her braid until every strand cascaded over her beautiful shoulders.
If that wasnt enough, her shapely legs with their miles and miles of soft skin made his throat go dry. Today, like most days, she wore low-heeled pumps and a dress that fell to just above her slim knees. Her garb wasnt practical for the demands of working in Emergency and shed probably switch to baggy scrub suits and tennis shoes tomorrow, but hed enjoy the view while it lasted.
His libido and personal preferences aside, he was still glad shed finally joined the emergency-services staff. For that reason, he found himself grinning like a loon whenever he saw her.
Actually, she hadnt joined as much as shed been transferred. Over the past year, hed created a paper blizzard that had gone to every department head, vice president and hospital-board member, protesting the fact that his departments extra medical position had never been filled. As soon as hed learned of Sierras credentials and past experience in Emergency, hed intensified his efforts. If Administration had agreed theyd needed the position, hed argued, then it was pointless not to fill it, especially when someone already on staff was ideal for the job.
While everyone agreed with his reasoning, Sierras boss, Lane Keegan, hadnt wanted to lose her from the medical unit. If not for pressure from above, theyd still be at an impasse, but finally, after weeks of negotiating details, Keegan had given in. On one point, however, hed refused to budge.
Sierra would only fill Treys position until they found a replacement who met the criteria, but not for longer than sixty days. Which meant Trey still had fifty-nine to work his magic and convince her to stick around permanently. His philosophy was, Better the devil you know than the one you dont, and hed prefer to keep Sierra, who got along well with the staff, rather than bring in a new person who might clash with everyone.
Roma Miller, the nursing supervisor whod just received her thirty-year service pin, strode in. Where was Dr. McAllaster going in such a hurry?
He shrugged. Lunch, I guess.
No kidding? Ive never seen her walk so fast.
Interesting. She must be hungry, he offered, although he suspected the reason for her rush had had nothing to do with her appetite and everything to do with regaining her composure after hed caught her studying him.
In spite of her cool attitude, in spite of her standoffish ways, Sierra McAllaster obviously wasnt as resistant to his charm as she pretended.
Munching on an apple, Sierra strolled along the circular concrete pathway of the hospitals favorite attractionthe Healing Garden and Labyrinthwhich had been created just outside Emergency. Normally, she walked the circular concrete pathway in order to recharge her mental batteries when she had a tough patient, but today her reflections were far more personal and far more immediate.
Her ridiculous reaction to Treys flattering comment still bothered her. Her marriage had taught her to not fall victim to a mans flattery and until now she hadnt. Why today was different remained a complete mystery. In her opinion, Treys charm was a strike against him.
He had also earned a second strike because if it werent for him, shed still be reporting to work on the fifth floor, where she belonged. Although, in all fairness, she didnt know if she should be upset with him or with herself.
If shed been in Treys position, she would have presented the same case he had, asking that the vacant position be filled with a doctor who was already on staff and who possessed ED experience. As Fate would have it, she was the one with the least senioritythe only one, in factwho fit the criteria.
Her options had been limitedeither take this assignment or end her contract.
Leaving hadnt been a viable option. Shed finally unpacked the last box of household goods this past weekend and the idea of hunting for a new job was too tiring to contemplate.
On the other hand, she did have a third option. If shed been honest and explained why she couldnt work in Emergency, perhaps Dr. Keegan might have chosen someone else. Pride, however, had stopped her. Shed come to Good Shepherd with a clean slate and if she dragged out her history to use like a get-out-of-jail-free card, her past would become an open book. The doubts, the pitying glances and every emotion in between would start, and she refused to deal with that from staff and her colleagues.
Consequently, shed decided it might be time to face her fears and put those horrors behind her. Although she didnt want to work in Emergency, she suddenly had a desire to prove she was able to.
Fortunately, Dr. Keegan had offered her several consolation prizes. Oneand the most importantshe was only filling in temporarily. So what if she was back in the area where shed sworn shed never work again, treating everything from acid reflux to herpes zoster infections, traumas to diabetic comas? Shed endured far worse and for a far longer period. Sixty days was nothing more than a wrinkle that would iron itself out in due time.
Two, Dr. Keegan had promised she could return to her hospitalist position on the fifth floor. Knowing how the other internist, William Madison, was already complaining about covering those patients as well as his own in the cardiac ICU, he was also eager for her to shake the E.R. dust off her feet and return to where she belonged.
Three, the odds of encountering a trauma that involved a close friend or family member were nonexistent. After three months in Pittsburgh, she still hadnt developed any serious friendships or personal relationships and as long as she was expected to staff the ED, she intended to keep it that way.
As she strolled around the labyrinth, a growing sense of acceptance and her natural can-do attitude filled her. Her transfer may have thrown her off balance, but she was slowly feeling more in control over her situation. Todays trauma had only caused her a few moments of anticipatory dread, but after that shed handled herself well. Shed still have some bad moments, but shed be able to deal with them. She would deal with them.
Her next mental project was to get Trey Donovan, including his twinkling eyes and his lazy grin, out of her head. After a single morning in his presence, hed already shattered her calm, making her wish for those happy-ever-afters shed stopped imagining were possible.
She knew better than to respond like a schoolgirl to a man who had enough charisma for three guys, but shed done it anyway. Maybe her reaction was due to first-day-on-a-new-job stress because shed been dreading this day for the past week. Maybe it was because she hadnt slept well last night and her defenses were down.
Maybe it was because her blood sugar had dropped. Shed chosen to take the late lunch break and that had been delayed because theyd been busy.
Then again, maybe it was all of the above. Yes, she decided. That was it. Shed been simply tired, stressed and hungry. This afternoon, shed be more like her old self, able to resist his wicked grins with the logic that they meant nothing.
Can I walk with you?
Startled out of her private thoughts, Sierra glanced down to see a girl, about ten years old, falling into step beside her on the concrete walkway. The child wore an oversize T-shirt, bright pink leggings and well-scuffed white-and-lavender tennis shoes. Her skin was tanned and her brown hair possessed lighter streaks, which suggested she spent a great deal of time outdoors. Several strands of hair had escaped her ponytail, which wasnt quite centered in the back of her head.
Although Sierra wanted to finish her walk through the labyrinth in contemplative quiet, she didnt want to be rude. Instead, she glanced around the garden, carefully scanning each bench for a potential parent or an otherwise responsible adult. Surprisingly, the garden was vacant and no one else was walking the labyrinth. They were alone.
Wont your parents wonder where you are? Sierra asked instead.
My moms dead and when my dads out of town I stay with my uncle, the girl informed her. He says I have to keep myself busy until he finishes his shift. He has a very important job, you know.
Really? she replied, amazed by how anyone could expect a child at her age to amuse herself in a hospital for hours on end. Surely a man who had this so-called very important job would realize that.
Hes a doctor, the child added meaningfully.
Sierra wasnt as impressed as the little girl obviously expected her to be. By virtue of his profession, the man should know better than to let a child run around a busy medical center completely unsupervised.
Immediately Sierra wondered if any of the physicians she knew had a niece this age, but none came to mind. Even so, something about this childs features seemed familiar.
Youre a doctor, too, arent you? the youngster asked, as if she already knew the answer.
Yes, I am. Are you supposed to be outside by yourself?
The girl drew herself up, adding an inch or so to her almost five-foot frame. Im almost eleven, she said, clearly affronted by Sierras question. My uncle says I can come out here if its not raining. She raised her hands, palms up. No rain today.
No. No rain today, Sierra echoed. Doesnt he worry about you wandering all over the hospital while hes working?
No, because I had to cross my hearts she pantomimed and promise to follow the rules. I can only go to certain places, like the li-berry, the coffee shop or this garden. Or his office, she tacked on. He trusts me.
At least this nameless man had set a few boundaries.
The other rule is that I dont talk to or go with a stranger, no matter where I am.
Im a stranger, Sierra pointed out, deciding she would hunt down this irresponsible uncle and give him a piece of her mind, colleague or not! The risk was too great to leave this little girl unattended. The garden saw a lot of foot traffic and anyone who weighed more than a hundred pounds could haul this youngster off without breaking a sweat, even if she was kicking and screaming.
No, youre not, she said, shaking her head. Ive seen you lots of times. She scurried in front of Sierra and peered at her identification badge. Youre Dr. McAllaster. Your name tag says so.
Yes, but
Im Hannah, she answered. Now we arent strangers anymore.
Hannahs logic was definitely lacking. Actually, we still are strangers, Sierra corrected her gently. I could be a not-very-nice person.
Hannahs ponytail bounced with each shake of her head. Nope, youre not. Ive been watching you cause you come here almost as much as I do. If you were a rotten person, you wouldnt feed the birds your leftover crackers.
Goodness! Had she been so self-absorbed that she hadnt noticed an unattended child before today? Or maybe shed seen her and thought shed been under the watchful eye of one of the many visitors who came to the garden for fresh air and sunshine. Regardless, it was still eerie to realize that someone had observed her so carefully without her knowledge. She would definitely have to pay closer attention to her surroundings in the future.
Plus, youre a doctor. Doctors arent mean people. Oh, they can do nasty things like give us a shot, but its for our own good, she said confidently.
While Sierra agreed that most physicians were caring individuals, she personally knew of several who should have chosen a different profession. Even so, she wouldnt destroy the girls illusions. Life would take care of those soon enough.
A lot of people come here to walk, dont they? Hannah asked.
They do.
My uncle says they built this because the lab-y-rinth, she stumbled over the word, is supposed to make people feel better. The Native Americans call it a medicine wheel.
Really?
Uh-huh. Theyve gotten really popular, he says, especially at hospitals. Walking the path helps people who have stuff like high blood pressure or who cant relax. He says that the twists and turns are sposed to represent the twists and turns in life.
The child sounded like a brochure that detailed the hospitals services. Hes right. The labyrinth helps people put the bad things in perspective.
Is that why youre here? So you can put the bad stuff in persperspective?
Hannahs insight surprised her. Sierra began visiting the garden during her lunch hour as part of her mental-health regimen when shed first joined the medical staff. Walking the circular concrete pathways, which were lined with colorful petunias, helped her deal with stress, especially after she lost a patient. She also knew of several surgeons who walked the labyrinth in order to clear their heads before performing surgery.
Yes, I do, Sierra said. Why do you come here? To be outdoors instead of being cooped up inside?
Hannah shrugged. I like this place. My mom died of cancer when I was little, and whenever I get sad, I walk until I feel better. Do you think she might have lived if thered been a lab-y-rinth at her hospital?
Hannahs matter-of-fact tone didnt minimize the compassion Sierra felt for her. Oddly enough, she almost wanted to give her nameless uncle a break. Being a single parent or, in this case, an uncle wasnt easy, especially when one dealt with an obviously precocious child like Hannah.
Sometimes cancer wins, no matter how hard people try to fight it.
Hannahs brown eyebrows drew together as she nodded. Thats what my uncle says, too. He says she didnt want to die, but it wasnt her fault she couldnt stay and watch me grow up.
No, it wasnt, Sierra agreed.
Oddly enough, her uncle seemed to have imparted good insight to his niece. Sierra added one mental point in his favor.
Suddenly, the sound of dogs barking broke the quiet. Hannah immediately pulled a hot-pink cell phone out of the matching pouch hanging around her neck and the barking stopped. Sierra chuckled at herself as she realized the noise was a ringtone instead of a pack of canines on the loose.
The youngster glanced at the display and winced. Gotta go. Bye!
Wait! Sierra called as Hannah began hurdling the flowers with an easy-limbed grace in her haste to head toward the north door. Whats your uncles name?
Hannah simply smiled and waved before she disappeared through the north door.
So much for discovering the childs identity, Sierra thought as she watched Hannah somewhat benevolently. Knowing Hannah had a cell phone made her feel somewhat better about the situation.
To Sierras disappointment, her wristwatch showed her allotted break time was over, too, even though she hadnt reached the center of the labyrinth. After taking one last look in Hannahs direction and seeing her disappear through the glass entrance doors, Sierra carefully stepped over the petunias as she strode in the opposite direction and disposed of her apple core in the trash.
Inside the main emergency hallway, ringing telephones, whispering gurney wheels and excited voices contrasted sharply with the tranquility shed left behind. Directly ahead, she saw two different paramedics from the ones shed met earlier, another ED physician and a nurse escorting another gurney into a trauma room. Meanwhile, Trey was heading toward an exam room as he reviewed the form on his clipboard. As soon as he saw her, his smile widened.
How was lunch? he asked.
She thought of the precocious Hannah. Interesting. Why dont I take over for you so you can take your break?
Thanks, but this case shouldnt take too long. Its also too early to meet my lunch date in the cafeteria, so I might as well earn my pay.
She should have known. The man probably arranged his personal schedule months ahead. Then I wont keep you.
Before she turned away, he stopped her. Save tomorrow for me, though.
She paused. Excuse me?
Lunch. Tomorrow. My treat. Itll be my official welcome to the department gesture.
Do you take every new person to lunch? she asked.
Everyone, he reassured her. Even the housekeeping staff. So dont pack your apple.
She stared at him in surprise. How did you know?
Im an observant kind of guy.
Of course he was, she thought wryly. Okay, fine. Well do lunch. Then, to make certain there would be no misunderstandings, she added, Strictly between colleagues.
His smile seemed as broad as his shoulders. Fair enough.
She turned away, but he stopped her. Out of curiosity, are you seeing anyone?
This time she smiled. What does the grapevine say?
Youre not.
Correct, as usual, she agreed lightly.
Is there someone back home? he pressed.
Sierra hesitated. How could she explain, and did she want to? However, if her answer prevented speculation and stopped people from pushing her towards every eligible man who came along, why not?
There was, she replied slowly.
Breakups are tough, he agreed, his expression sympathetic. So you came to Pittsburgh to start over?
If only it had been that simple. I did, but the situation is a little more complicated than a mere breakup. She met his gaze. When I left North Carolina, I left my husband in the Fairview Cemetery.
CHAPTER TWO
TREY didnt know what had possessed him to broach the subject of her personal life. Perhaps hed simply been looking for an excuse to stay away from Sierra and hearing of a fellow back home would have provided it. Perhaps he was simply a glutton for punishment and hearing of her unattached status would only provide a temptation hed be hard-pressed to resist.
Unfortunately, her response had been completely unexpected. Hed certainly never dreamed that the man shed left behind had been her husband, much less that he was dead.
Certainly, the information shed shared explained so muchher long hours, her avoidance of the dating scene, and her move to a new city and work environment. She hadnt come to Pittsburgh on some grand adventure to see the world. Like his brother, Mitch. Sierra was picking up the pieces of her life.
All of which proved his theorythe best relationships were temporary.
Im sorry, he murmured.
She nodded, apparently accustomed to hearing condolences if her frozen expression was any indication. Thanks, she murmured. Then, with a visibly shaky hand she smoothed her hair. Are you sure you wouldnt like me to see your patient?
Her abrupt change of subject couldnt have been more plain. Their question-and-answer period had come to a close, which was good. For a man who never had trouble finding something to talk about, he was suddenly at a loss for words.
He glanced at his watch. He only had ten minutes before his cafeteria appointment and it took nearly seven to walk there. Do you mind?
Not at all. Enjoy your lunch.
Eager to get away before he asked more questions, Sierra pulled the clipboard out of his hand and headed down the hall. Shed already shared more than shed ever planned, and if she gave him enough time, the inevitable What happened? would follow.
She simply didnt want to go there. Not now. Not yet. The tragedy had occurred over a year ago and she simply refused to dredge up those old feelings of shock, despair and anger, not to mention guilt. Shed finally come to the acceptance stage, but it hadnt been easy.
Now, however, was not the time to walk down memory lane and analyze the past. At the moment, the only person who deserved her full attention was her patientnot Trey Donovan, and certainly not David McAllaster.
By the time shed received the results of Karen Maxwells strep screenit was negativeand referred her to an ENT specialist to evaluate her chronic sinusitis, Trey had returned, looking as rested and refreshed as he had before their full morning of traumas and regular patients.
As Sierra sank onto a chair in the nurses station, she noticed he was chatting up one of the radiology techs. The poor girl was smiling as if hed single-handedly hung the sun, moon and stars.
He has quite a knack with the women, doesnt he? Sierra mused aloud to Roma, who was clicking away on her keyboard at a nearby terminal.
You must be talking about our famous Dr. Donovan, Roma answered, without glancing away from her screen.
How did you guess?
He does have a way with people, she commented. Young, old, male, female, staff, patients, it doesnt matter. Why, Ive seen him talk the most recalcitrant patients into behaving. When hes on duty, things just run more smoothly.
Sierra understood why. By virtue of his personality, he inspired people to dig deeply and give one-hundred-and-ten percent.
Just like David.
The only question was, did Trey do it for personal gain, or was he as altruistic as everyone believed? She wasnt quite convinced of the latter.
Roma finally glanced away from her screen to direct her gaze down the hallway. Hes so sweet to all of us. In fact, everyone fancies themselves a bit in love with him, she remarked.
Ive gotten that impression, Sierra said wryly. Given the way women act when hes around, Id bet he never spends an evening alone. Im surprised he has the energy to come to work.
The nurse laughed. Theres where youre wrong. He doesnt date as often as you might think. Oh, there are a lot whod give their right arm for a night with him, but hes very careful about who he takes out. And he never sees anyone more than a handful of times.
Really. Sierra wasnt convinced, but Roma seemed to know what she was talking about. I find that hard to believe.
Roma shrugged. Its true. Dr. Donovan seems like a happy-go-lucky sort, but dont let his winning ways fool you. Theres a lot more to our good doctor than meets the eye.
Sierra watched as the X-ray tech walked away with a light step, her face beaming in obvious delight over her encounter with Trey. Meanwhile, he wore his own satisfied expression, which suggested hed gotten whatever hed wanted.
Just like David, she thought with some disgust. Everything was a game, nobody was anything more than a chess piece. Thank goodness shed grown wise to such manipulations. Shed been a pawn once in her life. She wouldnt be one again.
After finishing with his next patient, Trey strode back to the doctors office. Hed requested a CT scan for one of his patients with a debilitating headache and Lila, the X-ray tech, had promised the images would be online by two oclock. It was five minutes till, so he didnt expect to see them posted, but it didnt hurt to check.
He accessed Joan Villierss computer file and, as hed suspected, the CT scan was still pending. A brisk knock at the door heralded Romas arrival.
Ive been looking all over for you, the nurse remarked as she entered.
Whats up?
Frances is here.
Whats wrong today?
Stomachache. Do you want me to give her to Dr. McAllaster?
He thought a moment. Yeah, but Id better introduce them first, dont you think?
Probably. Although I think the introductions are more for Dr. McAllasters benefit than Francess.
Right as usual. Because he was curious, he asked, From a nursing point of view, whats your opinion of our new doc?
Roma didnt hesitate. I think shes doing okay. Shes a little tense, especially during traumas, but other than that I dont have any complaints.
Its her first day, he reminded her. Shes bound to be a little tense.
Hey, I wasnt finding fault, Roma protested. Only making an observation which, as you said, is only to be expected. Now, if shed come in all cocky and acting like a know-it-all, then Id worry. She patted Treys shoulder. You done good, Doc, when you convinced them to transfer her to us.
Pleased by Romas praise, he smiled. I did, didnt I?
According to the nurses on the fifth floor, theyre extremely upset because we stole her away.
Its only for sixty days. More or less.
Yeah, well, theyre afraid they wont get her back. According to them, she knows her stuff. Better yet, and unlike some doctors who shall remain nameless, she doesnt treat them like theyre too stupid to live.
We were fortunate she came to Good Shepherd, he commented, keeping the story Sierra had shared to himself. If she wanted everyone to know she was a widowand she obviously didnt if the information hadnt circulated on the grapevineshe could divulge that news herself.
Rumor says she didnt want to be assigned to the E.R., Roma pointed out. As youre the one responsible for her transfer, I hope you intend to turn on the charm until she settles in.
Hey, I only made the suggestion, he protested. The decision came from people above my pay grade.
Be that as it may, if you hadnt pushed for her, she wouldnt be here.
Roma was right. If he hadnt waged his one-man war, his department would still be suffering from the lack of a physician. Probably not, he agreed. We were lucky the upper echelon saw the situation from our point of view.
Roma sighed. I wish shed applied for the E.R. post in the first place. Everything would be settled. As it is, who knows what her replacement will be like?
The same thought had crossed Treys mind on several occasions. Im hoping shell grow to love us and will stay.
Hope all you want, Roma said darkly, but given how other physicians feel about E.R. docs, my money says shell run back to the fifth floor as soon as she can.
Not if he could help matters I assume youre referring to how the rest of the physicians look down on us because of the popular belief that we only decide on whether or not to admit a patient.
Yeah.
It was a common stereotype, thanks to the nature of his profession. The people who presented themselves were either bleeding or sick and it was his job to either cure them or pass them off to someone who could, doing both as fast as possible. The department wasnt called Emergency for nothing. Being the metropolitan city that Pittsburgh was, their ED never had a dull moment.
We may not have an official client list like a private practice does, but we definitely have our regulars, he mentioned.
Like Frances.
Like Frances, he echoed. A lot of people list us as their primary-care physicians.
Probably, Roma agreed, but Ill bet Dr. McAllaster feels as if shes taken a step down in her career. Mind you, the nurses have a saying. If the doctor aint happy, then nobodys happy.
Trey disagreed. So far, Sierra hadnt lost her temper or raised her voice and shed been in various situations where it wouldnt have been inappropriate. While staying calm was a great trait to exhibit in an emergency situation, over the past few months of their quasi working relationship, from what hed seen, the woman gave the word unflappable new meaning.
I think youre wrong, he said. Sierra is too classy a lady to take out her frustrations on the rest of us.
She might be classy, but redheads can have fiery tempers.
As far as he was concerned, calling Sierra a redhead was like describing the Perseid meteor shower as a few shooting stars, or the Grand Canyon as a big hole in the ground. Im not sure one has anything to do with the other. Ive known lots of hot-tempered brunettes and blondes, too.
Okay, so Im stereotyping, she admitted, but well see fireworks down here before its over.
He was half-eager for Romas fears to come true. Sierra, with her brown eyes flashing with the same fire he saw in her hair, would be an awesome sight. Fireworks can be beautiful.
Yeah, in the night sky off the Roberto Clemente Bridge. Not in the hospital and without any warning.
I thought you liked to live life dangerously.
Me? Mrs. Boring whos married to Mr. Extremely Boring? She shook her head, smiling. Not a chance. As much as I like my job, it has enough inherent aggravation without me looking for trouble. Speaking of which, the sooner we take care of Frances, the better.
Okay, but I have to check my CT scan result first. If everything looks okay and the injection we gave Mrs. Villiers is working, we can send her home. A few keystrokes later, he found his report and read it with satisfaction. Sure enough. She can go.
After sharing his news with Mrs. Villiers, Trey found Sierra at the nurses station, ready to grab another clipboard out of the in-box.
Before you take that case, I have a person I want you to meet, he told her. Room Ten.
A patient?
How could he describe Frances? Yes and no, he admitted.
Her answering chuckle sounded sweet. Which is it? she asked.
Frances is one of our colorful regulars. Shes a twenty-five-year-old woman with a learning disability who lives about a block away. Her mother used to work here and so she understands that the Good Shepherd E.R. is where people come for help.
Okay, so whats unusual?
When I refer to help, Im using an extremely broad definition.
How broad is broad?
She comes in for minor things like a sliver in her hand, a skinned knee or a broken blister. She usually goes straight to the triage nurse, who finds out what she needs. Then, the nurse sends her to me or to one of the other doctors if Im busy. We give her a little TLC and send her on her way.
I assume that Im one of the other doctors? she said dryly.
Do you mind?
Not at all.
Good, because if you ever do see her, her visit will go easier if Ive introduced you.
Okay. Whats her complaint?
Stomachache.
She glanced at his empty hands. Wheres her paperwork?
We dont create any.
Sierra stared at Trey. No paper trail?
Like I said, she comes relatively often with such minor problems that wed waste more time filling out forms than if wed actually deal with her situation.
Shed been warned of Trey Donovans unorthodox style, but she hadnt expected to find an example of it so quickly.
A few administrative people might be upset by the way youre handling this individual, she commented cautiously, to test his response. Treating a patient without documentation. Legal liability issues, etcetera.
He shrugged as if he was unconcerned. I suppose they might be unhappy if Frances sues us for not removing a splinter properly. Until then, I guess youll have to decide if youll keep our secret or not.
Sierra ignored the challenge in his voice. Have you encouraged her to visit the outpatient clinic instead of the E.R.?
Frances has come here since she was a little girl so the concept is ingrained in her. Do you want to try and change her belief system at this late date?
Besides, he continued, the clinic staff doesnt know her like we do. They wont take time for the minor things and if they do, they certainly wont operate out of the goodness of their hearts. She wont understand when they turn her away or ask her to pay, and then shell get upset and fall apart, which I can assure you is not a pretty sight. It saves so much wear and tear on everyone if we just do what needs to be done. A regular win-win situation.
Sierra wanted to argue that Francess caseworker needed to be involved, but several things stopped her.
One, she was intrigued by how the ED staff had literally taken this woman under their wing.
Two, this was Treys domain. As the most senior ED physician, he knew his departments strengths and limitations far better than she did. He also had the authority to establish policies and procedures, with or without his immediate supervisors approval. If he wanted to handle Frances in his own way, he certainly had the clout to do so.
This also seemed to be a prime opportunity to either build a bridge or a brick wall. She could stick to the hospital rule book, which would earn her brownie points from her superiors, or she could save her energy for more important battles.
On the other hand, if she caved in on this issue, was she setting a precedent? What if ten more people like Frances decided to visit the E.R. for their scrapes and scratches? Theyd never have time or space to deal with the heart attacks, the broken bones or the car wrecks.
Would turning a blind eye signal that she was a pushover for a heartwarming story or a special case? The argument could be made that every person coming through the doors had special circumstances necessitating unusual solutions.
Cant you be flexible for once in your life?
Davids voice whispered the last question and she instinctively stiffened. Unfortunately, his concept of flexibility had been his excuse for taking advantage of every opportunity that had come his wayopportunities that had covered everything from his business activities to moral decisions.
Shed always prided herself on meeting the needs of her patients, so how was this any different? If Frances had been one of her regular clients, would she have chosen differently than Trey and his staff had?
She let out a breath and nodded. Lets see Frances.
Before she could take a step forward, he stopped her.
If it looks like she has something serious, I want you to take over.
Why?
Because if Im busy holding her hand to keep her calm, I cant do my doctor thing.
She chuckled at his choice of words. Cant walk and chew gum at the same time, eh?
He rolled his eyes melodramatically. Ah, now she makes a joke.
Sorry, she said, unrepentant, I couldnt help it. Okay, well do it your way. Ill examine her while you play nursemaid. From what Ive seen so far, youre pretty good at handholding and sweet-talking.
His grin was boyishly wicked. Im good at other things, too.
The sudden flare of heat in his eyes spoke of more physical activitiesactivities that her imagination so unhelpfully supplied in vivid, living color.
If she was going to work with the delectable Dr. D. so closely over the next few months, she really would have to get more sleep. Exhaustion didnt give her the mental fortitude to rein in her wayward thoughts.
Im sure you are, she said lightly.
Inside the room, Sierra saw the dark-haired woman curled into a fetal position on the bed. Another nurse, Billie, was taking her vital signs.
Hi, Franny, Trey said as he approached the bed and immediately took her pulse. I hear youre not feeling well today.
Frances opened her eyes and offered a weak smile. Hi Dr. D., she said in a singsong voice. My stomach really, really hurts bad. Can you fix it?
Her childlike question made Sierra wish for the several-hundredth time that medicine could solve the problem of a childs mind trapped inside an adult body. Not many people could deal effectively with people with learning disabilities, and she carefully watched Treys demeanor. She didnt know what she was expecting, but she was pleasantly surprised to watch him smile benevolently at Frances while he patted her arm and questioned her about her diet.
As he talked, she herself focused on his sinfully thick dark hair, dark eyes and long eyelashes. Shed never studied him up close and personal before, but she understood how hed developed his reputation of a dreamboat.
Thank goodness she wasnt taken in by appealing packages.
I think I was poisoned, Frances moaned.
Her temp is one-oh-two, Billie interjected.
Trey glanced at Sierra, his humor evident in his eyes. I dont think you have food poisoning, Frances. But you are sick, which makes me glad I brought our very best doctor to see you. This is Dr. McAllaster.
Sierra took her cue to come forward. Hi, Frances.
Frances gazed at Trey. She cant be the best cause you are.
He chuckled. Thanks, Franny, but stomachaches are Dr. McAllasters specialty. Will you let her examine you?
Frances apparently was convinced because she slowly nodded. If you say so.
Sierra immediately took over, not surprised by Treys ability to gain Francess cooperation. Hed obviously been dealing with this woman for quite a while.
Okay, Frances, she said softly. I need you to stretch out for me.
But it hurts when I do, she wailed.
I know, but I really need you to lie flat. After much maneuvering and moaning, Sierra gently prodded Francess abdomen. It didnt take long to decide that her problem didnt have a simple solution.
She turned to Trey. Do you remember the paperwork you said you didnt initiate? Youd better start it now.
Over the next hour, Sierra realized she couldnt have done her job without Trey. While Francess problem had been fairly straightforward, it had taken longer to arrive at the diagnosis because she hadnt been particularly cooperative. Thank goodness Trey was a salesman at heart. He explained, gave guarantees and promised her everything from watching television to an ice cream if shed allow them to do one more test.
He saw Frances through the pain of bloodwork and he did so with patience she hadnt expectedpatience that wasnt contrived.
Neither did he express any great relief to relinquish his task when Francess mother arrived. Instead, he simply changed gears from moral-support agent to physician as easily as he flashed his handsome smile.
Appendicitis? he asked as soon as he cornered Sierra at the nurses station.
Im impressed, she said, amazed at how hed pinpointed her diagnosis before theyd received any reports. You really can walk and chew gum at the same time.
What can I say? Im a man of many talents. Plus, it didnt take too much effort to add lower-right-quadrant pain and rebound tenderness with a fever to come up with appendicitis. I assume her white count is elevated?
According to the report that came through a minute ago, its eighteen point four. Ive already called Vijay. He said because its such a clear-cut case to save him a trip and send her upstairs to surgery.
Vijay Gupta was a fourth-year surgical resident assigned to Emergency. Sierra had consulted with him on several patients prior to her current E.R. stint and thought highly of him. After he completed his training, he planned to return to his native India and Sierra would be sorry to see him go.
Sounds good to me.
Sierra always took pride in making accurate and timely diagnoses, but none more so than when Trey stopped her a few hours later, not long before their shift ended.
Vijay called, he said without preamble. Francess appendix was the worst hes seen in a long time. Youll be pleased to know he was glad youd sent her up when you did, otherwise there would have been dire consequences.
Gracious, but she was blushing again. It was a team effort, she said lightly.
That may be, but I think we should celebrate with a cup of coffee.
Coffee sounds good, but Im not sure the occasion calls for a celebration, she said. I was only doing my job.
The second those words came out of her mouth she realized how much shed sounded like Professor Grumpy Gunderson. After shed pored over a patients medical file for clues about his illness, shed discovered an obscure fact which had led to a confirmatory test. Her fellow students had been impressed and shed been proud, but Grumpy had raised one eyebrow and sniffed.
Youre expected to make proper diagnoses, McAllaster, hed said in his most condescending voice. Every patient deserves your best. Its your job to provide it.
Now, a question begged to be asked. When had she become so cynical and turned into Grumpy Gunderson?
Working down here Trey interrupted her bleak thoughts as he herded her into the lounge we take our victories when we find them. Too many cases dont have happy endings.
As if shed needed a reminder, she reflected wryly as he began pouring two mugs of the strong coffee.
Black or white? he asked.
White. She fished among the containers for a packet of sweetener and dumped in a moderate amount of powdered creamer.
He leaned against the counter, mug in hand. Just so you know, our real partying takes place on Fridays, after work. Youll have to join us. No excuses allowed.
She thought about the days when shed ended the work week with the rest of her ED team at a nearby watering hole. Their tradition had been for the most senior member to make two toastsone to the staff for jobs well done and one to pay tribute to the people theyd lost.
Her finances could surely stretch far enough for her to resume the tradition, even if she honored it only during her temporary tenure in Emergency. While she took pride in her efforts when shed discharged a patient from the fifth floor, drinking a glass of wine alone in her apartment didnt generate the same emotional satisfaction as being surrounded by people whod shared in the experience.
Until Trey had dangled the notion of a celebration in front of her, she hadnt realized how much she missed the camaraderie associated with a group of her colleagues. Trey had inadvertently reminded her of another part of her life that David had stolen.
Well, no more. Shed come to Pittsburgh to start over, and creating a new routine was part of that. She may not be able to afford more than a glass of tea or a soft drink, but drinking wasnt the issue. Being with friends and colleagues was.
I didnt realize Id touched on such a deep subject, he joked. You looked like you were a hundred miles away.
Sorry, she said, embarrassed at being caught woolgathering. I was, but youre right. We should rejoice in our success stories when we can.
His smile nearly blinded her. Then youll join us on Friday night?
Sure, why not?
Great, he said with such enthusiasm that she knew hed hold her to her decision, no matter what. Well
Their pagers went off simultaneously. Sierra abandoned her mug and followed Trey out of the door.
A scuffle at the far end of the hall near the ambulance entrance doors caught her attention. Two police officers were escorting two punks in low-slung jeans and ripped T-shirts, but for every step forward they sidestepped two more in an effort to keep the two street hoods apart. Obscenities flew, along with several wild punches, but it was obvious that not long ago those punches had been landing.
One young man had a swollen, bloody nose and a bloodstained bandana wrapped around his right biceps. The other had one eye completely swollen shut as he limped forward.
Trey sighed. Looks like the natives are restless.
No kidding. I thought they saved their fighting for Saturday nights, she remarked.
Around here, any time is a good time, he answered. Ill take one and you can take the other so we can get them both out of here faster.
Okay.
She started forward, but he pulled her behind him. Stay out of the way until theyre stashed in separate corners.
Stay out of the way? For a few seconds she stood in amazement at his high-handedness. Did he really think she couldnt hold her own? Shed gone nose to nose with men who were far more belligerent than these two. Of course, she hadnt been wearing a dress and heels at the time, but sometimes looking feminine gave her an advantage. Goons like these were often busy ogling her legs and forgot their reason for fighting.
She hurried to catch up, but Treys long-legged stride had already put him at the scene. Although she was still half a hallway away, she heard and saw everything.
Take him Trey pointed to the one sporting a bloody nose to Trauma One and the other to Room Two.
Move it, buddy. Officer Wright gave his prisoner a not-so-gentle nudge in the appropriate direction. You heard the doc.
Hey, man, dont tell me what to do. The guy immediately began swinging.
Instinctively, Sierra knew this wasnt going to end well. She watched in horror as the situation deteriorated, taking Trey with it.
CHAPTER THREE
TREY saw the mans arm move out of the corner of his eye. He tried to duck as he watched a beefy fist come toward him, but his body didnt respond to his brains command. His instincts warned him of the impending blow, but before he had a chance to brace himself for impact, his ears rang and his vision blurred.
He heard shouts and curses as if they were coming from a distance, but he concentrated on trying to protect himself. Before his scrambled brain could convince him to duck, a body plowed into his midsection and he lost his balance. His fall inevitable, he twisted to minimize the damage, but five hundred pounds of angry males landed on top of him, effectively causing him to kiss the floor.
The bruise on his chin and the weight on his back seemed minor in comparison to the excruciating pain that he felt in his right knee.
Damn! This wasnt how this was supposed to play out, he thought, before everything faded to black.
Before Sierra could yell at Trey to watch out for the guy on his right, she heard the distinctive sound of flesh striking bone. For a split second, he stood upright, frozen in place, until the other man shoved Trey in his apparent haste to reach his enemy. Immediately, Trey crumpled like a broken toy and disappeared under the bodies of punks and police officers.
Call Security, she yelled over her shoulder as she hurried forward. She certainly couldnt fight this battle if she relied on muscle because she was definitely outgunned. However, she could win through chemistry.
Lorazepam, she called out, already calculating an appropriate dose of tranquilizer to use. Hand me lorazepam!
Suddenly, what seemed like the entire emergency department materialized around them. By the time someone had slapped the medication in her hand, there were too many arms and legs to identify the owners. She could accidentally sedate a staff member, which would definitely not be the best thing to do.
To her great frustration, she simply had to wait for stronger backs to peel back the pile, layer by layer. Finally, only Trey was lying facedown on the floor.
Sierra knelt beside him, half-afraid of what she might find. Trey, she said urgently as she frantically ran her fingers over his head to check for injuries. Can you hear me?
She found a goose egg on his forehead, presumably caused by his bounce against the linoleum. Trey? she asked again.
This time, he groaned. Must you scream in my ear? he complained.
Hed answered. What a relief. Im not screaming. Can you move?
Barely. He grimaced as he tried to roll over and only got as far as his side. Damn. My knee.
She placed a hand on his shoulder to steady him. Anything else?
You mean, other than the fact that my lungs will never be the same after being squashed within an inch of my life?
She smiled at his affronted tone. If he could be sarcastic, his injuries probably werent as bad as shed feared. His skin color was on the pasty side, but he didnt sound wheezy or raspy, which was good because she felt guilty enough for not wading into the fray with him. Yeah, other than that.
Youre the doc. You tell me.
She paused to study him with her practiced eye. Well need X-rays to check for hairline skull fractures or broken ribs, but as a purely preliminary opinion Id cancel any photo ops if I were you.
He swiped at the blood running down his chin. That bad, eh?
It could be worse, she said, taking a gauze pad someone had handed her to hold against his chin. Besides the goose egg thats probably giving you a headache and the gash youre already well acquainted with, youre developing quite a shiner. Dont worry, though. Youll be back to your handsome self in no time.
My handsome self, eh? He tried to grin, but it came out as a grimace. With shaky fingers, he gently probed his cheekbone. Oh, that hurts.
Im sure. Pain is a common side effect of having your face meet a fist, but ice will help. What about your chest? Can you breathe in and out easily?
He huffed first, then took a deep breath and let it out. Yeah. He rubbed the side of his chest. My ribs are sore, though. How do football players handle this day after day?
Conditioning and extra padding, she answered. Lets get you to a room so I can look at your knee. Ready?
He winced. Ill have to be.
Immediately, multiple hands pulled him upright. Any dizziness? she asked.
Not really, he muttered as he sank heavily into a waiting wheelchair, his face white with pain.
Whos on call for Orthopedics? Sierra asked Roma.
Abernathy. Ill page him, the nurse said.
She turned back to Trey. Ready for your ride down the hall?
No. I want to go home instead.
Dont be a baby, she scolded lightly as she pushed his wheelchair alongside a bevy of worried-looking staff.
Did anyone ever tell you your bedside manner lacks a little something? he grumbled. Like compassion?
Would you rather I stand here and gush all over you? she wanted to know. If so, I could hand you to another doctor, but I dont think Lamont or Ben are likely to treat you like spun glass either. Marissa might, but youre older than her usual clientele, so who knows?
Lamont Stedman and Benjamin Kryszka, both men pushing forty, were the other two ED physicians on duty. Marissa Landower, an attractive woman about ten years older, was the resident pediatrician. While any of them would fuss a bit over him, none would fall apart like a dewy-eyed debutante.
He peered at her, looking like a lopsided raccoon. I should get hazardous-duty pay.
If it will make you feel better, Ill give you one of the kids sugar-free lollipops. Cherry or grape?
Can you lace it with a painkiller? he asked, his voice hopeful.
Sorry.
Then Ill pass.
Sierra braked the wheelchair beside the bed. Do you want to hop up here or stay where you are?
Ill stay right here, thank you very much. Itll save on wear and tear when you send me to my car. So I can go home, he finished pointedly.
What? And miss a trip to Radiology? She tutted. Now, Dr. Donovan
This is so unnecessary, he grumbled. I have a minor bump on my head, my chins not bleeding nearly as badly as it was and I wrenched my knee. Nothing that a few ice packs and a bandage wont cure.
She leaned over to study the gash, fully aware of how wonderful he smelled. Youre right about your chin. A butterfly bandage should take care of it. As for the rest of your aches, we need X-rays.
No, we dont.
His expression reminded her of a little boy whose wishes were being thwarted. If he crossed his arms and stuck out his lower lip, the picture would be complete.
The diagnosis was in and it was definiteDr. Donovan was a lousy patient.
Yes, we do, she said, hiding her amusement. How would it look if I sent you home with a subdural hematoma, a concussion or a torn ACL?
I didnt tear my ACL, he said. Anterior cruciate ligament tears would be more painful and I would have heard a distinct pop, which I didnt. I also didnt fracture my skull and I absolutely, positively, do not have a concussion.
Heres your ice pack, Doctor. A nurse thrust the cold bag at him and he placed it on his face with heartfelt thanks.
You know your brain wasnt scrambled because? She waited for his response.
Ive had a concussion before and my current headache doesnt come close.
Thats good to hear, but while you may have Supermans X-ray vision, I, as your physician, do not. She motioned to one of the nurses to begin taking his vital signs. So your opinion is overruled. We might even spring for an MRI of your knee.
Youre making far too much of this.
Risk Management and Workmans Comp all require a thorough exam, which is what Im trying to do. As one of the hospitals finest and most illustrious staff members, you should sit back and enjoy the attention.
Id rather be at home, licking my wounds in private.
While his injuries were obviously painful, she suspected they were strictly of the minor variety. Youll get there soon enough, she predicted. Meanwhile, lets slip you into a hospital gown so we can take a look at
Not a chance.
Its either that or cut off your pants leg, she warned. I cant see through fabric either.
Grab your scissors, he said firmly. Losing a pair of pants is not worth the indignity.
Okay, but its a waste of a perfectly good garment.
Theyre mine to waste. Cut.
With an order like that, she couldnt refuse. She began snipping through the cotton, careful to avoid puncturing his skin. Each slice revealed more of his muscular leg and caused her mouth to suddenly go dry.
To make matters worse, she was oddly unsettled by her task, which was ridiculous because shed cut off clothing before without a second thought, and on a number of men more handsome than Trey. If she wasnt almost finished, she would have turned over the job to one of the hovering nurses, who clearly would have been thrilled at the honor.
Do you run? she asked, trying to deal with her view of his leg clinically.
Yeah.
His knee was too swollen for her to pull the free leg off, so she sliced the fabric lengthwise and laid it open. Youll have to postpone your daily jogs for a while.
You think?
She smiled at his sarcasm. You really are holding true to the stereotype about doctors being lousy patients.
Im entitled. This whole thing was so stupid! It should never have happened.
The guilt shed been holding at bay reappeared. Maybe next time youll let me handle it.
His battered face didnt hide his skepticism. And what would you have done? Ended up at the bottom of the pile with me? Or, worse yet, instead of me?
His outrage was obvious and she understood why. Men hated appearing weak. Being caught off guard and injured because of a misplaced punch would, in their opinion, epitomize the very trait they hated. Now, if hed earned his wounds because hed thrown a few blows of his own, they would have become badges of honor.
Maybe youre right, she conceded, but you shouldnt feel embarrassed either. In fact, once news gets out, youll become more popular than you already are.
I guess. He didnt sound too happy about his new status, which surprised her. David had always preened under extra attention and shed expected Trey to do the same.
Can I have some ibuprofen and ice for my knee now? he complained.
The ice is coming right up, she said. Well save the pain reliever until after your CT scan.
BP is one forty-five over eighty, the nurse broke in to report. Pulse is sixty-eight.
Your blood pressure is a little high
Of course it is, he snapped. Getting caught in the middle of a fight will do that.
Sierra exchanged a wry glance with Roma. Clearly the charge nurse held Sierras opinion about Treys attitude. She looked as if she was ready to comment when another nurse brought a fresh ice pack, breaking the moment.
Sierra secured the bag to his knee with elastic wrap. Thisll hold it in place while youre visiting Radiology. After youre back and Dr. Abernathy sees you, well wrap your knee more securely.
What? No Lachmans? No pivot shift test?
She smiled as he referred to the two tests performed to diagnose an ACL injury. Knowing an orthopedist will do those himself, do you really want me to manipulate your knee and leg just to prove I know how?
True. Good idea to wait.
Sierra stepped aside. Ill see you when you get back.
For the next hour, past the time Sierras shift should have ended, a steady stream of staff members approached her to ask how Trey was doing. Even the people who were just reporting for duty had heard of the mishap and begged for details.
The two prisoners stopped her in the hallway to gruffly pass on their apologies to Trey before their caretakers herded them to jail.
What was all that about? she asked Ben and Lamont, who acted rather pleased with themselves as they perched on the counter beside her.
We let it be known theyd better be on their best behavior if they ever come here again because we dont take kindly to our staff getting hurt, Lamont replied. The next time they lose their cool and need something more than a few stitches, well use drugs that produce some unpleasant side effects.
Like impotence, incontinence, hair loss, skin blemishes, boils, diarrhea and blurred vision, Ben chimed in.
Not to mention anal leakage and flatulence.
Sierra looked at her two colleagues in amazement. You didnt.
We did, Lamont assured her, before he exchanged a wide grin with his partner-in-crime.
She laughed. You guys are awful. You both look so meek and mild-mannered, but underneath you have an evil streak.
Hey, Lamont protested without heat, we protect our own. Now that weve done our good deed for the day, were going home. Are you sticking around?
Only until Radiology turns Trey loose.
While she waited, she impatiently checked the computer for his test results. One by one, the reports filtered in.
Normal chest film. No skull fracture. No concussion.
All she needed now was Dr. Abernathys recommendation and she could grant Trey his wish. Of course, she could have granted it sooner if she hadnt gone overboard with the X-ray requests, but she wasnt going to risk overlooking anything. There would be hell to pay if she did, not only from her boss and Treys, too, but also from Treys adoring public.
Finally, an X-ray technician wheeled him into the trauma room. His normally relaxed mouth was pinched with apparent pain and the orbit of his other eye was slowly turning dark.
What do you know, she said cheerfully. Your eyes match.
He looked so forlorn she wanted to give him a hug. Now, that would cause the rumor mill to kick into gear
Great, he said glumly. By the way, my CT scan was normal. Any chance I can have that ibuprofen now?
Because shed seen the report on her screen just moments ago, she agreed. Absolutely.
While she doled out two pills, then two more when he glared at her, Nathan Abernathy rushed in, apologizing for his delay. Sierra looked on as he conducted his own exam, including the tests Trey had previously mentioned. A few minutes later, Roma waved to her from the doorway.
Sierra slipped outside the room. Whats up?
Dr. Donovan has a visitor.
Only one? she asked wryly.
Roma smiled. Only one.
Female, Im presuming?
Yes, but
Shell have to wait until Abernathy is finished.
It would be better if she didnt.
Ah, I get it. A VIP?
Dr. Donovan would think so.
How typical, Sierra thought with some disgust. Hes busy flirting with every woman he meets, but he has a girlfrienda very important girlfriendwaiting in the wings.
I think you should talk to her before she sees him, Roma continued. Prepare her for what he looks like.
Imagining a blonde bimbo falling apart and weeping over him because he wouldnt be able to take her dancing for a few weeks, Sierra grimaced. She glanced inside the trauma room and saw Abernathy continuing his joint manipulation. Okay. Where is she?
Roma pointed toward the nurses station. There.
.
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, (https://www.litres.ru/jessica-matthews/maverick-in-the-er-39921778/) .
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Jessica Matthews
The Delectable Dr Donovan ER doctor Trey Donovan is sinfully sexy, seriously good at his job, and willing to do whatever it takes for his patients. His team at Good Shepherd Hospital is second to none including new doctor Sierra McAllaster.Trey can have any (and every! ) woman he wants as long as they dont expect a fling to end in a diamond ring! But Sierra makes maverick Trey want to break his own relationship rules
He spoke with a calm authority that sent staff scrambling to obey. Then again, who wouldnt want to do whatever he asked if it meant receiving one of his killer smiles?
His long eyelashes were partly to blame for his appeal to women, she decided. Add dark brown hair and blue eyes, a firm jaw and an attractive dimple, and infatuation was a given.
While he wore the requisite surgical green scrub suit under a protective yellow paper gown, the shapeless garments didnt detract from his muscular shoulders or his lean physique. If he could turn heads in this ugly garb, hed probably stop traffic when he wore street clothes that actually fit. If the hospital ever created a doctor-of-the-month calendar featuring him as the centerfold theyd make a fortune.
As great as his physical appearance was, he wouldnt have earned the moniker of the delectable Dr. Donovan if he didnt have the personality to match. His charisma explained how hed managed to get whateverand whomeverhe wanted in his department. His persistence and eloquent arguments had persuaded several top people to transfer her into his domain.
Apparently aware of her lingering presence, he flashed her a cocky grin.
Hating that hed caught her loitering, and was obviously thinking shed become one more member of his adoring fan club, she fled the room.
About the Author
JESSICA MATTHEWSS interest in medicine began at a young age, and she nourished it with medical stories and hospital-based television programmes. After a stint as a teenage candy-striper, she pursued a career as a clinical laboratory scientist. When not writing or on duty, she fills her day with countless family and school-related activities. Jessica lives in the central United States, with her husband, daughter and son.
Recent titles by the same author:
EMERGENCY: PARENTS NEEDED
HIS BABY BOMBSHELL
THE BABY DOCTORS BRIDE
Dear Reader
One day I stumbled across an article about labyrinths and their associated healing effects. I was intrigued by how hospitals in the US are building these labyrinths on their campuses to help patients achieve spiritual health while their medical needs are addressed. I began my research and was fascinated by what I learned.
Consequently, I wanted to incorporate this concept into a story. Ive taken a few liberties for my own purposes, but I simply had to create characters who needed the emotionally healing effects of a labyrinth.
I hope you enjoy what Ive done. Happy reading!
Sincerely
Jessica Matthews
MAVERICK IN THE ER
JESSICA MATTHEWS
www.millsandboon.co.uk (http://www.millsandboon.co.uk)
To Terry, for being my hero.
CHAPTER ONE
LET this be a lesson to you, Sierra McAllaster, she told herself in her rush to meet the incoming ambulance. Never say never.
Shed worked in Emergency Services before coming to Pennsylvania three months ago, and when shed left North Carolina, shed vowed that daily E.R. duty wouldnt be in her future. Shed been there, done that, and although shed once loved her work in that hectic department, it was time to pass the torch to others who thrived on the adrenalin rush. She wanted a more sedate pace with patients who werent broken bodies in need of an immediate fix, and shed found it on the fifth-floor medical unit at Pittsburghs Good Shepherd Hospital.
However, just when shed finally settled in to her new duties, her career plan had taken a one-hundred-and-eighty-degree turn. At this very moment she was in the middle of the very position shed never intended to fill again, thanks to a one-sentence clause in the fine print of her contract.
Come on, people, Trey Donovan, the senior emergency physician, yelled beside her. Lets move!
By the time their small entourage had reached the ambulance bay, two paramedics were already tugging a stretcher out of the back of their vehicle.
A feeling of dread swamped her, but she reasoned it away. You dont know this person. None of your friendsor family could possibly be on that stretcher. This is a car accidentnothing at all like Davids situation.
She swallowed hard and forced herself to fall back into her objective professional mode.
MVA, one medic reported, using the shorthand Sierra recalled so vividly. Motor-vehicle accident. Forty-five-year-old male with blunt trauma to the chest and abdomen, dislocated shoulder and sundry other injuries. BP is
Sierra noted the vital signs as she gazed down at the man lying on the gurney, strapped to a backboard and wearing a cervical collar. Bruises were already forming on his visible extremities and lacerations from broken glass crisscrossed his face. An oxygen mask covered his nose and mouth, but his nose was swollen and clearly broken, which meant theyd need an airway.
Lets go, Trey ordered, and off they scurried to the nearest available trauma room.
Hes wearing a MedicAlert bracelet, the other paramedic reported. According to the company records, hes a diabetic and hes currently taking Coumadin, hydrochlorothiazide and something called liraglutide.
The blood-pressure medicine wasnt unusual for someone his age, but the blood thinner was. Has he had a recent heart attack or stroke?
We dont know, but his left knee has a freshly healing scar. Maybe a recent joint replacement? The police are trying to locate his next of kin.
Any record of insulin?
The paramedic shook his head. None.
What was that last drug youd mentioned? Trey asked, his brow furrowed as if trying to place the medication.
Liraglutide, the paramedic repeated.
Trey turned to one of the nurses. Call the Pharmacy and ask
Dont bother, Sierra interrupted. Its a new drug just approved by the FDA for treating type 2 Diabetes.
Oh.
Treys dark-eyed gaze met hers over the gurney and she read his unasked question. I had a patient who had trouble controlling his diabetes, so we tried it. Its not the first line of therapy and has a number of side effects, but in his case it was a last-ditch resort and it worked, she explained.
He grinned, and the most endearing dimple appeared in the side of his cheek. Your first official day and youre already handy to have around.
Strangely enough, her face warmed under his appreciative comment. Sierra McAllaster did not respond to empty flattery with a blush, she reminded herself. Thanks to her husband, whod liberally used his charm to his own advantage, shed eventually determined it was merely a tool to get what he wanted. The lesson had been painful to learn as her illusions had been shattered, but shed never forget it. Never again would she fall for a fellow who troweled on charm as easily as a brickmason laid his cement. Shed become immune to men like him.
However, immunized or not, it seemed rude to refuse to return his smile so she did, even though she didnt know why she was smiling in the first place.
A few seconds later, theyd pushed the gurney against the awaiting bed in the trauma room. Sierra locked the wheels in place with the toe of one pump, having already decided shed overdressed for the demands of this department. Shed forgotten the frantic paceor maybe shed simply blocked it out of her mindwhich meant a dress and heels werent her most practical choice of attire.
Lift on three, Trey ordered. One, two, three.
Everyone complied in one smooth, well-rehearsed motion to move their patient to his new bed. Sierra hoped any residual blush on her face could be attributed to the strain and not Treys flattering comment.
Can you hear me, Mr. Klein? Trey spoke to the fellow. Youre in the hospital and were going to take care of you.
Unable to nod because his head and neck were immobilized, he simply blinked and mouthed, Okay.
Sierra hung around and helped the nurses organize the patients tubes and swap the paramedics equipment for hospital-issue while Trey issued orders for X-rays and lab work, requesting the same procedures Sierra would have if shed been in charge of this case.
His next command caught her by surprise. Go to lunch, Sierra.
She paused. You dont need help?
He shook his head and flashed his trademark grin. Thanks, but Im good.
Yes, he was, she thought as she moved out of the way, somewhat reluctant to leave just yet. Instead, she took a few minutes to observe her colleague in action.
Today might be her first official day in Emergency, but it wasnt the first day shed worked with Trey. In her previous position as hospitalist on the fifth-floor medical unit, shed received several patients hed admitted and had answered his call for a consultant on numerous occasions. His medical skills then, like now, seemed outstanding.
He spoke with a calm authority that sent staff scrambling to obey, but she could tell they did so out of a desire to please rather than a sense of fear. Then again, who wouldnt want to do whatever he asked if it meant receiving one of his killer smiles? Shed seen how his grin had turned even the most independent, career-minded woman into the equivalent of a simpering teenager.
He was also more than just a handsomely wolfish smile. His long eyelashes were partly to blame for his appeal to women, she decided. Add dark brown hair and midnight-blue eyes, a firm jaw and an attractive dimple, and infatuation was a given.
He was a tall man, which made nearly every female, no matter her size, feel dainty and feminine. While he wore the requisite surgical green scrub suit under the protective yellow paper gown, the shapeless garments didnt detract from his muscular shoulders or his lean physique. If he could turn heads in this ugly garb, hed probably stop traffic when he wore street clothes that actually fit.
If the hospital ever created a doctor-of-the-month calendar featuring him as the centerfold, theyd make a fortune.
As great as his physical appearance was, he wouldnt have earned the moniker of the delectable Dr. Donovan if he didnt have the personality to match. His charisma explained how hed managed to get whateverand whomeverhe wanted in his department. Because of his persistence and eloquent arguments that she was the one physician who could immediately fill the long-vacant position in his service, hed persuaded several top people to transfer her into his domain. Granted, she was only covering until the heads of Emergency Services and Internal Medicine hired a physician specifically for the post but, as far as she was concerned, a day spent in the ED was one day too many.
Apparently aware of her lingering presence, he flashed her a cocky grin.
Hating that hed caught her loitering and was obviously thinking shed become one more member of his adoring fan club, she fled the room. After a brief stop at the staffing board, where she slapped a Lunch magnet beside her name, she hurried outside, into the warm afternoon sun.
Trey surreptitiously watched Sierra leave as if a rabid dog were nipping at her heels and hid his smile. Hed first met her three months ago when hed called the fifth-floor medical unit to request a stat internal medicine consult and Sierra had responded, barely giving him a second glance.
Accustomed to dealing with flirty and simpering females, Trey had been taken aback by her disinterest at first but then hed been intrigued by it. In his earlier life as a footloose, carefree bachelor, he would have responded to the challenge she presented and pursued her with everything he had. However, that had all changed when his sister-in-law, Marcy, had died. While his relationships were still of the short-term variety, hed come to the conclusion that even those were difficult to juggle with everything else in his life. Acting as Mitchs big brother, helping Mitch raise his niece and coping with the demands of his job took nearly all of his free time.
As much as hed like to know Sierra on a more personal level, his gut told him that she wasnt the sort who would embrace such a temporary and superficial relationship.
Instead, she was the type to make a man think about the future in terms of the next twenty or thirty years. At times, he tried looking ahead that far, but he simply wasnt ready to let a woman get that close. Between coping with Mitchs downward spiral after Marcys death and his struggle to meet all of his family obligations, he didnt have the time or the energy to devote to anyone else.
That hard truth, however, didnt prevent him from wishing Sierra would be happy with what he could offer, especially after today when hed seen her face turn a beautiful shade of pink. What woman in this day and age, especially one whod survived the rigors of medical school and residency, actually blushed? Be that as it may, that small flaw only enhanced her already attractive features.
Her fine bone structure gave her an ethereal quality, as if she didnt belong in a field as brutal as emergency medicine, but her athletic frame suggested she wasnt a stranger to hard work.
As lovely as he considered her face and form, her thick auburn hair was nothing short of awesome. The color reminded him of flames dancing on the hearth and without any effort at all he pictured her shaking out her braid until every strand cascaded over her beautiful shoulders.
If that wasnt enough, her shapely legs with their miles and miles of soft skin made his throat go dry. Today, like most days, she wore low-heeled pumps and a dress that fell to just above her slim knees. Her garb wasnt practical for the demands of working in Emergency and shed probably switch to baggy scrub suits and tennis shoes tomorrow, but hed enjoy the view while it lasted.
His libido and personal preferences aside, he was still glad shed finally joined the emergency-services staff. For that reason, he found himself grinning like a loon whenever he saw her.
Actually, she hadnt joined as much as shed been transferred. Over the past year, hed created a paper blizzard that had gone to every department head, vice president and hospital-board member, protesting the fact that his departments extra medical position had never been filled. As soon as hed learned of Sierras credentials and past experience in Emergency, hed intensified his efforts. If Administration had agreed theyd needed the position, hed argued, then it was pointless not to fill it, especially when someone already on staff was ideal for the job.
While everyone agreed with his reasoning, Sierras boss, Lane Keegan, hadnt wanted to lose her from the medical unit. If not for pressure from above, theyd still be at an impasse, but finally, after weeks of negotiating details, Keegan had given in. On one point, however, hed refused to budge.
Sierra would only fill Treys position until they found a replacement who met the criteria, but not for longer than sixty days. Which meant Trey still had fifty-nine to work his magic and convince her to stick around permanently. His philosophy was, Better the devil you know than the one you dont, and hed prefer to keep Sierra, who got along well with the staff, rather than bring in a new person who might clash with everyone.
Roma Miller, the nursing supervisor whod just received her thirty-year service pin, strode in. Where was Dr. McAllaster going in such a hurry?
He shrugged. Lunch, I guess.
No kidding? Ive never seen her walk so fast.
Interesting. She must be hungry, he offered, although he suspected the reason for her rush had had nothing to do with her appetite and everything to do with regaining her composure after hed caught her studying him.
In spite of her cool attitude, in spite of her standoffish ways, Sierra McAllaster obviously wasnt as resistant to his charm as she pretended.
Munching on an apple, Sierra strolled along the circular concrete pathway of the hospitals favorite attractionthe Healing Garden and Labyrinthwhich had been created just outside Emergency. Normally, she walked the circular concrete pathway in order to recharge her mental batteries when she had a tough patient, but today her reflections were far more personal and far more immediate.
Her ridiculous reaction to Treys flattering comment still bothered her. Her marriage had taught her to not fall victim to a mans flattery and until now she hadnt. Why today was different remained a complete mystery. In her opinion, Treys charm was a strike against him.
He had also earned a second strike because if it werent for him, shed still be reporting to work on the fifth floor, where she belonged. Although, in all fairness, she didnt know if she should be upset with him or with herself.
If shed been in Treys position, she would have presented the same case he had, asking that the vacant position be filled with a doctor who was already on staff and who possessed ED experience. As Fate would have it, she was the one with the least senioritythe only one, in factwho fit the criteria.
Her options had been limitedeither take this assignment or end her contract.
Leaving hadnt been a viable option. Shed finally unpacked the last box of household goods this past weekend and the idea of hunting for a new job was too tiring to contemplate.
On the other hand, she did have a third option. If shed been honest and explained why she couldnt work in Emergency, perhaps Dr. Keegan might have chosen someone else. Pride, however, had stopped her. Shed come to Good Shepherd with a clean slate and if she dragged out her history to use like a get-out-of-jail-free card, her past would become an open book. The doubts, the pitying glances and every emotion in between would start, and she refused to deal with that from staff and her colleagues.
Consequently, shed decided it might be time to face her fears and put those horrors behind her. Although she didnt want to work in Emergency, she suddenly had a desire to prove she was able to.
Fortunately, Dr. Keegan had offered her several consolation prizes. Oneand the most importantshe was only filling in temporarily. So what if she was back in the area where shed sworn shed never work again, treating everything from acid reflux to herpes zoster infections, traumas to diabetic comas? Shed endured far worse and for a far longer period. Sixty days was nothing more than a wrinkle that would iron itself out in due time.
Two, Dr. Keegan had promised she could return to her hospitalist position on the fifth floor. Knowing how the other internist, William Madison, was already complaining about covering those patients as well as his own in the cardiac ICU, he was also eager for her to shake the E.R. dust off her feet and return to where she belonged.
Three, the odds of encountering a trauma that involved a close friend or family member were nonexistent. After three months in Pittsburgh, she still hadnt developed any serious friendships or personal relationships and as long as she was expected to staff the ED, she intended to keep it that way.
As she strolled around the labyrinth, a growing sense of acceptance and her natural can-do attitude filled her. Her transfer may have thrown her off balance, but she was slowly feeling more in control over her situation. Todays trauma had only caused her a few moments of anticipatory dread, but after that shed handled herself well. Shed still have some bad moments, but shed be able to deal with them. She would deal with them.
Her next mental project was to get Trey Donovan, including his twinkling eyes and his lazy grin, out of her head. After a single morning in his presence, hed already shattered her calm, making her wish for those happy-ever-afters shed stopped imagining were possible.
She knew better than to respond like a schoolgirl to a man who had enough charisma for three guys, but shed done it anyway. Maybe her reaction was due to first-day-on-a-new-job stress because shed been dreading this day for the past week. Maybe it was because she hadnt slept well last night and her defenses were down.
Maybe it was because her blood sugar had dropped. Shed chosen to take the late lunch break and that had been delayed because theyd been busy.
Then again, maybe it was all of the above. Yes, she decided. That was it. Shed been simply tired, stressed and hungry. This afternoon, shed be more like her old self, able to resist his wicked grins with the logic that they meant nothing.
Can I walk with you?
Startled out of her private thoughts, Sierra glanced down to see a girl, about ten years old, falling into step beside her on the concrete walkway. The child wore an oversize T-shirt, bright pink leggings and well-scuffed white-and-lavender tennis shoes. Her skin was tanned and her brown hair possessed lighter streaks, which suggested she spent a great deal of time outdoors. Several strands of hair had escaped her ponytail, which wasnt quite centered in the back of her head.
Although Sierra wanted to finish her walk through the labyrinth in contemplative quiet, she didnt want to be rude. Instead, she glanced around the garden, carefully scanning each bench for a potential parent or an otherwise responsible adult. Surprisingly, the garden was vacant and no one else was walking the labyrinth. They were alone.
Wont your parents wonder where you are? Sierra asked instead.
My moms dead and when my dads out of town I stay with my uncle, the girl informed her. He says I have to keep myself busy until he finishes his shift. He has a very important job, you know.
Really? she replied, amazed by how anyone could expect a child at her age to amuse herself in a hospital for hours on end. Surely a man who had this so-called very important job would realize that.
Hes a doctor, the child added meaningfully.
Sierra wasnt as impressed as the little girl obviously expected her to be. By virtue of his profession, the man should know better than to let a child run around a busy medical center completely unsupervised.
Immediately Sierra wondered if any of the physicians she knew had a niece this age, but none came to mind. Even so, something about this childs features seemed familiar.
Youre a doctor, too, arent you? the youngster asked, as if she already knew the answer.
Yes, I am. Are you supposed to be outside by yourself?
The girl drew herself up, adding an inch or so to her almost five-foot frame. Im almost eleven, she said, clearly affronted by Sierras question. My uncle says I can come out here if its not raining. She raised her hands, palms up. No rain today.
No. No rain today, Sierra echoed. Doesnt he worry about you wandering all over the hospital while hes working?
No, because I had to cross my hearts she pantomimed and promise to follow the rules. I can only go to certain places, like the li-berry, the coffee shop or this garden. Or his office, she tacked on. He trusts me.
At least this nameless man had set a few boundaries.
The other rule is that I dont talk to or go with a stranger, no matter where I am.
Im a stranger, Sierra pointed out, deciding she would hunt down this irresponsible uncle and give him a piece of her mind, colleague or not! The risk was too great to leave this little girl unattended. The garden saw a lot of foot traffic and anyone who weighed more than a hundred pounds could haul this youngster off without breaking a sweat, even if she was kicking and screaming.
No, youre not, she said, shaking her head. Ive seen you lots of times. She scurried in front of Sierra and peered at her identification badge. Youre Dr. McAllaster. Your name tag says so.
Yes, but
Im Hannah, she answered. Now we arent strangers anymore.
Hannahs logic was definitely lacking. Actually, we still are strangers, Sierra corrected her gently. I could be a not-very-nice person.
Hannahs ponytail bounced with each shake of her head. Nope, youre not. Ive been watching you cause you come here almost as much as I do. If you were a rotten person, you wouldnt feed the birds your leftover crackers.
Goodness! Had she been so self-absorbed that she hadnt noticed an unattended child before today? Or maybe shed seen her and thought shed been under the watchful eye of one of the many visitors who came to the garden for fresh air and sunshine. Regardless, it was still eerie to realize that someone had observed her so carefully without her knowledge. She would definitely have to pay closer attention to her surroundings in the future.
Plus, youre a doctor. Doctors arent mean people. Oh, they can do nasty things like give us a shot, but its for our own good, she said confidently.
While Sierra agreed that most physicians were caring individuals, she personally knew of several who should have chosen a different profession. Even so, she wouldnt destroy the girls illusions. Life would take care of those soon enough.
A lot of people come here to walk, dont they? Hannah asked.
They do.
My uncle says they built this because the lab-y-rinth, she stumbled over the word, is supposed to make people feel better. The Native Americans call it a medicine wheel.
Really?
Uh-huh. Theyve gotten really popular, he says, especially at hospitals. Walking the path helps people who have stuff like high blood pressure or who cant relax. He says that the twists and turns are sposed to represent the twists and turns in life.
The child sounded like a brochure that detailed the hospitals services. Hes right. The labyrinth helps people put the bad things in perspective.
Is that why youre here? So you can put the bad stuff in persperspective?
Hannahs insight surprised her. Sierra began visiting the garden during her lunch hour as part of her mental-health regimen when shed first joined the medical staff. Walking the circular concrete pathways, which were lined with colorful petunias, helped her deal with stress, especially after she lost a patient. She also knew of several surgeons who walked the labyrinth in order to clear their heads before performing surgery.
Yes, I do, Sierra said. Why do you come here? To be outdoors instead of being cooped up inside?
Hannah shrugged. I like this place. My mom died of cancer when I was little, and whenever I get sad, I walk until I feel better. Do you think she might have lived if thered been a lab-y-rinth at her hospital?
Hannahs matter-of-fact tone didnt minimize the compassion Sierra felt for her. Oddly enough, she almost wanted to give her nameless uncle a break. Being a single parent or, in this case, an uncle wasnt easy, especially when one dealt with an obviously precocious child like Hannah.
Sometimes cancer wins, no matter how hard people try to fight it.
Hannahs brown eyebrows drew together as she nodded. Thats what my uncle says, too. He says she didnt want to die, but it wasnt her fault she couldnt stay and watch me grow up.
No, it wasnt, Sierra agreed.
Oddly enough, her uncle seemed to have imparted good insight to his niece. Sierra added one mental point in his favor.
Suddenly, the sound of dogs barking broke the quiet. Hannah immediately pulled a hot-pink cell phone out of the matching pouch hanging around her neck and the barking stopped. Sierra chuckled at herself as she realized the noise was a ringtone instead of a pack of canines on the loose.
The youngster glanced at the display and winced. Gotta go. Bye!
Wait! Sierra called as Hannah began hurdling the flowers with an easy-limbed grace in her haste to head toward the north door. Whats your uncles name?
Hannah simply smiled and waved before she disappeared through the north door.
So much for discovering the childs identity, Sierra thought as she watched Hannah somewhat benevolently. Knowing Hannah had a cell phone made her feel somewhat better about the situation.
To Sierras disappointment, her wristwatch showed her allotted break time was over, too, even though she hadnt reached the center of the labyrinth. After taking one last look in Hannahs direction and seeing her disappear through the glass entrance doors, Sierra carefully stepped over the petunias as she strode in the opposite direction and disposed of her apple core in the trash.
Inside the main emergency hallway, ringing telephones, whispering gurney wheels and excited voices contrasted sharply with the tranquility shed left behind. Directly ahead, she saw two different paramedics from the ones shed met earlier, another ED physician and a nurse escorting another gurney into a trauma room. Meanwhile, Trey was heading toward an exam room as he reviewed the form on his clipboard. As soon as he saw her, his smile widened.
How was lunch? he asked.
She thought of the precocious Hannah. Interesting. Why dont I take over for you so you can take your break?
Thanks, but this case shouldnt take too long. Its also too early to meet my lunch date in the cafeteria, so I might as well earn my pay.
She should have known. The man probably arranged his personal schedule months ahead. Then I wont keep you.
Before she turned away, he stopped her. Save tomorrow for me, though.
She paused. Excuse me?
Lunch. Tomorrow. My treat. Itll be my official welcome to the department gesture.
Do you take every new person to lunch? she asked.
Everyone, he reassured her. Even the housekeeping staff. So dont pack your apple.
She stared at him in surprise. How did you know?
Im an observant kind of guy.
Of course he was, she thought wryly. Okay, fine. Well do lunch. Then, to make certain there would be no misunderstandings, she added, Strictly between colleagues.
His smile seemed as broad as his shoulders. Fair enough.
She turned away, but he stopped her. Out of curiosity, are you seeing anyone?
This time she smiled. What does the grapevine say?
Youre not.
Correct, as usual, she agreed lightly.
Is there someone back home? he pressed.
Sierra hesitated. How could she explain, and did she want to? However, if her answer prevented speculation and stopped people from pushing her towards every eligible man who came along, why not?
There was, she replied slowly.
Breakups are tough, he agreed, his expression sympathetic. So you came to Pittsburgh to start over?
If only it had been that simple. I did, but the situation is a little more complicated than a mere breakup. She met his gaze. When I left North Carolina, I left my husband in the Fairview Cemetery.
CHAPTER TWO
TREY didnt know what had possessed him to broach the subject of her personal life. Perhaps hed simply been looking for an excuse to stay away from Sierra and hearing of a fellow back home would have provided it. Perhaps he was simply a glutton for punishment and hearing of her unattached status would only provide a temptation hed be hard-pressed to resist.
Unfortunately, her response had been completely unexpected. Hed certainly never dreamed that the man shed left behind had been her husband, much less that he was dead.
Certainly, the information shed shared explained so muchher long hours, her avoidance of the dating scene, and her move to a new city and work environment. She hadnt come to Pittsburgh on some grand adventure to see the world. Like his brother, Mitch. Sierra was picking up the pieces of her life.
All of which proved his theorythe best relationships were temporary.
Im sorry, he murmured.
She nodded, apparently accustomed to hearing condolences if her frozen expression was any indication. Thanks, she murmured. Then, with a visibly shaky hand she smoothed her hair. Are you sure you wouldnt like me to see your patient?
Her abrupt change of subject couldnt have been more plain. Their question-and-answer period had come to a close, which was good. For a man who never had trouble finding something to talk about, he was suddenly at a loss for words.
He glanced at his watch. He only had ten minutes before his cafeteria appointment and it took nearly seven to walk there. Do you mind?
Not at all. Enjoy your lunch.
Eager to get away before he asked more questions, Sierra pulled the clipboard out of his hand and headed down the hall. Shed already shared more than shed ever planned, and if she gave him enough time, the inevitable What happened? would follow.
She simply didnt want to go there. Not now. Not yet. The tragedy had occurred over a year ago and she simply refused to dredge up those old feelings of shock, despair and anger, not to mention guilt. Shed finally come to the acceptance stage, but it hadnt been easy.
Now, however, was not the time to walk down memory lane and analyze the past. At the moment, the only person who deserved her full attention was her patientnot Trey Donovan, and certainly not David McAllaster.
By the time shed received the results of Karen Maxwells strep screenit was negativeand referred her to an ENT specialist to evaluate her chronic sinusitis, Trey had returned, looking as rested and refreshed as he had before their full morning of traumas and regular patients.
As Sierra sank onto a chair in the nurses station, she noticed he was chatting up one of the radiology techs. The poor girl was smiling as if hed single-handedly hung the sun, moon and stars.
He has quite a knack with the women, doesnt he? Sierra mused aloud to Roma, who was clicking away on her keyboard at a nearby terminal.
You must be talking about our famous Dr. Donovan, Roma answered, without glancing away from her screen.
How did you guess?
He does have a way with people, she commented. Young, old, male, female, staff, patients, it doesnt matter. Why, Ive seen him talk the most recalcitrant patients into behaving. When hes on duty, things just run more smoothly.
Sierra understood why. By virtue of his personality, he inspired people to dig deeply and give one-hundred-and-ten percent.
Just like David.
The only question was, did Trey do it for personal gain, or was he as altruistic as everyone believed? She wasnt quite convinced of the latter.
Roma finally glanced away from her screen to direct her gaze down the hallway. Hes so sweet to all of us. In fact, everyone fancies themselves a bit in love with him, she remarked.
Ive gotten that impression, Sierra said wryly. Given the way women act when hes around, Id bet he never spends an evening alone. Im surprised he has the energy to come to work.
The nurse laughed. Theres where youre wrong. He doesnt date as often as you might think. Oh, there are a lot whod give their right arm for a night with him, but hes very careful about who he takes out. And he never sees anyone more than a handful of times.
Really. Sierra wasnt convinced, but Roma seemed to know what she was talking about. I find that hard to believe.
Roma shrugged. Its true. Dr. Donovan seems like a happy-go-lucky sort, but dont let his winning ways fool you. Theres a lot more to our good doctor than meets the eye.
Sierra watched as the X-ray tech walked away with a light step, her face beaming in obvious delight over her encounter with Trey. Meanwhile, he wore his own satisfied expression, which suggested hed gotten whatever hed wanted.
Just like David, she thought with some disgust. Everything was a game, nobody was anything more than a chess piece. Thank goodness shed grown wise to such manipulations. Shed been a pawn once in her life. She wouldnt be one again.
After finishing with his next patient, Trey strode back to the doctors office. Hed requested a CT scan for one of his patients with a debilitating headache and Lila, the X-ray tech, had promised the images would be online by two oclock. It was five minutes till, so he didnt expect to see them posted, but it didnt hurt to check.
He accessed Joan Villierss computer file and, as hed suspected, the CT scan was still pending. A brisk knock at the door heralded Romas arrival.
Ive been looking all over for you, the nurse remarked as she entered.
Whats up?
Frances is here.
Whats wrong today?
Stomachache. Do you want me to give her to Dr. McAllaster?
He thought a moment. Yeah, but Id better introduce them first, dont you think?
Probably. Although I think the introductions are more for Dr. McAllasters benefit than Francess.
Right as usual. Because he was curious, he asked, From a nursing point of view, whats your opinion of our new doc?
Roma didnt hesitate. I think shes doing okay. Shes a little tense, especially during traumas, but other than that I dont have any complaints.
Its her first day, he reminded her. Shes bound to be a little tense.
Hey, I wasnt finding fault, Roma protested. Only making an observation which, as you said, is only to be expected. Now, if shed come in all cocky and acting like a know-it-all, then Id worry. She patted Treys shoulder. You done good, Doc, when you convinced them to transfer her to us.
Pleased by Romas praise, he smiled. I did, didnt I?
According to the nurses on the fifth floor, theyre extremely upset because we stole her away.
Its only for sixty days. More or less.
Yeah, well, theyre afraid they wont get her back. According to them, she knows her stuff. Better yet, and unlike some doctors who shall remain nameless, she doesnt treat them like theyre too stupid to live.
We were fortunate she came to Good Shepherd, he commented, keeping the story Sierra had shared to himself. If she wanted everyone to know she was a widowand she obviously didnt if the information hadnt circulated on the grapevineshe could divulge that news herself.
Rumor says she didnt want to be assigned to the E.R., Roma pointed out. As youre the one responsible for her transfer, I hope you intend to turn on the charm until she settles in.
Hey, I only made the suggestion, he protested. The decision came from people above my pay grade.
Be that as it may, if you hadnt pushed for her, she wouldnt be here.
Roma was right. If he hadnt waged his one-man war, his department would still be suffering from the lack of a physician. Probably not, he agreed. We were lucky the upper echelon saw the situation from our point of view.
Roma sighed. I wish shed applied for the E.R. post in the first place. Everything would be settled. As it is, who knows what her replacement will be like?
The same thought had crossed Treys mind on several occasions. Im hoping shell grow to love us and will stay.
Hope all you want, Roma said darkly, but given how other physicians feel about E.R. docs, my money says shell run back to the fifth floor as soon as she can.
Not if he could help matters I assume youre referring to how the rest of the physicians look down on us because of the popular belief that we only decide on whether or not to admit a patient.
Yeah.
It was a common stereotype, thanks to the nature of his profession. The people who presented themselves were either bleeding or sick and it was his job to either cure them or pass them off to someone who could, doing both as fast as possible. The department wasnt called Emergency for nothing. Being the metropolitan city that Pittsburgh was, their ED never had a dull moment.
We may not have an official client list like a private practice does, but we definitely have our regulars, he mentioned.
Like Frances.
Like Frances, he echoed. A lot of people list us as their primary-care physicians.
Probably, Roma agreed, but Ill bet Dr. McAllaster feels as if shes taken a step down in her career. Mind you, the nurses have a saying. If the doctor aint happy, then nobodys happy.
Trey disagreed. So far, Sierra hadnt lost her temper or raised her voice and shed been in various situations where it wouldnt have been inappropriate. While staying calm was a great trait to exhibit in an emergency situation, over the past few months of their quasi working relationship, from what hed seen, the woman gave the word unflappable new meaning.
I think youre wrong, he said. Sierra is too classy a lady to take out her frustrations on the rest of us.
She might be classy, but redheads can have fiery tempers.
As far as he was concerned, calling Sierra a redhead was like describing the Perseid meteor shower as a few shooting stars, or the Grand Canyon as a big hole in the ground. Im not sure one has anything to do with the other. Ive known lots of hot-tempered brunettes and blondes, too.
Okay, so Im stereotyping, she admitted, but well see fireworks down here before its over.
He was half-eager for Romas fears to come true. Sierra, with her brown eyes flashing with the same fire he saw in her hair, would be an awesome sight. Fireworks can be beautiful.
Yeah, in the night sky off the Roberto Clemente Bridge. Not in the hospital and without any warning.
I thought you liked to live life dangerously.
Me? Mrs. Boring whos married to Mr. Extremely Boring? She shook her head, smiling. Not a chance. As much as I like my job, it has enough inherent aggravation without me looking for trouble. Speaking of which, the sooner we take care of Frances, the better.
Okay, but I have to check my CT scan result first. If everything looks okay and the injection we gave Mrs. Villiers is working, we can send her home. A few keystrokes later, he found his report and read it with satisfaction. Sure enough. She can go.
After sharing his news with Mrs. Villiers, Trey found Sierra at the nurses station, ready to grab another clipboard out of the in-box.
Before you take that case, I have a person I want you to meet, he told her. Room Ten.
A patient?
How could he describe Frances? Yes and no, he admitted.
Her answering chuckle sounded sweet. Which is it? she asked.
Frances is one of our colorful regulars. Shes a twenty-five-year-old woman with a learning disability who lives about a block away. Her mother used to work here and so she understands that the Good Shepherd E.R. is where people come for help.
Okay, so whats unusual?
When I refer to help, Im using an extremely broad definition.
How broad is broad?
She comes in for minor things like a sliver in her hand, a skinned knee or a broken blister. She usually goes straight to the triage nurse, who finds out what she needs. Then, the nurse sends her to me or to one of the other doctors if Im busy. We give her a little TLC and send her on her way.
I assume that Im one of the other doctors? she said dryly.
Do you mind?
Not at all.
Good, because if you ever do see her, her visit will go easier if Ive introduced you.
Okay. Whats her complaint?
Stomachache.
She glanced at his empty hands. Wheres her paperwork?
We dont create any.
Sierra stared at Trey. No paper trail?
Like I said, she comes relatively often with such minor problems that wed waste more time filling out forms than if wed actually deal with her situation.
Shed been warned of Trey Donovans unorthodox style, but she hadnt expected to find an example of it so quickly.
A few administrative people might be upset by the way youre handling this individual, she commented cautiously, to test his response. Treating a patient without documentation. Legal liability issues, etcetera.
He shrugged as if he was unconcerned. I suppose they might be unhappy if Frances sues us for not removing a splinter properly. Until then, I guess youll have to decide if youll keep our secret or not.
Sierra ignored the challenge in his voice. Have you encouraged her to visit the outpatient clinic instead of the E.R.?
Frances has come here since she was a little girl so the concept is ingrained in her. Do you want to try and change her belief system at this late date?
Besides, he continued, the clinic staff doesnt know her like we do. They wont take time for the minor things and if they do, they certainly wont operate out of the goodness of their hearts. She wont understand when they turn her away or ask her to pay, and then shell get upset and fall apart, which I can assure you is not a pretty sight. It saves so much wear and tear on everyone if we just do what needs to be done. A regular win-win situation.
Sierra wanted to argue that Francess caseworker needed to be involved, but several things stopped her.
One, she was intrigued by how the ED staff had literally taken this woman under their wing.
Two, this was Treys domain. As the most senior ED physician, he knew his departments strengths and limitations far better than she did. He also had the authority to establish policies and procedures, with or without his immediate supervisors approval. If he wanted to handle Frances in his own way, he certainly had the clout to do so.
This also seemed to be a prime opportunity to either build a bridge or a brick wall. She could stick to the hospital rule book, which would earn her brownie points from her superiors, or she could save her energy for more important battles.
On the other hand, if she caved in on this issue, was she setting a precedent? What if ten more people like Frances decided to visit the E.R. for their scrapes and scratches? Theyd never have time or space to deal with the heart attacks, the broken bones or the car wrecks.
Would turning a blind eye signal that she was a pushover for a heartwarming story or a special case? The argument could be made that every person coming through the doors had special circumstances necessitating unusual solutions.
Cant you be flexible for once in your life?
Davids voice whispered the last question and she instinctively stiffened. Unfortunately, his concept of flexibility had been his excuse for taking advantage of every opportunity that had come his wayopportunities that had covered everything from his business activities to moral decisions.
Shed always prided herself on meeting the needs of her patients, so how was this any different? If Frances had been one of her regular clients, would she have chosen differently than Trey and his staff had?
She let out a breath and nodded. Lets see Frances.
Before she could take a step forward, he stopped her.
If it looks like she has something serious, I want you to take over.
Why?
Because if Im busy holding her hand to keep her calm, I cant do my doctor thing.
She chuckled at his choice of words. Cant walk and chew gum at the same time, eh?
He rolled his eyes melodramatically. Ah, now she makes a joke.
Sorry, she said, unrepentant, I couldnt help it. Okay, well do it your way. Ill examine her while you play nursemaid. From what Ive seen so far, youre pretty good at handholding and sweet-talking.
His grin was boyishly wicked. Im good at other things, too.
The sudden flare of heat in his eyes spoke of more physical activitiesactivities that her imagination so unhelpfully supplied in vivid, living color.
If she was going to work with the delectable Dr. D. so closely over the next few months, she really would have to get more sleep. Exhaustion didnt give her the mental fortitude to rein in her wayward thoughts.
Im sure you are, she said lightly.
Inside the room, Sierra saw the dark-haired woman curled into a fetal position on the bed. Another nurse, Billie, was taking her vital signs.
Hi, Franny, Trey said as he approached the bed and immediately took her pulse. I hear youre not feeling well today.
Frances opened her eyes and offered a weak smile. Hi Dr. D., she said in a singsong voice. My stomach really, really hurts bad. Can you fix it?
Her childlike question made Sierra wish for the several-hundredth time that medicine could solve the problem of a childs mind trapped inside an adult body. Not many people could deal effectively with people with learning disabilities, and she carefully watched Treys demeanor. She didnt know what she was expecting, but she was pleasantly surprised to watch him smile benevolently at Frances while he patted her arm and questioned her about her diet.
As he talked, she herself focused on his sinfully thick dark hair, dark eyes and long eyelashes. Shed never studied him up close and personal before, but she understood how hed developed his reputation of a dreamboat.
Thank goodness she wasnt taken in by appealing packages.
I think I was poisoned, Frances moaned.
Her temp is one-oh-two, Billie interjected.
Trey glanced at Sierra, his humor evident in his eyes. I dont think you have food poisoning, Frances. But you are sick, which makes me glad I brought our very best doctor to see you. This is Dr. McAllaster.
Sierra took her cue to come forward. Hi, Frances.
Frances gazed at Trey. She cant be the best cause you are.
He chuckled. Thanks, Franny, but stomachaches are Dr. McAllasters specialty. Will you let her examine you?
Frances apparently was convinced because she slowly nodded. If you say so.
Sierra immediately took over, not surprised by Treys ability to gain Francess cooperation. Hed obviously been dealing with this woman for quite a while.
Okay, Frances, she said softly. I need you to stretch out for me.
But it hurts when I do, she wailed.
I know, but I really need you to lie flat. After much maneuvering and moaning, Sierra gently prodded Francess abdomen. It didnt take long to decide that her problem didnt have a simple solution.
She turned to Trey. Do you remember the paperwork you said you didnt initiate? Youd better start it now.
Over the next hour, Sierra realized she couldnt have done her job without Trey. While Francess problem had been fairly straightforward, it had taken longer to arrive at the diagnosis because she hadnt been particularly cooperative. Thank goodness Trey was a salesman at heart. He explained, gave guarantees and promised her everything from watching television to an ice cream if shed allow them to do one more test.
He saw Frances through the pain of bloodwork and he did so with patience she hadnt expectedpatience that wasnt contrived.
Neither did he express any great relief to relinquish his task when Francess mother arrived. Instead, he simply changed gears from moral-support agent to physician as easily as he flashed his handsome smile.
Appendicitis? he asked as soon as he cornered Sierra at the nurses station.
Im impressed, she said, amazed at how hed pinpointed her diagnosis before theyd received any reports. You really can walk and chew gum at the same time.
What can I say? Im a man of many talents. Plus, it didnt take too much effort to add lower-right-quadrant pain and rebound tenderness with a fever to come up with appendicitis. I assume her white count is elevated?
According to the report that came through a minute ago, its eighteen point four. Ive already called Vijay. He said because its such a clear-cut case to save him a trip and send her upstairs to surgery.
Vijay Gupta was a fourth-year surgical resident assigned to Emergency. Sierra had consulted with him on several patients prior to her current E.R. stint and thought highly of him. After he completed his training, he planned to return to his native India and Sierra would be sorry to see him go.
Sounds good to me.
Sierra always took pride in making accurate and timely diagnoses, but none more so than when Trey stopped her a few hours later, not long before their shift ended.
Vijay called, he said without preamble. Francess appendix was the worst hes seen in a long time. Youll be pleased to know he was glad youd sent her up when you did, otherwise there would have been dire consequences.
Gracious, but she was blushing again. It was a team effort, she said lightly.
That may be, but I think we should celebrate with a cup of coffee.
Coffee sounds good, but Im not sure the occasion calls for a celebration, she said. I was only doing my job.
The second those words came out of her mouth she realized how much shed sounded like Professor Grumpy Gunderson. After shed pored over a patients medical file for clues about his illness, shed discovered an obscure fact which had led to a confirmatory test. Her fellow students had been impressed and shed been proud, but Grumpy had raised one eyebrow and sniffed.
Youre expected to make proper diagnoses, McAllaster, hed said in his most condescending voice. Every patient deserves your best. Its your job to provide it.
Now, a question begged to be asked. When had she become so cynical and turned into Grumpy Gunderson?
Working down here Trey interrupted her bleak thoughts as he herded her into the lounge we take our victories when we find them. Too many cases dont have happy endings.
As if shed needed a reminder, she reflected wryly as he began pouring two mugs of the strong coffee.
Black or white? he asked.
White. She fished among the containers for a packet of sweetener and dumped in a moderate amount of powdered creamer.
He leaned against the counter, mug in hand. Just so you know, our real partying takes place on Fridays, after work. Youll have to join us. No excuses allowed.
She thought about the days when shed ended the work week with the rest of her ED team at a nearby watering hole. Their tradition had been for the most senior member to make two toastsone to the staff for jobs well done and one to pay tribute to the people theyd lost.
Her finances could surely stretch far enough for her to resume the tradition, even if she honored it only during her temporary tenure in Emergency. While she took pride in her efforts when shed discharged a patient from the fifth floor, drinking a glass of wine alone in her apartment didnt generate the same emotional satisfaction as being surrounded by people whod shared in the experience.
Until Trey had dangled the notion of a celebration in front of her, she hadnt realized how much she missed the camaraderie associated with a group of her colleagues. Trey had inadvertently reminded her of another part of her life that David had stolen.
Well, no more. Shed come to Pittsburgh to start over, and creating a new routine was part of that. She may not be able to afford more than a glass of tea or a soft drink, but drinking wasnt the issue. Being with friends and colleagues was.
I didnt realize Id touched on such a deep subject, he joked. You looked like you were a hundred miles away.
Sorry, she said, embarrassed at being caught woolgathering. I was, but youre right. We should rejoice in our success stories when we can.
His smile nearly blinded her. Then youll join us on Friday night?
Sure, why not?
Great, he said with such enthusiasm that she knew hed hold her to her decision, no matter what. Well
Their pagers went off simultaneously. Sierra abandoned her mug and followed Trey out of the door.
A scuffle at the far end of the hall near the ambulance entrance doors caught her attention. Two police officers were escorting two punks in low-slung jeans and ripped T-shirts, but for every step forward they sidestepped two more in an effort to keep the two street hoods apart. Obscenities flew, along with several wild punches, but it was obvious that not long ago those punches had been landing.
One young man had a swollen, bloody nose and a bloodstained bandana wrapped around his right biceps. The other had one eye completely swollen shut as he limped forward.
Trey sighed. Looks like the natives are restless.
No kidding. I thought they saved their fighting for Saturday nights, she remarked.
Around here, any time is a good time, he answered. Ill take one and you can take the other so we can get them both out of here faster.
Okay.
She started forward, but he pulled her behind him. Stay out of the way until theyre stashed in separate corners.
Stay out of the way? For a few seconds she stood in amazement at his high-handedness. Did he really think she couldnt hold her own? Shed gone nose to nose with men who were far more belligerent than these two. Of course, she hadnt been wearing a dress and heels at the time, but sometimes looking feminine gave her an advantage. Goons like these were often busy ogling her legs and forgot their reason for fighting.
She hurried to catch up, but Treys long-legged stride had already put him at the scene. Although she was still half a hallway away, she heard and saw everything.
Take him Trey pointed to the one sporting a bloody nose to Trauma One and the other to Room Two.
Move it, buddy. Officer Wright gave his prisoner a not-so-gentle nudge in the appropriate direction. You heard the doc.
Hey, man, dont tell me what to do. The guy immediately began swinging.
Instinctively, Sierra knew this wasnt going to end well. She watched in horror as the situation deteriorated, taking Trey with it.
CHAPTER THREE
TREY saw the mans arm move out of the corner of his eye. He tried to duck as he watched a beefy fist come toward him, but his body didnt respond to his brains command. His instincts warned him of the impending blow, but before he had a chance to brace himself for impact, his ears rang and his vision blurred.
He heard shouts and curses as if they were coming from a distance, but he concentrated on trying to protect himself. Before his scrambled brain could convince him to duck, a body plowed into his midsection and he lost his balance. His fall inevitable, he twisted to minimize the damage, but five hundred pounds of angry males landed on top of him, effectively causing him to kiss the floor.
The bruise on his chin and the weight on his back seemed minor in comparison to the excruciating pain that he felt in his right knee.
Damn! This wasnt how this was supposed to play out, he thought, before everything faded to black.
Before Sierra could yell at Trey to watch out for the guy on his right, she heard the distinctive sound of flesh striking bone. For a split second, he stood upright, frozen in place, until the other man shoved Trey in his apparent haste to reach his enemy. Immediately, Trey crumpled like a broken toy and disappeared under the bodies of punks and police officers.
Call Security, she yelled over her shoulder as she hurried forward. She certainly couldnt fight this battle if she relied on muscle because she was definitely outgunned. However, she could win through chemistry.
Lorazepam, she called out, already calculating an appropriate dose of tranquilizer to use. Hand me lorazepam!
Suddenly, what seemed like the entire emergency department materialized around them. By the time someone had slapped the medication in her hand, there were too many arms and legs to identify the owners. She could accidentally sedate a staff member, which would definitely not be the best thing to do.
To her great frustration, she simply had to wait for stronger backs to peel back the pile, layer by layer. Finally, only Trey was lying facedown on the floor.
Sierra knelt beside him, half-afraid of what she might find. Trey, she said urgently as she frantically ran her fingers over his head to check for injuries. Can you hear me?
She found a goose egg on his forehead, presumably caused by his bounce against the linoleum. Trey? she asked again.
This time, he groaned. Must you scream in my ear? he complained.
Hed answered. What a relief. Im not screaming. Can you move?
Barely. He grimaced as he tried to roll over and only got as far as his side. Damn. My knee.
She placed a hand on his shoulder to steady him. Anything else?
You mean, other than the fact that my lungs will never be the same after being squashed within an inch of my life?
She smiled at his affronted tone. If he could be sarcastic, his injuries probably werent as bad as shed feared. His skin color was on the pasty side, but he didnt sound wheezy or raspy, which was good because she felt guilty enough for not wading into the fray with him. Yeah, other than that.
Youre the doc. You tell me.
She paused to study him with her practiced eye. Well need X-rays to check for hairline skull fractures or broken ribs, but as a purely preliminary opinion Id cancel any photo ops if I were you.
He swiped at the blood running down his chin. That bad, eh?
It could be worse, she said, taking a gauze pad someone had handed her to hold against his chin. Besides the goose egg thats probably giving you a headache and the gash youre already well acquainted with, youre developing quite a shiner. Dont worry, though. Youll be back to your handsome self in no time.
My handsome self, eh? He tried to grin, but it came out as a grimace. With shaky fingers, he gently probed his cheekbone. Oh, that hurts.
Im sure. Pain is a common side effect of having your face meet a fist, but ice will help. What about your chest? Can you breathe in and out easily?
He huffed first, then took a deep breath and let it out. Yeah. He rubbed the side of his chest. My ribs are sore, though. How do football players handle this day after day?
Conditioning and extra padding, she answered. Lets get you to a room so I can look at your knee. Ready?
He winced. Ill have to be.
Immediately, multiple hands pulled him upright. Any dizziness? she asked.
Not really, he muttered as he sank heavily into a waiting wheelchair, his face white with pain.
Whos on call for Orthopedics? Sierra asked Roma.
Abernathy. Ill page him, the nurse said.
She turned back to Trey. Ready for your ride down the hall?
No. I want to go home instead.
Dont be a baby, she scolded lightly as she pushed his wheelchair alongside a bevy of worried-looking staff.
Did anyone ever tell you your bedside manner lacks a little something? he grumbled. Like compassion?
Would you rather I stand here and gush all over you? she wanted to know. If so, I could hand you to another doctor, but I dont think Lamont or Ben are likely to treat you like spun glass either. Marissa might, but youre older than her usual clientele, so who knows?
Lamont Stedman and Benjamin Kryszka, both men pushing forty, were the other two ED physicians on duty. Marissa Landower, an attractive woman about ten years older, was the resident pediatrician. While any of them would fuss a bit over him, none would fall apart like a dewy-eyed debutante.
He peered at her, looking like a lopsided raccoon. I should get hazardous-duty pay.
If it will make you feel better, Ill give you one of the kids sugar-free lollipops. Cherry or grape?
Can you lace it with a painkiller? he asked, his voice hopeful.
Sorry.
Then Ill pass.
Sierra braked the wheelchair beside the bed. Do you want to hop up here or stay where you are?
Ill stay right here, thank you very much. Itll save on wear and tear when you send me to my car. So I can go home, he finished pointedly.
What? And miss a trip to Radiology? She tutted. Now, Dr. Donovan
This is so unnecessary, he grumbled. I have a minor bump on my head, my chins not bleeding nearly as badly as it was and I wrenched my knee. Nothing that a few ice packs and a bandage wont cure.
She leaned over to study the gash, fully aware of how wonderful he smelled. Youre right about your chin. A butterfly bandage should take care of it. As for the rest of your aches, we need X-rays.
No, we dont.
His expression reminded her of a little boy whose wishes were being thwarted. If he crossed his arms and stuck out his lower lip, the picture would be complete.
The diagnosis was in and it was definiteDr. Donovan was a lousy patient.
Yes, we do, she said, hiding her amusement. How would it look if I sent you home with a subdural hematoma, a concussion or a torn ACL?
I didnt tear my ACL, he said. Anterior cruciate ligament tears would be more painful and I would have heard a distinct pop, which I didnt. I also didnt fracture my skull and I absolutely, positively, do not have a concussion.
Heres your ice pack, Doctor. A nurse thrust the cold bag at him and he placed it on his face with heartfelt thanks.
You know your brain wasnt scrambled because? She waited for his response.
Ive had a concussion before and my current headache doesnt come close.
Thats good to hear, but while you may have Supermans X-ray vision, I, as your physician, do not. She motioned to one of the nurses to begin taking his vital signs. So your opinion is overruled. We might even spring for an MRI of your knee.
Youre making far too much of this.
Risk Management and Workmans Comp all require a thorough exam, which is what Im trying to do. As one of the hospitals finest and most illustrious staff members, you should sit back and enjoy the attention.
Id rather be at home, licking my wounds in private.
While his injuries were obviously painful, she suspected they were strictly of the minor variety. Youll get there soon enough, she predicted. Meanwhile, lets slip you into a hospital gown so we can take a look at
Not a chance.
Its either that or cut off your pants leg, she warned. I cant see through fabric either.
Grab your scissors, he said firmly. Losing a pair of pants is not worth the indignity.
Okay, but its a waste of a perfectly good garment.
Theyre mine to waste. Cut.
With an order like that, she couldnt refuse. She began snipping through the cotton, careful to avoid puncturing his skin. Each slice revealed more of his muscular leg and caused her mouth to suddenly go dry.
To make matters worse, she was oddly unsettled by her task, which was ridiculous because shed cut off clothing before without a second thought, and on a number of men more handsome than Trey. If she wasnt almost finished, she would have turned over the job to one of the hovering nurses, who clearly would have been thrilled at the honor.
Do you run? she asked, trying to deal with her view of his leg clinically.
Yeah.
His knee was too swollen for her to pull the free leg off, so she sliced the fabric lengthwise and laid it open. Youll have to postpone your daily jogs for a while.
You think?
She smiled at his sarcasm. You really are holding true to the stereotype about doctors being lousy patients.
Im entitled. This whole thing was so stupid! It should never have happened.
The guilt shed been holding at bay reappeared. Maybe next time youll let me handle it.
His battered face didnt hide his skepticism. And what would you have done? Ended up at the bottom of the pile with me? Or, worse yet, instead of me?
His outrage was obvious and she understood why. Men hated appearing weak. Being caught off guard and injured because of a misplaced punch would, in their opinion, epitomize the very trait they hated. Now, if hed earned his wounds because hed thrown a few blows of his own, they would have become badges of honor.
Maybe youre right, she conceded, but you shouldnt feel embarrassed either. In fact, once news gets out, youll become more popular than you already are.
I guess. He didnt sound too happy about his new status, which surprised her. David had always preened under extra attention and shed expected Trey to do the same.
Can I have some ibuprofen and ice for my knee now? he complained.
The ice is coming right up, she said. Well save the pain reliever until after your CT scan.
BP is one forty-five over eighty, the nurse broke in to report. Pulse is sixty-eight.
Your blood pressure is a little high
Of course it is, he snapped. Getting caught in the middle of a fight will do that.
Sierra exchanged a wry glance with Roma. Clearly the charge nurse held Sierras opinion about Treys attitude. She looked as if she was ready to comment when another nurse brought a fresh ice pack, breaking the moment.
Sierra secured the bag to his knee with elastic wrap. Thisll hold it in place while youre visiting Radiology. After youre back and Dr. Abernathy sees you, well wrap your knee more securely.
What? No Lachmans? No pivot shift test?
She smiled as he referred to the two tests performed to diagnose an ACL injury. Knowing an orthopedist will do those himself, do you really want me to manipulate your knee and leg just to prove I know how?
True. Good idea to wait.
Sierra stepped aside. Ill see you when you get back.
For the next hour, past the time Sierras shift should have ended, a steady stream of staff members approached her to ask how Trey was doing. Even the people who were just reporting for duty had heard of the mishap and begged for details.
The two prisoners stopped her in the hallway to gruffly pass on their apologies to Trey before their caretakers herded them to jail.
What was all that about? she asked Ben and Lamont, who acted rather pleased with themselves as they perched on the counter beside her.
We let it be known theyd better be on their best behavior if they ever come here again because we dont take kindly to our staff getting hurt, Lamont replied. The next time they lose their cool and need something more than a few stitches, well use drugs that produce some unpleasant side effects.
Like impotence, incontinence, hair loss, skin blemishes, boils, diarrhea and blurred vision, Ben chimed in.
Not to mention anal leakage and flatulence.
Sierra looked at her two colleagues in amazement. You didnt.
We did, Lamont assured her, before he exchanged a wide grin with his partner-in-crime.
She laughed. You guys are awful. You both look so meek and mild-mannered, but underneath you have an evil streak.
Hey, Lamont protested without heat, we protect our own. Now that weve done our good deed for the day, were going home. Are you sticking around?
Only until Radiology turns Trey loose.
While she waited, she impatiently checked the computer for his test results. One by one, the reports filtered in.
Normal chest film. No skull fracture. No concussion.
All she needed now was Dr. Abernathys recommendation and she could grant Trey his wish. Of course, she could have granted it sooner if she hadnt gone overboard with the X-ray requests, but she wasnt going to risk overlooking anything. There would be hell to pay if she did, not only from her boss and Treys, too, but also from Treys adoring public.
Finally, an X-ray technician wheeled him into the trauma room. His normally relaxed mouth was pinched with apparent pain and the orbit of his other eye was slowly turning dark.
What do you know, she said cheerfully. Your eyes match.
He looked so forlorn she wanted to give him a hug. Now, that would cause the rumor mill to kick into gear
Great, he said glumly. By the way, my CT scan was normal. Any chance I can have that ibuprofen now?
Because shed seen the report on her screen just moments ago, she agreed. Absolutely.
While she doled out two pills, then two more when he glared at her, Nathan Abernathy rushed in, apologizing for his delay. Sierra looked on as he conducted his own exam, including the tests Trey had previously mentioned. A few minutes later, Roma waved to her from the doorway.
Sierra slipped outside the room. Whats up?
Dr. Donovan has a visitor.
Only one? she asked wryly.
Roma smiled. Only one.
Female, Im presuming?
Yes, but
Shell have to wait until Abernathy is finished.
It would be better if she didnt.
Ah, I get it. A VIP?
Dr. Donovan would think so.
How typical, Sierra thought with some disgust. Hes busy flirting with every woman he meets, but he has a girlfrienda very important girlfriendwaiting in the wings.
I think you should talk to her before she sees him, Roma continued. Prepare her for what he looks like.
Imagining a blonde bimbo falling apart and weeping over him because he wouldnt be able to take her dancing for a few weeks, Sierra grimaced. She glanced inside the trauma room and saw Abernathy continuing his joint manipulation. Okay. Where is she?
Roma pointed toward the nurses station. There.
.
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Jessica Matthews
Тип: электронная книга
Жанр: Современные любовные романы
Язык: на английском языке
Издательство: HarperCollins
Дата публикации: 16.04.2024
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О книге: The Delectable Dr Donovan… ER doctor Trey Donovan is sinfully sexy, seriously good at his job, and willing to do whatever it takes for his patients. His team at Good Shepherd Hospital is second to none – including new doctor Sierra McAllaster.Trey can have any (and every! ) woman he wants – as long as they don’t expect a fling to end in a diamond ring! But Sierra makes maverick Trey want to break his own relationship rules…