Life Support
Praise for Candace Calvert
“In Life Support, Candace Calvert provides authentic medical thrills from characters so real you miss them when you turn the last page.”
—RICHARD L. MABRY, MD,
award-winning author of Heart Failure and Stress Test
“Calvert’s adventuresome story of romance and drama infuses faith into her characters’ motivations and makes readers eager for more.”
—BOOKLIST ON RESCUE TEAM
“Candace Calvert makes hearts race, raises anxiety levels, and heightens emotions—all against doctor’s orders—but it seems to be an ultimate cure for anyone in need of their reading fix!”
—RELZ REVIEWZ
“Candace Calvert’s Rescue Team had me intrigued by page 1, laughing by page 2, and in love with the hero by page 3. If you love inspirational romantic suspense and haven’t yet discovered Candace’s books, you need to go to the nearest bookstore and pick up a copy of this book—stat.”
—JORDYN REDWOOD,
author of Proof and Poison
“Just like an outstanding episode of Grey’s Anatomy, Trauma Plan weaves medical, community, and personal issues with blossoming romance and strands of mystery. . . . Full of memorable characters and guided by Calvert’s own experience as an ER nurse, the first novel in her Grace Medical series evokes a realistic and intriguing world readers will definitely want to return to.”
—BOOKLIST
“Trauma Plan is a humor-filled romance, woven throughout with suspense, medical intrigue, and faith. Readers will look forward to the rest of the Grace Medical series.”
—ROMANTIC TIMES, 4½ STAR REVIEW
“Calvert . . . infuses her story with detailed medical procedures and terminology along with honest questions about faith that anyone might ask in the face of difficulties. The characters are likable and receive rich and thorough development in this enjoyable ‘hope opera’ page-turner.”
—PUBLISHERS WEEKLY ON TRAUMA PLAN
“It is the bits and pieces of the other stories and characters that Calvert delicately and subtly (at the same time) twines together that makes Trauma Plan the type of book that you want to read over and over. . . . George Clooney would probably take on another doctor’s role after reading this book.”
—EXAMINER.COM
“Candace Calvert has crafted another gut-grabbing medical thriller. Trauma Plan kept me engrossed from beginning to end. . . . The faith message was clear, the medical traumas heart-stopping, and the romance heart melting.”
—LYNETTE EASON,
award-winning, bestselling author of the Women of Justice series
“[Critical Care] flows well and keeps the reader’s attention. . . . Characters find not only psychological healing, but also spiritual renewal.”
—CHRISTIAN RETAILING
Visit Tyndale online at www.tyndale.com.
Visit Candace Calvert’s website at www.candacecalvert.com.
TYNDALE and Tyndale’s quill logo are registered trademarks of Tyndale House Publishers, Inc.
Life Support
Copyright © 2014 by Candace Calvert. All rights reserved.
Cover photograph of doctor taken by Stephen Vosloo. Copyright © by Tyndale House Publishers, Inc. All rights reserved.
Cover photograph of woman copyright © Huseyin Tuncer/Getty Images. All rights reserved.
Cover photograph of city copyright © Ayman Aljammaz/Getty Images. All rights reserved.
Designed by Stephen Vosloo
Edited by Sarah Mason
Published in association with the literary agency of Natasha Kern Literary Agency, Inc., P.O. Box 1069, White Salmon, WA 98672.
Scripture taken from the Holy Bible, New International Version,® NIV.® Copyright © 1973, 1978, 1984, 2011 by Biblica, Inc.™ Used by permission of Zondervan. All rights reserved worldwide. www.zondervan.com.
Life Support is a work of fiction. Where real people, events, establishments, organizations, or locales appear, they are used fictitiously. All other elements of the novel are drawn from the author’s imagination.
Library of Congress Cataloging-in-Publication Data
Calvert, Candace, date.
Life support / Candace Calvert.
pages cm. — (Grace Medical)
ISBN 978-1-4143-6113-0 (pbk.)
1. Nurses—Fiction. 2. Physicians’ assistants—Fiction. 3. Brothers and sisters—Fiction. 4. Mentally ill—Fiction. 5. Hurricanes—Fiction. I. Title.
PS3603.A4463L54 2014
813´.6—dc23 2013036729
ISBN 978-1-4143-9074-1 (ePub); ISBN 978-1-4143-8446-7 (Kindle); ISBN 978-1-4143-9075-8 (Apple)
Build: 2014-02-13 08:59:12
For Dub and Carolyn Helm. Yours is a true love story.
Acknowledgments
Heartfelt appreciation to:
Literary agent Natasha Kern—you are forever a blessing.
The entire Tyndale House publishing team, especially editors Jan Stob and Sarah Mason and copy editor Erin Smith. (Patting my heart.) It’s an honor to partner with you all.
Nancy Herriman—talented author, dear friend, longtime critique partner. I can’t imagine doing this without you, pal. Let’s keep rolling!
Kathy—for your gracious gift of help in creating the character of Jessica Barclay.
Jeannie Campbell (The Character Therapist)—for giving my characters some “couch time.” Your expertise was beyond helpful.
Donna Weyd—for sharing your very real hurricane accounts, helping to create my fictional storm.
Reader Kristin Kertes—for stepping up with a new, perfect title: Life Support. Thank you!
Cousin Carolyn Helm—for allowing your feisty, real-life Hannah Leigh to sashay through this story. You both rock!
My husband and family—your loving encouragement lifts my heart, always.
And finally, to my dear readers—connecting with you is such a blessing. Thank you for inviting me into your homes, your hearts. You’re the reason I write.
I would hurry to my place of shelter, far from the tempest and storm.
PSALM 55:8
Contents
Acknowledgments
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
Chapter 26
Chapter 27
Chapter 28
Chapter 29
Chapter 30
Chapter 31
Chapter 32
Chapter 33
Chapter 34
Chapter 35
Chapter 36
Chapter 37
Chapter 38
Chapter 39
Chapter 40
Chapter 41
Epilogue
About the Author
Discussion Guide
“HEART RATE’S CLIMBED TO 148,” Lauren Barclay warned, her words blending with a monitor alarm in dark harmony. The clatter of resuscitation equipment being hustled into place by fellow ER nurses snuffed out the rest of her report. A strangled gasp from the head of the gurney validated Lauren’s concerns: this man was failing in the painful struggle to fill his lungs. Her stomach knotted. They couldn’t lose him. Not the brother of one of their team.
&n
bsp; Please . . .
“O2 saturation is tanking, Doctor.” She grabbed the hissing suction catheter and wedged closer, determined to get the physician’s attention. Her eyes watered at a sudden whiff of iodine and alcohol. “His skin’s really gray.”
“I see that, Lauren—I’m not blind.” The physician pulled the fiber-optic scope from his patient’s mouth, growling with frustration. “Suction! Clear his airway.”
“Got it.” Lauren moved in quickly, a respiratory therapist behind her with the Ambu bag. She slid the catheter between the unconscious man’s lips, struck again by the familiarity of his features: dark hair and lashes, that hint of olive in his complexion despite his pallor. She’d have known he was Eli Landry’s older brother even without seeing the medical record. Andrew Landry, thirty-six years old, had suffered a traumatic brain injury twenty-some years ago—a boating accident and near drowning that left him comatose on a ventilator for many months afterward. And severely disabled since. He was a man who should have been remarkably handsome, vital—embracing a hopeful, successful life—but was instead gaunt, withered, almost helpless. And dying?
Lauren glanced at his half-closed lids, the stray curl clinging to his clammy forehead. She’d never actually seen Andrew before today, but his tragic history was well known in Houston because his father—
“Hyperventilate him,” the doctor ordered as a respiratory therapist slid a mask over the man’s face. “And restrain those arms if you need to. Arm—he only has the use of the left one.” He pulled off dark-framed glasses and wiped them with the hem of his scrub top, watching as the therapist began to squeeze the bag to assist respirations. “He’s going to quit breathing. If I can’t get this tube in, I’ll have no choice but to trach him.”
The physician ran a gloved finger over a thickened, pearly scar on his patient’s throat, uttering something that sounded like “Why me?” He met Lauren’s gaze at last. “Look, I’m sorry for snapping at you.” Despite the air-conditioning, the young man’s thinning hairline and forehead glistened with perspiration. Nervous sweat. It spread across the neckline and chest of his green scrub top, as if the stifling June humidity had slammed through the doors of Houston Grace Hospital along with the rushing ambulance gurney. “It’s just that—”
“He’s Eli’s brother,” Lauren finished in a raw whisper, the physician assistant’s name never failing to cause her discomfort.
“And Judge Julien Landry’s oldest son.” The doctor lowered his voice. “Eli and his father have been at odds about Andrew for months. Everyone knows that. I need to be in the middle of that battle like I need a hurricane to flatten my house.”
“I hear you.” Lauren’s gaze darted toward the hallway that led to the ambulance bay. The Caribbean was brewing a trio of tropical storms. She’d almost prefer that over what might happen here today. Things were tough enough without added conflict. She’d moved back to Houston—accepted a position in this ER—to keep a protective eye on her younger sister, Jessica. The twenty-one-year-old was making reckless choices, and if she didn’t straighten up, her job at Houston Grace was at risk. As was her acceptance into nursing school in the fall . . . and even her life? No. Lauren refused to believe Jess’s problems were that serious. Unfortunately, there was one thing she couldn’t deny: Eli Landry was part of the whole mess.
“Okay, then.” The doctor signaled to the respiratory therapist that he was going to attempt another intubation. He glanced at the clock, then turned to Lauren. “What time is Eli due in the urgent care?”
“Not till four, unless he’s heard—”
There were voices outside the code room doors. A woman, their emergency department manager. The other voice was much deeper.
“Is that . . . ?” The physician’s gaze moved to the doorway, and the room went strangely quiet except for the whoosh-burp of the plastic mask bucking against its seal over Andrew Landry’s face.
“Oh no.” The words slipped out before Lauren could stop them. “He’s here.”
- + -
Eli Landry shoved the code room doors open, telling himself the same thing he always did: he was prepared for whatever he’d find. After years of trying, he still hadn’t convinced himself.
“Eli . . .”
The ER doctor, Mike Duhain, walked toward him. Sweating—always a bad sign.
“Mike.” Eli looked at the heart monitor: tachycardic but regular. Only then did he allow his gaze to move to his brother’s face, partially obscured by a translucent green resuscitation mask. Alive. He released the breath he’d been holding. “What’s going on with Drew?”
“The care home told the medics he was breathing hard last night, sleepy today. Had a shaking episode. He arrived here with severe respiratory compromise and hypoxemia.” Mike glanced toward the monitors as an alarm sounded. “Oxygen saturation’s 89 percent even with the high-flow bag assist.”
“Fever?” Eli noticed for the first time that Lauren Barclay was in the room. Pink scrubs, honey-colored hair rebelling against the summer humidity. Only concern for his brother could have provided enough distraction to make him miss such a staggering sight.
“His temp was 104.2,” she reported, moving to the computer a few feet from where they stood. She managed to avoid Eli’s eyes—a skill she’d perfected since her return to Houston. Right now, he was grateful. The last thing Eli wanted—besides for his brother’s heartbeat to suddenly flatline—was to see disapproval in Lauren’s eyes. Had she heard what was going on with his family?
“We sent blood to the lab and they’re drawing for arterial gases now,” Mike continued. “X-ray is coming for a portable chest; I hear coarse crackles throughout. I’ve made a couple of attempts to tube him. I was about to try again with a smaller—”
“You won’t get a tube in,” Eli interrupted. “His trachea’s a mess. There’s scarring and stenosis. Every med student and rookie paramedic in the county has used my brother for practice.”
He knew he’d spit out the last word and reminded himself that Mike Duhain was a skilled doctor and a more-than-decent guy. He was also providing physician support for Eli’s shift in the adjacent urgent care department. It would be an unwelcome role reversal for a PA to direct a board-certified emergency department physician. And unethical because this was a family member, but . . .
“Drew had that first trach after the accident,” Eli explained further, “and then an emergency crike during a drug reaction three years ago—multiple traumatic attempts to get that tube in. More scarring. And he’s had fractured ribs, sternum, and a contused spleen when some cowboy first responder couldn’t tell he didn’t need cardiac compressions.” Eli’s gut roiled. “My brother has been through way too much.”
Mike swiped at his forehead. “I hear you. But he’s in serious trouble right now.” His eyes met Eli’s, the meaning crystal clear: What do you expect from me?
Eli glanced at Drew with a sigh. “This is almost always pneumonia. Complicated by his asthma. He’s had some close calls the past two years. Ended up on a ventilator with ARDS last Christmas. There were heart-rhythm problems related to that.” Saying it out loud ripped a scab off things he wanted to forget: machines, tubes, shrilling alarms, sleepless nights. And his mother’s tearful midnight request for the Landrys’ pastor.
“I’ve put in a call to his pulmonologist,” Mike assured. “But right now . . .”
“If it’s early enough,” Eli suggested, risking a wish that it really was, “you might turn this around with BiPAP. It worked last time. Took a while, but it worked. Drew’s record will show the effective antibiotics.” He glanced toward his brother again as monitor alarms briefly sounded.
“Good. We’ll try that.” Mike gave an order to a second respiratory therapist, then turned back to Eli and lowered his voice. “The care home sent a copy of Andrew’s advance medical directive. It looks recent. And it says he’s a full code. No restrictions.”
Eli’s pulse quickened; it was time to do this. Past time. “That’s wrong. We’re
revising it. It should say ‘no artificial life support.’” No more painful interventions.
“You mean . . . do not resuscitate?”
“No ventilator, no cardiac compressions. No defibrillation,” Eli confirmed, remembering his long conversation with his mother last week. He’d left the paperwork with her. “Comfort care. That’s what we want. If it comes to that.”
The silence in the room was broken only by the squeeze-whoosh of the Ambu bag helping Drew to breathe. Lauren’s fingers hovered over the computer keyboard.
“This is something new?” Mike asked, observably wary.
New? Eli had a sick urge to laugh . . . or scream. Slam his fist into the wall and shout loud enough for God himself to hear. Did that huge dented scar on his brother’s head look new? Did it seem anywhere near possible that he’d tossed a football around even once in the last twenty years? Could they begin to imagine how many times he’d been poked, prodded, choked, and tied down? Eli’s heart cramped at the truth: he could hardly remember a moment in his life when their family tragedy wasn’t reflected in his mother’s sad eyes.
“Yes,” he confirmed, aware of Lauren’s gaze. “It’s a new medical directive. I’ll make sure the paperwork gets—”
“Hold on.” Mike’s wariness morphed into an expression of visceral discomfort. He took a few steps away, indicating that Eli should follow, and dropped his voice to a whisper. “I had a phone call from the chief of staff.”
Ah . . . no surprise. Eli heard the gargle from aggressive suctioning of his brother’s scarred airway. “Let me guess—after he was contacted by Judge Landry?”
“It was made clear that your father is still responsible for all decisions in Andrew’s care. He alone. Not your mother. Or anyone else.” The physician’s grimace could sell antacids. “Your father apparently mentioned a restraining order. Against you.”
“Threat. Not fact.” Eli’s jaw tensed. They might as well string the Landrys’ dirty laundry through the halls of Houston Grace. Post photos to Facebook. “Look, Mike, no one wants Drew to pull out of this more than I do. No one. Anybody who says otherwise is way off base. But I can’t stand by and watch my brother suffer, only to end up on the kind of ‘life support’ that means no life at all. If Drew can’t beat it this time, or the next time or the next, I want to promise him some peace. I need to do that much.”