Critical Care: 1 (Mercy Hospital) Read online

  Her fingers moved to the carving below the initials. Jer. 29:11. Kevin’s favorite Scripture. The one Gayle had stitched and framed as an engagement gift to him. For a wedding that never happened.

  Claire shut her eyes against a burst of pain. Heal my heart. Move me forward. Please, please . . .

  She pulled her hand away from the tree, feeling the shivers that often heralded the onset of an endorphin rush. Balm at last. But this time there was no runner’s high, no respite. Just trembling followed by an empty, lonely ache. And a new whispering doubt: Was it possible that Logan was right? that God didn’t listen to prayers? How else did she end up in urgent care?

  By 9 a.m. Claire had showered and dressed, pulling her pink scrubs from the corner of her closet, where she’d banished them after her last stint in urgent care. She stuffed her purple stethoscope into her purse and headed to the kitchen to check Smokey’s water bowl. It was full. And strangely so was his food dish. Untouched? She glanced around the room and spotted the black cat curled up on the back of the couch, sleeping in the same spot as when she’d left for her run.

  “Hey, boy,” she called out, reaching for his dish.

  He lifted his head at the sound of her voice.

  “What’s the deal? You don’t like Mom’s cook—” Claire halted as muddy animal tracks on the deck just outside the glass door caught her eye.

  She stepped closer, peering down at them through the glass. A series of dried paw prints that looked more like slender palm prints. Five toes. A raccoon. Right outside Smokey’s pet door. He’d smelled it.

  Claire glanced back at the one-eared cat, feeling a stab of guilt. She’d moved the dishes gradually closer to the little plastic door on purpose. With a grand plan of moving them outside in the next few weeks so Smokey would be lured into venturing into the world again.

  After snatching up the dishes, Claire trundled them over to the couch and set them down. She walked back and slid the stiff resin cover over the pet door, blocking it. Then she went to the fireplace, lifted Kevin’s pewter cross from the edge of the picture frame, and fastened it around her neck. The cool metal nestled into the hollow of her throat.

  Long-term plans would have to wait. Today was about survival.

  +++

  Logan turned the bike in one last circle, beeped the horn, and then braked to a stop in a puddle, waving as the old Toyota pulled away from the hospital parking lot. Inside it, Jamie grinned from his car seat and waved back with both hands. Logan smiled. The little guy was barely visible in a backseat crowded with flower arrangements, balloons, and stuffed animals. He’d be missed at Sierra Mercy.

  I’ll miss him. Logan was once again aware of how this child affected him. Drew him far beyond doctor-patient responsibility. Not something Logan was used to and most likely a result of all the rallying by the hospital staff or because Logan had also treated Jamie’s mother after the day care tragedy. Or because he makes me wonder what it would be like if I had a . . .

  Logan shoved the thought away. He’d promised to say good-bye to Jamie, and he’d done that. He glanced at his watch. And now it was going on ten o’clock. The rain had cleared, and he had the whole day off. He could zip up to Tahoe, hike along the river, eat a steak on the deck at Sunnyside resort, and enjoy the quiet solitude. He scanned the parking lot, and his gaze came to rest on Claire’s SUV. Her urgent care shift started in fifteen minutes. Since he was the one who’d put her there, he might as well see how she was doing.

  He parked the bike, slipped in the door beside the gift shop, and was heading for the clinic when he passed the partially closed chapel doors. He spotted Claire standing in a circle along with Erin, Glenda, and some of the part-time ER registration staff. All with eyes closed, praying.

  He started to chuckle about Erin escalating her God huddles to twice daily when instead he found himself watching Claire. Her beautiful face seemed paler than usual, and a length of dark hair escaped a clip to hang alongside her jaw. Dark lashes nestled against her cheeks, and there was a tiny line of tension between her brows as her lips moved earnestly. A knotted leather string with a metal cross hung around her neck. The one he’d seen at her house on the photo of her brother.

  Erin began to speak, and they joined hands. “Father, you’ve called us to be caregivers. Give us the skills to aid and comfort those in our care so they might know your healing presence. Make our spirits tender, our words compassionate, and our touch gentle. . . .”

  Logan exhaled softly, realizing that he’d been holding his breath. He inhaled again to ease an ache in his chest. To the left of center and way down deep. If a patient described the sensation, Logan would order a stat electrocardiogram and a five-grain dose of aspirin. But this had nothing to do with his health. And everything to do with his long, awkward struggle with faith. It was the reason he’d lain awake last night thinking of Jamie. About how the child pressed his small palm over that same spot on Logan’s chest and said, “Right in there.” A little boy with Jesus in his heart counseling a man who’d stopped praying long ago.

  +++

  The stump won out over Tahoe, and after three solid hours hefting the ax, Logan felt like a new man. His arms and shoulders ached like he’d wrestled a wildebeest, but the moment he finally let go of the ax, he had a much better grip on his priorities. If he was going to have any peace of mind, he needed to make a couple of important decisions. First, Beckah’s wedding. It was in Carmel only a few days from now. She’d invited him months ago and left at least two messages on his machine. “Are you coming?” Logan wiped his face on the sleeve of his thermal shirt and groaned. Could he? That was the question.

  He shook his head, picked up the sheet of house plans, and walked to the outcropping of granite boulders that would one day be part of his backyard. Thirty yards beyond, the earth dropped steeply away, affording a breathtaking view of the American River gorge and the tree-studded western slope of the Sierra Mountains. Dotted squares of apple orchards gave way to sprawling oaks, then to stands of cedar and, as the altitude climbed, to lofty and majestic pines. His house would be contemporary, utilizing redwood beams and stainless steel cable and slabs of local stone, with an entire wall of energy-efficient glass looking out over a deck to the view beyond. He’d let the acreage remain rustic and natural, a refuge for deer and California quail, with no lawn to mow or formal plantings.

  Logan smiled, remembering Beckah’s very different idea of a dream house—a midtown Sacramento Victorian fixer-upper with shutters and gables, window boxes full of flowers, old family furniture, hand-stitched pillows . . . and babies. Logan swallowed. He hoped she’d have that now. All of it. That she’d start fresh, remembering only the good parts of the years she’d shared with Logan. What they’d had. Not what we lost. How was he supposed to watch Beckah marry another man when he still didn’t understand why she left him?

  Frustrated, Logan strode back to the oak stump and picked up the ax; he’d chop until dark if he had to. Hack it down to the roots and start quarrying the bedrock beneath. But by the time he lifted the tool to his aching shoulder, he remembered that there were two questions he’d come out here to answer. What he’d do about Beckah’s wedding and what he should do about Claire.

  Beautiful Claire, the intelligent and determined educator intent on protecting his own staff from him. The ambitious professional with an unwavering career plan and the sensitive woman who fit in his arms—and spoke to his heart—in a way he hadn’t believed possible. “I understand. . . . I care.” Logan raised the ax a few inches from his shoulder, his brows drawing together. There was still the issue of their conflicting views on faith. But maybe he could work around that. Maybe they could find an answer.

  He gazed out across his home site, imagining, like so many times before, how it would be one day. But this time he saw scattered clumps of flowers rising among the rocks and grasses, yellow daffodils swaying in the breeze. And Claire’s beautiful smile. He set the ax down. Some things didn’t take a bushel of wood chips to figu
re out. Sometimes you had to trust your gut and take a risk.

  +++

  Just like riding a bike . . . I can do this.

  Claire unwrapped the needle set, an 18 gauge—a large enough bore to infuse IV fluids rapidly. This patient was more than a little dehydrated. She glanced at Jada Williams, a twenty-three-year-old who’d been sent to urgent care by her obstetrician because of persistent vomiting. Beautiful face, sweet smile—and almost as nervous as I am.

  “I’m going to do this as gently as I can,” Claire reassured her. “I’ll explain everything. So don’t worry.” Her heart tugged as she watched the mother-to-be bravely extend her right arm while keeping the other hand spread protectively over her barely rounded tummy.

  Jada’s eyes, dark as a fawn’s, lifted to Claire’s face, and she sighed. “I’ve had IVs before. I’m not really afraid. Only for my baby. Over five months along and I’m still sick. It doesn’t seem right. My doctor says not to worry, that some women have this problem, but . . .”

  “But mothers worry.” Claire tore strips of paper tape. “That’s a perfectly normal feeling.” She wrapped a tourniquet around her patient’s arm, just above the elbow, stretching it taut and tucking an edge under to secure it. Then pressed her gloved index finger against Jada’s skin, hoping—oh, please—to find a decent vein. Here it comes, thank heaven. She reached for an iodine prep swab and began wiping concentric circles across Jada’s molasses-dark skin. “You’ve had a recent ultrasound?”

  Jada smiled, her eyes lighting up. “Yes. It’s a boy. You should have seen his daddy’s face when they told us! He’s so proud. He was trying to get here today, but he’s working three jobs right now.” Her smile widened. “Because there’s this little house, and we’re hoping to buy it. It needs a lot of work, but it’s got a backyard and a bedroom perfect for a nursery—my husband’s got all these big plans.”

  “That’s so great.” Claire nodded, glad to see the smile replacing Jada’s earlier anxiety. “Trust me, I know all about making plans.” Plans that are supposed to keep me from being here right now. She picked up the needle set and removed the cap. “Are you ready to get this done? Your vein looks good, and I’m going to be as gentle as I can. I promise you.”

  “I’m fine. I just want my baby to be okay.”

  Claire pressed her finger one last time against the vein, feeling its spongy bounce under her glove, then carefully slid the needle, bevel side up, through the skin and toward the vein. Please, let there be . . . She grinned, resisting the urge to shout with relief as blood flashed back into the short length of transparent tubing attached to the needle set. Proof it was in the vein. Like riding a bike . . .

  “Looks good,” Claire said, securing the needle set with a strip of tape and connecting the IV tubing. “I’m just going to finish taping this; then we’ll get these fluids flowing. So you and your baby boy will be—” She looked up to give her patient a reassuring smile but stopped short when she saw Jada’s eyes filling with tears. “What’s wrong? Did I hurt you?” Claire stood and moved close.

  “No, I just . . .” She raised her other hand and pointed. “That cross . . . you’re a Christian?”

  “Yes.” Claire’s fingers moved to Kevin’s pewter cross at the neckline of her scrub top. “Is something wrong?” She raised her brows, sensing that Jada’s emotion came from far more than worry over morning sickness.

  Jada swallowed. “This will be my first baby, but . . . it’s not my first pregnancy. I did something . . .”

  Claire’s stomach sank and she nodded, understanding all at once the source of her patient’s pain. She exhaled softly, then rested her hand on Jada’s shoulder.

  “I was young and scared, and I made an awful mistake . . . a choice I’ve regretted every day since. Now with this new child—” her fingers spread across her abdomen—“I know what a precious gift God’s given me.” Jada’s tears spilled over, her eyes searching Claire’s. “Would you pray with me? It’s not against hospital rules, is it?”

  “No,” Claire whispered as best she could around the lump in her throat. “Not against any rules at all.” She smiled and patted Jada’s shoulder. “And better than any medicine we have.” She glanced at the drip chamber of the IV, feeling completely humbled; this moment had nothing to do with clinical skills. Yet it had everything—everything—to do with care and healing. Thank you, Lord.

  Claire joined hands with Jada and bowed her head.

  Ninety minutes later, Claire scanned the clinic’s exam rooms from her desk at the nursing station: child with a fever in room one, migraine patient in two, woman with urinary symptoms in three, four was empty, and a teen with mild asthma in five. Everyone in a holding pattern after initial treatment.

  She exhaled slowly. So far so good. She was on top of things, and thankfully there had been no Code 3 sirens arriving at the ambulance entrance to rattle her nerves. Glenda, the nurse-practitioner, was confident and efficient, and the nurse’s aide more than helpful. Another hour, and Claire could go back to her office in the education department. And call every single agency she could find. Stay until midnight if she had to. She’d find a new nurse for the ER, and Merlene wouldn’t make her come back here. Claire was pressing her luck. Even her most challenging task—starting Jada’s IV—had been without the pressure of emergency conditions. But what if she were faced with another critical situation like Jamie’s?

  She looked up as Erin approached the desk.

  “Thought I’d better do a welfare check over here,” Erin said, sinking onto a rolling stool beside Claire. “Make sure you’re not fainting or anything.”

  Claire froze, her eyes widening. “Why would I . . . ?”

  Erin continued, oblivious to Claire’s discomfort. “Like Sarah.”

  “Sarah fainted?” Claire asked, concern mixing with a rush of guilty relief that Erin hadn’t been questioning her competence.

  “Almost. About half an hour ago. Said she was woozy because she’d skipped lunch. So I had the cafeteria bring her a sandwich, along with a huge slab of banana cream pie.” Erin rested her elbows on the desk. “I stood over her while she ate it.” She glanced around. “How’re you doing over here after being shanghaied by Logan?”

  Claire’s stomach did a ridiculous dip at the mention of his name. Which gave way to continuing irritation at his insensitive arrogance. “Put down the phone and pamphlets. . . . You’re handling urgent care.” She’d been awake for hours last night, wrestling with anger at him for sending her here. And fear that he’d find out what a mistake he’d made.

  Erin watched Claire’s face for a moment. “I told him I wasn’t sure you’d be willing to do it. I thought you might be uncomfortable doing bedside care.”

  It was a statement, but Claire could hear the question beneath it, and her throat tightened. Erin knew. Of course she did. She’d been there during Jamie’s crisis; she must have noticed Claire’s apprehension.

  “How long has it been since you worked ER?” Erin asked gently.

  Claire’s pulse quickened. “Two years.” She cleared her throat. “I’d been working on my bachelor’s degree in education. And did some part-time work with the Loaves and Fishes clinic in Sacramento. But now I’ve been getting good experience in the education department, and I’ve interviewed for the clinical educator position. That’s my plan. It’s not that I’m unwilling to help you, but . . .” Claire’s words faltered. There was no way to explain without dredging up the past. I can’t do that again.

  “No problem. I understand. I really do.” Erin smiled warmly. “And I appreciate your being here. But if you need help—need anything—just holler for me, okay?” She reached over and touched Claire’s arm. “Besides, I loved having you show up for Faith QD.”

  Claire smiled, remembering the sense of comfort and the infusion of much-needed confidence she’d felt when gathering with the clinic team in the chapel. “I loved it too. I’ve missed that kind of fellowship,” she said, surprised by her revelation. It’s true. I miss it.


  “Good, then,” Erin said, patting Claire’s arm. “I only wish Dr. McSnarly could hear you say that. He thinks I’m bribing people with donuts to get them there. The day I lure Logan into that chapel is the day this humble mission goes on the map. Trust me, I’ve tried.” She shook her head. “He said Beckah had wanted them to start going to church together, but . . .”

  “Beckah?” Claire adjusted her stethoscope and feigned casual interest despite the fact that her stomach had plummeted. A girlfriend?

  “His ex-wife,” Erin answered. “I never met her, but I can sure understand what she was trying to do. I see so many solid couples at my church that I have to believe there’s a real connection between faith and successful relationships. Maybe it would have made a difference for Logan’s marriage.”

  Except that he doesn’t believe in prayer. Since his mother left. And he doesn’t trust counseling, either.

  Claire blinked, realizing that knowing those things—such intimate things—meant that she already knew Logan Caldwell far better than Erin or likely any of the Sierra Mercy staff. He’d shared those personal insights with her, taken that risk. She knew how vulnerable it felt to do that. Had Logan regretted talking with her? And kissing her? Is that why he hasn’t called? Claire forced the thoughts aside.

  “But then—” Erin pulled at a long strand of her hair and sighed—“what do I really know about relationships?”

  “You?” Claire tossed her a teasing smile. “So I imagined those roses in the ER?”

  Erin groaned. “You can’t know how much I wish Brad hadn’t done that. I look at them and it’s like a neon sign blinking, ‘fool, fool, fool’ in flaming red a dozen times over.”