Critical Care: 1 (Mercy Hospital) Page 4
Claire saw a fleeting look, almost like a memory of pain, flicker in his eyes.
He pressed his palm against the side rail of the gurney. “It’s like this: you go around telling people that they need to explore their feelings, all that sort of shrink-to-fit nonsense, and then the team starts falling apart.” He jabbed a finger in the air. “The links weaken.”
Weaken? Claire’s stomach twisted into a familiar knot as the thought struck her. That’s probably what the Sacramento doctor had labeled her in the weeks after her brother’s death, when despair left her numb and immobile and barely able to function. A weak link.
“I’m not saying that this isn’t killer work,” Logan continued, his voice fervent. “I’m just saying there are better ways to deal with it, that’s all.”
The knot in her stomach turned to anger, and Claire raised her chin, refusing to blink as she stared him in the eyes. “Oh?” she said, daring—maybe even needing—Logan Caldwell, of all people, to offer something that finally made heartbreak bearable. “And how do you deal with it, Doctor? Personally, I mean.” She walked around the end of the gurney to stand directly in front of him and crossed her arms. “Go ahead, enlighten me.”
“I . . .” He hesitated, unsure of his answer maybe or shocked by her nerve.
Claire waited, trying not to think about the hospital’s chain of command. How much influence did Goliath have over the education department? Could he block her promotion? get her fired completely?
Logan laughed softly and ran a hand over his dark hair. His face grew serious, and once again his fatigue was very apparent. When he spoke, his voice sounded far away, almost vulnerable. “Speeding, maybe? Sure. My motorcycle on a mountain road, fast as it goes. To any place where nobody needs anything from me and where time just passes. Instead of being measured as seconds lost on some unforgiving code room clock. Trees and quiet.”
Claire wished she could take the question back. All at once this felt too personal, too awkward.
“Or pizza,” Logan added, a surprisingly boyish grin crinkling the corners of his eyes. “Pepperoni pizza and country music. That’ll put things in perspective pretty fast.”
They both turned as a woman’s voice wailed in the distance.
“Where’s that coming from?” Claire tensed as the painful and wrenching sound repeated.
“The storage room,” Logan answered.
The nurse at the next bedside began jogging in that direction.
The temporary morgue. Hadn’t Claire seen a light in there when she passed by a few minutes ago? Yes, and it had been quiet. “But didn’t they take that little girl away?” she asked, filling with dread as she remembered the face of the anguished grandmother.
“No,” Logan answered. He turned and broke into a trot, calling back over his shoulder, “We got the okay to remove the tubes, but we’re still waiting for the medical examiner’s deputy to arrive for transport.”
Memories and images from another temporary morgue in Sacramento intruded into Claire’s consciousness, and she struggled to keep them at bay. Then, against an urge to run the other way, she followed Logan toward yet another haunting wail.
When they arrived at the doorway, she saw the nurse slip an arm around a tiny, dark-haired woman’s shoulders. Claire took in the scene in the dimly lit room, her eyes widening as she recognized the woman. Inez Vega, the registration clerk. Sitting in a chair beside an empty gurney, a plastic body bag crumpled at her feet and holding . . . Claire’s breath stuck in her chest. Inez held Amy Hester, the child’s face still and pale, like an earthbound angel. She’d wrapped the toddler in the lavender blanket and was gently rocking her. A rosary dangled from Inez’s fingers and her lips moved silently. She stared up at the ER nurse over Amy’s tousled curls, then over at Claire and Logan.
“This baby’s abuela—her grandmother—wanted her to have this blanket,” Inez said, tears streaming down her face. “Purple’s her . . . favorite color. I didn’t mean to break any rules, but it seemed wrong not to wrap it around her. I keep thinking about my own grandbabies and . . .” Her words faded into a mournful sob as the nurse lifted the child gently from her arms, laid her back on the gurney, and returned to Inez’s side.
More than anything, Claire wanted to let the staff nurse handle things now, be done with her unexpected and unwelcome responsibility to these people, but . . . She turned to Logan and grasped his arm, a rush of tears blurring her vision. “This is your team. I know how you feel about counseling, and I know you want me to just sign off and satisfy administration. But I can’t. These people are hurting, and they need help.”
She let go of his arm and took a deep breath, looking once again at Inez. How many times had this woman quietly ached, after how many shifts? As a peer counselor, Claire couldn’t offer the kind of help Inez needed, but she knew how to make it happen. “I’m calling the social worker to request a full debriefing for your department. Whether you like it or not.”
+++
Running was always a balm for what ailed her. And it was working; Logan Caldwell was fading away. Claire closed the cabin door against the night air and slithered out of the soaking, oversize T-shirt, deliciously dizzy for a moment. A rivulet of sweat trickled between her shoulder blades as she raised her arms to weave her fingers through the long strands of damp hair, lifting them away from her salty skin. Her head floated, disembodied, and her lips tingled as goose bumps rose and drew a shiver. Runner’s high. Endorphins.
She leaned against the wooden door in her racerback tank and running tights, closing her eyes and welcoming the familiar release. Her heartbeat whispered in her ears like the ocean trapped in a seashell. Endorphins were a blessing. Better than music, gooey chocolate, California sand under bare toes, or even the comfort of a warm and snuggly—
Oh, good grief. Claire opened her eyes, then wadded the T-shirt into a ball and hurled it across the cabin’s living room like she was battling an intruder. Why on earth did the thought of being hugged—held, after such a long time—suddenly summon the unlikely image of Logan Caldwell?
She bit back a laugh as the wadded shirt bounced off the wall and onto the scruffy black cat sleeping on the suede couch. He yowled and jerked upright, his only ear flattening out sideways, tail twitching, glaring at her. As usual. Great, a skirmish with Goliath and Demon Cat all in one day. Claire could run to New Jersey and back and not brew enough endorphins to cover that.
“Sorry, Smokey. I’ll fix it. Don’t bite me—I feed you.” Claire crossed the room in two strides, her Nikes scrunching on the plank floor. Unexpected tears threatened as she knelt to gingerly lift her brother’s engine company T-shirt off his cat. The truth was, neither fit her. Not the shirt, not the cat. No matter how much she wanted them to.
She glanced around the living area of the rustic, four-room A-frame: cedar paneling, woodstove, Mexican blanket rug, and a vase of yellow silk daffodils, her one pathetic attempt to add a feminine touch to what would always be a man’s house. Maybe her parents were smarter than she’d been. It didn’t take a shrink to guess that accepting a transfer to Arizona had less to do with old friends in Phoenix and a lot more to do with the pain of their only son’s death. Or to guess it was that very same thing that moved Claire into her brother’s house.
Her gaze traveled to the rough-hewn oak mantel on a wall of river rock behind the freestanding woodstove, topped by a collection of photos she hadn’t had the heart to pack away. The firehouse photo with Kevin mugging for the camera in a Superman T-shirt and red suspenders. Claire and Kevin with their parents at Lake Tahoe for their twenty-fifth wedding anniversary. Claire’s eyes moved to the next photo—framed in hammered tin and draped with her brother’s cross—a grainy black-and-white snapshot of Kevin with his fiancée, Gayle, on the church mission trip to Mexico. Her brother had one arm around Gayle and the other around the shoulders of a dark-eyed orphan. The last frame held Kevin’s favorite Scripture carefully stitched onto vintage family linen by his beloved Gayle:
“For I know t
he plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.”
Jeremiah 29:11
It had been an engagement gift. Claire looked away, the familiar ache making her swallow.
Since Kevin’s death, Claire had attended church infrequently; she couldn’t bear sitting there without him. It seemed easier to read her Bible alone, avoiding inevitable questions about how she’d been coping. Like those questions in recent letters from Gayle, who was apparently moving on with her life. Claire sighed. She was glad for Gayle, but for right now, Claire was better off alone. With her lists and her decisive red pen.
Heal my heart. Move me forward. God knew her plan.
Claire stroked a fingertip warily over the fluff where Smokey’s other ear should have been. Poor beast, he never purred. One of the firefighters figured that a raccoon attacked him, a common confrontation in the California foothills, but nobody would ever really know for sure how Smokey lost that ear and became so skittish.
Kevin couldn’t have known, either, that shortly after adopting Smokey he’d be gone, leaving his sister with the demented cat, a house in the woods, and just enough insurance money to help fund her bachelor’s degree in nursing education and pave her way out of the grim reality that was the ER. For a job opportunity that was still on hold because she’d been derailed by . . .
Claire hugged the damp T-shirt against her chest. The irony struck, making her stomach churn. Despite all her hard work and after endorphins by the quart, none of her troubles had faded away. Not a one. She’d simply run full circle. Back to the ER and smack into new turmoil with Logan Caldwell.
At 10:30 p.m., Claire picked up the phone, touched the first three numbers, then hit the End button and set the phone down. It was the second time she’d done that in half an hour. She took a sip of her chai tea and swung her legs up onto the bed. It was far too late to page the social worker again. The staff debriefing was scheduled, and it was best to leave things the way they’d been arranged.
“Right, Smokester?” Claire nodded at the lanky cat stretched across the foot of the double bed.
He raised his head and quit his silent kneading of the snowy comforter. His yellow eyes fixed on her big toe, and Claire gave it a risky wiggle, proving beyond a shadow of a doubt that she’d traded endorphins for insanity. Which would explain the continuous intruding thoughts of Logan Caldwell.
She groaned. She was acting like she was . . . what exactly? Attracted to him? Claire pressed her palms against her eyes. No. The last thing she needed was any more confusion in her life, any risk of losing the equilibrium she was fighting to maintain. And—
“Hey!” Claire jerked her foot away as she felt the dangerous brush of Smokey’s whiskers against her toe.
She shook her head, and her just-washed hair trailed across the shoulders of the pink pajama top. Close call—she’d almost been bitten. Good point: she needed to be just as careful about the medical director. Logan did nothing but dredge up painful reminders of Kevin, her humiliating last days as an ER nurse, and even her pitiful track record with men. It was best to avoid him, and that would be easy now that Social Services was taking over.
She reached for her shell-embossed teacup, and her gaze dropped to the business card next to her open Bible. It was for the social worker who would lead the debriefing tomorrow afternoon. Claire would take a minor role this time, letting Social Services and the hospital chaplain handle the real guts of the process. The nagging doubt resurfaced and Claire glanced at the phone again. She swallowed a sip of the creamy sweet tea, waiting for the feeling to pass. It had been pestering her for the last several hours. Am I making a mistake?
No. Absolutely not. Logan didn’t have to be at the debriefing. Wasn’t that what she’d told the social worker earlier? She’d been right. The people most affected by the injured children—the ones at risk for post-traumatic stress—were the nonphysician staff, nurses, aides, and technicians. And Inez Vega.
Claire rested the warm cup against her cheek. Her breath escaped in a soft sigh. As much as she’d tried not to, she kept seeing the image of that poor woman crying in the dim light of the temporary morgue. She wondered about the kind of person who cared enough to leave her normal world, the safety of an office cubicle, to venture into a place so full of chaos and pain. About the risk it was, the heart it took, to wrap a blanket around a dead child.
Then she thought of Logan Caldwell riding his motorcycle as fast as he could away from all that. And the way he’d talked about “shrink-to-fit,” touchy-feely counseling, about being tough and priding himself on not crumbling. But mostly Claire kept replaying over and over in her mind what he’d said about . . . weak links.
It had taken guts for Erin Quinn to defy him and call for peer counseling to help her staff. The same kind of dedication prompted the already exhausted Sarah Burke to volunteer for an extra shift, and Claire knew in her heart that Inez Vega was no weak link.
She swallowed the last of her tea and picked up the phone. Her foot tapped nervously against the down comforter as her call was transferred to voice mail.
“I’m sorry to be calling again so late,” she said, her stomach sinking faster than her foot could tap. “But I was wrong earlier. The medical director needs to be at the debriefing tomorrow.” Her foot tapped faster as she pictured herself squaring off with Goliath. “It’s his day off, but have administration page him and say Claire Avery insisted.”
She smothered a yelp as Smokey bit into her toe. “Dr. Caldwell is a big part of the problem.”
Chapter Four
Logan nosed the Harley into a physician’s parking space, then let his boots slide from the pegs and down to the asphalt, straddling the idling engine.
As he peered through the visor of his helmet at the brick and stucco back entrance to Sierra Mercy Hospital’s ER, he weighed his options. Cell phone messages failed, didn’t they? Who could prove he’d ever received notification of this Critical Incident Stress Debriefing? If he’d been thirty minutes deeper into the Sierra Mountains, he’d be out of phone range and on the threshold of granite slabs, roaring waterfalls, towering pines, and quiet escape.
It was his first day off in seven, and he shouldn’t be here. The week had been brutal and not only because of yesterday’s day care incident. Logan’s throat tightened at the thought of the toddler he’d worked so hard to save and the always awful moment of telling parents a child was gone—no, you had to say the word died to make it real, final. To leave no merciful hope. “I did everything I could, but Amy died.”
And he had done everything, even taken over the cardiac compressions himself, pressing the heel of his hand over and over against her little chest, willing the child to survive. Not wanting to quit, all the while knowing that was irrational. Even if he could have started her heart, she’d been robbed of oxygen too long to survive without devastating brain injury. Logan grimaced, remembering the stricken faces of the child’s mother and grandmother and the way the young father slammed his fist against the wall, his cry like a tortured animal. Ah, man.
He swallowed hard, pushing aside the memory. On his way back to the hospital, he’d passed the charred Little Nugget Day Care, its fence now adorned with flower bouquets, letters from children, stuffed animals, and at least a dozen purple balloons. But it wasn’t only the day care incident that was weighing on him. It was the continuing frustrations of limited staffing, the song and dance it took to get money budgeted to replace outdated equipment, and the need to jump through ridiculous hoops to comply with every new federal, state, and HMO mandate. He’d become a doctor to help people, make a difference in lives, and that shouldn’t take a backseat to anything.
Logan gave the throttle a twist and felt his bike respond, proving its readiness to transport him away. The political problems weren’t any worse than the personnel issues coming across his desk this week. Complaints: that agency nurse threatening to walk out yesterday because . . . What had she sai
d to Erin? “Dr. Caldwell is a slave driver and an inhuman beast.” Not his first complaint. Nor his last. It took time and effort to shape an effective medical team, and there would be a certain attrition rate. So be it.
Reaching down, Logan cut the bike’s engine. He pulled off his helmet and shoved the keys into the front pocket of his jeans. His fingers brushed against a worn and folded sheet of stationery. The invitation to Beckah’s wedding. Only a couple of weeks away now. Another reason he needed to escape today.
But instead of pines, fresh air, and solitude, he’d be sitting in a dank staff conference room. With hospital coffee and tense, nervous chatter. Being debriefed, for what that was worth. Maybe he could head some of it off at the pass and keep the inevitable psychobabble down to a dull roar. He’d meant what he’d said to that educator about dwelling needlessly on tragedy; it only made matters worse. Logan knew that better than most people.
Claire Avery was the one who’d insisted on his attending this meeting, and she’d be there. For some reason, that made the next hours seem almost bearable. He smiled, remembering the beautiful dark-haired woman and the way she’d gone toe-to-toe with him in the ER yesterday, with that determined lift of her chin when she faced him and the flush rising to her cheeks. Logan’s smile faded as he recalled the incident afterward in the temporary morgue. Inez and the toddler. Claire’s eyes filling with tears, followed by her decision to call for a staff debriefing.
He had no doubt she felt she was doing the right thing, just as Erin did with her efforts to support staff with the Faith QD meetings. The problem was that those things, no matter how well-intentioned, didn’t work. He’d learned the hard way that there was no pamphlet and no prayer with the answers. When bad stuff happened, you had to tough it out and soldier on. Simple.
That and keep Mountain Mike’s Pizza on speed dial.
+++
Claire took one look and knew Logan had been out on the bike. He arrived in the conference room at the last minute, wearing a black leather jacket, motorcycle chaps over his jeans, sunglasses, and the shadow of a beard. Along with a barely suppressed smirk aimed directly at Claire. He sat down in the empty chair directly opposite her.