“Go to triage. Tell them what we’ve got, while I see if I can get him looked at sooner.”
Cal called Jessica’s name, just as she was about to disappear behind a set of sliding doors. When she turned, he rushed over, ignoring the pain in his leg, the boy still in his arms. “I need your help.”
She looked at the boy, then at him with alarm. “What happened?”
“He wandered away from his house and fell down a service shaft. I’m worried about his heart rate and respiration.”
Jessica motioned for Cal to follow her into the emergency area. She checked a couple of curtained cubicles until she found an empty one and waved for him to place the boy on the bed. She checked his vitals; her hand shook as she brought the stethoscope to his chest. Her eyes were wide and round when she spoke. “He’s going to need surgery for the arm. It’s badly broken. I think he’s got a collapsed lung, too, and likely needs a chest tube. He...has to have help, and quickly,” she said before hastening out of the cubicle.
“Where’re you going?” Cal yelled. He wanted to run after her, but the boy’s breathing was getting worse by the minute and he didn’t want to leave him.
Where on earth was she going? She’d confirmed that the kid needed help fast—and then she just takes off?
He stuck his head out of the cubicle. “I need assistance here!” he bellowed down the corridor. “I’m a police officer. I have a boy here who needs aid now.”
Before he could decide what else he should do, a tall, slim man in hospital scrubs and a lab coat, with a stethoscope hanging around his neck, trotted toward him. “Are you the cop with the injured boy?”
“Yes, but...” He scanned the corridor for Jessica.
“Then let’s have a look at him,” the doctor said briskly.
Cal stepped outside the cubicle to make room for the doctor, and did one final scan of the emergency room area for Jessica. She was nowhere to be seen. The female cop, however, was jogging toward him.
“I take it you bypassed the triage altogether,” she said when she reached him.
“He needed help right away.”
She nodded. “I get that. I gave them the particulars so they could open a chart on him.”
“Yeah. Thanks.” He couldn’t stop wondering what had happened to Jessica. If she went to get another doctor, why hadn’t she come back? Couldn’t she see the rough shape the boy was in? He could’ve used her expertise in both trauma and pediatric surgery. But Jessica still was nowhere in sight.
The male doctor did a quick assessment, and a flurry of activity ensued.
The boy was under their care now. Cal and the other cop had done all they could here and they should head out, but he was still confused about Jessica. Where was she? What if her desertion of the young boy had cost him his life?
“Officer Palmer, did you hear me?”
“Sorry. What?”
“I asked if you’d be able to put in a good word for me with my sergeant. Collins, that’s the other cop, he’s pissed big-time about us transporting the boy in the cruiser. He’s going to want his pound of flesh from me for going against the rules.”
“Yeah. Sure.” Hearing noises, Cal turned back to the cubicle where the kid was. The doctor, aided by two nurses, was pushing the gurney rapidly down the hallway. Cal knew enough about the configuration of the hospital to realize they were taking him to the surgical suite.
And, he wondered again, where Jessica was, if she was the best?
CHAPTER SEVENTEEN
JESSICA HAD TROUBLE breathing and her head was pounding. She’d left the emergency room and run to a staff washroom, locking herself inside. She leaned back against the door, closed her eyes and waited for her heart rate to settle.
She’d nearly fallen apart. What was she thinking? She had fallen apart. The little boy, barely breathing, had reminded her so much of Jake—the boy whose death she still felt responsible for. She was terrified to provide care or make any decisions about his well-being. She was petrified that her actions could have been fatal for him. In that panicky moment, she hadn’t considered that with the boy’s life hanging by a thread, her inaction could have done the same thing.
The look Cal had given her when she’d glanced back as she was rushing away was a combination of fury and disbelief. And the last thing she’d seen as she turned to run was disappointment. Still, his reaction couldn’t come close to the self-loathing she felt. As a doctor, hadn’t she sworn to treat the ill to the best of her ability?
Over the past few weeks, she’d learned enough about Cal to know that he’d expect an explanation from her.
How was she going to explain her failure to Cal, to Richard? She never spoke about Jake anymore, and she didn’t want to talk to Cal about him, either.
And most importantly, how was she going to live with herself—especially if the boy didn’t make it?
After splashing cold water on her face, Jessica left the staff washroom. First she went to the emergency room nurses’ station to check on the boy’s condition, then made her way up the stairs and to her office.
She was furious with herself. She hadn’t even had a chance to become emotionally involved with the boy and she still couldn’t cope. Despite the age difference, he reminded her so much of Jake. Not just his overall appearance and coloring, but the fact that there was a serious arm injury. She remembered Jake had a sling on his arm, too, when the ambulance had first brought him in.
Her running away could have been a matter of life or death for the boy. She’d learned that he’d gotten a chest tube and been taken to surgery. She’d been right about the need for both, but being right meant nothing if she couldn’t help him.
Thank God he was getting the care he needed. Morris was an excellent doctor and a competent surgeon. At the moment, she couldn’t say the same about herself. The boy would be okay, she tried to assure herself. That was what mattered most.
She skirted the trauma unit nurses’ station, not wanting to talk to anyone. She let herself into her office, closing and locking the door behind her before anyone realized she was there.
The potential consequences of what she’d done appalled her.
She sat down and rubbed her temples. She had to wonder if she’d made the right decision by staying in medicine.
She’d have to tell Richard what had happened. If she didn’t, she suspected he’d hear about it from someone else. She didn’t think she could remain at the hospital.
But maybe there was another option. She’d decided against it in the aftermath of losing Jake. Maybe now she needed to rethink things...
She had a department meeting in half an hour that she couldn’t miss. She hoped she could pull herself together by then, but it gave her some time. She turned on her computer and entered the key words— “organizations providing doctors to developing countries.” The search engine quickly produced “about 123,000,000 results in 0.83 seconds.”
She groaned. Narrowing her search down to South and Central America produced “about 44,700,000 results.”
Scrolling through a few pages showed her that there was no shortage of need for doctors across the globe.
If there was one thing she understood about herself, it was her own inability to remain emotionally detached. Years ago, she’d kicked around the idea of working overseas; that was when she was first grappling with the feelings of guilt and inadequacy following Jake’s death. She’d considered joining one of the organizations that sent doctors to developing countries around the world to provide much-needed essential care. She hadn’t thought about it since she’d switched to trauma, but now that it seemed her decision paralysis had resurfaced and might have put a patient at risk, her options might well have narrowed down to reconsidering overseas work—or leaving medicine altogether.
She thought of Kayla and how the possibility of inadvertently hurt
ing her had scared her to death. And now, with what had just happened with the boy Cal had brought in... She couldn’t risk having that occur again, not to Kayla or to any other patient, young or old.
Working overseas, she’d be providing basic first aid—vaccinations, health education, stitches, helping with routine births. Nothing life-threatening that she couldn’t handle from an emotional perspective. She would travel around, visit remote villages that didn’t have access to health care. That kind of assignment would be ideal.
She stared at the daunting results of her search. If she was genuinely serious about exploring this, where should she start? And how would she know if an organization was reputable and credible?
She did another search for international aid organizations with headquarters in California, if for no other reason than to keep her mind off everything that was haunting her.
With a little more effort, she came across one organization, Care Across Continents, that had its corporate office in San Diego. Care Across Continents was an organization similar to Doctors Without Borders. It interested her, and after some more digging, she discovered that one of its board members was a former university professor of hers. She’d always liked Harold Massey. What better way to learn about the organization, to find out whether she’d be a good fit, than to meet with a long-standing director?
She chewed on the tip of her pen while she waited for the phone to be answered. When an elderly sounding lady picked up the phone, Jessica asked for Dr. Massey. She was told he wasn’t in the office. Jessica explained why she was calling, and she was given an appointment to see him the following Monday.
When Jessica hung up, she felt excited and panicked at the same time. She’d initiated the process, and she knew it was the right thing for her. She wouldn’t let anyone—not her parents, her friends or Cal—talk her out of doing this.
She rubbed her temples with her fingertips, but the headache that had been raging there was now only a dull ache.
If all went well during her meeting with Dr. Massey, she’d submit her application for a foreign assignment with Care Across Continents right there and then.
And at least temporarily, she’d managed to get her mind off the incident earlier that day.
* * *
AT THE END of his shift, Cal swung by the hospital. Learning that Jessica had left, he drove directly to her home. The kid he’d rescued was going to be okay. He was assured of that while he was at the hospital. But it was no thanks to Jessica. He needed to understand what had happened there.
He thought about leaving Scout in the back of his truck with the cooling system on, but decided to bring him along instead.
He knocked on Jessica’s door.
After knocking a few more times, he went back to her driveway and looked through a small decorative window in her garage door. Unless she’d gone out for a run or a walk, she was home since her car was in the garage.
This time he used more force, banged on the door, and didn’t stop until she finally opened it.
“What the...” he started, but the words died in his throat when he saw her. Her hair was still tied back, but it was disheveled, with strands sticking up all over. Her eyes were red-rimmed, and he suspected she’d been crying, but what concerned him the most was her color.
Her normally tanned skin was pale as alabaster.
“Hey!” He reached out for her, cupped her elbow with his hand and led her back inside. “You okay?”
She nodded listlessly, which did nothing to reassure him. “Here.” He guided her to the sofa. “Sit down and I’ll make you a cup of tea.”
“No, thanks. I’m fine. Really,” she said in a reedy voice.
His burning anger over what she’d done at the hospital was doused by his concern for her. She must be sick, he speculated, and that was why she’d rushed off and left the boy the way she had. “Are you ill?”
She shook her head.
It wasn’t making sense to him. “If you’re not ill, then what? What happened at the hospital today?”
She lowered her head into her palms.
Cal patted her back reassuringly. “Tell me what’s wrong,” he coaxed. “What happened today?” he asked again.
“I can’t...”
“Can’t what?”
“I... I can’t talk about it. The only people who know are my parents, some of my colleagues and the hospital administration. In all the years since I made the switch, I hadn’t confided in anyone else.”
“The switch?” He was trying to keep up with her. “You mean this has something to do with leaving pediatrics and moving to trauma?”
Her eyes filled with tears as she nodded.
“Help me understand,” he coaxed, as he passed her a box of tissues from the side table.
She was silent for a long moment but finally whispered, “Maybe it’s time I talked about it.” She paused, and gulped audibly. “I lost a patient,” she said so softly Cal had to lean in to hear her.
“I’m sorry, Jess.” He reached for her hand and held it. “Not too many people outside your profession would understand how that must feel, but as cops we have to face that sad reality sometimes, as well. Not being there in time to save someone. Unfortunately, it happens, despite our best efforts. We can’t save everyone.”
* * *
JESSICA UNDERSTOOD THAT he was trying to help, to make her feel better, but his comment cut deep. She felt her muscles tense. In her case it had been just the opposite. It wasn’t that she couldn’t save Jake. She was responsible for his death.
She tried to tug her hand back, but he held tight. “You don’t understand...”
She couldn’t continue. She lowered her head again and squeezed her eyes shut.
“I lost a friend once.” Cal filled the silence. “Todd was a good cop. He got called out to a domestic disturbance. Usually we don’t respond to domestics on our own. They’re often...problematic. But the 9-1-1 caller sounded desperate. Todd was closest and arrived in a few minutes. I was maybe twenty minutes away, normal driving time. I made it there in less than fifteen.
“It was too late. When Todd attempted to restrain and arrest the husband, the wife—the 9-1-1 caller—stabbed Todd in the back with a kitchen knife. Her aim was deadly.” Cal shook his head. “The wife had the crap kicked out of her by the husband, and she still tried to protect him.”
Jessica raised her head, and her eyes met his. She swallowed the lump in her throat. She understood the psychology of abused women. She knew a little about it from her classes in university, seen it firsthand with some of the patients in the emergency department. She covered their joined hands with her other hand, and it was her turn to momentarily give comfort. “I’m so sorry...”
“It was a long time ago. I’ve...well, I haven’t accepted it. I doubt that you can ever accept something like that. But I’ve learned to live with it. I just wanted you to know that if anyone can understand, I do.”
Jessica shook her head sadly. “No. I don’t think you can.”
She saw the flicker of hurt in his eyes. He’d shared an obviously painful memory with her, trying to make her feel better. Maybe, as she’d said earlier, it would help if she talked about it.
“It isn’t the same,” she began. “You couldn’t have done anything other than what you did. As tragic as it is, you didn’t have a chance to save him because you weren’t there.” She paused, willed herself not to let the tears fall.
“My situation was different. I could have saved the boy. Should have!” There was vehemence, anger, pain—she could hear it all jumbled together in her voice. She broke eye contact. It would be easier to tell him without looking at him, not seeing the judgment or censure that was sure to come.
“I was performing a procedure on a young patient and it went horribly wrong.” Now she did pull her hands back. Sh
e clasped them together, scraped at one thumbnail with the other. “Jake was under my care. He was a vivacious, athletic, previously healthy thirteen-year-old boy who sustained a deep-tissue infection in his arm. The infection was a rapidly spreading strep necrotizing fasciitis.” Realizing he might not know what that meant, she glanced up briefly. “He was playing football and tried to catch the ball in the end zone. He caught it high in the air, but landed hard on his side and past the end zone. There was a rusty, old survey stake in the ground and it tore through the fleshy part of his upper arm. He got strep—an infection—as a consequence.”
She rose and moved away from him to stare out the window. “With the spread of the infection, the hospital’s chief of surgery suggested it would be advisable to amputate the limb. Jake’s parents—Jake himself—begged me to save his arm. They thought he was good enough at sports and loved it enough to go pro. I couldn’t help caring about this bright, engaging young boy.” She turned to face Cal, and her vision blurred. “How could I not?”
In order to continue, she had to turn away again.
“The decision as to whether the arm should be amputated was ultimately mine, once I assessed the extent of the infection during the surgical procedure. I had to decide whether I could get all the infection out and save the boy and his arm. Or if the infection was too advanced, I’d have to amputate the arm to save Jake’s life.”
She pressed her lips together. She could remember standing in the bright glare of the operating room lights as she debated that very question for interminable minutes with her surgical team standing by. She could see Jake’s face—the mop of bright red hair, light smattering of freckles visible across his cheeks and the bridge of his nose above the oxygen mask. The image was so real, as it always was whenever it came to her, awake or in dreams, she could almost count the freckles. She wrapped her arms around her torso to fight off a terrible chill.
“I... I decided to save the limb. The procedure was successful. Jake and his parents were elated. They were grateful...so grateful. They sent me a huge fruit basket that I shared with the team. All of them loved Jake. It was impossible not to.”