Could I Have This Dance? (27 page)

“It was only a stupid emotion, Della. We don’t know. We never have. And we don’t have any reason to suspect it now.”

“Why are you so afraid? It was a long time ago.”

“That’s right. It was a long time ago. There’s no benefit in bringing this up now.”

“You’re avoiding my question. Why are you so afraid?” Della asked.

“And you’re not?”

“Maybe I am, but I asked you.”

Jimmy looked at the closed door leading to his house. His wife, Fiona, was there preparing supper, soup or a fruit plate perhaps, just as she had for every Sunday evening as long as he could remember. “I’ve never shared this with Fiona. This would devastate her.” He sighed deeply, exhaling into the phone. “Look, Della, I’m about to retire. News like this would taint my career. I’ve given my life to this town. Rumors spread like fire in this valley. I’d be ruined.”

“And what about Wally? Aren’t you concerned about him?”

“Sure, I am. But there’s little I can do. The man won’t see a doctor. And we know what his problem is. He’s fried his brain on the same liquor that has been the undoing of too many men around here.”

“So why did you tell me this? What can I do?”

“Talk some sense into Claire. Convince her to stop her crazy search.”

“She won’t listen to me. That should be obvious by now. I told her not to talk to Elizabeth, and she went right on. The girl has a mind of her own.”

He cursed. “You can try.”

“It won’t do any good. And what am I to do with this information about Steve Hudson? I can’t tell this to Wally. He’s in no condition to deal with news like this. Yesterday he went to get the mail without his trousers on. And he peed all over the carpet this morning. I don’t know what I’m going to do with him.”

“He’s going to need a nursing home.”

Della started to cry. “He won’t go. And how can I afford that?”

This conversation wasn’t going the way he’d planned. “Della. Something will work out. Certainly Elizabeth would care for her own son, wouldn’t she?”

“I—I hope.”

“Don’t cry, Della. Something always works out. I didn’t call to upset you. I just, well, I just hoped we could keep Claire from asking so many questions.”

“Claire’s my daughter. And she’s smart. Smarter than I ever was. Hopefully she’ll avoid the mistakes I made.” She sniffed. “If Claire has a medical explanation for this stupid town curse, maybe we should listen.”

“Let her keep talking then, Della. People are going to get hurt. And not just in your family. These things have a way of ripping communities apart.” He paced to the phone cord’s limit, looking first into an exam room, and then back toward his desk. “And I don’t need to remind you how jealous Leon McCall is over the McCall fortune. His lawyers would certainly find a way to keep the money away from anyone who isn’t a blood McCall. And it sounds like Wally’s going to need that money. He’s gonna need that money soon.”

There was an uncomfortable pause. “I’ll talk to Claire, Jimmy. But I can’t promise anything.”

He heard a click. He laid the phone down and put his head in his hands before heading to the medicine closet again.

Chapter Eighteen

S
ierra Jones was hit by a drunk driver while riding on her new bicycle on Claire’s last night of trauma call. It was Sierra’s seventh birthday. The bicycle was a gift from her father.

At eight-thirty, Claire stood anxiously awaiting the patient’s arrival. The team had gathered after receiving notification by the Lafayette paramedics that an unstable patient was en route.

She glanced at the other members of the team. Nervous laughter punctuated their conversation. Everyone was pacing, milling around the empty stretcher, unable to still the anxiety that accompanied the knowledge that soon, very soon, a child’s life would be in their hands. Claire sensed an unspoken heaviness that seemed to hover each time they cared for one so young. Adults, she supposed, mostly were in trouble because of their own choices. They drank. They took chances.

But children were different, at least for Claire. Their innocence captured her. Their cries, which rose from their ignorance and the fear of events unfolding around them, tugged on her heart like an adult’s never could. And worst of all, there was little margin for error. Children bled to death quicker, occluded their small airways faster, and coded sooner than their adult counterparts.

As Sierra arrived, the team began a symphony of critical care. The paramedics had been unable to start an IV, and a quick assessment revealed her peripheral veins were flat.

“Should we do a cutdown?” Claire pulled a flexible plastic tourniquet off of the patient’s arm. “There are no IV sites available.”

“I’ll do a central line,” Basil offered. “I’ll use the ultrasound.”

Claire leaned over the little girl and smiled. “Hi, Sierra. I’m Dr. McCall. We’re going to help you. Do you hurt anywhere?”

“My tummy hurts. And my arm.”

Claire carefully explained everything that was happening to her young patient. “Don’t try to move, Sierra. You’re neck is in a brace until we know it’s okay.”

Basil inserted a large-bore central venous line while the O-man did a primary survey. “Her lungs are clear. Her heart is tachycardic. Her abdomen is distended and tender throughout. Pelvis is stable. Left arm is abraised, tender above the elbow. Knees are abraded. No malangulation of the legs.”

Deb Parrish called out the vital signs. “B.P. sixty systolic. Heart rate 170.”

Dr. Overby gave the orders. “Let’s get a hematocrit, amylase, liver functions, and urinalysis. Type and cross for six units and give five hundred cc’s of lactated ringers stat!” He looked at Claire. “She’s going to need a CT of the abdomen. I want you to stay with her. Go over the scan with the radiology resident and call me. And arrange an ICU bed. She probably has a ruptured spleen, maybe a liver crack.” He looked at an X-ray technician. “Get a portable chest and c-spine film before she goes to the scanner.”

The team responded. Claire squeezed the IV bag and watched the heart monitor. Sierra’s blood pressure came up to eighty-five after the IV bolus.

“Careful,” the O-man cautioned. “Let’s not overdo it. Her normal blood pressure may not be much more than that.”

Claire put her face close to the patient’s. “Can you tell us what happened?”

“I was riding my bike on the sidewalk. A man in a red car ran into me.” Her chin quivered. “He smashed my new bike.”

“I’m sure it can be replaced, honey.”

“It was my favorite color. Purple. And it had a bell and a handlebar bag.”

“It sounds wonderful.”

“I got it for my birthday.”

“How old are you?”

“Seven.”

“Happy birthday, Sierra.”

“How did you know it was my birthday?”

“The men on the rescue squad radioed ahead, and told us about you. They said it was your birthday.” Claire looked up to see Cliff, the ward secretary, standing at the foot of the bed.

“Her family is in the waiting room. Can you talk to them, Dr. McCall?”

Claire looked at Basil. He nodded. “You talk to the parents. I’ll set up the CT scan.”

She walked into a crowded waiting room where she met Roger and Celia Jones. Mr. Jones was wearing a blue workman’s jumpsuit with his
name embroidered on the breast pocket. His hair was blond, and he had black grease on his hands. He put his arm around his wife, and his other around two boys, who looked to be preschoolers.

Mr. Jones looked at Cliff, who had escorted Claire to the waiting room. “I thought you said you would bring out the doctor.”

Claire ignored his comment. “I’m Dr. McCall. I’m helping take care of Sierra.”

“You’re a doctor?”

She nodded. “An intern.” Claire watched as the parents exchanged glances.

The father spoke again. “How is she?”

“She seems to have stabilized. We need to do some tests.”

Mrs. Jones frowned. “Tests?”

Claire nodded. “A CT scan of her abdomen. We want to check for internal injuries.”

“I want to see her.” The father stepped up, breathing down into Claire’s face. “Now.”

She stepped back. “Why don’t you come back with me, and you can see her for a few minutes until she goes to get her CT scan.”

Claire led the family back into the first trauma bay just as they were hooking Sierra up to a portable monitor for her trip to the scanner. Mrs. Jones rushed to her daughter’s side. “Sierra, we’re here, honey. Everything’s gonna be all right.”

Mr. Jones took his daughter’s hand.

Basil Roberts, the second-year resident, spoke. “They’re ready in the scanner, Claire. Josef will help you with transport.”

Claire nodded. Baby-sitting trauma patients in the CT scanner was old hat to her by now. “Let’s move.” She spoke to the parents. “You can come as far as the radiology waiting area, then you’ll have to leave her with us.”

The father looked at Basil. “Aren’t you going with them?”

“Sierra’s in good hands.”

Claire smiled. “She’s going to be fine. Let’s go.”

Josef and Claire pushed the stretcher down the corridor toward the scanner, with Mom, Dad, and two younger brothers trailing. Once they were in the CT suite, Claire pointed to some chairs and a magazine rack. “You can wait here by the entrance.”

Roger Jones gripped his daughter’s hand. “Can’t I go in there with her?”

The CT technician saved Claire from the confrontation. Shaking his head, he pointed to a radiation symbol on the door to the scanner. “Sorry, hospital policy. No family members can be in an area where they can be exposed to radiation.”

“We’ll be watching her through a glass window,” Claire explained.

Her mother’s hand went to her mouth. “She’ll be alone?”

“We’ll be with her, just a few feet away. And there’s a speaker so we can hear everything she says.” She watched them for a moment, understanding how hard this must be for them. “She’s going to be fine.”

Mr. Jones put his hand on his wife’s arm. “Come on, honey. Sit down.” He looked at Claire. “Take good care of our baby.” He leaned down and kissed his daughter. “We’ll be right out here, Sierra.”

“Okay,” Claire responded, wheeling the stretcher through the open door. She looked back at the parents. “We should only be a few minutes.”

Claire, Josef, and Ron, the CT technician, hoisted the patient from the stretcher to the CT table. Josef positioned the IV pole at the head of the CT table, and Claire adjusted the monitor so it would be visible from the control-room window. She looked at Sierra, whose eyes were wide with fear. “Don’t be afraid, Sierra. You will feel the bed move, but you shouldn’t feel anything else. When you hear the instructions, you’ll need to hold your breath. It won’t take very long, I promise.”

“I’m cold,” Sierra complained.

Ron responded by placing a white blanket across her. “Here.”

Claire checked the blood pressure again. It was down to sixty-five systolic. She adjusted open the IV fluids and looked at Josef. “Better run up to the blood bank. Bring me a unit of blood. If they haven’t got her typed yet, bring O negative.”

Josef nodded and jogged off.

Claire settled into a padded office chair on wheels in the control room. Beside her was Dr. Wendy Carrico, a third-year radiology resident, and in the control seat, Ron Burris typed in the patient information. Claire looked out at the cardiac monitor. Sierra’s heart rate was 150.

After the initial adjustments, the scanner was ready.

A recorded voice filled the control room and projected into the scan room. “Hold your breath. Don’t breathe.”

The CT table whirred to life and moved the patient through the large circular opening at the end of the scan table.

Twenty seconds passed. The recorded voice returned. “Breathe.”

As the images appeared on the computer screen, Claire looked at Wendy and rolled her eyes. They had shared many hours together since July first.

Wendy smiled. “What is it now?”

“Oh, you should have seen this girl’s father sizing me up. When the ward secretary brought me out to meet them, he says, ‘I thought you said you were bringing out a doctor.’”

“Chauvinists,” Wendy mumbled, and poked the technician’s ribs.
“That’s why I send Ron here out to explain the scan results. I hate to keep saying, ‘I am the doctor.’”

Ron grunted and mumbled something about being outnumbered, then pointed at the image on the screen. “Wowser! Look at this liver. It looks like this girl went a few rounds with the champion and lost.”

Wendy and Claire looked carefully at the images, slowly bringing up consecutive pictures beginning at the lung bases and scanning all the way through the pelvis. Wendy put her finger on the screen. “Look here. This is at least a grade-four liver laceration. It looks like this crack goes all the way back to the cava.”

“What’s all this?” Claire pointed to an area of solid color inside the bony pelvis.

“It’s fluid, Claire. And lots of it. And in the presence of that liver lac, I’d say we have to assume it’s blood.”

“How’s the spleen?”

“Back up to the first few cuts.” Wendy rubbed her chin. “It looks fine. There’s fluid around here, but I don’t see any evidence of splenic rupture. The fluid around the spleen is probably blood from the liver.”

Claire picked up the phone and dialed 0. “Could you page Dr. Overby for me?”

She laid down the phone and studied the image on the screen for a few moments longer. “Can you tell if the kidneys are okay?”

Wendy pointed at two bright dots on the screen. “Yes, here’s the ureters with contrast in them. That tells you the kidneys are getting blood flow.”

The phone rang. Claire picked up. “CT. Yes. I think you’d better look at this scan. The girl has a grade-four liver lac.” Claire held the phone away from her ear and whispered to Wendy. “I think he’s upset.” She heard a loud click. Claire shook her head. “The O-man must have been hoping for a quiet night.”

Ron pointed through the window toward the cardiac monitor. “I think you better check that thing. Looks like a lead may have popped off or something.”

Claire looked at the monitor. The EKG complexes were wide and rapid. She wasn’t sure, but it certainly looked like ventricular tachycardia. She pushed past the technician and into the scan room. Sierra was blue and there was dark blood around her chest, darkening a circle on the white blanket and dripping on the floor in a crimson pool. “What’s going on?” Claire yelled a little too loudly. Panic gripped her. She looked back to the control room and yelled, “Call a code!”