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She struggled through her mental procedural list, thought she was doing a fairly good job of it, all things considered. That was, until she noticed the sizable wrinkle that sprang up in the middle of the bed and crept all the way to the right side. How had that gotten there? she wondered as she tugged at the sheet from the opposite side, trying to smooth it out and, in effect, making the darned thing even worse.
“That could be uncomfortable, if you’re the one who has to sleep on it,” Damien commented from the end of the bed, where he was standing, arms folded across his chest, watching her struggle. “Causes creases in the skin if you lay on it too long.”
“I intend to straighten it out. Maybe remake the bed.” Actually, that was a lie. Her real intent was still to pat it down as much as she could, then move on to the next bed and hope the future occupant of this particular bed didn’t have a problem with wrinkles.
“You know you’ve been working on this first bed for ten minutes now? Alegria would have had all five beds changed in that amount of time, and been halfway through giving a patient a bed bath. So what’s holding you up? Because I have other things for you to do if you ever get done here.”
“This is taking a little longer because I’m used to fitted sheets,” she said defensively. Her response didn’t make any sense, not to her, probably not to Damien, but it was the best she could come up with, other than the truth, which was that she just didn’t do beds. How lame would that sound? Top-notch doctor felled by a simple bedsheet.
“Fitted sheets—nope, no such luxuries around here. In fact, our sheets are all donations from some of the locals. Used bedsheets, Juliette. The very best we have to offer. Rough-texture, well-worn hand-me-downs. But I’ll bet you’re used to a nice silk, or even an Egyptian cotton, maybe a fifteen-hundred thread count? You know, the very best the market has to offer.”
Who would have guessed Damien knew sheets? But, apparently, he did. And, amazingly, what he’d described was exactly what she had on her bed back home. Nice, soft, dreadfully expensive sheets covering a huge Victorian, dark cherrywood, four-poster antique of a bed. Her bed and sheets—luxuries she’d thought she couldn’t live without until she’d come to Costa Rica, where such luxuries were scarce, and only for those who could afford to have them imported. Which her father would do for her, gladly, if she asked him. Although she’d never ask, as that would build up his hopes that she was already getting tired of her life in Costa Rica and wanted her old life back. Back home. Same as before. Returning to her old job. Taking the position as her father’s chief administrative officer. Yes, that was the way his mind would run through it, all because she wanted better bedsheets.
OK, so she was a bit spoiled. She’d admit it if anyone—Damien—cared to ask but, since he wasn’t asking, she wasn’t telling. Not a blessed thing! “The sheet you’re describing would have cost a hundred and twenty times more than all the sheets in this ward put together. And that would be just one sheet.”
“Ah! A lady with a passion for sheets.” Damien arched mocking eyebrows. “I hope that same passion extends to your medicine.”
“You mean a lady doctor who’s being interrupted while she’s trying to do her job.” She regarded him for a moment. Well-muscled body. Three or four days’ growth of stubble on his face. Over-the-collar hair, which he’d pulled back into a ponytail, not too unlike her own, only much, much shorter. Really nice dimples when he smiled. Sexy dimples. Kissable dimples... Juliette shook her head to clear the train wreck going on inside and went back to assessing her overall opinion of Damien Caldwell. He was stunningly handsome, which he probably knew, and probably used it to his advantage. Insufferably rude. Intelligent. Good doctor.
“Does it bother you that I’m watching?” he asked.
“What bothers me is that you think you know all about me through my bedsheets. You’re judging me, aren’t you? You know, poor little rich girl. Never changed a bedsheet in her life. That’s what you’re thinking, isn’t it?” Judging her based on what she owned and not what she could do as a doctor.
“I wasn’t but, now that you brought it up, I could. Especially if you do own Egyptian cotton.”
“What I do or do not own has no bearing on the job here. And if you want to stand there speculating on something as unimportant as my sheets, be my guest. Speculate to your heart’s content. But keep it to yourself because I need to get these beds changed and I don’t need any distractions while I’m doing it.”
The ad she’d read about this job should have warned her that it came with a pompous boss because he was, indeed, pompous. Full of himself. Someone who probably took delight in the struggles of others. “And in the meantime I’m going to smooth this stupid wrinkle so I can get on to the next bed.”
“Well, if you ever get done here, I’ve got a patient coming into the clinic in a little while who has a possible case of gout in his left big toe. Could you take a look at him when he arrives?”
Gout. A painful inflammatory process, starting in the big toe in about half of all diagnosed cases. “I don’t suppose we can test for hyperuricemia, can we?” Hyperuricemia was a build-up of uric acid in the blood. With elevated levels, its presence could precipitate an onset of gout.
“Nope. Haven’t got the proper equipment to do much more than a simple CBC.” Complete blood count. “And we do those sparingly because they cost us money we don’t have.”
“Then how do we diagnose him, or anybody else, for that matter, if we don’t have the tests at our disposal?”
“The old-fashioned way. We apply common sense. In this particular case, you assess to see if it’s swollen or red. You ask him if it hurts, then find out how and when. Also, you take into account the fact that the patient’s a male, and we all know that men are more susceptible to gout than women. So that’s another indicator. And the pain exists only in his big toe. Add it all up and you’ve got...gout.” He took a big sweeping bow with his pronouncement, as if he was the lead character in a show on Broadway.
Juliette noticed his grand gesture, but chose to ignore it. “OK, it’s gout. I’ll probably agree with you once I’ve had a look at him. But, apart from that, what kind of drugs do you have on hand to treat him with? Nonsteroidal anti-inflammatories? Steroids? Colchicine? Maybe allopurinol?”
“Aspirin,” he stated flatly.
“Aspirin? That’s it?” Understaffed, understocked—what kind of place was this?
“We’re limited here to the basics and that’s pretty much how we have to conduct business every day. We start on the most simple level we can offer and hope that’s good enough.”
“What else do you have besides aspirin?”
“Antacids, penicillin, a lot of different topical ointments for bug bites, rashes and whatever else happens to a person’s skin. A couple of different kinds of injectable anesthetic agents. Nitroglycerine. Cough syrup. Some antimicrobials. Antimalarials—mostly quinidine. A very small supply of codeine. Oh, and a handful of various other drugs that we can coerce from an occasional outsider who wanders through. When you have time, take a look. We keep the drugs in the locked closet just outside the clinic door.”
“Are any of these expired drugs?”
“Hey, we take what we can get. So if it’s not too expired, we accept it and, believe me, we’re glad to get it. One person’s expired drug may be another person’s salvation.”
“Isn’t that dangerous?”
He shook his head. “I check with the pharmaceutical company before I use it. I mean, commercial expiration date is one thing, but some drugs have usable life left beyond their shelf life.”
“But you do turn away some drugs that are expired?”
“Of course I do. I’m not going to put a patient at risk with an expired drug that’s not usable.”
“So when you call these pharmaceutical companies, don’t they offer to stock you with new drugs?”
“All the time. But who the hell can afford that around here?” Damien shrugged. “Like I say, I check it to make sure it’s safe, then I use it if it is, and thank my lucky stars I have it to use.”
She hadn’t expected anything lavish, but she also hadn’t expected this much impoverishment. Of course, she knew little clinics like this operated all over the world, barely keeping their doors open, scraping and bowing to get whatever they had. But, in her other life, those were only stories, not a real situation as it applied to her. Now, though, she was in the heart of make-do medicine and nothing in her education or experience had taught her how to get along within its confines.
“How do you learn to get by the way you do?” she asked Damien. “With all these limitations and hardships?”
He studied her for a moment, then smiled. “Most of it you simply make up as you go. I was a general surgeon in Seattle. Worked in one of the largest hospitals in the city—a teaching hospital. So I had residents and medical students at my disposal, every piece of modern equipment known to the medical world, my OR was second to none.”
“And you gave it all up for this?” It was an admirable thing to do, but the question that plagued her about that was how anyone could go from so modern to so primitive? She’d done a little internet research on Damien before she’d come here, and he had a sterling reputation. He’d received all kinds of recognition for his achievements in surgery, and he’d won awards. So what made a person trade it for a handful of expired medicines and good guesses instead of proper tests and up-to-date drugs?
Maybe he had a father who ran the hospital, Juliette thought, as her own reasons for leaving her hospital practice crossed her mind.
“This isn’t so bad once you get used to it,” he said.
“But how do you get used to it? Especially when it’s so completely different from your medical background?”
“You look at the people you’re treating and understand that they need and deserve the best care you can give them, just the way that patients in any hospital anywhere else do. Only out here you’re the only one to do it. I think that’s the hardest part to get used to—the fact that there’s no one else to fall back on. No equipment, no tests or drugs, no excuses...
“It scared me when I first got here until I came to terms with how I was going to have to rely on myself and all my skills and knowledge. That didn’t make working in this hospital any easier, but it did put things into proper perspective.”
“You’ve gotten used to it, haven’t you?”
“Let’s just say that I’ve learned to work with the knowledge that the best I can hope for is what I have on hand at the moment, and the people here who want medical help are grateful for whatever I have to offer. They don’t take it for granted the way society in general has come to take much of its medical care for granted. So, once you understand that, you can get used to just about anything this type of practice will hand you.”
“Then you don’t really look forward, do you?”
“Can’t afford to. If I did, I’d probably get really disappointed, because anything forward from this point is the same as anything looking backward. Nothing changes and, in practical terms, it probably never will.”
“But you chose a jungle practice over what you had for some reason. Was it a conscious choice, or did you come here with expectation of one thing and get handed something else?”
“I got recruited to one of the leading hospitals by someone like you. They wanted my surgical skills and they came up with a pretty nice package to offer me. Since I’ve never stayed in any one position too long—”
“Why not?” she interrupted.
“Because there’s always something else out there. Something I haven’t tried yet. Something that might be better than what I’ve had.” Something to distract him from the fact that he’d never found what he wanted.
“In other words, you’re never contented?”
“In other words, I like to change up my life every now and then. Which is why I came here to Costa Rica. The country is recruiting doctors, the whole medical industry is competing in a worldwide arena and it sounded exciting. Probably like it did to you when they came calling on you. And I’m assuming they did come calling.”
“Something like that.” But her motive in coming here wasn’t because she was restless, or that she simply needed a change in pace. Her acceptance came because she needed to expand herself in new directions. Someplace far, far away from her father.
“Well, anyway—they did a hard recruit on me. Kept coming back for about a year, until I finally decided to give it a shot.”
“So you did work in one of the hospitals in San José?”
“For about a month. The timing was perfect. I’d just ended a personal relationship, which made me restless to go someplace, do something else. You know, running away. Which actually has been my habit for most of my adult life.” Damien grinned. “Anyway, they offered, eventually I accepted, and it took me about a week to figure out I hated it.”
“Why?”
“Because it was just like what I’d left. Brought back old memories of my last hospital, of how my former fiancée thought I should be more than a general surgeon, of how my future father-in-law said that being a general surgeon was so working class. Like there’s something wrong with being working class! I’d always loved working for a living but that one criticism so totally changed me, there were times I didn’t even recognize myself. Tried to be what my future family considered their equal. Put on airs I didn’t have a right to. Drowned myself in a lifestyle that I didn’t like, just to play the perfect part.” He shook his head. “I really needed something different after I got through all that. Got it all sorted—who I really was, what I really wanted to do with my life. So one day I saw an ad where a little jungle hospital needed a doctor...”
“Like the ad you placed?” He had so much baggage in his past, she wondered how he’d gotten past it to reach this point in his life. It took a lot of strength to get from where he used to be to where he was now. A strength she wished she had for herself.
Damien chuckled. “The same ad.”
“The exact same ad?” she asked him.
“One and the same. No pay, hard work, long hours. Nothing like I’d ever been involved with before. So, since I’d come to Costa Rica seeking a new adventure—hell, what’s more of an adventure than this?”
“Maybe a hospital with Egyptian cotton sheets?” Everyone had something to run away from, she supposed. He did. She did. It was lucky for both of them that their need to run away had coincided with a place for them to go. Whether running into each other would turn out to be a good thing remained to be seen.
“I’ve lowered my expectations these past few months. If I have any bedsheets, I’m happy.”
“But they didn’t train you in medical school to be concerned about the sheets.”
“And they didn’t train you in medical school how to be a recruiter. Which makes me wonder if it’s a good fit for you since you came knocking on my humble little door, wanting something different than what you already had. Ever think you made the wrong choice, that you belong back in your old life?”
OK, based on the little bit she knew about him, this was the Damien she’d expected. Not the one who almost garnered her admiration, but the one who annoyed her. “I made a very good choice coming to Costa Rica, regardless of what you think!” He was beginning to sound like her father. Bad choice, Juliette. Think about it. You’ll come to your senses. “Not that it’s any of your business.”
“In my hospital, it is my business. Everything here is my business, including you. Because you working here affects everything else around you, and I have to protect the hospital’s interests.”
“What’s your point?” she snapped.
“That’s for you to figure out. Which, I’m sure, will happen in time.”
“There’s nothing to figure out. I accepted a position that brings first-rate medical professionals here. It’s an honorable job and I like it. It’s...important.”
“I’m not saying that it’s not. With the need to improve medical conditions expanding, I’m sure it’s becoming a very important position. But is it important enough to you? Or is patient care more important?”
“Why can’t both be important to me?”
“In my experience, I’ve found that we poor mortals don’t always do a good job of dividing ourselves.”
“That’s assuming I’m divided.”
“Well, I suppose only you know if that’s the case.” Damien stepped away from the bed. “Anyway, your patient will be here shortly, so I’d suggest you figure out some way to expedite those bedsheets so you can go be a real doctor.” With that, he spun around and started walking away.
“Are you always so rude?” she asked him while he was still within earshot. He was not only rude, he was also nosy, presumptuous and out of line.
Damien stopped and turned back to face her. “I do it rather well, don’t you think?”
* * *
Struggling with simple bedsheets, the way she was doing right now, was almost cute. It was painfully obvious, though, that this was a chore far beyond her capabilities. Or one she’d never before practiced. Which reminded Damien of days gone by, and one of the reasons he was here in the jungle, hiding away from civilization. Juliette was obviously a rich girl, probably out on her own in the world for the very first time and, once upon a time, he’d almost married a rich girl who probably still wasn’t out in the world.
Spoiled was the word that always came to mind when he thought about Nancy. It was a word he wanted to apply to Juliette as well, but the determination he could see in her stopped him short of going that far. The fact was, Nancy would have never set foot in his jungle clinic and Juliette was here, fighting to make a difference. Which didn’t exactly fit his perception of a rich girl.
OK, he had a bias. He admitted it. Hated that he’d just shown a bit of it to Juliette, by raising the doubt that she could cut it here. But it was well deserved, considering how he’d endured months of spoiled behavior from a woman he’d planned on marrying. Not that Nancy had ever played spoiled rich girl when it was just the two of them. No, she’d been sweet and attentive, convincing him she was the one to settle down for. Or in Juliette’s case, she was the one he needed here to help him.
But in the end, Nancy had told him he could never be enough for her. He couldn’t give her enough, as her demands had grown larger. More time. More attention. More of everything. He’d tried. He’d honestly tried. Bought her everything she wanted, which put him into deep debt. Cut back his hours at the hospital to spend more time with her, which almost cost him his job. No matter what he’d done, though, it hadn’t been adequate. So he’d tried harder, and always failed.
As far as Juliette working here—could that be enough for her? Or was he overthinking this thing? Truth was, he was wary. With Nancy, the vicious circle he’d got himself trapped in had played against his self-esteem and it hadn’t helped when her parents told him that he’d always be struggling, that he’d never have enough to give her what she deserved. Things. Lots and lots of material things. And social status. Even with his surgeon’s salary and his position at the hospital, and all the awards he’d won, they were right. At least, he’d thought so at the time.
Anyway, she’d moved out of his apartment and gone home, straight into Mommy’s and Daddy’s arms. As far as he knew, two years later, she was still there, dwelling quite happily as their spoiled-rotten daughter. Probably waiting for Daddy to fix her up with a man who fit the family image. A man who could give her the things Damien could not.
Which, admittedly, stung. He’d reeled from the breakup for weeks, wondering what he could have done differently. Wondering why he’d thought he was good enough for Nancy when, obviously, he was not. Wondering why he’d chosen Nancy in the first place.
So, was Juliette that spoiled? Would she spend a day or an entire weekend here, only to discover that it wasn’t enough for her? Would she walk away when she realized he couldn’t give her proper bedsheets, let alone a proper bed? Bottom line—he needed her here. Recruits didn’t come knocking every day when he advertised. And when they did show up, they usually turned right back around and left. In fact, other than George Perkins, she’d been the first doctor in his entire year here to show any real interest in staying. And he needed her skills. But could he count on her coming through, the way he’d counted on Nancy before she’d let him down?
He didn’t know, couldn’t tell. Juliette was obviously of upper means and, yes, that did have a huge bearing on the way he was feeling so uneasy about her motives or dedication. But there was also something about her that caused him to believe that her upper means hadn’t knocked something basic out of her. She was a hard worker and, so far, she hadn’t complained about the menial tasks. Time would tell what she was really made of, he supposed. For now, he was simply trying to keep an open mind. Because for some reason other than his need of her medical skills, a reason he couldn’t quite put his finger on, he wanted her to stay. Maybe for a change of scenery? Or to break the monotony? He honestly didn’t know.
“You’ve only got just the one exam room in the clinic?” Juliette asked him, once all the beds were made.
“The clinic was originally my living quarters. One room for everything. But I built a divider so there would be a waiting room on one side and an exam room on the other. That’s all there was room for.”
“Then where do you sleep?” she asked him.
“In a hut next door. Another one-room setup. Not as nice as the hospital, though.”
Juliette cringed. “I hate to ask, but where will I stay when I’m here?”
Ah, yes. The first test. No sheets, no bed—no room of her own. This is where it began, he supposed. Or ended. “Well, I’ve got two choices. You could stay here in the hospital, use an empty bed and hope we don’t get so busy you’ll have to give it up. We’ll partition it off for you to give you some privacy. And the perk there is that the hospital has running water, a shower, a bathroom. Or, if you don’t like that idea, you can shack with me. And the drawbacks there are—I don’t have running water, don’t have a bathroom or a shower. I have to come into the hospital for all that. Oh, and rumor has it that I might snore.” He cringed, waiting for what he believed would be the inevitable.
“So if I choose your hut, I’d be what? Sleeping in bed with you?”
“No, I’m a little more gentlemanly than that. I’d give you the bed, and I’d take the floor.” Said with some forced humor, since humor was all he had to offer at the moment.
“But in the same room?”
“Kind of like the student years, when you’d crash in the on-call room, no matter who was sleeping next to you. You did sleep in an on-call, didn’t you?” Somehow, he could picture Juliette as the type who would lock the on-call door behind her and keep the room all to herself.
“I did,” she said hesitantly. “When I had to.”
