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His heart squeezed. Even though she wasn’t that easy around Rory it was clear she could see the appeal that made him thankful every single day that he’d found this little boy.
He turned to Rory and lifted the bowl away from him. ‘Give me that before you start licking the bowl.’ He wiped Rory’s face and hands with a napkin. ‘Time to go home, champ.’ He raised his fist and Rory bumped his against his dad’s.
‘What is that?’ asked Cordelia.
‘The fist bump? That’s just us. That’s our move.’
‘Your move?’
Rory wriggled out of his seat and Gene followed, picking up the bill from the table. ‘You know, everyone has a move, or a saying, something like that.’
She put her hands on her hips. ‘They do?’
He nodded. ‘Of course. Don’t you?’
She frowned for a second. ‘I don’t think so.’
He nodded as he settled the bill. ‘Leave it with me. I bet you’ve got one. I’ll figure it out.’
They walked out to the car and Gene strapped Rory in before making a grab for something in the back seat before Cordelia had even managed to climb in.
His Stetson. He plonked it on his head with a cheeky wink. ‘Is that fair? Going full cowboy on her? Like I said, I’ll even wear my boots and jeans if you think it will help.’
Cordelia laughed out loud. ‘You really are going to wear that to the institute tomorrow?’
He tipped his Stetson towards her. ‘I told you, it’s my lethal weapon.’
He watched her suck in a breath as his eyes connected with hers. He was joking. Of course he was joking. So why had his heart rate just quickened? Ridiculous. It was like being a teenager again.
He shook his head as he took off his Stetson and climbed back into the car. He was only here for a month. He had work to do. And a child to look after. He couldn’t afford any distractions.
But as Cordelia hitched up her dress to climb into the car, he had a distinct flash of toned, tanned leg.
And try as he may, he couldn’t get it out of his head on the drive home.
CHAPTER THREE (#u4ca38e24-895f-5d70-b3f1-dd27bbb9b6a0)
CORDELIA SIGHED AND leaned against the wall as she checked the chart again. One of her patients was failing. Truth was, most of the patients in the heart failure study were failing—that was why they were here.
But Jonas Delphine was one of her favourites. He was an old sea captain, eighty-six, and had smoked for forty years. His chest complaints, along with his cardiovascular disease and heart failure, made him a difficult candidate to manage.
Some trials only wanted ‘perfect’ candidates. Ones who had no other health complaints but who had unhealthy lifestyle issues that could be changed and monitored then assessed to within an inch of their lives. But the Reuben Institute didn’t work with unrealistic patients. What was the point of that? More complicated patients meant more bias for the trials. Some people didn’t like that. Some drug companies definitely didn’t like it. But Professor Helier had always been clear. The institute was here to help real patients. Not perfect ones who didn’t really exist.
Now, after listening to Jonas’s heart and lungs, she’d just ordered another chest X-ray and echo cardiogram.
‘Something wrong?’ Gene’s voice made her jump.
She couldn’t help but grin at the sight of him. He’d been a man of his word and had come to the institute this morning full cowboy.
The patients loved it. The staff loved it. The Stetson, cowboy boots and jeans had certainly made their mark. Even the normally frosty Marie had seemed to like his unusual appearance.
Gene was still wearing his Stetson and tipped it towards her. ‘Cordelia?’
She held up the electronic tablet. ‘Nothing that a new heart won’t cure.’ She straightened up. ‘Actually, now that you’re here, you can give me a second opinion on someone.’
He held up his electronic tablet. ‘Great minds think alike. I was just coming to get you to do the same.’
A tiny surge of pride welled in her stomach. She was pleased. Pleased that he’d came to her for a second opinion on one of his patients. Hopefully, that meant he thought she might be a good clinician.
They swapped tablets. ‘You tell me yours, and I’ll tell you mine.’
‘Aryssa Maia, forty-seven, hypertrophic cardiomyopathy. She’s had unsuccessful ablations for atrial fibrillation and she can’t tolerate the usual drugs. She also has a permanent pacemaker in place. I’ve checked her previous scans and just listened to her chest. I think her ventricle is getting to the stage it is barely functioning. She’s symptomatic, breathless and tired, with swollen extremities.’
She nodded. ‘I have a similar case. Jonas Delphine is eighty-six, with existing COPD and chronic heart failure. I think I’m going to have to take him off the study and put him on IV steroids and diuretics. In the space of one day he’s gone downhill fast.’
Gene nodded slowly. She knew he understood. The patient’s welfare was always their prime concern. But the regulations for any research study were strict. They didn’t want any findings skewed. If they used certain other drugs on patients then they were taken off the study programme. It was important that any improvement in a patient’s current condition was only attributed to the drug being studied—not to any other intervention made.
Cordelia sighed as she looked at Aryssa’s chart. ‘She was doing so well,’ she said sadly. ‘I really thought that this might be the one drug that could make a difference for her.’
Gene ran his fingers through his hair. ‘I get that. But my gut is telling me that something else is going on. I almost feel as if her pacing wire has moved. Her heart just isn’t functioning the way it should be.’
He glanced at Jonas’s chart and smiled. ‘Why do I feel as if this guy could teach me everything I need to know about life?’
‘He probably could. I’m not ashamed to say I love him and have a completely unnatural bias towards him.’ She lifted her hand. ‘That’s why I’m checking for a second opinion. I need someone who can just look at the clinical signs.’ She gave a slow nod and handed back Aryssa’s notes. ‘And as for your patient, I agree, she needs an ECG and a cardiac echo. I suspect her pacing wire has moved too. That’s what fits the symptoms, rather than anything happening within the trial.’
He gave a nod. ‘I ordered the tests. Just wanted to double check.’ He kept a hold of Jonas’s tablet. ‘Now, let’s go meet your patient, while mine has her investigations.’
* * *
Things moved so swiftly here. He was secretly pleased that Cordelia had come to him for a second opinion. By the time he’d sounded Jonas’s chest and looked at his hands and ankles, the nurse from his part of the clinic had brought along Aryssa’s ECG. It couldn’t be clearer. The pacing wire definitely wasn’t capturing, meaning Aryssa’s heart rate was erratic and low. Both he and Cordelia nodded.
‘I’ll come back and speak to her. But can you attach her to a portable cardiac monitor in the meantime and ask them to put a rush on that cardiac echo?’
The nurse gave a nod. ‘I’ll take her for the echo now.’
He gave Cordelia a nod and walked through to the treatment room. ‘It looks like we’re both about to lose patients from our trials. Jonas needs some IV steroids and diuretics.’
Her eyes were downcast for a moment. It probably wasn’t what she wanted to hear. But he knew she would always put the patients first. That’s the way it should be. Research work always brought these challenges and any medic who worked on the trials knew that.
She looked back up, nodding and opening the drug cupboard. ‘I’ll draw them up. Can you prescribe them on the tablet? Thanks.’
He gave her a nod and checked the bottles with her as she drew up the medicines. He couldn’t pretend not to notice the slight shake of her hands. ‘How about I do this for you? You can distract Jonas and persuade him this is a good idea.’
She sucked in a deep breath and let her hands rest back down on the counter top. ‘Do you know what? I’d like that. Thank you.’ She gave him a small smile and his insides clenched. He got the distinct impression that Cordelia Greenway didn’t normally let anyone help her. But from the way her jaw had been clenched and the shake in her hands he knew she was emotional about this. He knew she felt connected to this old guy. She’d worked here for four years. She might even have known him that long.
It was hard not to get attached to patients you saw on a regular basis, let alone nearly every day. It was harder still if those patients condition got worse—which inevitably frequently happened to doctors.
He understood. He’d been there and felt it himself. For the last few years he’d moved from place to place. All of his emotional investment had been in Rory. That’s the way it had to be. He’d had to learn to be mom and dad to the little guy. He’d always done a good job by his patients, but he hadn’t been around long enough to form lasting relationships.
And he missed that. He couldn’t pretend that he didn’t.
He moved his hand to lift the tray with the syringe and Venflon but Cordelia’s was still there. His first instinct was to pull away, but instead he put his hand over hers and left it there as she gave a little sad sigh.
She didn’t object. She didn’t jerk away. The heat of her hand filled his palm in a way he hadn’t expected.
It had been a long time since he’d touched a woman—held a woman. Of course he touched patients every day. But relationships in the last three years just hadn’t been possible. He didn’t want to be the guy who introduced Rory to a new girlfriend every few months so it had been easier just to let that part of his life slide.
So...this was different. Not new exactly, but just different. And up until this moment he hadn’t realised how much he’d missed connecting with someone.
She gave the briefest nod of her head and he knew it was time to pull away. He lifted his hand and let hers slide out from underneath his, picked up the tray, and gave her a conciliatory nod. ‘Let’s go and make Jonas feel better.’
* * *
It was the little things that made you realise how thoughtful someone could be. Her insides had twisted and turned at the thought of being the person who would deliver the treatment to end Jonas’s time on the trial. She knew it was essential. She knew it was the right thing to do. But part of her had ached, knowing she would have to be the one to do it.
The thought of not seeing him five days a week made her sad. After four years she was sure Jonas still had a world of stories to tell her. His cheery nature in the face of his heart failure made her feel more positive about her own condition.
She had to have hope. She had to feel as if one day her Wolff-Parkinson-White syndrome wouldn’t cause some odd arrhythmia that would send her heart into a whole host of problems. For some people with her condition it could lead to death.
Five years ago her physician had sat her down and given her the news she’d known would be coming. She should look at a permanent contraception choice. Her Wolff-Parkinson–White syndrome was progressing. Her condition was unpredictable. What was certain was that the extra stress and increase in pressure of a pregnancy would cause huge strain on her already struggling heart. Pregnancy was out of the question. She’d never have a family of her own.
She’d been living with a fellow researcher then. Han. They’d been working together in London and their relationship had just developed slowly. She’d liked that. He’d known about her condition and had helped her through difficult spells.
But the news from the consultant had been a turning point. Han had backed off, slowly but surely. Never with malice. But his plans for the future included a family. And as he’d drifted away she’d felt more and more hurt. More and more like less of a woman. Less of a partner.
She’d had to learn to accept that a family wouldn’t be in her future. She’d had to accept that any potential relationship would have to be one where she had that difficult up-front conversation. The one where she’d have to admit she was unsure what the future with her cardiac condition would look like.
In the meantime, she’d thrown herself into work. Her almost safe place. But every now and then, when a patient’s condition worsened at the clinic, it always brought home to her the fact that one day that could be her.
So she was grateful to Gene for the offer. And he’d been true to his word. He’d charmed Jonas and given him time to express his sadness at having to leave the trial before graciously accepting the other treatment that he needed. Gene kept him distracted with cowboy-type stories as he slowly administered the medicine to Jonas.
They’d just finished up when one of the other nurses came rushing in. ‘Dr Du Bois? We need you now. Aryssa has become unwell during her cardiac echo.’
Both of them moved at once, walking down the long white corridor rapidly. Gene reached the room first. He moved swiftly around Aryssa and examined her, taking in her vital signs. ‘She’s bradycardic,’ said Cordelia, moving to the other side of the bed.
The sonographer was pale-faced next to the bed. ‘She just seemed to fade while we were doing the echo,’ he said.
‘What did it show?’ asked Gene.
The sonographer gave him a serious look. ‘What you expected. The pacing wire has moved.’
Gene frowned as Aryssa’s eyes flickered open. ‘It’s odd. That’s unusual. A pacing wire shouldn’t move.’
Cordelia put her hand on Aryssa’s shoulder. ‘Aryssa, how are you feeling?’
The heart rate on the monitor seemed to rise for a few seconds. ‘Not good,’ she whispered.
Cordelia nodded. ‘Don’t worry. We’ll look after you. But has anything happened in the last day or so that could have dislodged your pacing wire?’
Aryssa lifted her hand to her chest. ‘I had an accident in the car on the way to the institute this morning. It was only a small bump, but the airbag exploded.’
Gene shot Cordelia a look. ‘Did the airbag hit you?’
Aryssa winced. ‘Yes. But I got more of a fright because of the noise. And the powder.’ She closed her eyes again, obviously exhausted just answering those few questions.
They moved outside into the corridor.
Gene didn’t hesitate. ‘That’s enough for me. We need to insert a new pacing wire. She’s too symptomatic to move her elsewhere.’
It was the weirdest feeling. All of a sudden she almost felt as if she were a spectator instead of part of the situation. As if she were dangling up somewhere in the corner of the room, watching everything.
She couldn’t remember the last time there had been an emergency in the clinic. Not like this anyway.
Everything she’d ever learned at medical school decided to fly out of her head in an instant. She couldn’t tell a clavicle from a femur, or an atrium from a liver lobe.
Crap. She’d never panicked as a medical student. She’d always been one of the calmest in the class. While others had fainted at the sight of blood, or any other body fluid, Cordelia had just wondered why on earth they wanted to be doctors.
So what was wrong with her now?
One of the clinic nurses appeared at her side. ‘Are we pacing?’
Simple words. And that was all it took. Her brain shifted gear.
Gene walked into the next-door cath lab. His actions were automatic. It was clear he’d dealt with this situation before. He pulled over a trolley and set out the equipment. He nodded to the nurse. ‘Can you bring the patient in, please, and we’ll explain what we need to do.’
Cordelia moved over to the sink and started scrubbing her hands. A temporary pacing wire wasn’t performed in a traditional operating theatre, but the cath lab was as good as it got around here. The wire went straight into a central vein, and everything had to be done aseptically to protect the patient from infection.
The nurse wheeled Aryssa in. She was lying on her back, her face pale and sweating. She was already attached to a portable cardiac monitor showing her very slow heartbeat and low blood pressure.
Gene gave Cordelia a nod. He moved over and took Aryssa’s hand. He mouthed one word to her. ‘Cold.’
Cordelia pressed her lips together. Cold extremities meant that the blood flow just wasn’t getting enough power to circulate properly. She dried her hands and held them out in front of her to where the nurse was holding out a disposable surgical gown. Next came the gloves then she checked the equipment on the trolley.
‘Percutaneous sheath, bipolar pacing catheter and bridging cables and pacing box.’ She murmured the contents out loud, mentally ticking them off in her head.
Gene spoke quietly to Aryssa. ‘Aryssa, I know you might be feeling light-headed. We’re sure that your pacing wire has moved. We’re going to insert a temporary pacing line to get your heart back on track. You’ll probably be a little woozy until we get this sorted. But trust us. We’ve got this.’
Aryssa’s eyes were closed but she tossed her head from side to side. ‘But I’ll be flung off the trial. I don’t want that. The drug is the only thing that’s worked for me.’
Gene met Cordelia’s gaze. Her heart gave a little flutter inside her chest and that made her freeze. Oh, no. Not now. Not here.
He spoke smoothly. ‘Aryssa, with a heartbeat of around forty we couldn’t let you stay in the trial. We’ve got to keep you healthy. This isn’t something we can debate. You need this procedure.’
A tear trickled down Aryssa’s cheek and Gene clasped her hand tightly while looking at Cordelia. It was awful. Aryssa had been doing so well on the trial. The new drug seemed to be having a good effect on her. Her symptoms had diminished over the last few weeks and up until the last day her heart function had looked a little better.
Hypertrophic cardiomyopathy could throw up a whole host of problems, depending on which part of the heart was most affected. Right now, they had no way of reversing the condition, but this drug had actually looked as though it could slow and stabilise the condition, optimising the output of the heart.
Gene looked so conflicted. She could almost see what he was seeing—Rory on the bed instead of Aryssa. It must be breaking his heart.
