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The loud sound of a cart rumbling down the hall and into the room made Katy sag in relief. The cavalry had arrived.
“Give me the patient’s history,” a guy said, as he moved from the crash cart to the head of the bed, quickly getting a bag on Mrs. Roberts to provide the oxygen she desperately needed. He was probably from the ICU team, but Katy wasn’t about to waste time asking questions.
“Patient is eighty-two, with cholecystitis, her surgery is on hold until she’s medically cleared by Cardiology.” Katy gulped as she stared at the still-unresponsive Mrs. Roberts and forged on. “She was talking to me and just kind of collapsed. She has fainting spells and we’re trying to figure out why.”
She stared at the monitor as the ICU guy attached the last EKG lead. Involuntarily, Katy let out a little stressed cry when she saw the heart rate was alarmingly slow at only thirty-five beats per minute. “Sinus bradycardia,” she said. “Atropine point five milligrams and we need pads for transcutaneous pacing.”
Had all that really come right out of her mouth? No time to give herself a pat on the back as the ICU guy barked to the nurse, “Get Cardiology on the line. You, Doctor, get her paced as I intubate.”
Katy blinked and a touch of panic welled in her chest that she resolutely tamped down. He’d just called her “Doctor”. She was part of this team, which would hopefully save this woman’s life. Concentrating intently on getting the pads placed amid a flurry of activity by the nurses, she didn’t even notice the tall, broad form that came to stand next to her.
“I’ll take over now,” a familiar deep voice said. “Good job, Dr. Pappas.”
Alec Armstrong brushed past her as she moved to one side, allowing him to deliver the electricity to Mrs. Roberts’s heart. Katy stood there, stunned, her hands now shaking like a tambourine. Beyond glad it wasn’t her trying to get the pacing finished and giving orders to the nurses.
Which wasn’t the right attitude, she scolded herself, since she wanted to be a doctor—was a doctor. But, dang it, how many newbies had to deal with their very first patient coding on them?
She watched Alec work, and couldn’t help but notice how different he was, and yet somehow the same as when she’d known him years ago. As a boy and teen, he’d practically lived in their house as Nick’s best friend. While he’d been as fun and adventurous as anybody she’d known, he’d always become calm and focused when there had been an important task at hand, his eyes intent, just like they were now. His hands moved swiftly and efficiently, as they had during all the crazy science experiments they’d done together. All the times he and Nick had worked on projects with her, teasing about her endless quest to learn new things and solve weird problems.
Her hero-worship of Alec was over. But the moment that thought came into her head, as she watched him work, she knew it wasn’t true. How could she not admire how capably he dealt with a critical situation? But she didn’t have to like him as a person to admire how good he was as a doctor and doubtless as a surgeon.
In a short time the frantic flurry of activity was over and the ICU guy began to wheel Mrs. Roberts from the room. As he left, he said over his shoulder, “I’ll dictate my procedure note. You got the code note?”
“I’ve got it,” Katy and Alec said at the same time. Their eyes met, his the amused, warm amber she remembered so well, and she felt her face flush. How could she have thought the guy was talking to her when attending surgeon extraordinaire Alec Armstrong had taken over?
“So, Katy-Did.” His lips curved as he folded his arms across his chest. “What the hell did you do to my patient to make her code like that?”
“Please call me Katherine or Katy. I’m not a kid anymore,” she said with dignity. Which he should know after her ill-advised behavior at her brother James’s wedding five years ago. Her cheeks burned hotter at the memory.
“Fine, Dr. Katherine Pappas.” His smile broadened, showing his white teeth. “How did you almost kill her?”
“I didn’t almost kill her, and you know it. I didn’t do anything.” Katy’s voice rose to practically a squeak on the last word and she cleared her throat, forcing herself to sound somewhat professional. “I was talking with her and giving her an exam, and she just fainted. I think she probably has sick sinus syndrome, which is why she’s sometimes fine and other times faints.”
“Do you, now?” He laughed. Actually laughed, and Katy felt her face heat again, but this time in annoyance.
“Yes, I do. I may be a total newbie, but I’m allowed to give my opinion, aren’t I? Isn’t it part of my training to form an opinion, even if it’s wrong?”
“It is. And you are. Right, I mean, not wrong. And why am I not surprised that on your first day you’ve figured out this woman’s likely diagnosis?” He stepped closer, touching his fingertip to her forehead and giving it a few little taps. “Some things never change, and one of them is that amazing, analytical brain of yours.”
Some things never changed? Wasn’t that the unfortunate truth? In spite of him making clear he had no interest in her as a woman, in spite of everything she knew about the kind of man he was, being so close to Alec made her breath a little short, which irritated her even more. How was it possible that the deepest corners of her brain still clung to the youthful crush she used to have? But being on Dr. Playboy’s teaching service for the next month would most definitely squelch the final remnants of that for good. She was sure of it.
His fingertip slipped to her temple then dropped away. “Teaching rounds begin in an hour. Not too many people get to brag about dealing with a code on their very first day.” That crooked grin stayed on his mouth as he gave her a little wink. “You did great. Welcome to Oceancrest, Katy-Did.”
He turned and walked from the room, and she found herself staring at his back. Noticing that his thick dark hair was slightly longer than the last time she’d seen him. Noticing how unbelievably great his butt looked in those scrubs, how his shoulders filled every inch of the green fabric.
Noticing how horribly unkempt she herself looked at that moment. She looked down at her own wrinkled scrubs before she glanced in Mrs. Roberts’s bathroom mirror at circles under her eyes the size of an IV bag. Ridiculously messy hair that had been finger-combed at best and now looked like it had been tamed by an eggbeater. Sleeping in the on-call room—if you could call the few hours her eyes had been closed sleeping—did not exactly lend itself to looking pulled together and rested.
She sighed and ran her fingers through her hair. Why did it have to be that the first time Alec saw her at the hospital, she looked like a wreck?
And why did she care, anyway? The man was a player through and through.
Never would Alec have guessed he’d someday have Katy Pappas on his surgical teaching service. The cute but clumsy little girl who’d bugged the hell out of him and her brother Nick when they’d been young, tagging along on their adventures and asking nonstop questions, for some reason believing they’d know the answers.
The worshipful gaze of her blue eyes had always made his chest puff up a little with pride. Despite how much he and Nick had complained about her hanging out with them, he’d always secretly liked it when she had. That someone had thought he was smart and worthy of that kind of adulation had felt damned good, since it had been in very short supply in his own home.
The nonstop criticism his father had doled out had made Alec want to live up—or down—to his father’s expectations of him. He’d worked as hard at partying as he had at football, and probably the only reason he hadn’t gone down in flames had been because he’d had the steady support of the Pappas family, and Dr. George Pappas in particular.
After he and Nick had headed off to college and medical school, he hadn’t seen the Pappas clan again until five years ago at a family wedding. Gobsmacked that Katy, awkwardly geeky child and studious teenager, had morphed into a drop-dead gorgeous twenty-one-year-old woman, he remembered standing stock-still, staring at her in disbelief. Shocked that he’d found her attractive in a way that was not at all brotherly.
He’d been even more shocked when, standing in a quiet corner at the reception, a champagne-tipsy Katy had grabbed his face between her hands and pressed her mouth to his. A mouth so warm and soft and delectable that every synapse in his brain had short-circuited and he’d found himself kissing her back. Their lips had parted and tongues had danced as he’d sunk deeply into the mind-boggling pleasure of it.
Then sanity had returned and he’d practically pushed her away, horrified. No way could he have anything like that with Katy Pappas, little sister of his best friend. She was totally off-limits. Period.
He’d tried to make a joke of it. Katy, however, hadn’t thought it was remotely amusing when he’d told her he didn’t feel that way about her, and that it would be all wrong if he did.
If she’d been pressed closer against him, she would have known part of that statement was a lie. But appropriate? Hell, no.
He sighed. From that moment on his friendship with Katy had been pretty much over. She’d been cool at other family functions since then. Aloof, even.
Alec had shoved down his feelings of disappointment that she was no longer the Katy who’d thought he was great. Hell, after the mess he’d made of some things in his life, he shouldn’t expect anyone to feel that way.
Then he’d walked into the coding patient’s room and seen her, wrinkled, messy, and nervous. Beautifully messy and nervous, yes, but so much like the Katy he’d once known he hadn’t been able to help but want that old friendship back.
And just like the old Katy, in the midst of all the chaos she’d still shown what a brainiac she was. That she was good at figuring out what to do in any circumstances, despite being brand new at the art and science of doctoring.
Maybe it was absurd, pathetic even, but he wanted to see again the Katy who used to like and admire him, who had tolerated and even enjoyed his teasing.
Alec remembered well the feel of her lips against his. But a woman like her no doubt had so many boyfriends that a little kiss five years ago would have been completely forgotten.
CHAPTER TWO (#ulink_2e4f1595-3e4c-5f27-be34-f8546cbf0e5b)
AS ALEC STRODE down the hall, he could see the residents and interns waiting for him at the end of it, but his gaze stuck fast on Katy.
She’d changed into street clothes and a lab coat, and had obviously found a minute to brush her hair, which was no longer in a tangle but instead covered her shoulders in lustrous waves. He remembered that thick hair of hers always falling into her eyes and face as they’d studied things together, and he’d gotten into the habit of tucking its softness behind her ears so she’d been able to see whatever he and Nick had been showing her.
Her hands waving around as she spoke—another thing that was such a part of who she was—Katy was talking intently to the young man next to her, a frown creasing her brows, which made Alec smile. If he had to guess, she was regaling the other new intern with details about some condition or patient she was wondering about, because that brain of hers never rested.
“Good morning, everyone. I’m Dr. Alec Armstrong, as most of you know.” He forced his attention from Katy to look at the young man she was speaking with. “You must be Michael Coffman, one of our new interns. We’re glad you’re here. Please tell us about yourself.”
“I’m going into general surgery, planning to specialize in urology.”
“Excellent. Our other intern here is Katy Pappas.” He smiled at her, but she just gave a small nod in return. “Tell us about your intended specialty.”
“I’m going into family practice medicine. I really enjoyed working with all kinds of people during med school.” She looked at the group around her and her expression warmed. “Older folks and little ones and everybody in between. Figuring out what their medical problems are, when sometimes it can be a bit of a mystery, fascinates me. Knowing I’m helping individuals and families alike. I’m going to love doing that kind of work.”
She spoke fast, her blue eyes now sparkling with the enthusiasm he remembered from their childhood whenever she had been tackling a puzzle or been deep into a science project, and his own smile grew.
“I’m glad you’ve discovered your calling. Figuring that out is sometimes the hardest part of medical school.” He found himself wanting to keep looking at her, wanting to hear her speak and see her smile, but he made himself turn to the rest of the group.
“So let’s continue our introductions. This is our fifth-year surgical resident, Elizabeth Stark, who performed some of the surgeries on the patients we’ll see this morning. You met our second-year surgical resident, Todd Eiterman, this morning on work rounds.”
Alec finished the spiel he always gave new interns, hoping they actually listened. “Beyond the nuts and bolts of diagnosis and surgery I want to teach you how to talk to people, to ask questions and listen carefully to the answers, which is the only way to truly learn their histories. Conclude what you think the working diagnosis might be then order tests based on those conclusions.”
“Excuse me, Dr. Armstrong, but last month Dr. Hillenbrand said the opposite, so I’m confused,” Todd, the second-year resident, said with a frown. “I thought we were to order tests then, based on those tests, come up with a working diagnosis.”
“Technology is an amazing thing, Todd. But it can’t replace hands-on doctoring, which is the single most important thing I want you to learn on my rotation.” Alec studied the expressions on the faces before him. Smug understanding from Elizabeth, who’d heard it more times from him than she wanted to, he was sure, and also liked to play suck-up to the doctor evaluating her. Skepticism from Todd. Bewilderment and confusion from Michael. And avid concentration and focus from Katy’s big blue eyes, which made him wish he could pin a gold star on her before rounds had even begun.
The thought sent his gaze to the lapels of her coat and the V of smooth, golden skin showing above her silky blouse, and he quickly shifted his attention to Todd. She was his student, damn it. And perhaps someday again his friend. But thinking of her as a very attractive woman? An absolute no-no.
“We’ll be seeing patients who had surgery the past couple of days,” he continued, keeping his eyes off Katy. “But first we’ll see Mrs. Patterson, on whom tests were run yesterday. I know you’ve made your work rounds, so a lot of what I’m going to say will be a repeat of what you already know.”
Alec led the way toward Helen Patterson’s room with the group of students following behind. Katy was closest to him, and her light, fresh scent seemed to waft to him, around him, pleasing his nostrils so much he picked up the pace to put another foot or so between them.
What kind of doctor was distracted by someone’s sex appeal while in the middle of work? Not the kind of doctor he demanded he be, that was for sure. Not the kind of doctor he’d been at one time, long ago when he’d been younger and stupid.
“Dr. Pappas, will you tell me about this patient from your work rounds this morning?”
“This is Mrs. Helen Patterson, and she has been in a rehabilitation nursing facility for one week, post-op after surgery for a broken hip,” Katy said. “She was admitted here yesterday for abdominal pain and referred to the surgery service. She had low blood pressure and her lactate was elevated.”
Katy licked her lips nervously, and Alec yanked his gaze away from them. He tried to simply listen and not notice the serious blue of her eyes as she spoke. “We ordered a CT scan of her belly, and there was no evidence of perforation in the bowel or appendicitis. We observed her overnight, gave her IV fluids and pain meds and she has spontaneously improved. We’ve determined that she has a mild case of ischemic colitis. She had a normal breakfast, and her physical exam is normal, so she can be released today.”
Her expression was both pleased and slightly anxious, and Alec hoped he wouldn’t have to remind her about the low potassium he’d read about in Mrs. Patterson’s chart, and that the repeat potassium was still slightly low. “And?”
“And her potassium was low this morning, but I gave orders that brought it up.”
“Except that those orders were all wrong, Dr. Pappas,” Elizabeth said. She had on her usual superior smirk that Alec had tried, with limited success, to get her to tone down when talking to less-experienced students. “You gave her forty mils to drink, which is way too much to give orally. How did you expect someone to drink that amount? I can only imagine how nasty it tasted to poor Mrs. Patterson. No surprise that she vomited it up and had to be given some intravenously to replace it.”
Katy’s smile froze, and all color seeped from her face, then surged back to fill her light olive skin with a deep rose flush. “What …? I … Oh. Oh, no! I didn’t order forty mil. I ordered four ml!”
“Really?” Elizabeth raised her eyebrows. “Nurses sometimes mishear an order, but it’s still your responsibility—”
To Alec’s shock, Katy turned and tore into the patient’s room, and he quickly followed. What in the world was she doing?
She slid to the side of the patient’s bed and reached for the woman’s hand. Katy’s expression was the absolute picture of remorse. “Helen, I didn’t know it was my fault you got sick to your stomach this morning. I feel terrible! I guess the nurse misheard me and gave you way too much to drink. That’s why you vomited. I’m so, so sorry.”
Alec was torn between being impressed that she instantly took responsibility for what technically wasn’t her mistake, and concern that the patient might get angry and let loose on her. He stood next to Katy, placed his hand on her back to let her know he was there to support her. “It’s unfortunate that orders get confused sometimes, Mrs. Patterson. You’re feeling okay now, though, aren’t you?”
“Yes, it was just an upset stomach. Don’t be angry with dear, lovely Dr. Pappas, now. She’s such a good doctor. Everyone makes mistakes once in a while.”
Dear, lovely Dr. Pappas? Alec smiled in relief. Obviously, the woman liked Katy and wasn’t going to create a stink about the error. He glanced at the residents standing at the end of the bed and almost laughed at the variety of expressions on their faces. Michael was wide-eyed, Todd scowling, and Elizabeth fuming. Having been raked over the proverbial coals often during their training, the two more experienced doctors had obviously been hoping for the same for Katy.
“I’m glad you’re feeling better.” He looked at Katy and, luckily, she understood that he wanted her to stop holding the woman’s hand and stand next to him in a more professional manner.
“Helen, as you can see, I have some interns and residents here with me this morning. Is it all right if they stay while we talk?”
“Of course, that’s fine.”
“Thank you.” He proceeded to ask her questions and explain tests that were run, while palpating her abdomen and listening to her heart and lungs. In the midst of it she held up her hand and interrupted.
“Wait a minute.” Helen frowned at him. “First, why don’t you warm up that stethoscope before you press it on my skin, like Dr. Pappas always does? That thing is cold!” She shifted her attention to Katy. “And why is he asking me the same things you asked me already, dear? Don’t you two talk to each other?”
Katy laughed a little, and glanced at him with a smile in her eyes that felt like old times, making him smile, too. “It’s just how it’s done when we’re being taught by the attending physician, Helen. I know it’s kind of annoying but Dr. Armstrong is an amazing surgeon. I promise you’re in good hands.”
How absurd that her words, which were just to reassure the patient, made him almost feel like puffing up his chest just like the teen Alec who’d always appreciated her faith in him. Helen nodded and waved her hand. “Fine. Carry on.”
“I appreciate the endorsement, Dr. Pappas.” Alec could hear warmth creeping into his voice as he spoke and concentrated on cooling it. On sounding professional and impartial.
Katherine Pappas was his best friend’s little sister and his own student. He had to make sure no one thought they saw any kind of favoritism in the way he interacted with her.
The term “bone-tired” took on a whole new meaning after all-night call with minimal sleep followed by a long day of rounding and scut work. Katy thought she’d worked long and hard in med school, but that had been a veritable party compared to this.
As she stepped through the front door into Nick’s living room, he emerged from the kitchen. “Katy-Did, you’re finally home! You look beat.”
“Now, there’s a surprise. I’m sure I look every bit as hot, sweaty, and wrinkled as I feel.”
“Living hot, sweaty, and wrinkled is an intern’s existence pretty much. Sometimes it’s a general surgeon’s existence, too.” Nick grinned. “I knew you’d be exhausted, so I’m fixing dinner. You don’t have to do a thing.”
“Aw, you’re the sweetest big brother anyone could ever have.” She gave him a quick hug, hoping she didn’t smell too bad. “What are we eating?”
“Steaks from the grill, baked potatoes, veggies. To celebrate your first day, and because you probably need iron and protein after practically twenty-four hours of work. How did it go, rounding with Alec?”
“He’s a good teacher, of course. I’m sure I’ll learn a lot from him.” She dropped into a chair in Nick’s living room because she thought her legs just might give out if she was on her feet another minute. “But you know how I feel about him personally.”
“Katy.” Her brother’s smile faded. “Alec is a good guy, and I regret that I ever told you what happened. Yes, he went through a hellion stage when there was too much partying and too many of the wrong kinds of women in his life, but that was a long time ago. You need to cut him some slack.”
“Why? He’s not the person I thought he was. I’m allowed to be bothered by that, aren’t I?”
“You thought he was cool and smart and cared about other people. You liked him because he treated you great. And that’s exactly who he is, along with older and wiser than he was back then. Hell, I’m still working on the older and wiser part.”
“Don’t worry, I’m not going to be unpleasant or anything. I just don’t want to be friends with him again, that’s all.”
“Well, that’s too bad. Just remember he’s still my friend. And a partner in my practice.” He frowned at her for a moment then sighed. “You never really knew that Alec’s dad was always putting him down, and I think that’s part of why he acted out some back then. But for a long time now he’s worked hard to gain respect. It’s important to him. While he never did get it from his dad, he has it in spades from everyone here.”
“I’m sure he’s a good doctor, so of course people respect him.”
“It’s more than that, but I’m not going to waste my breath trying to convince you.” He turned toward the kitchen. “I’m going to get the steaks on the grill and play with the dogs out in the yard. I’ll let you know when it’s ready.”
He disappeared, and she stayed slumped in the chair, closing her eyes. Which made ignoring the mess of stuff she’d left lying around the room, still packed and unorganized, much easier. She knew she should work on it right now since Nick was being so sweet about letting her live with him for a while, but she also knew he was happy to let her rest a moment.
Much as he’d teased her over the years, Nick had been good to her, too. All six of the Pappas kids were, in fact, close, which Katy was more than thankful for. As an only child, she knew Alec had never had a sibling that he fought with sometimes but who also always had his back, and she knew that had been a big part of why he’d been at their house so much. Her mother had welcomed him, and her dad had adored and mentored him.
Which was why learning of his unethical and distasteful behavior had cut Katy to her very core. Not only that, Alec’s parents had shoved what he’d done under a rug then wrapped it up with a nice tidy bow while someone else had paid the price.
Ah, who was she kidding? It hadn’t been just his mistake and the aftermath that remained stuck as a sharp barb in her soul. It was that he’d done it all practically right after she’d boldly kissed him and he’d pushed her away. Told her it wouldn’t be “appropriate.” Which obviously had just been another way of saying, I think of you as a little sister, not a woman, since “appropriate” clearly hadn’t entered his mind before the scandal.
Her chest burned in embarrassment and disgust but at the same time she couldn’t deny that the man was an impressive doctor and teacher. And, yes, even more ridiculously good looking than he’d been years ago. Today, in Mrs. Patterson’s room, as they’d smiled together at the woman’s comments, she had to admit it had felt nice. A little like old times, and thoughts of his past had momentarily faded from her brain until she’d sternly reminded herself.
She was smart enough to take advantage of his intelligence and experience and learn what she could from him, just as she had long ago. But as far as a friendship happening between them again? Never.
