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The minute he hung up the phone, his pager went off. He read the text message. McLeod’s BP is dropping, come to CT stat.
Simon didn’t waste any time heading over to the scanner, thankfully located right around the corner in the emergency department. When he arrived, Hailey glanced up at him, her expression grim.
“I told them to keep the IV in place. Do you want me to start a vasopressor to bring his blood pressure back up?” she asked.
“Yes, let’s start norepinephrine titrate to keep his blood pressure above 90 systolic.” He reached for the phone to stat page Leila Torres, the on-call surgeon working today. He quickly punched in the number for the CT scan, followed by a 911 so she’d know to come straight over. “How much of the scan were you able to complete?” he asked as he hung up the phone.
“Maybe half?” Hailey said as she pulled the IV medication out of the crash cart and hung it on the pump.
He crossed over to the reading room to look at the images. They hadn’t quite been able to get half the scan done, but he could still see there was the slightest hint of blood leaking near the guy’s descending aorta.
“What’s happening?” the patient asked Hailey. “Is the test over?”
“Your blood pressure dropped a little too low,” she explained. “We’re starting you on some medication to bring it back up.”
He caught Hailey’s hand. “Tell Myra I love her,” he said.
Simon caught the agonized look in Hailey’s eyes. “I will,” she assured him.
Leila strode into the room, glancing at Simon with an arched brow. “You rang?”
Simon pulled her into the reading room and indicated the worrisome spot on the CT scan. He kept his voice low so the patient couldn’t hear. “The only abnormal lab test he has is a low H/H. He just dropped his blood pressure so we couldn’t finish the scan. I think he has an aneurysm that’s about to rupture.”
“I think you’re right.” Leila was a petite woman with a hint of Asian heritage, and Simon had all the respect in the world for her skill as a surgeon. “I’ll take over from here.”
While Leila explained to Mr. McLeod what was going on, he called the OR to let them know an emergency case was on the way. Then he informed the radiology tech they needed a couple of transporters to run the patient up to surgery.
“We can’t forget his wife,” Hailey murmured, as they prepared to wheel Mr. McLeod down the hall.
“We’ve got it from here,” Leila told them. “Go back to the ED. Tell his wife I’ll talk to her when the surgery is over.”
“All right.” Simon stood next to Hailey as the team whisked the patient to the nearest elevator. This was the most difficult part of his job, giving bad news to families.
He turned and headed back to the arena. He was a little surprised when Hailey followed him into Mr. McLeod’s room. Some of the nurses left the bad news up to the doctor. He appreciated her support as Mrs. McLeod looked up at them questioningly.
“Where’s Hank? Have you finished his scan?” she asked, her gaze bouncing nervously between the two of them.
“Mrs. McLeod, your husband has an abdominal aortic aneurysm. What that means is that the biggest artery going from his heart down through his abdomen has a bulging section, where the artery wall is weakened.”
“A weak artery is causing his pain?” she asked, her brow wrinkled in a puzzled frown.
“It’s actually more than a weak artery, Mrs. McLeod,” Hailey said. “This is a very serious condition that needs immediate treatment.”
Simon nodded. “Your husband’s blood pressure dropped while he was getting his CT scan. We started him on some medication to bring it back up, but we think the weak spot of his artery has started to give way. I’m sorry to tell you this, but he was taken to the operating room for emergency surgery.”
“Emergency surgery?” Mrs. McLeod paled at the news. “But he’ll be all right, won’t he? I mean, you caught it in time, didn’t you?”
“We acted as quickly as we could, and he has an excellent surgeon taking care of him.” No matter how much he wanted to gloss over the risks, he knew she needed to hear the truth. “As Hailey said, this is a very serious condition. A life-threatening condition. He has a good chance of making it through this surgery alive, but there is a twenty-eight percent chance he might not make it.”
“No. Oh no. Hank, poor Hank.” Mrs. McLeod’s stoic expression crumpled. “Tomorrow is our wedding anniversary. Thirty-five years! I can’t lose him. Don’t you understand? I can’t lose him!”
Hailey put her arm around Myra McLeod’s shoulders and the woman sagged against her, sobbing as if her heart were breaking. Despite his resolve to keep a safe distance from his colleagues, a lump lodged in Simon’s throat when he noticed Hailey’s eyes filling with tears, several fat drops slipping down her cheeks. As she comforted the patient’s wife, his gaze locked with Hailey’s in unspoken, yet shared agony.
Hoping and praying Hank McLeod wouldn’t die.
CHAPTER TWO
ONCE she’d managed to get the poor woman to calm down, Hailey took Mrs. McLeod to the family center waiting area, leaving her in the kind, compassionate care of the elderly volunteer behind the desk.
It was the nature of the emergency department to move quickly from one patient to the next. She loved emergency nursing but sometimes, like now, she regretted not being able to follow patients for longer than a few hours.
As she tried to get caught up with the rest of the patients on her team, she couldn’t prevent her gaze from straying to Dr. Carter. Those moments when they’d stared at each other while Mrs. McLeod had cried in her arms had touched her heart—a heart she’d assumed was long frozen.
Cedar Bluff was so different from the big city trauma center where she’d worked before. Here, it seemed as if everyone took their patient’s welfare more seriously. No, not more seriously, that wasn’t the right word.
Personally. The staff took their patient’s welfare personally. Maybe because the community was so close. Because they ran into each other at the grocery store, at church or even at the park.
“Hailey, I put another admission for you in room seven,” the charge nurse informed her.
“Okay, thanks.” It was just after six o’clock in the evening and she was somewhat surprised she hadn’t had a new admission sooner. Not that she was complaining. The slightly slower pace made it easier to be thorough with every patient.
She enjoyed working with people, mostly because it helped her to remember that everyone had difficult situations to work through. Some worse than others.
She glanced down at her paperwork as she headed toward room two. A seven-year-old boy with a dislocated shoulder and possible broken arm. Her steps slowed as a chill snaked down her spine. One of the things every emergency nurse learned early on was to look out for the various signs of suspected abuse. A dislocated shoulder could be the result of a parent yanking on a child’s arm, and abuse cases often presented with broken limbs.
Quelling her nervousness, she entered the room, mentally prepared for the worst. A young boy was lying on the cart, dried tears on his face. His mother, a pretty and obviously pregnant woman, was sitting beside him, holding his uninjured hand.
“Hello, my name is Hailey and I’ll be your nurse for this evening,” she said, quickly introducing herself. Deliberately focusing her gaze on the child, she crossed over to the other side of his gurney. “Ben, can you tell me what happened? “
The child glanced up at his mother, as if seeking permission, and the pregnant woman offered a strained smile. “Go ahead, Ben. Tell the nurse what happened.”
“I was climbing the tree and I slipped,” he said. “My arm hurts real bad.”
“I know—we’re going to give you something for the pain. But can you tell me what happened after you slipped? How did you hurt your arm?” Hailey sensed the boy’s mother was frowning at her, but she kept her gaze on the boy. His story seemed a bit fishy.
“When I fell, I grabbed a branch, but it broke.” He sent another nervous glance at his mother.
“It’s okay, Ben. I’m not mad at you,” the woman told him softly.
“But I wasn’t supposed to climb the tree,” Ben said in a wobbly voice, sniffling loudly.
“No, you weren’t. But I’m not mad at you. Go ahead and finish your story.”
Hailey glanced at the pretty honey-blonde-haired mother, acknowledging that she sounded sincere. But she wasn’t going to let the woman off the hook yet. “What happened after the branch broke, Ben? Did you fall to the ground?”
“No, I didn’t fall, I jumped. The branch didn’t break all the way. I was hanging in the air when I felt my arm start hurting. When I jumped, I fell backwards on the same arm.” His wide eyes filled with tears. “I’m sorry, Mom.”
“Shh, it’s okay, Ben.” The pregnant mother sent Hailey a resigned glance. “It’s not the first time Ben’s had a broken bone. He’s a bit accident prone.”
Accident prone? The hairs on the back of her neck lifted. She highly doubted it. The way the child was so afraid of his mother’s reaction didn’t sit well with her at all. “All right, Ben, I need to look at your arm for a minute.”
She gently palpated the extremity, reassured that there was a good pulse in his wrist. “I’m going to get the doctor to take a look at this arm, Ben. I think you’re going to need X-rays. Do you know what an X-ray is?”
“Yeah. I know. It doesn’t hurt.” The calm acceptance in the child’s eyes bothered her. No child should be that familiar with X-rays.
Hailey left Ben’s room and crossed over to the closest computer, intent on bringing up the child’s past medical history to look more closely at his most recent accidents.
“Where’s Ben?” a male voice demanded. She glanced up in time to see Dr. Seth Taylor standing near Dr. Carter. The expression on Dr. Taylor’s face looked grim. “Kylie told me to meet her here.”
Hailey glanced at her patient’s name. Sure enough, Ben Taylor. Was this the reason no one had looked closely at this child’s multiple injuries? Because he was the son of a doctor on staff?
“I don’t know, Seth. But calm down, we’ll find him.”
“Um, Dr. Taylor?” Hailey spoke up. “Ben was just placed over here in room seven.”
“Thanks.” Relief flared in his eyes as he headed straight for Ben’s room. Dr. Carter crossed over to where she was standing.
“What happened to Ben Taylor?” he asked.
“Dislocated shoulder and possible broken arm,” Hailey answered. “I’m worried about him. Hasn’t anyone considered getting Child Protective Services involved? “
“Child protective services?” Dr. Carter stared at her for a few seconds and then started to laugh. “For Seth and Kylie? No, Hailey, you’re way off base.”
She bristled at his casual dismissal. “Oh, really? Just because his father is a doctor here doesn’t mean this boy isn’t the subject of physical abuse.”
Simon’s laughter ended abruptly. “You’re serious!” he exclaimed, his eyes widening comically. “Come on, Hailey, I know Seth and Kylie. They’re not hurting Ben.”
“Then why is Ben so accident-prone?” She’d pulled up the boy’s medical record. Six months ago he’d had a gash to his leg that was deep enough to need stitches. And another six months before that he was admitted for hypothermia after falling into Lake Michigan. And before that he was hit by a car while riding his bike.
Accident prone was an understatement.
“Because he’s a mischievous kid who’s probably looking for attention now that his mother has another baby on the way,” he pointed out reasonably.
“Maybe.” She couldn’t deny his theory made sense, if Ben was telling the truth about climbing the tree against his mother’s wishes. She glanced at the boy’s history again. Falling into Lake Michigan couldn’t be construed as abuse. Neglect? Maybe. But his mother hadn’t been the one driving the car that had hit him. More neglect?
Or was she simply overreacting?
“Seriously, Hailey, you have to trust me on this. Seth and Kylie are good people. They love Ben. They would never hurt him.”
“If you’re sure,” she finally agreed. She didn’t need Dr. Carter’s approval to call Child Protective Services—anyone could make a referral. But Cedar Bluff was a small town and the more she thought about it, the more likely it seemed that if something like physical abuse was going on, others would know about it.
“Hey, don’t be so hard on yourself,” Dr. Carter said quietly. “Actually, you did the right thing by raising the question. Sometimes we see these people so often, here at work and out in the community, we don’t even think about the fact that something horrible could be happening behind closed doors. Having new people work here is a good way to keep us on our toes.”
He was being nice, trying to make her feel better. Surely someone with integrity, like Dr. Carter, wouldn’t ignore a case of child abuse. “Thanks,” she murmured. “You’d better go in there to see him. He’ll need X-rays for sure.”
“Will do.” He flashed a quick smile before disappearing into Ben’s room. She followed and halted in the doorway, watching as Dr. Taylor and his pregnant wife hovered over Ben with obvious concern.
A family united.
Feeling foolish about her original suspicions, and maybe a bit envious at their closeness, Hailey turned away to check on her other patients.
After the fiasco with Ben, the rest of her shift flew by. Several times she thought about calling upstairs to the intensive care unit to find out how Hank McLeod was doing, but other issues needing her attention prevented her from following through.
But after her shift was over, Hailey couldn’t leave without checking on him. She didn’t call the ICU but simply walked up the few flights of stairs until she reached the third-floor surgical ICU.
Worrying her bottom lip with her top teeth, she read through the names on the census board. She didn’t immediately find his name and her stomach clenched, fearing the worst. But then she found him at the bottom of the list in the very last room.
She went down the hall toward his room, only to discover he was in the middle of a sterile procedure, a central line placement from what she could tell. She glimpsed at his vital signs on the monitor, reassuring herself that he was relatively stable, before she backed away.
Not an appropriate time to check with his wife to see how things were going. Maybe tomorrow she’d stop up to see Mrs. McLeod. As Hailey walked back out of the unit, she came face to face with Dr. Carter, who was apparently on his way in.
“Hi, Dr. Carter. Guess we’re both here for the same reason,” she said with a sheepish grin. She was impressed he’d cared enough to come up to check on their patient. “You can go in, but they’re in the middle of placing a central line on Mr. McLeod.”
“Ah, then I won’t bother them.” He stood for a moment, his hands tucked in the pockets of his lab coat as if he wanted to say something. “Hailey, stop the Dr. Carter stuff. You need to call me Simon.”
Her eyes widened and she swallowed hard. “I’ll—uh—try,” she hedged, stepping to go around him. “I have to run. I’ll—uh—see you later.”
“Wait, this is important,” he called, halting her escape. “I’m not trying to come onto you or anything.”
She sucked in a quick breath at his bold statement. “I never thought you were!” she said hastily, her cheeks burning with embarrassment.
Good grief, this was awkward.
Now it was his turn to avoid her gaze. Still, he continued, as if needing to clear the air. “The administration here at Cedar Bluff is working on a new initiative where we all work together as a team, keeping the patient at the center of all we do.”
“Okay,” she agreed slowly, trying to figure out where he was going with all this. “I’m all for making our patients a priority—why else would we be here?” And what in the world did that have to do with calling him Simon? She could feel her cheeks reddening at the thought of being on a first-name basis with him.
“Of course, we all do. But I think you’re missing the point. The most important part of achieving the goal of patient-centered care is teamwork. Cedar Bluff doesn’t want us to view ourselves as a hierarchical organization. Instead, they want us to have a team approach, where everyone has an equal say in what we do for our patients.”
“Really?” She couldn’t help the sliver of doubt in her tone.
Now his expression seemed a bit exasperated. “Haven’t you noticed how big the first name is printed on our hospital ID badge? Or heard everyone calling everyone else by their first names?”
She nodded slowly. “Yes. But I’m used to calling doctors by their formal titles. It’s a sign of respect. And I figured you all knew each other well enough to use first names, but I’m still new here.”
He looked a little taken aback by that statement. “Not at all. I mean, I know some of the people really well but others I don’t. Regardless, it’s about being a team. Not a doctor versus a nurse, or a tech versus a nurse. A team. Got it?”
What he was saying made some sense. She reluctantly agreed, “Got it.”
He looked relieved. “Good.” There was another awkward silence and he cleared his throat and then glanced at his watch. “I have to get home, too. Goodnight, Hailey.”
His expectant gaze forced her to respond in kind. “Goodnight, Simon.”
His name sounded strange when she spoke it out loud and for a moment there was a simmering awareness hovering between them. After a few moments he deliberately turned and walked away, breaking the intangible connection.
When he headed for the elevators, she decided to slip down the stairs to go to the staff locker room.
In the privacy of the female locker room, she peeled off her scrubs and pulled on her skin-tight florescent striped biking gear, reliving those few tense moments when Simon had told her he wasn’t coming onto her.
