Sleight of Hand (2 page)

"Driven's more like it.  Reckless, relentless.  And stubborn as hell.  Christ doc, you don't know stubborn until you've met Cassandra Hart."  Saying Hart's name aloud wrenched something deep in Drake's gut.  He sucked his breath in, turning away from the shrink to hide it.  Hart's face filled his mind, her porcelain skin with exotic high cheekbones, dark hair, eyes a man could drown in.  He took a deep breath and steadied himself, turning back to face the doctor.

"Speaking about Dr. Hart seems to disturb your equilibrium."

Understatement.  "Guess she kind of threw me off balance."

"Why do you speak of being with her in the past tense?" 

"It's not Hart that's in the past."  Drake fumbled to explain.  "It's just that overwhelming passion–you know what I mean.  That feeling like you're falling, drowning in a whirlpool that sucks you under, but you're too far gone to even care.  That's what is past."

White cocked his head.  "But isn't that what most people find exciting about being in love?  Doesn't that passion drive the relationship forward?"

"Maybe.  But that passion made me drop my guard, that feeling almost got Hart killed."

"And what about your Dr. Hart?  Does she agree with this new philosophy of yours?"

"Guess that's enough for today," Drake said in a casual tone as if they'd been talking about the Pirates' opener.  

He and Hart hadn't exactly talked about things since he got back from his mother's last week.  At least not important things.  Like the way his heart about jumped out of his chest every time she got too close.  Or the way his throat closed tight and he broke out in a cold sweat when he watched her move, her natural grace impeded by her healing Achilles' tendon, reminding him of what he'd almost lost.  "Time's up, right?"

The shrink didn't even glance at his watch.  "No," he said.  "We've a few more minutes.  Sit."

Drake took his seat once more, perched on the edge, hands hanging between his knees.

"How would you categorize your relationship with Dr. Hart?" White persisted in his torture.

Drake swallowed his groan and hung his head.  There were no words for the way he felt about Hart.  Why waste time trying to find any?  Besides, they were supposed to be talking about the shooting, about getting Drake back on the streets where he belonged.

The silence lengthened, but the shrink did nothing to alleviate Drake's discomfort.  Finally, the clock chimed the hour, and Drake popped from the chair like a schoolboy released for the summer.  

"I can get back to work now, right?" he asked, hands clenched at his sides as he waited for White's reply.

"Desk duty."  Came the grudging answer.  "I want to see you tomorrow morning, Detective.  We still have a lot of ground to cover."

Drake said nothing, only nodded his head.  He had to restrain himself from slamming the door behind him as he left the office.  He moved down the corridor, his gait unbalanced.  Not from the leg injury, but from the weight missing on his hip.  Amazing that thirty-four ounces, the weight of a fully loaded forty caliber Glock-27, could make such a difference.  

It made all the difference in the world.  A cop without a gun, chained to a desk, what good was he to anyone?

CHAPTER 2

Cassie made her way to the ER's locker room, changed out of her jeans and into scrubs.  She was glad there was no one there to watch her sit on the bench to maneuver her legs into her pants.  This shift was going to be long enough, no sense allowing stubborn pride force her to put more stress on her ankle.  

Her hands moved in a familiar routine, clipping her name badge to the top pocket, checking the trauma radio and fastening it to her waistband alongside a pair of hemostats that held a roll of tape.  The short-sleeved scrub top revealed the jagged scar that ran down her left forearm, and she debated on a lab coat to cover it.

Let ‘em stare, she decided.  They'd have to get used to it sooner or later.

The first person she encountered at the nurses' station was Rachel Lloyd, the day shift charge nurse.  Rachel stood several inches taller than Cassie's five-four and looked down on her with dark brown eyes set in even darker skin.  Her hair was arranged in an intricate coiffure of braids perched high on her head, not a strand daring to leave its designated position.  A definite contrast to Cassie's own frizzled curls, which resembled a wet mop struck by lightning.

"Good to have you back, Dr. Hart," Rachel said in her clipped Caribbean accent.  Her tone was neutral as if she didn't care whether Cassie succeeded or failed.  Either way, Rachel would be there to witness and document it for the record.  

Nice to know some things didn't change.  She and Rachel shared a mutual respect for each other's skills combined with a mutual disapproval of the other woman's methods.  This morning Rachel's look held the same frosty regard as it did six weeks ago.  Without a trace of pity, which Cassie was grateful for. 

Because she refused to be a victim–ever again.

"Ready for your first patient, Dr. Hart?" Rachel asked, holding a clipboard out to her.

Cassie tried to act nonchalant, ignoring the sudden clenching of her stomach as she took the chart and headed into exam room five.  Waiting for her there was a young black woman cradling a toddler on her lap.  They both looked up when Cassie entered, the woman's expression tired and anxious.  The toddler's face was tear stained.  He took one look at Cassie and threw his arms around his mother's neck, hiding his face.

"Is this Antwan?" Cassie asked, reading the name on the chart. 
Antwan Washington, age three, chief complaint ear pain. 
No fever, vitals normal, no complicating past medical history according to the nursing notes.  Looked like Rachel had picked out an easy one for Cassie's first patient back.

"I'm Dr. Hart."  Cassie sat in the rolling stool and wheeled her way across the room, stopping as soon as little Antwan's shoulders hunched.  "What brings you here this morning?"

"It's his ear," the mother replied.  Cassie snuck a quick peak at the demographic sheet; so many mothers had different names than their children.  Tammy Washington.  "I don't know what's wrong, he took all the medicine the clinic gave him, but all weekend he's been complaining and last night it hurt so bad he was up all night crying."

"Do you remember what medicine he was on?"

"The pink stuff."  Tammy shifted in her seat, rearranging Antwan's weight.  Cassie took the opportunity to inch closer, watched as the toddler slit one eye open but didn't pull away.

"Amoxicillin?"

"Right.  He took ten days, finished it last week.  I tried to wait until the clinic opened, but he was crying so bad."

"It's all right, Ms. Washington.  Hey, Antwan, I need you to give your mom a really big hug, all right?"  Cassie warmed her stethoscope between her hands then slid it under Antwan's t-shirt.  "Okay, big breaths now.  Good job, that's perfect.  How about if you turn around so I can listen to your heart?"  

Still wary, Antwan obeyed, even smiling when Cassie pretended for a moment that she couldn't find his heartbeat.  As she maneuvered through the exam she asked his mom more history but found nothing worrisome.  Finally it was time.  The big challenge in any toddler, but especially one whose ears were already painful: the ear check.

Cassie wrinkled her face in a mock expression of disbelief.  "I think there's kitty cats in your ears, Antwan."  His eyes grew wide and he shook his head, almost smiling but uncertain.  "Let's take a look.  We'll start with the one that doesn't hurt first.  Okay, hold still and listen for the kitty cat."  She gently positioned the otoscope.  "Meow."

"Hey, momma, I got kitty cats!"  No longer suspicious, he eagerly bounced forward on his mother's lap so that Cassie could check the other ear out.  

"He's right," she pronounced after finding another kitty cat as well as a rip-roaring otitis media.  "That ear is fire engine red and bulging with pus.  I'm going to get him some pain medicine and the first dose of antibiotic before you leave.  We're going to use a stronger medicine. It may give him diarrhea, so lots of yogurt, okay?  Schedule an appointment with the clinic for an ear check, but if things aren't getting better in two days or if anything gets worse, he needs to be seen."

"Yes ma'am.  Thank you."

"No problem.  Hey, Antwan, you take all your medicine and don't you drive your momma crazy, okay?"  Cassie fished out a Sponge Bob sticker and handed it to the little guy.  He beamed with delight.

"What do you tell the nice doctor?" his mother prompted him.

"Thank you," he chimed out.

Cassie left the room still smiling.  She loved it when kids weren't too sick.  The radio on her belt squawked.  "Dr. Hart to Trauma One, stat."

She limped down the hall, trying to restrain herself from running as the familiar rush of adrenalin humming through her veins.  It felt good to be back.

Eight hours later, by the time her shift was over at four o'clock, Cassie was wishing for the cane once more.  Not as a crutch, although her ankle now screamed with the ferocity of a toddler in the midst of a tantrum.  If she'd brought the cane she could use it to fend off the awkward glances and whispers of her co-workers.  Whispers that scurried underfoot like rats in the sewer, ambushing Cassie when she rounded a corner or entered a room. 

With the cane Cassie could announce her presence, salvage some pride, instead of flushing as people became silent and adverted their eyes from her, uncertain how to label her now that she was back at work: resilient victim, tough as nails survivor, or flavor of the month gossip.  

Finally, she'd retreated to the sanctuary of the dictation desk at the nurses' station and waited for her replacement.  She eased her left leg out, stretching it gingerly.

"Someone help me!"

The woman's cries reverberated from the tile walls of the ER.  Her high heels skidded on the white linoleum as she ran toward the nurses' station.  

Cassie jumped up from her chair.  Too fast, too fast, her leg shrieked.  Her vision blurred with pain for one brutal moment.  She grabbed the counter and steadied herself with a quick breath, then moved to intercept the frantic woman.

"What's the problem?"

"My baby, my baby."  The woman's purple designer suede jacket flew open, and Cassie could see that beneath the empire-waist silk dress, she was pregnant.  Very pregnant, at least seven months or so.

"Are you having contractions?" Cassie began to usher her down the hall, but she pulled away.

"You've got to help my baby!"  The pregnant woman whirled, looking behind her.  The ambulance bay doors slid open once more, and a security guard came running through, his arms filled with an ashen-colored toddler.

"Room one."  Cassie hobbled ahead to hold the door open.  The hysterical mother followed.  "I need some help here," Cassie called over her shoulder into the nurses' station.

The guard almost tossed the baby onto the bed, immediately backing away, his own face flushed and sweating.  Cassie began to undress the small boy, ripping apart snaps and buttons.  The boy's arm was still jerking, and his eyes were deviated to the right; he was in the midst of a seizure.  "What happened?"

"I don't know, he just started seizing–the monitor never went off–is he going to be all right?" the woman, his mother Cassie assumed, said.

Cassie stripped the boy to naked skin.  A wide belt bristling with brightly colored wires encircled his chest.  An apnea monitor designed to alert parents to breathing problems in their premature infants.  But she'd never seen one used in a child as old as this boy who appeared to be at least fifteen months.  Grabbing an oxygen mask, she stretched it over the boy's thick blonde curls, and listened to his chest.  Breathing was fair, heart sounded good.

"When did the seizure begin?" 

"About two-thirty, I had just put him down for his nap."  The mother clasped her purse to her chest.  She was taller than Cassie with blond hair styled in a neat bun and grey eyes framed by meticulous makeup.

"Why didn't you call 911?"  She bent over to examine the child. Rachel Lloyd rushed in before the mother could answer.

"What do you need?"  Then Rachel saw the boy on the table.  "Charlie."  She turned to the mother.  "Virginia, what happened?"

"Rachel, he's had a seizure.  I didn't know what to do, so I brought him here."

"Of course.  We'll take care of him, everything will be all right."

"Help me get an IV," Cassie interrupted their reunion.   If the boy had been seizing for over an hour, then Cassie was already out of time.  If she didn't stop it soon, he could suffer permanent brain damage.

"Of course, Dr. Hart."  Rachel moved to Charlie's side and began to search for a vein.  "Dr. Hart, this is Virginia Ulrich.  Charlie is her son."  Rachel made the introductions while trying without success to start the IV.

"What kind of medical problems does Charlie have?" Cassie asked the mother, continuing her examination.

"Dr. Sterling follows him for apnea."

"Has he had seizures before?"

"After his pertussis shot."

"Damn," Rachel swore under her breath.  Cassie looked up at that.  She'd never heard Rachel swear before.  "I can't get a line." 

"I'll take a look."  She searched for a likely vein, but the prolonged seizure had collapsed all of them.  "Set up for an IO," she ordered after her own attempt failed.

The mother moved closer, rubbing her belly with slow, rhythmic movements as she watched Cassie work on her son.  Rachel stopped what she was doing to stare at Cassie.  "Don't you mean you want me to call Peds to come start an IV?  That's what we usually do."

"We don't have time to wait for them.  An IO is faster."

"But Dr. Sterling doesn't like us to–"

"Sterling's not here.  Charlie's my patient.  I'll do what is best for him."  

Rachel glared at her, then turned to get the proper equipment.  Cassie straightened and placed a hand on Virginia's forearm, drawing the mother's attention away from Charlie to her.  "Mrs. Ulrich, Charlie is still seizing and he's in shock.  We can't get an IV started, so I'd like to insert an intraosseus line.  That is a special needle that will go into his lower leg bone, then we can give him the medicine he needs.  We'll take it out as soon as we can.  The main risks are damage to the bone and infection, but we do it under sterile conditions."