Sleight of Hand (3 page)

"That's fine, do it."  The mother was amazingly composed for someone who had basically just been told that they had to drill into her child's leg bone.  

"You might want to step outside.  It's not a pleasant thing to watch."

"No, I'm fine.  I want to stay."  

Cassie didn't have time to argue.  She turned back to Charlie, mentally visualizing the intraosseus procedure as she prepped his shin with Betadine. 

"Our usual protocol when we can't get a line on a child is to call Peds."  Rachel's tone was one of a schoolmarm instructing a recalcitrant student.

Cassie said nothing.  Rachel was an excellent nurse, but if she had her way, every patient would be handled according to a cookbook of procedures, each accompanied by the necessary paperwork in triplicate.  

Cassie reached for the sterile bone marrow needle.  She placed the needle against the skin and bore down, leaning her weight on the thin dagger of metal until she felt it break through the bone.  The resulting crack echoed throughout the room. She winced, she hated that noise, then looked up and saw Mrs. Ulrich at the head of the bed, watching closely. 

"There's good flow," she told Rachel as she secured the needle into position.  "Push a milligram of Ativan.  Get me a blood sugar, chem panel, CBC and blood culture."  

Cassie combed her fingers through Charlie's thick golden curls as she waited for the medication to take effect.  Slowly, his limbs relaxed, the seizure activity faded.  She bent over him, flicking her light into his eyes, then examined his mouth with a tongue depressor.

She frowned.  That was strange.  The inside of Charlie's upper lip was bruised, and there were tiny broken blood vessels on his face.  

"Have you noticed these little red dots before?" she asked Mrs. Ulrich.

"The petechia?"  

The mother surprised Cassie by knowing the medical term.  "Yes."

"A few days.  You can check his chart, we were here last week."

Charlie's color was finally improving, Cassie noted with satisfaction.  "Who's on for Peds?"

"Dr. Sterling." Rachel replied.  

"Thank God," Virginia gushed at the mention of the Chief of Pediatrics.  "Dr. Sterling will know what to do.  He always does."

In her two years as an attending physician at Three Rivers, Cassie had only spoken with Karl Sterling on the phone a handful of times and had yet to meet him in person.  Since most of his time was spent in administrative duties, Sterling rarely took call and only cared for a small, select group of patients.  

"Give him a call and tell the Peds ICU that we have a customer for them."  She'd finally get the chance to see the renowned Dr. Sterling in action.

Mrs. Ulrich looked up at that. "You're going to admit him?  Can't I take him home?"

Cassie swiveled her head to look at the mother in surprise.  "I'm afraid Charlie is going to be here for a while.  We need to find out what caused the prolonged seizure and those petechiae.  The Pediatric ICU doctors will be down to talk to you more."

"No, I want Dr. Sterling involved.  He's cared for Charlie all of his life.  No one knows him better."

"Certainly.  I'll call him myself," Cassie said.  "But you'll still have to talk to the ICU doctors."  

Virginia frowned.  "All right.  But I'm not going anywhere until Dr. Sterling says it's okay."

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"Any messages for me?" Cassie asked the desk clerk after she alerted Sterling that he had a patient.   The clerk shook his head in time to the Godsmack playing over his headphones.  Cassie tried to ignore the knot of disappointment that tensed her shoulders.  She'd hoped Drake would call.  He knew it was her first day back.

She wished she understood what was going on with him.  He hadn't touched her since the shooting almost six weeks ago.  Forty-one days ago to be exact.  And Cassie was definitely counting the days.

Why was he acting like this, holding her at arm's length?

Was Drake merely biding his time, waiting for her to get back on her feet again, before he called it off?  After all, she had saved his life–couldn't just dump her like a hot potato, could he? 

Next time she saw him, she'd find out.  She needed to know where she stood.

Thrusting aside all thoughts of Drake and her life outside the ER, Cassie gave the physician replacing her a quick sign out, then returned to the critical care room to check on Charlie Ulrich.  

Rachel had found a rocking chair for Mrs. Ulrich and was helping her into it.  By the time the Peds residents arrived, Charlie's color was improved, and there was no further seizure activity.

"Dr. Sterling is on his way," Cassie told Charlie's mother.

"Oh, thank goodness.  He'll know what to do.  He's a brilliant man.  If it wasn't for Dr. Sterling, Charlie wouldn't be alive today."

"Do you want me to place a central line?" Cassie asked the pediatric residents.  

"No, I think you've done quite enough, Dr. Hart," came a deep voice from behind her.  Cassie turned, and Karl Sterling was there.  A tall man with silver hair and pale blue eyes, the Pediatric Department Chairman resembled the stereotypical Norman Rockwell portrait of everything a physician should be.  A full professor with tenure, he had an established reputation in SIDS research.

"Was an intraosseus absolutely necessary?  If you can't get an IV in a child, I'd rather that you called us to come down and do it for you."  Sterling's tone was mild, not condemning, and he tempered his words with a fatherly smile.  "After all, that's what we're here for." 

Cassie bristled at the pediatrician's indictment of her and her department's skills but tried not to let it show.  She couldn't tell if Sterling was being sincere or patronizing.  Besides, with the mother in the room, this was hardly the time to be arguing about procedures.  

Sterling moved to take Virginia Ulrich's hand.  "How are you holding up?" he asked, his voice gentle.

"I'm so glad you're here, Dr. Sterling.  I don't know what happened, everything was going so well–"

"Don't worry, Virginia.  We'll work it out.  Let me just examine Charlie now."   Sterling donned his stethoscope and bent over the little boy on the gurney.

Cassie left.  The story was puzzling, but the pediatric residents and Karl Sterling could sort it all out.  

She headed down the hall to the security office inside the ambulance bay.  Video cameras were positioned in all of the critical care rooms, the tapes used for quality assurance and educational purposes. 

At least one good thing had come from Charlie's resuscitation.  Cassie was preparing a teaching video of emergency procedures.  If the video from Charlie's IO looked good, she would include it.  

"You mind making a dupe of the video from Trauma 1 for me?" she asked the security guard monitoring the surveillance.  It was the same man who had brought Charlie in.  "I only need the last hour or so."

"Sure thing, doc."

"Thanks.  Just drop it by my office when it's ready."

"I sure am glad the kid's gonna be all right.  The way that mother was shrieking, I thought he was dead already."

Not bad for her first day back, Cassie decided as she headed back to her office.  Her ankle was hurting, but nothing she couldn't handle.  And, despite the awkward encounters with her co-workers, it felt good to be back in the ER–like coming home.

Her office was behind the nurses' station, a windowless cement block cube that had been a broom closet in its previous incarnation.  The narrow confines barely held her bookcases, desk and two chairs, but, since Cassie was junior faculty, she wasn't complaining.  

She opened her office door to find Drake lounging in her desk chair, long legs stretched out before him.  A beautiful bouquet of exotic flowers graced the desk, white orchids glowing against the green florist paper.  So, he hadn't forgotten after all.

His eyes were rimmed by tiny worry lines that hadn't been there six weeks ago.  He climbed to his feet, still a little stiff.  She knew he had no idea how lucky he was that he'd recovered so quickly.  It didn't matter to Drake–all he wanted was to get back to work again.  

"How was your first day back?" he asked.

Cassie shrugged.  She was exhausted after her encounter with Sterling's patient, but that was the last thing he needed to hear about.  

"These are beautiful."   She dipped her face into the flowers and inhaled a deep lungful of the sweet fragrance.  Drake wore a flannel shirt over jeans with no telltale bulge of a gun, so she guessed his day had been worse than hers.  "What did the psychiatrist say?"  

He winced, and she knew she'd been too direct.  She couldn't help it–she just wasn't any good at this give and take stuff relationships were made of.

She pushed the door shut, noticed the way he tensed at the sudden bang.  The small room overflowed with everything unspoken between them.

"Can you go back to duty?" she asked, her face tilting up to meet his gaze.  She moved toward him, their bodies almost touching until he stepped out of reach.  His avoidance of her flared her anger further.  She couldn't stand this limbo any longer.  She needed to know one way or the other how he felt.

"He wants a few more sessions, but he said I could return to desk duty tomorrow."

Enough small talk.  Cassie took another step, forcing Drake back against the edge of the desk.  Before he could say anything more, she reached up, her fingers fisting in his hair, dragging his face down to meet hers.

She enjoyed his startled gasp as she pressed her lips over his.  He flinched, but she gave him no maneuvering room, and after a long moment, she felt his body respond.  His hands moved to rest on her hips, she could feel their heat through the thin cotton of her scrubs.

Yes
, she thought as his lips parted, allowing her to plunge deeper into the kiss. 
This is right; this is how it's supposed to be.

He closed his eyes.  She felt his inhalation echo through his chest.  Then his eyes snapped open and he pushed her away.  Cassie drew her breath in, swallowing her disappointment.  

"What's wrong?" she demanded, hands on her hips, hoping he didn't notice the tremble in her voice.  She'd screwed up.  Again. 

He seemed fascinated with the hospital issue linoleum as he spoke.  "I don't want–"

"You don't want to be with me?  Is that it?"  Her words tumbled over each other as her worst fears were confirmed.  

That was why he didn't want to touch her; he was trying to find a graceful way out of this.  What a gentleman, even brought flowers with him to cushion the blow.  

Might as well beat him to it.  Less painful that way.  

"Why didn't you just say so?  I don't need you hanging around out of pity or duty or whatever."  She flung the door back open.  He opened his mouth, began to speak, but she steamrolled over his words as the sucker punch of hurt and humiliation spiraled into her gut.  "You don't have to pretend anymore.  Take off, get back to your life.  Get out of here." 

CHAPTER 3

Drake stared at Hart, her small frame silhouetted in the light from the hall, long, dark hair bouncing in frizzled curls, anger hunching her shoulders.  The color in her cheeks glowed against her pale skin while her eyes blazed with fury.  

Christ, he wanted to shake her.  Why did she have to always rush into everything?

"Just go," she repeated, gesturing to the open door.  

Heat flooded over Drake.  He moved to the door, but instead of going through it, he reached above her and slammed it shut.  Caging her with his arms, he pressed her body back against the door, even though he knew she despised being trapped, confined in any way.

"I was trying to say," he placed one finger over her lips before she could protest, "that you are too important.  There's no need to rush.  I was trying," he lowered his head so that his forehead rocked against hers as she caught her breath, "to tell you that I'm not like your ex-husband, and I'm not going to force you into anything."

Her gaze rose to meet his.  She glared up at him, crimson flushing her face.  Drake saw a glint of humor enter her eyes and felt a surge of relief.  One thing about Hart–she had a temper but never held a grudge.

"I'm so sorry," she said in a voice dripping with sarcasm.  "Were you going to inform me about this ‛slow and easy' plan of yours?"

He opened his mouth to answer, but she hooked her good leg behind his recuperating one and pivoted him into the chair.  His breath emerged with a whoosh of surprise.  Then her body was straddling his.  

"What if I don't want to go slow?"  Her hands tugged at his shirt while her mouth buried his.

He struggled for a moment, just enough to sooth his dignity, then allowed himself to answer her passion with his own.  With his eyes locked onto hers, drowning in their dark depths, it was almost as if the shooting had never happened.  His heart geared down from panic to the steady thrill of arousal.  

"I guess we can discuss it," he said when they parted for air.

She slid one hand around to the small of his back, her fingers working their gypsy magic.  They found their target, the sensitive area at the base of his spine where her touch could make his blood boil.  He closed his eyes against the surge of pain and delight that resulted.  

"Discussion's over," she announced, nipping at his earlobe.

Drake had to agree.

A loud rapping on the door echoed like gunfire from the concrete walls.  Drake's heart slammed against his chest.  He almost dumped her on the floor as he leapt to his feet.  The sudden movement sent a wrenching pain through his thigh muscles. 

Hart pulled her top back into place and opened the door.  Drake heard a male voice.  His hand moved to his right hip.  But of course his gun wasn't there.  His world teetered off balance, his heart raced out of control.  He sank back into the chair, rubbed his sweaty palms against the coarse denim of his jeans, trying to relax the clenched muscles of his thighs, forcing himself to breathe.

"Dr. Hart?  I have that tape for you," the unseen man said.

"That was fast.  Thanks."