Solemn Oath (17 page)

And then Lukas felt the compassion. This was real. He reached over and pulled a couple of tissues from the container beside his chair, then got up, stepped silently across the deep carpet and sat down beside Theodore. He placed the tissues in Theo's hands and waited.

Lukas had no idea what it would be like to be caught in such a deadly habit. How would it feel not to have known about Christ from your earliest memories of childhood? Lukas knew from Mercy that Theodore's parents divorced when Theo was ten years old, and he was still in high school when his father died. Lukas could only imagine all Theo had gone through.

Lord, forgive me. Now I know how Jonah felt when he tried to escape his mission to Nineveh. Don't send the giant fish just yet. I really do want to do Your will. All these years I've asked You to use me, and now that it looks like You are, so
quickly and with so little effort, I'm resentful. Help me to forgive.

Theodore used the tissues to wipe his face and nose, and he rested his elbows on his knees and continued to cover his face with his hands. “Thursday night after Jarvis kicked me out of his house, I walked home.” He shrugged. “I don't have a car now, so I walk everywhere I go. Anyway, I passed the liquor store three blocks from my apartment, and then I turned around and went in. I bought a pint of whiskey, promising myself I wouldn't drink the whole thing, just a couple of swallows to kill the pain.”

Lukas leaned forward. “Pain from what?”

Theo wiped his face again and sat back. “From seeing myself more clearly than I ever have. Mercy was right—I hadn't changed, and I knew it. I couldn't stop thinking about it.” He looked at Lukas. “I drank half the bottle Thursday night before midnight, then I was so sick for the next three days, I barely got out of bed. I finished the bottle last night, and I couldn't get any more because the liquor store was closed. This morning when I woke up I decided that if I buy any more booze, I'll just buy a couple of gallons and keep on drinking until it kills me.” He continued to hold Lukas in his gaze. “I can't…1 won't live like this anymore.” Tears once more spilled from his eyes. He still looked sick.

Before Lukas could think of any comforting words, the door flew open and Buck rushed in. “Dr. Bower, Dr. Garcias sent me to tell you that Amanda's crashing. Also, Carol caught me on the way in here, and the paramedic with the drowning victim is calling for you from the ambulance. We need you—now!”

“I
want birth control pills.” Fifteen-year-old Shannon Becker did not make eye contact with Mercy but sat slumped on the table after her female exam, shoulders curved forward in a position that demonstrated a discomfort with her rapidly burgeoning female contours.

Mercy tried not to allow her sudden shock to show on her face. “I see.” Oh boy, did she see. What was she supposed to do about this? She refused to allow this sweet child to join the meat-market parade. “You mentioned a concern about your complexion.” That was lame and she knew it, but she had to stall for time. That could be Tedi sitting on that exam table in a few years. She turned toward the small desk along the wall of the exam room. “I can prescribe a cream for acne that will be safer than—”

“No, I don't want the pills for zits.” Shannon reached up and wrapped a strand of her shoulder-length light brown hair around her right forefinger. She blinked, looked at the floor, then back at the delicate cloud pattern of the wallpaper, anywhere but at Mercy. “My friends told me that a doctor can't report to a girl's parents if she gets birth control pills.”

With a silent sigh, Mercy stood and assisted her young
patient down from the exam bed and gestured toward a chair. “That's right. Legally I can't tell your parents about your request for contraceptives.” And right now Mercy hated the legalities of her profession.

She'd watched Shannon grow up for ten years, ever since her parents, Zach and Lee Becker, sought out Mercy to be their family physician. Even during the divorce and the rumors about Mercy's mental problems, the Beckers had been faithful to her, had trusted her judgment and medical expertise. And now she felt like a traitor.

“Our discussion will be confidential.”

Shannon's expressive gray eyes flicked toward Mercy for the first time during the visit. “Discussion?” Her face flushed.

“Of course.”

“But you gave me the exam. Can't you just write me a prescription for the pill now? Why do we have to talk about anything?”

Mercy made a notation on Shannon's chart and checked the noticeable weight gain since her last visit a year ago. Adolescence had attacked this child with a vengeance. “I talk to all of my patients, or their parents, about the treatment they will be receiving.”

“And you really won't tell Mom?” There was a faint quiver in Shannon's voice, the scared little girl hiding behind the crumbly veneer of a teenager.

Mercy patted the girl's slightly plump shoulder. This was the Shannon she had always known and loved. “Get your clothes on, honey, then come down the hallway to the second door on the right. It's my office. We can talk there.” She grinned. “Don't worry, I'm not going to eat you.”

 

Lukas rushed back into the E.R. from the private waiting room. “Buck, tell Dr. Garcias I'll be there as soon as I can.” He glanced at Theodore, who came out behind him. “Can you wait for me?” He suddenly wanted to
continue the conversation he'd been so anxious to avoid earlier.

“I've got to go to work.”

“If you're serious about what you said in there, can you find a Bible somewhere today?”

“My boss sells them at the print shop.”

“Then find time on your break to read the first chapter of Isaiah and start on the book of John.” Lukas stepped to the radio and pressed a button. “This is medical control.”

It was the ambulance with the young drowning victim. “We are currently inbound to your facility with a class-one medical full code. Repeat, patient is a full code. She is in v-fib, and we have attempted defibrillation three times without success. Patient is intubated and IV established times one. C-collar in place, patient on backboard. ETA of ten minutes. Further order at this time?”

“Does patient have obvious injuries?” Lukas looked up to see Claudia coming through the E.R. entrance. The cavalry had arrived.

The voice came back over the radio. “Patient has numerous abrasions, no active bleeding. Full assessment not done due to patient severity.”

“Understood. What was the initial rhythm?”

“Pulseless electrical activity.”

Lukas frowned. You couldn't shock someone with pulseless electrical activity. It did no good. Then he realized what had happened—they'd had to intubate her, and that had thrown her into v-fib. He'd seen it happen before.

In the background Lukas heard Lauren greeting Claudia with a patient assessment when Lauren's words registered.

“Claudia, would you withdraw an ampule of Inderal from the drug dispenser? We need it in exam room seven. Amanda's in there, and she's crashing.”

Lukas jerked around. “Hold it! Lauren, what's going on?”

She glanced over at him in surprise.

“Dr. Garcias is requesting Inderal for Amanda?” he said. That drug would not work for an ephedrine overdose. In fact, it could be lethal. “What's happening in there?”

Lauren stepped toward Lukas. “Her heart rate and blood pressure went up, and she's much less responsive. Her fever shot up, and she didn't improve with fluids.”

“Lauren, I need you in here,” came Cherra's voice from the exam room, and Lauren turned to obey.

The radio sparked to life again. “Medical control, be advised patient is extremely cold. Recommend you initiate hypothermia protocol upon arrival. Over.”

Lukas ignored the radio. “Lauren, wait! Tell her to wait!”

The voice from the radio came back. “Medical control, are you there? Did you copy our last transmission? Over.”

Lukas reached back quickly and punched the button. “Yes, we copied your last transmission. Keep us advised. This is medical control out.” He jumped up and ran into exam room seven.

Amanda lay on the bed with a clear oxygen mask on her face and a large IV tube attached to her left arm. Monitor leads were attached to her chest beneath her hospital gown. Tears streamed from her sea-green eyes and dripped into fine tendrils of curly brown hair around her face.

Claudia entered the room with the Inderal and handed it to Lauren.

Dr. Garcias bent over Amanda with her stethoscope. “You're going to be okay, hon.” She looked up and saw Lukas. “Dr. Bower, I just happened to notice this a few minutes ago.” She reached over and gestured toward the center of Amanda's throat. “Feel that?”

He stepped forward and gently palpated her neck. There was an unmistakable midline mass. He looked up at Cherra in surprise. “Goiter.” Immediately he remembered what Amanda had told him about her easy weight loss over the past few months, long before she'd begun taking the natural
herb. He nodded at Cherra. “Thyroid storm, possibly precipitated by the ma huang.” He'd overlooked the obvious. Why hadn't he listened better to his patient?

“Exactly what I think,” Cherra said. “I just ordered a thyroid profile plus TSH level, but we won't get that back for a while, so I decided to do this clinically. The curly hair confused me, because fine, straight hair is typical of hyperthyroid, but Amanda told me she has a perm.” Cherra indicated her own curly black hair. “That shouldn't surprise me, since I have one myself.”

Lukas exhaled heavily and nodded. “Nice pickup. You obviously know how to treat this. I'll leave you to it. I've got to get ready for a code.”

 

“Dr. Mercy, we have a little more time this morning than we expected.” Josie, Mercy's nurse, placed a chart on Mercy's desk. “Those Knights are a stubborn family.” Her short black hair reflected the rays of sunshine streaming through the window.

Mercy looked at the chart and felt a thrust of familiar frustration, something she often experienced when dealing with the Knights. “Did Darlene cancel another appointment?”

“Yes. That makes three times in two months.”

Mercy sighed and picked up the phone, but Josie shook her head.

“I just did that. Clarence told me he tried to get his sis to come in, but that she's stopped wheezing, and she says she's too busy. She's promised him she's doing her inhalers and drugs.”

“Just great.” Mercy slumped back in her chair. “I'm not going to have a chance to visit them for a few days, and I doubt if Lukas will. We're both teaching classes at the health seminar this week, and there's a weekend conference in Springfield that we're scheduled to attend.”

Josie sat down in the straight-backed chair across the
desk from Mercy. “Then maybe you should just stop playing superdoc and let Darlene take care of herself for once.”

Mercy blinked and straightened. “Is this
my
nurse talking? The one who gives free blood pressure checks to every person over the age of fifty in her church? The woman who has been known to pay patient bills when she knows they can't pay?”

Josie didn't smile. “You and Dr. Bower have been treating Clarence and Darlene free of charge for the past summer. Clarence is losing weight as a direct result of your bullying, but what about Darlene? She is totally noncompliant. Maybe pushing her just makes her more stubborn.”

Mercy thought about that for a moment, then shook her head. “I don't think so. I think she is afraid to let up on the work she's doing at home because they're struggling financially.”

“But she should realize for herself that she's sick. She needs help.”

“She's like a lot of patients who think they can push themselves past the limits, and then the doctor will make everything okay.”

“So what are you going to do about her?” Josie asked.

Mercy picked up the chart, thumbed through it and placed it back on her desk. “I guess I'll just try to be there for her when she needs me. Call them back, Josie, and try hard to set up an appointment for Darlene as soon as possible.”

A timid knock sounded at Mercy's open office door, and both women looked up to see Shannon Becker slumped there in her jeans and T-shirt, her straight, light brown hair combed as much over her face as possible to hide the slight decorations of acne scattered across pale skin. She still would not make eye contact with Mercy.

Josie jumped up. “Come on in, Shannon, I was just leaving. I've got temperatures to take, shots to give and patients to placate.”

 

The ambulance was running hot, and Lukas heard the echo of its siren long before it pulled into the bay and stopped. He looked around at his assembled team to get their attention.

“As you already know, this patient is coming in as a full code, and you know how to handle a code. Remember, however, that this case is complicated by hypothermia, so to give her any chance at all we've got to get her warmed up.”

He turned to Lauren. “I want a rectal temp as soon as possible, and then you can assist me in placing a central line. Claudia, heat the IV fluids and switch them out from the fluids she's getting in the ambulance.”

He turned to the respiratory therapist. “Mary, we need a heated aerosol generator hooked up to the ET tube. I also want a blood gas.”

He turned to the E.R. tech. “Buck, get me a central line kit, and then you can take over on the compressions. Carol, I want basic blood work and alcohol level. I'll also want a chest X-ray and c-spine series, but we won't break CPR to get it, so that'll have to wait.”

The door opened with an ambulance team guiding a cot with a young woman on board. One EMT walked alongside the cot pushing against the patient's chest, one pulled the cot and squeezed the ambu bag to breathe for the patient and another pushed from behind. They wheeled her into the cardiac-trauma room and transferred her to the bed.

“Okay,” Lukas said, “let's get to work.”

 

“So, Shannon, tell me what's been going on in your life.” Mercy sat back in her chair and tried not to see this young, innocent girl as just an older version of Tedi.
Don't condescend. Don't lecture.

Shannon tangled her fingers together in her lap, a flush creeping up her neck.

“I gather there's a special person in your life now?” Mercy prompted, trying to sound matter-of-fact and ignore the sound of Josie ushering a patient into an exam room.

Shannon shook her head jerkily, then hesitated and nodded. “I guess.”

“It's a wonderful feeling to be falling in love. I'm not surprised someone noticed a beautiful young woman like you. What's he like? Are you going steady?” She would not ask “parent” questions—Zach and Lee could do that.

The flush deepened. “No, we're not going steady or anything.”

Mercy stifled a sigh and waited for this suddenly silent girl—who used to be such a talker—to give her some hint about what was going on in her life. The burden of professional responsibility weighed heavily. Mercy couldn't help noticing, once again, that Shannon's young body had developed dramatically in the past year—and that her body language screamed out her feelings of awkwardness at this development.

“I met him while we were cruising the square this summer,” Shannon said softly. “One of my girlfriends is sixteen and can drive.”