Solemn Oath (27 page)

Ivy stopped kneading and started chopping out the muscles with the sides of her hands. “You say this guy weighs four hundred seventy pounds? How'd he get that way? I don't think—”

“He isn't what you think, Mom.” Mercy gave an abbreviated history on Clarence and Darlene.

“Sounds like a big project,” Ivy said at last. Then she realized what she'd said. “You know what I mean.” She pulled out a chair and sat down across from Mercy at the dining room table. “You have a giving spirit, Mercy. I'm
proud of you. Let me pray about it and sleep on it.” She leaned forward, wisps of gray-streaked hair falling, as usual, from the clasp that held them. She reached forward and laid a hand on Mercy's. “Now, why don't you tell me what's really bothering you.”

Mercy held her mother's dark, insightful gaze for a moment, heard the sound of Tedi's laughter in the other room, and tears sprang to her eyes. “I'll never have another child, Mom.”

A
t nine o'clock Friday morning Lukas fastened the top button of his worn Wrangler jeans, pulled on an old red-plaid shirt and stuffed his double-stockinged feet into his Danner hiking boots. A good mud-eating hike in the Mark Twain National Forest would clear his head. He should probably call Mercy to make sure she was still coming over tonight, but he couldn't. He knew it was sheer cowardice that kept him from picking up that phone, but the thought of talking to her brought too much pain. He didn't want to think about his sudden revelation at Theodore's apartment last night.

If Mercy did come for dinner tonight, it could be the last time. He couldn't think about it right now.

He was stuffing a water bottle, an apple and a package of Kellogg's Pop-Tarts into his small backpack when the telephone in the living room rang. His immediate thought was that it was Mercy, and then his automatic reaction to that thought was to rush to the phone to pick up. In spite of everything, he wanted to hear her voice.

“Hello, Dr. Bower? This is Judy at the hospital. Dr. Garcias asked me to call and see if you could please come in for a little while. We're having a rush like you wouldn't
believe, and we just got ambulance calls with more coming in, one class one and two class twos. They're supposed to be here in about six minutes.”

Lukas sighed. “I thought Dr. Hill was on backup call today.” He wished it were Mercy on the line.

“I just tried him. He told me he didn't have time to come over and coddle the new doctor. He said that's your job.”

Lukas stifled his frustrated anger. Here went the squeeze play again. Members of the medical staff were required to take medical backup for E.R., which meant that if the E.R. doc got into trouble or was overwhelmed with serious emergencies, the on-call doc would come in. It didn't always work that way when the backup doc had his own practice and a waiting room full of patients.

“Want me to call Mrs. Pinkley about it?” Judy asked. “Sounds like prejudice to me. One of Dr. Hill's office assistants overheard him complaining because you hired a Mexican. If you're busy, maybe I could call Dr. Mercy to—”

“No, Judy, don't call her. I'll talk to Mrs. Pinkley about it later.” Lukas knew Dr. Hill disliked E.R. call, but in a small hospital setting like Knolls, with no interns or residents to take up the slack, medical backup was important.

“Tell Dr. Garcias I'll be there.” He hung up, grabbed the package of Pop-Tarts and left his backpack on the overly cluttered kitchen counter. No time for a long hike today, but maybe he could take a shorter one if he escaped the hospital in time to clear out the congestion of clothing, dirty dishes and old mail that had accumulated around the house in the past few months.

As he drove his Jeep to the hospital, he thought again about Dr. Hill. What if there had been no one else to back Dr. Garcias up? What if someone died?

Hospital politics was one of the most frustrating aspects of E.R. practice. The E.R. doc and patient often became the components of a hot potato tossed back and forth between
the family practitioner and the specialist. The family practitioner was unwilling to admit an unstable patient. The neurologists, cardiologists, pulmonologists and others didn't want to take cases they felt could easily be managed by the family practitioners. Too many times there was a margin between the two opinions, through which the patient fell while the E.R. doc begged and pleaded and did a lot of ego stroking. Sometimes it was the patient who called the shots, when the condition worsened.

Ten minutes later Lukas drove into an overflowing E.R. parking lot. Two fire trucks were double-parked along the street with their lights still flashing. Three police cars took up space in patient parking, and two ambulances sat in the bay.

Inside, the scent of smoky clothes stirred through the air, and the E.R. proper sounded like a loud party minus the laughter, crowded as it was with firefighters, ambulance attendants, police and concerned family members. Somewhere in the chaos there must be patients. Judy had said so.

Lukas searched through the din and caught sight of the secretary at the desk waving toward him frantically.

“Thank goodness, Dr. Bower!” she called. “Dr. Garcias is doing a needle decompression in Trauma Two, but the woman in One has some bad burns and smoke inhalation, and they need you in there. Beverly's in with her now doing a saline soak. Then we have a fireman in three who also has some smoke inhalation and a possible concussion from a collapsed ceiling. We already had five others in exam rooms. We're full and running.”

Lukas pulled out the trauma gear. “Where was the fire this time, Judy?”

“Little Mary's Barbecue burned to the ground.”

“Oh no.” Little Mary's was practically a historic institution in Knolls. It was where the ambulance attendants and police and firefighters and courthouse employees all took their dinner breaks. According to Mercy, it was a community heart attack waiting to happen.

Lukas loved barbecue, but he'd had an unfortunate incident at Little Mary's soon after his arrival in town, and he was afraid to return for fear of arrest. He'd been mistaken for a pervert when he'd innocently carried a medical textbook in with him to study one evening—a textbook complete with illustrations that would have been considered graphic anywhere outside a medical classroom. The café employees did not seem to take it well.

Lukas walked into the first trauma room to the accompaniment of coughing and groans of pain. Beverly, soon-to-be Mrs. Cowboy Casey, was bent over a woman with a blackened face and singed hair and a deep grimace beneath the transparent blue oxygen mask. Sterile cloths were draped over burned portions of the woman's chest and arms, and Beverly murmured soothing words as she applied cool saline. She had already established two IVs with lactated ringers and had placed the patient on a monitor—carefully, between patches of red, blistered skin.

Beverly looked up long enough to see who had come in. “Oh, good, Dr. Bower, you're here,” she said, then returned to her work. “We have a fifty-year-old burn victim here, Mrs. Rose Dotson. She's in a lot of pain, with at least ten percent of her body covered in second-degree burns. She was one of the cooks who was trapped in an enclosed space with the fire.”

“Ouch.”

“Yeah, but not as bad as she could have been. The other cook was hit when the ceiling collapsed. Dr. Garcias did a needle decompression on her just a couple of minutes ago. We've had basic blood work and an arterial blood gas done on Rose, and the results should be back any time.” Beverly glanced again at Lukas as he checked the monitor, then she looked down at his hiking boots. “You didn't waste any time getting here. Going on a field trip?”

“Not anymore. Get out the morphine. We'll give it to her IV.” Through the clear blue oxygen mask, he could see soot around Mrs. Dotson's mouth and nose, and she con
tinued to cough between groans of pain. Lukas raised the mask long enough to check the patient's throat. She had soot there, as well. He checked Beverly's chart. Mrs. Dotson's heart rate was fast, with her pressure a little high, but most of that came from pain. The respiratory rate was elevated into the 20s. The O2 saturation on a nonrebreather was 94. Initial saturation was 88, so he would leave the oxygen mask on her, but there was no sign of imminent airway compromise. Lukas located the intubation kit just in case he might need it.

While Beverly went out to the computerized drug dispenser for the morphine, Lukas rechecked the patient's vitals. He couldn't help overhearing the buzz of conversation throughout the E.R. He heard Cherra Garcias talking in a calm, slightly accented voice in the next room. The needle decompression had been a success, and the patient was now conscious. Dr. Garcias was doing well, working with staff and patient, using just the right combination of authority and compassion. Now, if Lukas could hire a couple more docs just like her, he'd be happy.

When Beverly walked back into the room with the morphine, Lukas stepped out past a jumble of people and equipment. “Judy,” he called to the secretary, “make arrangements to transfer Mrs. Dotson to a burn center.”

Judy nodded and signaled to him, then picked up the phone. By the time Lukas grabbed a T-sheet for patient records and stepped back into the room, Mrs. Dotson's groaning and coughing had already begun to subside. Morphine was wonderful stuff…unless you were driving.

“Beverly, I want to start her on high-dose steroids IV.” He glanced at the monitor again, then began his own assessment, checking off preworded comments on the T-sheet.

“Have you heard from Mrs. Pinkley this morning?” Beverly asked.

He looked up. “No. Was she supposed to call me for something?”

“Well, I am either going to be fired, or the COBRA investigation is going to be called off, or both.”

Lukas waited.

“That woman interviewed me this morning when I first got here.” Beverly leaned forward to check Mrs. Dotson's IVs. The groaning had stopped, and the woman's eyes were half-closed.

Beverly stepped a couple of feet from the bed and lowered her voice. “You might say Ms. Fellows and I didn't hit it off. The woman's a witch. She even looks like one, with that pasty complexion and eyes like a shark. And did you see her fingernails?”

“No, I don't think I—”

“She demanded to know why I was just now turning in an AMA form about Dwayne Little. I tried to explain that I was afraid the president of the hospital board would fire me if I did, and that I had a family to support. She asked me if you or Mrs. Pinkley were trying to coerce me in any way. Then she accused me of trying to impede her investigation! Of all the vicious, unprofessional…I tried to keep my cool, but I asked her when this suddenly became ‘her' investigation instead of a COBRA investigation. She told me I was out of line, and I told her I'd read the book on COBRA rules and that I wasn't even close to any line as far as I could see. I told her she needed to take a refresher course.”

Lukas controlled his facial muscles with effort. Yep, this was the old Beverly, all right. He'd missed working with her.

“So Ms. Fellows implied that I could lose my job over this,” Beverly continued with a shrug. “I suggested to her that Bailey Little was either blackmailing her or having an affair with her, and she turned pale and left. But then, she's always pale, because she's a witch. Did you get a load of that hooked nose?”

“I didn't notice.”

Beverly shook her head. “If I lose my job, I lose my job. I wish I'd had the guts to do this months ago, and we
wouldn't have this problem.” She adjusted the IV and checked the blood pressure again. “It's coming down. Looking good, Dr. Bower. Mrs. Dotson doesn't look like she's feeling much pain.” She poured some more saline onto the sterile cloths. “I got some Silvadene cream out. Want me to use it?”

“No, we'll leave that up to the burn center. They don't like anything sticky on the skin. Give her a gram of Kefzol. We need to get her started on an antibiotic.”

Judy stepped into the open doorway. “Dr. Bower, the ambulance crew is getting ready to transfer Mrs. Dotson. They were still here from the run from Little Mary's, so they'll just take her now. The St. John's burn unit is waiting for her.” She looked around behind her, then stepped into the room and lowered her voice. “One of the patients is refusing to see Dr. Garcias. He saw you come through, and he wants you to treat him before you leave.”

“Why is he refusing to see Dr. Garcias?” Lukas asked.

Judy lowered her voice further. “He said he wants to see a ‘male American' doctor.”

“Tell him Dr. Garcias is the only American doctor on duty today. I'm not officially on duty. I'm just helping out with the emergency.” Lukas stepped to the sink to wash his hands. He would take care of the fireman in Three, then escape this place before any of the department directors discovered he was here. If he waited around he could get sucked into hospital politics for the rest of the day. Somebody always had a gripe or a bright idea that just happened to involve the E.R. in some way.

He glanced over his shoulder at Beverly, who had just walked back into the room with the steroids and antibiotic he had requested for Mrs. Dotson. “Beverly, how's Cowboy doing these days? Is he giving that gunshot wound time to heal?”

“His arm is healing well. His heart's a different matter.” She placed the needle of the syringe into the injection port of the IV. “He's still upset about Leonardo. For the past few
days he's been talking about getting another lion cub, and I told him when we get married he'll have enough wild animals to handle without adding more. My kids are a little on the spunky side. Good news, though. Berring is up to his old tricks, apparently. He jumped bail, and they found him over in Barry County, robbing a convenience store. They caught him and he's behind bars. From what I hear, he's practically in a straitjacket. The guy's nuts. Crazy. I just hope they keep him locked up tight this time.”

 

At ten o'clock Friday morning, Mercy's secretary-receptionist stepped into the office with the day's mail. “Got something besides bills today, Dr. Mercy.” She placed the stack squarely in front of Mercy and pointed to the top envelope, which had been slit open. Loretta always opened all the mail. “I stuck it back in the envelope. Just let me get out of here and close the door before you look at it.” She made an exaggerated dash for the hallway and pulled the door shut.