Solemn Oath (9 page)

He slowly pushed the blankets back with his free hand. “Yes, Mother.”

“Don't get smart with me, young man.” Lukas could hear the matronly nurse smiling through her words. “We've got an eleven-year-old girl in exam room three who is covered in blood and needs your attention. Looks like she's been playing jump rope with barbed wire. Her parents are in worse emotional shape than she is.”

“I'll be right there.” Lukas replaced the receiver and
climbed out of bed, combing his hair with his fingers as he stumbled out of the room. Maybe Claudia had gotten really smart and brewed some of that typical E.R. coffee that took fifteen cubes of sugar to kill the taste.

After reading Claudia's initial assessment, he entered the exam room to discover that, as usual, the nurse had not exaggerated her description. The eleven-year-old girl, Abby Cuendet, lay on the exam bed in pink pajamas with bloody rips in both legs. Lots of blood. Lukas frowned.

Abby tensed when she saw Lukas come in, and her dark eyes, behind thick-framed glasses, did not leave his face. Her parents, a young couple looking tear-streaked and shaky, hovered at her left side, and they, too, had blood on their clothes. Claudia worked on the other side of the bed, taking vitals and gently removing the pajama bottoms.

“Hello, I'm Dr. Bower.” Lukas stepped over to the parents and held out his hand.

They introduced themselves, separately, as Jason Cuendet and Lindy Cuendet. Not Mr. and Mrs. Cuendet.

“I'll be checking Abby out this morning,” he said, noting as they shook his hand that they avoided getting close to each other. “Can you tell me what happened?”

Lindy shot her husband a sharp glance before she answered. “Abby got up earlier than usual this morning, and we didn't know she was awake. She went out to feed the dog, and she got caught in a broken roll of barbed wire we had out back.” Her eyes narrowed at her husband. “Jason just had to bring it home because it was such a good bargain.”

Her husband didn't reply, but his chin jutted out and his face flushed with barely restrained anger.

Lukas smiled at Abby. “You're Tedi's best friend from school.”

Abby's face brightened and she nodded. “You recognized me.”

“Of course. Tedi talks about you all the time, and I remember you from the school picnic a couple of weeks ago.”

“Tedi's supposed to spend the night with me tonight,” Abby informed him.

“Well, we'll just have to get you all fixed up so you can do that.” He watched Claudia set up the suture tray, and he saw Abby's eyes widen with fear.

He bent over the wounds. “Now, don't worry, Abby. I'm just going to see what these look like right now.” She had three gashes on her left leg below her knee and one on her right ankle. They didn't look as bad as Lukas had expected from all the blood. They weren't deep puncture wounds, which was good, but they were fairly gapped, and a couple of them would need two-layer closures.

He bent to examine one of the gashes more closely, and Abby winced.

Her mother inhaled sharply, then let out a low moan. “I can't do this,” she muttered and rushed out of the room with her hand over her mouth.

Lukas let her go. It was easier on the child for the parent to leave the room than to pass out or become sick right there by the bed. He returned to the wounds, noting with concern that there was still some active bleeding, but since there was no involvement of the muscle, he didn't worry too much about it.

“Jason, when was Abby's last tetanus shot?” he asked. “Does she have any drug allergies that you know of?”

The man glanced at the wounds, then at Lukas, looking helpless. “I'll have to go ask Lindy.” He left to find his wife.

Lukas gave Claudia instructions for skin prep and topical anesthetic, then left to get more information from the parents. He had just reached the central desk when he heard low, angry voices in the entrance to the first trauma room.

“You have to blame me for everything, don't you?” Jason Cuendet spat. “But you can't even be there for your own daughter when she needs you most.”

“You know how I hate the sight of blood. I just can't stand to see her like this.”

“It's always about you, isn't it? Why don't you think of somebody besides yourself for once?”

“That's precious, coming from you. When do you ever think of—”

Lukas cleared his throat. “Um, excuse me, I'm sorry to interrupt. Is Abby's tetanus up to date?”

In a voice still filled with anger, Lindy replied that it was.

“Good,” Lukas said. “And how about drug or antibiotic allergies?”

Lindy shook her head, glaring at her husband.

Lukas took a couple of cautious steps closer to the couple. He hated interfering in what appeared to be a deep-rooted family dispute, but he often saw parents blame each other when a child was injured, and it always made the situation worse.

“Your daughter is going to be fine. We'll stitch her up and have her out of here in good time. Has Abby had other accidents like this?”

Jason switched his brooding gaze from his wife to Lukas. “What's that supposed to mean?”

“Oh, stop it, Jason,” Lindy snapped. “You're always trying to start something with somebody.” She turned to Lukas. “She fell and cut her knee at school last year. That's when she had the tetanus shot.”

“When was the last time her eyes were checked?” Lukas asked. “I had to have my glasses changed frequently when I was her age, and I was always tripping over things.” He saw Jason relax. The suspicion of child abuse never seemed to be far from anyone's mind lately.

As they talked about that, he slowly led them back toward Abby's room, where Claudia had everything ready to go.

“It'll be okay,” he assured Abby and her parents as he washed his hands and gloved.

But when he turned back to Abby, Lindy walked out into the hallway again.

Her husband's loud, disgusted sigh filled the exam room. “I don't believe this,” he muttered.

Abby tensed, and Lukas repressed a strong urge to ask him to leave, as well. At times like this he had to remind himself that he needed to learn more patience. Looked like Jason Cuendet could use some, too.

He picked up the anesthesia syringe. “Claudia says I'm not too bad with stitches, and she wouldn't say anything nice about me if she didn't have to.” He shot the nurse a teasing glance, then redirected his focus to Abby. “If the sight of blood bothers you, why don't you just look the other way?”

Abby shook her head. “I'm used to it. I've had some nosebleeds.”

“Why don't we play my favorite Popsicle game?” Ordinarily Lukas didn't use this tactic with a child as old as Abby, but she could be a little less secure than others her age. Her parents were behaving quite immaturely, and he found himself wondering if they acted like this all the time. “If these shots hurt after the first little sting, you let me know and you get a Popsicle. What flavor do you like?”

Abby looked from him to the nurse, her lips pressed together, eyes narrowed, as if making a monumental decision. “Grape.”

“I think we have that, don't we, Claudia?”

Claudia grinned at the girl. “Sure do.”

“Good.” He raised the syringe once more. “Now, we'll numb you up, and everything will go smoothly. Abby, you can't watch me when I do it, because that would be cheating.”

She turned her head and looked away, but her father hovered in an almost-threatening stance, watching every move Lukas made.

Lukas slid the point of the needle just underneath the edge of the skin cut.

“What're you doing it like that for?” Cuendet snapped. “Trying to kill the kid?”

Abby whimpered and drew back.

Lukas shot an irritated glance at the father, fighting the urge to plunge the needle into the wrong person. “Due to the nerve endings on the noninjured skin,” he snapped, then took a breath and tried to slow his words and his annoyance, “it's actually more painful to inject through the skin surface. As long as the wound is not grossly contaminated, I prefer to do this so it won't hurt the child.” He looked more closely at the man's pale, moist skin. “We have a water cooler and some paper towels out in the waiting room. Would you want to step outside for a moment?”

The man shook his head, but he didn't hover so close to his daughter. Lukas had barely stitched the first cut when Jason took a deep breath, released it and walked out of the room.

With both parents gone, Claudia managed to divert Abby's attention from the procedure. She asked about Abby's brother and sister and encouraged her to talk about her favorite sport, baseball. Then Abby's attention caught and held on something past the open threshold of the exam room. Her eyes widened, and she stared for a long moment.

“I don't need that grape Popsicle now,” she said at last, her voice soft, almost reverent.

Lukas finished tying off a stitch. “I'm that good, huh?” He winked at Claudia.

“That's not it.”

Claudia laughed.

Abby looked back at the sutures Lukas had placed, then looked up at him. “I'm too old for stuff like that. You won't tell Tedi how scared I was, will you?”

“Of course not. You don't act scared now.”

“Nope. Mom and Dad are more scared than I am.”

“I noticed.”

“At least I didn't get in trouble for making them miss work. I guess all that blood got to them. Wait'll I show Tedi my stitches. Are you going to marry Dr. Mercy?”

Lukas nearly dropped the needle driver he was using. “What?”

“She likes you. She always talks about you, and so does Tedi. You'd sure be a better father than Tedi's real father was.”

He glanced at Claudia, who was at least keeping her laughter to herself.

“Are you sure you don't want a Popsicle?” he urged. Children were growing up too fast these days. “Aren't sixth-graders supposed to still like Popsicles?”

Abby shrugged. “Nah, I'm not hungry.” She glanced again out the exam room entrance.

Lukas looked up to see what she was watching and caught sight of Abby's parents standing side by side, and Jason had his arm around Lindy's shoulders.

“I should get stitches more often,” Abby murmured.

A
t a quarter to seven Lukas finished his chart on Abby and decided to try to catch some more sleep. He had two meetings this morning before he could go home, but his shift would be over in fifteen minutes. Dr. Landon could handle it after that. Yawning, he walked into the call room and sat down on the side of the bed.

The day he unloaded the directorship would be a day for celebration. He would have so much time on his hands he might get a chance to check out more of the hiking trails in the Mark Twain National Forest, which surrounded Knolls. In the past few months he'd had very few opportunities to explore the countryside. Even though Estelle picked up a lot of the slack for him, there were still too many things going on at—

Someone knocked at the door he had just closed. “Dr. Bower, you got a minute?”

He opened the door to find Bobbie Jo White standing there, hands on hips, heavy brows drawn down farther than usual over a plump face. Bobbie Jo, an X-ray technologist, was the director of the radiology department, and although she rarely smiled, she seldom glowered this morosely.

“Bobbie Jo? What's wrong?”

She sighed, crossed her arms over her ample chest and slumped, uninvited, into the room. “It's this BO thing. You've got to do something about it, Dr. Bower. I don't have that much authority, and everybody's griping about—”

“Uh, wait a minute, Bobbie Jo. What ‘BO thing'? I don't know what you're talking about.”

“Oh, sure you know. That new E.R. tech they hired last month, Amanda? Everybody's talking about it, and even some of the patients complained. She works nights. In fact, she worked last night.” Her glower eased a little as she looked at Lukas hopefully.

“And you're telling me this because…?”

“We all want you to talk to her about it. Tell her to clean up.”

He definitely needed more sleep. Or maybe he already
was
sleeping, and this was just some weird dream. “Who is ‘we all,' and why me?”

“You know, several of the staff. You're the director. It's your job.”

“It's the
nurse
director's job.”

“She's not touching this one. It's up to you. The girl flat-out stinks.”

Lukas stared at her, dumbfounded. He hadn't noticed any unusually significant aromas emanating from the tech last night, or any other night—not that he'd been paying attention. Sometimes the patients got pretty rank, but an emergency department was not expected to smell like a field of spring clover. And he had come to Knolls to treat patients, not teach hygiene.

Before he could think of a kind but firm way to explain to Bobbie Jo how far off the mark she was, Claudia stepped up to the open doorway. “Oh, good, Dr. Bower, you're awake. I wasn't going to disturb you if you were sleeping, but we just got a call from Dr. Landon, and he's not going to be able to come in today.”

Lukas groaned. This was the second time this week he'd been stood up for a shift. It was getting ridiculous. “What happened?”

“His brother was in a wreck last night up in Jefferson City. I tried to find a replacement, but so far nobody wants the shift.” She took a step inside. “Are you up for a twenty-four?”

“No,” he snapped and was immediately contrite. It wasn't Claudia's fault he was getting dumped on this week. “I'm never up for a twenty-four.”

“Sorry. I'll keep trying to find someone if you want me to.”

Did she even have to ask? “Please, Claudia.”

She glanced hesitantly at Bobbie Jo, then back at Lukas. “Dr. Bower, we also got a call from your early appointment this morning.” She came farther into the room.

“Dr. Garcias? Don't tell me she canceled.”

“No, but she's coming earlier if you don't mind. She had something come up at home, and she has to be back in Little Rock, Arkansas, this afternoon.”

“Dr.
Garcias?
” Bobbie Jo exclaimed. She put her hands on her hips, and her frown deepened again.

Claudia shot the woman a surprised glance and walked out of the room.

Lukas turned a sleepy glare to Bobbie Jo. “Was there something else you wanted to discuss with me?”

“What are you going to do about Amanda?” Bobbie Jo demanded.

Lukas wanted to tell her to take care of it herself, but she wasn't exactly a people person. Besides, she was right. It wasn't any of her business. “I'll talk to her.” He specifically did not say what he would talk to her about, or when he would do so. “Now, if you'll excuse me, I'd like to get some rest.” He walked over and held the door and waited for her to huff out, then closed it a little too loudly behind her. On
a whim, he locked it. They would soon learn that he could get firm when necessary.

He had the blankets lifted and was ready to climb back into bed when the phone rang. He jerked up the receiver. “Yes?”

“Dr. Bower, I have to tell you something you're not going to like.” It was Claudia.

He groaned. “More? Haven't we had enough bad news this morning?”

“I'm sorry. This is the worst.”

Lukas immediately thought of his family. Were his father and stepmom okay? Was one of his brothers or their families—

Claudia sighed heavily over the phone. “Alma Collins lost her leg. They said there was too much damage for them to repair. Her husband, Arthur, called us this morning to thank us for all we did for them Monday, and he especially wanted us to tell you and Dr. Mercy how much he appreciated your kindness.”

Lukas slumped onto the side of the bed and exhaled. He felt as if he'd been slapped. He closed his eyes and saw the faces of Arthur and Alma, remembered the pain they'd experienced, remembered the love and concern they had displayed so openly toward each other.

“I'm sorry, Dr. Bower,' Claudia said softly.

“Me, too. Thank you for letting me know. Why don't we send some flowers from the department.” That seemed like such a frivolous gesture under the circumstances, but he couldn't think of anything else to do right now except pray.

“Good idea,” Claudia said. “I'll start collecting, and I'll call the florist when they open.”

When she hung up, Lukas sank back against his pillow, too depressed, suddenly, to think about sleep. “Why, Lord?” he muttered. “They're Your servants. They've dedicated their lives to serving You and helping others. Why did this have to happen to them?”

He knew the answer, of course. None of God's people were immune to the suffering brought to earth by sin, and it wasn't God's fault, but it sure was easy to blame Him.

A moment later, another knock sounded at the call room door. “Dr. Bower?” came a slightly familiar voice. “Bobbie Jo told me you wanted to see me.”

Amanda.

Lukas gritted his teeth. As of now, he would start locking the call room door any time he was in here. Then people like Bobbie Jo White would not have the freedom to barge in and start adding to his already overtaxing duties. She had no right. Why couldn't he have just told her that in the first place?

He went to the door and opened it to find a young tech with curly brown hair and sea-green eyes waiting expectantly. She looked clean. No dirt under her fingernails. In the month she'd been here, Lukas had heard no complaints about her work. In fact, she almost seemed to go at a run most of the time. Maybe she just worked too hard.

And maybe there was…Yes, there was a slight hint…Okay, make that a certain odor…Yes, okay, she smelled.

“Dr. Bower, did you want me for something?”

Lukas hesitated. How was he supposed to tell this young girl that she needed a bath? Estelle would not appreciate it if he dumped this on her, and it would be more painful coming from the hospital administrator than it would from a doctor who worked with her.

“Yes, Amanda.” He cleared his throat and willed his face not to flush. This was strictly a professional problem to be dealt with. “Uh, did you have an employment physical when you came to work here?”

Her light brown eyebrows rose in curiosity. “Yes. It was a requirement.”

“Good.” But those physicals were certainly not comprehensive. “Have you been having any health problems lately?”

She frowned at him. “No, I've been better than ever.” She tugged at the waistband of her scrubs, which showed some slack. “I've been on a diet, and I'm almost down to my target weight. I've got all kinds of energy.”

Target weight? She didn't look as if she needed to lose any weight. “Are you under a doctor's care?”

“Nope, I did it on my own. I've been taking ma huang since I came to work here—one of the nurses up on the floor told me about it. It sure helps curb the appetite.”

Ma huang? He didn't like the sound of this. He looked her up and down. “Why are you still trying to lose weight?”

She tugged at her scrub pants again. “Don't worry, there's still some flab. These baggy things cover a lot of cellulite. I've always had trouble with my weight, but when I moved to Knolls six months ago, the pounds just started to slip off. I don't know why. I guess I just got too busy moving, and I got a little homesick, too…Anyway, I wasn't hungry. It felt so good to lose the weight, I decided to keep going. It worked! I've lost forty pounds since I came here, and it wasn't hard at all.” She grinned at him. She had a sweet face, with dimples, rosy cheeks, the whole bit.

Lukas frowned. Forty pounds in six months? That was a little extreme. “Amanda, did you know that ma huang contains mostly ephedrine? That's an amphetamine-related compound. I don't like the idea of one of the hospital nurses recommending it for you.” He knew he probably sounded like her father trying to lecture her.

“But I feel so good.” Amanda looked around, then lowered her voice. “Except for maybe one thing. Lately I've been sweating a lot, and when I work twelve-hour shifts, I don't have a chance to shower.” Her face turned even pinker. “Sometimes I'm afraid a patient might notice when I get too close.”

Suddenly the odor was the least of Lukas's concerns. “Are you taking caffeine with the ma huang?”

“Well, I do drink a lot of soda, but I don't touch coffee, especially the E.R. brew. That stuff could kill a horse.”

“Soda can have a lot of caffeine. Are you having trouble sleeping at night?” He resisted the urge to take out his penlight and check her eyes.

She shrugged. “Yeah, sometimes.”

“You're overdosing yourself. That can be very dangerous, and it needs to stop.” Why did young girls do this to themselves?

She frowned at him, shook her head and spread her hands out. “But I don't want to gain all that weight back.”

“Didn't you do well on your diet for five months before you began taking the herb?”

“Well, yeah, but—”

“Just try to cut down, Amanda. The drug could be hurting you.”

She grudgingly agreed and left, and Lukas sighed with relief. He was congratulating himself on a situation well handled when Claudia came to the open threshold again.

“You know, Dr. Bower, you could use a revolving door if this keeps up. Sorry, but I can't find anyone to take the shift today. I've exhausted the list of prospects, and I can't even get Dr. Evans to come in early for you. His kid has a game. Hope you didn't have anything going on today.”

By now
everybody
was getting on his nerves. “Just
sleep
.”

“Oh, well, I hear that's overrated.” She hadn't caught the friction in his voice. “Are you ready to talk to Dr. Garcias? She's here.”

Lukas looked at his watch. “Now?” It wasn't even eight o'clock.

“Sorry.”

Lukas yawned and stretched. “I'll meet with her in the private waiting room in a moment.” If he didn't fall asleep first.

He watched Claudia leave, then realized there was one
person who wasn't getting on his nerves—possibly because she wasn't here right now, but there was a way to check out his theory.

He called Mercy at home, and she answered. Good, she hadn't left to take Tedi to school yet.

“Hi.” His voice held weariness.

“Lukas? What's wrong? Are you okay?”

He closed his eyes and let the warmth of her voice and the essence of her concern float through him like healing balm. As was happening more and more often lately, she picked up on every nuance of tone. She could almost read his mind, and sometimes she answered his questions before he even asked them. He found himself turning to her whenever things went wrong. Occasionally, the realization concerned him. Shouldn't he be turning to God before he turned to anyone else?

But right now he didn't want to think about that. “Sorry about the late notice, but I'm going to be a little late for our date tonight. I'm still working, and I have to cover today's shift.”