Where There's Smoke (29 page)

If she's not ill-" "She needs a gynecological examination."

Lara gave him a wide, inquiring stare that demanded further explanation.
 
He remained silent, his expression immutable.
 
The girl was anxiously gnawing her lower lip.

"Helen," Lara asked gently, "were you raped?"

"No."
 
She gave her head a hard shake.
 
"Nothing like that."

Lara believed her and was greatly relieved.

"I'll wait out here."
 
Key executed an abrupt about-face and stalked down the hallway to the dark waiting room.

His exit created a soundless vacuum.
 
It was several seconds before Lara let out her held breath.
 
She gave Helen Berry a reassuring smile and said, "This way, please."
 
The girl followed her into an examination room, where Lara pointed her onto the table.

"Don't you want me to undress first?"

"No," she replied.
 
"I'm not going to do a pelvic examination until I have more information.
 
Besides, my nurse isn't here to assist me.

I never conduct an examination like that without an assistant."

That was for her protection as well as the patient's.
 
In a sue-crazy society, doctors were paranoid about malpractice suits.
 
Because of the scandal that haunted her, she was more vulnerable than most.

Her patient's eyes filled with fresh tears.
 
"But you gotta examine me.

I gotta know.
 
I gotta know right now so I can decide what to do."

Obviously distraught, she was shredding the soggy tissue.
 
Lara clasped her hands to keep them still.
 
"Helen."
 
She spoke gently but with authority.
 
Her primary objective was to calm the patient.
 
"Before we can proceed, I must get some information from you.

She reached for a chart and a pen and asked Helen for her full name.

The paperwork could have been postponed, but doing it now forced the girl to compose herself.
 
Working her way down the standard form, Lara learned that Helen was a local girl who lived in a rural area.
 
She was eighteen years old and had graduated from high school the previous May.

Her father worked for the telephone company.
 
Her mother was a homemaker.
 
She had two younger sisters, one brother.
 
There was no history of serious illness in the family.

"Now," Lara said, setting the chart aside, "why did Mr. Tackett bring you to see me?"

"I asked him to.
 
I had to."
 
Her face crumpled and her lower lip fell victim to more brutalizing.
 
Tears streamed down her plump cheeks.

Lara, believing she knew the cause of Helen's distress, cut to the heart of the problem.
 
"Do you think you're pregnant?"

"Oh, jeer.
 
I'm so stupid!"
 
With that, Helen flung herself onto the examination table, drew her knees to her chest, and began sobbing uncontrollably.

Lara moved swiftly to her side and took her hand again.
 
"Helen, calm down.
 
We don't know anything for certain yet.
 
You might be crying over nothing.
 
A false alarm."

She kept her voice calm and soothing, but she wanted to grind her teeth.
 
She wished she had a double-barreled shotgun, loaded and aimed at Key Tackett's testicles.
 
Bedding wayward housewives like Darcy Winston was one thing; seducing high school girls was quite another.

Lara smoothed back strands of Helen's hair.
 
"When was your last period?"

"Six weeks ago.

"So you've only missed one?
 
That doesn't necessarily mean you're pregnant."

Helen bobbed her head emphatically.
 
"Yes it does.
 
I'm never late."

Perhaps, Lara thought, but there were myriad reasons for delayed menses, only one of which was pregnancy.
 
Still, she had learned that patients were often the best authorities on their own bodies.

She couldn't blithely dismiss Helen's conclusion.
 
"Have you had sexual intercourse?"

"Yes."

"Without using any contraception?"

Helen's head wobbled up and down in answer.

Lara was dismayed that high school students were still negligent in their use of condoms, which were the simplest and least expensive, yet reliable, protection against unwanted pregnancy and sexually transmitted diseases.
 
In a community like Eden Pass, open discussion about these safeguards was certain to generate opposition from conservative parents and religious groups.
 
Nevertheless, it was vital indeed a life or death matter to acquaint teenagers with the risks they were taking if they were sexually active and didn't take precautions.

"Any breast tenderness?"

"Some.
 
No more than usual.
 
But anyway, I did one of those home pregnancy tests."

"It was positive?"

"No question."

"They're fairly reliable, but there's always a margin for error in any test."
 
Lara gave her a hand up.
 
"Go into the bathroom and get a urine specimen.
 
I can do a preliminary test tonight."

"Okay.
 
But I know I'm pregnant."

"Have you ever been pregnant before?"

"No.
 
But I know.
 
If I am, he'll kill me."

She retreated into the adjoining toilet.
 
Thinking of Key Tackett sitting complacently in her waiting room made Lara want to confront him immediately and convey her disgust.
 
But her patient came first.

"I left it on the lid of the tank," Helen said when she emerged.

"Fine.
 
Lie down on the table and try to relax."

In a few minutes, Helen's worst fear was once again confirmed.
 
"I knew it," she wailed when Lara told her that the indications were positive.

She began to cry again.
 
Lara placed her arms around her and held her until the sobs became dry, racking hiccups.

"Until your pregnancy is confirmed beyond any doubt, I'd rather not give you a sedative.
 
Would you like something to drink?"

"A Coke?
 
Please."

Lara left her alone only long enough to fetch the soft drink.
 
When she returned, Helen was weeping quietly but was more composed.

She took several greedy sips of the cola.

"Helen, is marrying the child's father out of the question?"

"Yes," she mumbled.
 
"A baby is the last thing he wants or needs."

Angry heat spread throughout Lara's body.
 
"I see.
 
What about your parents?
 
How supportive will they be?"

"They love me," she said as more tears filled her eyes.
 
"They won't kick me out.
 
But Daddy's a deacon in our church.
 
Mom's .
 
. . Oh God, they'll just die of shame."

"Do you intend to have the baby?"

"I don't know."

"You could always make it available for adoption."

She shook her head morosely.
 
"I don't think he'd let me.
 
Besides, if I had it, I could never give it away."

"Have you considered abortion?"

"That's probably what I'll have to do."
 
She sobbed and blotted her nose.
 
"Except .
 
. . except I love him, you know?
 
I don't want to kill his baby."

"You don't have to make that decision tonight," Lara said softly as she stroked the girl's hand.

"If that's what I decided, would you do it so nobody would know?"

"I'm sorry, Helen, no.
 
I don't perform D and Cs to terminate pregnancy.

"How come?"

Having watched her own child die, aborting living tissue was something Lara simply couldn't do unless the mother's life was at risk.
 
"That's just my policy," she told the girl.
 
"However, if you are pregnant and that's the alternative you choose, I'll make the arrangements for you.

Helen nodded, but Lara doubted that she was retaining much of this conversation.
 
Dismay had numbed her.
 
Lara patted her hand and told her she would come for her in a few minutes.
 
"Lie quietly and finish your drink."

Stepping into the hallway, she bolstered herself for the coming encounter.
 
As she entered the waiting room, she flipped on the light switch and flooded the area with a cold, unforgiving, fluorescent glare.
 
Key was slouched on one of the short sofas.
 
Blinking to adjust his eyes to the sudden brightness, he slowly came to his feet.

"Why did you bring her to me?"
 
Lara demanded angrily.

"I figured you needed the business."

"I appreciate your thoughtfulness," she said caustically, "but I would rather not have been drawn into another of your intrigues."

He folded his arms across his chest.
 
"From your tone of voice, -I gather Helen was right.
 
She's pregnant?"' "It appears so.

His head dropped forward, and he swore elaborately.

"I take it you don't welcome this news."

His head snapped up.
 
"Damn right, Doc.
 
It sucks."

"You should have thought of that before sleeping with an unsophisticated girl like Helen.
 
And why didn't you take precautions?

Surely a man of the world like you keeps a handy cache of condoms.

Or does using one hamper your macho image?"

"Now just a frigging minute.
 
You-" "Clark told me all about your satyric reputation.
 
I thought he was exaggerating, but apparently he wasn't.
 
Key Tackett's women."

Around here, it's like a club, isn't it?
 
The only requirement for membership is to have gone to bed with you."
 
She looked at him contemptuously.

"Maybe they should change the name to Key Tackett's girls," she said with a sneer.
 
"What's the matter with you?
 
Are you losing your boyish charm?
 
Has aging bruised your ego?
 
Are you so insecure over your fading youth that you've resorted to bedding high school girls?"

"What difference does it make to you?"
 
With his eyes half-closed, he added softly, "Jealous?"

Lara drew herself up, angry for having stooped to his level.
 
By doing so, she'd left herself open to counterattack.
 
In a cool, professional voice she said, "Helen is seriously considering abortion.
 
Until she reaches a firm decision, I'll be happy to give her prenatal care, provided she comes here alone, without you."

"She won't be coming here at all.
 
All we wanted from you tonight was a yea or nay."
 
Angrily, he reached into the hip pocket of his tight, worn jeans and fingered out his money clip.
 
"How much do I owe you?"

"This one's on me, but I want something in exchange."

"Like what?
 
No, let me guess.
 
Let's see .
 
. . a free flight to Timbuktu?"