Where I share my love of books with reviews, features, giveaways and memes. Family and needlepoint are thrown in from time to time.
Showing posts with label Richard Mabry. Show all posts
Showing posts with label Richard Mabry. Show all posts

Sunday, October 3, 2010

Medical Error by Richard Mabry, MD (Book Review)

Title: Medical Error (Prescription for Trouble series - Book 2)
Author: Richard L. Mabry, MD
Publisher: Abingdon Press

About the Book:  Dr. Anna McIntyre's life was going just fine until someone else started living it.

Her patient dies because of an identity mix-up; her medical career is in jeopardy because of forged prescriptions; and her credit is in ruins.  She thought things couldn't get worse, but that was before she opened the envelope and saw a positive HIV test with her name on it. (synopsis from back cover)

My thoughts:  I enjoyed reading this medical mystery.  It was fun to read this, as being written by a doctor you know that the medical information in the book is correct - gives it an authentic feel.  With this one, the tie in to the stolen identity gave it a definite 21st century feel.  It just showed you how easily it really is to have your identity stolen - and the havoc it can wreck in your life. 

It was very smooth the way that things started to fall into place, and I didn't see the guilty party for who he was until the very end. Anna was a strong character, not willing to sit back any more and just let this stuff happen to her, but deciding to move forward and try to track down some answers on her own - not necessarily the smartest decision - but it does get results.  There is a nice romance starting with Nick, a pathologist on staff, and/or possibly Ross, the lawyer she has hired to handle her problems.  I am not going to tell you which - or maybe it is both! You are just going to have to read it yourself!

Dr. Mabry's website is http://rmabry.com/ . He blogs at http://rmabry.blogspot.com/


~I received a copy of this book from Abingdon Press in exchange for my review.~
 
Read the first chapter of Medical Error.
 
Medical Error
Publisher/Publication Date: Abingdon Press, Jul 2010
ISBN: 978-1-4267-1000-1
264 pages

Friday, September 10, 2010

First Wild Card Tour: Medical Error by Richard L. Mabry, MD

It is time for a FIRST Wild Card Tour book review! If you wish to join the FIRST blog alliance, just click the button. We are a group of reviewers who tour Christian books. A Wild Card post includes a brief bio of the author and a full chapter from each book toured. The reason it is called a FIRST Wild Card Tour is that you never know if the book will be fiction, non~fiction, for young, or for old...or for somewhere in between! Enjoy your free peek into the book!



You never know when I might play a wild card on you!

My thoughts:  I am loving this book!  Dr. Anna McIntyre knew she was having a bad day when her patient died on the operating table - A death that could have been prevented.  Within 24 hours though, she learns that she is under investigation for a deluge of narcotics prescriptions she claims were forged and someone has stolen her identity and charged up her credit cards! Due to the investigation she is sent on a two week "vacation" and basically told she needs to figure out how someone got her DEA number and prescription pad.
Nick Valentine was a pathologist at the same hospital as Anna.  Their paths cross when he has to do the autopsy on her patient.  After meeting Anna, he cannot get her off his mind and over the next few days continues to find opportunities to spend time with her.  He joins her in her investigation.

Watch for my more formal review in the next few days - meanwhile, be sure to check out the first chapter below:



Today's Wild Card author is:





and the book:


Abingdon Press (July 12, 2010)
***Special thanks to Maegan Roper, Marketing/PR Manager, Christian Fiction, Abingdon Press for sending me a review copy.***



ABOUT THE AUTHOR:




Dr. Richard Mabry built a worldwide reputation as a clinician, researcher, author, and teacher before retiring from medicine. He entered the field of non-medical writing after the death of his first wife, with the publication of his book, The Tender Scar: Life After The Death Of A Spouse.



Richard describes his work as "medical suspense with heart." Medical Error is his second novel. His first novel, Code Blue, was published by Abingdon Press in April of 2010, and will be followed next spring by the third book in the Prescription For Trouble series, Diagnosis Death.



He and his wife, Kay, live in North Texas.





Visit the author's website.

Visit the author's blog.



Product Details:



List Price: $13.99

Paperback: 288 pages

Publisher: Abingdon Press (July 12, 2010)

Language: English

ISBN-10: 1426710003

ISBN-13: 978-1426710001



AND NOW...THE FIRST CHAPTER:





Eric Hatley’s last day alive began routinely enough.



He paused beside his brown delivery truck, shifted the bulky package, and turned in a tight circle to search for the right apartment.



Shouts filled the air. Firecrackers exploded all around him. A dozen red-hot pokers bored holes through his gut.



The package flew from his arms. He crumpled into a privet hedge at the edge of the sidewalk, clutching his midsection and recoiling when his fingers encountered something wet and slimy.



A wave of nausea swept over him. Cold sweat engulfed him.



Eric managed one strangled cry before everything faded to black.



* * *



Dr. Anna McIntyre bumped the swinging door with her hip and backed into Parkland Hospital’s Operating Room Six, her dripping hands held in front of her, palms inward. “Luc, tell me what you’ve got.”



Chief surgical resident, Dr. Luc Nguyn, didn’t look up from the rectangle of abdomen outlined by green draping sheets and illuminated by strong surgical lights. “UPS driver, making a delivery in the Projects. Got caught in the crossfire of a gang rumble. Took four bullets in the belly. Pretty shocky by the time he got here.”



“Find the bleeding source?”



“Most of it was from the gastric artery. Just finished tying it off.”



Anna took a sterile towel from the scrub nurse and began the ritual of gowning and gloving made automatic by countless repetitions. “How about fluids and blood replacement?”



Luc held out his hand, and the nurse slapped a clamp into it. “Lactated Ringer’s, of course—still running wide open. We’ve already pushed one unit of unmatched O negative. He’s finishing his first unit of cross-matched blood. We’ve got another one ready and four more holding in the blood bank.”



“How’s he responding?”



“BP is still low but stable, pulse is slower. I think we’re catching up with the blood loss.”



Anna plunged her hands into thin surgical gloves. “Lab work?”



“Hematocrit was a little over ten on admission, but I don’t think he’d had time to fully hemodilute. My guess is he was nine or less.”



Anna turned slightly to allow the circulating nurse to tie her surgical gown. “Bowel perforations?”



“So far I see four holes in the small intestine, two in the colon.”



“Okay, he’ll need antibiotic coverage. Got that started?”



Luc shrugged. “Not yet. We don’t know about drug allergies. His wallet had ID, but we’re still working on contacting next of kin. Meanwhile, I have Medical Records checking his name in the hospital computer for previous visits.”



“And if he’s allergic—“



The nursing supervisor pushed through the swinging doors, already reading from the slip of paper in her hand. “They found one prior visit for an Eric Hatley, same address and date of birth as on this man’s driver’s license. Seen in the ER two weeks ago for a venereal disease. No history of drug allergy. They gave him IM Omnilex. No problems.”



The medical student who’d been assisting moved two steps to his left. Anna took his place across the operating table from Luc.



Luc glanced toward the anesthesiologist. “Two grams of Omnilex IV please.”



Anna followed Luc’s gaze to the head of the operating table. “I don’t believe I know you. I’m Dr. McIntyre.”



The doctor kept his eyes on the syringe he was filling. “Yes, ma’am. I’m Jeff Murray, first year anesthesia resident.”



A first year resident on his own? Where was the staff man? “Keep a close eye on the blood and fluids. Let us know if there’s a problem.” Anna picked up a surgical sponge and blotted a bit of blood from the edge of the operative area. “Okay, Luc. Let’s see what you’ve got.”



In the operating room, Anna was in her element. The green tile walls, the bright lights, the soft beep of the monitors and whoosh of the respirator, the squeak of rubber soles as the circulating nurse moved about the room—all these were as natural to her as water to a fish or air to a bird. Under Anna’s direction, the team worked smoothly together. Conversation was at a minimum, something she appreciated. Do the job in the OR, talk in the surgeons’ lounge.



“I think that’s got it,” Luc said.



“Let’s check.” Anna’s fingertips explored the depths of the patient’s belly with the delicate touch of a concert violinist. Her eyes roamed the operative field, missing nothing. Luc had done an excellent job. He’d do well in practice when he finished his training in three months.



Anna stepped away from the table. “I think you’re through. Routine closure, leave a couple of drains in. Keep him on antibiotic coverage for the next few days.”



Luc didn’t need to hear that, but she figured the medical student did. She might as well earn her Assistant Professor’s salary with a little low-key teaching.



She stripped off her gloves and tossed them in the waste bucket at the end of the operating table. “If you need me—“



“Luc, we’ve got a problem. Blood pressure’s dropping, pulse is rapid.” A hint of panic rose in the anesthesiologist’s voice.



The scrub nurse held out fresh gloves, and Anna plunged her hands into them. “He must be bleeding again. Maybe one of the ligatures slipped off.”



“No way,” Luc said. "Everything was double-tied, with a stick-tie on the major vessels. You saw yourself, the wound was dry when we finished.”



“Well, we’ve got to go back in and look.” Anna turned to the anesthesiologist. “Run the IV wide open. Hang another unit of blood and send for at least two more. Keep him oxygenated. And get your staff man in here. Now!”



He snapped out a couple of requests to the circulating nurse before turning back to Anna. “He’s getting hard to ventilate. Do you think we might have overloaded him with fluid and blood? Could he be in pulmonary edema?”



“I want your staff doctor in here now! Let him evaluate all that. We’ve got our hands full.” Anna snatched a scalpel from the instrument tray and sliced through the half-dozen sutures Luc had just placed. “Deavor retractor.” She shoved the curved arm of the instrument into the edge of the open wound and tapped the medical student’s hand. “Hold this.”



Anna grabbed a handful of gauze sponges, expecting a gusher of blood from the abdomen. There was none. No bleeding at all within the wound. So why was the blood pressure dropping?



“Pressure’s down to almost nothing.” The anesthesia resident’s voice was strained. “And I’m really having trouble ventilating him.”



Dr. Buddy Jenkins, one of the senior anesthesiologists, pushed through the swinging doors. “What’s going on?”



Anna gave him the short version. “Blood pressure’s dropping, pulse is climbing. We’ve gone back into the belly, but there’s no bleeding. And there’s a problem ventilating him.”



Jenkins moved his resident aside, then slipped a stethoscope under the drapes and listened for a moment. “Wheezes. And no wonder. Look at his face.”



Anna peeked over the screen that separated the patient’s head and upper body from the operative field. Her heart seemed to skip a beat when she saw the swelling of the lips and the red blotches on the man’s face.



“It’s not blood loss,” Jenkins said. “He’s having an anaphylactic reaction. Most likely the blood. Did you give him an antibiotic? Any other meds?”



Anna’s mind was already churning, flipping through mental index cards. Anaphylaxis—a massive allergic reaction, when airways closed off and the heart struggled to pump blood. Death could come quickly. Treatment had to be immediate and aggressive.



“He had two grams of Omnilex,” Luc said. “But his old chart showed—“



Jenkins was in action before Luc stopped speaking. “I’ll give him a cc. of diluted epinephrine by IV push now, then more in a drip.” He turned to the anesthesia resident. “Get that ready— one milligram of epinephrine in a hundred milliliters of saline.”



“Luc, you two close the abdominal wound,” Anna said. “I’m going to break scrub and help Dr. Jenkins.”



Jenkins handed her a syringe. “Give him this Decadron, IV push. I need to adjust the ventilator.”



Anna injected the contents into the patient’s intravenous line. She said a quick prayer that the epinephrine and steroid would turn the tide, that they hadn’t been too late in starting treatment.



The team battled for almost half an hour, at first gaining ground, then losing it steadily. Finally, Jenkins caught Anna’s eye. They exchanged glances. There was no need for words.



She sighed and stepped away from the table. “I’m calling it.” Her voice cracked. “Time of death is eleven oh seven.”



Luc let the instrument he’d been holding drop back onto the tray. Jenkins picked up the anesthesia record and began to scribble. Murray, the anesthesia resident, turned back to his supply table and started straightening the mess. The medical student looked at Anna. She nodded toward the door, and he slipped out of the room. She didn’t blame him. This was probably the first patient he’d seen die.



Anna tossed her gloves and mask into the waste container. She shrugged, but the tension in her shoulders didn’t go away. “Any idea why this happened? The blood was supposed to be compatible. He’d tolerated Omnilex before. What else could have caused it?”



No one offered an answer. And she certainly had none. But she intended to find out.



The OR charge nurse directed Anna to the family room, where she found Hatley’s mother huddled in a corner, twisting a handkerchief and occasionally dabbing at her eyes. The room was small and quiet, the lighting was soft, the chairs as comfortable as possible. A box of tissues sat on the table, along with a Bible and several inspirational magazines. Soft music playing in the background almost covered the hospital sounds drifting in from the nearby surgical suite.



Anna whispered a silent prayer. She’d done this dozens of times, but it never got any easier. She knelt in front of the woman. “Mrs. Hatley, I have bad news for you.”



Anna stumbled through the next several minutes, trying to explain, doing her best to make sense of a situation that she herself couldn’t fully understand. When it came to the matter of permission for an autopsy, Anna wasn’t sure of the medico-legal situation here. Hatley had died after being shot, but his injuries weren’t the cause of death. Would she have to call the County Medical Examiner and get him to order one? The weeping mother solved the problem by agreeing to allow a post-mortem exam.



There was a light tap at the door, and the chaplain slipped into the room. “I’m sorry. I was delayed.” He took the chair next to Mrs. Hatley and began speaking to her in a low voice.



Anna was happy to slip out of the room with a last “I’m so sorry.” Outside, she paused and took several deep breaths.



It took another half-hour for Anna to write a chart note, dictate an operative report and final case summary, and change into clean scrubs. She was leaving the dressing room when her pager sounded. The display showed her office number followed by the suffix “911.” A “stat” page—respond immediately.



As she punched in the number, Anna wondered what else could possibly go wrong today. “Lisa, what’s up?”



“Dr. McIntyre, there are two policemen here. They want to talk with you. And they say it’s urgent.”



* * *



Nick Valentine looked up from the computer and grimaced when he heard the morgue attendant’s rubber clogs clomping down the hall. The summons he knew was coming wasn’t totally unexpected. After all, he was the pathologist on autopsy call this week, which was why he was sitting in this room adjacent to the morgue of Parkland Hospital instead of in his academic office at the medical school. But he’d hoped for some undisturbed time to get this project done.



The attendant stuck his head through the open door. “Dr. Valentine, you’ve got an autopsy coming up. Unexpected death in the OR. Dr. McIntyre’s case. She asked if you could do it as soon as possible. And please page her before you start. She’d like to come down for the post.” The man’s head disappeared like that of a frightened turtle. More clomps down the hall signaled his departure.



There was nothing new about an attending wanting a post-mortem done ASAP. You’d think they’d realize there was no hurry any more, but that didn’t seem to stop them from asking. At least she was willing to come down and watch instead of just reading his report. Nick turned to the shelf behind his desk and pulled out a dog-eared list headed “Frequently Needed Pager Numbers.” He ran his finger down the page. Here it was: Department of General Surgery. Anna E. McIntyre, Assistant Professor. He picked up the phone and punched in her number. After he heard the answering beeps, he entered his extension and hung up.



While he waited, Nick looked first at the pile of papers that covered half his desk, then at the words on his computer screen. He’d put this off far too long. Now he had to get it done. To his way of thinking, putting together this CV, the curriculum vitae that was so important in academics, was wasted effort. Nick had no interest in a promotion, didn’t think he’d get one even if his chairman requested it from the dean. But his chairman wanted the CV. And what the chairman wanted, the chairman got.



The phone rang. Probably Dr. McIntyre calling back.



“Dr. Valentine.”



“Nick, this is Dr. Wetherington. Do you have that CV finished yet?”



“I’m working on it.”



“Well, I need it soon. I want you to get that promotion to Associate Professor, and I have to be able to show the committee why I’ve nominated you. Don’t let me down.”



Nick hung up and riffled through the pile on his desk. Reprints of papers published, programs showing lectures delivered at medical meetings, textbooks with chapters he’d written, certificates from awards received. His professional résumé was pitifully small, but to Nick it represented the least important part of his job. What mattered most to him was what he was about to do: try to find out why the best efforts of a top-notch medical staff failed to save the life of some poor soul. If he did his job well, then maybe those doctors would be able to snatch some other patient from the jaws of the grim reaper.



His phone rang. “Dr. Valentine, are you about ready?” the morgue attendant said.



Nick looked at his watch. Almost half an hour, and Dr. McIntyre hadn’t responded to the page. He hated to start without her, but he might have to. “Give me another ten minutes.”



While he waited, Nick figured he might as well try to make Dr. Wetherington happy. Now when did he deliver that paper before the American Society of Clinical Pathology? And who cared, anyway?



* * *



Her administrative assistant met Anna at the doorway to the outer office. “Dr. McIntyre, I didn’t know what to do.”



“That’s all right, Lisa. I’ll talk with them.” Anna straightened her white coat and walked into her private office, where two people stood conversing in low tones. Lisa had said, “Two policemen,” but Anna was surprised to see that one of them was a woman.



The man stepped forward to meet Anna. “Doctor McIntyre?”



Anna nodded.



He pulled a leather folder from his pocket and held it open for her inspection. Anna could see the gold and blue badge pinned to the lower part of the wallet, but couldn’t read the words on it. The card in the top portion told her, though. It carried a picture beside the words, US Drug Enforcement Administration.



Lisa had been wrong. These people were from the DEA, not the police. Still, an unannounced visit from that agency made most doctors sweat. You never knew when some innocent slip might get you into trouble.



The man flipped the credential wallet closed. “This won’t take long.”



“Good. I’ve just finished an emergency case, and I still have a lot to do.” Anna moved behind her desk and sat.



“Your chairman said you’d give us as much time as we need.”



Anna glanced pointedly at her watch. “Well, have a seat and let’s get to it. What do you need from me?”



The man lowered himself into the chair, his expression slightly disapproving. His partner followed suit. “We have some things we need for you to clear up.”



“Could I see those credentials again?” Anna said. “Both of you.”



They obliged, laying the open wallets on the desk. Anna pulled a slip of notepaper toward her and began copying the information, occasionally glancing up from her writing to match the names and faces on the ID’s with the people sitting across from her. The spokesman was Special Agent John Hale, a chunky, middle-aged man wearing an off-the rack suit that did nothing to disguise his ample middle. Anna thought he looked more like a seedy private eye than an officer of the law.



The woman, the silent half of the pair so far, was Special Agent Carolyn Kramer, a woman who reminded Anna of a California surfer bunny, complete with perfect tan and faultlessly styled short blonde hair. The resemblance stopped there, though. Kramer’s eyes gleamed with a combination of intelligence and determination that told Anna she’d better not underestimate the woman. Kramer wore a stylish pants suit that had probably cost more than Anna made in a week, How could a DEA agent have money for an outfit like that?



Anna handed the badge wallets back to Hale and Kramer. “All right, how can I help you?”



Hale pulled a small notebook from his inside coat pocket and flipped through the pages. “Doctor, recently you’ve been writing a large number of Vicodin prescriptions, all of them for an excessive amount of the drug. Can you explain that?”



“I don’t know what you mean,” Anna said. “I’m pretty sure I haven’t written any more Vicodin ‘scripts than usual, and I certainly haven’t changed my prescribing practices.”



Hale nodded, stone-faced. “What are those practices?”



“I prescribe Vicodin for post-operative pain in many of my patients, but always in carefully controlled amounts, usually thirty pills at a time. By the time they’ve exhausted that first prescription I can generally put them on a non-narcotic pain reliever. It’s rare that I refill a Vicodin ‘script.”



Apparently it was Kramer’s turn in the tag-team match. She picked up a thick leather folder from the floor beside her chair, unzipped it, and extracted a sheaf of papers held together by a wide rubber band. “Would you care to comment on these?” Her soft alto was a marked contrast to Hale’s gruff baritone,



Anna’s eyes went to the clock on her desk. “Will this take much longer? I really have things I need to do.”



Kramer seemed not to hear. She held out the bundle of papers.



“Okay, let me have a look.” Anna recognized the top one in the stack as a prescription written on a form from the faculty clinic. She pulled it free and studied it. The patient’s name didn’t stir any memory, but that wasn’t unusual. She might see twenty or thirty people in a day. The prescription read:



VICODIN TABS



Disp. [#100]



Sig: 1 tab q 4 h PRN pain



At the bottom of the page, three refills were authorized. The DEA number had been written into the appropriate blank on the lower right-hand corner.



Anna squinted, closed her eyes, then looked again. There was no doubt about it. The DEA number was hers. And the name scrawled across the bottom read: Anna McIntyre, MD.



“Can you explain this?” Kramer asked.



A familiar vibration against her hip stopped Anna before she could reply. She pulled her pager free and looked at the display. The call was from the medical center, but she didn’t recognize the number. Not the operating room. Not the clinic. She relaxed a bit when she saw there was no “911” entry after the number. If this was about the autopsy, she’d have to miss it.



Hale picked up the questioning as though there had been no interruption. “What can you tell us about all these prescriptions for Vicodin?”



“I suppose the most important thing I can tell you is that I didn’t write them.” She riffled through the stack, paying attention only to the signature at the bottom of each sheet. “None of these are mine.”



“That’s your number and name. Right?” Kramer said.



“Right. But that’s not my signature. It’s not even close.”



“Can you explain how someone else could be writing prescriptions on your pads using your DEA number?” Hale asked.



“I have no idea.” Anna made no attempt to keep the bitterness out of her words. “Sorry, I’ve just lost a patient, and I’m not in the best of moods. Can’t we wind this up? I didn’t write those ‘scripts, and I don’t know who did.”



Obviously, Hale didn’t want to let the matter go. “You’re sure there’s nothing you want to tell us?”



“What would I have to tell you? I said I don’t know anything about this.”



Kramer spoke, apparently filling the role of good cop. “Take a guess. Help us out here.”



Anna felt her jaw muscles clench. These people were relentless. She had to give them something, or this would never end. “I really don’t know. I mean, we’ve got an established routine, and all the doctors here are pretty careful.”



Kramer pulled a silver ballpoint from the leather folder and began twirling it between her fingers. “Why don’t you walk us through that routine?”



Anna wanted to follow up on Hatley’s autopsy, talk with her department chair about today’s events, eventually sit down and try to relax. She was drained. The agents, on the other hand, seemed to have unlimited time and energy.



“Doctor?” Kramer’s voice held no hint of irritation. Patient, understanding, all the time in the world. Just two women chatting.



“Sorry.” Anna tried to organize her thoughts. “The prescription pads in the faculty clinic are kept in a drawer in each treatment room. That way they’re out of sight, although I guess if someone knew where they were he could latch onto one when no one was in the room.” She looked at the agents. Kramer simply nodded. Hale scowled. “Hey, we know it’s not perfect, but that’s the way we have to do it. Otherwise, we’d waste all our time hunting for a pad.”



“And do you ever forget and leave the pads sitting out when you’ve finished writing a prescription?” Kramer asked.



“Sure. Especially when we’re in a hurry.” Anna’s cheeks burned.



Hale turned a page in his notebook and frowned. “How about your DEA number?”



“You’ll notice those aren’t printed on the forms. Each of us has to fill in our number.”



“Maybe someone else had access to your number. Do nurses ever write the prescriptions for you?” This came from Kramer. Anna felt as though she was watching a tennis match, going back and forth between the two agents.



“When we have a nurse in the room with us, yes, she’ll write the prescription. I don’t know what the other doctors do, but I sign the prescriptions after she writes them. And I add the DEA number to the narcotic ‘scripts myself.”



The questioning went on for another half hour. Anna’s throat was dry, her eyes burned, she felt rivulets of sweat coursing between her shoulder blades. Finally, she’d had enough. “Look, am I being charged with something? Because if I am, I’m not saying another word without a lawyer.”



Hale replaced his notebook in his pocket. Kramer picked up her folder and purse. They let the silence hang for a moment more before exchanging glances, then standing.



“Right now, we’re simply investigating, Doctor,” Hale said. “You may be hearing from the Texas Department of Public Safety and the Dallas Police as well. Also, since your DEA number and identity have been compromised, I’d advise you not to prescribe any controlled substances for now. You’ll receive formal notification in writing tomorrow about applying for a new permit.”



The agents walked out, leaving Anna with her hands pressed to her throbbing temples.



* * *



Nick stepped back from the autopsy table, pressed the pedal under his right foot, and spoke into the microphone hanging near his head. “No other abnormalities noted. The balance of findings will be dictated after review of the histopathology specimens and the results of the toxicology tests. Usual signature. Thanks.” He turned away from the body and gestured to the morgue assistant to close the incisions. “I’ll be in the office if you need me. Thanks for your help.”



Nick removed his goggles and stripped off his mask, gown, and gloves. He was standing at the sink outside the autopsy room, drying his hands, when he heard footsteps hurrying down the corridor toward him. He turned to see a woman approaching. The attractive redhead wore surgical scrubs, covered by a white coat. As she neared him, he could make out the embroidered name above the breast pocket: Anna McIntyre, MD. She stopped in front of him, and the set of her jaw and the flash of her green eyes told Nick she was in no mood for light banter.



“Dr. McIntyre?”



She nodded.



“Nick Valentine. I paged you, but when you didn’t answer I had to go ahead and get started. Sorry.”



She waved away his apology. “No, it’s my fault. I couldn’t break free to answer your page. What can you tell me?”



“Why don’t I buy you a cup of coffee and I’ll tell you what I’ve found so far? If we go to the food court, we can get away from the smell down here. I hardly notice it anymore, but I’ve learned that my visitors aren’t too fond of the odor of chemicals.”



She hesitated for a few seconds. “Okay. Lead the way.”



It seemed to Nick there was a Starbucks on every corner of every major city in the US. Most important to him, however, was the one here in the basement of the Clinical Sciences Building at Southwestern Medical Center. As he waited to order, he sniffed the rich aromas that filled the air. The smell of coffee never failed to lift his spirits. Maybe it would do the same for the woman who stood stoop-shouldered beside him. For most doctors, caffeine was the engine that helped propel them through long days and longer nights. Maybe all she needed was a booster shot.



When they were seated at a corner table with their venti lattes Nick filled her in on his findings at the autopsy he’d just completed. “That’s about it,” he concluded. “I’ll sign the death certificate with the preliminary cause of death as anaphylaxis due to an unknown cause.”



“But you won’t have a final diagnosis until—“



“Right. I’ll review the tissue samples and the results of the toxicology screen, but I doubt that we’ll find anything there. I’m going to have some tests run on the blood samples I took, and maybe that will help us. I’ll need to research whether there’s a good blood test for a drug reaction or latex allergy. The long and short of it is that we may never know the real reason he developed anaphylaxis and died.”



“I hadn’t even thought of latex allergy,” she said. “But that’s pretty rare, isn’t it?”



“Less than one percent of the population. Seen in people chronically exposed to latex: surgeons and nurses, industrial workers, patients with lifelong indwelling catheters.” He felt himself slipping into his lecture mode and made an effort to pull back. “I mean, we could talk about all these uncommon things, but I’ll bet you learned the same thing in medical school that I did. When you hear hoof beats—“



“Think horses, not zebras.” She managed a tiny smile. “Yes, I know. So we should concentrate on the blood or the antibiotic. If it was the blood, there’s a problem in the blood bank because he got one unit of unmatched O negative, which should have been okay, and one unit that was supposedly compatible by cross-match.”



“The residuals in both bags of blood are being re-typed and cross-matched against your patient’s blood as we speak. We’ll know the answer by the time we finish our coffee.” He drank deeply from his cup. “Don’t you think an antibiotic reaction is the most likely cause?”



She took a sip of coffee. “Probably, although I hope not. Choosing an antibiotic wasn’t a routine matter, because we didn’t know if Hatley had any drug allergies. The resident—one of our sharpest ones, by the way—thought he’d see if we could get the information another way. He had medical records check for a previous visit for the patient. They found a recent emergency room visit by the patient where he tolerated Omnilex. Since that antibiotic’s the best choice to cover spillage from a perforated bowel, I agreed with Luc when he ordered it.”



“But—“



“I know. If you give that drug to a patient who’s allergic to it or to penicillin, their reaction is likely to be severe—like this one. But I thought, since we had that history of tolerance, it was okay.” She blinked hard. “I should have known better. Should have made him use a different drug.”



Nick sensed he was treading on thin ice here. Maybe he should change the subject. Besides, he wanted to know more about this woman. “You know, I’ve seen you in the halls, but we’ve never actually met. Did you train here?”



She hesitated before reeling off what had apparently become a stock answer. “Raised in Oklahoma. Graduated from med school in North Carolina. Duke, actually. Lucky enough to get a surgery residency here at Parkland, and when I finished I was offered a faculty position in the Surgery Department. I’ve been here a little less than a year now.”



Nick held up a hand, palm out. “I know better. You don’t get a surgery residency here because you’re ‘lucky.’ You get one because you’re good. Let me guess. AOA at Duke?” If Anna was Alpha Omega Alpha, she must have been in the top ten percent of her class.



“Right. But I don’t guess it’s enough to be bright if you foul up and cost a patient his life.” She drank from her cup, and Nick noticed that she kept swallowing several more times after that.



Nick was barely aware of the activity around him, the ebb and flow of people, the sounds of pagers punctuating dozens of conversations. All he saw was Anna. She was one of the prettiest women he’d encountered in quite a while. But he was certain there was more to this trim, green-eyed redhead than striking good looks. Right now she was focused on medicine—it was obvious she cared a great deal about her patients, and this loss hit her hard—but Nick had a sense that in a different setting she’d be fun to know. And he intended to see if he couldn’t arrange that. Anna shifted in her chair. He couldn’t let her leave yet.



“Wait a minute,” he said. “Aren’t you curious about me at all? There may be a prize if you can answer all the questions later.”



Did he see the ghost of a grin? “Sure. Why not? What’s your story—the Reader’s Digest version?”



Nick moved his cup aside and leaned forward with his elbows on the table. He wasn’t sure how much longer he could draw out their time together, but he was determined to give it his best shot. “My roots are Italian. Named for my grandfather. He was Nicolo Valentino when he got off the boat, changed his name when he got his citizenship. I’m Nicolo the Third.” He ticked off the points on his fingers. “Worked my way through pre-med at Texas Tech. Got into the med school there by the skin of my teeth. Managed to get a residency in pathology here at Southwestern. When I finished, they had an opening in the department.” He held out his hand, palm up, fingers spread, thumb tucked under. “So here I am—four years in the department, still an Assistant Professor. Up for promotion now, and I suspect that if I don’t make it they’ll cut me like a dead branch from a tree.”



Nick’s last sentence rang a faint alarm bell in his head. He had to finish that project or the chairman would be royally ticked off, but it only took Nick a second to put that chore out of his mind. He was sitting with the most beautiful woman he’d ever met. He wanted to get to know her better, and he intended to keep her here as long as possible, even if it meant incurring Dr.. Wetherington’s wrath.

Friday, May 14, 2010

First Wild Card Tour: Code Blue by Richard Mabry

It is time for a FIRST Wild Card Tour book review! If you wish to join the FIRST blog alliance, just click the button. We are a group of reviewers who tour Christian books. A Wild Card post includes a brief bio of the author and a full chapter from each book toured. The reason it is called a FIRST Wild Card Tour is that you never know if the book will be fiction, non~fiction, for young, or for old...or for somewhere in between! Enjoy your free peek into the book!

You never know when I might play a wild card on you!


Today's Wild Card author is:


and the book:


Code Blue (Prescription for Trouble)

Abingdon Press (April 1, 2010)

***Special thanks to Susan Salley of Abingdon Press for sending me a review copy.***

ABOUT THE AUTHOR:


After his retirement from a distinguished career as a physician and medical educator, Richard turned his talents to non-medical writing. Code Blue is his debut novel, the first of the Prescription For Trouble series, featuring medical suspense. Richard and his wife, Kay, make their home in North Texas, where he continues his struggles to master golf and be the world’s most perfect grandfather.

Visit the author's website.

Product Details:

List Price: $13.99
Paperback: 288 pages
Publisher: Abingdon Press (April 1, 2010)
Language: English
ISBN-10: 1426702361
ISBN-13: 978-1426702365

AND NOW...THE FIRST CHAPTER:



The black SUV barreled out of nowhere, its oversized tires straddling the centerline. Cathy jerked the steering wheel to the right and jammed the brake pedal to the floor. Her little Toyota rocked as though flicked by a giant hand before it spun off the narrow country road and hurtled toward the ditch and the peach orchard beyond it.

For a moment Cathy felt the fearful thrill of weightlessness. Then the world turned upside down, and everything went into freeze-frame slow motion.

The floating sensation ended with a jolt. The screech of ripping metal swallowed Cathy’s scream. The deploying airbag struck her face like a fist. The pressure of the shoulder harness took her breath away. The lap belt pressed into her abdomen, and she tasted bile and acid. As her head cleared, she found herself hanging head-down, swaying slightly as the car rocked to a standstill. In the silence that followed, her pulse hammered in her ears like distant, rhythmic thunder.

Cathy realized she was holding her breath. She let out a shuddering sigh, inhaled, and immediately choked on the dust that hung thick in the air. She released her death-grip on the steering wheel and tried to lift her arms. It hurt—it hurt a lot—but they seemed to work. She tilted her head and felt something warm trickle down her face. She tried to wipe it away, but not before a red haze clouded her vision.

She felt a burning sensation, first in her nostrils, then in the back of her throat. Gasoline! Cathy recalled all the crash victims she’d seen in the emergency room—victims who’d survived a car accident only to be engulfed in flames afterward. She had to get out of the car. Now. Her fingers probed for the seatbelt buckle. She found it and pressed the release button. Slowly. Be careful. Don’t fall out of the seat and make matters worse. The belt gave way, and she eased her weight onto her shoulders. She bit her lip from the pain, rolled onto her side, and looked around.

How could she escape? She tried the front doors. Jammed—both of them. She’d been driving with her window partially open, enjoying the brisk autumn air and the parade of orange and yellow trees rolling by in the Texas landscape. There was no way she could wriggle through that small opening. Cathy drew back both feet and kicked hard at the exposed glass. Nothing. She kicked harder. On the third try, the window gave way.

Where was her purse? Never mind. No time. She had to get out. Cathy inched her way through the window, flinching as tiny shards of glass stung her palms and knees. Once free from the car, she lay back on the grass and looked around at what remained of the orchard, blessing the trees that had sacrificed themselves to cushion her car’s landing.

She rose unsteadily to her feet. It seemed as though every bone in her body cried out at the effort. The moment she stood upright the world faded into a gray haze. She slumped to the ground and took a few deep breaths. Her head hurt, her eyes burned, her throat seemed to be closing up. The smell of gasoline cut through her lethargy. She had to get further away from the car. How could she do that, when she couldn’t even stand without passing out?

Cathy saw a peach sapling a few feet away, a tiny survivor amid the ruins. She crawled to the tree, grabbed it, and walked her hands up the trunk until she was almost upright. She clung there, drained by the exertion, until the world stopped spinning.

Something dripped into her eyes and the world turned red. Cathy risked turning loose with one hand and wiped it across her face. Her vision cleared a bit. She regarded the crimson stain on her palm. Good thing she was no stranger to the sight of blood.

Now she was upright, but could she walk? Maybe, if she could stand the pain. She wasn’t sure she could make it more than a step or two, though. A stout limb lying in the debris at her feet caught her eye. It was about four feet long, two inches thick—just the right size. Cathy eased her way down to a crouch, using the sapling for support. She grabbed the limb and, holding it like a staff, managed to stand up. She rested for a moment, then inched her way along the bottom of the ditch, away from the car. When she could no longer smell gasoline and when her aching limbs would carry her no farther, she leaned on her improvised crutch to rest.

Cathy stared at the road above her. The embankment sloped upward in a gentle rise of about six feet. Ordinarily, climbing it would be child’s play for her. But right now she felt like a baby—weak, uncoordinated, and fearful.

Maybe if she rested for a moment on that big rock. She hobbled to it and lowered herself, wincing with each movement. There was no way she could get comfortable—even breathing was painful—but she needed time to think.

Had the SUV really tried to run her off the road? She wanted to believe it was simply an accident, that someone had lost control of his vehicle. Just like she’d wanted to believe that the problems she’d had since she came back home were nothing more than a run of bad luck. Now she had to accept the possibility that someone was making an effort to drive her out of town.

She’d never thought much about the name of her hometown: Dainger, Texas. She vaguely recalled it was named for some settler, long ago forgotten. Now she was thinking the name seemed significant. Danger. Had the problems she’d left behind in Dallas followed her? Or did the roots lie here in Dainger? Possibly. After all, small towns have long memories. Of course, there could be another explanation. . . . No, she couldn’t accept that. Not yet.

Cathy turned to survey the wreckage of her poor little car. She saw wheels silhouetted against the sky, heard the ticking of the cooling motor. Then she picked up new sounds: the roar of a car’s engine, followed by the screech of tires and the chatter of gravel. It could be someone stopping to help. On the other hand, it could be the driver of the SUV coming back to finish the job. She thought of hiding. But where? How?

She watched a white pickup skid to a stop on the shoulder of the road above the wreckage. A car door slammed. A man’s voice called, “Is anyone down there? Are you hurt?”

No chance to get away now. She’d have to take her chances and pray that he was really here to help. Pray? That was a laugh. Cathy had prayed before, prayed hard, all without effect. Why should she expect anything different this time?

“Is someone there? Are you hurt?”

How should she react? Answer or stay quiet? Neither choice seemed good. She tried to clear the dust from her throat, but when she opened her mouth to yell, she could only manage a strangled whisper. “Yes.”

Footsteps crunched on the gravel shoulder above her, and an urgent voice shouted, “Is someone down there? Do you need help?”

“Yes,” she croaked a bit stronger.

“I’m coming down,” he said. “Hang on.”

A head peered over the edge of the embankment, but pulled back before she could get more than a glimpse of him.

In a few seconds, he scrambled down the embankment, skidding in the red clay before he could dig in the heels of his cowboy boots. At the bottom he looked around until he spotted her. He half-ran the last few feet to where she stood swaying on her makeshift crutch.

“Here, let me help you. Can you walk?”

Blood trickled into her eyes again, and even after she wiped it away, it was like looking through crimson gauze. Cathy could make out the man’s outline but not his features. He sounded harmless enough. But she supposed even mass murderers could sound harmless.

She gripped her makeshift staff harder; it might work as a weapon. “I don’t think anything’s broken.” Her voice cracked, and she coughed. “I’m just stunned. If you help me, I think I can move okay.”

He leaned down and Cathy put her left arm on his shoulder. He encircled her waist with his right arm, supporting her so her feet barely touched the ground as they shuffled toward the slope. At the bottom, he turned and swept her into his arms. The move took her by surprise, and she gasped. She felt him stagger a bit on the climb, but in a moment they made it to the top.

Her rescuer freed one hand and thumbed the latch on the passenger side door of his pickup. He turned to bump the door open with his hip, then deposited her gently onto the seat. “Rest there. I’ll call 911.”

Cathy leaned back and tried to calm down. His voice sounded familiar. Was he one of her patients? She swiped the back of her hand across her eyes, but the image remained cloudy.

The man pulled a flip-phone from his pocket and punched in three digits. “There’s been a one-car accident.”

She listened as he described the accident location in detail—a mile south of the Freeman farm, just before the Sandy Creek Bridge. This wasn’t some passer-by. He knew the area.

“I need an ambulance, a fire truck, and someone from the sheriff’s office. Oh, and send a flatbed wrecker. The car looks like it’s totaled.”

“I don’t need an ambulance,” Cathy protested.

He held up a hand and shushed her, something she hadn’t encountered since third grade. “Yes, she seems okay, but I still think they need to hurry.”

Cathy heard a few answering squawks from the phone before the man spoke again. “It’s Will Kennedy. Yes, thanks.”

Will Kennedy? If she hadn’t been sitting down, Cathy might have fallen over. She scrubbed at her eyes and squinted. Will? Yes, it was Will. Now even the shape of his body looked familiar: lean and muscular, just the way he’d been—. No. Don’t go there.

Will ended his call and leaned in through the open pickup door. “They’ll be here in a minute. Hang on.”

He took a clean handkerchief from the hip pocket of his pressed jeans and gently cleaned her face. The white cotton rapidly turned red, and Cathy realized that the blood had not only clouded her vision. It had masked her features.

“Will, don’t you recognize me?”

He stopped, looked at her, and frowned. “Cathy?”

“Yes.” There were so many things to say. She drew in a ragged breath. “Thanks. I appreciate your stopping.”

He gave her the wry grin she remembered so well, and her heart did a flip-flop. “I’d heard you were back in town, and I wondered when you’d get around to talking to me. I just didn’t know it would be like this.” He paused. “And forget about telling me not to have them send an ambulance. I don’t care if you are a doctor now, Cathy Sewell. I won’t turn you loose until another medic checks you.”

Cathy opened her mouth to speak, but Will’s cell phone rang. He answered it and walked away as he talked, while she sat and wondered what would have happened if they’d never turned each other loose in the first place.

* * *

As the ambulance sped toward Summers County General Hospital, Cathy wondered what kind of reception she would get there. Who would be on duty? Would they acknowledge her as a colleague, even though she hadn’t been given privileges yet? When her thoughts turned to recent events, she forced herself to shut down the synapses and put her mind into neutral.

The ambulance rocked to a halt outside the emergency room doors. Despite Cathy’s protestations, the emergency medical technicians kept her strapped securely on the stretcher while they offloaded it. Inside the ER, Cathy finally convinced her guardians to let her transfer to a wheelchair held by a waiting orderly.

“Thanks so much, guys. I’ll be fine. Really.”

At the admitting desk, the clerk looked up from her computer and frowned.

“Cathy?” She flushed. “I . . . I mean, Dr. Sewell?”

“It’s okay, Judy. I was Cathy through twelve years of school. No reason to change.” Cathy looked around. “Who’s the ER doctor on duty?”

“Dr. Patel. He just called in Dr. Bell to see a patient. Dr. Patel thought it might be a possible appendix.” She lowered her voice. “Dr. Bell took one look and made the diagnosis of stomach flu. I couldn’t see the need to call in another doctor for a consultation, but Dr. Patel is so afraid he’ll make a wrong diagnosis.” She pursed her lips as she realized her mistake of complaining about one doctor to another.

“Just be sure Dr. Patel doesn’t hear you say that.” Cathy tried to take the sting out of the words with a wink, but the blood dried around her eyes made it impossible. “Can you call him? I’ve been threatened with dire punishment if I don’t get checked out.”

Judy reached for the phone.

“Don’t bother, Judy. I’ll take care of Dr. Sewell myself.”

Cathy eased her head around to see Marcus Bell standing behind her. He wore khakis and a chocolate-brown golf shirt, covered by an immaculate white coat with his name embroidered over the pocket.

This was a trade Cathy would gladly make—finicky Dr. Patel for superdoc Marcus Bell. In the three years he’d been here, Marcus had built a reputation as an excellent clinician. He was also undoubtedly the best-looking doctor in town.

“Let’s get you into Treatment Room One,” Marcus steered Cathy’s wheelchair away from the desk. “Judy, you can bring me the paperwork when you have it ready. Please ask Marianne to step in and help me for a minute. And page Jerry for me, would you? Thanks.”

Cathy had been in treatment rooms like this many times in several hospitals. Now she noticed how different everything looked when viewed from this perspective. As if the accident and the adrenaline rush that followed hadn’t made her shaky enough, sitting there in a wheelchair emphasized her feeling of helplessness. “I feel so silly,” she said. “Usually I’m on the other end of all this.”

“Well, today you’re not.” Marcus gestured toward the nurse who stood in the doorway. “Let’s get you into a gown. Then we’ll check the extent of the damages.”

Marcus stepped discreetly from the room.

“I’m Marianne,” the nurse said. Then, as though reading Cathy’s mind, she added, “I know it’s hard for a doctor to be a patient. But try to relax. We’ll take good care of you.”

Marianne helped Cathy out of her clothes and into a hospital gown. If Cathy had felt vulnerable before this, the added factor of being in a garment that had so many openings closed only by drawstrings tripled the feeling. The nurse eased Cathy onto the examining table, covered her with a clean sheet, and called Marcus back into the room.

“Now, Cathy, the first thing I want to do is have a closer look at that cut on your head.” Marcus slipped on a pair of latex gloves and probed the wound.

Cathy flinched. “How does it look?”

“Not too bad. One laceration about three or four centimeters long in the frontal area. Not too deep. The bleeding’s almost stopped now. We’ll get some skull films, then I’ll suture it.” He wound a soft gauze bandage around her head and taped it.

Marcus flipped off his gloves and picked up the clipboard that Cathy knew held the beginnings of her chart. “Why don’t you tell me what happened?”

At first, Cathy laid out the details of the accident and her injuries in terse clinical language, as though presenting a case to an attending physician at Grand Rounds. She did fine until she realized how close she’d come to being killed, apparently by someone who meant to do just that. There were a couple of strangled hiccups, then a few muffled sobs, before the calm physician turned into a blubbering girl. “I’m . . . I’m sorry.” She reached for a tissue from the box Marcus held out.

“No problem. If you weren’t upset by all that, you wouldn’t be normal.” Marcus took an ophthalmoscope from the wall rack and shined its light into her eyes. “How’s your vision?”

“Still a little fuzzy—some halos around lights. I figured it was from the blood running into my eyes.”

He put down the instrument and rummaged in the drug cabinet. “Let’s wash out your eyes. I don’t want you to get a chemical keratitis from the powder on the air bag. I’ll give you some eye drops, but if your vision gets worse or doesn’t clear in a day or so, I want you to see an ophthalmologist.”

“Oh, right.” The fact that she hadn’t thought of that underscored to Cathy how shaken she still was.

“Now, let’s see what else might be injured.” Marcus took her left wrist and gently probed with his fingers. Apparently satisfied, he proceeded up along the bones of the arm. His touch was gentle, yet firm, and Cathy found it somehow reassuring. “We’ll need some X-rays. I want you to help me figure out the right parts.”

“I can’t help you much. I’m hurting pretty much everywhere,” Cathy said. “But, I haven’t felt any bones grating. I think I’m just banged up.”

Marcus turned his attention to her right arm. He paused in his prodding long enough to touch her chin and raise her head until their eyes met. “You’re like all of us. You think that because you’re a doctor you can’t be hurt or sick.”

“That’s not true. I don’t— Ow!” His hand on the point of her right shoulder sent a flash of pain along her collarbone.

“That’s more like it. We’ll get an X-ray of that shoulder and your clavicle. Seatbelt injuries do that sometimes. Now see if you can finish telling me what happened.”

This time she got through the story without tearing up, although Marcus’s efforts to find something broken or dislocated brought forth a number of additional flinches and exclamations.

“I really do think I’m fine except for some bruises,” she concluded.

“Really?”

“Okay, I’m also scared. And a little bit mad.”

A tinny voice over the intercom interrupted her. “Dr. Bell, is Marianne still in there?”

“I’m here,” the nurse replied.

“Can you help us out? There’s a pedi patient in Treatment Room Two with suspected meningitis. They’re about to do a spinal tap.”

“Go ahead,” Marcus said. “We can take it from here.”

No sooner had the nurse closed the door than there was a firm tap on it.

“Jerry?” Marcus called.

“Yes, sir.”

“Come in.”

The door creaked open, and Cathy turned. The pain that coursed through her neck made her regret the decision. A man in starched, immaculate whites strode into the room and stopped at an easy parade rest. A smattering of gray at the temples softened the red in his buzz-cut hair.

Marcus did the honors. “Dr. Sewell, this is Jerry O’Neal. Jerry retired after twenty years as a Marine corpsman, and he’s now the senior radiology technician at Summers County General. He probably knows as much medicine as you and I put together, but he’s too polite to let it show.”

“Pleasure to meet you, Doctor,” Jerry said.

Marcus handed the clipboard chart to Jerry. “Dr. Sewell’s been in an auto accident. She has a scalp laceration I’ll need to suture, but first, would you get a skull series, films of the right shoulder and clavicle?” He thought a bit. “Right knee. Right lower leg. While we’re at it, better do a C-spine too.”

“Yes, sir,” Jerry said. “Is that all?”

Marcus looked back at Cathy. “If you catch her rubbing anything else, shoot it. Call me when you’ve got the films ready.”

Cathy half- expected Jerry to salute Marcus. Instead, he nodded silently before helping her off the exam table and into a wheelchair.

“Don’t worry, Dr. Sewell. You’re in good hands.”

She tried to relax and take Jerry at his word. “Why haven’t I seen you around before this?”

Jerry fiddled with some dials. “I work weekdays as a trouble-shooter for an X-ray equipment company in Dallas. I’m only here on weekends. It fills the empty hours.”

That’s why I was taking a drive on Saturday afternoon. Filling the empty hours. That started a chain of thought Cathy didn’t want to pursue. Instead, she concentrated on getting through the next few minutes.

The X-rays took less time and caused less discomfort than Cathy expected. She could see why Marcus thought so highly of Jerry. Soon she was back in the treatment room, lying on the examination table. Jerry put up two of the X-rays on the wall view box and stacked the others neatly on the metal table beneath it.

“I’ll get Dr. Bell now. Will you be okay here for a minute?”

Cathy assured Jerry that she was fine, although she finally realized how many bumps and bruises she’d accumulated in the crash. Every movement seemed to make something else hurt.

When she thought about what came next, her anxiety kicked into high gear. Would Marcus have to shave her scalp before placing the stitches? She recalled her own experiences suturing scalp lacerations in the Parkland Hospital Emergency Room. Maybe it was a woman thing, but she’d felt sorry for those patients, walking out with a shaved spot on their head, a bald patch that was sometimes the size of a drink coaster. She hated the prospect of facing her patients on Monday in that condition. Truthfully, she even hated the prospect of looking at herself in the mirror. She was thinking about wigs when Marcus reentered the room.

“Let’s see what we’ve got.” He stepped to the view box and ran through the X-rays. “Skull series looks fine. . . . Neck is good. . . . Shoulder looks okay. . . .The clavicle isn’t fractured. . . . You are one lucky woman. Looks like all I have to do is suture that scalp laceration.”

Cathy was surprised when Marcus didn’t call for help, but rather assembled the necessary instruments and equipment himself. When he slipped his gloves on, she closed her eyes and gritted her teeth. The fact that she’d been on the other end of this procedure hundreds of times just made her dread it more.

Marcus’s touch was gentle as he cleaned the wound. Soon she felt the sting of a local anesthetic injection. After that, there was nothing except an occasional tug as he sutured.

Cathy processed what she’d just felt. “You didn’t shave my scalp.”

“Now why would I want to mar that natural beauty of yours? I didn’t paint the wound orange with Betadine, either. I used a clear antiseptic to prep the area and KY jelly to plaster the hair down out of my way. The sutures are clear nylon that won’t be noticeable in your blonde hair. When I’m finished, I’ll paint some collodion over the wound to protect it. In the morning, clean the area with a damp cloth, brush your hair over it, and no one will know the difference.”

Cathy couldn’t believe what she’d heard. “Natural beauty?” This was certainly at odds with what she’d been told about Marcus Bell. Since the death of his wife, Marcus apparently wanted nothing to do with women. Rumor had it he’d turned aside the advances of most of the single women in Dainger. Was he flirting with her now? Or was this simply his bedside manner?

Marcus snapped off his gloves and tossed them in the bucket at the end of the table. “See me in a week to remove the stitches—unless you want to stand on a box and look down on the top of your own head to remove them yourself.”

“Okay, I get it. I’ll stop being my own doctor,” she said.

“How about something for the pain?”

“I think I’ll be okay.”

“Tetanus shot?”

“I’m current.”

“Then how about dinner with me next Thursday?”

Once more, Cathy felt her head spin, but this time it had nothing to do with tumbling. about in a runaway auto.

* * *

Cathy had always dreaded Monday mornings, but none so much as this one. Today it was time to show her face to the world.

She took one last look in the mirror. Cathy had figured that her fair complexion would make her bruises show up like tire tracks on fresh snow, but the judicious application of some Covermark had done its job well. The redness she’d noticed in her eyes two days ago had responded well to the eye drops Marcus prescribed. And, true to his prediction, she’d been able to style her hair so that the blonde strands almost hid the stitches in her scalp. A little more lipstick and blusher than usual, drawing attention to her face instead of her hair, and maybe she could fake her way through the day.

No matter how successful she’d been in covering the outward signs of the accident, it was still impossible for her to move without aches and pains. She popped a couple of Extra Strength Tylenol, washed them down with the remnants of her second cup of coffee, and headed out the door to face another week. If the medication kicked in soon, maybe Jane wouldn’t notice that Cathy moved like an old woman. Maybe Jane hadn’t heard the news about the accident. Yeah, and maybe the President would call today and invite Cathy to dinner at the White House.

Cathy tried to sneak in the back door, but Jane’s hearing was awfully good for a woman her age. She met Cathy at the door to her office, clucking like a mother hen and shaking her head. “Dr. Sewell, what happened to you?”

What a break it had been for her when Jane—a trim, silver-haired grandmother with a sassy twinkle in her eye—answered her ad for a combination office nurse and secretary. She’d helped Cathy set up the office, given her advice on business, and provided a sympathetic ear on more occasions than she could count.

Cathy recognized Jane’s question as rhetorical. Having grown up in Dainger, Cathy knew how quickly news spread in her hometown. She’d bet that Jane had known about the accident before Cathy had cleared the emergency room doors on Saturday. By now, probably everyone in town knew.

“I was out for a ride in the country. I needed to relax and clear my mind. Then someone ran me off the road out near Big Sandy Creek. My car went out of control, flipped, and took out a row of Seth Johnson’s peach trees.” Cathy winced as she dropped her purse into the bottom drawer of her desk. “Dr. Bell sutured a laceration on my scalp.”

“Any other injuries? Do we need to cancel today’s patients?”

Cathy shook her head, aggravating a headache that the Tylenol had only dulled. “Other than the fact that I feel like I’ve just finished a week of two-a-day practices with the Dallas Cowboys, I’m okay.”

“It’s good that you have a nice light schedule today. You can take it easy.”

Cathy frowned. A “nice light schedule” for a doctor just getting started as a family practitioner wasn’t exactly the stuff she dreamed about. She needed patients. The money from the bank loan was about gone, and her income stream was anything but impressive. But, she’d do the best she could. Anything had to beat living in Dallas, knowing she might run into Robert.

Speak of the devil. Cathy actually shuddered when she saw the return address on the envelope sitting in the middle of her desk: Robert Edward Newell, M.D.

She clamped her jaws shut, snatched up a brass letter opener, and ripped open the envelope. Inside were two newspaper clippings and a few words scribbled on a piece of white notepad with an ad for a hypertension drug at the top of the page. The first clipping announced the engagement of Miss Laura Lynn Hunt, daughter of Dr. Earl and Mrs. Betty Hunt, to Dr. Robert Edward Newell. The second featured a photo of Laura Lynn and Robert, she in a high couture evening gown, he in a perfectly fitting tux, arriving at the Terpsichorean Ball. The note was brief and to the point: “See what you’ve missed?” No signature. Just a reminder, one that made her grit her teeth until her jaws ached. Leave it to Robert to rub salt in her wounds.

She forced herself to sit quietly and breathe deeply, until the knot in her throat loosened. Then she wadded the clippings and note into a tight ball, which she consigned to the wastebasket with as much force as she could muster.

No use rethinking the past. Time to get on with her life. “Jane,” she called. “May I have the charts for today’s patients? I want to go over them.”

Jane returned and deposited a pitifully small stack of thin charts on Cathy’s desk. The look in Jane’s eyes said it all. Sorry there aren’t more. Sorry you’re hurting. Sorry.

Cathy picked up the top chart but didn’t open it. “Do you think I made a mistake coming here to practice?”

Jane eased into one of the patient chairs across the desk from Cathy. “Why would you ask that?”

“I applied at three banks before I got a loan. When I mention to other doctors that I’m taking new patients, they get this embarrassed look and mumble something about keeping that in mind, but they never make any referrals. Several of my patients tell me they’ve heard stories around town that make them wonder about my capabilities. And my privileges at the hospital have been stuck in committee for over a month now.” Cathy pointed to the stitches in her scalp. “Now the situation seems to be escalating.”

“You mean the accident on Saturday?”

“It was no accident. I’m convinced that someone ran me off the road and intended to kill me.”

“Did you report it?” Jane asked.

“Yes, but fat lot of good it did. If Will Kennedy hadn’t insisted, I think the deputy who came out to investigate the accident would have written the whole thing off as careless driving on my part.” Cathy grimaced. “Of course, he may do that anyway.”

“What was Will Kennedy doing there?”

“He came along right after the wreck. When I couldn’t manage under my own power, Will carried me up the embankment. Then he insisted I go to the emergency room, and when they were loading me into the ambulance he slipped his card into my hand and whispered, ‘Please call me. I want to make sure you’re okay.’” Cathy pulled a business card from the pocket of her skirt, smoothed the wrinkles from it, and put it under the corner of her blotter.

“Did you phone him?”

Cathy shook her head. “I started to, but I couldn’t. I’m not ready to get close to any man. Not Will Kennedy. Not Marcus Bell. Not Robert Newell.” She took in a deep breath through her nose and let it out through pursed lips. “Especially not Robert Newell.”

“Who is—?”

Before Jane could finish, Cathy spun around in her chair and pulled a book at random from the shelf behind her. “Not now. Please. I need to look up something before I see my first patient.” She paged through the book, but none of the words registered.

Jane’s voice from behind her made Cathy close the book. “Dr. Sewell, you asked me a question. Let me answer it before I go. I don’t know if someone’s really making an effort to run you off. I’ve heard some of those rumors. They’re always anonymous, like ‘Somebody told me that Dr. Sewell’s not a good doctor.’ Or ‘I heard Dr. Sewell came back to Dainger because she couldn’t make it in Dallas.’ You have to ignore the gossip and rumors. They’re part of living here.”

Cathy swiveled back to face Jane. “I thought it would be easier to get my practice started in my hometown.”

“It might be, except that people here will compare you to your daddy, who was the best surgeon Dainger ever saw. In that situation a young, female doctor will come up short, no matter how qualified she is.”

Cathy tossed the book on her desk and held her hands up, palms forward. “If someone wants to get rid of me, they’re close to succeeding. I don’t know how much longer I can go on.”

“You’re a fighter, and I’m right here with you. Just stick with it.” Jane turned and walked toward the doorway.

“Thanks. I appreciate it.”

Jane stopped and faced Cathy once more. “Have you been out to visit your folks?”

“It won’t do any good. There’s nothing for me there. I don’t have anything to say.”

Jane shook her head. “Sometimes you don’t have to say anything. Sometimes you simply have to make the effort and go. It’s the only way you’ll ever put all that behind you.”




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