Critical Care (11 page)

Sarah hesitated before answering. "I don't get to see him
much."

"But Pollock Pines is only like twenty minutes away."

"My mother and I ... have some issues." Sarah looked away.
"You want me to finish up here?"

"Yeah, sure." Logan said, sorry he'd pushed it. He was the last one to judge the dynamics of family relationships. "I suppose I'd
better go see why the chief's nosing around our department."

"He's gone." Sarah pointed toward the door. "Out of the war
zone and back to the safety of administration, no doubt." She
squeezed antibiotic ointment onto the flat end of a tissue forceps
and smoothed it across the suture line. Her hand trembled slightly
as she reached for bandaging material.

Logan noticed the shadows under her eyes and how her fair
lashes seemed to flutter in fragile hollows. Had she always been
that thin? Maybe he'd get her some pizza for lunch. Double cheese
and make sure she ate it.

Sarah looked up, her pale eyes lit with sudden amusement. "Our
Claire, on the other hand, has been drawn to the dark side."

"Hmm." Logan busied himself with prying the patient's eyes
open to check pupil responses. The man's eyes were reddened and
jerked slightly side to side-nystagmus, from the effects of alcohol
intoxication. But his pupil sizes were normal and equal on both
sides, constricting in reaction to the penlight. Wild Man would
have a CT scan to check for brain injury, then a gurney to sleep on
until his blood alcohol level legalized. Logan set the light down
and glanced at Sarah, keeping his voice casual. He was not going
over to that clinic. "So, how's Claire doing over there? Using brochures as compresses?"

Sarah smiled and shook her head. "Hey, careful. Code of
honor-can't let you disrespect a fellow ER nurse."

"Education nurse," Logan corrected as he began to strip off his
bloody gloves inside out. "There's a mile of floor between those
offices and ER." And I've been tempted to walk it a dozen times this
past week.

"But she worked ER first until a couple of years ago." Sarah rolled a soft Kerlix gauze bandage around the patient's head to
cover the wound and reduce swelling. "I talked to one of the nurses
at UCD in Sacramento, and she heard of her."

Logan let the glove dangle and stepped back toward the gurney. "Really? The trauma center?" He shook his head, remembering
asking Claire about her career yesterday. It was odd she didn't mention ER. Most nurses considered that experience a badge of honor.
He'd seen some with a few measly shifts in ER label themselves
trauma nurses forever after.

"This nurse said Claire left after the big warehouse disaster a
couple of years back." Sarah's brows drew together. "It sounded like
she had a family member injured in that fire."

"Whoa, that's rough. I've talked with docs who worked that
disaster. Weren't there like seven firefighters-?"

"Dr. Logan!"

They both turned as Inez shouted outside the patient cubicle.

Sarah pulled the curtain aside to reveal the breathless and flustered clerk.

Inez clasped her chest, her dark eyes wide and blinking. "Lo
siento-I'm sorry. . . ," she said, gulping for air, "but Erin said grab
you quick. They've got mijo Jamie in urgent care. And something's
going very, very bad!"

Claire fought a dizzying mix of emotions as Logan entered the
clinic exam room, but bone-deep relief surpassed all else. Jamie
had been sent down from pediatrics for a routine bandage change
and a look-see at some breathing trouble, but now his asthma was
full-blown and he was deteriorating fast.

No. Claire's heart began hammering in her ears. This boy was the hospital darling, the sweet face of life after tragedy.
Please, God, don't let me crumble like that other time. Don't let me
fail this child.

"Second treatment's nearly finished," she explained as Logan
bent down for a moment to make eye contact with the sick boy.
She watched as he began to speak, eyes gentle but concerned, patting the boy's shoulder. He called Jamie "buddy" and reassured
him that Doc Logan was going to make him well. Claire's heart
squeezed. He does care. Overhead, the PA buzzed with a stat page
for respiratory therapy.

Claire adjusted the misting treatment mask, alarmed that
Jamie's blue eyes now swam listlessly and his breathing rate was
more than twice what it should be. His dark pupils drifted side
to side and then partially disappeared beneath his drooping
upper lids.

She stroked his head gently, trying to comfort him, then looked
at Logan. "He's far more fatigued now. Respirations are 56 per minute, and-" she glanced at the red digital display on the monitor,
and her stomach sank-"oxygen saturation is still too low-only
86 percent, even with the supplemental." Oh, please.

Claire brushed the child's flaxen hair from his forehead, and
her hand came away sickly damp. Jamie leaned forward to support
himself on both little arms, the flesh around his ribs and over his
breastbone retracting with each fish-out-of-water breath. His nostrils flared wide with the effort, and his lips were ashen.

"His heart rate's dropped from 160 to 90 . . . 86 now," she
reported. Slowing pulse-bradycardia-from impending respiratory failure. We could lose him. I can't do this again.

Logan frowned and glanced at Glenda, the nurse-practitioner,
and then back at Claire. "You've given steroids?"

"Prednisone syrup. But he vomited, so I'm not sure he got
the full dose." Claire turned toward the door at the sound of
Erin's voice. Behind her were a trio of respiratory therapists and
Sarah.

Logan's brows furrowed for a split second before he nodded.
"Let's get him to the ER. I need to be ready to tube this kid. He's
tiring."

Claire's throat tightened, imagining Jamie on a ventilator with
an endotracheal tube down his throat and the terror that would
bring his mother. Carly was in a room upstairs. Had they told her
there were problems yet?

Logan pressed a fingertip gently into Jamie's forearm and
watched the skin color blanch white and return sluggishly to normal, another indication his condition was worsening. "I'd like
to get an IV in, though. We'll need it for steroids." His eyes met
Claire's. "You want to pop one in before we move? He's looking
dry, and if his veins collapse ..."

Collapse. Logan's voice and the familiar order yanked Claire
across the span of two years and back to the Sacramento trauma
room. The words from her nightmares filled her ears, her own
voice, that horrible day. "His veins are collapsed, Doctor. I can't get
the line in. Oh, please get someone else.... I can't do this! My brother's
dying-don't let my brother die!" Claire's legs weakened and the walls
closed in, suffocating her like she was trapped in a smoke-filled
room. She saw it all clearly again: her brother's eyes, lashes singed,
staring helplessly up at her from the gurney as she reknotted the
tourniquet around his blackened and blistered arm and tried and
tried. No, stop this.

Claire nodded at Logan. "I've ... got it," she whispered, reaching for a tourniquet as Jamie's head began to wobble and nod behind his nebulizer mask. The wheezing continued but his respiratory effort grew weaker, his reddening eyes trying to focus as
drowsiness overpowered his anxiety. Ominous signs. Don't panic.
Help him. She forced her hand to steady and reached for the tray
with iodine swabs, tape, and needle sets. She'd been very good at
this once. She could do it again; she had to.

"No. Wait, Claire." Erin hurried forward and released the brake
on the gurney. "Let's move him, Logan," she said, gesturing for the
respiratory therapist to switch the oxygen to a portable tank. "I've
got everything set up in the ER; IV therapy's there too. It'll just take
a minute to get him there. And we can let the clinic staff get back
to their other patients."

"Good point," he agreed. "Let's roll."

Claire released a sigh and helped prepare for Jamie's quick
transport down the short corridor to ER. She met Logan's eyes
for an instant before he marched away but could read nothing in
them. His team followed, closing in like soldiers in formation; then
they all disappeared out the door.

She stood alone in the littered exam room, wondering at her
sudden jumble of emotions. Strangely, part of her wanted to follow
Logan and be part of the team working to save Jamie, and yet ...
She picked up the discarded tourniquet and frowned. She'd nearly
panicked over the thought of starting an IV, a skill that had been
second nature before. Had Logan noticed her moment of hesitation? Had the others? Was that why Erin interrupted?

Claire stretched the tourniquet tight and let one end go, feeling
the latex strip snap sharply against her wrist. It stung far less than
a disturbing new suspicion: Am I a weak link? Tears filled her eyes,
and she wiped them away before returning to the clinic's nursing
station. Two more hours and she'd be out of here.

Claire waited an hour before peeking into the ER's code room, listening first from the doorway and expecting to hear the mechanical whoosh of a ventilator. But when she parted the curtain, she
was amazed to see Jamie smiling. With his mom in a wheelchair
beside him and flanked by two pediatric nurses, he was holding
a lime green Popsicle and sitting cross-legged on the gurney like
a prince holding court. If it weren't for the tethers of the oxygen
tubing and an IV, Claire was certain he'd be toddling out the door
to visit with the ER staff. His cheeks were pink, his breathing nearly
normal, and-thank you, God-his eyes bright and animated. He
waved at Claire just as Erin appeared by her side.

"The third treatment turned him around," Erin explained,
"along with the IV steroid. We're going to send him back upstairs
to pediatrics in about an hour."

Claire blinked quickly before tears could well. Goose bumps
rose. How could she have forgotten how good this kind of moment
felt? So amazingly good.

Erin raised her hand in a high five and kept nodding until
Claire joined palms with her.

"And we're thinking this team's more than ready for a little
celebration," Erin said with a smile.

"Celebration?"

Erin nodded. "Tonight's Denim and Diamonds Night at the
fair. It's that family event, the benefit for Sierra Children's Services. They've got it all fixed up with a root beer bar, fake cowboy
shoot-outs, and someone said the chaplain and his wife are teaching country-western dance lessons. I bought a few extra tickets,
so now we've decided to go as a group. Come with us, okay? My
treat. We'll dress up like cowgirls, make fools of ourselves on the
dance floor, and eat way too many nachos. Maybe even ride the mechanical bull." She winked. "After today, I'd say it's just what
the doctor ordered."

Doctor. Claire glanced around the department. Where was
Logan?

"So, how about I stop by and get you around six thirty? C'mon.
I think Sarah's coming and Glenda. Maybe even Inez." Erin rolled
her eyes. "Logan never comes to these social things, but who needs
him anyway?"

But he came to the rodeo. To see me. Claire's face warmed, and she
laughed to cover it. She started to make some excuse about going
for a run, getting home to feed Smokey, then turned as she heard
a boyish squeal in the code room followed by cough-peppered
giggles. Jamie was batting a SpongeBob balloon and laughing. A
boy who an hour earlier could have been taking his last breaths was
now embracing life. Just for tonight, Claire needed to feel that way
too. For the first time in a long time, being alone felt ... lonely.

"Count me in," she said, giving Erin a thumbs-up. She shook
her head, remembering the chaplain's advice: dancing and laughing. Looked like she was going to do it after all. Without Logan.
But then he'd never been part of her plan, anyway. Erin was right.
Who needed him?

Logan hesitated outside the door of the 4-H pavilion housing the
Denim and Diamonds fund-raiser event. He smiled; hopefully
they'd relocated the livestock. He glanced down at his watch.
Seven thirty and he'd just seen Erin standing in the gravel parking
lot beside her boyfriend's Corvette. They seemed deep in conversation. Though he didn't really know Brad well, Logan was glad
to see Erin having a little fun. From what he'd observed, most of Erin's activities revolved around the hospital. That wasn't much of
a life. Of course, he was a fine one to point fingers-or give dating
advice.