PATIENT CARE (Medical Romance) (Doctor Series) (3 page)

The stifling atmosphere in her office was the least of Melissa’s worries that day. The hours passed in a controlled frenzy. Her handpicked team of consultants made suggestions; she listened to endless concerns from managers, sat in on three conference calls in an effort to transfer patients to other hospitals and managed only two hasty trips up to Betsy’s room.

Both times, Betsy insisted she had no pain and was feeling just fine, which seemed highly unlikely just a few hours after surgery. Inevitably, those assurances were followed by a plaintive “So when can I go home?”

Melissa told the supervising nurse about her mother’s stoic refusal to complain even if she was in agony, and the nurse promised to keep a particular eye on Betsy.

By four in the afternoon, the sleepless night Melissa had spent was taking its toll. But there was no possibility of leaving the hospital. A mound of urgent faxes and messages sat on her desk, and if she didn’t deal with them immediately, a mountain would be there by morning and the task would be insurmountable.

For an hour-and-a-half she worked, struggling to stay alert while her body signaled exhaustion. At 5:45, Arlene, who was also working overtime, brought in an egg salad sandwich, a chocolate doughnut and a bottle of iced tea, and plopped them on Melissa’s desk.

“If you don’t eat something, you’ll get sick,” she scolded. “I’m gonna go look in on your mom before I leave. If I think she needs you for anything, I’ll buzz you on your cell.”

“Thanks.” Tears choked her, and it was all Melissa could do to keep from crying at her assistant’s kindness. Being tired and stressed made her weepy.

The other three secretaries had long since gone home, and the outer office was deserted. As the day ended and evening came, Melissa could sense the old hospital relaxing around her.

She ate the sandwich and drank the sweet tea, but the moment arrived when the last shreds of her energy fled and she knew she couldn’t do another thing. She got to her feet, and then had to bend over as a wave of dizziness washed through her.

Whew. She shook her head and hung on to the edge of the desk as she slowly straightened. She needed a good eight hours of sleep.

In a weary fog, she made her way up to her mother’s room. Betsy was sleeping, and Melissa took her hand and kissed her cheek, but her mother didn’t awaken.

“She’s doing really well,” the nurse at the desk assured Melissa. “She was a bit restless this afternoon. A good sleep is the best thing for her.” She smiled her reassurance. “Go home and get some rest. We’re keeping a close eye on her for you. We’ve got your phone number at home if we need you.”

Soothed, Melissa dragged herself out to her car. The intense heat outdoors shocked her. The parking lot seemed to shimmer with it, but at least her personal parking spot was in the shade, under one of the cedar trees that bordered the lot. The leather seats in her car were almost hot enough for third-degree bums. Sweating, she climbed in, drove home and headed straight for the shower.

Five minutes later, feeling clean and blessedly cool at last, she staggered from the bathroom straight to her bed. Never had fresh sheets and soft pillows felt so good. She groaned and wriggled deeper into the nest, and between one breath and the next she was asleep.

The phone was ringing. It took her a long time to surface enough to fumble it to her ear and mumble hello.

“Ms. Clayton, it’s Rena Johns calling from St. Joe’s. I’m the nurse in Surgical Recovery, where your mom is a patient.”

Melissa sat up and her heart began to hammer.

“Ms. Clayton, could you come as quickly as possible? Your mother suffered cardiac arrest a few moments ago. The emergency medical team has resuscitated her. Her heart rhythm is stable at the moment, but she hasn’t yet regained consciousness.”

“C-cardiac arrest? But—but how can that be? Mom’s heart is strong. Are you su-sure—” Melissa gulped and then croaked, “Are you sure it’s the right patient? My mom is Betsy Clayton....”

But even before the nurse assured her it was Betsy Clayton, Melissa knew there was no mistake. Nurses didn’t make mistakes like that. She also knew from personal experience that they didn’t call in the middle of the night unless it was urgent, unless they thought a patient was dying. All of a sudden she could hardly get her breath.

“How—how long was she...?” If Betsy’s heart had stopped briefly, she had a good chance of recovering without side effects. If, however, her heart had stopped for a prolonged period before resuscitation, she would probably have suffered irreversible brain damage.

“We were really lucky. One of the nurses heard something and went in to check. She was there when it happened. We had a team on her in seconds.”

Melissa sent a silent thank-you heavenward. “I’ll be right over.”

The bedside clock said 2:33 a.m. It took her shocked brain moments to figure out it was Wednesday morning.

The normally traffic-choked Vancouver streets were nearly deserted at this hour. Melissa’s tires squealed as she pulled into the parking lot. This, too, was nearly deserted, although brightly lit. She tore out of the car and ran through the eerie, flickering yellow light toward the hospital.

She’d never realized how long it took to get to St. Joe’s from the lot, or how slow the elevators that led to the upper floors were.

Betsy was now in the Coronary Care Unit. Her eyes were partly open, the left more than the right, but it was obvious she wasn’t awake or aware. She was hooked to a battery of machines. Melissa threaded her way through them and took Betsy’s limp hand in her own.

“Mom? Mom, it’s me, Melissa. Can you hear me, Mom?”

No response. Melissa went on speaking, reassuring Betsy that she was going to be fine, that everything was under control, that there was no reason to be alarmed, all the lies that Melissa had tried to console herself with on the way over, with no success.

Rena Johns, a tiny nurse with a long braid of blond hair, reconfirmed that Betsy hadn’t regained consciousness after the resuscitation, which Dr. Wong had supervised.

There was no sign of him. He was an intern, Rena explained, and he’d been called away to another emergency. Because of the job action, the hospital was already seriously short of doctors.

Melissa saw compassion in the nurse’s dark eyes. “Didn’t Dr. Wong order an MRI? A CT scan?” The tests would show if any damage had occurred, and give some indication of how Betsy should be treated.

Rena shook her head. “There was no point in running tests at this hour—there aren’t any doctors around to read the results,” she stated.

Melissa was losing control. “Did anyone call Dr. Burke? Mom’s his patient.”

“Of course we did,” Rena soothed. “He’s on his way. He’ll be here any moment.”

For the next ten minutes, Melissa stood beside Betsy’s bed, murmuring comforting words, while inside her head a madwoman shrieked that this couldn’t be happening, not to her mother. She wouldn’t let it happen. There had to be something she could do.

But for the life of her, she couldn’t think what it might be.

Melissa heard James Burke before she saw him. He was talking in a low, intense voice to Rena at the nursing station. Melissa knew he was getting the medical lowdown on Betsy, what drugs had been administered, what procedures had been followed. Having him here taking charge, doing something, was a relief. A little of her anxiety dissipated.

“Melissa—”

She turned toward him. He was wearing jeans and a white T-shirt, and his hair was sleep rumpled. He wasn’t looking at her. Instead, he was frowning down at Betsy as he spoke, his expression disapproving, as if his patient wasn’t behaving the way he’d ordered and he was not amused.

“If you’ll excuse me a moment, I’d like to examine your mother.”

Melissa felt like saying that he could do so with her in the room, too, then thought better of it. She swallowed the words and walked over to the nursing station.

Rena poured her a cup of coffee and silently handed it to her. It was strong and hot, and Melissa sipped it, feeling the caffeine jolt her nervous system.

The cup was almost empty by the time Burke joined her.

“Your mother’s vital signs are all fairly normal again,” he commented. “There was no indication whatsoever of any heart problems, and the operation was successful. I don’t understand why this happened.”

“Well, successful or not, she’s unresponsive now,” Melissa snapped.

Burke scowled at her. “I’m well aware of that fact. First thing in the morning I’m ordering extensive tests to determine exactly what’s going on with her.”

“And will you be around to read them? Because with the job action—”

He nodded, impatient as always. “I’ll be here, of course. After all, your mother is my patient.” He sounded irritated, but Melissa was beginning to realize that for Burke, irritation and impatience were probably the norm.

He said to Rena, “You have my pager number. Call me if there’s any change whatsoever in Mrs. Clayton’s condition. I want her monitored closely. I’ll be in the doctors’ lounge for the rest of the night.” He turned to Melissa. “I suggest you go home and get some rest, as well. There’s nothing to be gained by sitting around here.” He headed off down the corridor.

Melissa knew that, logically, he was right. But she also knew she wasn’t about to get in her car and drive home, leaving her mother here in CCU. When Betsy woke up, she’d want her daughter at her side. Didn’t Burke understand that?

If Betsy woke up
. Melissa was too much of a realist, too much of a nurse even after all these years, not to fully understand that her mother might well not come out of this. She shuddered and had to struggle against the urge to burst into tears. Worst of all was the memory of how she’d promised her mother everything would be fine.

“I’m not going home. I need to be here when Mom wakes up,” Melissa said to his retreating back.

“Of course you do. Burke has all the people skills of a rock sometimes,” Rena, who had been quietly observing the exchange, remarked. “There’s an empty room just down the hall. Why don’t you try to get some rest? If there’s the slightest change in your mom, I’ll come and get you.”

“Thanks, that’s what I’ll do.” Melissa realized she wouldn’t be able to sleep, but she also realized she needed to be alone, to get her emotions under control and figure out what else she could do to help her mother.

For the remainder of the night, she lay sleepless on the narrow hospital bed, alternately agonizing about Betsy and going over the millions of details she’d have to see to in the morning. Each day the job action continued, the problems she had to contend with would multiply. Why did everything have to happen at once? She’d only been in her position for six months, and those who’d opposed her appointment would be watching gleefully, waiting for her to make some fatal mistake.

Well, they’d better not hold their breath. About her job, at least, she was confident.

At five in the morning she went back to CCU. There’d been no change whatsoever in Betsy’s condition.

“I’m going home to shower and change for work. I’ll be back by six-thirty at the latest,” she told Rena. “If there’s any change, call me on my cell.”

“Absolutely,” Rena assured her.

But Melissa could see by the expression in her eyes that the nurse had no expectations Betsy would wake up while Melissa was gone.

Outside the hospital, the dawn air was blessedly cool, although the clear blue canopy overhead and the coral pink in the east where the sun would soon rise heralded another record-breaking day in Vancouver’s uncharacteristic heat wave. Melissa drove home, showered, yanked another of Barry’s ensembles from her closet, pulled it on and raced back to the hospital to begin a day even more frantic than the previous one had been.

For the next forty-eight hours, Melissa all but lived at St. Joe’s, dealing with one crisis after the next as the job action escalated. She attended meeting after meeting, none of which accomplished much as far as she could see. She held press conferences to reassure the public that emergency services were still available. She frantically called other hospitals to arrange for procedures that couldn’t be postponed.

And through it all, a part of her mind was constantly with Betsy. There’d been no improvement at all in her mother. Burke had done an entire battery of tests, and he’d promised to discuss them with Melissa at noon on Friday.

She was late for their meeting. That morning’s appointments, first with the Ministry of Health and then with the financial committee, both went past their allotted times. It was twelve-twenty by the time Melissa made it to the Coronary Care Unit, where Burke was waiting. He was standing, arms folded across his chest, foot tapping impatiently.

“I’m sorry to keep you waiting, Dr. Burke.”

He didn’t nod or accept her apology, or even indicate that he’d heard her.

Melissa was tired to the bone. She hadn’t had a decent meal in days. She was sick with worry about her mother, and she had three more meetings that afternoon before she could even hope to get to the paperwork that almost buried her desk. She still hadn’t managed to find suitable placements at other hospitals for four urgent surgical patients, three of whom would have been operated on by this same Dr. Burke, who was acting as if his time was of the essence. The patients’ relatives were out of their minds with worry, and their frustration and anger had to be dealt with—by Melissa.

It was hard to be sympathetic to the doctor’s position when she was confronted hourly with the human misery it created. And how could a man who looked so blasted attractive be so lacking in people skills?

“This office will do,” he said in a stiff tone, ushering Melissa into a small room the nurses used for meetings. He gestured to a chair and she sat down, but he remained standing, which annoyed her further. It was such an obvious way of taking control of the proceedings.

She wasn’t about to let him get away with it. She was a veteran of subtle power plays. The thing to do was take control of the conversation. “So what do the test results indicate about Mom’s condition, and what do you suggest as treatment, Doctor?” She used her most professional tone.

He cleared his throat and shoved a hank of dark hair away from his forehead.

“I’ve evaluated your mother carefully,” he began without meeting Melissa’s gaze. He stared at some point three feet above her head. “As a result of the tests I’ve done, I’ve decided to withdraw all medication immediately.”

“Oh? Why is that, Doctor?” Melissa frowned and waited, not understanding what he was getting at, although a tiny thread of alarm began to wind itself into a knot inside her.

“In my opinion, your mother has suffered irreversible brain damage.”

Melissa heard the words, and her blood seemed to freeze in her veins. She swallowed hard and stared at him in horror, unable to say a word.

“I don’t believe your mother is going to recover or improve. I suggest you begin looking at placement in a care home for her. Not immediately, of course. But there are a limited number of openings in the better facilities, and it would be best to get her name on lists.”

“A...a care home?” Melissa was aghast. She’d trained herself to deal with emergencies in a controlled and rational manner. As an administrator, she’d attended numerous workshops on anger management. But none of the techniques she’d learned even occurred to her now.

“You’re saying—” Rage, red and urgent and violent, began somewhere in her gut and traveled to her brain as if it were a lit fuse linked to nitroglycerine. “You’re saying I should put my mother in a care home? My mother is only fifty-six.” As she got to her feet, she was dimly aware that he was still talking.

“As I mentioned, there are waiting lists, and getting into the best of these facilities may take some time, as I’m sure you’re well aware.” His voice was composed, his manner cold, distant and totally impersonal.

“But—I just can’t believe—this is my
mother
we’re talking about here, Doctor.” Melissa’s voice was suddenly so loud he jumped. “It hasn’t even been a week since you operated on her, and you’re suggesting placement in a care home?”

Her voice was getting even louder, and it felt wonderful. She let all her feelings surface; they spilled out in a gush of invective. “You arrogant, egotistical, insufferable—why, a veterinarian would show more compassion for a patient than this. How can you possibly be so certain my mother isn’t going to improve? Do you actually believe you’re God, Dr. Burke? Because you sure as hell sound as if you do.”

His expression didn’t change an iota.

“Don’t you have a mother of your own? Don’t you have some concept of how this feels, to be told that—that—” Melissa tried to go on screaming at him, but instead of words, a mental image of her poor mother, helpless and trapped in a coma, frightened and alone in a place Melissa couldn’t go to comfort her, came vividly to mind. A sob caught in her throat. She couldn’t hold it back, and neither could she stop the explosion of tears that burst from her. She covered her face with her hands and wept.

He made no attempt to comfort her. He didn’t even offer a tissue.

Melissa heard the office door open and shut, and she knew James Burke was gone. She sank onto the chair she’d been sitting in, dropped her head into her hands and gave in to the desperate grief and fear she’d been holding at bay for days.