Trauma Plan (15 page)

Kate pulled her fingers from the window, leaving smudges. She shouldn’t come here anymore. What was the point? Even if the media was calling Baby Girl Doe a miracle, Kate knew deep in her heart that the true miracle would come only when they identified Jane Doe and found her family. This tiny girl was innocent; she shouldn’t have to begin her life like this.

Any more than my son should have been left on the steps of a fire station, minutes old and wrapped in a ratty sweatshirt.

She squeezed her eyes shut for a moment, then squared her shoulders and headed down the corridors toward the ER. The police had brought in the FBI and the search was continuing nationwide. Kate would hold on to that hope for now.

She shook her head, knowing that The Bluffs’ action committee was equally hopeful that this second grisly incident at the free clinic would provide the impetus to shut it down. They’d had plenty to say to reporters. But then so had Jack, when he’d answered questions arising from the police report.

In the newspaper article, he’d confirmed that the persons who’d initially found Jane Doe were clinic building manager Bandy Biggs and registered nurse Riley Hale—further identifying her as “chaplain and safety officer at Alamo Grace Hospital and a valuable new member of our volunteer staff.” Kate had read it twice, surprised at his enthusiastic statement. Especially considering how tight-lipped Jack usually was around reporters and since Riley had only recently agreed to volunteer at his clinic. Today was her first day.

Kate punched in the door code for the ER, wondering if her friend had seen the
Express-News
article. Riley was protective of her privacy. And there wasn’t much doubt how the Houston Hales would feel about their daughter’s recent brush with violence.

* * *

Jack watched from the exam room door as Riley applied the last of the bandage tape, surprised that she’d repeated the final instructions in Spanish.

“Por favor, mantener el vendaje seco. Y volver aquí el lunes . . . para que podamos cambiar.”

Keep the bandage dry . . . come back on Monday.
At least that’s what Jack thought she’d said. Though he continued to try, his Spanish wasn’t the best; that’s what bilingual aftercare instruction sheets were for. Still, Riley’s facility with a second language was a definite plus. As was her easy manner with the patients, even the grouchy woman who poked her finger at Jack, complaining that they didn’t provide free X-rays. Riley’s nursing skills had proved more than adequate for today’s simple cases.

Besides, Bandy liked her. Jack smiled. The old bull rider had already given Jack a few pointed watch-yourself-pardner looks to ensure that Jack behaved himself—didn’t stage any confrontations with The Bluffs neighbors. Which pointed to the most important reason to have Riley here: the real possibility that her influence, the Hale family name, might be the only thing left to save his clinic from demolition. He’d begun to imagine her standing beside him at the city council meeting, impressing the pants off everyone in the room. It could happen if Jack could manage not to throw a CPR manikin—literally or figuratively—and alienate this woman during the last half hour of her first shift. He was trying.

“Adiós, señor,”
Riley said, handing their patient a printed discharge sheet.

Jack stepped aside as the man exited the exam room—a gardener who’d gladly offered the ten-dollar pay-if-you’re-able clinic donation. And left a trail of boot-embossed topsoil down the hallway.

Jack smiled as Riley glanced his way. “You speak Spanish.”

“My nan—uh, babysitter was from Monterrey,” she explained, her silky ponytail sliding across her shoulders as she hurried to replace the exam table paper.

Your nanny. And your gardeners, too, I’ll bet.

She looked back up at him, a faint flush on her cheeks. “It was great, actually. I knew
Buenas noches, Luna
by heart.” She smiled at his confusion. “
Goodnight Moon
—it’s a children’s book. And Estrella made these amazing, sugary churros, drizzled with chocolate and so fresh you could burn your tongue. And there was
tres leches
birthday cake, piñatas, and . . .” She stopped, flicked her ponytail back with a sigh. “So I speak Spanish . . .
un poquito
.”

He nodded, sorry to see her girlish delight disappearing. If possible, it had made her even prettier. He cleared his throat. “You must feel right at home with Fiesta going on. Battle of the Flowers, river parade, A Night Out in Old San Antonio. Tamales, shrimp tacos, music . . . you know. All the great excuses for an eleven-day party. And the reason I’ve had to pick confetti out of someone’s eye more than once.” Jack tried to read the look on Riley’s face. He blinked. “Wait . . . don’t tell me—”

“I’ve never been. To Fiesta, River Walk, the Alamo . . . any of that.”

He opened his mouth to ask why, but there was something in her eyes that made him decide against it.

“I’ll get your last patient into an exam room,” she said abruptly, her fingers rubbing the side of her neck. “Asthma. Coughing, no wheezes—I took a quick listen in the waiting room.”

“Good, thanks.” He stepped away from the doorway and she passed through, leaving the now-familiar scent of peaches in her wake. And more than a hint of a curious chill. It left Jack wondering if his clumsy attempt at conversation had been worse than hurling Toddler Tim.

* * *

Riley had started down the hallway toward a patient room when Bandy emerged from the reception office in the distance, beckoning urgently. “Um . . . out in the waiting room. It’s—”

“Coming!” Riley broke into a trot, battling a memory of Jane Doe lying in a pool of blood.
Oh, please. Not again.
She grabbed for the waiting room doorknob, hustled through, and stopped short.

“Mom? How did you find—is everything okay?”

“Yes, darling. I just . . .”

Vanessa Hale’s voice was drowned by a fit of phlegmy coughing from somewhere in the crowded waiting room. A giggling child stumbled by, and his half-melted Fudgsicle tagged her immaculate linen skirt like gang graffiti. She ignored all of it, gracious as always, and smiled warmly at Riley. “I was in the neighborhood.”

“Mrs. Hale,” Jack boomed, wedging into the doorway behind Riley. “Come in. Please. This way.”

After a flurry of introductions in the narrow hallway and a quick hug between Riley and her mother, the three of them made their way toward the kitchen, where scents and gurgling sounds indicated that Bandy had already put on a fresh pot of coffee. There was an awkward moment while Jack tried to find Riley’s mother the least battered vinyl chair, but she responded with a polite remark about the vintage decor reminding her of a neighbor’s kitchen when she was a child. Followed by a few long moments of nice-to-be-here-and-to-have-you-here sort of chatter.

Riley told Bandy no thank you on the coffee and reluctantly took a seat at the table, knowing that this unannounced visit was happening as a direct result of the article about Jane Doe in the newspaper. Because Riley’s name was mentioned, and . . .
I didn’t tell her I was working here.
She watched Jack shift in his chair, noticed that he’d pulled a white lab coat on over his scrubs . . . and combed his hair? Damp marks scoring his hairline said that was true.

“You’re volunteering here?” Riley’s mother asked after thanking Bandy for the coffee. She glanced at Hobo as he crossed the room, cart wheels squeaking. Then back at her daughter.

“My first day.” Riley looked anxiously toward the patient rooms. “And as you saw, we do have patients waiting. I should—”

“It’s okay,” Jack interrupted. “We’re good for a few minutes.” He turned to Riley’s mother. “I appreciate that your daughter is willing to help here at the clinic, Mrs. Hale. We’re staffed entirely by volunteers. Though, as director, I make certain each member of my staff is highly qualified. And that we operate under stringent standards. Would you like a short tour?”

Tour?
Riley inspected her watch, thinking of the waiting patients. And trying not to imagine what could happen to her mother’s sedan in the parking lot.

“No. Thank you.” Riley’s mother began to stand. “That’s kind. But I can see that you’re busy. And I really do have to meet friends over in Alamo Heights. We’re driving on to Dallas for an event tomorrow. I never intended to take up your time. I was simply too close not to stop and give my daughter a quick hug.” She offered her hand to both Jack and Bandy, told them it had been a pleasure to meet them, then turned to Riley. “Walk me out, darling?”

Riley led her outside, grateful to find that her mother’s car still had four wheels and that no one was camped alongside it in a drunken stupor. Amazingly, though Riley suspected her mother had wanted to fingerprint both Bandy and Jack, she offered no criticism of Riley’s decision to work at the clinic. Only a sigh, a lingering hug scented by her familiar classic fragrance . . . and a discreet glance at the newly installed parking lot lights.

“Motion sensors,” Riley explained before she could ask. “I parked close. I’ll have someone walk me out.”

It’s not going to happen again.

“Yes . . . good.”

Riley watched her mother drive away, and then mercifully she was back inside the clinic, finding Jack’s white coat draped over the chair, Bandy adding jelly to a sandwich, and Hobo yipping in his sleep on the floor. All normal, as if Vanessa Hale’s surprise inspection had never happened at all. For some reason, it felt like a small victory in Riley’s polite battle for freedom.

“Brianna?” Riley tapped on the door to the lavender exam room, then stepped inside with a gown. “Here you go. I’m new, so it took me a few minutes to find the extra—” She stopped, staring. The young asthmatic was scratching furiously at her neck. “What’s wrong?”

“Can’t . . . stop . . . itching.” The young woman coughed and rubbed at her eye. “I think it’s that medicine. From the dental clinic. Penicillin. I took a pill out in the—” she coughed again—“waiting room, and now it feels like I’ve been stung all over by fire ants.”

Allergic reaction?

“Here,” Riley said, feeling her own pulse quicken as she noted some redness and mild swelling around the young woman’s eyes. “Pull that shirt off, and let me have a quick listen to your lungs.”

Hives, swelling of the face and airway, drop in blood pressure . . .
Signs and symptoms of allergic anaphylaxis ticked through Riley’s brain. She prayed she wouldn’t see them and wished she hadn’t told the second clinic nurse that it was okay to leave. Riley was glad that she’d assigned Brianna to the room with the quilt—and the crash cart. “Are you having trouble breathing?”

“A little.” Brianna stripped off her T-shirt, eyes widening. “Oh, wow, look at this rash.” She inhaled and exhaled, following Riley’s instructions. “I’m sort of dizzy, too.”

“Lie back, please,” Riley said, struggling to elevate the head of the exam table. She hauled at the protective side rails with her right arm to no avail and then switched clumsily to her left. “I’ll be right back with the doctor.” She offered what she hoped was a calm, reassuring smile. “Hang tight, Brianna. We’ll take care of this.”

Riley caught Jack at his office door. “Our asthma patient took a dose of penicillin in the waiting room. Looks like she’s reacting—itching, hives, a few wheezes, no stridor.”

They were back in the exam room in seconds, with Bandy and Hobo standing guard outside the door . . .
“Just in case, Doc.”

“BP is 92 over 48,” Riley reported, glad the clinic had sprung for a user-friendly electronic unit. “Pulse 112. Respirations . . . 22. I’m getting the pulse oximeter. And the oxygen.” She glanced at the bag of normal saline hanging from the crash cart IV pole, remembering the bruises on Kate’s arm.
Please, Lord, don’t let her need an IV. And don’t let this be a mistake that I’m here.

Jack finished listening to Brianna’s lungs, put his stethoscope back around his neck. Then checked the label on the dental prescription. He glanced at Riley. “What’s that pulse ox reading?”

“Ninety-six percent.” Riley switched on the oxygen and portable monitor.

“Good.” Jack reached for the cannula, slipped the prongs gently into Brianna’s nostrils. “Only precautions,” he assured her. “You’re having a reaction to the penicillin. We’ll do a few things to take care of that. The medicines might make you drowsy, though. Do you have someone who can drive you home?”

“My sister’s in the waiting room.”

“Great.” Jack stepped back as Riley placed the monitoring electrodes on Brianna’s chest. “Keep the oxygen at two liters,” he instructed. “Then let’s give Brianna some sub-q epi. Zero point three. And fifty milligrams of diphenhydramine IM.” He gave a quick nod. “It should be right there, top drawer of the cart.”

“It is. . . . I checked.” Riley swallowed, mouth suddenly dry.
Please don’t let my hands shake. Please let me be able to draw it up from the vial.

“Um . . .” Jack’s brows drew together. “If you’ll hand me the epi preload, I’ll give that myself while you go to the medicine room. I changed my mind; we’ll give that Benadryl by mouth instead. Same dose. It’ll be just as effective as an injection.” He smiled down at their patient. “No need to feel like a pincushion, right?”