Within My Heart (20 page)

And voicing them in front of the well-mannered, proper, and always dignified Dr. Rand Brookston—she sighed inwardly—that constituted an even greater offense.

Not caring for the silence in the room or the way Rand was staring at her, Rachel gave the buttons on her nightgown a discreet check, then pushed herself up in the bed. She needed to use the chamber pot but wasn’t about to ask him for assistance with that.

“Here, let me help you.” He came behind her and arranged the pillows to better support her back.

Seeing him up close, Rachel noticed the dark circles beneath his eyes. He looked as if he hadn’t slept in days. The dark stubble on his jawline was becoming the norm, it would seem, as were his rumpled clothes and the way his bow tie hung loosely about his neck. Yet something about him made her look twice. And something about the way he looked back at her, lingering close a second or two longer before he straightened, made her look away.

“Thank you,” she said softly, smoothing the bedcovers, the ache in her back already lessening. “You look tired.”

He ran a hand across his face and sighed. “I could use some shut-eye about now, as my grandpappy used to say.”

Hearing the endearment in his tone, she started to ask him about his grandfather, wanting to know more, and then caught herself. It was one thing to discuss medical issues with him. It was another to invite conversation on more personal topics. Best stick to the medical.

He knelt and studied the framed photograph on her bedside table. “Elizabeth took this?”

“Yes. Last year.” She loved that picture of her boys.

“How did she manage to keep them still for that long?”

“Bribery,” she answered, surprised at how much she enjoyed his spontaneous laughter.

“I use a similar tactic.” He stood and glanced toward his bag. “I’ve got a sugar stick with me. You want one?”

She did but shook her head no. She didn’t really know why.

He walked to his bag and pulled one out. “Sometimes it’s all right to simply say yes and accept the gift.” He handed it to her.

Surprised at being so easily read, she took it and smiled.

He studied her for a moment. “My spies tell me you tried to get out of bed today.”

The comment caught her off guard. She bristled slightly at the mild reprimand, and at the fact that either Molly or Elizabeth had tattled on her. Yet remembering her indebtedness to this man, she summoned patience, and pulled the candy from her mouth. “I appreciate all you’ve done for me, Doctor. Truly, I do. But . . . I have a ranch to operate and a family to raise. I’m afraid I don’t have the luxury of lying abed right now.”

A muscle twitched in his jaw, and oddly enough, seeing it enabled her to further sweeten her disposition. “But don’t worry, I’ve had sutures before. I won’t push past my limits, I assure you.”

The steadiness of his stare became unnerving, and she looked away first.

He walked to the corner, where she thought he was going to take a seat in the straight-back chair. Instead, he picked it up and plunked it down backward on the floor beside her, and straddled it.

15

R
achel could count on one hand, with fingers left over, the times that Thomas had been truly exasperated with her. She remembered the look in his eyes as clearly as if he were standing in front of her now. Rand wore a similar expression.

“Did Mrs. Ranslett fail to pass along my instruction that you stay in bed with your leg elevated?”

Feeling like a child and resenting his attempt—no, his
ability
— to make her feel like one, Rachel laid aside her candy. “Yes, she told me you’d
left orders
for me to stay in bed. But I’m familiar with incisions and am aware of the possible complications.” She lifted her chin. “That’s what I’m trying to tell you. I’m not your
usual
patient.” Grateful as she was, she also found his behavior to be absurd—his preoccupation with always being right, being obeyed. So like her father, in that respect. “If it will relieve you of unnecessary concern, I’ll take full responsibility for my healing. You needn’t worry.”

He gave a humorless laugh. “I needn’t worry,” he repeated, rubbing his eyes. Hands clasped, forearms resting on the back of the chair, he pinned her with his gaze. “You’re familiar,
Mrs. Boyd,
with the femoral artery.”

It wasn’t a question, but still she nodded.

“Are you also familiar with the complications stemming from an occluded femoral artery?”

Wanting to say yes with everything in her, she couldn’t lie, not with his being so close and watching her the way he was. She shook her head.

“A severe blow to the body—let’s say . . . being kicked by a heifer, for instance—renders a contusion, which, in turn, causes the tissue in the affected area—for example . . . your
thigh
—to swell.” He leaned forward, his shirt pulling taut against broad shoulders, his focus intent. “Imagine the muscles, ligaments, nerves, and blood vessels in that affected area forming a kind of . . . compartment. The swelling in that particular compartment”—he made a fist— “cuts off the circulation of blood, and you know what happens to the body when the circulation is obstructed.”

She knew, only too well.

“The symptoms are”—he counted on his left hand—“pain, swelling, weakness, warmth of the bruised area, tenderness of skin”—then moved to his right—“tingling and numbness of the leg or foot, and the inability to lift the toes, so that a person must limp to keep the foot from dragging. Sometimes,” he said, his voice lowering, “one so afflicted might even resort to using a cane.”

Rachel stared, wordless, feeling as if she’d wandered into a house that wasn’t hers. A house that should have been locked, for her safety, as well as that of the owner. Instinctively, she reached down and covered the bandage on her leg.

“Would you like to know what happens when these symptoms remain untreated?” Rand stared back. “Or if, following the surgery, the artery isn’t given proper time to heal?”

The same muscle in his jaw corded tight, and she knew his question was rhetorical.

“Gangrene, leading to permanent dysfunction of the limb”—his gaze moved down over her body—“or as I witnessed during the war more times than I care to remember . . . amputation.”

Still struggling to absorb the words
gangrene
and
permanent
dysfunction of the limb
, Rachel went cold inside. She confined her focus to her lap, unable to look at him. Here she’d thought he’d made a simple incision, and that it was his arrogance that was causing him to be so . . . “I’m sorry,” she heard herself whisper, seeing Mitch’s and Kurt’s faces in her mind. “I . . . I didn’t realize h-how serious it was. I just assumed . . .”

Seconds passed, strained and silent.

He finally exhaled, and his sigh seemed to drain the tension from the room.

He rose and returned the chair to the corner. “May I check your incision?” he asked, hand on the footboard.

“Yes,” she whispered, turning onto her side.

“Would you like for me to ask Molly to come in?”

Face half hidden in the pillow, Rachel shook her head. “No. I’m fine.”

She glimpsed his profile in the mirror above the dresser. He looked as if an invisible weight were strapped to his shoulders, and she felt responsible, at least in part, for putting it there.

Gently, he removed the bandages, examined the incision, and applied a fresh dressing.

Aware of his warm hands on her skin and the cool air on her bare thigh, Rachel felt a continued unease with his closeness, regardless of his being her doctor. But her discomfort seemed minuscule in comparison to what he’d just told her. She saw blood on the soiled cloths, and thought again of Mitchell and Kurt, and about what would become of them if something happened to her. “Did I tear the sutures?”

“Only one. But I’ve been stitching up patients long enough to know to add an extra knot or two.” She couldn’t see his face, but his voice sounded like he was smiling, at least a little. When he finished, he arranged her nightgown over her legs, pulled the covers up to her chest, and paused, his hand on her shoulder. “You didn’t do any damage that I can see.”

“That I can see . . .”
The words reverberated inside her. She’d seen the blood on her father’s surgical apron after he’d removed someone’s limb due to gangrene. No matter how many times the apron was washed, the stains never left. She felt Rand looking at her in the mirror.

“Mrs. Boyd,” he said softly.

She couldn’t look back.

He gently squeezed her arm. “Rachel . . . look at me.”

Slowly she did as he asked, watching him in the mirror’s reflection, glad for the distance between them, even if he was standing right behind her.

“There’s no evidence on the skin of internal bleeding, which there would be if you’d damaged the artery again. You know that.”

She nodded, needing for him to leave before the knot in her throat made it impossible to breathe.

He repacked his instruments in his bag, then turned to her. “Ben Mullins needs surgery. And I need for you to assist me.”

That brought her attention back. She rose on one elbow. “What kind of surgery?”

“He has fluid on his lungs. I can remove it, and that will buy him more time.”

She eased back down on the bed, hand resting on her forehead, the truth sinking in. “How
much
time?”

“A few weeks, at best. Perhaps less.”

She sank back onto the pillow. Tears pricked the corners of her eyes. “Does Lyda know?”

“I don’t think so. Ben said he wanted to be the one to tell her. But if he doesn’t tell her soon, I will. She needs to know the truth.”

Rachel nodded. A wife deserved to be told if her husband was about to die, just as children deserved to be raised by both their father and their mother. But it didn’t always turn out that way. “I’ll help you in whatever way I can with Ben’s surgery, and . . . I’ll do whatever you advise to get well.”

Rand stared at the man, unable to mask his disappointment. “I understand the reasoning behind your decision, Mr. Welch.” And he did. He just didn’t like it.

“I’m sorry, Dr. Brookston, but that building’s been sittin’ empty for months now. I needed to get it sold.” Harold Welch’s attention swept over the street teeming with Saturday shoppers to a building on the opposite side, adjacent to the Mullinses’ store. “I know what you’d planned on doing with it, and that’s real noble of you. But I needed money in my pocket now, not the promise of money in the future. And no offense, Doc, but”—Welch glanced back, his laughter abrupt—“I’ve seen the way folks around here pay you for your services. Smoked hams and jars of jam don’t pay a mortgage.”

Rand swallowed a bitter sigh. How well he knew. . . . With effort, he extended his hand. “Thank you for seeking me out to tell me, Mr. Welch.” Knowing he shouldn’t inquire further, his curiosity got the best of him. “If it’s not too far out of line, may I ask if the selling price was much beyond what I’d proposed?”

Welch’s satisfied look gave answer before he did. “The buyer met my asking price, plus he gave me an extra hundred dollars to get the place cleaned up and ready by the end of the month.”

Rand whistled low, knowing he’d been beat—and
good
. “I’d say that’s a mite better than my offer. What’s he going to do with the building?”

“Don’t know and don’t care. He gave me cash on the table. Every last penny.” Welch adjusted his hat and gave Rand an odd sideways glance. “I hope you’re not the type to hold a grudge, Doc.”

Rand eyed him, not certain what he meant.

“You know . . .” Welch shrugged. “In case me or my family comes down with the typhoid.”

Rand exhaled, allowing the hint of a smile. But only just. “You know me better than that, Welch. Although”—he shook his head— “I can tell you right now I won’t be giving you any candy.”

Welch laughed and clapped him on the shoulder. Rand continued down the boardwalk, trying to shake the feeling of having failed. He’d had such vision for that building, but apparently God didn’t think Timber Ridge needed a real clinic. At least not yet.

No new cases of typhoid had been reported in the past two days, so the number of patients held at seven, which wasn’t many, considering how swiftly typhoid could spread. It wasn’t enough to mandate a quarantine of the town—yet—and Paige’s condition continued to be the most serious by far. With every evaluation, she’d grown weaker.

Rand reached the buckboard and tossed his bag up on the seat. He could still see the girl clutching the half-melted stick candy in her sweaty little hand.

“I’m saving this one . . . for later,” she’d whispered to him late last night between coughing spells. “Mama says . . . I need to . . . eat my soup first.” After sharing with the Fosters about their daughter’s worsened condition, he’d encouraged Helen Foster to let Paige have anything she wanted to eat, to make all of Paige’s favorite foods, whether it be cookies or meatloaf. Mrs. Foster’s expression had sobered, and Rand had spoken to them more plainly about their daughter’s prognosis.

It was a fine line to walk, deciding how forthcoming to be with patients—or in this case, the patient’s parents—about the prognosis. He wanted to give them hope, wanted to leave room for God to intervene if He chose to, yet he also wanted them to know the truth so they could have time to be better prepared. If there was such a thing. Knowing death was coming, or not knowing . . . Both ways held blessings, he guessed.