Unrivaled, p.3
Unrivaled, page 3
“Were you,” Honor said gently, her piercing gaze tenderly surveying the shaky barricades of Dec’s defenses. “I’m glad. We needed you this morning. We’re still waiting for the day staff to arrive, and everyone else is overseeing the patients we just admitted. I’ll introduce you to the group as soon as the storm settles.”
“No hurry. The last of the patients are on their way in now,” Dec said. “What do you need me to do?”
“Can you make rounds on the ones waiting for disposition who haven’t been seen by staff? Check with the residents and make sure everyone’s had a thorough assessment?”
“Sure.” Dec surveyed the full house and the bustling throng of residents, PAs, and nurses. She’d been one of them once, but now all the faces were unfamiliar. All except one. Zoey Cohen. She stood out from the others. Draped in the ubiquitous yellow cover gown, a mask dangling around her neck, she might have been just one more rushing body among many, but Dec found her instantly, as if drawn to her by some second sense. Zoey only stood out when you looked at her—at the unusual shade of silver-blond hair, at the delicately sculpted but unmistakably strong face, at the sleek body. Once you saw her, the way Dec had seen her that first moment in the shimmering glow of the breaking dawn, you would never mistake her for anyone else, or anyone else for her. She was too singularly lovely.
And she looked like she had things totally under control. Zoey stood by the patient’s bed in the first trauma bay, talking with a husky young guy with tight black curls and a baby-smooth face that looked like it’d never seen a razor. His attention was riveted to her face, and he nodded emphatically at regular intervals. Dec could almost hear his brain memorizing every syllable Zoey uttered. Sponges. Good residents were sponges, soaking up every crumb of wisdom and experience they could before they were all alone on the firing line. Dec had no reason to walk over and talk to her. She chose to interpret the crashing sensation in her midsection as relief and turned away.
✥ ✥ ✥
Zoey parted the curtains surrounding the cubicle and slid inside. A teenage or early-twenties male, most of his body obscured by the cervical collar, the breathing tube, the Aircast on his right leg, and the multitude of lines and monitors, lay unconscious, his face miraculously untouched and looking somehow peaceful. To someone who didn’t know better, he would look like he was merely asleep. She surveyed the monitors automatically, taking in the vital signs by second nature. A resident she didn’t recognize in a pristine white coat—ironed, no less—stood by the side of the bed, a slightly wild look in his eyes that morphed almost instantaneously into one of relief when he saw her. She glanced at his name tag. John Quan. Surgery.
Translation: first year, one day out of medical school and now presiding over the care of a multiple trauma victim. She remembered those first days with crystal clarity, the terror and exhilaration that combined to create a near-constant roller coaster of amazing highs and terrifying lows.
“Well?” she said.
“Sorry?” he said with just an edge of that long-remembered fear in his voice.
“I’m Zoey Cohen, your senior resident for the moment. Do you want to present the patient?”
“Oh,” he said, nearly jumping to attention. “This is…I don’t know his name.”
“Then that would be unidentified male.” Zoey made a slight come-along gesture with her hand.
“Right.” John took a deep breath and, to his credit, visibly got himself together. “Back seat passenger in a sedan, restrained, found unconscious, other occupants dead at the scene.” He swallowed. “They had to cut them out.”
“Vitals in the field?” Zoey said sharply, glancing again at the monitors. With a history like that, internal injuries were almost a certainty, and sometimes they didn’t show themselves immediately.
“Stable in the field with just Ringer’s resuscitation.”
“Labs?”
“All normal, except first round hemoglobin was 11.5. I…uh…sent off another one just now.”
“Good. That might be just hemodilution from the Ringer’s, but if he’s bleeding somewhere, that will show us. Exam?”
John wet his lips. “Neuro—”
“Start with the basics,” Zoey said.
“Right. Lungs are clear on both sides, heart sounds are clear—no murmurs, normal sinus rhythm, abdomen is soft. Obvious fractures of his left upper extremity and right lower leg. Neuro exam…” As John recited the physical findings, Zoey moved around the bed, verifying his findings, listening for any muffling of his heart sounds that might indicate he was developing an effusion or other signs of cardiac or major vascular trauma, palpating his abdomen, looking for rigidity or fullness where there shouldn’t be any.
As she worked, she sensed the curtains parting behind her, and someone moved up beside her. Her pulse quickened and she looked up, expecting Declan. Out of habit, she straightened almost as abruptly as her intern had when she saw Quinn Maguire, the trauma chief and the head of the training program. Quinn looked like she’d just come from the OR—she still wore her signature maroon surgical cap covered in soccer balls, a gift from the team she coached—and the faint lines from her mask creased her bold cheekbones. Her hair was black like Declan’s, but her eyes were nothing like hers. Gorgeous, but not— Zoey blinked away the image. Indescribable, and what was wrong with her?
“Hi, Chief,” Zoey said.
“Everything stable in here?” Quinn asked.
“Yes, but we ought to ultrasound his abdomen all the same. His hemoglobin’s borderline.”
“Hasn’t been done yet?”
“No, we’ve had acutes that needed doing first.”
“All right, see to it, then.”
“Got it,” Zoey said.
Quinn nodded to the first year. “Dr. Quan.”
“Um, yes?” Quan’s voice might have squeaked just a little.
Quinn smiled. “Welcome to PMC. Have fun.”
Quinn disappeared back through the curtains, and John stared at Zoey. “She knew my name. We just got here today, and there are twenty-five of us.”
“She knows more than your name,” Zoey said. “You can count on her knowing every single thing you do every day for the next five years. So don’t screw up.”
“Right.” John swallowed. “I’ll go find the ultrasound machine.”
“Good idea.”
John disappeared, and Zoey dug the tablet out from beneath the plethora of lines and paperwork at the foot of the bed to enter her notes.
A woman on the other side of the curtain in the next cubicle murmured in a husky whisper, “Did you see her?”
“Who?” a second woman said.
“Declan.”
“Declan?”
“Declan Black. She’s back.”
“Donna, I have no idea who you’re talking about.”
“Oh, wait—you haven’t been here long enough. She’s been gone…goodness, must be almost ten years.”
After a pause, not-Donna said, “And? From your tone, there’s a story. Hand me the Foley bag, will you?”
“Here.” A pause. “She was a student here—resident too. Everyone expected her to join the staff, but her wife—”
Zoey stiffened. Wife?
She wasn’t usually interested in hospital gossip, although sometimes it was the only thing that broke the unrelenting tension. There was so much of it, with everyone living in close quarters, sometimes never leaving the hospital for days at a time, that usually the constant chatter became just more background noise. Who hooked up with who, who wasn’t hooking up with who, and who might be hooking up with who. This time, though, every word was as sharp and clear as a heartbeat through her stethoscope.
Not-Donna laughed. “Oh, now I understand. I might have seen her but not noticed. Not being, you know, girl crazy.”
“I’m not.”
“You so are. So I guess you didn’t know she was coming?”
“No,” Donna said. “It’s not like they tell us who they’re hiring. But I’m surprised that Honor kept that one secret. Considering how close they were.”
Close? Zoey tried to remember how long Quinn and Honor had been together. Like with all couples who seemed perfect together, it just seemed like forever. But she couldn’t make a picture of Honor and Declan, and when she tried, her skin prickled.
“I wonder what she’s doing down in the ER?” Donna mused. “Maybe it has something to do with the accident.”
“All right. This story is getting deep,” not-Donna said. “What happened?”
“I don’t know the details, other than she was almost killed. Her wife—”
Honor Blake’s distinctive honeyed-steel voice cut in. “Are we ready in here? Transport’s on the way to take Ms. Santorini up to the neuro ICU.”
“Yes,” Donna said brightly. “All set.”
The conversation ended, but the words swirled in Zoey’s brain. Accident. Of course there had been an accident. There was almost no other way Declan could’ve gotten a scar like that on her forehead. And she remembered watching for a few seconds as Declan’d walked by. She had the faintest limp. But wife?
There was no reason for the sinking feeling that settled in the pit of her stomach, but there it was. She’d indulged a fantasy for a few minutes when she was too busy to remind herself that fantasies never came true, and wishing for something never made it so. Well, she didn’t need any more reminding now. Wife? No way.
Chapter Three
PMC Trauma Admitting
6:29 a.m.
Once the critical patients had been moved to the OR or the ICUs, Honor scanned the admitting area to check that all six remaining patients were stable while their workups proceeded. Satisfied, she finally settled at the central station to review the steady flood of lab and X-ray results streaming in.
Her best friend Linda plopped down beside her and blew a lock of blond hair off her forehead with a sigh. The Scooby-Doo cartoon characters on her smock cavorted across her very pregnant abdomen.
“Hi,” Honor said.
“Hi yourself. Is that all you have to say?” Linda frowned. “I can’t believe you didn’t call me. I’m five minutes away, and you know I’m always up since Robin and the monsters hit the ground running at the butt-crack of dawn.”
“You practically worked a double yesterday. And you’ll be on your feet all day today making sure none of the newbies get into trouble. And,” Honor said, holding up a finger to halt Linda’s expected retort, “your back is bothering you.”
Linda pressed her lips together, not bothering to deny it. “You try carrying a load like this around for an eternity. Your back will kill you too.”
“Been there, done that. Twice. So we’re in agreement. You work one shift, and you sit every chance you get. Direct, oversee, review—but leave the actual patient care to the staff.”
“I don’t remember agreeing to that.”
“You just did.” Honor smiled, her amusement at Linda’s attempts to ignore the obvious limitations of her condition turning to pleasure when she spied her wife striding down the hall. Quinn automatically glanced into the occupied cubicles as she passed, and Honor was certain Quinn could have reported every one of their occupants’ vital signs by the time she reached the station.
“Am I interrupting?” Quinn asked as she walked behind the counter to join them.
“Only your wife mother-henning me,” Linda said.
“Ah.” Quinn raised a brow but wisely remained silent.
“How are things upstairs?” Honor asked. She and Quinn had left the house at the same time that morning, both of them wanting to arrive early for new resident orientation. Thank goodness she had, or she wouldn’t have been as prepared for the onslaught of trauma victims as she had been, which wasn’t saying a tremendous amount. Most of the new house staff, or any of the staff for that matter, had yet to arrive. Shift change wasn’t until seven, so none of the day people were actually in the hospital or even on their way. Luckily some of the residents, especially the surgery residents, lived close enough to get there in just a few minutes, and when they’d gotten the alert, they’d shown up in record time. And by some miracle, Dec had arrived early and picked up as if she’d never left. Of course, she wasn’t a resident now, and technically she was a brand-new attending—at least here. But Honor wasn’t going to pretend she didn’t know the truth, even if Dec had asked her to keep her arrival low-key. Low-key in a place like this wasn’t really possible—plenty of people would remember her, and some probably even knew the whole story. Since news was the lifeblood of a hospital, a mainstay of keeping the tragedies witnessed every day from draining the soul, Dec couldn’t hope to go unnoticed. But Honor’d do what she could to protect Dec’s privacy.
Setting worries about Dec aside, Honor added, “We sent quite a few patients to the OR. I’m surprised you didn’t close us to trauma.”
“We pulled staff in, but we haven’t even started the elective schedule yet,” Quinn said. “Plus I’ve got half my senior residents checking the ICU patients you sent up, and the other half down here. We’re stretched thin.”
“You can take them,” Honor said. “Just make sure they sign out to one of mine before they go.”
“I’d rather they finish up here.” Quinn grabbed a stool and rolled over next to Honor. “We’ll have the backlog sorted out soon. Let them finish their workups. If we need them, we’ll pull them, as long as everything is quiet down here now.”
Honor nodded. “We’ve still got patients to clear before they go upstairs, but we don’t have anything surgical cooking right now.”
“You’ve got a bunch of my first years down here. They doing all right?”
“No one has fainted.”
At that, Linda laughed and stood to go. “That might be a record. I’m going to make rounds and check on them.”
Quinn grinned as Linda visibly waddled away. “Are you really worried about her or just being careful?”
Honor waited a beat until Linda was well out of earshot. “Not about anything specific. But she refuses to admit this pregnancy is hard on her, probably because she doesn’t want any of us to worry, so she overdoes it.”
“Maybe,” Quinn murmured, tucking a strand of Honor’s auburn hair behind her ear, “that’s her way of dealing with her own worries.”
“I know,” Honor said. “But she’s high risk, age-wise, and pretending otherwise will not change that. So I plan on reining her in as long as I can, and then I’m sidelining her.”
“Let me know when you decide to do that, so I can be somewhere else.”
Honor squeezed her thigh. “Coward.”
Quinn leaned closer. “We both know which one of us is toughest.”
“Depends on the circumstances,” Honor said softly. “I can think of a few times when you definitely call the shots.”
“Those would be the times when you let me.”
Honor laughed. “I’d say we’re even on that score.”
“Agreed.” Quinn grinned. “I’d better get back upstairs. I’ve got elective cases scheduled as soon as we clear the board of the traumas.” She tilted her head as Declan Black walked by with Dani Chan. “Who is that with Dani?”
Honor followed her gaze. “Oh, that’s Dec Black. She got here with the first of the rescue vans. She’s been outside triaging since then.”
“Huh.” Quinn regarded Honor with a question in her eyes. “How’d she do?”
“She’s solid, Quinn. I knew she would be.”
“I don’t doubt your judgment in hiring her.” Quinn blew out a long breath. “I just don’t know if I could…”
Honor stroked the top of Quinn’s hand, curled into a fist on the countertop. “I know. Me neither.”
Quinn straightened and, without even bothering to look around, kissed Honor soundly on the mouth. “Right. And I’m headed back to work. Let me know if any of my residents screw up.”
“Your senior residents really stepped up, Quinn. Every one of them. They’re a great bunch.” Honor rose. “I’ve—”
Honor’s trauma cell phone rang, and Quinn waited while Honor answered.
“PMC trauma unit.” The rushed words assaulted Honor’s ears like a jumble of discordant cymbals. “I’m sorry. Repeat that, please.”
A few seconds later she ended the call and met Quinn’s gaze. “They’re bringing the last victim here. They found part of a PMC ID in the wreckage, but they don’t have a name.”
Quinn stood abruptly. “What department?”
“They didn’t say. Probably don’t know. At five in the morning, though, it wouldn’t be a seven-to-three employee or anyone from admin. It’s most likely someone medical.” Honor glanced toward the entrance as the sounds of an approaching siren grew louder. “I have to get out there.”
“Honor,” Quinn said as she jogged beside Honor, “you’ll need attending staff to handle this, especially if it turns out to be one of the house staff. They’re all friends to one degree or another, and doing the initial eval will be tough.”
“I know. I’ll direct the triage and resuscitation myself. Declan can oversee everything in here until the other staff arrive and get up to speed.”
“I’ll see if I can get someone to cover my cases and help out,” Quinn said.
Honor slowed as the double doors slid open. “You’ve got a full ICU, new house staff, and all your ORs running. Let’s see what we have first.”
Reluctantly, Quinn said, “All right. But call me as soon as you know anything.”
“I will. Go do what you have to do.”
Quinn sprinted away, passing Zoey, who turned to stare after her. Honor stepped out into a surprisingly bright, warm summer morning. 6:32 a.m. The flash of red and the screaming siren, usually so familiar as to go unnoticed, filled her with foreboding. She steeled herself against the disquieting sensation. For one fragile second she remembered with crystal clarity that long-ago summer morning when she’d waited with a different ER team for the ambulance that carried Terry. Dec had been here that day too.
