Katie Canizaro leaned on the counter of the nurses’ station, her back to Holly. She was in animated conversation with another doctor, a graying, middle-aged guy wearing jeans and a wildly-patterned Hawaiian shirt. Only the stethoscope around his neck identified him as a physician.
Canizaro turned around as Holly approached, looking concerned. “Dr. Bell, were you able to talk to Tyler’s dad?”
Holly nodded an affirmative and held out her hand to the other doctor. “I’m Holly Bell. I don’t believe we’ve met.”
“Richard Morris,” the man said, a smile creasing his tanned face. “Cardiologist. The ER attending gave me a call about Tyler Arnold, because he knows I live close by. I figured I might as well drop over and check on him for myself. In fact, I was just getting an update from Dr. Canizaro.”
“Nice to meet you, Doctor, and thanks for coming in,” Holly replied.
Morris smiled. “I’m pleased to finally meet you, too. Your excellent reputation as a surgeon preceded you here.”
“Uh, thanks,” she said, repressing the urge to deflect his compliment. Everybody seemed to know that PCH had enthusiastically recruited her. It was great to be appreciated, but she’d rather do without the effusions until she’d actually had the chance to prove herself. “I believe you’ve been treating Tyler for some time, according to his file.”
“About two and a half years, since the family moved down from Pittsburgh. He’s a good kid, but he’s never known a minute of life with a normal heart.”
Another kid dealt a truly rotten hand, especially with a father like Arnold. Holly pushed another stray lock of hair away from her eye and tucked it behind her ear. “Dr. McMillan briefed me on the case earlier in the week.”
“According to Dr. Canizaro, you think the valve repair is failing?”
“I do. But you’ll listen for yourself. And as soon as we get the echo back, we’ll let you know.”
“Fair enough.”
“Dr. Morris, would you mind if we had a brief chat outside?” Holly turned to her resident. “Dr. Canizaro, would you excuse us?”
“Of course,” Morris said.
Canizaro gave her a puzzled look, but nodded.
Holly led him back to the corridor outside the swinging door to the trauma center. “I just spoke with Mr. Arnold,” she said. “He’s in the waiting room.”
She wondered if she’d let her expression betray her thoughts, since Morris arched his eyebrows.
“Ah, yes,” he said.
She shifted uneasily, not sure how to voice her concern. “He struck me as a little odd. What can you tell me about him?”
Morris pulled at his short, gray-flecked goatee. Combined with a thick mustache, it gave him a rather distinguished look. “The man’s a single parent. His wife committed suicide a few months before Tyler was referred to me. After her death, father and son moved here from Pittsburgh.”
“He seemed surprisingly blasé when I told him Tyler’s condition was serious,” Holly said.
Morris gave his goatee another little pull. “I’ve noticed that, too. More so, I think, as time has passed. He’s often barely interested in what I’m saying to him. The grandmother seems to be more involved in Tyler’s care than he is. She’s a lovely woman, but the poor dear was mowed down by a car crossing South Street last year. A hit and run that left her paralyzed from the waist down, if you can believe that.” He shook his head. “She doesn’t get around very well, of course, so I don’t see her as much anymore.”
The family situation was far from optimal, but Holly felt some relief knowing Tyler at least had a devoted grandparent in his life. She would need to find a way to have a talk with the woman. Still, though, she couldn’t ignore her gut.
“I don’t want us to get ahead of ourselves,” she said, “but I have a sinking feeling this guy could be a problem. I’m thinking we may even have to bring DHS into this at some point.”
Department of Human Services staff—and specifically those of the Children and Youth Division—were often called in by the hospital to consult on suspected cases of lack of proper parental responsibility, or even child abuse.
“Maybe he’s a decent parent,” she continued, “but he sure got my antenna up tonight.”
Morris frowned and pursed his lips. “You are getting ahead of yourself, Doctor. Lance Arnold’s not going to win any parenting awards, but I haven’t seen evidence that Tyler has been abused or neglected. I don’t see any point in speculating about DHS.”
He was probably right, but Holly couldn’t help bristling at his sharp tone. Although she’d only met Arnold once, he’d clearly ignored signs of Tyler’s illness, and in her book that constituted neglect in a child with such a serious heart condition. Dr. Morris should be an ally if it ever came time to take action, but his “show me” attitude was not a good sign.
She bit back a retort, deciding to let the issue drop for now. “Okay, I’ll see how it goes. Are you planning on sticking around for the echo and lab results?”
Morris gave a little snort and shook his head. “You know how long that could take around this place? No, somebody can call me, tonight if necessary, but preferably tomorrow morning.”
Holly frowned. Why had Morris bothered to stop by in the first place if he wasn’t going to check the test results tonight?
Then she gave herself a little mental slap. After all, Morris had come right over after the attending called him, and the last thing Holly needed to do was make adversaries out of colleagues—especially after only a few days on the job. “Well, I’ll be here,” she said, making sure she didn’t inject a note of judgment into her voice. “I’ve booked an O.R., just to be on the safe side.”
“Really?” Morris said, a bemused smile breaking through between the mustache and the goatee. “I realize you’re the boy’s surgeon, and you’ll do what you will, but I’d certainly appreciate being consulted unless it really is an emergency situation.”
This time she had to physically bite her tongue to keep her mouth shut. Of course she would only act in an emergency! Morris’s patronizing tone made her teeth clench with frustration. She’d battled that kind of dismissive attitude from older doctors her entire career, especially from men who seemed to think their female counterparts couldn’t manage without their gratingly superior guidance.
Calm down, Holly. Keep your eye on the ball.
She swallowed her resentment and inhaled a deep breath. “That goes without saying, Doctor,” she said, calmly. “Whatever happens, you’ll definitely be in the loop.”
Morris opened his mouth, apparently ready to argue. But then he closed it again and inclined his head, as if in submission. “Much appreciated, Dr. Bell. Well, I’ve enjoyed our chat, but I think it’s time I examined my patient.”
Without waiting for her reply, he pivoted and strode back into the trauma center.
That went well. Not.
Sighing, Holly began to massage her neck. The muscles on the right side felt like frozen rope, and the pain extended all the way down to below her shoulder blade and all the way up into her sinuses. Sudden stress and tension often triggered the reaction, and tonight she’d had her share. A sick little boy with a leaky heart valve was bad, but it presented the kind of challenge she was used to handling. What she thrived on.
But what she wasn’t very good at was working with difficult parents or paternalistic colleagues. Sometimes she wished she’d gotten just a little more in the social skills department to go along with her academic ability. She’d never had much luck learning those skills, either. At least not according to her mother.
Shrugging that unpleasant thought away, Holly headed to the only hospital coffee shop that stayed open until midnight. She ordered a decaf skinny latté, and spent twenty minutes trying to clear her mind of the encounters with Arnold and Morris. There was no point trying to plan three or four or ten steps ahead, or speculating what Lance Arnold would or wouldn’t do in any given scenario. Whatever happened, she’d react and deal with it. Of course, for a life
long control freak, that kind of acceptance ran completely counter to the grain. But she’d been working on it, and she liked to think she’d been making progress. After all, she hadn’t bit Morris’s head off, had she?
After twenty minutes, Holly figured Morris would have long since completed his examination and gone home. She worked her way back through the maze of corridors to the trauma center. Canizaro sat at the nurses’ station, engrossed in paper work. Holly nodded and headed into bed six, drawing the curtains tight to completely enclose the cubicle. She pulled the lone metal chair closer to the bed and sat.
The intubation tube had been withdrawn and Tyler, asleep, was breathing fairly comfortably without assistance. She glanced at the monitor. His temp remained the same, which she’d expected. The rest of his vitals—pulse-ox, heart rate, blood pressure—were in the acceptable range for his condition. She let out a tight breath of relief.
Her professors and mentors had drummed it into her head that she couldn’t afford to let herself get too invested in her patients. She knew it was sensible advice—a survival tactic. But even after years of med school, residency, and surgical practice, Holly couldn’t easily swallow the realization that all her skills, and all the technology the best hospital could offer, sometimes weren’t enough to prevent a child’s death. Her mind acknowledged and accepted the cold, clinical reality, but her heart and her gut always rebelled.
She stretched in the uncomfortable chair. Her neck ached, and she knew she should go home and get some sleep. But she decided to stay right there. She had nothing to rush home to, no one waiting for her. For now, all she could do was hold this little boy’s hand, and that was exactly what she planned to do.
Chapter Four