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Excuse me, where is the patient I'm operating on this morning?" Dr. Nora Blake stood impatiently at the nurses' station in the Pediat-ric Intensive Care Unit. Two nurses in brightly colored uniforms were laughing about something until they heard her voice. Then they immediately fell silent, their smiles vanishing.
Nora knew she wasn't a favorite with the staff. She didn't possess the people skills many of her colleagues displayed. Her insistence on attention to detail and her intolerance of mediocre work had earned her the reputation of being difficult.
It wasn't that she didn't care what her coworkers thought of her—she did. It hurt to see how quickly their expressions changed from cheerful to guarded, but making sure her patients received the highest quality care was far more important than being popular.
Arching one eyebrow, the slender nurse with short blond hair asked, "Do you mean Cara Dempsey?"
Nora raised her chin. Her skill was saving children with heart defects, not winning popularity contests. Professionalism was the key to getting things done right in the hospital, not sociability.
"I'm looking for the patient who came in from Blackwater General yesterday with transposition of the great arteries. Do you have the chart?" The words came out sounding sharper than she intended.
The ward nurse held out a black three-ring binder. "The patient is in room five. Dr. Kent just finished talking to the parents."
"Thank you." Nora nodded, relieved to hear that her partner had arrived first. Peter Kent would have explained the coming procedure to the family. It saved Nora the time and headache of trying to make laypeople understand the complex nature of the upcomingoperation.
If she found any fault with Peter, who was ten years her senior and had been her partner for the past two years, it was that he was too upbeat in dealing with the families. As far as she was concerned, he often sugarcoated the truth and offered false hope. She would need to impress on the Dempsey family the risks involved, especially for an infant. Not every patient survived open-heart surgery.
Thumbing through the chart, she paid special attention to the laboratory values and medications being given to the two-day-old infant. Satisfied that everything had been done correctly, she closed the binder and moved to the computer in the corner of the desk area reserved for use by physicians. She pulled up the echo-cardiogram images of her patient.
She had already studied the scans extensively in her office late last night, but she wanted to make sure that she hadn't missed anything, so she watched the movie of the child's beating heart one more time. As always, a profound sense of wonder and awe engulfed her. The human heart was a beautiful thing.
She quickly focused on gathering the information she would need to repair the child's flawed heart. Operating on a newborn baby was always hard for her. It brought back too many painful memories. She preferred her patients to be at least six months old, but this child wouldn't live a week without surgery. It had to be done now.
The quality of the echocardiogram and tests were excellent, but Nora wouldn't know what she was actually dealing with until she looked inside the patient's chest. If there was one thing that she had learned during her years of training, it was that every heart was unique.
Leaving the desk, Nora walked to room five. Outside, she paused a moment to brace herself. Drawing a deep breath, she pasted a smile on her face, knocked once and then entered.
Inside, she saw a young couple sitting on the small couch at the back of the room with their arms around each other for support. They both had red-rimmed eyes, either from crying or from lack of sleep or both. They looked shell-shocked and barely out of their teens—far too young to be facing what lay ahead.
They both rose to their feet, and their hopeful eyes begged her for help she wasn't sure she could give. For a split second she envied them each having someone to hold on to during the coming hours. She had been in their shoes once with no one to comfort her. The memory of those terrible days haunted her still.
On the warming bed, a baby girl with thick dark hair lay unnaturally still. A white tube taped to her mouth connected her to a ventilator. IV pumps and monitors took up most of the space around her and beeped softly. Drugs kept her from moving and fighting the very machines that were keeping her alive. Even with the ventilator breathing for her, the child's lips were dark blue. It wasn't a good sign.
Nora nodded at the parents. "I'm Dr. Blake and I'll be performing your child's surgery this morning."
The father spoke quickly. "You can make her well, can't you? Doctor Kent, he said you were the best."
"As you know, your daughter was born with the blood vessels leading from the heart in the wrong places. Outcomes are usually good with this procedure, but five percent of the children who have this done don't survive or survive with serious brain damage. You need to be aware of that."
Cara's mother laid a loving hand on her daughter's small head. "God will be with you and with Cara. He will save her. God can do anything."
Nora bit back the comment that rose to her lips. She didn't share this young mother's belief in a benevolent God, but she had learned that revealing her philosophy with families frequently increased their anxiety.
Instead, she said, "I'll meet with you in the surgical waiting room when the operation is over. It will take several hours, but one of the staff will come out to give you updates during that time."
The door to the room opened and the blond nurse looked in. "Mr. and Mrs. Dempsey, would you please step out to the desk? I have some forms for you to sign."
As the couple followed the nurse out into the hall, Nora found herself alone with her patient. Looking down at the baby depending on her for so much, she experienced a pang of overwhelming compassion. Reaching out, she stroked the child's hair with one hand. The tiny curls were soft as silk.
"If God can do anything, then why am I always fixing His mistakes?" Nora whispered.
She touched the small oval locket that hung on a gold chain around her neck. There was no answer to her question today. There never had been.
Catching her lower lip between her teeth, she closed her eyes and regained the composure she would need in surgery. Intense focus, not sympathy, would save this child.
After leaving the baby's room, Nora headed to the elevators. At the fifth floor, she stepped out and walked quickly toward the operating suites.
She passed the pre-op nurses' station without pausing, barely noticing the women in green surgical garbs identical to her own standing in a group behind the tall, black granite counter.
Her mind was already intent on the delicate surgery she would be doing in the next few minutes. She rehearsed each move in detail.
Step-by-step, she visualized the course of the entire procedure, taking into account the obstacles and challenges the walnut-sized heart of this baby might present. Once the operation was under way, timing would be critical. The child couldn't afford to have her surgeon wondering what to do next.
The hallway led her past the family waiting room outside the surgery doors. Nora didn't bother glancing in. The parents would stay upstairs until the OR and PICU staff moved the baby to the surgery. If all went well, Nora would find Mr. and Mrs. Dempsey in about four hours and tell them their baby was still alive.
If all went well? It was a big if. There were so many things that could go wrong.
"Dr. Blake, may I have a word with you, please?"
Startled by the sound of a deep male voice behind her, Nora spun around. It took her a second to place the tall man with wavy dark brown hair who stepped out of the waiting room. When she did, she scowled.
Mr. Robert Dale, persistent reporter for the Liberty and Justice newspaper jogged toward her.
He was a man most women would notice. Dressed in jeans and a blue button-down shirt, he exuded confidence. His long stride and easy grace had her guessing that he was a runner, an activity that she enjoyed as often as her work permitted. His rugged features and deep tan made it clear that he preferred the outdoors over a treadmill. His bright blue eyes were fixed on her now with the intensity of a sprinter sighting the finish line.
She didn't intend to become his journalistic prize.
"I'm on my way to surgery, Mr. Dale. I'm afraid I don't have time to answer your questions."
Not bothering to hide her annoyance, she turned back toward the OR and quickened her pace. The wide, gray metal doors were only a few yards away. He couldn't follow her in there.
The man had been practically stalking her in his quest for information about the Ali Tabiz Willis case. The story of a five-year-old war orphan from the Middle East being flown to Texas for life-saving open-heart surgery apparently made a good human interest story. At least, Mr. Dale's paper seemed to think it did.
Or maybe they were so interested because the boy's grandfather was a retired U.S. Army general.
Either way, Mr. Dale had called her office enough times over the past few days that she had finally instructed her secretary to stop taking his messages. It seemed he couldn't take a hint.
A sudden thought struck her—how had he found out that she would be here? She hadn't known until late last night that she would be doing surgery this morning. Annoyance flared into anger at the possibility that her secretary or one of the hospital nurses had informed him of her schedule.
Determined to find out who had leaked the information, she spun around to confront him. Her abrupt change in direction caught him off guard and he plowed into her. The impact knocked her backward.
His strong hands shot out and grabbed her arms to keep her upright. "Sorry about that, Doc."
The feel of his long fingers curled around her bare arms triggered a thrill of awareness that shocked her. She drew a deep breath to steady her nerves. It didn't help. Instead, it flooded her senses with the masculine scent of his aftershave and a hint of caramel coffee.
She focused her gaze on a small damp stain on his pale blue shirt. He must have sloshed coffee on himself just as she walked by the waiting room. The thought that he had been lurking there expressly to waylay her brought her anger rushing back. She used it to suppress the strange and unbidden attraction she felt as she jerked away from him. "Who told you I'd be here this morning?"
His eyes sparkled with mirth and a grin tugged at the corner of his mouth, revealing a dimple in one cheek. For a split second, she envied his self-confidence and friendly poise.
"Now, Doc, you know a reporter never reveals his sources. Besides, you haven't returned my calls. I wasn't left with much choice except to track you down at work."
She rubbed her upper arms trying to dispel the tingle his touch caused. "How often do you have to hear that I have no comment, Mr. Dale?"
"Call me Rob."
"I prefer not to, Mr. Dale." She turned and began walking away.