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LET this be a lesson to you, Sierra McAllaster, she told herself in her rush to meet the incoming ambulance. Never say never.
She'd worked in Emergency Services before coming to Pennsylvania three months ago, and when she'd left North Carolina, she'd vowed that daily E.R. duty wouldn't be in her future. She'd been there, done that, and although she'd once loved her work in that hectic department, it was time to pass the torch to others who thrived on the adrenalin rush. She wanted a more sedate pace with patients who weren't broken bodies in need of an immediate fix, and she'd found it on the fifth-floor medical unit at Pittsburgh's Good Shepherd Hospital.
However, just when she'd finally settled in to her new duties, her career plan had taken a one-hundred-and-eighty-degree turn. At this very moment she was in the middle of the very position she'd never intended to fill again, thanks to a one-sentence clause in the fine print of her contract.
"Come on, people," Trey Donovan, the senior emergency physician, yelled beside her. "Let's move!"
By the time their small entourage had reached the ambulance bay, two paramedics were already tugging a stretcher out of the back of their vehicle.
A feeling of dread swamped her, but she reasoned it away. You don't know this person. None of your friends or family could possibly be on that stretcher. This is a car accidentnothing at all like David's situation.
She swallowed hard and forced herself to fall back into her objective professional mode.
"MVA," one medic reported, using the shorthand Sierra recalled so vividly. Motor-vehicle accident. "Forty-five-year-old male with blunt trauma to the chest and abdomen, dislocated shoulder and sundry other injuries. BP is "
Sierra noted the vital signs as she gazed down at the man lying on the gurney, strapped to a backboard and wearing a cervical collar. Bruises were already forming on his visible extremities and lacerations from broken glass crisscrossed his face. An oxygen mask covered his nose and mouth, but his nose was swollen and clearly broken, which meant they'd need an airway.
"Let's go," Trey ordered, and off they scurried to the nearest available trauma room.
"He's wearing a MedicAlert bracelet," the other paramedic reported. "According to the company records, he's a diabetic and he's currently taking Coumadin, hydrochlorothiazide and something called liraglutide."
The blood-pressure medicine wasn't unusual for someone his age, but the blood thinner was. "Has he had a recent heart attack or stroke?"
"We don't know, but his left knee has a freshly healing scar. Maybe a recent joint replacement? The police are trying to locate his next of kin."
"Any record of insulin?"
The paramedic shook his head. "None."
"What was that last drug you'd mentioned?" Trey asked, his brow furrowed as if trying to place the medication.
"Liraglutide," the paramedic repeated.
Trey turned to one of the nurses. "Call the Pharmacy and ask"
"Don't bother," Sierra interrupted. "It's a new drug just approved by the FDA for treating type 2 Diabetes." "Oh."
Trey's dark-eyed gaze met hers over the gurney and she read his unasked question. "I had a patient who had trouble controlling his diabetes, so we tried it. It's not the first line of therapy and has a number of side effects, but in his case it was a last-ditch resort and it worked," she explained.
He grinned, and the most endearing dimple appeared in the side of his cheek. "Your first official day and you're already handy to have around."
Strangely enough, her face warmed under his appreciative comment. Sierra McAllaster did not respond to empty flattery with a blush, she reminded herself. Thanks to her husband, who'd liberally used his charm to his own advantage, she'd eventually determined it was merely a tool to get what he wanted. The lesson had been painful to learn as her illusions had been shattered, but she'd never forget it. Never again would she fall for a fellow who troweled on charm as easily as a brickmason laid his cement. She'd become immune to men like him.
However, immunized or not, it seemed rude to refuse to return his smile so she did, even though she didn't know why she was smiling in the first place.
A few seconds later, they'd pushed the gurney against the awaiting bed in the trauma room. Sierra locked the wheels in place with the toe of one pump, having already decided she'd overdressed for the demands of this department. She'd forgotten the frantic paceor maybe she'd simply blocked it out of her mindwhich meant a dress and heels weren't her most practical choice of attire.
"Lift on three," Trey ordered. "One, two, three."
Everyone complied in one smooth, well-rehearsed motion to move their patient to his new bed. Sierra hoped any residual blush on her face could be attributed to the strain and not Trey's flattering comment.
"Can you hear me, Mr. Klein?" Trey spoke to the fellow. "You're in the hospital and we're going to take care of you."
Unable to nod because his head and neck were immobilized, he simply blinked and mouthed, "Okay."
Sierra hung around and helped the nurses organize the patient's tubes and swap the paramedics' equipment for hospital-issue while Trey issued orders for X-rays and lab work, requesting the same procedures Sierra would have if she'd been in charge of this case.
His next command caught her by surprise. "Go to lunch, Sierra."
She paused. "You don't need help?"
He shook his head and flashed his trademark grin. "Thanks, but I'm good."
Yes, he was, she thought as she moved out of the way, somewhat reluctant to leave just yet. Instead, she took a few minutes to observe her colleague in action.
Today might be her first official day in Emergency, but it wasn't the first day she'd worked with Trey. In her previous position as hospitalist on the fifth-floor medical unit, she'd received several patients he'd admitted and had answered his call for a consultant on numerous occasions. His medical skills then, like now, seemed outstanding.
He spoke with a calm authority that sent staff scrambling to obey, but she could tell they did so out of a desire to please rather than a sense of fear. Then again, who wouldn't want to do whatever he asked if it meant receiving one of his killer smiles? She'd seen how his grin had turned even the most independent, career-minded woman into the equivalent of a simpering teenager.
He was also more than just a handsomely wolfish smile. His long eyelashes were partly to blame for his appeal to women, she decided. Add dark brown hair and midnight-blue eyes, a firm jaw and an attractive dimple, and infatuation was a given.
He was a tall man, which made nearly every female, no matter her size, feel dainty and feminine. While he wore the requisite surgical green scrub suit under the rotective yellow paper gown, the shapeless garments didn't detract from his muscular shoulders or his lean physique. If he could turn heads in this ugly garb, he'd probably stop traffic when he wore street clothes that actually fit.
If the hospital ever created a doctor-of-the-month calendar featuring him as the centerfold, they'd make a fortune.
As great as his physical appearance was, he wouldn't have earned the moniker of "the delectable Dr. Donovan" if he didn't have the personality to match. His charisma explained how he'd managed to get whateverand whomeverhe wanted in his department. Because of his persistence and eloquent arguments that she was the one physician who could immediately fill the long-vacant position in his service, he'd persuaded several top people to transfer her into his domain. Granted, she was only covering until the heads of Emergency Services and Internal Medicine hired a physician specifically for the post but, as far as she was concerned, a day spent in the ED was one day too many.
Apparently aware of her lingering presence, he flashed her a cocky grin.
Hating that he'd caught her loitering and was obviously thinking she'd become one more member of his adoring fan club, she fled the room. After a brief stop at the staffing board, where she slapped a Lunch magnet beside her name, she hurried outside, into the warm afternoon sun.
Trey surreptitiously watched Sierra leave as if a rabid dog were nipping at her heels and hid his smile. He'd first met her three months ago when he'd called the fifth-floor medical unit to request a stat internal medicine consult and Sierra had responded, barely giving him a second glance.
Accustomed to dealing with flirty and simpering females, Trey had been taken aback by her disinterest at first but then he'd been intrigued by it. In his earlier life as a footloose, carefree bachelor, he would have responded to the challenge she presented and pursued her with everything he had. However, that had all changed when his sister-in-law, Marcy, had died. While his relationships were still of the short-term variety, he'd come to the conclusion that even those were difficult to juggle with everything else in his life. Acting as Mitch's "big brother," helping Mitch raise his niece and coping with the demands of his job took nearly all of his free time.
As much as he'd like to know Sierra on a more personal level, his gut told him that she wasn't the sort who would embrace such a temporary and superficial relationship.
Instead, she was the type to make a man think about the future in terms of the next twenty or thirty years. At times, he tried looking ahead that far, but he simply wasn't ready to let a woman get that close. Between coping with Mitch's downward spiral after Marcy's death and his struggle to meet all of his family obligations, he didn't have the time or the energy to devote to anyone else.
That hard truth, however, didn't prevent him from wishing Sierra would be happy with what he could offer, especially after today when he'd seen her face turn a beautiful shade of pink. What woman in this day and age, especially one who'd survived the rigors of medical school and residency, actually blushed? Be that as it may, that small flaw only enhanced her already attractive features.
Her fine bone structure gave her an ethereal quality, as if she didn't belong in a field as brutal as emergency medicine, but her athletic frame suggested she wasn't a stranger to hard work.
As lovely as he considered her face and form, her thick auburn hair was nothing short of awesome. The color reminded him of flames dancing on the hearth and without any effort at all he pictured her shaking out her braid until every strand cascaded over her beautiful shoulders.
In spite of her cool attitude, in spite of her standoffish ways, Sierra McAllaster obviously wasn't as resistant to his charm as she pretended.
Munching on an apple, Sierra strolled along the circular concrete pathway of the hospital's favorite attractionthe Healing Garden and Labyrinthwhich had been created just outside Emergency. Normally, she walked the circular concrete pathway in order to recharge her mental batteries when she had a tough patient, but today her reflections were far more personal and far more immediate.
Her ridiculous reaction to Trey's flattering comment still bothered her. Her marriage had taught her to not fall victim to a man's flattery and until now she hadn't. Why today was different remained a complete mystery. In her opinion, Trey's charm was a strike against him.
He had also earned a second strike because if it weren't for him, she'd still be reporting to work on the fifth floor, where she belonged. Although, in all fairness, she didn't know if she should be upset with him or with herself.
If she'd been in Trey's position, she would have presented the same case he had, asking that the vacant position be filled with a doctor who was already on staff and who possessed ED experience. As Fate would have it, she was the one with the least senioritythe only one, in factwho fit the criteria.
Her options had been limitedeither take this assignment or end her contract.
Leaving hadn't been a viable option. She'd finally unpacked the last box of household goods this past weekend and the idea of hunting for a new job was too tiring to contemplate.
On the other hand, she did have a third option. If she'd been honest and explained why she couldn't work in Emergency, perhaps Dr. Keegan might have chosen someone else. Pride, however, had stopped her. She'd come to Good Shepherd with a clean slate and if she dragged out her history to use like a get-out-of-jail-free card, her past would become an open book. The doubts, the pitying glances and every emotion in between would start, and she refused to deal with that from staff and her colleagues.
Consequently, she'd decided it might be time to face her fears and put those horrors behind her. Although she didn't want to work in Emergency, she suddenly had a desire to prove she was able to.
Fortunately, Dr. Keegan had offered her several consolation prizes. Oneand the most importantshe was only filling in temporarily. So what if she was back in the area where she'd sworn she'd never work again, treating everything from acid reflux to herpes zoster infections, traumas to diabetic comas? She'd endured far worse and for a far longer period. Sixty days was nothing more than a wrinkle that would iron itself out in due time.
Two, Dr. Keegan had promised she could return to her hospitalist position on the fifth floor. Knowing how the other internist, William Madison, was already complaining about covering those patients as well as his own in the cardiac ICU, he was also eager for her to shake the E.R. dust off her feet and return to where she belonged.
Three, the odds of encountering a trauma that involved a close friend or family member were nonexistent. After three months in Pittsburgh, she still hadn't developed any serious friendships or personal relationships and as long as she was expected to staff the ED, she intended to keep it that way.
As she strolled around the labyrinth, a growing sense of acceptance and her natural can-do attitude filled her. Her transfer may have thrown her off balance, but she was slowly feeling more in control over her situation. Today's trauma had only caused her a few moments of anticipatory dread, but after that she'd handled herself well. She'd still have some bad moments, but she'd be able to deal with them. She would deal with them.