The Royal Doctor's Bride

“Did you?” he replied mildly.

Lucy raised her chin. “She’s done a lot for us. The staff are intensely loyal to her.”

Ruark locked his gaze on hers, but she held her ground. “Is this a warning?”

“Not unless it needs to be.”

He grinned at her tart tone. “Dr Sutton’s place remains secure,” he assured her. “Although I would appreciate it if, when Dr Sutton is relieved of some of her duties, the staff will understand it isn’t because she hasn’t done an excellent job. As head of Belmont’s emergency department, I don’t intend to follow in Bill Nevins’s footsteps and shirk my own responsibilities.”

“They’ll understand,” she promised, a smile returning to her face. “I’ll see to it myself.”

Certain he’d gained the head nurse’s co-operation, which meant everyone else’s would follow, he pointed to the schedule taped to the counter’s backsplash. “Other than Gina, I rarely see the same doctor’s name twice in a week.”

“Because it doesn’t take long for most doctors to get fed up with being overworked and underpaid, so they leave. When Gina assigns the shifts, she relies heavily on locums, friends, or previous on-staff physicians who just can’t say no.”

She sighed. “Then again, none of us seem to be able to say no to her. It’s impossible to refuse someone who works harder and more hours than you do. She takes up a lot of the slack herself.”

He thought about Frank Horton. “What about residents? Shouldn’t a surgeon be available all the time?”

“Belmont only has a few residents,” Lucy mentioned. “An OB-GYN who spends most of her time on the maternity floor and a neurology fellow who’s usually in ICU or Rehab.”

“And Frank?”

“Oh, don’t let him hear you call him anything but a board-certified physician,” she warned. “He’s hired as a hospitalist and is assigned to our department, but he only drops by when we call him.”

“He’s allowed to do that?”

She shrugged. “Who’s going to stop him? Gina’s tried, but without having the authority she didn’t get very far.”

“Why didn’t Nevins stand behind her?”

“As long as Frank responded in a ‘timely’manner…” she emphasized the word with quotes in the air “…Bill wasn’t going to force the issue.” She glanced at him slyly. “If you’re looking for quality improvement ideas, you should start with that one.”

After dealing with cases she could have handled blindfolded, Gina had silently begged the fates to send a patient with something more complicated than shingles or an ingrown toenail. After suffering two major personal surprises today, with the arrival of both Prince Ruark and a letter from a grandmother she’d never met, she suspected the upcoming evening would have more surprises in store. Already her imagination was running rampant with possibilities of what a famous radio commentator liked to refer to as “the rest of the story”. Rather than waste her time worrying or second-guessing what Ruark would tell her, she needed a case that required her full attention.

Fortunately for her, twenty-one-year-old Janice Myers arrived, complaining of abdominal pain.

Gina flipped through the latest lab and radiology reports. In spite of all the tests she’d run, she still couldn’t pinpoint the woman’s problem.

She wasn’t going to give up, though.

“Your beta HCG is negative, so we can rule out an ectopic pregnancy,” Gina informed Janice and her fiancé Kyle Burnham.

“I told you I wasn’t pregnant,” Janice said weakly as she lay on the gurney, clutching Kyle’s hand in a white-knuckled grip.

“I know, but I had to check as a precaution,” Gina told her kindly. “You’d be surprised how many women claim they aren’t expecting and the test turns up positive.”

“Then what’s wrong with her, Doctor?” Kyle demanded. Tall, lanky, and wearing a mechanic’s uniform, his worry was as obvious as the grease stains on his clothing. “She’s been like this since last night.”

“Abdominal pain, fever and your slightly elevated white blood count suggest appendicitis,” Gina admitted, “although those symptoms could be due to a number of other things as well.”

“Like what?”

She stuck to the more minor conditions on the list of possibilities. Suggesting Crohn’s disease or cancer at this stage was premature. “Pelvic inflammatory disease,” she said, thinking of how Janice only noted tenderness during her pelvic exam. “A hernia or diverticulitis, to name a few.”

“What about food poisoning?” Janice asked.

“Food-borne illnesses usually manifest themselves rather abruptly. You mentioned your pain actually started two days ago and gradually grew stronger, which doesn’t fit the picture.”

“So what do we do now?” Kyle asked, his gaze focused on Janice. “Wait and see if the pain goes away on its own?”

Gina tucked the metal chart under one arm. “Absolutely not. I’m going to ask for a surgical consult.”

“Surgery?”

Noting the horrified look the couple exchanged, Gina explained, “Your ultrasound didn’t show anything unusual, so he may decide it would be best to take a peek inside you with a laparoscope. But we’ll let him decide.” She patted Janice’s shoulder. “Try to relax. Dr Horton should be in shortly.”

She strode toward the nurses’ station and plunked the chart on the counter, conscious of Ruark and Lucy at the opposite end. “Call Horton for a stat consult,” she told Ruby. “Possible appendicitis in room three.”

“He won’t be happy,” Ruby warned, her kohl-lined eyes matching her short black-out-of-a-bottle hair. “He only left a little while ago.”

“I don’t care if he walked out the door and has to turn around and come back—it can’t be helped. My patient needs a surgery consult. If he won’t come, he should send someone else.”

“I’ll get right on it.”

“Please do.”

“When you’re free, Dr Sutton,” Ruark interrupted as Ruby picked up the phone, “I’d like a few minutes.”

She couldn’t refuse, although she wanted to. At times she’d been able to pretend the events of that morning had all been a bad dream. At others the throbbing in her cheek and the occasional whiff of his expensively masculine cologne as she stepped out of a patient’s cubicle reminded her otherwise. Now, with hope borne of desperation, she glanced at the whiteboard room grid.

To her regret, other than Janice’s name written in room three’s square, someone had wiped the board clean. “OK,” she said.

If he heard her reluctance, he didn’t comment. Instead, he politely followed her into his office.

She immediately noted the room’s appearance as she gingerly took the chair he offered. “You’ve been busy.”

He propped one hip on the edge of his desk. “It wasn’t as bad as it looked,” he admitted. “Most of the papers didn’t stray too far from their folders, so it was a matter of slipping them back inside. Until I figure out the filing system, I thought it best to enlist help and Ruby obliged. According to her, you might know where these belong.” He handed her a thin stack.

She quickly scanned them. “Contracts are kept in the accounting department. We certainly don’t deal with real estate down here.” She turned another page. “Selling equipment? We didn’t sell anything…” The list of items caught her attention.

“Why, that rotten…scoundrel,” she muttered under her breath.

“From your reaction, I assume you weren’t aware he was selling the department’s medical equipment?”

“Not at all.” She shook her head before one entry caught her eye and she pointed to it. “I recognize this ophthalmology scope. We had a patient with a scratched cornea and I couldn’t find it. Bill said he’d sent it out for repairs and we had to scrounge an ancient model out of storage.”

“No wonder he reacted so strongly when I wouldn’t give him time to clear out his desk,” he mused.