Maverick In The Er

Sierra immediately took over, not surprised by Trey’s ability to gain Frances’s cooperation. He’d obviously been dealing with this woman for quite a while.

“Okay, Frances,” she said softly. “I need you to stretch out for me.”

“But it hurts when I do,” she wailed.

“I know, but I really need you to lie flat.” After much maneuvering and moaning, Sierra gently prodded Frances’s abdomen. It didn’t take long to decide that her problem didn’t have a simple solution.

She turned to Trey. “Do you remember the paperwork you said you didn’t initiate? You’d better start it now.”

Over the next hour, Sierra realized she couldn’t have done her job without Trey. While Frances’s problem had been fairly straightforward, it had taken longer to arrive at the diagnosis because she hadn’t been particularly cooperative. Thank goodness Trey was a salesman at heart. He explained, gave guarantees and promised her everything from watching television to an ice cream if she’d allow them to do one more test.

He saw Frances through the pain of bloodwork and he did so with patience she hadn’t expected—patience that wasn’t contrived.

Neither did he express any great relief to relinquish his task when Frances’s mother arrived. Instead, he simply changed gears from moral-support agent to physician as easily as he flashed his handsome smile.

“Appendicitis?” he asked as soon as he cornered Sierra at the nurses’ station.

“I’m impressed,” she said, amazed at how he’d pinpointed her diagnosis before they’d received any reports. “You really can walk and chew gum at the same time.”

“What can I say? I’m a man of many talents. Plus, it didn’t take too much effort to add lower-right-quadrant pain and rebound tenderness with a fever to come up with appendicitis. I assume her white count is elevated?”

“According to the report that came through a minute ago, it’s eighteen point four. I’ve already called Vijay. He said because it’s such a clear-cut case to save him a trip and send her upstairs to surgery.”

Vijay Gupta was a fourth-year surgical resident assigned to Emergency. Sierra had consulted with him on several patients prior to her current E.R. stint and thought highly of him. After he completed his training, he planned to return to his native India and Sierra would be sorry to see him go.

“Sounds good to me.”

Sierra always took pride in making accurate and timely diagnoses, but none more so than when Trey stopped her a few hours later, not long before their shift ended.

“Vijay called,” he said without preamble. “Frances’s appendix was the worst he’s seen in a long time. You’ll be pleased to know he was glad you’d sent her up when you did, otherwise there would have been dire consequences.”

Gracious, but she was blushing again. “It was a team effort,” she said lightly.

“That may be, but I think we should celebrate with a cup of coffee.”

“Coffee sounds good, but I’m not sure the occasion calls for a celebration,” she said. “I was only doing my job.”

The second those words came out of her mouth she realized how much she’d sounded like Professor “Grumpy” Gunderson. After she’d pored over a patient’s medical file for clues about his illness, she’d discovered an obscure fact which had led to a confirmatory test. Her fellow students had been impressed and she’d been proud, but “Grumpy” had raised one eyebrow and sniffed.

“You’re expected to make proper diagnoses, McAllaster,” he’d said in his most condescending voice. “Every patient deserves your best. It’s your job to provide it.”

Now, a question begged to be asked. When had she become so cynical and turned into Grumpy Gunderson?

“Working down here…” Trey interrupted her bleak thoughts as he herded her into the lounge “…we take our victories when we find them. Too many cases don’t have happy endings.”

As if she’d needed a reminder, she reflected wryly as he began pouring two mugs of the strong coffee.

“Black or white?” he asked.

“White.” She fished among the containers for a packet of sweetener and dumped in a moderate amount of powdered creamer.

He leaned against the counter, mug in hand. “Just so you know, our real partying takes place on Fridays, after work. You’ll have to join us. No excuses allowed.”

She thought about the days when she’d ended the work week with the rest of her ED team at a nearby watering hole. Their tradition had been for the most senior member to make two toasts—one to the staff for jobs well done and one to pay tribute to the people they’d lost.

Her finances could surely stretch far enough for her to resume the tradition, even if she honored it only during her temporary tenure in Emergency. While she took pride in her efforts when she’d discharged a patient from the fifth floor, drinking a glass of wine alone in her apartment didn’t generate the same emotional satisfaction as being surrounded by people who’d shared in the experience.

Until Trey had dangled the notion of a celebration in front of her, she hadn’t realized how much she missed the camaraderie associated with a group of her colleagues. Trey had inadvertently reminded her of another part of her life that David had stolen.

Well, no more. She’d come to Pittsburgh to start over, and creating a new routine was part of that. She may not be able to afford more than a glass of tea or a soft drink, but drinking wasn’t the issue. Being with friends and colleagues was.

“I didn’t realize I’d touched on such a deep subject,” he joked. “You looked like you were a hundred miles away.”

“Sorry,” she said, embarrassed at being caught woolgathering. “I was, but you’re right. We should rejoice in our success stories when we can.”

His smile nearly blinded her. “Then you’ll join us on Friday night?”

“Sure, why not?”

“Great,” he said with such enthusiasm that she knew he’d hold her to her decision, no matter what. “We’ll—”

Their pagers went off simultaneously. Sierra abandoned her mug and followed Trey out of the door.

A scuffle at the far end of the hall near the ambulance entrance doors caught her attention. Two police officers were escorting two punks in low-slung jeans and ripped T-shirts, but for every step forward they sidestepped two more in an effort to keep the two street hoods apart. Obscenities flew, along with several wild punches, but it was obvious that not long ago those punches had been landing.

One young man had a swollen, bloody nose and a bloodstained bandana wrapped around his right biceps. The other had one eye completely swollen shut as he limped forward.

Trey sighed. “Looks like the natives are restless.”

“No kidding. I thought they saved their fighting for Saturday nights,” she remarked.

“Around here, any time is a good time,” he answered. “I’ll take one and you can take the other so we can get them both out of here faster.”

“Okay.”

She started forward, but he pulled her behind him. “Stay out of the way until they’re stashed in separate corners.”

Stay out of the way? For a few seconds she stood in amazement at his high-handedness. Did he really think she couldn’t hold her own? She’d gone nose to nose with men who were far more belligerent than these two. Of course, she hadn’t been wearing a dress and heels at the time, but sometimes looking feminine gave her an advantage. Goons like these were often busy ogling her legs and forgot their reason for fighting.

She hurried to catch up, but Trey’s long-legged stride had already put him at the scene. Although she was still half a hallway away, she heard and saw everything.

“Take him…” Trey pointed to the one sporting a bloody nose “…to Trauma One and the other to Room Two.”

“Move it, buddy.” Officer Wright gave his prisoner a not-so-gentle nudge in the appropriate direction. “You heard the doc.”

“Hey, man, don’t tell me what to do.” The guy immediately began swinging.

Instinctively, Sierra knew this wasn’t going to end well. She watched in horror as the situation deteriorated, taking Trey with it.