KAT was horrified to see the amount of damage the building had sustained when they arrived in the children’s ward. Many of the younger kids were crying, but one older boy had already stepped up to take charge. He’d obviously gathered all the children on several beds located as far away as possible from the crumbled corner of the building.
“Good job, Pedro,” Miguel said as they rushed in. “Where’s your nurse, Elouisa?”
“I’m not sure, but I think she went to get medication,” Pedro answered. Kat was impressed that the boy spoke English and seemed to accept the responsibility of staying here with the children alone.
Miguel’s mouth tightened, but he didn’t say anything else. “Okay, then, we’ll need to transport the sickest patients down to the I.C.U. first.”
“DiCarlo is the worst, I think,” Pedro said, pointing to a boy who was lying listlessly in bed. Kat estimated there were at least a dozen kids gathered on three beds surrounding the obviously very sick boy. “Elouisa said something about how he needed more antibiotics.”
“She should have stayed here with all of you. He can get his antibiotics in the I.C.U.,” Miguel said firmly.
“I’ll take him down, but do you think it’s safe to use the elevators?” she asked warily. She didn’t mind transporting the sick child downstairs but the thought of being stuck in an elevator alone with him was scary.
Just then Elouisa returned, hurrying in with an IV bag in her hand. She came straight over to DiCarlo’s IV pump to prepare the medication.
Miguel said something to her in Spanish, which she assumed was something related to the care of the children. She responded in Spanish as well, even while she hung the IV antibiotic. When they finished their conversation, Miguel turned to her.
“Okay, you and I together will take DiCarlo in his bed down to the I.C.U. Elouisa has promised to stay with the children.” He turned to Pedro. “I am counting on you to stay here and to help Elouisa until I can return, okay? Once we have DiCarlo safe in the I.C.U., we can find other beds for the rest of you.”
Pedro nodded. “I understand Dr. Vasquez. You should have trust that I will wait here for you.”
“Good, Pedro. Thank you.”
“Give me a quick rundown on DiCarlo’s condition,” she said to Miguel as Elouisa used an old-fashioned crank to lift the bed higher off the floor so it would be easier for them to push him. “I need to understand what to watch for.”
Miguel set a small bin of emergency supplies on DiCarlo’s bed, and again she was struck by the similarities between medical care here in Seville and in the U.S. When she worked in the I.C.U., they would always take a small pack of emergency supplies on what they called road trips, when patients needed to leave the I.C.U. to go down for certain X-rays or CT scans. Miguel started pushing the boy’s bed towards the elevator as he gave a brief report.
“What started as pneumonia has turned into full-blown sepsis. He’s been fighting the infection as best he can, but he’s had heart trouble since he was born so he’s not as strong as most children his age.”
She digested that bit of information as they left the children’s ward through a long, empty hallway. As they waited for the elevator, which seemed to take a very long time, she looked down at DiCarlo’s wan features, hoping and praying he’d survive the infection.
Miguel’s impatience was obvious when he stabbed the elevator button a second time.
“Where is everyone?” she asked. Miguel’s features tightened. “We were short-staffed to begin with, but some left, wanting to check on their loved ones. I honestly didn’t think we would lose this many staff members.”
She could understand why some staff had felt compelled to leave, and worry over the safety of her son gnawed at her. She pushed her fears aside. For one thing, Diana would have called her if something bad had happened. Their hotel was new and sturdy. Surely they’d be safe. The elevator arrived and she helped Miguel push DiCarlo’s bed inside. The doors closed and she pushed the button for the second floor when suddenly the boy began coughing so hard his face turned bright red.
“Miguel, he’s having trouble breathing,” she said urgently, reaching for the dial on the oxygen tank and turning the knob to give him more oxygen. “Do we have a pediatric ambu bag?”
“Yes, along with intubation supplies.” Miguel opened the small bag of emergency supplies and pulled out the ambu bag. “We can intubate if we have to.”
She hadn’t assisted with an intubation since the time she’d worked in the I.C.U., but she nodded anyway. She gently placed the small face mask over DiCarlo’s mouth and nose, and used the ambu bag to give him a couple of breaths.
DiCarlo squirmed beneath the ambu bag, fighting her at first, but then abruptly went limp, and she quickly reached over to feel for a pulse. “Miguel? His pulse is fading fast.”
“I’ll have to intubate him now, rather than waiting until we reach the I.C.U.” He took the laryngoscope in his left hand and then gently slid the endotracheal tube into DiCarlo’s throat. She took Miguel’s stethoscope from around his neck and listened to the boy’s lungs to verify the tube was in the correct place. Thankfully, it was. She quickly connected the ambu bag tubing to the end of the endotracheal tube so she could give DiCarlo several breaths.
Miguel secured the tube with tape and then gestured behind her. “Check his pulse and then push the button again. The doors have already closed.”
She’d never heard the elevator ding. She made sure DiCarlo’s pulse was stable before she turned around to hit the button for the third floor. This time it only took a couple of minutes for the doors to open.
She was very happy to see the critical care area. “Which bed?” she asked, as she walked backwards, pulling the bed as Miguel pushed, keeping one hand on the child’s endotracheal tube.
“Twelve,” he directed.
She knew the basic layout of the unit from visiting her sister and quickly pulled the bed towards the vacant room number twelve. Nurses came over and assisted her with getting DiCarlo connected to the heart monitor overheard.
“Gracias,” she murmured, smiling weakly. She glanced up and was reassured to note that DiCarlo’s pulse had stabilized. Miguel spoke to them in Spanish, and they quickly brought over a ventilator. She stepped back, allowing the staff room to work.
Crisis averted, at least for the moment.
She hesitated, not sure if she should go back down to the children’s wing alone or wait for Miguel. He was still examining DiCarlo, and the grave concern in his gaze as he listened to the boy’s lungs wrenched her heart.
Would he look at Tommy like that?
Just then he glanced up and caught her staring at him. She swallowed the lump in her throat, holding his gaze for a long moment. Watching him, the way he was so gentle with DiCarlo, gave her hope and reassurance that he would never do anything to hurt their son. Including taking him away from her.
“He’s fine for now,” Miguel said, putting his stethoscope away. “Give me a few minutes here while I make sure his orders are up to date.”
“Of course,” she murmured, turning away, her hand on her phone. Outside DiCarlo’s room, she made sure she was out of Miguel’s hearing distance before she quickly pressed the number for Diana, holding her breath while she waited for an answer. Diana’s voice brought instant relief. “Kat? Are you okay?”
“Yes. Are you and Tommy safe? Was there damage to the hotel?”
“We lost power for a while, and there seems to be a lot of confusion, but we’re fine. No damage to the hotel that we know of.”
Kat closed her eyes with relief. “I’m so glad. Listen, I have to stay here for a bit yet—will you be okay for a while?”
“Sure. We’ll be fine.”
“Thanks, I’ll check in with you later.” She closed her phone just as Miguel came around the corner of the nurses’ station. She quickly tucked the phone back into her pocket.
“Ready to go?” Miguel asked.
“Of course.” She felt bad for deceiving him, but obviously this wasn’t the time or place for a conversation about his son. As they walked together toward the stairwell, their hands brushed lightly. A tingle of awareness shot up her arm.
“So, maybe I should apply to be a nurse here, huh?” she said jokingly, in a feeble attempt to break the closeness that seemed to grow deeper between them every moment they spent together.
“Are you planning to stay?” he asked, in shocked surprise. The brief flash of horror in his eyes pierced the tiny balloon of hope that had begun to grow in her heart.
“No! Of course not. That was a joke, Miguel.” Ridiculous to be hurt that he didn’t want her to stay. She preceded him down the stairwell, wondering if he’d change his opinion once she told him about Tommy.
She had to tell him about his son. The sooner, the better.
* * *
Miguel mentally smacked himself on the side of the head, understanding from the stiffness in her shoulders and the sharpness of her tone that he’d inadvertently hurt her.
He hadn’t meant to make it sound like he didn’t want her to stay. He’d just been taken aback by her statement, especially after they’d worked together to save DiCarlo. He couldn’t help making comparisons with his mother. Maybe if his mother had been able to work in a career, other than helping his father run the olive farm, she would have been happier.
Could Katerina really be happy in Seville? And why did it matter as he himself wasn’t planning to stay?
He hadn’t slept well last night because all he’d been able to think about had been Katerina. And even now, in the aftermath of a small earthquake, he still wanted her.
But their situation was no different than it had been back when he’d met her in Cambridge. He’d already committed to Doctors Without Borders. He was finally going to live his dream. He couldn’t start something with Katerina that he wasn’t willing to finish.
A tiny voice in the back of his mind wondered if she’d be willing to go with him. But then he remembered Juliet. No, the Katerina he knew wouldn’t pack up and leave her sister. Especially not when Juliet had a potentially long road of recovery ahead of her. Several months of rehab at least.
He pushed thoughts of Katerina possibly going with him to Africa aside to concentrate on the situation down in the children’s ward.
Thankfully, Elouisa had kept her word, staying with the rest of the children. He was glad to see an additional staff nurse had come up to help.
“Which wing can we use as the children’s ward?” he asked, joining the group. “I’d like to keep them together if possible.”
“We can use the east wing of the third floor,” Elouisa informed him. “I too would like to keep them together if possible. How is DiCarlo?”
“Very ill. We had to intubate him in the elevator,” Miguel said. “You were right to make sure he received his antibiotic,” he said by way of apology. He’d been upset to find the children alone, but he understood she’d prioritized the best she could.
“I was hoping to get him to the I.C.U.,” Elouisa admitted. “But you were right, I shouldn’t have left the children alone.”
“Difficult decision either way, so don’t worry about it.” He noticed Pedro was listening to their conversation. He was impressed with how the boy had taken charge in Elouisa’s absence. “Pedro, are you able to walk or would you like us to get you a wheelchair?”
Pedro practically puffed out his chest. “I can walk. I’m fine, Dr. Vasquez.”
He could tell Pedro had some pain, but the boy wasn’t about to admit it. He vowed to make sure Pedro took some pain medication as soon as they were all relocated in their new rooms.
Elouisa gathered up several wheelchairs and between the three of them they assisted getting all the children ready for transport. Pedro helped, as if he were a hospital staff member rather than one of the patients needing to be relocated.
The elevator was too small for everyone to go at once, so Elouisa and Pedro took three children first, while the second nurse, Maria, took two patients with her. Miguel and Katerina waited for the next elevator with their three patients. They were lucky there hadn’t been more patients in the children’s wing.
“Pedro’s English is amazing,” Katerina said while they waited for the elevator. “I’m impressed at how he seems to understand everything we’re saying.”
“He takes learning English very seriously as he is determined to go to America one day,” he admitted. “You’d never know he had a burst appendix last evening, would you?”
Katerina’s eyes widened. “No, I certainly wouldn’t. He’s doing remarkably well.”
“Yes, but as his appendix ruptured, I want him to get a good twenty-four to forty-eight hours of IV antibiotics before he’s discharged.”
The elevator arrived and as they quickly maneuvered the three remaining patients into the elevator, Miguel found himself watching Katerina with awe. He’d always known she was an excellent O.R. nurse but seeing her interact with the young patients, managing to overcome the language barrier with smiles, simple words and hand gestures, he thought her skills would be better utilized in a position where she could care for awake and alert patients on the ward or in the I.C.U.
Or in the Doctors Without Borders program. They needed nurses to work with them, too.
Not that her career choices were any of his business.
It didn’t take long to get the children settled on the east wing of the third floor. The entire layout of the area was very similar to the one where the building had collapsed. Even Pedro reluctantly took to his bed, and Miguel made sure he took a dose of pain medication that was long overdue.
Afterwards, he glanced at his watch, thinking he should go up and check on DiCarlo. But he was hesitant to leave Elouisa here alone as Maria had been called away to help elsewhere. He walked up to the nurses’ desk where Elouisa was busy organizing the charts. “Have you requested additional nursing support?” he asked.
“Sí, but so far Maria has not returned,” she told him. “Thankfully, most of the children are very stable, especially now that DiCarlo is in the I.C.U.”
“True, but I still think you should have someone with you. What if you have to leave the unit for some reason?”
Katerina stepped forward. “I can stay for a while,” she volunteered. “I would just like a few minutes to check on my sister first.”
He nodded, filled with gratitude. Even though Katerina wasn’t licensed to practice nursing here in Seville, she could stay on the unit as a volunteer, offering a second pair of hands as needed. And her knowledge of nursing would be invaluable. He would feel much better knowing Elouisa wasn’t here on the children’s wing alone.
“Why don’t you run over to see your sister, and I will wait here until you return?” he offered.
“Gracias,” she murmured. “I promise to be quick.”
He couldn’t begrudge her the chance to make sure Juliet’s condition hadn’t changed since they’d been up there. “I will need to check on her too, but I will wait for you to return.”
“¿Que?” Elouisa asked, indicating she hadn’t understood his conversation, so he quickly translated for her. “Both of you go and check on her sister,” Elouisa said firmly. “I will be fine alone here for five minutes until Katerina returns. Pedro has been a huge help. He will get help in an emergency.”
Miguel reluctantly agreed and led the way down to the I.C.U., using the stairwell as the elevator was so slow.
“You’re going to have to make Pedro an honorary nurse, soon,” Katerina teased as they walked towards Juliet’s room. “Maybe after all this he’ll decide to pursue a career in medicine?”
He chuckled. “There are not nearly as many male nurses here in Seville as there are back in America.”
They entered Juliet’s room and Katerina immediately crossed over to take her sister’s hand. “I’m here, Jules,” she said in a gentle tone. “Don’t worry, you’re still doing fine.”
Juliet was moving restlessly on the bed, as if she was uncomfortable. Katerina tried to comfort her, talking to her in a soothing voice as Miguel took the clipboard off the foot of the bed and scanned the latest laboratory results and vital signs that had been recorded.
“Miguel?” He glanced up at Katerina’s urgent tone. “Look! I think she’s having a seizure!”