BY THE TIME Ella finished the splenectomy it felt like she’d run a marathon. Her whole body ached. She was tired, but she had no time to stop as she leaned over the scrub-room sink and rubbed her neck, trying to stretch herself.
Her feet were aching.
She had to stand on a stool to operate. Operating Room Two’s table didn’t go down low enough for her and Mr. Jones was a tall man. Taller than her. Her feet and her were not friends at the moment. They were screaming at her in protest for still working. When she went off she planned to get a good massage.
“You look tired,” Zac said as she leaned against the scrub-room door.
“You’re done?” she asked. Then he frowned and her stomach sank and she understood why he was done. “That bad.”
He nodded. “Even if a cardiothoracic surgeon had been available, there was just too much damage. She wasn’t wearing a seatbelt, the paramedics told me, and her blood was filled with crystal meth. Her tissue was so friable that sutures wouldn’t hold.”
Ella sighed. “Mr. Jones is stable but in the ICU. Splenectomy, and also his labs showed the drug in his system.”
Zac nodded. “I’ll give him some time before I tell him about his wife.”
Ella’s heart hurt. This was the worst part of the job. Especially in light of the holiday. “I’ll go with you.”
“You don’t need to, Ella. You’re exhausted.” There was concern on his face, as if he really cared about her, but she didn’t need his pity.
“I know, but he’s my patient and, it’s not like I haven’t delivered bad news before.”
Zac nodded. “A sad reality to our job.”
“Have you been down to the emergency room?” she asked as she stretched her back. “Do you know how it is?”
“The same as it was before.”
Ella tsked under her breath. “The calm before the storm.”
“Except it’s storming now.” He gave her a half-hearted smile at his pathetic joke and she couldn’t help but chuckle. “At least Charles’s new generator system is holding.”
“That’s something.” And she tried not to think of the chaos caused a couple of months ago, the last time the power had gone out.
“Want to go get some coffee before the fray?” Zac asked.
Ella nodded. “Yes.”
They walked side by side, not touching and not saying a word as they headed to the staffroom where they’d had their first run-in at the beginning of this crazy shift.
“Look, about that kiss...” He cleared his throat. “I’m sorry. I really didn’t mean that to happen. Just exhaustion. As you know, I haven’t been really sleeping.”
“Traumatic experiences can do that. I’m sorry your last tour was so hard.”
“It wasn’t,” he snapped. “I wish you’d let it go.”
“Zac, you had a near meltdown when those lights when out and then at Charles’s wedding...”
“What about Charles’s wedding?”
“The corks popping? You ducked under the table,” she said.
“I dropped my napkin. I don’t recall corks popping.” He laughed. “It’s absurd to think I’d hide from something like that. Really.”
“And the lights-going-out thing?”
“A momentary lapse. I have it under control. Just like the kiss. It was a lapse and it won’t happen again.”
Her cheeks heated in embarrassment. It stung that he was apologizing for something that had been wonderful, even if she hadn’t wanted it to happen again.
Liar.
“It’s okay. It was my fault. As for that not-sleeping thing, do you want to talk about it?”
“No, there’s nothing to discuss,” he said matter-of-factly. “I had a bit of insomnia, trying to get into the routine of working at Manhattan Mercy and living in New York again and not on a naval base or on a ship.”
“I bet that’s quite an adjustment,” she said, pushing him, and when he frowned at her, his eyes narrowing, she realized that perhaps she shouldn’t push him too far. Although there had been a time when they’d been younger when she and Zac had shared a lot.
This closed-off attitude...this wasn’t like Zac.
How do you know? You didn’t think Zac could hurt you like he did, but he did. He humiliated you. You don’t know him.
“It is.”
“Okay, but I’m here if you ever need to talk.”
“Thanks.” There was no sincerity in that remark. He wasn’t grateful, his tone was annoyed. And she knew there would be no discussion. Zac had thrown up a wall.
Even when they’d been young, there had been a wall. He’d hidden his emotions well. He’d played with a poker face, which was why she’d been duped all those years ago. For a brief moment she’d seen past the rebel and she’d got to see a glimmer of what she thought was the real Zac Davenport, the one she’d known before he’d become a teenager and a man, but after he’d humiliated her, she hadn’t known what to believe.
She didn’t trust him.
And she was having a hard time trusting him and his surgical abilities right now.
What if something else set him off?
Another loud noise?
He says he’s cleared.
Still, she knew what she’d seen at Charles’s wedding.
But she really had no proof so she could pull him.
The staffroom was thankfully empty and she poured herself a cup of tepid coffee and dumped a lot of sugar into it. It was probably more than was good for her, but she needed the boost. She sank down in the same chair she had been in earlier.
“Well, at least there’s no nurses lying in wait with plastic mistletoe like this morning,” he joked.
“They’re two emergency room nurses. Do you even remember their names?” she challenged.
“Uh, no...”
She shook her head. “You should get to know your staff better.”
He crossed his arms. “Oh, and what’re their names, then? Do you remember?”
Damn.
She always referred to them in her head as gold-digger one and two.
“Carol and...”
Zac grinned smugly. “You don’t know. Now who’s distancing who? You should really know your staff better.”
“I don’t distance myself from anyone.”
“Yeah, right. Those interns are terrified of you. You’re so formal. There’s a wall up around you, Dr. Lockwood.”
You’re one to talk about walls.
But she kept that thought to herself.
“I could easily page them and they’d be here in a flash,” she teased, changing the subject.
“No, thanks,” he said, and he sat down with a sigh, craning his neck to watch the snow still swirling and blowing outside. “Want to make a bet?”
“What?”
“Remember when we were younger we’d make bets? Like how long would it take for Charles to notice how many spitballs I could launch at the back of his head or who could outrun my brother Elijah after we prank-called his girlfriend?”
Ella chuckled. “Right, and we’d wager things like candy and stuff. I don’t have any candy.”
“How about a dare?”
She cocked her eyebrow. “Seriously? A dare? What’re you, like twelve?”
“You’re not chicken, are you?” Those blue eyes twinkled.
“No, but I am a professional and I have a reputation to uphold.”
Zac snorted. “Oh, yeah, I heard about that reputation. The bulldog, I believe it was referred to as.”
“Bulldog?” Her voice rose an octave and then she cleared her throat, annoyed by her nickname. “I’m hardly a bulldog.”
“It has nothing to do with appearance. Well, other than your height and the fact that you charge through. Tough.”
“Fine. I like that better.”
“You do have a lot more gumption than you did when you were younger. It’s refreshing.” He was giving her a compliment, but it embarrassed her instead. There was a reason she kept people at a distance and it was Zac’s fault.
It was easier than letting people in.
It was because of the way he’d humiliated her, crushed her hopes. The way he’d brushed her aside so easily that had made her work hard to overcome her debilitating shyness and stick up for herself. In a way she should thank him.
Still, the hurt was still raw, because Zac had been the one person she’d thought would never hurt her. She’d thought they were friends. And then more than friends.
“Medical school was tough. You don’t become a surgeon by hiding in the corner.”
“I never understood why you hid in a corner,” he said.
Don’t you?
“It’s hard to have a voice with a domineering mother.” She cleared her throat and changed the subject, didn’t want to talk about the way she had been. She was no longer that shy little girl in the frumpy clothes. The girl who was never comfortable in her own skin. The girl who was unpopular and shy. “So what did you want to bet on?”
“Snowfall. How many inches do you think?”
Ella snorted. “That’s a pretty pathetic bet.”
“What?” he asked, mildly outraged. “Why?”
“If we’re going to wager dares then you have to make the bet more interesting.”
“Like what?” he asked, leaning forward, those blue eyes and that devious smile making her heart skip a beat.
She drew a total blank. She had to think of something, but a resident knocked on the door.
“Excuse me, Dr. Lockwood?”
“Now’s your chance to prove you’re not so formal,” Zac whispered, but she ignored him.
Ella looked up. “Yes, Dr.—Yes, Ryan?”
The resident looked shocked. “Uh, Dr. Lockwood...”
“You can call me Ella when no one is around.”
Ryan the resident didn’t look convinced. “I have the liver enzyme panel of the patient complaining about chronic cholecystitis.” Dr. Trace handed Ella the tablet.
Zac leaned over her and whispered, “Was that so hard?”
“Shut up,” Ella mumbled, as she took the tablet.
“Pardon, Dr.—Ella?” Ryan asked nervously.
“Nothing.”
Ella frowned when she saw the high number of enzymes in the blood panel. It meant the liver was working too hard and soon it could cause inflammation to the pancreas known as pancreatitis, which was a worse infection than cholecystitis. And if there was a stone, fragments could break off a gallstone, blocking the bile duct or in very rare cases causing the gall bladder to rupture.
“Take the patient down for a CT scan. I need to know if there are stones blocking the bile duct. If the bile duct is clear, prep the patient for an emergency cholecystectomy by starting them on a course of antibiotics.”
“And if there are stones in the bile duct?” Dr. Trace asked.
“I don’t suppose Dr. So is in?” Ella asked hopefully.
“No, Dr. So is stuck in Boston.”
Dammit.
Ella could perform an emergency cholecystectomy as long as the bile duct was clear. If there were stones in the bile duct, the only way to remove them without doing an open laparotomy was to do an endoscopic retrograde cholangio-pancreatography or ERCP. An ERCP was a delicate procedure only done by trained surgeons, involving cutting into the sphincter of Oodi and sending a small instrument up the bile duct to crush or retrieve the stones.
Even then the ERCP came with complications and they weren’t always successful.
“Then we monitor the patient, give them morphine until Dr. So can return.”
“If the patient needs an ERCP, I can do one,” Zac said suddenly.
Ella was shocked. “You can do an ERCP? That’s a highly skilled endoscopic procedure.”
Zac nodded. “I know, but I was trained in a lot of different procedures when I was studying at Annapolis. I did a stint on a medical ship and since the particular medical frigate I was on couldn’t carry as many staff as a hospital that had specialists, surgeons on these ships were prepared for a lot of things. I can also do a crash C-section if need be.”
Ella was impressed and even Dr. Trace was looking at Zac with a gaze of admiration.
“Okay, Ryan, well, you heard Zac. Get the patient started on a round of IV antibiotics and down to CT.”
“Yes, Ella.” Dr. Trace took back the tablet and left the staff room.
“I’m impressed, Davenport. You really are a jack-of-all-trades.”
“Yeah, well, being on duty taught me a lot of things.” His expression changed and his brow furrowed, worry lines deepening, and he crushed the empty plastic cup in his hand.
What happened over there?
“I’m going to finish my rounds,” he said, standing up. “I know you’re here, but I’m officially on duty and I do have some rounds to attend to.”
Ella nodded. “Good. Once I hear about the patient I’ll have you paged, but if the bile duct is clear I can handle a laparoscopic cholecystectomy on my own.”
Zac didn’t look her in the eye. “Okay.”
That was all he said as he disappeared from the staffroom. The jovial, fun conversation was over and he was distant again. The wall was up and she wasn’t sure she should even bother trying to climb it.
Zac would never change.
And she was foolish to think he ever would.
* * *
“That is a nasty third-degree burn you have there. How did you get it?” Zac asked as he examined a patient’s forearm.
“Deep-frying the turkey.” The man winced. “Only my brother’s apartment in SoHo couldn’t really handle my deep-frying. We shorted the fuse and then the fat tipped over. I caught the turkey, though.”
Zac raised an eyebrow. “Deep-frying a turkey is a thing?”
“Oh, yeah,” the patient said. “I always deep-fry the turkey. Granted, my wife makes me do it outside, and we have way more property in Nashville, but my brother and his fiancée insisted we spend Christmas in Manhattan in a cramped apartment that they pay a ridiculous amount for.”
“Yes, that is true. Small apartments and large rents.” The burn would need to be debrided. There was a plastic surgeon resident at the hospital. The least he could do for this poor man was have his burn properly taken care of. “I’m going to page one of our plastic surgeons on call to help clean up the burn and then wrap it. Do you have a way home in this storm?”
“The cabbie could only get me so far and then I hiked in the rest of the way,” the patient said.
Zac nodded. “Well, you can stay here until the storm lets up and they clear the streets. If you’re not from New York you could get really turned around in this storm.”
“Thanks, Doc. I appreciate it.”
Zac turned to one of the nurses who had kissed him under that horrible fake mistletoe, but he couldn’t remember her name for the life of him. He’d berated Ella for not knowing or calling the residents by their first names and now he couldn’t remember this nurse’s name. So instead he plastered on one of those flirtatious Davenport smiles that he used to be famous for. “Nurse, can you page Dr. Onge to assist this patient?”
The smile worked and the nurse didn’t seem upset that he didn’t know her name.
“Of course, Dr. Davenport.”
“Thanks.”
He left the exam room as quickly as he could. He knew that women like that nurse were only interested in him because of his money, his name and his outward appearance. If they knew what a mess he was inside, they probably wouldn’t touch him with a thirty-foot pole.
Yes, they would. You said it yourself: money and prestige.
Prestige and the name. That’s all people saw in him, which was why he had been so adamant to head to Annapolis and get his medical training there, instead of at an Ivy league college. He had seen what marrying for money and prestige did to people in his parents’ circle.
His parents had seemed so happy, but obviously that wasn’t true. Even though he and his father hadn’t seen eye to eye on many things, it had shattered his whole world when it had come out that Hugo had had an affair. He couldn’t take it and instead of staying around for any of the fallout, the navy had been an escape for him. The navy had been his salvation, until that changed, and all he’d wanted was to be back in the safety of his family. Even though he hadn’t thought he deserved it.
Zac loved his family, which was why he’d come back to the fold. After moving through natural disasters and war zones, he’d understood the fragility of life all too well. How precious life was, but he still hadn’t wanted to have anything to do with any woman.
Except Ella.
Ella had been the only woman who had got to him, but she deserved so much better than he could give. He had nothing to give.
You’re afraid, that’s why.
He wanted her more than anything and that kiss in the on-call room had reminded him just how powerful her hold was on him, but he couldn’t have that.
There were no more emotions left in him.
Only nightmares. He felt numb.
And as he stood at the unit desk in the ER, charting, reality melted away and all he could see was the edge of a jungle, the explosions from an air raid, screams and crumbling buildings.
And then the child.
The child was cradled in his arms while the mother screamed out her grief. She was a local who was a nurse and had come to help. The child was well loved around the base. His name had been Rojas.
The child was dead. And the horror of it all...
He’d tried to save that little boy, but had failed. There was nothing he could’ve done. Logically he knew that, but in his mind he relieved that moment again and again.
Heard Consuela’s screams.
His own body was racked with grief as he held a child, broken, lifeless, who he had spent off time with, playing soccer and helping to do schoolwork.
Gone.
A life cut too short.
“Stay with me, Zac. I’m scared.”
“I’m here, buddy.”
Get a grip on yourself. You’re not there.
Zac knew he had to get better control of this. He couldn’t let anyone see him struggling. He’d told Charles he was fine. He’d convinced the Annapolis counsellors that he was fine. The post-traumatic stress disorder didn’t control him. He was still a surgeon above all else.
Maybe it was stupid, but he could work through this himself.
Sure you can. Which is why you hardly sleep.
Zac hurried through his charting and then headed down an empty hallway, where he began to jog the length of it.
The one advantage to the snowstorm was that there was hardly any staff around. No one would question him. No one would notice him down this hallway, running back and forth through a glass walkway where outside the storm still howled, dumping snow on Manhattan.
Even if the storm stopped right at that moment it could take days to shovel out.
He wasn’t sure that he could handle being holed up here for days with no escape. He needed some air. It had become harder to breathe. Zac paused and leaned against the glass, watching the snow swirling. There were times the wind kicked up and he couldn’t even see the buildings that surrounded Manhattan Mercy.
It was like he was alone here.
Trapped.
Of course, that’s the way he always felt. Trapped in his own nightmares. The guilt from not saving Rojas’s life, for leaving his family behind and broken, ate away at him.
The sound of a door at the other end of the hallway snapped him out of his reverie and he glanced up to see Ella’s possible cholecystectomy patient being wheeled up from CT by Dr. Trace.
“Well, Ryan, what’s the verdict?” Zac asked as they came closer. The patient was still out of it. The pain meds they’d given her were doing their job.
“There is a stone in the common bile duct,” Dr. Trace said. “The gall bladder is quite enlarged and the patient is running a fever.”
Dammit. The patient was on the verge of a burst gall bladder or maybe a burst bile duct. It wasn’t good.
“Inform Ella that I will be preforming an ERCP. Have the patient prepped for an endoscopic procedure in the endoscopy suite. Hopefully, all day surgery in the endoscopy suite has been cancelled today due to the weather and we can get our patient in.”
“With Dr. So out of town there were no endoscopies scheduled for today. The endoscopy suite is probably not staffed.”
Zac cursed under his breath. “Tell Ella that I will need her and you to assist me. Also an anesthesiologist to sedate the patient.”
“Yes, Dr. Davenport.” Dr. Trace continued to wheel the patient away.
“Don’t call me Dr. Davenport—that’s my father, my brother and one of my sisters.”
Dr. Trace laughed. “Okay, Zac.”
Zac scrubbed his hands over his face.
You can do this.
Although Charles wouldn’t be happy that Zac was encroaching on Dr. So’s department, but really what choice did they have? This was a dire situation.
This patient was getting worse. The bile duct had to be cleared and the gall bladder had to come out.
There was no choice.
He could save this life. He wouldn’t let another person die if he could help it. He knew the ERCP was a dangerous procedure, but he knew how to do it.
Control it.
Zac closed his eyes and breathed deeply. That’s when he saw Ella’s face. She was smiling at him, in his thoughts. In his dreams. He’d missed her too during those years away. He’d missed her even if she hadn’t missed him.
You are a good surgeon.
You’ve got this. You can save this life.
He had no choice.