NICOLA WAITED FOR the explosion. The one that normally accompanied challenging a surgeon’s diagnosis.
Dr. Danvers held up his hand when the intern standing next to him looked like he was going to argue Danvers’s point. “So you’re saying what we saw on the MRI slides is an incidental finding. Care to explain your reasoning?”
How was she going to convince him that the conclusion from two doctors—that the patient’s condition was due to a brain tumor—was really something else entirely? Something a whole lot more simple. Something that wouldn’t involve cutting open the patient’s skull and digging around with a scalpel. It would be easier to let them go in and send off a sample to pathology and have her idea confirmed, but why do that when she could show them another possibility?
Out of the corner of her eye, she saw someone push through the door to the staff lounge.
Great. Kaleb. Just the person she was trying to avoid.
He made his way over to them, and, of course, Dr. Danvers had to fill him in on what they were talking about.
Eying her, Kaleb said, “What do you think it is?”
“A bit of fat.”
Dr. Danvers stared at her as if in disbelief. “Fat.”
“You know it happens. You see something on the film that you don’t like. Something that looks nefarious and assume that it’s the worst-case scenario. We all do it.”
“Sometimes it is the worst-case scenario.” Kaleb folded his arms across his chest.
Was he thinking of his own patient? The one who’d had malignant melanoma? Hadn’t her own brother’s misdiagnoses over the years turned out to be far worse than anyone believed possible?
Something inside of her turned soft as compassion swirled to life. “Yes. Sometimes it is. But not always. Let’s do another scan. With contrast, this time. Surely waiting another day or two won’t make a difference at this point. And if, God forbid, it is a tumor, there’s no sign of it having spread. But if we take another look, using a different technique, we might be able to know for sure. She’s young. Her brain is still developing.”
Kaleb glanced at Danvers. “She’s got a point.”
That surprised her. Especially since his last statement had carried a pessimism that made her chest tighten.
She knew that feeling all too well. But she couldn’t let it cloud her judgment about other cases. If she did, the temptation to over test, over treat, would always be there whispering in her ear. Instead, she was somehow able to push her brother’s case into a little compartment, one she kept locked tight. Except for that one time—when she’d gone to a bar and let it consume her, hoping by drowning it, she could finally come to terms with it. Only she’d done much more than drink that night. She’d let a moment of impulse direct her to a hotel room. A lapse in judgment that she was having a very hard time kicking aside. Especially seeing that lapse standing here in the flesh.
Dr. Danvers and the intern glanced at each other and Danvers finally shrugged. “Okay. Let’s order up another study—with contrast this time—and see what we get. But, I want to be very clear here...if the new scan doesn’t look any different, we’ll be recommending surgery to her parents.”
That was fair. All she’d wanted was a hearing. For them to take a breath before jumping into something that couldn’t be taken back.
Like she’d done with Kaleb? Jumping into something that couldn’t be taken back?
“If that happens, I’ll back you up a hundred percent. But I really feel it’s not a malignancy.”
“We’ll see.” Dr. Danvers and his partner in crime retreated, but not before throwing a pointed look at Kaleb that she couldn’t quite read.
Once they were gone, Kaleb nodded at a nearby table in the cafeteria. “Still taking advantage of every opportunity that comes your way?”
“Excuse me?”
He shook his head. “Never mind. Do you have a minute?”
She tensed. Was he going to bring up the night at the bar or what had happened after they wound up in a hotel room? Oh, Lord, she hoped not. Especially since she’d been thinking about just that when the NYC Memorial’s administrator had been introducing her to people. Then to realize that Kaleb was actually here, at her new hospital... “Sure.”
She dropped into one of the lounge’s seats before her legs decided to desert her. She’d been pretty successful at steering clear of him, not that it was hard in a hospital this size.
“Coffee?”
“Yes, please. One sugar, no cream.” It would give her a minute or two to compose herself after her confrontation with Danvers and his intern. There hadn’t been an explosion, but she could tell both doctors had been irritated with her. But they’d come to her with the question, not the other way around. It wasn’t like she was some ambulance chaser trying to drum up business. If her time at Grace Central was any indication of how things would go in New York, she wouldn’t have to chase anyone. She would have more work than she’d have time for very soon.
He came back with the coffee and set hers in front of her. “So how are things going so far?”
Instead of her tension draining away at the question, it coiled in her gut, squeezing tight. There seemed to be some secondary meaning behind almost everything he said to her. It had to be her imagination. Right? “Things are going fine. It’s all pretty new, though.”
She’d moved into her office exactly a week ago. But in that short period of time, she’d had a couple of run-ins like she’d had with Danvers. She considered it part of her job to question things, to be that little devil sitting on someone’s shoulder.
“Danvers is a pretty nice guy, you’ll find. Quite reasonable, actually.”
Was he saying she wasn’t? “Really? Why would that matter to me?”
He stared at her for a minute or two. “They’re going to be your colleagues, Nicola. Hell, they already are.”
The squeezing inside tightened even more. “Ah. I get it. Don’t challenge the good-old-boy way of doing things.”
“That’s not what I’m saying at all.” He sighed. “Look, I wish you’d been here when that case I’d had landed on my desk. I’m sure Harvey filled you in on what happened.”
“He did, and I’m sorry.” Her brother’s face swirled in front of her, dredging up the sick feeling of horror she’d had. She forced the emotion back to the pit of her stomach.
“It’s why I went...” He shook his head. “Never mind. None of that matters.”
She took a sip of coffee. He wasn’t the enemy. He was trying to help. “Sorry. My answer just now was defensive. So was the way I approached Dr. Danvers. It’s just that it’s sometimes hard to get a hearing, especially if I’m not patting someone on the back and telling them exactly what they want to hear. There are times when, instead of letting them go ahead and do the treatment their way, I have to disagree and speak my mind. It’s why I was hired. And, believe me, it’s not always easy for me. In fact, it’s damn hard, so I know I sometimes come across as a—”
“Hard ass?”
She laughed. “Wow, you don’t pull any punches, do you?”
“No more than you do.”
“Touché. But in the end, my concern has to be for the well-being of the patient, rather than worrying about soothing another doctor’s ego.”
“Which is, like you said, exactly why Harvey brought you in. But that also means there might be some feelings of resentment, in the sense that some might feel the hospital’s administrator is overstepping his bounds—as if he’s looking over their shoulders and busting their chops.”
She hadn’t really thought about it that way. Her opinions had been respected, for the most part, at Grace Central. So to find out there was some animosity toward her at her current hospital was a hard pill to swallow. “What do you suggest I do?”
“Collaborate.”
She frowned. “I thought that’s what I was doing.”
“Is it?”
Looking back at her interaction with the two doctors a few minutes ago, she could acknowledge the brusqueness in her responses. “I guess it’s hard to be challenged.”
“It is. And that works both ways. People tend to mimic the tone they sense in someone else.”
“And my tone wasn’t pleasing to the ear?” This time the words were accompanied by a smile to show she was joking.
He laughed. “Like you said. It’s hard to be challenged. And for the record, I hope you’re right about the patient.”
“Me, too. Especially after what you just said.”
“Looking forward to delivering the I-told-you-so?”
“No. Hoping that a little girl doesn’t need brain surgery.”
He rested his forearms on the table and stared at her. “If you’re right and the MRI image was just a piece of fat, what is causing her diplopia? Or did you already share that with Dr. Danvers?”
“I haven’t seen all of the tests yet. Just the MRI reading. But I plan to review the case tonight when I get home.”
“Why not do it right now? I’d like to see your process.”
“Here in the cafeteria?”
“How about in my office?”
She wasn’t sure how she felt about having someone watch her. It reminded her of his comment about the hospital administrator looking over someone’s shoulder. “My process isn’t all that exciting. It basically consists of me staring at a piece of paper for a long time and then muttering to myself. Repeatedly.”
“That’s okay. I’ve been known to mutter from time to time myself.”
Sudden heat washed up her neck and into her face. She’d been a witness to that muttering. Only what she remembered most were the things he’d said with his lips pressed tight to her throat. Not to mention his...
Oh, Lord. This was the last thing she should be thinking about. Especially since she didn’t want him to know she remembered that night. It was a whole lot easier to just sit here and pretend they only knew each other from work.
Because it was the truth. She knew about his lovemaking—and that was some pretty fantastic stuff—but she didn’t know him as a person.
She still didn’t. And if she were smart she would make sure it stayed that way. Which meant having him watch her work would be excruciating. But if she turned him down, he would wonder why and maybe start asking questions she really didn’t want to answer. Like maybe about a certain night. Or her reasons for being in that bar.
So she’d let him watch. And satisfy his curiosity, she hoped.
Then after they were done, she would steer clear of both Dr. Sabat and her memories of that night in the hotel room.
He’d hoped he was wrong. That he’d imagined she didn’t remember him. But evidently she really didn’t. Once the shock of seeing her had worn off, he’d watched her face for some hint that she was simply trying to hide from Harvey the fact that they’d had a one-night stand. In fact, he’d been mentally rehearsing what to say if she told the administrator they’d already met.
He hadn’t needed to say anything. Her “nice to meet you” had been smooth and polite. And totally believable. Even to him. She had him doubting his memories of that night. Until she bit the corner of her lip, the way she had that night. Whenever he’d done something she liked.
Like lick the little hollow at the base of her throat. Or touch...
Don’t go there, Kaleb.
But as that firm bottom swished back and forth in front of him with each step she took, it was damn hard not to relive those memories. It was also damn hard to understand why this was so difficult. He’d always been able to keep his professional life separate from his personal one. He’d done it ever since his breakup with his ex.
But then again, he’d never had a woman forget she’d slept with him before.
That had to be the difference. His ego was wounded.
One side of his mouth went up. Isn’t that what she’d said? That she wasn’t interested in stroking anyone’s ego? Well, maybe not, but she’d seemed pretty interested in stroking his...
Hell! Knock it off, dammit!
They got to her office, and she unlocked the door and went in, and he finally managed to remove his gaze from her ass and focus on the interior of the room.
It was as stark and unadorned as her words to Dr. Danvers had been. “I like what you’ve done to the place. Looks like you’re making yourself at home.” He couldn’t hide the slight irony behind the words.
She swung around to look at him and then glanced at the space. “I wasn’t actually expecting to have an office, so I decided to wait and make sure this wasn’t some kind of mistake.”
It took him a second to realize she was joking. Well, maybe not the part about having an office, but the rest. “I’m pretty sure you’re supposed to at least put a family photo on your desk, so your patients know you’re not a robot.”
Her face changed in a millisecond, a stricken look coming over it. There was a huge pause. “I’m not a robot.”
This time she wasn’t joking. Maybe his earlier words had stung more than he’d meant them to. “I’m sorry. I never meant to imply you were.”
“I know. You were kidding. So was I.”
No, she hadn’t been. And there was still a strained look at the corners of her eyes. Like he’d said something that had struck a nerve. But he was at a loss to figure out what.
Her lips twisted. “Putting a family picture in here might be a little problematic for me. And my family.”
“Oh?”
“My brother passed away recently, so I’m not quite ready to stare at a picture of him every time I come into this room. To see him smiling and full of life would be hard right now.”
Shock froze his vocal cords for a second before he recovered. “Hell, Nicola, I didn’t know. I’m really sorry.”
“It’s okay.” She pulled in a deep breath, then let it out on an audible note. “It was so...unexpected, and we’re all still grieving. So yes. Complicated to put a picture in here. Do I display one with him in it? Omit him, as if he’d never existed? And if my parents come to visit me at the hospital, it might make things harder on them.”
“I can see how that might.” He wanted to ask what had happened, but it was none of his business, and like she’d just said, it might make it harder on her. His earlier thoughts about the way her bottom swished seemed way out of line in light of what she’d just revealed.
“Anyway, that’s not why you came to my office, right? To admire the decor? Or lack of it?”
No. The only decor he’d admired so far had been her. But that was going to stop right here, right now. It was how he’d ended up in two very bad relationships. It also made him decide not to ask about that evening. Especially since he’d been so shocked to find he’d spent the entire night there. If she wasn’t going to bring it up, then neither was he. After all, what good would it do? And she didn’t seem worried about him saying anything to anyone, so she probably really didn’t remember. Or had her reasons for keeping quiet about it.
“Nope. So how do you want to do this? With me behind your desk? Or you in front of it?”
Her eyes widened. “Pardon me?”
Damn. He was losing it. It had to be the shock of what she’d said. “To look at the scans on your computer.”
Her shoulders seemed to relax in a rush. “Got it. Sorry. I don’t know what I was thinking.”
Well, that made two of them, because he didn’t know what the hell he was thinking, either.
“Let’s sit in front of it. It’ll be easier.” She swiveled her screen around and moved her keyboard in front of one of the two chairs, then grabbed a large spiral-bound notebook off her desk.
Well, the paper and pen seemed a little low-tech, but then again, he liked to write his thoughts by hand and then enter them into the computer later, too. “It seems we agree on one thing, anyway,” he said.
“What’s that?” She came around and sank into her chair, waiting for him to do the same.
“You take handwritten notes.”
She flipped her notebook open to a bookmarked page and set it on the desk, then turned it toward him. “I tend to think in linear terms, and since I don’t have a whiteboard in my office yet, this is how I’m doing it.”
It was actually more of a sketchbook than a notebook, and he saw why. On the sheet in front of him was something that looked like a series of filled-in rectangles with lines going here, there and everywhere.
“This was a case I had at Grace Central.” She pointed at the top row. “I write down symptoms in the order they happen and draw a line toward possible causes. I keep going until the lines begin to converge.”
Her pen moved to the third row, where some of the conditions had only one line drawn to them, while others had multiples. “Then I move the most likely down a row and start all over again, asking the patient questions about other things they may or may not have noticed. Sometimes, after living with some kind of minor irritation for a period of time, it becomes a type of background noise that gets drowned out by the more pressing symptoms.”
He noticed that she’d added hair loss to the new row. He tapped a finger on it. “So this was one of those minor issues she hadn’t noticed?”
“Yes. She started noticing more hair tangled in her hairbrush, along with gradual weight gain, which she attributed to menopausal symptoms.”
“But it wasn’t.”
“I didn’t think so. So we worked our way down to a group of subsets and ran a more narrow spectrum of tests to see what, if anything, it added to our search.”
The test results were added to the graph, and this time the lines all converged on one diagnosis: Hashimoto’s, an autoimmune condition where the body’s cells attack healthy tissue. In this case, the thyroid.
“Amazing. Okay, so I take back the part about our processes being similar. This goes way beyond anything I do.”
“I bet you do other things that are equally amazing,” she said, before her face flamed to life, and she suddenly became very interested in switching between her computer screens.
If he didn’t know better, he’d think there was something more behind those words. As if she might actually remember...
No. It was probably just like when he’d said something that could be construed a different way. Except she hadn’t tried to correct herself and say she was talking about his work.
Good try, Kaleb. It really does bother you that she doesn’t remember that crazy sex you had together.
And it had been crazy. The brusque attitude she now carried around with her at work had been nowhere to be seen. Instead she’d been...
Incredibly sexy. Scorchingly hot.
Unforgettable.
And that last word was the one that bothered him the most. Because he couldn’t seem to shake it off, no matter how hard he tried. Was it just the juxtaposition between the raw sensuality of that night and the chilly aloofness she’d shown him at work? It made for a combination that intrigued him. Made him want to explore that contrast a little more in depth.
But he wasn’t going to. And from her attitude, she would not welcome him asking her out on a date.
And then there was the issue of keeping his personal life separate from his private life. It had been working just fine for him so far. And Snow would laugh him out of town if he knew how he was dwelling on this, especially after that toast they’d made last winter.
Nicola’s voice pulled him back from his thoughts.
“So here’s what we know about Dr. Danvers’s patient so far. She developed diplopia in her left eye about four months ago. Right eye is normal. A trip to an optometrist, followed by an appointment with an ophthalmologist, revealed no structural problems with the eye other than some astigmatism. Before this incident, her vision had been twenty-twenty. It’s still perfect in her right eye, but her left eye has double vision. Enough to interfere with her daily activities.”
He nodded. “I can see why Danvers ordered an MRI. And why he assumed the shadow was a microadenoma, especially since it’s near her pituitary gland. A growing tumor can cause vision problems.”
“Yes. The only thing that bothers me is that a microadenoma of that size shouldn’t cause as much disruption in her vision as the patient has. Now a macroadenoma, that’s a different story.”
Strangely, Kaleb was enjoying listening to her bouncing around ideas. It was no different than the back-and-forth he’d shared with other colleagues, wasn’t it? Except he hadn’t slept with his other colleagues.
“So what else besides a tumor could be causing the problem?” He nodded at the screen. “We have her vision tests from two years ago that show her with perfect vision.”
“Lots of things. Multiple sclerosis. Myasthenia gravis. Stroke. Guillain-Barré—”
“Yes, I’ve seen something as simple as heavy eyelids causing vision changes as people age. But this patient is young.”
“Yes, she is.” She tapped her pencil on the paper of her sketchbook and then started writing up a chart much like the one she’d just shown him. “I hadn’t thought about eyelid weight. Or something else affecting the eyelids. Any mention of chalazions?”
He wasn’t sure if the question was directed toward him, but she was suddenly moving through different doctors’ reports and tests. “Hmm...not seeing it.”
“What does that mean?”
“It means I would like to meet with her and ask a couple of questions. Do you think Danvers would object to me talking to his patient?”
“I can’t see why not. Like I said earlier, he’s a pretty reasonable guy.”
She smiled. “Yes, you did. Right before you told me I wasn’t.”
“I never said you weren’t reasonable.”
“Not in so many words. But I’m pretty good at reading between the lines.”
He held up a hand. “There was nothing there to read, I swear. I only said that you and Danvers were now colleagues and that you might want to take a more measured approach.”
“In other words, be more reasonable?” Her eyebrows went up and she turned to meet his gaze.
“Looks like I’m not going to win this particular argument.”
“Do you want to? Win, I mean?”
He leaned back and crossed his arms over his chest. “Not particularly. Especially not this kind of argument. If I’m in it to win, it needs to have a pretty big payoff at the end.”
“I totally agree. When that happens, I have a fight-to-win, take-no-prisoners mentality.”
He clapped a hand to his chest. “Should I be worried?”
“Not today...” She gave a soft laugh that was very attractive.
He glanced at her face and liked what he saw. It’s what had drawn him to her in the bar. That delicate bone structure and the hint of crow’s feet at the corners of her eyes. It was an indication that she liked to smile. And although he hadn’t seen as much of that particular feature here at work, the evidence was there for all to see.
And she’d smiled a lot that night as she’d sipped her drink.
Then again, so had he. Only his smile had been fake. He’d been shocked by the events surrounding a patient and had needed a drink. Or two or three. By the end of that night, neither he nor Nicola had been under the legal limit, so they’d shared a cab. And instead of having it take them home, they’d made out in the back seat, and then asked the driver to drop them off at a hotel. The rest was history.
Well, his history, since Nicola didn’t seem to remember that night.
Her brother had died. She’d said it had been recent. As in before their night together? Or after it?
On impulse, he leaned closer and covered her hand with his. He realized it was a mistake when the softness of her skin reminded him of how much he’d enjoyed stroking it. Kissing it. He cleared his throat so he could force out the words. “Hey, I really am sorry about your brother.”
Her eyes met his for a long moment, then she said, “Thanks. I appreciate it. It’s been hard. On me. On my parents. He worked with me at Grace Central as a researcher. If we could have known what was coming... Well, maybe things might have been different.”
“How so?”
“I don’t know. We could have talked to him. Tried to make sure he knew that we would always be there for him. That we wanted him there with us.”
A chill went up his spine, a type of déjà vu that never boded well for what was about to follow.
“Had he been sick?”
Her hand shifted under his, index finger hooking over his as if needing to hold on to something. He had a feeling she wasn’t even aware of what she’d done. But it was doing a number on his gut—a strange protective instinct rose up, just like it had at the bar.
“He’d been diagnosed with ankylosing spondylitis.”
“Damn.” Ankylosing spondylitis was a devastating inflammatory condition where bones of the back, or even ribs, could fuse, causing pain and severe loss of motion, sometimes to the point of impeding respiration. “That doesn’t normally carry a death sentence, though.”
“Not directly, no, but for a man who prided himself on being strong and fit—he loved to windsurf, sail and go mountain climbing—it was a life-altering diagnosis. To him, it might as well have been a death sentence. And it ultimately became one.”
“Did he have complications from treatment?”
She gave a visible swallow. “No, Kaleb, he didn’t. Danny died before he ever started treatment. He received his diagnosis, then went home and ended his life. My dad found him the next day when I called saying Danny hadn’t arrived at work yet. I asked Dad to check on him. Something I wished I’d never done, because...” She shook her head. “Well, it’s why having his picture on my desk right now would be so hard.”
His throat squeezed at the pain in her voice and a million thoughts and emotions went through him. It was so eerily similar to what had happened with his melanoma patient. The despair and fear that both of them must have felt. Damn. They’d been caught between a rock and a hard place with what seemed like no way out.
“Damn, Nicola. I had no idea.”
She let out a laugh that was far from amused and took her hand from his, using it to flip through the pages of her sketchbook. Back, back, back she went, stopping at a page and staring at it. “He told me he’d been having some hip and back pain, and so I did up one of my nifty little charts. When I asked if he was having light sensitivity—never dreaming he’d answer yes—my world shifted. Became a dark hole. I wanted to scrub away everything I’d written down and pretend like I didn’t know. Except I did.”
Nicola pointed to a box that had the condition listed. The word no! appeared as a long silent scream on the page. She’d known it was going to be a devastating blow to her brother, especially with what she’d said about his lifestyle.
“Did you break the news to him?”
“No. I—I couldn’t. I referred him to a doctor friend, telling that friend what I suspected. The sooner treatment is started, to knock down the inflammation, the better. Tests were rushed and for once, I prayed I was wrong. I would have given anything to be wrong, Kaleb.”
“I know.”
One shoulder went up in a half shrug, and her chin wobbled. “But I wasn’t.” Her voice lowered to a whisper. “Oh, God, I wasn’t. And Danny...”
He couldn’t stop himself from wrapping an arm around her shoulder and drawing her close. “I can’t imagine how hard it was to realize his pain wasn’t due to simple muscle strain.”
“You have no idea.”
No, he didn’t. His mom had endured a mastectomy and radiation treatments, but he hadn’t been the one who’d diagnosed her, so as hard as that had been, it would have been even tougher if he’d had to do what Nicola had done.
She leaned her head against his chest, and Kaleb’s hand slid under her hair to support her neck, the honeyed strands sliding over his skin like silk. Just like they had that night. The tightening in his throat shifted to somewhere lower, and he cursed himself. Told himself to move away. Now.
But his mind and his body seemed disconnected from each other at the moment.
His ears picked up a sigh, and she murmured against his chest, “Thank you. I’m sorry for blubbering all over your shirt. I’m not sure why it suddenly hit me again.”
“Maybe because I pressed you for information, when I shouldn’t have.”
“It’s not that. Every once in a while it just seems to build up inside of me, looking for an exit. I think that’s why I ended up...”
Her words trailed away for a second, and he wondered if she was going to say it was why she’d ended up in the bar that night.
But when her voice came back, she simply said, “I think that’s why I seem short sometimes when I talk to people.”
It made sense. It also made him feel pretty damn crappy for lecturing her about the way she’d talked to Danvers. A good reason not to assign motive to things he knew nothing about. And she wasn’t being short now. In fact, she was being...soft, approachable. And he liked it. Way too much.
And if he didn’t move away, he might do something he’d regret even more than their night together.
He shifted sideways a bit, so it wouldn’t seem as awkward, then moved his hand down to her shoulder and gave her what he hoped was a reassuring pat or two. She moved back upright quickly. So quickly that it knocked his hand away.
“Sorry, again.” She brushed her hair off her forehead, and the movement was probably meant to cover the fact that she’d swiped the area below her eyes. “And I probably need to get ready for my next consultation, which is in less than an hour.”
“Got it. I probably need to get going, as well.” He pried himself from his chair and stood to his feet. “Let me know when Danvers’s patient has her new MRI. I’d like to know where all your little arrows wind up.”
“I will.” She stood, too.
He moved toward the door, only to have her voice stop him when he gripped the handle to open it.
“Oh, and Kaleb...”
“Yes?” He glanced back at her.
“From now on, I’ll try to be a little more ‘colleaguey’ toward those I work with. Feel free to call me out if I don’t succeed.”
No way was he going to do that. Especially given how he’d felt when she told him about her brother. But rather than argue, he simply nodded and pushed through the door.
As he walked down the hall, he gave himself a stiff lecture, which he quickly counteracted. Nothing happened, so just settle down.
Some good advice, if he’d ever heard it.
The problem was, he’d wanted something to happen. And if he allowed it to, it might be a bigger disaster than that night in the hotel. And she might end up as a third notch on his belt of failed relationships.