“I know about your experience. I know the conditions you practiced under, because I practiced under similar conditions years ago, with the army.”
And this meant?
“Yes, doctor.”
“I want to make it very clear that this is a different kind of medicine we practice here.”
“That’s what I was hoping.” She tried to smile, but her dislike for him was rapidly growing. Kind of sad, because he was actually an attractive man. Not that she wanted to be attracted to any man right now.
“The thing is, Ms. Tate, on severe emergencies, we stabilize and transport. The cases we have here are uncomplicated. They don’t require any extraordinary measures, as a rule, and they don’t require any creative treatment. I know what it’s like in a field hospital and in a trauma center, and I’m telling you right now, you will follow proper protocols at all times, and you will not step outside your legal responsibilities as a nurse.”
That’s when she began to simmer. Really simmer. Part of her wanted to take him on and ask what kind of yahoo he thought she was, what kind of nurse? Instead she kept her voice level. “Nurse practitioner,” she corrected.
“Nurse whatever, I don’t care. Your experience is all wrong for this kind of hospital, and I want you to be aware of it before you make a decision you have no authority to make. I want you to review protocols to re-familiarize yourself with the proper way to practice medicine. Are we clear?”
“Yes, sir!” she said smartly, when what she really wanted to do was crawl across that bed and shake him until his teeth rattled. Who did he think he was? And how dare he make judgments about her when he knew absolutely nothing about her or the way she worked?
“I will be watching you,” he said sternly. “Now let’s go on rounds.”
She followed him, feeling like a dog on an extremely tight leash, waiting for a command to sit or roll over. A nurse didn’t go on rounds with a doctor, didn’t trot after him this way. A nurse was supposed to be treated as a professional who could read a patient’s chart and follow the orders on it, not as someone who needed to be instructed on every step in the treatment plan, certainly not in uncomplicated cases like these.
With the patients, however, he was a different man entirely. Trying to swallow her anger with him, she watched as he spoke gently to the boy and to the older patients, showing genuine interest in everything they said as he checked them out and entered information about them on the computer that now held pride of place in each room, having replaced the old paper charts.
In the last room, however, things changed. Mrs. Hester Alexander lay on her bed, asleep. She was recovering from congestive heart failure. Her chart showed she had already lost about thirty pounds of excess water, and her urine outputs were subsiding as the edema vanished. Her heart monitor trace showed a slightly altered lambda wave, sure indicator that a heart attack at some point had caused enough damage to her heart muscle to lead to the arrhythmia which had caused the edema. The lady had been drowning in her own bodily fluids, but now was stabilizing at near normal. The arrhythmia was also being treated.
Dr. Marcus moved quietly, gently palpating the woman’s skin to test its sponginess. “That’s good,” he murmured. “That’s excellent. If she’s still doing well tomorrow, we may be able to send her home.”
“That’ll make her happy,” Krissie volunteered quietly. “Earlier she was talking about how tired she is of being here.”
For the first time, David Marcus smiled. “She’s been complaining about everything since she got here. She especially hates the salt-free diet.”
“We talked about that. I made her promise to give it two weeks, and assured her by then she won’t miss the salt anymore.”
At that he faced her. “She has to stay on this diet forever, not just two weeks.”
“I didn’t tell her…” Krissie trailed off as Marcus turned away. Her simmer rose a notch closer to boil.
“What’s that doll?”
“Doll?” Reluctantly, Krissie stepped closer to look across the bed. On the pillow, partially tucked under the blanket, was an awkwardly sewn doll, made of stuffed hopsacking. The eyes and mouth had been stitched of brightly colored embroidery floss. “The family must have left it.”
“It shouldn’t be in the bed. We don’t know what’s in it.”
At once Krissie stepped around him and removed it, placing it on the window ledge. She looked at it, feeling unnerved in some way. “It looks like a child did it.”
David Marcus came to stand beside her. “Yeah,” he said after a moment. “She doesn’t have any small children or grandchildren, though.”
“Maybe something she made when she was a child?”
“Could be.” With that, the doctor turned away, as if he were done with the doll. He typed a few things into the computer. “I want to cut her dose of diuretics by half and see how she’s doing in the morning. Start that immediately, and keep a close eye.”
“Yes, doctor.”
“If, for any reason, the change seems to cause the slightest distress, raise the dose immediately and call me.”
“Yes, doctor.”
Back at the nurses’ station, he began to scrawl notes in manila folders he apparently kept for his personal records. Krissie left him to it, walking the floor again to find her LPNs busying themselves tightening beds and talking to patients…in short, taking the low profile and staying out of the way.
Which told her a lot about Dr. David Marcus. The only question remaining was why he was such a pain. Was he an egotist? A perfectionist? Or was there something more?
And here she’d been thinking that she’d come home to calm and peace and a nursing job that wouldn’t wake her with nightmares. Boy, her dad was going to have a laugh at this. The former sheriff had warned her just last week when she’d finally come home for good, “Krissie, baby, the harder you look for peace, the more elusive it gets.”
Yup, he was going to have a major laugh at her expense.
David Marcus was still at the nurses’ station when she returned. She considered walking past and finding another place to busy herself, then decided that avoidance wasn’t going to solve the problem or make her situation with him any easier. Best to just act like nothing had happened.
She settled into the chair at the station, checking all the monitors and finding everything green. Even Mrs. Alexander appeared to be still soundly asleep. The poor dear probably needed to catch up on a lot of rest after what she had been through.
Dr. Marcus cleared his throat. Krissie reluctantly looked his way.
His expression revealed little, but he said, “I guess I should explain.”
Krissie remained silent. She wasn’t going to give this man an inch unless she had to. He wasn’t the only one allowed to get angry.
“Until about three years ago, I was in the army. Iraq mainly.”
The light in Krissie’s brain began to come on.
He looked down at the folders in front of him. “Ms. Tate, I know what we had to do in those field hospitals. Medicine gets invented under those conditions. And before medical school, I was a medic. I…just know that kind of experience can affect how we practice in the civilian world. Sometimes we do things that could cost us our licenses under normal conditions.”
At that Krissie gave him a nod. No more, just a nod. He was looking at her now, his dark eyes steady.