Nods were exchanged and hands shaken, but Rachel quickly returned her attention to Lena, noting that her breathing had slowed and her blood pressure had come up slightly. Positive signs.
Finally, she heard the siren they’d been waiting for. “The ambulance is here, Lena. You’ll be in the hospital in just a few more minutes.”
The vehicle stopped in the drive outside, lights flashing. Two emergency medical technicians came across the porch.
Rachel met them at the door. “I’m Dr. Vale, and this is Lena Smith.” She stood out of the way as one of the EMTs knelt by the couch, stethoscope in hand. “She’s in ketoacidosis. I started fluids and gave her ten units of insulin.”
The EMT nodded. “Got it.” The two men proceeded with their standard routine and, in only a few moments, had taken Lena out on a stretcher and put her into the ambulance.
“I want to come with her,” Justino said, following. “Please don’t make her go alone.”
The second EMT shook his head. “Not allowed. Sorry, son.”
The boy staggered, as if he’d been shoved.
Garrett put a hand on his thin shoulder. “You can come with me, Justino. I’ll follow the ambulance. Ford, could you call Lena’s dad to let him know what’s going on? Dr. Vale, I assume you want to come along, as well?” He ushered Rachel toward his truck.
“To begin with anyway. If Lena is part of this community, then I will be overseeing her care to some extent.” He opened the back door for her to stow the duffel on the bench, then held the front door so she could get in.
Once in the driver’s seat, he fastened his own belt and started the engine. “So today isn’t a onetime emergency?”
“I’m afraid not.” Rachel blew out a deep breath. “From all indications, this is a life-changing event.”
“What do you mean?”
“Lena will be under a doctor’s care for the rest of her life. She has juvenile-onset diabetes.”
* * *
THE TRUCK TOOK a sudden leap forward, then slowed as Garrett relaxed his foot. “She’ll be taking insulin shots?” He glanced at Justino in the rearview mirror. The teen was staring out the side window, lost in his own thoughts.
Rachel nodded. “Unless researchers find a cure. They’re always working on it.”
The prospect daunted him. “That’s a real challenge for a young girl.”
“The adults around her will have to help her cope. Are her parents going to be cooperative?”
“Her mother died last year. Since then, her dad has expected Lena to take care of her younger brothers and the house, as well as doing her schoolwork. She’s at the ranch because she’s been picked up for shoplifting several times in Buffalo and Kaycee and even Casper. She was cutting school with some of the older girls who can drive, and they’d spend the day out of town, getting into trouble. Caroline chose her for the camp, hoping it would turn her around so she could focus more on long-term goals.”
“Well, now she has the long-term goal of staying healthy to worry about.”
“I’ll pray for her to develop the strength she needs.”
“I’m sure that will help.” There was no mistaking the sarcasm in her voice.
He sent her a puzzled look. “Why do you say it like that?”
She blew out a breath. “Sorry. I didn’t mean to insult you.”
“I’m not insulted. But I want to understand your reaction. You don’t believe prayer can change events?”
“It might change the person who prays, because I believe in the power of the mind to affect behavior. But otherwise...no. Your prayer won’t call down some unseen power to help Lena deal with her diabetes.”
“You don’t believe in God?”
She didn’t answer for a minute. “I grew up going to church,” she said finally. “I can’t dismiss the possibility of a universal power. But as I observe life on this planet, I don’t detect much evidence of any kind of divine intervention. Good or bad, what happens, happens.”
There was silence as he drove the truck onto the highway exit ramp. “I’d be interested in talking more with you about that,” Garrett said, once they’d merged into traffic. “Meanwhile, we’ll have to work with Lena for the rest of the summer and get her started on the road to managing her condition.”
The doctor shook her head. “A summer ranch camp is probably not the best place for her to do that.”
Her opposition surprised him, but now wasn’t the time for a debate. “We’ll figure that out once she’s better.”
At the hospital, they pulled into the ER parking lot and went to the registration desk. Garrett showed the paperwork that granted him treatment permission, and they were allowed to join Lena in her cubicle. Justino went to the side of the bed and took hold of the girl’s free hand.
“That’s what you need,” Rachel said, nodding at the bag of fluid hanging near Lena’s head. “You’ll feel better soon.”
Lena rolled her head on the pillow. “I want to go back. To the ranch.”
Garrett faced her from the end of the bed. “We’ll take you as soon as the doctors say it’s okay,” he said.
“Lying around being sick at camp is no fun.”
People wearing scrubs came and went, asking the girl questions and drawing blood for tests. A nurse brought some food and urged Lena to eat a little. Finally, a man wearing a white coat over his scrubs entered the cubicle, a medical chart held in one hand.
He nodded at Garrett but then shifted his attention to Rachel. “Dr. Vale? I’m Brad Stevens, from the medicine service. I understand you’re the new doc down in Bisons Creek.”
She gave him one of those bright smiles. “I just pulled in to town today.”
“And ended up at work. That’s the way it goes, doesn’t it? Good call on the diagnosis.” Then he moved forward to stand beside the bed. “Hi, Lena. I’m Dr. Stevens. We’ve run some tests and I have some news.”
Lena opened her eyes to focus on his face. “What’s wrong?”
“You’ve haven’t been well for a few days, have you?” Lena shook her head. “Well, that’s because your blood glucose is very high.”
“I don’t understand.”
“Your cells use the glucose, or sugar, in the food you eat to produce energy and to function normally. There’s a chemical in your body called insulin, made by the pancreas, which helps release glucose into the cells so it can be used. But sometimes there’s not enough insulin. The glucose doesn’t get into the cells and instead stays in your blood. Your cells are starved and you become sick.”
“How do I get better?”
“We’re giving you insulin, and that will make a big difference.”
“Then I can leave?”
“Not right away. We want to watch you for a couple of days, ensure your system returns to a more normal state. And we have to talk about the changes you’ll need to make to manage your health. You see, Lena, your condition is known as diabetes. And you’ll have it for the rest of your life.”
Tears welled up in Lena’s big brown eyes and spilled over to run down her cheeks. “My mother had diabetes. She died.”
Rachel