“Technology is an amazing thing, Todd. But it can’t replace hands-on doctoring, which is the single most important thing I want you to learn on my rotation.” Alec studied the expressions on the faces before him. Smug understanding from Elizabeth, who’d heard it more times from him than she wanted to, he was sure, and also liked to play suck-up to the doctor evaluating her. Skepticism from Todd. Bewilderment and confusion from Michael. And avid concentration and focus from Katy’s big blue eyes, which made him wish he could pin a gold star on her before rounds had even begun.
The thought sent his gaze to the lapels of her coat and the V of smooth, golden skin showing above her silky blouse, and he quickly shifted his attention to Todd. She was his student, damn it. And perhaps someday again his friend. But thinking of her as a very attractive woman? An absolute no-no.
“We’ll be seeing patients who had surgery the past couple of days,” he continued, keeping his eyes off Katy. “But first we’ll see Mrs. Patterson, on whom tests were run yesterday. I know you’ve made your work rounds, so a lot of what I’m going to say will be a repeat of what you already know.”
Alec led the way toward Helen Patterson’s room with the group of students following behind. Katy was closest to him, and her light, fresh scent seemed to waft to him, around him, pleasing his nostrils so much he picked up the pace to put another foot or so between them.
What kind of doctor was distracted by someone’s sex appeal while in the middle of work? Not the kind of doctor he demanded he be, that was for sure. Not the kind of doctor he’d been at one time, long ago when he’d been younger and stupid.
“Dr. Pappas, will you tell me about this patient from your work rounds this morning?”
“This is Mrs. Helen Patterson, and she has been in a rehabilitation nursing facility for one week, post-op after surgery for a broken hip,” Katy said. “She was admitted here yesterday for abdominal pain and referred to the surgery service. She had low blood pressure and her lactate was elevated.”
Katy licked her lips nervously, and Alec yanked his gaze away from them. He tried to simply listen and not notice the serious blue of her eyes as she spoke. “We ordered a CT scan of her belly, and there was no evidence of perforation in the bowel or appendicitis. We observed her overnight, gave her IV fluids and pain meds and she has spontaneously improved. We’ve determined that she has a mild case of ischemic colitis. She had a normal breakfast, and her physical exam is normal, so she can be released today.”
Her expression was both pleased and slightly anxious, and Alec hoped he wouldn’t have to remind her about the low potassium he’d read about in Mrs. Patterson’s chart, and that the repeat potassium was still slightly low. “And?”
“And her potassium was low this morning, but I gave orders that brought it up.”
“Except that those orders were all wrong, Dr. Pappas,” Elizabeth said. She had on her usual superior smirk that Alec had tried, with limited success, to get her to tone down when talking to less-experienced students. “You gave her forty mils to drink, which is way too much to give orally. How did you expect someone to drink that amount? I can only imagine how nasty it tasted to poor Mrs. Patterson. No surprise that she vomited it up and had to be given some intravenously to replace it.”
Katy’s smile froze, and all color seeped from her face, then surged back to fill her light olive skin with a deep rose flush. “What …? I … Oh. Oh, no! I didn’t order forty mil. I ordered four ml!”
“Really?” Elizabeth raised her eyebrows. “Nurses sometimes mishear an order, but it’s still your responsibility—”
To Alec’s shock, Katy turned and tore into the patient’s room, and he quickly followed. What in the world was she doing?
She slid to the side of the patient’s bed and reached for the woman’s hand. Katy’s expression was the absolute picture of remorse. “Helen, I didn’t know it was my fault you got sick to your stomach this morning. I feel terrible! I guess the nurse misheard me and gave you way too much to drink. That’s why you vomited. I’m so, so sorry.”
Alec was torn between being impressed that she instantly took responsibility for what technically wasn’t her mistake, and concern that the patient might get angry and let loose on her. He stood next to Katy, placed his hand on her back to let her know he was there to support her. “It’s unfortunate that orders get confused sometimes, Mrs. Patterson. You’re feeling okay now, though, aren’t you?”
“Yes, it was just an upset stomach. Don’t be angry with dear, lovely Dr. Pappas, now. She’s such a good doctor. Everyone makes mistakes once in a while.”
Dear, lovely Dr. Pappas? Alec smiled in relief. Obviously, the woman liked Katy and wasn’t going to create a stink about the error. He glanced at the residents standing at the end of the bed and almost laughed at the variety of expressions on their faces. Michael was wide-eyed, Todd scowling, and Elizabeth fuming. Having been raked over the proverbial coals often during their training, the two more experienced doctors had obviously been hoping for the same for Katy.
“I’m glad you’re feeling better.” He looked at Katy and, luckily, she understood that he wanted her to stop holding the woman’s hand and stand next to him in a more professional manner.
“Helen, as you can see, I have some interns and residents here with me this morning. Is it all right if they stay while we talk?”
“Of course, that’s fine.”
“Thank you.” He proceeded to ask her questions and explain tests that were run, while palpating her abdomen and listening to her heart and lungs. In the midst of it she held up her hand and interrupted.
“Wait a minute.” Helen frowned at him. “First, why don’t you warm up that stethoscope before you press it on my skin, like Dr. Pappas always does? That thing is cold!” She shifted her attention to Katy. “And why is he asking me the same things you asked me already, dear? Don’t you two talk to each other?”
Katy laughed a little, and glanced at him with a smile in her eyes that felt like old times, making him smile, too. “It’s just how it’s done when we’re being taught by the attending physician, Helen. I know it’s kind of annoying but Dr. Armstrong is an amazing surgeon. I promise you’re in good hands.”
How absurd that her words, which were just to reassure the patient, made him almost feel like puffing up his chest just like the teen Alec who’d always appreciated her faith in him. Helen nodded and waved her hand. “Fine. Carry on.”
“I appreciate the endorsement, Dr. Pappas.” Alec could hear warmth creeping into his voice as he spoke and concentrated on cooling it. On sounding professional and impartial.
Katherine Pappas was his best friend’s little sister and his own student. He had to make sure no one thought they saw any kind of favoritism in the way he interacted with her.
The term “bone-tired” took on a whole new meaning after all-night call with minimal sleep followed by a long day of rounding and scut work. Katy thought she’d worked long and hard in med school, but that had been a veritable party compared to this.
As she stepped through the front door into Nick’s living room, he emerged from the kitchen. “Katy-Did, you’re finally home! You look beat.”
“Now, there’s a surprise. I’m sure I look every bit as hot, sweaty, and wrinkled as I feel.”
“Living hot, sweaty, and wrinkled is an intern’s existence pretty much. Sometimes it’s a general surgeon’s existence, too.” Nick grinned. “I knew you’d be exhausted, so I’m fixing dinner. You don’t have to do a thing.”
“Aw, you’re the sweetest big brother anyone could ever have.” She gave him a quick hug, hoping she didn’t smell too bad. “What are we eating?”
“Steaks from the grill, baked potatoes, veggies. To celebrate your first day, and because you probably need iron and protein after practically twenty-four hours