No—the young woman was not a nurse. She was an orderly. Jamie had noticed her before, when she’d worked in the emergency room. The orderly was certainly working in the right field; she had a natural talent for noticing patients’ needs. She’d been working in the pediatric playroom more and more often, something Jamie had been glad to see. Sammy was in good hands when that particular woman was on duty.
“Come on, Sammy, give me a burp to make any college frat boy proud.”
Instead, Sammy vomited a substantial amount of formula over the blanket that Jamie had laid over his lap. The formula wasn’t curdled, not even partially digested. What went down came right back up, every feeding.
Sammy had been born with a birth defect, a hole in the wall of his heart. It would be repaired soon, and Sam would grow up never knowing it had been there. That particular birth defect shouldn’t cause feeding issues. Jamie had assumed all this spitting up was normal, but now the orderly—Miss Harrison was her name—had said Sam needed to sit up to drink his bottle.
As he soothed Sam by rubbing his back, Jamie’s medical training kicked in automatically. Consider the options. Eliminate them one by one.
What conditions caused a baby to need to be fed upright? Cleft palate? Jamie tapped his index finger to Sam’s perfect, bow-shaped lips. Obviously, Sammy didn’t have a cleft palate.
Jamie tried to feed Sam a few more ounces of formula, this time sitting him far more upright. It did make a difference. He could feel Sam’s body relaxing as the ounces went down with less struggle. Was this how most babies fed, then? Settling in, relaxing, not fighting to get each swallow?
This time, when Jamie burped Sam, he slipped his finger in his son’s mouth and felt the palate. The roof of the baby’s mouth was there, intact. Of course, this had been checked early in Sam’s life, part of the routine exam American doctors gave all newborns. Jamie had flashed his penlight down his son’s throat more than once. The roof of his son’s mouth was fine, intact on visual inspection. This time, Jamie pressed a little harder, moved a little more slowly, working his way toward the throat, millimeter by millimeter.
Sam objected, but Jamie concentrated as he would with any patient. He kept palpating despite Sam’s whines and wiggles—and then he felt the roof of the mouth give. The palate wasn’t formed correctly toward the back of the throat. It looked normal because the membrane covering the roof of the mouth had grown over it, but there was a definite cleft, hidden.
Miss Harrison had noticed a symptom that Sam’s pediatricians and Jamie himself had missed. Sam had a cleft palate. A very slight, easily overlooked, but definitely malformed palate. One that hindered his swallowing.
Guilt.
If any parent should have figured that out, he should have. He was an M.D., but this was his first child, the first baby he’d ever given a bottle to, and it hadn’t occurred to him that the amount of formula that came back up was greater than normal.
Like the doctor he was, his brain kept working despite the guilt. After the diagnosis, treatment options needed to be reviewed. As medical problems went, this one was simple. Sammy would have to go under the knife one more time, but it was fixable.
“Me,” Sammy whined, reaching toward the empty bottle. “Me!”
“This is what you want, little buddy?”
Jeez, his kid was probably hungry, ready to eat more, now that he could get it down and keep it down, thanks to Miss Harrison figuring out the best position.
“Me.”
“Got it. Coming right up.” Jamie carried Sam into the kitchen, tossing the balled-up dirty blanket into the laundry room as he went, then started the process of opening the can of formula.
Jamie owed Miss Harrison more than a simple thank-you. He could write her a commendation, although the possibility for a raise or a promotion was slim when the hospital was under a strict budget.
“Me.” Sammy grabbed for the freshly filled bottle.
Jamie chuckled to himself. “Yes, this is yours. Trust me, I don’t want it.”
At least his son did well communicating. He was advanced for his age when it came to expressing his needs verbally, as he was doing now. “Me” was an effective way for the baby to say he wanted something. He’d used it earlier today, when Jamie had come to pick him up at the hospital day-care center. Sam had wanted—
Jamie stopped in the middle of the living room.
Sam had wanted Miss Harrison.
Chapter Four
Jamie MacDowell, emergency room physician and war veteran, very nearly chickened out.
Last night’s revelation that Sam was attached to Miss Harrison warranted further investigation at his first opportunity, but when Jamie spotted her sitting alone in the hospital cafeteria, he felt like a boy in sixth grade, ready to turn tail and run rather than sit next to a girl.
The cashier charged the lunch to Jamie’s account. Instead of looking toward Miss Harrison’s table, Jamie made eye contact with the cartoonish scarecrow that was taped to the cash register for the fall. In four weeks, Jamie would be reporting to his reserve unit for two days of military training.
For the next six months, he’d report once a month, train for two days and come back home. Unless, of course, the medical unit was activated and deployed to Afghanistan, or any other corner of the world where they were needed. Jamie would go, and Sam would be left behind.
Sam needed a mother.
With a brief nod at the cashier and a fresh sense of determination, Jamie picked up the plastic cafeteria tray in one hand and turned toward Miss Harrison’s corner of the cafeteria. Sam’s favorite caregiver sat, alone, at one of the smaller tables. She was concentrating on her meal, so Jamie studied her face as he approached. He’d thought of her as plain, but she wasn’t homely. If they shared a house, it wouldn’t be a punishment to look at her across a dinner table. She had even features. Her mouth was compressed into a bit of a frown right now, but her lips were pink and not too full, not too thin.
Not that it matters. Mothers were always beautiful to their children, and this woman might make a good mother. He was here to find out.
“Is this seat taken?”
She looked up at him and froze for a moment, her spoon halfway to her mouth, before she glanced toward the entrance to the physician-only dining room.
“I’m not required to eat in the physicians’ lounge.” He smiled at her and stood there like an idiot, holding his tray. Middle school had never been this uncomfortable. “May I join you?”
She nodded, so he sat.
“Thanks,” he said. “I thought you’d like to know how your dialysis patient was doing today.”
“You mean Myrna?”
Jamie silently awarded her a point in her favor. She knew each child in her care by name. The patients were more to her than their pathologies.
“Was the incision site infected only near the surface, or had it spread outward from her kidney?” she asked.
“It appears to be localized at the incision site. Her kidneys are clear.” Jamie was glad she understood the pathology, however, because his son had his share of medical issues. The kids whose parents were the best informed tended to be the kids who did well. Another point in her favor. “It was caught early, thanks to you.”
“I’m glad to hear it, Dr. MacDowell.”
“Call me Jamie.”
For a split second, she looked at him like he’d just suggested they go somewhere and get naked. Dropping titles could indicate that kind of