David pulled Janie’s films from the viewer and clicked off the light. After looking through the chart, he walked down the hall and into ICU where he saw Courtney holding her daughter’s hand. The little girl was awake and when she saw him, she tensed.
“Mommy—”
Courtney glanced over her shoulder. Like mother, like daughter. She tensed, too. But he had a feeling her fear wasn’t all about what he had to tell her. On some level it was personal. Instinctive. He wasn’t sure how he knew that, but he’d bet his favorite stethoscope it was true.
Her arm immobilized in a dark-blue sling, she looked back at her daughter. “Sweetie, this is Dr. Wilder. He’s come a long way to look at you and tell us what to do to make you better.”
David walked over to the bed and smiled down at his patient. “Hi, beautiful.”
Janie studied him with her one good eye. It was blue. “Hi.”
Underneath the bandage he knew her shattered cheekbone was dragging down her other eye and there was damage to the eyelid. The long gash on her chin and the injury to her ear were the least of the problems and the easiest to fix. There was a six-hour post-trauma window during which repair work could be done without debriding in surgery to avoid infection. It was simplest for the patient and the clock was ticking.
“If I take your mom away for a few minutes will you be all right?” he asked her.
She glanced apprehensively at her mother, then back at him and her mouth trembled. “Why does Mommy have to go with you? Are you gonna fix the bump on her head?”
David knew the injury didn’t need his intervention and would heal nicely on its own. Courtney’s face would be as flawless as the first time he’d seen her. The fact that she’d refused anything besides basic medical attention in order to remain at her daughter’s side showed selflessness and character and a beauty on the inside where it counted most.
He smiled at Janie. “Your mom will be fine without my help. But I need to talk to her for just a couple of minutes.”
“’Bout me?”
“Yes,” he answered.
“’Bout my face?” Janie asked, a tear sliding down her good cheek. “Mommy said my arm is broken. Is my face broken too?”
Something shifted and stretched in his chest and the feeling made him acutely uncomfortable. A doctor wasn’t supposed to become personally involved with a patient, but some had a way of sneaking through his defenses. Janie Albright could easily be one of them.
“Did your mom tell you that Dr. Ella fixed your arm and that’s why it’s in a cast?” When she nodded, he said, “It’s going to be good as new.” He chose his words carefully. “There are doctors who can make your face good as new.”
“Really?” Courtney asked, hope chasing the wariness from her eyes.
“Really.” He looked at the little girl. “And I need to tell your mom all about that, but it’s pretty boring. Is it okay with you if we go over there?” he asked, pointing to a spot just inside the door. “You can still see her and we’ll be right here if you need anything. How would that be?”
“Okay, I guess,” Janie said uncertainly.
“Do you hurt anywhere?” he asked.
“A little.” She glanced at the cast on her wrist. “My arm.”
“They gave her something for pain a few minutes ago,” Courtney told him.
He nodded. “Give it a few minutes, kiddo. You’ll feel better. I promise.”
“Okay,” Janie said.
David moved away from the bed and Courtney followed, cradling her injured arm.
“You promised to tell me like it is,” she reminded him, as if she didn’t believe he would keep his word.
“And I have every intention of doing that.”
She nodded and winced at the movement. “Okay. How bad is her face? Will she really be all right?”
“Yes,” he said firmly. “Before I get specific you need to know that she will look normal again.”
“Thank God,” she said, breathing a sigh of relief.
“But it’s going to take work.”
Instantly, worry snapped back into place. “Please, explain.”
“The damage needs to be repaired in two phases. There’s a long deep gash in her chin and her ear needs repair. Also a nick near her eye. With facial trauma we like to suture the damage within six hours of the initial injury or the repairs need to be done in surgery.”
Courtney glanced at the clock. “Then there’s still time.”
“Yes,” he agreed. “The second part comes later. Her cheekbone is shattered and the right side of her face needs to be realigned.”
Her mouth trembled, and she caught her top lip between her teeth, composing herself as if by sheer force of will. “Go on.”
“Instead of trying to piece together the bone fragments, it’s my opinion that she’ll have a better outcome with an implant.”
Courtney considered that for a moment. “She’s only six. She’s still growing. Will she need more surgery in the future?”
“Possibly. But let’s take it one step at a time. And the first step is repairing the superficial damage. Since I’m here, I’ll take care of that.”
“I don’t mean to sound mercenary, especially with my daughter’s welfare in question,” she said. Her chin lifted a notch as if fierce pride was in major conflict with her survival instincts. “And I’m grateful that you were able to examine her, but it would be best for Janie to have a doctor who’s covered under my insurance plan here at work.”
“They can do it,” he agreed. “But without a specialist’s training, the results won’t be as favorable. If you want the best possible outcome for Janie, a plastics guy is the way to go. My brother has extended me temporary privileges here at Walnut River General.”
“Does that mean my health insurance would cover your services?”
“No.” But he was here and this child needed his help now. “But I’m the best man for the job, and there won’t be a charge.”
She stiffened. “Charity?”
“Your independent streak is showing. I just want to help Janie.”
A range of expressions crossed her face, all the way from wariness to resignation. She sighed and said, “Thank you.”
“Don’t mention it.”
She looked fragile, vulnerable and more worried and desperate with every word that came out of his mouth. “How long until phase two?” She took a deep breath. “The implant?”
“After the swelling goes down. My best guess is about three to four weeks.”
“Tell me it’s not more complicated than phase one,” she said.
He met her gaze head-on. “She’s going to need surgery.”
“That’s complicated.”
“And someone who specializes in reconstructive surgery,” he confirmed.
“Okay. Three to four weeks.” She nodded and glanced at her daughter, clearly trying to process the information as rationally as possible. “Then I’ll have time to check out my health-care coverage.”
David knew for a fact that there wasn’t a doctor in Walnut River who could do the procedure. “I’d be happy to recommend