“Get a CT of his head, chest and abdomen, continue to monitor his neuro status closely.”
“Fine. Let me know as soon as you have some diagnostic results.” He moved away, intending to check on the second patient in the motor-vehicle crash. Richard was assisting the other female intern, Dr. Barkley, with that one, and from what he could tell, they had the patient under control.
Hannah’s patient was by far the sicker of the two.
“Dr. Holt?” Hannah’s familiar husky voice caused a reaction deep down, making him grind his teeth in frustration. He refused to be made a fool of again.
“What?” he snapped.
“The chest X-ray has been completed, but his abdomen is growing more tense by the minute,” she said, pulling aside the hospital gown to show him. “I think he’s bleeding internally. Do you want me to perform a peritoneal lavage?”
He didn’t want to be impressed by her sharp assessment skills, or the way she managed to remain calm in the middle of a crisis. “Have you done one before?”
“Yes.” Even as she responded, Hannah pulled out the peritoneal-lavage tray and began prepping the patient. If she was nervous, she didn’t let on. Once the patient’s skin was prepped, she pulled on a pair of sterile gloves and then carefully measured two centimeters above the umbilicus. Using the scalpel, she made a quick incision.
“Nice job,” he said, before he could stop himself. Once she’d deftly inserted the catheter, she opened up the IV of fluid and then watched, as he did, for the results. He wasn’t surprised she’d been right, when bloody drainage came flowing out. “Guess this guy has earned a trip to the O.R.”
Hannah’s eyes widened a bit. “Right now?”
“As soon as possible. But we need to know the status of his labs before we go anywhere.”
“His hemoglobin is low at ten,” one of the nurses reported. “And he’s not oxygenating very well, either, with a PO two of seventy-eight.”
“Transfuse two units of blood now, and then make sure he has four units of blood on hand at all times.”
“I bet he’s bleeding from a liver laceration,” Hannah said.
“Why do you think that? Why not his spleen?” he challenged.
“His spleen could be the source of his bleeding, but he was on the driver’s side and wearing his seat belt, which means most of the pressure would have been on the right side, over his liver.” Hannah kept her gaze focused on the bloody drainage coming out of the peritoneal catheter as she spoke. “If the injury had been lower, his bowel might be affected, but in that case, we’d likely see intestinal contents mixed in with the blood.”
As much as it annoyed him, he agreed with her. “Yes, we would.”
“So he might need a liver resection?” Hannah asked.
“Possibly, but that depends on the source of the bleeding. Could be a blood vessel and not the organ itself.” He glanced at the nurse. “Where’s the chest X-ray?”
“Right here, Dr. Holt.”
Jake glanced at the chest X-ray one of the nurses pulled up on the computer monitor at the bedside. He frowned and gestured to it. “And what do you see here?”
“A pneumothorax in the right lower lobe.” Hannah finally looked directly at him, her blue gaze seriously intent. “He needs a chest tube before he goes to the O.R.”
“Have you done one?”
There was the slightest hesitation. “I’ve assisted with one,” she murmured.
He was tempted to put the damn thing in himself, but this was a teaching institution and he was obligated to at least give her a chance. “I’ll talk you through it,” he said.
Hannah was already getting the supplies ready. Once the chest-tube insertion tray was open and ready to go, Hannah prepped the right side of their patient’s chest and then picked up the scalpel. She made a one-inch incision between the fourth and fifth ribs, but it was too shallow.
“You’ll need to go deeper in order to get through the cartilage,” he instructed, coming up behind her, to once again peer over her shoulder as she worked.
He hadn’t known who she was when he’d helped her intubate this very same patient, but now it seemed as if every one of his senses were on red alert. Being this close was difficult. The familiar vanilla scent of her skin tormented him.
He watched as she took a deep, bracing breath and then ran the blade through the incision again, going deeper this time. Then she used the tip of her finger to make sure the opening went all the way through. Using the trocar, she inserted the chest tube into the opening.
“Suture it in place,” he said, forcing himself to step back. Distance. He needed to keep as much distance as possible. “We don’t want that tube coming out on the trip to the O.R.”
“Will do.” The look of satisfaction on her face almost made him want to smile. Almost. “Will I get a chance to scrub in on this case with you?” she asked.
The softening he’d felt toward her quickly evaporated. This was exactly what she’d wanted, wasn’t it? This was why she’d set him up at the marina bar, Shipwrecked, and had flirted with him.
Because she’d wanted to advance her career. He could see the plan she’d formulated in her mind—get intimate with the attending and receive special treatment.
“Not this time, Dr. Stewart,” he said bluntly, even though in reality this was the best procedure for an intern to scrub in on. But too bad. He needed an assistant, but he’d get Richard to come into the O.R. with him.
The flash of surprised hurt in her gaze almost made him change his mind. But she forced a smile. “I understand.”
Did she? Because he sure as hell didn’t.
Images flashed through his mind, the way he’d taken her frantically up against the wall. And then again, when he’d gently tossed her onto his bed and she’d laughed.
Damn, but she was beautiful. So full of life. A breath of fresh air compared to the other women he’d tried to go out with since the fiasco with Allie. The moment he’d seen Hannah, the instant flare of attraction had stunned him speechless.
Discovering she’d played him for a fool was a cruel twist of fate.
“I’ll just observe, then,” she continued, as if he wasn’t in the middle of an internal war.
“Fine.” He turned to find Richard, knee deep in assisting the other intern, Andrea Barkley, with a full-blown trauma resuscitation on their second patient. He scowled. What in the hell had happened? The patient had been stable last time he’d checked. But as he watched for a few minutes, he knew that he couldn’t drag Richard away from this case. Not now.
Resigned, he turned back to Hannah. “Actually, I will need your help in the O.R. after all.”
“Really? Thank you!” she exclaimed earnestly, her eyes bright with excitement.
For a moment he railed at the unfairness of it all. She looked so enticing. So eager to learn. He tore his gaze away with an effort, and then turned his attention back to his patient. If he could get the internal bleeding under control, this guy would make it.
This should be his priority right now. Saving James Turkow’s young life. Not worrying about Hannah’s ulterior motives for sleeping with him.
One month, he thought grimly. He’d be forced to work with her for one month. Surely he could manage to keep his professional distance from her for a measly thirty days.
* * *
Hannah was proud at how well she managed to hide her internal emotional turmoil