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 of work. How did it go, rounding with Alec?”
“He’s a good teacher, of course. I’m sure I’ll learn a lot from him.” She dropped into a chair in Nick’s living room because she thought her legs just might give out if she was on her feet another minute. “But you know how I feel about him personally.”
“Katy.” Her brother’s smile faded. “Alec is a good guy, and I regret that I ever told you what happened. Yes, he went through a hellion stage when there was too much partying and too many of the wrong kinds of women in his life, but that was a long time ago. You need to cut him some slack.”
“Why? He’s not the person I thought he was. I’m allowed to be bothered by that, aren’t I?”
“You thought he was cool and smart and cared about other people. You liked him because he treated you great. And that’s exactly who he is, along with older and wiser than he was back then. Hell, I’m still working on the older and wiser part.”
“Don’t worry, I’m not going to be unpleasant or anything. I just don’t want to be friends with him again, that’s all.”