Maybe she really had grown as a doctor over the past five years, after the anesthesia resident’s nearly catastrophic error and her mistake of not supervising well enough what the guy was doing. An error that had nearly ended up with their young patient dead. Maybe he wouldn’t have been as angry if the teen hadn’t been having the same surgery Gabriel had died from, or maybe it wouldn’t have made any difference at all. But he had to believe that not a soul alive would blame him for being furious and distraught about a member of his staff nearly losing a child’s life through completely avoidable actions.
It was hard for him to think beyond that upsetting day when it came to Annabelle. Hard to give her the benefit of the doubt now, his chest still constricting at the memory of the chaos as they’d struggled to keep the boy alive. Another teenager, this one under Daniel’s watch, nearly dying. Was he supposed to just look the other way? Forget about it? The boy’s family had no idea how close they’d come to losing him that day, a fate that would have changed their world forever.
Some would say he should move on and give Annabelle another chance since she was older and more experienced now. And maybe they’d be right. But he’d already gotten the wheels greased for him to work with a new doc, and for her to do other, still important, work but at a different clinic, far away from him. He would feel under less stress in the OR here, and patients at the new clinic would get Annabelle’s help facilitating the surgeries they needed. So nothing but good would come from his plan.
“You got this?” he asked the team after the patient’s vital signs were normal and he was satisfied the surgery was a success.
“Yes, Dr. Ferrera,” Annabelle said in a cool, professional voice. “Ready to remove the breathing tube and IVs.”
“Good. I’ll be over at Administration, evaluating tomorrow’s patients, making final decisions about who’s on the list and when.”
Annabelle and the nurses all nodded, focusing on the patient, as they should. Daniel stripped off his gloves and mask and went to the other cement block building that served their bare-bones administration staff and doubled as a waiting room/sleeping room combo. Families with children sat on the folding chairs and sprawled on the floor, many of whom he knew had come from miles away. Patiently waiting to be seen, they slept there or outside on homemade blankets they’d brought with them, along with bags of food, since the clinic could only provide bottled water to drink. They waited to find out if they’d be one of those chosen to get well, or be put on the list for the next time a clinic was run. Some looked deceptively healthy, others were visibly ill. Far too thin, too pale, too quiet and motionless for a child to be.
Daniel’s own heart abnormality had always been hidden behind a facade of good health. He’d played sports, he’d skied, he’d seemed fine in every way. With both their heart functions in reasonably good and manageable conditions, it had been decided that surgery on the identical twins wasn’t worth the risk to either of them. That was, until Gabriel’s heart condition had worsened and he’d ended up needing the surgery that had ultimately killed him.
Daniel hadn’t had to face that.
He knew it was possible that things might change. The hole in his heart that both brothers had been born with, and that medical professionals had always kept an eye on, could get larger and more problematic than the simple arrhythmia he had to deal with sometimes. Living with his heart abnormality was a little like carrying around a ticking bomb. It might never go off. Or it could someday result in endocarditis or sepsis. Stroke. Death.
It meant Daniel lived every day as if it were his last and never committed to a forever. No long-term relationships, no children. He simply couldn’t promise anyone that he’d be here on earth for a long time, and it wouldn’t be fair to put a woman or a family through that kind of uncertainty. Through the possibility of future pain.
Twenty years had passed since his brother had died, and time had dulled the intense grief. He and his parents and grandparents still dealt with the kind of deep pain that came from a sudden, shocking loss. The ache would always be there.
Holding in a deep sigh, he moved his gaze from the throngs of patiently waiting families to the front desk, trying to detach himself by focusing on the list of patients there. He shoved down the ache that came with every mission trip, knowing he couldn’t fix everyone who needed it. Knowing that his decisions about who would get on the surgery lists and who wouldn’t meant more worries for the people who loved them. More kids who couldn’t play in a normal way until their hearts were repaired. More who might die if the tests done before he’d arrived didn’t show how serious their situation really was. More whose families might lose them forever if he made the wrong choice.
“May I have the list of possible patients for tomorrow?” he asked the receptionist. With the long sheet in hand, he moved from family to family, child to child. Reading their charts and talking with them about their symptoms. Listening to their hearts to evaluate murmurs and arrhythmias, and to figure out the best course of action to help them to get better.
Hoping and praying he got it all right.
“I think that’s it for the day,” he said in Spanish to the clinic receptionist, who seemed as worn out as he did, and he knew the whole team had to feel the same way. “I’ll let everyone know we’re done until tomorrow morning.”
“Sí, Dr. Ferrera. I’m sure more folks will arrive by morning, and I’ll try to sort them by health priority before you talk with them after surgery tomorrow.”
“Be sure to let me know if any seem critical, and I’ll look at them between patients to see if they need to be fitted into the rotation as soon as possible.”
She nodded, and Daniel bit back a tired sigh at the thought of more patients to evaluate even before the medical team started surgery in the morning. But that was the whole reason they were here, wasn’t it? To see the maximum number of the most ill children was the name of the game.
When Daniel stepped back inside the cement block building that housed the OR, he was surprised to see Annabelle helping Jennifer and Karina wash out the masks and tracheal tubes they’d used for their patients, sterilizing them, then hanging them to dry. Most docs left that to the nursing staff and local tech assistants, and he watched her lean over to dig out surgical items like sponges and syringes from a box he hadn’t seen before.
“What’s all that stuff in there, and where did it come from?” he asked.
“I brought it.” Annabelle didn’t look up at him, just kept laying out items for tomorrow morning’s surgeries.
“Did your hospital donate it?”
“Dr. Richards started a—”
Annabelle sent Jennifer a deep frown, accompanied by a small shake of her head, that had Jennifer quickly closing her mouth.
What was that all about? He looked from Annabelle to Jennifer, then back to see Annabelle intensely concentrating on sorting the equipment. He couldn’t help but wonder what it was that she clearly didn’t want him to hear, and he would definitely be asking Jennifer later when Annabelle wasn’t around to shush her.
“It’s just a few things. Not as much as we’d like to have, but I didn’t have much room in my suitcase and, of course, I had to bring the useless monitor.”
So she was still angry with him about that. Not that it was any real surprise.
“I never said it was useless. I said we’d functioned without monitors plenty of times in the past, and that missing a whole day of surgeries, then being late with a patient already on the operating table and putting us hugely behind schedule, wasn’t worth the time wasted getting one here.”
As soon as he finished speaking, the strident sound of his words made him feel a little ridiculous. It was history at this point, and the woman had worked hard all day with the