Maverick In The Er. Jessica Matthews
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far better than she did. He also had the authority to establish policies and procedures, with or without his immediate supervisor’s approval. If he wanted to handle Frances in his own way, he certainly had the clout to do so.
This also seemed to be a prime opportunity to either build a bridge or a brick wall. She could stick to the hospital rule book, which would earn her brownie points from her superiors, or she could save her energy for more important battles.
On the other hand, if she caved in on this issue, was she setting a precedent? What if ten more people like Frances decided to visit the E.R. for their scrapes and scratches? They’d never have time or space to deal with the heart attacks, the broken bones or the car wrecks.
Would turning a blind eye signal that she was a pushover for a heartwarming story or a special case? The argument could be made that every person coming through the doors had special circumstances necessitating unusual solutions.
Can’t you be flexible for once in your life?
David’s voice whispered the last question and she instinctively stiffened. Unfortunately, his concept of flexibility had been his excuse for taking advantage of every opportunity that had come his way—opportunities that had covered everything from his business activities to moral decisions.
She’d always prided herself on meeting the needs of her patients, so how was this any different? If Frances had been one of her regular clients, would she have chosen differently than Trey and his staff had?
She let out a breath and nodded. “Let’s see Frances.”
Before she could take a step forward, he stopped her.
“If it looks like she has something serious, I want you to take over.”
“Why?”
“Because if I’m busy holding her hand to keep her calm, I can’t do my doctor thing.”
She chuckled at his choice of words. “Can’t walk and chew gum at the same time, eh?”
He rolled his eyes melodramatically. “Ah, now she makes a joke.”
“Sorry,” she said, unrepentant, “I couldn’t help it. Okay, we’ll do it your way. I’ll examine her while you play nursemaid. From what I’ve seen so far, you’re pretty good at handholding and sweet-talking.”
His grin was boyishly wicked. “I’m good at other things, too.”
The sudden flare of heat in his eyes spoke of more physical activities—activities that her imagination so unhelpfully supplied in vivid, living color.
If she was going to work with the delectable Dr. D. so closely over the next few months, she really would have to get more sleep. Exhaustion didn’t give her the mental fortitude to rein in her wayward thoughts.
“I’m sure you are,” she said lightly.
Inside the room, Sierra saw the dark-haired woman curled into a fetal position on the bed. Another nurse, Billie, was taking her vital signs.
“Hi, Franny,” Trey said as he approached the bed and immediately took her pulse. “I hear you’re not feeling well today.”
Frances opened her eyes and offered a weak smile. “Hi Dr. D.,” she said in a singsong voice. “My stomach really, really hurts bad. Can you fix it? “
Her childlike question made Sierra wish for the several-hundredth time that medicine could solve the problem of a child’s mind trapped inside an adult body. Not many people could deal effectively with people with learning disabilities, and she carefully watched Trey’s demeanor. She didn’t know what she was expecting, but she was pleasantly surprised to watch him smile benevolently at Frances while he patted her arm and questioned her about her diet.
As he talked, she herself focused on his sinfully thick dark hair, dark eyes and long eyelashes. She’d never studied him up close and personal before, but she understood how he’d developed his reputation of a dreamboat.
Thank goodness she wasn’t taken in by appealing packages.
“I think I was poisoned,” Frances moaned.
“Her temp is one-oh-two,” Billie interjected.
Trey glanced at Sierra, his humor evident in his eyes. “I don’t think you have food poisoning, Frances. But you are sick, which makes me glad I brought our very best doctor to see you. This is Dr. McAllaster.”
Sierra took her cue to come forward. “Hi, Frances.”
Frances gazed at Trey. “She can’t be the best ‘cause you are.”
He chuckled. “Thanks, Franny, but stomachaches are Dr. McAllaster’s specialty. Will you let her examine you?”
Frances apparently was convinced because she slowly nodded. “If you say so.”
Sierra immediately took over, not surprised by Trey’s ability to gain Frances’s cooperation. He’d obviously been dealing with this woman for quite a while.
“Okay, Frances,” she said softly. “I need you to stretch out for me.”
“But it hurts when I do,” she wailed.
“I know, but I really need you to lie flat.” After much maneuvering and moaning, Sierra gently prodded Frances’s abdomen. It didn’t take long to decide that her problem didn’t have a simple solution.
She turned to Trey. “Do you remember the paperwork you said you didn’t initiate? You’d better start it now.”
Over the next hour, Sierra realized she couldn’t have done her job without Trey. While Frances’s problem had been fairly straightforward, it had taken longer to arrive at the diagnosis because she hadn’t been particularly cooperative. Thank goodness Trey was a salesman at heart. He explained, gave guarantees and promised her everything from watching television to an ice cream if she’d allow them to do one more test.
He saw Frances through the pain of bloodwork and he did so with patience she hadn’t expected—patience that wasn’t contrived.
Neither did he express any great relief to relinquish his task when Frances’s mother arrived. Instead, he simply changed gears from moral-support agent to physician as easily as he flashed his handsome smile.
“Appendicitis?” he asked as soon as he cornered Sierra at the nurses’ station.
“I’m impressed,” she said, amazed at how he’d pinpointed her diagnosis before they’d received any reports. “You really can walk and chew gum at the same time.”
“What can I say? I’m a man of many talents. Plus, it didn’t take too much effort to add lower-right-quadrant pain and rebound tenderness with a fever to come up with appendicitis. I assume her white count is elevated?”
“According to the report that came through a minute ago, it’s eighteen point four. I’ve already called Vijay. He said because it’s such a clear-cut case to save him a trip and send her upstairs to surgery.”
Vijay Gupta was a fourth-year surgical resident assigned to Emergency. Sierra had consulted with him on several patients prior to her current E.R. stint and thought highly of him. After he completed his training, he planned to return to his native India and Sierra would be sorry to see him go.
“Sounds good to me.”
Sierra always took pride in making accurate and timely diagnoses, but none more so than when Trey stopped her a few hours later, not long before their shift ended.
“Vijay called,” he said without preamble. “Frances’s appendix was the worst he’s seen in a long time. You’ll be pleased to know he was glad you’d sent her up when you did, otherwise there would have been dire consequences.”
Gracious, but she was blushing again. “It was a team effort,” she said lightly.
“That