Assignment- Baby Page 10
The EMTs hooked Jack up to a portable monitor, which showed a flat line. No heart activity except for when compressions were made. They delivered an electrical shock, causing Jack's body to jump, then waited. This time, the monitor showed the jagged shark-tooth rhythm of ventricular tachycardia. An airway was placed in his throat and an IV started while continuing CPR. They zapped him again, and after a long pause, an abnormally slow heart rhythm of thirty beats a minute—sinus bradycardia—appeared. Amanda's hopes soared at the sight. They placed him on the gurney and rolled him to the ambulance.
Amanda realized she'd wrapped her arms around Hunter and that he held her close. But she needed to be leader and calm the students down, so she broke away.
"How's everyone doing?" she asked.
Heads shook, and worried lines were etched across everyone's brows. Many were dumbstruck, others chattered nonstop, repeating all the events leading up to Jack's collapse.
Hunter closed the distance. He stroked her back and rubbed her burning shoulders. It felt good to have him near.
Dreaded thoughts of feeling responsible for harming one of her patients made her mute. But not Hunter.
"We may have saved someone's life today," he said, addressing the students, reframing the dramatic event and turning it into a teaching opportunity. "If you've never taken a class on CPR, I suggest you sign up for one." He glanced at Amanda.
"We'll be covering CPR in week six," she said, almost inaudibly.
"Week six. Good."
"Just before graduation," she said, already thinking that if she got the opportunity to teach another group she'd see to it they went over CPR the very first week.
Wendy ran back from the ambulance with bright red cheeks and an excited expression. "Jack's coming around."
They all rushed to the curb, and just before the ambulance door shut, the EMT gave the A-OK sign, which made a spring of relief trickle throughout Amanda's tense body.
Everyone, including Hunter and Amanda, cheered, and suddenly tears leaked from the corners of Mandy's eyes. Hunter cupped her face. With a look of pure empathy, he smiled and said, "You did good." Even Sophie squealed and kicked her legs from her stroller.
"Thank you," she said. "We did good."
* * *
"Knock it off." Back in the office that afternoon, Hunter chided Mandy for trying to take responsibility for Jack Howling's heart attack.
"What do you know about failure, Hunter? You've never washed out at anything you've ever done."
"That's baloney and you know it, Mandy."
"Name one thing you've ever screwed up at."
He approached and stared darkly into her eyes. "Us."
Her lids twitched when she realized she'd led him into forbidden territory. "I mean professionally."
"I was sent to boarding school from the time I was eight. My high school was strictly college prep. Failure was not an option. Look, we've been through this before. No one ever expected me to mess up. That doesn't mean I didn't."
"Name one professional thing that you screwed up."
"I wasn't the least bit interested in my dad's health. If I'd watched over him, made sure he'd seen his doctor more regularly, maybe he wouldn't have had a stroke and died."
"I'm sorry, but that wasn't your fault. Your father always kept you at a distance. You finally gave in and let him."
"You've probably got a point there, but it doesn't make me feel any better."
"At least your parents prepared you to go to university." She'd told him a million times how her parents had completely overprotected her. How they'd thought she should be working as a salesgirl at a department store. They had had so little confidence in her academic capabilities. She'd been so psyched out about her abilities that she hadn't even been able to qualify for university without going to the local community college first. "I felt so insecure that I had to give myself pep talks every day during nursing school, telling myself I was as good and as qualified as everyone else. Do you have any idea what it's like to be doubted every step of your life?"
"Then quit doubting yourself." He shook his head, fighting a strong desire to hold her in his arms and reassure her for the thousandth time that she was a natural-born nurse. "Mandy, you're a nurse practitioner. Shouldn't the last laugh be on them?"
"All my doubts came flooding back today. Suddenly I thought, What am I doing, taking these people's lives in my hands? They aren't just subjects in a study. I care about them." She shivered and he wrapped her in his arms. "I never thought anyone would go down in front of us like that. I know the odds are high—some of these people are high-risk for an MI—but I want to help them, not make them worse. They're not just names with numbers. They mean something to me."
"Jack never complained about anything," Hunter said. "He said he didn't feel any chest pain before he went down. You know damn well that sometimes it happens that way."
He'd just gotten off the phone with L.A. Mercy Hospital, where their patient had undergone an emergency angiogram only to discover one hundred percent blockage in a major artery and sixty percent in another. A stent would be of no use. Soon he would be rolled into the OR for a bypass graft.
"If that had happened when he was jogging alone, he'd be dead now, so quit kicking yourself," Hunter said.
"But how could we miss it in our EKG tests?"
They'd gotten out his twelve-lead EKG and twenty-four-hour halter monitor strips and searched for signs of Jack's condition.
Hunter shrugged. "Some really fit people compensate so well for their clogged arteries that they don't have symptoms. Has he ever complained about any chest tightness or feeling odd?"
Mandy shook her head. "Maybe he was covering for himself?"
"Or was in total denial. Either way, he fooled us." Hunter stood behind Mandy's chair and put his hands on her shoulders to rub away the obvious tension. She didn't protest.
"We need to make sure that every one of these participants reports any unusual symptom immediately to us," she said.
"Agreed."
"I thought we'd gone over that." She wove her fingers through her hair and took a deep breath. "I'll have to report this data under risk factors."
"It's a good thing everyone signed a disclaimer."
"Jack was such a fit guy I practically had to twist his arm to sign the consent."
"What made him change his mind?"
"He couldn't participate in the program without signing it.
I think deep down he knew something was going on with his heart. It's just a hunch, but you know…"
"Yeah. Us guys hate to admit to our mortality. My father was a perfect case in point. He denied he had blood pressure problems until he had a massive stroke. His denial killed him."
"What about you, Hunter? Are you hiding anything?"
He laughed at the absurdity. "No more than you are," he said, and wondered why a peculiar expression suddenly covered Mandy's face.
* * *
That evening, Amanda stopped what she was doing at the sound of Hunter's voice. At her bedroom desk, she turned her swivel chair to face him and watched his shadow in the hall. He looked hesitant to enter.
She motioned him closer. When he didn't readily respond, she said, "Come in!" saying "in" as though it had twenty n's.
Hunter ventured into her room, scanning every corner with a sweep of his eyes. It made her a tiny bit nervous. "This is nice," he said. He sat on the edge of her bed and bounced a little on the mattress. "Nice."
"Is that what you wanted to tell me?"
A playful chagrined look changed his handsome face to almost boyish. "No. I thought we should throw some ideas around for Monday's Mending Hearts Club session."
"You must be reading my mind. Here's what I think." Amanda leaned forward, resting her elbows on her knees, lacing her fingers. She'd been contemplating nonstop the morning's dramatic events, and how to smooth things out with the other students. "We need to skip PT on Monday and call everyone together for a debriefing session," s
he said. "Maybe I can bring Social Services in for stress counseling if anyone wants it."
"Sounds like a plan," Hunter agreed.
"And maybe we can give them statistics on the odds of this incident repeating itself. Do you know any stats?"
He hopped up from her bed and pointed to her computer. "Not offhand, but I can find some."
They switched places, and she hovered over Hunter's shoulder while his fingers clicked and clacked across her computer keyboard. She wasn't trying to notice, but his hair smelled great.
Her legs wired with excess energy, she paced. "And we'll give them an update on Jack's condition," she said. "Do you think he's out of surgery yet? Maybe we should call again." She bit at a fingernail.
"Mandy, they said they'll be in touch. And the fact that he was in such good physical condition will make all the difference in the world with his recovery. That's what we need to emphasize. He almost died. We saved him. And once they fix him up, his prognosis will be outstanding."
"Maybe he'll agree to come back and talk to the class when he's out of the hospital—so everyone can see how well he's bounced back," she said, chewing on another nagging hangnail.
"I don't see why not. The way Jack likes to be the center of attention, I'm sure he'd do that."
She stopped pacing and grabbed her forehead. "Oh, God, Hunter. I told everyone right off that the program was meant to help them avoid invasive procedures like angioplasty, but in Jack Howling's case it would have detected his blockage without this trauma."
"No doctor would have ordered an angiogram for Jack according to his heart studies. He had no symptoms. His stress tests were stellar. Maybe if we routinely did echocardiograms after the stress test portion of this program, we would have caught it, but that's not how health maintenance organizations work. So quit trying to find ways to guilt yourself."
She paced in deep thought. "Maybe we should do that for future classes. That is if I get the opportunity and the funding. What if everyone in the group demands an angiogram now?"
"Will you quit worrying? We'll tell them exactly what they'll be in for, show them a film on the procedure, and most of them will reconsider. And if that doesn't change their minds, the sky-high cost of elective angiograms will. Trust me—no one wants to go through it unless it's completely necessary."
Amanda thought about the procedure, so similar to the one she'd need to go through to correct her Wolff-Parkinson-White syndrome, and fought back a shudder. She had several reasons for not wanting the procedure. Could she in good faith recommend it to others?
"I bet Noreen would get one," she said. Noreen was the thirty-five-year-old class hypochondriac, who'd signed on with the Mending Hearts Club without having any of the risk factors for coronary artery disease.
Hunter chuckled. "You may be right about that." He turned to face her. "This program you've created is going to change lives. You're doing a great service for these patients. Now, for the last time, quit knocking yourself."
The phone rang. She rushed to her bedside table and scooped it up before he could say another word.
"Hello?" she said. The heart surgeon was on the line. "Yes…Uh-huh…I see…Oh, that's great! Thank you for calling."
She hung up the phone and gave a relieved smile. "He did great! They wound up doing a triple bypass once they got inside. See? Even the angiogram didn't show all the blockage!"
Hunter clapped his hands and beamed back. Amanda tugged the air and let out a hoot. Without thinking, she ran toward him and jumped into his arms. He caught her, and she threw her arms around his neck, wrapped her legs around his hips. He spun her around in a circle and grinned while she continued to cheer.
The backs of his knees must have met with the bed mid-spin, and he lost balance. The next thing she knew, they'd fallen onto her mattress, with his back down and her straddling his hips.
CHAPTER SEVEN
AMANDA looked down into Hunter's eyes and found them darkened with desire. He held her hips tightly in place over his, and neither of them dared to breathe. She watched his throat lift and roll with a swallow.
"I guess we got carried away," she apologized. He lightened his hold and she backed off from him.
Hunter catapulted off the bed as if it was a trampoline. "Well, it was great news." His intense gaze darted away from her face.
The sudden change in his demeanor both relieved and confused her. "This has been such a crazy day. I hope I can fall asleep."
Oh, that was a mistake. She could clearly read his mind, and his obvious ideas for helping her relax and go to sleep. They stood awkwardly for a few tension-escalating moments, considering the unspoken solution. She'd learned since their divorce that she couldn't handle casual sex. Besides, sex with Hunter could never be casual. Bottom line—neither of them had changed enough to venture into a deeper relationship, and, like it or not, sex would force them closer together.
Nah. Not going to happen. Why mess with the careful balance they'd worked so hard to keep while living together?
Hunter quietly cleared his throat. "A nice long bath might help," he said as he headed toward the door.
She scratched her cheek, where warmth had started to blossom. "Yeah, that's a great idea," she said, toeing the carpet.
"And I'll take a cold shower," he mumbled.
"What's that?"
"I said good night," he lied.
She'd heard him perfectly well.
Realizing it was Friday night, and he'd soon be packed up and safely on the road for home, a familiar empty hole returned to the pit of her stomach.
Hunter almost left the room, but stopped. "I've been thinking…instead of going home tonight, Sophie and I might stick around. Then tomorrow we can go to Mercy Hospital to check up on Jack. What do you think?"
Hunter's earnest support and his presence lifted her spirits more than she cared to admit. "I'd really like that."
Once he closed the door, she grabbed her robe off the bed and headed for the bathroom. She turned on the water spigots.
Even with her going to great lengths to avoid Hunter at every turn, they'd found their way back into each other's arms. How many times, since they'd started living together, had she stopped herself from slipping into old routines? It seemed so easy. After the initial shock of having him living in her home—with a baby, no less!—they'd learned to live civilly. But underneath every encounter, their old sexual connection thrummed. Lately it felt more like a beating drum.
She'd jumped into his arms and thrown her legs around his waist. What had she been thinking? Obviously she hadn't thought at all. When they'd been married, she'd done it all the time. Good news? Jump into his arms. Make love. Laugh. Love more. Work hard. Love more. Dream. Make love. That had been their well-rehearsed routine—until her dreams had clashed with his expectations. It had hurt like hell when he wouldn't fight to keep her. Why hadn't he?
Amanda suspected she knew the reason—because his parents had never fought for him, and he didn't know any different—but she wasn't ready to accept it. They'd dumped Hunter and Jade into boarding schools and kept them at a distance all their young lives until it was time to send them out into the world. How could he learn to completely open up with anyone when he'd never been shown how? And couldn't he ask the same question? Why hadn't she fought harder to stay with him?
With her body still tingling from being so close to Hunter, she slid into the tub. Subtle pulsations clouded her thoughts. One absurd thought popped into her mind: was it really so out of the question to have sex with her ex-husband?
* * *
Saturday morning, Amanda wore her favorite sundress, put on extra makeup and curled her hair. The look Hunter gave her when he first saw her was worth all the extra effort.
They packed up Sophie and headed forty miles south to Los Angeles, and Mercy Hospital.
"Mandy, if you don't mind, I'd like to stop on the sixth floor to see one of my patients. Mrs. Peters is having surgery on Monday, and I wanted to say hello and review h
er chart."
"Sure. I'll watch Sophie. Send me a text message when you're ready to meet in the cardiac unit."
"It may be a while. Her biopsy and thyroid scan confirmed papillary adenocarcinoma, and she's still in shock."
Amanda knew that, of the four main types of thyroid cancer, this was the most manageable. Yet she could totally understand being panicked over getting diagnosed with any kind of cancer and losing such a vital gland as your thyroid.
"Take all the time you need."
While they waited, Amanda took Sophie on a tour of the hospital maternity ward, where she could see other babies through a long window. But Sophie didn't seem too interested in the pink and blue blankets, so Amanda took her to the cafeteria where they shared some yogurt. Glancing around the room, she realized that people probably thought Sophie belonged to her. She sighed. Maybe someday.
They were halfway through their treat when a text message arrived from Hunter. She wiped Sophie's mouth and headed for the elevators to meet Hunter.
Jack Howling had already been moved from ICU to the step-down unit in the cardiac wing by the time she and Hunter stopped by for a visit. The pregnant ward clerk, obviously anxious to practice her mothering skills, offered to watch the baby while they paid Jack a visit.
He sat up in bed, looking pale but sturdy. His silver-dusted blond hair looked grayer than Amanda remembered. He wore the hospital gown backward, with loud flannel boxer shorts, and his chest was bandaged down the sternum with thick white pads and adhesive tape. Evidence of dried blood had been outlined with a pen on the top pad, to help the nurses assess the amount of oozing that continued from the surgical incision.
Only the surgeon was allowed to make the first dressing change. After that the nurses would do the daily bandaging honors. A chest tube containing bright red blood drained into a bedside container. An IV and piggyback bag infused into one of his arms, and another smaller dressing covered the incision in his right leg, where they'd stripped the veins to use for the bypass grafts.
Regardless of the daunting change in his life plans in the last twenty-four hours, Jack Howling seemed happy to see Amanda and Hunter.