Back To You (A Remington Medical Contemporary Romance) Page 11

  “Good morning,” she said as professionally as possible, seeing as how whatever was in the bag smelled like cinnamon and spice and pure fucking heaven.

  Parker, already decked out in scrubs and his doctor’s coat, stepped in next to her. “The lady who owns the bakery by my apartment was running a special on these nine-grain pumpkin muffins. I’m usually a little skeptical of anything with more than five grains, myself, but as it turns out, they’re freakishly delicious. I’ve got an extra. It’s got your name on it if you’re hungry.”

  Charleston bit back the urge to give in to both the offer and Parker’s flirty little smile. Godzilla. Be Godzilla. You’ve got this. “No, thank you,” she said, all business. “I already ate, and we’ve got patients waiting.”

  “Oh.” Parker lowered the bag, his smile fading slightly. “Okay. What’s up first?”

  “More like, what’s up first, second, third, and fourth. The ankle injury in curtain one needs films”—she held up the tablet, tapping her way into the chart—“the lacs in two and four need sutures”—two more taps—“and I hope you don’t like those shoes very much, because the guy in three”—one last chart flashed over the screen—“looks an awful lot like food poisoning.”

  Before Parker could add words to his brows-up expression, Don interrupted. “Looks like we’ve got two more pukers who ate at that all-you-can-eat place last night, too. Where do you want ’em?”

  “Exam one and two,” Charleston said, grabbing a trauma gown and passing it over to Parker. “Grab extra emesis basins from the supply closet, would you, Dr. Drake? It’s going to be a long shift.”

  The last ten hours had been one hell of a lesson in Be Careful What You Wish For. Charleston’s muscles ached, her stomach growled, and her bladder reminded her that they were at least two hours too late for a date with the ladies’ room. But she’d started today’s shift in the weeds, and things had only gone downhill from there. Between the food poisoning patients (there had to have been two dozen of them total) and the regular flow of illnesses, injuries, and traumas on top of them, she’d had to juggle the patients on the board like a circus clown, putting Parker and all of the residents to the test. They’d had to divide to conquer—not her favorite method by half, but today, it had been necessary. She’d assigned Parker to the cases she’d been confident he could handle with minimal supervision, which meant he’d pretty much been on puke patrol all day. Much to her surprise, he hadn’t complained, at least not out loud. He’d simply treated and monitored the patients she’d passed off to him per the protocol she’d set. He’d even managed to start a couple of IVs in patients who were pretty dehydrated, to the point that Charleston had even overheard Kelly tell a couple of the other nurses how impressed she’d been with his technique.

  Against all odds, Parker Drake was becoming a man of his word. Not to mention the best intern in his class.

  Which meant Charleston had more reason than ever to keep things all business between them.

  “Dr. Becker?” Connor came running down the hall from the nurses’ station, and whoa, she’d never seen him so serious. “Just got a call from Ambulance Twenty-Two. They’re en route with a thirty-two year old woman, forty weeks pregnant. Vaginal hemorrhaging. ETA two minutes.”

  Tess. A ripple of fear, cold and clammy, moved up Charleston’s spine, and she reached into her pocket for her cell phone.

  No messages. No texts.

  She exhaled in a burst of relief that was immediately followed by a swift mental kick right to the ass. She knew better than to trust something as wonky as a gut feeling, especially from a gut that hadn’t been fed more than a granola bar since breakfast. She needed to focus on what she knew, what she could quantify and trust.

  Charleston stuffed her arms into the trauma gown she’d automatically plucked from the box of them at the supply station by the door to the ambulance bay. “Clear trauma four. Page OB and make sure we have four units of O-neg ready to go, just in case. Where’s Drake?”

  “Last I saw, he was taking the wrist injury in curtain two up to radiology for films.”

  “Good. He and the residents can hold down the ED while you and I take this.”

  “Copy that,” Connor said, already reaching for the phone.

  Charleston measured her breathing with a series of slow, steady in-and-outs, checking her phone one last time as she moved toward the ambulance bay. Her text stream with Tess looked exactly as it had when they’d ended it this morning, and she forced her composure all the way into place. There were hundreds of pregnant women in Remington Memorial’s call radius. Logic dictated that Tess was almost certainly at home, having dinner and grumbling about her swollen ankles.

  So, why were Charleston’s palms so damp?

  The red and white strobe lights and diesel growl of an incoming ambulance interrupted her thoughts. Ditching pleasantries, Charleston reached for the rear door latch the second the thing came to a halt in the ambulance bay.

  “What’ve you got?” she asked, lasering her attention to the patient on the gurney even though all she could readily visualize was the fact that the woman was lying on her left side, a blanket covering her baby-swollen belly.

  A male paramedic with a nearly shaved head and light brown skin slid to the head of the gurney, unlocking the mechanism beneath it as Connor did the same at the foot, both men working in quick tandem to get the thing out into the ambulance bay. “Thirty-two year old female, forty weeks pregnant, low but steady vaginal hemorrhaging.”

  He rattled off the woman’s vitals and symptoms as his partner, a blonde woman whose nametag read Q. Copeland, rounded the back of the rig to join them. Charleston processed the information, ordering the facts into a mental flow chart. What she knew. What she wanted to know. What she could rule out.

  But all of those facts shrank back violently as the gurney wheels clacked to the pavement and Charleston saw the patient’s face.

  “Tess?” Oh, God. Oh, God, no, no, no. Horrific fear gutter-spiked into Charleston’s chest, but no. She couldn’t let it last. She had to move. “Okay, honey, I’ve got you. Talk to me.”

  “Charlie! Thank God.” Tess’s face was drawn and pale, her voice barely grading above a whisper. “I had some cramps at maybe four-thirty? Felt like shit, so I went to lie down. Then about a half an hour ago, I started bleeding. Not a ton, but enough. My water hasn’t broken, though.”

  Alec, whose presence Charleston belatedly registered, interjected, “I wanted to bring her in myself. It would’ve been faster. But she insisted on the ambulance.” He frowned. “They took forever.”

  “Quinn and Luke only took twelve minutes,” Tess argued weakly, lifting her chin to look at Charleston. “I wanted the baby’s vitals.”

  The uncharacteristic vulnerability in Tess’s voice jabbed Charleston right in the throat. Focus on the facts. Treat your patient. Right fucking now.

  “Calling nine-one-one was smart,” she told Alec as they hustled from the ambulance bay into the trauma room. “These paramedics know what they’re doing, plus they were able to keep her stable on the way.”

  The blonde paramedic—who must be Quinn—eked out a smile. “The baby’s heart rate is steady at 142. We started Dr. Michaelson on saline and stabilized her to try and control the bleeding.”

  Charleston nodded. “Okay, everyone,” she said as they all came to a stop beside the gurney in the center of the trauma room. “We’re going to do this nice and easy, on my count. One, two, three.”

  She flexed her muscles for the lift and pull, moving in time with Connor and both paramedics to get Tess moved from one gurney to the other as gently as possible. The routine and rhythm, the reflexive order of treating a patient—even if that patient was her best friend—stamped out another corner of Charleston’s fear. Facts, facts. She needed facts.

  She could not let anything happen to this baby.

  “Are you having any contractions at all?” Charleston asked, once Tess was settled on the trauma gurney and the paramedics had slipped quickly from the room with the gurney they’d used for transport.

  Tess shook her head. Damn it, she was the color of the sheet beneath her. “No. I don’t think so. My pain is a three. Mostly achy cramps, nothing localized. No nausea or vomiting.”

  Oh, but she knew the drill. Charleston ordered the symptoms and vitals in her head again, her stomach clenching. “And you called your OB?”

  Alec spoke up from the spot where he’d been hovering by the trauma room door. “He’s meeting us here.”

  “Good. Let’s take a look and see what we’re dealing with in the meantime.”

  Despite her dread, Charleston knew she didn’t have the luxury of either a pause or any emotions whatsoever if she wanted to keep Tess and her baby stable. She lifted the blanket covering her best friend’s lower body, steeling her expression and choke-holding her adrenaline into submission at the sight of the bright red blood staining the lap pads the paramedics had placed between Tess’s legs, along with the gurney sheet beneath her.

  Facts. Facts. FACTS. “Connor, can I get a few more lap pads, please? And let’s get a portable ultrasound and a fetal monitor in here, too.”

  Charleston kept her voice as neutral as possible, and if the patient had been anyone other than Tess, she’d have probably pulled it off.

  But Tess had always been able to see right through her. “It’s an abruption, isn’t it?”

  The last thing Charleston was going to do was bullshit her best friend, especially when Tess knew better, anyway. “It looks like a partial, yes.”

  “Oh, God.” Tess cranked her eyes shut.

  Alec looked at Tess, his perfectly groomed brows tugged low in confusion. “What does that mean? A partial what, exactly?”

  Charleston cobbled together
a deep breath. “What Tess is experiencing is called a placental abruption. It’s what happens when the placenta starts to detach from the uterine wall,” she started, but Alec cut her off with a shake of his head.

  “That can’t be what’s wrong with her. The baby hasn’t even been born yet,” he pointed out, as if she were as thick as a brick.

  “Tell that to the freaking placenta,” Tess said on a soft groan. “Because it thinks he has.”

  “The good news is, I don’t think you’re going to have to wait much longer to meet this little guy,” Charleston said, squeezing Tess’s shoulder. She was full term—overdue by a day now, actually. She might not be in labor, but with an abruption like this? Her OB was sure to schedule a C-section for tonight.

  Clearing his throat, Alec looked at Charleston expectantly. “Great. So, what’s the bad news?”

  Not something I can bear to consider. Clamping down on the fear making her heart race, Charleston grasped her composure with both hands, digging her nails in good and deep. “If the placenta detaches completely, it would cause hemorrhaging that could be dangerous to Tess. It would also put the baby in distress,” she said.

  The phrases were specifically engineered to be concise, truthful enough to convey the facts, but not so much as to incite panic. But since they were so much better than their unvarnished counterparts, Charleston had been all too happy to say them.

  She was not going to let Tess’s vitals tank. She was not going to let Tess bleed out. And she was damn sure not going to let Tess lose her baby.

  Connor appeared with a cart bearing both a fetal monitor and a portable ultrasound machine. “I snuck this from peds,” he said, winking jovially at Tess. “But only because you’re my favorite attending. No offense, Dr. Becker.”

  “None taken.” In fact, Charleston made a mental note to buy him all the romance novels his brawny, tattooed heart desired for doing his best to loosen the tension knotting the air in the trauma room. “Okay. Let’s have a look at this placenta and get you hooked up to the monitor so we can keep a close eye on the baby. Sound good?”

  A smile touched Tess’s lips, her first of the night. “Yeah.”

  Connor helped Charleston get Tess comfortably situated on her back, then raised the gurney just enough for Tess to be able to see the ultrasound monitor. Alec kept his distance, watching cautiously from the periphery as Connor put the leads for the fetal monitor on Tess’s belly and Charleston took the ultrasound gel from the warmer. The orderly step-by-step took yet another chip out of Charleston’s nerves, and she turned toward the screen, her pulse hopscotching at the sound of the baby’s heartbeat thrumming over the fetal monitor Connor had just clicked on.

  “Hey, little guy,” Charleston said, unable to contain her smile as she moved the probe over Tess’s abdomen. The baby’s heart rate was a touch lower than Charleston would’ve loved, but he still looked—

  “Perfect,” Tess whispered, a tear sneaking past the corner of one eye. “And Connor Bradshaw, so help me God, if you tell a single living soul you saw me cry, I will make sure you change bedpans on every shift you do until you’re fifty.”

  Connor laughed, taking Charleston along with him. “Aw, there’s the girl we know and love. Your secret’s safe with me.”

  Charleston moved the probe higher, concern pinpricking beneath the top of her scrubs. Damn it, the abruption wasn’t small. “Page Tess’s OB to give him an update and get an ETA,” she said to Connor, who had turned toward the phone on the far wall before she’d even finished asking.

  Tess’s smile disappeared as if it had never existed. “Charlie, what if—”

  No. “It’s okay, Tess. This is exactly what we thought it was.” Bigger, sure, but in an hour, it wouldn’t matter, because Tess would be up in an OR by then, giving birth to a happy, healthy baby. “The placenta is still partially in place, and the baby’s vitals look good. All we have to do is keep you stable for a little while longer until your doctor gets here.”

  “Don’t worry, sweetheart,” Alec said, his tone making Charleston’s teeth hurt. “Dr. Booth will know just how to fix this. He’s the best, remember? It’s why we picked him.”

  “You picked him,” Tess corrected, and Alec frowned, his arms crossing over the front of his shirt and silk tie combo as if he were still in court.

  “Well, excuse me for wanting the best doctor in the city to deliver my baby,” he muttered. Although the words needled Charleston’s nerves, she bit her tongue. She didn’t want to add to the stress of the situation by asking Alec when exactly he’d become such an arrogant dillhole. Plus, as condescending as he’d been, what went on between him and Tess wasn’t any of her business until Tess made it so.

  But the way Tess’s blood pressure had just spiked upward? Now that was very much her business.

  “Tess? You feeling okay?” Charleston asked, fear climbing the back of her throat as the monitor keeping track of Tess’s vitals started flashing and beeping in ominous alarm.

  “I feel dizzy. Sort of”—her chin whipped up, brown eyes round and wide—“I think my water just broke.”

  Charleston yanked back the fabric covering Tess’s lower half, and no, no. No, no, no. Her water hadn’t broken.

  She was bleeding. A lot.

  Charleston threw the blanket back over Tess’s legs to keep her friend from panicking and to nail down her focus, disconnecting the leads from the fetal monitor with two swift tugs. “Connor.” She said it firmly enough to make him thrust the phone back to its cradle with a hard clack, and, as weird as it was, the sound cemented her focus. “We’ve got to move. Page OB and tell them we’re bringing her to surgery for an emergency C-section. Right now.”

  “Wait, a what?” Alec asked, stepping forward. “Are you sure she needs surgery? Right this minute? Maybe we should wait for our obstetrician to be sure.”

  “No time.” Charleston looked at Tess. “Your water didn’t break. You’re hemorrhaging.”

  “Oh, my God. Charlie, please. The baby—”

  “The baby is going to be fine,” Charleston said, yanking the bag of saline attached to Tess’s IV stand and placing it on the hook attached to the gurney. “You are going to be fine. You’re just going to have an emergency C-section to get that way.”

  Tess’s nod slammed Charleston’s resolve into place, and she turned toward Alec first—“I am one hundred-percent certain that Tess needs surgery immediately, and your OB had better get his ass here if he’s going to do it instead of whoever’s on call here at the hospital”—she swung toward Connor, who was back on the phone, just as she’d told him to be—“I don’t care who they have to yank out of what fucking procedure, do you understand? Tell them we’ve got a full abruption and we’re coming up now. Tess”—Charleston looked into Tess’s eyes, the same way Tess had done for her when she’d been the one on the gurney six and a half years ago, refusing to let her stare or her voice or her resolve waver even though somewhere, in another part of her brain, she knew she was terrified—“you are not going to bleed out, do you hear me? You and Jackson are going to be just fine. I swear it.”

  Tess nodded, but Charleston was already rushing for the door, praying to God and every other deity she could think of that she hadn’t just lied to her best friend.

  11

  Parker was so sick of vomit, he could vomit. He’d triaged, treated, and eventually turfed nearly three dozen patients suffering from various degrees of food poisoning, which had to be some sort of record, he was sure. He’d also taken on a litany of sprains, strains, and sutures, to the point that he’d been damn near certain everyone in the city was suffering from one or the other (and in one case of man versus nine-foot ladder, all three).

  Logically, he knew he should be happy that Charlie had at least let him get his hands on the patients today. After all, it had technically been a step up from the whole look-don’t-touch thing she’d had him do during their last shift together. But she still hadn’t let him tackle anything a med student couldn’t handle with ease, nor had she let him do anything close to the level of difficulty that any of the other attendings had. For Chrissake, he’d placed a central line in one of Sheridan’s patients—under a shit-ton of pressure, thanks—less than two days ago. Now Charlie had him handing out emesis basins and IV fluids like Halloween candy.