Surgeon Boss, Surprise Dad
“She’s breaking out in a rash,” he said. “DC the anesthesia. Stat. She’s reacting to it.” He turned to the nurse. “Give epinephrine subcutaneously stat and then add diphenhydramine to her IV line.”
“Yes, sir,” the nurse said, giving the injection seconds later.
Adam hoped no one noticed that he massaged his fingers through the rubber gloves. What was wrong with him?
His gaze met the nurse’s. He feigned calm, reassuring himself that she’d think his hand motions were due to stress, worry over his patient. He was worried about his patient. “We’ll finish once she’s stable.”
Adam stayed with his patient until her vitals settled down, and he felt confident he could proceed without fear Beverly was in greater danger than normal.
Two hours later he propped his head against the doctors’ lounge wall. The cold concrete soothed the throb in his skull. He ran over everything with Beverly’s mastectomy, trying to recall if he’d done anything out of line, anything that might have made a difference in her outcome. He hadn’t. Sure, he was tired, his right eye blurred and his fingertips burned. But even if he’d been at his best, he couldn’t have prevented Beverly from reacting to the anesthesia.
Fortunately, they had gotten her severe allergic reaction under control before the situation had become even more critical. Before he’d been forced to deliver bad news to Beverly’s waiting family.
“You OK?” Dr Roger Bell asked from behind him.
Startled, he raised his head. He hadn’t heard the orthopedic surgeon enter the lounge.
“I heard what happened this afternoon,” his friend said. “Dr Krick told me if you hadn’t realized what was happening so quickly you might have lost the woman. Good going, man.”
Adam shrugged. He couldn’t let go of the idea that he might have somehow been at fault. “It’s my job to keep my patients safe.”
Was he compromising his patients’ safety just by operating on them? But he couldn’t put his life on hold while he awaited test results. Tests he needed to reschedule and have done so he could await results. Why was he procrastinating?
“But not your job to predict the future,” Roger countered, pulling items from his personal locker. “No one can say when someone’s going to have an unexpected allergy like that. Not even you.”
Hearing his earlier thoughts from an excellent surgeon like Dr Bell reassured him that what happened with Beverly truly hadn’t been his fault. Still, he couldn’t quite shake his guilt.
“Just thought you should know that those in the OR with you this afternoon were impressed with how quickly you came up with the correct diagnosis and credit you with saving the woman’s life. The nurses are saying you’re brilliant.” Dr Bell added the last with a grin.
Brilliant? He’d been tired, distracted, wrestling with his fingers, and hadn’t been at his peak. Far from brilliant. “Like I said, I was just doing my job.”
Dangling a shower bag and fresh clothes, Dr Bell closed his locker. “I was surprised to hear you were back today. I figured you’d take off a while with Liz. I was really sorry to hear about her grandfather.”
Adam nodded at his colleague. “I’ll let her know.”
Roger lingered rather than hitting the showers. “You planning to make an honest woman of her now that she’s free?”
None of your damn business, was what he wanted to growl, but instead he met his friend’s eyes. “Liz and I have no definite plans for the future.”
He couldn’t make plans with Liz until after he’d had the tests Larry had ordered, until he knew what the hell was going on with him.
Until he knew if he had a future to plan.
“Your lab results all came back perfect,” Larry, the family physician Adam had been good friends with since he’d moved to Robertsville, said. From the look on Larry’s face, not everything had come back perfect, though.
“The MRI?”
Larry took a deep breath, met his gaze head on. Premonition filled Adam. This was going to be bad. Very bad. Like maybe he didn’t want to know after all bad.
“I wish I could say it was perfect, too, but it wasn’t.” Larry didn’t seem in a hurry to tell Adam the results, seemed to be struggling with how to wrap his tongue around the words.
“Just get on with it,” Adam spat out, no longer willing to wait patiently for the results of the scan he’d gone for yesterday morning.
Did he have a brain tumor? It was the explanation that kept running through his mind. Then he’d tell himself he was being foolish, a hypochondriac of the worst kind. Of course his scan was going to come back normal. Of course he was going to be just fine and have a future with Liz.
Brain tumors didn’t happen to regular guys like himself. Not in the prime of their lives.
“Your MRI showed demyelization of gray matter in your brain.”
Demyelization? The breakdown of the protective lining around nerve cells? But…
“What does that mean?” Even as he asked, possibilities ran through his mind. Demyelization. An autoimmune response. His body was attacking itself? Why the hell would it do that? Why now?
Larry took another breath. “It means I’m going to schedule you to see a neurologist in Jackson.”
“A neurologist?”
Larry looked at him oddly. Adam imagined he did sound a bit odd, but Larry was talking about his body, his life, his future. Could he help it if he was asking questions that as a physician he should know the answers to? Questions he did know the answers to? A neurologist specialized in diseases of the brain and nervous system. Demyelization diseases such as…no, he wouldn’t go there. Wouldn’t think the worst.
“There’s a specialist in Jackson. He’s involved in multiple sclerosis research.”
Damn it. He’d just decided not to go there. With Larry saying the words out loud, he couldn’t help but go there.
“MS?” Did he sound as blown away as he felt? MS. He could end up paralyzed, completely dependent on others for even the most basic of things. He didn’t have MS. He couldn’t have MS.
“I want you to see Dr Winters. I put in a call to his office as soon as I got your report. He’s out of town at a convention until next week, but you’re scheduled for an early morning appointment on his first day back in the office.”
“MS?” he repeated. There had to be a mistake. The MRI must be wrong. This wasn’t happening to him.
“With the demyelization, I have to consider MS on the list of differential diagnoses. You know that. You’ll need further testing before any diagnosis can be confirmed, but I suspect Dr Winters is going to verify my suspicion.”
Adam winced, knowing what that further testing would involve. “A spinal tap.”
Larry nodded. “And evoked potential testing, where an electrical impulse is applied to various parts of your body to see how the nerve cells conduct the impulse and if there’s any demyelization of the peripheral nerve cells.”
Adam attempted to digest what he was being told. MS. Him. It couldn’t be true.
Visual changes. Pin-prickling sensations in his fingers. Numbness in his hands. Fatigue. Muscle aches and weakness. Headaches.
Hell. It could be true.
If it was true, his entire life would never be the same.
If true, he would lose everything he’d ever held dear. His career. Liz.
Because there was no way in hell he’d ever tie Liz to a doomed man, and if he had MS that’s exactly how he saw himself. Doomed.
CHAPTER THREE
FROM where Liz spoke to the director of the assisted living facility where she was donating Gramps’s medical equipment, she glanced toward the man coming through the automatic glass door.
Despite the gloom of the occasion and her grief of the past week and a half, her heart lightened at seeing Adam. Her gaze met his blue one and she flashed a quick smile at him, but he looked distracted. Actually, he’d seemed distracted all morning.
Bless him, he’d been really busy in the OR ever since he’d run into complications with a breast cancer patient’s mastectomy on the day after Gramps’s funeral. He’d spent the night at the hospital in case the woman had problems during the night. Since then, they’d gone to dinner a few times, but he’d been distracted, his mind obviously on work.
Kind, dedicated, dependable, decent—all those words described the man carrying in Gramps’s nearly new walker.
“Is there anything more?” she asked, feeling guilty that he’d had to finish by himself. She’d helped carry in the first load, but the medical director had stopped her to express gratitude for the equipment that would now be loaned out to those in need.
“I think this is the last of it except for the hospital bed,” Adam said, placing the walker next to the other items he’d carried in. Beneath his T-shirt his muscles rippled and Liz sighed in appreciation of his physical beauty. No doubt about it, Adam was a gorgeous man, but his inner beauty was what had stolen her heart.
He’d borrowed a friend’s truck and helped haul the equipment. Getting rid of the medical equipment, the signs of Gramps’s prolonged illness, had seemed the easiest place to start in going through his things. Besides, she needed that hospital bed out of her living room or she was going to cry herself silly. Her grandfather would have wanted the equipment donated to some needy person who might otherwise have to do without.
Yes, giving away the equipment was a good beginning. She’d tackle Gramps’s wardrobe and closet later, when she felt stronger, more capable of dealing with the emotional baggage that would come with doing so.
She glanced toward Adam and found him clutching the handles of Gramps’s walker. White-knuckled, he wore a far-away look, as if he imagined being forced to use assistive devices for ambulation. Was he remembering the few times early in their relationship when Gramps had puttered along behind the walker he’d quickly grown too debilitated to use?
“I’ll get a couple of male employees to assist you with the hospital bed,” Glenda volunteered, interrupting Liz’s heartfelt stare.
Whatever Adam’s thoughts, he shook them off and nodded at the director. “Thanks.”
Two maintenance workers helped guide the bed off the truck and they rolled it inside the building.
Liz bit the inside of her lip as she watched the bed being rolled down the hallway.
“It’ll be alright,” Adam said from beside her. She glanced toward him, his gaze fixed on the disappearing hospital bed. At first she’d thought he was reassuring her, but despite the fact he stood next to her, he didn’t seem aware she was there. His attention riveted on that bed, not her.
In her grief she’d forgotten that during the time she and he had been dating, Adam had spent a lot of time with her grandfather. He’d loved Gramps, too.
Oh, Gramps.
“It seems strange,” she said softly, placing her hand on Adam’s arm. “That bed has been a central part of my life for so many months. When I think that I’ll never see it again, I…” Her voice trailed off.
Adam’s gaze cut to her. He took her hand and gave a gentle squeeze. “I know.”
“Thank you,” she whispered, standing on tiptoe to kiss his cheek. “Losing Gramps is the hardest thing I’ve ever dealt with. You’ve been so wonderful, Adam. I can’t imagine not having you by my side.”
An odd look passed over his face. One she almost thought laden with guilt. But that was ridiculous. Adam had nothing to be guilty about. Still, the look caused nervous tremors in her stomach.
“Oh, Liz! We’re so happy with the equipment. Thank you. Thank you. Thank you,” Glenda gushed, returning to their side. The woman sent an engaging smile toward Adam. “And, Dr Cline, it’s always a pleasure to see you.”
Liz thought so, but wasn’t sure she liked the way Glenda eyed Adam’s body. Still, she couldn’t blame the woman for admiring what so deserved female admiration.
Adam in form-fitting but not too tight jeans and his black T-shirt was the kind of pin-up calendar fantasy women dreamed of meeting in real life.
“I know you aren’t dressed for house calls…” Glenda swept her gaze over Adam again “…but Irene Guess has a wound I think is going to need debridement. About a year ago she had a similar wound she was hospitalized for. Would you mind taking a quick look so I’ll know whether or not to schedule an appointment? It’s so hard for her to get in and out, not to mention getting her a ride. I thought while you’re here you might have a quick look.”
Adam didn’t bat an eyelid at being asked to check a patient during his day off. But Liz couldn’t help but wonder if it bothered him because he rubbed his right temple. He caught her watching him and quickly dropped his hand.
Finding his behavior odd, Liz followed him and Glenda to check on Mrs Guess. The older woman was sitting on her sofa, watching a soap opera. She seemed more interested in the program than in discussing the wound the director was concerned about.
Adam washed his hands, massaging the soap into his fingertips for longer than normal, once again making Liz question if he felt OK. But with a smile on his face, he dried his hands before putting on gloves and assessing the older lady, asking about the sore that had come up on her abdomen.
“I don’t know what caused it,” Mrs Guess said in her sweet grandmotherly voice, her gaze still on the television. “I woke up with a red spot one morning, and each day it’s worse than it was the day before.”
“Does the area drain?”
The woman waited until a man on television finished expounding an argument in court to a serious-looking jury. Once the scene cut to a commercial, she shifted her glasses-rimmed eyes to Adam. “Yellowish stuff is on the bandage when I take it off.”
“Can you show me the place while sitting, or do I need to help you lie down?”
“You can see.” Mrs Guess raised her shirt and lifted a pasty white skin roll. A gauze pad crumpled. She removed the pad and held the bandage out. “This is the drainage I was talking about. Just yellowish gunk.”
“I see.” But Adam’s gaze had already taken a quick glance at the dirty dressing and gone to the ulceration on the woman’s abdomen. An open nickel-sized lesion with a large area of surrounding redness oozed a sticky honey-colored exudate. Streaks of angry red shot out.
Liz had seen worse wounds, but Mrs Guess did have a serious problem. From the look of the ulcer and drainage, she’d need IV antibiotics and possibly isolation as discovering MRSA had caused the infection wouldn’t surprise her.
“Have you had a fever, Mrs Guess?”
“How am I supposed to know?” She seemed annoyed that Adam had asked her another question now that the program she’d been watching had come back on.
“I don’t have a thermometer, but I have felt a tad warm the past day or two. I thought it was from the heat.”
Adam took her hand, forcing her to keep her attention on him rather than the television. “You’ve got an infection. From the way the wound looks, I suspect a particular strand of Staph.” He confirmed Liz’s suspicions. After burning the gloves and washing his hands again, Adam returned to Mrs Guess’s side. “I’m going to call for a non-emergency ambulance to take you to the hospital.”
The woman looked alarmed. “The hospital? Surely a little sore isn’t that serious?”
“It can be. You need strong antibiotics through an IV. In the morning I’ll recheck you and may opt to surgically clean the wound. Similar to what I did last year to the place on your leg.” Placing his fingertips to his temple, Adam closed his eyes and rubbed the spot for such a brief moment that someone who didn’t know him so well might have missed the tell-tale action. Liz saw.
Did he have a headache? After he finished with Mrs Guess, she’d offer to drive the truck back to his place, run him a hot bath, maybe give him a neck rub. Goodness knew, he hadn’t been getting enough rest with the hours he was pulling at the hospital. But he’d said he needed to make up for the couple of days he’d taken off to be with her following Gramps’s death.
But when Adam turned to Liz, any traces of a problem had disappeared and he wore only a concerned professional expression. “I’ll drop you by your place and meet the ambulance at the hospital. That way I can do a direct admission and Mrs Guess won’t have to go through the emergency room.”
“I’ll go with you.” She’d be there when he finished. She wanted to ask him about his headache, to make sure he got some rest tonight. He’d been taking such good care of her. Tonight she’d make him prop his feet up and she’d pamper him.
Not meeting her eyes, he shook his head. “No, I’ll drop you at your place. I may be a while.”
Huh? Liz blinked at him, sure she failed to hide her surprise. “I’d rather go with you.”
“Liz,” he began, and she’d swear he winced. “I need to make rounds on my other patients. It would be better to drop you off since I don’t know how long I’ll be.”
She didn’t bother to point out that until Glenda had asked him to check Mrs Guess he’d planned to spend the entire day with her. But she did think it and wondered why he’d want to drop her at her place.
They’d always had to make use of every available second because of busy schedules and her limited free time. Maybe he thought time wasn’t so precious now that Gramps was gone and the confines of their relationship not so rigid.
Yet she’d barely seen him since the day of Gramps’s funeral.
“I don’t mind,” she assured him, sending a smile his way to let him know she wanted to spend whatever time they could together. Later, when they were in private, she’d reassure him that every moment they spent together was precious.
“But I do,” he stunned her by saying. He cast a quick glance at Glenda and Mrs Guess, then continued. “You’ve been clearing out your grandfather’s things all day. The last thing you need is to get stuck at the hospital for hours on end. I’m taking you home.”
Bewildered, Liz nodded her agreement, knowing there must be a good reason he didn’t want her with him.
* * *
“Adam? Is something wrong?” Liz asked the following night. Concern filled her voice and he could just picture her twirling a strand of hair around her finger while she asked.
Adam closed his eyes and gripped his cellular phone all the tighter.
From his caller ID he’d known the caller was Liz. So why had he answered? He should have just avoided the call altogether.
Avoiding Liz was what he’d done for the past twenty-four hours. Why stop now?
But he’d eventually have to talk to her, tell her that he was…was what? No longer a whole man? Not healthy? Not sure exactly what was going on with his body, but that he’d be seeing the neurologist for a spinal tap and the other tests in the morning?
On Monday the specialist had agreed with Larry. He believed Adam had MS.
Which was why he’d wanted to spend yesterday with Liz, but gripping that walker in his palms had messed with his head, had panicked him. All he’d been able to think was that if he had MS, the day might come when he wouldn’t be able to walk without a walker. Or worse. The day might come when he wouldn’t be able to walk at all.
Each time he’d looked at Liz, all he stood to lose had constricted his throat, made it difficult to breathe, made him afraid she’d see the anxiety in his eyes.
Then, while examining Mrs Guess, a searing pain had stabbed the right side of his head, making him wonder if he’d black out from the intensity.
Even in her distress over losing her grandfather, Liz was too smart to miss that something was wrong with him. She’d noticed yesterday. He couldn’t keep hiding his symptoms from her. Others perhaps, but not Liz. She knew him too well.
He should have told her the moment he’d started having the blurred vision, the pinpricks in his fingers, the tiredness. He should have told her the night her grandfather had died. Before then.
Instead, he’d pretended that everything was fine, not letting on that he was having symptoms of any kind.
He’d thought he was saving her pain by delaying, but the more time that went by the more he wondered if he wasn’t making things more difficult by keeping his symptoms, his fears to himself.
He should tell her now.
He opened his mouth, intent on telling her the truth. “I’m just busy.”
That wasn’t what he’d meant to say. Not even close.
“OK.” She didn’t sound convinced. He didn’t blame her. His unusual behavior confused her. Hell, he was pretty confused himself.
Silence buzzed over the line, acutely broadcasting that change was eminent whether he wanted it or not.
“I looked for you after I finished my shift. They told me you’d already left for the day. Are you coming over? I could order take-out.” Her voice held hopefulness.
“Not tonight,” he managed to say. What if he had another episode of pain? How would he explain it to her? “I had a long day and am tired.” True. He seemed to always be tired these days. “I’m flying to Alpharetta in the morning and want an early start.”
A lame excuse and they both knew it. An avid pilot of his own Cessna, a scheduled trip had never stopped him in the past. And why had he lied to her? He was going to Jackson, to see the specialist, to find out the truth behind his symptoms.
Which was why he’d lied to her.
He didn’t want her to worry, didn’t want her sympathy, didn’t want her to possibly be tied to another invalid. Liz deserved a life.
“If you’re sure, then…” She hesitated, making him want to tell her how much he needed her, just to have her wrap her arms around him and tell him everything would be OK, that she’d be there for him no matter what those damned tests showed.
The crux of it was Liz would be there for him in a heartbeat. If he let her. But he wanted better than that for her. Lots better.
Be strong, man. You’ve got to see this through, find out for sure what’s going on before involving Liz.
“Sorry, Liz, but I’ve got to go.” He hung up before she could say anything more.
But mostly before he could say anything more.
The next morning Adam sat in a Jackson Neurology Clinic exam room, staring at a framed Norman Rockwell print that hung on the wall opposite him.
Too bad real life wasn’t as idyllic as Norman Rockwell presented it.
When the neurologist walked into the room, Adam knew by the expression Dr Winters wore that the test results hadn’t been good.
By now he should be used to that expression. Hadn’t every bit of news he’d gotten thus far been bad?
The neurologist pulled up his stool, glanced down at the piece of paper containing words that would forever change Adam’s life, and then glanced up. “There’s no good way to put this and we pretty much already knew what the conclusions of the tests were going to be, so I’m going to be blunt. You have MS.”
Adam’s ears roared. His blood boiled. His skin crawled. He gritted his teeth. He clenched his tingling fingers. Still his body threatened to explode from the impact of those words.
He had MS.
“You’re sure?”
“Yes. The analysis of the cerebral spinal fluid shows protein, cells, and increased antibody production. Antibodies containing oglioclonal bands. Unfortunately, that in combination with the demyelization revealed on the MRI are conclusive even if the evoked potential testing hadn’t been positive.”
There was that damned expression again.
“But they were positive, too, weren’t they?” Because all his tests pointed in one direction. A direction he didn’t want to go, but had no choice but to take.
He had MS.
The specialist nodded. “I’m sorry.”
All night he’d lain in bed preparing himself for this, preparing to hear that his body was attacking itself. Yet he shook. Any moment he expected the earth to open, for lightning to strike, for a tornado to rip him from the ground. Because any of those things were possible and expected in this horrible nightmare.
This had to be a nightmare.
God, he hoped it was only a nightmare.