LITMIR.BIZ

      At six o’clock Thursday morning Lukas finally awoke to an intermittent alarm and reached out toward the bedside table to slap the off button. The shutoff didn’t work. He hit it again, but it kept ringing. He opened nearsighted eyes, put on his glasses and realized he’d been abusing the call room telephone. He picked up the receiver.

      Claudia, the RN on duty, didn’t wait for him to say anything. “Good morning, Dr. Bower.” Her mellow alto voice was pleasant and soothing, as it always was with patients. She knew how to tread lightly with a deadhead in the morning. “You’ve had at least four good hours of uninterrupted sleep, and it’s time for you to get to work.”

      He slowly pushed the blankets back with his free hand. “Yes, Mother.”

      “Don’t get smart with me, young man.” Lukas could hear the matronly nurse smiling through her words. “We’ve got an eleven-year-old girl in exam room three who is covered in blood and needs your attention. Looks like she’s been playing jump rope with barbed wire. Her parents are in worse emotional shape than she is.”

      “I’ll be right there.” Lukas replaced the receiver and climbed out of bed, combing his hair with his fingers as he stumbled out of the room. Maybe Claudia had gotten really smart and brewed some of that typical E.R. coffee that took fifteen cubes of sugar to kill the taste.

      After reading Claudia’s initial assessment, he entered the exam room to discover that, as usual, the nurse had not exaggerated her description. The eleven-year-old girl, Abby Cuendet, lay on the exam bed in pink pajamas with bloody rips in both legs. Lots of blood. Lukas frowned.

      Abby tensed when she saw Lukas come in, and her dark eyes, behind thick-framed glasses, did not leave his face. Her parents, a young couple looking tear-streaked and shaky, hovered at her left side, and they, too, had blood on their clothes. Claudia worked on the other side of the bed, taking vitals and gently removing the pajama bottoms.

      “Hello, I’m Dr. Bower.” Lukas stepped over to the parents and held out his hand.

      They introduced themselves, separately, as Jason Cuendet and Lindy Cuendet. Not Mr. and Mrs. Cuendet.

      “I’ll be checking Abby out this morning,” he said, noting as they shook his hand that they avoided getting close to each other. “Can you tell me what happened?”

      Lindy shot her husband a sharp glance before she answered. “Abby got up earlier than usual this morning, and we didn’t know she was awake. She went out to feed the dog, and she got caught in a broken roll of barbed wire we had out back.” Her eyes narrowed at her husband. “Jason just had to bring it home because it was such a good bargain.”

      Her husband didn’t reply, but his chin jutted out and his face flushed with barely restrained anger.

      Lukas smiled at Abby. “You’re Tedi’s best friend from school.”

      Abby’s face brightened and she nodded. “You recognized me.”

      “Of course. Tedi talks about you all the time, and I remember you from the school picnic a couple of weeks ago.”

      “Tedi’s supposed to spend the night with me tonight,” Abby informed him.

      “Well, we’ll just have to get you all fixed up so you can do that.” He watched Claudia set up the suture tray, and he saw Abby’s eyes widen with fear.

      He bent over the wounds. “Now, don’t worry, Abby. I’m just going to see what these look like right now.” She had three gashes on her left leg below her knee and one on her right ankle. They didn’t look as bad as Lukas had expected from all the blood. They weren’t deep puncture wounds, which was good, but they were fairly gapped, and a couple of them would need two-layer closures.

      He bent to examine one of the gashes more closely, and Abby winced.

      Her mother inhaled sharply, then let out a low moan. “I can’t do this,” she muttered and rushed out of the room with her hand over her mouth.

      Lukas let her go. It was easier on the child for the parent to leave the room than to pass out or become sick right there by the bed. He returned to the wounds, noting with concern that there was still some active bleeding, but since there was no involvement of the muscle, he didn’t worry too much about it.

      “Jason, when was Abby’s last tetanus shot?” he asked. “Does she have any drug allergies that you know of?”

      The man glanced at the wounds, then at Lukas, looking helpless. “I’ll have to go ask Lindy.” He left to find his wife.

      Lukas gave Claudia instructions for skin prep and topical anesthetic, then left to get more information from the parents. He had just reached the central desk when he heard low, angry voices in the entrance to the first trauma room.

      “You have to blame me for everything, don’t you?” Jason Cuendet spat. “But you can’t even be there for your own daughter when she needs you most.”

      “You know how I hate the sight of blood. I just can’t stand to see her like this.”

      “It’s always about you, isn’t it? Why don’t you think of somebody besides yourself for once?”

      “That’s precious, coming from you. When do you ever think of—”

      Lukas cleared his throat. “Um, excuse me, I’m sorry to interrupt. Is Abby’s tetanus up to date?”

      In a voice still filled with anger, Lindy replied that it was.

      “Good,” Lukas said. “And how about drug or antibiotic allergies?”

      Lindy shook her head, glaring at her husband.

      Lukas took a couple of cautious steps closer to the couple. He hated interfering in what appeared to be a deep-rooted family dispute, but he often saw parents blame each other when a child was injured, and it always made the situation worse.

      “Your daughter is going to be fine. We’ll stitch her up and have her out of here in good time. Has Abby had other accidents like this?”

      Jason switched his brooding gaze from his wife to Lukas. “What’s that supposed to mean?”

      “Oh, stop it, Jason,” Lindy snapped. “You’re always trying to start something with somebody.” She turned to Lukas. “She fell and cut her knee at school last year. That’s when she had the tetanus shot.”

      “When was the last time her eyes were checked?” Lukas asked. “I had to have my glasses changed frequently when I was her age, and I was always tripping over things.” He saw Jason relax. The suspicion of child abuse never seemed to be far from anyone’s mind lately.

      As they talked about that, he slowly led them back toward Abby’s room, where Claudia had everything ready to go.

      “It’ll be okay,” he assured Abby and her parents as he washed his hands and gloved.

      But when he turned back to Abby, Lindy walked out into the hallway again.

      Her husband’s loud, disgusted sigh filled the exam room. “I don’t believe this,” he muttered.

      Abby tensed, and Lukas repressed a strong urge to ask him to leave, as well. At times like this he had to remind himself that he needed to learn more patience. Looked like Jason Cuendet could use some, too.

      He picked up the anesthesia syringe. “Claudia says I’m not too bad with stitches, and she wouldn’t say anything nice about

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