LITMIR.BIZ

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weathered Cowboy was such a frequent visitor in this E.R., Lukas wondered how the forty-three-year-old man had survived his occupation. He’d been kicked, gouged, bitten and knocked senseless on that exotic animal ranch of his—he believed in personal contact with his bison, zebras, lions and whatever else he raised on his three hundred acres of reinforced paddocks. Scars on several areas of his hard-bodied frame attested to his dedication.

      Today blood covered Cowboy’s upper right arm and splattered his chest and back. The left arm of his long-sleeved denim shirt had been ripped off and tied over his upper right arm in a crude attempt at a pressure dressing.

      Lukas pushed back from the desk and got up to help. “Cowboy, what happened this time?” He took a closer look at what appeared, surprisingly, to be a bullet wound. “Has Leonardo started bearing arms?” Everybody knew the rancher wouldn’t touch a gun.

      Cowboy shook his head as he allowed his helper to transfer his leaning weight to Lukas.

      “The neighbor shot him,” the farmer said. “He chased Cowboy clear out of the woods into my field with a rifle. I saw it myself. Didn’t take the time to call the sheriff. Guess we oughta call him now, huh, Doc?”

      “No need, the police are already here doing an accident report. Would you please go tell them about this? They’ll want to check it out and take your statement.”

      The man nodded, then patted Cowboy on his bare good arm. “Don’t you worry, Jake, I’ll take care of it.”

      Lukas helped Cowboy to exam room five. “How many times did the guy shoot you?”

      “Once.” Cowboy grunted as Lukas lowered him to sit on the bed. “Lost some blood. The guy’s crazy.”

      “Is that the one who moved onto that farm next to yours, then started complaining about the smell of the animals? I heard about him.” Lukas removed his patient’s shirt and then helped him lie back. “How much blood do you think you lost?”

      “Maybe a pint.” Cowboy’s deep voice thickened with pain as the shirt came off. “No time to measure.”

      Lukas stepped out into the hallway and called for a nurse, then returned to the bedside. He made a quick check of airway, breathing and circulation, then listened to Cowboy’s heart. Not bad, a little fast, but understandable under the circumstances. The left wrist had a strong pulse, and the fingers were warm and healthy.

      When the relief nurse from upstairs stepped into the room, Lukas gave immediate orders for an IV and a trauma panel, then repeated his check on Cowboy, this time on the arm that had been shot. To his relief, it looked good. “Okay, Jake, I’ll regret this, but give my hand a firm squeeze.” He braced himself for the man’s well-known iron grip, but it didn’t come.

      Cowboy grimaced again, the lines of his face deepening as his color faded. “Hurts to squeeze. Is it bad?”

      “Not as bad as it could have been.” Lukas pulled on a pair of sterile gloves and reached for a packet of 4x4s. He removed the makeshift bandage and saw no active bleeding. He found the entrance and exit wounds. “What did he shoot you with?”

      “Looked like a .22 rifle, almost point-blank. Just up and shot me in cold blood, the same way he did—”

      A young steel-faced policeman pulled back the curtain and stepped into the room. “Dr. Bower? Do you mind if we interrupt? The sooner we talk to Cowboy, the faster we’ll be on the guy’s trail.”

      Judy came in behind the policeman. “Dr. Bower, we just got a call from the fire department. They’re bringing in two more patients.”

      Lukas shook his head in frustration. The day was exploding like popcorn in a microwave. Why did everything have to happen at once?

      The secretary continued, “The nurse with Air Care just radioed us, and they’ll be here in a few minutes to pick up Mrs. Collins.”

      “Thanks, Judy.” Lukas ripped open one of the sterile packs of 4x4s and a roll of elastic gauze, then regloved and dressed the wound. He looked over at the policeman. “Officer, you can do your interview now. Looks like I’ll have my hands full.” He turned and followed the secretary out of the room. “Judy, I need a right shoulder X-ray in five, and he’s going to need a surgical consult. Is Dr. Wong on call? He usually is when Cowboy gets hurt.”

      “Yes, Dr. Wong’s the lucky guy today.” Judy grinned at him. “Cowboy won’t want a surgeon, he never does. Dr. Mercy will be here soon.” Her expression turned serious. “One of the patients they’re bringing in is our part-time EMT, Buck Oppenheimer. He got hurt in a fire.”

      “Buck! How bad?”

      “Haven’t heard yet. There was an explosion at the Pride of Knolls out by P Highway, and his buddies are bringing him in so he won’t have to wait for an ambulance. I sure hope he’s okay, and I hope his wife doesn’t kill him when she finds out he played hero again.”

      Lukas nodded, then went in to check on Alma again and read her X-rays. There were no pneumothorax or rib or pelvic fractures, but the X-ray of her right tib-fib confirmed his worst fears. Both bones of the lower leg were shattered. If the blood vessels and nerves were as badly damaged as the bone, they would be doing an amputation in Springfield instead of a vascular and orthopedic repair.

      Someone cried out in Spanish in one of the rooms, and Lukas hoped the interpreter would arrive soon. That patient was the one who reportedly had driven the car into Arthur and Alma’s tour group.

      One of the most frustrating things in emergency medicine was treating those responsible for the pain and suffering of others—and one of the most difficult things to do was to have compassion for everyone involved.

       Lord, give me strength and wisdom. Give Alma and Arthur Your peace, and use me as a vessel of healing. And, Lord, would You please slow things down a little?

       Chapter Two

       I f this was another disaster drill, Mercy Richmond was going to make someone pay dearly. She kept her white lab coat on to protect the pink-and-blue bunny scrubs she wore underneath—her family practice consisted mostly of women and children. After apologizing to the six long-suffering patients in her waiting room, she marched out the front door and down the block toward the hospital.

      Mercy’s stomach growled. Monday afternoon was the worst time to get called out. There’d been no time for lunch. Everyone in this town of ten thousand must have developed strep, flu or pneumonia over the weekend. She shouldn’t have agreed to be E.R. backup today. Her patient volume had increased to the point that she was going to have to stop seeing new patients or start keeping the office open an extra day a week.

      This spring she might have considered that possibility, but she’d won custody of her eleven-year-old daughter a few months ago, and she wanted to spend more time at home with Tedi. Since she no longer had to make two house payments, two car payments, and cover the bills her ex-husband had run up, she didn’t need the income she made from E.R. shifts. She hoped Theo never got out of that detox unit in Springfield. Her life was going so well with him out of the way…and with Dr. Lukas Bower taking more of an interest in her and in Tedi. Everything was looking good.

      As she stepped across the parking-lot curb and strode toward the E.R. entrance, the distant, thrusting rhythm of a helicopter in flight reached her for the first time. She noticed that the landing pad on the parking lot had been cleared of cars.

      Okay, so this time it probably wasn’t a drill.

      She looked down. That probably wasn’t fake blood on the concrete, either. In the back rooms of her clinic, she had never been able to hear the ambulances when they pulled into the E.R. Always before, she had considered that to be a good thing. Today, though, she could have used a little warning.

      She rushed through the sliding glass doors to find the waiting room filled with people in various stages of fluster. A patient with a splinted arm was being helped inside by a friend. The buzz of voices and the aura of worry greeted her like

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