LITMIR.BIZ

Скачать книгу

into action, protecting the girl’s head while assisting Jan in turning Cassie onto her side. The patient went back into the stiff tonic phase. Jan turned on the wall suction and hooked up a suction device. She knew not to put anything into a patient’s mouth during a seizure, but waited for a chance to suction the excess saliva from the corner of Cassie’s mouth.

      “How’s her O2 sat?” Jan asked, distracted with the convulsing patient.

      “It’s good,” he said, with his large hand guarding Cassie’s head as it jerked and twisted.

      Having Beck near felt reassuring, though there was nothing they could do until the seizure had settled down. Within another minute Cassie stopped jerking and grinding her teeth. Her heart rate was still rapid, but her blood pressure was normal as was her oxygen level. She stared blankly into the distance.

      Jan suctioned her mouth thoroughly, which got a reaction from Cassie. She pulled in her chin and looked annoyed but didn’t utter a sound. Beck started an IV in her arm.

      Gavin appeared and began issuing orders. “Get a glucose, BUN,’ lytes, drug screen. IV normal saline, TKO. Order a stat EEG and CT scan of the head.”

      “Write the orders down,” Carmen called out from her nurses’ station perch. “They’re a little busy to take verbal orders, Dr. Riordan.” She’d emphasized the word “doctor”.

      He followed her recommendation, grabbed a green sheet and scribbled out his orders at the nearby patient bedside table.

      Beck found the proper-colored tops for the lab-test vials in the IV tray and drew the required blood before hooking up the intravenous line to fluids. Jan noticed the ease with which he worked as she labeled the specimens. She rushed the vials down to the lab to expedite the results and to get away from Beck. After last night’s kiss, she couldn’t afford to be in the same vicinity as him for any length of time. She couldn’t allow herself to fall under his spell and forget the secret that was bound to keep them apart forever.

      Jan returned to the triage room, surprised to see the patients with the rectal pain and infected lip piercing still waiting to be seen. The waiting room had filled up again, and a new case needed her immediate attention. Evidently, Sunday night pot roast dinner had turned scary when the forty-six-year-old patriarch had forgotten to chew.

      The wife frantically explained they’d tried the Heimlich maneuver, to no avail.

      “If he’s breathing, there’s no need to use that maneuver. See the constant drooling?”

      The woman nodded.

      “The meat is lodged in his esophagus and he can’t swallow it. Fortunately, it’s not blocking his airway.”

      “What does that mean?”

      “It means we’ll have to call the on-call GI guy to come down and do an endoscopy to remove it.”

      “Will he be OK?”

      “They’ll sedate him first, and he should be fine, but he may need to stay overnight for further evaluation.”

      The drooling man bobbed his head up and down in agreement, looking as though he’d do anything to get the lodged chunk of meat out of his throat.

      An hour before the end of shift there was a lull in triage and Jan snuck back to the nurses’ lounge for a bottle of water. Gavin called out her name before she could return to her station. He motioned to her from his office to come over.

      When she stepped inside, she found Beck already seated. When Dr. Riordan gestured for her to sit, she had no choice but to take the only remaining chair in the room…next to Beck.

      “Tell me about Cassie,” Gavin started.

      Jan leaned forward and took a breath to gather her thoughts. She’d seen so many cases that night she needed to make sure she was talking about the same patient. “The seizure patient?”

      “Yeah. It wasn’t a seizure.”

      “What do you mean?” Jan glanced at Beck for back-up.

      “You could have fooled me,” Beck said.

      “The electroencephalograph was normal. Completely normal. So was all of the lab work. The preliminary toxicology is negative for the usual suspects. No cocaine, speed, alcohol, or barbiturates.”

      They all sat in silence, considering the implications of the findings.

      “What about the CT?” Beck asked.

      “Normal. No sign of brain lesion or injury.”

      “Are you saying hers was a pseudo-seizure?” Jan asked.

      Gavin shrugged. “Could be.”

      “Once this soldier in my squad developed seizures and they eventually figured out they were psychogenic in nature,” Beck said. “They looked like regular convulsions and he wasn’t faking them. They were real to him, but he didn’t have any abnormal brainwave activity. Turned out he’d developed post-traumatic stress syndrome and certain sounds and smells triggered these events.”

      “Cassie mentioned that the boy who brought her in had wanted to break things off today. She didn’t seem too upset about it. He couldn’t seem to get away fast enough when he heard her parents were coming in, though. I’d never in a million years have guessed that she was faking it.”

      “She wasn’t necessarily faking it. In some instances personal problems can trigger seizure activity, though, like Beck said, it’s psychosocial in nature,” Gavin said. “I’m admitting her for observation and calling Psych and Neuro in for an evaluation and we’ll go from there. But what I do know is, she’s pregnant.”

      Jan’s head shot up. “But she’s as thin as a waif.”

      “I know. I stopped the lorazepam the minute I got the results. She may not have told her parents yet, so I’ll wait until she’s alone and more alert before I talk to her. Anyway, if you guys didn’t spot anything else while you were with her, I’d better get on,” he said, before bustling off.

      Jan glanced at Beck and quickly away, before he could beat her to it. If convulsions could develop from hoarding personal and emotional trauma, or from being unwed and pregnant, hell, she should have been seizing for years now. She shook her head and rose to leave. Beck followed her outside.

      He tapped her on the shoulder. She turned and found an earnest expression on his face. “I happened to hear you have tomorrow off, and was wondering if you’d meet me for breakfast.”

      After a short burst of palpitations, Jan squinted and flashed a glare at Carmen, who averted her eyes rapidly. What should she do? The man should hate her for jilting him all those years ago, yet he’d been a perfect gentleman at work and had just asked her out for an innocent breakfast. Could she trust the amiable smile?

      Deep groves bracketed his mouth and stretched all the way down to his chin. His eyes softened with the gesture and she fought the desire to look at him again, more thoroughly.

      “Why?” she asked, staring at her feet.

      He lowered his voice. “We used to be friends, January. Remember? I’d just like to do some catching up.” He lifted his palms. “But if that’s not OK with you, I’ll understand.”

      Jan swallowed, guilt rolling in like a huge wave. “I guess breakfast would be OK.”

      His relieved smile reminded her how easy it had been to fall for him. She couldn’t let that ever happen again.

      What was his story? Why would he want to spend time with her after she’d done such a dirty trick by running away and breaking things off when he’d needed her most? When she’d needed him most?

      Could she trust him with his little innocent breakfast proposal, or was she walking into some kind of trap?

       CHAPTER

Скачать книгу