My Kind of Christmas
Page 12
And then the tree lit up and the lights were so grand in the town, the street was filled with the brightness of an afternoon sun. There was a chorus of “Ahhhhh,” then applause. Patrick’s arms tightened around her. She leaned back against him and enjoyed the closeness. She had barely begun her fantasy of what else might happen between them when a truck came into town, horn blowing. The street was filled with people and the old truck’s horn was separating them, parting the crowd, until it finally came to a stop right in front of the clinic.
Angie, acting on sheer impulse, wiggled out of Patrick’s arms and ran toward the vehicle just as a woman got out of the passenger’s side of the truck. She was holding a very large child wrapped in a blanket—a blanket on which there was a considerable amount of blood. A bloodstained towel covered most of the child’s face.
On instinct, Angie went toward them. At precisely that moment, Mel and Dr. Michaels burst through the crowd, running toward them.
“Frank?” Mel asked. “Lorraine?”
“It’s Megan! She slipped—there was ice on the porch and a nail sticking out of the porch post got her right on the forehead. It’s bleeding bad.”
“Come inside. Frank, you come, too. Let’s have the doctor look at it.”
Angie turned to Patrick very briefly, holding up her hand toward him. That was her only gesture before following the man, woman, child and practitioners into the clinic.
It felt odd to her. First of all, no one questioned her presence there, as though she was already an assistant of some kind. Second, Mel began barking orders at her as if she had been trained in this clinic. “I’ll need a sterile pack of four-by-four gauze, sterile water, not saline. Cameron? Want an antibiotic?”
“I don’t think we need an IV, but I’ll go with cephalexin, broad spectrum IM. She had a tetanus shot last summer but give me some Valium and lidocaine. I’ll get a suture kit.”
“Can you get that together, Angie?” Mel asked, handing her the keys to the drug cabinet. “I’ll take care of the syringes.”
“Yes. Please check my work, make sure I have the right things.”
“Absolutely.”
Angie got out the gauze and water and then went after the drugs, but what really had her attention was the fact that the little girl didn’t make a sound.
“I’m going to put pressure on the wound, Megan,” Mel said gently, softy. “Just for a little while.”
Angie had only seen a little bit of this injury, the blood on her face, but the child was so silent. She shook like a leaf, however—either terrified or in shock. And Mel was dabbing at her face and forehead with gauze. “Easy, Meg, it’s not bad,” Mel was murmuring.
“Let’s get this cold, bloody blanket out of here,” Mel said, leaving a thick padded gauze over half of Megan’s face. She reached into the cupboard behind her and produced a clean, warm blanket. To Angie, she said, “Roll Megan toward you, then toward me—gently, now.”
They wrapped her up in a fresh blanket while her parents waited as close to the treatment room door as possible. Then Cameron was back, pushing his way in close, pushing Angie away. His suture kit sat on the counter behind him and he looked at Megan’s pupils with a flashlight, asked her to follow his finger with her eyes, asked her a couple of simple questions like her birthday, her brothers’ names.
“Is it terrible, Doctor?” Megan asked, her voice quivering on the edge of tears.
“It’s not, sweetheart,” Cameron said. “It’s going to be fine.”
In the first year of medical school, a med student had very little, if any, clinical experience. In fact, the only experience Angie had came from following around an instructor in a clinic. Without that little bit of experience, she would have no idea what a four-by-four was or how to select drugs from the locked cabinet. And while the injury was a bloody mess, especially on the face of a little girl, it didn’t overwhelm Angie. She knew even the smallest head wounds could bleed like the devil.
By the time Cameron had opened up his suture kit, the wound had been cleaned and much of the blood wiped away. That’s when Angie had her first real look at the little girl’s face and tried not to gasp. The laceration on her forehead didn’t appear too serious, but the sweet thing already had a horrific scar on her face, already healed. It looked as though she’d been cut from the corner of her mouth almost to her eye; her mouth lifted on one side and her lower lid of her right eye drooped, exposing pink tissue. The scar was thicker in some places than others—it was vicious. Disfiguring.
The little treatment room was very crowded and growing quite warm. Cameron was working carefully but quickly on the laceration, cleaning and washing with lidocaine. “I think we can take care of this here, Megan,” Cameron said. “It’s going to need some stitches, but it’s small. It won’t hurt. I’ll numb it. And because of the size and location at your hairline, I wouldn’t fear a bad scar.” Then he looked over at Lorraine. “Is that all right with you, Lorraine?”
Although the woman twisted her hands, she nodded.
“I don’t think she has a concussion,” he went on. “I’m going to ask you to keep an eye on her tonight—I’ll give you some instructions before you take her home.”
Mel drew a syringe of something while Cameron donned sterile gloves. Then he leaned over her and said, “Tiny little mosquito bite, Meg, that’s all. I bet you don’t even have a headache tomorrow.”
Angie leaned so close to watch Cameron suture that Mel smiled and Cameron looked over his shoulder at her as if to say, Do you mind? When the stitches were in and a bandage covered the wound, Mel pulled Angie out of the room.
“Cameron’s going to ask Megan to just lie still for a while. He’ll examine her again before sending her home with her parents. I’m going to write in her chart.”
Angie followed her to the desk in the reception area. “Mel…?”
Mel stopped, turned and quietly answered the question she knew was on Angie’s lips. “Almost a year ago Megan fell and hit her head, her face, on a shovel that was lying on the ground partially buried by snow. It cut her cheek but, to tell the truth, it wasn’t that bad. It was actually the treatment that worked against her. Cameron took her to the emergency room—he wouldn’t dare try closing up such a large facial laceration on a child. But there was no plastic surgeon, the E.R. doctor wouldn’t call anyone in because Meg’s family is very poor and has limited insurance—certainly nothing that would cover plastics, and he stitched her up himself. It didn’t take too long to see scar contractures, which I can almost guarantee will only get worse. Megan is growing—the scar is tightening while the rest of her face and surrounding tissue is soft and elastic. It causes severe distortion. And then there’s ectropion, scar tissue pulling down her lower eyelid. She needs plastic surgery.”
“And why isn’t she getting it? Is she afraid?”
Mel shook her head. “It’s considered cosmetic. Elective. It would cost thousands of dollars, and that’s speaking conservatively. This is a struggling family. They’re doing well if they can keep the heat on all winter.”
“She’ll be disfigured for the rest of her life,” Angie said.
“I keep looking for a break. A friend of mine, a doctor in Grace Valley, managed to get a morbidly disfigured woman help several years ago—there was a plastic surgeon with a surgical team who took on some of the most challenging cases for free, but it goes without saying—he can’t operate on everyone with an ugly scar. Megan’s is hard to look at and very sad—she’s a beautiful girl—but it’s not the worst we’ve seen. I’d be so happy if we could just get that eye fixed. That’s going to give her problems. It could lead to vision trouble, if it hasn’t already.”
“But by the time she’s a teenager…”
Mel put a hand on Angie’s arm. “I’ll keep trying. It’s hard in places like this, Ange. This isn’t a rich place. People work hard, but most of them don’t work for employers that provide good benefits—we’re a lot of family ranches and farms out here. Most can’t afford hundreds of dollars a month for medical coverage. Lorraine is a waitress and puts in a long week, so they have some benefits—the bare minimum. But there’s no coverage for plastic surgery that isn’t considered a medical necessity. I’ve already argued with them about the eye.”
“Have they seen pictures? The insurance company?”
“Oh, of course. I’ve done my best so far and I won’t give up. But the hard reality is that the Thicksons will have trouble even with the deductible and twenty percent of the costs. Frank was a logger with a good job, but he lost his arm in a logging accident. He has a prosthesis now. Between his part-time work and a disability check, they get by, but there are four kids and it’s tough for them.”
“It’s wrong,” Angie said, shaking her head. “This shouldn’t be so impossible.”
“We do our best—we do as much as we possibly can. Let me update this chart now. You can go if you want to, Angie. I can manage.”
“Nah,” she said. “There’s a treatment room to clean up.”
Mel smiled. Then she pointed at the reddish brown stain on Angie’s pretty yellow sweater. “Hydrogen peroxide on that—takes blood right out. Grab a bottle out of the supply cabinet and take it home with you.”
* * *
It was nearly nine by the time they’d finished cleaning up and Angie was finally leaving the clinic with Mel. Megan had long since gone home with her parents and Cameron broke free to find his wife and twins. When Angie stepped outside the first thing she noticed was Patrick, sitting on the porch steps at the clinic. “Hey!” she said in surprise.
He stood up while Mel turned to lock the door. “I wanted to see how you were. I already know the little girl went home with some stitches.”
“You must be freezing,” she said, noting the collar on his jacket turned up and his hands in his pockets. “Did you want to go to the bar for a while? Warm up?”
He shook his head. “I’ll just walk you to where you’re going and be on my way. Hi, Mel.”
She smiled warmly. “Nice to see you, Paddy. And how nice of you to check on Angie. She was a wonderful help, by the way.”
“I have no doubt. Angie, are you headed for the bar?”
“Ordinarily I might, but—” she spread her jacket open to reveal the bloody stain on her sweater “—I think I’d better go home and get out of these clothes. I’m parked right down the street.”
Once Mel had walked in the direction of the bar, Patrick looped his arm through Angie’s and walked her in the direction of her car. “You okay?”
“Sure. Of course. A little distressed about the situation that poor little girl is in, but I’m fine.”
“Tired? Hungry?”
“I think my cookies wore off, but I’m not fit to go anywhere with blood on me.”
“Home,” he said. “I could follow you and, while you change clothes, I can fix you something to eat. I’m not much in the kitchen, but I heat a mean can of soup, scramble some very fancy eggs, that sort of thing.”
She laughed. “Between the two of us, we could starve to death. Come on, follow me. I think I could use the company.”
“And I’d like to hear more about Meg’s situation.”
At the side of her SUV she stood on her toes and gave him a small kiss on the cheek. “Prepare to feel sad about that,” she said. “I’ll wait for you to find your Jeep.”
As she was driving to the cabin with his headlights in her rearview mirror, she wondered if he had planned something like this all along—another evening together. She wasn’t likely to be demure or shy away. She’d never known anyone like Patrick before. She’d known guys like Alex—the self-absorbed and spoiled science freak who was used to having his way with little effort. Alex was so strong academically that it never occurred to him he wasn’t perfect. When they studied together, Alex treated her like an equal; when they made out or made love, he definitely acted as though it were all about him. He was greedy. Impatient. Since she wasn’t experienced, the whole thing was usually a little clumsy. Completely dull for her.
Angie, acting on sheer impulse, wiggled out of Patrick’s arms and ran toward the vehicle just as a woman got out of the passenger’s side of the truck. She was holding a very large child wrapped in a blanket—a blanket on which there was a considerable amount of blood. A bloodstained towel covered most of the child’s face.
On instinct, Angie went toward them. At precisely that moment, Mel and Dr. Michaels burst through the crowd, running toward them.
“Frank?” Mel asked. “Lorraine?”
“It’s Megan! She slipped—there was ice on the porch and a nail sticking out of the porch post got her right on the forehead. It’s bleeding bad.”
“Come inside. Frank, you come, too. Let’s have the doctor look at it.”
Angie turned to Patrick very briefly, holding up her hand toward him. That was her only gesture before following the man, woman, child and practitioners into the clinic.
It felt odd to her. First of all, no one questioned her presence there, as though she was already an assistant of some kind. Second, Mel began barking orders at her as if she had been trained in this clinic. “I’ll need a sterile pack of four-by-four gauze, sterile water, not saline. Cameron? Want an antibiotic?”
“I don’t think we need an IV, but I’ll go with cephalexin, broad spectrum IM. She had a tetanus shot last summer but give me some Valium and lidocaine. I’ll get a suture kit.”
“Can you get that together, Angie?” Mel asked, handing her the keys to the drug cabinet. “I’ll take care of the syringes.”
“Yes. Please check my work, make sure I have the right things.”
“Absolutely.”
Angie got out the gauze and water and then went after the drugs, but what really had her attention was the fact that the little girl didn’t make a sound.
“I’m going to put pressure on the wound, Megan,” Mel said gently, softy. “Just for a little while.”
Angie had only seen a little bit of this injury, the blood on her face, but the child was so silent. She shook like a leaf, however—either terrified or in shock. And Mel was dabbing at her face and forehead with gauze. “Easy, Meg, it’s not bad,” Mel was murmuring.
“Let’s get this cold, bloody blanket out of here,” Mel said, leaving a thick padded gauze over half of Megan’s face. She reached into the cupboard behind her and produced a clean, warm blanket. To Angie, she said, “Roll Megan toward you, then toward me—gently, now.”
They wrapped her up in a fresh blanket while her parents waited as close to the treatment room door as possible. Then Cameron was back, pushing his way in close, pushing Angie away. His suture kit sat on the counter behind him and he looked at Megan’s pupils with a flashlight, asked her to follow his finger with her eyes, asked her a couple of simple questions like her birthday, her brothers’ names.
“Is it terrible, Doctor?” Megan asked, her voice quivering on the edge of tears.
“It’s not, sweetheart,” Cameron said. “It’s going to be fine.”
In the first year of medical school, a med student had very little, if any, clinical experience. In fact, the only experience Angie had came from following around an instructor in a clinic. Without that little bit of experience, she would have no idea what a four-by-four was or how to select drugs from the locked cabinet. And while the injury was a bloody mess, especially on the face of a little girl, it didn’t overwhelm Angie. She knew even the smallest head wounds could bleed like the devil.
By the time Cameron had opened up his suture kit, the wound had been cleaned and much of the blood wiped away. That’s when Angie had her first real look at the little girl’s face and tried not to gasp. The laceration on her forehead didn’t appear too serious, but the sweet thing already had a horrific scar on her face, already healed. It looked as though she’d been cut from the corner of her mouth almost to her eye; her mouth lifted on one side and her lower lid of her right eye drooped, exposing pink tissue. The scar was thicker in some places than others—it was vicious. Disfiguring.
The little treatment room was very crowded and growing quite warm. Cameron was working carefully but quickly on the laceration, cleaning and washing with lidocaine. “I think we can take care of this here, Megan,” Cameron said. “It’s going to need some stitches, but it’s small. It won’t hurt. I’ll numb it. And because of the size and location at your hairline, I wouldn’t fear a bad scar.” Then he looked over at Lorraine. “Is that all right with you, Lorraine?”
Although the woman twisted her hands, she nodded.
“I don’t think she has a concussion,” he went on. “I’m going to ask you to keep an eye on her tonight—I’ll give you some instructions before you take her home.”
Mel drew a syringe of something while Cameron donned sterile gloves. Then he leaned over her and said, “Tiny little mosquito bite, Meg, that’s all. I bet you don’t even have a headache tomorrow.”
Angie leaned so close to watch Cameron suture that Mel smiled and Cameron looked over his shoulder at her as if to say, Do you mind? When the stitches were in and a bandage covered the wound, Mel pulled Angie out of the room.
“Cameron’s going to ask Megan to just lie still for a while. He’ll examine her again before sending her home with her parents. I’m going to write in her chart.”
Angie followed her to the desk in the reception area. “Mel…?”
Mel stopped, turned and quietly answered the question she knew was on Angie’s lips. “Almost a year ago Megan fell and hit her head, her face, on a shovel that was lying on the ground partially buried by snow. It cut her cheek but, to tell the truth, it wasn’t that bad. It was actually the treatment that worked against her. Cameron took her to the emergency room—he wouldn’t dare try closing up such a large facial laceration on a child. But there was no plastic surgeon, the E.R. doctor wouldn’t call anyone in because Meg’s family is very poor and has limited insurance—certainly nothing that would cover plastics, and he stitched her up himself. It didn’t take too long to see scar contractures, which I can almost guarantee will only get worse. Megan is growing—the scar is tightening while the rest of her face and surrounding tissue is soft and elastic. It causes severe distortion. And then there’s ectropion, scar tissue pulling down her lower eyelid. She needs plastic surgery.”
“And why isn’t she getting it? Is she afraid?”
Mel shook her head. “It’s considered cosmetic. Elective. It would cost thousands of dollars, and that’s speaking conservatively. This is a struggling family. They’re doing well if they can keep the heat on all winter.”
“She’ll be disfigured for the rest of her life,” Angie said.
“I keep looking for a break. A friend of mine, a doctor in Grace Valley, managed to get a morbidly disfigured woman help several years ago—there was a plastic surgeon with a surgical team who took on some of the most challenging cases for free, but it goes without saying—he can’t operate on everyone with an ugly scar. Megan’s is hard to look at and very sad—she’s a beautiful girl—but it’s not the worst we’ve seen. I’d be so happy if we could just get that eye fixed. That’s going to give her problems. It could lead to vision trouble, if it hasn’t already.”
“But by the time she’s a teenager…”
Mel put a hand on Angie’s arm. “I’ll keep trying. It’s hard in places like this, Ange. This isn’t a rich place. People work hard, but most of them don’t work for employers that provide good benefits—we’re a lot of family ranches and farms out here. Most can’t afford hundreds of dollars a month for medical coverage. Lorraine is a waitress and puts in a long week, so they have some benefits—the bare minimum. But there’s no coverage for plastic surgery that isn’t considered a medical necessity. I’ve already argued with them about the eye.”
“Have they seen pictures? The insurance company?”
“Oh, of course. I’ve done my best so far and I won’t give up. But the hard reality is that the Thicksons will have trouble even with the deductible and twenty percent of the costs. Frank was a logger with a good job, but he lost his arm in a logging accident. He has a prosthesis now. Between his part-time work and a disability check, they get by, but there are four kids and it’s tough for them.”
“It’s wrong,” Angie said, shaking her head. “This shouldn’t be so impossible.”
“We do our best—we do as much as we possibly can. Let me update this chart now. You can go if you want to, Angie. I can manage.”
“Nah,” she said. “There’s a treatment room to clean up.”
Mel smiled. Then she pointed at the reddish brown stain on Angie’s pretty yellow sweater. “Hydrogen peroxide on that—takes blood right out. Grab a bottle out of the supply cabinet and take it home with you.”
* * *
It was nearly nine by the time they’d finished cleaning up and Angie was finally leaving the clinic with Mel. Megan had long since gone home with her parents and Cameron broke free to find his wife and twins. When Angie stepped outside the first thing she noticed was Patrick, sitting on the porch steps at the clinic. “Hey!” she said in surprise.
He stood up while Mel turned to lock the door. “I wanted to see how you were. I already know the little girl went home with some stitches.”
“You must be freezing,” she said, noting the collar on his jacket turned up and his hands in his pockets. “Did you want to go to the bar for a while? Warm up?”
He shook his head. “I’ll just walk you to where you’re going and be on my way. Hi, Mel.”
She smiled warmly. “Nice to see you, Paddy. And how nice of you to check on Angie. She was a wonderful help, by the way.”
“I have no doubt. Angie, are you headed for the bar?”
“Ordinarily I might, but—” she spread her jacket open to reveal the bloody stain on her sweater “—I think I’d better go home and get out of these clothes. I’m parked right down the street.”
Once Mel had walked in the direction of the bar, Patrick looped his arm through Angie’s and walked her in the direction of her car. “You okay?”
“Sure. Of course. A little distressed about the situation that poor little girl is in, but I’m fine.”
“Tired? Hungry?”
“I think my cookies wore off, but I’m not fit to go anywhere with blood on me.”
“Home,” he said. “I could follow you and, while you change clothes, I can fix you something to eat. I’m not much in the kitchen, but I heat a mean can of soup, scramble some very fancy eggs, that sort of thing.”
She laughed. “Between the two of us, we could starve to death. Come on, follow me. I think I could use the company.”
“And I’d like to hear more about Meg’s situation.”
At the side of her SUV she stood on her toes and gave him a small kiss on the cheek. “Prepare to feel sad about that,” she said. “I’ll wait for you to find your Jeep.”
As she was driving to the cabin with his headlights in her rearview mirror, she wondered if he had planned something like this all along—another evening together. She wasn’t likely to be demure or shy away. She’d never known anyone like Patrick before. She’d known guys like Alex—the self-absorbed and spoiled science freak who was used to having his way with little effort. Alex was so strong academically that it never occurred to him he wasn’t perfect. When they studied together, Alex treated her like an equal; when they made out or made love, he definitely acted as though it were all about him. He was greedy. Impatient. Since she wasn’t experienced, the whole thing was usually a little clumsy. Completely dull for her.
