Critical Care (6 page)

"For I know the plans I have for you," declares the Lord,
"plans to prosper you and not to harm you, plans to give you
hope and a future."

Jeremiah 29:11

It had been an engagement gift. Claire looked away, the familiar ache making her swallow.

Since Kevin's death, Claire had attended church infrequently;
she couldn't bear sitting there without him. It seemed easier to read
her Bible alone, avoiding inevitable questions about how she'd
been coping. Like those questions in recent letters from Gayle, who
was apparently moving on with her life. Claire sighed. She was glad
for Gayle, but for right now, Claire was better off alone. With her
lists and her decisive red pen.

Heal my heart. Move me forward. God knew her plan.

Claire stroked a fingertip warily over the fluff where Smokey's
other ear should have been. Poor beast, he never purred. One of the firefighters figured that a raccoon attacked him, a common confrontation in the California foothills, but nobody would ever really
know for sure how Smokey lost that ear and became so skittish.

Kevin couldn't have known, either, that shortly after adopting
Smokey he'd be gone, leaving his sister with the demented cat, a
house in the woods, and just enough insurance money to help
fund her bachelor's degree in nursing education and pave her way
out of the grim reality that was the ER. For a job opportunity that
was still on hold because she'd been derailed by ...

Claire hugged the damp T-shirt against her chest. The irony
struck, making her stomach churn. Despite all her hard work and
after endorphins by the quart, none of her troubles had faded away.
Not a one. She'd simply run full circle. Back to the ER and smack
into new turmoil with Logan Caldwell.

At 10:30 p.m., Claire picked up the phone, touched the first three
numbers, then hit the End button and set the phone down. It was
the second time she'd done that in half an hour. She took a sip of
her chai tea and swung her legs up onto the bed. It was far too late
to page the social worker again. The staff debriefing was scheduled,
and it was best to leave things the way they'd been arranged.

"Right, Smokester?" Claire nodded at the lanky cat stretched
across the foot of the double bed.

He raised his head and quit his silent kneading of the snowy
comforter. His yellow eyes fixed on her big toe, and Claire gave
it a risky wiggle, proving beyond a shadow of a doubt that she'd
traded endorphins for insanity. Which would explain the continuous intruding thoughts of Logan Caldwell.

She groaned. She was acting like she was ... what exactly?
Attracted to him? Claire pressed her palms against her eyes. No. The last thing she needed was any more confusion in her life,
any risk of losing the equilibrium she was fighting to maintain.
And-

"Hey!" Claire jerked her foot away as she felt the dangerous
brush of Smokey's whiskers against her toe.

She shook her head, and her just-washed hair trailed across the
shoulders of the pink pajama top. Close call-she'd almost been
bitten. Good point: she needed to be just as careful about the medical director. Logan did nothing but dredge up painful reminders
of Kevin, her humiliating last days as an ER nurse, and even her
pitiful track record with men. It was best to avoid him, and that
would be easy now that Social Services was taking over.

She reached for her shell-embossed teacup, and her gaze
dropped to the business card next to her open Bible. It was for the
social worker who would lead the debriefing tomorrow afternoon.
Claire would take a minor role this time, letting Social Services
and the hospital chaplain handle the real guts of the process. The
nagging doubt resurfaced and Claire glanced at the phone again.
She swallowed a sip of the creamy sweet tea, waiting for the feeling
to pass. It had been pestering her for the last several hours. Am I
making a mistake?

No. Absolutely not. Logan didn't have to be at the debriefing. Wasn't that what she'd told the social worker earlier? She'd
been right. The people most affected by the injured children-the
ones at risk for post-traumatic stress-were the nonphysician staff,
nurses, aides, and technicians. And Inez Vega.

Claire rested the warm cup against her cheek. Her breath
escaped in a soft sigh. As much as she'd tried not to, she kept seeing
the image of that poor woman crying in the dim light of the temporary morgue. She wondered about the kind of person who cared enough to leave her normal world, the safety of an office cubicle,
to venture into a place so full of chaos and pain. About the risk it
was, the heart it took, to wrap a blanket around a dead child.

Then she thought of Logan Caldwell riding his motorcycle as
fast as he could away from all that. And the way he'd talked about
"shrink-to-fit," touchy-feely counseling, about being tough and
priding himself on not crumbling. But mostly Claire kept replaying
over and over in her mind what he'd said about ... weak links.

It had taken guts for Erin Quinn to defy him and call for peer
counseling to help her staff. The same kind of dedication prompted
the already exhausted Sarah Burke to volunteer for an extra shift,
and Claire knew in her heart that Inez Vega was no weak link.

She swallowed the last of her tea and picked up the phone. Her
foot tapped nervously against the down comforter as her call was
transferred to voice mail.

"I'm sorry to be calling again so late," she said, her stomach
sinking faster than her foot could tap. "But I was wrong earlier.
The medical director needs to be at the debriefing tomorrow." Her
foot tapped faster as she pictured herself squaring off with Goliath.
"It's his day off, but have administration page him and say Claire
Avery insisted."

She smothered a yelp as Smokey bit into her toe. "Dr. Caldwell
is a big part of the problem."

Logan nosed the Harley into a physician's parking space, then let
his boots slide from the pegs and down to the asphalt, straddling
the idling engine.

As he peered through the visor of his helmet at the brick and
stucco back entrance to Sierra Mercy Hospital's ER, he weighed
his options. Cell phone messages failed, didn't they? Who could
prove he'd ever received notification of this Critical Incident Stress
Debriefing? If he'd been thirty minutes deeper into the Sierra
Mountains, he'd be out of phone range and on the threshold of
granite slabs, roaring waterfalls, towering pines, and quiet escape.

It was his first day off in seven, and he shouldn't be here. The
week had been brutal and not only because of yesterday's day care
incident. Logan's throat tightened at the thought of the toddler
he'd worked so hard to save and the always awful moment of telling parents a child was gone-no, you had to say the word died to
make it real, final. To leave no merciful hope. "I did everything I could,
but Amy died."

And he had done everything, even taken over the cardiac
compressions himself, pressing the heel of his hand over and over
against her little chest, willing the child to survive. Not wanting
to quit, all the while knowing that was irrational. Even if he could have started her heart, she'd been robbed of oxygen too long to
survive without devastating brain injury. Logan grimaced, remembering the stricken faces of the child's mother and grandmother
and the way the young father slammed his fist against the wall, his
cry like a tortured animal. Ah, man.

He swallowed hard, pushing aside the memory. On his way back
to the hospital, he'd passed the charred Little Nugget Day Care, its
fence now adorned with flower bouquets, letters from children,
stuffed animals, and at least a dozen purple balloons. But it wasn't
only the day care incident that was weighing on him. It was the
continuing frustrations of limited staffing, the song and dance it
took to get money budgeted to replace outdated equipment, and
the need to jump through ridiculous hoops to comply with every
new federal, state, and HMO mandate. He'd become a doctor to
help people, make a difference in lives, and that shouldn't take a
backseat to anything.

Logan gave the throttle a twist and felt his bike respond, proving its readiness to transport him away. The political problems
weren't any worse than the personnel issues coming across his desk
this week. Complaints: that agency nurse threatening to walk out
yesterday because ... What had she said to Erin? "Dr. Caldwell is a
slave driver and an inhuman beast." Not his first complaint. Nor his
last. It took time and effort to shape an effective medical team, and
there would be a certain attrition rate. So be it.

Reaching down, Logan cut the bike's engine. He pulled off his
helmet and shoved the keys into the front pocket of his jeans. His
fingers brushed against a worn and folded sheet of stationery. The
invitation to Beckah's wedding. Only a couple of weeks away now.
Another reason he needed to escape today.

But instead of pines, fresh air, and solitude, he'd be sitting in a dank staff conference room. With hospital coffee and tense,
nervous chatter. Being debriefed, for what that was worth. Maybe
he could head some of it off at the pass and keep the inevitable
psychobabble down to a dull roar. He'd meant what he'd said to
that educator about dwelling needlessly on tragedy; it only made
matters worse. Logan knew that better than most people.

Claire Avery was the one who'd insisted on his attending this
meeting, and she'd be there. For some reason, that made the next
hours seem almost bearable. He smiled, remembering the beautiful
dark-haired woman and the way she'd gone toe-to-toe with him in
the ER yesterday, with that determined lift of her chin when she
faced him and the flush rising to her cheeks. Logan's smile faded
as he recalled the incident afterward in the temporary morgue.
Inez and the toddler. Claire's eyes filling with tears, followed by
her decision to call for a staff debriefing.

He had no doubt she felt she was doing the right thing, just
as Erin did with her efforts to support staff with the Faith QD
meetings. The problem was that those things, no matter how wellintentioned, didn't work. He'd learned the hard way that there
was no pamphlet and no prayer with the answers. When bad stuff
happened, you had to tough it out and soldier on. Simple.

That and keep Mountain Mike's Pizza on speed dial.

Claire took one look and knew Logan had been out on the bike.
He arrived in the conference room at the last minute, wearing a
black leather jacket, motorcycle chaps over his jeans, sunglasses,
and the shadow of a beard. Along with a barely suppressed smirk
aimed directly at Claire. He sat down in the empty chair directly
opposite her.

Great. Cat bite on her big toe and Goliath within spitting
distance.

"I'm sorry," he told the social worker with a smile. He dropped
the sunglasses into his helmet. "I was halfway to Yosemite when I
got the voice mail." He stared into Claire's eyes.

Yes, my fault-deal with it. Claire lifted her chin and stared back,
willing herself not to blink. Today was about doing what she could
to help coworkers at risk, then bidding farewell to this whole mess.
She'd shrink her world down to a comfort zone again, where the
worst that could happen was insomnia or a joust with a one-eared
cat that never purred. And then she'd move forward with her master plan.

The heavyset social worker, Elaine Best, rose from her chair,
and Claire glanced around the table. All the involved ER staff was
here, including a security guard, Erin Quinn, Merlene Hibbert,
Sarah Burke, and Inez Vega. The registration clerk, her hair in a
single braid today, looked nervous but so much better than she
had last night. It was a relief to know she'd talked with both her
priest and a hospital social worker before she left the ER. Claire
was surprised to see her shyly wave at Logan Caldwell. And even
more so to see his return wink and warm smile. What was that
all about?

"We are here because of the Little Nugget Day Care tragedy,"
Elaine began after introducing the CISM team, including Claire
and the hospital chaplain, Ric Estes. "This process is not intended
to be psychotherapy or to prevent and treat symptoms of posttraumatic stress. It is simply designed as a discussion to provide
emotional support."