From the Beginning (2 page)

Sobs choked her and she could barely stop the scalding tears from falling.

“Call it,” Jack ordered.

Her gaze met his. “You already—”

“Call it.” His voice was implacable, his look compassionate as he stared her down. “As you said, he was your patient.”

She glanced at the clock, then cleared away the lump in her throat. “Time of death—11:44.” Her breath hitched and she felt—actually felt—her heart break wide open. She’d been right. Mabulu’s death had been one too many, Somalia one country too many in a list so long she’d learned years ago to stop counting.

“I want to speak with you in my office,” Jack said, his voice uncompromising.

“My patient—” Their eyes locked in a battle of wills she didn’t have the strength to win—at least not today.

“Nola will take care of him.” He nodded toward the head nurse, then turned, without waiting to see if Amanda would follow, confident of his power and leadership even here, in this hospital composed of a series of olive-green tents and overstressed generators in the middle of the desert.

Amanda followed slowly, trying to steady herself for the confrontation she knew was coming. Her behavior was growing more and more erratic, her inability to let Mabulu go just the latest in a series of bad judgment calls. She was exhausted, overemotional, burned out. She knew the symptoms well, had witnessed them in others time and again in the past decade.

She’d simply never expected it to happen to her. Then again, she could say that about so many of the things in her life lately.

“What exactly
was
that?” Jack asked, closing the curtain on his makeshift office.

Her spine stiffened at his strident tone. “That was me trying to save my patient’s life.”

“That was you completely out of control, Amanda, and we both know it.”

“That’s not true,” she protested, but her voice wasn’t as solid as she would have liked.

“Yes, it is. I’ve worked with you off and on for fifteen years and I’ve never seen anything like that from you.”

“It was a rough one.” She tried—and failed—to shrug off the incident. “I’ll be okay.”

He studied her, and she knew his blue eyes were taking in the strain around her mouth and the cloudiness of her usually clear gray eyes. Telltale signs she’d noticed herself. “I’m not so sure about that.”

She stiffened. “What’s that supposed to mean?”

Sighing, he gestured to one of the two chairs in the room. “Sit down, Mandy.”

“Are you firing me, Jack?” If so, she would prefer to stand.

“Of course not,” he snorted. “You know more about practicing medicine in these conditions than most of my staff put together. But I do want to examine you.” He put his stethoscope in his ears and motioned her to sit.

“Absolutely not!”

“I’m not arguing with you about this. Before you go back on duty, I’m going to make damn sure you’re all right.”

She started to protest more vehemently, to tell him her health was none of his business. But she had enough self-preservation to realize that doing so would only reinforce his beliefs about her fitness for the job.

Plus, for the first time in her life, she just couldn’t summon up the effort to fight.

“I told you I’m fine,” she said as she sank into the chair reluctantly, but she could hear the shakiness in her voice.

“Which is obviously a falsehood.” He put the stethoscope to her chest. “Take a deep breath.”

“Jack—”

“Do it.”

Amanda sucked in air as loudly as possible, before letting it out slowly. “I’m just tired. We all are.”

“But we’re not all in tears when one of our patients dies.”

“Sometimes it gets to me. You know what it’s like.”

He reached for her wrist to check her pulse. “Sometimes it does,” he agreed. “But
this
isn’t you, Mandy. Tired or not.”

“Well, who is it, then?” She laughed bitterly. “Please, tell me. If this isn’t my life, whose hellish existence is it? Believe me, I’d love to give it back to her.”

Jack didn’t respond and she regretted the words as soon as they were spoken. “I didn’t mean that the way it sounded.”

“I think you did.” He checked her reflexes and she took a childish delight at the involuntary kick that landed in the middle of his shin. “You need a break.”

“Not now.”

“Yes,
now.
You’ve been going hell-for-leather for eighteen months straight—more if you count everything that happened before you came back here. Is it any wonder that you’re burned out? You need to get away from here for a while and remember that there’s more to life than suffering.”

“I can’t.” She stood and walked over to the crude window near his desk. “We’re understaffed as it is.”

“We’ll manage. We always do.”

“I’m overtired. A couple of nights’ sleep and I’ll be fine.”

His smile was sad. “Not this time. You need to step back for a while, go home, live a normal life for at least a year.”

“A
year?
” She whirled to face him. “You can’t be serious.”

“I’m very serious. You’re the best doctor I’ve got, one of the best I’ve ever worked with, but even you can’t keep going at this pace indefinitely. You’re strung out, stressed-out and you’re going to make yourself sick.”

He paused, stared at her for a long minute as if debating with himself. Finally he quietly commented, “You can’t hide from what happened to Gabrielle, Amanda. And you can’t bring her back.”

The words hit her like an out-of-control freight train, had her fists clenching and her blood pounding even as they flattened her completely. “You think I don’t know that?” she demanded, unable to look at him. “You think I don’t wake up every morning, wishing that my daughter was alive?”

“I think you do.” His tone was compassionate, his voice matter-of-fact. “Which is part of the problem. It’s been a year and a half, and you haven’t even begun to deal with what happened.”

“I deal with it every day.”

“No, you
hide
from it every day. Here, and in Uganda. In Mozambique. You’ve been running from the truth since the funeral, and all it’s gotten you is one step away from a nervous breakdown.”

“Is that your professional opinion,
Doctor?
” She sounded like a sulky four-year-old, but couldn’t help herself. If he kept pushing, the emptiness yawning inside of her would completely overwhelm her.

“It is.” He sighed, then reached out to cover her hand with his. “I know what I’m asking of you, Amanda.”

Her laugh was bitter. “You couldn’t possibly know, Jack. If you did, you wouldn’t have the nerve to ask.”

He squeezed her hand, letting the silence build until her eyes—once again—met his. “You can’t save her. No matter how many children you help, no matter how much you punish yourself, you still can’t bring her back.”

“It’s my job to save these children.” She yanked her hand away, then ran it carelessly through her short, dark hair. Her fingers snagged in one of the many curls, but she barely felt the pain. These days, she rarely allowed herself to feel anything at all. “They became my responsibility the day I signed up to come here.”

“I know.” His voice was soothing.

“This has nothing to do with Gabrielle,” she insisted. But her voice broke and Amanda rubbed the heels of her hands over her eyes as the tears began to flow. “It’s about there never being enough. Enough food, enough medicine, enough doctors. Enough time. Nowhere on this whole damned continent is there enough of anything.”

She gave a watery, sarcastic laugh, then corrected herself. “Except the bad stuff. There’s plenty of that. Corruption. Famine, drought, poverty.”

Glancing out the screened-in window, she watched a trio of vultures circle above the camp, impatient to get their claws into Mabulu’s frail, bloated body. She wouldn’t let that happen.

“And death. There’s always enough death.” Her voice cracked, and the sobs she’d been trying to hold in for months finally broke free.

“Oh, Mandy.” Jack sighed, then pulled her into his oversize embrace. “That’s it, honey. Have a good cry.”

She tried to stop the meltdown—she really did—but she was too exhausted, and her emotions overcame her iron will. A small part of her stood back, untouched, watching in horror as her professional demeanor crumbled like clay left too long in the vicious African sun.

This wasn’t what they’d taught her in medical school. This wasn’t who she was. The Amanda Jacobs she knew was cool, professional, in control at all times. That Amanda Jacobs had graduated top of her class at twenty-four, had worked eleven years in the world’s battle zones with barely a grimace. She’d sat by her daughter’s bedside, dry-eyed and composed, doing everything she could to comfort Gabrielle as she suffered a slow and painful death from cancer.

That Amanda hadn’t shed so much as one tear at the funeral.

Where was that woman now? she wondered hysterically. She wanted her back. Living like this, her emotions an open, aching wound, was too hard.

Jack continued to rub her back soothingly as she sought to pull herself together. It took a few minutes, but when she’d finally managed it, he drew back and asked quietly, “Do you feel any better?”

Was he kidding? Her head throbbed, her eyes burned and her mouth felt as if something had crawled inside it and died. How could she possibly be feeling better when she’d never felt worse? But she nodded as she reached across his desk for a tissue. There was only so much humiliation a woman could stand in one day.

He watched silently as she wiped her face and blew her nose, struggling for the composure that was still a little out of reach. Finally he said, “You know I’m right. If one of your patients came in like this, you’d tell her the same things I’m telling you.”

“I can’t, Jack.”

“You mean, you won’t. But this time, you don’t have a choice. I run this place and I say you go.”

She studied him with narrowed eyes for a minute, then shrugged even as unease crawled up her spine. “There are other clinics.”

“And you won’t get a job at any of them. Not with this organization or any other.”

“You can’t do that!”

“You’d be surprised what I can do.” He took a deep breath, then let it out slowly. “You’re on the edge, Amanda. No reputable clinic will take on a doctor who is so obviously going to blow. And I won’t give you a recommendation—not right now.”

“Why are you doing this?”

“Because I care about you.” He ignored her snort of derision. “Because you’ve been here too long.”

She folded her arms over her chest and glared at him accusingly. “You’ve been here as long as I have.”

“Yes,” he agreed. “But I know when to draw the line—for myself and others. You don’t. You never have. It’s what makes you such an incredible doctor, but it’s also what brought you to this point. You’re used up, Mandy.”