Genesis (3 page)

Sara pressed the cold paper towel to the woman's forehead. "Any
nausea?"

"In the mornings," Faith managed. "I thought it was morning
sickness, but . . ."

"What about the headaches?"

"They're pretty bad, mostly in the afternoon."

"Have you been unusually thirsty? Urinating a lot?"

"Yes. No. I don't know." She managed to open her eyes, asking,
"So, what is it—the flu or brain cancer or what?"

Sara sat on the edge of the bed and took the woman's hand.

"Oh, God, is it that bad?" Before Sara could answer, she said,
"Doctors and cops only sit down when it's bad news."

Sara wondered how she had missed this revelation. In all her years
with Jeffrey Tolliver, she'd thought she had figured out every one of
his tics, but this one had passed her by. She told Faith, "I was married
to a cop for fifteen years. I never noticed, but you're right—my husband
always sat down when there was bad news."

"I've been a cop for fifteen years," Faith responded. "Did he cheat
on you or turn into an alcoholic?"

Sara felt a lump in her throat. "He was killed three and a half years
ago."

"Oh, no," Faith gasped, putting her hand to her chest. "I'm so
sorry."

"It's all right," Sara answered, wondering why she'd even told the
woman such a personal detail. Her life over the last few years had
been dedicated to not talking about Jeffrey, and here she was sharing
him with a stranger. She tried to ease the tension by adding, "You're
right. He cheated on me, too." At least he had the first time Sara married
him.

"I'm so sorry," Faith repeated. "Was he on duty?"

Sara didn't want to answer her. She felt nauseated and overwhelmed,
probably a lot like Faith had felt before she'd passed out in
the parking lot.

Faith picked up on this. "You don't have to—"

"Thanks."

"I hope they got the bastard."

Sara put her hand into her pocket, her fingers wrapping around
the edge of the letter. That was the question everyone wanted answered:
Did they get him? Did they catch the bastard who killed your husband?
As if it mattered. As if the disposition of Jeffrey's killer would
somehow alleviate the pain of his death.

Mercifully, Mary came into the room. "Sorry," the nurse apologized.
"The old lady's kids just dropped her here. I had to call social
services." She handed Sara a piece of paper. "CMP's back."

Sara frowned as she read the numbers on the metabolic profile.
"Do you have your monitor?"

Mary reached into her pocket and handed over her blood glucose
monitor.

Sara swabbed some alcohol on the tip of Faith's finger. The CMP
was incredibly accurate, but Grady was a large hospital and it wasn't
unheard of for the lab to get samples mixed up. "When was the last
time you had a meal?" she asked Faith.

"We were in court all day." Faith hissed "Shit" as the lancet
pierced her finger, then continued, "Around noon, I ate part of a
sticky bun Will got out of the vending machine."

Sara tried again. "The last
real
meal."

"Around eight o'clock last night."

Sara guessed from the guilty look on Faith's face that it had probably
come out of a take-away bag. "Did you have coffee this morning?"

"Maybe half a cup. The smell was a bit too much."

"Cream and sugar?"

"Black. I usually eat a good breakfast—yogurt, fruit. Right after
my run." Faith asked, "Is something wrong with my blood sugar?"

"We'll see," Sara told her, squeezing some blood onto the test
strip. Mary raised an eyebrow, as if to ask if Sara wanted to place a
wager on the number. Sara shook her head:
no bet
. Mary persisted,
using her fingers to indicate one-five-zero.

"I thought the test came later," Faith said, sounding unsure of
herself. "When they make you drink the sugary stuff?"

"Have you ever had any problems with your blood sugar? Is there
a history in your family?"

"No. None."

The monitor beeped and the number 152 flashed on the screen.

Mary gave a low whistle, impressed by her own guess. Sara had
once asked the woman why she didn't go to medical school, only to
be told that nurses were the ones who practiced the real medicine.

Sara told Faith, "You have diabetes."

Faith's mouth worked before she managed a faint, "What?"

"My guess is that you've been pre-diabetic for a while. Your cholesterol
and triglycerides are extremely elevated. Your blood pressure
is a little high. The pregnancy and the rapid weight gain—ten
pounds is a lot for nine weeks—plus your bad eating habits, pushed
you over the edge."

"My first pregnancy was fine."

"You're older now." Sara gave her some tissue to press against her
finger so the bleeding would stop. "I want you to follow up with
your regular doctor first thing in the morning. We need to make sure
there's not something else going on here. Meanwhile, you have to
keep your blood sugar under control. If you don't, passing out in the
parking lot will be the least of your worries."

"Maybe it's just—I haven't been eating right, and—"

Sara cut her off mid-denial. "Anything over one-forty is a positive
diagnosis for diabetes. Your number has actually inched up since
the first blood test was taken."

Faith took her time absorbing this. "Will it last?"

The question was one for an endocrinologist to answer. "You'll
need to talk to your doctor and have him run some more tests," Sara
advised, though, if she had to make an educated guess, she would say
that Faith was in a precarious situation. Except for the pregnancy, she
would be presenting as a full-blown diabetic.

Sara glanced at her watch. "I would admit you tonight for observation,
but by the time we processed you and found you a room,
your doctor's office would be open, and something tells me you
wouldn't stay here anyway." She had spent enough time around
police officers to know that Faith would bolt the minute she got the
chance.

She continued, "You have to promise me that you'll call your
doctor first thing—and I mean that, first thing. We'll get a nurse educator
in here to teach you how to test your blood and how and
when to inject yourself, but you've got to follow up with him immediately."

"I have to give myself shots?" Faith's voice went up in alarm.

"Oral meds aren't approved for use in pregnant women. This is
why you need to talk to your doctor. There's a lot of trial and error
here. Your weight and hormone levels will change as the pregnancy
progresses. Your doctor's going to be your best friend for the next
eight months, at least."

Faith seemed embarrassed. "I don't have a regular doctor."

Sara took out her prescription pad and wrote down the name of a
woman she'd interned with years ago. "Delia Wallace works out of
Emory. She has a dual specialty in gynecology and endocrinology.
I'll call her tonight so her office knows to work you in."

Faith still seemed unconvinced. "How can I suddenly have this? I
know I've put on weight, but I'm not fat."

"You don't have to be fat," Sara told her. "You're older now. The
baby affects your hormones, your ability to produce insulin. You
haven't been eating well. The stars lined up and it triggered you."

"It's Will's fault," Faith mumbled. "He eats like a twelve-year-old.
Doughnuts, pizza, hamburgers. He can't go into a gas station
without buying nachos and a hot dog."

Sara sat down on the edge of the bed again. "Faith, this isn't the
end of the world. You're in good shape. You've got great insurance.
You can manage this."

"What if I . . ." She blanched, breaking eye contact with Sara.
"What if I wasn't pregnant?"

"We're not talking about gestational diabetes here. This is full
blown, type two. A termination won't suddenly make the problem
go away," Sara answered. "Look, this is probably something you've
been building up to for a while. Being pregnant brought it on faster.
It will make things more complicated in the beginning, but not impossible."

"I just . . ." She didn't seem capable of finishing a sentence.

Sara patted her hand, standing. "Dr. Wallace is an excellent diagnostitician.
I know for a fact that she takes the city insurance plan."

"State," Faith corrected. "I'm with the GBI."

Sara assumed the Georgia Bureau of Investigation's plan was similar,
but she didn't quibble. Faith was obviously having difficulty absorbing
the news, and Sara had not exactly eased her into it. You
couldn't unring a bell, though. Sara patted her arm. "Mary will give
you an injection. You'll be feeling better in no time." She started to
leave. "I mean it about calling Dr. Wallace," she added firmly. "I
want you on the phone with her office first thing in the morning, and
you need to be eating more than sticky buns. Low-carb, low-fat, regular,
healthy meals and snacks, okay?"

Faith nodded, still dumbstruck, and Sara left the room feeling like
an absolute heel. Her bedside manner had certainly deteriorated over
the years, but this represented a new low. Wasn't that anonymity
why she had come to Grady in the first place? But for a handful of
homeless men and some prostitutes, she seldom saw a patient more
than once. That had been the real pull for Sara—the absolute detachment.
She wasn't at a stage in her life where she wanted to make connections with
people. Every new chart was an opportunity to start all
over. If Sara was lucky—and if Faith Mitchell was careful—they
would probably never see each other again.

Instead of going back into the doctors' lounge to finish her charts,
Sara walked past the nurses' station, through the double doors, into
the overfilled waiting room and finally found herself outside. There
were a couple of respiratory therapists by the exit smoking cigarettes,
so Sara kept walking toward the back of the building. Guilt about
Faith Mitchell still hung heavy on her shoulders, and she looked up
Delia Wallace's number in her cell phone before she forgot to follow
up. The service took her message about Faith, and Sara felt slightly
better as she ended the call.

She had run into Delia Wallace a couple of months ago, when the
woman had come in to see one of her wealthy patients who had been
airlifted to Grady after a bad car accident. Delia and Sara had been the
only women in the top five percent of their graduating class at
Emory University Medical School. At the time, it was an unwritten
rule that there were two options for female doctors: gynecology or
pediatrics. Delia had chosen the first, Sara the latter. They would
both turn forty next year. Delia seemed to have everything. Sara felt
like she had nothing.

Most doctors—Sara included—were arrogant to one degree or
another, but Delia had always been an avid self-promoter. While
they drank their coffees in the doctors' lounge, Delia quickly offered
the highlights of her life: a thriving practice with two offices, a
stockbroker husband and three overachieving kids. She'd shown Sara
pictures of them all, this perfect family of hers who looked as if they
had walked out of a Ralph Lauren advertisement.

Sara hadn't told Delia about her own life after medical school,
that she had gone back to Grant County, her home, to tend to children
in rural areas. She didn't tell Delia about Jeffrey or why she
moved back to Atlanta or why she was working at Grady when she
could open her own practice and have some semblance of a normal
life. Sara had just shrugged, saying, "I ended up back here," and Delia
had looked at her with both disappointment and vindication; both
emotions conjured by the fact that Sara had been ahead of Delia their
entire time at Emory.

Sara tucked her hands into her pockets, pulling her thin coat
closed to fight the chill. She felt the letter against the back of her
hand as she walked past the loading dock. She had volunteered to
cover an extra shift that morning, working straight through for
nearly sixteen hours so that she could have all of tomorrow off.
Exhaustion hit her just as the night air did, and she stood with her
hands fisted in her pockets, relishing the relatively clean air in her
lungs. She caught the scent of rain under the smell of car exhaust and
whatever was coming off the Dumpster. Maybe she would sleep
tonight. She always slept better when it rained.

She looked down at the cars on the interstate. Rush hour was at its
tail end—men and women going home to their families, their lives.
Sara was standing at what was called the Grady Curve, an arc in the
highway that traffic reporters used as a landmark when reporting
trouble on the downtown connector. All the taillights were bright
red tonight as a tow truck pulled a stalled SUV from the left-hand
shoulder. Police cruisers blocked the scene, blue lights spinning, casting
their eerie light into the darkness. They reminded her of the
night Jeffrey had died—the police swarming, the state taking over,
the scene combed through by dozens of men in their white suits and
booties.

"Sara?"

She turned around. Mary stood with the door open, waving her
back into the building. "Hurry!"

Sara jogged toward the door, Mary calling out stats as she got
closer. "Single car MVA with pedestrian on foot. Kraukauer took
the driver and passenger, possible MI on the driver. You've got the
woman who was hit by the car. Open frac on right arm and leg,
L-O-C at the scene. Possible sexual assault and torture. Bystander
happened to be an EMT. He did what he could, but it's bad."

Sara was sure she'd misunderstood. "She was raped and hit by a
car?"

Mary didn't explain. Her hand was like a vise on Sara's arm as they
jogged down the hallway. The door was open to the emergency
triage room. Sara saw the gurney, three medics surrounding the patient.
Everyone in the room was a man, including Will Trent, who
was leaning over the woman, trying to question her.

"Can you tell me your name?" he asked.