Heart Like Mine (10 page)

Josh raised his eyebrows. They'd been having issues all week getting Charlotte to eat enough calories.

He looked at Charlotte. “You agreed to this deal?”

Charlotte shrugged, but then she smiled sassily. “No one else promised me a sundae.”

He turned to Delaney, but she put up a hand before he could remind her not to make promises without first running things by him. She wasn't a medical person, after all. Next thing he knew, she'd be promising candy to a diabetic.

She raised her eyebrows in challenge. “I checked with Millie before I offered.”

“Oh.” He cleared his throat. “Oh.”

Delaney tipped her head and waved at Charlotte. “I'll be back after lunch, beautiful. Start thinking about what toppings you want.”

After she'd left the room, Josh took a look at Charlotte's records, then sat down in the chair beside her bed.

“How are you feeling today?”

“Pretty okay. Just can't stop coughing. I hate chest PT.”

“I know. But it's more important than ever to keep those lungs as clear as we can.”

She looked down at her blanket, picking at a thread. “So I can have a transplant, you mean?”

“Well … that, yes. But also so you can feel better. I imagine you've got friends waiting for you at home, and we want you swimming and hanging out with them, not staying here.”

“I know.” She still didn't look up, and Josh cocked his head to try to look at her eyes.

“Keep getting all dolled up like this, and I'm going to have to make sure any guys who come onto the floor get the rooms on the
way
other side.”

Charlotte let her eyes flit up to meet his as a tiny giggle escaped her mouth.

“Delaney's nice.”

Josh felt his eyebrows hike upward at her words. He'd attached a lot of adjectives to Delaney Blair in the past few days—smart, sexy, ballsy, and shy at the same time—but
nice
might work, if he could convince her not to leave him beached without funding.

Looking at Charlotte, who was smiling for the first time in days, he realized maybe there was a lot more to Delaney Blair than met the eye.

*   *   *

At eight o'clock that night, Delaney pushed back from her desk and rubbed her neck, spinning her chair to look out at the sun setting over Echo Lake in the distance. She'd stayed on the pediatric floor until four, and since then had been back up on the sixth floor trying to peck away at her own job's normal to-do list. Despite Gregory's promise to move some things to Megan's plate, she wasn't even half-done with what she needed to finish before she could leave tonight.

It was going to be a long week.

A knock on the door startled her, and she whipped her chair around, embarrassed to be caught with her shoes off, staring out the window like a zombie.

“I took a chance that you'd still be here.” Joshua smiled as he held up two salads from the downstairs cafeteria. “I also took a chance that you hadn't stopped to eat dinner yet, so I brought you something. Hopefully you like chicken Caesar salad.”

In answer, her stomach growled, making him laugh.

“Thank you.” She reached out for the salad as he handed it to her, along with a plastic fork. “I thought you were probably annoyed with me for bribing your patient with ice cream. I didn't expect—dinner.”

“Well, you'll be happy to know outright bribery worked. She ate her lunch like a champ.”

“That's good, right?”

He sat down and opened his salad. Apparently he was staying for dinner. “Depends on your ice-cream-sundae budget, I guess. It worked this time, but we can't let her make a habit of it.”

“I know. I'm sorry. I should have thought further ahead. I just thought maybe—it would help. That was probably a total first-year-resident move, wasn't it?”

He laughed. “I'm not correcting you. It worked for today, and bonus points for the hair.”

“What's the story with her, anyway? She said her family lives over in New York?”

Joshua nodded as he swallowed a bite of chicken. “They do. Dad has an auto body garage, and Mom's a waitress. They can't get down here to visit when she's admitted because neither of them can afford to take a day off.”

Delaney nodded slowly, a sad feeling gnawing in her gut.

“So she's down here for two weeks, and nobody comes?”

“Right.” He shook his head. “That's why Millie has kind of taken her under her wing. She and Kenderly, actually—the child life specialist.”

Delaney took a bite of her salad, anxious to switch gears and get some questions answered, since he was here. “So have Charlotte's parents ever been adequately trained for home care?”

“Depends on how you define
adequately
. They've been trained, but they've got full-time jobs and four other kids. It's easy to let stuff go when somebody doesn't seem all that sick.”

“But by letting that stuff go, doesn't that make her sicker?”

“Yes. But it's also a progressive disease, so depending on the family, sometimes it's hard to convince them that their efforts will have any worthwhile effect.”

“Oh, God. That's terrible.”

“Charlotte's also really good at hiding her symptoms until she's really sick, and she doesn't always do a great job with her own self-care, so it's kind of an endless circle of neglect that ends up landing her in here more and more.”

“That's so sad.”

He nodded. “But while she's here, we hit her with all barrels. She gets good medicine, good therapy, good nutrition, and every single time, we teach her all of the stuff we taught her the previous time. One of these admissions, it'll finally stick.”

“Is this common? Patients not really taking care of themselves? Or—parents not doing the care their kids need?”

Dr. Mackenzie looked at the floor, silent for a long moment. “It's not really that simple. There's a lot none of us know about what goes on in these families once we release the kids back home.”

“Is that why your stay rates are higher than the average? Do you try to keep some of them longer than—maybe you need to?”

He raised his eyebrows, pausing his fork on the way to his mouth. “I try to keep them as long as they need to be here. Sometimes that's longer than—the national average.”

Delaney's shoulders fell as she heard his sigh. She really hadn't meant to make him feel like he was on trial, but she knew that's exactly how her question had come out.

“I'm sorry. I wasn't making a judgment about whether our stay rates are acceptable. I'm just trying to understand why the numbers sit where they do. One of my goals is to look at reducing inpatient days for chronic patients like her.”

“I know. And again, I'd urge you to take into account a wide variety of demographic factors before you determine whether those national averages hold water with our particular patient population.”

“I'm trying. Promise. Charlotte was somebody I wanted to meet because, on paper, she's exactly the kind of kid who should garner a seven-day stay, not two weeks.”

“By
exactly the kind of kid
, are you referring to the fact that she's covered by Medicaid?”

She bristled at his question, but obviously he'd ask. After all, how many meetings went on where the number of Medicaid beds was discussed? How many times were the words
lost revenue
mentioned in connection with those beds? And in all honesty, wasn't it the primary reason she'd poked her head into Charlotte's room in the first place?

She wasn't ready to admit that to Dr. Mackenzie. “I was actually referring to her age and her general level of health, not her insurance status.”

He looked down, closing his eyes. “I'm sorry. That was out of line.”

“Listen.” She paused. “I know you don't know me, and I know I'm from the evil sixth floor, but here's the thing—my personal goal here is to get the best care to every child who needs it. I'm not looking at ways to cut services to vulnerable kids. I'm not looking to slash staffing on a floor that can't afford to lose nurses. I'm not looking to boot patients back home, if they should really be here.”

“That's all fine and good, but none of that will help you make budget cuts, and if I understand correctly, that part's nonnegotiable, right?”

She sighed, letting her eyes skate over his broad shoulders, over those hands she'd been trying not to fantasize about since they'd met. For about the hundredth time this week, she wished they were working on an uncontentious project together, rather than this unwelcome, unfair exercise in prioritizing a set of items that could all arguably vie for the number one position.

She closed her salad. “If there's any way to make your floor run leaner, we need to figure that out. It's late, and I'll be blunt—I imagine more than
my
job will be on the line if we don't.”

“I get it.” He put up his hands. “If we really dig deep, we might be able to save a few hundred here or there, but not the kind of money you're talking about. It just isn't there, and I'm not being evasive. I'm telling you straight out that there's just nothing you're going to find that'll have the effect you're looking for—unless you want to start playing God and deciding who gets care and who doesn't.”

“Of course not.”

“So what do we do?”

Delaney looked up at the ceiling. “We've got a budget number to land on. If we can't get there by cutting expenses, then we need to find a way to increase revenue. I think the first step is for the two of us to sit down with my revised proposal so I can understand the impact of every line item on there.
Then
we can move to alternative avenues. But I've got to be able to show due diligence on this, Dr. Mackenzie. I cannot go before that board and propose level funding because you said so. It'll never fly.”

“Understood. Why don't you come down tomorrow and spend another day observing, and then we'll meet when you're ready?”

“I think … that sounds fine.”

He looked out the window again, then back at the hallway through her open door, shaking his head.

“I can't believe how quiet it is up here.”

“Well, it's late. Everybody's gone home.”

He nodded, looking in no hurry to leave. “Do you work this late often? Or is this because you spent the day downstairs?”

“Little of both.” She shrugged slowly. “It's a nice time of day to get stuff done. No interruptions.”

“Ah.” He straightened up and gathered his salad container. “Except for rogue docs trying to convince you not to cut their funding?”

“It's a problem. But you brought dinner, so you're excused.” She pointed to her salad. “Thank you again, by the way.”

He shrugged, smiling. “I figured inviting you out for a lobster dinner would be completely transparent. The other department heads would talk.”

She let out a surprised laugh, but felt it falter as she looked at his face, which had grown suddenly serious. In the soft light of her desk lamp, it was easy to imagine the two of them having a quiet little dinner in her office, followed by—dessert. She felt her cheeks flush as she pictured closing the door, sliding into his arms, clearing her desk as he kissed her silly in the moonlight.

“Right.” Her voice was embarrassingly shaky. “Not a big lobster fan, unfortunately.”

He pushed the chair back toward her desk, not at all hurried. But then he took two steps toward the door, and she stood up to follow, intending to close it behind him. Clearly, he didn't hear her, because before he reached it, he turned around, and she almost ran into him.

He chuckled as he put out a hand to steady her, and this time, he didn't let go. She looked up, and his eyes scanned her face, landing for a long beat on her lips. Then he blinked hard and let his hand slide from her arm while he reached for the door.

“Good night, Delaney.”

 

Chapter 9

Early the next afternoon, Delaney was walking by a patient room when she heard a commotion and then a scared scream.

“Oh, no! Help!
Help!
”

Delaney looked left, then right, but the hallway was empty for the first time all day. She was the only hospital employee in sight, and somebody needed help. Oh, God. She wasn't trained to help with emergencies down here.

She wasn't trained to help with emergencies
anywhere
.

She ran into the room, then stopped short as she saw a mom with her little boy on the bed. And the blood. So much blood.

“Help! Please help me! He's bleeding!”

The woman grabbed a towel and pushed it down onto the boy's leg, but it quickly turned red. Delaney's stomach lurched when she caught sight of the boy's eyes, which were open wide and terrified.

She ran closer, but couldn't see his call button anywhere on his bed.
God!
Where was it? Where was everybody?

She spotted a pile of white washcloths on a little shelf near the foot of the bed, so she grabbed the whole pile and pressed down on the boy's thigh, keeping her eyes on his face so she didn't faint.

“It's okay, buddy.” She tried to keep her voice even and calm. “We'll fix you right up. The doctor's coming.”

Please, God, let the damn doctor be coming.

His eyes rolled back as the washcloths soaked through, and Delaney panicked.

“What happened? Where's his call button?”

“I don't know!” The mother looked terrified as she let go of the cloths and pawed through his blankets.

“Go get help!” Delaney motioned with her chin. Somebody had to hold pressure, or this poor kid was going to bleed out. “Go get somebody!”

The woman fled the room, and ten seconds later, Delaney could hear feet running down the hallway. A lot of feet. She'd pulled the end of the boy's sheet loose and was trying to add that to the pile of washcloths, but the bleeding wasn't stopping. Oh, God. Why wasn't the bleeding stopping?