Reunited with the Children's Doc
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Susan Carlisle
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11
CHAPTER ONE
“MORNIN’, DR. NELSON,” said the staff tech of the cancer center as Dylan pushed through the clinic doors.
“Good morning,” he called over his shoulder, not slowing down.
“You have company today,” the tech returned.
He hesitated a step. “Oh, yeah, I do.” As lead pediatric oncologist at Atlanta Children’s Hospital, he had patients waiting, along with a full schedule. And now a researcher was here to do a new drug trial. He entered the Infusion Room and pulled up short. Aliza, one of his sweetest and sickest patients, was talking to a slim woman with her back to him. His eyes narrowed and his lips tightened. Something about the woman sitting on a rolling stool looked familiar.
Dylan’s heart squeezed when Aliza laughed and smiled. Both were rare. For the stranger to draw them from Aliza shocked him. He continued to watch as the woman worked with the port in the child’s chest and carried a conversation in the calmest of manners.
Who was this winning over his most difficult patient and undertaking the care that he or one of his nurses should provide? It had taken him months to get Aliza to trust him and this woman had already achieved it. What kind of miracle worker was she?
He approached.
Aliza’s mother looked at him. “Hi, Dr. Nelson.”
The woman turned and Dylan’s footsteps faltered. Marcy.
The galloping of his heart had nothing to do with racing up the stairs. Dylan had never expected to see Marcy Wingard again, yet after all these years she’d turned up in his department. He’d thought of her many times during the fifteen years since he’d last seen her. Had compared more than one woman to her.
His startled gaze locked with her wide-eyed one. Yes, the same green eyes but with a wariness in them he’d not seen before. The shock he felt matched the look on her face.
“Dylan?” Circles of pink graced her cheeks. “Uh... Dr. Nelson?”
“Yes.”
She glanced at the girl and mother. “I’m Dr. Montgomery. I was told you’d be coming in. I was just telling Aliza and her mother here about how I got lost on the way to the hospital this morning.”
Montgomery? Oh, yeah. She must have married. “Sounds like I need to hear that story sometime.” He forced his attention back to Aliza. “How are you doing this morning?”
“I’m fine.” The girl looked at her hands.
Dylan crouched on his heels beside the girl’s lounge chair, getting to her eye level. “So what’s going on here?” He spoke to the child, noting the thin strands of hair where once there were beautiful yellow ringlets. His words were meant for Marcy. He was protective of his patients. Dylan didn’t want other doctors interfering with them unless he was present. He needed to know what Marcy was really doing there.
He couldn’t help but be particular about how his patients were treated or approached. Beau, his boarding school roommate, had developed cancer while they were in school. His friend’s experience had influenced Dylan’s style of care. He’d heard Beau’s complaints about how he was treated and taken them to heart. Dylan vowed early in his career not to be the doctor who didn’t take time to get to know his patients and listen to them. Even to this day he heard Beau’s voice in his head when he first met a patient. Thankful Beau had survived to talk to Dylan regularly over the phone.
“We were just getting acquainted,” Marcy said.
Dylan stood then spoke to Aliza and her mother, who sat beside her daughter. “If you’ll excuse us, I’d like to speak to... Dr. Montgomery for a moment.”
“Sure,” Aliza’s mother said.
He stepped to the nurses’ desk and Marcy followed. He’d not seen her since college. They’d been lab partners their senior year of undergrad and he would’ve liked for them to have been more. To his deep disappointment, he’d been forced to accept nothing was going to happen between them.
“Uh... Marcy it’s good to see you.” He cleared his throat. “What a surprise.”
“For me as well.” Her words sounded more formal than necessary for old friends. At one time they had been friends. Good friends.
Marcy looked the same, just a few years older. She’d aged well. She was the one that had gotten away. He’d had his fair share of women since...he’d even been engaged and deep into wedding plans when his fiancée had broken it off. It still hurt.
“Hello, Dylan. I had no idea you were working here.” She touched her hair as if checking to see if it was in place. The Marcy he’d known had worn it loose, wild and free unless she had to tie it back for their work in the lab.
He remembered all too well the brush of her long chestnut-colored hair against his cheek as they leaned over a notebook, working on an experiment. Today it was shorter. It was pulled tightly back and secured at the nape of her neck. He preferred it unbound.
More often than he wished to admit, Marcy had traveled through his mind when he least expected it. He’d checked social media a few times to see if he could find her, just to see what she was doing, but hadn’t found anything but professional information.
“So you’re the research doctor I was told to expect.”
“Yes, that’s me. Sorry I didn’t mention that sooner. I was just surprised to see you.”
“Me too.”
“Dr. Nelson, would you please come check this port?” a nurse asked from nearby.
“Marcy, if you’d excuse me. I need to see about this.” He turned, almost grateful for the chance to collect himself.
“May I come with you? I need to get to know your patients. After all I’ll be working with them for the next few weeks.”
“Sure. I’ll introduce you.” At least he couldn’t fault her bedside manner with Aliza. If she was that good with all his patients, he could let his guard down. He shielded them where he could. They were already under stress and fearful, and not feeling well from medicine that should be helping them. Dylan pulled a stool near his patient’s lounge chair and sat. “Hi, Lucy. How’re you doing today?”
The girl smiled.
Dylan always enjoyed seeing that expression because too often his patients didn’t feel like giving him a smile. “Nurse Racheal says I need to have a look at your port.” He glanced toward Marcy. “Do you mind if my friend Dr. Montgomery has a look too?”
“It’s okay,” the girl said.
Marcy moved so she stood at his shoulder.
“Lucy, will you pull your T-shirt out of the way for me? I promise this won’t take long.” Dylan helped the girl adjust her shirt so he could see the port clearly just below her left shoulder. He searched for redness around the site.
“I’ve never seen an implantable venous access port placed like that.” Marcy’s voice held a tone of disapproval.
Dylan ignored her. Now wasn’t time to discuss that. Especially in front of a patient. “Lucy, I’m going to need to touch your skin around the port. You tell me if it hurts.” He pressed his fingertips against the girl’s skin, moving in a clockwise motion. Dylan made it almost all the way around before the girl winced.
“It hurts there.” Lucy gave a squeak of an answer.
“I think we should take a closer look in the lab.” He gave Lucy a reassuring smile. “Why don’t I meet you in the port lab in a few minutes? I’ll take this port out and in a few weeks we’ll place another.”
Mrs. Baker, Lucy’s mother sagged. “You mean we’ll have to wait to get this started?”
“Yes, I know it seems like a setback but it’s only for a few weeks.” Dylan continued, “Lucy’s going to be fine. You wait right here, and I’ll send someone to get you when I’m ready.” He patted the girl on the shoulder.
He sensed Marcy’s rigid posture as she followed him across the open room toward the port lab.
When they reached the lab and were out of hearing from everyone else, Marcy asked, “Why was the port put in that way?”
Dylan faced her. “Because I didn’t do it. It was done across town at another hospital. Lucy became unhappy there and her mother brought her here. She didn’t want to take the port out if we didn’t have to. Lucy had already been through enough trauma. I agreed but warned them this might happen.”
“So what’re you thinking?”
“That it might be an infection brewing.” His mouth tightened.
“I saw the small area of redness.” Marcy still had sharp eyes. “Could be tunnel cellulitis in the superior vena cava?”
“Maybe but I don’t think so. The situation is rare and that would be more so. We’ll pull it out and try antibiotics then see. If you want to be in on the procedure you need to gown up.”
Fifteen minutes later Marcy stood like a statue beside him. An uneasiness he couldn’t describe circled her. Lucy and her mother sat in chairs against the wall, neither of them looking happy.
His attention returned to his patient. “I hate to say it, but I think you’re gonna need to have a new port,” he said to the girl then looked at her mother. Tears fell from Lucy’s eyes. “I don’t like it any better than you do but it’d be worse if we put medicine in and it didn’t go where we need it to. Trust us. We’ll take care of it.”
The mother nodded. “We do trust you to know what’s best.”
Dylan smiled. “I hope we never abuse that trust.”
“Lucy,” Dylan said, “why don’t you get up on the table here. I’ll need you to lie down.” To the mother he said, “Michelle, I’m going to have you kiss Lucy then wait for her outside in the waiting room. This will only take a few minutes.”
The girl scrambled up on the exam table using the footstool. Michelle kissed and hugged her. “I’ll call your dad and tell him to pick up some ice cream on the way home. I think we’ll both deserve it.”
“Chocolate syrup too?” Lucy asked, the fear still hanging in her voice.
Her mother gave her a weak smile. “Chocolate syrup too.”
“I may need to get an invite to that.” Dylan came to stand beside the bed.
“You’re welcome anytime,” Michelle said over her shoulder as she left the room.
Lucy lay on the table in the port lab with tears in her eyes. Marcy seemed to be having much the same reaction but was covering it better.
Two nurses entered wearing the same sterile cover-ups.
Dylan smiled down at Lucy. “Dr. Montgomery will be here with me today, okay?”
The girl nodded. “It’s okay.”
Marcy stepped to the table. “Would you like me to hold your hand? I know that always helps me.” She offered her hand, and Lucy took it.
Marcy gave the child a reassuring smile. “If it hurts just squeeze my hand.”
Lucy nodded.
Dylan liked the care Marcy gave the child. As if Marcy had been through this before. “This shouldn’t take long but I’m going to make you a little sleepy first.”
“Just like last time?”
“Just like last time.” Dylan prepared the pain medicine. He checked around the port after the nurses had removed the protective covering, and then glanced at Marcy. Her complete attention remained on the girl as if willing her not to have any pain.
He was impressed. Most research doctors spend so much time in the lab they forget how to have empathy for a patient. Apparently not Marcy. She was great with them. Marcy had been easy to be around in college. Her disposition served her well in these situations.
Lucy’s eyes drooped.
Clipping the sutures holding the port in place, he asked, “Marcy, would you hold this open while I pull the port out?”
She nodded, letting go of Lucy’s hand. Taking the long surgical tweezers, she held it steady. He gently pulled the nickel-size port out from under Lucy’s skin along with the catheter. Quickly one of the nurses applied a bandage and pressure to the opening. Marcy placed the instrument in a dish the other nurse held. Moments later a nurse applied butterfly strips and a bandage to Lucy’s chest.
“How long before she can have another port put in?” Marcy asked.
“At least three weeks”
She winced. “Can’t you do it sooner? The wait will be horrible and her parents will be in a panic at the delay. How could this happen?”
“Take it easy, Marcy. We must have patience here. This doesn’t happen often, but I want to give the antibiotics time to work. I’ll place the next port below this one.” He spoke to one of the nurses, “Would you tell her mother she can come sit with Lucy until she wakes. After that she can go. I’d like to see Lucy back on Thursday.”
“I’ll take care of it.” The nurse left the room.
A noise from the area of the Infusion Room grew into rhythmic rapping. A voice sang out while the others harmonized. Marcy asked, “What’s going on?”
Dylan stripped out of his protective covering and she followed his lead. They left the room to stand in the infusion area. A young dark-skinned teenage boy led a group of other patients around the same age all singing and taking a part. Their harmonizing sounded wonderful. They finished the song with a slap of their hands against the loungers they all lay on. The smiles were contagious. The staff and parents clapped.
“They’re good,” Marcy said.
Dylan grinned. “Yeah, until they make up one about you. Now I have to interrupt them to check on their chemo, then I have clinic this afternoon. You’re welcome to join me. It would be a good chance for you to review charts and put faces to patients.”
“I’d liked that. I’ll review what charts I can and start determining canadines for the trial on Monday.”
“Sounds like a plan.”
Marcy moved on into the room behind Dylan. She couldn’t have been more surprised to learn he was the head of the cancer clinic where she was doing her trial. She would never have thought in a million years they’d both become oncology doctors. Life had a way of taking you down roads you hadn’t thought possible. She knew that better than most.
Dylan walked toward the patient who’d sat to the right of Lucy. He turned to Marcy. “Do you mind waiting here a moment? Dan is a particularly sensitive patient. This is stressful for him, and I don’t want him upset. I’ll check with him first, then introduce you.”
Marcy nodded. She understood. Her son, Toby, hadn’t always welcomed new faces especially at his young age. Dylan’s dark chocolate gaze regarded her before he gave her a slight nod.
Dan sat in the first tan cushioned lounge chair next to a window. An IV pole stood beside his bed and a small individual TV hung on the wall.
Dylan rolled up a stool beside the patient. “How’re you doing today, Dan?”
“I am okay.”
“Just okay?” Dylan pulled his stethoscope from around his neck.
He glanced back to where Marcy stood looking at the charting pad. Dylan tilted his head toward her. “That’s Dr. Montgomery. She’s going to be helping us here for a few weeks. She’d like to meet you. I think you’ll like her. Would it be okay if she joined us?”
The ten-year-old boy studied Marcy for a moment then nodded his agreement. Would Dylan have turned her away if the boy had said no? She felt like he would have. He acted protective of his patients. She liked that. It showed he cared. Toby’s doctor had the same boundaries. It was nice to know a doctor thought of his patients first and treated them as people.
Dylan waved her over with a small motion of his fingers. “Dan, I’d like you to meet Dr. Montgomery.”
“Hello Dan.” Marcy smiled as her chest tightened. Toby would’ve been about this boy’s age if he’d lived. She couldn’t help Toby, but she believed she had the answer to giving this child many more years of life.
“Hey,” the boy said weakly.
“How’re you doing?” Marcy pulled a stool up beside Dylan.
You can do this.
She hadn’t expected to have so much interaction with the patients. She’d expected to do medical procedures, not to get to know them as individuals. Dylan knew them all by their first name. How did he handle it when he lost one?
Dylan studied the chemo IV line running through an infusion machine attached to the rolling pole stationed beside the boy’s chair. “Dan, don’t you usually play a video game?”
The boy quirked his mouth. “They forgot to bring it to me. It’s okay. I get tired pretty easy, so I have a hard time not taking a nap.”
Marcy blinked. Toby had slept more than normal trying to regain his strength after chemotherapy.
“I’ll see that a nurse brings it to you just in case you feel like playing. Maybe we’ll try to get a game in.” Dylan patted Dan’s shoulder. “You only have a few more weeks before this chemo round will be finished. Then you can get back to school.”
The boy gave Dylan a sad look. “I hope my friends still remember who I am.”
“I’m sure they will,” Marcy offered before she thought about speaking.
A warm look flickered in Dylan’s eyes before his attention returned to Dan. “Everything looks good. I’ll see you next week.”
“I’ll be here. Mom says I have no choice.”
Dylan chuckled. “Moms have a way of making us do what we don’t want to.”
“Bye, Dan. It was nice to meet you.” With a tight chest Marcy joined Dylan as he moved to the next patient. She continued to follow him around the room, seeing all the patients there for the day. Each one climbed to the top of her emotional pile and sat, but she never let on. Instead, she focused on the children and Dylan’s interactions with them. To her amazement he knew all their names.
The last patient in the line of chairs was a seventeen-year-old girl. The smile on her face when she saw Dylan said it all. She had a crush on her doctor.
“Hey, Mindy. How’re you doing?” Dylan’s smile was bright.
The girl’s cheeks pinked, and she touched a turban on her head where her hair should have been. “Pretty good.”
“That’s always nice to hear. We doctors like to know we aren’t making our patients too sick. This is Dr. Montgomery. She’ll be helping me out for a few weeks. Do you mind if she has a look at you?”
Marcy gave the girl a reassuring smile.
Mindy’s smile dimmed. She’d obviously rather have Dylan doing her exam. “Yeah, that’s okay.”
Marcy took the lead in checking the chemo setup, making sure the infusion level was correct per the chart. “Mindy, I’ll need to get your vitals.”
She pulled on her faded cloth hospital gown. “Okay. Don’t you just love these gowns. So attractive. I’m going to design some cute ones when I get well. So that cancer patients can have something pretty to wear.”
Pulling the stethoscope from around her neck, Marcy prepared to listen to Mindy’s heart. She’d never thought about hospital wear for patients. They were rather drab and ugly. “That sounds like a fine idea.”
“I’ve already started making sketches. Would you like to see them?”
“Sure, I would.” Marcy moved on to taking Mindy’s respirations and pulse.
Marcy glanced at the teen’s mom. She knew the pain in the parent’s eyes too well. That hit too close to home. Still, Marcy refused to let her pain show. She had a job to do here, one she planned to do well.
Years ago, she’d been like Mindy’s mother. Walking around in constant fear. If she got as personally involved as Dylan, could she continue to hold it together? The next few weeks would tell. After all this time she’d believed that wouldn’t be a problem. That she could compartmentalize the patients and the work, remaining unemotionally involved. Dylan’s way of dealing with patients certainly wasn’t that.
He’d finished up with Mindy’s charting then double-checked her chemo flow. “You look good today. I’ll see you next week. You don’t have many more weeks of this.”
“I hope so. This doesn’t make for a great senior year.”
Dylan smiled and patted her arm. “No, it doesn’t but it’s necessary.”
She curled up her lips. “I don’t have to like it.”
Dylan chuckled. “No, you don’t. With your attitude you should be fine. Be ready for the prom.”
“Who’s going to want to take me to the prom. I don’t even have any hair.”
Dylan gave her a reassuring smile. “By then you should have some.”
“I hope so.” Mindy didn’t look encouraged.
“You just wait and see.”
Marcy leaned in close as if to share a secret. “I’d believe him. I’ve known him a long time.”
Mindy smiled.
Finished with seeing patients, Dylan asked, “How about getting some lunch with me? We can catch up.”
She shook her head. “I wish I could, but I have some calls to make and a few details to review before I start this trial.”
“Okay.” She sensed his disappointment as his lips tightened. “Maybe later, then. I’ll meet you here in an hour.”
“I’ll be here.” She went to the small closet she had been given to serve as an office.
It had been nice to learn that Dylan worked at Atlanta Children’s. Nervous and out of her element with doing actual work with patients—and more disturbing, children with cancer—she couldn’t help but be pleased to see a friendly face.
Still as good-looking as she remembered, his shoulders were broader and sturdier than they had been in his youth. He seemed taller as well. What hadn’t changed was his ready smile. It might be the one thing she’d missed most about him.
It had already taken great emotional fortitude for her to come here. If she hadn’t taken this chance, then the drug she’d been working on for years might not see its way to helping children. She’d devoted her days, many nights and holidays to work. This drug must be successful. With it might come a promotion which would give her updated equipment, along with a chance to focus on cancer advancements in the future.
Later, as she walked down the hall, she saw Dylan standing beside the doors of the Infusion Room. She blinked. He was certainly tall, dark and handsome. Where had that thought come from? She’d not noticed a man in years. How could she? She’d rarely left the lab.
His head tilted a moment as if questioning her reaction before his look turned serious. “The clinic is located in the building across the road.” They started walking. “I’ve not even had a chance to ask you how you’ve been. I can’t get over you being here.”
“I’ve been good.” She wasn’t about to tell him she’d lost a child to cancer or had a failed marriage. “And just as surprised to see you.”
“You were great this morning with the kids. I was wondering how much experience you have with clinic work?”
She shrugged. “Not much really. You know how we lab people are—we don’t come out much.” Her in particular. Work had become her life. Her life saver. “Why?”
“I know this is going to sound controlling, but I still have to say it.” Dylan took a deep breath. “Most of the patients we’ll be seeing in a few minutes are scared. Their parents are as well. Adding another stranger in their life, asking them to do something they’re even more insecure about, might tip them over emotionally.”
“I understand.” She didn’t need to be told that. She remembered her fear as a parent too well.
“Also try to speak at their level. Catheter is a tube. Superior vena cava is an artery in the neck. No fancy medical talk.”
“I have no intentions of upsetting your patients, but I do need to have contact with them to complete my research. It’s time sensitive. At some point I’ll need to ask them questions. I don’t have the time to ask you for permission before every interaction I have with a patient.”
He stopped, giving her his full attention. “I understand that. I just want you to hedge on the side of caution.”
“Then there’s no problem.” She held his look.
“What I’m saying is, this needs to be all gently and calmly presented.” He started walking again.
She hurried to keep pace with him. “Cancer is a nasty disease that doesn’t wait on us to be nice. We must eradicate it. What I learn from your patients can save others.”
“I’m interested in saving these patients and doing it without creating more emotional scars. Like fearing life.”
Emotional scars she could understand well. Her scar tissue was thick. “I promise to follow your lead.” She would until she couldn’t. Her work was important too. The drug must be tested so that these children could have the chance to live when others hadn’t. Others like Toby.
