Night Shifts with the Miami Doc
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Ann McIntosh
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CHAPTER ONE
SIXTY-EIGHT-YEAR-OLD MRS. MORALES not only looked unwell, she looked terrified, too. According to her chart, she’d collapsed at home, by all indications from an arrhythmia that caused her to faint. After being examined in the ER, she’d been admitted for further tests and monitoring, but although her heart seemed to be the main concern, Dr. Regina Montgomery had her doubts.
“Ask her how long she’s been suffering from the swelling in her ankles,” Regina requested of the assisting nurse, who, thankfully, spoke Spanish. “And the abnormal itchiness. And ask again if she’s been experiencing muscle cramps.”
As nurse Amelia Jackson relayed the questions, Regina took another look at the chart, displayed on her tablet. Some of the test results had come back, all focused on heart function, but, like the emergency room doctor before her, she was wondering if heart disease was Mrs. Morales’s main problem. They’d asked for a cardiology consult, but it was Regina’s responsibility as internist to ensure that if the patient needed additional treatment, it was provided.
“She says the swelling started about eight months ago, but she was itching before that. Only occasional muscle cramps, though,” Amelia told Regina.
All classic signs of kidney problems.
“Has she seen a nephrologist?”
That earned her a skeptical look from the nurse, but she dutifully asked the question anyway, and was met with a breathless spate of words in reply.
At the frantic tone in the elderly lady’s voice, Regina looked up to see tears streaming down her wrinkled cheeks. Putting down the tablet, she grabbed a couple of tissues from the handy box beside the bed.
“It’s okay, don’t be upset.” Trying to soothe the older woman, she placed a hand on one shaking shoulder and held out the tissues. The last thing they needed was the patient’s already elevated blood pressure going higher. She turned to the nurse. “What is she saying?”
“She’s scared,” Amelia replied. “She’s only been in the US for a year, and it sounds as though her medical care has been spotty. I don’t think she trusts doctors very much.”
Mrs. Morales looked from Regina to Amelia and back again, and Regina was struck by the mute appeal in her eyes. It made her wish she could speak to the older woman directly, explain that she understood.
“I get it,” she said quietly, using the tissues, which Mrs. Morales seemed not to have noticed, to mop gently at her patient’s cheeks. “My grandparents came to America when they were older, too, and they were the same way—only going to the doctor when the pain got too bad to bear. Tell her not to worry, that we’ll take good care of her. Have you been able to contact her son?”
“Yes, but he’s in Tampa, so it’ll take a while for him to get back to Miami. He’s a construction worker, and the group had traveled there together. He’s getting on a bus as soon as he can. He also asked his wife to come to the hospital, but she has to arrange for someone to take over her shift before she can leave work.”
While Amelia spoke to the patient, gesturing to Regina, Mrs. Morales reached out her hand. Regina hesitated only for an instant before taking it gently and receiving a tremulous smile in return.
While looking at the chart, Regina hadn’t put on gloves, and now noticed the texture of Mrs. Morales’s skin. The older lady’s hand was well-worn, her fingers and palm roughened by work and age. It brought to mind walking hand in hand with Granny through Brooklyn, and with it came the sense of safety and happiness she’d experienced at the time.
How she wished she could give those sensations back to her patient. But all Regina could do was smile and give the trembling fingers a light squeeze. It was tempting to stay where she was, giving comfort, but unfortunately it wasn’t possible.
She had too much work to do, and acting as a locum was no excuse to be lackadaisical.
“Please tell her I’ll be checking on her test results, and I’ll be back in a little while to update her.”
Then, with one last squeeze, she let go of the older woman’s hand, and left the room to hurry the lab for the rest of the information she needed.
Once Mrs. Morales had been transferred up from Emergency, Regina, as internist on duty, was in charge of her care. It was up to her to ensure the older lady got the appropriate treatment and saw the right specialists. Similar as it was to her usual job of intensivist, there were enough differences to keep her happy, and as she walked toward the main desk, she couldn’t help noticing one of the biggest ones.
Any speculative looks she received were because of her newness, not because of her personal life.
She couldn’t afford any blemish to her character, because although things had improved, as a woman, and a minority one at that, she had to be that much better than her peers to make it to the top.
And making it to the top—to Chief of Medicine—was her goal.
One unexpected and distressing moment had lowered her reputation, and she’d struggled to continue to act normally afterward.
“Take a vacation,” her friend Cher had said. “By the time you get back, the rumor mill at the hospital will have something else to talk about.”
But vacations weren’t part of her plan. She’d never taken them, unless she needed extra study time or wanted to attend a conference. As far as she was concerned, if it didn’t bolster her résumé, it was a bit of a waste.
Then she’d found a site that matched doctors with hospitals in need of locums, and signed up. Accepting a seven-week stint in Miami served two important purposes: taking her far away from San Francisco and the uncomfortable situation she’d found herself in, and showcasing her versatility. She was out of the ICU, where she usually worked, and on the wards, handling a different set of patients and diseases. The variation, and the challenge it presented, appealed to her, too.
“A change is as good as a rest,” her mother always said, and after two days in her temporary position, Regina was inclined to agree.
She really felt as though a weight had been lifted off her shoulders.
Getting to the desk, she gave the nurse behind it a slight smile—the kind that showed she appreciated how important all the nurses were but was calculated to keep a professional distance.
“Could you contact the lab and ask them to put a rush on the rest of Mrs. Morales’s results, please? Especially the ACR and creatinine level tests.”
“Of course, Doctor.”
The nurse reached for the phone, and Regina looked down at her tablet, getting prepared to look in on her next patient.
“Please contact me when the results come in,” she said, already walking away.
Once she had that information, she could decide whether she needed to bring in a nephrologist or not. Until then, rounds awaited.
Dr. Mateo Herrera shifted to tuck his phone between his chin and shoulder, so he could sign the form nurse Janie Curtis held out to him.
“I don’t belong here, Mateo.” The sound of tears in his sister’s voice wrung his heart. “Everyone is so smart and so put-together, and I’m a mess.”
“None of that is true, Serena. You’re one of the smartest people I know, and all those people you think have everything together are only pretending, believe me.” No eighteen- or nineteen-year-old had it all together, but some were more adept at pretending than others.
“Why’d you make me come all this way to college? I bet you were glad to get me out of the house.”
She was working herself up to a full-on anxiety attack, but Mateo knew getting angry would only make it worse.
“Sure I was,” he said easily, letting a hint of amusement tinge his voice. “Which was why I was trying so hard to encourage you to go to UM.” The University of Miami was only forty minutes away from their house, and Serena could have lived at home if she wanted to. “If I remember correctly, it was someone else who wanted to go all the way to Gainesville.”
He heard Serena inhale, and waited to see if his tactic had been effective or she’d go off on him. To his relief, she sighed.
“Yeah. You’re right.” He could usually count on her common sense to prevail in the end, and today was no different. “But I don’t think I’m going to make it here on my own.”
Instead of annoying him, her words filled him with deep warmth, since they showed how strong the bond between them was. Yet, he couldn’t let his protective instincts win out over the knowledge that Serena needed to spread her wings.
“Okay, listen. You’ve only been there for a couple of weeks. Give it your best shot, and if you still hate it that much by the time you come home for my birthday, we’ll talk about you transferring.”
“All right.” It was grudging, but at least she sounded as though she’d gotten her frazzled emotions under control. “Oh, hell! I have to be in class in twenty minutes. Gotta go.”
“Love you,” Mateo said quickly, knowing her habit of hanging up before he was ready. “Call me later, if you want.”
“K.”
Then she was gone.
Janie gave him a sympathetic look. “Your sister’s first time living away from home?”
He smiled and nodded, unsurprised that she knew who it was he was talking to, since most of the people he worked with were aware of his family’s story.
“She’ll settle in quickly. My daughter cried on the phone to me every day for three weeks, and then suddenly I couldn’t even get her to call me back, she was so busy and happy.”
“I hope you’re right,” Mateo replied.
“You’ll see,” she said with conviction, then it was back to business. “They’ve called for a consult on the fourth floor.” She slid a slip of paper toward him. “Should I get Dr. Timmins to go?”
Mateo glanced at his watch. He had an hour and a half before the biweekly clinic for patients with chronic kidney diseases started.
“No, I’ll go.” He picked up the paper and headed for the elevators, but his thoughts were still with Serena.
The child psychologist he’d consulted with eleven years ago, after his parents’ deaths, had warned that of his three adopted siblings, Serena would probably have the hardest time coping. She’d been eight at the time, but unlike the other two children who’d been a part of the family for six and seven years, she’d only been adopted by Emilio and Isabella Herrera the year before. There hadn’t been time for her to completely accept she was an integral part of the family, and at that age, might even try to blame herself for their deaths.
And the psychologist had been right. Serena needed more reassurance than the other two put together, but the effort had been worth it to see her turn into the beautiful young lady she’d become. Now, if she could just build up the confidence to stay at the University of Florida, he’d be happy.
As he stepped into the elevator, he pushed thoughts of his family responsibilities aside. It was hard to do, since he’d been father figure, caregiver and everything else to his three younger siblings all these years. But they were, for the most part, all grown up now, and he knew he had to start stepping back and letting them live their own lives.
Not that he’d ever stop being there for them, in whatever way they needed. To abdicate that responsibility would be like thumbing his nose at his parents and their wish to give their adopted children a happy, loving family and a good life.
They hadn’t lived long enough to see their dreams come true, but Mateo was dedicated to carrying the torch for them, no matter what he had to give up to do so.
On the fourth floor, he went toward the desk to check in, pausing as he heard a voice both strange and familiar.
“Has anyone come down from Nephrology yet?”
“Not yet, Dr. Montgomery.”
Montgomery? Regina Montgomery?
Something stirred, hot and low, in Mateo’s belly at the name and the memories it and her voice inspired. Drawn forward by excitement and surprise, he took the couple steps necessary to see around the intervening wall to where the woman in question stood.
Wow.
It may have been eleven years since he’d last seen her, but Regina Montgomery was as gorgeous and as sexy as he remembered. Back then, he’d been one of the residents under her supervision and, as such, had to maintain a respectful professional distance. It hadn’t stopped him from experiencing hard-to-contain desire each time they’d interacted.
She was tall and statuesque, elegant in a cool, untouchable type of way. Her smiles back then were considered: just enough to show she was amused or engaged, but not enough to draw you in. She’d kept everyone at a firm yet polite distance. With eyes that unusual shade of dark gold, you’d expect them to spark with sunshine, but instead, they gleamed with the hauteur of a lioness.
Everything about her had made him want to ruffle her, get her messy, make her belly-laugh—anything to break that tranquil facade.
But that wasn’t all he’d dreamt of doing.
Her smooth, dark bronze skin made his fingers itch to touch. The containment, so essential to her character, had him wild to crack it open and see what lay beneath. Something about her every move, thin smile or brisk order made him want her more.
At the time he’d thought it just a young man’s fantasy—lusting after a woman ten years older than him had such a puerile ring to it—but now it seemed he hadn’t outgrown the impulse.
In fact, with the way his body stirred and hardened, it seemed the attraction was as strong as it had ever been.
The surprise of seeing her here in Miami sent a seismic shock wave through his system, and he drew a deep breath, pulling himself together before he moved forward.
“Dr. Regina Montgomery.” Although he tried to make the words friendly and professional, he heard the hint of roughness in his tone. “Fancy seeing you here.”
