He pointed to the middle of his chest.
When the line connected, Jama requested a helicopter, explained the situation and location. The emergency personnel would have to land in the parking lot of the winery, the only large, paved surface in River Dance. The gravel on the clinic lot would spray in every direction if the chopper landed here. Jama needed help to make sure the winery lot was cleared. This early in the morning, it should be empty except for employee vehicles.
She disconnected and returned her attention to Monty. “I’ve checked you over, and can’t appreciate any obvious deformities. There was a lot of blood, but it was superficial. Since I don’t have an X-ray tech, I can’t get a film right now, but, Monty, your EKG shows classic ST elevation. I’m going to establish a large bore IV and—”
“English, Jama.” He was looking gray again.
“Sorry. It looks like you’re having a heart attack. I’ve called for an airlift, but—”
“Somebody need a seventy-six-year-old nurse?” came a screechy shout from the waiting room. Zelda Benedict.
Jama was flooded with relief. That voice, recalled from Jama’s past, brought to mind memories of strength and calm assurance. “In here,” Jama called. “Second room to the left. When’s the last time you established an IV in a patient?”
The tall, slender woman entering the room wore orange jogging shorts that matched her hair, dusty tennis shoes and a light green tank top that matched her eyes. She had a green jacket that matched her tank top, but it was tied by the sleeves around her waist. Zelda Benedict looked closer to fifty than seventy-six.
“I did one yesterday, that recent enough for you?” Zelda peered at the monitor, then clucked her tongue. “Large bore? Tell me where everything is.”
“I can’t. I just got here, myself. We aren’t exactly open for business.”
“You got that right. If you’re the one who broke that glass, the mayor’s gonna tear you a new one.”
“Tear a new one…” Monty mumbled. “That’s it, Jama. That’s how my chest felt.”
Zelda patted his hand. “We’ll get you feeling better. An aspirin, a little heparin, a little trip to the hospital, and you’ll be fixed—”
“Hold it,” Jama said. “Monty, what do you mean? You felt something tearing in your chest when you fell?”
“Felt that way. Something seemed to rip, but I didn’t think much of it—didn’t have time after the fall.”
“So you’re saying you felt this tearing pain in your chest before you fell?”
He nodded.
Jama closed her eyes. She’d heard of bad first days, but this was becoming a nightmare. “Zelda, find the sublingual nitro.”
“Where do I look?”
Jama turned, scanned the glass-doored cabinets and pointed to one. “Try there. And locate the heparin and aspirin, but don’t get them out yet.”
“Why not? If this is a heart—”
“Wait a minute, will you?” How could this be happening, today of all days? Was this punishment from God so many years after the original sins?
Jama checked Monty for neurological deficits and found a decided weakness in his left leg.
Zelda brought the nitro. “Here you go. Now, how about the—”
“Forget the heparin,” Jama said.
The nurse arched a finely drawn eyebrow that matched her hair. “An aspirin, at least?”
“Can’t risk the bleeding.”
“What bleeding?” The question was threaded with the steel of Nurse Zelda’s teacher voice, honed from her years of being nurse director of River Dance Nursing Care. “This arm isn’t bleeding enough to warrant withholding blood thinners.”
“Something about this doesn’t seem to be a simple MI,” Jama said.
“So what is it? We need a diagnosis before we can treat.”
Jama touched Monty’s arm. “The ripping in his chest could be a clue about what caused the MI.”
“Did you call Fran?” Monty asked, eyes closed. Under the harsh, bright lights, his pale, grayish skin and leathered wrinkles from years beneath the sun made him look suddenly aged.
“I called Tyrell. He’s on his way here.”
“Don’t let him bully you.” Monty’s words had begun to slur. “Tell him you’ll take good care of me.”
Jama met Zelda’s inquiring look, and all the years of training fled. She was just Jama Keith again, the girl who tagged after Zelda Benedict at the nursing home like a lost puppy, finding acceptance from the elderly patients she loved, even before she began receiving pay as an aide.
Who was Jama Keith now, standing here making life-and-death decisions for the man who had been her second father? How could she—
“Dr. Keith?” Zelda’s soft green eyes held only respect. “What are your instincts telling you?”
“Dissecting aortic aneurysm. A tear in the wall of the aorta—”
“What do you need for a positive diagnosis?”
“I need to see if he has mediastinal widening, and for that, I need a chest X-ray.”
“You’ve got no tech scheduled?”
Jama shook her head. “As I said, we’re not open yet.”
Zelda’s frown finally showed her age. “Well, folderol. I knew I should’ve taken that course at the university.”
“If we treat him for a classic MI with blood thinners of any kind, and this is a tear in the aorta—”
“I know,” Zelda said. “He could bleed to death.”
“I’ve called for airlift to St. Mary’s.”
“How long do we have?”
Jama looked at the large wall clock. “They should be here in ten minutes.”
“I’ll contact the hospital for an accepting physician.”
“I need someone to clear a landing space for—”
There was another shout from the waiting room—one Jama recognized. For as far back as she could remember, that voice had meant comfort, friendship and much, much more.
And now? Tyrell Mercer’s voice stirred conflicting emotions, but she didn’t have time to deal with anything but Monty.
“There’s our man,” Zelda said with a wink. “Just
