of the fruity aroma surrounding the patient gave her all the information she needed. “Did she say anything?” From the front pocket of the duffel, she pulled out a glucometer to test Lena’s blood glucose level.
“She was acting kinda crazy this morning.” A tanned, black-haired boy sat in a recliner nearby. “I said she shouldn’t ride, but she wouldn’t listen.” His dark eyes were wide with fear. “Is she okay?”
Caroline came over and put a hand on his shoulder. “We’ve got help now, Justino. Dr. Vale will know what to do.”
“Did she eat breakfast?” Rachel asked. The blood-sugar result was high. And her blood pressure was low.
Justino shook his head. “She’s been sick for a couple of days. Throwing up and stuff.”
“Why didn’t she say something?” Garrett asked. “Why didn’t you?”
Rachel cut in. “She’s quite slender. Has she always been thin?”
“Yeah. But she said her jeans are getting loose, even though she’s been hungry a lot.”
“And thirsty?” Rachel asked.
“Oh, yeah. She drinks all the time.”
Lena fluttered her eyelashes and moved her head slightly.
“There you are,” Rachel said. “Hi, Lena, I’m Dr. Vale. How are you?”
“So thirsty,” Lena whispered without opening her eyes. “So tired.”
Turning again to her bag, Rachel began pulling out materials—an IV bag of saline and tubing, a syringe and a bottle of insulin. “Raise her legs,” she ordered over her shoulder. “Above her heart.”
While the others bustled around to help her, she handed the IV bag to Justino. “Hold this up high.” After inserting the needle into Lena’s arm, Rachel attached the tubing and adjusted the flow. Then she drew up ten units of insulin and injected it into the IV. “You’ll start to feel better soon,” she told the girl. Lena didn’t answer.
“That’s all I can do,” she said, getting to her feet. “She’s got to get to the hospital. How long ago did you call the ambulance?”
“They should be here any minute,” Caroline said. “What’s wrong? Why did she collapse?”
“She’s dehydrated and her blood glucose is very high. With fluids and insulin, though, she’ll start to improve.”
“Thank God,” Garrett said. “And thank you.” He glanced around the room. “These are my brothers, by the way. Ford’s the blond in the green shirt and Wyatt’s the one wearing the back brace.”
Nods were exchanged and hands shaken, but Rachel quickly returned her attention to Lena, noting that her breathing had slowed and her blood pressure had come up slightly. Positive signs.
Finally, she heard the siren they’d been waiting for. “The ambulance is here, Lena. You’ll be in the hospital in just a few more minutes.”
The vehicle stopped in the drive outside, lights flashing. Two emergency medical technicians came across the porch.
Rachel met them at the door. “I’m Dr. Vale, and this is Lena Smith.” She stood out of the way as one of the EMTs knelt by the couch, stethoscope in hand. “She’s in ketoacidosis. I started fluids and gave her ten units of insulin.”
The EMT nodded. “Got it.” The two men proceeded with their standard routine and, in only a few moments, had taken Lena out on a stretcher and put her into the ambulance.
“I want to come with her,” Justino said, following. “Please don’t make her go alone.”
The second EMT shook his head. “Not allowed. Sorry, son.”
The boy staggered, as if he’d been shoved.
Garrett put a hand on his thin shoulder. “You can come with me, Justino. I’ll follow the ambulance. Ford, could you call Lena’s dad to let him know what’s going on? Dr. Vale, I assume you want to come along, as well?” He ushered Rachel toward his truck.
“To begin with anyway. If Lena is part of this community, then I will be overseeing her care to some extent.” He opened the back door for her to stow the duffel on the bench, then held the front door so she could get in.
Once in the driver’s seat, he fastened his own belt and started the engine. “So today isn’t a onetime emergency?”
“I’m afraid not.” Rachel blew out a deep breath. “From all indications, this is a life-changing event.”
“What do you mean?”
“Lena will be under a doctor’s care for the rest of her life. She has juvenile-onset diabetes.”
* * *
THE TRUCK TOOK a sudden leap forward, then slowed as Garrett relaxed his foot. “She’ll be taking insulin shots?” He glanced at Justino in the rearview mirror. The teen was staring out the side window, lost in his own thoughts.
Rachel nodded. “Unless researchers find a cure. They’re always working on it.”
The prospect daunted him. “That’s a real challenge for a young girl.”
“The adults around her will have to help her cope. Are her parents going to be cooperative?”
“Her mother died last year. Since then, her dad has expected Lena to take care of her younger brothers and the house, as well as doing her schoolwork. She’s at the ranch because she’s been picked up for shoplifting several times in Buffalo and Kaycee and even Casper. She was cutting school with some of the older girls who can drive, and they’d spend the day out of town, getting into trouble. Caroline chose her for the camp, hoping it would turn her around so she could focus more on long-term goals.”
“Well, now she has the long-term goal of staying healthy to worry about.”
“I’ll pray for her to develop the strength she needs.”
“I’m sure that will help.” There was no mistaking the sarcasm in her voice.
He sent her a puzzled look. “Why do you say it like that?”
She blew out a breath. “Sorry. I didn’t mean to insult you.”
“I’m not insulted. But I want to understand your reaction. You don’t believe prayer can change events?”
“It might change the person who prays, because I believe in the power of the mind to affect behavior. But otherwise...no. Your prayer won’t call down some unseen power to help Lena deal with her diabetes.”
“You don’t believe in God?”
She didn’t answer for a minute. “I grew up going to church,” she said finally. “I can’t dismiss the possibility of a universal power. But as I observe life on this planet, I don’t detect much evidence of any kind of divine intervention. Good or bad, what happens, happens.”
