bin?” He turned toward Mark’s mother. “Mrs. Kennedy, I need to put a breathing tube into Mark’s throat to protect his airway. He’s so lethargic I’m afraid he’s going to stop breathing. I’ve already made arrangements for him to be transferred to the PICU.”
Watching Gabe in action, Holly had to admit he was impressive. Especially the way he took the time to explain everything to Mark’s mother. Emergency medicine wasn’t her specialty and she stepped back to stay out of the way and to give him the space he needed to take care of Mark, but Gabe stopped her. “Holly, wait. I’ll need your help.”
“Of course.” Her earlier anxiety returned as she walked back toward the bed, watching Gabe set up his equipment with deft fingers. She placed a reassuring hand on Mark’s arm, hoping and praying that somewhere deep down he’d feel her touch. “Mark, we’re going to place a breathing tube in your throat. It will be uncomfortable for a few minutes, but then your breathing will be much better.” Mark didn’t indicate that he’d heard her but that didn’t mean much. He might not be able to make his muscles obey his commands.
“Help me position his head. With his stiff neck, I’m going to have trouble getting his head tilted to the correct angle.”
She understood Gabe’s dilemma, and moved over to help. The nurse sat next to Mark’s mother, who’d started to cry. Holly wanted to cry right along with her but focused instead on helping Gabe place the lifesaving breathing tube in Mark’s throat. Gabe’s face was close to hers, the worry in his eyes contagious.
“A little more,” Gabe said urgently, as he tried to slide the breathing tube down. “I can’t quite get it.”
Mark’s neck muscles resisted the movement as she struggled to tilt his chin toward the ceiling. She met Gabe’s eyes over his face mask. “I can’t move his head back any more without hurting him.”
Gabe nodded. “All right, then, we need a paralytic. There’s some succinylcholine in a vial on the table. Give him a milligram and see if that helps.”
Holly’s hands were shaking as she tried to draw up the medication. She hadn’t been this involved in an emergency situation since she’d been a resident. The medication would help relax Mark’s muscles, but it would also stop him from doing any breathing on his own. She injected the medication and shot an apprehensive glance at Gabe. “How long before it works?”
“Not long.” He met her gaze, as he gave Mark several deep breaths, using the ambu-bag. “Are you ready?”
She nodded. After the third big breath, Gabe set the mask and ambu-bag aside and she helped tilt Mark’s head back to the correct angle. This time she was able to give Gabe the extension he needed. He slid the breathing tube into place, and pulled out the stylet. “Hurry. Hand me the ambu-bag.”
After disconnecting the face mask from the end, she handed him the bag. He clipped a small device to the end of the endotracheal tube before connecting the ambu-bag, giving several deep breaths. The end-tital carbon-dioxide detector turned yellow, showing the tube was in the correct place. “Listen for bilateral breath sounds, just to make sure,” he told her.
She tucked her stethoscope into her ears and listened as he gave more breaths. She nodded and folded the stethoscope back in her pocket with a sigh of relief. “Sounds good.”
“Melanie, call for a portable chest X ray,” Gabe directed. “And get a ventilator in here.”
“We have the breathing tube in place, Mrs. Kennedy. Mark’s breath sounds are good. I know this is scary, but Mark is better off now with this breathing tube in place.” Holly did her best to reassure her.
“We’ll give him some sedation too, so he doesn’t fight against the breathing tube,” Gabe added.
“Thank you,” Mrs. Kennedy whispered.
Holly was glad to help. She reached over to hold the ET tube while Gabe secured it in place. “Nice job,” she said in a low tone. Gabe’s quick action had helped to save Mark’s life.
His eyebrows rose in surprise and his gaze warmed, lingered on hers. “Thanks.”
For a moment the years faded away, the easy camaraderie they’d once shared returning as if it had never left. She’d missed him, she realized with a shock. She’d missed Gabe’s friendship.
And more? No. What was she thinking? Taking a quick step back, Holly decided it was time to leave.
“I’ll check on the LP results,” she murmured, before leaving the room. Glancing back over her shoulder, she saw Gabe was watching her with a speculative glance.
Her stomach tightened as she let the door close behind her and began stripping off her protective gear. She and Gabe had grown close in those months up until her wedding. But that had been nearly six years ago.
She’d learned two hard lessons since then. Men couldn’t be trusted and never, ever mix personal relationships with professional ones.
Unfortunately, Gabe lost on both counts.
Gabe instructed the respiratory therapist on the vent settings he wanted Mark to be placed on and spent a few minutes reassuring Mark’s mother that they were doing everything possible for her son. He took the time to make sure Mark was comfortable and that his vitals were stable before he left the room. While stripping off his protective gear, he glanced around the ED arena, disappointed to realize Holly was gone.
He opened Mark’s electronic medical record and read her note. She recommended changing the antibiotics now that the LP results were back, confirming streptococcal meningitis. She went on to recommend prophylaxis to any exposed staff and for all of Mark’s immediate family.
He finished arranging for Mark’s transfer to the PICU, and then followed up with the nursing staff who’d been exposed to Mark before he’d been placed in protective isolation. He wrote prescriptions for Mrs. Kennedy’s family and one for himself.
Once he was caught up with his work, he went over to the unit clerk. “Will you page Dr. Holly Richards for me again?”
Susan, the unit clerk, frowned at him. “Holly who? You mean the infectious disease doctor? Dr. Davidson?”
Davidson? She’d changed her name from Richards to Davidson? Had she been wearing a wedding ring? He didn’t think so. The truth hit him like a brick between the eyes. Holly must have divorced Tom, taking back her maiden name.
Guilt burned the lining of his stomach as he realized her divorce might be a part of the reason she’d returned home. He furrowed his fingers through his hair, not entirely surprised by the news.
Damn. It wasn’t too hard to figure out what had happened. He’d bet his life savings Tom had cheated on her. The jerk.
Guilt swelled again, nearly choking him. He should have handled things differently. Why had he believed Tom when he’d claimed he’d changed? Tom had always been too much of a womanizer, and Gabe suspected Tom hadn’t changed, even after Tom had asked Holly to marry him. But he hadn’t had any proof, just the deep niggling suspicion that wouldn’t go away.
On the day of Holly and Tom’s wedding, he’d noticed Tom flirting with Gwen, Holly’s maid of honor, and confronted him. They’d argued bitterly. Tom had sworn he’d given up other women, promising he’d gotten them out of his system once and
