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“Is there some way to get this thing delivered early? Induce labor, maybe?”
A quick survey of Angela’s chart revealed she was due two weeks after Gabby. She was healthy and there was nothing of alarm going on except, perhaps, her attitude. “Would it make any difference if I said that you’re over two thirds of the way there and the rest is downhill from here?”
A laugh broke through Angela’s mood. “The one thing I could always count on with Doc Graham was that he would be at least as grumpy as I was. And now I’ve got a doctor who smiles. Guess that means I have to smile, too, doesn’t it?”
“It helps. You ought to try it.” Gabby sat the chart aside and extended her hand to Angela. “Hi, I’m Gabby Evans, and I’ll be smiling at you for the next few weeks. Five or six, if I’m lucky.”
“So we’re due almost the same time,” Angela responded, taking Gabby’s hand. She was a small woman, with short-cropped brown hair and dark brown eyes. Almost a pixie…a pixie with a sizeable tummy spread, side to side.
“Just a few weeks apart, and I know what you mean, wanting to get it over with. There are times I’d really love to see the floor again.” She wrapped the blood-pressure cuff around Angela’s arm and pumped it up. “Or my ankles. But I guess that comes soon enough, doesn’t it?” Then she listened for the dull sound of the blood pressure through her stethoscope. It was high. Not alarmingly so, but enough that Gabby took a second reading to make sure. Again, it registered barely on the high end of normal.
“Did Doc Graham ever diagnose you with hypertension?”
Angela was instantly alarmed. “No, why?”
“You’re on the verge. Nothing to worry about yet, but I want to keep an eye on it. So, do you live far from here?” she asked Angela.
“No, about twenty minutes.”
“Good, then I’d like you to stop in tomorrow for another blood-pressure check.”
“Should I be nervous about this?”
Gabby shook her head. “Could be nothing. Could be because you’re stressing. Of course, even bringing it up puts you under more stress, which could raise your blood pressure. But I want to stay on top of this, keep it under control if it’s the start of something, or rule it out if it’s not.” The only real concern was that, according to Doc Graham’s notes, Angela’s blood pressure had been normal all along. “And in the meantime, reduce your salt intake, stay away from highly processed foods with a lot of sodium in them, and if you’re not walking, walk.”
“I walked. In fact, that’s all I did until Doc Graham made me quit working. I manage the kitchen up on the older Sister…”
“Older sister?”
“The mountain peak to the south. It’s the older Sister. The one to the west is the middle Sister, and the one to the north is the younger Sister. Anyway, I’m at Pine Ridge Ski Resort up on the older Sister. Head chef, temporarily sidelined to paperwork. Which is driving me crazy, making me grumpy, probably responsible for raising my blood pressure.”
“So besides the obvious, let me guess. When you’re at a desk, you’re not exercising, and probably eating away your frustration? And getting angry thinking about what you’d rather be doing?”
Angela laughed. “Something like that. And I should know better, being a chef and a dietician, but I’ve been having a craving for salty things lately.”
“Well, elevated blood pressure isn’t necessarily a problem when it’s still in the high normal range the way yours is, so don’t stress over that. But like I said, I want to keep an eye on it and make sure it isn’t about something other than your change in lifestyle and…” Gabby smiled, thinking about the chocolate craving she’d been having for a while “…bad habits. So, for the next few days I’d like to see you every day to get a reading. Oh, and get back to the kitchen, at least on a part-time basis. Cook a little and use common sense.” She scribbled a hasty note on her prescription pad. “According to your chart you’re perfectly healthy, and I think it’s good to stay working as long as you can. Light duty, though. Maybe some baking. The note gives you permission to get back into the kitchen on a limited basis, and I trust you’ll use good judgment in deciding whether or not you feel like it.”
“Really?” She read the note twice, blinking her surprise both times. “You’re going to let me go back to work?”
“In case you haven’t noticed, I’m not particularly an advocate of inactivity during pregnancy. People treat pregnancy like it’s an illness, but I prefer to treat it like a normal condition, one the body’s prepared to deal with.”
“But Doc Graham said…” She stopped, frowned, then smiled. “I can work a little?”
Gabby laughed. “There’s old-school and new-school thinking here. My dad, also an obstetrician, was a brilliant doctor, but he was very old school. Like Doc Graham. He thought pregnancy was a time when a woman should rest, put her feet up, be pampered. I, on the other hand, believe in the benefits of working through a pregnancy, if a woman’s physical condition allows it. And studies back that up. My dad and I used to argue over this all the time.”
“And who won?”
“He did with his patients. I did with mine.” And neither of them ever budged from their position. “So, in other words, be indulgent. Of course, you’re the one who has to define what indulgent is, according to your condition. Now, how about I do the rest of your physical, then we’ll talk about the really important things, like decorating baby’s room.”
“So tell me about your hospital.” Gabby caught up to Neil in the hall and fell into step with him. Big steps, tall man. Broad shoulders that swayed naturally with his steps. Neil Ranard had an impressive stature, and for Gabby to notice was something out of the ordinary. Usually she didn’t pay attention, because most men looked her directly in the eyes, and she had a definite preference for tall. But he was tall, taller than Gabby by a good head, which put him well over six feet. Nice, considering how her five-feet-eight height towered over so many people. And intimidated so many men. “Tell me the five most important things I need to know in order to succeed here.”
“Well, the first is that coffee breaks are essential. Do you prefer your coffee with, or without, cream and sugar?”
“We’re on our way to a coffee break? That’s why you’re in such a big hurry?”
“Believe me, at the end of ski season, you look for any excuse you can find to take a break. For five months we’re ridiculously busy. There’s hardly enough time to catch your breath. Never enough time to sit down and put your feet up. Sometimes you’re on call for days. Meaning, no coffee breaks whatsoever. Then the season changes and there’s time to take a break, so you do even if you don’t necessarily want one, because you know that will change in due course and soon you’ll bemoan the fact that you don’t have time to take a break. The two phases of our medical life here—with, and without, coffee breaks—are a vicious cycle.”
“And you like that, don’t you? I see it in your eyes.”
Neil laughed. “Or maybe I just like to complain.”
“Ah, the foibles of being self-indulgent. I just had a talk with my patient about that.”
“My foibles have more to do with leaving here and being so damned grateful to come back, under any circumstance, break or no break. I was away for a while, working in a clinic in Los Angeles, somehow deluding myself into thinking that I wanted steady hours, five days a week. It was a job most doctors would envy, because I was able to live like everybody else does. You know, getting up in the morning, going to work, coming home in the evening. Weekends for tennis and golfing, which I absolutely hate, but did anyway because I had the time. It was so amazingly normal it drove me crazy inside four months. Probably because it wasn’t…enough. Wasn’t personal the way it is here in White Elk, and by the time I’d worked to the end of my contract, I was more than ready to come back here, where nothing is normal. For me, that makes it better.” He motioned Gabby around the corner to the staff lounge, where he practically lunged at the coffee pot. “How do you take yours? I mean, I’m assuming you still allow yourself a little caffeine at this stage of your pregnancy.”
“Caffeine in moderation is fine, and there’s always decaffeinated coffee if the caffeine causes side effects. But I don’t like coffee.” She turned up her nose. “Used to, but after I got pregnant I lost my taste for it. Started craving hot chocolate.”
“But you do like the coffee breaks, don’t you?”
“As long as I can sit down and put my feet up then, yes, I like the coffee breaks.” Which is exactly what she did. She sat down in one chair, then Neil nudged another one across the room to her, so she could prop up her feet.
“Is this your first?” he asked, sitting down next to her.
“Yes. And just so we can get past this awkward moment, I’m not married, don’t plan to be married, I’m not involved in any kind of relationship with the baby’s father or anyone else, and I’m very much looking forward to single motherhood. And in case that sounds defensive, I really don’t mean for it to be, but I’ve said this by rote a few dozen times and that’s just the way it comes out now.” So, if that wasn’t an ice-breaker, nothing was. “And it’s not a secret, Neil. People will ask, they’ll want to talk, and that’s fine. If I’m going to be here for a couple of months, I’d rather everyone knows this isn’t one of those circumstances where they need to whisper and speculate. My pregnancy is the best thing that ever happened to me, and I’m ecstatic.”
“I’m glad. When I was in family practice in Los Angeles, I saw too many pregnant patients who weren’t ecstatic, and it made me…sad. Sad for the mother, sad for the baby.” A deep frown confirmed his sentiment, but he wiped it away after a sip of coffee, and his normal sunny smile returned. “So, you asked me about the hospital, didn’t you? Five important things everyone needs to know…Well, as you’ve seen, it’s small. That’s important because we like the intimacy. We have forty beds that can expand to fifty, if we have to. Sixty in a dire emergency. Also, we offer general service here, no elective major surgeries, emergency major surgery only when it’s vital, and most minor procedures are welcomed. We specialize in pediatrics, not so much because that’s what we set out to do but by virtue of the fact that the two co-owners have pediatric specialties in their backgrounds, meaning we do get a few more peds referrals than we normally would. Although it’s not technically a pediatric hospital.” He paused, then grinned. “Was that four or five things?”
“Technically, four. So, you were in pediatrics?”
“Still am, but for White Elk and the whole Three Sisters area, it’s too limiting, so I have a secondary specialty in family practice. Like my partner, Eric Ramsey. He was a pediatric surgeon, but to be flexible enough to work here he had to expand his horizons. So, besides a couple of doctors who seem to be the proverbial jacks-of-all-trades, we also have a state-of-the-art trauma department, headed by Eric, a full obstetrics department headed by, well, you, for the moment, a neonatal nursery, a good orthopedic set-up, and we also coordinate mountain rescue from here. Just a couple of ticks off full service on a very small scale—and growing, I guess you’d say. And now that’s more than five.”
“And I’m more than impressed. So, you’re a co-owner?”
He nodded. “The hospital was struggling when I came back, and Eric Ramsey and I bought it in order to keep it going. In an area such as this you can’t afford to have the hospital go under, because that affects the whole local economy. A ski resort area—and we have three ski resorts in the vicinity—needs a hospital nearby. So Eric and I decided to invest, and see if, together, we could get it back on track. So far, so good, if you don’t count the fact that everybody here is grossly overworked and underpaid.” He chuckled. “I get credit for the good stuff and I let Eric take credit for the bad. Although I think he says it the other way around. Anyway, you’ll meet him when he gets over his sore throat…caught it from his twins. He’s the one who coordinates mountain rescue, by the way.”
“How many more doctors do you have?”
“Two full-time orthopedists, Kent Stafford and Jane McGinnis, John Ellis, who’s another family practitioner, only he’s part-time, in semi-retirement now, and we have a part-time rehabilitation specialist, Jackie Pennington, who comes in from Salt Lake city two days a week. Oh, and an obstetrician on the way, but not for another few weeks. We have nurse practitioner Fallon O’Gara, whom you met earlier and who practically runs the hospital—she’s probably the most essential team member we have. And we have a couple of respiratory therapists, three physical therapists, and a dozen staff nurses. We also have a few doctors who come in to help out in the clinic on a rotating basis once or twice a month—a cardiologist and a rheumatologist. Then there’s Henry Gunther, a retired anesthesiologist, on call. He moved here to engineer the ski train—trains were his hobby—so he’s always close by when we need him. Then we have a number of volunteers and support staff, and that’s about it. White Elk Hospital. Struggling, but surviving.”
“Seems adequate for the area.” And impressive. White Elk Hospital appeared to be a well-run medical facility, even if Neil did admit to a few shortcomings, and it was almost too bad she wouldn’t be part of it for long. It could have been what she was looking for, professionally, anyway. Someplace nice, where people cared about each other
“Most of the time it is. And the one thing I failed to mention is that we all take our turns in the emergency department and trauma, even if that’s not our specialty. At present, we don’t have enough funds to staff it regularly, so we all get our chance to work there. I’m hoping that before the start of next year’s skiing I’ll be able to hire one more physician, another trauma doc, and bring in a couple of moonlighters. But Eric and I are still talking it over, crunching numbers, crossing our fingers.”
“It sounds…compact.” And not at all complicated, like so many of the large hospitals were—hospitals where the doctors fit into their own little niche and rarely, if ever, wandered out of it. Some might say there were advantages to staying where you belonged, but she liked the idea of working different areas, especially if the doctors’ medical qualifications suited that. Her own father, an obstetrician, had been a general field surgeon in the army and she’d had training in general surgery, too, at his urging.
“Coming from Chicago, the way you do, I suppose it would.”
“Well, coming from Chicago, the way I do, I have a different appreciation for what medicine should be.”
“Which is?”
“Uncomplicated.”
“In an ideal world,” Neil said.
“In a real world, if that’s how you want it to be. Where I worked, everything was complicated. The more complicated it became, the further away the patients seemed to get. I got used to it, I suppose, but…” She frowned. Shrugged. “It was OK then, but not any more.”
“What changed you?”
“I’d like to attribute it to my pregnancy hormones but, to be honest, I haven’t been happy for a while. Not unhappy either. Just existing. Nothing was wrong, nothing was bad. But nothing made me happy about my work, and I think to be a good doctor…to be the best doctor you can be…you need to be happy about your work. My dad always was. He jumped out of bed in the morning and couldn’t wait to get started. He thrived in the complicated system, turned it into his playground and worked it to the advantage of his patients. I suppose I thought I should, too, which is why I stayed in practice with him so long, doing just that. But…” She shrugged again. “I wasn’t suited to the manipulations, I guess you could say. I became too restless to be as effective as I wanted to be and decided I finally needed to make a change. Getting pregnant was the last shove I needed. Don’t know what that permanent change is yet, but I’ll know it when I see it.” She was positive of that.
“So you came here, to White Elk, looking for…happiness?”
Not even close, but that was a complication she felt no pressing urge to discuss with him. “Handmade baby clothes and peace of mind. And I’ve already found the handmade baby clothes.”
“I’m done for the day,” Gabby said, plopping down onto the exam table in emergency room one. In the past two hours she’d seen one scheduled patient, one walk-in and done a regular pelvic exam on one of the staff nurses. It wasn’t an overwhelming schedule, which was fine with her. Working again felt good. She’d missed it, and she was glad to be back in any capacity.
Neil, who was sitting on a chrome stool across from her, looking all rigid and uncomfortable whilst reading an outdated medical journal, glanced up, took off his reading glasses and tucked them into his pocket. “Did you have a good first day? It wasn’t too much for you, was it?”
“Good first day, yes. Too much, no. In fact, it was a little slow.”
“Like I said earlier, you’ll learn to appreciate those lulls since they don’t come too often.” He put his journal aside, and stood up. “Look, are you up to a quick dinner? We’re not busy right now. Fallon is down the hall stitching up a kid who took a header off his bicycle, and that’s all we’ve had this past hour. So I was thinking about going across the street to the café before I have to come back and spend the night in emergency on call. You’re welcome to join me, unless you have other plans.”
“Plans? My plan this time yesterday was to go back to Chicago and get my condo ready to sell. Now here I am, working in a place I’d never heard of until…” she glanced at her watch “…twenty-nine hours, forty-two minutes ago. Meaning no plans, and I’ve love to join you.”
“So, what do you eat?”
“Lately, everything I can get my hands on. A little light on meat, but other than that no dietary restrictions, no self-imposed taboos. Just point me in the direction of food and I’ll show you what I eat.”
“Then you’ll love Catie’s Overlook, because they fix a little bit of everything.” Neil hurried down to exam three to check on Fallon, who was coming along nicely with her patient. In fact, the procedure was finished and she was at the lollipop stage—the hardest part of the ordeal, trying to get her young patient to choose between red and green. Neil took a look at the stitches, wrote an antibiotic prescription, gave the boy both the red and the green, and sent him home with his mother. Then off with his white lab coat and on with his denim jacket. A quick gesture to Gabby and they were on their way.
“So what’s the specialty of the house?” she asked. Heading down the hall, his strides were long, and his heels clicked briskly on tile floor. She liked that confidence in him, liked the way he held the door open for her but didn’t overstep his bounds by taking hold of her arm as she half expected him to do. “And are the portions huge? Because I eat a lot these days. I tell myself it’s because Bryce is going to be an athlete and he’s storing up the calories early.”
“Bryce?”
“My son. I’m calling him Bryce Evans, after my father.” She sighed wistfully. “That was the first decision I made after I found out I was having a boy. A fitting tribute, I think.”
“I take it your father’s not with you any more?”
Not her father, not Bryce’s father. Things should have been different. “Not any more. Just when I was ready to make the big move, he made a bigger one. Too young, too soon.”
“I’m sorry, Gabrielle. I get the feeling you and your father were close.”
“We were.” Stepping up onto the curb, she stopped for a moment as Bryce kicked, and laid a hand on her belly. Then she smiled. “But it’s an amazing circle of life, isn’t it? I lose one Bryce who meant the world to me, and another one’s about to enter my life who means even more.”
What an amazing woman. He didn’t think he’d ever met anyone like Gabrielle Evans before. Confident, selfassured. Maybe a little too defiant with her self-reliance, probably a reaction to her having a baby alone. He guessed that she probably fought against things she didn’t have to, but that was OK. It made her even more interesting. So why was it that he’d met her now, when the timing was so wrong on so many different levels? “Table for two, Helen,” he said to the waitress who greeted them at the door. “Oh, and this is Dr Evans. She’ll be working as our obstetrician for the next few weeks.”
Helen looked down at the lump under Gabby’s coat with a dubious frown, then nodded. “Which Sister?” she asked. Catie’s Overlook boasted the best view in town—windows overlooking each of the Three Sisters.
“Older Sister. Better view, more lights.” Not that it really mattered, since he’d seen each of the Sisters from every angle more times than he could remember, but he thought Gabrielle might like the nicer view.
“Angela Blanchard works up there,” Gabby commented as Neil pulled out the chair for her.
It was quaint, old-fashioned, all wood, and surprisingly not as uncomfortable as it looked. But on the other side of the room there were cozy, romantic booths, where several couples sat all tucked into each other. He’d done that, once upon a time. In fact, he’d brought Karen here, and he’d been the one so distracted by the moment that he hadn’t noticed the obvious—that she had eyes for him, but not him alone. Well, not any more. He’d sworn off relationships a while ago, and he wasn’t yet in the mood to swear back on. If he ever did, there would be no cozy booths and candlelight, though. Next time, it was going to be a matter of practicality. His one and only promise to himself was head before heart. A down-to-earth partnership.
“She came into the clinic today,” Gabby continued.
“Grumpy?” Neil asked, as he took his seat, purposely keeping his back toward the row of romantic booths. “She usually is lately.”
“No, not grumpy. More like frustrated with her situation. And with her inactivity. So I gave her permission to return to work, be active again on a limited basis, which is what she wanted. It had a pretty good effect on her mood.”
“Ah, going against Walt Graham’s sage advice to stay home and keep your feet up for nine months. His wife had seven children, and we always teased that she kept getting pregnant so she could take the nine-month holiday. Because Walt wouldn’t let her do a thing. He waited on her hand and foot, and hired someone to do it for him when he wasn’t there.”
“And…”
“He was lost after she died. Lost a lot of the joy in his life, I think. Woke up one morning a few weeks ago and said it was time to do something else, and he did. He quit his practice. Now he’s out hiking in the woods, skiing, doing the things he never had time to do before. But he’s a good man, and a good doctor with old-fashioned ways.”
“He sounds a lot like my father. Dad always had my mother on a pedestal. It’s hard for me to even imagine the kind of love he had for her, but I think that’s what Walt Graham must have had for his wife, because Dad never got over her after she died. Never dated, never looked at another woman, never took off his wedding ring.”
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