Hot Docs On Call: His Christmas Wish
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Unfortunately, chest compressions didn’t work either. Time was of the essence. Typically, there was a small window of about four minutes to get oxygen inside the man’s body or there would likely be permanent brain damage. If they could revive him at all.
McKenzie tilted the man’s head back. When several seconds of CPR didn’t give the reassuring gasp of air to let them know the food had dislodged, she flashed her crude cricothyroidotomy instruments at Lance.
“Let me do it,” he suggested.
She didn’t waste time responding, just felt for the indentation between the unconscious man’s Adam’s apple and the cricoid cartilage. She made a horizontal half-inch incision that was about the same depth into the dip. Several horrified cries and all out sobbing were going on around her, but she drowned everything out except what she was doing to attempt to save the man’s life.
Once she had her incision, she pinched the flesh, trying to get the tissue to gape open. Unfortunately, the gentleman was a fleshy fellow and she wasn’t satisfied with what she saw. She stuck her finger into the cut she’d made to open the area.
Once she had the opening patent, she stuck the ballpoint-pen tube into the cut to maintain the airway and gave two quick breaths.
“Good job,” Lance praised when the man’s chest rose and fell. “He still has a heartbeat.”
That was good news and meant their odds of reviving him were greatly improved now that he was getting oxygen again. She waited five seconds, then gave another breath, then another until their patient slowly began coming to.
“It’s okay,” Lance reassured him, trying to keep the man calm, while McKenzie gave one last breath before straightening from her patient.
“Dr. Sanders opened your airway,” Lance continued. “Paramedics are on their way. You’re going to be okay.”
Having regained consciousness, the man should resume breathing on his own through the airway she’d created for him. She watched for the reassuring rise and fall of his chest. Relief washed over her at his body’s movement.
Looking panicky, he sat up. Lance held on to him to help steady him and grabbed the man’s hands when he reached for the pen barrel stuck in his throat.
“I wouldn’t do that,” Lance warned. “That’s what’s letting air into your body. Pull it out, and we’ll have to put it back in to keep that airway open.”
“Is he going to be okay?” a well-dressed, well-made-up woman in her mid-to-late fifties asked, kneeling next to McKenzie a little shakily.
“He should be.” She met the scared man’s gaze. “But whatever is stuck in your throat is still there. An ambulance is on the way. They’ll take you to the hospital where a general surgeon will figure out the best way to remove whatever is trapped there.”
The man looked dazed. He touched a steady trickle of blood that was running down his neck.
“Once the surgeon reestablishes your airway, he’ll close you up and that will only leave a tiny scar,” she assured him.
Seeming to calm somewhat the longer he was conscious, the man’s gaze dropped to her bloody finger. Yeah, she should probably wash that off now that the immediate danger had passed.
“Go wash up,” Lance ordered, having apparently read her mind. “I’ll stay with him until the ambulance arrives.”
With one last glance at her patient she nodded, stood, and went in search of a ladies’ room so she could wash the blood off her hands and her Swiss army knife.
Carrying McKenzie’s purse and the contents she’d apparently gathered up, Cecilia fell into step beside her. “Omigosh. I can’t believe that just happened. You were amazing.”
McKenzie glanced at her gushing friend. “Not exactly the festive cheer you want spread at a charity Christmas show.”
“You and Dr. Spencer were wonderful,” Cecilia sighed.
She shrugged. “We just did our job.”
“Y’all weren’t at work.” Cecilia held the bathroom door open for McKenzie.
“Doesn’t mean we’d let someone choke to death right in front of us.”
“I know that, I just meant…” Cecilia paused as they went into the bathroom. She flipped the water faucet on full blast so McKenzie wouldn’t have to touch the knobs with her bloodstained hands.
“It was no big deal. Really.” McKenzie scrubbed the blood from her finger and from where it had smeared onto her hands. Over and over with a generous amount of antibacterial soap she scrubbed her skin and then cleaned her knife. She’d rub alcohol on it later that evening, too. Maybe even run it through the autoclave machine at work for good measure.
Cecilia talked a mile a minute, going on and on about how she’d thought she was going to pass out when McKenzie had cut the man’s throat. “I could never do your job,” she added.
“Yeah, and no one would want me to do yours. They’d look like a two-year-old got hold of them with kitchen shears.”
When she finally felt clean, she and Cecilia returned to the dinner theater to see the paramedics talking to the man who’d choked. Although he couldn’t verbalize, the man nodded or shook his head in response.
As he was doing well since his oxygenation had returned to normal, they had him climb onto the stretcher and they rolled him out of the large room. Lance followed, giving one of the guys a full report of what had happened. McKenzie fell into step with them.
“Dr. Sanders saved his life,” Lance told them.
He would have established an airway just as easily as she had. It wasn’t that big a deal.
The paramedic praised her efforts.
She shook off the compliment. It’s what she’d trained for.
“You’re going to need to go to the hospital, too,” Lance reminded her.
Her gaze cut to his, then she frowned. Yeah, she’d thought of that as she’d been scrubbing the blood from the finger she’d used to open the cut she’d made. Blood exposure was a big deal. A scary big deal.
“I know. I rode here with Cecilia. I’ll have her take me, unless I can hitch a ride with you guys.” She gave the paramedic a hopeful look.
“I’ll take you,” Lance piped up, which was exactly what she hadn’t wanted to happen. The less she was alone with him the better.
She arched a brow at him. “You got blood on you, too?”
He didn’t answer, just turned his attention to the paramedic. “I’ll bring her to the hospital and we’ll draw necessary labs.”
In the heat of the moment she’d have done exactly the same thing and saved the man’s life. After the fact was when one started thinking about possible consequences of blood exposure. In an emergency situation one did what one had to do to preserve another’s life.
She didn’t regret a thing, because she’d done the right thing, but her own life could have just drastically changed forever, pending on the man’s health history.
She didn’t have any cuts or nicks that she could see on her hands, but even the tiniest little micro-tear could be a site for disease to gain entry into her body.
Whether she wanted to or not, she had to have blood tests.
“Cecilia can take me,” she assured Lance. Beyond being alone with him, the last thing she wanted was to have to have him there when she had labs drawn.
McKenzie hated having blood drawn.
Blood didn’t bother her, so long as it was someone else’s blood. Really, it wasn’t her blood that was the problem. It was her irrational fear of needles that bothered her. The thought of a needle coming anywhere near her body did funny things to her mind. Like send her into a full-blown panic attack. How could she be so calm and collected when she was the one wielding the needle and so absolutely terrified when she was going to be the recipient?
She could do without Lance witnessing her belonephobia. He didn’t need to know she was afraid of needles. Uh-uh, no way.
McKenzie gave Cecilia a pleading look, begging for her friend to somehow rescue her, but the grinning hairdresser hugged her goodbye and indicated that she was going to say something to someone she knew, then headed out rather than stay for the remainder of the show. Unfortunately, several of the other attendees seemed to be making the same decision to leave.
“I’m going to the hospital anyway, so it wouldn’t make sense for someone else to bring you.”
“But I…” She realized she was being ridiculous. One of the local doctors going into hysterics over getting a routine phlebotomy check would likely cause a stir of gossip. Lance would end up hearing about her silliness anyway. “Okay, that’s fine, but don’t you have to finish your show?”
He glanced back toward the dinner theater. “Other than thanking everyone for coming to the show, I’ve done my part. While you were washing up, I asked one of the singers to take over. The show can go on without me.” A worried look settled on his handsome face. “The show must go on. It’s for such a great cause and I don’t want what happened to give people a bad view of the event. It’s one of our biggest fund-raisers.”
McKenzie frowned, hating that the incident had happened for many reasons. “It’s not the fault of Celebrate Graduation that the man choked. Surely people understand that.”
“You’d think so,” he agreed, as they exited the building and headed toward the parking lot. “That man was Coopersville’s mayor, you know.”
“The mayor?” No, she hadn’t known. Not that it would have mattered. She’d done what had needed to be done and would have done exactly the same regardless of who the person had been. A life had been on the line.
“Yep, Leo Jones.”
“Is he one of your patients?” she asked, despite knowing he shouldn’t answer. He knew exactly why she was asking. Did she need to worry about the man’s health history? Did Lance know anything that would set her mind at ease?
“You know I wouldn’t tell you even if he was.”
Yes, she knew.
“But I can honestly say I know nothing about any mayor’s health history.” He opened the passenger door to his low-slung sports car that any other time McKenzie would have whistled in appreciation of. Right now her brain was distracted by too many possibilities of the consequences of her actions and that soon a needle would be puncturing her skin.
Was it her imagination or had she just broken a sweat despite the mid-December temperatures?
“Thank you,” she whispered back, knowing her question had put him in an awkward position and that he’d answered as best he could. “I guess I won’t know anything for a few days.”
“Probably not.” He stood at the car door for a few seconds. A guilty look on his face, he raked his fingers through his hair. “I should have cut the airway, rather than let you do it.”
She frowned at him. “Why?”
“Because then you wouldn’t be worrying about any of this.”
She shrugged. “It was my choice to make.”
“I shouldn’t have let you.”
“You think you could have stopped me from saving his life?”
His grip tightening on the car door, he shook his head. “That’s not what I meant.”
“I know what you meant and I appreciate the sentiment, but I’m not some froufrou girl who needs pampering. I knew the risks and I took them.” She stared straight into his eyes, making sure he didn’t misunderstand. “If there are consequences, I’ll face them. I did the right thing.”
“Agreed, except I should have been the one who took the risks.”
“Because you’re a guy?”
He seemed to consider her question a moment, then shook his head. “No, because you’re you and I don’t want anything bad to happen to you.”
His answer rang with so much sincerity that, heart pounding, she found herself staring up at him. “You’d rather it happen to you?”
“Absolutely.”
CHAPTER TWO
LANCE DROVE TO the hospital in silence. Just as well. McKenzie didn’t seem to be in the mood to talk.
Was she thinking about what he’d said? Or the events of the evening? Of the risks she’d taken?
When he’d realized Leo Jones had been choking, he’d rushed to the man and performed the Heimlich maneuver. Too bad he hadn’t been successful. Then McKenzie wouldn’t have any worries about blood exposure.
Why hadn’t he insisted on performing the procedure to open Leo’s airway? He should have. He’d offered, but precious time had been wasting that could have meant the difference between life and death, between permanent brain damage and no complications.
He’d let her do what she’d competently done with quick and efficient movements. She’d saved the man’s life. But Lance would much rather it was him being the one worrying about what he’d been exposed to.
Why? Was she right? Was it because she was female and he was male and that automatically made him feel protective?
Most likely he’d feel he should have been the one to take the risks regardless of whether McKenzie had been male or female. But the fact she was female did raise the guilt factor, with the past coming back to haunt him that he’d failed to protect another woman once upon a time when he should have.
Plus, he’d been the one to invite McKenzie to the show. If he hadn’t done so she wouldn’t have been at the community center, wouldn’t have been there to perform the cricothyroidotomy, wouldn’t have possibly been exposed to something life threatening.
Because of him, she’d taken risks she shouldn’t have had to take. Guilt gutted him.
If he could go back in time, he’d undo that particular invitation. If he could go back in time, he’d undo a lot of things.
Truthfully, he hadn’t expected McKenzie to accept his invitation to watch his show. She’d shot down all his previous ones with polite but absolute refusals.
He glanced at where she stared out the window from the passenger seat. Why had she semiaccepted tonight?
Perhaps the thought of seeing him onstage had been irresistible. He doubted it. She’d only agreed to go and watch and so had technically not been there as his date.
Regardless, he’d been ecstatic she’d said she’d be there. Why it mattered so much, he wasn’t sure. Just that knowing McKenzie had been attending the show had really upped the ante.
Not knowing if she’d let him or not, he reached out, took her hand, and gave a squeeze meant to reassure.
She didn’t pull away, just glanced toward him in question.
“It’s going to be okay.” He hoped he told the truth.
“I know. It’s not that.”
“Then what?”
She shook her head.
“Seriously, you can tell me. I’ll understand. I’ve had blood exposure before. I know it’s scary stuff until you’re given the all-clear.”
She didn’t look at him, just stared back out the window. “I don’t want to talk about it.”
“What do you want to talk about?”
She glanced toward him again. “With you?”
He made a pretense of looking around the car. “It would seem I’m your only option at the moment.”
“I’d rather not talk at all.
“Ouch.”
“Sorry.” She gave a nervous sigh. “I’m not trying to be rude. I just…”
“You just…?” he prompted at her pause.
“Don’t like needles.” Her words were so low, so torn from her that he wasn’t sure he’d heard her correctly.
Her answer struck him as a little odd considering she was a highly skilled physician who’d just expertly performed a procedure to open a choking man’s airway.
When he didn’t immediately respond, she jerked her hand free from his, almost as if she’d been unaware until that moment that he even held her hand.
“Don’t judge me.”
How upset she was seemed out of character with everything he knew about her. She was always calm, cool, collected. Even in the face of an emergency she didn’t lose her cool. Yet she wasn’t calm, cool or collected at the moment. “Who’s judging? I didn’t say a word.”
“You didn’t have to.”
“Maybe I’m not the one judging?”
She didn’t answer.
“If you took my moment of silence in the wrong way, I’m sorry. I was just processing that you didn’t like needles and that it seemed a little odd considering your profession.”
“I know.”
“Yet you’re ultrasensitive about it.”
“It’s not something I’m proud of.”
Ah, he was starting to catch on. McKenzie didn’t like to have a weakness, to be vulnerable in regard to anything. That he understood all too well and had erected some major protective barriers years ago to keep himself sane. Then again, he deserved every moment of guilt he experienced and then some.
“Lots of people have a fear of needles,” he assured her. They saw it almost daily at the clinic.
“I passed out the last time I had blood drawn.” Her voice was condemning of herself.
“Happens to lots of folks.”
“I had to take an antianxiety medication to calm a panic attack before I could even make myself sit in the phlebotomist’s chair and then I still passed out.”
“Not unheard of.”
“But not good for a doctor to be that way when she goes around ordering labs for her patients. What kind of example do I set?”
“People have different phobias, McKenzie. You can’t help what you’re afraid of. It’s not like we get to pick and choose.”
She seemed to consider what he’d said.
“What are your phobias, Lance?”
Her question caught him off guard. He wasn’t sure he had any true phobias. Sure, there were things that scared him, but none that put him into shutdown mode.
Other than memories of Shelby and his immense sense of failure where she was concerned.
Could grief and regret be classified as a phobia? Could guilt?
“Death,” he answered, although it wasn’t exactly the full truth.
She turned to face him. “Death?”
His issues came more from having been left behind when someone he’d loved had died.
When his high school sweetheart had died.
When it should have been him and not her who’d lost their life that horrific night.
When he didn’t answer, she turned in her seat. “You are, aren’t you? You’re afraid of dying.”
Better she think that than to know the horrible truth. He shrugged. “Aren’t most people, to some degree? Regardless, it isn’t anything that keeps me awake at night.”
Not every night as it had those first few months, at any rate. He’d had to come to terms with the fact that he couldn’t change what had happened, no matter how much he wanted to, no matter how many times people told him it wasn’t his fault. Now he lived his life to help others, as Shelby would have had she lived, and prevent others from making the same mistakes two teenagers had on graduation night.
“The thought of needles doesn’t keep me awake at night,” McKenzie said, drawing him back to the present. “Just freaks me out at the thought of a needle plunging beneath my skin.”
Again, her response seemed so incongruent with her day-to-day life. She was a great physician, performed lots of in-office procedures that required breaking through the skin.
“Is there something in your past that prompted your fear?” he asked, to keep his thoughts away from his own issues. Shelby haunted him enough already.
From the corner of his eye as he pulled into the hospital physician parking area he saw her shake her head.
“Not that I recall. I’ve just always been afraid of needles.”
Her voice quivered a little and he wondered if she told the full truth.
“Medical school didn’t get you over that fear?”
“Needles only bother me when they are pointed in my direction.”
“You can dish them out but not take them, eh?”
“I get my influenza vaccination annually and I’m up to date on all my other immunizations, thank you very much.”
He laughed at her defensive tone. “I was only teasing you, McKenzie.”
“If you knew how stressful getting my annual influenza vaccination is for me, you wouldn’t tease me.” She sighed. “This is the one thing I don’t take a joke about so well.”
“Only this?” he asked as he parked the car and turned off the ignition.
Picking up her strappy purse, she shrugged. “I’m not telling you any more of my secrets, Lance.”
“Afraid to let me know your weaknesses?” he taunted.
“What weaknesses?” she countered, causing him to chuckle.
That was one of the things that attracted him to McKenzie. She made him laugh and smile.
They got out of the car and headed into the hospital.
The closer they got to the emergency department, the more her steps slowed. So much so that currently she appeared to be walking through molasses.
“You okay?”
“Fine.” Her answer was more gulped than spoken.
Stupid question on his part. He could tell she wasn’t. Her face was pale and she looked like she might be ill. She’d made light of her phobia, but it was all too real.
Protectiveness washed over him and he wanted to scoop her up and carry her the rest of the way.
“I’ll stay with you while you have your labs drawn.”
Not meeting his eyes, she shook her head. “I don’t want you to see me like that.”
“You think I’m going to think less of you because you’re afraid of needles?”
“I fully expect you to tease me mercilessly now that you know this.”
Her voice almost broke and he fought his growing urge to wrap her up into his arms. If only he could.
“You’re wrong, McKenzie. I don’t want to make light of anything that truly bothers you. I want to make it all better, to make this as easy for you as possible. Let me.”
“Fine.” She gave in but didn’t sound happy about it. “Write an order for blood exposure labs. Get the emergency room physician to get consent, then draw blood on our dear mayor. Let’s hope he’s free from all blood-borne pathogens.”
He definitely hoped that. If McKenzie came to any harm due to having done the cricothyroidotomy he’d never forgive himself for not insisting on doing the procedure, for putting her in harm’s way. He’d not protected one woman too many already in his lifetime.
McKenzie counted to ten. Then she counted backward. Next she counted in her very limited Spanish retained from two years of required high school classes. She closed her eyes and thought of happy thoughts. She told her shoulders to relax, her heart not to burst free from her chest, her breath not to come in rapid pants, her blood not to jump around all quivery-like in her vessels.
None of her distraction techniques worked.
Her shoulders and neck had tight knots. Her heart pounded so hard she thought it truly might break free from her rib cage. Her breathing was labored. Her blood jumped and quivered.
Any moment she half expected her feet to take on minds of their own and to run from the lab where she waited for the phlebotomist to draw her blood.
Lance sat with her, telling her about Mr. Jones and that the surgeon was currently with him. “Looks like they’re taking him into surgery tonight to remove the stuck food and close the airway opening you made.”
Only half processing what he said, she nodded. She tried to focus on his words, but her skin felt as if it was on fire and her ears had to strain beyond the burn.
“The surgeon praised the opening you made. He said it would be a cinch to close and would only leave a tiny scar.”
Again, she nodded.
“He also said you’d nicked two main arteries and the guy was going to have to be seen by a vascular surgeon. Shame on you.”
As what he said registered, her gaze cut to Lance’s. “What? I didn’t nick a main artery, much less two. What are you talking about?”
The corner of his mouth tugged upward. “Sorry. I could tell your mind was elsewhere. I was just trying to get your attention back onto me.”
“I didn’t hit two arteries,” she denied again.
“No, you didn’t. The surgeon really did praise you, but didn’t say a thing about any nicked arteries.”
“You’re bad,” she accused.
Not bothering to deny her claim, he just grinned. “Sometimes.”
“All the time.”