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“When did you cry, Kate?” Memories of the two times he had ever seen Kate cry revolved in his mind. Both instances had been extreme, when she had been pushed to her limit.
“When I was talking to Mrs. Weber after her husband died.” Still no elaboration. He hated this. Hated that his job was to force her to discuss something she had no desire to share with him. It went against everything they had once been.
“I need you to tell me exactly what happened.” She stared at him and he couldn’t tell what she was thinking. Minutes went by and he started to worry she would refuse him. Not for the first time he reconsidered whether he should be representing Kate, or whether the past between them was too much to overcome.
Finally she sighed, obviously resigning herself to the situation. “After Mr. Weber died, Tate, as the attending surgeon, went to talk to Mrs. Weber to disclose his death. When he was done I joined her in the operating room’s family room. I had met her earlier in the night and felt compelled to see her. She already knew her husband was dead and was crying alone in the room when I got there. When she saw me she reached for me and I let her embrace me, and she didn’t let go. The more she cried, the harder she held me. Eventually I started to cry too and I told her I was sorry.”
“What were you sorry for, Kate?”
“I was sorry that she had lost the love of her life. That she was going to have to go on by herself and try to make a life without the one person she was meant to be with.”
“Do you think it’s possible that she misinterpreted your empathy as guilt?”
“Given that we are talking about it, I would say yes, wouldn’t you?” Her derision was very clearly focused on herself, despite the sarcasm in her response.
Yes, he would. Kate crying and saying she was sorry would definitely raise suspicions when reflected on after the fact.
“Are there any other patients, nurses, or colleagues that would speak for a pattern of behavior? That you frequently empathize with your patients and their emotions?”
“No. That was the first and only time I have lost my composure at work.”
“Is there anyone else in your life who can testify to your emotional nature?” He was reaching, looking for some way to get her out of a situation that now seemed partially her own making.
Her face changed. Gone was the steely armor and replacing it was the same softness he recognized from the past. “You.”
“Me what, Kate?”
“You are the only person who has ever seen me cry.” Her words were a painful confession, but the information was just the opposite. It highlighted to him what he had always known. They had been something different, something special, something he should have held onto at all costs. He couldn’t let those thoughts take over; he needed to keep his focus. He knew bringing up the past would be a sure way to make Kate retreat and he wasn’t willing to lose another minute with the real her.
“What was different about that night?”
“I’m not sure.” She raked her hand back through her hair and looked down at the table as if she would find the answer she was looking for in the grain of the wood. “She really loved him and he loved her. I saw it between them in the emergency department, true love. Then within hours it was gone and I couldn’t put together what would happen next. She was so lost without him already and all I could remember was what it felt like to lose the person you love. I remembered that feeling and knew that my love and pain were only a tenth of what she was experiencing, and I didn’t know how to help her.”
The most remarkable woman he had ever met looked defeated and it was enough to break his resolve. He didn’t stop to question whether she was referring to her mother, him, or Tate Reed in her memories of pain and loss. He rose from his chair and crossed around to her, the drive to hold her in his arms breaking through his common sense. She looked up as he drew her up from her chair, her lips parting in shock. He didn’t mean to kiss her, his intent, brief as it had been, had been to comfort and hold her, but one look into the depths of her eyes and the sweet fullness of her lips was enough to change his mind.
It was an experience in contrasts. The softness of her lips to the hardness of his mouth; the surprise in her reaction to the deliberate intent that drove him; the sweetness within her to the ruthlessness of the man he had become. She didn’t pull away and the small surrender drove him harder. He explored her, reminding his mind and body of the places he had once been and had never forgotten. His tongue teased hers while his hands roamed her body in his embrace. Her hands clung to him, grabbing handfuls of the fabric of his shirt until the moment was broken and he felt her step back from the kiss and push him away.
She was staring at him, her eyes wide. “You want me.”
His arms were still holding her and he was unwilling to let her move further away. He also wanted to make it clear to her who she was with and who was responsible for the dilation of her pupils, her parted moist lips, and the points of her nipples, which were pressing against the fabric of her long-sleeved cotton shirt.
“Why?” she whispered, the word coming at the end of a gasp to find her breath.
“Why what?” His brain had been robbed of its blood supply and his ability to comprehend her question was inhibited by the physical desire he was struggling to restrain.
“Why are you really back?” It was the question that had been in the background of their every interaction and had remained unasked and unanswered between them.
“Code Orange. Code Orange, Emergency Department. All available personnel.” The hospital intercom sounded within the room, the intrusion startling both of them. His arms dropped and she moved away. He had no idea what the announcement meant, but as he watched her face change from the intimacy of her question to immediate business, he realized it was serious.
“That’s a mass casualty code. I need to go.” She went back to her spot at the table, shoved her textbook into her shoulder bag and then left without another look at him.
He was torn between anger at the interruption and relief that he didn’t have to answer the question he didn’t have an answer for.
He knew why he had left her but had no explanation for why he was back. He paced around the room, the motion helping him to organize his thoughts. It wasn’t the first time he had thought it through. It was an argument he had had over and over again, and never once had he come to a different conclusion. Kate was special. She was beautiful, selfless, and genuine in her feelings and actions. She was everything he wanted and he had loved her enough to let her go before his world ruined her and robbed her of everything that made her the woman he loved.
Why was he back? He had asked himself a thousand times since coming to Boston. Why, after nine years of being apart, had he finally given in to the temptation to return to her? It wasn’t that he had forgotten her. In the beginning it had taken every ounce of his willpower to break away from her. When she’d called and emailed he had forced himself to erase the messages before listening to or reading her words.
He had begun filling his life with women and alcohol, neither providing any comfort. For a time he’d actually thought he was losing his mind, because out of the corner of his eye he would think that he saw her across campus or heard her voice in a crowd. One afternoon he had walked into a campus coffeehouse and seen a woman that could have been her. The long brown hair, the way she had been bent over a textbook, intensely concentrating, reminding him so much of Katie that when she had started to look up he’d had to turn and leave. He had been unable to face the crushing disappointment that would have come when he discovered it was not her.
After that he realized he needed something in his life that reminded him of her without being with her. That was when he discovered medical defense law. It brought out the best in him, just as Kate had. The ability to defend and protect physicians who dedicated their lives to caring for others brought a purpose to his life that he desperately needed. It was also the first step in breaking free of his family’s self-serving dysfunction.
After finishing law school, it had been understood that he would join the firm and he did, but with one condition—he wanted to specialize in medical defense. When faced with the prospect of having his grandson work for another law firm, his grandfather relented and let him start a separate division for medical defense within the family firm. Matt was the best at everything he did, but as a medical defense lawyer he excelled. Within two years the firm’s value had tripled and Matt was made a partner. By twenty-eight, Matt was a millionaire, having channeled his share of the firm’s profits into successful investments.
Despite being born into privilege, Matt became a self-made man, and with that came insight into the family dynamic that had dominated his life. He loved his family, but that feeling was marred by the sense of responsibility he felt toward them and disdain for their way of life. They judged and treated people entirely according to wealth and background with no regard for true character. They would have eaten the old Katie alive, and Matt knew that, despite his best efforts to protect her, his family’s resentment of who she was and her position of importance in Matt’s life would have slowly eroded her spirit and the small amount of self-confidence she had.
But now things were different. New money was no longer vulgar, not when Matt had accumulated more wealth than the rest of his family combined. He had also learned to draw some hard lines surrounding his personal life and they no longer dared to interfere in his relationships or other choices.
If his ability to control his family was the reason he was back in Kate’s life, he would have found her years ago. He could more easily explain why he’d stayed away than why he’d returned. He’d stayed away out of guilt. No matter how noble his reasons had been for ending their relationship, he had done it horribly, his mind reacting instead of thinking.
To avoid her sacrificing who she was and wanted to be for him, he had sacrificed his own character. He had stayed away because after all these years He knew he couldn’t offer her what they had once had—trust. If she asked him again why he was back, he would be honest. He was back because she needed him and after nine years apart he finally had something to offer her, and he wasn’t going to let her refuse.
CHAPTER FIVE
KATE REACHED THE emergency department within minutes of hearing the overhead call for help. A code orange was one of the most rare codes and in her entire career she had never heard one called. A code blue was called when a patient stopped breathing. A code red when there was a fire in the hospital. A code orange was reserved for when some sort of disaster occurred and the emergency department was overwhelmed and unable to cope with the patient load.
She wasn’t working, she wasn’t even supposed to be in the building, but that didn’t matter. She had been trained to care for the sick and no office hours applied to that duty.
She threw her bag into the locker room, exchanging her shirt for a scrub top, not so much to protect herself but more to identify her in the sea of people that would be filling the department.
She walked to the trauma bay, coming alongside Chloe and her attending physician, Dr. Ryan Callum. They showed no surprise at her arrival.
“What’s going on?” she asked, her eyes darting around the department, evaluating.
“Multiple vehicle collision in the tunnel, including a city bus, with an unknown number of casualties. The Boston fire department and medics have been on scene for at least fifteen minutes but they are having trouble extracting some of the passengers. We are the closest and the first-response site for all trauma cases, with County and other surrounding hospitals as overflow.”
“What would you like me to do?”
“The operating room has been notified and all nonurgent cases are on hold until we evaluate how much surgical trauma there is. Chloe and the other emergency residents are going to triage the victims according to their injury severity score. If you could be on hand for the critical and severe patients and work with the trauma team to decide who goes to the operating room and in what order, that would help immensely.” He didn’t elaborate further as the team poured into the ambulance bay to meet the first arriving victims.
Within an hour, fifteen patients had been classified with severe and critical codes. Kate mentally ordered the surgical cases for the operating room, taking into account both the severity of their injuries and their readiness for the operating room. She picked up the phone and asked to be put through to the attending surgeon responsible for the trauma team.
“Jonathan Carter,” the surgeon answered, obviously waiting for this call.
“It’s Kate Spence. I have seen the critical and severe tracked patients from the tunnel accident. Nine are presenting as clear surgical cases and four need to go immediately. There is an obstructed airway, a rib fracture with flail chest, a compound femur fracture, and a penetrating trauma to the abdomen.”
“The operating room has four rooms available with nursing and anesthesia. Orthopedics has a team in place and can start with the femur and work through the orthopedics cases. I’m here and so is Dr. Reed, but we don’t have a third surgeon in-house on a Saturday and the nearest person is one hour away because of the tunnel closure.”
“Are you asking me which two of the three non-orthopedic cases we should take first?” she asked, knowing the wrong choice could lead to a patient’s death.
“No, I’m telling you that you are taking the penetrating abdominal wound to the OR without an attending surgeon.”
Her train of thought changed from patient triage to shock. She didn’t need him to repeat himself; he had been clear and his words were echoing in her mind.
“Dr. Spence, you are three months away from being a board qualified surgeon. I’ve worked with you, Dr. Reed has worked with you, and we both agree that you are more than capable of acting alone. The patient is better served with you now than waiting around for someone else.”
“Thank you.” She felt humbled and terrified and neither emotion was she going to allow to show in her voice.
“Don’t thank me. You’ve earned this. I’ve already notified the operating room that you will be doing the case solo. They are just waiting for the patient details and then will send for the patient immediately.”
The team moved quickly. She made the necessary call and then went upstairs to change into her surgical attire. Within ten minutes the patient was on the table, being anesthetized. She moved to the left-hand side of the table and waited for the signal from the anesthetist to start. She could hear the monitors firing, her patient’s heart rate racing, just as hers was. She knew she could do it. Knew they wouldn’t have let her if she couldn’t. But there was something about being the most qualified person in the room, with no one to help her if she got in over her head, that was terrifying.
She needed to set the tone. Everyone in the room was on edge because of the severity of the situation. The only way to bring people down was to lead by example, to stay calm. She could do that. She held out her gloved hand. “Knife.”
She worked meticulously, creating an incision extending from either side of the metal shard that was plunged into the center of the man’s abdomen. She couldn’t just pull it out, she needed the shard in place to act as a tamponade for the bleeding until she could identify which organs and vessels had been damaged. She worked through the layers of the abdominal wall until she was able to place a retractor to hold open the wound and give her the complete visualization she needed.
Damn, she thought to herself. The metal was extending into the transverse colon and the abdomen was completely contaminated, placing the patient at high risk for postoperative infection. Thankfully, the shard had stopped before reaching the aorta, which lay two centimeters below the tip.
Typically this was when her attending would ask her what she wanted to do. Did she want to repair the bowel or remove a segment of the damaged bowel, and if she chose the latter, did she want to do a primary or secondary repair? She knew the answer, but this was thefirst time she was taking one hundred percent ownership of the decision.
She called out to the circulating nurse and requested the necessary staplers and devices. Within an hour she was sitting in the recovery room with her patient, completing her postoperative orders and dictation.
Her emotions were mixed. On one hand she was proud of her surgical accomplishment; on the other, she felt for her patient, who still had a long road ahead of him to full recovery.
The automatic doors swung open and Dr. Carter walked in alongside the stretcher on which his patient was being transferred to the recovery room. He approached Kate, and she prepared to defend her decision to resect the bowel with delayed anastomosis.
“Dr. Shepherd has just arrived and is going to take over the third room until things are clear. Thank you for your help today. Your patient has been formally admitted under my care, but you should consider him yours until he goes home.”
“Thank you again.”
“Don’t thank me. You proved yourself long ago.”
She retraced her steps through the hospital, collecting her belongings from the various locations she had been. She had never questioned her decision to become a surgeon but in that moment she had never been more certain that she had made the right choice. She felt like the doctor and woman she wanted to be, confident and in control, and it was time for her to take control of all aspects of her life.
She dug through her bag in search of her phone and the business card the hospital’s lawyer, Jeff Sutherland, had left her after the initial meeting. She dialed the number and waited as it rang.
“McKayne.”
“It’s Kate. We need to talk.” It was the understatement of the year, but what she needed to say she needed to say in person. She wasn’t going to take the easy way out over the phone.
“I won’t dispute that.” His assuredness irritated her and she tried to stay on track.
“Where are you now?”
“I’m at my apartment—do you need the address?” Yes, she would need the address. Leaving a man’s apartment at three in the morning after an unexpected sexual encounter did not typically lend itself to remembering logistics, but it did remind her of the dangers of entering a lion’s den.
“No. I mean I don’t need the address because I’m not coming over. Can you meet me at Gathering Grounds on Beacon Street?” She held her breath, waiting for his response.
“I can probably be there in about an hour.”
“Okay. I’ll see you then.” She pushed the off button, not wanting to prolong the conversation. She needed to keep every ounce of the confidence she had gained this afternoon for when she met Matt.
Almost exactly an hour later Matt entered the coffee shop. She knew he was there the moment he walked through the door, and she watched him get a coffee and then join her at her table.
“We need to speak quietly while we’re talking about the case.”
“I don’t want to talk about the case,” she said, still quietly, her personal life just as confidential to her as the details of the lawsuit.
“Okay, so what do you want to talk about?”
“Us.”
“You said you didn’t want to discuss the past.”
“I don’t. I want to make things clear now.”
“Kate, nothing is more clear. You want me and I want you.”
He was right. She wouldn’t deny it. How could she when he had witnessed her response to him? Even as he spoke the words her body flushed with the memory of him. She swallowed hard and forced herself to remain focused. “That doesn’t matter.”
“How can it not matter that every time we touch, neither of us can keep control?”
“Because I can keep control, Matt. I don’t know you, I never did. But I remember what it feels like to be hurt by you and those memories are way stronger than any physical attraction that still lingers between us.”
His face, which had been heated describing the passion between them, cooled, and she faced a steely expression before he spoke. “Do you want a different lawyer?”
“No. You need to fix this for me, because I know you can. But while you are doing that I want you to forget everything else that is between us. The only relationship we have is of lawyer and client.”
“The attraction between us isn’t going away, Kate, no matter how hard you try to control it or tell me to ignore it.”
“But you are, Matt. When this case is done you are going to move on back to your high-society life and you’ll forget that I ever existed.”
“And what if I can’t?”
“You can, Matt, and you have. You just need to do it again.”
Kate spent the remainder of the weekend trying to get caught up with life. Her work schedule made even basic life tasks seem like monumental challenges. Cleaning her apartment, doing laundry, shopping for groceries, and sorting her mail were all luxuries saved up for a rare day off. Her student-loan statement was a grim reminder of the ruin she faced if they lost the case. She had no way to pay back that amount of debt, not to mention the money she owed her father, unless she was employed as a surgeon, and that was dependent on the case. Not to mention the pain of losing her chance to devote her career to women with breast cancer, women like her mother.
She moved through the apartment, trying to restore the same order to her home life as she had her personal life, and eventually she felt more herself than she had since Matt’s return. She had done it. She had taken the steps she needed to protect herself and her heart. She would never let him hurt her again, because if she did she knew she wouldn’t survive it.
Her sense of peace remained with her until Monday afternoon. Matt’s office called and scheduled a meeting for Thursday. The receptionist didn’t provide any details about why they were meeting. She could only assume it was to continue the conversation that had been cut short on the weekend. Two feelings filled her and neither was welcome. One was a sense of dread at having to relive the night of Mr. Weber’s death and her time with Mrs. Weber. The other was hurt that Matt hadn’t called her himself. The latter she resented deeply, despite it being what she wanted: lawyer and client, nothing more.
She operated all day Tuesday and took a call shift on Wednesday in order to be able to leave early for the meeting on Thursday afternoon. By that time her sense of peace had long left her. It was just fatigue, she lied to herself. That was why she felt so on edge about meeting Matt, because she was in control and had every intention of staying that way.
“Kate, are you okay?” Tate’s voice interrupted her thoughts as she made her way through the hospital atrium towards the building’s exit. It was jarring to hear his voice when she was thinking about Matt. She looked up to find him walking beside her, and she hadn’t even noticed.
“I’m sorry, Tate, what did you say?”
“I asked if you were okay.”
She wasn’t going to lie to Tate. “No, but I am going to be,” she said, with enough conviction to convince both of them.
“So where are you headed?” she asked as they left the hospital, his early departure as uncharacteristic as her own.
“I’m guessing the same place you are, to a meeting with Matt McKayne.”
She shook her head from side to side, the momentary lightness now gone. Who was she kidding? The only person in control was Matt. He had always been in control, it was one of the things that had drawn her to him, but now she was terrified. If he was in control then she wasn’t, and the small whisper of doubt she had over her ability to keep her emotional distance from him blossomed into fear.