Critical Praise for
HANNAH ALEXANDER'S
Novels

SACRED TRUST

“Alexander is great at drawing the reader into her story line and keeping them hooked until the resolution of the plot.”

— Christian Retailing

A KILLING FROST

“Running dialogue and a few twists will keep romantic suspense fans coming back for more.”

— Publishers Weekly

DOUBLE BLIND

“Native American culture clashes with Christian principles in the freshly original plot.”

— Romantic Times BOOKreviews

GRAVE RISK

“The latest in Alexander’s Hideaway series is filled with mystery and intrigue. Readers familiar with the series will appreciate how the author keeps the characters fresh and appealing.”

— Romantic Times BOOKreviews

FAIR WARNING

“The plot is interesting and the resolution filled with action.”

— Romantic Times BOOKreviews

LAST RESORT

“The third novel in Alexander’s Hideaway romantic suspense series (after the Christy Award-winning Hideaway and Safe Haven ) is a gripping tale with sympathetic characters that will draw readers into its web. The kidnapped Clarissa’s inner dialogue may remind some of Alice Sebold’s The Lovely Bones. ”

— Library Journal

Sacred Trust
Hannah Alexander

www.millsandboon.co.uk

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To the Great Physician,

the Author and Finisher of our faith.

In memory of our fathers:

Johnie R. Cook & Ralph B. Hodde

We wish to thank Joan Marlow Golan and her excellent staff for giving us this opportunity to share our books with a new reading audience.

Sacred Trust

Contents

Prologue

Chapter One

Chapter Two

Chapter Three

Chapter Four

Chapter Five

Chapter Six

Chapter Seven

Chapter Eight

Chapter Nine

Chapter Ten

Chapter Eleven

Chapter Twelve

Chapter Thirteen

Chapter Fourteen

Chapter Fifteen

Chapter Sixteen

Chapter Seventeen

Chapter Eighteen

Chapter Nineteen

Chapter Twenty

Chapter Twenty-One

Chapter Twenty-Two

Chapter Twenty-Three

Chapter Twenty-Four

Chapter Twenty-Five

Chapter Twenty-Six

Chapter Twenty-Seven

Chapter Twenty-Eight

Chapter Twenty-Nine

Chapter Thirty

Chapter Thirty-One

Chapter Thirty-Two

Chapter Thirty-Three

Epilogue

Questions for Discussion

Prologue

F rankie Verris held the plastic cup in his trembling left hand and stared out the bedroom window. Broken limbs from winter storms littered an unmowed lawn. Weeds lay flattened in the vegetable garden. The jonquils and tulips, which Doris had always loved so much, had refused to bloom this spring. It pretty well summed up Frankie’s life over the past year, with Doris gone. Another sleepless night, filled with pain and loneliness, had brought him to this despair.

He looked at the easy-open prescription vial in his right hand, cherishing even the look of his wife’s name on the white label. Why hadn’t he cherished her more when she was alive?

With unsteady fingers, he flipped off the cap and poured the pills onto the dusty chest beside the window. They had helped Doris sleep. Would they work for his pain?

He gagged on the first swallow, but it finally went down. He sank into the bedside chair and took two more. They went easier. He watched the silent flight of a hawk as it winged over the horizon of forest past the yard. Everything seemed to remind him of Doris these days. She’d loved the hawks because of “the poetry in their wings.” She’d loved so many things. She’d loved him, unworthy as he was.

She’d loved God most of all.

For years Frankie had been jealous of God, often resentful because of the special relationship Doris seemed to have with Him. And now God had taken her and there was nothing left.

He swallowed two more pills, then kept going, two at a time. It grew easier and easier.

The drug was fast acting, and he appreciated that. He didn’t want to sit around and wait for it to work. In fact, he thought he might be feeling the first effects already….

Jacob Casey gripped the telephone receiver hard, fighting back another wave of pain in his upper thigh. “Hello, emergency room? This is Cowboy again. I’m coming in with another injury.” It had been a few months since they’d seen him, and he’d never been there in the daytime. Maybe today’s would be a different staff, and maybe this time the doc on duty wouldn’t give him the familiar three-hour sermon about being careful around wild animals.

He grimaced as the secretary questioned him. “Nope, no ambulance. I’ll do it myself.” He’d called an ambulance once—last year when the bison had kicked the paddock gate over on him. It had taken him longer to get to the hospital then than ever before or since.

He looked down to find more blood dripping from his thigh. “Can’t take the time to talk. Just be ready for me. My pet cat bit me. No rabies, so don’t even think about shots.” Leonardo was well vaccinated.

With a short grunt Cowboy hung up the phone and reached for his hat. The room started to go black on him, and he lowered his head. Must be losing more blood than I thought. Forget the hat. He picked up his keys from the kitchen table and flung one last, angry glance out the window toward the cage outside where Leonardo the lion paced from end to end. Let him go hungry if he was going to behave like this.

At this rate there would be blood all over Cowboy’s beautiful vintage Mustang. That cat had a lot to answer for.

Frankie stood up unsteadily from his perch at the un-curtained window. The sun had passed the tree line and now blasted through the bedroom with unrelenting force. Dust particles danced in the sunbeams, and Frankie stared at them for a moment, fascinated. The neighbor kids would want to see this. He’d have to show them the next time they came over….

No, he wasn’t planning to be here to show them. He was going to be with Doris by then.

He would be with Doris, wouldn’t he? She was dead and he’d be dead, in the ground.

His mind worked through that thought slowly. Doris had never believed she would just end up in the ground. She was sure she was going to heaven. He’d gotten sick of listening to her talk about heaven so much. But it sure had comforted him after she was gone.

Frankie’s hands felt numb. He wiggled his fingers and tried to shake the muzziness from his head, but it just made him dizzier. Man, oh, man, this drug is working fast.

Maybe he didn’t want it to work so fast. What about the kids next door? He hadn’t thought about them. What if this drug worked and he died, and those little kids found him?

He did not want that to happen.

Using all his strength to force his feet to move, he walk-stumbled from the bedroom toward the living room. He’d better try to reach that phone. He could call 9-1-1 and stop all this. Then, even if he died, the kids wouldn’t be the ones who found him.

Ivy Richmond sat on the chair closest to the front door and listened to the siren. Soon the ambulance would pull up outside. They’d take care of everything. She pressed her hands against her chest and tried to breathe slowly, as if that would help normalize the crazy rhythm of her heart. This was not a heart attack. She wouldn’t let it be.

So what was it? Stress? She could get philosophical about it and say she had a broken heart. It would be true. Her heart was breaking more and more every day, but she hadn’t expected to get so physical about it. She’d experienced grief before, but maybe it was different every time. Maybe it dug deeper each time until it finally destroyed either the mind or the body. Or maybe she was just being melodramatic. She needed to snap out of this.

The siren stopped as the ambulance pulled up outside. She could see the reflection of the lights against her living-room drapes. Time to let them in.

She stood up and opened the door just as they stepped up to knock.

“Mrs. Richmond?” It was the big guy she’d seen before.

She nodded and stepped back. “This way. She’s in the first bedroom.” She gestured down the hallway, and her hand shook.

The man stopped in front of her. “Are you okay?”

“I didn’t call for me,” she snapped. “It’s my mother. Cancer. Get her to the hospital!”

Frankie never realized how much effort it took just to walk. He could not concentrate long enough to form his steps. He finally leaned against the wall and pulled himself down the hallway that seemed to stretch for miles. If he could just get to the phone…

Doris would be so ashamed of him, trying to buy his way out of life like this. He couldn’t do it. He wanted her to be proud of him when they greeted each other again.

Would they ever see each other? What if she was right about heaven and hell?

He needed time to think about it. He had to reach that phone.

There it sat on the end table. Frankie teetered as he stepped away from the wall and reached forward. His foot caught on something, and he fell as if in slow motion.

Yes, he should have thought about this to begin with. He could crawl so much easier than he could walk. He inched across the remaining space on his elbows and knees and raised his hand toward the phone. He knocked off the receiver, and it fell next to him. He squinted at the face of the dial pad and realized he’d lost his glasses. He peered closer, fighting the heavy darkness that rushed in toward him like a hard wind. He hit the first button: nine. He found the one and poked it, then raised his finger to hit it again, but the black wind grabbed him.

The receiver slipped from his hand, and his head and shoulders slumped helplessly onto the carpet.

Chapter One

A delicate carpet of spring-green crept across the central Arkansas-Missouri border. The buds of serviceberry and dogwood had clothed their trees in pristine white just in time to welcome Dr. Lukas Bower to his new place of residence in Knolls, Missouri. He refused to call it home yet. After his most recent experiences in the job market, he couldn’t place his trust in these strangers. Nevertheless, nestled between patchwork properties of Mark Twain National Forest, this Ozark community of ten thousand promised to meet the needs of a country boy who loved the outdoors, especially hiking. When he had driven down from Kansas City to check out the area, the first order of business, before interviewing for the position of full-time emergency room physician, was to count the logging trails and off-road-vehicle paths that crisscrossed the forest. He’d even followed several of the trails in his Jeep. By the time he’d appeared for the interview with Mrs. Estelle Pinkley, the hospital administrator, he was sold on the place.

He was just finishing his usual morning repast of grease and eggs in the hospital cafeteria when the phone rang for him. He recognized the voice of an emergency room registered nurse.

“Dr. Bower, this is Beverly. We have a man by the name of Jacob Casey on his way here in his own car. He says he’s been bitten by his pet cat. He sounds pretty excited about it.”

Lukas frowned. “His cat bit him?”

“I gathered that the bite was pretty bad,” answered the RN.

“Rabies?”

“He specifically said there were no rabies. From the way he talked, the secretary thinks he’s been here before.”

“Okay, Beverly, I’ll be there shortly. Would you please pull his chart?” How much damage could a house pet do?

“But I’ve got good news,” she said. “We’ll have double nursing coverage through the noon rush.”

“As far as I know, this cat bite is the noon rush.”

Beverly chuckled. “Don’t worry, when Lauren and I do a double-coverage shift together, we always have some excitement.”

“I’ll trust your judgment.” Lukas hung up and took the one-minute walk to the emergency room.

He stepped in to find everything quiet. “Beverly, did Mr. Casey estimate how long it would take him to—”

The sudden blare of a car horn interrupted him and continued, obnoxiously loud.

“What on earth…?” Beverly walked through the open E.R. entrance and disappeared down the hallway. In less than fifteen seconds the honking stopped. Beverly came running back.

“Dr. Bower, Carol, I need your help.” She reached for one of the two gurneys sitting just inside the entrance. “There’s a man parked in the ambulance bay who looks like he’s bleeding all over the place. He’s alone.” She pushed the gurney out the door, with Lukas and Carol, the secretary, close behind.

By the time they reached the bay, the forty-odd-year-old man had opened his door and now clung to it desperately as he tried to get to his feet.

“Can’t seem to stand up,” he grated in a deep voice. His face was the color of recycled paper, and even his lips looked bloodless. “Cat bit me.”

Lukas, Beverly and Carol grabbed him and eased him onto the gurney.

Beverly gaped at him, then at the blood around his upper right thigh. “A cat did this?”

He held out a set of keys to her. “I always wanted a beautiful redhead to drive my Mustang. Take good care of her.” His eyes shut and his head dropped sideways.

“Let’s get him inside.” Lukas closed the car door. “Beverly, give those keys to Carol. She can drive this car out of the way and park it as soon as we get him transferred to a bed.”

“Oh, come on!” Beverly protested. “He told me I could take care of it.”

“He needs you worse than his car does.” Lukas held out his hand as they pushed the gurney through the automatic sliding glass doors. “The keys, please.”

Beverly curled her lip at him, but handed over the set of keys. “I’ve never driven a Mustang before.”

“Thank you.” Lukas handed them to Carol. “Would you do the honors? Beverly, let’s get an IV established on this man immediately, and we need to get his clothes off and see where the blood is coming from.”

While they worked on him, the double-coverage nurse arrived. Lauren groaned when she saw Beverly. “We’ll be swamped.” Even as she spoke, the ambulance radio blared. She pulled her long, blond hair into a ponytail and fastened it as she sat down at the desk to take the call.

In fifteen minutes, the emergency room was nearly full. The man in exam room seven had a deep laceration in his right forearm from an industrial accident. Lukas called industrial accidents his “graveyard specials,” because they happened most often during the predawn hours when the need for sleep was at its highest. Lukas used them as an example when arguing against twenty-four-hour shifts for emergency room physicians. This patient had worked since midnight, having had no sleep the day before. Dangerous?

A high school track student in room two had a possible broken wrist. The E.R. staff was waiting for parental consent to treat, enduring endless telephone calls from classmates to check on the patient’s progress while the track coach searched for the completed consent form. Naturally the parents were out of town for the day.

A baby in room three had a red ear, and Lukas was still trying to decide if it was serious enough to treat with an antibiotic. The young mother had come in crying almost as loudly as her baby, and for a while no one had known which of them was here for treatment.

Two unwashed females stood out at the reception desk complaining loudly because they hadn’t been treated yet for their head lice.

“No, you did not ‘wimp out,’ Mr. Casey.” Lukas stood beside the bed of their first arrival, thirty minutes after they’d wheeled him in. The man still looked weak, although his color had improved. “You lost a couple of pints of blood. Your loving pet nicked an artery in your thigh.” He indicated Casey’s bare leg.

Lukas traced the stablike wounds on the inside of Casey’s right thigh. “That’s some cat.”

“This is just a love bite, Doc. My name’s Jake, or Cowboy, but don’t call me Mr. Casey.”

“A love bite?”

“Male African lion.”

“A pet?”

“Had him for four years, since he was a cub. I raise exotic animals for parks and zoos, but I kept Leonardo. He’s good company.”

“When he’s not eating various parts of your anatomy. You must live alone.”

“How’d you guess?”

Beverly entered the trauma room to recheck Cowboy’s vitals and help Lukas finish irrigating the wound.

Covered in nothing but a towel, Cowboy’s whole body blushed. “Uh, Doc, I’d be grateful if you could spare one of those skimpy hospital gowns. It’d cover a whole lot more.”

Lukas grinned at him. “I think that could be arranged.” He glanced at Beverly. He had already seen the way Cowboy looked at her—and the way she looked back. “Maybe I should help him dress.”

“You don’t have time,” Beverly said. “I hear the ambulance phone now, and we have a mom out in the waiting room with three children she wants to have checked out for sore throats and earaches.”

“How long before our surgeon arrives?” Lukas asked.

Beverly wrote down Cowboy’s vitals on a clipboard. “Any minute now, Dr. Bower. He laughed when I told him who it was. He says he’s had this patient before.” She grinned at Cowboy. “I hear you’re pretty adventurous.”

He returned her smile and blushed again. “The folks I work with aren’t always predictable. Dr. Wong took care of a gash I got in the head when a scared zebra kicked me.” He looked at Lukas. “But why do I need a surgeon for this bite? Can’t you just sew me up and let me get home? Leonardo will be hungry before long, and he’s probably worried.”

“Good,” Beverly said. “Let him worry. Maybe he’ll remember this the next time he confuses you with a beefsteak.”

“Sorry, Cowboy,” Lukas said. “Leonardo bit into a deep artery. That’s surgeon territory.”

“But you’ve stopped the bleeding.”

“With pressure. When we remove the pressure, we’ll be leaving an unstable wound that can burst open at any time. You’ve lost enough blood already. You can’t afford to lose more.”

“But, Dr. Bower—”

“Listen to your doctor.” Beverly laid a hand on Cowboy’s arm. “He knows what he’s doing. Besides, if you’re too eager to get out of here, we’ll think you don’t like our company.” She winked at him. “You never want to offend your local emergency department personnel. You can’t tell when you’ll need them.” She dug into her pocket and pulled out the set of keys she had retrieved from Carol. “I’ll make a deal with you. If you’ll let me drive your car and give me some instructions, I’ll go out to your place when I get off work and feed Leonardo for you.”

Both men stared at her.

“Uh, Beverly,” Lukas said, “you do realize we’re talking about an African lion.”

“I heard through the crack of the door. Besides, I’ve read the chart.”

“Sorry,” Cowboy said in his gravelly voice. “No way am I sending a pretty female out to do the job I should’ve done. Get a man to feed Leonardo, and you can drive him out there in my car.”

Lukas expected Beverly, with her obviously independent spirit, to spit fire. Instead, she gazed bemusedly at Cowboy and nodded. “I’ll see what I can do.”

Someone approached the trauma room entrance. “Dr. Bower?” It was Lauren’s voice.

“Oh, Doc, please,” Cowboy said. “I’m still practically naked here. Don’t give me an audience.”

Lukas slipped through the partially open door, leaving Cowboy his privacy. “Yes?”

“We have an elderly man in exam room one who has just been brought in unresponsive.”

“I’ll be right there.” He rechecked Cowboy’s wound, then crossed to exam room one, where Lauren was rushing through the vitals of an unconscious, toothless elderly man in his pajamas, who was already hooked to a monitor and a nonrebreather oxygen mask.

A worried-looking woman in her thirties stood at the patient’s side, her eyes puffy and red from crying.

“Hello, I’m Dr. Bower,” he said to the woman. “Are you his daughter? Granddaughter?”

“No, I’m Shelly, Frankie’s neighbor. My children go over to see him every day, and today they found him like this on the floor of his living room. I think he’d been trying to call someone, because the telephone receiver was off the hook and lying beside him.”

“Did you bring him in by yourself?”

“Another neighbor helped me get him into the van. We should have called an ambulance, but I just didn’t think. We only live four blocks from the hospital.”

Lukas adjusted his stethoscope and did a quick auscultation of the man’s chest. He had mild tachycardia and slow respiration. His skin was pale and cool to the touch. A quick check of his head and upper body revealed no signs of injury. Lukas didn’t smell alcohol.

“Lauren, let’s get a bedside glucose on him.”

“Yes, Doctor. We have a new patient in room eight who needs you next.” She lowered her voice. “It’s cancer. She’s a DNR.”

Lukas grimaced. Those were the hardest. “Okay, thank you, Lauren.” He checked Frankie’s eyes. The man had good papillary sparing. Lukas quickly but gently turned the patient’s head, holding his eyes open. The eyes remained fixed on the ceiling. Positive doll’s eyes told him that this was either drug related or that there was bilateral brain swelling.

“Shelly, has he been ill recently? A cold? Flu?”

“No. Yesterday he was fine. He always brags about never getting sick.”

“Does he ever drink?”

“You mean liquor? Never.” She held out two prescription bottles. “I brought these. I found them on the bureau in his bedroom. His bottle is almost full, but the other one is empty. It belonged to his wife. She died last year.”

Lukas took the bottles from her and glanced at the names of the drugs. Both were benzodiazepines for sleep. He glanced at the patient and didn’t like what he was thinking.

“Blood sugar’s 125, Dr. Bower,” Lauren said.

“Thank you.” He glanced again at Shelly, hating to ask his next question. “These are tranquilizers. Is it possible he might have taken an overdose of his wife’s prescription?”

Her eyes widened with alarm. “On purpose? No way! I don’t even want to consider it. He’s so good with the kids, and he never seems depressed. He was doing so well after his wife, Doris, died.”

Lukas was also reluctant to believe this kindly looking older gentleman would do anything so drastic. He’d probably flushed his wife’s pills after her death. But what if he hadn’t?

“He hasn’t talked about going to be with his wife lately?” he asked Shelly.

“No.”

“Has he displayed any changes in his normal habits, like changes in sleep time or amount? Changes in eating habits? Has he given any of his personal items, such as jewelry, to friends or neighbors?”

“Nothing that I know about.”

“How long ago did his wife die?”

“About eight months ago. Long enough for him to show signs of depression if he’s going to, I would think.”

“Not necessarily. A wedding anniversary could have set him off, or her birthday, anything of significance to him.” Lukas was well aware of this because his own father had gone through a similar depression after Mom’s death. So had Lukas, though not as severe as Dad’s.

“But they had just celebrated their wedding anniversary before she died,” Shelly said. “And her birthday was two weeks before their anniversary. We celebrated it with them.”

“Okay, thank you, Shelly. Lauren, set him up for a CBC, a comprehensive chemistry panel, a portable chest, and a drug screen. Then set up a heplock. I want him to have a milligram of Romazicon at 0.2 milligrams per minute. We’ll repeat the dose after twenty minutes.”

“What’s that for, Doctor?” Shelly asked.

“Romazicon is the antidote for benzodiazepine overdose, just in case.” At her blank look, he explained gently, “He may have taken too many of these tranquilizers. I don’t want to dismiss the possibility and take a chance on being wrong.”

He glanced at Frankie’s prescription bottle again. Dr. Robert Simeon had prescribed the drug. “Lauren, also put a call in to Dr. Simeon’s office. He’s the family doc. I’m going to check on Cowboy, then look in on the cancer patient. Would you see if that permission to treat has come in for the track student? We’ll need a CT head scan on Frankie if our workup is negative.”

Dr. Wong entered the E.R. and greeted Lukas with a cheery smile and warm handshake. “Lukas, I hear you have one of my favorite patients visiting with you this morning.”

“Yes, and your patient is already asking for some clothes. Beverly will assist you.”

As soon as Cowboy was settled with his new doctor, Lukas heard Beverly’s cajoling voice through the door.

“Dr. Wong, you’re a kindhearted person,” she said. “What time do you get off?”

“Um, excuse me? Hold it, Beverly, you know I’m married.”

“I know that, silly. How would you like to help out a hungry house pet?”

“Forget it. I know all about Cowboy’s house pets. He just happens to be here because that ‘pet’ mistook his thigh for a drumstick. Isn’t that right, Cowboy?”

Lukas chuckled as he walked back to the central desk. Beverly wanted that Mustang.

His laughter died when he entered exam room eight with a chart for Mrs. Jane Conn. The eighty-six-year-old woman lay moaning in pain in spite of the morphine Lauren had just injected at Lukas’s order. A smooth, shiny sheath of mottled scar tissue obliterated half of Mrs. Conn’s face and showed up plainly beneath the nonrebreather oxygen mask she had received upon arrival. She had been brought here from her daughter’s home about thirty minutes ago, her pain unresponsive to oral medication or morphine suppositories. Lauren had established an IV where dark bruises attested to the failure of the new paramedic to do so.

Since Lauren and Beverly were both busy, Lukas checked the blood pressure himself. It was going down, and the heart rate was dropping, probably due to a decrease in pain—or Mrs. Conn was dying.

Lukas found Lauren and gave instructions for blood tests and X-rays. “You did say Mrs. Conn had filled out a do-not-resuscitate form for her family, didn’t you?”

“Yes, but we haven’t received it yet.” Lauren wrote his instructions down on a sheet. “Her daughter, Ivy Richmond, should have it.”

“I’ll need to get it from her, or we’ll have to take measures to resuscitate if…” He shrugged, hoping they would have no trouble getting the DNR form. He’d been forced to run codes on late-stage cancer patients before, and it had been very painful for everyone, especially for the patient.

As Lauren ran orders for the tests, Lukas listened once again to Mrs. Conn’s chest. He glanced up, and to his surprise, he saw her one unaffected eye watching him.

He took her hand. “Mrs. Conn, we’re trying to reduce your pain. How does—”

“Let me…” her damaged mouth twisted in an effort to form the hoarse words “…go.” Her eye held him a few seconds, then glazed over and closed.

Sadness overwhelmed Lukas as he watched her. He hated to see the pain, had always hated to see suffering of any kind. It was one of the things that had driven him to be a doc in the first place, and ironically, it had been one of his worst hindrances in premed vertebrate physiology. He’d always been physically sick afterward, even though the animals were anesthetized and even though he reminded himself over and over again that human lives would be saved because of the sacrifice.

Mrs. Conn’s moaning had stopped. Lukas placed a hand on her frail arm, then looked over to find the eye watching him again. He couldn’t read the expression, for there was little expression to be displayed on the harsh mask.

She moved her mouth.

Lukas leaned closer to hear her.

“Ready.” The word wasn’t even a whisper, but a breath of sound that barely carried past the barrier of the transparent oxygen mask. “I’m…ready.”

When he looked at her eye it was closed again. For some reason, some infinitesimal sign relayed itself to him—some lightening of expression on that scarred mask? He felt almost…a peace…assurance. Or was he just trying to comfort himself? Cancer was the hardest of all to take since Mom’s days of suffering. Lord, help her.

“Dr. Bower?”

He turned to find the X-ray tech waiting to do the portable chest. Lauren stepped into the room behind her.

“Lauren, where is Mrs. Conn’s daughter?” he asked.

“She’s in the private waiting room. I’m surprised Dr. Mercy isn’t already with her.”

“Dr. Mercy?”

“She’s Mercy Richmond, Ivy Richmond’s daughter and Mrs. Conn’s granddaughter. Dr. Mercy is a nickname a lot of her patients and staff members called her to keep from confusing her with her father, who was also a physician. He was Dr. Cliff, she was Dr. Mercy. If you haven’t met her yet, you will. She hasn’t had an E.R. shift in a couple of weeks. She has a family practice across the street.”

“Good,” replied Lukas. “We can call her when we need to. But I’m going to need to see Ivy Richmond soon. I need that DNR sheet, and she needs to be prepared.”

Lauren stood gazing at Mrs. Conn. “This has been a rough one. Everyone knows and loves Mrs. Conn. She used to do a lot of volunteer work here. Her daughter Ivy has made several large contributions to the hospital in the five years since her husband died.”

The X-ray tech finished her work in the room, and Lauren took Mrs. Conn’s vitals once more. “Down again. BP is 95 over 55 with a 90 pulse.”

“Thanks, Lauren. I’ll go have a talk with her daughter as soon as I check the test results.”

“Okay, I’ll go see Frankie again.” Lauren gave Mrs. Conn another sad look and walked out of the room.

Had there been time, Lukas would have sat with the patient, but he had to return to reassure the mother with the sick baby, talk to the girl with the sprain, and check on Frankie. Where was Mrs. Conn’s daughter, Mrs. Richmond? Why wasn’t she in here? More than likely she was exhausted and had found a sofa or chair on which to sleep.

When Lukas finished his round of the patients, he returned to Mrs. Conn and read the test results. As expected, they looked normal for an elderly woman with late-stage cancer. She continued to rest peacefully, but her blood pressure and respiration were falling.

He found the E.R. secretary at the central desk. “Carol, would you please call Dr. Richmond’s office and advise her of her grandmother’s condition? I’m going—”

Carol raised a hand. “Wait a minute, Dr. Bower. We received permission to treat Cindy Hawkins with the injured wrist. Also, I have Dr. Simeon on the line. You wanted to talk with him about his patient, Mr. Verris?”

After a quick consultation with Dr. Simeon, Lukas made arrangements to have Franklin Verris, the possible suicide attempt, admitted to ICU, then went back to check on the seventy-three-year-old gentleman one more time.

Shelly kept her vigil at her neighbor’s bedside. Lauren stood at the other side of the bed, adjusting an IV line.

“Any change, Lauren?” Lukas asked.

“I’m not sure. There’s no difference in his vitals, but his breathing seemed to change a moment ago. It’s been twenty minutes, and I’m getting ready to give him the next dose. Do you want me to go ahead with it?”

Lukas bent over Mr. Verris and gently raised his right eyelid. He took out a penlight and shone a beam directly at the pupil. There was a faint reaction. The man didn’t look as pale as he had looked before. But according to Dr. Simeon an overdose was highly unlikely. He had disagreed with Lukas’s request for Romazicon. However, Lauren was prepared for another dose, and since Lukas had already given the order, he decided to carry it out.

“Go for it, Lauren. I need to stay and watch him, but I also need to talk to Mrs. Richmond. I’ll be back.”

Chapter Two

L ukas opened the door to the private waiting room and saw a tall, slender woman pacing the floor. Her casual attire of jeans, jogging shoes and a “Hiking is Life” T-shirt skewed the impression he’d formed in his mind of a wealthy, polished benefactress of the hospital.

Mrs. Richmond’s long, dark brown hair was pulled back into a ponytail at the nape of her neck. She turned to face him, and he saw that the hair was liberally streaked with gray around the temples. Her large, dark eyes met his with deep gravity. She was at least sixty, and the gaunt face told him of recent weight loss. The prominent dark circles under her eyes told him she probably hadn’t slept well for weeks.

“Mrs. Richmond?”

“Yes.” Her voice held fear.

“I’m Dr. Bower, the emergency room physician on duty today. I need to speak with you about your mother.”

Mrs. Richmond nodded. “I should be in there with her, I know, but the moaning…I just couldn’t handle it, had to get away from it for a while.” She resumed her pacing. “She moaned all night. I gave her morphine suppositories twice as often as…” She turned back. “I’m sorry. I’m rambling. It’s just so hard to think straight these days.”

“I understand. Have you had an aide helping you with your mother at home?”

“No. I didn’t want my mother thinking I’d abandoned her to a stranger.”

“So you’ve been taking care of her yourself?”

“My daughter helps when she can.”

“I’m sure that’s very hard on you, Mrs. Richmond.”

“Call me Ivy. Is she still moaning?”

“She was peaceful when I left her a few minutes ago. We gave her an injection. We ran some tests to see if there might be a pneumonia or something else causing her deterioration.” He paused. “I’m sorry, Ivy, but none of the tests show a secondary problem. I’m afraid the cancer is taking her.”

Ivy nodded slowly. “Hard to believe a little mole on her cheek could do such damage. Melanoma, you know.”

“Yes. I’m sorry. Her oncologist is in Springfield?”

“Yes, but it’s no use calling him. He’ll just increase the morphine.” Fatigue sharpened her voice. “She’s not worth his time. She’s just an old woman.”

“We want to make her as comfortable as possible. I understand you have the DNR request she signed?”

Ivy grew still as her eyes flashed back to his face. Her chin lifted a fraction. “Why?”

“Would you like to sit down?”

“I’ll stand.”

“I know you must be tired. I want to honor your mother’s advance directive, and to do so, I need the DNR sheet. This is all just legalities, and I apologize for having to ask you for it at a time like this.”

“You mean to just let her die?”

Lukas flinched at the harsh tone of her voice and the sudden, angry-suspicious expression in her eyes.

“If her heart should stop,” he said gently, “we wish to honor her request not to restart it.”

“What’s this ‘we’ business? You’re the doctor. You call the shots. I don’t want my mother’s heart to stop, and if it does, I want you to start it again.”

He held her suddenly angry gaze for a moment. She couldn’t know what she was saying.

“Mrs. Richmond, I thought you understood about your mother’s request.”

“My mother is not capable of making that decision now. I have power of attorney, and I don’t want you to just let her die like some worthless old woman. She’s a living human being with a soul.”

“Of course she is.” He hadn’t foreseen this. How could he get through to her? “I’m not talking about euthanasia. I’m talking about allowing nature to take its course, allowing your mother to retain her dignity and keep her from unnecessary pain. I’ve asked a nurse to call your daughter, Dr. Richmond, and she should be here—”

“You did what?” Her dark eyes flashed, and fatigue tightened the tension in her voice.

Lukas blinked at her helplessly. This was not going well. She was clearly, and understandably, irrational from lack of sleep. There had to be some way to make her see, without becoming too graphic.

“I specifically delayed calling my daughter because I wanted to put her through as little heartache as possible,” Ivy said. “She’s been through enough. You had no right to call her.”

“I’m sorry you feel that way, but Mrs. Conn’s condition is getting worse. I felt family needed to be here.”

“Not yet!” She paused with a gasp, placing a hand on her chest.

He stepped toward her. “Are you okay?”

“I’m fine.” Lowering her hand, she took a deep breath and held his gaze. “I don’t care what the DNR form says. I have durable power of attorney, and I want you to do everything for my mother. She’s not ready to die. She’s not…”

“I didn’t mean for this to be so difficult.” Lukas kept his voice gentle, resisting the urge to ask if he could examine her. He’d seen this kind of family reaction before, during his oncology rotation, when a caregiver was so exhausted that they became confused and combative. They often blamed the physician for the pain of their dying loved one. “I will contact Mrs. Conn’s family physician and clarify the matter.” He turned to leave.

“You don’t believe I have power of attorney?” she challenged, her voice rising a decibel.

He paused with his hand on the door. Lord, give me compassion.

But what about Mrs. Conn? She would suffer even more pain if they managed to resuscitate her.

He turned back to face Ivy, and he tried to keep his voice gentle. He knew his words were not. “What I believe is immaterial, Mrs. Richmond. For instance, I believe that to impose heroic measures onto a patient suffering the last stages of advanced carcinomatosis is not only transferring much-needed care from the living to the dying, it is inhumane to the dying.”

“Only if you don’t believe in hell.”

“Mrs. Richmond—”

“Ivy! My name’s Ivy!”

“I’m sorry, Ivy. I do believe in hell. I also believe that your mother is at peace about this. She told me she was ready to go.”

“What do you mean, she told you?” Ivy snapped. “Mother hasn’t spoken in days. What are you trying to pull here?”

Be gentle. Be patient. But what about Mrs. Conn? “Ivy, to try to resuscitate your mother at this stage would only cause greater, unnecessary suffering. And for what? A few more minutes or hours for the family to say goodbye? What about your mother’s feelings? She’s made her decision already.”

There. He’d done it again, him and his bad habit of stating his opinion to the wrong people at the wrong time. But if there was the slightest chance Ivy would listen…

She bent her head, her eyes closed for a moment. He watched her hopefully.

She reached into the right back pocket of her jeans and drew out a folded three-page form. “I had hoped it would never come to this.” The strength had left her voice. She unfolded the papers and held them out with shaking hands. “I have the power of attorney. Are you satisfied?”

Beverly caught up with Lukas as he reentered the E.R. proper. “That Mustang’s mine!”

Lukas struggled to work up some enthusiasm. “Don’t tell me you cajoled Dr. Wong—”

“Nope.” She jingled Cowboy’s keys. “Sweet-talked one of the new EMTs to help me. Buck likes animals.”

“Yes, but did you tell him this wasn’t a gerbil?”

She grimaced. “He knows it’s a big animal.”

“Horses are big animals. How will you feel if your helper comes back in here on a stretcher?”

“Awful.” She shrugged. “Dr. Wong’s finished with Cowboy. Got any patients for me?”

“Have I ever.” He gestured toward the charts at the desk. “Enjoy.”

He left her staring at the sudden overload and stepped back into exam room one to check on Mr. Verris. Shelly still sat there beside his bed, and Lauren entered behind Lukas, as if geared to his location by radar.

“Any change?” Lukas asked Lauren.

“Test results are in.”

Lukas checked the printouts. Nothing. Everything was normal. Even the drug screen was not helpful, because all it showed were benzodiazepines, and that was to be expected for someone who occasionally took them to sleep. Lukas could have done a quantitative drug screen, but that would have taken too long.

“BP’s gone up just a little, but not much,” Lauren continued. “Pulse and respiration are the same. They’ve called from upstairs to let us know they’re coming to take him to ICU.”

“Let’s make sure they know he still needs a CT scan.” Lukas did his own assessment. Was it his imagination, or was the man breathing more deeply? As he watched, Frankie’s head moved a fraction of an inch.

Lukas looked up to see if Lauren had noticed. “Has he moved like that before?”

“I don’t think so.”

He watched a moment longer. It was probably just a stimulation of the limbic system, a common event in a coma patient.

Lukas did an auscultation of Frankie’s chest one more time, then shook his head. With a nod at Shelly, he left the room. He was feeling more and more frustrated as the day progressed.

Lauren stepped out of the room behind him. “Dr. Bower? Some of the staff are getting together after this shift over at the cantina across the street. Want to join us?”

“Uh…sure. Yes, I’ll be there. Thank you for asking.” Lukas nodded and continued down the hall, knowing he would be kicking himself tonight when it came time to show up at the cantina. He would be starving when he got off, as usual, and since he always ate out anyway, this would be a good way to get better acquainted with the people who worked here. Unfortunately, he knew that by the time he arrived at the restaurant, he would be feeling so awkward about meeting with a group of near strangers, he would have lost his appetite. Almost.

Moving to a new place was lonely business, especially for him. Funny, he could face patients and coworkers all day long with no problem, but when his time was not regimented, he had trouble forcing himself to reach out to others. It wasn’t that he didn’t like people, because he did. The youngest of three boys in a loving Christian family, Lukas was the only shy one in the bunch, and he had often been teased about it. The teasing had only made him more self-conscious, turning him inward, and now his family despaired of ever seeing him married. But this was a new place, and no one here knew about his shyness. It was time to dig himself out of the rut—or pray that God would move him out.

He took Mrs. Richmond’s papers to the secretary. “We’ll need copies of these, Carol. Please call Dr. Richmond back and tell her that she needs to be on standby. Her grandmother is holding her own at the moment, but she could deteriorate fast, and she’s now a full code.”

“Yes, sir.” Carol grabbed the papers from him, dark eyes glowering as she spun around to the copier. She muttered something under her breath.

Lukas watched the characteristically cheerful secretary in surprise. “Carol, are you okay?”

She put the first sheet into the copier and pressed the button. “Fine, just fine,” she mumbled. “We’re swamped, we’ve got patients dying back there, and all I hear are complaints that we’re not seeing people fast enough.” She indicated the waiting room. “Griping because you haven’t looked at their scalps yet. They’d be in here right now, except one of them had to step outside for a smoke. I get so tired—”

“Have they been signed in?”

“No, I’ve been too busy with these other—”

“I’ll take care of them.” Lukas glanced out the door, where one of the women he’d seen earlier stood smoking, talking to the other. He strolled out to join them.

“Hello, ladies, I’m Dr. Bower. I hear you’re unhappy about our service. What’s the emergency?”

The smoker quickly shoved her half-smoked cigarette into the receptacle like a school kid caught by the teacher.

“We need to be treated for head lice,” the nonsmoker said.

The patio was deserted, Lukas noticed. He took another step forward, carefully looked at first one over-permed head of hair, then at the smoker’s long, stringy brown hair.

He took out a notepad and a pen and wrote the name of a shampoo. He held it out toward the smoker. “Wash with it once, then wait a week and wash again. You can buy this at your local pharmacy.”

She stared at the note in his hand. “No prescription?”

“You don’t need a prescription for this. The two of you can share a bottle.”

“But we’ll have to pay for it.”

Lukas felt his skin tingle with growing irritation. He inhaled slowly, counting to ten as he placed the note on the top of a trash can nearby. It had suddenly become a stressful day, the worst he’d had in a long time. He couldn’t blame it all on these two misguided souls.

He turned and opened the heavy glass door. “Ladies, the shampoo costs less than a pack or two of your favorite brand of cigarettes.”

“But we have Medicaid cards,” the smoker called after him. “We can report you for refusing to treat us!”

He stopped midstride and slowly turned back toward them. “Feel free,” he said, keeping his voice calm. “I feel I should warn you, however, that when a card carrier tries to use the card in the E.R. for nonemergency care, she can lose her card. It’s called Medicaid abuse. I think you’ll find that shampoo works very well as long as you follow the directions.” He stepped inside and let the door close silently behind him.

There were other Medicaid cardholders—for instance, the little baby in exam room three—who needed treatment today, not next week, and Lukas saw to it that they received good care. Lots of Medicaids used the emergency room here because many family practitioners refused to take assignment. Those who did still limited their patients. Medicaid paid so little that a physician who took too many could go broke. The system didn’t work. Many times the people who behaved with integrity got left out entirely—both the honest Medicaid recipients and the honestly compassionate physicians. Greed was the culprit on all sides. Lawmakers spent their time writing more laws because people kept figuring out ways to take advantage of the system. It was frustrating. Lukas had to keep reminding himself not to blame the patients who sometimes misunderstood the constantly changing rules.

Lukas glanced around at the emergency department. He liked this little ten-bed setup. The exam rooms surrounded a large central station. Each room was well equipped. Five of the ten rooms had excellent cardiac equipment. There was a separate ambulance entrance and two physician call rooms.

Mrs. Estelle Pinkley, the hospital administrator, had done a remarkable job when she’d convinced the county to pay for this upgrade. Lukas had jumped at the chance to receive a dependable salary with benefits so far away from the congestion and stress and corruption of the city. Yes, he knew corruption was everywhere, but right now, with specific, damaging events so fresh in his memory, Kansas City represented everything painful.

Carol met Lukas as he entered the E.R. proper. “Dr. Bower, Mrs. Conn is getting worse. Lauren said to notify you.”

“Thanks, Carol. Please call Dr. Richmond back.”

“Lauren already did so.”

“Get ready to call a code if necessary.”

“Dr. Richmond will have a fit about that, you know.”

“Maybe she can do more about it than I was able to.”

Chapter Three

M ercy Richmond ran the block from her medical office to the hospital, not bothering to remove her lab coat. Mom had promised to call when the time came, but she hadn’t done so. Instead, Lauren had been the one to break the news.

Shoving open the glass doors into the emergency room reception area, Mercy barely slowed her stride. “Carol, where’s Grandma?”

“She was in exam room eight, but they called a code and moved her to trauma room one.”

Mercy stopped and wheeled back. “What? There’s not supposed to be a code!”

Carol shook her head in sympathy. “I’m sorry. Dr. Bower called it. He had to.”

“We’ll see about that.” Mercy swung back on course. First, administration had arbitrarily decided to bring in a full-time E.R. doc from Kansas City, and now this hotshot doc had decided to ignore a perfectly legal DNR request. Perhaps he’d never learned to read.

She pushed through the swinging double doors that pretended to lend privacy to the open emergency room. A secretary manned the central station. All other hands were gathered in the trauma room, six people altogether, including Grandma’s frail, still body on the bed. Others worked with quick efficiency, responding without question to the soft-spoken commands of a slender, brown-haired man in green scrubs. He knew the drill well.

“Get me a blood gas…. Push the epi now, Lauren…. Any pulse…? Continue CPR.”

Mercy stopped just inside the doorway as a nurse from upstairs pushed methodically against Grandma’s chest and another bagged her.

“What’s going on here?” Mercy demanded. “Doctor, what are you doing to my grandmother?”

He looked up, his blue eyes behind gray-framed spectacles holding her with gentle concern. “You must be Dr. Richmond. I’m sorry, but as per your mother’s request, we are attempting resuscitation.” He turned back to the table.

“Stand clear,” he called as he prepared the paddles to send a jolt of electricity through Grandma’s chest. He placed one paddle above her right breast, and the other paddle he placed to the side below her left breast.

Mercy stood in stunned horror as the frail body jerked, arms flying out, legs up. Mercy had done the same procedure herself many times during her shifts in E.R. but not on someone she loved like Grandma.

“Check pulse,” Dr. Bower said.

Lauren gently felt the carotid artery for a moment, then shook her head. “Nothing, Doctor.”

“Continue CPR. Prepare more epi, and I need lidocaine, 1.5 milligrams per kilogram. What’s that blood gas?”

“Not back yet, Doctor.”

Mercy stepped toward him. “Dr. Bower, I’m her granddaughter. Stop this code.”

He was barely taller than her five feet eight inches, but his expression held calm authority. “As I said, Dr. Richmond, your mother—”

“I heard what you said, but my grandmother signed a DNR form weeks ago. Surely that has some bearing on this case.”

“You know that form does me no good. Believe me, I wish it did.” Dr. Bower’s voice betrayed frustration. He lowered his voice. “Your mother showed me her papers for legal power of attorney. Her order is to resuscitate.”

“Forget that order. As a fellow physician—”

“I can’t break the law, Dr. Richmond.”

“Don’t abuse this patient any more than she has already been abused!”

Dr. Bower grimaced at her words, sighed and shook his head. “I’d love to comply, but I can’t. If you want to sway the decision, please talk to your mother. I tried.” He turned back to the table. “Stop CPR.”

The monitor showed an irregular, sawtooth pattern. Grandma’s heart was in ventricular fibrillation. Mercy hoped it would not change back.

“Where is my mother?” she asked, her voice heavy with frustration.

“She was in the private waiting room when I left her.” Dr. Bower shook his head at the monitor. “No change. We need to shock again.”

He charged the defibrillator to 360 joules. “Clear.”

Mercy stepped back and almost turned to leave, but she couldn’t. A sort of morbid amazement held her there, watching the scene of horror play out before her. She gripped the door frame. A loud pop and flash preceded the stench of burned flesh. An electrode had blown. Lauren and Dr. Bower checked for signs of life while another nurse replaced the electrode.

“No change,” Dr. Bower said.

Mercy felt sick. Mom should be here to see what her crazy order was doing to Grandma. But then, Mom, too, had suffered enough.

Again they shocked, and Mercy could not bring herself to leave. CPR resumed. The longer they worked, the more convinced she became that Grandma was already far past their so-called help. And that meant she was also past any more pain.

Dr. Bower called a halt a seeming eternity later. Mercy did not move until he pronounced the time of death.

She stepped from the doorway as the code team cleaned up the mess of scattered monitor strips and plastic wrapping that had been tossed on the floor during the code. One by one, they filed out past her, some avoiding her eyes as if ashamed of the work they had just done.

Lauren stopped and laid a tanned, slender hand on Mercy’s shoulder. “I’m sorry, Dr. Mercy.” Tears filled her pretty green eyes.

“So am I, Lauren. Thanks for calling me over.”

“It was Dr. Bower’s request. Your mom told us not to.”

“Figures.” Mercy was thirty-nine, and Mom had still not overcome the need to hem her in with maternal over-protectiveness. Often it rankled. It showed lack of respect for Mercy’s ability to cope. For goodness’ sake, she was a doctor.

Dr. Bower paused for a moment at the bedside, his hand resting gently on Grandma’s arm, his head bent and eyes closed. When the last team member had left the room, Mercy walked over to stand beside the man and gaze into Grandma’s silent, scarred face.

Dr. Bower raised his head and looked at her. “I’m sorry, Dr. Richmond, I’ve been told she was a much loved lady.” He had a kind voice, deep and masculine, but with a gentle quality.

Mercy nodded, dry eyed. “She was.”

“I apologize for my abruptness. I could have handled the situation better.”

The sincerity in his voice disarmed her. She’d been prepared for battle when she came in here. Now she felt spent. Empty. “I wouldn’t let you.” She shook her head. “I had always sworn that I would never do to another doc what patients and families have done to me, and here I led the pack—aided by my mother, of course. I know the law, Dr. Bower. It’s just that she’s my grandma.” Her voice caught, and her professional demeanor abandoned her for a moment. Her throat ached with tears she refused to shed. She was grateful for the man’s thoughtful silence.

“My mother died of metastatic breast cancer three years ago,” he said after a few moments. “I remember the feelings of helplessness and anger. I wanted to do so much more for her, and there was nothing more to do except keep her comfortable. Had we revived your grandmother…”

“I know.”

There was another pause, then Dr. Bower asked, “Would you like me to go with you to tell your mother?”

Mercy took a final look at Grandma and turned away. “No, thank you. It’ll be best coming from me.”

He hesitated. “Did you not have a chance to discuss the DNR form with your mother?”

“I tried. Mom wouldn’t talk about it.”

“It’s a difficult subject to discuss. I gathered that your mother was the main caregiver.”

“Yes. I tried to help more, just to keep her from exhausting herself.” Mercy shook her head. “Mom can be stubborn and self-sufficient. She’s lost so much sleep lately…she hasn’t been her usual, rational self—not that she’s ever been a perfect example of rationality.” Why was she talking to this stranger like this? And a man, to boot.

“I know what you mean,” he said. “My father was the same way after Mom’s death. Be patient with your mother. This kind of grief and exhaustion can do strange things to the mind. And it can last a lot longer than anyone expects.”

“Let me talk to Mom.” She forced a smile and looked again into those blue eyes. “It’ll be easier for all of us.”

A few moments later, after taking a drink of water from the fountain and a few deep breaths to compose herself, Mercy opened the door to the private waiting room. The first thing she saw was Mom standing there in the middle of the floor, glaring in her direction.

“Where is that blasted doctor? I told them not to call you yet.” Ivy Richmond turned to pace across the room toward the thickly cushioned sofa on the far side, then back again. “It’s been over an hour, and no one has seen fit to tell me anything. Do you know that man came in here and asked for permission to just let Mother die?”

“Grandma had an advance directive, Mom.”

“How can he just take it upon himself to decide who is and who isn’t worthy to live? Mother couldn’t have known what she was doing when she signed that form.” Tears filled Ivy’s eyes. “Oh, Mother.”

Mercy’s eyes grew moist, too. She’d thought they would have been drained of emotion months ago, but the stages of grief had continued to batter them. Right now confusion ran high, and Mercy knew Mom was exhausted and weak from too many nights of sleeplessness.

Ivy jerked another tissue from the box on an end table and blew her reddened nose. “I wish they hadn’t called you against my wishes.”

“It’s a good thing they did.”

Ivy stiffened at those words.

“She’s gone, Mom.”

Ivy’s face twisted into a mask of pain. “Mother wasn’t ready to die.”

Mercy closed the door behind her and took a seat on the nearby recliner, perching on the edge with her hands in her pockets. “We’re the ones who weren’t ready.”

Ivy turned away. “I can’t believe my own daughter, the learned doctor, cannot grasp the reality of an afterlife.”

Mercy suppressed a sigh. Now was not the time to bring up that old argument again, but if Mom had found peace in her so-called God these past few years, where was that peace now?

Ivy reached up toward her chest with both hands and bent forward, as if on a sob.

“Mom…?”

Ivy shook her head.

Mercy stepped up and laid a hand on her mother’s shoulder. “Mom? Are you okay?”

Slowly Ivy straightened and turned around. Her face was as gray as the clouds gathering outside, but she nodded and patted Mercy’s hand.

“I’ll be fine. This just brings back so many memories.”

“I know.” Mercy’s father had also died a lingering, painful death five years ago. That was when Mom had suddenly started babbling about “finding Jesus.” At the time, Mercy was sure she would get over it, but she hadn’t. Where was her Jesus now?

Ivy took a deep breath and squared her shoulders. “That doctor is dangerous. He doesn’t hold human life sacred. He tried to manipulate me into allowing Mother to die. He was going to go over my head to keep from doing anything for her. Did he even try to save her?”

“He called a code. I saw it.”

“How hard did he try?”

“He did everything to resuscitate her. He had already begun when I arrived.”

“And he didn’t revive her at all?”

“No.”

“Is that normal for someone whose heart has just stopped?”

“It would be hard for me to say, Mom. Everyone is different. Most of the codes I get have been out for at least fifteen minutes.”

“I think he could have bought us more time. Do you know that he as much as told me he had other patients who needed him more than she did and that doing more for her would be inhumane?” Ivy put a hand to her chest again, then quickly dropped it.

Mercy held her mother’s dark gaze and said nothing.

“Jarvis didn’t want this new doctor here in the first place, did he?” Ivy asked. They both knew that Dr. Jarvis George, E.R. director, had been bitterly opposed to bring in a full-time physician for the E.R.

“No, and neither did I. But to be fair, I disagreed with the code, too. I even tried to stop him. He did what he felt he had to, and I can’t blame him for that. Granted, he could have been a little more tactful with you, but…”

“I’ll have a talk with Jarvis. Maybe he can put my mind at ease about this guy, but if he can’t, I may have to have a talk with administration.”

Lukas Bower could find his way around an unfamiliar hospital or a forest trail almost by instinct. Let him loose in a strange town, however, and he would be lost the moment he stepped out the door. By the time he entered the front door of the cantina—little more than a house with a small unlit sign in the front yard—where he was supposed to meet the others Wednesday night, the tiny place was nearly empty and a Hispanic waiter was clearing the tables. It still smelled wonderful, full of smoky spices and warmth.

Lauren waved at him from the far back left corner, where two smaller tables had been pushed together for a larger group. Much larger. Only Lauren was left.

“You’re late,” she called out, still waving for him to join her.

Lukas stood, staring at her in dismay. He had no desire to be rude, but he also had no desire to have dinner alone with a nurse who worked with him. Was he that late? Where were the others? Still, how could he turn around and walk out now?

He stepped hesitantly toward the back. “Sorry. I had to finish my charts; then I had to find this place. That turned out to be more of a challenge than I’d expected.” He glanced at his watch. It was eight-thirty and the shift had ended at seven. Okay, so he was pretty late. “How long have you been waiting?”

“It’s only been about twenty minutes since the last person left. Carol and Rita had to get home to their hubbies as soon as they ate. Connie and Ron, the ambulance team on duty tonight, got a call. Beverly and Buck had a lion to feed, and I know for a fact that Beverly took that Mustang by the car wash to clean it out.” Lauren indicated the cluttered stack of plates that had not yet been cleared. “Sorry, you’re stuck with just me.” She signaled the waiter and kicked out a chair across the table from her. She had released her long, blond hair from its rubber band, and wispy tendrils framed a face devoid of makeup. “I ordered for you, and they’ve been keeping it warm in back.”

Lukas wished she hadn’t done that. “Could they make it to go? I’ll just take it with me. There’s no reason for you to have to sit—”

“Sorry, too late.” She gestured toward the waiter, who carried out a sizzling platter of chicken, onion and peppers, and a steamer with hot flour tortillas. “I overheard you telling one of the patients today how much you loved authentic chicken fajitas, so I took the liberty of ordering them for you. Come on, sit down. They won’t taste nearly as good cold.”

This had been a stupid idea. Why had he agreed to come? But Lukas was hungry, and that hunger overrode his sense of caution. And this wasn’t a date. He pushed the chair back in that she had kicked out for him, and instead he took the chair next to it, in spite of the mess of cluttered dishes he had to move aside. He would not get lured into an intimate dinner for two, or even the appearance of one.

If Lauren took offense at his small act of rebellion, her expression hid it well. She leaned back and rested her feet on the rail of the chair he had discarded. “Dig in, Doc. I know you’re hungry. I don’t think you’ve eaten anything since lunch, have you?”

“Breakfast, actually. Late breakfast.” He bent his head in a short, silent blessing, then looked up to find Lauren nodding with approval. Big deal. The nurse in KC had pretended to approve of his faith, too, at first, until it got in the way of other things she wanted.

“Found a church yet?” Lauren asked, watching Lukas overstuff his first tortilla.

“Not yet. I haven’t had a chance.” He took a large bite, the force of which pushed half the meat and veggies back onto the plate from the wrap. The smoky heat so filled his mouth and senses that for a few seconds he didn’t realize Lauren had resumed talking.

“…Covenant Baptist, just about four blocks from where you live.”

Lukas shot her a wary glance as he chewed and swallowed. “You already know where I live?” He’d just been there a few days.

“Oh, don’t worry, I’m not checking up on you. The real estate agent who sold you the place is a friend of mine,” she explained as he took another bite and washed it down with water. “You don’t grow up in a small town like Knolls without getting to know most of the other natives. Everyone’s talking about the new full-time E.R. doc, and they probably all know where you live.”

Lukas gulped another bite without comment. He, too, was from a small town, and because of that he knew he probably wouldn’t be accepted here as one of them for twenty years.

“So do you think you’ll come?” she asked.

He stopped chewing and looked at her.

“To church Sunday.”

“I’ll probably go somewhere.” He built another fajita, this time with less filling, while Lauren chatted on about the hospital.

He learned quite a few interesting facts about his new place of employment, such as the doubled volume of patients seen through the emergency department since Mrs. Estelle Pinkley took over as administrator five years ago. The lady had, according to Lauren, brought the hospital out of the computerless dark ages and out of debt for the first time in over a decade.

“But you’d better watch yourself,” Lauren warned as Lukas finished his last bite of chicken. “The E.R. director doesn’t want a full-time physician working here.”

“Why not?”

She shrugged. “With Dr. George, who knows? He fought Mrs. Pinkley about the computers, too. He’s about ready to retire, and he doesn’t like change.”

Lukas glanced around to find the waiter flipping around the Closed side of the sign in the front window. “Looks like we should be leaving. Will they give us a ticket at the cash register?”

“Don’t worry, I paid it already.”

Lukas reached into his pocket and pulled out a ten-dollar bill. He smiled as kindly as he knew how and placed the money on the table in front of her. He knew as he left that he was behaving like a jerk. It bothered him. Lauren seemed like a good, caring person, and she was probably just being kindhearted to a newcomer. Still, he wasn’t going to take any chances.

Chapter Four

T hursday morning Lukas arrived at work later than usual, dripping with dew from the light rain outside. He could have kicked himself for oversleeping. The shift change would just have to be with the emergency department director, Dr. Jarvis George.

“Morning, Judy. Any patients waiting?” Lukas asked as he checked his mail cubicle.

“Good morning, Dr. Bower.” The E.R. secretary for today’s shift turned from her computer and smiled at him. “Dr. George is in the laceration room sewing a nursing-home patient who was injured when she became combative. We’ve got an irritable child in five and a possible sprain or fracture in seven. Dr. George hasn’t seen them.”

Lukas glanced at his watch. Even though he was ten minutes late, he had time to change into his scrubs. The patients weren’t critical, and Dr. George would want to finish his own sutures. “Thanks, Judy. I’ll be right back.”

He glanced into the emergency room and glimpsed the director bent over his patient. Jarvis George’s graywhite hair, army-cut short, could have depicted a kindly older gentleman who loved his patients and whose patients trusted and loved him. Maybe that was the case. Lauren’s warning about Dr. George echoed from last night.

When Lukas walked into the laceration room a few moments later, he was friendly and upbeat.

“Good morning, Jarvis. Do we have any patients you want me to take?” He glanced at the elderly female who lay prone on the table, her nearly fleshless tailbone and hip exposing a small gash beside a partially healed bedsore.

The older man straightened from his work and pierced Lukas’s friendliness with a glare. “I don’t know how you were taught to address your superiors in your Kansas City hospital, Dr. Bower, but I prefer a little less familiarity, if you don’t mind.”

Lukas managed not to stare. “Excuse me, Dr. George. I meant no disrespect. I guess I am accustomed to a more casual atmosphere.” Wow, Lauren was right. There seemed to be a problem here.

Dr. George returned to his sewing. “You can see to the whiny kid in five. He’s got an earache. The patient in seven has a probable sprained ankle. I’ve been busy sewing, and since you came in late, I haven’t had a chance to—Ouch!”

Lukas had watched it happen, had seen the needle pierce the glove in the palm of the man’s left hand, and winced as he imagined the puncture.

“Can’t believe I did that,” the director muttered to himself. He shot a quick look toward Lukas, as if blaming him for the distraction.

Lukas stepped out of the room. “Nurse,” he called and found redheaded Beverly coming from the child’s room. “We need a needlestick protocol in here, please.”

“I beg your pardon,” Dr. George rumbled as he stepped around the laceration table and out toward Lukas. “Nurse, ignore that request,” he said, not taking his gaze from Lukas.

Lukas cleared his throat, staring back at his new director in dismay. “I’m sorry, Dr. George, I didn’t mean to offend. I’ve just been reading about protocol, and—”

“I’m aware of protocol, Bower,” Dr. George snapped. “I helped write it.”

Lukas winced. He was not winning a friend here.

The director waved Beverly away, still glaring at Lukas. “If you will kindly take care of your patients and leave me alone with mine, I’ll be able to get home sometime this morning.”

“Yes, Dr. George. Sorry. I’ll go see my patients now.” Lukas hustled away, resisting the urge to ask the director if his tetanus was at least up-to-date.

The sprain turned out to be a hairline fracture. The earache did not require antibiotics. After Lukas had splinted the ankle and convinced a distraught mother that the medicine she requested could actually set her child up for a more resistant strain of ear infection later, Lukas finished his charts and checked for more arrivals.

“Think I’ll go to breakfast now, Beverly,” he said when he found no other patients listed on the schedule board. He started down the hallway, then turned back. “Oh, by the way, where are the incident report forms kept?”

Beverly raised a brow at him. “They’re filed in the secretary’s cabinet. Tell me you’re not going to report Dr. George.”

“Rules are rules. Even if he doesn’t follow protocol, I’m required to make a report. It’s plainly listed in the little booklet I received the other day.”

“You’re going to find that we don’t always follow the rules to the letter around here.”

“Thanks, Beverly, but safety comes first. There’s a good reason for those rules.” He’d gotten into trouble before when he’d been lenient with a nurse and overlooked a break in protocol when she had violated a direct order from him. It gave her a chance to falsify the record.

“He’ll find out. He knows everything that goes on around here,” Beverly warned.

He waved and left for breakfast.

Theadra Zimmerman—Tedi to anyone who valued life—couldn’t concentrate. She could barely keep her eyes open even to look outside, where the rain fell as if God had decided to wash off the new leaves and speed the growth of the grass.

Good thing she sat behind Jeff McCullough in class. His broad shoulders would cover her from Mrs. Watson’s probing eyes and catch-you-off-balance questions. The fifth-grade teacher always seemed to ask Tedi more questions than anyone, and she even expected better answers from Tedi than she did from Abby Cuendet, who always got straight As.

Tedi leaned her chin down onto her fists on the desk as Mrs. Watson droned on about new discoveries regarding the rings of Saturn.

Dad and Julie had fought last night, the first time Tedi had heard them fight since they’d begun dating two months ago. Julie didn’t like Dad drinking so much. Big surprise. Tedi didn’t like it, either, but that didn’t stop him. Last night she’d sat up in the hallway, eavesdropping, wondering if maybe he would listen to Julie, even though he wouldn’t listen to anyone else.

When Julie finally left, she’d slammed the front door behind her. Apparently Dad had not listened to her, either.

Tedi felt a weird combination of disappointment and satisfaction. Why should a near stranger be able to do something she herself had tried to do for such a long time?

And what made Julie think that just because she was blond and pretty and wore a lot of makeup…

“Tedi Zimmerman, I asked you a question,” came Mrs. Watson’s sharp voice.

Tedi jerked. Her chin slipped off her fist.

Jeff’s shoulders shifted as he turned to look at Tedi along with the rest of the fifth-grade class. This gave Mrs. Watson a clear view of Tedi trying to straighten up and look alert.

Mrs. Watson gave her that “I’ve had it with you, kid” look and shook her head.

“Class, I want you to read the next few pages on Neptune. No talking while I’m gone. Tedi, come with me.”

For a moment Tedi sat and stared at Mrs. Watson. “Where?”

“Now, Tedi.”

This was new.

“Theadra Zimmerman—”

“Okay.” Tedi didn’t look at anyone else as she got up and followed Mrs. Watson out the door. She could imagine Abby’s smirk behind her back, but who cared? Nobody liked Abby.

Mrs. Watson closed the door on the classroom and turned to face Tedi, arms folded in front of her. “Ordinarily I would send a sleeping child to the nurse’s office to take a nap, but you are not an ordinary child. I’ve had high hopes for you, but you’ve done more daydreaming, talking and disrupting than you’ve done homework in the past few weeks. I want to know why.”

Tedi stared at her teacher’s frowning face. She didn’t look mad, but she wasn’t happy.

“Are you taking me to the principal’s office?” Tedi asked in a meek voice.

Mrs. Watson sighed and leaned against the hallway wall. She studied Tedi’s face. “Does your father help you with homework?”

Uh-oh, she is going to drag Dad into this. “He’s been really busy lately.”

“How about your mother?”

“I don’t see her every night.” And she wasn’t about to waste time on homework during visitations.

Mrs. Watson put a gentle hand on Tedi’s shoulder. “What’s going on at home?”

Tedi looked away. “Nothing.”

Another sigh. “Look, I’m trying to be fair about this, but your parents are paying a lot of money to send you to this school, and—”

“My mother is paying the money.”

Mrs. Watson nodded thoughtfully. “Nevertheless, this is an accelerated class, and you’re falling behind. We need to do something about it.”

Tedi didn’t know what to say. She hadn’t done all her homework lately. Dad wasn’t there to nag her about it much, and it was just easier to read or watch TV.

“Come on.”

Tedi’s eyes widened. “Where are we going?”

“We’re going to call your father. Maybe he can help us find out what the problem is.”

Tedi drew back. “Why don’t we call Mom? She’s the one—”

“Your father has custody.”

Tedi didn’t move. “I still have a mother.”

Mrs. Watson continued down the hallway. “Fine, stay there. Your father will find you there when he comes to get you.” She turned around. “Unless you want to talk about it.”

Tedi shrugged. “I guess he’ll find me here.” Then he’ll kill me. My blood and guts will be all over the hallway when class gets out. Hope it makes Abby Cuendet throw up.

But then what would happen to Mom and Grandma Ivy?

At least an hour later, Tedi saw Dad coming down the hallway from the principal’s office. She held her breath until he reached her. His neck and face were flushed all the way up to his short blond hair.

The bell rang, and classroom doors opened all along the hallway.

“Let’s go,” Dad said.

Tedi breathed again, following him out the side exit. She ignored the other kids as they rushed out of class. Dad ignored them, too, which probably broke Lyssa Cole’s heart. She had a crush on him. She was weird.

After Tedi stepped into the passenger side of their red BMW, Dad slammed the door so hard she went cold all over. Yep, he was mad.

Her hands gripped each other tightly in her lap as the engine roared into life and the car sprang forward. Why had she been so stubborn with Mrs. Watson? She’d refused to even go back into the classroom and get her books. Now she’d not only be in trouble, but she would be making trouble for herself for later.

But she wasn’t trying to be stubborn. Not really. She just hadn’t wanted to face the class.

Okay, maybe she was a little mad at Mrs. Watson. Why did she expect so much?

Tedi glanced sideways at Dad. Was that alcohol she smelled?

He made a turn too fast, and Tedi fell against the door. She didn’t have her seat belt on. She reached up and pulled it down and fastened it. Just in time.

Dad slammed on the brakes, screeching the tires for at least three feet.

Yes, that was alcohol on his breath.

Tedi looked at him. He had “patriotic” eyes—red, white and blue. She’d heard Mom use that term about him often enough that it wasn’t funny anymore. Especially now.

He stared straight ahead. “You think I’m a reckless driver?” he demanded.

Reckless was a stupid word. Made it sound like you could never have a wreck. Dad was “wreckful,” not “wreckless.” He’d had several accidents to prove it.

“No, Dad, I don’t think you’re reckless. I just forgot to put my seat belt on when we got into the car. I always wear my seat belt. Mom makes me wear it. When you turned—”

Dad gunned the motor and sped along Highway F toward home. “I get your point.”

How could he get a point she was trying not to make?

She glanced sideways at him again. “Um, Dad, would you please slow down a little? This is scaring me.”

“You should’ve thought of that before you made that airhead teacher of yours call me.”

Tedi grimaced with growing anger. “I didn’t make her call you. I fell asleep in class, and she made a big deal out of it.”

“That’s not the way I heard it from her. I heard this isn’t the first time you’ve caused trouble in class lately. Do you know she had me paged from an important luncheon meeting with some prospective buyers for the Reynolds Ranch? Do you know how much commission I stand to lose on that deal?” He turned into their drive at home.

Tedi wondered if that was one of those martini lunches she’d heard about. “Sorry I’m such a pain to you, Dad.”

He didn’t even catch the sarcasm in her voice. “If I lose that sale, we may think about taking you out of that fancy school of yours.”

Tedi gritted her teeth. Why should he care? He wasn’t paying for it.

He got out and slammed his door. She did the same with hers, pushing the door with as much force as she could. It made a satisfying WHOMP!

Dad just walked on up the sidewalk toward the front entrance.

Tedi opened the car door wide, then slammed it even harder. “I hate you,” she said under her breath, glaring at Dad’s back. “I hate you, hate you, hate you.”

He unlocked the house and turned to wait for her.

She continued glaring.

He just waited.

Her glare wavered. Grandma Ivy said that hatred destroyed everything it touched. Tedi didn’t really hate Dad. She just wanted him to stop drinking and stop saying bad things about Mom.

Dad kept waiting, and Tedi finally went in.

He closed the door behind them, slowly and quietly. He did that when he was really mad and trying to keep from losing his temper. He’d lost his temper and kicked a dog so hard once that he broke its ribs. He’d broken windows with his fists and kicked holes in walls. Always he’d been drinking when he did it.

“Can I go up to my room?” Tedi asked. “I’m tired.”

He raised a brow at her. He didn’t act drunk now. “Why are you tired? You went to bed early enough last night. Besides, you slept in class today, didn’t you?”

His sarcastic tone made her madder. “Only because your fight with Julie kept me awake last night,” she snapped. “I’m falling behind in class. Mrs. Watson thinks there might be something wrong at home. She asked me if you helped me with my homework, and I told her you were too busy.” Tedi knew she shouldn’t be saying all this, but she couldn’t help herself.

“So I’m supposed to be doing your homework for you now? Is there something wrong with trying to make a living for my family?”

Tedi narrowed her eyes at him. “But you don’t.”

He stood for a long moment, glaring at her as red color once more crept up his face.

She glared back at him, heart pounding. She felt now as she did when she argued with Abby Cuendet during lunch—mad enough to say just about anything.

But Dad was bigger than Abby, and Abby didn’t drink.

He took a step toward her.

“Can I go to my room now?” Without waiting for a reply, Tedi pivoted away from him.

His left hand came down hard on her right shoulder, and he jerked her around to face him, his thumb and fingers digging painfully into her flesh. His other hand drew back. Way back. His angry eyes burned out at her.

“Daddy, don’t!” Tedi ducked.

She caught her breath and braced herself, tensing for a strike that didn’t land. She remained braced for a long time, then raised her head to find Dad frozen in position, eyes wide, face drained of color.

He released her shoulder and lowered his hand, but the pain still spurted down her arm. “Go to your room, Tedi.” He took a deep breath and let it out. “I’m going back to work.”

The spacious corner office that Dr. Jarvis George had used at Knolls Community for the past twenty years reflected the passion of his life: hunting. A moose head overlooked his credenza. The head and rack of a twelve-point buck peered out from between two glass-fronted bookcases filled with outdated medical texts. A rich, dark brown leather couch and two overstuffed chairs were situated so that visitors had a chance to peruse several hunting pictures taken in the field.

At the moment, Jarvis found no pleasure in his surroundings. He sat behind his massive oak desk and stared at the report. That insolent new doctor had decided to fill it out after that stupid needlestick incident this morning. The RMQA—risk management and quality assurance officer—was a personal friend. Dorothy had seen fit to call this to Jarvis’s attention. Unfortunately, this was not the only copy. The administrator and chief of staff would know about it, and if anything came of it…But of course, nothing would.

Jarvis crumpled the sheet into a ball and threw it into the trash. “Big mistake, Bower.”

He glanced at his left hand, flexed it. He’d scrubbed it well after the needlestick. There was nothing more to do. You don’t catch Alzheimer’s from contaminated blood, and that was this poor old gal’s problem—increased dementia over the past weeks. Alzheimer’s.

Someone knocked on the door. “Jarvis? You in there?”

The sound of Ivy Richmond’s voice lightened his expression as he jumped up from his chair and rushed over to open the door for her.

His frown returned when he saw her face, drained of color and lacking its usual smile.

“Come in, dear, come in.” He gently took her arm and led her to the leather couch, where he sat beside her. “How are the funeral arrangements coming? Do you need any help?”

Ivy shook her head and disengaged her arm from his grip. “Got it done. It’ll be tomorrow at ten at my church. Will you sit with the three of us? No other family is coming.”

“I’d be honored, Ivy. Pardon me for saying this, my dear, but you could do with some rest. Are you feeling okay?” He reached up and felt her cheek with the back of his hand.

She leaned her head back on the couch and closed her eyes. “Maybe some chest congestion…or something. I don’t know. I’m just tired, Jarvis.”

He eyed his stethoscope over on his desk, but before he could decide to get it, Ivy opened her eyes and fixed him with an intent look.

“I’m worried about something, and I don’t know if I have a valid complaint. I’m just confused. I’ve gone through this grief process before, and I know what it can do to your mind. I think it’s working a number on me, but I just can’t tell.”

Jarvis took Ivy’s right hand in both of his. “Why don’t you tell me about it? If there’s anything in my power I can do to help, I’ll do it. You know that.”

She nodded. “But I’m not sure it’s fair to drag you into it—not fair to you or Dr. Bower.”

Jarvis tensed. “Dr. Bower?”

“I shouldn’t even be talking to you about him. I know you didn’t want him here.”

“I still don’t.” And the whole thing was getting harder to swallow as time went on. “We don’t need a full-time doctor here.” And especially not Bower. Already two of Jarvis’s regular patients had been treated by the younger doctor in the emergency room, and their glowing reports about Bower’s compassion and kindness hit a raw nerve. He could be a horrible diagnostician, write scripts for all the wrong drugs, but as long as he had a “good bedside manner,” he was praised as a good doctor. Sounded like slick politics. What about good, honest medicine? How long would it take Bower to convince administration to get rid of all the older docs and replace them with fresh grads who cared more about covering their tails from lawsuits than they cared about human beings?

Ivy pulled her hand from his.

Jarvis released her, shrugging off the bitter thoughts. “I’d like to think I’m enough of a professional to be objective. I think I can make a sound judgment call, especially for your sake.”

She shook her head and sighed. “I may be stirring up trouble for nothing.”

“Hey, I’ve been practicing objectivity as long as I’ve been practicing medicine. You trust me as a friend, don’t you?”

“Yes.”

“Then let’s figure out this Bower business together.”

Ivy took another deep breath, let it out and leaned forward, elbows on knees. “I had to fight him to get him to try to save Mother yesterday. I felt as if he wanted to dismiss her as just a dying old woman. Maybe it was my emotions talking, I don’t know, but I question his ethics, Jarvis. I don’t think he holds human life sacred. That’s important to me, especially in my financial relationship to this hospital.” She spread her hands “What do we know about him?”

“Just the basics. What do you want to know? I’ll try to find out for you.”

“For instance, what is his background? Where did he come from? I know he’s a Doctor of Osteopathy. Is he an experienced emergency room physician? How does he feel about abortion and euthanasia?” She shook her head apologetically at Jarvis. “I’m sorry, but these are questions I really want answered.”

Jarvis frowned. Okay, maybe he was going to have more trouble with objectivity than he thought. It was too tempting to play on Ivy’s suspicions, but it wouldn’t be fair to Ivy. He didn’t care about Bower.

“I don’t know much about him,” Jarvis said. “His credentials are obviously in order, or our administrator would not have cleared him to treat patients here. She’s conscientious. I’ve heard that Bower comes from Truman Medical Center in Kansas City, so he’s obviously had some good experience.”

“Is he board certified?”

“I don’t think so. Most docs will include that with their title, and he hasn’t. He would at least have done his internship before he could practice medicine in Missouri, so I’m sure he has a permanent licensure.”

“Did he bring any references from Truman?”

“I’m sure he did, but no one has seen fit to share them with me. Remember, I’m just the director.” Jarvis didn’t try to keep the resentment from his voice. It had even been suggested by the hospital’s chief financial officer that this new upstart should receive the director title since he was going to be the only full-time physician on staff for emergency room. Even the gung ho administrator had refused to consider that—for now. She’d suggested that they try this guy out first and see how capable he was. These people had no loyalty to their tried-and-true medical staff.

“Jarvis, did you hear me? Do you know anyone at Truman? I would think after all these years and all the medical seminars you’ve attended—”

Jarvis straightened. “Of course. One of the advanced trauma life-support instructors is a trauma surgeon at Truman. I’ve taken the course with him several times, not that I couldn’t teach it myself if I were so inclined.”

“Would he have worked with Dr. Bower?”

Jarvis got up from the couch and went to his desk. He fanned out a business card file. “Dr. Sal Probstfield just happens to be a duck hunter. Ducks aren’t my forte, of course, but you get a couple of hunters into a room with 150 golfers, racquetballers and tennis jocks, the hunters will tend to find each other. Ah, here it is.” He pulled out a card with a mallard printed on it.

“Don’t tell me that a trauma surgeon hands out business cards.”

“For his guide service. During duck season he takes groups out on hunting trips. It’s what he plans to do with his time when he retires in three years.”

“Sounds like you know him pretty well.”

Jarvis reached toward the speakerphone and punched his numbers. “Well enough to get information from him about Bower.”

They reached Dr. Probstfield at home. After a few preliminaries, Jarvis asked, “Sal, we have a new full-time doctor down here. Does the name Lukas Bower mean anything to you?”

There was a pause, then a low whistle. “So you’re the guys who stole our whiz kid.”

Ivy raised a brow at Jarvis. She mouthed the words, “Whiz kid?”

Sal continued. “He’s awful at hospital politics, so his colleagues tend to resent him. He’s great with patients and diagnoses and he puts on a good show of confidence, so his colleagues tend to resent him.” He chuckled at his own attempt at humor. “Give him time. He’s not obnoxious. He’s just got a small problem with social graces. He’s not as cocky or self-confident as he seems.”

Jarvis saw the relief in Ivy’s expression.

Sal’s voice came again. “Those guys over at Cunningham Memorial lost themselves a good internist when they kicked him out of the residency program.”

Ivy’s head jerked up.

Jarvis stiffened, trying to control the surge of hope he felt. “What?”

“You know he’s not board certified, don’t you? That’s why. The hospital’s board of internal medicine decided he was endangering patients, and they fired him. He never got into another residency program. I know the trainer Bower had over there. Vicious man, very vindictive. He didn’t like being shown up, and I’d hazard a guess that Bower did so without even realizing it. The director of internal medicine backed up Bower’s trainer. They even tried to block Bower’s permanent licensure. I hear he had to take them to court to get it through.”

“I see,” Jarvis muttered, glancing at Ivy. “Is that all you know about it, Sal?”

There was a pause. “I’ve heard other rumors, but nothing was substantiated.”

“How did they feel he was endangering patients?”

“You’ll have to get that information from somebody else. Remember, I liked the guy. All you have to do is ask Bower about it. He’s an innocent, and he’s never learned to keep his mouth shut.”

“Thanks, Sal, I owe you. See you soon.” Jarvis hung up and looked at Ivy. “I know some people at Cunningham. I’ll give them a call later and see if I can come up with more info.”

“Why don’t you just ask Dr. Bower?” Ivy suggested.

Jarvis shot her a skeptical glance. “I’ll call Cunningham.”

Chapter Five

L ukas didn’t often visit a patient after admitting, because he didn’t want to interfere with the family docs. Friday morning, however, he’d received a special request from ICU that he could not refuse.

Mr. Franklin Verris had apparently just awakened from his mysterious deep sleep late yesterday evening, and he wanted to meet the doctor who, according to Dr. Robert Simeon, had probably saved his life. Dr. Simeon must be mistaken, and Lukas intended to tell Mr. Verris that.

Mr. Verris looked different in a hospital gown, but someone had been kind enough to bring him his teeth and help him comb his full head of white hair. His skin appeared pink and healthy this morning. Shelly had probably been by to see him already.

“Mr. Verris?” Lukas said quietly as he stepped up to the bed. “I’m Dr. Bower. I saw you in the emergency room Wednesday.”

The man glanced at Lukas, nodded and reached up to take Lukas’s hand in a firm shake. “Call me Frankie. My doctor tells me you kept me from doing something terrible. I thank you.” He looked away. “I don’t…don’t know what got into me.”

Lukas bent closer. “Frankie, did you take too much medication?”

There was a slight pause, then the man nodded, still not looking at Lukas.

“But your prescription bottle was almost full.”

Frankie sighed. “I know. Tuesday evening I was going through the medicine cabinet for the first time since…since my wife died. I came across her bottle of Xanax. She used it sometimes to help her sleep when her arthritis acted up.”

“So you did take hers.” Lukas had noticed that the script was for sixty pills.

“She’d used about half the bottle before she died.” Frankie closed his eyes for a moment, then opened them and looked at Lukas. His eyes were pale gray. It made him seem more vulnerable. “Tuesday was the sixtieth anniversary of our first date. When I saw that bottle, it occurred to me that I enjoyed life with Doris so much more than I enjoy life now, I just wanted to be with her again. I didn’t want to live.” He shrugged. “No reason to. No children or family.”

“I’m sorry you felt that way. You do seem to have some neighbors who care about you a great deal.” Lukas could have kicked himself for not trusting his own instincts. “How do you feel now?”

Frankie considered the question for a moment. “I’ve been thinking about Doris a lot today. When I allow myself to believe, as she insisted, that her spirit still lives, I feel better.” A gentle smile lit his face.

That was it. Lukas realized that the lines of this man’s face held humor. That was another reason why Lukas couldn’t believe he had tried to kill himself when he came into the emergency room the other day.

“Was Mrs. Verris a Christian?” Lukas asked.

“Yes. Oh, I know a lot of people claim to be Christians, then live like the devil, but my wife…my sweet, giving wife…” The man’s eyes filled with tears. “She lived it.” He looked out the window for a moment and waited for his eyes to clear. “How she put up with an old reprobate like me for so long, I don’t know. When the drug started taking effect the other day, it occurred to me that I probably wouldn’t follow her anyway.”

“Why is that?”

“God would kick me out of heaven.”

“He doesn’t kick His own children out. You don’t share your wife’s faith?”

Frankie continued as if he hadn’t heard Lukas. “My wife was the most beautiful woman in the world.” He said it softly, as if he were recalling her face. “She was beautiful inside, as well as outside, and she just grew more beautiful over the years.” His attention returned to Lukas. “I want to thank you for giving me another chance.”

“I’m glad I was here to help.” Lukas paused, then cleared his throat. “There is a way to make sure that you follow Doris when you do leave this earth.”

Frankie shook his head slowly. “I could never be the kind of person Doris was.”

“You don’t have to be. God created you as you are, and He wants you as you are.”

Frankie continued to shake his head.

“Tell me,” Lukas said, “would Doris be silly enough to worship a useless God?”

Frankie glanced sharply at Lukas. “My wife was a very wise lady. She wasn’t silly.”

“Then wouldn’t the God she worshiped at least be able to love you and accept you as generously as she did?”

Frankie watched Lukas for a moment. “You’re a Christian.”

“Yes, I am.”

“You talk just like Doris used to.” His eyes filled with tears again. “Sure do miss her.”

“Then why don’t you start making your travel plans—and not the way you did Wednesday. Why don’t you make sure you can be with her again? Get to know her Savior personally. Then when the time comes, in His time, not yours, He will see to it that you find her. Meanwhile, Frankie, He will be with you here, and He’ll give you peace you never believed you could have…or deserve.”

“What makes you think He’d do that for me?”

“He did it for me, and He keeps forgiving me every time I mess up. I keep asking Him to use me, and He sent you my way at just the right time. He loves you and wants you to join Him.”

More tears filled Frankie’s eyes, and this time he let them fall. “Give me some time to think about it.”

“Okay, Frankie. Meanwhile, I’ll be praying for you.” Lukas laid a hand on the man’s arm and squeezed, then said a silent prayer for him as he walked back to the emergency room.

Beverly was on duty that morning, and she met him as he entered. Stereotypical as it seemed, Beverly had a quick, impulsive temperament to match her flaming red hair. At the moment, the color of her face also matched her hair.

“Dr. Bower, there’s a very obnoxious patient in three who has threatened to sue if I don’t personally escort you to see him now.” She lowered her voice. “His father is Bailey Little.”

At Lukas’s blank expression, she explained, “You know, Bailey Little, the attorney. He’s the president of our hospital’s board of directors.”

“So the son is in the E.R. throwing his father’s weight around?”

“Yes. I know you want to get to that funeral.”

“But you don’t think this one can wait.” All he needed was a difficult patient whom Dr. Camp might refuse to take over when he arrived. It had been hard enough to convince someone to let him off a couple of hours, especially since he wasn’t sure himself why he felt the need to attend the funeral of a stranger.

He glanced at his watch. It was only eight o’clock. If all the ancillary services would cooperate, he could take care of this patient and still make the service.

“Okay, Beverly, what’s his complaint?”

Beverly lowered her voice. “He’s out of his stuff, if you ask me.”

Lukas raised a brow at her. “Drug seeker?”

She nodded, folding her arms across her chest, her thick, red brows drawn together in a disapproving glower.

“Okay, I’ll come willingly. What does he say is the problem?”

“Headache. Again.”

“Again? He’s been in for this before?”

“Yes. At least twice when I was on duty, and I think he’s been here a lot more than that, according to the secretary.”

“Which doctor treated him?”

“Dr. George.”

“And he got the drugs?”

“Dr. George believed his story. Dwayne is a good actor. Besides, Dr. George is good friends with Dwayne’s father. Dwayne even calls him ‘Uncle Jarvis.’”

“Pull Mr. Little’s old chart, will you?”

“Sure thing.” She turned to go, then hesitated and turned back. “I wouldn’t cross this guy, Dr. Bower, not unless you can afford to lose your job. I know I can’t.”

“Thanks for the warning, Beverly.”

She watched him for a moment. “I mean it. I heard about you turning in Dr. George for the needlestick. Bailey Little can get us both in trouble, and I’ve got kids to support.”

Lukas frowned. “You’re not going to get into trouble for doing your job.”

He found the clipboard for room three at the central desk, then added a copy of a special form he had brought with him from KC.

The patient who perched on the doctor’s exam stool in the darkened room didn’t look like a typical drug abuser. Lukas wondered if Beverly had just been irritated by the man’s personality. The young man, in his early to midtwenties, sat cradling his forehead in his hands. He wore a dark brown suit. His hair was short and neat. He looked clean. He glanced up when Lukas entered, then put his head back down and groaned.

“Hello, Mr. Little, I’m Dr. Bower.” Lukas placed the clipboard down on the counter and remained standing. “I hear you have a headache this morning.”

“Yeah, Dr. Bower.” The man continued to rub his forehead. “It’s the worst I’ve ever had.”

“Then you’ve had headaches like this before? Any nausea associated with them? Fever?”

“I’ve had some before, but not as bad as this. I’m puking my guts out.”

Lukas knew from checking the chart that the man’s temperature was normal. “Have you ever seen a doctor for headaches before, Mr. Little? Ever had a CT head scan?”

“Not yet.” The man leaned forward and pulled a card out of his back pocket. “Here. I’m supposed to go see a Dr. Pippin next week in Springfield. He’s a neurologist.”

Lukas took the card and glanced at it. It was a blank appointment card, one anybody could pick up from a front desk of a busy office. Lukas was not impressed.

“What time is your appointment? Maybe I can call for an earlier—”

“I don’t have an appointment yet, okay?” the man snapped. “Look, I’ve had this thing for two days, and it’s getting worse. Are you going to help me, or—”

Beverly rushed into the room. “Dr. Bower, we just put an asthma patient in six who sounds really tight. She’s not panicky or anything, but—”

“I’ll be there.” Lukas reached for the clipboard.

“Hey, hold it a minute!” Little came halfway off his stool. “What about me? I want to know about my headache.”

“Sorry, Mr. Little, I’ll be back,” Lukas soothed. “We have an emergency.” He knew the irony of his words would be lost on this guy.

In exam room six, a woman in her forties sat forward on the bed with her legs dangling over the side. She wore a clear face mask attached by six feet of tubing to an oxygen regulator on the wall at the head of the bed. Lukas saw that her oxygen was running at 12 liters. Good. Beverly knew her stuff. The patient wore a pulse ox gauge on her right forefinger. It looked like a plastic clothespin with a thin cable attached to a small box on the bed.

Lukas glanced over Beverly’s shoulder as she hurriedly took the woman’s vitals. The O2 sat had been 87 percent before the mask. Not good.

He stepped around to the other side of the exam table. “Good morning, Mrs. Knight.”

“Miss. I’m Darlene,” she said between breaths.

“Thank you, Darlene. I’m Dr. Bower. I’m going to listen to your lungs to get a better idea about what’s going on.” He pressed his stethoscope against her back and heard a soft, musical wheeze, both inspiratory and expiratory. She was moving very little air.

He straightened. “Beverly, do you have the vitals yet?”

“Yes, Doctor. BP 130 over 90, heart rate 120, respiration 36, temp 100.6.”

“Okay, thank you.” He gave orders for IV treatment and reassured Darlene. While Beverly carried out the orders, he went to the desk and ordered a stat respiratory therapy, blood tests and a chest X-ray.

Beverly had the IV established and was pushing the Solu-Medrol when he returned.

He glanced at the chart. “Darlene, we’ll have someone here in a few minutes to give you a breathing treatment. It’s going to help.”

She nodded, not looking at him, still fighting to breathe. “Thanks.”

Lukas frowned at her for a moment. Interesting. Her eyes were bloodshot, and dark circles shadowed them—not the typical signs of an asthmatic. She avoided eye contact. She acted as if she had other things on her mind. Other asthmatics watched every move he and the nurse made, desperate for help, needing their reassurance and attention.

He sat down in front of her. “After we get your breathing improved, then we’ll need to do some tests to check you out.” He glanced at the chart again. Beverly had only had time to do the vitals, not a complete assessment.

“Do you take any medicines, Darlene?”

She shook her head. “Supposed to take theophylline and two inhalers, but I haven’t lately. I ran out. Can’t afford refills.”

Lukas nodded. “Any drug allergies?”

She shook her head.

“Any chance of pregnancy?”

This got her attention. She shot him a very startled look, blushed, shook her head. “No.”

“Sorry, I had to ask. We’re doing an X-ray.”

She shot him another startled look. “Do you have to? I don’t have insurance.”

He considered it a moment. He’d like to see an X-ray, but with the other tests, it may not be necessary. “Okay, we’ll put a hold on that for now, but we still may need it, depending on what the other tests show.” That could be what was bothering her.

She looked slightly relieved.

“Hello.” There was a knock at the open door, and Kaye, the respiratory tech, walked in. “Are you Darlene Knight? I’ve got orders to make you start feeling better, or I lose my job. Got a few minutes?”

Lukas smiled at her. “Thanks for coming so quickly, Kaye. Darlene, I’ll be back after your treatment.” He braced himself to face the man with the migraine.

“Do you make a habit of abandoning your patients in this emergency room?” Mr. Little demanded as Lukas walked back in and laid the clipboard down on the counter.

“Not if we can avoid it,” Lukas said calmly. “Would you mind stepping to the bed?”

“Why?”

“If I’m going to treat you, I’m going to check you out. Please move to the bed. If you need some help, I can—”

“I don’t need help,” the man snapped, then grudgingly obeyed Lukas.

Lukas checked heart, lungs, reflexes. Normal. Then he lowered the lights and checked the eyes. Bingo. They were pinpoint, no dilation. In this dimly lit room, that didn’t fit.

He picked up the chart. “Mr. Little, it says here that you’re allergic to Imitrex and Reglan. Those are our drugs of choice for migraine. What medications have you taken before?”

“Demerol and morphine work best.”

“But I can’t in good conscience give you a narcotic without running some tests to make sure you’re not in danger. I need a CT and a urine—”

“What?” Little brought his hands down from his head and glared at Lukas. “What’re you trying to do to me? I just want some simple pain relief! No urine test.”

Lukas checked the time. Forty-five minutes until Camp took over. No problem with this patient; he was about to leave. Federal law had to be satisfied first, though. Lukas knew the regulations well. Unfortunately, Little probably did, too, if he was habitual.

Darlene was another problem. For some reason, Lukas wanted to finish her himself.

“Okay, Mr. Little, I’ll send the nurse in with a shot for you.”

The man visibly relaxed. “It’s about time.”

Lukas had Beverly take a dose of Toradol to Mr. Little in room three while Lukas looked for and found the young man’s old chart at the central desk. Very interesting—eleven E.R. visits in four months, all for pain shots and pills. How many other area hospitals had records on him?

“Carol, please call the area emergency departments and check to see if Mr. Dwayne Little has visited them recently for pain medication.”

Carol raised a brow at him. “Yes, Doctor, but you know who he is, don’t you?”

“Yes. Thank you for your concern.”

Lukas returned to Darlene in room six.

She still wore her mask and the finger probe. Her O2 sat was still low, but better. Her arterial blood gas turned out to be better than Lukas had expected. He checked her breathing.

The wheezing was louder. Good. That meant more air movement. She was still working for her air, but she was holding her own.

“Well, Darlene, you’re doing better, but we’ve got a way to go yet. You’re still doing some inspiratory and expiratory wheezing. I can’t send you home like this.”

Her eyes grew wide. “Please, Doctor, don’t put me in the hospital. I can’t stay.”

“We’ll see. I want to give you a couple more treatments. How long have you been breathing this poorly?”

“Not quite a week. It didn’t get really bad until yesterday. I know I should have come in sooner, but I already feel much better.”

The woman was slightly more animated than she had been a few moments ago, but not much. Lukas would guess by the circles beneath her eyes that there were other things going on he hadn’t discovered yet. Stress could bring on an asthma attack, especially when exacerbated by lack of sleep.

“Dr. Bower,” came Beverly’s flustered voice from the doorway. She glanced at Darlene, then back at Lukas. “The patient refuses the shot.”

Lukas excused himself with Darlene and walked with Beverly to the central desk. “Of course he refuses the shot,” he said. “It’s not a narcotic. He probably requested Demerol.”

“His usual,” Beverly muttered.

“Please make a notation on your chart that pain relief was offered and he refused it. Did he give a reason?”

“Said he’d had it before and it upset his ulcer.” She looked around and lowered her voice. “I don’t think it’s a good idea to mess with this guy. He could cause a lot of trouble for all of us. I told you, I can’t afford to lose my job.”

“We could cause him a lot of trouble, too. It doesn’t change the treatment plan. There’s no record of ulcer history or medication. Time for our trump. Would you please call for Kaye to give Darlene another treatment? Then I need you to join me in room three. I need a witness.”

“For what?”

“You’ll see. Carol, what did you find out?”

The secretary bit her lip and glanced toward the room where Little waited. “He’s been to at least three different places several times each in the past two months.”

“Thank you. Call them back and warn them that he may be a drug seeker and he may be headed their way soon.”

While Beverly called for Kaye, Lukas filled out his part of the form he’d placed with Little’s chart earlier. They went together to room three.

“Mr. Little, so sorry to hear about your ulcer. Is it still giving you trouble?”

“That’s not what I’m here for,” the patient snapped.

“Sorry. You’re not allergic to morphine in any way, are you?”

The man couldn’t hide his surprise. “No.”

“Good. I think we can fix you right up.” Lukas couldn’t resist a glance at Beverly. She gaped at him in shock mixed with relief. He grinned. “First, Mr. Little, I have a form for you to sign.” He pulled out the sheet he’d just filled out and put it at the top of the papers on the clipboard. He placed it under Little’s nose. “I need you to read this over first, of course. It states that you are aware of the nature of the drugs I am going to give you, and that you understand the effects Narcan has on you if you are an addict. It will precipitate violent withdrawal symptoms, up to and including death.”

The man’s mouth flew open. “Narcan!”

“Yes. Maybe you’re familiar with it? It’s a narcotic antagonist. You’ll still get good pain relief from the morphine, but you will not have to put up with the resulting high. I was sure you would approve.” He pushed the sheet forward. “Your signature, Mr. Little.”

The man jumped from the bed. “You’re saying I’m a junkie!”

“Not at all. I’m saying that if you aren’t an addict, you should have no problem with this course of pain relief. If you do have a problem, we can get you into a drug treatment prog—”

Little stomped toward the door, shouldering Beverly aside. “I’m getting out of here. You people are crazy.” He turned back and pointed a finger at Lukas. “You won’t get away with this, Bower. Do you know who my father is?”

“Does your father know you’re here looking for drugs?”

Little swung away and stalked out of the hospital.

“Dr. Bower!” Beverly exclaimed. “You don’t listen very well.”

“He was a drug seeker. What did you want me to do?”

“He could get us both into a lot of trouble.”

“How can you get into trouble for doing your job and following the doctor’s orders?”

She stared at him, shaking her head. “Those shots could have killed that man.”

Lukas nodded. “Don’t worry. I’ve never had anyone take me up on the offer. Where do we keep the AMA forms? If he’s going to refuse medical advice, we need to fill one out, and we both need to sign it.”

Beverly stared at him a moment longer. “They’re at the central desk. I need to check on Darlene, so just have Carol get it out for me to sign later.”

Darlene’s numbers still weren’t up to acceptable levels when Lukas checked her again. She wheezed only upon expiration now—a good sign. But Lukas didn’t yet feel comfortable.

“I feel so much better, Doctor,” Darlene said. Healthy pink tinged her cheeks now, and her posture was more relaxed. “Can I go home?”

“I’m sorry, Darlene, but I can’t make any promises at this point. I’ll cut your oxygen down and see how you do. I’ll waive the X-ray. But we have to watch you awhile longer before I can decide.”

She stared at him rebelliously for a moment, as if she might check herself out against medical advice.

Lukas glanced at his watch. Thirty minutes until Camp got here. Lukas completed some charts, then returned to Darlene’s room and took her off the oxygen to see how she would do on room air. Then he went to change out of his scrubs. He would be cutting it close, but he still didn’t feel right leaving Darlene.

After fifteen minutes on room air, Darlene did a peak flow test. She registered 250, which was not enough for her age, weight and sex.

“I’m sorry, Darlene,” Lukas said. “We tried.”

She moved halfway off the table, her eyes wide. “Please, can you give me another treatment before you make your decision? I can’t stay.”

He went into his usual spiel. “I know it’s never convenient to be sick, but—”

“I’m not talking about convenience.” Her whole body radiated tension. “I have to go home. I’ll be fine.”

“Is it worth risking your life? You can work out a payment plan with the hospital. Asthma can be fatal if not treated properly.”

“I’ll take care of it,” she snapped.

“You weren’t taking your medicine before. I don’t think you realize how—”

“Please, Dr. Bower! I have a brother at home who needs me. He doesn’t have anyone else to help him. I didn’t even want to leave him this morning, but I just couldn’t breathe anymore.”

So that was what was going on. Lukas sat down. Time to find out more. “What’s wrong with your brother?”

Her warm hazel eyes shimmered with tears. Her finger worried the pulse ox probe as if she’d like to slip it off and falsify the reading. “Clarence is very sick, and he won’t see a doctor.”

“Sick?”

“He’s extremely obese. The last time he got on the scales, he broke them. He made a big joke of it, but that was two years ago. He’s gained continually since then. He doesn’t leave the house, and these past few weeks, I’ve had to take his meals to his room. The only place he goes is to the bathroom.”

“He won’t see a doctor?”

She shook her head as tears flowed down her cheeks. Lukas set a Kleenex box beside her on the bed.

“He’s given up. He’s tried so hard. He was such a hard worker, so proud of his mechanic skills. He helped me buy my house, then he lost his job because of a layoff. Which meant he lost his insurance. Then he developed pneumonia, went into the hospital, and used up the last of his savings to pay the bill. He had to give up his own home and move in with me, which really hurt his pride. He went into a deep depression, and he just kept gaining weight.”

“You can’t convince him to see a doctor?”

“He knows I can’t pay for it. Even when I worked outside the home as a bookkeeper, I couldn’t put him on my company insurance. I ended up having to quit my job and stay home and work as an indexer on computer so I could take care of him.”

“Surely he qualifies for disability.” Lukas couldn’t believe his own words, but if anyone truly needed state aid, this family did.

“He wouldn’t consider it.”

“But doesn’t he see what he’s doing to you?”

“He can’t help it. He’s just waiting to die. That’s why I have to go home. I don’t dare leave him alone for long. Please let me go. We don’t…we aren’t close to family.”

“Are you sleeping at night?”

“Not well.”

“You need more help. This is too much of a strain on you. Would you consider counseling?”

She pulled a single tissue from the box and dabbed at her face. She took another tissue and blew her nose. “I don’t have the money.”

“There are local agencies that can help. We can make some calls for—”

“No.”

He sighed in frustration. “Darlene, sometimes we all have to ask for help. That’s why those agencies are set up, for people like you, who are really struggling, trying to make an honest living for yourself and your brother. There is no shame in—”

She burst into tears. “Please let me go home, Dr. Bower. I can’t ask those people for help. Clarence and I were second-generation welfare kids. We grew up on handouts. We swore together when we left that mess that we would die before we asked for help again. We meant it.”

Lukas bit his tongue. Clarence might indeed die. Darlene obviously knew that.

He gave her a spare inhaler, some antibiotic samples, and a theophylline tablet, then gave her a script for that, and for Vistaril to help her sleep.

“These are fairly inexpensive,” he told her as he handed them to her. “Take them. You really need them. Remember that you’re not going to be able to care for Clarence if you end up back here.”

She stared at the bounty he had given her, then looked up at him. “You mean you’re letting me go home?”

“Against my better judgment. I wish I could do more to help you. If you need someone to talk to, call me.”

For the first time since she’d arrived, he saw her smile. She reached out and grabbed his right hand with both of hers. “Oh, thank you, Doctor. Thank you.”

Chapter Six

D ad backed the red BMW out of the drive, with Tedi safely buckled in, just like on any other school day. This day, however, Tedi was getting out of classes. For the first time in her life she would rather be going to school.

Granny Jane had been sick almost for as long as Tedi could remember, and Tedi had felt so bad for her. It hurt to watch someone suffering the way Granny Jane had suffered, and Tedi knew it had been really hard on Mom and Grandma Ivy. That’s why she had to go to this funeral. She wanted to be there for them.

“I’ll drop you off in front of the church,” Dad said as he turned onto the highway from their street.

“Fine.” Tedi didn’t look at him, but she felt him looking at her. Last night she’d hid out in her bedroom when he came home, and he hadn’t bothered her.

This morning Dad had fixed her favorite breakfast: French toast and fruit, with powdered sugar and hot maple syrup. Dad could cook when he wanted to, and this morning he’d done almost as good a job as Grandma Ivy. Almost.

“How about a trip into Springfield this weekend?” he asked. “We can go to the mall and get some summer clothes, then catch a movie, maybe do the zoo while we’re there. They’ve got a new baby elephant.”

Tedi didn’t stir from her inspection of the roadside scenery. “You go ahead, Dad. Maybe Julie would like to go.”

“Julie doesn’t like elephants. You and I do.”

Tedi shrugged. “I’m not in the mood.”

Dad sighed. He slowed the car and pulled to the side of the road. He turned on the flashers, then turned in his seat to face Tedi.

“Aren’t you even going to let me try to make up for yesterday? I should never have scared you like that.”

“You were drinking.” She watched a robin hopping along the wire fence beside the road.

“That’s no excuse.”

Tedi turned to look at him then and almost gave in at the pleading look in his eyes, the sorrowful expression on his face. But she knew that could all change in a second. She was tired of it. “I’m not excusing you, Dad. I’m telling you that your drinking scares me. I’m still scared. I don’t know when it’s going to happen again. I never know. That was a good breakfast this morning, and Springfield could be fun, but nothing makes up for being scared of my own father. You get mad too easy when you’re drinking.”

His intent blue eyes held hers for a moment. “What’ll make it up to you? How about I lay off the booze for a while?”

She bit her lip and took a deep, long breath. Here it comes. “How about I go live with Mom until you’re off the booze?” She continued to hold his gaze so he’d know she meant it.

He looked away first, but not before she saw a flash of anger in his expression. Big surprise. She braced herself for another temper tantrum.

“She doesn’t want you,” he said quietly.

Tedi caught her breath. She hadn’t been braced for that. “Why not?”

He didn’t look back at her. “She’s too busy with her job.” His voice was bitter. “Got to make the almighty buck. You’ll just slow her down.” He turned off the flashers and signaled to pull back onto the highway.

“You’re lying! If I ask her to, she’ll take you back to court for custody.”

A break came in the traffic, but Dad didn’t take it. His face lost color until it nearly matched the shade of his short, light blond hair. “She’ll be sorry if she does.” He looked down at Tedi with narrowed eyes. “Don’t forget why I have custody in the first place—mental patients don’t make good parents.”

Tedi almost said, “Neither do drunks,” but she remembered yesterday.

“And public opinion matters here in Knolls,” he continued. “She’s spent these past five years trying to rebuild her practice after the last custody battle. She won’t thank you if she loses it all again.” He pulled out onto the road at last.

Tedi said nothing more until they reached Grandma Ivy’s church—Covenant Baptist—at the edge of Knolls. Grandma and Mom stood outside the building waiting for her. She waved at them, then released her seat belt and opened the door.

Someday she would learn to shut her mouth and keep it shut, but not today. Today she was mad.

“You know, Dad,” she said as she stepped from the car, “if Mom lost her job, we’d all be in big trouble.” She slammed the car door as hard as she could and turned toward the church.

Seconds later, Dad gunned the motor. The tires spun on blacktop.

Tedi waved at her mother and grandmother and wished her father would drive out of her life forever.

Lukas Bower hated the term “backseat Baptist.” It implied a person one step away from backsliding. Although Lukas always preferred to sit at the periphery of the congregation, he by no means felt himself to be at the spiritual edge of God’s family. Just because he was shy did not mean he was not a sincere Christian.

On the other hand, he knew he had a lot of growing to do before he was a mature Christian.

It was a moot point in this church today, since this was not a worship service.

The first strains of soft organ music reminded him of the circumstances leading up to today’s funeral, and he had the typical critique session with himself. He could have shown more compassion to Ivy Richmond during Mrs. Conn’s final hour. He could have tried harder to reassure Mrs. Conn during those short moments of lucidity—if indeed she had truly been lucid.

He could not, however, have been more aggressive with the code. Ivy Richmond probably disagreed, but he could do nothing about her sentiments, much as he would like to. She obviously possessed a great deal of power at the hospital, and he didn’t have enough insight into her character to know how she might play that power. She was strong willed, much like another, younger woman with power whose influence had affected his career with devastating ease. Best not to allow his thoughts to wander in that direction.

Lukas couldn’t decide whether to approach the Richmond ladies with his condolences after the service or to leave them in peace today. The latter course looked more favorable as more and more people filled the auditorium, and the old, familiar prickling of self-consciousness made him wonder why he had even bothered to come. No one would have expected him to. He’d lost other elderly patients and hadn’t felt it necessary to see them off. Doctors didn’t do this kind of thing, especially not for someone they didn’t even know.

Dr. Mercy Richmond, however, was a colleague, and although she had covered her feelings well on the day of her grandmother’s death, he had identified with her loss. He’d had several recollections of his mother’s death three years ago. Maybe that was why he was here.

A shadow loomed low outside the window near his seat, then pulled up at the last second—a robin on a strafing run. Her aerodynamics put modern technology to shame, just as God’s design of the human body made modern medicine look like kids playing with a chemistry set from Toys “R” Us. Lukas felt that way sometimes, as if he were playing games with the lives of his patients. But he wasn’t playing. Some people had even complained that he took things far too seriously, and perhaps they were right. But how could he behave any other way?

The robin sidled along the roof guttering, oblivious to Lukas and the rapidly filling auditorium. She used her beak to toss rotted leaves out onto the yard. Then she selected some good stems she could carry and flew to a neighboring tree.

Maybe Lukas could entice the robins to clean out the guttering on his new house. Guess one could say the guttering had gone to the birds, he spent so little time there. He’d never been good at home maintenance, mostly because he seldom paid attention to his surroundings. He’d spent too much time in hospitals these past few years. But home was lonely and had been for a long time.

He needed to force himself to get out and meet people, take part in some activities, find something that would interest him in community service. Knolls was a nice, peaceful little town, complete with a town square that surrounded the courthouse. As a center of industry, Knolls drew people from the surrounding area for employment. The population nearly doubled on weekdays, thus increasing the need for more restaurants and shopping centers—and a full-time physician in the hospital emergency room to take care of accidents.

“Dr. Bower?”

Lukas looked up with a start to find Lauren McCaffrey standing expectantly beside the pew where he sat.

“Yes?”

“May I sit here?” She gestured around the nearly full sanctuary. “There aren’t many places left.”

He couldn’t help a slight hesitation before scooting over. She took the place he vacated while he struggled to hide his discomfort with a smile.

“I didn’t expect to see you here,” she murmured under cover of the organ music.

He raised a brow at her in query.

“Everyone knows you didn’t hit it off with Ivy.”

“I don’t think there’s a problem just because—”

The funeral director chose that time to usher in the family.

It was a small group, and since this was a Baptist church and not a funeral home, there was no private room for grieving. The family consisted of both Richmond women and a little girl with long, chocolate-brown hair and serious brown eyes who looked like a small reproduction of Mercy. Mercy, in turn, looked like a younger version of Ivy. Dr. Jarvis George accompanied the ladies.

Dr. George presented another reason for Lukas to keep his mouth shut, his head down, and get out as soon as the funeral ended. The man had made his antipathy to Lukas quite obvious, and since he held the directorship for the emergency room, he was Lukas’s immediate supervisor. Not a good situation.

“Dr. George was partners with Ivy’s late husband, Dr. Cliff Richmond,” Lauren volunteered quietly. “He’s always been close to the family.”

Lukas nodded. Just great.

“Poor Tedi,” Lauren whispered.

In spite of himself, Lukas raised a questioning brow.

“Mercy’s daughter,” Lauren explained, leaning closer. “The little girl. She’s ten, and she’s a darling, very precocious. Her dad’s not a darling, and he’s had custody since the divorce five years ago. He doesn’t mind causing trouble for Dr. Mercy, and he isn’t above dragging Tedi into it to keep Mercy from defending herself.”

Lukas cleared his throat. “Um, perhaps I don’t need to know this.”

“If you don’t, you’ll be the only person in the county who doesn’t. Dr. Mercy doesn’t smile and laugh like she used to, and I miss that. She used to be a warm, outgoing lady, always ready with a joke or a one-liner to make the patients laugh and relax.”

Lukas glanced sideways at Lauren. She wasn’t exactly a gossip. She was just filling him in on some inner workings of the community she apparently felt he needed to know. He didn’t feel the same way.

“Ivy’s kind of a loose cannon,” the nurse continued, apparently unaware of Lukas’s discomfort with the conversation. “Everyone loves her, just like they did her mother, but she can sometimes go off on a harebrainer. Three years ago she decided she wanted to backpack the Appalachian Trail.”

“And did she?”

“She hiked for two weeks and got through part of Georgia before she got a stress fracture in her left leg and had to call Mercy. As usual, Mercy flew to the rescue. Ivy can be outspoken about a lot of things, and she takes a special interest in the hospital since she helps support it. The problem is, she sometimes throws her financial weight around. I think she means well, but the administration has trouble convincing her to trust them and keep out of politics.” Lauren paused and waved at someone across the aisle.

Lukas was rescued from any more information by the pastor, who rose from his seat on the stage and bowed his head to pray.

Mercy stood for a moment at the casket after the service, tears sliding down her cheeks. She heard Tedi sniffling beside her and laid an arm around her daughter’s shoulders.

“I can’t believe he came,” Mercy heard Ivy mutter as they filed out of the church behind the casket.

“Why not, Mom?” The question came out more sharply than Mercy had intended. Ivy Richmond was one of the most stubborn people in Knolls, and she wasn’t afraid to express her views. She was obviously still laying blame at Dr. Bower’s feet for Grandma Jane’s death. “He seems to be a caring doctor, and he was very concerned about Grandma. He’s not her murderer.”

Ivy shushed Mercy, then glanced pointedly at Tedi, who walked ahead of them.

Mercy shrugged. “Just because the two of you disagreed on ideology doesn’t mean he’s a bad person. May I remind you I agreed with him.”

“You didn’t try to force me or manipulate me into changing my mind. Besides…you don’t understand my reasoning. Not really.”

“You expect a stranger to understand something your own daughter doesn’t?”

Tedi glanced up at her mother as they reached the vestibule. “It’s because Granny Jane wasn’t saved, Mom. Grandma Ivy was concerned for her soul.”

Mercy sucked in her breath in a sigh of irritated frustration. That again. This Christian business was just going too far, and Ivy never wasted a moment in her attempts to try to indoctrinate Tedi into every aspect of it.

As they turned to greet the first of the funeral attendees, Mercy had no time to comment.

This part of the funeral procession was the most trying to Mercy, as it had been five years ago at Dad’s funeral. As with Dad, it looked as if the whole town had shown up to pay their “respects.” Mercy had learned long ago not to trust what people said to your face. At times like this, they were all high on emotionalism. Try them later, when you were fighting for custody of your child and needed a friend, or you lost your practice and needed patients.

She saw Dr. Bower coming toward them, walking beside Lauren McCaffrey. He probably didn’t realize it, but his expressive face showed his discomfort clearly. So why was he here? He didn’t even know Grandma. And he didn’t seem like the politicking type.

He took Mercy’s hand gently. “Again, Dr. Richmond, I’m sorry.” He seemed sincere, his clear blue eyes steady and earnest as he spoke. When he reached Ivy he hesitated.

To Mercy’s surprise, Mom took his hand. “Thank you so much for taking the time out of your busy schedule to attend Mother’s funeral.”

If he caught the sarcasm in her voice, he didn’t show it.

Then Jarvis spotted him. “Hello, Dr. Bower. Who’s watching the shop?”

“Dr. Camp agreed to spell me for a couple of hours. Today’s his day off.”

“You might consider going through me next time.”

Jarvis’s tone held no rancor, but Mercy tensed. She would not allow Jarvis to reprimand one of his staff right here at her own grandma’s funeral.

“Sorry, Dr. George,” Dr. Bower said quietly. “I tried to contact you.”

“No harm done. Camp’s a good doc.”

To Mercy’s surprise, Jarvis shook the younger man’s hand and even smiled, though it looked more like a grimace.

Later, as the four of them rode in the limousine to the cemetery, Mercy overheard her mother speaking to Jarvis quietly under cover of the soft gospel music that floated over them.

“What’s up between you and Dr. Bower?” Ivy asked. “You waiting for him to hang himself?”

Jarvis tugged at the collar of his starched white shirt—probably the only starched shirt he had. “He’s too smart for that. Do you know he ranked third in his class when he graduated from Kirksville?”

“You checked his personnel file?”

“Yes, and I called Cunningham today to find out more about the little contretemps Sal mentioned to us yesterday. I have an old friend who works there. Nurse. Great gal.”

“And she told you about Dr. Bower?” Ivy asked.

“She told me what she knew, which wasn’t much, except that about the rank, and the fact that Bower never dated, had very little social life at all, and spent most of his spare time—which was rare—at the hospital working and learning. She liked him. I mean, she really liked him.”

Mercy suppressed a smile at the hint of frustration in Jarvis’s voice. Ivy’s brows rose in surprise. “So isn’t that good news?”

“Of course it is,” he said just a little too brightly.

“Are you still going to check him out?”

“June will call me when she has more info. She said something about a lawsuit, but no explanation.” Jarvis reached over and patted Ivy’s hand. “We’ll get this thing figured out.”

“Mom?” Tedi said softly, just loud enough for Mercy to hear.

Mercy leaned sideways and put an arm over her daughter’s shoulders. “Yeah?”

“How’s…the practice going?”

“Great, honey. Just great.”

“You still doing some E.R. shifts to fill in on your days off?”

“Some. Not as many since the new full-time doctor joined us.”

“Oh.” Tedi frowned and glanced out the window for a moment.

Mercy watched her daughter, whose dark eyes were even darker than usual. Mercy hadn’t forgotten the slammed car door and the squeal of tires on blacktop when Theo dropped Tedi off at the church before the funeral.

“Everything okay at home?” Mercy asked.

Tedi grimaced, still looking out the window.

Mercy repressed the urge to demand what that puny excuse for a father had been doing to make Tedi so unhappy. Just watching her daughter made her want to choke Theodore.

“So I guess you’re pretty busy,” Tedi said at last.

Mercy quirked a brow at her. “Busy? Do you have something in mind? You know I’m never too busy for you, Theadra Zimmerman.”

Tedi made a face at the sound of her full name. “Oh, I don’t know…maybe we could go to Springfield some weekend. You know, like to the zoo and to a movie or something.”

“Sounds great. And maybe we could go to Bass Pro Shop and eat at Hemingway’s.”

“Yeah, and hike at the nature center and watch the deer and squirrels and birds eat. And maybe we could even take a whole week and drive down to the Boston Mountains in Arkansas.”

“We could camp out,” Mercy said, playing the little game they had always played, with their dreams and wishes getting bigger and bigger and more unreachable. “And maybe we could take a whole month and go to the Grand Canyon.” She had forgotten how heartbreaking this little game could become as she named the things she most wanted to do with her daughter.

“And no one could find us, except we would know where we were,” Tedi added. “And maybe you could set up practice in Arizona, and we could call Grandma, and she could come and join us, but no one else would know.”

“Maybe we could, honey.” Mercy leaned closer and kissed her daughter’s forehead. “First we’ll concentrate on getting to Springfield. Do you want to talk about it?”

Tedi turned and looked seriously into Mercy’s eyes. The all-too-grown-up expression made Mercy’s throat choke with tears.

“Would you, Mom? Would you do it for me?”

Mercy’s eyebrows rose in surprise. “Why wouldn’t I want to spend time with the person I love more than anyone on earth?”

Tedi shrugged. “I don’t know…I guess I thought you might be too busy.”

“Where did you get that—” Mercy paused, and a flash of fresh anger accosted her. She reached out and touched her daughter’s shining dark brown hair. “Tedi, don’t ever let anyone tell you that I don’t have time for you or that I don’t love you.” The anger grew. The day’s grief and the past weeks of struggle with Grandma’s cancer had taken their toll. Mercy struggled for a moment with tears; then she gave up and let them fall.

Tedi watched Mercy for a moment, her own eyes growing larger. She reached a hand up and caught a tear and held her mother’s gaze. “Don’t cry, Mom. Really. It’s going to be okay.”

Mercy pulled a Kleenex tissue out of her purse and blew her nose. Her own daughter shouldn’t be having to comfort her.

To Mercy’s surprise, Tedi’s spirits seemed to lift after that. She smiled when her grandmother and Jarvis teased her, and the smile was real. It was as if Mercy had reassured her of something vital. The mood relaxed until they reached the cemetery.

As the limousine driver held the door for Ivy, she clutched her chest and stumbled.

Mercy scrambled forward. “Mom!”

“Grandma!” Tedi cried.

Ivy caught herself against the seat as her face grew pale. Jarvis eased her back.

“Relax, it’s okay,” she said. “I just got a little dizzy.” She breathed deeply through her nose, then exhaled through her mouth. “It’s okay.”

“You grabbed your chest, Mom. I saw you grab you chest. Does it hurt? What’s wrong?” Mercy demanded.

Jarvis leaned toward Ivy. “You weren’t feeling well yesterday, were you? You mentioned chest congestion. Are you still feeling ill?”

“Apparently so,” Ivy snapped.

“Mother, why haven’t you seen a doctor?” Mercy asked.

“Very funny. I’ve seen more doctors in the past two days—”

“That’s not what I mean, and you know it.” Mercy’s voice carried more volume than she’d intended, and other arrivals at the cemetery turned to look through the open limousine door with concern. She lowered her voice. “How long has this been going on?”

“For pete’s sake, don’t lecture me like a—”

“Stop it!” came a ten-year-old voice.

All three adults turned in time to see Tedi’s eyes fill with tears. Her lower lip quivered. “Grandma, you’re scaring me.”

Mercy quickly wrapped her arms around her daughter. “It’s okay, honey. You know how stubborn your grandma can be sometimes.” She cast a reproachful look at her mother, who did not hold her gaze. Good. She felt guilty. “Now that we know she’s sick, we’ll take care of her. I know she doesn’t want you to worry. Do you, Grandma?”

“No.”

Tedi sniffed and smeared tears over her face with the back of her hand. “But what’s wrong, Grandma?”

The color had already begun to return to Ivy’s cheeks. She eased herself back more comfortably on the velour seat. “Nothing serious, I’m sure, Tedi. Sometimes I just get the hiccups, but it isn’t in my throat. It’s deeper in my chest.”

“Do you think it’s your heart?” Fresh tears formed in Tedi’s eyes. She’d heard her mom talk too many times about heart attacks and the dangers of heart disease. Mercy wished she’d never discussed the subject in front of her.

“I don’t know, honey,” Ivy said.

“We’ll know soon enough,” Mercy said. “Mom, we’re going straight to my office as soon as we leave here.”

“No, we aren’t. I don’t feel it’s ethical for a daughter to treat her own mother.”

“Then we’ll go to my office,” Jarvis said. “You’re not getting out of this, Ivy Richmond.”

“And you’re not getting your stethoscope on me, either, Jarvis George. I’ll go to an unbiased doctor who doesn’t know me and doesn’t have preconceived ideas about the care I should receive. The two of you would have me trussed up like a full backpack and never let me out of the house again.” Her color continued to improve, and Mercy relaxed. Tedi’s tears had done more than any amount of browbeating could have done, and whatever was wrong with Mom, she was recovering for now.

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