CHAPTER ONE
Nicole Milbourne leaned in with a gloved hand to swab the patient’s hive-covered leg for yet another culture. It shouldn’t be this hard to diagnose a simple rash. Red blotches admittedly covered fifty percent of the patient’s legs, so Nicole corrected her assessment. Maybe it wasn’t so simple.
“Ouch.”
The sound startled Nicole and the applicator flew out of her hand, settling with a soft thunk on the floor.
Nicole glanced at the portly woman she’d been assigned to follow up on. The head of the hospital bed was raised and the woman peered over her glasses at Nicole, her arms folded across her chest. With her lips set in a thin line of censure, it didn’t take a body language expert to determine the woman’s mindset.
“I’m sorry,” Nicole said. “I didn’t expect it would hurt.”
“Well, it did,” the woman answered. Her artificially carrot-colored hair didn’t budge as she bobbed her head up and down.
Nicole tried to smile, certain it looked more like a jerky group of still frames end to end than a natural gesture of friendliness. If she couldn’t carry on an ordinary conversation like this with a patient, how was she ever going to survive the residency program?
She reached for another swab kit.
“You’re doing another culture?”
“Yes,” Nicole said, focused on opening the stubborn paper and space-age plastic packet.
“Why?”
“It’s possible we cultured too soon and the infection hadn’t really taken hold, even though the symptoms were manifesting themselves.”
The quiet whoosh of the hospital room door startled Nicole and the swab in her hand went spiraling to the floor. With a sigh, she reached for a third kit, quite certain it was going to be a very long three years.
Glancing up, her heart skipped about ten beats when her worst fears came true and the head resident walked in to the room.
Dr. Damien Reed was a legend in the halls of Rochester Regional. With an impressive scholastic resume’, Kennedy looks, and a smile that could disarm the Middle East, the man was both respected by his peers and ogled by just about every woman in the place.
From a resident’s perspective, that smile meant a thorough textbook grilling generally followed, which explained the pounding heart syndrome she got when she spotted him in the hallways.
Nicole had managed to escape his notice for her entire first week...almost. She clutched the swab kit. Today was day six of her residency.
She offered him a quick, professional nod and prayed he wouldn’t ask her any questions. After taking a long moment scrutinizing her, he turned his charms on his patient. Nicole exhaled relief as she watched him interact with the woman.
“Mrs. O’Malley,” he said with a wide grin as he held her hand between his and dug up some bad Irish charm. “And how are we doing this fine morning?”
As usual, Dr. Reed’s dark hair was unkempt and shaggy. Nicole reached up to touch her own auburn hair, neatly captured in a bun at the nape of her neck, then remembered her gloved hands and dropped them to her side. The man’s hair was reminiscent of a college student, not someone who’d risen to the position that put him in charge of newly indoctrinated medical residents. She tried to ignore jeans that fit too well, yet seemed completely inappropriate for someone with his status. This was Rochester Regional Medical Center, after all. There were protocols to be observed.
She studied him as he spoke with the patient and the conversation faded to gray. Even inappropriate, the hairstyle worked for him, framing a strong face, green eyes, and an effortless smile. No one appeared immune to his easy charm, least of all Mrs. O’Malley.
With the personality of a politician, everything seemed easy for Dr. Damien Reed. Not so for herself. A part of her envied him those skills.
Nicole yanked open another swab kit, surprised when it came apart in one pull and almost went flying again. When Dr. Reed’s steady hands grasped hers as well as the kit, she chalked the slight quake in her arms up to first week nerves. If he held on longer than necessary, Nicole decided it had been to keep the swab from falling to the floor.
Nicole mumbled a thank you as Dr. Reed held out the swab for her to take.
“Anytime.” Even the man’s voice was designed for effect. The single word rolled off his tongue like warm honey. She could understand why patients sought him out. He made everything seem better with a simple word.
As Mrs. O’Malley ran down her list of complaints to Dr. Reed, Nicole, with extreme care this time, swabbed the rash, and then pulled the blanket back over the patient’s leg.
“Thank you, dear. That was much better,” Mrs. O’Malley said. “She was a bit rough on the first try,” the patient explained to Dr. Reed, sending Nicole’s already pink complexion into overdrive, if the warmth of her face was any indication. The man had the power to toss her out of the program with little or no reason, but he simply patted Mrs. O’Malley’s hand and turned to Nicole.
For a moment, he held her gaze. When Nicole realized her lips were parted, she clamped them shut. Irritation replaced nerves when she watched his eyebrow lift in response.
“How are we on bringing this rash of Mrs. O’Malley’s under control?”
Nicole took a deep breath. She would not be escaping his infamous grilling today, it appeared. Taking a moment, she reminded herself that this was where she excelled. She knew her diseases and what needed to be done to diagnose them. No one in the residency program would best her at diagnostic medicine. It was her strong point, as she’d proven over and over again in school.
Granted, Mrs. O’Malley’s rash was being stubborn. The unexplained low grade fever was also an issue. But Nicole was certain she would determine the reason.
“We’ve done a blood work-up. Blood chemistry has all come back normal. As well, the first culture did not turn up a viable reason for the breakout. At this point, I’ve ruled out viral causes and am in the process of ruling out bacterial infections.”
“It sounds like you’ve been very thorough, Doctor.”
Nicole beamed. “Diagnosis has been elusive so far, but I feel confident we’ll find the cause and get the patient back on track medically.”
Mrs. O’Malley drank some of the water she’d picked up shortly after Dr. Reed entered the room.
“Thirsty?” he asked the patient.
She looked at the cup in her hand as if surprised. “It’s strange. I never used to like water. Now I find myself sipping at it all day long.”
Nicole frowned. What did that have to do with a rash?
Damien turned back to her. “Have you tested her blood sugar?”
Diabetes? He thought Mrs. O’Malley had diabetes? Nicole ran through the tests she’d ordered and the heat in her cheeks increased to inferno level. She wanted to crawl under the hospital bed and never come back out. No, she’d never tested the patient’s blood sugar.
The medical encyclopedia in her head opened up to the page that dealt with complications of uncontrolled diabetes. Life threatening ones like coma and cellulitis were followed by lesser known symptoms. An unexplained rash was listed right there.
How could she have forgotten?
It took a real effort on her part to keep her hands from covering reddened cheeks. Oh, God, her first week here and she’d already screwed up. She shook her head. Well, there was nothing to do but own up to the colossal mistake she’d just made.
She glanced at her patient, who thankfully was busy watching Dr. Reed. “No, Doctor. I did not order a blood sugar. I’ll be sure and order it stat.”
“I think we’ll have you fixed up in no time,” he said to Mrs. O’Malley, patting her hand. What looked like a genuine smile on his face never wavered despite the fact he must be annoyed at the rookie mistake she’d just made. Even mortified as she was, she had to respect his ability to keep his emotions so well hidden.
“Can I speak to you outside, Dr. Milbourne?”
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