Czytaj książkę: «Marrying the Playboy Doctor»

CHAPTER ONE

LIFE was too short.

Dr. Seth Taylor grimly watched the patient being rolled into trauma bay number two. From the paramedic report, he saw the woman on the gurney was only fiftyseven—the same age his mother had been when she’d unexpectedly died six months ago.

Ignoring the knot in his stomach, he stepped forward to take charge of the resuscitation.

“Hold CPR. What’s her underlying rhythm?”

“Still PEA,” a honey-blond female paramedic said as she climbed off the gurney from her position doing CPR. PEA was the acronym for pulseless electrical activity, which basically meant the electrical system of the heart was working, but the heart wasn’t actually pumping any blood.

“Get a set of labs, stat, continue CPR and give me a history.” Seth scowled, hoping this wasn’t another cerebral aneurysm like his mother had suffered. “We need to find the source of her PEA.”

“Labs are in process,” one of the nurses said. “Her pulse ox is low at eighty-two percent, despite being on one hundred percent oxygen.”

“Double-check the tube placement,” Seth ordered. “Did she have surgery recently? Is there a reason she might have thrown a pulmonary embolus or a tension pneumothorax?”

“No surgery, according to the husband, and no other reason to have a blood clot or tension pneumo that we’re aware of.” The female paramedic responded without hesitation. “Her history is fairly benign. The only complaint she had prior to passing out was nausea, lasting from the night before, and some vague complaint about neck pain, so our working assumption was that she’d suffered a myocardial infarction.”

Since women experiencing a heart attack generally didn’t present with the same symptoms of crushing chest pain, shortness of breath and dizziness as most men did, Seth was forced to consider the paramedic might have nailed it right. The honey-blonde looked young, with her hair tied back in a bouncy ponytail, but she obviously knew her stuff. A myocardial infarction would explain the patient’s lack of oxygenation.

“Should I get a cardiology consult?” asked Alyssa, the brunette trauma nurse beside him.

Cedar Bluff Hospital, located in the less populated rural area off the shores of Lake Michigan, only had two cardiologists on staff, and if their patient needed something complicated like open heart surgery they’d end up transporting her to Milwaukee.

“Yeah, tell them they need to get down here ASAP. Make sure a troponin level and cardiac enzymes are being run on the blood sample, too.”

Alyssa hurried off, and he continued running their resuscitation efforts. “Let’s give a dose of epinephrine and get a chest X-ray. Have we verified tube placement?”

“I did when I placed the tube.”

The female paramedic’s tone was defensive. He didn’t have time to tell her not to take it personally. He would have verified anyone’s ET tube placement, even his own.

“I’ve listened. There are breath sounds bilaterally,” Cynthia, another trauma nurse, spoke up.

Alyssa returned. “Dr. Hendricks is on the way.”

He nodded, somewhat relieved his colleague and friend Michael Hendricks happened to be the cardiologist on call today. He trusted Michael’s judgment and didn’t mind the extra help.

A radiology tech wheeled in a portable X-ray machine. As they shot a quick chest X-ray, another nurse spoke up. “Lab results are back. Electrolytes are a little abnormal, her potassium is low, but her hemoglobin is within normal range so she’s probably not bleeding.”

Seth took a deep breath. Okay. So far they’d ruled out two of the six possible causes of PEA. “What about her troponin and cardiac enzymes?”

“They’re still being processed.”

He pinned the radiology tech with a fierce gaze. “I want to see that film now.”

The young tech nodded and scurried off, downloading the image onto the designated radiology computer terminal. Seth waited, and was forced to admit technology was amazing when the chest film image was available on the screen in less than a minute.

“No tension pneumothorax. There might be some blood around the heart, though.” Finally a potential diagnosis. Cardiac tamponade was a potential cause of PEA. He spun back toward the patient. “I’m going to do a pericardial tap, to see if that helps.”

He drew on a pair of sterile gloves as the nurse on the right side of the patient pulled out a sterile cardiac needle and syringe, carefully opening the packages so he could grab the items. The nurse on the other side of the patient doused her chest with an antibiotic solution while he connected the needle and syringe and picked out his landmarks. He took a quick, steady breath and slid the needle into the V beneath her sternum, hoping and praying he didn’t cause more harm than good. When he saw the flash of blood, though, he knew he’d hit the right spot. Pulling back on the syringe, he drew out a good fifty milliliters of blood.

“Nice job,” Michael drawled from behind him. “Why did you bother calling me?”

Seth spared his friend a quick, exasperated glance before putting another syringe on the needle to see if there was more blood to be removed. He withdrew another eighteen cc and then glanced up at the heart monitor. “Hold off on CPR. Let’s see if she finally has a blood pressure and pulse to go with her rhythm.”

There was a moment of complete silence as several staff members, including Michael, felt for a return of the patient’s pulse.

“I feel a pulse, but it’s weak.” Michael spoke up.

Alyssa nodded, confirming she felt it, too.

“She has a blood pressure, but it’s only sixty-five systolic,” Cynthia added.

“Start a dopamine drip, and find out what that troponin level is.” Seth stepped back and stripped off his sterile gloves. “Michael, our working diagnosis so far is an acute myocardial infarction with a pericardial effusion. I called you so you can take her to the cath lab if needed.”

“It would be nice to see the troponin first,” Michael said.

“I have it—her troponin is 0.51, which has been reported as critical,” Alyssa informed them.

The number didn’t sound high, but anything over 0.03 was considered indicative of an MI, so 0.51 was way above the accepted range.

Seth glanced at his friend. Michael nodded, understanding his unspoken question. “Okay, she’s mine now. Let’s prepare to get her transferred immediately to the cath lab.”

The nurses sprang into action, placing the patient on a portable heart monitor and then gathering all their paperwork together. Seth noticed the female paramedic stood off to the side, watching as the events unfolded. Once the cardiology team had taken over Seth could sign off on the case, although he knew the odds weren’t in this poor woman’s favor. She wasn’t out of the woods yet. It was a sad fact that women who suffered from acute myocardial infarctions had a much lower survival rate than men, mostly because of their atypical presenting symptoms. At least in this case the paramedics had realized the potential and had treated the patient accordingly.

“Excuse me? Dr. Seth Taylor?”

He turned when he realized the female paramedic was speaking to him. “Yes?”

She held out her hand. “I’m Kylie Germaine, the new paramedic education coordinator here in Cedar Bluff.”

This was Kylie Germaine? He’d seen the honey-blonde a couple of times but he hadn’t known her name. He’d heard about a new paramedic education coordinator coming on board, but for some reason he’d expected someone older, more experienced. Kylie looked too young to have the expertise needed to provide education and training for the entire paramedic team. But then again she had pegged this particular patient’s diagnosis correctly.

“Nice to meet you.” He took her hand in his, feeling a slight jolt at the brief contact. He let go and took a step back, wondering if she’d felt the brief sizzle, too. “Nice call on the MI—helped steer us in the right direction.”

“Thanks.” A small smile tugged the corner of her mouth. “I’ll confess, my partner thought I was nuts.”

He raised a brow. “I guess you proved him wrong, didn’t you?” Her ringless fingers made him smile. He liked her. She might be young, but Kylie was gorgeous, and he hadn’t gone out on a date in what seemed like forever. He was on the verge of asking if she’d like to get together for a drink when she continued speaking.

“As part of my job I have started setting up meetings with each of the ED physicians, to get insight into potential training needs. I believe you and I are scheduled to meet in a couple of hours?”

They were? Seth wasn’t always very good at keeping up with his calendar. “Uh—yeah. A couple of hours.” He glanced at his watch and rubbed the back of his neck. “Actually, I’m free now, if you have time.”

“Now?” Kylie didn’t look happy at the abrupt change in plans.

“We could wait until later. But you need to know patient care comes first. If I’m needed in the trauma room then we’ll have to reschedule anyway.”

Cedar Bluff only had one hospital, and they provided the only level two trauma services within a seventy-five mile radius. They stayed busy—especially in the height of the tourist season.

Seth swept a pointed glance around the momentarily empty trauma bay. “Your choice.”

She narrowed her gaze, but nodded. “Give me a minute to talk to my partner, then.”

He could wait, and he watched as she went back to talk briefly to the short guy who’d brought the patient in with her. Actually, now that the resuscitation was over he couldn’t even remember noticing the other paramedic at all, only Kylie. Perky ponytail and youthful face aside, Kylie had certainly taken the lead in the situation.

He was glad she’d stopped by to talk with him.

She returned a few minutes later. “Okay, I’m ready.”

“Great.” He tried to soften her up with a smile. “My office is just down the hall.” He waved to a short hallway off to the right.

She preceded him down the hall, and he had a hard time pulling his gaze from her swinging ponytail. He found himself thinking how to best approach her—because he was interested in getting to know young-miss-paramedic-liaison better.

And, as he knew only too well, life was too short not to go after what you wanted.

Kylie was far too conscious of Dr. Seth Taylor following behind her as she made her way to his office.

Maybe he was a good-looking guy, with his broad shoulders, dark brown wavy hair and deep brown eyes, but she wasn’t interested. She’d just moved to the quiet rural town of Cedar Bluff from the crime-laden city of Chicago, and she didn’t have time for men.

Of course if he knew she was the single mother of a six-year-old Kylie had no doubt Seth Taylor would back off in a hurry. Most men did. Which suited her just fine.

She found his office and walked in through the open door, taking a seat as he made his way around to the other side of his desk.

“So, Kylie.” His smile lit up his whole face. “How can I help you?”

His smile was lethal, and she was shocked to feel the impact all the way down to her toes. She licked her lips and struggled to remember why she was here. Seth Taylor had the uncanny knack of making her feel like she was in high school again, garnering the attention of the quarterback of the football team.

Focus, Kylie. Focus. She cleared her throat. “One of my goals is to revamp our training program, and I guess I’d like your opinion on any deficiencies you might have noticed in the crew.”

“Deficiencies, huh?” Seth drummed his fingers on the desk. “One area we can all stand to review is how women suffering an acute MI present differently than men. Today was a prime example.”

She nodded. “Yes, I’ve already made a note of that—considering how Jim thought I was crazy to think along those lines.”

Truthfully, she hadn’t been too impressed with Jim’s performance today, and hoped he wasn’t an indication of how all the paramedics in Cedar Bluff worked. If so, she was in for a long haul to bring their skills up to what she considered an acceptable level.

“What about intubation techniques? You questioned my placement of the ET tube.”

“Kylie, don’t take it personally,” he chided gently. “Double-checking endotracheal tube placement is routine for any resuscitation, especially if the patient is experiencing persistent hypoxia. If you’re asking me if I’ve seen many tubes placed incorrectly by the paramedics, I’d have to say no, I haven’t.”

“Then what have you seen?” she challenged. “There must be some areas for improvement you’d like to discuss.”

“There are, actually, several areas of improvement needed.” Seth leaned forward, shooting another of his dazzling smiles. “But I’ll need some time to get my thoughts together. Maybe we can talk about this later—say, over dinner tonight?”

What? Her mouth dropped open. Was he actually hitting on her?

“I’m sorry, I’m not available this evening,” she said coolly. As a professional, she didn’t appreciate his assumption she’d be willing to drop everything to go out with him. What was it with some men? Ben’s father had been charming, too, but look how that had turned out. Not good. “However, I’d be happy to reschedule this meeting to another time that’s more convenient for you.”

Seth stared at her for a long moment, and then flashed a cajoling smile. “I suppose lunch tomorrow is out of the question, too?”

She narrowed her gaze, not finding his self-deprecating humor the least bit amusing. Seth Taylor was handsome, and obviously, from what she’d seen in the trauma room, a very capable ED physician. But why ask her out? Did he see her as some sort of easy mark? Or was he like this with all women? “Dr. Taylor, I’m not interested in sharing a meal with you. All I want to know is what areas of improvement you see for education and training in our paramedic crew.”

“Okay.” He lifted his hand as if in surrender. “Let me think about this for a minute.”

She was glad he dropped the flirtatious smile and sat back in his chair. He idly doodled on the slip of paper in front of him.

“One thing that I’d personally like to see is for the paramedic crew to start using hypothermia on all resuscitated patients.”

“Hypothermia?” Kylie sat up straighter, her interest piqued in spite of her annoyance. “In what way?”

Seth lifted a shoulder. “There are devices that can be placed over a patient right in the field to start bringing their temperature down.”

They’d been talking about instituting a hypothermia protocol in Chicago when she’d left. How amazing to discover that even small-town Cedar Bluff was up on the latest resuscitation techniques. “I’d love to institute some sort of protocol. Do you have one already written up?” “Not yet. But I’d be happy to work on one with you.”

His smile wasn’t entirely innocent, yet at the same time she couldn’t let such a fantastic opportunity pass by. “I’d love to help create a protocol. Anything we can do in the field to save lives is worth the effort.”

“I agree.” Seth raised a brow. “I’m not trying to cross your boundaries—clearly you’re already involved in a relationship—but my schedule is tight. We may need to meet over a lunch hour, since that might be the only available option.”

Kylie stared at him suspiciously, wondering if he was really being sincere or if he was simply probing for more information. Either way, it didn’t really matter. This job was a promotion for her, and since her sole reason for taking the job and moving to a safe, rural area was to provide a better home life for Ben, she wasn’t about to do anything to mess it up.

Which included falling for Seth Taylor’s not-so-subtle charm.

“I do have a man in my life,” she said, playing along with his assumption. The man was her six-year-old son, but Seth didn’t need to know that. “I’ll try to be as flexible as possible, though, in order to meet your needs.”

“Great. You’re a beautiful woman, Kylie, and I’m sorry if I made you uncomfortable.” Seth pulled out his PDA and scrolled the buttons on the tiny screen. “Okay, how does next Monday work for you? Say about twelve-thirty?”

Beautiful? He’d actually called her beautiful? No man, not even Ben’s father, had ever used that word to describe her. Cute—pretty, maybe, in a girl-next-door type of way—but never beautiful.

Seth Taylor was charming, and she was just beginning to realize how dangerous his smooth charm really was—especially when she was feeling at her most vulnerable. Living in a new town, with people she didn’t know, wasn’t easy. And she’d been so focused on helping her son adjust to his new day care that she hadn’t done anything for herself. Luckily she wasn’t interested in relationships, or she might have been tempted.

She found her voice. “Monday at twelve-thirty is perfect. Thank you.”

As she stood and moved to leave, he called out, “Kylie?”

She turned. “Yes?”

“I hope the man in your life realizes how lucky he is.”

She doubted Ben would think so. At least not in the way Seth meant. But she nodded and quickly escaped before she blabbed the truth.

If Seth knew she didn’t really have a man in her life outside her son, Ben, then he might just continue his charming assault on her defenses.

And she wasn’t too certain she possessed the strength to withstand a second attack.