Chapter 5
Chapter Five
Finn River, Idaho
I finish my check-up with the two-year-old twins, then pause in my office to wolf down a banana and a bran muffin while I review the chart of the teenaged patient with stomach pains who’s waiting for me in room two.
Outside, it’s still snowing, the big, soft flakes drifting down. With rain in the forecast for tomorrow, it won’t stick. Typical spring. I gulp down water as I read, skimming the chart for any past history I should be aware of like allergies or medication issues.
My nurse, Vivian, leans into my office. “They’re ready for you.”
“Great, thank you,” I pick up my tablet.
“Are you going to want a blood draw?” she asks.
“You know me well,” I say with a smile.
Her face brightens. “On it.” She spins away.
I slip out of my office and take a moment to soak in the positive vibes. The nurse’s station where Vivian and Sepp, my PA, are exchanging a quick laugh about something as they work, the waiting area to my right where two littles are playing in the mini playhouse my dad built, my receptionist’s warm greeting to the family just walking in.
It’s been nine months of hard work, but it’s becoming my practice more and more every day. I can even see a change in my staff. Not that Dr. Boone wasn’t wonderful, but I get the feeling he was a little old-school when it came to making decisions. Vivian was downright skittish when I first took over, and Sepp seemed surprised when I consulted him.
I give the exam door a quick knock and wait for the “come in” before I enter. Inside, a woman sits on the chair against the window and her daughter sits on the exam table, her gangly legs dangling off the edge.
“Hi, I’m Dr. Greely,” I say, setting down the tablet on the small desk in the corner so I can shake Mom’s hand.
“I’m Kelly. Nice to meet you,” Mom says, offering me a weak smile, while the teen eyes me suspiciously.
I’ve grown used to the lukewarm welcome since taking over for a physician that everyone loved so much. I remind myself that it’s going to take time to build people’s trust. In that regard, time is on my side because it’s always been my plan to devote my career to the families of Finn River.
Greta’s eyes stay focused on the floor as I settle onto the small round stool. Her shoulder-length blonde hair hangs past her thin face, the tips dyed a shocking pink. She’s wearing black Converse high-tops, ripped jeans, and a faded purple hoody.
I notice that she’s filled out the mental health questionnaire provided at check-in, but I ignore it for now.
“I’m sorry to hear you’re having stomach aches, Greta,” I say. “Can we talk about it for a bit?”
Greta shrugs.
We go through a basic history. When the stomach aches started, how long they last, what the pain feels like, and if she’s noticed a pattern of onset. From her history, I know that her parents divorced last year, she’s an eighth grader at Finn River Middle School, and is passionate about art and her Cocker Spaniel, Baron.
“Okay if I listen to your belly?” I ask Greta.
Her eyes meet mine for the first time. “It’s okay.”
I pump hand sanitizer into my palms and rub them together, then slip my stethoscope from my pocket and slide the earpieces into place. The exam reveals no surprises, and I even get Greta to giggle when I comment on the vigorous gurgles I hear in her lower abdomen. I tap each quadrant, watching Greta’s face for a reaction. If she had inflammation, or a festering appendix, it would show.
“I’d like to run a blood test,” I ask Greta, then glance at Kelly, who nods. Girls at this age are often low in iron and vitamin D, which could cause several kinds of symptoms.
The mom gathers her coat, like she thinks we’re done.
“Okay if I talk for a few minutes alone with Greta?” I say to them both.
Greta’s eyebrows lift.
“Why?” Kelly asks, scowling.
“It’s important for Greta to be able to share whatever she wants with me.”
Kelly eyes Greta, then me, her eyes wary. “Do you want me to go?” she asks her daughter.
“It’s okay, Mom,” Greta says.
Kelly stands. “All right.”
Twenty minutes later, Greta and I have covered a lot of ground. She’s worried about her mom, who cries at night, but she’s also worried about school and the bullies who hang out in the bathrooms making videos for their social media channels. Greta and I part ways with a plan. She’s going to try some grounding activities before bed, go on two walks per week with Baron, and hug her mom. I promise to call the school’s principal to work on the bathroom issue.
The extended visit cost me time I don’t have, and I’m practically running all morning. I finally catch a break to scan the day’s lab results in my office when my phone screen lights up with a text from Sofie. We sometimes share patients, and I’m expecting an update on one of them, but what flashes on my screen is something much different.
Louisa got checked into Evergreen Medical Center last night.
My stomach drops. I get up and close my door so I can call Sofie back.
“Did something happen?” I ask. In the background, Zach laughs with their little boy, Curren. I imagine them playing in their living room. Zach tickling him or the two of them knocking over the block towers he loves to build.
Sofie gives a tight sigh, yanking me back to the conversation. “It’s her heart, but I don’t know how serious.”
“I have to check on a patient there later today,” I say. “I can stop by.”
“Does Hutch know?” she asks.
A jagged, rough pain jostles my insides. “I’m sure Beth would have called him.” Hutch’s other sister, Thea, is in her final semester at Cornish in Seattle and is probably practicing like a madwoman, plus she’s auditioning for summer symphony opportunities.
“Right,” Sofie says.
We end the call with the promise to share intel as we get it.
I sit for a moment, my fingers hovering over Hutch’s number. I’m sure one of his sisters have notified him about Louisa. But what if he needs someone to talk to?
With a measured sigh, I flip my phone facedown.
I finish my morning of patient checkups and immunizations and treating sick kiddos, my concern for Louisa growing by the hour, then drive the short distance to the hospital, where one of my patients had emergency surgery yesterday.
Inside the hospital, I clip on my MD badge and stop at reception. Earl, my favorite volunteer, greets me with a giant smile.
“Afternoon, Dr. Greely,” he says, pushing a cut-glass candy bowl toward me. Today, he’s filled it with Werther’s hard candies and rolls of Smarties.
“Hey, Earl.” I pluck a Werther’s and unwrap it. “Is a patient named Louisa Hutchins still here?”
Earl slips his thick black bifocals on and taps his keyboard, his pale blue eyes focused on his screen. “Cardiac floor. Room 216.”
“Thank you.” I smile at him and pop the candy into my mouth.
“You have a great day,” Earl says.
I give him a wave and head for the stairs, making the quick decision to visit Louisa first, then my patient.
At the cardiac wing, I enter through the frosted glass doors and stop at the nurse’s station. I have yet to treat a patient in need of cardiac care, so the staff in this area of the hospital don’t know me.
A short nurse with dark hair and kind eyes glances up from her computer. Her nametag says Callie. “Can I help you?”
I introduce myself and the reason for my visit.
Callie nods along. “Her daughter brought her in. Scared it was a heart attack, but she was in AFib.”
Atrial Fibrillation is an irregular heartbeat caused by faulty electrical messages happening in the heart’s upper chambers. Though not necessarily life-threatening, it could hint at underlying heart issues. That Louisa is still here means they’re likely working to identify them, or maybe they’re preparing to treat it.
“Dr. Shelby will be doing rounds in an hour. Do you want me to give her a message?”
I smile. “Louisa is a special lady. If there’s anything I can do, please let me know?”
Callie’s eyes soften. “Will do.”
I continue down the hall to room 216. Inside, Louisa is dressed in a washed-out hospital gown, Beth lying next to her in the bed. Beth is tall and reedy, with long, wavy hair the same color as Hutch’s. So many of her features remind me of him that I have to pause and force a breath into my lungs.
She and her mom are focusing on what I’m guessing is the TV hanging above the door, but when I peek into the room, Louisa’s face brightens in surprise. “Ava!”
“I heard you were here.” I step into the room. It smells strongly of bleached cotton and stale pine.
“Hi Beth,” I say as the TV goes silent.
“Hey,” Beth replies as she rolls upright and steps from the bed, her deep green eyes rimmed with dark circles. She gives me a furtive glance, her hostility like quills on a porcupine’s back. This could be misplaced blame—I’m a doctor and her mom is sick—or something else.
Beth turns to her mom. “I’m…gonna get a coffee. You want anything?”
Louisa reaches for her hand, and the two share a brief connection I can feel from the other side of the bed. “I’m okay, thanks, honey.”
Beth slips free and disappears through the door.
I put Beth’s attitude out of my mind and pull up a chair.
“Nice of you to stop by,” Louisa says, her soft brown eyes clear, though her face is edged with exhaustion.
Up close I can see that she’s pale, the wide neck of the gown revealing skin that’s beginning to thin with age. Monitoring leads connect from inside her gown to machines set up behind her on the left. An IV in her left arm is set to a slow drip from the bag of fluid hanging above her head.
“They taking good care of you?” I ask. From one of the monitors, one of the lines jumps. Louisa doesn’t seem to feel the irregularity, which is good, but my problem-solving brain starts working. If the medications they’ve been giving her since she arrived haven’t fixed her heart rhythm, it could be why she’s still here.
“The best,” she says. “Even the food’s not bad.”
I laugh. “You don’t need to lie to me.”
With a grimace, she runs a hand through her short dark hair threaded with silver. “I could use a shower, though.”
“Want me to help?” Finally, something I can do .
Louisa’s eyes go wide. “Really? I can wait for one of the nurses. Maybe after Dr. Shelby comes.”
“I’m here now,” I say with a smile.
Relief fills her eyes. “That would be amazing.”
“Let’s do it.”
I use the call button to alert the nurse, who appears in the doorway seconds later.
“Go ahead,” she says after I give her our plan. “There’s a call cord in the shower if you need me. I’ll bring a fresh gown.”
Louisa isn’t frail by any means, but she’s a little shaky when we start walking. If her heart isn’t pumping efficiently, it can cause dizziness. Over time it can cause fatigue, even weakness.
“I’m sorry about Beth,” Louisa says once we get into the bathroom. “She’s…angry.”
“It’s okay,” I say. “She’s worried about you. I completely understand.”
Louisa doesn’t reply, and an awkward silence stretches between us. When I moved home last year, she was one of the first people to call and congratulate me. She invited me to come riding, but I haven’t had the courage yet. Moonbeam Farm holds too many memories.
I reach into the shower and turn it on, testing it until it’s the right temperature.
“You need some privacy?” I ask.
Louisa laughs. “Goodness, no. Once you get to be my age, modesty is a foreign concept.”
I assist her with the gown then help get her seated on the sturdy plastic chair inside the shower.
Louisa closes her eyes and leans back, so the water wets her hair and runs down her face. “Wow, that feels good.”
I roll up my sleeves and help shampoo her hair, then give her the nozzle and a handful of soap so she can wash up and rinse wherever she needs it.
“How’s it been taking over Dr. Boone’s practice?” she says over the crashing of the water. “He was such a kind man. I still remember when I brought Ryan in with his broken arm. He took extra time to make sure I was okay too.”
I swallow hard. I remember that broken arm. It was the second thing I noticed about him. The first was the mischievous glint in his eye. Like he was trouble…and knew it.
“He left me some big shoes to fill,” I say to move the conversation along.
“I have every faith that you’ll do just that,” Louisa says. “Okay, all done.”
After turning off the water, I hand her a towel. From the bed, I grab the fresh gown and help Louisa slip it on, being careful of the IV port.
We’re shuffling back to the bed when she says, “They’re recommending surgery.”
My stomach twists. “I wondered if that might be the case.”
I help her back under the covers, then hook up her leads and IV line. “How do you feel about it?”
She huffs a slow sigh, her mouth tensing. “I don’t know. The medication we tried made me dizzy and forgetful. Very worrisome.”
Memory problems and ataxia are early signs of dementia, which can start as early as middle age, so a doctor could easily draw the wrong conclusion. “Wait, so this isn’t new?” Why didn’t I know about this?
The realization is like a spear to my lungs. Because Hutch and I don’t talk like we used to.
“It started two years ago.”
Damn. I settle on the side of her bed and take her hand. Though it goes against everything in my training, I can’t help the words from tumbling free. “You’re going to get through this.”
Louisa’s gaze flicks to something behind me.
I turn, expecting Dr. Shelby or Beth.
The man who fills the doorway steals my breath. It’s Hutch, dressed in jeans and a moss-green henley the same rich color as his eyes.
“Damn right she is,” Hutch says.
My heart is like a jackrabbit inside my chest, frantically racing for cover. I jump up. “Oh! Uh, hey.”
He’s as handsome as ever, but the look on his face isn’t the casual, cocky grin I’m used to.
His gaze sweeps past me to Louisa as he covers the distance to her bed. “Hey, Mom.”
A knot tightens in my stomach. I want to stay and comfort them both, but Hutch and I…things aren’t like they used to be.
“I’ll let you two visit.” I give Louisa a quick smile. “I can come back…later.”
“Thank you,” Louisa says. “You’re always welcome at the farm. Come ride with us this summer.”
Hutch has pulled the chair on the other side of the bed close to Louisa, his back partially turned to me now.
“I will,” I promise Louisa, then force my feet to move. Once I’m in motion, it’s hard not to take off running.
After breezing past the nurse’s station, I’m almost to the stairway when I hear someone behind me.
“Ava!” Hutch calls out, his tone sharp.
Steeling myself, I turn around, my breaths coming fast and painful in my chest.
“Don’t go,” he says.
I can’t meet his eyes. They remind me so much of that night. My mistake.
“The cardiologist will be here soon,” I say. “You won’t want to miss meeting her. Sounds like they’re recommending surgery.”
Hutch runs a hand through his thick dark hair. “I talked to the doctor last night.”
He must have gotten emergency leave. That he got here so fast means he’s between missions. I remember how he used to text me as soon as his sergeant allowed, to let me know he’s safe. Then the letters would come. Sometimes full of funny stories, other times so full of heartbreak I would cry in agony, wishing I could be there for him.
“That’s why you came.”
He nods, but his face looks pale. “She’s going to need my help.”
“How long?” I ask before I can snatch the words back.
Something flickers in his gaze, but it’s gone just as fast. “Until she gets back on her feet.”
“Good,” I say with a nod. Louisa boards horses and runs a small but busy flower farm. A couple of her older 4H kids help out, but someone needs to steer the ship. Thea is in the final months of university, consumed with finals and auditions. Beth could learn to run things, with guidance. Maybe that’s Hutch’s plan. Because I know he’s not staying indefinitely.
Hutch’s lips tense. “You doing okay?”
The question throws me, but I force a smile. “Yeah.”
He swallows hard. “Okay.”
The elevator doors open and Dr. Shelby and two other providers step out.
In the moment Hutch is distracted, I slip into the stairway.
Safe. For now .
But I won’t be able to avoid Hutch for long. Finn River is a small town. And our friends will want to get together. They’ll want to help him and Louisa. I know I do.
So I’ll just have to fake that seeing him isn’t breaking me all over again.