Ch. 15 – Prem
G astric ulceration. Prem was almost sure of it.
After a monumental effort, Hilda, the 200-pound pig, now lay on the table in Exam Room 1, her small eyes clouded with pain. According to the family, Hilda hadn’t been eating for several days. This morning, she’d vomited blood.
Gently, Prem placed his hands on Hilda’s stomach. The pig writhed in pain, releasing a sharp cry of protest.
“Sorry, old girl,” Prem murmured, scratching her behind the ear. “I just wanted to be sure.”
He set his shoulders. “Fluids,” he barked at Deja. “And I need a morphine drip. We’ll have to test for anemia.”
Deja disappeared into the back and returned with an IV kit, which she expertly assembled and placed in Hilda’s shoulder. Calm and efficient under pressure, she also had a way with animals that no school could teach. Prem couldn’t deny that Deja was a damn good vet tech.
While Deja worked, Prem stepped into the waiting area where the two siblings and their mother waited in a nervous cluster. The young man popped up from one of the chairs. The older woman rubbed her teenage daughter’s back.
Prem sucked in a breath. Dealing with the families was always the hardest part of his job. He could mend broken bones, defeat viral infections, and medicate struggling organs. But dealing with heartbreak? Facing off against fear and panic and sorrow? He felt utterly helpless.
“How is she?” the young man asked. He picked at a hole in his jeans with dirt-rimmed fingernails. Fine flecks of hay coated his shirt, as if he’d come directly from feeding horses. Probably had.
“I’m curious, have you changed Hilda’s feed recently?” Prem asked.
The man grew pale as he nodded. “The local feed store accidentally doubled an order for a different kind of feed. Put it on sale. I thought…I thought it was a good deal.” He stared at Prem. “Is that the reason Hilda’s sick?”
“Could be,” Prem admitted. “All signs point to gastric ulceration. I’d like permission to perform an ultrasound and a GI endoscopy.”
“What’s gastric ulceration?” the teenage girl asked. She possessed the same honey-blonde hair and freckles as her older brother.
“It’s relatively common in pigs,” Prem answered. “Especially when their diets change. Usually, the ulcers heal on their own, but in serious cases they can perforate.”
The mother frowned. “Perforate?”
Right. English. Prem tried again. “I believe Hilda has sores in her stomach and digestive tract, probably due to the change in the feed.”
“Will she die?” the girl asked, her voice hitching in fear.
In a worst-case scenario, the ulcers could burst, causing a gastric hemorrhage and death. Hilda seemed perilously close to that stage.
“We need to wait and see,” he hedged. “If the tests come back positive, there are medicines I can give Hilda to help reduce her stomach acid. That will help give her stomach a chance to heal. We’ve also got to get food and fluids in her so she has the strength to heal. Ultimately, though, it’s up to Hilda.”
The girl’s brown eyes swam with tears. Discomfort prickled across Prem’s skin. The family seemed to want some sort of reassurance, but Prem couldn’t promise any miracles.
“Hilda’s a fighter,” Layla spoke up just behind his shoulder. “And Dr. Dhawan is an incredible vet. Hilda is in the very best hands possible, I promise you. We’ll do absolutely everything we can for her.”
Layla stepped forward and wrapped the daughter in a warm hug. The mother smiled, and the young man’s shoulders dropped from his ears.
How did Layla do it? Prem wondered in awe. How did she seem to know exactly what to say and do? It was like she could read a person’s soul and give them exactly what they needed.
Magic, Prem thought to himself. Magic and utterly magnificent .
*
Hilda’s ultrasound ruled out GI obstruction, intussusceptions, and peritonitis, as Prem had expected. It did show what looked to be a range of ulcerations. The only way to be sure was an endoscopy.
The pig was too large to easily move into the back area of the clinic, so she remained on the table in Exam Room 1 under the largest heated blanket the clinic owned. After Deja administered a mild sedative, Prem gently guided the camera down Hilda’s throat and into her upper GI tract. Just as he suspected, the video feed showed a range of ulcers dotting the pig’s stomach and upper GI tract. Some of the ulcers looked particularly bad.
Well, at least he had his answer. And a possible solution.
“Proton pump inhibitor therapy,” he said to Deja. The medicines were the best way to lower Hilda’s stomach acid content and give those ulcers time to heal. “We also need to get some food in her and set up a morphine drip for the pain.”
Today would be crucial. If Prem could lower the pig’s stomach acid, and if she survived the night, she’d most likely recover.
The day didn’t so much fly by as hurtle forward, seemingly propelled by rocket fuel. Prem checked on Hilda whenever he could grab time between appointments. Miraculously, his schedule adapted to Hilda’s care. His appointments for serious issues continued flowing into the clinic while his wellness exams evaporated, reappearing again on next week’s schedule.
It was Layla, of course. She seemed to know exactly how much work he could handle and which appointments still needed to be seen today while giving him just enough time to manage Hilda’s care.
At some point, Deja disappeared, replaced by Kate, who was finally able to coax a soupy mix of critical care high-calorie feed into Hilda. Somewhere along the way, the windows of the clinic grew shadowed then darkened into night. The appointments gradually slowed until the last patient, a cocker spaniel with cataracts, left the building with a removal surgery on the books in two weeks.
Kate performed one more check of Hilda, shrugged into a light jacket, then headed out with a gruff goodbye. Prem managed a nod in her direction as the back door swung closed. Then he dragged himself into Exam Room 1. His hip throbbed.
As if all at once, a blanket of quiet fell over the clinic. From the exam table, Hilda stared at him with groggy eyes. Her respiration was smoother, her pulse steady. She seemed to be resting easier with the help of morphine and, hopefully, the proton drip.
Prem stroked the short, bristly hairs of Hilda’s forehead. “I think you just might make it,” he whispered to her just as his eyes landed on a mangled yellow toy tucked next to Hilda. He picked up the battered, grinning banana and studied it in confusion. He squeezed. It let out a tired, whooshing squeak.
“That’s her favorite toy,” Layla spoke behind him.
Prem hadn’t realized she was still in the building. But of course, she was. He practically had to kick her out each night.
“The family came by this afternoon when you were in with another patient,” Layla explained, stepping up next to him at the exam table. “They dropped off her toy and her favorite blanket.”
She picked up a thin, flannel piece of cloth from the table that looked like a napkin next to the huge pig. “Can you believe they used to wrap her in this?” Layla’s gentle smile sent zaps of electricity through Prem’s tired body. “Here, look. The family brought this, too.”
The framed picture she lifted from the counter showed a gangly boy standing next to a chubby toddler in a pink jumper. The boy beamed proudly as he held a tiny piglet in his arms.
“That’s Hilda,” Layla said. “Amazing, right?”
Prem took the picture from her fingers and studied it. “She must mean a lot to this family.”
“She’s their baby,” Layla confirmed. “I remember when she was half this size, and they would walk her into the clinic on a dog harness.”
Prem smiled as they both bent their heads over the picture. When he looked up, he realized how close Layla stood to him. He could reach out and stroke her face, run his thumb over her lush lips, or wrap his hand around her golden braid and gently pull her into his body.
Fire ignited through him. Dangerous fire that licked through his veins and crackled across his groin. He stepped back, frowning and held the picture out to Layla.
“Thanks for showing me.”
As she accepted the framed photo, her eyes darted up to his and then back down. Could she read his expression? Feel the heat of his desire? Prem tried desperately to school his face, clenching his teeth.
“I’ll, uh, go work with Sunny,” Layla said, placing the photo back on the counter.
“Good,” Prem answered, his throat suddenly dry. “Good,” he repeated.
When she left, he tucked the ancient banana toy next to Hilda and dropped into a plastic chair next to the exam table. Switching on his tablet, he studied the patient files from today’s appointments, updating notes, reviewing blood panels, and researching a few conditions and treatment protocols he wanted more information about.
“Here.”
A brown bag appeared in front of him. Prem nearly startled out of his chair. Layla stood inches from him. Had the woman been a cat in another life?
“What’s that?” Prem stared at the bag she held.
“Your lunch.”
At these two magic words, pangs of hunger clawed his empty stomach. In all the madness of the day, he’d completely forgotten to eat.
“Thanks.” He took the bag.
“Whatever’s in there smells divine,” she said.
“It’s sabzi,” he answered carefully.
“Sabzi,” Layla tried out the word.
“A vegetable curry over rice. It’s my mom’s recipe.”
“Wow. That sounds delicious.”
Prem studied her face. He didn’t think Layla was making fun of him, but his nerves jangled with wariness even after all these years. Growing up, the other kids at school mercilessly mocked his lunches. The food his mother made was “gross,” “smelly,” or would inevitably cause “Delhi belly.”
Prem burned with shame, remembering how he’d finally put an end to the taunting by tossing his lunch in the trash every morning as soon as his mother drove away from the school. He’d used his allowance to buy from the cafeteria instead, filling his body with Doritos, Pepsi, and oozing sloppy joes instead of defending his cultural heritage. He hadn’t been the only Indian kid at school to bow to the pressure of social conformity. Didn’t make it right, though.
“Why don’t you eat your lunch in the break room? Get off your feet a bit,” Layla said. “I’ll watch Hilda.” Her soft, gentle voice brought him back to the present. She leaned against the exam table, stroking Hilda’s head.
That sounded… amazing. “You sure?” he asked.
“I’ve known Hilda most of her life.” Layla scratched under the pig’s chin, causing Hilda to grin in that silly way only pigs could manage. “She’s my friend.”
A few golden wisps of hair had escaped Layla’s braid and floated around her face. Magic and magnificent, Prem thought again. The vision of her smiling down at the pig filled his heart, stretching the delicate coronary tissue so much it almost hurt.
“Thanks,” he said gruffly, pushing himself to his feet and striding into the back.
The sabzi, once heated, tasted divine. He felt like a character in a video game, the depleted energy bar hovering over his head slowly filling with each forkful he ate. After finishing the sabzi and an apple he’d also thrown in his lunch bag, he returned to the exam room.
Layla still leaned against the table, stroking Hilda’s face and humming softly. Stitched sunflowers dotted her mid-length jean skirt, and her sequined sandals winked in the overhead light. The pig continued to grin, moving her head this way and that to allow Layla to find just the right spots.
Prem’s heart stretched and stretched.
“I think you’re going to make it,” Layla whispered to Hilda.
“I was thinking the same thing,” Prem spoke. She looked up and offered him a shy smile as he joined her at the exam table. “You really have a way with the patients. Ever thought of becoming a vet tech?”
Bitterness ate through the melody of her laugh. “Dr. Goldman thought the same thing.” Her hand dropped from Hilda’s forehead. “I actually did enroll in a vet tech program a few years ago. Didn’t finish it, though.”
“Why not?” he demanded, a little too gruffly.
Layla turned her face away from him. “My fiancé didn’t like all the time it took. He made good money, so he said I didn’t need to advance my career.”
Prem gritted his teeth. What an utter douchebag. “But what did you want?”
Layla finally looked at him, her eyes round and filled with regret. Prem fought the urge to eliminate the space between them and take her in his arms. He wanted to destroy that sadness in her eyes. Shoot it with a bazooka.
“What did I want?” Layla whispered his question. “I wanted to make my fiancé happy.” She laughed again. “You must think I’m so foolish.”
“No.” The word barked out of him. But I do think your fiancé is a dick. He didn’t say those words out loud. It wasn’t his place. Wasn’t his business in the slightest, though his hands had curled into fists for some reason. “What I think is that you’d make a great vet tech, and it’s never too late to go back to school.”
And you’re not wearing that atrocious engagement ring anymore, he added silently. So I hope to every God in the universe that you’ve kicked that asshole to the curb where he belongs.
Layla’s smile tightened. “All I really want is to help animals, which is what I get to do here.”
It was a cop-out. Why was she downplaying her clear skill and talent? Disappointment filled Prem. Not your place. Not your business, he reminded himself, though the thoughts curdled in his stomach.
“Well, thanks for letting me grab a break,” he said into the awkward silence. “I can take it from here.”
Though Hilda seemed to be moving in the right direction, anything could happen during the night. She would need more fluids and food if he could manage to get her to eat. And if she took a turn for the worst, he wanted to be there regardless. No pet should ever die alone. And they wouldn’t at his practice. Not if he could help it.
Layla pursed her lips. “Are you sure? I can call Deja and Kate. We’d all be happy to take shifts watching Hilda tonight.”
Prem grimaced. Tag-teaming an all-nighter would be a huge help, but he couldn’t afford to pay his employees for the extra hours, especially at the higher rates they would expect for a night shift. His first payment to his parents was due at the end of the month, and he’d burned through the entire loan to upgrade the clinic’s equipment and software. He’d even dipped into his minuscule retirement account to buy the new dental laser.
As if reading his mind, Layla said, “You wouldn’t have to pay any of us. We all love Hilda. We would help Dr. Goldman with overnight patients all the time. The poor man would fall asleep on his feet sometimes. It’s what you do for family.”
Prem dropped into the chair, trying not to overtly favor his right hip. “Thank you, but I’ll be fine.”
How many times did he have to tell her? This practice was a business, not a family. Even if his employees were willing to help him out for free now, what if they demanded back pay in the future? What if he had to fire one of them, and they turned around and accused him of unfair labor practices?
No. It was simply too risky.
Layla’s eyes clouded with disappointment. “Okay, if that’s what you want.”
Through the open door of the exam room, Prem watched her collect her massive purse from behind the reception desk. For some reason, her disappointment hurt him. He leaned back in his chair and blew out a long breath.
His feelings for Layla were magma. And just as dangerous. If he got too close, he’d get burned.
Badly.
She walked into Exam Room 1 and gave Hilda a soft kiss on the cheek. “See you tomorrow, my love,” she whispered.
Prem almost groaned as heat shot to his groin. He ached for those words, those lips, that gentle, loving kiss to be for him. How the hell was he going to run an effective veterinary practice with her constantly stirring up his insides?
“Goodnight, Dr. Dhawan,” Layla said softly as she left the room.
Prem listened as the back door scraped open then shut with a soft thud.
“Goodnight,” he whispered into the empty clinic.