Perfectly Honest (12 page)

Chapter 20

Zodiac Zach
—
Don’t leave home without him.

ARIES (March 21-April 19) Be strong as others look to you for support. Don’t limit what you can do or question your worth because of an emotional situation. You will gain respect through your actions.

Mikaela waited until Monday morning to drive back to Emerson. Her clinic didn’t start until nine o’clock in the morning, the forecast was clear so the roads would be dry, and it meant she could avoid any possible awkwardness for another night. Just in case. She knew she was being a chicken, but convinced herself that it was cautious, even wise. Mikaela texted Sam to let him know she wouldn’t be back on Sunday night and then spent the night tidying her condominium in case it was another month before she returned.

At seven a.m., Mikaela wrote a quick note of thanks to the neighbor who brought in her mail, lowered the thermostat, and with a sigh of regret, locked the door behind her.

The sun was shining and glistened off the snow-covered trees that lined the highway. Traffic was light and the roads dry, so she cranked up the radio and sang along, out of tune, making the time pass quickly. She drove directly to the hospital and made it there in under an hour.

Mikaela looked forward to the day. She had prenatal clinics booked all day, and with the nurse running two patients ahead of her, it usually went smoothly. There was a good chance the clinic would finish on time, maybe even with a break for lunch.

The day passed quickly. Only one patient left and she could head home to Sam. Mikaela pressed a hand to her stomach to settle the butterflies fluttering at the thought of being alone with Sam again. It had only been four days, but she missed him. He usually had dinner waiting for her on Mondays and she wanted to sit down, share a bottle of wine, and hear about his day.

Would she move back into her own room? Did she want to? She thought fleetingly of his hard body pressed against her and the soft kisses that made her knees go weak. He took her breath away and stole her heart.

But until the butterflies settled, she preferred to keep things as they were. He didn’t need to know how he affected her. All she had to do was keep the picture of a naked Sam out of her mind, and she would be fine. She just wished that wasn’t getting harder to do.

Mikaela reviewed her notes for the last patient. Joanne Sycamore. Age thirty-six. First pregnancy. Expecting twins. Joanne was thirty-four weeks along and had been coming in every two weeks for prenatal care, usually accompanied by her husband, Rob.

At the most recent visit, one week ago, Mikaela had raised concerns about the size of one of the twins, and Joanne had broken down in tears. She’d lost her twin brother at the age of twelve in a motor vehicle accident.

The brother and sister had been inseparable, and twenty-four years later, Joanne still grieved his death. She had a deep-rooted fear of the same thing happening to her babies and was very particular, almost obsessed, with doing everything she could to ensure a healthy outcome.

Paula, Mikaela’s nurse, came out of the examining room. The worried frown on her face was not encouraging. “Her urine screen and blood pressure are fine, but her weight is down two pounds, and I can only get one fetal heartbeat.” She pressed her lips together. “Joanne is . . . upset.”

Mikaela nodded. “I’ll go and examine her. Bring the ultrasound in, and we’ll take a quick look. Maybe you should give the OR a heads up, too.”

Paula nodded and headed off as Mikaela entered the room.

Joanne looked up with damp eyes. “The nurse said she could only hear one baby’s heartbeat. For the last two days, they haven’t been as active,” she said as she wiped tears from her cheeks. “I thought maybe it was just getting crowded in there. I didn’t think to come in.” She covered her face with her hands.

“Joanne, try to stay calm,” Mikaela put her hand on Joanne’s shoulder and spoke in a low voice. “Let me examine you, and we’ll do another ultrasound and see what’s happening.”

Mikaela examined and measured the size of Joanne’s uterus and then picked up the Doppler to listen to the heartbeat. She moved the probe from one quadrant to another and caught and counted one fetal heartbeat. It was a strong one hundred and forty-two beats a minute. Mikaela’s heart sank as she moved the probe around and heard only silence. Paula knocked on the door and pushed the ultrasound machine in.

“Let’s do another ultrasound, Joanne,” Mikaela said.

Mikaela set up the screen, adjusted the image, and scanned Joanne’s abdomen. She focused on the healthy twin first, measuring its size and noting the strong heartbeat. She paused as she found the second twin. Its size was unchanged from a week ago, and even scanning from a different angle, Mikaela could not see a heart beat. The baby had died in utero.

Mikaela set the probe down and pushed the machine to the side. She wiped the gel from Joanne’s abdomen and lowered her gown.

She watched tears stream down Joanne’s face, as she looked her in the eye. “I’m so very sorry, Joanne. I can only find one heartbeat. The smaller twin has died.”

“No,” Joanne cried, covering her ears. “I don’t want to hear that. I don’t want it to be true. No. No,” she pleaded.

Mikaela looked at her helplessly. “I’m sorry.”

Joanne covered her face as she sobbed.

There was a quiet knock on the door, and Paula poked her head in. “Her husband is here.”

Mikaela motioned for her to let him in.

A tall man with a rumpled suit, loosened tie, and harried expression hurried into the room. He glanced at Mikaela and gathered his wife in his arms.

“I’m sorry, Rob, one of the twins has died,” Mikaela said quietly.

“Oh.” Rob sighed heavily and with a look of utter sadness, closed his eyes and kissed the top of his wife’s head. “I’m so sorry, honey,” he whispered.

Joanne buried her head in his shoulder as her small frame wracked with sobs.

“I’ll give you a few minutes alone,” Mikaela said to them.

Rob nodded as he held his wife.

Joanne would need an urgent Cesarean section to deliver the other twin. Mikaela wrote the orders and reviewed the chart. She flipped to the clinic notes from the last visit and, with a frown, wondered why there was no record of the babies’ heart rates. She made a mental note to review the chart more closely after the surgery. More pressing was breaking the news to Joanne about the C-section. The operating room was ready and the pediatric team on hand. Things had to move quickly.

Mikaela pulled off her surgical gown and threw it in the linen hamper. She peeled off her gloves and tossed her mask and surgical cap in the bin outside the surgery. One baby had been sent to the morgue, and the other was in the neonatal intensive care unit. He was six weeks premature but was a good size and had a good prognosis. Joanne was already in recovery with her husband by her side. Mikaela needed to check on her one more time before she left for the evening, but technically everything had gone well.

Wearily, Mikaela sat to write the post-op orders. Just the basics tonight. Tomorrow when she did rounds, she would talk to Joanne about counseling and see what would be helpful. But tonight Joanne needed to rest and start to heal.

It was late and the hospital was quiet as Mikaela made her way to her office. She glanced at the stack of papers in her inbox, but couldn’t summon up the energy to go through them. That could wait another day. She shrugged into her coat, tugged on her boots, and made her way slowly to her car.

Sending a tiny little person to the morgue was heartbreaking. It happened, Mikaela knew. Even when they did everything right, with all the technology at their fingertips, it happened. Was it genetics? A virus? She sighed. Shitty luck? Who the hell knew? It didn’t make any difference to the mother. Once they felt the flutter of life inside them, the death was devastating. And when she had to write ‘development incompatible with life’ on the death certificate, her heart broke as well.

Mikaela felt her eyes fill as she pulled into the driveway. She knew she couldn’t get wrapped up in it and had managed to hold it together for Joanne and Rob. But now, alone, in the silence of the night, she could shed a tear for the little life that she had to pronounce dead at its birth. She would never get used to it.

Mikaela wiped her eyes, gathered her briefcase, and stepped out of the car. Damn. She had forgotten to text Sam to let him know she’d be late. She had remembered as she closed the incision, but had forgotten again by the time the surgery finished. Sighing, she went inside.

Chapter 21

Written in the Stars by Esmeralda Garnet

ARIES (March 21-April 19) Leaning on others doesn’t make you less strong. An unexpected surprise lightens your day. Love is highlighted.

Mikaela hung up her coat, shed her winter boots, and wandered into the kitchen. She peaked under a dish covered with aluminum foil and found lasagna, topped with melted cheese. She could smell the basil and garlic. It was her perfect comfort food. First she would find Sam, apologize for not calling, and change into comfy clothes.

Mikaela poked her head into the family room and found it empty. She wandered down the hall to the study.

Sam was bent over his desk reading and looked up when she came in. “Hi,” he said. “You’re home late.”

“I am. Sorry for not letting you know,” she said quietly.

“No problem. There’s lasagna, if you haven’t eaten.”

“Thanks. I haven’t. I’m just going to change, and then I’ll get it.”

Sam saw dark circles under her eyes and traces of tears she hadn’t quite managed to wipe away. “Rough day?”

Mikaela shrugged. “Rough ending to the day.”

“Come here.”

“What?”

“Come here.”

Mikaela moved closer, and when Sam held out his hand, she placed hers on his. He gave a tug, and she fell into his lap. She was so surprised she started to get up.

“Relax,” Sam whispered.

With a sigh, Mikaela did just that. She closed her eyes, rested her head against his chest, and listened to the steady beat of his heart. He wrapped his arms around her and rubbed her back as the tension of the day melted away.

“Do you want to talk about what happened?” Sam asked after a few minutes.

“A twin died at birth.”

Sam hugged her close. “That would be tough.”

Mikaela blinked tears away and nodded.

“How’s the mom doing?”

“She’s not taking it very well. Obviously it was a shock, and then she had to be rushed to the OR to save the other twin. He’s in NICU, but he looks good. Technically, the surgery went well.”

“And how are you doing?”

She sighed. “I’m okay. Just sad.”

“Shit happens. You can be the best doctor out there and do everything you can for the best possible outcome. And still, shit happens.”

Mikaela felt a fresh wave of tears and blinked rapidly to stop them from falling. She hugged Sam close. He probably didn’t even realize how much his faith in her, what his simple acceptance and understanding, meant to her.

“Thanks,” she said, when she could speak again. “I know that. When I look at everything with a critical eye, when I consider all the options and ways this could have been handled, I know in my head that the outcome wouldn’t have been different. If anything, the health of the other twin could have been compromised. I know that. But it was such a tiny life. And the family will never be the same.” She sat quietly listening to the soothing sound of his heartbeat.

“At first when I looked at the chart I couldn’t find vitals from the last visit. But they were there. I’ve gone over everything in my head, and nothing we could have done would have made a difference. But I’m going to grieve for a time.” She closed her eyes and inhaled the earthy scent of his skin.

“I’m here if you need a shoulder to lean on,” Sam said as he brushed a lock of hair from her face. “For as long as you need.”

Mikaela leaned back and looked at Sam. “Thank you,” she whispered and pressed her lips to his.

Sam stirred and deepened the kiss. He pulled back and rested his forehead on hers. “You’re welcome. Why don’t you go change, and I’ll heat up some dinner for you. Mrs. Davy makes a mean lasagna.”

“That sounds wonderful.”

Sam’s hands spanned Mikaela’s waist as he lifted her off his lap. The causal brush of his hand against her breast caused Mikaela’s heart to skip as she rose unsteadily to her feet. She looked away and hoped he hadn’t noticed her reaction.

Mikaela walked into the guest room automatically, but finding the closet empty, remembered her clothes were still in Sam’s bedroom. She went to his room, and the tangled sheets and tousled covers made her imagine Sam in bed. Naked. Focus, she chided herself and changed into soft pants and a sweatshirt. Mikaela splashed cool water on her face and ran a brush through her hair. She’d have to deal with her stuff later. Right now she was ravenous.

Sam set a plate of garlic toast beside a bowl of steaming lasagna at the kitchen table. He poured them each a glass of wine and sat down across from her.

“Thank you. This looks lovely.”

“My pleasure. Mrs. Davy is a great cook. And her lasagna is a specialty.”

Mikaela smiled and dug in, moaning with pleasure at the roasted vegetables, melted cheese, and fresh pasta. “Delicious. Did your parents get off okay?”

“Yep. They left on Sunday afternoon. They were hoping to get a solid five hours of driving in on Sunday, stop for a good night’s sleep, and have a longer day today. Just before you came in, I heard from them and all is well.”

“That’s great. I enjoyed meeting them.”

Sam smiled. “They enjoyed meeting you, too. They were sorry you didn’t stay the weekend and hoped you didn’t leave because of them?”

Mikaela winced. “Well, not directly. What did you tell them?”

“Oh, just that you had stuff to do at your condominium and that you had been working pretty long hours since you got here. You hadn’t had a chance to go and check on it until now.”

“They were okay with that?”

“Yeah, they were fine. They’re pretty easy going. Although, my mom did ask me about the wedding several times. I just deferred to you. I’m sure she’ll be in touch,” he said with a grin.

“Great.” She took a sip of wine. “Does it bother you to lie to them about us?”

Sam shrugged. “I don’t know. You never know what the future will hold. How was your weekend?” he asked, changing the subject.

“It was good. Margo came over for pizza and a movie on Friday night, and on Saturday we went out to a little club. A med school classmate is a sax player in a jazz band, and we went to see him. The band was good.”

“Sounds like it was busy.”

“Just busy enough.” She broke a piece of garlic toast in half. “Margo had to work early on Saturday and Sunday so we had early nights. But it was fun to see her again. And I had a chance to clean the condo and deal with the mail. It was . . . productive,” she said, wiping garlic butter from her chin. Also a bit lonely without him, she thought, but didn’t have the courage to tell him.

Mikaela scooped the last of the lasagna from her plate. “That was delicious,” she said, setting down her fork.

“Would you like some more? There’s more in the fridge.”

“No, I’m full. That feels a lot better.”

“Did you eat today?”

“I had lunch, but it seems like forever ago.”

Sam nodded. “I have something for you.”

Mikaela raised questioning eyebrows when Sam disappeared to the study and returned holding a small bag. He handed it to her.

“Did I miss an occasion?” she said, taking the bag reluctantly.

“It’s an unbirthday gift.”

Mikaela laughed. “I love unbirthdays!” She opened the bag and slowly pulled out a bobblehead doll. She burst out laughing. “This is great.”

“I thought it would be a fitting tribute to you for taking on the headship.”

“Sir William Osler as a bobblehead. He’s probably rolling over in his grave.”

“What? It’s an honor. Being a bobblehead is the highest form of flattery.”

She took the doll from the package and set it on the table, watching its oversized head bounce agreeably. She had to laugh. “I’ll take it to work and put it on my desk. His words ‘First, Do No Harm’ always run through my head when I’m trying to figure out what to do with a patient. I’ll try to aspire to his greatness. Thank you, Sam.”

“You’re welcome. Maybe some day there’ll be a Mikaela Finn bobblehead.”

“Something the world could definitely do without.”

He laughed. “I was just going to watch a hockey game on TV. Would you like to join me?”

“That would be nice.”

They picked up their wine glasses and headed to the sitting room. Sam flicked on the television and sank down on the sofa. He put his feet up and tugged Mikaela’s hand, pulling her down beside him. Mikaela sighed and curled up beside him, tucking her feet up under her, and resting her head on his shoulder.

Sam kept his arm around her and rested his cheek on her hair. He missed her the last few days. He missed sharing meals and sharing the ups and downs of their day. When she didn’t come home for dinner and didn’t text, he had a moment. He hadn’t been absolutely sure she would come back at all. It had hit home that she really didn’t need to. She could live in Rivermede and commute. No one would be the wiser, and their ‘engagement’ wouldn’t be compromised. But it didn’t sit well with him at all.

At the start, he was sure they would tire of each other and the charade. It was a means to an end, full stop.

It may have started that way, but slowly, over the last month, the ‘end’ had changed. He wasn’t looking to keep up appearances for his job. The job was fine, but he was still frustrated and disappointed with the operating time. What he had with Mikaela was the opposite. He enjoyed her company and couldn’t wait to see her at the end of the day. For the first time, he actually thought about settling down, making the engagement real, and spending his life with one woman.

Funny how the idea of spending the rest of his life with one woman never even entered his airspace in the past. Now, the notion of Mikaela not wanting to be in his life squeezed his chest in a vice grip. He was pretty sure Mikaela didn’t think of him as husband material, and he could hardly blame her. Hell, he didn’t think of himself as husband material, until just recently. But, he had to admit, when he heard her car drive up, it was a wave of relief that gripped his gut and had him closing his eyes and taking a deep breath of reprieve. Sam figured he had to take it slowly, for both their sakes, but in his mind, there was a definite shift toward a new goal.

“Who’s playing?” Mikaela asked drowsily.

“Boston and Chicago,” Sam replied.

“Which team is which?”

“Boston is black and gold. Chicago is red and white.”

“Hmmm. Which team are you rooting for?”

“Uh. I’m not a die-hard fan of either. Probably Boston though.”

“Oh, okay then. Me, too. Go black and gold.”

Sam chuckled. A few minutes later, he listened to Mikaela’s steady breathing and looked down to see her features relaxed in sleep. Long lashes brushed her cheeks. Gently stroking the dark circles under her eyes, he thought how lovely she was. She was flourishing in her new role. She had taken to it like a duck to water and seemed to enjoy the different aspects of her job — the clinical work, administrative responsibilities, the meetings. He heard snippets of conversation about her around the hospital about her knack for soothing ruffled feathers, her energy. They loved the new design and her unique ideas. She was positive, never said no, always listened.

Mikaela had found her niche and Sam envied her that. He wished this move had gone that way for him and tried to blow away the disappointment. He should have known it wouldn’t be an easy path when it was so difficult to get there. Despite putting pressure on his department head, getting more operating time didn’t look promising.

He needed to operate, not only for his patients’ sake, but to keep his skills sharp. He picked up extra days here and there, and so far that was working. But it was tedious to cancel a clinic full of patients every time he grabbed a half-day of operating time. It wasn’t fair to patients, especially when they were bumped to a new day. Some were starting to complain, and he didn’t blame them. So yeah, that end had been disappointing. He hoped the hardest part was behind him.

Sam sat quietly, enjoying the feel of Mikaela in his arms. She was warm and soft and slept quietly. She wouldn’t have stayed cuddled so close for so long if she had been awake. She was still tentative with him, especially if he tried to get close.

The game finished so Sam switched off the set. Mikaela didn’t stir. He twisted around, and hooking his arm under her legs, he carried her to his bedroom. He set her gently down and covered her with a warm comforter, tucking the edges around her. He looked at her for a long time before getting ready for bed himself.