The Passion of Patrick MacNeill (23 page)

The senior surgeon checked, as if he suspected her of some deeper meaning, and then inclined his silver head.
"Always a pleasure to advise you on your technique.
You have a nice, light touch."

Two compliments in one morning? Now Kate was suspicious.

Swaim turned his hands to run water under his nails. "I'll want you to assist on the MacNeill case next week," he added.

Her heart stopped. The water hissed into the sink.
The MacNeill case?
Jack? He didn't need that surgery. He shouldn't have that surgery. And yet against her advice and in spite of Billy's quick acceptance of Jack's scars, Patrick must have scheduled it. He'd ignored her opinion. She was so far outside the link he shared with his son that he hadn't even bothered to tell her his decision.

Hurt flared in the pit of her stomach. She swallowed it. Swaim was waiting for her answer. And Jack's well-being depended on her response.

Carefully, she rinsed the foam from her hands.

"Are you sure," she asked cautiously, "that the operation is in the patient's best interest?"

"Boy can't live with the scar."

"He can. He does. He's not severely disfigured."

"He's not your patient, Dr. Sinclair."

Kate winced at the posted limits. Damn. She didn't want to alienate the director. Not only was it politically unwise, she was reducing her chance to make him listen to her. And since Patrick would not, she needed to convince Swaim to delay this surgery. She reached for a sterile towel.

"I understand that. But don't you think it would be better to wait until Jack is older? Won't the results be compromised by his picking at the sutures afterward?"

"His compliance with his postoperative care is not our responsibility. It's our job to make him better."

She wanted to agree with him. Her whole career rested on her determination to succeed, to make things better for all her patients. Yet Patrick's words rang in her head.
Your patients deserve a doctor who will treat them with her heart as well as her hands and her brain
. "It's our job to treat the whole child."

The director of the burn unit glared at her. "It's not up to you to make that decision."

Heavy on the air hung the implicit threat:
It's not your job at all.

Kate
swallowed,
sick at the risk she was taking. But there was one decision she could make.
Had to make, in Jack's best interest and for the sake of her own integrity as a physician.
"I won't do it. Please don't ask me to do it."

Underneath his sterile cap, Gerald Swaim's face stiffened. "I have to assume you are withdrawing from the procedure because of your personal involvement with the patient."

Bleakly, Kate reflected that if she were truly involved personally in Jack MacNeill's life, they wouldn't be having this discussion. "Are you asking me if I'm seeing Jack MacNeill's father?"

"I don't have to ask. I've been at this hospital a long time, far longer than you. I'm well acquainted with the hospital grapevine."

Her hands were shaking. She hid them in the towel. "I see."

Swaim's aristocratic face softened slightly. "To be frank with you, Kate, I understand
your
having difficulty performing the procedure if you've developed a friendship with the boy."

She looked up, in disbelief and hope. Was he actually prepared to accept her involvement and her judgment?

He went on. "Certainly, I prefer that explanation to the possibility that you're flouting my authority."

The hope died. He might be offering her an unexpected out, but for Jack's sake, she couldn't take it.

She twisted the towel in her hands. "My personal relationship isn't the problem. I don't think the operation is appropriate at this time."

Swaim's eyebrows climbed to the edge of his cap. "You're refusing to do it?"

Crazy, stupid, foolish risk.
It flew in the face of years of purposeful effort and circumspect decisions. Officially, her fellowship ended in three short weeks. As a pediatric surgeon, Kate could write her own ticket anywhere. But to stay at
Jefferson
, doing the work she loved at the hospital where she'd trained, she needed Gerald Swaim's goodwill. She needed to be offered a slot as an attending physician.

Kate thought she'd proved her usefulness in the last few months, as the director left more and more of the procedures to her. But she was relatively young and still highly expendable. She didn't kid herself that she had any influence with the Board or the chief of surgery. If Gerald Swaim decided she was no longer useful to him, she was out.

"Well?" Swaim prompted impatiently.

Her mind skittered like a squirrel on the road faced with an inevitable collision. How could she refuse and risk her chance of staying at this hospital, near her family? And yet how could she agree, when doing so violated both her medical judgment and little Jack's trust?

Dammit, why hadn't Patrick consulted her before he agreed to this procedure? Why hadn't he listened to her?

Kate drew a short, sharp breath. "I… Yes."

Swaim stared her down.
"You mean, you'll do it."

"No," Kate said miserably. "I mean, I refuse."

Swaim threw his towel into the sink. "You know you're not irreplaceable."

She lifted her chin, accepting both the judgment and the implied threat. "I know."

"I can still do the operation myself. Roberts can assist."

Kate didn't point out that Swaim had excused himself from such procedures for weeks. What good would it do? If Patrick were determined to seek this operation for his son, he would find some surgeon enchanted with his own abilities willing to do it. Whatever the risks to her job, whatever the hurt to her heart, she had to see Patrick and convince him not to go through with this.

"That's your choice, of course."

Swaim shrugged.
"Very well.
Let's not deprive
another
little boy of your expertise, Dr. Sinclair. Your patient is waiting. If you're ready…?"

Kate flushed. Swaim was being unfair. But because, in her own way, she was as good at repressing her feelings as Jack's father, she buried her hurt and anger and burning sense of injustice. She thrust her hands into her gloves.

"Quite ready," she said stiffly, and went in to operate.

* * *

The white farmhouse glimmered through her windshield like water at the end of a long, dry day, but Kate felt no freshening of spirit at the sight, no promise of relief. She bumped down the graveled road, her throat tight and her gut churning. Half-sick with tension, she pulled in front of the house and cut the car's engine.

The door swung open. Patrick strode onto the porch, his shoulders broad beneath his white knit shirt and his voice warm with welcome. "Kate!"

She wanted to be angry with him. But faced with the reality of those wide shoulders and that potent grin, she had to fight the urge to lay her head against his hard chest and sob out her worries and complaints. He wasn't to blame for disregarding her judgment in the face of Swaim's advice, even if his dismissal struck at the heart of who she was. It wasn't Patrick's fault that she'd duped herself into believing that she meant something more to him than a second medical opinion. She was the one who'd misread their situation, weaving foolish dreams around a few shared confidences and some incredible sex.

Patrick hadn't deceived her. She'd deluded herself. It was a bitter pill to swallow.

She got out of the car. "Hello, Patrick."

He checked halfway, his shoulders tensing, before he continued slowly down the steps.
"Problem?"

She remained by the car, resisting the pull of his closeness, resenting the advantage his height gave him. "You could say that." She glanced toward the house. "Where's Jack?"

"Watching TV.
What is it?"

She fiddled with her purse strap. "Could we talk?"

"Sure." He raised his voice, his gaze never leaving her face. "Jack! I'm walking Dr. Kate down to the fence. Stay put, buddy."

A muffled shout from inside the house signaled Jack's compliance.

"Okay. Let's go." Patrick descended the last step, reaching for her hand.

Her insides aching, Kate pretended not to see. If he touched her, she would never get through what she had to say. His hand dropped.

"This way," he said shortly.

She fell in beside him, her sensible shoes silent on the soft, moist ground, her footing uneven. Somewhere overhead, a bird chuckled and was still. Before them, the field stretched gray and green in the late afternoon sun to the shadowed line of woods. The breeze, rich with dirt and growing things, stirred the branches of the trees and Patrick's hair, and cooled Kate's hot cheeks. But the sweetness of the scene did nothing to restore her peace.

Patrick propped his elbows and one foot on the split rail fence and waited.

"Well?" he asked at last.

Kate drew a deep breath, her hands tightening on her purse. "Swaim asked me today if I would operate on Jack's face."

He looked surprised. "I asked you that myself.
Before the visit to your sister's."

"And I suggested it would be better to wait."

"Yes. But Swaim told me to go ahead and schedule the surgery."

"And you didn't think you should discuss it with me first."

He took his foot off the rail, straightening defensively. "I didn't see the need."

No, of course not.
Wounded pride flayed her soul. The bitter memory of
Wade's
expedient desertion haunted her. Nothing Patrick could have said could have demonstrated more clearly how inconsequential she was in his life.

"Because I'm not Jack's doctor?"

"Well, yes. Swaim—"

"Or because I'm not his mother?"

Patrick was silent.

Her hand curled around the purse strap until her nails dug into her palm. "Then, what am I?" she forced herself to ask. "Somebody you sleep with, your girlfriend, what?"

He jerked his head impatiently. "I don't do labels, Kate. You don't need one."

But she did. Oh, she did. If not a label, then at least some assurance that he regarded her as more than a convenience.

Her heart tore. She staunched the internal bleeding and went on. She had to, for Jack's sake.

"Look, I know this challenges your father-knows-best routine. But speaking as a doctor, the risks of this surgery out-weigh the benefits. Multistage reconstruction on the external ear alone is going to take three to four operations. Every time you put Jack under general anesthesia, you have to consider the outside possibility that he will die as a severe complication of the surgery. He should have some say in that decision."

He turned away, rejecting even the idea.
Rejecting her.
"He's not going to die."

"Probably not," Kate agreed, fighting to keep her voice even. "But do you really want to take that risk?"

He swung back to face her, blue eyes blazing. "If the alternative is Jack living with the scar for the rest of his life—"

She stood her ground. "Not for the rest of his life. For four or five more years, until Jack can decide what he wants done. Because he won't understand now that he won't wake up from this surgery as good as new. A surgeon, even a good surgeon, even me, might not make a difference a child can see and appreciate." She put her hand on his arm, pleading now. "Wait until he's older. Wait until he can decide."

His face was stony. "He shouldn't have to face that kind of responsibility."

Frustrated, she snapped, "You mean
,
you don't want to give up that level of control."

He shook off her hand. "You don't know what you're talking about. He's my son. I have to make him better."

She honored him for his caring. She agonized for him in his misplaced determination. But she couldn't stand by and watch him batter himself against the wall of things he could not change. "You can help Jack get better," she agreed carefully. "But you can never make it as if the accident never happened."

He glared at her. "Of course it happened. But Jack needs to get on with his life."

He wouldn't tolerate her interference in his decisions regarding his son, Kate thought in despair. And he wouldn't see how those decisions were shaped by his needs as much as by Jack's.

"He is getting on with his life, his life with his face the way it is. You're the one who can't accept his scars. Maybe you need to get on with
your
life."

Patrick froze. "You're being ridiculous."

Her heart was beating so high in her throat it threatened to choke her. "Am I?" she asked quietly. "Then why can't you accept that things will never be the same? Why do you have so much trouble putting the accident behind you?"

"I have put the damn accident behind me. I've made a new life. I have this house and my job and my son. I have you."