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CHAPTER ONE

DR. JILLIAN DAVIS kept her head high, hopefully portraying a confidence she didn’t feel as she strode through the emergency department at Trinity Medical Center.

“You’re late.” Dr. Wayne Netter, one of her colleagues, glared at her from his arrogant stance behind the arena nurses’ station.

She ignored him, refusing to explain she was late as a result of her MRI scan being delayed. Her personal problems were none of his business. Impervious to his glare, she eyed the list of patients written on the whiteboard. “I see we have a full house.”

“There’s a couple of trauma victims on the way in,” Luanne, the charge nurse, piped up. “Multiple gunshot wounds. ETA less than two minutes.”

“Maybe I should stick around, in case you need help.” Wayne Netter suffered from delusions of grandeur, acting as if he was the backbone of the emergency department, which was why he could barely tolerate knowing Jillian had been chosen for the role of interim medical director over him.

She raised a brow. “Sure, if you like. Although it’s Friday night, and I wouldn’t want to hold up your plans.”

Wayne’s gaze narrowed and she imagined he was already internally debating with himself. Was it more important she believe he had big plans on a Friday night or that she needed his dubious expertise for two simultaneous traumas?

Decisions, decisions. She fought a smile, especially when Luanne comically rolled her eyes from behind Wayne’s back. Neither one of them particularly cared for the guy.

Clearing her throat, she turned her attention to Luanne. “Any other patient-care issues I need to know about?”

“Nope.” Luanne shot a quick glance at Dr. Netter and belatedly Jillian realized Wayne might take her innocent remark as something derogatory. She stifled a sigh as Luanne hastened to assure her, “Everything’s fine. The hospital beds are still pretty full and we have a few patients waiting on discharges upstairs.”

“Great. I’ll head over to the trauma room, then.” Jillian walked away, feeling Wayne’s piercing gaze boring into her back. To make a bad situation worse, she’d also once turned down his offer to go out for dinner, and he’d been impossible to deal with ever since. He just couldn’t believe she wasn’t interested. Of course, he didn’t realize she hadn’t dated a lot of guys in her lifetime. At first because her mother had been ill and later because she just hadn’t found anyone interesting enough.

Wayne did not even come close to tempting her. When he didn’t follow, she figured he’d decided not to stick around after all.

Breathing a sigh of relief, she focused her attention on the ED nurses and techs scurrying around to prepare the rooms for the incoming traumas. Sirens wailed from the ambulance bay and in moments the double doors burst open, spewing chaos into the room.

“John Doe number one, approximately sixteen years old with a gunshot wound to the belly, normal saline running wide open through two anticubital peripheral lines.” A paramedic called out pertinent information as the patient was wheeled into the first trauma bay.

“John Doe number two, approximately the same age at sixteen, was shot in the chest. We intubated him in the field but his vitals are deteriorating rapidly. Fluids going wide open through two peripheral antecubital IVs.”

Of the two, the chest wound was by far the more serious and required immediate attention. Jillian raised her voice. “Call for a cardiovascular surgery consult, stat.”

“We already did, when the call about a gunshot wound to the chest first came in,” Bonnie, one of the trauma nurses, quickly explained. “They were finishing up in surgery and planned to send a surgeon down.”

“I don’t see anyone yet. Call them again,” Jillian ordered.

Another nurse picked up the phone to send a second page.

“Blood pressure barely 70 systolic and heart rate irregular and tachy at 120,” Bonnie called out. “Looks like he may be trying to go into a wide complex rhythm.”

Jillian wasn’t surprised to see one of the paramedics kneeling on the gurney beside the second victim, keeping pressure on the chest wound. As the nurses fell into their respective roles on each side of the gurney, she donned sterile gloves and moved closer to examine the severity of the wound.

“Thanks, I have it now.” She waved a hand, indicating he could let up on the wound. A flash of silver on a badge caught her eye and belatedly she realized the man holding pressure wasn’t a paramedic at all but a cop.

He released pressure and immediately blood pooled in the center of the young man’s chest. The cop slammed his hands back down, covering the gaping wound and leaning his weight over the area. “Dammit, he’s going to bleed to death before the surgeon gets here.”

Jillian couldn’t argue—the brief glimpse she’d had of the injury told her it was bad. She snapped out orders. “I want four units of O-negative blood running through both IVs for a total of eight units, using the rapid infuser. Get this kid’s blood pressure up before we lose him. I also want a portable suction unit here so I can examine this wound.”

Marianne, another nurse, wheeled over a suction unit. Grabbing a pack of sterile gauze off the instrument table, Jillian turned back to the patient. She glanced up at the cop, registering a flash of recognition as she met his intense dark green eyes. “Let up on the wound again and this time stay off.”

His expression grim, he nodded.

When he lifted his hands she shoved the sterile end of the suction catheter into the area to clear most of the blood. Using the gauze to soak up the remaining blood, she examined the wound.

“The bullet must have gone through the pericardial sac and injured his heart.” The injury to the boy’s chest was bad, but he had youth on his side. The young could survive a lot more than your average older adult. “Where’s the surgeon?”

“He’s on the way,” Bonnie responded.

“Blood pressure continuing to drop despite the blood transfusions,” Marianne informed her in a terse tone. “We’ll need to start CPR.”

“Give me another minute.” Jillian continued sucking the blood from the wound, and then carefully packed the area with gauze, hoping to buy the kid a little more time.

“Dr. Raymond from CT surgery is here.”

Finally.

“We lost his pressure!” Marianne cried.

No! Jillian stared at the monitor then glanced down at the boy. “Start CPR.”

The cop still kneeling on the gurney placed his hands over the center of the kid’s chest and began giving chest compressions. Blood continued to seep from the wound. She didn’t waste time telling him to get down—for one thing the strength of his compressions were better than most, and for another, if they didn’t fix the hole in this kid’s heart soon, their efforts would be futile anyway.

“A bullet punctured the pericardial sac and grazed his myocardium.” Jillian quickly gave the surgeon the details. “He’ll need to go to the OR.”

Todd Raymond shook his head as he glanced at the vital signs displayed on the heart monitor. “It’s no use. He won’t make it to the OR, he’s lost too much blood.”

Jillian couldn’t believe his caviler attitude. Was he really going to give up that easily? She held onto her temper with an effort. “Are you telling me you’re not even going to try?”

He shrugged. “What do you want me to do—open his chest here?”

“Get the chest tray, stat!” Jillian knew their efforts might be useless but this was a teenager, for heaven’s sake! Didn’t this child deserve every chance possible? “I’ll give him some sedation.”

When the tray was open and ready, the cop stopped giving compressions and jumped down from the gurney, knowing without being told that his assistance was no longer needed.

The alarm on the monitor overhead went off as the kid’s heart rhythm went straight line without the aid of CPR. Jillian wasn’t a surgeon but she didn’t flinch when Todd drew his scalpel down the center of the boy’s chest, meeting up with the open area left by the bullet.

“Hand me MacMillan forceps,” Todd said as he opened the ribs to inspect the damage to the boy’s heart.

She did as he asked, but at that moment the fingers of her right hand went numb and tingly, causing her to drop them. For a split second her horrified gaze met the cop’s. Good thing the forceps had dropped onto the sterile field. She quickly picked them up again and handed them over.

“His left ventricle is severely damaged,” Todd muttered as he used the forceps to trace the path of the bullet. Jillian stuck more gauze into the blood-filled cavity. “The right lung is also a mess—the bullet tore through both the middle and upper lobes.”

“Try open heart massage,” Jillian demanded. “Maybe if we can get his blood circulating long enough to get him on the heart-lung bypass machine…”

Todd Raymond did as she asked and massaged the heart, coaxing it back to some semblance of normal function, but even as they all stared at the straight line where the heart rhythm should have been on the monitor, she knew it was too late.

“It’s over.” Todd removed his hands from the kid’s chest and turned away. “I’m sorry. But with the injuries he’d sustained, his chance of survival was less than five percent.”

He wasn’t a percentage, he was a child! She wanted to scream, rant and rave at the tragic death but held herself in check. This boy wasn’t the first patient she’d lost and unfortunately she doubted he’d be the last. She opened and closed the fingers of her right hand, trying to shake off the strange sensation. “Thanks for coming down, Todd.”

“Sure.” The surgeon stripped off his bloody gown and gloves, tossed them in the red-trash bag and left.

Jillian forced herself to turn her attention to the team of personnel working over the first victim. She’d left her senior resident in charge, using her expertise on the sicker of the two patients. “How are things going, Jack?”

“Fine. He’s stable. The trauma surgery team is taking him to the OR to repair the damage to his intestines.” Jack Dempsy seemed to have everything under control. As she watched, the surgeons packed up the gurney and wheeled John Doe number one away.

“Good.” At least they hadn’t lost them both. Losing one young man was bad enough.

When she turned back to the first victim, she saw the cop still standing there, staring down at the kid, seemingly unaware of the nurses who were clearing equipment out of the way.

When Marianne moved to pick up the remains of the boy’s bloody shirt and pants, the cop held out his hand. “I’ll take those.”

Marianne glanced at Jillian for confirmation and she nodded, granting her permission. The nurse dropped the bloody clothes in a plastic bag and handed them over. He took the bag absently, staring at the boy, not appearing to be in a huge hurry to leave.

Now that the heat of the emergency was over, she cast through her memory for the cop’s name. Alex? No, Alec. That’s right. Alec Monroe. He’d come in about two months ago with a serious knife wound slashed diagonally across his flank requiring a good twenty-five stitches.

Embarrassed at how she’d remembered his name over the dozens of other patients she’d treated over the past few weeks, she wished she could slink away, especially knowing he’d seen the way she’d dropped the forceps. Did he wonder what was wrong with her? Or had he attributed the action to pure clumsiness?

“Thanks for going above and beyond with him,” Alec said in a low tone, still staring at the dead victim.

“I’m sorry we couldn’t do more.”

He raised his gaze to hers, and her heart fluttered stupidly in her chest when she noticed he’d recognized her as well. His mouth quirked in a half-hearted smile. “Not your fault, Dr. Davis. He had the best doctor in the state as far as I’m concerned.”

She felt her cheeks warm and inwardly cursed her fair skin. The cop had made her blush two months ago, too, teasing her as she’d stitched his wound. He was tall, well over six feet, and wore his chocolate-brown hair long and shaggy. She remembered his body was pure solid muscle. She’d been more aware of him than had been proper when taking care of a patient.

Opening and closing her hand again, she reminded herself to maintain her professionalism. “I hope your wound is all healed…”

“Sure.” His smile disappeared. “I only wish these two kids had tried to settle their dispute with a knife instead of a gun. Then this kid might have had a chance.”

“I know.” She understood what he was saying. Once she would have argued that violence was violence regardless of the weapon of choice, but the crime rate in Milwaukee, Wisconsin had been climbing over the past few years and so had the use of guns. As a result, they’d treated more and more victims of gunshot wounds, many of them fatal.

Like this poor boy.

“Thanks again, Dr. Davis.” Alec flashed a crooked smile.

Call me Jillian, she wanted to say, then realized the urge was inappropriate so she gave a brief nod instead. “You’re welcome.”

Alec turned away, heading for the door. Jillian watched him walk away, hoping she wouldn’t have a reason to see him as a patient in the emergency department any time soon.

Cops like Alec put their lives on the line every day just to protect the innocent. To protect the public. People like her.

She couldn’t imagine a more thankless job.

Or a more dangerous one.

Yet from the little she’d seen of him, between this visit and the previous one where he’d been cut with a knife, he seemed to thrive on his role, throwing his whole heart and soul into his career. Not many cops would have held pressure on a bleeding chest wound like he had.

Jillian shrugged off her troubled thoughts. Tucking her hands into the pockets of her lab coat, she spun on her heel to head back into the arena. No reason to worry about Alec—she had enough problems of her own.

Like how long would she have to wait to hear the results of her MRI?

And did she even want to hear the results?

Her gut instincts shouted no, even though she knew it was better to find out the truth now so she could figure out the potential impact on her career. Her stomach clenched in fear. She knew firsthand, after caring for her mother, just how badly this could affect her future. Although likely not for years yet.

Small comfort.

“Dr. Davis?”

Surprised, she glanced over her shoulder. A deep frown furrowed Alec’s forehead as he strode back toward her.

“Yes?” She pivoted and waited for him to reach her.

“Do you have a minute?” His eyes, the color of jade, mesmerized her.

Her heart thudded in her chest. She should say no because, heaven knew, the arena was full of patients who might need her attention. But she found herself nodding her consent. “Of course. Is something wrong?”

“You could say that. I pulled these out of the kid’s pants pocket.” Alec’s mouth thinned in a grim line as he held the items up for her to see.

“Percocets?” She frowned when she saw the individually wrapped packages of narcotics. “Was he recently hospitalized?”

Alec cocked his head questioningly. “Do medications come individually wrapped like this when you fill a prescription?”

“No.” The implication of what he was telling her hit with the force of a brick. “You’re saying those were stolen? From a hospital or clinic?”

“Yes.” His gaze didn’t waver from hers. “Would you know if anyone around here or anywhere else recently reported missing narcotics?”

Jillian opened her mouth and then closed it again without saying anything. Because the answer was yes.

Less than a week ago, twelve percocet tablets, just like the kind Alec held in his hand, had been discovered missing from the locked narcotic drawer right here in Trinity Medical Center’s ED.