Good Medicine
“Resident G.P. wanted for isolated First Nations village, Vancouver Island’s West Coast. Ahousaht, Clayoquot Sound, Flores Island.”
The salary wasn’t what Jordan earned in the E.R., but at least there wouldn’t be shift work. And housing was included. And it was somewhere Garry wasn’t.
Impulsively Jordan took out her cell phone and dialed the number she’d copied down. The phone rang and rang, and she was about to hang up when a man answered.
“Hello?” There was a note of impatience in the man’s deep and resonant tone.
“Oh, um, yes, hello.” Damn, her hands were sweating and she could hear the strain in her voice. “My, um, my name is Jordan Burke, Dr. Burke, and I’m calling about the medical position. Is it still available?”
There was a moment’s silence. “I don’t know. You need to speak to Bennie. Call back another time.”
“Bennie? Bennie who?” Jordan was over feeling nervous and well on the way to being annoyed. Surely he could be more helpful?
“Just Bennie will do. He’ll be here in the morning.”
“And you are?”
“Silas Keefer. And I’m hanging up now, Jordan Burke.”
“But first can you—”
The line clicked and she heard a dial tone. The bloody man had hung up on her.
Dear Reader,
There’s a motto I try to live by. It is Whatever is happening now is right for me. It embodies acceptance and trust, and applying that concept every day is my greatest personal challenge. When life is filled with joy and excitement, it’s easy to say, “Yup, things are progressing exactly as they should—lucky me.” But when huge challenges seem insurmountable—that’s when it’s tough to let go of outcome and simply trust.
As a writer, I hand challenges to characters and then watch how they manage to surmount them. In Good Medicine, as in life, family became a central theme. And a trip to Ahousaht on Vancouver Island’s wild west coast made me realize that no matter how far we travel in distance and culture, the problems we encounter in life are universal. Not only that, they obligingly come right along with us.
This book taught me invaluable lessons about the different ways culture affects our attitudes toward the science of medicine and the gift of healing. The paths may vary, but the final answer is always the same—true healing begins in the heart. Love is the most powerful medicine. And yes, whatever is happening now is absolutely right for me!
With love, and gratitude to all of you who read my books.
Bobby Hutchinson
Good Medicine
Bobby Hutchinson
To Marie Donahue and the other Nuu-chah-nulth women who greeted me in the Ahousaht Health Centre one rainy morning. Truly, the Ancestors were there.
Books by Bobby Hutchinson
HARLEQUIN SUPERROMANCE
166—SHELTERING BRIDGES
229—MEETING PLACE
253—DRAW DOWN THE MOON
284—NORTHERN KNIGHTS
337—A PATCH OF EARTH
376—REMEMBER ME
443—JOURNEY’S END
492—VAGABOND HEARTS
556—MAN, WOMAN AND CHILD
595—NOT QUITE AN ANGEL
643—EVERY MOVE YOU MAKE
723—SIDE EFFECTS
753—THE BABY DOCTOR
797—FALLING FOR THE DOCTOR
844—FAMILY PRACTICE
876—THE BABY TRUST
906—WOMAN IN THE MIRROR
925—FULL RECOVERY
1000—ALL SUMMER LONG
“Temperature Rising”
1010-—INTENSIVE CARING
1051—THE FAMILY DOCTOR
1124—VITAL SIGNS
CONTENTS
CHAPTER ONE
CHAPTER TWO
CHAPTER THREE
CHAPTER FOUR
CHAPTER FIVE
CHAPTER SIX
CHAPTER SEVEN
CHAPTER EIGHT
CHAPTER NINE
CHAPTER TEN
CHAPTER ELEVEN
CHAPTER TWELVE
CHAPTER THIRTEEN
CHAPTER FOURTEEN
CHAPTER FIFTEEN
CHAPTER SIXTEEN
CHAPTER SEVENTEEN
CHAPTER EIGHTEEN
CHAPTER NINETEEN
CHAPTER TWENTY
CHAPTER TWENTY-ONE
CHAPTER TWENTY-TWO
CHAPTER TWENTY-THREE
CHAPTER TWENTY-FOUR
CHAPTER TWENTY-FIVE
CHAPTER ONE
DOCTOR JORDAN BURKE walked over to the automatic sliding glass doors and peered out at the wet April night, not really seeing the eerie fluorescent glare or the deserted cement apron that led to St. Joseph’s Emergency entrance.
It was her birthday. A glance at her watch told her it was 12:40 a.m. She had no idea the exact hour she’d been born, so she might as well make it midnight on the nose. Which meant she was now thirty-two.
Spending the first six hours of her birthday working the graveyard shift in Emerg suited her fine. John Frankel, one of the other doctors, had the flu, and since Jordan was on her long break from day shift, she’d eagerly volunteered to fill in.
It wasn’t as if she’d be sleeping much, anyway. She might as well be working tonight as lying in bed tossing and turning, wide-awake and worrying.
She shivered, even though it wasn’t cold, and crossed her arms, hugging the front of her white lab coat.
Where the hell are all the patients? On most nights, the E.R. was so busy there wasn’t time to do anything except concentrate on the stream of desperate, frightened people needing medical assistance. But it had been nearly an hour since Jordan’s last patient was treated and released, and she was restless. Anxious.
She ought to be used to the anxiety. It never really went away these days.
“Quiet tonight, eh? Downtown Vancouver must be closed for spring break or something.” The tiny Asian nurse was new, and she laughed at her own joke.
“It is quiet.” Jordan nodded and attempted a smile. When did smiling become such an effort? “Calm before the hurricane,” she commented, aware of how callous it was to long for patients. It was just that she needed action, needed the degree of intensity that drove everything else out of her head.
“At least it gives us time to think,” the young woman replied.
“Yeah.” Jordan forced herself to nod, even though time to think was the very last thing she wanted. She glanced at the ident tag pinned to the nurse’s shirt. Jordan had been introduced when they came on shift, but now she couldn’t remember the woman’s name.
Lola. Her name’s Lola, numskull.
Forgetting things had become the norm. She’d lost her keys today, she’d misplaced her cell phone yesterday, she hadn’t remembered what she needed when she got to the grocery the day before last. Thirty-two was nowhere near menopause, but she knew that constant low-level anxiety could cause memory lapses. Eight months of anxiety. Ever since her husband’s accident.
She thought of Garry now, and her gut heaved as an all too familiar mixture of emotions coursed through her: anger, sadness, guilt, longing and an overwhelming sense of frustration and futility.
Two years, is that all it had been? She felt as if she’d been Garry’s wife for at least two long, painful lifetimes. She wanted desperately to help him, she longed for an end to the problems they were having, she—
Stop. Stop.
She would not obsess over her personal problems here, not while she was on shift. She turned away from the doors and walked over to the admitting desk. So there were no patients, okay, she could catch up on patient files. That tedious task was every doctor’s least favorite activity.
“No point getting your blood pressure up doing paperwork, Jordan.” Edd
ie, the desk clerk, grinned at her, revealing crooked teeth. “There’s an 18-year-old female on her way, severe headache, vomiting, recent history of stomach pain. Her dad called, he’s bringing her.”
A few moments later the patient arrived, a college student named Ardyth Malone, slender and very fit looking, but obviously in severe distress. Jordan escorted the girl to a cubicle and began taking a history.
Ardyth responded with negative answers to questions about drugs, alcohol, allergies, blows to the head. A careful physical examination ruled out appendicitis, inflamed ovaries, gallbladder problems. Each successive test was normal, until Jordan examined Ardyth’s eyes with the ophthalmoscope. There was a slight papillidema, a swelling of the optic nerve.
By now Jordan was beginning to feel really concerned, wondering if this was a brain tumor, but there were a few questions she still needed to ask.
“Ardyth, has there been any change in your diet recently?”
The girl shook her head. “I’m a vegetarian. I’m very health-conscious and careful about what I put in my body.” Her expression was virtuous. “I take tons of vitamins and I don’t eat sugar or saturated fat. Oww! Oh my God, do something! It hurts.” Bent double, she cradled her stomach, moaning.
A warning bell went off in Jordan’s brain. Taking iron tablets on an empty stomach could lead to excruciating cramps.
“Exactly what vitamins do you take, and how many?”
As the pain eased, the girl rattled off a dozen or more names, adding that she swallowed massive quantities.
“Have you taken any new ones recently?”
“Only more vitamin A.”
“How much more?”
“Seven extra pills. My skin’s been breaking out—vitamin A cures acne.”
“How long have you been taking that dose?”
Ardyth shrugged. “A couple of months now, I guess.”
“How many international units per pill?”
“Five thousand.”
“And when did you take your last mega dose?”
“A few hours ago.”
Thirty-five thousand units of A, ten to twenty times a normal dose, taken daily for sixty days. Jordan was pretty sure she had the answer to Ardyth’s symptoms, and it gave her a feeling of satisfaction. At least her personal problems weren’t interfering with her diagnostic ability. Yet.
“My guess is you have acute vitamin A intoxication, Ardyth,” she said gently. “I think if you stop taking it, your symptoms will disappear. We’ll run some tests, though, just to be absolutely certain we’re not missing anything here.”
Jordan was jotting down orders for a CAT scan and an upper GI series when Lola stuck her head into the cubicle.
“Jordan, a guy’s just been dumped outside Emerg. He’s unconscious—whoever brought him sped off in a car. They’re bringing him in now. Billy says he’s got track marks, so it’s probably an overdose. Can you come?”
“Be right there.” Jordan handed orders to an aide and then sprinted after Lola. There’d been a series of drug overdoses in the past two weeks, a result of exceptionally strong heroin having hit the downtown Vancouver streets. Usually the Emergency Response Team brought the victims in, but sometimes bodies were dumped at the door by people who didn’t want to get involved.
Orderlies and nurses were lifting the limp male figure onto a stretcher when Jordan arrived. The patient’s face was obscured by a nurse’s arm, but Jordan saw at a glance that this wasn’t the usual skid-row addict.
Caucasian, well-dressed, charcoal sports jacket, black trousers, blue silk shirt—
She struggled to get her breath as a wave of dizziness swept over her. She recognized that shirt. Reaching past the nurse, Jordan took hold of the man’s jaw and turned his slack face toward her, and her worst fears were confirmed.
Garry. It was her husband. She’d bought him the shirt for Christmas.
Someone on the medical team was calling out his vitals, but Jordan barely heard it. One of the nurses was holding Garry’s wallet, going through it to determine his identity.
“Hughes, Garry M., DOB 1968, March 13.” As the woman read out the information on his driver’s license, for one shameful instant Jordan was relieved she’d retained her maiden name.
“I’ll see if he’s listed in the book,” the nurse said. “We may need next of kin.”
The number was listed, but Jordan knew there was no one home in their Kitsilano apartment. The nurse would get the message Garry had recorded for the answering service.
“Jordan? Hey, Jordan, what’s up? You okay?”
She suddenly realized everyone was waiting for her, looking at her—puzzled, impatient.
She should tell them about Garry and have someone else take over. It was against policy to treat a relative. Instead, like an automaton, she began the necessary assessment, even though she knew beyond a doubt what was wrong. Of course he’d taken an overdose. Her husband was a junkie.
“Pulse forty, respiration down to eight,” Lola reported. “We’re not getting a BP, Jordan. This guy’s on his way out…. He’s flat! Now we’re not getting much of a pulse at all.”
“Establish a line. Let’s give him Narcan.” She felt cold and detached and far away as she picked up the syringe with numb fingers and inserted naloxone hydrochloride into the IV valve.
In cases of overdose, the drug’s effect was miraculous. It instantly reversed the action of narcotics, and a patient who’d been on the verge of death only seconds before suddenly became awake and alert, just as if nothing had happened. In the E.R., they called it the Lazarus Effect. Except Lazarus had probably been grateful.
Everybody watched and waited. It only took a few seconds.
“Brace yourself, boys and girls,” someone murmured.
The instant the powerful drug reached Garry’s bloodstream, his sky-blue eyes flew open. A frown flickered across his smooth forehead as he stared up at the faces of the medical team grouped around the stretcher.
Inevitably his gaze came to rest on Jordan. As recognition dawned, his features contorted with rage. He grasped the sides of the gurney and pulled himself up as staff members struggled to control him. He was a big man, and it looked as if they were going to lose the battle.
“Call a code white,” someone yelled. “He’s freaking on us.”
Code white was an emergency call to security.
“Jordan?” Garry spat her name out. “What the hell have you done to me?”
Her mouth felt numb, her throat dry. She cleared it, amazed that her voice still worked. “You overdosed. I used Narcan to bring you out of it.”
It took a moment for Garry to react to that, and when he did Jordan wanted to turn her back and run from the room.
“You bitch!” he screamed at her. “You filthy bitch, you ruined my high, what the hell’s wrong with you? Do you have any idea what you’ve done, you stupid fool?” He tried to shake off the hands restraining him so he could climb off the table.
Jordan couldn’t move. She saw shock on the faces of her co-workers. They were staring at her, some of them open mouthed.
She was surprised when her voice burst out loud and strong. “Call a code white and get him out of here,” she ordered.
“You know this guy, Jordan?”
“Yes.” Her voice was unnaturally calm now. It seemed to come from a long distance away and belong to someone else. “I know him. Of course I know him. He’s my—he’s my husband. Get the equipment off him, I’m discharging him.”
She saw the glances that passed among the staff. They knew she could have committed him to the psych ward for treatment. They probably figured that’s what she ought to do, and maybe it was, but she just wanted him gone.
She had no energy left to deal with Garry and his problems. Over the past weeks she’d made appointments with the best drug treatment clinics in the city, appointments that she pulled strings to arrange and Garry hadn’t bothered to keep. She’d spent hours talking to him, trying to understand, to reason wi
th him. She’d tried every way she knew to help him make the decision to stop. Nothing had worked.
Now, she was worn out. She’d done her best to keep her work and her personal problems separate, and look where that got her. She hadn’t wanted her co-workers to know how desperate and degrading her personal life had become. Garry had managed to take away even that last tiny shred of dignity.
Two security guards hurried in, and between them they restrained Garry as the staff quickly removed the IV apparatus from his body.
“Escort him to the exit and see that he gets a cab,” Jordan instructed the men.
The guards flanked him, and Garry’s broad shoulders sagged as they started to hustle him out of the treatment room. Over his shoulder he gave her the look she’d come to despise in the past months, the contrite, little-boy-lost look from under long, curling blond lashes. Those baby blues had charmed her when she first fell in love with him. At this moment they made her stomach churn with nausea.
Yesterday morning he’d begged her to write him yet another prescription for morphine. She’d refused, and he’d sworn at her, just as he had a moment ago. For a man with an expensive education, he had a limited vocabulary.
“Hey. Hey, Jordie,” he called over his shoulder as the guards hustled him out. “I’m sorry, babe, I’m really sorry. I didn’t mean it, it was just, you know, the shock of coming to in this place.” He dragged his feet, going limp.
“Jordie, tell these goons to back off me, okay? Please, honey?”
She didn’t reply. The security guards had stopped, holding him upright. They turned and looked at her, questioning. Her co-workers were all pretending hard to be busy with other things. By morning the whole episode would be all over the hospital, probably posted on some Web site.