An Informal Arrangement (Informal Romance Book 2), page 7
“What if I stayed with you?”
Whoa. Where had that come from? “I can’t ask you to do that.”
“I lost a patient yesterday.” She gulped. “It got me to thinking. I’m taking some time off work to regroup and recharge.”
Knowing how upset she’d been after someone else’s patient had died, he couldn’t imagine how she’d handled the death of one of her own.
She sat up and clapped her hands down onto her knees. “Anyway. I took sixty days off, and I’d like to use them to help get you home and on your feet. I’m not licensed for home health care, so it would be an informal arrangement.”
Disbelief, anxiety, and hope froze his tongue.
Maddie must have mistaken his silence for something else entirely, because her professional nurse mask fell abruptly into place. “I’m not getting into a religious discussion with you, but I will say this: Are you worried about what God thinks or about what people think? Anybody who’s spent more than two minutes with you knows you’re no threat to me. Even if you wanted to, which I doubt you do, you’re not physically capable of being up to no good. Furthermore, if you live the kind of life where that’s the first thing people suspect, you’re not the man I thought.”
She stood and drained the last of her coffee then threw the empty cup in the garbage. Her hands were fisted at her sides, and he needed to find the right words.
Lord, what am I supposed to do? It’s a perfect solution, but what will my family… Okay, forget I said that. She’s right. I need to worry about what You think and not what people think. I could sure go for a generous dose of wisdom right about now. And if You’ve got one, I’d love a vaccination to prevent future episodes of foot-in-mouth disease…
“I don’t have any way to pay you. At least, not yet.”
She waved his concern away. “I’m not worried about it. We’ll work something out.”
Holden bit his bottom lip. He wanted to argue, to tell her that wasn’t good enough… but he couldn’t. This was his chance, possibly his only chance, to get out of rehab. Even if it meant taking advantage of Maddie, could he afford to say no? “I accept your offer. But tell me, how do you plan to convince the doctor to let me go?”
“Leave it to me. You know I have a cat, though, right? Fishy’s part of the deal.”
“The cat’s fine.” Holden grasped the laptop she held out to him. “You’re different from most women.”
“Just how many women have been in and out of your life?” An arched eyebrow accompanied her words.
“Not many.” He shrugged.
She laughed. “How can you get to be as old as you are and have so little experience with the female of the species?”
“Who are you calling old?” Not giving Maddie a chance at a comeback, he continued. “Small town. Plus, I have four sisters and two sisters-in-law. They’re enough to scare any sane man away from women for life.”
Chuckling, she held out the adapter to him before settling back into her chair to read. “You’re one-of-a-kind, too, Holden Jenkins. That’s all I can say.”
He booted up the computer and began sorting his way through email again, a renewed purpose burning in his gut.
The morning quickly slipped by. The time had almost come for Holden to go to his next round of therapy when the doctor walked in. Dr. Demir was a tiny little slip of a woman and, as he’d told Maddie, looked like she was barely out of pigtails.
“Mr. Jenkins, you asked to see me. Is anything wrong?”
He saw no point in dancing around the subject. Besides, his tango was a little rusty. Or was she more of a foxtrot doctor? “I have someone to stay with me while I recover.” A head-tilt in Maddie’s direction indicated who he was talking about. “Can I go home now?”
Dr. Demir tapped her foot. “Now, Mr. Jenkins, we’ve been over this. You need appropriate care and supervision. Home nursing would be more suitable to your needs, but your insurance won’t pay for it. Plus you still have a significant amount of rehabilitation to complete before you’re capable of being on your own. Not to mention the fact that your transverse myelitis has been classified as idiopathic. All the tests were inconclusive and we have no idea what caused it. What if something in your home causes a relapse? You need a skilled professional with you who can handle something like that.”
Maddie stood and held out her hand to the doctor, who reluctantly shook it. “I’m a nurse.”
Holden bit back a smile at her take-charge voice.
“I’ve worked ICU the past eight years and can provide references if you require them. I am taking a leave of absence to stay with Mr. Jenkins. I’m qualified to oversee his medication, make sure he is doing his rehab, and transport him to any necessary appointments. Remaining in here will cost him his business and eventually his house. If that happens and he gives up, he has little chance of improvement. Recuperation from any illness is about a lot more than the physical steps needed, wouldn’t you say, Doctor? Patients need to be encouraged and motivated as well. You can’t strip a man of everything he’s worked his entire life to build and expect him to fight for his recovery. There is latitude for personal judgment in these matters, isn’t there?”
Maddie didn’t raise her voice. She kept it professional and crisp, matching the manner and tone of the doctor who now inspected them both with studious disdain. Holden refrained from singing halleluiah when Maddie began reciting her qualifications and the doctor’s eyes widened. For the first time in too long, gaining the advantage became a possibility. Never mind that his health and life were under discussion and that getting care on his terms shouldn’t feel like an unrelenting battle to climb the Matterhorn.
He mentally shrugged off the remaining potentiality — that he was wrong to push so hard for release…
“Fine, Mr. Jenkins, I will take this into consideration. You,” she said, pointing to Maddie, “need to provide me with at least two references and a sworn affidavit saying you will be present to supervise and assist the patient. I need proof this is not some ploy to get him out of here with the intent of abandoning him to his own devices once he’s home.”
It was as though Maddie sensed victory, too, for she softened her voice from drill-sergeant nurse to respectful-compliant nurse. “I have those references right here.” She reached into her backpack and withdrew two envelopes. “One is from the ICU Nursing Director who hires, schedules, and reviews the staff. She’s my direct supervisor. The other is from one of the ICU intensivists.” She handed the letters over. “I didn’t realize I would need an affidavit. I wrote a letter, though, stating what I would be doing for Mr. Jenkins.” She pointed to her signature on the document. “Will that suffice?”
Burt walked in, his usual smile in place. He nodded a greeting in Maddie’s direction and to the doctor before glancing at the bed’s occupant. “I was told to come collect you. Is this a good time?”
Holden waved him in. “It’s fine. I think they’d rather talk without me in the room anyway.” Then he moved himself to the edge of the bed and, without any help from the orderly, stood and got himself into the wheelchair.
The move — pushing his limits to prove he could take care of himself — was a risky one. He kept his face averted from the doctor so she wouldn’t witness the toll the action took on him. Maddie saw, though, and the intensity of her gaze scorched all the way to his bones.
“You shouldn’t have pushed yourself so hard when your physician was here.”
He glowered in reply.
She shook her head. “It’s a good thing I’m a fast talker.”
Certain he’d been condemned to life in rehab indefinitely, Holden hesitated. “Did she...?”
“She’s filling out the paperwork and says we might be able to get you out of here by nightfall.”
Either he was going home or Maddie was trying — badly, he might add — to joke with him. “You did your best. I appreciate the effort.” It couldn’t hurt to test his theory.
“Uh…” She glanced over her shoulder at the empty doorway. “Who are you talking to?”
“There was no chance Dr. Demir would agree, but it means a lot to me that you were willing to try.”
Maddie rested the back of her hand against his forehead. “Huh. Your temperature seems fine. Maybe you overdid it more than I realized.”
Butterflies started tap-dancing in his stomach and fluttering up into his chest. She’d done it. She’d really done it. He was going home.
“I’ve got most of your stuff moved out to my car. I think one more trip ought to about do it.”
“You’re packing for me?” That came out louder than he’d meant it to, but what could he say? If she was packing, then she’d been in his drawers. Should he explain that the tighty whities were all from the Ladies’ Auxiliary and weren’t his preferred style, especially in such varied sizes?
“Unless you think you’re in good enough shape to do it yourself. Keep in mind — you don’t own a suitcase — at least not one that’s here.”
She bustled about the room as he tried to think of something to say.
“I didn’t want to leave the computer here while going back and forth to the parking lot, so I kept it with me.”
“I’m going home.”
Maddie stopped what she was doing and gave Holden a goofy grin.
Even in light of his joy, he couldn’t help the question. “Doctors don’t usually change their minds this fast, do they?”
Before he second-guessed himself out of his joy, she cut him off. “Not normally, so let’s be content and not give her reason to change it back.” She drew his attention with a tap to his arm. “Don’t ask me to pinch you, okay? Just trust me.”
For days he’d been asking God to get him out of this place. Was this an answer to prayer? No other explanation made sense. Dr. Demir didn’t take kindly to having her authority questioned. If anything, when Maddie had pushed for his release, the good doctor should have become more resistant to the idea just as she’d done every time he’d brought it up with her. Either the Almighty had stepped in on his behalf, or Lakeview’s doctor was so fed up with him that she couldn’t wait to push him off onto Dr. Matthews, his primary care physician. As long as she sent him home, he wasn’t sure he cared why.
Maddie’s back was to him, her arms full and one foot out the door, when Holden spoke. “Thank you. I mean it. I owe you more than I can ever repay.” He held himself back from a dramatic declaration of how she’d saved his life or an offer to name his firstborn after her. Every word, though, had come straight from his heart.
She didn’t look back or acknowledge hearing him, but Maddie’s step stuttered as she exited, adding a little extra bounce to her golden curls. She’d heard him. He’d bank on it.
With a fistful of paperwork and documentation for all the prescriptions they needed to pick up, Maddie and her new patient headed toward the exit.
Burt insisted on taking Holden to the car and getting him settled. “Now, Mr. Jenkins, you do what this nice young lady here tells you.”
The urge to snort was hard to resist. Nobody had called her a young lady in more years than she remembered.
“You got to take care of yourself, yessirree,” the orderly went on. “One day, when you’re walking around fit as a fiddle, you come back here and show off for all the nurses and doctors. They need to be reminded that what they do matters.”
“I’ll remember to do that.”
After situating Holden in her car, Burt shook his hand and delivered his parting words. “I’ll be prayin’ for you, man. God’s got great things in store for you, I jus’ know it.”
Maddie climbed behind the wheel and snapped her seatbelt into place. Checking her rearview mirror, she started the car. Their to-do list ran through her mind as she backed out of the ergonomically slanted parking space. “I asked them to call your prescriptions in to a little pharmacy I know. Next door to it is a durable medical equipment place. The owner of the equipment shop is waiting for us. Normally they’d be closed by now, but I called in a favor, and he’s got a wheelchair and walker for you.”
“I don’t have my wallet. How am I going to pay for this stuff? Or provide insurance information? I can’t. At least not today.”
“Lakeview sent your insurance info to the pharmacy for me. As far as the equipment goes, I’ll cover the deposit tonight.” She cast a glance his way and caught him tugging at the chestnut hair at the nape of his neck. “You’ll call him tomorrow with your provider, group number, and all that good stuff. He’ll let us know after that if we owe anything more or if I’m due a refund. And don’t worry. I’ll submit all my receipts to you for reimbursement.” She threw in a wink for good measure.
To avoid any possible argument from Holden, she quickly went on to get the rest said. “By the way, the wheelchair is a rental. They’ll apply your rental fee toward the purchase if you decide to buy one within sixty days. The walker is a keeper, but I’m getting you a good one.”
He started to protest, but she cut him off. “I promised the doctor I’d insist you use it everywhere — including in the house — until your therapist says otherwise. It comes with a padded seat, too, so if you get tired or want to rest, you’ll have a soft place to park your posterior. Make sure you engage the brake first, though.” Maddie shuddered to think what would happen if the walker rolled out from under him when he tried to sit.
Silence — the comfortable kind — surrounded them as she drove until, seemingly out of the blue, Holden asked, “What does PRN mean, anyway? The nurse said it a lot when she was going over discharge instructions. I heard it in the hospital, too.”
“Per Request or Need.” She waggled her hand in the space between them. “In my mind, at least. It’s actually Latin. A lot of medical terms are. PRN means pro re… Hm. Pro re something. In nursing school, we memorized a bazillion letter codes for different procedures, medications, conditions, and more. I made up words to go with the letters so I could remember them easier. The Latin basically translates to as needed, but I still think of it as Per Request or Need.”
“So which of my meds are PRN, then?”
“The ones for pain. There’s two of them. You may experience more tenderness than usual the first couple days because you’ll be trying to do more, and you won’t be able to control your environment as much. Even now, riding along in the car, I’m sure every bump I hit in the road is painful for you.”
Holden’s expression confirmed she wasn’t far from the truth.
She shook her head at his refusal to answer out loud before continuing with her explanation. “One makes you drowsy. The other one, not so much. They work in different ways, too. We’ll figure out which one is best at controlling the worst of the pain for you.”
“Did you ask her if I’m going to be like this for the rest of my life?”
Her voice matter-of-fact, Maddie answered, “There’s a high probability you’ll endure at least a measure of lifelong pain. I think, however, doctors sometimes forget the basics of life. Once you get back into the swing of things and something besides every twinge and spasm is occupying your mind, the soreness you’re suffering won’t seem as significant. That’s just my opinion, and I could be wrong, but sitting in bed with nothing to do but think about how much you’re hurting — it’s not exactly conducive to pain management. Know what I mean?”
“Do you think I’ll ever get past it — the pain? You know, enough to not have to make every decision based on how much it’s going to hurt. I had hoped that once I built up the strength in my back muscles again, the rest of my problems would fade away. They aren’t, though. I can’t help but wonder…” He shook his head. “Nobody seems to appreciate how much it hurts, and I can’t help but wonder if it’s going to be like this for the rest of my life.”
She could hedge. She wanted to hedge. That wouldn’t be fair to him, though. Holden was asking her because he wanted a real answer. “You’ll likely experience it in some measure for the rest of your life, and if that’s the case, you need to get used to it and find a way to deal with, minimize, and work around it. Whatever it takes. You can’t let the discomfort — no matter how severe — stop you from living.”
“I still don’t understand why I’m in so much pain. It’s not like I had a limb amputated.”
Maddie switched lanes as she considered what she should say. “I’ve done some reading up on Transverse Myelitis recently. A third of patients have some measure of lifelong pain or dysfunction.”
“And the other two thirds?”
“Another third recovers fully, and the other third spend the rest of their lives much worse off than you are right now.”
His sigh filled the small car. “So I should be thankful.”
“That’s not for me to say.”
“How long does your research tell you recovery should take?”
Maddie mentally ran through the different data she’d gathered before answering. “Most of what I read said that within three months of the acute phase, you will likely be recovered as far as you’re going to recover, but even that’s not absolute.”
“Mine was subacute. Does that matter?”
“The subacute just means it came on slowly rather than suddenly. You still had an acute phase, mostly back when you were in the ICU.”
“So three months…”
Holden had been in the ICU for about a week and a half before Maddie had him as a patient that one day. As she ran through the calendar in her mind, she realized he was coming up on three months from when he’d been admitted. He had to be running the same numbers in his head. “I’m not sure exactly how long your acute phase lasted, but I’d say that you’ve got another month before you need to invest too much time in doom and gloom.”
“You really think my being at home will help? I mean, I know I’ll feel better mentally and all, but do you really think it’ll help physically?”
“I think a person’s physical health is closely tied to their emotional and mental health, and that you can never underestimate the power of being in a place where you feel comfortable and at ease. Good things can happen.”
