A Steadfast Companion, page 19
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His Alaskan Redemption
by Heidi McCahan
Chapter One
Mia Madden rarely second-guessed her decisions.
Raised on an island in the middle of an unforgiving ocean, she’d learned to adapt to severe weather, grounded flights, even delayed package deliveries. Living in Hearts Bay, Alaska, often required embracing a Plan B. Despite the obstacles and harsh elements of island living, she thrived in her role as a physician assistant. Nothing brought her more satisfaction than responding to illnesses, acute injuries and even life-threatening emergencies.
Until tonight.
Tonight, she wished she’d silenced her phone. Or left the thing charging on the kitchen counter, instead of falling asleep with it lying on the mattress beside her. She blamed the late-night internet sleuthing. Ever since her mother’s health had rapidly declined last summer, Mia had embarked on a desperate quest to find a viable treatment. The specialist they’d visited in Seattle had recommended a bone-marrow transplant as the best option to combat the aplastic anemia.
Mom had insisted they take a break from searching for a donor and focus on the holidays, but Mia hadn’t backed off. They didn’t have the luxury of slowing down. How was she supposed to sit back and do nothing when Mom was battling fatigue and frequent infections? Mia had done enough research to know that if the condition wasn’t treated effectively, heart failure was a real possibility.
And they couldn’t lose Mom. Her family had suffered enough loss already.
Finding a donor wasn’t the only challenge keeping Mia awake at night. Someone she’d never met, Lexi Thomas, had contacted her three weeks ago and insisted they’d been switched at birth. How was it possible? Did her parents know? She hadn’t worked up the courage to ask them. The notion that she might have a different family in a small town in Georgia wasn’t something she wanted to think about. It was too shocking. The kind of thing that only happened in a book or a movie. She couldn’t ignore Lexi forever, though. Other than acknowledging she’d received the message and needed time to process, Mia hadn’t initiated a follow-up conversation. The woman deserved an answer, and Mia felt a little sick admitting it, but they might need Lexi in the very near future.
That was a dilemma to resolve another day. Tonight, her patients deserved her full attention.
She trudged across the hospital’s dark parking lot, one gloved hand clutching the hood of her parka over her head as she hunched her shoulders against the blowing snow. When she’d answered Dr. Rasmussen’s midnight call a few minutes ago, the tremor in his voice had sent an uneasy feeling skittering down her spine. The man was a legend. Hearts Bay’s beloved physician of over thirty years. If he was overwhelmed, how in the world would she handle whatever waited inside the emergency room?
Floodlights beside the building illuminated the bright orange Coast Guard Jayhawk sitting on the helipad, its rotors spinning. She averted her gaze then quickened her pace, determined not to let the sight of that stupid helicopter undo her. Almost four years had passed since her brother, Charlie, and her fiancé, Abner Rossi, passed away in a boating accident. She still couldn’t look at the rescue helicopter without thinking of that horrible day.
Don’t. Not now.
Revisiting those painful memories would only send her mentally to a place she couldn’t afford to go. Before she could swipe her employee badge, the automatic doors opened with a whoosh. Dr. Rasmussen stepped outside. The rumble of the ambulance’s diesel engine punctured the night air as the vehicle backed into the bay.
“Thanks for coming in, Mia,” Dr. Rasmussen said. “This is our seventh victim right here.”
“Motor-vehicle accident?” She glanced toward the driver as he and his partner jumped from the cab and jogged around toward the back doors of the ambulance.
“Fishing vessel. Seven crab fishermen went overboard. The storm is brutal. Everyone made it off the boat alive, thanks to the Coast Guard’s quick maneuvers and their rescue swimmers, but I really need you to bring your A game tonight.”
“Of course,” she said, even though the cautious side of her brain sounded the evasive-maneuver alarm and her limbs tingled with the urge to flee.
“I’ll see you inside.” He turned to speak to the EMTs.
Mia swiped her badge then hurried into the ER. The warm air and familiar antiseptic smell greeted her. They’d been woefully understaffed this week after a nasty stomach virus had kept more than half their employees at home.
“Hey, Mia. The guy behind curtain number three is all yours.” Tammy Adams, a seasoned nurse and the mother-in-law of Mia’s sister Eliana, wheeled the crash cart down the corridor. “We’re swamped.”
“Got it.” She barely squeezed out the words. She shed her jacket and dropped it on a chair in the nurses’ station. The tightness in her chest scared her. Usually, a situation like this was right in her wheelhouse. But any kind of accident related to the water still provoked fear. Undermined her confidence. Okay, so seven victims might overwhelm their depleted staff, especially in the middle of a January storm, but she could still do her part.
Right?
She looped a stethoscope around her neck, jammed her phone in the pocket of her scrubs, then strode toward the makeshift cubicles designated for triage patients. The doors behind her slid open again and cold air swept in, swirling around her legs. The EMTs rushed in, transporting the man on the stretcher into the corridor. Dr. Rasmussen trailed behind, calling out instructions.
Mia slid a disposable mask in place, then squirted a generous dollop of hand sanitizer into her clammy hands and rubbed her palms together. Drawing a deep breath, she pushed aside the curtain. An orange survival suit and heavy-duty brown rubber boots had been discarded on the gray speckled linoleum and the sight made her legs quake.
The man reclining on the bed groaned. One large hand braced his other arm across his broad chest. Slowly, he turned his head toward the curtained entrance. His handsome features crimped.
Those familiar icy blue eyes bore into her. “Mia?”
His voice made her heart pinch. Her patient was an injured crabber. And not just any crab fisherman, either. The shock of white-blond hair and ruddy splotches of color that clung to his strong cheekbones were impossible to forget. Gustav Coleman, her late fiancé’s best friend, had survived yet another accident.
“Wh-what are you doing here, Gus?”
Stupid, stupid question. She was supposed to ask him to rate his pain on a scale of one to ten. Or wiggle his fingers. She should check his pupils’ reaction to light in case he had a concussion. There were so many crucial pieces of information she needed to gather in order to assess his condition. Instead, demanding to know why he was in her hospital seemed critical to her mission. Because everything about this awful scenario felt terribly familiar.
Her brother and fiancé had met their watery demise in a capsized fishing vessel. It was an accident Gus had avoided because he’d been a no-show and the boat had left port without him. Yeah, she was probably supposed to forgive him for surviving, but she couldn’t.
The guy behind curtain number three is all yours. Tammy’s directive reminded her that she had a job to do. Even if she wanted nothing to do with him.
Gus tried to shift onto his side, but grimaced. His skin was turning a terrifying shade of pale blue. She stuck her head back out the curtain. “I need help in here.”
“My chest.” He squinted up at her and clawed at his grimy plaid button-down. “Hurts.”
His pain propelled her into action. She moved to his side, and with trembling fingers, searched for his pulse first at his wrist and then at his neck. “Can you tell me anything about what happened, Gus?”
“My body hit...the railing. Went overboard... Really hurts...” His gravelly voice trailed off as he struggled to breathe.
Blunt trauma to the chest. Struggling to breathe. Rapid, weak pulse. She mentally catalogued his symptoms. “Do you have pain on the left side or the right side of your chest?”
“I don’t... I don’t know. It all hurts,” he mumbled. Then his eyelids fluttered shut.
She quickly unbuttoned his plaid flannel shirt. “I’m going to help you.”
A nurse joined her. “What can I do?”
“I’m concerned about a possible rib fracture that may have punctured his lung. We’ve got to work quickly. This could be a traumatic pneumothorax.”
The nurse handed her a pair of shears. Mia slit his white T-shirt in half and pushed it aside. Her breath caught at the sight of the gray-blue ink on his chest. The letters CM and AR. Gus had Charlie and Abner’s initials tattooed on his skin? Her legs wobbled and she clutched the bed railing.
The nurse studied her. “Mia. Are you okay?”
“Yeah.” She closed her eyes for a second. “I, um... Gus and I go way back, that’s all.”
She flung a silent prayer for strength toward heaven, then opened her eyes. Gus writhed in agony on the gurney. He was supposed to have been the best man at her wedding. A wedding that had never happened because Abner and her brother had been taken far too soon.
None of that mattered when there were lives at stake. Come on. Focus.
“Stay with me, Gus. I’m going to get you through this. I promise.”
She pushed aside the painful memories that threatened to steal her concentration and helped the nurse prep Gus for a procedure to reinflate his lung. She’d do her best to save his life. Even if he was the last person she ever wanted to see again.
* * *
Broken bones and a capsized boat weren’t part of his plan.
Gus squinted against the morning light glowing behind the window blinds, then slammed his eyes shut. He wasn’t ready to face the day. Between the pain in his chest and arm, frequent interruptions from the nurse to check on him and activity outside his room, he’d slept in short, fitful bursts.
At least he had survived.
He wanted to be grateful. Scratch that. He was grateful. It was just that the timing really stank. Finally, after years of struggling, he’d made peace with his past. Crabbing was all he knew, all he wanted to do, and he’d found a position on a boat with a great crew. Ironically, with a captain who had a stellar reputation for running a safe operation. This was going to be his season. No more excuses. He’d ditched the victim mentality and welcomed the New Year with a promise that he’d be the man his little girl needed him to be.
But how could he provide for a child when he’d lost his livelihood and the use of his arm? A tremor wracked his battered body as he mentally replayed the nightmare that had unfolded only hours ago. Ice had solidified on every surface. Waves washed over the bow, and the winds howled, dousing the crew in freezing spray. They’d swung baseball bats and hammers, and even heaved a few rubber mallets—any tool they could find—to break up the ice and keep the boat from listing under the weight. His crewmates’ screams as they slid off the deck and plunged into the bone-chilling Gulf of Alaska had been an awful sound he’d never forget.
Gus shifted in the bed, desperate for a more comfortable position. The sling helped stabilize his shoulder and broken collarbone, but even the slightest movement made him grit his teeth against the pain. The three cracked ribs weren’t helping, either. He had outsmarted death, but his injuries rendered him useless. No captain would take a one-armed deckhand. He had to get back out there, though. Too much was at stake. With only six weeks left in crabbing season, he desperately needed at least one more good run.
Especially since everything they’d caught yesterday had gone down with the boat.
The realization filled his stomach with a hollow ache. He wasn’t supposed to focus on the lost income, considering some of his crewmates might’ve lost their lives. The boat’s crew and their families waiting back in Dillingham would never be the same if their men didn’t come home.
Hinges on the door squealed and light spilled in from the corridor, silhouetting a woman as she stepped inside the room pushing a cart.
“Mr. Coleman, good morning,” she greeted him. “We brought you breakfast.”
“Gus?” It was a different voice. One that he knew from memory.
“Mia?” He could barely get her name past his parched throat.
She paused next to his bed and reached for a switch. The fluorescent light mounted on the wall overhead flickered on. “How are you feeling?”
Grunting, he squinted against the light. His mouth felt like he’d swallowed a bag of cotton balls. “I’ve had better days.”
“Same.” Her flawless features stretched into a weary smile. Her hopeful expression and polite smile buoyed him, helped him push through the pain and the medication fog. He surveyed her creamy skin and auburn hair, which was twisted into a bun. Basked in the concern filling her green eyes. Behind her, the woman pushed the cart closer. The aroma of scrambled eggs and oatmeal made him queasy.
“Thanks, Beth. I’ll take it from here,” Mia said.
“You’re welcome. Have a good day, sir.” The woman offered a polite nod then left the room.
Mia pulled a penlight from the pocket of her scrubs. “On a scale of one to ten, how’s your pain?”
He didn’t want to admit it, but everything hurt. He had to get out of here, though. Had to get back on another boat. More importantly, he had to get back to Dillingham so he could take care of his little girl. Poppy wasn’t quite two yet, and his ex-wife was quite controlling when it came to making childcare arrangements. She’d give him a hard time if he didn’t show up for his weekend visit with their daughter.
“Gus, can you rate your pain for me?” Mia lifted her stethoscope from around her neck. “Scale of one to ten.”
“Six, or maybe a seven.” He clenched his teeth against a white-hot sensation stabbing him under his shoulder blade.
“We’re going to try and get some food in you, and it will be time for more meds soon. It’s best if we try and stay ahead of that pain.”
Too late. He fumbled under the sheet for the button that raised his bed.
“What do you need?” she asked.
“I need to get out of here.”
Worry creased her brow. “Not yet. I need to reassess your injuries. You might have to stay at least one more day.”
“No, you don’t understand.” He jabbed at the remote control beside him. Nothing happened.
“Here. You need to be careful. Let’s try sitting up.” She took the plastic device from his hand and the bed elevated slowly. He swallowed back a growl. Just that subtle movement made him miserable.
“You have several fractured ribs. We put your shoulder back in its socket and you’ve had a tension pneumothorax.”
“What’s that?”
“Your lung collapsed, pushing air out into your chest. It’s a life-threatening situation, mainly because it compromises your cardiac function, as well as your ability to breathe.”
“Wow, Doc, you got any good news?”
Her lips tipped up in a half smile. “I’m a physician assistant, not a doctor. The good news is we saved your life.”
“Great. Thanks.” Stabbing pain returned to his chest. He tried to staunch the sensation by pressing his hand to his side. It didn’t help.
“I’d like to check your vitals again. Were you able to sleep at all?”
“Not really.” He tried to breathe normally but the warmth of her hand brushing against his skin as she dipped her stethoscope inside his gown had him distracted.
Easy, tiger. This is Abner’s girl.
“We need to talk about next steps. In your current condition, you can’t fly on an airplane for at least two weeks. You’re going to need to learn to manage that chest tube and I’ll refer you to physical therapy. Do you have any family in Hearts Bay?”
Chest tube? He glanced down. Sure enough, a shoelace-like tube protruded from under his gown and snaked into a container somewhere beside his bed. “How long do I have to have that?”
“A few days.” She removed the stethoscope. “Once we’re confident your lung has reinflated properly and there’s no infection, we’ll remove it. You didn’t answer. Any family close by?”
“No. My brother lives in Montana, my mom’s in New Mexico looking after my grandfather and my sister and daughter are in Dillingham.”
Her eyes widened, then she looked away.
Did the news that he was a father bother her? They hadn’t exactly kept in touch after Abner’s memorial service. He’d lived a lot of life in the last four years. Maybe she had, too. He stole a glance at her left hand. No ring. Interesting.
“Let me evaluate your pupils.” She leaned closer and he couldn’t help but notice a strand of hair had slipped loose and framed her heart-shaped face. “How old is your little girl?”
“Poppy. She’s almost two. And, man, what a firecracker.” Thinking about his daughter softened the edges of the pain digging into him. “She’s the reason I have to get back to fishing. Crab season will be over in several weeks. I can’t afford not to be out there right now.”
She straightened and put the penlight back in her pocket. Her pretty eyes filled with empathy. “Gus, I get it. You want and need to be fishing, but your vessel sank. Your injuries are significant.” She frowned. “No captain in his right mind should have you on his crew in your condition. It would be dangerous, possibly even life-threatening, if you went back out there now.”
He fisted the covers in his uninjured hand. Frustration swelled in his gut. Her prognosis wasn’t something he could accept. There was too much at stake. Besides, plenty of men fished with injuries. That was life at sea. Crabbers had the most dangerous job in the world.
“Let’s try eating and drinking for now. How about some water?” She offered a plastic cup with a lid and a straw.
