Chapter 10
Mariah lost all hope of ever catching up after her third train wreck of a patient visit in as many hours at the rural clinic attached to the hospital. Normally, a patient with ten major medical issues and a laundry list of concerns to discuss? Bring it on. She loved the challenge. But today she was too distracted to delve into the long, complicated appointments.
Didn't help that the face of a certain man kept popping up at inopportune times, pulling her concentration in directions it shouldn't go. Crazy how she kept thinking about him and his changing moods. Explainable by his worry for family, sure. But whenever she talked with Vaughn, it felt like he held back important information. Or secrets.
She was a fine one to talk about secrets. She had a roomful of them.
She took in a big breath and blew it out slowly. Focus on work.
Last patient of the day would be a doozy.
After a pause, she knocked on the room holding Patricia Brand, the widowed matriarch of the Brand family who Mariah had just yesterday discharged from the hospital for aspiration pneumonia secondary to multiple sclerosis.
"Hello, Mrs. Brand," she called as she shut the door behind her. "How are you doing today?"
"What's it to you? You're late, by the way," the woman in the wheelchair snarled and sniffed. Made perfect sense to Mariah. Unfortunately, not all of Mrs. Brand's bad attitude could be chalked up to a long battle with multiple sclerosis with increasing complications and the resultant depression. Some of that bearish temperament was simply... her. Maybe some of the attitude had to do with her family, too.
Well, most of them.
The other woman in the room, her daughter, Izzy, shook her head and mouthed sorry, her face drawn and lined. Her long, blonde hair hung in limp, unkempt waves. Her blue eyes flicked up briefly, then she stared at the floor.
"You're right, and I'm sorry to make you wait." Mariah plowed ahead. "My goal is for you to feel better, Mrs. Brand. And I have to say that you look better than a few days ago."
"No thanks to you. Would have gotten better on my own anyway." The woman's atrophied hands flopped on her lap. When she inhaled, the on-demand portable oxygen tank gave a puff of air into her nostrils.
"Mom, please," Izzy whispered.
"Hush up. This is my visit. I don't even know why you're here anyway."
"Because you can't drive. And you need someone to push your wheelchair while the power chair is in the shop."
"Besides that."
Izzy clamped her mouth closed and peered into space, away from her mother.
At least Izzy had a mother present. A twinge caught Mariah between the ribs and she mentally shook it off.
Mariah plowed ahead. She refused to calculate how many more minutes of work remained in this never-ending day. "Has your breathing changed any since you left the hospital?"
"No. It's crappy as usual." Mrs. Brand sniffed. "Not sure why you couldn't fix that particular problem while I was in the hospital." A wet cough punctuated her words.
Izzy grimaced.
Mariah groaned to herself. The reason she couldn't completely fix the woman's lungs was due to equal parts an incurable underlying health condition and the fact that she kept smoking two packs per day.
No problem. Mariah could handle grumpy, ill patients all day long. "Any other issues like palpitations or chest pain?"
"No."
"Good. How about ankle swelling or fevers?"
"No." She waved her thin fingers near her face. "I must be perfectly fine, then. Good job, super doc." The harsh laugh held zero humor.
Mariah rolled her neck as she exhaled. "So I know that having multiple sclerosis makes it more likely to get certain health problems, like pneumonia. But also having a chronic illness can cause depression or anxiety."
Mrs. Brand grimaced. "What are you, a rocket scientist?"
Keep trying. "Sometimes being ill can make people angry or lash out at people they love." She paused. "Have you ever noticed yourself doing that?"
Izzy studied at the floor.
Mrs. Brand sneered, "What business is it of yours?"
Taking another calm, centering breath, Mariah answered, "My business is your health. I want you to be as healthy as you can be, inside and out."
"How about a total body transplant?" There, a flash of fear and vulnerability flitted over the woman's lined face. Getting closer.
"Boy, do I wish." Mariah smiled. "But until I can order a complete overhaul, how about we fix the things that we can?"
Mrs. Brand shifted, bumping the foot peg of her wheelchair. "What are you saying?"
"Well. I'm saying maybe you want to talk with a counselor or psychiatrist. They can give you good tools to deal with the frustration that comes along with chronic illnesses. Might help avoid hurting the people around you."
"That's not an issue," she snapped. And just like that, they were back to the irascible woman Mariah knew well. "Not sure why it matters, anyway. No one can fix what's wrong."
"Well. You matter. And my job is to help you as best I am able."
"Whatever that's worth." She sniffed.
"Mom! Please." Izzy leaned forward.
Mrs. Brand rolled her eyes.
"Come on, now." Mariah walked over and listened to the woman's heart and lungs, anything to redirect the negative emotions. She palpated her abdomen and checked her legs for swelling and adequate circulation. "Lungs sound better today. Let's continue with the antibiotics and steroids. It would be good to recheck you by the end of the week."
"Easy for you to say. Do you know how hard it is to get out here for an appointment? Especially when it's so cold out." The woman motioned toward the door.
"Mom, we'll get you here. Don't worry." Izzy patted her mother's arm even as she waved her off.
"Can you do anything that doesn't involve me leaving my house?" Ms. Brand said.
Mariah turned to the computer next to her and reviewed her work schedule for the week. The weariness worming through every inch of her body made her want to curl up and take a nap. Last weekend's call, a full workweek, and a scheduled ringside physician gig in Lander this weekend. At this point, adding one more item to the schedule could be the straw on the camel's back. But she had a job to do. "You know, I could probably do a home visit Thursday late afternoon if you'd prefer."
Izzy shook her head. "No. We can't ask you to do that. We live pretty far out of town."
"It's okay. I sometimes do home visits for patients who are homebound or it's a hardship for them to make the trip in for appointments."
"Are you sure?" Izzy asked. Her eyes locked onto Mariah, like Mariah was some kind of life buoy.
Mrs. Brand shook her head. "No way. I don't want her snooping around the ranch."
"Mom, come on. Dr. West is trying to help you."
"Fine, but she comes straight to the house and then she has to leave." Mrs. Brand struggled into her winter coat. "Let's go."
Izzy dropped her forehead onto her palm.
Mariah smiled. "It's decided, then. I'll see you Thursday." Glancing at her watch, she said, "Did you want some help getting out to the car? It's almost six, and most of the staff are gone."
"You don't have to—" Izzy started.
"'Bout time I got something for free," Mrs. Brand said, zipping her coat and pushing on the rims of the wheels, almost running over Mariah.
Jumping out of the way, Mariah got behind the wheelchair and maneuvered Mrs. Brand down the hall, waving at her medical assistant to leave. Then Mariah, Mrs. Brand, and Izzy went through the empty reception area, through the automatic doors, and into the cold night. This time of year, the sun went down early, and full night had fallen. Mariah hunched into her lab coat, a poor substitute for an insulated jacket.
Gloves would have been nice, too. The chilly wind cut right to her bones.
Above her, stars twinkled in the stark, clear sky. Temperatures were forecasted to be near zero tonight. Welcome to winter in Wyoming.
An uneasy sensation settled in her bones. Deeper than the chill. The feeling made her shoulder blades twitch. She glanced behind her, expecting to see something lurking there.
Nothing.
In the empty parking lot, they accompanied Mrs. Brand to a minivan in a handicapped spot. A bright parking lot light illuminated the vehicle from above. Rust bubbled the wheel wells, and dried mud and frozen slush coated the running boards.
Beneath the unending barrage of her mother's criticisms, Izzy heaved open the side door. She struggled to extend the heavy iron ramp.
"Sorry." One corner of Izzy's mouth rose. "Automated gate no longer automates."
"Technology, huh?" Mariah grabbed the other side of the large metal square and helped pull it down and fold a section out with a creak and a clank.
"Took you long enough. I'm freezing my venison off out here," Mrs. Brand grumbled as she tried to wheel herself onto the ramp. She made it a foot and rolled backward. With a grunt, Izzy pushed her mother's chair into the van.
A truck pulled up nearby, and the driver got out, his duster catching in the wind. He walked over with a slight limp.
"Hi Izzy." Kerr's face was half hidden beneath his hat. "How's it going?"
"Good, um. Nice to see you. We gotta go." Izzy turned her back on him to stow the ramp. Her attempts resulted in more clanks.
He frowned and reached down. "Can I help?"
She froze, then looked back over her shoulder. "Yeah. That would be great," she breathed, a smile lighting up her face for a moment.
"Who's out there? Is that one of those dirt-grubbing Taggarts?" Mrs. Brand hollered from the van, the dome light giving her face a skeletal, spidery appearance. "Get the hell away from my property."
"You can pick your nose, but can't pick your family," Izzy muttered.
Mariah and Kerr both covered laughs.
"Here, Iz, I've got it." Kerr hefted the solid ramp back in place like it weighed only a few pounds. He grinned at the car's occupant and tipped his Stetson. "Nice to see you, Mrs. Brand. You take care now." He slid the door closed on her profanity-laced response and brushed off his hands.
Izzy peeked up at him. Her exhausted expression transformed into one of exceptional beauty. "Thanks, Kerr. You, um, doing okay? With, the, uh...?"
He rubbed his thigh, almost as an absent motion. "Missing limb? Yep. Peachy."
A hand drifted to her mouth. "I didn't mean—"
All of a sudden, Mariah felt like a frigid third wheel as she stood there shivering. Behind her, she heard the front door of the hospital whoosh open.
Muffled epithets filtered from the depths of the van in front of her. The shadow of a raised claw fist inside the vehicle completed the surreal image as the van rocked.
Izzy scraped back her hair. "Man, my family puts the 'fun' in dysfunctional, huh?"
"Nothing in life is perfect, Iz." He stared at her, then shoved his hands in pockets. "Hey, if you ever want to grab a bite to eat, let me know."
"You... what?" she asked.
Kerr's smile fell. "Or not. No big deal."
"No. That sounds great, but I can't."
"Because of...?" He gestured generally toward his lower body.
"Geez, no. You're fine. I mean, of course you're fine. You're more than fine. Oh, heck. But we can't. Not because of your leg. Missing. Or not. Crap." Izzy palmed her forehead.
"Stressed much?" Kerr sucked on a tooth.
Out of the corner of Mariah's eye, a large man made a direct path from the front entrance of the hospital. The temperature on her skin dropped ten degrees, and the temperature in her chest rose twenty. She couldn't deal with another uncomfortable confrontation.
Vaughn strode toward her, his big work boots crunching snow and asphalt. Her heart rate sped up, but her stomach clenched, like she braced for a punch. Meanwhile, Romeo and Juliet were still flirting.
Let's go already, people.
"Iz, let me give you my number." Izzy held out the phone; Kerr punched in numbers. "Call me if you want, okay?" His casual smile turned into a tight grimace.
Izzy headed around the van, keys jingling in her hand. "See you Thursday, Dr. Mariah." She opened the door and a thick flow of invectives spilled out.
"G-good night," Mariah called.
"What's Thursday?" The sound of that deep male voice behind her slid straight down her spine to her... libido.
Izzy shut the car door and the cursing abruptly ceased once more.
Shivering harder, Mariah wrapped her arms over her chest and hurried back to the clinic, Vaughn keeping pace. Kerr trailed behind.
"Thursday?" Vaughn asked again, more gently. Like he was trying to be nice.
"That info is really HIPAA p-protected." Her teeth chattered. Icicles were probably forming in her eyeballs. God, it was cold out.
For his part, Vaughn wore jeans and a thin shirt, topped by his hip-length leather jacket. Unbuttoned, of course. And he didn't appear to be shivering at all. "You can't tell me?" he asked. But still with a calm tone and a disarming half smile. Like maybe he was a nice guy who had just had a bad couple of days and was trying to make up for it.
Mariah could appreciate someone who tried to be better. To be fair, she had seen how careful he was with his sister and how he'd stood up to Wyatt Brand on Mariah's behalf.
She, of all people, understood second chances.
Could she take another chance on him, after their rough beginning? She studied his earnest expression, crooked nose, hard jaw, and dark, intense eyes. Another shiver rippled down her spine, but it had nothing to do with the temperature.
While she owed him nothing, Mariah could at least keep an open mind. Frankly, she was intrigued. It was okay for a woman to want to know more about a guy. No rule against that at all.
"I c-can't tell anyone." At the main clinic entrance, she swiped her badge and the doors opened with a swoosh. She sighed as the heated air rushed over her.
"Bro, here are the keys." Kerr pointed toward the door to the main hospital. "I'm going thataway for the night shift with Shel. Anything new to report?"
"No. She's still sleeping. Nothing new, right?" He glanced over, brows raised.
"Not yet," Mariah said. "But she's stable."
"Stable." Vaughn's mouth pressed into a line. "Let me know if anything changes, okay?"
Kerr tipped his hat. "Will do."
In the low-lit reception area, Vaughn appeared tired and much older, like the weight of the world fell on his broad shoulders. She studied the strong lines of his frame, and the easy way he clasped hands with his brother.
"Night, Doc." Kerr smirked at her perusal of Vaughn's broad shoulders.
Her cheeks warmed. "Sure thing," she said to his retreating backside.
Which left Mariah and Vaughn alone in the empty reception area.