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Hardball

V.K. Sykes




  Hardball

  Philadelphia Patriots

  Book 1

  By

  V.K. Sykes

  Copyright © 2011by V.K. Sykes

  https://www.vksykes.com/

  Cover Art © Kimberly Killion of HotDamn Designs

  https://www.hotdamndesigns.com/

  Formatted by Jessica Lewis

  https://www.authorslifesaver.com/

  Chapter One

  Holly Bell’s feet flew over the big red dots on the scuffed, white floor. The path markers were there to guide patients, parents, and visitors from the Cardiac Center to the ER’s trauma center.

  Red dots. They always reminded Holly of blood spatter.

  Stupid thing for a surgeon to be thinking about.

  Still, if it had been up to her, she would have used another color, maybe yellow or orange or purple. Anything but blood red. What parent rushing to the ER needed that kind of visual reminder?

  It was late, after ten, and she’d been at the High Speed Line station waiting for her train home when her resident paged her. A fast walk, almost a jog, had her back at the Children’s Hospital in six minutes.

  She flipped a mental switch and envisioned Tyler Arnold. Caucasian male. Not quite five years old. She hadn’t met him yet, but she’d practically memorized his file. Congenital heart disease had trashed the poor kid’s heart in a half-dozen ways, the worst being the damage to the mitral valve. This crisis wasn’t his first, but Holly worried that it could be his last. That’s why when the resident called her on her cell, she’d taken off straight down Walnut Street, covering the six blocks to the hospital in a blur.

  Two security guards monitored the doorway separating the waiting room from the trauma center—one outside, one inside. She recognized the outside guy, and he waved her through. The inside guy was probably new. But, then again, so was she, and she’d only been to the ER a handful of times. She gave him a quick smile and waved her ID card at him. She didn’t look like much like a doctor tonight. No lab coat. No stethoscope. Medium heels instead of hospital flats or sneakers. A red, lightweight sweater over the black, form-fitting dress she’d worn to the concert.

  “Tyler Arnold?” she said a little breathlessly to one of the nurses at the central station. “I’m Dr. Bell. His surgeon.”

  The young woman looked wary, obviously not recognizing her. “Uh, he’s in six.”

  “Thanks.” Holly hurried around the central desk. Bed six was on the opposite side of the spacious, square room. She shoved the yellow curtain aside and stepped in. Katie Canizaro, one of her surgical residents, stood beside the bed, stethoscope in hand. Holly gave her a quick nod and began her examination.

  The boy had been sedated and intubated, and was hooked up six ways to Sunday. Sweat matted his delicate blond hair, his face was pale, his form under the sheets slight and insubstantial. Normal saline dripped into his arm through an IV, and a bedside monitor recorded his vitals as stable.

  Holly exhaled a relieved sigh.

  For nine years, she’d watched children fighting for their lives, gripped in the maw of technology that often terrified them. She wouldn’t change her career path for anything in the world, but every patient like Tyler still affected her deeply. Holly welcomed the responsibility she had for their lives, because she knew she was good. But sometimes that responsibility threatened to swallow her up with fear.

  Holly brushed the matted hair back from Tyler’s forehead, then turned to Canizaro. “What happened?”

  “He complained to his father of chills, pain in his arms and legs, difficulty breathing. Shortness of breath. By the time he got here, his pulse-ox had crashed. The attending put him on the ventilator, then paged our service and got me.” Canizaro dropped her eyes toward the floor. “I’m sorry for calling you out, Dr. Bell. But I wasn’t sure, so—”

  “You did the right thing.” Holly flicked a glance at the monitor. “Low grade fever. Did the father say how long he’s had it?”

  “He wasn’t sure. Said he never took the boy’s temperature.”

  “Nice,” Holly said with a grimace. “Sounds like Tyler needs a mother.”

  Canizaro gave a fatalistic shrug. “Hasn’t had one since he was two.”

  “I know. McMillan briefed me and I reviewed the file. Did you check his skin?”

  “Yes. There’s been some hemorrhaging—fingers and toes.”

  Holly nodded and held her hand out to borrow the resident’s stethoscope. Bending down, she listened to Tyler’s heart and lungs, lifting him gently with one hand as she slid the stethoscope under him. She didn’t like what she was hearing. Tyler’s heart was regurgitating blood. More than she’d expected, given his file and the briefing his former surgeon, had given her. The valve repair McMillan had performed some time ago had clearly broken down.

  Still, new valve lesions wouldn’t be causing the fever.

  She straightened up. “The valve’s failing.”

  Canizaro nodded. “But new lesions wouldn’t account for the most of the symptoms.”

  “No, they wouldn’t,” Holly said. “Did you order an echo?”

  “Yes. And blood cultures.”

  “Good. But I don’t want to wait for the cultures. Start him on gentamicin right now. He’s stable enough to remove the ventilator, so get him moved over to Cardiac ICU as soon as they can get a bed ready.”

  “You’re thinking endocarditis?”

  “Yes,” Holly said, handing her back the stethoscope. “On top of the frigging valve prolapsing again.”

  Canizaro sighed. “That’s a heck of a combination.”

  “Sure is.” Holly pushed back the strands of hair that had fallen loose in her mad dash from the train station. “I’m going to head over to my office. Call me as soon as you get the results of the echo. I might need to get him in the O.R. tonight, so book one just in case and make sure a team is on standby.”

  Canizaro looked surprised, but nodded. “Will do.”

  Holly glanced around the room. “Where’s the ER attending? Why are you all alone with Tyler?”

  “The attending took off almost as soon as I got down here. In his defense, I did tell him you were only a few minutes away. It’s busy out there tonight.”

  Holly gave a little snort. “I assume the nurse did the intake, not him?”

  “That’s always the case.”

  “So, he probably didn’t talk to Tyler’s parents. I mean parent,” she corrected herself.

  “I’m pretty sure he didn’t.”

  Holly grimaced, knowing she had to do it. What a time for a first meeting with a parent. She’d have to put a brave face on it, but she had nothing for Mr. Arnold that resembled good news.