Emergency Marriage

“But her GCS is 5—6 at best!” Centrally depressant drugs were contra-indicated when consciousness was compromised and scoring on the Glasgow coma scale measuring responsiveness and alertness was below 8. “How can you consider sedating her?”

“I believe she lost consciousness with respiratory distress and shock, not from a head injury. If you hadn’t noticed, she’s lightened up.”

“What if she has? Why not just let her wake up, extubate her and put her on positive pressure ventilation with a face mask?”

“She’s a cervical spine injury suspect. If we need to operate further, and it turns out she does have a cervical injury, this ET is our one safe chance of having one in. I want it left in.”

Laura mulled this over, watching his every move as he slipped in the nasogastric tube and emptied the woman’s stomach. Incisive, ultra-efficient.

And right.

Damn him.

In seconds, she’d slipped the diazepam into the woman’s drip, hooked her to the cardiac monitor and raised her head. She found him watching her in turn, something like surprise in his bloodshot eyes.

He shook his head, made a strange, wheezy sound—an incredulous laugh? “Good work!”

He was surprised, double damn him! How dared he be surprised?

But really, why should she be surprised? She should be used to his opinion of her medical competence, of her worth in general, by now.

Still biting her tongue, she watched as he checked their patient one last time, then rummaged for a syringe, loaded it with an ampule diluted with saline and injected himself subcutaneously.

“Ventolin,” he rasped, then muttered something else under his strident breath.

So he did need a bronchodilator and… What had he said?

It sounded too much like Laura Loca to her. Crazy Laura.

“What did you say?”

“So you heard me, huh?” His shrug was careless as he crossed to the driver’s compartment, throwing a calm “Good” over his shoulder.

In seconds he was revving the engine loudly and putting the van in gear, forcing her to scramble to the passenger seat.

“I’m crazy? I’m not the one driving a car fifteen minutes after being zapped with tear gas.”

“One of us has to and apart from my eyes stinging like hell and my skin and lungs feeling about to combust, I’m in a far better condition than you—Laura Loca!”

“You’re saying it again!”

“Don’t mention it. What the hell do you expect? What did you think you were doing, running out like that? Was reporting me such a desperate priority that you didn’t mind risking your life to do it?”

“Reporting…? Listen here, Salazar—”

“No, you listen here, Laura Loca. You didn’t have to sneak behind my back. You wanted a report delivered to GAO’s central liaison office, I would have delivered it for you myself, even if you’d painted me black in it, even if you’d lost me GAO’s backing. And no matter what else you think of me, I’m your surgeon and I, and only I, say when you can leave your hospital bed. When I do, it won’t be so you can go on another death-defying escapade. This one almost got me killed. Your last one did manage to kill Diego!”

CHAPTER TWO

“NOBODY asked you to come after me!”

And nobody had asked Diego either. She’d told him she’d had nothing more to say to him. But he’d intercepted her. Just giving her a lift, he’d insisted. He’d tricked her, again, had been so confident he’d talk her out of leaving, seduce her into forgetting what she’d come to realize. He’d been incensed when he’d failed. Then he’d crashed the car.

“And my death-defying escapades?” She hissed her outrage at the blatant lie. “Diego was driving, if you remember! Without a seat belt. And he almost killed me, too.”

“My point exactly. Yet you walked out today as if all you’d suffered a week ago was a sprained ankle, and not a lacerated liver and abdominal aorta with a hemothorax and intraperitoneal hemorrhage to make our patient’s here look like a minor leak. I won’t even mention your facial wounds, or the ten units of blood we pumped into you, or the six-hour operation to gain hemorrhage control—”

“It was only a limited laparotomy.”

“Only? Oh, yes, you were damned lucky. But don’t be so smug. That I didn’t have to open you up from your neck down was a piece of luck that, along with surviving today, used up all your luck—for this lifetime at least. You walked out of hospital today against every rule in the book.”

“You removed my drains three days ago. It was perfectly all right for me—”

He interrupted her again. “Every moment you’re on your feet you’re compromising your healing, inviting complications.”

“Early ambulation is good for healing,” she objected.

“Ambulation as in getting out of bed, walking around the room then getting back into bed.”

“I’m a surgeon myself, no matter how you might like to forget that, and if I feel anything alarming—”

“If you don’t listen to reason, you might still die! You do know how many complications can set in, don’t you?”

This morning, she’d been confident she’d been well enough to discharge herself, against his orders. But that had been then. She hadn’t expected to be sucked into a nightmare. The sting of every ram and blow she’d suffered was a grim reminder of yet another catastrophic miscalculation. Complications were now a definite possibility. She’d concede that. Just not to him.

When she kept her face averted, he grated on, “How about another slow leak of blood into your pleural cavity, turning into a clot this time? Or a bath of pus that only a thoracotomy will empty? Do you want your chest opened from side to side? Your sternum sawed open? You want to have a scarred lung or a chronic, debilitating respiratory infection? I won’t even mention the complications from renewed abdominal bleeding… Por Dios! I can’t believe we’re having this conversation! You did go to medical school before you became a ‘surgeon’, didn’t you?”

He growled under his breath and pressed harder on the gas pedal. “Quit playing the heroine, Laura. No one’s snapping photos now. Or will there be another press release soon?”

“A press…!” That was it! The antagonism she’d felt towards him ever since she’d laid eyes on him erupted. “You may have gotten used to doing and saying anything you please, to flaying and bossing people around—certainly Diego, and me too when you wormed your way into GAO’s good favor—but now I’m—”

“Now I’m up to here with daredevils, Laura!” His usually dismissive, cool black eyes flashed something unknown, harsh and hot. Their inflammation added a sinister effect as his bronzed, powerful fingers chopped a sharp movement. His daunting body and singular looks created an impression that was overwhelming. With his wet, tousled hair and livid darkness, he was downright intimidating. Not that intimidation featured in the chaotic feelings he provoked in her. “And if I’d had that kind of power over Diego, he’d probably be alive today,” he continued.

“Oh, so it wasn’t me who got him killed, then? Or do you only mean you’d have banned him from knowing me, the reason for his death?”

Something flitted in his eyes. Her eyes narrowed, trying to catch and nail down the elusive expression. He snatched it out of her reach with an exhalation and a turn of his head. “That was out of line.”

What? The infallible Armando Salazar admitting to a transgression? And to her? That had to be another first. Adding to every other world-shattering first she’d had in Argentina. Her first lover. Her first command. Her first break-up. Her first car crash, emergency operation and riot. And now the first thing that sounded like an apology from the man who’d been the common factor in it all.

“I was—still am—furious with you, but that’s no excuse. It was an accident, and no matter where your relationship was at the time—which is no business of mine…” He stopped, tossed her a turbulent look. “Infierno, Laura. You’re not dragging me into a pointless dissection of the past. You’re going back to La Clínica and this time you’re not walking out before you’re fully healed, even if I have to chain you to your bed.”

Anger spiked. “Well, let me tell you something, you—”

“I lost Diego, Laura.” His forceful baritone was so unexpectedly, so unbearably soft, it had her retaliation sticking in her throat. “He slipped through my fingers and I couldn’t save him. But I saved you, and I’m damned if I’ll lose you now!”

Something hard tumbled in her chest. What was that in his steel eyes? Pain? The juggernaut who played as hard and fast as he worked, who swept everyone and everything aside and did as he pleased, actually had…feelings?

For the three months she’d been in Argentina she’d been busy avoiding him, then resenting him. In the past few days, she’d been battling death then emotional turmoil, desperately seeking closure. It never occurred to her to look through his eyes, feel his turmoil. Diego had been his cousin, more of a younger brother. And he’d died in his hands.

And he had saved her. Not that she couldn’t undo all his efforts. The pain in her side was sobering—frightening even. It was pointless, childish, arguing with him when he was right. And he did make her feel childish, stupid.

The need to defend herself to him rose again, and this time it wouldn’t be denied. “I never intended jeopardizing myself, but I couldn’t ignore the victims.”

His laugh was furious. “That’s probably the one thing I’m not angry with you about. It was stupid, unbelievably so—but it was very brave. I didn’t know you had it in you.”

Don’t rise to that. He expects it.

What the hell. She’d satisfy him, the callous creep. “Oh? You mean I wasn’t after another photo and headline?” He grimaced, shrugging away his earlier maligning words. “What the hell do you know what I have or don’t have in me? What gives you the right to pass judgement on people—just who do you think you are?”

“I’m your surgeon, that’s all I am right now. And I may not know you, but can you deny you’ve had way too many photos in magazines and newspapers since you arrived?”

“It wasn’t me as me all over those pages. It was me as so-called head of Global Aid Organization’s Argentina Project. And it wasn’t even a GAO initiative. It was your local newspapers that developed that unhealthy interest in me and my team, and I’m damned if I know why!”

Armando knew why all right. Couldn’t believe she didn’t. She was too tempting to the paparazzi. The dazzling American surgeon, turning her back on her family’s riches, throwing away a lucrative private practice in the US to come to Argentina, devoting herself to humanitarian work. Add that to the trendy hook of her online romance with Diego and the stunning sight they’d made together…

He hadn’t had the stamina to look at newspapers lately. He would bet, with the accident and Diego’s death, interest in her must have spiked to fever pitch. And if they found out she’d risked her life to save riot victims…

“And I wasn’t in Buenos Aires to report you.”

Her forceful statement jerked his attention back to her. His gaze slid off the road and over her. Took her all in. Glossy, rain-straight hair, the perplexing blend of black, blue and indigo, pulled into that down-to-her-waist, unflattering braid. The unique bone structure and drained tan of a face that spoke of her brush with death. Bluish-yellow bruises, spreading like leaking ink stains from beneath her dressings. Lips, usually dimpled, flushed bows, now a taut, colorless line. And eyes. Those eyes! Sooty-lashed chameleon emeralds, now murky jades set in fragile purple. A body that had gone from luscious to almost skinny.

And she still sent his hormones raging.

He swore.

“Boy, I knew you were…many things. I’m adding plain crude to my list!”

“Your Spanish is taking off if you understood that.”

“Swear words are a must-know-first in any foreign language. A universal defense against locals who enjoy insulting you to your face, counting on your ignorance!”

“That was a strictly inner debate, not intended for your ears. Sorry I blurted it out loud.”

Her eyes lightened, becoming emerald again with suspicion. “It’s too late to pretend, Salazar!”

“I agree. It is too late. You’ve called me Armando at last, so you can’t go back to calling me Salazar.”

“I used to call you Dr. Salazar, and I called you Armando…” She stopped, shook her head, looked away.

“Only because you thought I’d been shot,” he completed for her. “I always did wonder at your insistence on calling me Doctor, even when we were meeting socially, daily, when I’m on a first-name basis with everyone. You are, too. Why do you find it so hard to say my name?”

Was the man for real? He didn’t realize she’d rather not call him anything, not be near him at all? That he made her feel defensive, vulnerable, useless?

That first time Diego had dragged her to Armando’s house, to show her off to “the Salazar patriarch”, Armando had taken one look at her, one hard, drawn-out, enervating look, then, thankfully, had dismissed her. He’d looked at Diego as if he’d lost his mind, getting mixed up with her. He hadn’t said anything, though. A month later, he’d made it equally clear he thought GAO crazy to give her the aid operation reins. This time he’d done something about it.

One day she’d been head of GAO’s mission in Argentina, the next, for all intents and purposes, his subordinate. He’d swooped in and snatched it from beneath her feet, then shoved her out of the picture.

He wasn’t only local and a medical jack of all trades, a surgeon/emergency doctor/search-and-rescue operative all rolled into one; he was also director of La Clínica—Argentina’s most revolutionary medical facility. He’d established it after Argentina’s financial collapse had torn apart all systems, the medical system being the paradigm of disintegration.

She’d met Diego when he’d been in the US recruiting medical personnel for his cousin’s project. And before she’d met him, she’d thought it the most exciting, enterprising medical endeavor ever. If it hadn’t been for her previous commitment to GAO, she would have loved to have joined herself.

But then she had met him.

It had all gone nightmarishly wrong. Coming to Argentina was supposed to have been the start of her new life—the love she’d never had, the work she’d always dreamed of and people who really needed her. So many expectations, so much advance work and plans.

But no amount of logistics or fantasies could have prepared her. Not for the reality of the situation at ground zero, or for the meteoric deterioration of her relationship with Diego. She’d needed time. To sort out her mess with Diego. To start becoming effective in her job.

But Armando had denied her that time. He’d talked GAO’s administrative body into making La Clínica GAO’s base of operations in Argentina. And in La Clínica he made his own rules and dispensed them with an iron hand.

He stopped at nothing to achieve his goals. Distorting truths, manipulation, outright lying. He hadn’t needed her team’s expertise as he’d said, he’d only needed GAO’s resources. In the month they’d been in La Clínica, he’d totally excluded them and was dispensing GAO’s resources whichever way he pleased, throwing its agendas and protocols out the window. No wonder he felt he deserved to be reported.

What infuriated her more was her own reaction. She’d taken his abuse lying down. It didn’t make her feel any better, wailing that her personal mess had drained most of her stamina. An excuse worse than the offense. Weak, foolish, stupid!

But it was over now. Diego was dead, and her love for him long before that, and she wasn’t needed in any other way here.

Time to put her expertise in cutting her losses to use.

“Well?”

So he was still waiting for an answer! “I’ll call you whatever I like, not what you like.” Her words were cool, tight. “And I will continue to recuperate. Just not at La Clínica.”

“Oh, no?” He slowed down and shoved his face closer to hers. Space shrank and air disappeared. “Where else will you have your operating surgeon, the only one really qualified to follow you up? To handle any complications that may yet develop? To remove the stitches all over your face? Or do you intend to do it yourself back in your villa before your posh welcome-home party?”

An involuntary hand went to her facial dressings. “I can remove my own stitches.”

“Even the ones you can’t see without the help of a mirror?”

His persistence finally wore her nerves down. “Don’t you understand? I don’t want to dwell on my injuries, on the accident, on…on… I want—I need closure.”

“Who doesn’t? But you think you’ll ever have it if you have scars to remind you every time you look in the mirror? Maybe every time you take a breath?”

“I’m sure you did a great job putting me back together, that there’ll be no complications…”

“Is that your informed medical opinion, Dr. Burnside?” His generously shaped lips twisted, and suddenly she felt something new towards him. The need to physically strike out at him. To wipe off that abrasive superiority written all over him.

Stupid urge. You can’t afford more of those. Just shut him up.

She breathed in. “Listen, if anything happens, I’ll seek immediate help. But right now I’m not going to La Clínica. Not as a patient. Haven’t you demoted me enough already? I’ll just get on with my life. I don’t need your permission to do that.”

His fleeting, severe look hit home. Then he spoke the three words, slow and distinct, “Yes, you do!” A few strands of his hair caught the sun that had bleached them copper as he took a turn into a road she recognized, the road leading to Santa Fe and La Clínica. “Going back for your full postoperative period is non-negotiable, Laura.”

“I—”

“Drop it.”

Staring ahead at the boundless horizon she was still unused to, she fell silent, stymied.

Armando heard her frustration loud and clear. He kept his still-scalding eyes on the demanding road, slowed down some more. She’d been battered too much already.

“So how bad am I beneath these dressings?”

Her subdued question surprised him into biting off, “Bad enough!”

He caught a more-than-crude expletive back at the last moment.

Why had he said that?

Oh, what the…? It was just as well. She had to face the reality of her injuries, didn’t she? And anyway, at the moment her injuries did look bad. And they could remain so if she compromised her recuperation. Laura Loca Burnside, philanthropist extraordinaire, glittering, brilliant society darling, who had no idea just how dangerous and desperate it really was here.

The moment he’d learned she’d left, he’d predicted she’d head for GAO’s headquarters, smack dab in the middle of the city center the riots were ravaging. He’d never driven so recklessly. All the way, Diego’s accident, his death, haunted him, taunted him. He could have ended up the same today, chasing after her.

But in either case, she hadn’t asked either of them to…

“Anything more specific to add to that delightful and sensitive report of my impending metamorphosis into a monster?”

His attention snapped back to her. Was that sarcasm? She had a sense of humor? He’d thought she took herself too seriously. She’d never cracked a smile, not in his presence. And he’d been present almost all the time she’d been in Argentina. Her glares were something, though. It was almost a surprise he hadn’t turned to stone. Parts of him had…

He was really losing it! If her resentment affected him this way, he didn’t want to know what a smile, a touch would do…

Stop it, moron!

He inhaled. “You’ll see for yourself when I remove your stitches.”

“I must be really mangled if you elected to do a primary repair of my facial wounds during a life-saving operation, risking extending the already dangerously long anesthesia time.”

He had been aware of that danger. But he’d weighed everything—her condition while on the table against the risk of the wounds healing by secondary intention, raising the probability of scarring. He’d felt it safe to go ahead.

So why was the unfamiliar urge to justify his decisions to another, to her, riding him—again? Her eyes on him had always made him feel this way. Ever since he’d laid eyes on her—the last thing he’d expected Diego’s new woman or GAO’s mission head to be.

He tried to stifle the urge as usual. He failed this time. “For best esthetic results, you know it’s optimum to close wounds within eight hours of injury.” Wasn’t it enough to feel defensive? Did he have to sound it, too?

She tilted her head, her braid sliding with an audible thud to her right shoulder. He tightened, ached. He’d never had it this bad. Then she gave him a strange look—a skeptical one?—and his heart, his hands, itched.

“If the patient isn’t stable enough, if it’s in any way risky, primary repair could be delayed by as much as seventy-two hours without significant change in esthetic outcome.”

“Significant being the operative word here. Scars might seem insignificant to you now, but later they will be. Trust me.”

“I trust my clinical experience. I used significant as a figure of speech. In my experience, delayed repair—with proper wound occlusive care—yields the same esthetic result.”

“You mean I should’ve waited until you revived from anesthesia, then put you under again while you were recovering from major trauma surgery and even more vulnerable? Not to mention that I couldn’t predict how your post-operative period would go. What if you’d deteriorated? For long enough to lose the golden time window for primary repair?”

“You know you could have done it under local.”

“I’m sure you would have appreciated the extra joy of local anesthetic jabs in your condition!”

“I wouldn’t have minded a few nerve blocks, and I would have preferred to be awake while you worked on my face.”

“Why? Did you want to hold my hand through it?”

“And why not? Maxillofacial surgery was part of my six-year surgical residency. I might have given you a few tips on how to handle facial soft tissue injuries.”

His foot eased off the gas pedal and the car almost slowed to a standstill.

He’d suspected there was more to her than the sullen, haughty façade she projected. So was this at last the real her? All that fire and diamond-sharp toughness?

Whatever confrontations she’d tried to kick up with him before, she’d done so in arctic reserve and infuriating politeness. It had all been about who was supposed to be in charge. There’d never been implied criticism of his professional or surgical prowess before. Implied? Hell, there was no implication involved now. She was telling him he’d made a lousy call, combining her procedures, that his surgical judgement stank.

But was she lashing out at him for thwarting her plans, for dragging her back? Or was it the stress of trauma? Or had her orders and his connection to Diego kept her from expressing her opinions, opinions she now felt free to voice?

All of the above, most probably. Not that he cared what she said to him or thought of him. She was letting go of the tight reins of social propriety and professional diplomacy and letting the real her shine through.

And it delighted him.

Delighted him? Now? The tear gas must have left him more oxygen-deprived than he’d realized!

“Why did you stop bickering with me?” One sable eyebrow disappeared in mockery beneath her bandages. “Stymied?”

“I don’t ‘bicker’. And I didn’t know there was a contest going on.”

“No? Then why do I have the distinct feeling that you’ve won again?”

“Por Dios! Won what? What is there to win?”