Saved By Doctor Dreamy

“I know about medical recruitment. Lost a top-rate radiologist to Thailand a couple of years ago.”

“So you know how important it is to put the best people in situations where they can help a hospital or, in Costa Rica’s case, provide the best quality of care they can to the greatest number of people.”

“Which leaves people like me in the position of having to find a new radiologist or transplant surgeon or oncologist, depending on who you’re recruiting away from me.”

“But you’re already in an easier position to find the best doctors to fill your positions. You have easier access to the medical schools, a never-ending supply of residents to fill any number of positions in the hospital and you have connections to every major hospital in the country. These are things Costa Rica doesn’t have, so in order for them to find the best qualified professionals they have to reach out differently than you do. Which, in this case, will be through me.”

It was an exciting new venture for her and, while she wouldn’t be offering direct medical care herself, she envisioned herself involved in a great, beneficial service. And all she ever wanted to be as a doctor was someone who benefited her patients, and by providing the patients in Costa Rica with good health-care practitioners she’d be helping more patients than she’d ever be able to help as a single practitioner in a clinic. In fact, when she thought about how many lives only one single recruited doctor could improve, she was overwhelmed. And when she thought of how many practitioners she would recruit and how many patients they would touch, it boggled her mind. “It’s an important job, Dad. And I’m excited about it.”

“Excited or not, you’re throwing away a good medical career. You were a fine hospital physician, Juliette. In whatever capacity you chose.”

“You were, too, once upon a time, but you traded that in for a desk and thousand-dollar business suits. So don’t just sit there and accuse me of leaving medicine, because I’m not doing anything that you haven’t already done.”

“But in Costa Rica? Why there? Why not investigate something different closer to home, if you’re hell-bent on getting out of Memorial. Maybe medical research. We’ve got one of the world’s largest facilities just a few miles from here. Or maybe teaching. I mean, we’ve got, arguably, one of the best medical schools in the country right at our back door.”

“But I don’t want to teach, and I especially don’t want to do research. I also don’t want to work for an insurance company or provide medical care for a national sports franchise. What I want, Dad, is to find something that excites me. Something that offers a large group of people medical services they might not otherwise get. Something that will help an entire country improve its standard of care.”

“There’s nothing I can do to change your mind?” her dad asked, sounding as if the wind had finally been knocked out of his sails.

Juliette shook her head. “No, Dad. There’s not. I’ve been looking into the details of my new position for weeks now, and I’m truly convinced this is something I want to do at this point in my life.”

“Well, I’m going to leave your position open for a while. Staff it with a temp, in case you get to Costa Rica and decide your new job isn’t for you. That way, you’ll have a place to come back to, just in case.”

Her dad was a handsome, vital man, and she hoped that once she was gone, and he didn’t have anybody else to depend on, he might actually go out and get a life for himself. Maybe get married. Or travel. Or sail around the world the way he used to talk about when she was a little girl. In some ways, Juliette felt as if she’d been holding him back. She still lived with him, worked with him, was someone to keep him company when no one else was around. It was an easy way for both of them but she believed that so much togetherness had stunted them both. She didn’t date, hadn’t dated very much as a whole, thanks to her work commitments, and she’d certainly never gone out and looked for employment outside of what her father had handed her.

Yes, that was all easy. But now it was over. It was time for her to move on. “If I do come back to Indianapolis in the future, I won’t be coming back to Memorial because I don’t think it’s a good idea that we work together anymore. We need to be separate, and if I’m here at Memorial that’s not going to happen.”

“Is this about something I’ve done to you, Juliette?” he asked, sounding like a totally defeated man.

“No, Dad. It’s about something I haven’t done for myself.” And about everything she wanted to do for herself in the future.

* * *

One month down, and so far she was enjoying her new job. She’d had the opportunity to interview sixteen potential candidates for open positions in various hospitals. Seven doctors, three registered nurses, three respiratory therapists, a physical therapist and two X-ray technicians, one of whom specialized in mammograms. And there were another ten on her list for the upcoming two weeks. The bonus was, she loved Costa Rica. What she’d seen of it so far was beautiful. The people were nice. The food good. The only thing was, her lifestyle was a bit more subdued than what she was used to. She didn’t have a nice shiny Jaguar to drive, but a tiny, used compact car provided by the agency. And her flat—not exactly luxurious like her home back in Indiana, but she was getting used to smaller, no-frills quarters and cheaper furniture. It was a drastic lifestyle change, she did have to admit, but she was doing the best she could with what she had.

Perhaps the most drastic change, though—the one thing she hadn’t counted on—was that she missed direct patient care in a big way. She’d reconciled herself to experiencing some withdrawal before she’d come here, but what she’d been feeling was overwhelming as she’d never considered that stepping away from it would take such an emotional toll on her. But it had. She was restless. When she didn’t stop herself, her mind wandered back to the days when she’d been involved directly in patient care. And it wasn’t that she didn’t like her job, because she did, and she had no intention of walking away from it. But she could physically, as well as emotionally, feel the lack in herself and she was afraid it was something that was only going to continue growing if she didn’t find a fix for it.

“Are you sure you want to go through with this?” Cynthia Jurgensen, her office mate as well as her roommate, asked her. Like Juliette, Cynthia was a medical recruiter. Her recruitment area was the Scandinavian countries, as she had a heritage there. And, like Juliette, Cynthia had experienced the thrill of being called to a new adventure.

“Well, the note I found posted on the internet says the scheduling is flexible, so I’m hoping to work it out that I can commute in Friday night after I leave work here, and come home either late Sunday night or early Monday morning, before I’m due back on this job.”

“But it’s in the jungle, Juliette. The jungle!”

“And it’s going to allow me to be involved with direct patient care again. I’m just hoping it’s enough to satisfy me.”

“Well, you can do whatever you want, but leave me here in the city, with all my conveniences.”

San José was a large city, not unlike any large city anywhere. Juliette’s transition here had been minimal as she really hadn’t had time to get out and explore much of anything. So maybe her first real venture out, into the jungle of all places, was a bit more than most people would like, but the only thing Juliette could see was an opportunity to be a practicing doctor again. A doctor by the name of Damien Caldwell had advertised and, come tomorrow, she was going to go knocking on his door.

* * *

“Could you get one of the volunteers to take the linens home and wash them?” Damien asked Alegria. The hospital’s sheets and pillowcases were a motley assortment, most everything coming as donations from the locals. “Oh, and instruct Rosalita on the particulars of a mechanical diet. I’m admitting Hector Araya later on, and he has difficulty chewing and swallowing since he had his stroke, so we need to adjust his diet accordingly.”

Back in Seattle, Damien’s workload never came close to anything having to do with linens and food but here in Bombacopsis, everything in the hospital fell under his direct supervision. This morning, for instance, during his one and only break for the day, he’d even found himself fluffing pillows and passing out cups of water to the five patients now admitted. He didn’t mind the extra work, actually. It was just all a part of the job here. But he wondered if having another trained medical staffer come in, at least part-time, would ease some of the burden. That was why, when he’d gone to Cima de la Montaña last week to mail his letter to Daniel, he’d found a computer and posted a help-wanted ad on one of the local public sites.

Low pay, or possibly no pay.

Lousy hours and hard work.

Nice patients desperately in need of more medical help.

That was all his ad said, other than where to find him. No phone service. Come in person.

OK, so it might not have been the most appealing of ads. But it was honest, as the last thing he wanted was to have someone make that long trek into the jungle only to discover that their expectations fell nowhere within the scope of the position he was offering.

“There’s a woman outside who says she wants to see you,” Alegria said as she rushed by him, her arms full of bedsheets, on her way to change the five beds with patients in them.

“Can’t one of the volunteers do that for you?” Damien asked her. “Or Dr. Perkins?”

“Dr. Perkins is off on a house call right now, and I have only two volunteers on today. One is cleaning the clinic, and the other is scrubbing potatoes for dinner. So it’s either you or me and, since the woman outside looks determined to get in, I think I’ll change the sheets and leave that woman up to you.”

“Fine,” Damien said, setting aside the chart he’d been writing in. “I’ll go see what she wants. Is she a local, by the way?”

Alegria shook her head. “She’s one of yours.”

“Mine?”

“From the United States, I think. Or maybe Canada. Couldn’t tell from her accent.”

So a woman, possibly from North America somewhere, had braved the jungle to come calling. At first he wondered if she was some kind of pharmaceutical rep who’d seen the word hospital attached to this place and actually thought she might find a sale here. As if he had the budget to go after the newest, and always the most expensive, drugs. Nah. He was totally off the radar for that. So, could it be Nancy? Was she running after him, trying to convince him to give up his frugal ways and come back to her?

Been there, done that one. Found out he couldn’t tolerate the snobs. And if there ever was a snob, it was his ex-fiancée.

“I’m Juliette Allen,” the voice behind him announced.

Damien spun around and encountered the most stunning brown eyes he’d ever seen in his life. “I’m Damien Caldwell,” he said, extending his hand to shake hers. “And I wasn’t expecting you.” But, whoever she was, he was glad she’d come. Tall, long auburn hair pulled back into a ponytail, ample curves, nice legs—nice everything. Yes, he was definitely glad.

“Your ad said to come in person, so here I am—in person.”

In person, and in very good form, he thought. “Then you’re applying for a position?” Frankly, she wasn’t what he’d expected. Rather, he’d expected someone like George Perkins, a doctor who was in the middle of a career burnout, trying to figure out what to do with the rest of his life.

“Only part-time. I can give you my weekends, if you need me.”

“Weekends are good. But what are you? I mean, am I hiring a nurse, a respiratory therapist or what?”

“A physician. I’m a family practice doctor. Directed a hospital practice back in Indiana.”

“But you’re here now, asking me for work?” From director of a hospital practice to this? It didn’t make sense. “And you only want a couple days a week?”

“That’s all I have free. The rest of my time goes to recruiting medical personnel to come to Costa Rica.”

Now it was beginning to make some sense. She aided one of the country’s fastest growing industries in her real life and wanted to be a do-gooder in her off time. Well, if the do-gooder had the skills, he’d take them for those two days. The rest of her time didn’t matter to him in the least. “You can provide references?” he asked, not that he cared much to have a look at them, but the question seemed like the right one to ask.

“Whatever you need to see.”

“And you understand the conditions here? And the fact that I might not have enough money left over in my budget to pay you all the time—or ever?”

“It’s not about the money.”

Yep. She was definitely a do-gooder. “So what’s it about, Juliette?”

“I like patient care, and I don’t get to do that in my current position. I guess you can say I’m just trying to get back to where I started.”

Well, that was as good a reason as any. And, in spite of himself, he liked her. Liked her no-nonsense attitude. “So, if I hire you, when can you start?”

“I’m here now, and I don’t have to be back at my other job until Monday. I packed a bag, just in case I stayed, so I’m ready to work whenever you want me to start.”

“How about now? I have some beds that need changing and a nurse who’s doing that but who has other things to do. So, can you change a bed, Juliette?”

CHAPTER TWO

COULD SHE CHANGE a bed? Sad to say, she hadn’t made very many beds in her life. Back home, she and her dad had a housekeeper who did that for them. Twice a week, fresh sheets on every bed in the house, whether or not the bed had been slept on. At her dad’s insistence. Oh, and brand-new linens ordered from the finest catalogs once every few months.

That was her life then, all of it courtesy of a very generous and doting father, and she’d found nothing extraordinary about it as it had been everything she’d grown used to. Her dad had always told her it was his duty to spoil her, and she’d believed that. Now, today, living in San José, and in keeping with what she was accustomed to, she and Cynthia rented a flat that came with limited maid service. It cost them more to secure that particular amenity in their living quarters, but having someone else do the everyday chores was well worth the extra money. So, at thirty-three, Juliette was a novice at this, and pretty much every other domestic skill most people her age had long since acquired. But how difficult could it be to change a silly bed? She was smart, and capable. And if she could cure illnesses, she could surely slap a sheet onto the bed.

Easier said than done, Juliette discovered after she’d stripped the first bed, then laid a clean sheet on top of it. Tuck in the edges, fold under the corners, make sure there were no wrinkles—

She struggled through her mental procedural list, thought she was doing a fairly good job of it, all things considered. That was, until she noticed the sizable wrinkle that sprang up in the middle of the bed and crept all the way to the right side. How had that gotten there? she wondered as she tugged at the sheet from the opposite side, trying to smooth it out and, in effect, making the darned thing even worse.

“That could be uncomfortable, if you’re the one who has to sleep on it,” Damien commented from the end of the bed, where he was standing, arms folded across his chest, watching her struggle. “Causes creases in the skin if you lay on it too long.”

“I intend to straighten it out. Maybe remake the bed.” Actually, that was a lie. Her real intent was still to pat it down as much as she could, then move on to the next bed and hope the future occupant of this particular bed didn’t have a problem with wrinkles.

“You know you’ve been working on this first bed for ten minutes now? Alegria would have had all five beds changed in that amount of time, and been halfway through giving a patient a bed bath. So what’s holding you up? Because I have other things for you to do if you ever get done here.”

“This is taking a little longer because I’m used to fitted sheets,” she said defensively. Her response didn’t make any sense, not to her, probably not to Damien, but it was the best she could come up with, other than the truth, which was that she just didn’t do beds. How lame would that sound? Top-notch doctor felled by a simple bedsheet.

“Fitted sheets—nope, no such luxuries around here. In fact, our sheets are all donations from some of the locals. Used bedsheets, Juliette. The very best we have to offer. Rough-texture, well-worn hand-me-downs. But I’ll bet you’re used to a nice silk, or even an Egyptian cotton, maybe a fifteen-hundred thread count? You know, the very best the market has to offer.”

Who would have guessed Damien knew sheets? But, apparently, he did. And, amazingly, what he’d described was exactly what she had on her bed back home. Nice, soft, dreadfully expensive sheets covering a huge Victorian, dark cherrywood, four-poster antique of a bed. Her bed and sheets—luxuries she’d thought she couldn’t live without until she’d come to Costa Rica, where such luxuries were scarce, and only for those who could afford to have them imported. Which her father would do for her, gladly, if she asked him. Although she’d never ask, as that would build up his hopes that she was already getting tired of her life in Costa Rica and wanted her old life back. Back home. Same as before. Returning to her old job. Taking the position as her father’s chief administrative officer. Yes, that was the way his mind would run through it, all because she wanted better bedsheets.

OK, so she was a bit spoiled. She’d admit it if anyone—Damien—cared to ask but, since he wasn’t asking, she wasn’t telling. Not a blessed thing! “The sheet you’re describing would have cost a hundred and twenty times more than all the sheets in this ward put together. And that would be just one sheet.”

“Ah! A lady with a passion for sheets.” Damien arched mocking eyebrows. “I hope that same passion extends to your medicine.”

“You mean a lady doctor who’s being interrupted while she’s trying to do her job.” She regarded him for a moment. Well-muscled body. Three or four days’ growth of stubble on his face. Over-the-collar hair, which he’d pulled back into a ponytail, not too unlike her own, only much, much shorter. Really nice dimples when he smiled. Sexy dimples. Kissable dimples... Juliette shook her head to clear the train wreck going on inside and went back to assessing her overall opinion of Damien Caldwell. He was stunningly handsome, which he probably knew, and probably used it to his advantage. Insufferably rude. Intelligent. Good doctor.

“Does it bother you that I’m watching?” he asked.

“What bothers me is that you think you know all about me through my bedsheets. You’re judging me, aren’t you? You know, poor little rich girl. Never changed a bedsheet in her life. That’s what you’re thinking, isn’t it?” Judging her based on what she owned and not what she could do as a doctor.

“I wasn’t but, now that you brought it up, I could. Especially if you do own Egyptian cotton.”

“What I do or do not own has no bearing on the job here. And if you want to stand there speculating on something as unimportant as my sheets, be my guest. Speculate to your heart’s content. But keep it to yourself because I need to get these beds changed and I don’t need any distractions while I’m doing it.”

The ad she’d read about this job should have warned her that it came with a pompous boss because he was, indeed, pompous. Full of himself. Someone who probably took delight in the struggles of others. “And in the meantime I’m going to smooth this stupid wrinkle so I can get on to the next bed.”

“Well, if you ever get done here, I’ve got a patient coming into the clinic in a little while who has a possible case of gout in his left big toe. Could you take a look at him when he arrives?”

Gout. A painful inflammatory process, starting in the big toe in about half of all diagnosed cases. “I don’t suppose we can test for hyperuricemia, can we?” Hyperuricemia was a build-up of uric acid in the blood. With elevated levels, its presence could precipitate an onset of gout.

“Nope. Haven’t got the proper equipment to do much more than a simple CBC.” Complete blood count. “And we do those sparingly because they cost us money we don’t have.”

“Then how do we diagnose him, or anybody else, for that matter, if we don’t have the tests at our disposal?”

“The old-fashioned way. We apply common sense. In this particular case, you assess to see if it’s swollen or red. You ask him if it hurts, then find out how and when. Also, you take into account the fact that the patient’s a male, and we all know that men are more susceptible to gout than women. So that’s another indicator. And the pain exists only in his big toe. Add it all up and you’ve got...gout.” He took a big sweeping bow with his pronouncement, as if he was the lead character in a show on Broadway.

Juliette noticed his grand gesture, but chose to ignore it. “OK, it’s gout. I’ll probably agree with you once I’ve had a look at him. But, apart from that, what kind of drugs do you have on hand to treat him with? Nonsteroidal anti-inflammatories? Steroids? Colchicine? Maybe allopurinol?”

“Aspirin,” he stated flatly.

“Aspirin? That’s it?” Understaffed, understocked—what kind of place was this?

“We’re limited here to the basics and that’s pretty much how we have to conduct business every day. We start on the most simple level we can offer and hope that’s good enough.”

“What else do you have besides aspirin?”

“Antacids, penicillin, a lot of different topical ointments for bug bites, rashes and whatever else happens to a person’s skin. A couple of different kinds of injectable anesthetic agents. Nitroglycerine. Cough syrup. Some antimicrobials. Antimalarials—mostly quinidine. A very small supply of codeine. Oh, and a handful of various other drugs that we can coerce from an occasional outsider who wanders through. When you have time, take a look. We keep the drugs in the locked closet just outside the clinic door.”

“Are any of these expired drugs?”

“Hey, we take what we can get. So if it’s not too expired, we accept it and, believe me, we’re glad to get it. One person’s expired drug may be another person’s salvation.”

“Isn’t that dangerous?”

He shook his head. “I check with the pharmaceutical company before I use it. I mean, commercial expiration date is one thing, but some drugs have usable life left beyond their shelf life.”

“But you do turn away some drugs that are expired?”

“Of course I do. I’m not going to put a patient at risk with an expired drug that’s not usable.”

“So when you call these pharmaceutical companies, don’t they offer to stock you with new drugs?”

“All the time. But who the hell can afford that around here?” Damien shrugged. “Like I say, I check it to make sure it’s safe, then I use it if it is, and thank my lucky stars I have it to use.”

She hadn’t expected anything lavish, but she also hadn’t expected this much impoverishment. Of course, she knew little clinics like this operated all over the world, barely keeping their doors open, scraping and bowing to get whatever they had. But, in her other life, those were only stories, not a real situation as it applied to her. Now, though, she was in the heart of make-do medicine and nothing in her education or experience had taught her how to get along within its confines.

“How do you learn to get by the way you do?” she asked Damien. “With all these limitations and hardships?”

He studied her for a moment, then smiled. “Most of it you simply make up as you go. I was a general surgeon in Seattle. Worked in one of the largest hospitals in the city—a teaching hospital. So I had residents and medical students at my disposal, every piece of modern equipment known to the medical world, my OR was second to none.”

“And you gave it all up for this?” It was an admirable thing to do, but the question that plagued her about that was how anyone could go from so modern to so primitive? She’d done a little internet research on Damien before she’d come here, and he had a sterling reputation. He’d received all kinds of recognition for his achievements in surgery, and he’d won awards. So what made a person trade it for a handful of expired medicines and good guesses instead of proper tests and up-to-date drugs?