Silent Pledge

Buck cleared his throat, tried to speak, cleared it again. “She was feeling sick earlier, Dr. Mercy. She had some shortness of breath.”

Mercy turned around and saw Clarence standing in the doorway. “Call an ambulance for me, would you?”

“No!” Kendra cried out. She reached toward Buck, eyes wide and frightened, and tried to sit up. “Don’t let them haul me away!”

“It isn’t for you,” Mercy took Kendra’s arm and eased her back down. “I have another patient tonight. I need to transport her over to the hospital, and I can’t leave you right now.”

Clarence picked up the telephone in the room, then hesitated and frowned at Mercy. “You want to call an ambulance to haul somebody less than a block? Doesn’t make sense to me.”

Mercy checked the pulse oximeter box. “Do you have a better idea? I have a sick child in there, and her great-grandmother isn’t in much better shape.”

“Let me take ’em.” Clarence spoke the words against his will, as if something outside himself were making the decision for him.

“I can drive, long as I can fit behind the wheel. I’m a mechanic, you know. My driver’s license is up to date.”

“Thank you, Clarence. Take my car.” Mercy leaned back over Kendra. “My keys are on the desk in my office, and use the south entrance at the hospital. Get a move on. They’re waiting for the patient.”

For a moment, disbelieving, he could only stare at her. Just like that? He hadn’t driven in two years, and she trusted him with her new car?

And then, in spite of the pain that still lingered in the room from Kendra’s tears and Buck’s stoic silence, he felt a glow of satisfaction that he hadn’t felt in a long, long time. For once, he was on the giving end.

Chapter Three

T ex blotted and held, blotted and held as Lukas finished the last of the twelve interrupted sutures on Catcher’s arm. The big biker hadn’t even grunted through the ordeal. In fact, Lukas was sure that he himself had been the only one who grimaced every time the needle pierced flesh. Even with alcohol to mask the pain, it had to hurt. This man was tough.

Company had begun to arrive halfway through the procedure, as the first of Catcher’s biker friends came clomping into the E.R. carrying plastic packs of pimento cheese sandwiches and chips and soda they’d purchased from the vending machine in the waiting room. After an irritable glance in their direction, Tex had shown no reaction to their arrival. Even when one of the buddies came in and handed half a sandwich to Catcher, Lukas didn’t make a remark. They weren’t supposed to have food in the E.R. and if OSHA found out about the infraction, there would be complaints and fines and forms filled out in quadruplicate, but Lukas wasn’t in the mood to play hall monitor to a bunch of aging tattoos this early on a Sunday morning. Most of them just came in for a minute to check on their buddies, then wandered out to the waiting room, which was separated from the treatment area by a door and a sliding window where the secretary sat.

One husky woman wearing tight denim jeans and a heavy gray sweater shoved through the dividing door, food and soda tucked against her side by her left arm, holding a pack of cigarettes and a lighter in her right hand.

“Hey, Catcher!” she blared. “They treatin’ you okay back here? I’ll bash heads if they’re not.” She took a deep whiff of air. “Phew, smells like medicine and puke back here. Don’t you guys have any air freshener?”

Lukas clipped the nylon thread. “Okay, two more and we’re finished poking you, Catcher.”

Someone else in leather and tattoos stepped into the E.R. doorway from the waiting room beyond. “Hey, look, they got a TV! Hey, nurse, you guys got cable here?” A blare of music screamed through the rooms.

Lukas heard Tex’s sharp intake of breath and caught a glimpse of her angry scowl, and he shook his head at her. “We’re almost finished here.” Lord, please just hold this all together a little longer. Give me patience and compassion.

A loud clank and clatter pierced his concentration. His hands almost jerked the final suture too tightly. Neither he nor Tex could look up from their work just now, but as soon as he’d snipped the last of the threads, Tex put her things down and snapped off her gloves.

“If you’ll finish up here, I’ll check out the crash,” she said.

Lukas could almost see her flexing her muscles as she metamorphosed from Tex the paramedic to Tex the bouncer. Uh-oh. Not only was she about to make a scene, but she was also about to make him look like a coward. He did have a little pride left.

“Um, Tex, why don’t—”

Catcher groaned. “Oh, Doc, I think I’m gonna hurl.”

With a final glance over his shoulder to see Tex strutting off to bash heads, Lukas grabbed an emesis basin. “Breathe in through your nose if you can, Catcher, then out through your mouth. There you go.” He took the ice pack from Catcher’s limp hand and placed it against the man’s forehead.

More voices shouted from the other room. Tex’s was the loudest. “I said put that chair back down where it belongs and give me that coffeepot!”

Lukas had Lauren McCaffrey to thank for all this. Sweet-faced, innocent-eyed Lauren. When her cousin Tex heard through the family grapevine that there was an E.R. physician temporarily without a job, she’d called Lauren, looking for a replacement for a doctor on suspension.

“Scenic views, right there on the Lake of the Ozarks,” Lauren had said. “Small-town E.R. probably a lot like Knolls. It’ll be like a vacation. How much trouble could a five-bed E.R. be?”

And so Lukas had signed on for three months—until the earliest estimated time of completion for the Knolls E.R.

More shouts rang out from the waiting room, and then Lukas heard the squall of a siren as an ambulance pulled up outside, lights flashing.

This place needed more staff on Saturday nights. It was time to call the police. And he would never trust Lauren McCaffrey again.

“No!” Kendra’s shoulders came up from the pillow, her hands grasping Buck’s shoulders in desperation. Her eyes widened in fear above the clear oxygen mask. “You’re gonna shut me away like I’m crazy!”

Mercy saw Buck’s expression freeze as he held his wife.

“No, Kendra,” she said firmly. “That’s not what this is.” She took the younger woman by the shoulders, eased her back down and readjusted the mask. “Listen to me for a moment.” She waited until she felt some of the tension release from Kendra’s arms, then took her by the hand and squeezed. “Honey, you’re in trouble. You have an illness that is causing you to behave the way you are, and we need to get you help.” She paused. How would she explain this to a child? “We need to protect you until we can get your illness under control with medication. We’re going to put you in the hospital for ninety-six hours, and the doctors and nurses up there will keep a close eye on you and make sure you’re safe.”

Kendra held Mercy’s gaze for a moment, focusing first on Mercy’s left eye, then on the right, with disconcerting intensity. Her whole body quivered, and again tears dripped down her cheeks. “Where?”

“Cox North in Springfield. They’re specially trained to take care of cases like this.”

“What kind of a case is this? What’re you talking about?”

Mercy tried to pick her words carefully, but she had to be honest. “From what I’ve heard and seen, and from what I know of you personally, I’d say you have bipolar disorder, but I’m not a psychiatrist, so…”

Kendra tightened her grip on Mercy’s hands. “Does that mean I’m crazy?”

“No,” Buck snapped in frustration. He closed his eyes and sighed, combing his fingers through his short hair. He stepped back from the bed and flexed his shoulders wearily. “What am I going to do with her, Dr. Mercy?”

“Stop talkin’ over my head like I’m a kid.”

“Then stop acting like one.”

The antipathy shot between them like an electric bolt as their gazes held for a long moment.

“This won’t help,” Mercy said softly. She gave them a few seconds to calm down as she watched the changing emotions play over Kendra’s face. She looked like a young Michelle Pfeiffer, with an exquisite beauty that could easily have transmitted itself onto the movie or television screen. But all she’d ever wanted was a husband and children. Lots of children. They’d discovered recently that she couldn’t have kids, just a few months after her fireman father was killed in the line of duty.

“I won’t go to any psychiatrist.” Kendra’s soft soprano voice once again held anger and pain.

“You’re going,” Buck said, frustration still evident in his voice.

“I’m sorry, Kendra,” Mercy said, keeping her voice firm. “You tried to commit suicide tonight, and we can’t take the chance that it’ll happen again. Too many people love you.”

Kendra snorted. “That’s a laugh.”

Mercy leaned forward. “You feel that way right now because your mind isn’t processing your emotions properly. But your condition can be treated. You’re sick, and just like we’d do if you had some kind of bacteria in your body that was making you sick, we can treat you with something that will help your brain work better. We’re going to keep you safe and administer some medication and give you time to heal.”

Kendra glanced around the small exam room as if seeking a way to escape. “Can’t you just do that here? Why do I have to go all the way to Springfield?”

“Because our hospital doesn’t have the facilities to care for you.”

Kendra closed her eyes, and her whole body stiffened. “You mean you don’t have a padded room here,” she said.

Mercy understood, and the identification she felt with Kendra right now was disconcerting. Depression was painful, but manic depression must be like standing on a fault line during an earthquake. It was frightening how easily your mind could betray you.

Kendra sniffed and wiped several stray tears from her cheeks with the back of her hand. When Buck grabbed a tissue from the exam-room desk and tried to give it to her, she ignored him and withdrew from his touch.

Mercy suppressed a sigh. She’d tried several times to explain to Buck why she thought Kendra was behaving the way she had been in the past six months. And Buck had tried, without success, to bring Kendra in to see Mercy for a thorough exam. All he’d managed was to get her checked for strep throat a couple of months ago.

The tears in Kendra’s eyes shimmered like blue crystal. “What kinds of drugs would they make me take?”

“I’m not sure,” Mercy said. “The doctor in Springfield will decide that.”

“I don’t want a doctor in Springfield. You know me better than they would.”

Buck reached over and covered her hand with his. She tried to jerk free, but he held her fast. “Stop fighting this, Kendra.” He looked at Mercy. “I know the procedure. If you’ll do the paperwork and call Cox North, I’ll take her up. I’m a trained EMT, so it’ll be legal, and I’ll see if Clarence will come with me, just to make sure she stays in the truck.” He shot Kendra a biting glance. “Otherwise, Kendra, the ambulance will have to take you, with a policeman riding shotgun.”

“Why should you care?” she snapped back. “Just as long as you get rid of me. They could be hauling me to the junkyard.”

“Cox is a good facility,” Mercy said quietly. “I know from firsthand experience. I was there for a ninety-six-hour involuntary stay five and a half years ago, and I remember the time well. The staff treated me with patience and concern.”

Husband and wife focused their suddenly silent attention on her. Neither showed surprise at her words, because most people in town knew about the incident.

Mercy had seldom spoken about those days, though, and she did so now with difficulty. During a nasty custody battle over Tedi, at the same time Mercy’s father was dying of cirrhosis of the liver, Mercy sought help for her own depression. Unfortunately, the physician on call that night was a buddy of her ex-husband, Theo. They had joined forces, double-crossed Mercy and had her committed before she could do anything to stop them. When Theo used the incident in court against her, she lost custody of Tedi. She had worked five years to rebuild her practice.

For months after that horrible time in her life, she’d vowed never to “ninety-six” a patient. She’d been adamant about it until the night when a patient she had so kindly released nearly died from a second suicide attempt.

She placed her hand on Kendra’s arm. “Honey, I’m sorry, but you no longer have a say in the matter. You’re going to Cox North.”

Clarence carefully parked Mercy’s car exactly where he’d gotten it. He pulled the keys out of the ignition, then leaned heavily on the door and steering wheel to heave himself out. He couldn’t get that little girl, Crystal, or her grandma Odira, out of his mind. Because of his help they were tucked safe and warm in a comfortable hospital room with smiling, cheerful nurses. Sure, he’d only driven them a block down the road, and any taxi could have done that, but the taxis in Knolls didn’t run this time of night.

Most people wouldn’t understand being so helpless. They could do for themselves and didn’t think much about it. But up until just a few months ago he’d been stuck in his bed most of the time, too heavy and in too much pain from pulled muscles to even walk out the front door. He’d been so bad that even his own baby sister had nearly died trying to take care of him. A guy could feel like he’d lost his manhood in a situation like that, but tonight, in just the past couple of hours something had changed.

The squeaky hinges on the front door of Mercy’s clinic interrupted Clarence’s thoughts.

Buck Oppenheimer stepped out into the darkness. “Clarence, is that you?” He squinted and peered harder, raising his hand to shade his eyes from the glow in the room behind him. “I need a big favor.” His hoarse voice cracked with weariness as he pulled the door shut behind him.

Clarence shivered in the icy winter wind. “From me? Sure. What’s that?”

“Would you ride shotgun? Dr. Mercy said she’ll let me take Kendra to Springfield without a police escort if you’ll go along. I don’t want to take any chances. Kendra’s fighting this, and there’s no telling what she’ll do. Sorry, pal. I know it’ll be a long night for you, but—”

“When do we leave?”

Buck stared at him in silence for a moment. “Thanks, Clarence. You don’t know how much you’ve…helped.” His voice caught, and he turned away. “You can’t know what this means to me.”

“Wanna bet?” Clarence knew better than to get sentimental or sappy with Buck. “How about when you drove me to the E.R. when Darlene almost died? You visited me in the hospital when I wasn’t a very nice guy to be around.” Buck’s life had been the pits, too, back then. Kendra had kicked him out, and he’d been suspended from his job with the fire department pending an arson investigation.

Buck turned back around and held out his hand. “Call it even after tonight?”

Clarence took the hand and looked Buck in the eyes. “It’s never even, you know. That’s what friendship’s all about.”

Lukas hovered closely over seventy-year-old Mrs. Flaherty so he could hear her above the noise of the continuing party in the waiting room and the snores emanating from the sleeping bikers in two of the other exam rooms.

“Can’t figure out what happened,” Mrs. Flaherty said in a voice barely above a whisper. “One minute I was brushing my teeth at the sink, and the—”

“Catch that before it falls, Boots!” came a shout from the other room.

“—woke up no telling how long after that. I called my daughter, but before—”

“Hey! Get away from that set! I wanna watch—”

“—and you can imagine how she felt when she came in and found—”

Tex walked into the room. “I called the police, Dr. Bower. They’re busy with a break-in down at a dock and can’t come right away.” She glared over her shoulder at the noise. “If I had a stun gun…”

Mrs. Flaherty reached up and touched Lukas’s arm. “Dr. Bower, do you think I’m having a stroke or something?”

Lukas glanced over at the lady’s middle-aged daughter, who sat in the far north corner of the exam room, hands clasped at her knees.

“Mom was just lying there when I found her, Dr. Bower. I couldn’t wake her up for at least five minutes. When I did I just brought her in. I didn’t wait to call an ambulance or anything. Do you think it’s her heart?”

Lukas studied his patient’s chart—or that part of it Tex had managed to fill out before leaving to call for backup. There were no security personnel at this hospital. Mrs. Flaherty had managed to walk in assisted by her daughter, and she showed no muscle weakness. A quick finger-stick glucose check had revealed normal blood sugar.

Another shout of raucous laughter reached them, and Mrs. Flaherty flinched. She didn’t look bad now. Her color was pink and healthy, and perspiration no longer beaded her skin. Lukas would put her on a monitor.

Another shout. And from the exam rooms where Catcher and his friend were sleeping came loud snoring.

Lukas knew trying to listen to Mrs. Flaherty’s chest right now would do no good. He wouldn’t hear anything above the noise. This town needed military intervention. He took the stethoscope from around his neck and placed it on the tray table, then took a deep breath. He was stuck with Catcher and friend until they sobered up, but he would not allow their crowd of troublemakers to endanger the lives of other patients in this facility, not while he was in charge—or at least not as long as he was alive. How long that would be after he’d voluntarily thrown himself to the wolves…Oh, well, time to get tough.

“Tex, keep an eye on Mrs. Flaherty. Get her on a monitor, do an EKG, check electrolytes, and if you can hear above the noise, get a history. If I’m not back in five minutes, call the county sheriff. Or maybe the ambulance…No, wait a minute, Quinn’s still on duty. Forget that.”

Anger. Work with the anger now. He wrenched open the door that separated the waiting room from the E.R. proper and flung it back so hard it crashed against the wall. Then the door bounced back and slammed him in the shoulder and shoved him sideways. He felt the pain, which only served to make him angrier. As he stomped into the battered waiting room, he saw at least ten pairs of eyes directed toward him. Silence fell for just a moment, and he made his move.

“Everybody! Out of here! Now!” he shouted in his deepest, most fury-filled voice, but just then a commercial blared on the TV, negating the effect. He continued anyway for a few seconds, taking advantage of the shock on their faces and the impetus his anger gave him to overwhelm the terror he knew was in his mind somewhere, seeking an outlet.

“Look at this mess!” He gestured toward the chairs toppled onto their sides and the pages of newspapers scattered across the floor. The coffeepot was empty, and it looked as if half the coffee had spilled onto the carpet.

He marched over to the TV and ripped the cord from the socket, plunging the room into complete, blessed silence this time. “I said out of here! This isn’t your own personal nightclub.” So much for patience and compassion.

The partiers stared at him as if he were an alien being. Then three of the biggest, meanest-looking men exchanged nods and slowly moved toward him.

Lukas swallowed and forced himself not to back up or turn and run. Lord? I could use some help here!

“We’re not goin’ anywhere till Catcher and Moron can come with us!” a woman shouted back.

What was her road name? Birdbrain? What a weird bunch. He glanced at the three men who continued to move toward him, one step at a time, from three different areas of the room, as though they were stalking a wild animal. He just hoped the end wasn’t too painful.

He cleared his throat and tried not to flick a nervous glance at the stalkers. Don’t act afraid. “I’ll gladly release them if any one of you is sober enough to sign them out and take care of them until they can take care of themselves.” He looked from face to face—three women, seven men, with grubby, not-quite-in-focus faces—and didn’t get a volunteer. “Fine, then. I’ll keep them here.”

“Fine, then. We’ll stay, too,” the woman shouted.

“Then you’re a brave bunch,” Lukas said.

“Why’s that?” she taunted.

“When Catcher finds out you left his bike alone down by the lake for anybody to carry off, nobody will be able to save you.”

“My bike!” The loud, gruff voice came from the E.R. entranceway, and at the sound all attention pivoted in that direction. Even Lukas’s stalkers halted their steps to turn and see Catcher, all six feet four inches, two hundred fifty pounds of him, glowering from the threshold, his clothes splattered with drying blood.

He took a step forward, and Lukas wondered if the rest of them could see how unsteady the movement was.

“You left my baby down there all alone!” he thundered, then groaned and hunched forward. Lukas rushed over to grab him before he fell. But Catcher straightened himself and sent Lukas a warning glance. He raised his good arm and pointed toward the door. “Get out of here! All of you, get out of here! Boots, you’re walking, and I’m taking your bike. If my baby has a scratch on her when I get there, I’ll take it out of all your hides!”

Lukas’s stalkers were the first ones out the door, followed by Birdbrain and the other women. Catcher turned to bring up the rear of the procession. Lukas let him go.

Chapter Four

A t two o’clock Sunday morning Mercy stood on the front step of the Richmond Clinic and watched the taillights of Buck Oppenheimer’s big red pickup disappear into the cold darkness. Kendra’s condition was stabilized. She had recovered, clinically, from the carbon monoxide poisoning and now sat between Buck and Clarence on her way to four days of forced hospitalization in Springfield.

This was the right thing to do; Mercy knew it.

So why did it hurt so badly to remember the look of betrayal in Kendra’s eyes when the men placed her gently into the cab of the truck? Mercy shivered at the wind and stepped back inside the waiting room, though she didn’t shut the door.

As she watched tiny flakes of snow glitter in the light from the front step, other memories haunted her—of seeing her daughter terrified and in danger, and being unable to help; of feeling frightened herself by her own father’s alcoholism. She’d lived with past pain for so long she frequently had trouble enjoying the present.

Another gust of wind scattered tiny flakes across her face, and she finally closed and locked the door behind her. “Lord, help Kendra to see the truth of Your love,” she whispered. “Heal her, Lord. And please complete the healing in me.”

Mercy had begun, in the past few months, to put her patients in God’s hands as quickly as possible when her worry for them began. All she had to do now was learn to leave them there, to stop trying to control every situation.

She went into the front office and e-mailed the final pages they would need at Cox North for Kendra’s admittance.

The telephone rang beside her as the information was posted, and she picked up quickly.

“Hi, Dr. Mercy, this is Vickie over at Knolls Community. I thought you might still be in your office. I just wanted to let you know that Crystal and Odira are both settled in, and Crystal was already asleep when I left the room. We’ll keep a close eye on both of them tonight.”

Mercy felt a little easing of tension at the nurse’s reassuring tone. “Thank you, Vickie. I’ll be over in the morning to check on Crystal.”

After hanging up, Mercy walked back into her office.

She stepped over to her desk and plopped down into the leather chair for a moment. She stretched out her arms and flexed her shoulders, rolled her head around and took a few deep breaths. Odira hadn’t looked healthy tonight. Maybe in the morning Mercy could check her out.