Silent Pledge

“What’s your problem, Texas, can’t take the pressure?” Quinn reached over to remove the equipment from the body of the deceased. “No wonder you couldn’t handle your resident training.”

“No!” Lukas reached out to stop Quinn’s movements. “Don’t touch anything on her.”

Quinn raised his hands in an exaggerated show of obedience. “Hey, Doc, lighten up. I’m just trying to help out. After all, she was alive until we brought her to you. ”

Sandra gasped and looked over at her partner.

Tex shoved some trash into a biohazard container and straightened to tower over the man. “Breathing into her belly all the way here was what killed her. We might have saved her if you’d given her a chance in the first place, but no, you didn’t even bother to check.”

“Tex.” Lukas was too tired and grief-stricken to break up any more fights on this shift. “Quinn, everything has to stay in place in case the coroner wants to have an autopsy performed. Tex, will you go call him?” Maybe that would get her away from Quinn long enough to get her temper under control. To see that she did so, he walked out with her.

“That man shouldn’t be allowed to touch patients,” she muttered to him as they left the curtained room.

Lukas shushed her. Her voice carried past the thin barrier of curtain like the growl of an angry crocodile. Even though he agreed with her, he had to look at both sides. “You know an intubation like that can be difficult. Even the most skilled practitioner could have missed it under those circumstances.”

“Yeah, but I’d’ve at least checked her breathing. Couldn’t you tell by Quinn’s expression that he hadn’t?” She lowered her voice at last to a hoarse whisper. “I’m going to talk to Sandra later. That girl’s scared of her own shadow, but maybe I can bully her into telling the truth. Quinn’s incompetent. It’s probably because he works too many hours, but that doesn’t excuse his disregard for human life. They need to get rid of him.”

“And who would they find to replace him?” Lukas asked dryly.

She grimaced. “Good question. The hospital doesn’t want to pay anything. That’s why we’ve got a bunch of losers here already.”

“And where does that put you and me?”

She didn’t even blink. “You’re here to keep busy until the E.R. is rebuilt in Knolls.”

“And why are you here?” Lukas asked. “You’re no loser. I’ve seen you work. You know your stuff. I couldn’t help picking up on Quinn’s reference. Are you a resident?” He studied her more closely and saw the sudden tightening of her lips, the hooding of her eyes.

She looked away. “I’m a paramedic right now, Dr. Bower. I’m here because this is home…or it was.” She sighed. “The guy you’re replacing? Dr. Moss? He thought he was coming here for a break from family practice. Ha! Now he’s on suspension here and his license is in question, and it’s not even his fault. You’d better look over you shoulder around here. No telling who’ll try to stab you in the back.” She glared in Quinn’s direction and walked off to use the phone at the nurses’ desk.

Carmen swiveled in her chair to face Lukas. “Dr. Bower, a friend of mine from the police department just called. They didn’t find any baby, but they called the landlord of the building where the woman was living. He’d gotten complaints from the neighbors for the past two or three days about a baby crying.”

“Did he say how many people lived in that apartment with her?”

“Just the woman. Last time he saw her she was pregnant, and that was last week, when he dropped by to try to get rent payment from her, which he didn’t get. Looks like she was broke, and the room was a mess, like she’d been sick for a while. The baby was obviously a newborn.”

“Did they give you a name?”

“Said the woman was Marla Moore. She stayed inside a lot. I guess the landlord’ll have to come down and make identification or something. The police haven’t found any relatives yet.”

“But the baby,” Lukas said, “what about the baby?”

Carmen shrugged. “If it’s a newborn, it couldn’t’ve crawled off. Somebody’s got to be taking care of that baby.” The telephone buzzed again, and she turned back to the desk.

“Hey, Dr. Bower?” came a quiet male voice from behind him.

Lukas turned to find Quinn standing there, head bowed, arms folded across his chest. “I shouldn’t have given you such a hard time in there. I guess I was pretty nervous.”

“You don’t walk out on a code, Quinn. We needed you. Where did you go?”

“I…I’m sorry. I nearly lost my cool for a little bit. I mean, we were fighting for a young mother’s life, and Tex made it sound like I’d really blown it.” He shot a quick glance toward Carmen and Tex, who were both on the telephone at their desks. “What are you going to put on your report?”

“What do you mean?”

Quinn shrugged. “I need this job bad, and I can’t afford to lose it. What are you going to say about me?”

Lukas felt the fresh weight of grief sharpen his tongue. “The truth usually works.” He turned away and left Quinn standing there.

He went into the call room for a moment. He had reports to fill out, work to do, but he knew from experience that if there were no other patients who needed him, it was best to spend some quiet time after a painful event like this one. If there was any time he needed prayer more…

And then he realized something. During that whole code, in all the confusion and angry words and difficult decisions, he’d forgotten the most important thing. A habit that he’d developed in his first E.R. rotations years ago was to pray on the run while treating victims of severe illness or trauma. Praying had become second nature for him; he did it without thinking. But this time…this time he’d been caught off guard. He’d allowed his anger at Quinn to divert him from the most important treatment.

“Forgive me, Lord.” He covered his face with his hands. He knew God didn’t need his permission to save a life or to guide the hands and minds of the staff when they were working with patients. Still, he had no doubt that prayer was an energizing touch, a powerful connection between God and the caregivers. Yes, prayer operated on a spiritual level, but weren’t human beings as much spirit as body?

And what if Marla Moore did have a baby? Was there a husband? She was so young….

Just three months ago Lukas had lost a drowning victim, a young woman like this one. Some fishermen had found her at the shore of the lake and had contacted him by car phone as they raced with her from the lake to the hospital. They’d been devastated when they couldn’t save her. So had Lukas. The loss always hurt the worst with the young ones, as if fresh new canvas had been ripped from the center of a painting in progress. With Marla it looked as if an even newer life was involved.

“Lord, please take care of Marla’s baby. When they find her family, touch them with Your healing power and give that baby an earthly mother. And help me not to push You to the side next time.”

He paused and took a new breath. He had to return to work, but he might not have a chance to get back here soon, and he needed to eat something to keep his strength up and his mind sharp—he hadn’t eaten for eight hours, and he’d barely slept.

Quickly he pulled open the top side drawer of the desk and reached in for the peanut butter sandwich he’d packed yesterday before coming to work. He unwrapped the aluminum foil and pulled it back, then recoiled with disgust. Someone had taken several bites out of his sandwich—he could see the teeth marks clearly. In place of those bites was a dead fly.

He smashed the foil back together over the sandwich and threw the whole thing into the trash can.

He was beginning to hate this place.

A soft call reached Mercy through the darkness, indecipherable through the haze of the drug she had used so she would be sure to get some rest before returning to the hospital. But in spite of the drug, her eyes flew open. She listened. Had her mysterious visitor at the clinic followed her home?

“Mom?” Her bedroom door slid open, and a glow came through from the hallway night-light to reveal the dark outline of Tedi’s sleep-mussed hair. “Can I sleep with you?”

Automatically Mercy scooted over and pulled the covers back. Tedi came forward quickly and climbed into the nest of warmth Mercy’s body had generated. She placed her icy feet on Mercy’s legs, then giggled when her mom gasped.

“Nightmares?” Mercy asked, grimacing at her daughter’s late-night-snack breath. She should have let Tedi say at Mom’s for the rest of the night instead of waking her again and dragging her out into the cold air to come home. She felt so lonely without her…but that was a selfish motive.

“Yeah.” Tedi paused a moment, then said more softly, “And I missed you.”

“I’m right here.” Mercy reached out and gathered her daughter close, bad breath and all.

Tedi snuggled against her. “You’re gone so much, though. Can’t Lukas just come back and help you at the clinic until the E.R. opens up and you don’t get as many calls?”

“I don’t think so, honey.” Mercy sighed and glanced at the clock. She’d only slept three hours. This was going to be another tough one. Now she would lie awake and worry that she wasn’t giving her daughter enough attention, that too many of her patients were falling through the cracks, and that if she did get back to sleep she might miss another emergency call. Had she done the right thing keeping Odira and Crystal here at the community hospital?

And if she continued to worry like this, would she ever sleep again?

Tedi’s rhythmic breathing deepened and her body relaxed. Mercy couldn’t even close her eyes. So she started doing what she’d been practicing lately when the nagging specter of insomnia attacked her—she prayed. And she began with a prayer for Lukas to return.

Lukas struggled with his frustration as he returned to the E.R. proper. All his life he’d wanted to be a doctor, although when he was growing up he envisioned himself as the faithful family practitioner who had an office attached to his home, who made house calls and whose wisdom and compassion alone could make people feel better. He’d watched too many Marcus Welby, M.D. reruns. By the time he reached his third year of premed, he’d been forced to acknowledge that medical practice wasn’t what it used to be. Still, being a doctor was all he’d ever wanted to do.

It wasn’t until his first experience in an emergency room during fourth-year rotations that he felt the adrenaline rush of life-and-death decisions. He’d been addicted ever since. He could get high on a successful pediatric code. His heart could break at the death of an elderly nursing-home patient. And it was still all about people.

People were also what made the job difficult. There were so many extremes, and so many burnouts, and he kept in mind that it could also happen to him. His first burnout with people had come before his ninth birthday.

When he was a skinny, shy kid of eight, he’d had to get glasses. His two older brothers picked on him and teased him when their parents weren’t watching. Because of that, he remembered backing further and further into a shell until he barely spoke to anyone at all, and their teasing only grew worse.

One day Dad took him on a walk, just the two of them, out through their vegetable garden to a small grove of apple trees that always produced the crispest, sweetest apples in the farming community where they lived.

Dad picked an apple from the tree and held it out to Lukas. There was a brown, worn-looking spot near the top. “See this, Lukas? The apple grew too close to the branch, and that branch rubbed against it when the wind blew. Some years these are the apples I like the best, because a lot of times they seem to have the sweetest taste.”

Lukas took a bite of the apple, grimaced at the hard bitterness and heard his dad chuckle.

“Oh, yeah, I forgot to mention something,” Dad said. “Strange, isn’t it? The same rubbing that makes a lot of the fruit sweet some years can also make the fruit bitter and hard other years. Guess it has to do with how much sunshine they’ve had.” He placed an arm around Lukas’s shoulders. “Anyway, that’s my opinion. People are like that, and you’re not too young to learn the lesson. God’s love is your sunshine, you know. Just let Him shine through you in spite of the bad weather and the teasing you always get from your brothers. You’ll be glad you did.”

And so as Lukas approached Carmen at the front desk he forced a smile. This was her first office job, and she was understandably nervous, especially with the unforgiving attitude of many of the staff. Her harried expression always seemed on the verge of panic when an ambulance came in or when Lukas gave orders. She was one of the youngest on the staff.

“How’s it going, Carmen?” he asked as he stepped up to the computer where she worked.

She jerked and looked up at him, her fingers fumbling on the keyboard. Her gaze darted quickly to an item on her desk, then away again. “Fine, Dr. Bower. The coroner’s on his way, and Quinn and Sandra took off a few minutes ago. Tex finally went to grab a bite because she’s starving, and nobody else has checked in.” She got to her feet, eyes wide, movements nervous.

Lukas wished the poor woman could relax a little. If she didn’t, she wouldn’t last here very long. He frowned and glanced again at an item on her desk that he’d noticed earlier—a blue-and-white tube of surgical jelly.

He shrugged and started to walk away when the phone buzzed beside Carmen’s left elbow. She jumped and jerked it up, answered sharply and listened, catching Lukas’s gaze. When she thanked them and hung up, she shook her head. “That was Sandra. She and Quinn went back to the apartments where they found Marla. Did you know that’s where the bikers are staying? The police checked the place out. They found baby stuff, but no baby. A couple of the neighbors heard the commotion and came out. They said they’d heard a baby crying for a while, but they’d gotten used to that in the past couple of days. Nobody can find anything now.” She shrugged and sat back down in front of her keyboard.

Lukas stared at her. “But they’re still looking, right?”

She repeated her shrug. “I don’t know, Dr. Bower. Quinn said the police are busy tonight. Maybe they just don’t have time to look.”

Lukas glanced at the wall clock. It was 4:00 a.m. Sunday and freezing outside. “Where could a newborn baby possibly be? Surely if someone found a baby they’d call the police immediately.”

“You would think,” Carmen said darkly, “but I’ve already heard some rumors. You know the little girl who disappeared from the park last week? Some people think she was kidnapped. Quinn told Sandra there was a black-market baby ring in the area, and he thinks those bikers have something to do with it. I wouldn’t put it past them.”

Chapter Seven

A t seven o’clock Sunday morning, Mercy Richmond walked down the second-floor hallway of Knolls Community Hospital. Her stomach growled at the aroma of breakfast. She listened to the clatter of plastic and the clink of china and glasses as the aides collected trays from the fifty-three private-room patients. Census was up. Foot travel was heavier than usual, and the low rustle of charts and papers in the nurses’ station and the talk and laughter from televisions in the rooms were more pronounced.

“There you are!” came a deep female voice behind her, and she turned to find Mrs. Estelle Pinkley, hospital administrator, stepping around a tall kitchen cart.

Mrs. Pinkley, a few years past retirement age, had the bearing and vitality of a college student. Her white hair, feathered back from her face in feminine lines, exposed a high forehead. She was as tall as Mercy’s five-eight, and she always made Mercy feel dowdy. Today she wore an elegant blue dress with a cowl neck. The blue brought out highlights in her lively and intelligent gray eyes. If Mercy made it to church at all this morning, she would wear what she had on—blue jeans and a red cable-knit sweater.

Estelle showed few outward signs of the injuries she had sustained in the October explosion. The general public was seldom aware that arthritis, from which she’d suffered for several years, now concentrated itself on her injured arm and leg during flare-ups. People usually didn’t know what took place in her personal life unless she revealed it. For instance, everyone in Knolls knew she was an ethical lady who made intelligent decisions. Everyone knew she was a churchgoer. Few people knew that she and her husband dedicated the majority of their combined income to support three missionaries—one in Minsk, Belarus; one in Guatemala; one in China. And she seldom displayed the scope of her biblical knowledge here at the hospital.

Estelle reached out and drew Mercy with her into the small conference room beside the nurses’ station. The heady aroma of freshly brewed coffee filled the room. Mercy took a deep whiff. The smell was wonderful. Coffee was off her diet, however. Lately it had been giving her the jitters.

“I’ve just been on the telephone talking to our contractor,” Estelle said.

“This early on Sunday morning?” Mercy said dryly. “I’m sure he appreciated the call.”

“He didn’t complain.” Estelle reached into her pocket, pulled out a dollar and deposited it in a collection cup for the purchase of future refreshments for staff. Then she picked up the coffeepot and filled a clean mug. “He has a good head for business. He’s polite, and he knows how to get the most out of his workers. I wish more of our directors were like that. We’re ahead of the initial schedule by at least three weeks.” Estelle’s sharp, decisive voice with its gravelly timbre held the familiarity of some of Mercy’s earliest memories. Estelle and Mercy’s mom, Ivy, had been friends since they attended Knolls Elementary School together.

“He hired three more men last week at my request,” she continued.

“Why do that if they’re already ahead of schedule?”

“Because I want the job done sooner. I hope to see our emergency department up and running by the end of February if possible.”

“You’ll probably get what you want,” Mercy said.

A pleased smile flitted across Estelle’s face and was gone quickly. When she was in fighting form—which was all the time, even right after her near-death experience in the explosion—she could take on an Angus bull.

“I see you’re still working out of the storeroom,” Mercy said.

Estelle took a sip of the coffee and grimaced. “And that is where our offices will stay until the rest of the hospital is complete. Patients come before carpeting and wallpaper, and if anyone wants to complain, they can come and talk to me.”

Mercy laughed. “If that happens I want to be there to see it.” Before Estelle became hospital administrator five and a half years ago, she had been prosecuting attorney for Knolls County. A handful of people in the area who had found themselves on the wrong side of the law resented her. The rest loved and respected her, and Mercy was one of them. Estelle represented safety and stability in their small town, and Knolls Community Hospital was now one of the best small hospitals in the state—and would be again, once the damaged areas were rebuilt.

“So,” Estelle said with a penetrating look at Mercy, “I don’t like the looks of those dark circles under your eyes. Can you get Lukas back here to help us out until then? Both of us need him.”

Mercy felt the truth of those words, but she knew her own personal need to have him in her life was not what Estelle meant.

The administrator put the coffee cup down and poured in some powdered creamer, stirred it, tasted again, and nodded, satisfied. “Think of your patients if you refuse to think about your own health. We need our E.R. doctor available for them. Even with the additional lab and X-ray capabilities in your clinic, you can’t do it all yourself. There isn’t another E.R. within an hour of here.”

“There are other doctors in town.”

“Yes,” Estelle snapped, “and they’re complaining about being overworked, but I don’t see any circles under their eyes.”

“They aren’t going through menopause,” Mercy said.

“Maybe you wouldn’t be, either, yet, if you didn’t have so much stress. We need another doctor, and Lukas should realize that just by talking to you.” She paused and gave Mercy a thoughtful, penetrating glance. “You two are still seeing each other, aren’t you?”

Sometimes Mercy wondered if Estelle had some mind-reading ability. “Mom’s been talking to you about me again.”

Estelle shrugged. “Ivy knows you’re being overwhelmed at the clinic. She worries about you.”

“That doesn’t give her any rights to interfere in hospital politics.”

“She’s doing what any concerned mother would do.”

Mercy could only shrug and shake her head. Her mother was a generous benefactress of the hospital, and sometimes, when she found some strings she wanted to pull, she used her advantage.

“I’ve taken steps to help with the overload,” Mercy said. “I hired Lauren McCaffrey to work at the clinic until the E.R. is operational again. She’s a good E.R. nurse. She’s taking up a lot of the slack.”

“She’s not on call twenty-four hours a day like you are,” Estelle said. “Get Lukas back here, for all our sakes.”

“I’m not sure he wants to come back.”

“Then convince him otherwise.”

“He’ll listen to you before he’ll listen to me.”

Estelle studied Mercy’s face for a moment and gave an astute nod. “But he’ll listen to you with his heart.” She laid a hand on Mercy’s shoulder and squeezed. “Bring him home, my dear. It’s where he needs to be.” She glanced at her watch. “I must get to early service before they start praying for my wayward soul. Then I have a day’s work in my office to complete.”

“Sounds like you need to practice what you preach,” Mercy said.

With a final pat on Mercy’s shoulder, Estelle poured the leftover coffee into the tiny sink in the corner, rinsed the cup in the sink and strode out of the room, leaving the scent of lavender in her wake.

Before Lukas ended his shift at 7:00 a.m. Sunday morning, he had treated three babies ranging from two weeks to three months. Their cries haunted him and made him think, once again, about Marla Moore’s missing baby. Judging by the conversation he overheard from other staff members, most people supposed the child had been kidnapped. Much suspicion hovered over the presence of the bikers so close to the scene of disappearance. The landlord was questioned at length, and the authorities had decided to autopsy Marla.

Lukas had been told by the police that the Missouri Special Crimes Unit had been called in. The delivering physician had been contacted and gave more information about Marla. She was nineteen, alone, frightened. The baby’s name was Jerod Andrew Moore. There was no father listed. Maternal grandparents were both deceased.

While treating the final patients of the shift for the usual assortment of January colds, influenzas and strep throats, Lukas hadn’t been able to forget the young woman’s deathly pale face.

He was just sitting down at the small workstation next to the nurses’ desk to chart his last patient when he heard a husky, easily recognizable female voice behind him.

“So…have they started initiation yet?”

He turned to see Tex striding toward him from exam room two, her scrubs stretched tightly across her shoulders. She did resemble her cousin, Lauren, in a superficial way, with those green eyes, straight white teeth and high cheekbones. But where Lauren had a delicate beauty that attracted men wherever she went, Tex had an independent nature about her that said “Back off.” Her physical stature added to the impression, with a voice to match, and a glare that could send a strong man reeling. She hadn’t aimed her look at Lukas, but he figured Quinn’s days were numbered.

“Initiation?” Lukas asked.

She pulled her chair out, turned it around and straddled it as if she were riding a horse. “We’ve got some juvenile delinquents on staff here that try to pass for human beings. They like to play practical jokes on the new guys, and you’re the newest.”