His Shock Valentine's Proposal

A twinge of guilt ate at him and he felt bad for declaring war on her.

“You declared war on her? How does that even happen?” Luke had had a good laugh over that.

Of course, the last time Carson had declared war on someone was when Luke and he had been kids. Carson had declared war on Luke when he was ten and Luke had been fifteen. Carson had gone about booby-trapping parts of the house. The ceasefire had come when Luke had set a snare and Carson had ended up dangling upside down in a tree with a sign that said bear food.

Their father had put a stop to all present and future wars.

Carson sighed. He hadn’t been thinking that day in her surgery. She got on his nerves a bit and he had been put out that the Johnstone twins had thought he was grumpy and old. He honestly was glad to be rid of the little hellions.

It was the principle of the matter.

In all the years his father had practiced he’d never been called grumpy or old. He’d never lost a patient to another doctor.

There never was another doctor in Crater Lake.

A lot of new families had come into town over the past couple of years. Dr. Petersen was advertising. He’d heard her ad on the local radio station. Perhaps he needed to advertise. Maybe he was a bit too comfortable in his position and he was in a rut.

Carson rubbed the back of his neck.

He should go make amends with her.

He crossed the street and peered inside the clinic window to see if he could catch sight of her, get her attention, then maybe he could talk to her.

Before he knew what was happening there was a shout, his wrist was grabbed and he was on the ground staring at the pavement.

“What in the heck?” Carson shouted as a pain shot up his arm. He craned his neck to see Esme Petersen, sitting on his back, holding his left wrist, which was wrenched in an awkward position behind him. “Um, you can let go of me. I kind of need my arm.”

“Oh, my gosh. Dr. Ralston, I’m so sorry.” She let go of his wrist and got off his back. “I thought you were a burglar.”

Carson groaned and heaved himself up off the pavement. “There aren’t many burglars around Crater Lake. It’s a pretty safe town.”

“I’m really sorry for attacking you like that, but you scared me. Why the heck were you skulking around the outside of my office?”

“How the heck did you do that?” Carson asked, smoothing out his shirt.

“Do what?” Esme asked.

“Take me down?”

Esme grinned. “Krav Maga.”

Carson frowned. “Never heard of it. What is it?”

Esme shook her head. “You still haven’t answered my question. Why were you peering through the windows and generally acting suspicious? This doesn’t have to do with the war, does it?”

“Kind of.” Carson touched his forehead and winced. “I think I’m bleeding.”

“Oh, my God. You are.” Esme took his hand and led him to the open door. “Come inside and I’ll clean that up. It’s the least I can do.”

“No, thank you,” Carson murmured, trying to take his hand back. “I think you’ve done enough damage.”

“No way. You owe me this.” She dragged him into her very bright and yellow clinic waiting room. It was cheery and it made him wince. “You can head into the exam room and I’ll take a look at the damage.”

Carson snorted. “Are you going to charge me a fee?”

Esme rolled her eyes. “So petulant. I just may, since you were creeping around in the shadows trying to scare me.”

Carson sat on the exam table as she came bustling into the room and then washed her hands in the sink, her small delicate hands. They looked soft, warm, and he wondered how they would feel in his. He couldn’t think that way.

“I wasn’t trying to scare you,” he said.

“You said it was about the war you declared on me. Doesn’t that usually involve trickery and scaring tactics?” Esme stood on her tiptoes and tried to get a box from a high shelf. She started cursing and mumbling under her breath as she couldn’t quite reach it.

Carson stood and reached up, getting the box of gauze for her, his fingers brushing hers as she still tried to reach for it.

So soft.

His heart raced, he was standing so close to her, and he looked down at her and she stared up at him in shock that he’d done that for her. He hadn’t realized how blue her eyes were or how red her lips were and the color was accentuated by the white-blond of her hair. She kind of reminded him of a short, feisty Marilyn Monroe.

Focus.

Carson moved his hand away and tossed her the box of gauze. “If you can’t reach it, you shouldn’t put it up so high.”

“I didn’t. My nurse did. He is a bit taller than me.”

“He?” Carson asked, teasing her.

“Sexist, too, are we?”

“Please.”

“Sit down. You’re such a whiner, Dr. Ralston.”

Carson sat back on the table; his head was throbbing now. “Dang, you did a number on me. What did you call that again?”

“Krav Maga.” Esme pulled on gloves. “Sorry.”

“No, it’s fine. You’re right. I shouldn’t have been … what did you call it?”

“Skulking.” She smiled, her eyes twinkling as she parted his hair to look at his injury.

Carson winced again, ignoring the sting. It wasn’t the sting that bothered him, it was her touch. Just the sudden contact sent a zing through him. It surprised him. It was unwelcome. He wanted to move away from her, so he wasn’t so close, but that was hard to do when she was cleaning up his wound. “Right. Skulking. I shouldn’t have been doing that outside your office.”

She nodded and began to clean the wound. “So why were you?”

“I came to apologize.”

Her eyes widened. “Oh, really?”

“Yeah. I shouldn’t have come barging over here and accusing you of stealing my patients.”

“So are you calling a truce?”

“I am. Ow.”

Esme tsked under her breath. “It’s just a scrape. Don’t be such a baby.”

“Do you talk to all your patients this way?”

“Only ones who whine so much.” She smiled and continued to dab at his scrape. “There. I’ll just put some ointment on it. Do you want a bandage?”

“No, thanks.”

Esme shrugged and then rubbed some antiseptic ointment on the scrape.

“Ow.”

“Doctors are the worst patients,” she muttered.

“For a reason.” Carson chuckled.

“I’ve never really understood that reason.” She pulled off her gloves and tossed them in the medical-waste receptacle. “There. All done.”

“Thanks.”

“Are you sure you don’t want a bandage? Maybe a pressure dressing.” She was chuckling to herself and he rolled his eyes.

“Pretty sure.” Carson sighed. He had to get out of the clinic before something else happened. Such as him doing something irrational. Only he couldn’t move. “I better be going. Again, I’m really sorry for being such an idiot before.”

She grinned. “Apology accepted.”

Esme didn’t really know what else to say. She felt very uncomfortable around Carson, but not in a bad way. In a very good way and that was dangerous. When their hands had barely touched a few moments ago, it had sent a zing through her. One that wasn’t all that unpleasant. Actually, it had been some time since she’d felt that spark with someone. Of course, relationships never worked out for her. Men couldn’t handle her drive and focus to commit to surgery and she had liked her independence and career too much. No one messed with her career.

Well, not anymore. She couldn’t forget why she was a surgeon.

Hold on, Avery. Please.

Let me go, little sister. It hurts so much … let me go.

She’d dedicated her life to surgery. To save lives.

And until Shane, surgery had been her life. Her father had been so proud and she’d been training under Dr. Eli Draven, the best cardio-thoracic surgeon on the West Coast.

She’d thrown herself into her work. So much so, that she hadn’t had time to date, until Eli had introduced her to his son.

She’d met Shane and surgery had become second, because he had always been taking her somewhere. Esme had been swept off her feet and, being the protégée of Dr. Eli Draven, she’d become too cocky. Too sure of herself. She’d thought she’d had it all.

Then in a routine procedure, she’d frozen. A resident had jumped in, knocking sense back into her and they’d worked hard to save the patient’s life. But in the end they’d lost the fight.

Esme hadn’t been able to go on, because in that moment—in that failure—she’d realized that she didn’t know who she was anymore. She didn’t know who she’d become, but it wasn’t her.

Pulled back from her memories, Esme stared down at her hands, watching how they shook.

You’re not a surgeon anymore, she reminded herself.

She’d come here to rebuild her life and right now she should be focusing on building her practice up, because every last dime of her savings had been sunk into this building. She’d bought the clinic, the license and the apartment upstairs.

This was her life now. She didn’t have a retired parent to hand off a practice to her. Her stepmother had been a teacher and her father a cop.

They’d scrimped and saved to send her to the best medical school. Scholarships only went so far and she owed it to them to pay them back, since she could no longer be the surgeon they expected her to be.

She’d lost herself.

And she’d lost Shane. If only she’d come to the realization that he wasn’t the man for her before she was in her wedding dress and halfway down the aisle on Valentine’s Day. It was something she had to live with for the rest of her life.

Her father had made that clear to her. He’d been so disappointed. She’d let him down.

I don’t know who you are anymore, Esme.

She didn’t deserve any kind of happiness, or friendship. All she deserved was living with herself. Living with the stranger she’d become.

“Well, I have a bit of work to do tomorrow. I better hit the hay,” she said awkwardly, rubbing the back of her neck and trying not to look at him.

“Yeah, of course. I …” Carson said, trying to excuse himself when there was banging on her front door. Incessant and urgent.

“Who in the world?”

“Just stay here.” Carson pushed her down into her chair, letting her know that he wanted her to stay put, before he headed out to the front door.

“As if,” she mumbled, following him.

“I told you to stay in the exam room,” he whispered as he stood in front of the door.

She crossed her arms. “You don’t know Krav Maga. I do.”

He rolled his eyes. “Fine.”

Esme stood on her tiptoes and peered around him. When he opened the door a man let out a sigh of relief.

“Thank God I found you, Doc Ralston.”

“Harry, what’s wrong?” Carson asked, stepping aside to let the man in.

The man, Harry, was sweating and dirty, dressed in heavy denim, with thick work boots and leaving a trail of wood chips on her floor. He nodded to her. “Dr. Petersen.”

“How can we help you … Harry, is it?”

“Yes, ma’am.” He was twisting a ball cap in his hands and it looked as if he was in shock. “There’s been an accident at Bartholomew’s Mill.”

“An accident?” Carson asked. “What kind?”

“Jenkins had a nasty incident with a saw, but there’s bad smoke from a remote forest fire and we can’t get a chopper in to airlift him to a hospital and paramedics are still two hours away.”

Esme reeled at that information. She knew they were far off the beaten path, but medical help was two hours away? Why wasn’t there a hospital closer?

“Let’s go. I’ll go grab my emergency medical kit.” Carson slapped Harry on the shoulder. “I hope you don’t mind driving, Harry. You know those logging roads better than me in the dark.”

“No problem, Dr. Ralston.”

“Can I help?” Esme asked.

Carson nodded. “Grab as many suture kits as you can.”

Esme panicked. “Hospitals take care of suturing. We’re not surgeons.”

Carson shook his head. “Not around here. I hope you have some surgical skills. We’re going to need them.”

Harry and Carson disappeared into the night. Esme’s stomach twisted in a knot. Suturing? Surgery? This wasn’t what she’d signed up for.

When she’d moved here she’d put that all behind her. She wasn’t a surgeon.

No.

Then she thought of Avery. Her brother bleeding out under her hands. She was being foolish. They needed her help. Someone was in pain. This wasn’t an OR. She would make sure she wouldn’t freeze up. She wouldn’t. She couldn’t. This was about sustaining a man’s life until paramedics arrived. Esme rushed into her supply room, grabbed a rucksack and began to pack it full of equipment. Her hands shaking as she grabbed the suture kit.

I can do this.

Besides, she might not even have to stitch him.

Carson could handle it and nothing was going to happen.

This man wouldn’t die.

This wasn’t a surgery case. At least she hoped it wasn’t.

CHAPTER THREE

ESME BIT HER lip in worry as they slowly traversed some windy hills up into the mountains. At least that was what she assumed by the bumps and the climbs that tried the engine of Harry’s truck. She couldn’t see anything.

She’d thought she knew what pitch-black was.

The sky was full of clouds and smoke from a forest fire, which Carson had assured her wasn’t any threat to them. California had wild fires, but not really in Los Angeles, at least not when she was there. Then again, she wasn’t a native Californian.

Fire, wilderness, bears, this existence was all new to her, but then this was what she wanted after all. This was a big wide place she could easily blend in. She was small here. A place she could hide, because who in their right mind would come looking for her here?

A large bump made her grip the dashboard tighter. She was wedged between Harry and Carson as they took the logging road deep into the camp.

Another bump made her hiss and curse under her breath.

Carson glanced at her. “You’re mighty tense.”

“Just hoping we don’t die.”

Harry chuckled. “We’re not on the edge of a cliff. Our only threat is maybe a rock slide or a logging truck careening down the road, but since there are no trucks running we’re pretty safe.”

“I’ll keep telling myself that we’re safe, Harry.”

He shook his head, probably at the folly of a city girl. Only it was a dark night like this when Avery had died. She’d only been ten years old, but the memory of her brother’s gaping chest wound was still fresh. The feel of his exposed heart under her small hands, the warmth of his blood felt fresh. It was why she’d wanted to be a cardio-thoracic surgeon.

Why she’d worked so hard to be the best, because Avery had been a constant in her parents’ strained marriage. Even though he’d been twelve years older than her.

He’d been her best friend and when he’d died, her world had been shattered. So she’d dedicated her life to surgery.

The nightmares of his death faded away but nights like this made it all rush back.

Carson slipped an arm around her shoulders and then leaned over. “Relax. You’re okay.”

She glanced at his arm around hers and she wanted to shrug it off, but it felt good there. Reassuring. It made her feel safe and she wished she could snuggle in. Esme let out the breath she hadn’t realized she’d been holding in trepidation and leaned back against the seat, shrugging off Carson’s arm. She could handle this. Alone.

“So what happened again, Harry?” Carson asked.

“Jenkins was overtired and nervous. Our new client, Mr. Draven, was headed out our way tomorrow. One wrong move and …” Harry trailed off.

Esme froze at the mention of the name Draven.

Dammit.

Though it couldn’t be Dr. Draven, her former mentor. Eli was a cardio-thoracic surgeon. Still the name sent dread down her spine.

Draven was a common name. So there was no way it would be Eli or Shane. Dr. Draven had money, but he invested it in medicine and science. All of Shane’s money was tied up in his company. She doubted he would invest in lumber or a hotel in Montana.

Harry slowed the truck down and she could see light through the trees as the forest thinned out. There were floodlights everywhere and people milling around one of the buildings, which looked like an administrative building. Harry pulled up right in front of it.

Carson opened the door and jumped out, reaching into the back to grab their supplies. Esme followed suit, trying to ignore all the eyes on them as they made their way into the building. The moment the door opened they could hear a man screaming in pain.

Esme forgot all the trepidation about anyone recognizing her. That all melted away. Adrenaline fueled her now as she headed toward the man in pain. There was blood, but it wasn’t the damage done by the saw that caught her attention. It was his neck, and as she bent over the man she could see the patient’s neck veins were bulging as he struggled, or rather as his heart struggled to beat. Only it was drowning.

She’d seen it countless times when she was a resident surgeon, before she’d chosen her specialty. Before she’d become a surgeon to the stars. First she had to confirm the rest of Beck’s Triad, before she even thought about trying to right it.

She didn’t want to freeze up. Not here. Not in her new start.

“Dave, you’re going to be fine,” Carson said, trying to soothe the patient. Only Dave Jenkins couldn’t hear him. “It doesn’t look like he’s lost a lot of blood.”

“He’s lost blood,” she said, trying not to let her voice shake.

Just not externally.

Carson took off his jacket, rolling up his sleeves to inspect the gash on Dave’s right arm. “It’s deep, but hasn’t severed any arteries.”

The wound had been put in a tourniquet, standard first aid from those trained at the mill. It wasn’t bleeding profusely. It would need cleaning and a few stitches to set it right.

“That’s not the problem.” Esme pulled out her stethoscope.

Carson cocked an eyebrow. “Really?”

“Really.” She peered down at Dave. His faceplate, his eyes rolling back into his head. He was in obstructive shock. “Who saw what happened? There’s more than a gash to the arm going on here.”

“A piece of timber snapped back and hit Dave here.” Esme glanced up as the man pointed to his sternum.

“The gash came after?” she asked.

“No, before, but Dave didn’t get out of the way and he didn’t shut off the machine after the first malfunction. He was overtired—”

“Got it.” Esme cut him off. She bent over and listened. The muffled heart sounds were evident. A wall of blood drowning out the rhythmic diastole and systole of the heart. Drowning it. Cursing under her breath, she quickly took his blood pressure, but she knew when the man pointed to his sternum what was wrong.

Cardiac tamponade.

Dave wouldn’t survive the helicopter coming. He probably wouldn’t have survived the trip to the hospital.

“What’s his blood pressure?” Carson asked.

“Ninety over seventy. He’s showing signs of Beck’s Triad.”

“Cardiac tamponade?”

Esme nodded and rifled through her rucksack, finding the syringe she needed and alcohol to sterilize. “I have to aspirate the fluid from around his heart.”

“Without an ultrasound?” Carson asked. “How can …? Only trained trauma surgeons can do that.”

Esme didn’t say anything. She wasn’t a trauma surgeon, though she worked in an ER during her residency. She’d done this procedure countless times. She was, after all, the cardio God. She knew the heart. It was her passion, her reason for living. She loved everything about the heart. She loved its complexities, its mysteries.

She knew the heart. She loved the heart.

Or at least she had.

“It’s okay. I’ve done this before. Once.”

She was lying. She’d done this countless times. She’d learned the procedure from Dr. Draven. It was a signature move of his that he taught only a select few, but they didn’t need to know that. How many general practitioners performed this procedure multiple times? Not many.

“Once?”

“I really don’t have time to explain. It’s preferable to have an ultrasound, but we don’t have one. I need to do this or he’ll die. Open his shirt.”

Carson cut the shirt open, exposing Dave’s chest where a bruise was forming on the sternum.

You can do this.

“I need two men to hold him in case he jerks, and he can’t. Not when I’m guiding a needle into the sac around his heart.”

There were a couple of gasps, but men stepped forward, holding the unconscious Dave down.

Esme took a deep breath, swabbed the skin and then guided the needle into his chest. She visualized the pericardial sac in her head, remembering from the countless times she’d done this every nuance of the heart and knowing when to stop so she didn’t penetrate the heart muscle. She pulled back on the syringe and it filled with blood, the blood that was crushing the man’s heart. The blood that the heart should’ve been pumping through with ease, but instead was working against him, to kill him.

Carson watched Esme in amazement. He’d never encountered Beck’s Triad before. Well, not since his fleeting days as an intern. It was just something he didn’t look for as a family practitioner. Cardiac tamponade was usually something a trauma surgeon saw because a cardiac tamponade was usually caused by an injury to the heart, by blunt force, gunshot or stab wound.

Those critical cases in Crater Lake, not that there were many, were flown out to the hospital. How did Esme know how to do that? It became clear to Carson that she hadn’t been a family practitioner for very long. She was a surgeon before, but why was she hiding it?

Why would she hide such a talent?

It baffled him.

Because as he watched her work, that was what he saw. Utter talent as she drained the pericardial sac with ease. She then smiled as she listened with her stethoscope.

“Well?” Carson asked, feeling absolutely useless.

“He’ll make it to the hospital, but he’ll need a CT and possibly surgery depending on the extent of his injuries.”

There was a whir of helicopter blades outside and Harry came running in. “The medics are here to fly him to the hospital.”

Esme nodded. “I’ll go talk to them. Pack the wound on his arm.”

Carson just nodded and watched her as she disappeared outside with Harry. She was so confident and sure of herself. She had been when he’d first met her, but this was something different. It reminded him of Danielle. Whenever she was on the surgical floor Danielle was a totally different person.

Actually, Carson found most surgeons to be arrogant and so sure of everything they did, but then they’d have to be. Lives were in their hands. Not that lives weren’t in his hands, but it was a different scale.

Carson rarely dealt with the traumatic.

He turned to Dave’s wound and cleansed it, packing it with gauze to protect it on his journey to the nearest hospital.

Esme rounded the corner and behind her were two paramedics. He could still hear the chopper blades rotating; they were going to pack him and get out fast, before smoke from the forest fires blew back in this direction and inhibited their takeoff.

Esme was still firing off instructions as they carefully loaded Dave onto their stretcher and began to hook up an IV and monitors to him. Carson helped slip on the oxygen mask. They moved quick, and he followed them outside as they ran with the gurney to the waiting chopper.

Esme stood back beside him, her arm protecting her face from the dust kicking up. There was no room on the chopper for them and they weren’t needed anymore. The paramedics could handle Dave and he’d soon be in the capable hands of the surgeons at the hospital.