Almost A Family

“He said he had big grants coming, too,” she scoffed. “He spent thousands and thousands of dollars on feasibility studies and planning, and even contracted some expensive remodeling projects. Most of it fell through, leaving the hospital in debt.”

“Everyone must have been upset,” Erin murmured.

“More than that. When the other hospital folded, those doctors didn’t transfer their patients here. Instead, they started referring clear over to Henderson Regional, and even some of our own doctors jumped ship. Henderson is more than fifty miles away, so our town lost trade, as well. There’s still a lot of hostility over it.”

“And George—how did he handle the situation?”

Madge’s expression softened. “He did his best. He and his wife were wonderful assets to this community.”

“He didn’t handle it,” Grace said shortly. “Not well. George was good with the staff. He was honest and caring. But he didn’t like controversy and preferred smoothing ruffled feathers to taking an assertive stance.”

Erin stifled a sigh. “So you don’t think it’s possible to lure specialists here.”

“You know what it’s like at state nursing or medical conventions. People talk, word spreads. I’d say it would take a miracle.”

Erin shuffled through her papers, withdrew a summary of the financial status of the hospital that had been presented to the board last year, and pushed it across the table. “I know you’ve both seen this before, but this is the past. The future has to bring change, or we’re looking at significant layoffs within the next six months.”

Madge stiffened. “George never—”

“The hospital has been running at eight full-time equivalents per occupied bed.” At the look of confusion in the woman’s eyes, Erin added, “That’s like saying we have eight full-time employees per patient, when you add full- and part-time staff. That’s almost twice what the ratio should be, and we also have a high number of empty beds.”

“But the patient care we give is excellent!”

“Maybe so, but that level of revenue per employee just isn’t feasible if we’re to operate in the black,” Erin said firmly. “Still, if we can offer more services, build our market share and reduce staffing through attrition rather than layoffs, I know we can turn this place around.”

At the word layoffs, Madge blanched.

“I need support—from the doctors, the community and especially the staff. Anyone not willing to change will need to think about whether or not they still belong here.”

After a long pause, Grace’s eyes twinkled. “I do believe you can do it.” She gave Madge a nudge. “Right?”

Madge swallowed hard. “I need my job. So do my niece and my brother-in-law, and all the other people who work here. I…guess we’ll have to do what it takes.”

Erin stood and shook Grace’s hand, then Madge’s. She watched pensively as they left her office.

It was a lukewarm response, but it was a start.

CHAPTER FOUR

BY THE TIME SHE GOT the kids ready for school and dropped them off at George Washington Elementary, Erin was ready for a strong cup of coffee and a few minutes’ peace.

Lily had burst into tears over a missing homework assignment. Tyler hadn’t been able to find his shoes or his baseball mitt. And Drew had announced that his teacher was dumb, school was a waste of time and he wasn’t going back.

Not for the first time, she thought grimly about her ex-husband, who’d chosen to cavort with some pretty thing half his age rather than face the responsibilities he’d chosen when he and Erin had decided to adopt.

Single parenting was a challenge she hadn’t expected, though given the choice of being married to Sam or having these children, she knew she’d gotten the far better deal.

At the single-story brick hospital, Erin walked through the wide front doors and greeted Beth, the receptionist, who was sitting at the desk in the lobby. Past the open double doors to the left, the west wing housed a nurses’ station, thirty long-term care beds and five beds designated for skilled care. The recreation and dining rooms were at the far end.

She waved to several patients in wheelchairs who were out in the hall, then continued straight ahead to the north wing, which housed her office, the other administrative areas, the main pharmacy and several infrequently used surgical suites.

From the first moment she’d stepped inside, she’d loved this place, with its big, old-fashioned windows and small-town atmosphere. It was a microcosm of a big city hospital, really—offering many of the same services, but on a much smaller scale.

At the sound of a shrill alarm, she spun around and hurried through the lobby to the east-wing nurses’ station, which served the single, long corridor of hospital in-patient rooms. A few patients peered into the empty hallway from their doorways, then disappeared. At the end of the corridor, the double doors into the emergency department remained closed.

Surprised, Erin watched the lone nurse at the east desk reach across a stack of patient charts and flip a button to silence the alarm, then pick up a phone and dial a number.

“I think Frieda is dusting again,” she whispered to Erin, her hand over the receiver. “This happens every Tuesday, the day she cleans her—” She suddenly held up a hand and talked into the phone. “Frieda, this is Marcia at the hospital. Are you all right?” The nurse rolled her eyes. “I know, I know. Just don’t worry about it, okay?”

After another few minutes of conversation, Marcia cradled the receiver and grinned up at Erin. “There’s a base receiver in her living room, and she carries an emergency alarm on a cord around her neck. I’m not sure if she really worries that much about the dust or if it’s an excuse to talk to us, but she sets off that alarm every Tuesday morning, and almost at the same time. If we ever didn’t hear from her, we’d worry.”

“Sounds like you know her well.”

Marcia smiled. “In this town, we know everyone well. Frieda’s ninety-six, still does her own housework and she’s sharp as a tack. We should all be so lucky.”

Erin glanced at the chart rack along the back of the station. This morning, eight of the charts bore name labels. Not many, given the number of available beds. “How is everything going down here?”

“Three patients in the E.R. last night—one asthma, a broken wrist and a chest pain. Dr. Olson was on call.”

“Anyone admitted?”

Marcia chuckled. “Not on his watch—unless you’re about dead.” She ran a finger down a clipboard in front of her. “The Paulson boy has been discharged and will be going home this afternoon. Frank Willoughby will probably be going back to the nursing home after the radiologist reads his chest X-rays tomorrow.”

“He had pneumonia, right?”

“Yep. A double, but he’s doing really well.” The blonde smiled. “He’s the first patient the new doctor has admitted since he took over for Hadley on Monday. Nice guy.”

“Oh?”

“Definitely the strong and silent type—and man, those gorgeous eyes…” Her voice drifted off in pure appreciation. “Like a guy would ever need those lashes, you know? It just isn’t fair.”

“Really,” Erin said dryly.

The nurse’s eyes flew open and she blushed. “Um…sorry.”

“No problem. Have you seen Grace this morning?”

“On Wednesdays she usually comes around ten and stays until seven. Should I leave her a message?”

“I’ll just catch her later, but thanks.”

Erin moved on down the hallway, inspecting the terrazzo for dust and the door frames for paint chips and scratches. At the far end, she pushed through the double doors marked E.R.—Staff Only and found the hospital’s third-shift housekeeper industriously attacking the gleaming floor with long swipes of her mop.

From her employee file, Erin knew Mrs. Banks was a widow of nearly seventy, but from all reports she still considered the hospital’s cleanliness her mission in life, and had no intention of slowing down. According to Madge, she often talked to people who weren’t there, and rarely deigned to speak to people who were, but that disconcerting tendency had never affected her efficiency.

“You’re doing a fine job,” Erin called out to her.

The woman glanced over her shoulder and nodded as she mopped her way past the admissions desk.

Carl Miller, the hospital’s only male nurse, glanced up from the chart he was working on at the desk and smiled.

“Did you have a busy night?” Erin asked.

He peered at her over his glasses. “Yes, but that makes the time go faster…or so they say.”

“What do you do when it’s slow?”

“With all the regulations these days, there’s never enough time to catch up on documentation. Believe me.”

“Is the staffing adequate?”

“No, but what place can afford that? We all pitch in, and Grace does call in an extra nurse if the census goes high enough.”

Erin moved past the desk and peered into the exam rooms, one by one. “Tell me—if you could write up a wish list, what would it be?” she called out to him.

“New state-of-the-art crash carts, fully stocked,” he replied without hesitation, his voice edged in sarcasm. “A new cardiac monitoring system for the E.R. and hospital side. New beds and new mattresses for every room. A new PACS system, for digitalized X-rays. But of course, I’m dreaming.”

At the sound of footsteps behind her, she turned. Connor Reynolds was coming down the aisle. “Good list,” he said. “Personally, I’d add a larger MRI, a dialysis unit and a wellness program. That’s just for starters.”

Erin ignored the heightened awareness she felt at the sound of his voice. Awareness? How about hunger, just simple hunger. With the ruckus at home, she hadn’t had time for breakfast, and after her morning walk-through, she really needed to grab something from one of the snack machines in the staff lounge. “I couldn’t agree more. If money wasn’t an issue, those items would all be part of a very long list.”

“There are ways,” he countered. “Rental programs. Grants. Building a bequest program.” A faint smile played across his sensual mouth. “Bake sales.”

“I’ll keep all that in mind.”

When he walked past her, his dry glance suggested he didn’t believe change was possible at Blackberry Hill Memorial.

Feeling a flash of irritation, she watched him disappear into a patient room. Just wait, she said under her breath, wishing not for the first time that she was five inches taller and had a far more imposing demeanor.

Like her three sisters, she’d been gifted with her family’s genetic heritage for fine bones, which apparently made men think she was helpless, and she had the pixie sort of face that made them assume she couldn’t think for herself. That she’d been a tomboy, ran on the track team in high school and had taken more self-defense classes than she could count had never given her the aura of strength she’d like to project.

Nodding at Carl, she turned to go.

“Carl—come in here, stat.” Connor’s sharp voice cut through the silence.

Surprised, she looked over her shoulder and saw Carl hurry into room 22. A split second later he darted back out, grabbed the electronic blood pressure unit sitting in the hallway, and pushed it into the room.

Frank Willoughby’s room, she remembered. A sweet old guy and a favorite with the nurses, from what she’d heard. Please, Lord, let him be all right.

But one minute stretched to three, then five. No code blue, no rush for equipment or race to surgery.

Walking over to the nurses’ station, she looked at the shelves of patient charts. On the spine of Willoughby’s there was a bright orange DNR—Do Not Resuscitate—sticker, so there hadn’t been an option to call a code blue.

She knew, even before Carl came out and shook his head, that Frank was gone.

His expression grim, Carl settled down at the phone to make the usual calls to family members, the nursing home and the mortuary designated on the face sheet of the chart.

Erin moved to the doorway of the old man’s room and found Connor in a chair by the bed, his head bowed and his hands clasped loosely between his knees.

He glanced up at her. “Lost him. His last X-ray showed a lot of improvement, and he was on the verge of being discharged. But with his overall health and age, he’d signed the Do Not Resuscitate forms.”

“I’m sorry.” Erin stepped inside the room. “Was it his pneumonia, do you think?”

“That, or his heart, or any number of other things. He had a diagnosis list a mile long. But dammit, he was doing well last night. If I could have coded him…” Connor shook his head as he stood and smoothed back the old man’s wispy hair. “He swore he planned to beat me at a round of golf the day he was discharged, and I bet he would have, if either of us actually knew how to play.” Connor straightened the man’s gown, then pulled the blanket up. “He teased me about that, too. Said he didn’t think it was natural that a doctor didn’t play golf.”

The emotion in Connor’s voice touched her. “Will there be an autopsy?”

“Doubt it. He was ninety-three, he had chronic health problems. He was hospitalized for pneumonia. In cases like this one, the coroner usually just goes ahead and releases the body to the funeral home.”

She knew that was true. “Sorry—I hear he’s your first admission to this hospital.”

With a heavy sigh, Connor settled back in his chair. “You never get used to this.”

“Are you staying here awhile?”

“As long as I can—hopefully, until his family arrives. I don’t need to be at the clinic until nine. I asked Carl to call the chaplain, so he’ll be here, as well.”

Surprised, Erin stepped out of the room and headed down the hall toward the main lobby and her office.

Death was a given in a hospital setting. Healthy people weren’t admitted, and despite the very best of care and technology, not everyone made it. Most doctors and nurses eventually developed a level of professional distance, trying to protect themselves from the pain of losing a patient, and Connor’s reaction was unusual.

She recalled the man she’d known during her college days. His cool, sophisticated manner. His bored indifference.

So who would’ve guessed he actually did have a heart?

DREW KICKED A ROCK into the ditch as the big yellow school bus pulled away. “This sucks. Two whole days until the weekend!”

“At least we get to ride a real school bus home now. That’s cool.” Tyler hurried to catch up, tugging on his sleeve as a reminder that Lily was lagging behind. They both turned to see her bent over something in the ditch.

“Come on,” Drew shouted impatiently. “You can pick some stupid flowers at home.”

“Isn’t flowers. Come here, quick!”

Drew rolled his eyes at Tyler. “Like I’m gonna care about this.” But he headed back anyway, through the chest-high weeds in the ditch, with Tyler at his heels.

His heart flopped like a fish on a hook when he saw what she was looking at.

A black-and-white-spotted dog.

More of a half-grown puppy, really, with huge dark eyes, silky ears and soft wavy hair. Its ribs and hip bones stuck out and its long pink tongue lolled from its panting mouth. Clumps of dried mud covered its legs.

“Ooh,” he breathed as he sank to his knees next to the cowering animal. “How’d it get here?”

Tyler hovered over his shoulder. “Is he hurt? Maybe he got hit by a car.”

Lily shook her head. “I touched him and he didn’t whimper. I think he’s just lost and scared. I think we should take him home.”

The three looked at each other.

“Erin did say we could get a dog,” Tyler murmured.

Drew fought a smile. “And that man said it was okay.”

“Maybe he belongs to someone, though. Someone who misses him a lot,” Lily said sadly. “Wouldn’t be fair.”

“What if we put up a notice?” Imagining a very small notice, maybe just one of them, tacked to that telephone pole across the street, Drew stroked the dog. He felt knots of brambles tangled in its coat. “But I don’t think the owner cares much—just look at how bad his fur is. No one has brushed this poor guy in a long time.”

Lily sighed with joy. “We could name him… Buttercup!”

Drew shuddered. “Or Bruno.”

“Or Scout, because he was looking for a new home,” Tyler ventured.

“C’mon—maybe he’ll follow us.”

They scrambled out of the ditch, all calling to him, but the puppy hung back, whimpering, then crept farther into the weeds.

“He’s too scared,” Lily whispered. “We need a leash.”

Drew surveyed all three of their backpacks for any straps that could be detached, then scanned the ground. “Maybe we can take turns carrying him. If he’ll let us.”

Drew struggled back through the tall weeds and knelt by the shivering pup. “Come on, Bruno.”

The puppy had such fear in his eyes that a lump grew in Drew’s throat and hot tears prickled beneath his eyelids.

“I know, buddy,” he said softly, remembering his mother’s belt and explosive temper. He never let anyone see the scars on his back from the lash of that belt buckle, but even now he could feel the pain and the terror. Her boyfriend’s fists had been worse. “I’ve been real scared sometimes, too.”

He held out a hand, palm up, until the puppy belly-crawled forward a few inches. “Would you rather be Scout?” He laughed a little as the pup nuzzled his fingers. “That must be a yes.”

Gathering the puppy in his arms, he scrambled back to his feet and made his way up onto the road through the treacherous underbrush, stumbling under the weight of the dog.

Breathless, he grinned at Tyler and Lily. “He’s happy, I think. Let’s go.”

After a few hundred feet, Drew handed him over to Tyler, then Lily took a turn. By the time they reached the turnoff for their cabin, Drew’s feet hurt and his throat felt dry as sandpaper. He’d ended up carrying the dog most of the way, and now it felt twice as heavy as it had at first. At the sound of a car coming up the road, he turned eagerly to flag Erin down.

It wasn’t her minivan, darn it—it was Dr. Reynolds’s black Tahoe. Disappointed, Drew turned back toward home, but the vehicle pulled up beside them, and Reynolds rolled down his window. “I see you three got your dog.”

“Sorta,” Tyler said. “We kinda found h—”

“Yeah, we got a dog,” Drew interrupted, elbowing Tyler in the ribs. “Come on, Ty. Let’s go.”

But Lily was too far away to silence.

“We found him in the ditch by the highway,” she piped up. “We named him Scout.”

Reynolds frowned. “He’s probably just lost. Does he have tags?”

“He doesn’t have no collar,” Drew said quickly. “And he’s skinny, like he’s been starving. He doesn’t have a home.”

“And he’s full of brambles,” Lily added.

“Just don’t get your hopes up too high.” The man had sunglasses on, but a corner of his mouth sort of curved up, as if he was almost going to smile. “You kids know you shouldn’t ever go with strangers, but can I give you a ride up to your house? You’ve had a long walk up here with that dog.”

Lily nodded and started to speak, but Drew gave a sharp jerk of his head and cut her short. “No. We can almost see our house from here.”

“I understand. You’re a good big brother, kid.” He twisted in the front seat to reach for something in the back, then stepped out of his car with a leather leash. “You can keep this—it might help a little.”

“Thanks,” Drew mumbled as the man fashioned a loop at one end and slipped it over Scout’s neck.

“I’m no vet, but I think this guy needs a thorough exam, his vaccinations and a good worming.” Reynolds ran a practiced hand over the dog’s thin body. “If he has a home, it sure isn’t a good one. What do you think your mom is going to say about this?”

“She said we could get a dog,” Lily said shyly.

“And now we have one that’s free!” Tyler added with an exuberant victory punch in the air.

“Good luck.” Reynolds paused at the open door of his vehicle and gave Drew a level look that said, Don’t get your hopes up, kid.

“Jeez,” Drew muttered irritably after the black SUV headed on up the hill. “Why don’t you guys tell the whole world that we found a stray?”

Tyler’s wide grin faded. “He’s our neighbor.”

“But did you hear what he said? I bet he’s gonna ask everyone he sees in town, and then for sure someone will come after Scout!”

He curved his arms a little tighter around the dog, and immediately Scout gave him a slurpy kiss up the side of his face.

There was no way anyone was going to take this dog away, he vowed silently. No way at all.

CHAPTER FIVE

“PLEASE, PLEASE, PLEASE,” Lily begged. “We gotta keep him. Someone prob’ly just dumped him out on the road and left him to starve!”

Erin surveyed the three children standing on the porch above her, and adjusted the shoulder strap of her purse. “Let’s talk about this inside, okay?”

They parted like the Red Sea for her to pass, Drew clutching the puppy to his chest, his mouth curled mutinously, Lily’s face a mask of desperate hope and Tyler… His expression alone would have melted the coldest heart. Clearly, he’d already decided that the situation was hopeless, and the sadness in his eyes made her own burn.

“I’m not an ogre, you know.” She smiled as she hoisted her sack of groceries and her purse onto the kitchen counter. “I did promise you could get a dog. I was hoping we could go on Saturday.”

“But this one needs us,” Lily persisted. “We wanted a dog, and this one just appeared. It’s like it was meant to be.”

Erin reached out to stroke the dog’s damp, silky head. He smelled suspiciously like her twelve-dollars-a-bottle shampoo, and a glance toward the kitchen revealed a very wet floor littered with her best company towels.

“He’s darling. But what if there are kids just like you who are crying over their lost friend?”

Tyler bit his lower lip. “We figured we could post some notices.”

“Yeah. I could do that,” Drew said quickly. “All over.”

“If someone loved him, how come he’s so skinny?” Lily reached out and ran her hand along his ribs. “Just look. And he was covered with burrs, and one of his paws had dry blood on it. Anyway, there aren’t even any houses close to here, ’cept the man up on the hill.”

“And he already saw Scout, and he didn’t say anything about not letting us keep him here,” Drew added triumphantly.

“Connor—Dr. Reynolds—was here?”

“Just on the road.” Drew felt his smile droop into a scowl. “I don’t like him much.”

Erin’s senses sharpened. “Why do you say that?” she asked, carefully keeping her tone neutral.

“He kept saying stuff like we shouldn’t be disappointed, because Scout probably has a home. I bet he hopes it’s true!”

Erin’s heart tightened. “Maybe he was just trying to help.”

“So can we keep Scout? Please?”

She gave a distracted wave. “We’ll see. I’ll, um, call the animal shelter, and put an ad in the local paper.”

Tyler blanched. “An ad? For everyone to see?”

“Honey, wouldn’t that be fair? What if you lost a dog you loved very much? You’d always wonder and worry about what happened to him.”

The children’s expressions fell into deep despair.

“There’s always the possibility that someone just dumped him on the side of the road, though,” she added. “People can be very cruel, or ignorant—they think it’s better than taking a pet to the shelter, and never consider that the animal may starve or be injured. If no one claims this guy, we’ll keep him. If someone does, we’ll go to the shelter and find another dog. I promise.”

While she put away groceries and started supper, she watched them through the kitchen window.

Lily, the limp from her poorly repaired clubfoot so much more noticeable when she tried to run with the pup, beamed with a joy that lit up her sweet face.

Drew so rarely smiled, but now his shouts of laughter echoed through the meadow. And Tyler had for these past few moments seemed like any other carefree child you’d see playing in a backyard, instead of one who’d lived through hell. Please, Lord, let this dog stay with us, she whispered.