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"Dr. Mackenzie, it seems you still think you're on vacation rather than in an overcrowded ER. If you have time to chat on your phone, maybe you're not doing your job."
She stiffened and thrust the phone back in her pocket. Dr. Tyler Ward was head of the ER, a real son of a bitch, and friends with David. "Sorry." Giving any excuses would just make the situation worse. His bushy brows lowered in a disgusted frown, and his gaze swept over her. "We need bed three for incoming. What's the status?"
"Waiting on the ultrasound report, sir."
"Get it faster."
"Yes, sir." She already knew the tech probably buried her request in the back of others, so she hunted him down again. Gen glanced through the report, which came back clean for acute abdomen. Good sign. But something niggled at her that didn't sit right. She went back to talk to Susan.
"Did you get the results yet?" Susan asked.
"Yes, the ultrasound came back fine."
"That's good, then, right? Maybe I should just switch antacids and sleep it off?" The joke fell flat as her hand settled on her stomach, obviously uncomfortable.
"I want to check a few more things."
"Sure."
Gen rechecked the blood pressure. Hmm. Still elevated, and she didn't think it was nerves. She touched the woman's skin, which felt clammy and sweaty. As she pressed over her muscles and examined her, she noticed her ankles were definitely swollen. How many times had a cardiac problem in women been misdiagnosed as indigestion?
"Anything big going on at home?" Gen asked casually, listening to her heartbeat again.
"Just the normal stress. I'm planning a bridal shower for my daughter and it's been taking a lot of time. And my promotion at work is good news, but I've been working late a lot."
"Congratulations on both. I'd like to run one more test to rule out any other possibilities before sending you home. Excuse me for a moment."
Gen grabbed the chart. With no insurance and the ultrasound coming back negative, she'd need approval to run the cardiac enzymes test. She fell in step with Dr. Ward, who was barking at a nurse for existing on the same planet.
"I need bed three."
"I know. Dr. Ward, I want to run one final test on her for cardiac enzymes."
"Why?"
"She's having abdomen issues and the ultrasound came back clean."
"Then why the hell would you run another test? Send her home."
"I think it's her heart."
"Oh, for God's sake, give me the chart." He stopped, glancing through. "She has no insurance. Send her home."
Stubbornness hit her. "I'm asking you to look at her."
The gleam of hatred that sprung from his eyes made her take a step back. "Seeing things that aren't there, Doctor? We don't have time for babysitting in the ER. You better not be wasting my time."
He followed her, pulling back the curtain and turning into Dr. Charm. "Hello, Susan, I'm Dr. Ward. Your ultrasound came back fine. Did you eat anything strange last night that could have contributed to your stomach problems?"
"Chinese."
"Hmm, lots of salt intake." He shot Gen a glare and knew he'd just ruled out her swollen ankles. "How about stress? Anything going on that's unusual?"
Susan laughed. "I was just telling Genevieve my daughter's getting married and we were on the phone for an hour last night, arguing over the guest list. My goodness, by the time the wedding comes I don't know how I'll survive."
"Weddings are wonderful but stressful events. Did you take antacids?"
"Yes, just Tums though."
"Hmm. Well, the good news is you're fine. We'll set you up with Prilosec and make sure you eat bland for a while. No Chinese."
"Thanks, Doctor."
"Welcome."
Gen followed him out. "Dr. Ward, I think--"
He whipped around and jabbed a finger at her. "I don't care what you think. Do your damn job and stop wasting hospital resources on ridiculous tests for patients with no insurance. Another incident like that and I'll throw you out of my ER. Understood?"
He marched off. Frustration shot through her. Dammit, in a way she didn't blame him. In another way, her gut was screaming that there was something bigger going on, and if she sent Susan away she'd regret it.
In medical school, there was so much information to absorb her brain was constantly on overload. But she'd always felt she had good instincts. If she listened and looked beyond the surface facts, letting the individual and the body guide her, she discovered things that routine exams or logic didn't. She used to pride herself on such an ability until David. Over the past two years, he had showed her to trust the evidence only. The tests were God; the facts were survival. Gut instincts in a surgeon only led to chaos, and death.
So she'd changed. Smothered the voices and primitive instincts that she used to respect.
Today she made a different choice.
She swallowed hard and went back to her patient. "Susan, if you don't mind, there's just one test I'd like to run before we release you. I think it's important."
"Oh, okay. It's probably more restful here than at home anyway."
"Thanks. I'll have a nurse come by shortly."
Her hands barely shook as she ordered the cardiac enzymes test from the lab. "I need a signature on this one," Ted said gruffly.
She didn't miss a beat. "David--er, Dr. Riscetti approved." Ted let out an annoyed huff and punched out the number. He spoke briefly, then looked up. "He wants to know if you asked Dr. Ward."
The lie fell easily from her lips. "Of course, but he's busy right now." Ted repeated her words, nodded, and clicked o
ff. "We'll run it."
"Thanks. Can you put a rush on it? We need the space."
Her heart pounded, but for the first time in a long while, she felt like she'd done the right thing. Gen ran back to her other patients, checking the time and hoping she'd get the results back before things blew up. But maybe she'd get lucky. Maybe Ward was so crazed he'd miss the extra test she ordered and things would work out. Maybe--
"Why the hell is bed three still not empty?"
She ducked her head and pretended to be busy doing something vitally important so she couldn't respond. "She's almost ready, sir."
"She was ready twenty minutes ago. What's going on?"
Sweat dampened her brow. Crap, this was bad. "Umm, I'm just running one more test, which should be done shortly."
He blocked her path. Fury rumbled from him. "What test?"
"The cardiac enzymes, sir."
His voice dropped. "I told you to release her. Who signed off on the test?"
She paused and wished she could lie. "Dr. Riscetti."
Ward gritted his teeth. "I don't care if you're screwing him on your personal time, but don't think you can run my show here." He grabbed his phone and pounded out numbers. "David, why the hell did you give approval on the tro-ponins when I specifically denied it?"
Gen closed her eyes. It was over.
"I see. Yes. You better get down here now."
Ward narrowed his gaze. "Go wait in the conference area for your boss. And get out of my ER."
She didn't respond. Why did she suddenly feel like she was living out an episode of Grey's Anatomy? Except on the show the residents got to do crazy-ass things and never got kicked out or in real trouble. She knew she'd stepped over the line, but she'd do it again no matter what the results. Did that make her a bad doctor? Or a good one?
David walked through. His burnished hair was mussed, and his eyes looked tired. She'd heard he was doing double shifts, trying to drown his sorrows in work, while the bitch that she was looked healthier than she'd been in a while. No wonder everyone hated her. In only one week, she'd eaten, slept better, and laughed more than she had in the past year.
"What are you trying to prove, Genevieve?"
