Sacred Trust Read online

  “Has she been taking any new medications in the past few weeks?”

  Emmett raised his eyebrows at Lukas. “Only time she ever sees a doc is here. She calls the stuff she drinks her medicine. Dr. George gave us something for her stomach a few months ago when she came in, but I don’t think she ever took it.”

  “So she doesn’t have a family doctor?”

  “I guess we’ve got Dr. George for a family doc. That’s who we put on her check-in papers. He’s the one who admits her when she comes in drunk.”

  Lukas suppressed a grimace. He was not in the mood to face Jarvis, even over the telephone. “Okay, Mr. Taylor. I’ll have Rita get a form for you to sign. We may call Dr. George in a little bit.”

  Emmett followed him to the central desk, where Rita sat studying the computer screen. “Doc, do you think the boys and I could go back home for a while?” Emmett asked. “We left before we could do our morning chores, and if those cows don’t get milked, they’ll go dry for sure. We could come back later on in the morning after we’re done.”

  “Do you have a telephone at home so we can call you if we need to?” Lukas asked.

  “Nope, the line doesn’t come that far out. We’ve always kinda liked it that way.”

  After the form was signed and Emmett and the boys left, Lukas returned to the exam room in time to see Ruby burst into tears. “They left me here to die.”

  “Why do you think you’re going to die, Ruby?” Claudia asked gently, stroking the woman’s hair. “We’ve always taken good care of you before. We’re not going to let anything happen to you.”

  “But I’m not drunk. I told you, I didn’t even drink a whole jar.”

  Lukas frowned. Drinking from a jar? She had stomach cramps that made her scream as if she were in labor. She displayed irrational behavior, possibly even when there was very little alcohol in her system. Emmett had mentioned headaches. It didn’t add up to simple alcoholism.

  But what? Lukas walked out to the desk to check for old records on Ruby that might show him something, but he didn’t make it.

  “Dr. Bower,” Claudia called from the exam room door. “Our patient just passed out.”

  Lukas turned and headed back for the room. “Put her on the monitor, then get her vitals. Rita, call lab. CBC, chemistry panel, amylase and alcohol level.” He stepped into the room and bent over Ruby with his stethoscope. Good heart tones. Breathing fine. Strong pulse.

  He straightened, pulled the penlight out of his pocket, and checked her pupils. They were somewhat dilated, but equal and reactive. A quick look at the monitor showed normal sinus rhythm, no acute changes. Claudia reported good vitals.

  A sleepy-looking lab tech came in with her tray. “This the patient?” She looked down at the requisition sheet she’d just picked up at the desk. “Ruby Taylor?”

  “This is her,” Lukas said. He did a sternal rub, with his knuckles over Ruby’s breastbone, but the pain only brought a slight moan in response. “Let’s get a heplock started,” he told Claudia. “Then give her thiamine 100 milligrams. IV.” He turned to the lab tech. “I need her blood glucose level as soon as possible.”

  “Yes, Doctor. It’ll all be back quickly, except the alcohol.”

  Lukas stepped over to a window that overlooked a parklike garden outside the emergency department. The sun didn’t even hint at an appearance, and stars still filled a cloudless sky. There would probably be no more rest tonight, and he had a date with Mercy Richmond at one. Maybe he could use his earplugs and catch a few more hours of sleep in the call room.

  The word date made him uneasy. He hadn’t been out with anyone since last year when his father and stepmom had set him up on a blind date with an acquaintance of theirs. It turned out she was ten years younger than Lukas, and she’d complained all evening about the movie they saw, the restaurant where they ate, even the clothes Lukas wore. It made him appreciate his solitary existence for several months. But this date with Mercy was work related. Business. That was it.

  For some reason his mind switched to Lauren. She’d seemed sincere yesterday when she told him she was praying for him. Her words had actually comforted him, although her warning had disturbed him. Lauren chattered a lot, but what she talked about had always turned out to be true. Sometimes at work she caught her word flow and apologized for gossiping, but she was never vicious about the things she said, just painfully honest.

  Could Lauren’s appearance and words yesterday have actually been part of God’s answer to his prayer?

  He shook his head and turned away from the window. He’d learned long ago to accept comfort where God gave it, but not to read some significant message from God in every passing word spoken or action taken.

  He heard the outside door open and turned to see the fireman, Buck Oppenheimer, enter the emergency room alongside a smaller man who held a towel over the front of his face. Blood stained the front of the smaller man’s gray sweat suit.

  “I told you to put ice on that,” Buck muttered to his friend. “You’re going to make me look bad, like I don’t even know how to take care of a patient.” He caught sight of Lukas and smiled. “Oh, it’s Dr. Bower. You’re in good hands, Reese.”

  “Hi, Buck,” Lukas greeted. “Did you come by ambulance? I didn’t hear a report.”

  “No, this is my cousin,” Buck said. “Name’s Reese Oppenheimer. A drunk landed his car in Reese’s front yard about three this morning, and being a Good Samaritan, Reese tried to help out—I think he’s got a broken nose.” He shot his cousin a sleepy glance. “Of course his first thought was go call good ol’ Cousin Buck and get him out of bed.”

  “So you’ve already reported this to the police?” Lukas reached over to a tray and picked up a pair of latex exam gloves.

  “Sure have,” Buck said. “They’ll need a report from you after you fix the damage.”

  Lukas gently removed the towel from Reese’s nose. Both eyes had begun to swell. “Were you hit by the car?” he asked Reese, gently touching the center part of the nose, which was swollen and already turning blue.

  “Ouch!” Reese jerked back. “No, the drunk hit me. He missed the curve in front of my house and just plowed out the front fence. Didn’t hurt him none, I don’t think. Didn’t act like it, anyways.”

  “Why did he hit you?”

  “I don’t think he wanted me calling the police. I helped him get his car loose from the fence, then told him to come on inside while I called the sheriff.”

  “And he hit you for that?” Lukas asked, reaching for a chemical ice pack from a shelf. He popped the pack, shook it, and gently placed it over Reese’s nose. “This is cold.”

  “Sure is!” Reese complained. “Ever had one of these things on your nose?”

  “Nope. I’ve never been hit by a drunk. Yet. If it’s too cold, we can insulate it with a washcloth, but it’s best to take it straight if you can. I’m going to have our secretary check you in; then we’ll get an X-ray and I’ll finish looking you over. Did he hit you anywhere else? Any other damage you know about?”

  “No, Doc, this is it.” Reese slumped down in front of Rita’s desk. “I hate drunks.”

  “That’s what you get for being a Good Samaritan,” Buck said. “You’ll think twice next time someone plows into your fence and tears up eighteen feet of sod and three rose bushes.”

  “No, I won’t,” Reese said. “What if they were seriously injured? I couldn’t live with myself. Don’t give me a hard time. You’re the fireman who wanted to be an EMT.”

  “Doc, can I go with him to X-ray?” Buck asked.

  “As long as there’s no chance you’re pregnant,” Lukas said with a straight face.

  Buck scowled at him. “You’re doing too many night shifts.”

  Lukas turned back toward Ruby’s room and found the lab tech approaching him.

  “Here’s your report, Doctor. It all looks pretty normal, except she’s anemic.”

  “Thanks. I’ll want that alcohol level as soon as you get it.�
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  As the tech turned to leave, Claudia stepped out of Ruby’s room. “She’s coming around just a little, Dr. Bower.”

  “Good, the thiamine’s working. Let’s see if we can’t get a Breathalyzer test as soon as possible. I don’t want to wait on the blood alcohol level.”

  “I’ll see what I can do.”

  She came back just a few moments later with a smile of triumph. “Got it. It’s 2.86.”

  “Okay, thanks. We have enough to admit her. Have Rita call the family physician.”

  Claudia grimaced. “It’s Dr. George.”

  “I know. We have to call him. I’m going to talk to Ruby for a few minutes. Let me know when we have Dr. George on the phone.”

  Claudia shrugged. “Whatever you say.”

  Lukas entered the room to find Ruby groaning softly with her hands over her abdomen.

  “Does your stomach still cramp, Ruby?” he asked.

  She frowned up at him. “Some,” she admitted. “When do I get outa here?”

  “As soon as we make you feel better.” He sat down on the exam stool. “How much did you really have to drink last night?”

  “I…I don’t know.”

  “You told us earlier you hadn’t had a whole jar. What kind of jar do you use?”

  “Jelly,” she said irritably. “You know.” She held her hands out about the length of a pint canning jar.

  “Do you make your own wine?”

  She glared at him. “I’m no wino! That stuff’s for little old ladies.”

  “Where do you buy your liquor?”

  “Buy? Whad’ya mean, buy? I don’t buy no booze.”

  “I see.” He tried to keep the sarcasm out of his voice. “You make your own, then?”

  She narrowed her eyes in suspicion. “What’d Emmett tell you? He’s got no right givin’ out fam’ly secrets.”

  Lukas stared at her in surprise. He leaned forward. “Ruby, do you have a still?”

  Her face contorted once again in pain. She put her hands over her abdomen and curled up in a fetal position.

  Claudia came back in. “Dr. Bower, we have Dr. George on the phone.”

  “Good. Send it back to the wall phone, then come back in here. I don’t want her left alone.” He stepped outside the room and picked up the receiver as soon as it rang.

  “Dr. George, this is Dr. Bower. We have a forty-nine-year-old Caucasian female with complaints of nausea and vomiting, severe headache, mental status change—”

  “Who’s the patient?” Jarvis snapped.

  “Ruby Taylor.”

  “What’s the ethanol level?”

  “We don’t have a blood alcohol level yet, but the Breathalyzer is 2.86.”

  “Like usual. Admit her to my service for short stay only.”

  “But there could be more than that going on this time,”

  Lukas said. “I think the Taylors have a still. Depending on how the still is made, it’s possible she could be suffering from—”

  “Do you always believe what every drunk tells you?”

  “But this could mean possible lead poisoning, and we may need to transfer her. Is it possible to get a stat lead level in our lab?”

  “Can’t you even take a simple order?” Jarvis growled. “You have my instructions. Follow them!” The line went dead.

  “Doctor,” Claudia called from exam room two, “Ruby’s pain is getting worse. Can’t we give her something for it?”

  In frustration, Lukas hung up the phone and rushed back into the room.

  Ruby cried out, still in her fetal position, holding her abdomen with both hands.

  “Where does it hurt, Ruby?” Lukas bent over her. “Is it your stomach? Lower? Can you point it out exactly?”

  Ruby didn’t acknowledge him.

  Lukas turned to Claudia. “Let’s give Nubain, 10 milligrams, slow IV push.” He put a hand on Ruby’s arm. “The nurse is going to give you a shot for pain.”

  Ruby grew still. Her eyes widened as she stared at Lukas’s hand on her arm. She bolted up. “No! Get those needles away from me! Help! Emmett, they’re killing me! They’re killing me!” Her lips drew back in a feral snarl, and she caught sight of the IV needle in her right arm. “What’s this?” Get this thing outa me!” She groped for the IV needle with her left hand.

  “No, Ruby, here, don’t do—” Lukas reached for her left arm.

  She drew back and swung at him. Her fist jabbed his right eye, and pain shot across his face. As he stood there, stunned, she drew back and punched at him again. He blocked the blow, and her fist connected with his chest.

  “Ruby, we’re not going to—”

  She bared her teeth and tried to bite his arm.

  He jerked his arm back and grabbed both of hers, stepping around behind her. “Claudia, get Rita in here now! And get Buck in here, too. He’s with Reese in radiology. Forget the Nubain. Get me Haldol, 2 milligrams IV push, and hurry, or she’s going to pull out the IV.”

  Ruby screamed like a raging tiger, jerking and pulling him with surprising strength.

  Claudia rushed forward, shouting over her shoulder, “Rita, get Buck and get in here! We’ve got a wild one!”

  Lukas tried to hold Ruby still while Claudia tried to connect her needle to the IV hub. Every time she came close, Ruby jerked.

  Buck rushed in behind Rita. “What’s the matter, Doc, can’t you even handle a little old—” He caught sight of the thrashing patient. “Uh-oh, it’s Ruby.” He rushed forward and grabbed the patient’s right arm. “Okay, Claudia, I’ll hold the arm still. Get the shot in fast.”

  While Claudia worked, Buck frowned at Lukas. “Looks like you’re going to have a shiner, Doc. How many times did she hit you?”

  “One more time than I expected.”

  Buck grinned. “Don’t you hate getting the drunks?”

  Some of the tension began to ease from Ruby’s arms.

  Lukas didn’t dare release her yet. “This one isn’t a drunk.” He watched her face as it slowly relaxed with the influence of Haldol. “There’s something else going on here.”

  Ruby’s eyes gradually lost their wild look and closed.

  “Whew!” Rita helped Ruby lie back on the bed. “She’s never done that before. What’s gotten into her?”

  “I have an idea.” Lukas reached down and gently pulled back the patient’s lower lip. She obviously disliked dentists, as well as doctors.

  “Dr. Bower, what are you doing?” Claudia asked.

  “Playing a hunch. See this thin, blue-black streak at the gum line? That’s the hallmark of lead poisoning. Get lab again. I want a stat lead level. Rita, call an ALS ambulance. Tell them to be here in ten minutes.”

  “An ambulance?” Claudia exclaimed. “Don’t you want to see what the level is first? We need to call Dr. George back.”

  “Her level is obviously high enough to be symptomatic, and I know we don’t have any of the antidotes for treatment here. Dr. George didn’t want to discuss the possibility of lead poisoning. He hung up on me. I’m not wasting time on this one.”

  “Here, Doc,” Buck said from behind him. He held out a chemical ice pack, already cold. “You’ll need this on that eye. Want me to check it for you? I know about black eyes.”

  “Thanks, Buck.” Lukas took the pack. He almost reached for a cloth to place beneath it, but just then Reese walked in from radiology.

  “Hey, what happened to you?” Reese asked.

  Lukas placed the ice pack on his eye. The cold stung, but he didn’t let on.

  “Drunk got him,” Buck said.

  Reese shook his head. “Don’t you just hate drunks?”

  Tedi sat in a chair that was too little for her and faced the red-headed, freckle-faced man who was supposed to be helping her. He hadn’t helped her yet, and she’d already been here for twenty minutes according to the big clock on the wall behind him. Her appointment was for eight o’clock Thursday morning, and he’d been ten minutes late, which would make her later for school. S
he’d already missed too much school. But she was supposed to talk to this man as if he were her best friend or something.

  “I had a nightmare one night that a monster was trying to kill me.” Tedi frowned at her interrogator. “You have to keep this confidential, don’t you? You can’t tell anybody.” She watched him for a moment. “You’re a friend of Dad’s. How can I trust you?”

  “Do you feel you can’t trust me because you don’t trust your dad?”

  “I asked you the question.” She glared at him. “Mom said she wants me to be able to talk about anything to my counselor. Does that mean you can’t tell anybody what I say?”

  “You’re a minor, Tedi. Your legal guardian has a right to know what’s going on.”

  “Even if he kills me?”

  “Why do you think your dad would kill you?”

  “He gets drunk and loses his temper, and if you tell him I told you this, he’ll remember it next time he drinks.” Tedi stared silently at Dr. Carpenter. The man had pale red hair and light green eyes. He wouldn’t hold her gaze. She didn’t like him, and she’d already decided she wasn’t going to come back. “Mom’s paying for this. You can tell her anything I tell you.”

  “She’s not your legal guardian.”

  “You’re just talking like that because Dad’s a friend of yours, Dr. Carpenter. Are you going to help him gang up on my mom?”

  “I told you to call me Nick.” He leaned forward and formed a little steeple with his hands. He met her gaze then. “Tedi, this is my job. It’s what I do for a living, and I love my job. I don’t mix business with pleasure, and I don’t play favorites with friends. I’ll do what I feel is best for you no matter what my friendship is with your father.”

  “Good. Will you testify for me in court so I can go live with Mom?”

  He raised a nearly invisible eyebrow. “For now the court has decided that it is in your best interests for you to live with your father.”

  Tedi gritted her teeth. “My mom was set up. She’s not mentally ill. She’s a doctor with a bunch of happy patients. Crazy people can’t do what she does. Besides, isn’t alcoholism an illness?” She stood up, grabbed her book bag. “I’ve got to get to school.”