Between You and Me Page 28

  And now, years later, Caleb’s father was still a problem. After the woman from the state agency had paid a visit, he’d been locked in a power struggle with Asa. It was true that Asa was in fact the legal guardian of Jonah and Hannah. When John and Naomi were killed, there had been a flurry of official paperwork to assign guardianship. It was given to Asa so the children could stay in the home they’d always known.

  The family court didn’t know about Asa’s temperament. His rages, his intolerance, and his cruelty had been a secret protected by the community’s strict adherence to Ordnung. Caleb had realized that the only way to protect John’s children was to return to the farm and raise them himself, simple as that. Asa had been only too happy to hand the work over to someone else.

  But now that Jonah needed the modern world, now that English intervention was the best way to help him, Asa had finally decided to assert his rights of guardianship. He was trying to forbid further therapy for Jonah. There were moments when Caleb saw in Jonah’s eyes the hopelessness he’d once seen in John, who had tried to take his own life because of the things Asa said and did to him.

  Caleb was mad, and mad made him careless. As he threw the end of the rope from the high branch, he missed his mark and lost his hold. Grabbing at nothing but air, he fell through a lower branch, feeling the jagged broken wood score the back of his shoulder before he hit the water with an enormous splash. Breaking the surface, he heard Jonah yell.

  With his shoulder on fire, he swam to the edge and climbed out of the water. Blood coursed down his left side.

  “Uncle Caleb!” Jonah rushed forward. “You hurt yourself.”

  “It looks bad,” Samuel said, his face chalk white. “You cut yourself on a broken limb.”

  “Does it hurt?” Jonah asked. “Should we go get help?”

  Caleb wasn’t much for swearing, but a few choice phrases came to him as he tried to see the damage.

  “It’s real bad,” Jonah said. “You’re going to need stitches.”

  “No, I’ll just have Hannah bandage it up.”

  Jonah shook his head. “You’re not seeing what I’m seeing. You’re cut to the bone.”

  It was clinic day, and Reese, Ursula, and Mose were headed to the satellite facility in Pine Creek. She was still finding her footing as a working doctor, and one of the things she loved about clinic days was that she never knew what might come through the door—a woman in labor, an injured child, an elderly patient having breathing troubles. Despite a rocky beginning, the residency was all she could have hoped for and more.

  With the top down, they drove through the glorious summer morning. In the passenger seat, Mose held his hat on his lap. Ursula was in the back seat, her face tilted to the sky. The drive took them along misty country roads, past small towns, pristine farms, and fields clad in summer glory. Old German names marked the mailboxes, and Amish and Mennonite buggies crept along the narrow byways. A few miles from Pine Creek was a milestone pointing toward Middle Grove.

  Though she told herself to keep her mind on work, she kept remembering all the moments she’d shared with Caleb, the deep, impossible connection she felt, the exquisite intimacy. She thought about Jonah, too, wondering how he was doing now that he’d gone home to Middle Grove. Mose and the rest of the team were well aware of the boy, having seen him when he used to come for his sessions with the prosthetist. Lately, though, he hadn’t been going to his sessions, and it was all she could do to keep herself from intruding.

  She parked at the clinic, a low, modern building nestled in the heart of the small town, shaded by old maple trees. Most days were fairly routine, but today they were going to see Rebecca Zook. Clad in layers of plain clothing, her head covered in a bonnet, she was incredibly beautiful, blond and delicate, every hair in place. The fingernails of her dainty hands were chewed to the quick. She sat impassive and expressionless while her mother, a humble-looking woman dressed exactly the same as Rebecca, said the young woman was exhibiting strange behavior.

  “Sometimes she puts her clothes on backward,” explained Gretchen Zook, worrying her bonnet strings with nervous hands. “Yesterday, she wandered into a cornfield and couldn’t find her way out. It’s worrying.”

  Mose murmured something soothing in their dialect, and the mother nodded. “She gets scared of small things, like leaves and birds.”

  Ursula gave Reese a nod, and Reese took a seat on a swivel stool in front of Rebecca. The chart was filled with notes from the past several months. “How are you feeling?” she asked, fighting a familiar feeling of helplessness.

  “Not so good,” Rebecca mumbled. “My head aches all the time. I can’t sleep.”

  “Can I check your eyes with this?” Reese took out her scope, and when Rebecca nodded, shone the light into one eye, then the other. Rebecca’s eyes moved rapidly back and forth. “Can you look straight ahead?”

  “I’m trying. But no.”

  Reese did what she could, feeling a mounting uncertainty and bafflement. They tested Rebecca’s vision, coordination, and cognitive skills. There were abnormalities, but nothing conclusive. They gave Rebecca something for the headaches, and then the two women left. “She needs a full neuro exam,” Reese said.

  “For that, she would need to go to the city,” Ursula told her.

  “And let me guess. She won’t go. Damn it.”

  “Neuro will verify what we already know,” said Mose. “I’ve been following this case for a long time. Rebecca knows aggressive treatment would affect her fertility, and she won’t hear of it.”

  Gaining the trust and confidence of the patients in Dr. Shrock’s practice was a challenge medical school never prepared her for.

  “Not so long ago, a lot of the Plain people consulted a braucha—you’ve heard of this?”

  “After our interview, yes. I read up on powwowing,” said Reese. “I read enough to know it’s quackery.”

  “It is that,” he said. “Some folks think there are certain people who can heal by touch, or by moving around a sick person, or through incantations.”

  “What’s even more frustrating are the therapies that are harmful,” Ursula said. “I had a woman last year who actually had an untreated fistula, of all things.”

  “Trust is a friable thing and an Amish community is a delicate sanctuary,” Mose said. “You earn trust by respecting the patient’s beliefs, and you have to be careful how you intrude.”

  Reese studied his face—tired and wise. “Is it hard for you, trying to help people who don’t want your help?”

  “Of course it is,” he replied, taking off his glasses and wiping them on his shirttail. “We do what we’re called to do. But so do our patients.”

  They treated a few more patients—poison ivy, a guy with terrible bunions. Later in the day, there was a summons to urgent care. Ursula led the way to the exam area. Reese’s heart skipped a beat when she saw who was waiting there. “Jonah.”

  He looked wonderful, sun-browned and tousle-headed, inches taller and more filled out than when she’d last seen him. “Are you hurt?” she asked.

  “You know this boy?” asked Ursula.

  “From Mercy Heights,” Reese said without looking away from him. She wanted to hug him and never let him go. But he was off-limits now. “Jonah—”

  “Caleb got hurt.” He gestured at a curtained area.

  Her knees nearly buckled, and her stomach felt like a ball of ice. Caleb . . . hurt. She was supposed to hang back and let the nurse do a preliminary eval, but protocol flew out the window. She swept back the blue curtain to find him sitting on a paper-covered exam table. His shirt was off, and a nurse stood behind him, frowning as she gingerly dabbed at his bare back with gloved hands.

  “Caleb.” She nearly forgot to breathe. From some small part of herself, she dug out a crumb of professionalism. “I’m Dr. Powell,” she said to the nurse. “Caleb’s a . . . friend of mine.” Her heart pounding, she looked at him. “I’m probably the last person you expected to see,” she said. “W
hat happened to you?”

  “They say I got a big cut on my back,” he said. “I haven’t seen it, but it hurts like hellfire.”

  “Twenty-centimeter laceration,” the nurse said. “It’s going to need suturing.”

  “Perfect,” Ursula murmured, standing behind Reese. “I’m Dr. Mays,” she said, “and it appears you already know Dr. Powell. She’ll be taking care of you today.”

  Thus far, Reese hadn’t had a major laceration to treat. “Lucky you,” she said to Caleb. She walked behind him, unable to keep from noticing his physique and feeling ridiculously unprofessional.

  Focus. Check the wound, assess the patient. It was probably good that he hadn’t looked at the gash. It was long and deep, exposing the muscle. She asked the nurse to prepare a suture tray. “Wow, how did you do this to yourself?”

  Jonah poked his head through the curtain. “He climbed way up high in a tree to hang a rope swing over the creek,” he said. “He fell and got gouged by a broken limb on the way down. I was there. I saw the whole thing.”

  Caleb nodded. “That’s about the way it happened. At least I landed in the water.”

  That would explain the damp trousers and bare feet.

  “I’m going to give you a shot for the pain,” she said, noticing the stiffness with which he held himself. “After that, I’ll numb the area.”

  “It looks horrible,” Jonah said, peering at the wound. “Was my arm even more horrible than that?”

  “Even more,” Reese said, administering the pain meds. “Way more.”

  “He was real brave. He didn’t howl or nothing.”

  “That’s pretty brave. I’ve missed you, kiddo,” she said.

  Jonah flashed his trademark killer smile, then nattered on. “I couldn’t figure out how to do a bandage so I used a couple of Hannah’s sampler cloths to stanch the bleeding. She won’t miss them, on account of she throws away her samplers if they’re not perfect.” He held up something from a pink plastic basin. “Look at all this blood.”

  The cloth was embroidered with the phrase No Winter Lasts Forever, and some other words that were obscured by sticky, drying blood.

  “Are you going to operate on him?” Jonah asked. “Do you need to stitch him up? How’re you going to fix that giant cut, huh?”

  Reese gritted her teeth, trying to concentrate.

  Caleb said something to Jonah in German, and the boy got quiet. In English, Caleb said, “I bet they have some of those Highlights magazines over in the waiting area.”

  Jonah shuffled over to the waiting area with a stack of well-thumbed magazines. Ursula settled herself at the nurses’ station and opened her laptop. The nurse set up a sterile tray, and Reese went to the sink to wash her hands, which were now raw from so many washings, and smarting from the alcohol hand rub. She was ready for this. That was what she told herself, anyway. In actuality, she stared at the tray of supplies and instruments, and everything she’d learned about wound care and suturing emptied out of her head.

  “What was that shot?” he murmured.

  “It’s for pain and swelling.” She had a moment of panic, thinking of the long list of rare but possible side effects. “How are you feeling?”

  “Like I’m dreaming. Like I could translate the language of frogs.”

  She suppressed a smile. “That means it’s taking effect.” Then she turned to Caleb. Her wounded patient. “I did want to see you again,” she said. “Not like this, though. I need you to lie on your stomach.”

  He nodded, seeming to melt onto the paper-covered treatment table. The lac was relatively clean, though she observed slivers of wood and debris. She glanced over at Ursula, who looked up from her computer and nodded a go-ahead. Ursula was not only the most laid-back resident; she was the most likely to push. She refused to let an intern look for someone who could do a procedure better.

  Reese tried to shore up her confidence. If she didn’t learn to handle a situation, someone could end up in worse shape than when he’d come in. “Let’s get you fixed up.”

  “I’m all yours,” he said.

  Though she couldn’t see his face, she heard a smile in his voice. “This might sting,” she said. “Try to hold still.” She injected anesthetic solution along the edges of the wound, watching the flesh around it swell slightly and whiten from the epinephrine in the solution. She’d done this a hundred times or more, but the patient had been a foam roller or a pig’s foot. The fact that this was a man’s living flesh—Caleb’s living flesh—was starting to mess with her head.

  She set the syringe on the sterile tray and closed her eyes. Anything less than total focus could harm her patient. Remember that, she told herself.

  “You got this,” Caleb said softly, as if he could read her thoughts.

  Her eyes flew open. “Yes,” she said simply and picked up the syringe again. She infiltrated the wound itself, since it was so deep, sending numbness through the superficial fascia and all around the jagged edges and corners of the gash, gaining confidence as the syringe slowly emptied. Then she probed with tweezers to make sure he was numb. “Let me know if you feel this.”

  “Nope,” he said simply. “So far so good.”

  “Can I watch?” Jonah had wandered back over.

  Reese exchanged a glance with the nurse, who shrugged. “Okay by me,” Reese said.

  “Were you there when they sewed up my stump?”

  “I was not. They did that in surgery, not the ER.” She irrigated the wound, the blood-tinted water soaking the absorbent paper towels under Caleb’s torso. The nurse placed a piece of sterile drape over his back, centering the hole over the cut. Reese put on gloves and picked up the first blister pack of sutures for the interior. “I need to close the inside wound first. These sutures will be absorbed gradually.”

  Glancing briefly at Jonah, she saw him blanch at the sight of exposed sinew deep in the wound. “You should take a seat,” she murmured. “We don’t want to have to deal with two patients today.”

  He nodded and stepped back. “I might go watch for babies.”

  Caleb sent him a confused smile. “How’s that?”

  “There’s a baby box outside the door, like the book drop at the county library.”

  “Did you give him some of that shot?” Caleb asked. “He’s high too.”

  She watched Jonah scurry outside. “He means the safe haven box,” she said. “You should see this cut. I swear, Caleb. Tree climbing?”

  “Lost my hold,” he said simply. “It happens.”

  “All set, Doctor?” asked the nurse.

  There was a flurry of activity at the admittance desk—another kid with a wheezing, asthmatic cough. Reese glanced at the nurse. “Yes, thank you.” The nurse hurried away, and Reese was on her own with Caleb and his gaping wound. “I’m going to get to work now,” she said, aware of the time window for the lidocaine. She closed her eyes again, seeking that sense of total focus. Her patient’s well-being depended on her. By the time she opened her eyes, she was ready. Everything fell away except this single, driving thought. Willing her hands to stay steady, she sutured the deepest layer of the wound with the absorbable material, probably taking twice as much time as a more experienced physician would.

  “It’s kind of blowing my mind, seeing you here like this,” she said quietly.

  “Is that a good thing or a bad thing?” he asked.

  “It’s just . . . a thing.”

  “I heard you were working at the regional hospital,” he said. “That was a surprise, Reese. I thought you would be working in the big city.”

  “I changed my mind.” You changed my mind, she thought. She bit her lip, feeling a deep need to connect to him. Finishing the inner layer of suturing, she switched to the outer repair, using a curved needle with the filament attached. Deep breath again. “This is a jagged cut,” she said. “It’s not going to be too pretty for a while.”

  “Never had much use for a pretty back,” he said.

  A smile flickered. “Go
od point. But I don’t want any scarring. Get someone at home to put some white petroleum jelly on it every day.” She put the edges together, matching them like pieces of a puzzle. Ursula came over to check her work, approving it with a simple nod; then she went to look after another patient. Reese used the needle driver to push the curved needle through his flesh and pull the filament through behind it. Stitch and tie, stitch and tie, putting him back together again. She finished the sutures and counted them up. “Twenty-four,” she told him. “Are you doing all right?”

  “I am.” He hesitated. “I didn’t expect to see you again, either. Especially like this.”

  Her heart leaped. With deliberate care, she removed the drape, swabbed the flesh clean, then covered the suture line with surgical tape. “I miss you,” she whispered, her voice rough with stark honesty. “I’ve been missing you ever since you left.”

  “I feel the same way,” he said simply. “You . . . were—I liked spending time with you. But you understand, I had to go.”

  “I get why you left,” she said. “I do, but . . . I miss you,” she repeated, finishing with the tape. “And now you’re done. Take your time sitting up. You might be light-headed.”

  He sat up, and she found herself facing his bare chest. She turned away quickly and grabbed a pamphlet from a shelf. “Here’s some information about wound care and follow-up. Promise you’ll do what it says.”

  “I promise,” he said, stepping down from the table.

  “What did you do to yourself, young man?” Mose ambled into the urgent care clinic. “I hear you’ve been swinging through the trees like Tarzan of the Apes.”

  “I’m all put back together now,” Caleb said.

  “You got a shirt to put on?”

  Caleb’s ears reddened. “Didn’t see the point in ruining a good shirt.”

  Reese found a set of scrubs and tossed him the top. “It wouldn’t be the first time you had to wear hospital clothes.”