Chapter 3

CHAPTER THREE

Aaron was so preoccupied by the situation with Maggie and Joey that he was certain he'd given the worst presentation of his career. At least he hadn't been booed off the stage or gotten bizarre looks from the crowd.

Then again, maybe he had gotten odd looks but hadn't noticed. Whatever. He wasn't concerned about that now. The moment he was finished, he bolted out of the hotel conference room and quickly took the grand staircase down to the main lobby level. He didn't have a room since he lived locally, but as he passed the front desk, it occurred to him that Maggie probably had a room and luggage.

What about a handbag? Or other personal items?

Thinking back, he realized she hadn't had any of her personal items with her when they'd attended to the bus crash victims.

He turned and headed back upstairs to the grand ballroom. Sweeping his gaze over the area, he spied an empty seat with a large black computer bag sitting on the floor beneath the table. He strode over to remove the bag, taking a moment to look inside.

Seeing Maggie's familiar handwriting on a notepad was a jolt.

After double-checking to make sure her phone was inside as well, he carried the bag out of the room and to his car. He was glad to be able to do this much for her and was anxious to know what was happening with Joey.

Kyle hadn't called him about taking the boy to surgery, but it was only two o'clock in the afternoon. The boy wasn't tentatively on the schedule until three. And Aaron knew how easily a routine procedure could end up being anything but uncomplicated.

He'd called the local police after leaving Maggie and Joey at the hospital. The officer he'd spoken with had assured him that they'd follow up with Joey Johnson's family. He hadn't contacted his brother Alec yet, but he was next on the list if the local police weren't any further along in finding the boy a parent or guardian.

He used the physician's parking lot at Children's Memorial even though he was not technically on duty today. His next cardiac surgical procedure was scheduled for the following week, and as today was Friday, he had hoped to have the weekend off.

But if something urgent came up, his colleagues knew to call him. Days off were somewhat of a misnomer in the world of medicine. Especially for those in leadership roles.

He'd thought his attempt to bury himself in his career would distract him from his failed marriage. One chance meeting with his ex-wife had proven him wrong. Shaking his head at his own foolishness, he grabbed her oversized handbag and headed inside.

Finding Maggie and Joey was easy enough as they were still sitting in the emergency department room they'd been in before he'd left. He frowned when he found Joey asleep on the cot and Maggie sitting with her face in her hands. When she lifted her head to look at him, it was clear she'd been crying.

Her brown eyes widened when she saw her bag. She reached for it, then stood to draw him from the room.

"What happened?" He searched her gaze. "Is Joey still having surgery?"

"I don't know about that, but the police were here. An Officer Thomas told me that he has not found anyone related to Joey. At least not yet. We tried to question the boy, but he claims he doesn't have a father, aunts, or uncles." Her gaze was stricken. "Then we had to tell him his mother was dead and never coming back. I've had to give bad news to parents before but telling that sweet boy his mother had died and went to heaven was the hardest thing I've ever done. I'm heartbroken for him."

"Ah, Maggie. I'm so sorry." Her damp puffy eyes were evidence of how badly that conversation had gone. His arms itched to draw her close the way he used to.

Before their divorce.

He made a move toward her but stopped when she reached up to rub her temple. "I'm not sure what will happen with the surgery now that he doesn't have a parent or guardian to give consent."

"Kyle was concerned about that," he admitted. "Unless he can say the procedure is emergent, meaning loss of life or limb within twenty-four hours, he'll have to wait until the court provides a temporary guardian."

"And how long does that usually take?"

He grimaced. "Not sure. Being a Friday doesn't work in our favor. I doubt the courts are in session over the weekend."

"Then let's get the wheels in motion now." Maggie's eyes flashed with urgency. "We can't afford to wait. What if his condition deteriorates?"

He understood her concern. "I'll go to the hospital leadership with this, but what exactly did the police say? Are they still looking for his family?"

"Yes, and the social worker has also contacted Child Protective Services." She frowned. "I know they'll want to put him into emergency foster placement, but I'm not sure how that works if he needs surgery."

He wasn't an expert on this sort of thing either but remembered his brother Adam's wife Krista had gone through the process of becoming a foster parent prior to their engagement. "I'll make a few calls. Give me some time to work through my connections."

"Of course. I—uh, you have my number, right?" She flushed, then said, "I hope my phone is still in my bag."

"It is; I checked." He rested his hand on her arm. "We'll get through this, Maggie. There's always a way."

"Thanks for your help." She tucked her hair behind her ear. "I forgot to ask, how did your presentation go?"

"Fine." He waved a hand. "Not important now. Stay here with Joey, I'll let you know what I find out."

"Okay." She managed a wan smile. "I had planned on staying with Joey no matter what Child Protective Services says."

He wasn't surprised. Maggie could be doggedly stubborn when she believed she was in the right.

As evidenced by their divorce.

Aaron turned away and reached for his phone. He decided it would be easiest to head for his office to make the calls. For one thing, it was quieter than standing in the middle of the emergency department.

And for another, he felt certain he'd have to use everything he had to his advantage. Including his role as Chairman of Pediatric Cardiac Surgery.

* * *

Maggie was surprised Aaron had returned right after his presentation. Not only that, but he'd found her bag and brought that along too. He was being so sweet and considerate she was having trouble remembering their arguments.

Maybe because for the first time in years, they were on the same side of an issue. One little boy had pulled them together in a joint effort to get him the care he needed.

Ironic that an orphaned boy had brought them together when her inability to conceive had torn them apart. God worked in mysterious ways, but in this case, she would rather have had Joey's mother sitting there, alive and well.

Joey stirred on the cot, so she quickly went over to place a hand on his arm. "Shh, it's okay. You're fine."

Thankfully, the child settled back down. After crying himself to sleep, the little boy had woken several times complaining of pain in his belly. The nurse had finally obtained an order for pain medicine, and that had helped.

Maggie had asked for a copy of the CT scan report, and the images confirmed a three-by-four-centimeter hematoma. She wasn't an expert in pediatric trauma surgery but suspected that if Joey's mother was there and able to give consent, the child would already be in the OR to have it removed.

But she wasn't. And Maggie couldn't give consent in the absence of a parent. So here they sat, waiting for—what? The court to decide who could make decisions for the child?

As an anesthesiologist, she wasn't usually involved in this sort of thing. Surgeons must face this dilemma on a regular basis, but she only became involved once they had someone to give consent.

She didn't much like being on this end of the bedside.

A coughing child from two rooms over caught her attention. She left Joey's room to look inside, expecting to see someone with the child, but there was no one sitting at the little girl's bedside.

The little girl coughed again with a suspiciously croupy sound. Frowning, Maggie went into the room and pushed the call button.

Less than thirty seconds later, a nurse rushed into the room. Not Rachel, Joey's nurse, but a male nurse. "Sorry about that. I was tied up in another emergency."

"I'm not the child's guardian, but she sounds like she has croup. You may want to get her in a croup tent."

"Are you a doctor on staff?" the male nurse asked. His name was Greg, and he seemed nice enough.

"No, but I am a physician." She shot one more glance at the coughing girl as she edged toward the door.

"I'll call the resident about that croup tent," Greg promised.

She nodded and hurried back to Joey's room. She knew better than most that healthcare facilities were short-staffed these days, more so since the pandemic. Yet that didn't make her feel any better when it came to Joey getting the care he needed.

Would a court-appointed guardian sit at the little boy's bedside? Make sure he was comfortable and call the nurse if his condition changed?

Probably not.

"Mommy," Joey whined, still half asleep.

She pulled the chair closer to his cot and leaned over to stroke his back. "It's okay. You're fine. I'm here," she whispered.

The little boy moved restlessly but then quieted under her soothing touch.

She wondered if Aaron was getting anywhere with the hospital administrators. He hadn't called her, but she belatedly realized she'd put her phone on silent during the conference. Reaching into her bag, she pulled out her phone and turned the ringer back on but then made sure to lower the volume so as not to disturb Joey.

No missed calls from Aaron , she thought with a sigh. Although to be fair, he hadn't been gone for long. She tucked the phone beneath her thigh so it was well within reach before resting her hand on Joey's back.

Then she frowned. Was it her imagination, or did the little boy feel warmer than before?

Concerned, she reached for the wall thermometer. Hoping he wouldn't wake up, she gently placed the tip of the ear probe into his ear. A moment later, a reading popped up on the screen.

His temperature was 100.8 Fahrenheit.

When Rachel had first taken Joey's vital signs, his temperature had been normal. While this temperature reading wasn't scary high, it could mean the child's body wasn't responding well to the hematoma.

If the pocket of blood became infected, the issue of parental consent would be moot. The surgery to remove it would be considered an emergency.

She would rather they didn't wait for that to happen. She grabbed her phone just as it rang. Seeing Aaron's name on the screen, she didn't hesitate to answer. "This is Maggie."

"I've asked the hospital administrator to get the lawyers on the phone with the judge about an emergency guardian hearing," he said. "I'll be honest, Maggie, it doesn't look good that this will happen today. They're talking about having the hearing on Monday morning."

"Joey's running a fever of 100.8," she said, keeping her tone low so as not to wake the child. "I think Kyle Flores needs to get down here to look at him. In my medical opinion, we can't wait until Monday."

"I'll call Kyle and be right down." Without saying anything more, Aaron ended the call.

Reassured that Aaron was doing his part, she sank into the chair at Joey's bedside. She hadn't brought her stethoscope to the conference but wished she had it now so she could listen to the little boy's heart and lungs. Since she couldn't do that herself, she pressed the call button to summon the nurse.

"Maggie?" Aaron entered the room, his expression full of concern. He'd gotten down there quicker than she'd expected. "Kyle's on his way. His previous case took longer than he'd expected."

"Good." She pressed the call button for the nurse, stood, and crossed over to join him. "What do you think? Will Kyle take him to the OR?"

"I'm not sure." He surprised her by wrapping his arm around her shoulder. "We'll do our best to talk him into it."

That made her smile. "Works for me."

Rachel hurried into the room. "Is there a problem?"

"I'd like a full set of vitals," Maggie explained. "I'm concerned Joey is running a fever."

"Of course." Rachel appeared flustered but quickly went to work. Joey didn't appreciate being woken up and began to whine again about his tummy hurting.

"It's okay. I'm here." She bent over the little boy, smoothing his dark hair from his forehead. His skin felt warmer now, and she glanced at Aaron in concern. "I hope Kyle gets here soon."

"He will." Aaron came over to stand beside her. Rachel removed the stethoscope from her ears, glancing at the two of them. "His blood pressure is much lower than it was before, and his pulse is higher."

"Double-check his temperature," Maggie said.

Rachel did so, then turned so they could read the screen for themselves. Joey's fever was now 101.6 degrees Fahrenheit.

Not her imagination. She exchanged a concerned glance with Aaron as Rachel entered the readings into the computer.

She was about to ask Aaron to call his colleague again when Kyle hurried into the room. He glanced from Joey to her and Aaron and finally addressed Rachel. "What's going on? What's changed?"

"His vitals are not good," Rachel admitted. "He's running a fever, and his blood pressure has dropped. He's running tachycardic, too, likely because of the fever."

"Let me borrow your stethoscope," Kyle said to Rachel. When she handed it over, Kyle bent over Joey to listen to his heart and lungs. When he finished, Kyle handed the stethoscope back and addressed Aaron. "Have we gotten in touch with his parent or guardian?"

"No," Maggie said. "The police and I questioned Joey. He says he doesn't have a father or aunts and uncles." She glanced at Aaron. "It sounds like the hospital administrators have reached out to legal counsel, but it may be too late in the day to get an emergency guardian hearing in front of a judge."

"I tried," Aaron said. "They were sympathetic but determined to go through proper channels."

Kyle blew out an exasperated sigh. "His condition is growing tenuous. But I cannot honestly say he's on the verge of dying."

"Hospital policy considers a procedure emergent if there is a high likelihood of loss of life or limb within twenty-four hours," Aaron said. "Do you really think Joey's condition will improve?"

"I didn't say that," Kyle argued, his tone testy. Then he sighed again. "Okay, okay. I can't be responsible for risking this child's life. I'll document that the procedure is emergent, and we'll get him ready to go to the OR."

"Thank you," Maggie said. "I know you're in a difficult position, but I appreciate your willingness to take the risk."

"Yeah, well, better to risk getting yelled at or sued rather than losing a child's life," Kyle muttered. He turned toward Rachel. "I need you to place an IV and start maintenance fluids. I'll write the orders," he added when she looked as if she might argue.

"Of course." Rachel hurried off to gather the supplies, leaving Kyle to enter the orders into the computer.

"What can I do to help?" Aaron asked. "Would you like me to call up to the OR?"

"Yeah, sure. Let them know the three o'clock patient is going forward as scheduled," Kyle said as he typed on the keyboard. "I had him listed as tentative, pending the outcome of his scans."

Maggie knew the scan itself wasn't the reason they were moving forward with the procedure, but rather the abrupt change in Joey's condition. Sepsis, which is caused by an infection that enters the blood stream, could be deadly.

And the problem with kids was that they tended to compensate for their illness but then abruptly crash.

She couldn't bear for that to happen with Joey.

Aaron stepped to the side to make his calls to the OR while Rachel and Kyle discussed treatment options for Joey. She was glad to hear Kyle wanted the child to get his first dose of antibiotics prior to the procedure.

"I'll put a rush on that," Rachel said.

"Thanks." Kyle glanced at her. "I'm sorry, I don't think we've met."

"Dr. Maggie Dall, anesthesiologist." She shook his hand.

"Nice to meet you," Kyle said with a tired smile. "If you don't mind my asking, if you're not Joey's guardian, why are you here?"

She flushed. "I responded to the bus accident with Aaron. I…we…" She faltered, then said, "We used to be married. Anyway, Joey latched onto me in the bus, so I've stayed with him."

Kyle's eyebrows shot up in surprise, but he didn't have time to respond as Aaron stepped forward. "Everything is all set. The OR team is getting room eight ready for Joey's emergency abdominal exploration procedure."

"Great." Kyle checked his watch. "As soon as the IV is placed and the antibiotics are infusing, we can move."

Rachel returned with the supplies. Maggie was impressed she had gotten the antibiotics rushed up from the pharmacy. She held Joey as Rachel started the IV; his crying made her heart hurt.

"There now, the poke is over," she said, as Rachel secured the IV in place. "You'll feel better soon."

"I want my mommy," Joey said between sniffles.

"I know you do." She kept him close to her side. "Don't worry, I'll stay with you."

He nodded, resting his head against her chest. His little body was warm to the touch, radiating heat. She glanced over to see Kyle and Aaron talking in low voices.

"Okay, we'll head up to the OR now," Kyle finally said, after they were finished. "Maggie, do you want to walk along with us?"

"Yes." She tried to slip away from Joey, but he clung to her much the way he had on the bus, as if he were deathly afraid to let her go. "Actually, I'll carry him."

Kyle looked at Aaron who shrugged. Then he nodded. "Rachel, will you push the IV pole as we go?"

"Ah, sure." From the shocked expression on Rachel's face, Maggie assumed carrying a child to the OR wasn't normal practice.

She didn't care. She cradled Joey close while following Kyle through the hallways to the OR suites. When the anesthesiologist met up with them, she continued to hold Joey while he was given medication to put him to sleep. Only once the little boy was completely relaxed and asleep did she allow the medical team to place the child on the OR table.

Forcing herself to back away wasn't easy. As the medical professionals surrounded the little boy, she asked God to heal Joey.

And to guide Kyle's skilled hands as he performed surgery.