But his broad shoulders appeared to carry a heavy burden, and those lines of strain around his eyes and mouth hadnt been there when shed known him.
What was he doing here, anyway? She could only be surprised that she hadnt thought of that question sooner.
Jacob Landsdowne III had been a neurosurgery resident in Philadelphia two years ago, known to the E.R. staff and a lowly paramedic only because hed been the neurosurgery consult called to the E.R. Hed been on the fast track, everyone said, the son of a noted neurosurgeon, being groomed to take over his fathers practice, top ten percent of his med school class, dating a Main Line socialite who could only add to his prestige.
Now he was a temporary Chief of Emergency Services at a small hospital in a small city in rural Pennsylvania. She knew, only too well, what had happened to the socialite. But what had happened to Jake?
Hed changed. But one thing hadnt changed. He still stared at Terry Flanagan with contempt in his face.
Glad you could join us, Dr. Landsdowne. Sam Getz, Providence Hospitals Chief of Staff, didnt look glad. Lets see how you measure up, thats what his expression always said when he looked at Jake.
I appreciate the opportunity to meet with the board. He nodded to the three people seated around the polished mahogany table in the conference room high above the patient care areas of the hospital.
A summons to the boardroom was enough to make any physician examine his conduct, but Getz had merely said the boards committee for community outreach was considering a project he might be interested in. Given the fact that Jakes contract was for a six-month trial period, he was bound to be interested in anything the board wanted him to do.
Last chance, a voice whispered in his head. Last chance to make it as a physician. They all know that.
Did they? He might be overreacting. He helped himself to a mug of coffee, gaining a moment to get his game face on.
Getz knew his history, but the elderly doctor didnt seem the sort to gossip. In fact, Sam Getz looked like nothing so much as one of the Pennsylvania Dutch farmers Jake had seen at the local farmers market, with his square, ruddy face and those bright blue eyes.
Dr. Getz tapped on the table, and Jake slid into the nearest chair like a tardy student arriving after the lecture had begun. Time to get started, folks. He nodded toward the door, where two more people were entering. You all know Pastor Flanagan, our fellow board member. And this is his cousin, Paramedic Terry Flanagan. They have something to say to the board.
Good thing his coffee was in a heavy mug. If hed held a foam cup, it would have been all over the table. Terry Flanagan. Was she here to lodge a complaint against him?
Common sense won out. Terry would hardly bring up that painful incident, especially not to the community outreach committee. This had to be about something else.
The other people seated around the table were flipping open the folders that had been put at each place. He opened his gingerly, to find a proposal for Providence Hospital to establish a clinic to serve migrant farmworkers.
He pictured Terry, bending over the migrant child in the E.R., protectiveness in every line of her body. Was that what this was about?
Hed been so shocked to see her that hed handled the situation on autopilot. Hed read equal measure of shock in her face at the sight of him. What were the chances that theyd bump up against one another again?
He yanked his thoughts from that, focusing on the minister. Pastor Flanagan spoke quickly, outlining the needs of the migrant workers and the efforts his church was making. So he was both Terrys cousin and a member of the boardthat was an unpleasant shock.
This was what shed done then, after the tragedy. Shed run home. At the time, hed neither known nor cared what had become of her. Hed simply wanted her away from his hospital. Not that it had stayed his hospital for long.
The minister ended with a plea for the board to consider their proposal, and Terry stood to speak. Her square, capable hands trembled slightly on the folder until she pressed them against the tabletop.
Had she changed, in the past two years? He couldnt decide. Probably hed never have noticed her, in that busy city E.R., if it hadnt been for her mop of red curls, those fierce green eyes, and the air of determination warring with the naiveté in her heart-shaped face.
That was what had changed, he realized. The naiveté was gone. Grim experience had rubbed the innocence off the young paramedic.
The determination was still there. Even though her audience didnt give her much encouragement, her voice grew impassioned, and the force of her desire to help wrung a bit of unwilling admiration from him. She knew her stuff, tooknew how many migrant workers came through in a season, how many children, what government programs were in place to help.
William Morley, the hospital administrator, shifted uneasily in his chair as her presentation came to a close. His fingers twitched as if he added up costs.
What you say may be true, he said. But why cant those people simply come to the emergency room? Or call the paramedics?
Theyll only call the paramedics in case of dire emergency. Terry leaned forward, her nervousness obviously forgotten in her passion. Too many migrants are afraid of having contactafraid their papers arent in order or theyre simply afraid of authority. As for the E.R., no one from the migrant camps comes in unless its a case where the police or the paramedics become involved. Theyre afraid, and theyre also dependent on the crew chief for transportation.
Jake heard what she didnt say. He hadnt thought too highly of the unctuous crew chief, either. But would he really refuse to transport someone who needed care? And did Terry, in spite of her enthusiasm, have the skills necessary to manage a job like this? He doubted it.
Morley was already shaking his head, the overhead light reflecting from it. If hed grown that pencil-thin moustache to compensate for his baldness, it wasnt working. Starting a clinic isnt the answer. Let the government handle the situation. We do our part by accepting the cases in the E.R. And, might I add, we are rarely paid anything.
Thats a point. A board member whose name escaped Jake leaned forward, tapping his pen on the table for emphasis. Wed put ourselves at risk with a clinic. What about insurance coverage? When they come to the E.R., we have backups and safeguards. If Ms. Flanagan or one of her volunteers made a mistake, wed be liable.
He thought Terrys cheeks paled a little at that comment, but she didnt back down. The hospital can establish any protocol it wishes for treatment. And I plan to recruit staff from among the medical professionals right in our community.
How many people do you think have the time to do that? Morleys head went back and forth in what seemed his characteristic response to any risk. Really, Ms. Flanagan, I dont see how you can make this work in such a short time. Perhaps in another year
The mood of the board was going against her, Jake sensed. Well, he couldnt blame them. They didnt want to take a chance. He understood that.
I have several volunteers signed up from my congregation, Pastor Flanagan said. And Ive spoken with the owner of Dixon Farms, the largest employer of migrant workers in the county.
Youre not going to tell me old Matthew Dixon agreed to help. Dr. Getz spoke for the first time, and Jake realized hed been waitingfor what, Jake couldnt guess. The man still has the first dollar he ever made.
If the minister agreed, he didnt show it. Hell allow us to establish the clinic on his property. Theres even a building we can use.
If you can sell this idea to Matt Dixon, Pastor, youre wasted in the ministry. You should be in sales. Getz chuckled at his own joke, and Pastor Flanagan smiled weakly.
That hardly solves the problem of liability, Morley said. No, no, Im afraid this just wont do. We cant
Getz interrupted with a gesture. I have a solution that will satisfy everyone. The fact that Morley fell silent and sat back in his chair told Jake volumes about the balance of power in this particular hospital. We need a volunteer from our own medical staff to head up the clinic. Thats all. He turned toward Jake, still smiling. Im sure Dr. Landsdowne would be willing to volunteer.
Silence, dead silence. Jake stared at him, appalled. He could think of a hundred things that could go wrong in an operation like this, and any one of them could backfire on him, ending his last hope for a decent career. He had every reason in the world to say no, but one overriding reason to say yes. He had no choice. This wasnt voluntary, and he and Getz both knew it.
He straightened, trying to assume an expression of enthusiasm. Of course, Id be happy to take this on. Assuming Ms. Flanagan is willing to work with me, naturally.
Terry looked as appalled as he felt, but she had no more choice than he did. Yes. She clipped off the word. Fine.
Thats settled, then. Getz rubbed his palms. Good. I like it when everything comes together this way. Well, ladies and gentlemen, I think were adjourned.
Chairs scraped as people rose. Jake glanced at Terry, his gaze colliding with hers. She flushed, but she didnt look away. Her mouth set in a stubborn line that told him he was in for a fight.
He didnt mind a fight, but one thing he was sure of. Terry Flanagan and her clinic couldnt be allowed to throw him off course toward his goal. No matter what he had to do to stop her.
Chapter Two
Its not the best thing that ever happened to me, thats for sure. Terry slumped into the chair across from Harriet in the E.R. lounge a few days later, responding to her friends question about working with Jake Landsdowne. It looks as if hes not any more eager to supervise the clinic than I am to have him. He hasnt been in touch with me at all.
Actually, she was relieved at that, although she could hardly say so. Shed tensed every time the phone had rung, sure it would be him.
Thats too bad. How are you going to make any progress if Dr. Landsdowne wont cooperate?
Terry shrugged. Ive gone ahead without him.
Im not sure thats such a good idea. Harriet frowned down at her coffee mug. Hes very much a hands-on chief. Hes been shaking up the E.R., let me tell you.
Im sorry. But not surprised. Jake Landsdowne had always been supremely confident that his way was the best way. The only way, in fact.
Harriet shrugged. I expected it. Just be careful with him. I know how much this clinic means to you. You dont want to put the project in jeopardy by antagonizing the man.
Terry thought of Juans frightened face, of the suppressed anger shed sensed in Manuela. Of the other children shed glimpsed on her trip to the migrant camp.
Ill be careful. She had more reason than most to know she had to tread carefully. For a moment the need to confide in Harriet about her past experience with Jake almost overwhelmed her caution.
Almost, but not quite. She had to watch her step.
Please, Father, help me to guard my tongue. Telling Harriet would put her in an impossible position, and it wouldnt be fair to Jake, either. I just wish Youd show me a clear path through this situation.
Did you know Dr. Landsdowne when you worked in Philadelphia? You must have been there at about the same time.
Harriets question shook her. She hadnt realized that anyone would put the two things together, but naturally Harriet would be interested in her new bosss record.
I knew him slightly, she said carefully. She wouldnt lie, but she didnt have to spell out all the details, either. Mostly by reputation.
Anybodys life could be fodder for hospital gossip, and the handsome, talented neurosurgery resident had been a magnet for it. Still
Excuse me.
Terry spun, nerves tensing. How long had Jake been standing in the doorway? How much had he heard?
Dr. Landsdowne. Harriets tone was cool. Clearly Jake hadnt convinced her yet that he deserved to be her superior.
I heard Ms. Flanagan was here. The ice in his voice probably meant that he knew shed been talking about him. Im surprised you havent been here before this. We need to talk about this clinic proposal.
Not a proposal, she wanted to say. Its been approved, remember?
Still, that hardly seemed the way to earn his cooperation. Do you have time to discuss it now?
He nodded. Come back to my office. He turned and walked away, clearly expecting her to follow.
Shed rather talk on neutral ground in the lounge, but she wasnt given a choice. She shrugged in response to Harriets sympathetic smile and followed him down the corridor. All she wanted was to get this interview over as quickly as possible.
The office consisted of four hospital-green walls and a beige desk. Nothing had been done to make it Jakes except for the nameplate on the desk. Maybe that was what he wanted.
He stalked to the desk, picked up a file folder, and thrust it at her. Here are the regulations weve come up with for the clinic. Youll want to familiarize yourself with them.
She held the folder, not opening it. We?
His frown deepened. Mr. Morley, the hospital administrator, wanted to have some input.
She could imagine the sort of input Morley would provide, with his fear of doing anything that might result in a lawsuit. Well, that was his job, she supposed. She flipped open the folder, wondering just how bad it was going to be.
In a moment she knew. She snapped the folder shut. This makes it practically impossible for my volunteers to do anything without an explicit order from a doctor.
Both Mr. Morley and I feel that we cant risk letting volunteers, trained or not, treat patients without the approval of the physician in charge.
You, in other words.
Thats correct. His eyebrows lifted. You agreed to the terms, as I recall.
I didnt expect them to be so stringent. My people are all medical professionalsI dont have anyone with less than an EMT-3 certification. Youre saying you dont trust them to do anything without your express direction.
Were they talking about her volunteers? Or her?
You can give all the sanitation and nutrition advice you want. Im sure that will be appreciated. Anything else, and
His condescending tone finally broke through her determination to play it safe with him. Are you taking it out on the program because you blame me for Meredith Stanleys death?