* * *
"Who paged psych?"
Jess's head jerked up at the sound of Kim's voice. Thank God, came the unbidden thought. She didn't know why Kim was answering the page when Roberts was covering the ER but was grateful nonetheless.
"I did, Dr. Donovan." Bates called out above the din of the bustling nurses' station.
Jess scowled as she stepped out from behind the nurses' station. She was just in time to see Bates make a beeline for Kim. Damn it. I told him to page psych, not take over the case.
Jess snatched the patient's chart off the counter. She strode up to Kim and Bates.
Bates was not discussing the case with Kim. He was busy trying to chat her up.
Irritation warring with outright anger, Jess cut him off mid-sentence. "Thank you, Dr. Bates. Dr. Donovan and I have this under control."
Jess motioned down the hall. "Dr. Donovan, if you'd follow me." She turned on her heel and quickly walked away, pleased when Kim followed without a word.
This case was going to take a skilled clinician and someone good with children. Jess couldn't think of anyone better qualified than Kim.
Jess stopped opposite the door to one of the private treatment rooms.
"Sorry about Bates."
Kim waved off the apology. "What have you got?"
The release of a tension she had not even been aware of eased the set of Jess's shoulders. Right to business. And she's not even supposed to be here. Too bad she doesn't cover the ER all the time.
Reaching up and rubbing the back of her neck, Jess sighed. This case had her worried. "Patient is a nine-year-old female. She presented as an accidental poisoning. According to the mother, the girl mistakenly took a whole bottle of the mother's sleeping pills. The mother claims her daughter mistook the red pills for candy."
A frown marred Kim's face. "Is she developmentally delayed?" She pulled a notebook from her pocket to record the salient facts.
"Not that I've been able to determine."
"Who found her?"
"Her father. Apparently, she didn't come down for dinner and he went up to her room. She was sitting in bed. The empty pill bottle was sitting on her nightstand. He asked her about the bottle and she admitted to — in his words — eating them."
"So she was awake and alert when he found her?" Kim asked.
Jess nodded. "And she was still alert and responsive upon arrival in the ER. Best I've been able to establish there was about ten minutes between her swallowing the pills and her father discovering she had taken them." Jess raked her fingers through her hair. "We did a gastric lavage, followed up by activated charcoal." She hated having to subject a young child to such an invasive procedure but had not had any choice. "There were approximately twenty pills in her stomach contents." While she knew the scenario presented by the parents was possible, it wasn't very believable.
As if reading her thoughts, Kim said, "Doesn't sound very plausible to me, especially considering the patient's age. A nine-year-old would know what a pill bottle is versus a package of candy. Not to mention the obvious, a child of nine can or should be able to read." Kim stared at the door of the treatment room as if she could see inside. Her brow furrowed. "How did the parents present?"
"That's what bothered me, aside from the obviously less than believable story," Jess said. "The mother appeared distraught, but her behavior was off. She fawned all over her daughter, but it came across as just going through the motions. There was no genuine emotion behind it that I could see."
"What about the father?" Kim asked as she continued to scribble notes.
"The father seemed truly upset and scared. The other thing that struck me was the little girl. The whole time her mother was holding her, she never took her eyes off her father. She didn't seem to take any comfort from the mother at all. Her body posture was stiff and distancing."
Jess shook her head. "I don't know, maybe I'm seeing something that isn't there." She blew out a breath and stuffed her hands in the pockets of her lab coat. "But I can't get past the gut feeling that this was if not an outright suicide attempt, it was certainly a cry for help."
Kim lightly touched Jess's arm. "I trust your instincts." She shoved her notebook in her pocket and then scrubbed her hands over her face. "Which begs the question, what would drive such a young child to do something like this?"
"Exactly. I'm concerned that she may be actively suicidal." Jess sighed. "I tried talking to the little girl but got nowhere." Jess had seen for herself how good Kim was with children. "Would you evaluate her and see if you can get the real story?"
"Sure," Kim said with a smile.
"Let me know what you find out." Jess rubbed her neck. "Fair warning. I've already told the parents that I'm requesting that pediatrics admit the girl overnight for observation. The mother was not happy." Having the girl admitted to pediatrics was the only option at this point. "Unless you decide she needs to be on a psych hold, then we'll need to get her transferred to a hospital that has psych facilities for children."
"Okay, I'll —"
"Dr. McKenna!"
Terrell rushed toward them.
"We just got the call. We have multiple traumas coming in. First ones are five minutes out. Cement truck versus a bus."
Adrenaline pumped through Jess. "Call everyone together. Get both trauma bays set up," Jess said. They were most likely in for a long night.
Terrell raced off to do Jess's bidding.
Jess glanced at the treatment room door, where the little girl and her parents waited, and then back at Kim.
"Go. I've got this under control," Kim said.
"Find me when you're done," Jess said. She turned and sprinted down the hall.
* * *
Brightly painted animals chased across the walls of the small room. The muted light above the bed illuminated the diminutive figure in the bed. In stark contrast to the glaringly lit, harsh, sterile ER, the pediatric floor room was warm and welcoming.
Kim was sitting on the edge of the hospital bed. "Now you're never going to do something like that again... right?"
"I promise, Dr. Kim."
"Good girl." Kim gently patted Charlene's leg. "You're really going to like Dr. Kate."
Tears welled in Charlene's eyes. "But I like you, Dr. Kim."
"I know, sweetie, and I like you too. But remember what we talked about? How Dr. Kate is a special doctor that only takes care of children? I promise, she's going to take good care of you. You can talk to her and tell her anything that is bothering you. Okay?"
Charlene sniffed. "Okay." Her gaze darted toward the door. Tension suddenly radiated from her.
Kim turned to see what had caused the reaction. She smiled when she spotted Jess standing in the doorway.
"Oh good. You got my note." Motioning Jess in, Kim said, "Charlene, do you remember Dr. McKenna?"
Charlene inched closer to Kim. She nodded slowly, fear written clearly on her face.
A brief flash of dismay marred Jess's face. She quickly replaced it with a smile. "Hi, Charlene." Her tone was calm and soothing. She reached into the pocket of her lab coat and pulled out a small, stuffed frog. "I brought a friend along. I'm really busy downstairs and I was wondering if you could keep him company for me?"
Ah, Jess. You act emotionally distant, but what a soft heart. Kim knew how difficult it must be treating children in the ER. The invasive procedure Jess had performed on Charlene, although for her own good, had to have been emotionally hard on Jess.
The smile started small but quickly grew when Jess handed over the stuffed animal. Charlene ducked her head not quite willing to meet Jess's eyes. "Thank you," she said in a quiet voice.
Jess smiled. "You're very welcome." She turned her attention to Kim. "Can I talk to you?"
Kim stood and moved around Charlene's bed. "Why don't we step outside?"