Dangerous Waters Read online

  “I still don’t see why we have to be able to identify poisonous snakes,” Marco said with a hint of a whine. He flicked his shock of jet-black hair out of his eyes with an impatient gesture, managing to look put out and put-upon at the same time. “I’m not going to be practicing in the Everglades.”

  A couple of his colleagues grinned, and he laughed, enjoying the subtle applause.

  Dara bit back her reflex reply: Because I expect you to.

  Marco, who undoubtedly planned on working at one of the posh local private hospitals when he finished, was the oldest son of an influential Miami family and, like many of the sons and daughters of the privileged Dara had grown up with, hadn’t yet cultivated a tolerance for frustration. Hard to do when you were used to every whim being instantly satisfied. Not his fault, really, and her job was to help him, and the rest of his group, learn to exchange arrogance for confidence in their own judgment.

  “All right, let me show you why.” Dara opened PowerPoint again, scrolled down to her ancillary slides, and selected one.

  Kirk, the other male in the group—when had the gender ratio flipped and women begun to predominate in med schools across the country? Probably when men decided that medicine wasn’t the prestigious career it used to be and definitely wasn’t the most lucrative—grunted and said, “Nasty.”

  “Indeed,” Dara said dryly. The foot in the middle of the slide was three times its normal size, fire-engine red with a hint of blue-black along the tips of all the toes, the skin peeling off in wet sheets. She picked out the resident who’d been half asleep during the lecture. “Suki, what’s the pathology here?”

  “Um.” Suki cast wide eyes at her colleagues, barely hiding her desperation as she grasped for an answer. “Snakebite?”

  “Good deduction, considering the topic for this morning’s lecture was venomous bites. But that’s the etiology, not the pathology.”

  Suki frowned, and Dara sighed inwardly.

  “Anybody? The difference?”

  “Cause and effect,” Naomi, who’d graduated top of her class at Howard, answered quickly.

  “Correct. The clinical signs resulted from the snakebite. So, Suki, want to try again?”

  “Cellulitis?” she said with a hopeful lift in her voice.

  “Correct. What else?” After a long silence, Suki had clearly exhausted her diagnostic acumen for the morning, and Dara shifted her focus to Consuela. “Thoughts?”

  “The discoloration of her—or his—toes looks like ischemia. Early onset gangrene?”

  “Good. Anyone want to venture what the cause of that might be?”

  Six bodies shuffled in their seats.

  “All right. Let’s go around the table and list the causes of reduced blood flow to the lower extremity.” Dara nodded to the resident on her left. “You’re up first.”

  When she’d finally walked them through all the potential causes for toes falling off, they finally made their way to compartment syndrome, caused by swelling and inflammation from the poisonous snakebite.

  “Good. Now, what antivenom should you use? Marco?”

  Silence.

  “There’s no way to know,” Kirk, who for some reason hid his intelligence behind a perpetually bored facade, replied as if the effort was an annoyance.

  “And why would that be?”

  He met her gaze. “Because you don’t know what the snake is.”

  Dara smiled. She’d been watching him since he’d first sauntered into the ER eight weeks earlier and hadn’t needed long to decide he had the potential to be one of the best residents she’d trained in a long time. He underplayed his book smarts but couldn’t conceal his innate clinical sensibility, something that couldn’t be taught. If he wanted to cover up his native intelligence, she’d let him, as long as his practice lived up to his potential. She understood the need to wear a different public face when the private one left you vulnerable.

  “What if the patient told you it was red, black, and yellow striped.”

  Suki shot up in her seat. “That’s a coral snake!” She blushed and looked around. “I grew up down here.”

  Dara pointed a finger at her. “Exactly. And that’s why all of you need to know what the indigenous poisonous species are in your area. With any luck, your patient will be able to describe for you what happened, and you can prescribe an antidote.”

  “Can’t you just get somebody from infectious disease to do that?” Marco said.

  Dara narrowed her eyes. “As long as you’re in this residency program, you take care of the emergencies. If you need a consultant, it better be after you’ve made the appropriate diagnosis to begin with. All clear on that?”

  Six heads nodded, even Kirk’s.

  Dara closed up her computer. “Okay, we’re done, then. If you worked last night, get out of here. The rest of you, go grab charts.”

  As the residents filed out, the head ER nurse, and Dara’s best friend, Penny slipped into the room.

  “How are they doing?” Penny asked.

  Dara sighed. “They seem to get younger and less prepared every year, but maybe that’s just because I’m older and getting more tired every year.”

  “Yeah, like thirty-two is ancient.” Penny scoffed. “Haven’t you set the record for being the youngest section head ever or something like that?”

  “Age is a state of mind,” Dara muttered.

  “Well, I’m about to make your morning even better. There’s a Gold Coaster in room seven who insists on seeing an attending, and you’re the only one free.”

  Dara gritted her teeth. Gold Coaster. Back in her residency days, she’d heard the term applied to herself when people thought she wasn’t listening, as if her family’s money somehow bought her a pass. Maybe it had in terms of getting into the college she wanted, which unfortunately also happened to be her father’s alma mater, although she’d put her grades up against anyone’s. Being a bona fide heiress—God, she hated that term—sure hadn’t paved the way during her residency. If anything, training in Miami, where her family name showed up on buildings, parks, and even a road sign or two, made her life hellish. A couple of her attendings had obviously resented her presumed special status, and trying to have a personal life where her social connections didn’t surface was impossible. Good thing she was too damn busy most of the time to care.

  “Can you see her?” Penny prompted.

  As much as she worked to distance herself from her family’s reputation and the social network attached to it, she couldn’t deny a patient the right to request an attending. She’d just bring a resident with her and insist they be involved in the care. “What is it?”

  “A facial laceration, of course.”

  “And they’re not requesting plastic surgery right off the bat?”

  “We’re trying to ward that off.” Penny grinned sheepishly. “I might have suggested you were highly skilled with facial lacerations, could see her sooner, and wouldn’t charge as much.”

  “Oh, thank you.” Dara shook her head and tucked her computer under her arm. “All right, I’ll be there in a couple of minutes.”

  “Thanks, you saved me one headache.”

  “How are you feeling?”

  Penny made a wry face and patted her stomach. “I’m gonna have two in diapers when this one comes along. Of course I’m ecstatic.”

  Dara knew she meant it. Some people were born to be parents. “How about Sampson? Is he ready for the double dose of daddyhood?”

  Penny rolled her deep-brown eyes in an expression of fond exasperation. “We were really happy when Evie came along, kind of unexpectedly after, you know, six years of trying and a year of considering other options, and then poof! It’s like somehow we unlocked the fertility vault, and without even trying, number two is on the way. Sam has been marching around with a puffed-out chest like he’s the father of the year.”

  Dara laughed. “If your BP gives you any problems this time, I want to know about it.”

  “Believe me, you’
ll be the first to hear.” Penny waved and hurried back to the central station.

  Dara exchanged her computer for her tablet and joined Vincie Duval, the chief ER resident, who leaned against the counter entering notes into a laptop. Taller than Dara by a few inches and willowy where Dara was slender at best, Vincie was a top candidate to join the ER staff at the end of the residency year if she wanted. So far she’d been quiet about her plans. Vincie’s parents had immigrated from Guadeloupe when Vincie, the oldest of four, was only six. Her father had died on a fishing boat lost at sea, and she’d grown up helping to raise her sibs. If she wanted to take a job closer to her family, Dara could understand. She’d ended up staying close too, although their stories couldn’t be further apart. She shrugged the past away with the realities of the moment, a habit that was second nature now. “Got a minute to see a patient who might need sutures?”

  “Sure.” Vincie’s perennially smiling light-green eyes brightened, complementing her smooth, tawny complexion. With her boundless energy and effortless beauty—if she wore any makeup it was too expertly applied for Dara to tell—Vincie somehow always managed to look ready to take on anything.

  If she’d ever been that optimistic, Dara couldn’t remember when. Sometimes Vincie’s enthusiasm made her feel decades older than she was. Granted, her blond hair, naturally tanned coloring, and blue eyes gave her a perpetual south Florida beach glow even without trying, but inside she was weary. And she really didn’t have time for that, today or any other time. Dara pulled up the intake form on her tablet and held open the curtain enclosing cubicle seven for Vincie. Once inside, she stepped to the bedside of an elderly woman propped up on the stretcher, a small square of gauze taped to her forehead and a bruise purpling her left upper lid. She wore a red cardigan that looked like cashmere over a mismatched, incongruous stained yellow T-shirt along with an imperious expression.

  “Who are you?” she demanded querulously.

  “Ms. Hastings?” Dara held out her hand. “I’m Dr. Sims, and this is Dr.—”

  “Finally.” The woman dismissed Vincie with barely a glance and glared at Dara. “I asked for one of the attending physicians, and I don’t want to see a resident.”

  Dara kept her smile in place. “I am one of the attendings, and this is Dr. Duval, one of our senior in-house physicians. Can you tell us what happened?”

  The woman plucked at the hem of her sweater and, after a second, waved a hand toward the tablet. “I’m sure it’s all in there. I already told several people.”

  “Perhaps you could tell me again,” Dara said.

  “What did you say your name was again?”

  “Dr. Dara Sims.”

  “Sims. Sims.” The elderly woman—her intake form put her at seventy-four—frowned. “Any relationship to Barrister Sims?”

  An ache started at the back of Dara’s head. She could ignore the question or, in the interest of time, simply answer. She surrendered, at least partially. Barrister did not deserve a mention. “Priscilla Sims is my mother.”

  “Oh,” the woman said, her expression softening. “Well, then, I suppose it’s all right.”

  Dara nodded, feeling her smile begin to slip. “Can you tell us what happened,” she asked again as she pulled on gloves and removed the gauze. The laceration was superficial, and she glanced over her shoulder at Vincie. “What do you think?”

  “I can clean it up and Steri-Strip it.”

  Dara nodded and replaced the gauze. “How did this happen?”

  “I…I…the maid or someone must have moved a footstool. Careless of them.”

  “I see.” Something in the woman’s tone tugged at Dara’s memory. The familiar oh, it’s nothing, I’m just busy she’d heard from her grandmother so many times as her memory and awareness had begun to slip away. “Did you experience any dizziness or loss of balance before you fell?”

  The patient’s gaze flickered away. “No.”

  “Light-headedness, chest pain?”

  “No, no.” Another hand wave. “Oh, perhaps I was dizzy for a second.”

  Dara asked a few more questions as she examined her, noting how Ms. Hasting’s answers changed when Dara repeated some of the same questions. She wasn’t sure if the patient was being intentionally evasive or really couldn’t remember.

  “How did you get here?” Dara asked.

  “I had the doorman call a car.”

  “Good,” Dara said. “The laceration isn’t bad, and I don’t think you need sutures. While we set up to put some Steri-Strips on that, I’d like to get an MRI.”

  “All right,” she said, strangely acquiescent.

  “We’ll be right back.” Dara motioned for Vincie to follow her into the hall. “What do you think?”

  “She’s definitely confused,” Vincie said. “Maybe as a result of the fall, but possibly something else is going on that caused it to begin with.”

  “I know. The MRI will rule out anything physical. Let’s find out who’s with her from her family, and if there’s no one here, let’s get someone. She shouldn’t go home alone.”

  “I’ll take care of it.”

  “Call me when you get the MRI results.”

  “Got it.”

  Dara headed for the workstation to check on the charts of patients waiting to be seen. When the clerk saw her coming, he held up the phone.

  “There’s a call for you, Dr. Sims,” he said. “I was just about to page you.”

  “Who is it?”

  “Brian from Shoreline Residential.”

  Dara’s heart jumped and she held out her hand. “I’ll take it, thanks. This is Dara, Brian. Is something wrong?”

  “I’m sorry to bother you, Dara, but your grandmother is asking for you.”

  Dara checked her watch. “I’ll be there as soon as I can. I just have to get things covered here.”

  “Sure thing. I’ll be here.”

  Dara hung up and swung around. Penny was right behind her. “Hey, I need to leave for a while.”

  “I heard.” Penny squeezed her arm. “Go. Everything here is under control. I’ll call if anything changes.”

  “I won’t be long,” Dara said.

  If she was in time at all.

  Landfall minus 10 days, 1:30 p.m.

  Roc Hotel

  Miami Beach, Florida

  “Morning, Harry.” Sawyer slid onto a stool at the thatch-topped cabana next to the pool outside her room. She braced herself against the hundredth round of Jimmy Buffett singing about the mythical Margaritaville of some long-ago endless summer.

  “The usual?” Harry asked.

  Man, had she really had enough to drink in two days to have developed a usual? She squinted in the glare from the water and tried to picture where she’d left her shades. Bedside table, where she would have placed her weapon if she’d been on duty. Getting sloppy now that no one was likely to be shooting at her. “Hold the vodka this morning. Just make it hot and spicy, though.”

  “Like your women, huh?” Harry the bartender’s sun-leathered skin crinkled around his watery blue eyes as he winked and reached for the Stoli. He waggled the bottle. “You should take the hair of the dog. Start your day off right.”

  Sawyer smothered a wince. Harry was wrong on several counts, but a lesson in PC-terminology was beyond her at the moment. She needed a headache remedy, true, but hair of the dog was definitely not on the menu. If she’d been enough of a drinker to handle the vodka, she wouldn’t have a hangover to begin with. “Just the juice, thanks, Harry.”

  “You know best,” he said dubiously. “I saw your blondie friend come down for a swim this morning. You don’t like the beach?”

  “I like it fine.” Sawyer passed him a ten and palmed the sweating glass. The celery fronds drooped over the top, looking about as lively as she felt. She pushed them aside, sipped the blood-red juice, and coughed when the horseradish hit the back of her throat. She blinked tears from her eyes. “Just not before noon.”

  He laughed. “Late night.”


  “Catching up.” She was only two days into her fourteen-day leave, and last night had been the first night in a year she’d said more than ten words to a woman who wasn’t her best friend’s wife, her CO, or her barista. Not for lack of poolside company, true, and Harry clearly had noticed the traffic to her table. But talking was not doing—at least not in her book, and she’d heard enough bragging on supposed sexcapades in mess halls and Humvees to know the difference. Last night had ended after a round of drinks in her room with Bridget from Brussels, an abbreviated make-out session she hadn’t even been sure she wanted and hadn’t initiated, and a hasty apology when she’d bowed out of anything more intimate. Bridget had taken the rebuff with a shrug and an air-kiss before sashaying back out to poolside. No doubt to have better company before too long.

  Alone under a clear, star-studded sky, Sawyer’d stretched out in the lounge on the postage-stamp-sized patio and finished her drink and one more she really didn’t need. Thus explaining waking up at noon with a crick in her neck, a tracer barrage of too-bright sun lighting up the insides of her eyelids when she tried to open them, and a deuce of 50 mm’s pounding away at her cerebellum. In civilian terms, a mother of a hangover.

  Stateside for less than a month and pathetically out of practice in more ways than one. Well, she had twelve more days to catch up on living in a non-war zone before the next round of reservists arrived for training on the HH-60s. Coordinating pararescue team maneuvers on the Pave Hawks wouldn’t leave her much time to think about what shape her future was going to take now that she was home. Of course, she might get deployed again, and that would solve all her problems. True.

  Chapter Three

  Landfall minus 10 days, 2:00 p.m.

  Shoreline Residential Center

  Miami, Florida

  “How is Priscilla?” Caroline Sims asked as she carefully straightened the blanket over her lap. The typical September Miami day edged into the mid-eighties, but she wore a pale-rose crocheted shawl around her shoulders over a faded blue dress with small white pearl buttons down the center. Her white hair was recently permed in the nondescript style of so many women her age, a style Dara knew for certain her grandmother would have hated if she’d been aware of it. The dress was hopelessly out of date as well, but one of the few items her grandmother still recognized.