Falling Again in El Salvador Read online

  “It must have been hard to miss out on so much.”

  She sighed. “Missing out was bad enough, but my parents treated me as though I were made of glass. Everyone was constantly telling me what not to do so that I wouldn’t put a strain on my heart. Even things that were normal for other kids were deemed too dangerous for me. You mentioned summer camp last night. I’ve never been to summer camp in my life. I couldn’t climb trees. I couldn’t ride bikes. Hell, after I had my last surgery, there were a few weeks where I was so weak I couldn’t even tie my own shoes.”

  “I bet all of the rules and restrictions were suffocating.”

  “Actually, all of that overprotectiveness backfired. I promised myself that as soon as I was strong enough, I’d never let anyone tell me anything was too dangerous ever again.” She smiled ruefully. “And then I went to medical school and got my big chance. My heart was finally completely healthy. I was living on my own for the first time in my life.”

  “And you wanted to seize the day.” All of this explained a lot. But it also made him consider Cassie in a new light. He’d always thought her fearlessness was an inherent part of her personality. But the information about her heart defect put everything in a different context. Now he found himself wondering if she wasn’t such a natural risk-taker, after all. Instead, she’d been pushing herself to take risks. Somehow, thinking about her in this way gave him an unexpected pang of warmth for her. For the small girl Cassie had been and the young woman who had been trying so hard to prove herself.

  Her next words confirmed his hunch.

  “Carpe diem, indeed. Half the reason I argued so much with the other residents and attending physicians was because the feeling of going against authority was so new to me. From the outside, I looked like a med student advocating for her patients, but inside I was basically a teenager who saw rules as something to be broken.”

  He couldn’t stop himself from asking. “Was our relationship another opportunity to break the rules?”

  She looked as though he’d slapped her. “Wait a minute. Is that what you think? That our relationship was just about me getting a thrill?”

  He shrugged. “I get it. You’d been sheltered your whole life and were chafing against the rules, understandably so. And you decided to use me as one more way to rebel.”

  For a moment, her eyes blazed, but then she grew thoughtful. “That was part of the appeal at first,” she admitted. “But only at the very beginning.”

  What did she mean by only at the very beginning? Did she mean that she’d eventually developed deeper feelings for him later on? Or that the appeal had faded and she’d ultimately viewed their relationship as a mistake? He wasn’t sure he wanted to know.

  She was staring at him as though she expected him to say something. But his mind was spinning with questions, and his heart was full of a feeling he couldn’t name. All he could manage to say was, “Everybody has regrets.”

  “Well, I regret the way I left. I shouldn’t have left a note. I should have talked things over with you, ended it face-to-face. For all the risks I took that year, I should have at least been able to handle that. But I couldn’t and... I’m sorry.”

  She was trying to move on, he realized. She was trying to do exactly what they’d talked about last night: find a way to move forward, as professionals. Maybe even as friends.

  He realized she was still watching him for some response. He decided that if she could move forward, then he could, too.

  “Apology accepted,” he said, and he found that the words did leave him feeling as though a weight had been lifted from his chest.

  But any relief he felt was short-lived. Because the moment the tension in his chest eased, he found himself confronting a new problem.

  He no longer struggled with the two conflicting impulses that had been tearing him apart since she first arrived. That problem was solved. Because the urge to run from her was gone.

  But the impulse to gather her into his arms was stronger than ever.

  Apparently, moving on was going to be harder than he’d thought.

  CHAPTER FOUR

  CASSIE SPENT THE next few weeks adjusting to life at the camp. Because her patients came from such varied situations, each day was different, and she never really knew what was in store for her when she began her work in the morning.

  The camp was unlike any setting she had ever worked in. It was difficult not to have modern medical equipment, but she also found that the limitations she faced made her rise to the occasion and work harder than ever before. During each delivery, she had to keep her attention focused in numerous directions. Without a monitor to alert her of when a fetal heart rate was dropping or a pulse oximeter to measure oxygen levels in a patient’s blood, she had to rely on her training and her observational skills, and she couldn’t afford to lose focus for a second.

  Delivering babies had always held its share of drama. If something went wrong, it meant tragedy for everyone involved. The despair of losing a new life or of a mother being at risk, all of it was the price Cassie paid for the other side of obstetrics: the side filled with celebration and joy. But practicing in El Salvador raised the stakes to a whole new level. The more Cassie saw of the struggles that her patients faced, the more she felt that she was in the right place. Her patients wanted what any parent wanted: to give birth in a safe place, with the best care available. Cassie was determined to offer them that in any way she could.

  She found herself rediscovering some of her most deeply held beliefs as a physician. She’d started her career in medicine with the dream of showing each patient the same kind of personalized care her family had received when she was a child. Each doctor who’d operated on her heart had taken the time to get to know her family and had closely followed Cassie’s recovery afterward. But by the time she’d graduated medical school, the landscape had changed. Many of the hospitals with the most resources were private hospitals, where the administration’s focus was on the bottom line. That meant less time spent with patients and more pressure to complete as many billable procedures as she could each month. She’d chosen to work at a private hospital so that she could provide her patients with the best care possible, but she wasn’t sure, now, if it really was the best care. There was so much focus on profits that she’d felt more like a baby delivery service than a real doctor.

  And for a long time, she’d accepted that as the way of things. She hadn’t started out that way. Back when she’d been a medical student who pushed herself to be fearless, she was a fierce advocate for her patients. If she felt that one of her patients needed extra time or care or a risky procedure, she wouldn’t hesitate to fight on her patient’s behalf. But she’d buried that part of herself behind after she’d left Bryce, blaming her outspoken, adventurous side for causing so much trouble.

  Working at the camp was making her wonder how she could have gone for so long without challenging the status quo. That young rebellious version of herself hadn’t been afraid to go against the system or take unorthodox steps if she felt she needed to advocate for the well-being of her patients. At some point, she’d lost sight of that person, but as she spent more time working at the camp, she realized that this was a setting in which risk and improvisation were far from discouraged. In fact, they were viewed as a necessary part of providing care. She was reconnecting with her passion for medicine, just as she’d hoped she would.

  She also found that she was reconnecting with Bryce. It was impossible for them to avoid running into one another in such a small camp, and they often worked on the same cases together.

  It was so easy to fall back into a steady rhythm of working with him. She’d forgotten how well they’d collaborated, but as they shared more cases, they resumed their natural tempo as though the years hadn’t passed. They worked together seamlessly, especially during difficult or complex cases that required taking medically necessary risks, as well as exerc
ising extreme caution with the same patient. The patients who needed more risky procedures were often the most fragile, and Cassie noticed that she and Bryce balanced each other out especially well with these cases.

  She still hadn’t found out why he’d become an obstetrician. Somehow, she couldn’t get up the nerve to ask him outright. There was so much she didn’t know about what had happened to Bryce over the past five years. Had he ultimately lost his job after she left? Even if he had, why would he give up surgery?

  And the conversation she’d had with Bryce as he’d bandaged her ankle continued to reverberate in her mind. His words had cut her to the bone.

  Was our relationship another opportunity to break the rules?

  At first, she couldn’t believe he’d think that of her. He made it sound as though to her the relationship had just been some meaningless fling, a chance for her to rebel. But as their conversation continued, she’d realized, horrified, that he did see it that way. And worse, she could understand why.

  She’d left her short, terse little note because by giving up Bryce, she felt as though she were giving up everything. She couldn’t find the words she needed to say to him, and she knew she wouldn’t be able to go through with it if she saw the pain on his face. But when he’d lost his fellowship...she couldn’t stand to hurt his career anymore. Leaving him was the hardest decision she’d ever made.

  But she realized now that Bryce hadn’t understood that at all. He thought she’d left because she didn’t care about him. He thought, now that she’d had the fun of a secret relationship, she’d dashed off the note and left because the relationship had never been that important to her in the first place.

  And now she didn’t know if there was any way she could convince him to see things differently. To make him know just how much she cared.

  In order to go through with the breakup, she’d tried to convince herself that giving up Bryce was the right thing. The brave thing. But after hearing Bryce accuse her of taking their relationship lightly, after learning that he believed she’d just been enjoying a fling, she had to admit that the way she’d handled the breakup hadn’t been brave at all. Instead, she’d just been afraid.

  As far as she could tell from Enrique and their other colleagues, fear was not an emotion that Bryce struggled with. Apparently, he volunteered for daring missions into the mountain territory as often as possible. That was something unexpected about him, as well. The Bryce she remembered had been exceptionally cautious, careful and measured. Why had he changed?

  Manny Martinez, the child who’d carried her backpack to her room on the day she arrived, held a wealth of information about Bryce. The boy seemed to hero-worship Bryce and followed him everywhere, although he often tagged along with Cassie and ran errands for her when she made her morning rounds. He enjoyed regaling her with stories of Bryce’s exploits, many of which had clearly been enhanced by Manny’s imagination. For example, she didn’t believe that while traveling miles to deliver medicine to a remote village, Bryce and Manny had crossed a river by stepping on the backs of crocodiles, only to be accosted by a nest of snakes when they reached the other side. She expressed her doubts to Manny, with the result that he doubled down and implied that jaguars may have been involved, as well.

  He’d proudly shown her Rosibel, his newborn sister, at the first opportunity. Apparently, Bryce had delivered the baby on the day Cassie arrived in El Salvador.

  “I wanted a brother, but girls aren’t all bad,” Manny said. “Mama is so busy taking care of Rosibel that she never even notices how many pieces of chocolate I have.” The grin on his face suggested he was making the most of his mother’s distraction, and Cassie noticed that his pockets bulged with sweets pilfered or begged from other doctors.

  Cassie held her finger out to little Rosibel now as she checked in on the mother and baby. The baby instantly closed her tiny hand in a firm grip. So Bryce had brought this sweet baby into the world. Bryce the obstetrician, not Bryce the surgeon. There was something about a newborn that always made her feel hopeful. A new life with so much possibility ahead. When Cassie had been born, everyone had been afraid for her. But in spite of everything, she’d focused on pursuing life as vigorously as she could. For her, that was what delivering babies was all about: focusing on life. And now Bryce was delivering babies, too.

  Who was this mysterious man who apparently delivered babies one day and jumped onto the backs of crocodiles the next?

  There was so much she didn’t know about him.

  Over the past five years, whenever she’d thought about Bryce, she always pictured the man she’d known in the past. She’d never thought that he might change.

  But of course he had, and she knew that she shouldn’t be surprised. They were both different people than they used to be.

  She’d always been drawn to his tenderness. She recognized it in the solicitous way he’d helped her bandage her ankle and the patience he exercised with Manny. But now there was also a toughness to him that she’d never expected. She noticed it whenever she saw him tearing away from the camp on his motorcycle or shouting orders to medical teams as they prepared for a new influx of refugees. The same tenderness she’d always seen in him was still there, but now it was balanced with a rugged determination to do whatever it took to get a job done.

  She found it damned attractive, if she were honest with herself.

  She’d seen glimpses of that determination when she’d watched him work as a surgeon.

  She wondered again why he’d ever given up surgery. It was such a vastly different process from obstetrics. In surgery, patients were usually anesthetized, and the skill lay entirely in the doctor’s hands. But delivering babies was a team effort. The patient’s role was every bit as active as the doctor’s, often more so. Building trust between the patient and medical personnel was crucial, especially if the patient was scared or if things weren’t going as expected.

  Why would Bryce, a masterful surgeon, seek out such a different experience? What had made him change?

  It could have been anything. Five years was a long time. Perhaps he’d met someone else who’d inspired him to switch to obstetrics?

  Another thought settled into her stomach like a block of ice. What if switching specialties hadn’t been Bryce’s choice at all?

  Changing specialties was no small feat. He would have had to redo his residency, probably at a completely different hospital.

  She could think of only one reason why Bryce might have needed to move to a different hospital and redo his residency. Thanks to her, he’d been on probation when she’d left the hospital. Another mistake could have cost him his job.

  For example, if anyone had found out that he’d dated a medical student, it might have been the final straw for Bryce. That was why she’d left—to avoid causing him any more pain.

  But what if someone had found out? What if, despite everything she’d given up by leaving him, Bryce had been fired because of her, after all?

  But if he had been fired, wouldn’t he have been able to finish his residency somewhere else? He’d been such a talented surgeon. Any hospital would have been lucky to have him. Surely, she couldn’t have ruined his career that much... Could she?

  She needed to know. Even if she didn’t like the answer, she absolutely needed to know if Bryce had lost his job and put himself through the ordeal of changing specialties because of her. Because despite what Bryce might think, their relationship had been important to her. She’d left him in order to protect him, hoping not to cause any more damage to his career than she already had. And even if there was nothing she could do about it now, she needed to know if she’d ruined his career. And if she had, she’d find a way to make it up to him. Somehow.

  * * *

  Bryce was surprised when Cassie showed up at the front door of his quarters, asking if he wanted to join her in the mess hall for a morning coffee. He was even more su
rprised when he found himself saying yes.

  Slipping back into professional mode with Cassie had turned out to be far easier than he’d thought. He found he enjoyed working with her as much as ever. In fact, all the things he’d missed about working with her had come rushing back. The banter over patients and the ease with which they anticipated one another’s decisions was refreshing after the years they’d spent apart. And he had to admit that despite himself, his curiosity had continued to burn after their conversation in the dispensary. He’d never known that Cassie had a heart defect. She had kept that information from him all that time.

  Before the accident, he might not have understood her choice to keep the secret. But he could understand all too clearly now. For so long, his family had seen him only as the superstar surgeon. They’d focused on that one single part of him so much that when his life changed, they could only see what he’d lost. Sometimes it was still hard for Bryce himself to see that he was more than his past.

  Cassie wanted to keep her heart condition private for the same reasons he wanted to keep the accident and his former career as a surgeon private. Once people knew something so serious, there was a chance they might only view you through that lens. He didn’t want to be known as a person who used to be a gifted surgeon. That wasn’t his identity anymore. He’d fought hard to become more than an accident victim, more than someone who used to be something.

  It sounded as though Cassie had also been fighting to be seen as a whole person and not just one thing.

  He remembered what she said her childhood nickname had been—Heart Defect Girl. What must it have been like for her to constantly feel singled out like that?

  He wondered what else she hadn’t told him.

  When they reached the mess hall, he got their cups of coffee while she waited. When she put her cup to her lips, she smiled. “You remembered just how I like it.”