Falling Again in El Salvador Read online

  For a moment, Cassie wasn’t sure what he was talking about, but as she took another look at her patient, she saw it—the faintest flicker of motion inside the abdomen. She drew closer and saw a tiny hand.

  Twins.

  “I’d have missed it if it hadn’t been moving just a bit,” said Bryce. “You want to do the honors?”

  In response, Cassie gently placed her fingers inside the abdomen, reaching for that tiny hand. She removed the second twin, a boy, and passed him to the midwife, as well.

  Bryce started working on closing Elena’s abdomen while two thin cries began to fill the room. For Cassie, it was the sound of victory. There would be no neonatal CPR today.

  She stripped off her gloves, exhausted. Bryce gave her a huge grin and a nod. So he was impressed? Good. He should be. She was still baffled by his hesitation earlier. In a situation where every second counted, what could possibly have led Bryce to stop an emergency surgical procedure and hand the scalpel to her? She couldn’t fathom what would lead him to hesitate at such a crucial moment.

  She could only come to one conclusion: despite all the reports she’d heard of his daring exploits, he was just as cautious as ever. But that still didn’t make sense.

  Cassie knew that if she’d taken charge of the OR, she would never have stopped to question whether she or Bryce should perform the surgery. She’d simply have taken a scalpel into her hand and started, and dealt with any problems as they arose.

  Then she was overcome with a wave of contrition. Despite Bryce’s hesitation, they’d saved three lives that day. She smiled, knowing how much Elena had wanted to be a mother. Well, now she was, twice over.

  Bryce squeezed her shoulder as he left the tent. She was determined to ask him why he’d hesitated. But before she could say more than, “Bryce, why—” he’d rushed past her.

  Why would Bryce Hamlin, of all people, hesitate to do a surgery? And why did it seem as though he didn’t want to talk to her about it?

  CHAPTER FIVE

  BRYCE SAT BENEATH his usual balsa tree, exhausted. The complicated delivery that he and Cassie had performed that morning had been the first of a day full of challenging cases, and his mind was aching for some peace. He’d worked a twelve-hour shift, but it felt like twelve years since he and Cassie had shared coffee together in the mess hall.

  Now dusk was falling, and he could finally have a moment to breathe. He leaned his back against the tree’s broad trunk and tried to let the tension drain from his body. The camp was surrounded on most sides by thick forest. But the trees fell away on the west side, and he could gaze at the rolling hills leading up to the mountains miles away. The sun had almost set but still cast a golden glow over the mountaintops, and underneath the balsa tree, a few early fireflies were beginning to make their appearance.

  As he sat in the quiet, his stomach rumbled. He hadn’t had any time to eat since breakfast. Despite the stress of the day, it had been a relief to be so busy. The rush of deliveries had meant that he hadn’t been able to have a moment alone with Cassie, which meant the two of them hadn’t been able to talk since that morning. He wasn’t trying to avoid her, exactly. He was just certain that she’d have some questions on her mind after his noticeable hesitation during the procedure that morning, and he didn’t think he was ready to answer them.

  Bryce knew on an intellectual level that his tremor wasn’t severe enough to prevent him from performing C-sections. Still, he was anxious whenever they were necessary. Knowing that he could do something wasn’t the same thing as feeling confident about it. It was as though he’d been asked to relearn how to ride a bicycle. He could know that sitting astride a bicycle and pedaling should move him forward, but that wouldn’t make him feel any more certain about keeping his balance.

  Usually, if his hands started to tremble, a few deep breaths were enough to calm their twitching and allow him to continue. But this time, they hadn’t stopped, and he had a feeling he knew the reason why. It was because Cassie had been there.

  He wasn’t sure why Cassie’s presence would affect him so much, but he thought he could make a reasonable guess. Cassie was the first person he’d met in El Salvador who knew the old version of himself that he’d been in New York. When he’d first arrived in El Salvador, it had been such a relief to finally be free of everyone’s expectations. His family, in their attempts to be supportive, had always spoken about what a talented surgeon Bryce used to be. But in El Salvador, everyone only cared about who he was now. He didn’t have to live up to any expectations about who he’d been in the past. Instead, all he had to do was be the best doctor he could be right now. But Cassie would expect to see the great Bryce Hamlin in action. She would expect things to go smoothly. She wouldn’t understand if he got nervous, or if he needed extra time with a procedure, or if the patient’s stitches didn’t look like they’d been completed by a master when he closed.

  Their relationship had undergone a strange reversal. When they’d dated, he’d been an up-and-coming surgeon. He’d taken pride in his talents, and his reputation was growing. He was especially adept at maneuvers that required extra dexterity and precision. He supposed that he’d gotten used to others looking up to him. But now he found himself admiring Cassie’s skills. He’d been struck by her quick action in the delivery tent, her ability to soothe Mrs. Hernandez’s nerves while deftly navigating the difficult delivery. When they’d dated, she’d been a promising medical student, but she’d grown into a dedicated physician.

  He, on the other hand, was no longer the star surgeon he’d been five years ago. He’d noticed her confusion as he handed her the scalpel. And he was sure she would want an explanation.

  A rustling of the trees startled him for a moment, and then Cassie emerged, holding a white paper lunch bag. “Care for some company?”

  He leaned his head back against the tree. “I don’t know if I can be the best conversationalist right now. It’s been a long day.”

  “I know,” she said, sitting down beside him and opening the paper bag. “That’s why I brought some snacks.”

  “Pupusas!” he cried, a smile breaking over his face. The bag contained fluffy pieces of flatbread, each stuffed with different fillings of cheese, chicken and beans. He bit into one with gusto.

  “Mmm,” he said. “Chili cheese...my favorite.” Only, it came out sounding like, Hilee eese, um havorite.

  “Glad you approve. Now, I haven’t been in El Salvador long, but I don’t think you’re supposed to eat the entire thing in one bite. At least leave yourself some room to breathe. And don’t hog those. I brought them for us to share.”

  He slowed his chewing and passed the bag back to her. They sat on the forest floor, companionably munching their flatbread as the twilight faded.

  He could only see a faint outline of her face. She sat close beside him so that she would have enough room to lean back against the balsa tree. Maybe it was because he was unable to see her face clearly, or maybe it was because of the food she’d brought him—he had been very hungry—but Bryce found himself feeling glad of her presence. Usually he preferred to be by himself after a long day. But Cassie didn’t barrage him with questions or try to pull him into a conversation. Instead, they just sat together, watching the fireflies.

  After they’d been silent together for a while, she said, “This is a nice spot.”

  “It’s my favorite spot in the camp. I come here to unwind after a tough delivery, or a tough day.”

  “Like this morning?”

  He rubbed his temples. “This morning was scary. I wasn’t sure the patient was going to make it.”

  “But she did. They all did. There was one complication after another, but we saved three lives. I felt like I was holding my breath through the whole procedure. I still can’t believe we pulled it off.”

  “It was mostly you who pulled it off,” he said, wanting to give credit where it was due.
r />   “It was a team effort, and you know it.”

  Well, Cassie certainly seemed to be thriving in the camp’s intense atmosphere. He supposed he shouldn’t be surprised. Despite how she’d changed, in many ways, she was still the Cassie he’d known five years ago. He wondered how long she would stay. Some of the camp’s staff were lifers, returning year after year. They considered Medicine International to be their professional home. Others only joined for occasional yearlong stints. Bryce had stayed for three years, and could easily see himself staying longer. He could also see Cassie staying for a long time. To his surprise, he realized that the idea of Cassie staying at the camp for a long-term assignment held some appeal.

  “It’s been just over a month since you got here,” he said. “Think you’ll plan on sticking around for a while?”

  She gave him a sidelong glance. “Trying to figure out how long you have until you’ll be rid of me?”

  Quite the opposite, he thought. If he were being honest with himself, he had to admit that he liked seeing her every day. But he wasn’t about to tell her that. He didn’t want to say anything that would lead them to revisit a host of complications.

  “It’s not that. It’s just that it takes some people a while to adjust. You wouldn’t have to deliver babies in situations like this without modern equipment back in New York.”

  “Are you kidding? This is exactly what I came here for. Yes, that was a stressful delivery this morning. And it was also awesome. And amazing. And incredible.”

  “That sounds like the Cassie I remember. You never did let a few challenges scare you off.”

  Even in the darkness, he could see her smile. “I’m glad to hear that you think that part of my personality hasn’t changed. Before I came here, I was starting to worry that my life would be all about making sure celebrity moms got their preferred brand of organic granola, or helping some internet influencer set up cameras in the delivery room so she could livestream the moment she gave birth. But this morning was as different from my old life as I could possibly imagine. It’s some of the most rewarding work I’ve ever done. I think I’m going to stay for a long time.”

  He noticed that even though her tone was casual, she seemed to be watching his face intently, trying to gauge his reaction.

  Over the past few weeks, he’d grown far more comfortable with the idea of working with her than he’d been when she first arrived. He often found himself looking forward to running into her, whether it was to consult on a case or just to chat.

  “I’m glad to hear you’re enjoying it here,” he said. “And I think...that I might be enjoying it, too.”

  Her eyes widened in surprise, and he quickly clarified, “I mean, I’m enjoying working together again. It’s like old times.”

  “Old times with some new twists?”

  “Exactly.”

  She tilted her head to one side, causing her hair to swing past her face. He often found himself wondering what it would feel like to wrap a strand of hair around one finger. He’d noticed himself banishing such thoughts from his mind more and more frequently in his attempts to respect their professional working relationship.

  “I’m so glad to hear that you feel okay about working together,” she said. “I was shocked to see you here, that first day, but we’ve done pretty well so far, haven’t we?”

  Her body was close enough to his that he could feel the warmth radiating from her. He mustered all of his professionalism and said, “I think so.”

  “And I think I figured something out this morning.”

  His body tensed. Had she noticed his shaking hands during the procedure?

  “I finally get how you fit in to all this. Until this morning, I’ve been trying my hardest to solve the mystery of how cautious, mild-mannered surgeon Bryce Hamlin ended up at a medical outpost in El Salvador. But after this morning, it all makes sense. The challenges, the excitement, the adrenaline rush. How could you want to work anywhere else?”

  He relaxed, relieved that she hadn’t brought up his hands. “It’s not always like this. Sometimes things even go pretty smoothly.”

  “I’ll believe that when I see it. Ever since I’ve gotten here, each case has had its own unique chaos.”

  “And you love it.”

  Even in the dim light, he could see that her eyes sparkled. “You know I do.”

  “I wouldn’t expect anything less from you.”

  “Speaking of expectations, we didn’t really get a chance to talk about your new career this morning. The last time we worked together, you were a surgeon.”

  “Yeah. That would be one of those new twists we were talking about.”

  “What happened? The Bryce I remember loved his work more than anything. But that’s not the only thing that’s changed. All those stories about you wrestling crocodiles, negotiating with gang members... I don’t know what to make of them.”

  “As much as I wish the story about wrestling crocodiles were true, I’m afraid that one’s the result of an overactive imagination.”

  “Still. You’ve changed. You’re not a surgeon anymore. You started the C-section this morning, but then stopped and handed me the scalpel during a critical moment. You used to be obsessively protective of your hands, but now apparently you tear around on your motorcycle and jump out of helicopters without a second thought. There’s something you’re not telling me. Spill it.”

  It should have been so simple to tell her about the accident. And yet somehow, he couldn’t.

  He didn’t want to go through explaining about the accident, everything it had taken from him and the long recovery afterward. But even more than that, he didn’t want her to stop looking at him the way she was now. She seemed to think he’d grown braver and more adventurous over the years. If she knew how devastated he’d been after the accident, how it had taken away his identity, his calling, she might not look at him the same way. If she knew how he’d had to cobble a new life together out of broken pieces of his past, she might pity him. He didn’t want pity from anyone, but especially not from her.

  “It’s true that I’ve been through some changes,” he said. “I switched specialties. I’ve been living here in El Salvador for three years, and I suppose that would change anyone. But does it really matter why? Maybe I just needed something different, like you did.”

  “It matters if it’s my fault.”

  “Your fault? What are you talking about?”

  “You lost your fellowship because of me.”

  Now he remembered. The Beaumont Fellowship. Weeks before the accident, he’d learned he had been removed from consideration for the fellowship because he was on probation. At the time, the news had been terribly disappointing. But then being hit by a drunk driver several weeks later had put things in perspective.

  But Cassie hadn’t known about the accident. And now she sounded absolutely wretched. She felt guilty, he realized. She thought that his change of careers had something to do with her.

  “First of all, I lost the fellowship because I was on probation,” he said. “And I was on probation because of a decision that we made, together. And even though the hospital administrators disagreed, I still think we made the right decision.”

  “But starting the operation was my idea. If I hadn’t convinced you, you never would have followed through with it.”

  It was true that when they’d dated, he’d been known for being cautious, always leaning toward the safest option. Had she thought that just because he was reserved he didn’t have a mind of his own?

  “That’s simply not true. Despite what you may believe, it is possible to stand up to Cassie Andover. The final judgment call was mine, and I’d make the same call again today. So I’m not sure why you’re feeling so guilty about it.”

  “Because I got off so lightly!” she cried. “They blamed you for everything. I should have been suspended at the
very least. But instead, I got a stern warning and a talking-to, and before I knew it everything was back to normal. I worked so hard to repair my reputation. In fact, I worked too hard. I gave up everything that made me feel like myself, because I didn’t like who I was. I don’t deserve to be known as the best obstetrician in New York. I don’t deserve any of it. I didn’t deserve you.”

  He could see that tears were streaming quietly down her face. He put his arm around her, rather gingerly at first, but then he held her closer. The whole time he was recovering from the accident, he’d known nothing about the guilt Cassie was holding on to. How could he?

  As he held Cassie, he wondered if he should have handled things differently. He’d told himself that his anger and hurt over the way she’d left had prevented him from trying to reach out to her, to talk things over, but now he wondered if his own pride had gotten in his way.

  She’s the one who left me, his anger had retorted. He’d spent years clinging to that anger, painting himself as the victim in their breakup because anger was easier to deal with than pain.

  Except it was one thing to blame her for the breakup from afar. But now, holding her in his arms in the darkness while she cried, somehow it didn’t seem to matter whose fault the breakup had been. All that mattered was that it was in the past. Here, in the present, he just didn’t want Cassie to hurt anymore.

  “I had no idea you felt this way,” he said. “But for what it’s worth, you are not the reason I stopped being a surgeon. And when I finally did stop, it was freeing. It opened up a whole new world for me that I never would have considered otherwise.”

  “Really?” she said, drying her eyes on the sleeve of her coat.

  He hesitated. He’d meant to tell a small white lie designed to make Cassie feel better. After the accident, nothing had felt freeing at all. He’d been heartbroken when he realized that no matter how much work he put into physical therapy, his hands were never going to be steady enough to be a surgeon’s hands again. But if he told Cassie about the accident now, it would only add to her guilt.