Family Practice Read online

  Being away from her hometown for so many years, Callie had forgotten how quickly the townspeople could all come together for the betterment of the community and how satisfying it was to be part of such an effort. Lately she had been reminded in ways large and small how good it was to be home.

  Unfortunately, the examining room’s warm color palette, chosen for its calming influence, didn’t seem to be having the desired effect on her stepmother. Ginger perched uncomfortably on the edge of the paper-covered exam table, her distended stomach very evident beneath her lightweight summer top. The baby was moving, and vigorously, too, it seemed, by the grimace on Ginger’s face as she pushed gently on a protruding elbow or knee, hoping the little one chose a more comfortable position to settle in.

  Callie stared for a moment, distracted by the realization that the tiny being was her blood, too. Her half brother or sister, tied to her forever by the love they would share for the man who was father to them both. Usually she could consider the situation with some detachment, but not today. It was Friday, the end of a second busy, stressful week, and her guard was down.

  “I assumed I’d be seeing Zach,” Ginger said.

  “You will be,” Callie assured her. “I just stopped in to say hello and make sure you’re okay and to apologize for having to cancel dinner the other night.” The clinic had been swamped with patients on Wednesday. A nasty summer virus had decided to pick White Pine Lake’s population as a “target of opportunity,” as Zach described it. They’d had to squeeze half a dozen unscheduled appointments in that day and then do a hurried disinfect of the exam rooms after the last patients left.

  Callie had been exhausted by the time she finished dictating her patient notes. Zach, on the other hand, had returned to the clinic that night to help Rudy and his crew lay the flooring in this very room.

  “Don’t mention it,” Ginger said, visibly relaxing. “You’ve been swamped here. Rumor has it you’ve put in nearly as many hours decorating as the Physician’s Committee.”

  “I really didn’t do that much,” Callie insisted, although she was pleased that her effort hadn’t gone entirely unnoticed in town.

  “You’ve done wonders. You’d never guess two weeks ago this place was a disaster area.”

  “Just about everything’s up and running again.”

  “It’s one of the good things about living in a small town,” Ginger said with a little edge to her voice, as if there were other aspects of small-town living she didn’t appreciate quite as much. “Brandon was disappointed. He missed you the other night,” she said, changing the subject.

  “I promised to take him to meet my mother, but I couldn’t find a spare moment. Perhaps this weekend.” Karen had dropped off a half-dozen eggs from The Girls’ laying earlier in the week. Desperate to find some way to connect with her stepsiblings, Callie had asked if she could bring the twins to visit. Karen had appeared surprised at the request, then shrugged and said sure. Callie appreciated her mother’s help in making progress with the twins. She doubted Karen would be as generous helping her find common ground with Ginger, however.

  “Please don’t feel as if you have to entertain my son,” her stepmother said.

  “I want to. And I hope we can persuade Becca to come, as well.”

  She didn’t hold out a lot of hope in that regard. Her young stepsister hadn’t seemed very enthusiastic about the proposed visit, or anything else to do with Callie, for that matter.

  Ginger sighed. “I hope so, too, but please don’t be offended if she refuses to go. Preteens can be difficult.”

  A knock sounded on the half-open door and Zach’s face appeared around the edge. “Hi, Ginger.” He walked over and held out his hand. Ginger gave it a quick shake. “Sorry to keep you waiting.”

  “Callie and I have just been catching up.” Ginger scanned their faces. “Is there some reason other than small talk that Callie’s here? You aren’t considering transferring me to her care, are you?” She must have realized how ungracious the words sounded because she lifted her hands in apology. “I mean, I understood Callie wasn’t supposed to treat family members. I’m sure I remember J.R. telling me that.”

  “That’s true,” Callie agreed with a smile she hoped wasn’t as tight as it felt on her face. She had anticipated this was going to be an awkward conversation, but it was even more difficult than she had imagined. She wanted to be on good terms with Ginger; she hoped that they could grow close enough to call each other friend and mean it. But so far they hadn’t made much progress. Between the hints of a rough patch from Mac, her mother’s gossip and the tension she’d sensed for herself between J.R. and Ginger, she didn’t want to be forced into a more intimate relationship right away. So far her good intentions of repairing any cracks in J.R. and Ginger’s relationship hadn’t amounted to much. She hadn’t even had a chance to talk more with Mac. She’d been too busy working on her own relationships with Zach and the clinic staff. “It’s clinic policy that staff not treat family members, except in emergency situations.”

  “Callie is also the physician in charge here, though,” Zach said, his hands thrust deep into the pockets of his white coat, his head cocked a little to one side, that darn, gorgeous half smile just visible at the corners of his mouth. And try as she might, Callie couldn’t hear any patronizing undertones in his statement about her being in charge. “So I would like your permission to be able to consult with her if I have any concerns about your pregnancy.”

  Ginger laid her hand protectively on her stomach. “Concerns? What concerns are you referring to? Is something wrong? Bonnie did say my blood pressure’s up slightly, and my ankles are swollen, and my hands, too, but it’s been so warm, and I’m on my feet a lot—”

  She glanced at Callie, who kept her expression pleasant but unreadable despite her own worries. This was the first she’d heard of Ginger’s blood pressure being elevated. She didn’t like the sound of it.

  “There’s nothing to be alarmed about today, Ginger,” Zach continued, “but we’ve been over this before. A woman in her late thirties is considered at high risk for complications during pregnancy.”

  “But this is my second pregnancy. Everything’s checked out fine so far, all the blood tests and the ultrasound. And the baby’s active. Very active.” She grimaced as a wave of movement rippled over her distended belly. “See, and he’s strong, too. And I’m not really so old these days—lots of women over forty have babies, and I have given birth to twins, remember.” She tried to make it a joke and almost succeeded.

  “That’s a second complicating factor, a multiple first pregnancy, although we all know there’s only one baby this time.”

  “He’s right, Ginger,” Callie said soothingly, hiding her own disquiet. “And you are only eight weeks from your due date. Dr. Carmichael is already bending the rules for you. You should be seeing her in Petoskey weekly.”

  “But she agreed—if I see Zach twice a week here I only have to go to her once a month until September. She has a lot of confidence in Zach. She said so herself.”

  “Then you have to have confidence in Zach, as well.” She could give credit where credit was due without diminishing her own authority. “He is an excellent PA.”

  “Thank you, Dr. Layman,” he replied with equal formality.

  Ginger missed the slight stiffness in the exchange. “I really don’t want to spend most of a day coming and going to a doctor’s appointment,” she said fretfully. She began twisting her wedding ring around on her finger. The gold band was tighter than it should be. Something Callie had noticed before, but then she hadn’t realized how serious the situation might be. “We’re shorthanded at the White Pine. I’d have to leave the kids alone with J.R.” Her face flamed. “I only meant to say he’s busy, too, and the twins can be a handful.” She tried to explain. “We’ve been alone since they were babies. Their father died so young. It’s ha
rd for them to have a man in the family.” She made a little gesture of defeat. “They’re good kids, and your dad’s great with them, Callie, he really is, but we’re all still adjusting. And the baby coming makes everything that much harder.” She stopped abruptly.

  Callie didn’t have any trouble getting her smile right this time. Even if she had taken offense for her father’s sake, which wasn’t the case, she couldn’t let any patient continue in such distress. “It’s okay, Ginger. I understand what you meant to say, but Zach’s right. You are at a higher risk than you were eleven years ago when you were pregnant with the twins. It’s simply a fact of life, especially if we can’t keep your blood pressure under control. But if we can, everything should be fine.”

  “And if we can’t control it?”

  “Dr. Carmichael will probably want you to go on bed rest,” Zach said. “As a precaution.”

  “Oh, no, I can’t do that again. I had to go on bed rest with the twins, and I only had to take care of myself then. Well, me and my late husband, who was about as much trouble as a child. How will I ever manage now? Please, what do I have to do to avoid that?”

  “Watch your salt,” Zach began. “Get off your feet as much as possible. Take a nap in the afternoon. And stop worrying.”

  Ginger stared at her clasped hands. “I’m not very good at that.”

  Callie rose, sensing her stepmother wanted her to go so she could talk to Zach in private. “Ginger, remember, I’m only on board to consult on your physical condition. Anything else you discuss with Zach is totally confidential. You’re still Zach’s patient. We both want you and the baby to have the best care possible.”

  “Thanks, Callie, I appreciate your concern.”

  Callie opened the door. “I have some patient notes to dictate. I’ll leave you two alone now.”

  “Mac baked cookies today,” Ginger said to Callie as she took a step into the hallway. “Brandon said I should tell you. He’s hoping to bribe you into stopping by.”

  Callie laughed. “He’s going to be a heartbreaker in a few years. He’s already discovered the best way to wow the ladies is to offer them Mac’s triple-fudge chocolate-chip cookies.”

  “He takes after his father in that respect. He was a real charmer, Kyle was. But when all is said and done, I hope Brandon grows up to take after your father and not his own.”

  Callie nodded, touched by her stepmother’s words. “Dad is a good man and a great father.”

  “He is.” Ginger smiled brightly, but anxiety still clouded her eyes. “And thanks for watching over us.”

  “You’re welcome.” Callie closed the door softly behind her. Maybe she couldn’t give J.R. and Ginger a happy ever after all by herself. But she would do her best to not be part of the problem. She’d try harder to have a better relationship with Ginger and the twins for J.R.’s sake—and her own.

  * * *

  “GOT A MINUTE?”

  “Of course, come in.”

  Zach stepped inside and closed the door of Callie’s office. There were still a couple of stacks of plastic storage bins containing old records shoved in one corner, with a pyramid of boxes of salvaged supplies stacked on top, but for the most part the small space no longer looked as if it was part of a disaster zone.

  When the committee had decided to repaint the entire clinic, Callie had picked a rich, warm brown for this room. White miniblinds covered the single window, and she was planning to order sheer curtains of the same color to soften the look and frame the view of the wildflowers in the overgrown meadow bordering the narrow strip of lawn behind the building. Other than that, the walls were bare. Her diploma was on the wall above the reception desk where everyone could see it, next to Zach’s. Leola had insisted they be prominently displayed, and she and Bonnie had badgered Rudy until he hung them precisely where they wanted them. But when she found a free hour, Callie was going to visit the galleries on either side of the White Pine to find a print or two. With the finishing touches of the framed prints, the little room would truly be her space.

  “What can I do for you?” she asked, motioning Zach to a chair. For a moment she feared he might refuse the offer and continue to stand with his shoulder against the door frame, taking up more than his fair share of the space. He was just a little scruffy after a long, hard day and week, but nowhere near as wrung out as she must appear. It wasn’t fair that men could look sexy and desirable when they were tired and women just looked tired.

  As he came near she caught a whiff of his cologne. It was suddenly hard for her to take a breath. “Please, have a seat,” she said a little more forcefully than she’d intended.

  He didn’t appear to notice her tone and she relaxed slightly. She was simply going to have to get used to having so much high- octane testosterone so close at hand—day and night. She leaned forward on her elbows and rested her chin on her crossed hands. “What can I help you with?”

  “First of all, thanks for backing me up in there with your stepmother.”

  She nodded. “You’re welcome.” She almost added something about partnership but didn’t. They weren’t really partners, not in the way most people used the term. And as far as she could, see they probably never would be, although surprisingly she hadn’t even thought about the job with the cruise line for almost a week—she simply hadn’t had time the past week, she excused herself.

  “I got Ginger to agree to cut some of her hours at the White Pine and to try to get off her feet at least two hours every afternoon.”

  “But will she follow through?”

  He shrugged. “I hope so.” He rested his forearms on his thighs and stared down at the floor between his spread legs. After a moment he straightened, giving her the full effect of those rain-cloud-blue eyes. “Callie, do you think your father is aware of how dangerous a situation his wife and baby could be in?”

  “I...I’m not sure,” Callie said. “We’ve never talked about it in any detail. It was an unplanned pregnancy, but that’s about all I know. I’ve been home so little these last eighteen months.”

  He waved off her explanation. “I get what the final year of a family-practice residency can be like.”

  “My dad’s a smart guy, but I can’t say he has a lot of experience with pregnant women. He probably isn’t aware of the extent of the risks for both Ginger and the baby. I noticed she was retaining water, but as far as her blood pressure being elevated, no one mentioned it.” High blood pressure could lead to premature birth and even death for both Ginger and the baby if the condition wasn’t kept under control. She shuddered, letting the sentence trail off. They were coming close to the boundaries of patient/practitioner confidentiality. But they were also talking about her family, her flesh and blood. J.R.’s greatest fear was that something might happen to Ginger or the baby. She made up her mind. “Should I talk to him?”

  Zach shook his head. “Not unless he brings up the subject. We don’t want Ginger to think we’ve gone behind her back.”

  “No, I certainly don’t want that. Perhaps I should talk to her instead?”

  “Are you comfortable doing that?”

  “No,” she said ruefully. “Not as a doctor and not as a stepdaughter. If there are problems between Ginger and my father, I’d much rather they come to you with them. Perhaps she’s kept them from him so he doesn’t worry about her. Or she might simply be blocking it out of her mind?” She made it a question.

  Zach nodded. “She wouldn’t be the first person to behave that way.”

  “It’s complicated all around,” she said. “My mother says there’s talk in town about them.”

  “There’s bound to be some jokes and teasing when a man your father’s age finds himself with a new baby on the way. I imagine it’s good-natured ribbing for the most part.”

  “Are you sure?”

  “Your dad’s a popular guy. He�
��s got a lot of friends. He can take care of himself. But I’m not so sure about Ginger. She might believe she has a lot to prove to the residents of White Pine Lake.” He shrugged. “I’m a PA, not a psychologist. But just so we’re on the same page—if I think the situation warrants it, I’ll call J.R. and Ginger in for a consultation. She’ll listen to him if he’s the one insisting she slow down and take it easy. And he’ll make sure that she does.”

  Callie smiled, relieved. “He will do that.”

  “Can I share a little observation of my own?” he asked.

  “Certainly.” She sat a little straighter.

  “I understand the delicacy of your situation, but your stepmother’s still new in town,” he said, one big hand closing around the bell of the stethoscope hanging around his neck. “I said I’m not a shrink, and I’m not, but it doesn’t take one to see Ginger could use a friend.”

  “I’m trying,” Callie said honestly. “I’ll do my best.”

  “But...?”

  “I’m not sure where to start. I don’t know very much about her,” she said, ashamed to admit all the things she’d never asked.

  “I’m not sure anyone around here does, except your dad.”

  “I’m not so sure he does, either. It was a whirlwind romance. Love at first sight, I’d guess you’d say.”

  Zach picked up on the skepticism she hadn’t been able to filter out of her voice. “Don’t believe it’s possible?” he asked, just a tiny hint of his killer smile flickering across his mouth.

  “I might if I’d ever experienced the phenomenon.”

  “I can’t fault you there, although I believe love at first sight is possible.”

  “My dad is convinced of it. He said he felt that way about my mom, too. But it’s still so out of character for him. He’s methodical and reasoned in every other aspect of his life.”

  “There’s nothing wrong with letting your heart take the lead now and then.”

  “My mom’s heart led her to leave us. Was that the right thing to do?”