“That would be”—Presley scanned her mental files—“Carson Rivers.”

“That’s right.”

“Let me guess.” Presley paused. “Sister?”

“Third oldest, right.”

“Wait a minute.” Presley smiled, warmth softening the usually cool planes of her face. “Harper, Flannery, Carson. Who in the family is the Southern-author fan?”

“They’re some of my mother’s favorites,” Harper said. “She and my father met when he was doing his residency in Charlotte. She said if she had to move north into Yankee territory, her children would be reminded of their Southern roots.”

“Harper,” Presley turned the word over musingly. “It’s Harper Lee, isn’t it? Harper Lee Rivers?”

Harper nodded.

“Flannery O’Connor Rivers?”

Harper grinned. “That’s right.”

“Carson McCullers Rivers?”

“Right again.”

Presley laughed, and her laughter transformed her. She was still elegant, but softer, more approachable, the light dancing in her blue eyes hinting at hidden humor. “Tell me, is there a Kate Chopin Rivers too?”

The punch to the heart was no less powerful for being familiar. Harper kept her smile in place. “Kate was the fourth.”

Presley’s laughter disappeared and gentle sympathy filled her gaze. “I’m sorry.”

“Yeah. Me too.”

“Are there others?”

“Margaret Mitchell, the youngest. Margie is fifteen.”

“No boys?”

“I guess my mother wasn’t as fond of the Southern male authors.”

“Hmm. Is Margie bound for medicine too?”

Harper laughed. “She swears she’s forgoing medicine for professional soccer.”

“Breaking the family mold.”

“We’ll see. I went through a period when I was planning on being an organic farmer.”

“You, a farmer?” Presley shook her head. “I can’t see it.”

“I grew up on a farm, although I didn’t do a whole lot of hands-on farming. I was too busy following my dad around. But we’ve got some cows, chickens, a few pigs, and plenty of fertile pastureland. One of our neighbors farms that for us.”

“Never thought about leaving?”

“I left for medical school and residency.” Harper pushed open the stairwell door and held it for Presley. “And I was ready to come back. Not enough time to think. Too much noise.”

“Noise?”

“In the city. Always something moving, always something changing. Always something making noise.”

“Most people think of that as progress. And exciting.”

“I don’t see why progress has to be noisy.” Harper opened another door. “This is the fifth floor—the top floor. A mixed population of med-surg patients who no longer require acute nursing supervision. Most of the patients up here will be ready for discharge in a few days.”

“How many beds?”

“Eight rooms a side, two beds each on this floor. We’re about half-full up here right now.”

While Harper went to the supply room to get what she needed for rounds, Presley looked over the physical facilities, taking note of the number of nurses, aides, clerks, and other personnel. The staffing seemed adequate, but not excessive. The hospital was obviously old, but in good repair. The walls were freshly painted a neutral eggshell, the floors practical industrial tiles in a complementary tan. When she glanced into one of the patient rooms, she saw two large windows overlooking a grassy lawn. Pleasant. Peaceful.

Harper guided her down the hall. “The patient we’re about to see is ready to go home. Euella Andrews. She had a stroke about a year ago and has been managing at home with her daughter’s help. Unfortunately, she fell several weeks ago and suffered a hairline fracture to her femur. Flann decided not to operate and put her in traction. She started—”

“Your sister’s a general surgeon, isn’t she?”

“That’s right, with a trauma certification. She’s qualified to handle straightforward orthopedic problems, and the consulting orthopedists are just as happy for her to do it. Saves them getting out of bed at night to put on casts or review X-rays.”

“What happens if you have a complicated orthopedic problem—open fractures, joint replacements, that sort of thing?”

“Then we’ll refer or transfer.”

“Orthopedic procedures reimburse well, but the rehab can be costly,” Presley said. “Not a bad compromise.”

“Our thinking was it made sense to treat what we could—keeps the patients closer to home and our staff busy.”

“There, you see? We can find common ground.”

“Good to know.”

From there, they worked their way down through the wards, checking patients, ordering tests, charting progress. The patients greeted Harper as if Harper held the key to all the mysteries of life. She was relaxed and conversant with the patients, good-naturedly answering their questions and reviewing the treatment plan when they were ready to go home, chiding some of them to follow instructions. She introduced Presley as one of the hospital managers, and that seemed to be all that was necessary for her to be accepted. If the same thing had happened in Phoenix, the risk management team would probably have had people sign consent forms before they even let her into a room. Here, all it took was Harper’s introduction. She could see how that kind of freedom would appeal, especially to someone like Harper for whom the hospital was like a second home. Unfortunately, the days of medical fiefdoms were long over. Everyone from the state to the insurance companies wanted a say, and part of her job was seeing that the hospital and everyone in it stayed on the right side of the line. Breaches in regulations were costly.

As Harper was finishing a note, the phone rang at the nurses’ station. A male clerk who looked all of fifteen answered, listened, and held the phone out to Harper. “Page operator for you, Harp.”

“How do they know where you are?” Presley asked.

Harper laughed. “They always know.” She took the phone. “Harper. Okay, tell them I’ll be down in fifteen.” She passed the phone back, racked the chart, and motioned to Presley. “ER consult. Let’s grab a cup of coffee on the way.”

Presley snuck a peek at her watch, surprised to see how much time had passed. Usually when she was forced into social situations, she was bored senseless before the hors d’oeuvres were finished. This had been unexpectedly engaging. Harper was warm and compassionate while being thoroughly professional and effortlessly in command. The patients obviously loved her. “I suppose I can spare a few more minutes. Coffee sounds delightful. I’m buying.”

“You’re on.”

They took the stairs to the first floor, since Harper apparently did not believe in using the elevators. After pouring a large cup of dark coffee from a stainless steel urn, Presley grabbed a doughnut on the way to the checkout counter. Harper introduced her to Luanne, the cashier, who gave her a long inquiring stare. Luanne looked to be in her early twenties, full-bodied, with bottle-blond hair and sharp, appraising eyes. She turned slightly, a subtle redirection of her attention to Harper.

“Haven’t seen you out to Elmer’s the Hilltop lately, Harper.”

“Been pretty busy.”

“A little relaxing will do you good, don’t forget.”

Harper took Presley’s change and picked up their tray. “I’ll keep that in mind.”

Presley slid into a seat at the dining table next to Harper and reached for her powdered-sugar doughnut. “I imagine you know everyone here.”

Harper sipped her coffee. “Pretty much. One way or the other.”

“Ah, yes.”

Harper laughed. “Not that way.”

“I can see where that might be problematic. Hospitals aren’t known for privacy.”

“That might be the first understatement you’ve made.”

“Still, I imagine after a while no one has any secrets.” The idea disturbed her. She much preferred the seclusion of her offices, where she knew what to expect and could decide how much to reveal.

“You might be surprised by the place.”

“You might be right.” Already, Presley’s normal routine had been upended. After all, she was sitting in the cafeteria in the middle of the morning with a woman she had nothing in common with, enjoying herself.

Chapter Eight

“So tell me,” Harper said, leaning back in her chair at the cafeteria table, “what do you need to know from the medical staff?”

Presley hesitated. She rarely interfaced personally with the staff at institutions SunView acquired, her decisions being several levels removed from the employees. Somehow she’d already broken her pattern at ACH and wanted to extricate herself diplomatically. She would far prefer the occasional smile from Harper than the barely disguised suspicion. “Well, I’ve just started and—”

Dr. Rivers, STAT, ER. Harper Rivers, STAT, ER.

“Come on.” Harper shoved her chair back and took off at a jog.

Presley automatically followed, whispering a silent thanks she’d worn low heels she could actually manage to run in that morning. Dimly aware of people hurriedly stepping aside, she focused on Harper as they sprinted through doorways, down hallways crowded with staff and patients, and around corners. Finally she recognized the entrance to the emergency room. Harper slapped an oversized red button on the wall and the big metal doors swung inward. Harper, steadying the stethoscope draped around her neck down against her chest with one hand, raced through without breaking stride. Presley ducked in as the doors closed, vowing to take up jogging as she struggled to catch her breath.

“What have you got?” Harper called to no one in particular.

A woman wearing a Snoopy smock pushed aside a curtain and leaned out into the hall. “Down here.”

Presley stopped at the edge of the curtain as Harper hurried into the cubicle, taking in the eight-by-eight space in one quick glance. Her stomach plummeted. She didn’t belong here in this harshly lit place where the air crackled with foreign energy and fear. She belonged in the quiet, orderly realm of benchmarks, options, and margins. She didn’t look away, having agreed to see Harper’s world.

A toddler, naked except for plastic training pants covered with multicolored polka dots, lay in the middle of a stretcher far too large for the tiny form, surrounded by towering adults who dwarfed the small body even more. Only the face was visible, haloed by blond ringlets, the features covered by a breathing mask that a grim-faced woman of fifty inflated with rhythmic squeezes to a gray football-shaped bag filled with air. A young woman, not more than twenty, stood staring with terrified eyes behind the people gathered around the stretcher, arms wrapped around her midsection, a keening sound rising from her throat.

Presley tugged her lower lip between her teeth. Leaving was akin to surrender, and she would not do that while the struggle continued.

The woman wearing the Snoopy smock, her name tag indicating she was Rose Aello, RN, said, “She came in with a URI. Her O2 sat was a little low. That’s why we called you. Then she just stopped breathing.”

The older woman squeezing the bag, Paula Jones by her ID badge, said, “I’m getting a lot of resistance. We’re not aerating very well.”

Harper pushed her way to the head of the stretcher and Paula made room for her. After a quick listen to both sides of the child’s chest, Harper slid both hands under the child’s shoulders and pulled her upward until her head was at the very edge of the stretcher. “Where’s the laryngoscope?”

“Here.” Rose handed Harper an impossibly large-looking instrument with a fat silver handle and a curved extension with a light at the end. Somehow Harper got that enormous thing into the toddler’s mouth and peered inside. “I’m going to need a tube. Let’s try a number four pedi.”

Rose rummaged in the cabinet and pulled out an assortment of long plastic tubes, individually wrapped in clear cellophane. She tore one package open and pulled out a tube. “Ready.”

Everything was probably happening quickly, but to Presley time seemed to stand still. Breathe, breathe, breathe kept running through her mind, eclipsing all else.

Someone pushed in beside her and Presley glanced away from the bed. Flannery Rivers, in scrubs, a paper mask hanging around her neck, her sandy hair tousled.

“You need me, Harper?” Flannery said in a strong, steady voice.

“Not yet.” Harper didn’t look up. She held out her hand and Rose handed her the tube.

“Thanks,” Harper muttered.

“Paula, honey,” Flannery said casually, “want to get a cut-down tray in here, just in case?”

“Got one right over here,” Paula replied.

“Good enough.” Flannery leaned back against the wall and crossed her arms, looking as relaxed as if she was waiting for a bus. Presley caught her eye and Flannery winked.