SUSAN CARLISLE’s love affair with books began when she made a bad grade in maths in the sixth grade. Not allowed to watch TV until she brought the grade up, she filled her time with books and became a voracious romance reader. She has ‘keepers’ on her shelf to prove it. Because she loved the genre so much, she decided to try her hand at creating her own romantic worlds. She still loves a good happily-ever-after story.
When not writing Susan doubles as a high school substitute teacher, which she has been doing for sixteen years. Susan lives in Georgia with her husband of twenty-eight years, and has four grown children. She loves castles, travelling, cross-stitching, hats, James Bond and hearing from her readers.
The Nurse He Shouldn’t Notice
Susan Carlisle
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Dear Reader
Often when we stop focusing on ourselves and start concentrating on others good things happen that we never dreamed were possible. Too many times we become so secure in our own world that we must step out beyond our comfort zone to change our perspective. When we do that we are more aware of others around us, and that can make a difference in our own lives. My characters, Court and Maggie, are no different from us. They must struggle, but they find the truth in the saying ‘Give and it will be returned to you.’
Although the hospital in Teligu is fictitious, and Maggie and Court’s story comes completely out of my imagination, there are dedicated and hard-working doctors and nurses who spend their lives working to provide healthcare to the people in the remote areas of northern Ghana. You can find out more about the medical work being done there on my website: www.SusanCarlisle.com
I hope you enjoy Court and Maggie’s love story as much as I enjoyed telling it.
Susan Carlisle
My special thanks go to:
My Tuesday night critique group for all your advice.
Dr. Chupp for giving medical details.
Sia Huff and Carol Burnside
for being such great critique partners.
Flo Nicoll for being such a supportive editor.
THE dry season dust surged past Maggie Everett as she halted the battered Jeep next to the sleek jet. Raising a hand, she shielded her eyes from the sun and the haze of the plains of northern Ghana in West Africa.
As the passengers disembarked from the plane, one in particular drew her attention. Maggie hadn’t seen many American men near her age of twenty-eight in the last couple of years but she could still recognize a fine-looking specimen when she saw one.
He looked in her direction, while behind him the three other newcomers sorted out their luggage. A balding man pointed and issued orders while pulling boxes and baggage from the belly of the aircraft. Two young women, chatting with excitement, searched through bundles that were unloaded. They must be the nursing students who’d be working during their summer break from college.
These were the latest medical personnel to fill in at the remote hospital for a few weeks. She appreciated the assistance but what the hospital desperately needed was enough financial support to hire additional physicians who would be committed to staying for years.
The man caught her full attention again as he strode toward her. His aviator sunglasses added mystique. Slimhipped, wide-shouldered and, if she had to guess, over six feet. He reminded her of the guys in those year-old magazines her mother sent in care packages. Like one of the models from a cologne ad. An undertone of ruggedness, offset by a touch of refinement. Maggie’s pulse beat a little faster in anticipation.
Reaching her, he flipped the glasses up to rest on the top of his head, revealing crystal-blue eyes, made sharper by the deep tan of his skin. “I’m Dr. Court Armstrong. I’ve two sensitive pieces of equipment that need to be seen about right away.”
No hello, nice to meet you. His crisp New England accent caught her off guard. Could he be? “Armstrong? As in the Armstrong Foundation? Boston?” She didn’t try to keep her disgust out of her voice.
“Yes.”
He could be the very one who had denied the hospital’s request for aid, including her plan for an urgently needed children’s clinic. The locals were desperate for medical care, children the most. The hospital required help to stay open, and her new program could make a difference. But the hospital didn’t meet their requirements for funds. It was in too remote an area, not seeing enough patients. She gritted her teeth. Not qualify! She couldn’t imagine a project more qualified or a hospital more in need.
“So why are you here if you’ve already denied our application?”
His mouth compressed for a second before he said, “I’ll be glad to discuss that with you after we get this equipment out of the sun.”
Before she could respond with the sharp retort that sprang to mind, her name filled the air.
“Missy Maggie, Missy Maggie.” Neetie, a young African boy, ran across the parched ground toward her. Clouds of dust trailed behind. He halted beside the Jeep. “Truck. Hit. Hurt,” he said in his native tongue between panting breaths. “Come. Now.”
“You’re needed,” she said to the doctor. “Get in, Neetie.”
The long-legged doctor gave a curt nod and picked up a knapsack from the pile of luggage before climbing into the seat beside her. Maggie noted his split-second hesitation before he reached for Neetie.
Using one arm, Dr. Armstrong swung the boy into the back and called over his shoulder, “John, see to the machines.” Turning to her, he said, “Let’s go.” He returned his dark glasses to their place on his nose. She missed the clear blue coolness of his eyes. What a shame to hide those pools, and an even greater shame they belonged to such an insufferable man.
The Jeep cranked on the first turn of the key. Maggie floored the gas and the vehicle shot forward. She steered a circle around the plane and back toward the compound. “Where, Neetie?” The wind whipped the words away.
“In front of Arthur’s.”
Dr. Armstrong gripped the edge of the windshield, one foot propped on the raised edge, a hand on his bag as if he wasn’t comfortable racing to an emergency in an emerging country. After he realized the conditions he’d have to practice medicine in, she wouldn’t be surprised if twenty-four hours from now, he took off in that fancy jet, looking for his pressed-white-lab-coat world again.
She slid the Jeep to a stop in front of the hospital. When Dr. Armstrong’s hand slapped against the dash to stop his forward motion, Maggie’s mouth lifted slightly at the corners.
“Why’re we—?”
“Supplies.” She gathered up a handful of her skirt’s material, climbing out of the Jeep. This was one of those times when the clothes she was required to wear were a nuisance.
Minutes later, Maggie returned with a large black bag she kept prepared for this type of situation.
Dr. Armstrong jumped out and met her. “I’ll take that,” he said, reaching for the bag. He placed it beside Neetie.
Before she put the Jeep in gear he’d returned to his seat.
Maggie said nothing to her passengers as she drove. Instead she concentrated on weaving her way through streets lined with clay-brick, one-story buildings and filled with people and animals. She glanced at the man beside her. The doctor made no attempt to speak either, seeming to absorb everything around him.
Reaching the accident, she could see that a truck had hit a cart. People mingled around an elderly man who must have been pushing the cart. He lay off to the side, clutching his chest, while a child of about nine had her legs pinned beneath the cart. A woman chattered in a loud voice at the man standing beside the truck.
Maggie’s stomach clenched. She hated to see a child hurt most of all. No matter how far she ran, she still couldn’t outrun her mothering nature when a child was in trouble.
The Jeep had almost come to a jolting stop when Dr. Armstrong’s feet touched the ground. Slinging his pack over his shoulder, he lifted the other bag from the back. “You check the child. I’ll take the old man. Looks like a heart attack.”
Well, he certainly had no trouble giving orders! Who did he think he was to drop out of the sky and five minutes later start telling her what to do? As lead nurse, she’d been the one who’d made most of the daily decisions. She knew what to do, and didn’t need super-Doc to take over before he’d even seen the hospital in Teligu. She made no comment regarding his high-handedness. Having someone in charge during an emergency was critical to maintaining order, and Dr. Armstrong made it clear he believed that was him. “Neetie, you go with Mr. Doctor. Talk for him,” she instructed the boy.
Going to the girl, Maggie used a gentle voice hoping to calm her fears. Her ex-emergency-room nurse instincts took over. Quickly she assessed the girl’s injuries while keeping an eye on the doctor’s progress. She couldn’t have a newbie fresh off the plane damage the relationship and trust that the hospital had painstakingly built with these people.
He gave curt, simple directions that Neetie translated from a distance, as if the doctor had placed Neetie in that spot, not too far away but not too close.
Using hand gestures, Maggie instructed three men on how to raise the cart off the child. Maggie pulled the girl out by the shoulders and then examined the girl’s injured right leg.
Dr. Armstrong joined her. “Thankfully no heart issues. The man’s forehead will require stitches but those can wait. I applied a couple of four-by-four gauze bandages and told Neetie to tell him to hold them in place. The girl?”
“Fractured leg,” Maggie said, not looking at him. “Thank God that appears to be the only injury.”
He pulled the supply bag over to him and knelt across the girl from Maggie. The doctor ran long tapered fingers over the girl’s distended skin with medical thoroughness but something was missing. No soothing voice, no tender touch, no personal involvement. His actions were all strictly clinical. “Let’s get this stabilized and get her to the hospital.”
Despite the negative emotions his last name and attitude kindled in her, Maggie grudgingly admitted he seemed to know his medical care despite his almost non-existent bedside manner. Still, he wasn’t going to push her out of the way as if this was her first day in Ghana, instead of his.
Maggie handed him splints. He gave her a quick glance of admiration. She squeezed the girl’s hand, before holding one of the boards in place while the doctor gripped the other.
Pursing her lips, she drew in a breath. The pain in the girl’s eyes pulled at Maggie’s heart. She reassured the girl that she would be fine. If it hadn’t been for her own accident, Maggie might have been the mother of a little girl close to the same age. Because she couldn’t have her own children, she’d embraced each native child as hers. She even planned to adopt Neetie. It made her livid to think about how much she could do for them if the Armstrong Foundation would support the hospital. “The bandage is in the right-hand corner of the bag, Dr. Armstrong.”
He reached for it. Passing the material back and forth, they slowly began to wrap it around the boards holding the leg straight.
“You make my surname sound like a dirty word. Why don’t you call me Court?”
“What?” she asked, distracted by her thoughts of getting the bandage just right.
“My name. After an emergency—what, less than five minutes after I land?—I think we can survive on a firstname basis. And you’re Missy Maggie.”
Her usually efficient movements faltered when his fingers slid over hers as he handed her the wrapping. “I’m Maggie Everett. The head nurse. You can call me Maggie.”
He glanced at her as she returned the wrapping. With deft movements suggesting years of practice, he secured the end by tucking it under the edge of the material. Without looking at the girl, he said, “Maggie, tell her that we are taking her to the hospital.”
No “please” there but Maggie did as he instructed, then went to move the Jeep closer. She couldn’t fault the new doctor’s care, but she was used to the visiting doctors showing more personal attention, more personal interaction with patients. He was no different than his family’s foundation.
The people of Teligu needed help and this man had the influence to see they got it. Could she convince him to persuade the foundation to reverse its decision?
Court stepped into the cool evening. He ran his hands through his hair and took a deep breath. The air smelled fresh compared to the busy city of Boston. Even the noises of the night were a sharp contrast to those of home. He took a moment to listen to the wildlife bickering back and forth, and the shuffles of an animal searching for food outside the compound fence. He’d never call this place home.
Was Ghana something like his parents had experienced all those years ago? Part of what had kept them going on medical mission trips even when his mother had become pregnant? He shook his head. His parents should have been in the States, not off in the wild, especially with his mother so far along.
He shook his head. With his kind of luck, his first patient in Ghana had to be a young girl. He’d not trusted himself with a child’s care since that awful night. The girl had required his attention and he’d had no choice but to tend her. The constant reminder to focus ticker-taping through his mind kept his hands steady.
The soft casting of the girl’s leg hadn’t been challenging. Yet he felt exhausted. He’d flown all day, crossed three time zones and was coming down from the adrenaline rush of an emergency. It did feel good to be practicing medicine again, even if he had to start with a child. Still, he needed sleep.
Heck, he didn’t even know where he was to bunk. Scanning the compound, he didn’t see anyone to ask. The screen door behind him slammed, and Maggie stepped out.
They’d worked well together, despite his feeling that she didn’t like him. He’d been impressed by her efficiency in casting the girl’s leg regardless of the rudimentary exam room and equipment. She did everything with precision and care. In America, these facilities would be comparable to a back-alley clinic. Like the one he and his brother had been born in. The one without enough technology to help his brother. Now wasn’t the time to start dredging up those ugly, negative memories. He pushed them back into the corner of his mind where they belonged.
Even with the events of the past few hours, Maggie still had a fresh look about her. Her dark, wavy hair was pulled high on her head and brushed the top of her shoulders. What would it be like down? A dark flowing waterfall? In the dim light, he could just make out her quizzical expression. Had he voiced his curiosity out loud?
“I guess you’d like to settle in.” Her businesslike voice eclipsed the evening sounds. “I’ll show you to your bungalow. Someone will have already put your bags there.” She didn’t sound as if she welcomed the chore.
“I could use some rest. Long day and even longer evening.”
“I’d like to tell you a day like today is unusual but it isn’t.” She stepped away and headed down a winding path.
Her look implied she’d expected a negative reaction. “Have I done something to make you angry?”
“Your foundation has done something to these people.” She stopped. Her words were cutting as she spread her arm out in a dramatic arc. “The hospital requested support and we were denied!”
“Now, Ms. Everett, you know the foundation must make tough decisions. We would like to give—”
“Don’t patronize me and don’t give me the party line. From what you’ve seen today, can you think of another medical facility that needs help more?” Her voice rose with her ire.
He found Maggie even more interesting fired up and fighting. “To be honest, I need to spend more time here to answer that question.” He brushed his hand across his forehead slick with sweat, even in the night air. All he wanted right now was a bath and bed.
“Cop-out,” she huffed. The words hung between them for a second before she asked, “By the way, are you on the foundation board?”
He took a deep breath. She wasn’t going to like his answer. “Yes, I’m the acting CEO.”
Her shoulders squared and her back went straight as a pole. “So you knew the foundation had turned the hospital down before you came here.” She almost spat the words.
“I did. I also read your appeal letter. It’s why I’m here.” Her impassioned plea for the foundation to reconsider its decision had touched a chord in him. He’d decided to come and see for himself if all she’d written was true, if perhaps he could finally do some good. Still, he had no intention of telling her the other reasons he’d come to this desolate place. Like making a decision about whether or not to continue practicing medicine. “I thought I’d see what the hospital’s needs were for myself. The foundation receives numerous applications for assistance but we can’t fulfill them all. Not every request has merit.”
“I can assure you ours does.”
“I’ve yet to make that determination.”
She looked him square in the eyes. “Then I’ll have to convince you.” She glanced away, then said, “You don’t practice medicine?”
“I’m a trained pediatrician but I’ve taken a leave of absence. The foundation takes all my time right now.”
He’d stopped practicing when he’d allowed a little boy and his parents to suffer for his inattentiveness. The boy now lived with brain damage, just as Court’s brother had. Court should’ve gone when he’d been paged but he had been too busy with foundation business, trying to make points with his parents. Trying to fill some juvenile need to be noticed. Even thinking about it disgusted him. A grown man should’ve gotten over it by now. But he’d hurt a child. Everyone said that Jimmy’s reaction to the meds wasn’t his fault but they would never convince him. Either way, there was still a child living as his brother had because of him.
“Really?”
“Why the sound of surprise?”
“You were good enough with the girl today, but you don’t act like the typical ped doc.”
Ouch, Missy Maggie was way too perceptive. He’d thought he’d covered up how anxious he’d been while seeing to the child. “How’s that?”
“I don’t know how to explain it. I’ve seen all kinds of doctors come through here and I can usually tell by how they interact with a patient what field they’re in. I’ve not missed one in a long time.”
“Well, it’s nice to know that there’s still some mystery to me.”
Maggie shrugged before she started down the worn dirt path toward a copse of squat, low-canopied trees. “The bungalows are out this way.”
He watched the soft sway of her hips under her long cotton skirt. All the women here wore some type of flowing skirt or dress. Hers was too lengthy to give him any more than a glimpse of well-formed calf. She wasn’t waiting to see if he followed.
“Have you worked here long?” he asked as he caught up with her.
“I’ve been working in the Teligu Hospital for a little more than two years.” The words flowed over her delicate shoulder.
“And you’re already the head nurse?”
She chuckled low in her throat. “Yeah, and sometimes nutritionist, health inspector and ward housekeeper. Around here we do it all.”
Her dry mirth punctuated her earlier anger. “We all pitch in. Locals are hired to do some of the work but there’s always something needing to be done. Like today.”
“How many are on staff?”
She turned round, her eyes having gone serious. “Including you and me? Not enough.”
“Why not?”
“For the same reason you’re only here for a short while.” She looked out across the compound as if taking it in for the first time. “Lack of supermarkets, malls and night life …” Her voice trailed off into a soft, accepting voice, which told Court she’d run out of energy to fight.
He said nothing for a while. For some reason he wished he could commit to staying forever just to see her happy. That was an odd thought. “So what does the hospital need most?”
“Doctors. Not for a couple of weeks or months. Staff willing to commit to staying for a year or more. Pharmacists, nurses, a hospital director, or any other medical professional you can think of, we could use them all. And the money to encourage them to stay longer and …” she paused for effect “… a children’s clinic.”
“What about doctors and nurses local to the area?” He would continue to pepper her with questions as long as she agreed to answer them.
“No native doctors. For pretty much the same reason others don’t stay.” Her voice strengthened, a steel edge entering it with her passion for the subject. “If they get out of the villages, they find they like the life at the coast. And the money. There’re five full-time nurses. We’re training local women, and some go off to school with the help of the government.”
“Doctors?”
“Just Dr. Roberts full time, we fill in with visiting doctors. For the next couple of weeks it will be Dr. Roberts and you. But Dr. Roberts will take a few days of vacation next week. He’s not had any time off in months.” She finished with a flourish.
The more she spoke, the more animated Maggie became. He couldn’t take his eyes off the petite woman who spoke like a lioness protecting her young. What would it be like to have someone who loved so unconditionally in his corner?
Court leaned back. “We’ve more help. Another doctor flew in with me.”
“Really?” She seemed excited by the news. “Great. We’ll be able to do the clinic in one of the neighboring villages after all.”
They’d reached a simple, cinder-block structure, covered by a tin roof. She opened the screen door and held it for him. He stepped into the tile-floored room. A lamp illuminated two well-used chairs and a small bare table in the sitting area. A ceiling fan produced the only air circulation.
“There’s a small kitchen area, bedroom and bath through there.” She pointed in the direction of a dark doorway.
Her skirt brushed against his cargo pants as he moved to tug on a light pull so he could see down the hall.
She shifted, putting distance between them. “You can fix your own meals or we’ve a mess hall. Since there’s no food stored here, I’ll be by at six-thirty in the morning to show you where you get breakfast. If we have a few minutes before rounds, I’ll take you around the hospital. Clinic starts promptly at seven-thirty.”
Her words were all but rolling over each other. Did he make her nervous? He would’ve never imagined anyone could rattle this unflappable woman.
Stepping out the door, she warned, “Be sure and latch the screen before you go to bed.”
Maggie was running. And she wasn’t half as impressed with him as he’d like. She certainly shared no love for his family’s philanthropic endeavors. Missy Maggie reminded him of his favorite kind of candy, hard on the outside, gooey in the center. He’d like to find out what other surprises she hid.
The next morning Court started down the bungalow’s short hall as a knock sounded at the door.
Maggie stood outside the screened entry. She wore a scooped-neck shirt and a floral skirt, hiding what he imagined were enticing curves. Her chestnut hair hung from the nape of her neck secured by a rubber band. She looked shiny, natural and young. And completely out of place in this stark land.
“I didn’t think you’d be up,” she said through the wire mesh.
“You told me six-thirty, and it’s six-thirty.” He pushed the door open, stepping out.
The glint in her eye suggested she might be laughing at him. “We’ll see if you feel this chipper tomorrow morning.”
He still felt the same chill from her that had been present the day before. He fell into step beside her as they took a different path from last night. This one ended at a long, low building adjacent to the hospital.
“This is what we affectionately call the mess hall.” She led the way to a short buffet line set up at one end.
It resembled a military mess hall he’d seen in pictures.
“The food’s prepared for the in-patients Monday through Saturday. Families bring the meals in on Sunday. Most of us find it easier to eat here than to go to the town market daily.” After filling her plate, she moved toward an empty table.
“Hey, Court,” John Weber, the doctor who had flowm in with him, called. “Come join us. Tell us where you disappeared to yesterday.”
“Sure.” He and Maggie took chairs at the table. “Maggie, you haven’t had a chance to meet John Weber. He works with the foundation. This is Lisa Mills and Jen Skindowski.” He directed a hand toward first the blonde and then the brunette woman sitting beside the doctor.
She nodded to the women and shook hands with John. “I’m sorry. I thought you were the pilot.”
John laughed. “No, I’m a general practitioner. The pilot would be Court. It’s his jet.”
Court shrugged when her piercing gaze came back to him. She didn’t look impressed. Did she think he should sell the plane and offer the money to the hospital?
“In fact, you could call it his baby, he loves it so much.” John took a bite of scrambled egg.
“I imagine a plane makes it easy to get around,” she mumbled. What she left unsaid made him uncomfortable.
“John, did you get the equipment taken care of?”
“Yeah, the director put it in storage. I made sure it was handled carefully. So tell me about the big emergency yesterday.” John kept his focus on Court.
“Truck and cart accident. Cart lost. A child with a clean fracture. An old man who needed a couple of stitches. The girl was doing well when I checked on her at midnight.”
Maggie’s head jerked up. “You went to check on her in the middle of the night?”
“Don’t sound so shocked. I like to keep a personal eye on my patients.” He’d failed to check on a patient once and he’d never make that mistake again, even if he was still a long way from feeling comfortable around children. She gave a nod of approval. It felt good to think her opinion of him had taken at least a slight upturn. Something about how she’d reacted to the girl being injured made him believe the children routinely received her special attention.
Lisa asked Maggie a question about the facility, and they began discussing the hospital and the area. There were additional questions about the people and the type of care they most often required. Court listened, impressed by how involved Maggie was with her patients. She clearly loved her work and the Mamprusi people.
She pushed her plate away and said to the group, “If you’re finished, why not join Court for a tour?”
Court lagged behind the others as Maggie pointed out buildings within the compound.
She turned to the nurses. “Don’t go outside the fence after dark and only with a companion during the day. It isn’t like at home. There’s no police or law like you’re used to.”
Inside the hospital building she pointed out the pharmacy, office area, supply area, and the two ORs. She led them to the women’s ward where the beds looked to be World War II surplus. Family members were sitting or sleeping on the floor around their loved ones.
Jen asked, “Why’re there people everywhere?”
“We ask families to help care for their loved ones. There’s not enough staff to do it all,” Maggie explained.
Had he been wrong in his evaluation of the hospital’s application? Maybe, but he wasn’t ready to concede that so early in the visit. He couldn’t let her emotional play on the situation get in the way of a comprehensive evaluation.
The men’s and the children’s wards were much the same. Leaving the latter, Maggie stopped and looked straight at Court. “You’re the pediatrician so you need to know we don’t tell the parents if their child is dying because they’ll desert them.”
If her intent was to drive home the point the hospital could use foundation money to hire additional stuff, she’d done it. With one-two punches.
He’d been born in a small jungle clinic but he’d been reared around glistening state-of-the-art hospitals in Boston. Aware of the type of work the foundation supported, he’d still never been in a hospital this primitive.
“It’s time for rounds,” Maggie said. “Lisa and Jen, I’ll leave you to help out in the children’s ward. One of the staff members will show you what needs to be done. Doctors, we’ll meet Dr. Roberts in the men’s ward.”
Court looked out the window of the hallway linking the two buildings while they walked. The line of people waiting, sitting or standing stretched as far as he could see. He couldn’t keep the amazement out of his voice. “Are all those people waiting to be seen?”
“Yes. We see around three hundred a day. And do eight to twelve surgeries.”
He whistled. She made it sound like there was nothing to it.
She met his look. “Another reason we have difficulty keeping doctors and nurses.”
They entered the men’s ward. “Dr. Roberts, I brought you help. Gentlemen, I’ll see you later in clinic.” Maggie turned and left.
Maggie looked across the packed dirt yard in the direction of the patient clinic. She scanned the crowd of people waiting in the open-air treatment area. With relief, she spotted Court’s dark-haired head. He had stepped out of the building, deep in conversation with one of the local orderlies who spoke English.
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