at first. With a small nod, she extended her hand. “Kayla Doherty, Visiting Nurse Service.”
Eyes tipped down, he didn’t give way, just stood for long seconds, contemplating her hand. Then he moved back, allowing her to enter while ignoring her gesture.
Kayla stepped into coffee-scented air. She breathed deep, wishing she’d had time for a caffeine fix, but weather reports had spurred her to this farm before conditions worsened. Sniffing the air with appreciation, she stood in a sparse but clean entry. The kitchen lay ahead, while a stairway hugged the wall to her left. A throw rug took up one corner of the polished hardwood floor.
Various footwear stood along the colorful weave. Reading the silent message, she placed her bargain-basement-priced short-boot Sudinis next to taller, hardier boots. Setting down her tote, she slipped into jeweled, open-toed clogs. She’d tricked-out the shoes herself, using a flashy array of sequins and beads. Her older female patients loved the effect. Fun shoes became an easy conversation starter, and often jogged memories of easier times. She hoped so.
“In January?”
The deep, masculine voice showed disbelief and…scorn? Sure sounded like it.
Kayla didn’t try to examine the vibes as she eyed rugged work boots and their tall, rubber companions. Proper barn wear for a man of the fields, a person who faced the prolonged winters of St. Lawrence County, New York, on a personal level. She assumed a look of patience and straightened, facing a good-looking man about her age, his features dimmed by shadows of anger and death, a formidable combination. “They’re comfortable for working with patients, Mr….DeHollander?” She ended on an up-note, making the statement a question, hoping he’d introduce himself.
Um…no.
She’d heard of Marc DeHollander. Women loved to talk about men, and the gals comprising the medical community of greater Potsdam were no exception. The rumor mill labeled Marc total eye candy, with a great personality.
Well. One out of two ain’t bad.
She’d dated one of Marc’s friends several years back, but Marc had never crossed her path. This man was the right age, but the taciturn expression didn’t fit the image. Imminent death had a way of changing a person. Kayla understood that. He’d probably lighten up as time went on.
He glared at the outside thermometer through semi-frosted glass. “Six degrees. Wind chill’s at least twenty below. Who wears foolish shoes like that in the dead of winter?”
Kayla scratched her whole “lighten up” theory. Some clients were just downright ornery, regardless. Marc DeHollander’s name just got tucked under the heading “resident jerk.” She ignored his negativity and swept the small room a glance. “Warm enough in here.”
“It’s comfortable for Dad.” Face taut, he headed into the kitchen. Kayla followed as he tugged the collar of a black turtleneck layered beneath a green plaid flannel. The inside temperature was a little much for his mode of dress.
Kayla understood. End-stage patients often suffered effects of temperature. Extremities chilled, causing discomfort. She glanced around the kitchen.
The room lay spare, like the entry, but neat other than some breakfast clutter. Old-style, glass-fronted cabinets marched in formation around the upper level, offset by wood-fronted, thicker partners below. The cupboards wore a soft shade of green, faded with time. A chipped but uncluttered laminate counter met a backsplash of ivory tile. The effect appeared old and utilitarian, but cared for.
A man’s house.
Kayla glanced up at the disgruntled man nearby. A big guy, about six feet and one-eighty, she wondered if he meant to intimidate her. If so, he was doing a good job. She hoisted her work case, determined to make nice. “Would you like to talk first, or introduce me to your father?”
His facial shadows deepened. A muscle in his right cheek twitched. He worked his jaw, then grimaced. “Dad’s through here.”
Thank you, Mr. Congeniality. Kayla followed him through a dining room into a small bedroom beyond.
A hospital bed dominated the space. The patient opened his eyes as they approached. His look darted, confused. Sighing, he settled into the pillow.
Dreaming, Kayla decided. Normal sleep or drug-induced, she couldn’t quite tell, but the startle-awake reflex was not unlike a newborn. Cradle to grave, full circle.
“Your nurse is here.” The son’s tone left no doubt she wasn’t here by his grace.
Kayla bit back a smart remark and focused on the sick man. She approached the right side of his bed, cheerful. “Mr. DeHollander?”
He nodded. His eyes cleared somewhat. “Yes.”
She broadened her smile. “I’m Kayla Doherty from Visiting Nurse Service. Dr. Pentrow requested our services. Did he explain that to you?”
The older man glanced Marc’s way. “He told us, didn’t he, Marc?”
Gone was the look of antagonism that greeted Kayla’s arrival. Marc leaned down and brushed a thin lock from his father’s brow, his big hands gentle against his father’s pale skin. “He did. And a home health aide to help out.”
“Having people come to the house could get expensive.” The dying man sent a look of concern his son’s way. The bottom line had obviously ruled his decision making a long time, a concept Kayla comprehended.
“Your insurance covers both, Mr. DeHollander.”
“Does it?” His frown deepened, trying to reason things out.
“Have you had pills this morning?” Kayla inquired. She angled her head and waited for his response.
“Yes,” Marc answered, but didn’t meet her eye. “Around five-thirty. I gave him two of these.” He reached across his father’s bed to hand her a bottle.
“You started this yesterday?”
Mr. DeHollander frowned.
Marc nodded. “I picked it up around four when I went into town to get my sister,” he explained. This time he looked at her. “Is it the right stuff?”
“Yes,” she confirmed. “It’s a hydrocodone and acetaminophen mix,” she continued, including both men in her explanation. Successful hospice care meant developing a strong working relationship with the caregivers and the patient. At some point the patient would likely lose the ability to participate in his/her own care. A satisfying hospice experience blossomed from establishing good rapport all around.
Kayla was good at working both sides of the bed, and that made her an effective hospice nurse, a fact she’d realized during her first years in the North Country. One of her hospital patients had brought her to faith, to hope, and eventually to her present gig.
She raised the container. “Effective for moderate pain. Side effects generally ease after a few days.”
“Side effects like…?” Marc’s look sharpened. He glanced at his father, then back to her.
Kayla addressed her patient. “Sleepiness. Confusion. Dreams.”
Her list relaxed Pete DeHollander’s features. “All of the above.”
Glad to have relieved his mind, Kayla offered a proposal. “Since you just started this, I’d like to see if the side effects level out. They usually do as the body acclimates. Can we try that, Mr. DeHollander?” She posed the question with a look of inquiry. “I don’t want you to think this is an automatic trade-off. Less pain for a state of confusion. We have lots of things at our disposal. Your care will be based on what works for you. Adjustments in meds are common.”
He contemplated her words, then looked at Marc. “I’m not thinking too clear,” he admitted. He fiddled with the uppermost blanket, nervous. “What do you think?”
Kayla met Marc’s eyes across the bed. She read the look in them. His expression