were exchanged and hands shaken, but Rachel quickly returned her attention to Lena, noting that her breathing had slowed and her blood pressure had come up slightly. Positive signs.
Finally, she heard the siren theyâd been waiting for. âThe ambulance is here, Lena. Youâll be in the hospital in just a few more minutes.â
The vehicle stopped in the drive outside, lights flashing. Two emergency medical technicians came across the porch.
Rachel met them at the door. âIâm Dr. Vale, and this is Lena Smith.â She stood out of the way as one of the EMTs knelt by the couch, stethoscope in hand. âSheâs in ketoacidosis. I started fluids and gave her ten units of insulin.â
The EMT nodded. âGot it.â The two men proceeded with their standard routine and, in only a few moments, had taken Lena out on a stretcher and put her into the ambulance.
âI want to come with her,â Justino said, following. âPlease donât make her go alone.â
The second EMT shook his head. âNot allowed. Sorry, son.â
The boy staggered, as if heâd been shoved.
Garrett put a hand on his thin shoulder. âYou can come with me, Justino. Iâll follow the ambulance. Ford, could you call Lenaâs dad to let him know whatâs going on? Dr. Vale, I assume you want to come along, as well?â He ushered Rachel toward his truck.
âTo begin with anyway. If Lena is part of this community, then I will be overseeing her care to some extent.â He opened the back door for her to stow the duffel on the bench, then held the front door so she could get in.
Once in the driverâs seat, he fastened his own belt and started the engine. âSo today isnât a onetime emergency?â
âIâm afraid not.â Rachel blew out a deep breath. âFrom all indications, this is a life-changing event.â
âWhat do you mean?â
âLena will be under a doctorâs care for the rest of her life. She has juvenile-onset diabetes.â
* * *
THE TRUCK TOOK a sudden leap forward, then slowed as Garrett relaxed his foot. âSheâll be taking insulin shots?â He glanced at Justino in the rearview mirror. The teen was staring out the side window, lost in his own thoughts.
Rachel nodded. âUnless researchers find a cure. Theyâre always working on it.â
The prospect daunted him. âThatâs a real challenge for a young girl.â
âThe adults around her will have to help her cope. Are her parents going to be cooperative?â
âHer mother died last year. Since then, her dad has expected Lena to take care of her younger brothers and the house, as well as doing her schoolwork. Sheâs at the ranch because sheâs been picked up for shoplifting several times in Buffalo and Kaycee and even Casper. She was cutting school with some of the older girls who can drive, and theyâd spend the day out of town, getting into trouble. Caroline chose her for the camp, hoping it would turn her around so she could focus more on long-term goals.â
âWell, now she has the long-term goal of staying healthy to worry about.â
âIâll pray for her to develop the strength she needs.â
âIâm sure that will help.â There was no mistaking the sarcasm in her voice.
He sent her a puzzled look. âWhy do you say it like that?â
She blew out a breath. âSorry. I didnât mean to insult you.â
âIâm not insulted. But I want to understand your reaction. You donât believe prayer can change events?â
âIt might change the person who prays, because I believe in the power of the mind to affect behavior. But otherwise...no. Your prayer wonât call down some unseen power to help Lena deal with her diabetes.â
âYou donât believe in God?â
She didnât answer for a minute. âI grew up going to church,â she said finally. âI canât dismiss the possibility of a universal power. But as I observe life on this planet, I donât detect much evidence of any kind of divine intervention. Good or bad, what happens, happens.â
There was silence as he drove the truck onto the highway exit ramp. âIâd be interested in talking more with you about that,â Garrett said, once theyâd merged into traffic. âMeanwhile, weâll have to work with Lena for the rest of the summer and get her started on the road to managing her condition.â
The doctor shook her head. âA summer ranch camp is probably not the best place for her to do that.â
Her opposition surprised him, but now wasnât the time for a debate. âWeâll figure that out once sheâs better.â
At the hospital, they pulled into the ER parking lot and went to the registration desk. Garrett showed the paperwork that granted him treatment permission, and they were allowed to join Lena in her cubicle. Justino went to the side of the bed and took hold of the girlâs free hand.
âThatâs what you need,â Rachel said, nodding at the bag of fluid hanging near Lenaâs head. âYouâll feel better soon.â
Lena rolled her head on the pillow. âI want to go back. To the ranch.â
Garrett faced her from the end of the bed. âWeâll take you as soon as the doctors say itâs okay,â he said.
âLying around being sick at camp is no fun.â
People wearing scrubs came and went, asking the girl questions and drawing blood for tests. A nurse brought some food and urged Lena to eat a little. Finally, a man wearing a white coat over his scrubs entered the cubicle, a medical chart held in one hand.
He nodded at Garrett but then shifted his attention to Rachel. âDr. Vale? Iâm Brad Stevens, from the medicine service. I understand youâre the new doc down in Bisons Creek.â
She gave him one of those bright smiles. âI just pulled in to town today.â
âAnd ended up at work. Thatâs the way it goes, doesnât it? Good call on the diagnosis.â Then he moved forward to stand beside the bed. âHi, Lena. Iâm Dr. Stevens. Weâve run some tests and I have some news.â
Lena opened her eyes to focus on his face. âWhatâs wrong?â
âYouâve havenât been well for a few days, have you?â Lena shook her head. âWell, thatâs because your blood glucose is very high.â
âI donât understand.â
âYour cells use the glucose, or sugar, in the food you eat to produce energy and to function normally. Thereâs a chemical in your body called insulin, made by the pancreas, which helps release glucose into the cells so it can be used. But sometimes thereâs not enough insulin. The glucose doesnât get into the cells and instead stays in your blood. Your cells are starved and you become sick.â
âHow do I get better?â
âWeâre giving you insulin, and that will make a big difference.â
âThen I can leave?â
âNot right away. We want to watch you for a couple of days, ensure your system returns to a more normal state.