the right. Is this always the case?”
Cole jumped up and strode toward his father and Lizzie. “No.”
“Raise your arms for me, Mr. Montgomery.” The right arm went only half as high as the other. “Can you say ‘the sky is blue’?”
It came out slurred and jumbled. “Sy… boo.”
“I’ll call 911.” Cole dug for the phone in his pocket and made the call.
“He seemed to walk in here just fine, but then I noticed his droopy smile.” Lizzie went down on her knees to look Tiberius in the eyes. “Is your vision blurry?”
He made a tiny shake of his head.
“He needs thrombolytics ASAP. Time is brain,” she said, slipping into doctor mode, stating the obvious door-to-IV necessity for early treatment. “We’ve got a three-hour window.”
Cole filled in the emergency operator. “We need a stroke team ready to go,” he said when he’d finished. She assured him an ambulance would be on the way with estimated time of arrival twenty minutes. The nearest hospital was in Laramie. He did the math and knew time was of the essence if they wanted the best results with his father’s evolving stroke. Panic ripped through him at the thought of losing his dad. He went to him and squeezed his shoulder. “We’ll get the help you need, Dad.”
Tiberius glanced up, seeming a bit disoriented. Trevor’s wedding had taken more of a toll than Cole had realized.
“We should give him an aspirin right now,” Lizzie said.
“He’s already on daily aspirin.”
“Let’s give him another. Research shows the benefits outweigh the risk of causing bleeding in the brain.”
Cole also knew this was an ongoing debate among clinicians. Some researchers said early aspirin was beneficial, others said it could prove risky. The key was whether a clot or a burst vessel was the cause of his father’s stroke, and only a CT scan could prove that. Yet, the overemphasis of TPA, tissue plasminogen activator, as the only treatment could also cause bleeding in the brain. He wasn’t about to take up that debate now with Lizzie when his father was in the middle of a stroke.
“Out of…” Tiberius mumbled.
What? “You’re out of something?” Cole repeated what he thought his father meant.
“Asp.” He looked and sounded like someone who’d just had Novocain injections at the dentist.
His father had a history of TIAs, transient ischemic attacks, and that was caused by blockage. Why hadn’t he gotten a new bottle of aspirin immediately? Cole wanted to wring his dad’s neck, but quickly remembered there’d been a lot of activity going on over the past week with wedding plans and parties and Cole moving back home. Today’s wedding had been an all-day affair. He’d cut his father some slack, but still wondered if this TIA could have been prevented, and whether or not it would turn into a full-blown cerebrovascular accident this time around. The thought sent a shard of fear deep into his chest.
“Let’s do it, then,” Cole said, jogging to the closest medicine cabinet in the hall bathroom. “There isn’t any here,” he called out. Frustration blended with panic.
“I’ve got some in the kitchen,” Gretchen said, close on his heels. “You should have told me you were out, Monty,” she called over her shoulder.
When they returned, Lizzie had remained with Tiberius, reassuring him and distracting him by showing her newborn to him. She cooed over her baby and smiled up at the man. That lopsided smile returned, and his eyes looked calmer and more focused since gazing at the sleeping child.
“Take this, Dad.” Cole gave him the aspirin. “Can you swallow okay?” He tested his dad with a tiny sip from the cup of forgotten tea on the table next to his chair. He seemed to swallow okay, so Cole gave it to him. If this was a true TIA, his symptoms would go away within ten to twenty minutes. If it was a CVA, there was no telling how long or how much worse it could get. By Cole’s count it had already been over ten minutes since Lizzie had astutely noticed his father’s quirky grin, and as of now the symptoms remained unchanged. A foreboding shadow settled around Cole’s vision; worry kicked up the fear he’d tried to suppress. He wasn’t ready to lose his dad. Nowhere near.
“I’m calling the Laramie ER, giving them a preliminary report. I already told them to have the stroke team ready to go the second Dad arrives.”
“Do you have a blood-pressure monitor in the house?” Lizzie asked as he dialed his cell phone.
It’d been so long since Cole had lived here, he didn’t rightly know.
“There’s one in Monty’s bedroom,” Gretchen said, setting off in that direction of the house.
Cole studied his father, then looked at the beautiful baby with a full head of dark hair, just like her mother. The child squirmed and stretched while still deeply asleep, and that simple marvel kept that odd smile on his father’s face. Whatever helped or distracted him. The man must be scared as hell of having another stroke. He prayed their actions would be enough for now.
Gretchen produced the portable blood-pressure cuff while Cole gave his report to the ER. He watched as Lizzie carefully placed her baby, who was obviously still exhausted from the big airplane trip, across Tiberius’s lap, then she went right to work setting up and checking the numbers. “Well, we can’t blame his blood pressure for this CVA.” At one hundred and thirty over eighty-five it wasn’t greatly elevated.
Cole repeated the BP to the doctor on the phone. He knew that eighty percent of all strokes were ischemic, caused by a blockage of blood flow. The fact that his father had kept his blood pressure under control since his first TIA a couple of years ago, plus his BP wasn’t exceptionally high right now, meant the odds of a hemorrhagic stroke were much less. But you never knew, he couldn’t be too cautious and the man belonged in the hospital for treatment and best outcome. And just before he finished the call, there was the sweet sound of a distant ambulance siren.
“Our ride’s here,” he said to the doctor on the other end, then gave his dad a reassuring smile. “ETA an hour and ten.” That left a one- to two-hour window to get his father on thrombolytic therapy for best chance of full recovery. He hoped it would be enough.
WELL AFTER MIDNIGHT, Lizzie struggled with her colicky baby. These fits always seemed to happen at night. The child had been so intent on crying she couldn’t calm down enough to nurse. At the end of her tether, Lizzie walked the floor of the cathedral-ceilinged living room, with the spiral staircase winding up to a huge loft library at the back.
She had no business being a mother. Didn’t this prove it? She didn’t know what she was doing, and poor Flora sensed it. The baby bore the brunt of her overworked and undertrained parent. She wanted to cry right along with her child, but held it in, afraid if she let that gate open she’d never regain control.
She’d put on quite a show that afternoon, walking into a strange house with her baby, acting as if she were the most confident girl in the world. Oh, yeah, move out of state? Take a temporary job? Piece of cake. How long before Cole Montgomery sees through me?
Headlights flashed across the arched, church-sized window. Oh, great, just what she needed—now Cole would know what a failure she was as a mother, too. She thought about running off to her room set away from the rest of the house. Maybe he wouldn’t hear Flora’s wails there. But her curiosity about Tiberius overpowered her desire to run and hide—was saving face really that important?—so she stayed put. Her one hope being Cole wouldn’t demand she shut Flora up because if he did, she might have to quit the job before she even started.
She took a deep breath and switched her little one to the other arm and bounced her. Maybe Flora had worn herself