Not if he could help matters… “I assume you’re referring to how the rest of the physicians look down on us because of the popular belief that we only decide on whether or not to admit a patient.”

“Yeah.”

It was a common stereotype, thanks to the nature of his profession. The people who presented themselves were either bleeding or sick and it was his job to either cure them or pass them off to someone who could, doing both as fast as possible. The department wasn’t called Emergency for nothing. Being the metropolitan city that Pittsburgh was, their ED never had a dull moment.

“We may not have an official client list like a private practice does, but we definitely have our regulars,” he mentioned.

“Like Frances.”

“Like Frances,” he echoed. “A lot of people list us as their primary-care physicians.”

“Probably,” Roma agreed, “but I’ll bet Dr. McAllaster feels as if she’s taken a step down in her career. Mind you, the nurses have a saying. ‘If the doctor ain’t happy, then nobody’s happy.’”

Trey disagreed. So far, Sierra hadn’t lost her temper or raised her voice and she’d been in various situations where it wouldn’t have been inappropriate. While staying calm was a great trait to exhibit in an emergency situation, over the past few months of their quasi working relationship, from what he’d seen, the woman gave the word unflappable new meaning.

“I think you’re wrong,” he said. “Sierra is too classy a lady to take out her frustrations on the rest of us.”

“She might be classy, but redheads can have fiery tempers.”

As far as he was concerned, calling Sierra a redhead was like describing the Perseid meteor shower as a few shooting stars, or the Grand Canyon as a big hole in the ground. “I’m not sure one has anything to do with the other. I’ve known lots of hot-tempered brunettes and blondes, too.”

“Okay, so I’m stereotyping,” she admitted, “but we’ll see fireworks down here before it’s over.”

He was half-eager for Roma’s fears to come true. Sierra, with her brown eyes flashing with the same fire he saw in her hair, would be an awesome sight. “Fireworks can be beautiful.”

“Yeah, in the night sky off the Roberto Clemente Bridge. Not in the hospital and without any warning.”

“I thought you liked to live life dangerously.”

“Me? Mrs. Boring who’s married to Mr. Extremely Boring?” She shook her head, smiling. “Not a chance. As much as I like my job, it has enough inherent aggravation without me looking for trouble. Speaking of which, the sooner we take care of Frances, the better.”

“Okay, but I have to check my CT scan result first. If everything looks okay and the injection we gave Mrs. Villiers is working, we can send her home.” A few keystrokes later, he found his report and read it with satisfaction. “Sure enough. She can go.”

After sharing his news with Mrs. Villiers, Trey found Sierra at the nurses’ station, ready to grab another clipboard out of the in-box.

“Before you take that case, I have a person I want you to meet,” he told her. “Room Ten.”

“A patient?”

How could he describe Frances? “Yes and no,” he admitted.

Her answering chuckle sounded sweet. “Which is it?” she asked.

“Frances is one of our colorful regulars. She’s a twenty-five-year-old woman with a learning disability who lives about a block away. Her mother used to work here and so she understands that the Good Shepherd E.R. is where people come for help.”

“Okay, so what’s unusual?”

“When I refer to ‘help,’ I’m using an extremely broad definition.”

“How broad is broad?”

“She comes in for minor things like a sliver in her hand, a skinned knee or a broken blister. She usually goes straight to the triage nurse, who finds out what she needs. Then, the nurse sends her to me or to one of the other doctors if I’m busy. We give her a little TLC and send her on her way.”

“I assume that I’m ‘one of the other doctors’?” she said dryly.

“Do you mind? “

“Not at all.”

“Good, because if you ever do see her, her visit will go easier if I’ve introduced you.”

“Okay. What’s her complaint?”

“Stomachache.”

She glanced at his empty hands. “Where’s her paperwork?”

“We don’t create any.”

Sierra stared at Trey. “No paper trail?”

“Like I said, she comes relatively often with such minor problems that we’d waste more time filling out forms than if we’d actually deal with her situation.”

She’d been warned of Trey Donovan’s unorthodox style, but she hadn’t expected to find an example of it so quickly.

“A few administrative people might be upset by the way you’re handling this individual,” she commented cautiously, to test his response. “Treating a patient without documentation. Legal liability issues, etcetera.”

He shrugged as if he was unconcerned. “I suppose they might be unhappy if Frances sues us for not removing a splinter properly. Until then, I guess you’ll have to decide if you’ll keep our secret or not.”

Sierra ignored the challenge in his voice. “Have you encouraged her to visit the outpatient clinic instead of the E.R.?”

“Frances has come here since she was a little girl so the concept is ingrained in her. Do you want to try and change her belief system at this late date?

“Besides,” he continued, “the clinic staff doesn’t know her like we do. They won’t take time for the minor things and if they do, they certainly won’t operate out of the goodness of their hearts. She won’t understand when they turn her away or ask her to pay, and then she’ll get upset and fall apart, which I can assure you is not a pretty sight. It saves so much wear and tear on everyone if we just do what needs to be done. A regular win-win situation.”

Sierra wanted to argue that Frances’s caseworker needed to be involved, but several things stopped her.

One, she was intrigued by how the ED staff had literally taken this woman under their wing.

Two, this was Trey’s domain. As the most senior ED physician, he knew his department’s strengths and limitations far better than she did. He also had the authority to establish policies and procedures, with or without his immediate supervisor’s approval. If he wanted to handle Frances in his own way, he certainly had the clout to do so.

This also seemed to be a prime opportunity to either build a bridge or a brick wall. She could stick to the hospital rule book, which would earn her brownie points from her superiors, or she could save her energy for more important battles.

On the other hand, if she caved in on this issue, was she setting a precedent? What if ten more people like Frances decided to visit the E.R. for their scrapes and scratches? They’d never have time or space to deal with the heart attacks, the broken bones or the car wrecks.

Would turning a blind eye signal that she was a pushover for a heartwarming story or a special case? The argument could be made that every person coming through the doors had special circumstances necessitating unusual solutions.

Can’t you be flexible for once in your life?

David’s voice whispered the last question and she instinctively stiffened. Unfortunately, his concept of flexibility had been his excuse for taking advantage of every opportunity that had come his way—opportunities that had covered everything from his business activities to moral decisions.

She’d always prided herself on meeting the needs of her patients, so how was this any different? If Frances had been one of her regular clients, would she have chosen differently than Trey and his staff had?

She let out a breath and nodded. “Let’s see Frances.”

Before she could take a step forward, he stopped her.

“If it looks like she has something serious, I want you to take over.”

“Why?”

“Because if I’m busy holding her hand to keep her calm, I can’t do my doctor thing.”