What happened in Vegas...

Has life-changing consequences!

An impulsive Las Vegas encounter that left practical Dr. Emily West married to world-renowned neurosurgeon Dr. Ryan Gary should have simply been a lesson learned—except now she’s pregnant with his baby! When Ryan arrives at Emily’s Seattle hospital to assist on a case, they’re reunited and their powerful spark reignites. But can working side by side with Emily convince lone-wolf Ryan he’ll be the perfect dad, now and always?

Born and raised just outside Toronto, Ontario, AMY RUTTAN fled the big city to settle down with the country boy of her dreams. After the birth of her second child Amy was lucky enough to realise her lifelong dream of becoming a romance author. When she’s not furiously typing away at her computer she’s mum to three wonderful children, who use her as a personal taxi and chef.

Also by Amy Ruttan

Tempting Nashville’s Celebrity Doc

Unwrapped by the Duke

Alejandro’s Sexy Secret

His Pregnant Royal Bride

Convenient Marriage, Surprise Twins

Navy Doc on Her Christmas List

The Surgeon King’s Secret Baby

A Mummy for His Daughter

A Date with Dr Moustakas

NY Doc Under the Northern Lights

Discover more at millsandboon.co.uk.

Carrying the Surgeon’s Baby

Amy Ruttan

www.millsandboon.co.uk

ISBN: 978-1-474-08978-4

CARRYING THE SURGEON’S BABY

© 2019 Amy Ruttan

Published in Great Britain 2019

by Mills & Boon, an imprint of HarperCollins Publishers 1 London Bridge Street, London, SE1 9GF

All rights reserved including the right of reproduction in whole or in part in any form. This edition is published by arrangement with Harlequin Books S.A.

This is a work of fiction. Names, characters, places, locations and incidents are purely fictional and bear no relationship to any real life individuals, living or dead, or to any actual places, business establishments, locations, events or incidents. Any resemblance is entirely coincidental.

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Version: 2020-03-02

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This book is dedicated to my son Aidan

and to all who see the world in a different way

that the rest of us aren’t privileged to see.

Contents

Cover

Back Cover Text

About the Author

Booklist

Title Page

Copyright

Dedication

PROLOGUE

CHAPTER ONE

CHAPTER TWO

CHAPTER THREE

CHAPTER FOUR

CHAPTER FIVE

CHAPTER SIX

CHAPTER SEVEN

CHAPTER EIGHT

CHAPTER NINE

CHAPTER TEN

CHAPTER ELEVEN

CHAPTER TWELVE

CHAPTER THIRTEEN

EPILOGUE

Extract

About the Publisher

PROLOGUE
Las Vegas, Nevada

SHE WASN’T COMPLETELY sure how she’d got here.

“And do you, Dr. Emily West, take Dr. Ryan Gary as your lawfully wedded husband?”

“Yep!” she said brightly, and she narrowed her eyes to get a better look at the Elvis impersonator standing in front of her. She couldn’t figure out why he was slightly sideways.

This is the most irrational thing I’ve ever done.

At least that’s what she thought, but Emily wasn’t completely clear right now. She glanced over at the man standing next to her and a silly grin spread across her face.

She didn’t know how she’d ended up in this wedding chapel with the most eligible, sexiest, charming neurosurgeon in the world, but right now she wasn’t feeling any pain. Which was good. Usually, she struggled with anxiety in any kind of social situation. It had been hard to attend his lecture on conjoined twins and then to talk to Dr. Ryan West after the lecture to tell him how much she admired his work.

After her relationship with Robert, another surgeon, had crashed and burned because of professional jealousy, the last thing she had expected was Ryan asking her for a drink. She’d told herself she shouldn’t, but had then thought one drink with a colleague couldn’t hurt.

It had been the other five that had hurt, but the more they’d talked about surgery and the conference, the more she’d felt comfortable around him.

She certainly hadn’t expected a marriage proposal either. At least, that’s what she thought had happened. It had been dinner, dancing, drinks and then making out in the back of his hired car. Now they were here, in a chapel off the strip.

And he was sort of leaning to one side too.

What is happening here? When did you lose control?

Emily smiled to herself. It was kind of fun to let loose. She never did have any fun. She hadn’t dated after her relationship with Robert had ended. She’d had no interest in other men and really didn’t understand the social nuances of dating, so she didn’t bother.

But then Ryan had seemed just as keen about her work as she was about his. And his smile, his confidence just made her completely weak in the knees.

Being around Ryan made her lose control.

“And do you, Dr. Ryan Gary, take Dr. Emily West as your lawfully wedded wife?”

“What?” he asked, leaning in a bit closer and squinting those bright blue eyes that had twinkled at her when they were having dinner.

Maybe it wasn’t her spinning, but Ryan who was doing the spinning. She closed her eyes for a moment but could still feel the room spinning. Maybe it was both of them.

The Elvis looked concerned.

“Of course! Of course I do.” Ryan grinned at her and she felt her knees go weak. Again, that could be from the mojitos. At least she’d thought it was a mojito.

“Then by the power vested in me by the State of Nevada, I now pronounce you man and wife.”

Emily threw her bouquet at the Elvis and Ryan scooped her up in his arms.

“This is the craziest thing I’ve ever done,” he said breathlessly as he carried her down the aisle.

“I think you’re supposed to carry me over the threshold and not down the aisle.”

“You’re light as a feather,” he whispered against her ear. A zing of electricity raced down her spine. Then he teetered slightly to the right and set her down. “Perhaps I should wait until the hotel room to carry you over the threshold. Those mojitos were strong.”

Emily laughed because he had said the word mojito again.

“What’s so funny?” he asked as he slipped his arm around her and they walked over to the hired car.

“Mojito is a funny word.”

“What?”

“You know when you say a word a lot it’s funny?”

“Mojito,” he said again, emphasizing the mo in the mojito.

Emily giggled.

The driver cocked an eyebrow as he opened the back door of the town car and they climbed in. Ryan was still chuckling.

“Man, those drinks were strong! I have a flight tomorrow...or is that today?” He glanced at his wrist.

“Today. I think it’s after midnight.”

He grinned lazily at her, making her heart skip a beat. “Does that mean you’re going to turn into a pumpkin?”

“Nope. Are you?”

He touched her cheek and kissed her. It was hot, heavy and in that kiss it all made sense. And suddenly she wasn’t questioning her decision to marry Ryan when he’d asked.

It felt so right and she hadn’t felt right with a man in a long, long time.

And Robert had never, ever had made her want someone this bad before.

He touched her cheek again. “I’m glad I asked you out to dinner and I’m glad we got married.”

Emily giggled again. “What happens in Vegas stays in Vegas, right?”

“Right!”

The car pulled up in front of the hotel. Ryan slipped out first after the driver opened the door for them.

“You sure you’re okay, Dr. West and Dr. Gary?” the driver asked.

“Couldn’t be better,” Ryan said.

Emily nodded. “This is awesome!”

And she wasn’t particularly sure if she’d used the word awesome before, but she liked the way that sounded, just as much as she liked the way mojito sounded. It rolled off the tongue.

The driver raised his eyebrows and then nodded.

Ryan slipped his arm around her and they walked into the hotel. They took the elevator up to his suite and Emily helped him open the door, as he was fumbling a bit with the card. When the door was open, he bent down and scooped her up in his arms.

Her pulse was racing. Anticipation coursing through her. This felt right. She wanted this. Maybe doing this would help her to move on.

“You’re sure?” Ryan asked, his blue eyes twinkling as he held her close.

“So sure.” She kissed him, running her hands through the hair at the nape of his neck. “I want this, Ryan. If I didn’t want this I wouldn’t be here.”

He smiled at her. “Then let me carry you over the threshold, wife.”

Emily felt giddy.

It was just one night. What harm could one night cause?

CHAPTER ONE
Seattle, six months later

“WOW.” EMILY LOOKED again at the ultrasound scan that her colleague Dr. Ruchi had sent her from her hospital, which was in a small town that was sandwiched between Portland and Seattle. She leaned back in her chair and stared at the ultrasound again.

“Yeah, the conjoined twins have two separate spines, they share a lot of nerves at the base of the spine. They also share a liver, part of their colon and there are three kidneys between the two babies.”

“I’m glad to see they have four fully formed limbs and separate genitalia.”

Dissecting a liver and separation was easier when the separation gave each twin the chance of being able to survive on their own. The twins didn’t share a heart or a brain, and shared organs that could easily be split. It was promising, risky but promising.

It was whether or not all limbs would be fully functional or whether the twins survived their birth. That was the scary part, surviving.

“Yes, that is a positive,” Dr. Ruchi said.

“And the parents have consented to being moved up to Seattle and me preforming the surgery?” Emily asked as she zoomed in on the most recent scan of the babies in utero.

“Yes. The mother was informed that her twins were conjoined and she was given all the details about the risks of separating them postdelivery, but chose to proceed with the birth.”

Emily felt a faint kick and looked down at her belly. At six months pregnant there was no longer any hiding her baby bump. And it hit her hard when Dr. Ruchi said that the patient had chosen to proceed with the birth. What a hard decision for a mother to make. She was glad that she didn’t have to be put in that position to make a choice. Her baby was, so far, healthy.

“When are you planning to deliver them?”

“Well, I’m not. I would rather send the parents up to Seattle and have her in your care. My hope is that the mother remains on bed rest with yourselves pending a delivery by C-section in a few weeks, once the babies are more developed. It’s important that the twins are delivered there so they can benefit from your immediate expertise. You’re one of the best pediatric surgeons in the country and have done successful separations before.”

“Sure, of course. I would be happy to, but my concern is about the bundle of nerves that the twins share. That worries me. I can work with them on separating the liver and kidneys, even the colon, but for the nerves I would need a world-class neurosurgeon who was familiar with this kind of work to assist me with that part of the operation.”

“I have a neurosurgeon for you.”

As soon as Dr. Ruchi said the words, Emily’s stomach did a flip, a flop and then nose-dived to the bottom of her shoes and she found herself trying not to let her breakfast make a second appearance.

“You...what?” Emily asked, relieved that Dr. Ruchi could not see her expression over the phone, because she knew exactly who Dr. Ruchi was referring to.

“Dr. Ryan Gary. He’s agreed to fly to Seattle from San Diego and help with the case. This is my patient, I delivered her first child and I really want you and Dr. Gary to handle the separation.”

Dr. Ruchi was right about Ryan. He was the best. He’d done separations before. She just didn’t know if working with a man she had just sent divorce papers to would be a touch too awkward.

Her previous relationship had ended badly. So badly it had crushed her. Which was why Emily had been wary of getting into any kind of personal relationship with another surgeon.

Not just wary...determined she was never going to again. So her one-night stand with Dr. Ryan Gary had been a huge mistake. It had been an amazing night, but it had been bad for her afterwards. She was pregnant and alone. She regretted it.

No, you don’t.

She wasn’t going to disappoint Dr. Ruchi by telling her that she couldn’t work with Dr. Ryan Gary because he’d been the one to knock her up after a drunken night in Las Vegas. That night in Vegas had been the biggest mistake of her life.

And when she’d reached out to Ryan to tell him about the baby, she’d found he’d left for a tour of duty providing medical aid abroad in war-torn countries. He’d never responded to her, even when she’d sent him divorce papers.

Which was fine. She’d get the divorce finalized one way or another.

Emily hadn’t planned to have a family now, or raise a baby alone, but waiting around for Ryan to respond to her wasn’t going to stop her from doing just that.

“Emily, are you okay?” Dr. Ruchi asked, interrupting her train of thoughts.

“What?” she asked. “Yes, sorry. Dr. Gary, you say?”

“Yes. Is there a problem?” Dr. Ruchi asked. Emily could hear the concern in her friend’s voice. It had taken Emily years to pick up on social cues like this. She didn’t always get them, but since Robert had left her five years ago, and now, on the verge of becoming a single mother, she could tell when someone was concerned about her. She saw it enough in the way people spoke to her, like they felt sorry for her.

“Nope. I might have to clear it with the chief of surgery first. I mean, we do have pretty top-notch neurosurgeons at SMFPC.”

Liar.

Yeah, she did have a problem with his arrival. When he hadn’t responded to her emails about being pregnant she’d assumed he’d wanted out.

Emily had been hurt again by a man, but she could raise this baby on her own. She didn’t need help. She didn’t want Ryan back in her life, but it would be best for the patients. He was an excellent surgeon.

“I’ve already cleared it with your chief,” Dr. Ruchi said gently. “I wanted to make sure that I had you on this case. I didn’t want him to pass off my patient to another pediatric surgeon!”

Emily chuckled. “Ana, you know that I’m Head of Pediatrics.”

Ana sighed and then laughed. “Okay, so I wanted to make sure that he’d allow Dr. Gary to practice there too.”

“And it’s okay, I take it?” Emily teased.

“It is. Thank you for doing this, Emily. There’s no one else I trust. Both you and Ryan have done separations and done them successfully, with both twins surviving. I know that you can do this.”

“I know that I can too,” Emily admitted. What she didn’t say was that she wasn’t sure that she could do this with Ryan.

Although he was one of the best at separation surgeries. It was just that part of her wanted to throttle him for not responding to her. She wasn’t sure that was conducive to a good working environment.

It can be if you ignore it. He’s a surgeon, you’re a surgeon. He’s a professional and so are you.

She shook that thought from her head. Her admiration for him, her attraction to his confidence, his charm and his devilishly handsome good looks was what had got her into this mess in the first place.

When she had been with him she hadn’t felt awkward or anxious. It was like his confidence had rubbed off on her. He’d made her feel desirable.

“When will they arrive?” Emily asked.

“I’ve emailed you her chart and all the paperwork. I’m planning on sending them by air ambulance tomorrow, but Dr. Gary will be arriving sooner. He arrived in Portland last night, when I spoke with him about the conjoined twins. He’s taking the helicopter in. He should be there soon. He’s accompanying another pediatric patient with a spinal injury who arrived this morning. Thank goodness he was here.”

Emily glanced at her pager. That was another patient she’d been waiting on.

Great, he was going to be working with her on that case too?

“Okay. Thanks, Ana. I’ll take care of your patient. Just let me know when you think the transport with your patient will be arriving and I’ll meet her.”

“Will do. Thanks, Emily.”

Emily disconnected the call and then groaned, burying her head in her hands.

This can’t be happening.

After the debacle with Robert, when he hadn’t been able to handle her promotion and her acceptance as a pediatric attending, she’d sworn she would never open her heart to a fellow surgeon again. She didn’t want to deal with professional jealousy in her personal life.

It was awful.

For five years she’d managed not to date anyone. She didn’t trust men. Until that conference in Vegas when Ryan had swept her off her feet. She had been a weak fool and he’d been, oh, so charming.

When Ryan hadn’t responded to her messages about the baby she’d mentally kicked herself for falling into that trap again.

It had hurt to know that she’d been used like that, but she’d moved on. She wasn’t going to wallow in self-pity, she had her work and this baby. She was going to make sure that she was a strong role model for her child, even if it scared her senseless to do this on her own.

Now he was on his way here and there was no hiding her pregnancy.

At least with him in Seattle she could finally get him to sign the divorce papers.

You’re a professional, Emily. You’ve got this.

She took a deep, cleansing breath. This would be no different than dealing with the angry, pushy parents who screamed at her staff because their child’s elective surgery had been canceled because a child with traumatic injuries was being rushed to the hospital.

She could deal with those people with grace, decorum and a firm hand, so she could deal with Ryan and his arrogance.

He might be a neurosurgeon, and he was one of the best in the world, but she was a more than competent pediatric surgeon, who had carried out the most successful separations of conjoined twins on the western seaboard.

She could handle Ryan for a short period of time for the sake of a patient.

Can you?

She could deal with patients and their parents because it was her job. When it came to her relationships, things went downhill fast.

Robert had often belittled her near the end of their relationship. He’d made fun of what she lacked. Differences between herself and others she’d fought hard to understand her whole life.

That moment she’d met Ryan in Vegas it had become personal and she wasn’t sure she could handle him. She was afraid he’d see what she lacked.

He’d see her vulnerabilities.

Her pager went off. The air ambulance was coming in.

Her heart did a flip-flop.

Deep breath. You’ve got this.

Emily picked up her pager and placed it in the pocket of her white lab coat. She stood up and stretched. Her baby did a little scramble across her belly and she couldn’t help but smile.

Yeah. She could do this.

She’d faced a lot worse, a lot more adversity, dealing with her mild form of high-functioning Asperger’s, which meant she’d never quite fitted in. But she could handle this.

Slipping her stethoscope around her neck, she left her office and headed straight for the elevator that would take her to the helipad on top of the SMFPC.

“Teal, you’re with me,” she said, speaking to Dr. Amanda Teal, a surgical intern who was hovering around the nurses’ station, working on her charts. “Bring a gurney and meet me on the helipad, stat.”

“Of course, Dr. West.” Teal ran off. The doors to the elevator dinged as they opened and Emily got on, pushing the button and code for the roof. Her nerves were shot. She stepped into the alcove and waited. It was a sunny day, and from her vantage point on the roof of Seattle Maternal Fetal Pediatric Center she could see Puget Sound clearly and the ferries on the water.

She closed her eyes and drank in the peace and quiet of a late spring morning. Then she heard the distant whirr of the helicopter and she could see the bright orange of the medical helicopter coming across the Seattle skyline.

Her heart skipped a beat.

Get a grip.

In response, she crossed her arms and bit on her bottom lip as she grounded herself to deal with facing Ryan again.

This was just about work. This was about saving lives. Children’s lives, and that was a job she took seriously. There were going to be no pleasantries. Nothing.

As the helicopter came closer, getting ready to land, she moved back to the shelter of the elevator alcove, her short blonde hair being tossed out of the neat and tidy angled bob as the wind picked up.

Dr. Teal was waiting in the alcove with a gurney.

Emily nodded to her, because it was no use talking to her over the roar of the chopper blades as the medical helicopter gently landed on the roof.

Once the helicopter had landed, the blades of the chopper began to slow and the doors of the helicopter opened.

“Come on,” Emily shouted to Dr. Teal as the engines began to power down.

They ducked and ran toward the open door. The paramedics were in action, getting ready to transfer the child to her care.

As she approached the helicopter, she caught sight of Ryan and her heart did a flip-flop again. He hadn’t changed much in the last six months. He was just as handsome as ever. He took her breath away. His light brown hair was perfectly tousled, those stunning blue eyes focused on the patient and paramedics. Ryan still had the scruff on his strong jaw, but it didn’t hide the delectable cleft in his chin.

Get a grip.

And just as she was telling herself that, his gaze went from the patient to her. His blue eyes widened in shock, but only for a moment. It was if he was surprised to see her, like he hadn’t expected her to be here, but she found that hard to believe. She looked away and moved toward the paramedic as she and Dr. Teal stepped up to take over care of the patient.

The only way she was going to survive this was to treat him like every other surgeon she dealt with, at a distance and professionally.

Which was what she should’ve done six months ago in Vegas, instead of letting down her guard and letting him sweep her off her feet.

Maybe because you needed that?

Emily shook that thought away.

“Patient is male, ten years old and sustained a spinal injury while riding an ATV. Patient suffered a break in his spine between C7 and T3. Dr. Gary has induced a state of medically induced coma and hypothermia,” the paramedic said as they slid the stretcher out of the helicopter onto the gurney.

“Hypothermia?” Emily asked.

“To preserve the spinal cord so maybe he can walk again,” Ryan said from across the stretcher as he helped load the patient onto the gurney.

Emily didn’t say anything to him.

“We’ve got it from here,” she said to the paramedic.

The paramedic nodded and handed her the chart. Emily placed it on the end of the gurney and began to wheel the patient toward the elevator. She could feel that Ryan was looking at her but she didn’t care. They had to get this patient to the ICU and stabilized. The only things she wanted to discuss with Ryan was work and signing the divorce papers.

That was it.

And now was not the time to discuss the divorce.

Dr. Teal had called the elevator and the three of them got the patient’s gurney onto the elevator while Emily pushed the code for the floor holding the ICU. As the doors shut, she could hear the roar of the helicopter engine come to life again. She wished that Ryan had got back on that helicopter.

Inducing hypothermia on an adult in a traumatic spinal injury often had a good outcome, but a pediatric patient? It was frowned upon.

What was Ryan thinking? Was he this arrogant that he believed he was God or something?

“What the heck were you thinking, inducing therapeutic hypothermia in a pediatric patient?” Emily berated. She was so angry, but it really wasn’t about his method of treatment. She wanted to scream at him for ignoring her for the last six months.

For not responding about the baby.

For hurting her. But she couldn’t say those things in front of Dr. Teal so she attacked him over his treatment choice to blow off the anger she felt in that moment of seeing him again.

Dr. Teal’s eyes widened and for one moment Emily felt bad for exploding in front of her intern, but it was only for a moment, because when she looked across the gurney at Ryan he was smiling. That charming, arrogant smile that had got her into trouble in the first place.

“It’s good to see you too, wife.”

CHAPTER TWO

WHY DID HE have to be so cocky?

The moment he said the word, he was sure that fire was going to come shooting out of Emily’s nostrils and he really understood the meaning of that old saying, If looks could kill, from the way she was glaring at him. But, dammit, she looked just as good as ever.

Her blonde, almost platinum-colored, hair was shorter, but it suited her and he couldn’t help but remember the way that if he kissed her just below her earlobe it made her sigh in pleasure. He’d been a fool to walk away from her.

You weren’t the only one who walked away, remember?

When he’d woken up in that Las Vegas hotel room, he had been alone and the only thing left of her had been the marriage certificate on the night stand.

He’d tried to reach out to her but she hadn’t responded, and by the time she’d reached out to him, he’d been boarding a plane heading to the Middle East.

And Emily had never reached out to him again until he’d received the divorce papers a week ago. That was the first he’d heard from her. It had been around the same time that Dr. Ruchi had asked him to consult on the conjoined twins case.

He’d figured it would be nice to hand deliver the divorce papers to her and put an end to that reckless night in Las Vegas, and also lay her ghost rest, because for the last six months she’d been all he could think about.

The fact that another woman haunted him so much scared him, because he remembered the last time that had happened.

He’d thought Morgan had loved him. She’d fallen pregnant and, without telling him, she’d terminated the pregnancy and left.

He never wanted to get involved with another woman again. Not in a serious relationship anyway. One-night stands were fine, but marriage?

What had he been thinking?

It was a relief that Emily seemed to want the same thing.

He had mentally prepared himself for the worst by coming to Seattle and facing his demons, but he hadn’t been prepared to really see her again, because when he’d first seen Emily in Vegas he’d been a lost man. She had been gorgeous and though she’d been a bit shy, there had been something about her that had made him want to know her better.

He’d fallen for her intelligence, her beauty, her charm, her lack of dancing skills, but, just like every other woman, she’d used him and she’d left.

He’d become used to leaving first. He wasn’t used to it being the other way around. It suited him, though, because he’d been unable to deal with that heartache Morgan had inflicted on him.

Emily opened her mouth to say something else and then glanced over her shoulder at the intern, who was at the end of the gurney, and thought better of it.

The doors to the elevator opened and they wheeled the gurney toward an open room in the ICU where they could get his patient settled and Ryan could reverse the hypothermia and get busy repairing this young boy’s spine.

“Dr. Teal, would you get Dr. Gary some scrubs and a surgical cap?” Emily asked as they made sure the patient was stabilized.

“Of course, Dr. West.” The intern left the ICU room and the team of ICU nurses took over as Emily picked up the patient’s chart and motioned him to follow her. She set the chart down at the nurses’ station and turned to face him, her arms crossed, and it was then he noticed the round swell under her scrubs.

His heart skipped a beat. He couldn’t believe what he was seeing. She was pregnant and she hadn’t told him? Just seeing her like that caused a flashback.

“You could’ve told me you were pregnant!” Ryan shouted as Morgan packed up her belongings.

“Why? We’re not married and I don’t want to be a mother. My career is my focus now.”

“I have a right to know!”

“You do. I just told you, but it’s done. Now we can both move on.”

He shook that memory away. He hadn’t wanted to be a father, but by the time he’d come back to New York after a business trip Morgan had already terminated the pregnancy and the relationship.

He’d been kept in the dark.

Apparently, history was repeating itself.

And he was scared by the prospect. He just had to handle this delicately.

“You look good, Emily.”

“Don’t,” she said, shaking her head.

“What?”

“You know what.” She looked toward the ICU pod. “That is a pediatric patient.”

“With a traumatic spinal cord injury,” he answered, confused. “I did what was best for transfer from Portland.”

Emily bit her bottom lip and shook her head. “Therapeutic hypothermia is not tolerated well in pediatric patients.”

“The boy is ten,” Ryan snapped. “He’s not an infant and I put him in a medicated coma. He’s old enough to tolerate it for a short time and he’s young enough to bounce back. There won’t be significant loss in brain function that he can’t recover with extensive physiotherapy, which he was going to need if I left him a quadriplegic.”

She sighed and her expression softened. “I assume you got the parents’ permission.”

“This is not my first time performing this on a preteen pediatric spinal cord injury. We’ll reverse the hypothermia and I’ll repair the spine,” he snapped, annoyed she was questioning him. And he realized this argument had nothing to do with his treatment plan of the patient and everything to do with the pregnancy and divorce papers.

She was angry.

Well, he was angry too.

“Is it mine?” he asked, catching her off guard.

“Yes.” She blushed, the pink creeping her way up into her high cheekbones. “So, you did get my emails?”

Ryan cocked an eyebrow. “What emails?”

“I sent you an email when I found out I was pregnant and then several others. There was no response so I assumed you didn’t want anything to do with me and the baby.”

“You assumed?”

“You didn’t answer me,” she hissed.

“I didn’t get the emails, Emily. I didn’t know that you were pregnant.”

Emily was going to say something further when Dr. Teal returned with scrubs.

“I have the surgical scrubs, Dr. West.”

“Thanks,” Ryan said, taking them from the intern. “Can you prep an operating room for me?”

“Of course, Dr. Gary.” Dr. Teal left and Emily glared at him.

“She’s a surgical intern. She’s here to learn under my guidance today.”

“And isn’t it her job to prep the operating room? It was when I was a surgical intern,” Ryan said.

Emily’s eyes narrowed. “You’ll want a resident. Dr. Sharipova is one of the best and most promising pediatric surgical residents. He’s been an invaluable asset to me.”

“Thank you. I’m sure he’ll be great help, but I would also like you in there. I was told that you would be in the operating room with me on this and I told the patients’ parents that the best pediatric surgeon on the western seaboard would be assisting me in the operating room.”

“Of course I’ll be in there.”

“Good.” There was more that he wanted to say to her, but he didn’t want to say it in the middle of the ICU with patients and other staff members around them. This was not the place to talk about their baby or their marriage.

Of course, after calling her his wife in front of her surgical intern that secret was going to spread around the hospital like wildfire.

“Can you show me a place I can get changed into my scrubs and possibly store my stuff? All my luggage is being shipped to my rental in Seattle, so I don’t have a bag or much with me.”

Her expression softened again. “Sure, I’ll show you where the attendings’ lounge is. Follow me.”

Emily could feel all the eyes on her as she and Ryan left the ICU. She was pretty sure that most of the staff by now knew what he’d called her. Not that she could blame Dr. Teal for saying something. It was pretty shocking and she felt bad that Amanda had been mixed up in that tense moment.

She was feeling bad for calling Ryan out and for putting Amanda into the middle of all those emotions she was feeling.

Although she’d never used therapeutic hypothermia on a patient, she shouldn’t have questioned his tactics. He was a brilliant surgeon. Her reaction was not keeping her emotions out of the mix. If anything, it was causing more problems.

Her plan had been to treat Ryan like any colleague and it was rare that she called out another practitioner on their methods in public like that. Especially when neurosurgery was not her specialty. And especially since it wasn’t even about that. She was angry he’d never responded to her and then he’d made her look like a fool in front of Dr. Teal. She’d hated it when Robert had done that to her.

Usually she was calm, cool and collected. She prided herself on professional behavior. Behavior she’d worked so hard to learn. What she’d just pulled was not her usual behavior and she was annoyed with herself for letting her emotions get the better of her.

The attendings’ lounge was, mercifully, empty.

“There’s an empty cubby over there.” She pointed to the one that was furthest from the door but she stayed close to the door, because it was an escape route.

“Thanks.” Ryan walked over to the cubby, slipped off his leather jacket and placed it inside. “I did get one message, by the way.”

That shocked her. “Oh?”

“The divorce papers.”

“But not news of my pregnancy. I sent you ten emails.”

“I told you the night we got married that I had to catch a flight. I was overseas and in an area where internet connection was spotty. I wasn’t trying to ignore you.”

He was unbuttoning his shirt to put on his scrubs and Emily tried not to watch. She wanted to believe him.

“I’d had a lot to drink that night. I don’t remember you telling me that.”

“I remember, sort of. I guess we’ both had a lot to drink that night because an Elvis impersonator married us? Really? That sounds tacky.” It was a joke meant to break the tension and it did.

A smile tugged at the corners of her lips and she couldn’t help but laugh just a little. “Right. Completely tacky.”

“I’m glad you decided to keep the baby,” he said softly.

“Of course I would.”

A strange expression crossed his face as he slipped off his shirt and then pulled his scrub top over his head. For a moment Emily thought that he didn’t quite believe that she would’ve kept this baby. Everyone had a choice, but she knew she’d wanted this child the moment the stick had turned blue.

Was it planned? No, but she was happy to be pregnant. She liked kids, which was why she’d become a pediatric surgeon.

“After this surgery we really need to sit down and talk,” he said.

“Right. About the conjoined twins. I have to go over the chart...”

He cocked an eyebrow. “What’re you talking about?”

“The conjoined twins case. What’re you talking about?”

“I’m talking about our marriage and the baby.”

Her heart skipped a beat and she could feel the warmth creeping up her necks into her cheeks. “Ryan, we don’t have a marriage.”

“We’re still married. We can’t get an annulment and I’m not sure about signing the divorce papers.”

Of course.

He had to make this difficult by not signing the papers. It was frustrating.

“Is that what you want to talk about? You want to talk about the divorce? It’s all laid out in the papers.”

“No, I don’t want to talk about a divorce, Emily,” he said in frustration. “I want to talk about you and me and the baby. About what we should do.”

She couldn’t help but laugh at that. “There is no you and I, Ryan. We made a silly mistake in Vegas.”

“I don’t think it was silly,” he said seriously.

“What? You can’t be serious.”

“I am serious, Emily. I want to raise our baby...” He paused and looked a bit uncertain. “I want us to raise our baby together.”

CHAPTER THREE

EMILY DIDN’T WANT to talk about it. She thought the whole idea was absurd. He wanted to talk about their relationship? He wanted to make it work? To raise a baby together? They didn’t have a relationship. They’d met, had a few drinks and had a one-night stand. And she wasn’t even sure she totally believed him about not getting her emails.

He’d acted surprised, though.

Although Robert had been a good actor too. She’d been duped before. Emily bit her lip. She wasn’t sure what to think.

Other than the work he’d published and the talks she’d listened to, she knew nothing about him and he knew nothing about her. That was not the basis for any kind of relationship. Her parents were best friends. They’d taken their time to get to know each other and they’d had a long, happy marriage.

They still had a good marriage.

Ryan and she didn’t have that.

They’d had one night together. That was the basis for nothing.

There was a tiny kick and she looked down at her belly. Well, maybe it wasn’t completely nothing, but still she didn’t want to talk about this with Ryan. They didn’t have a real marriage. Why did he seem so keen to get involved now?

“We’re not talking about this,” she said quickly. “I’ll meet you down in the OR.”

“I don’t know where the OR floor is and I don’t have access to it.”

Dammit.

“Finished getting dressed,” she said through pursed lips.

“Emily—”

“No,” she snapped. “The only thing we’re going to talk about after this surgery is the conjoined twin case. It’s a very important case and the mother is arriving tomorrow. If the babies survive the birth and make it through their first week of life, we have to talk about a plan to do the separation. That’s all I want to talk about right now. Just patients, just cases. That’s it, Ryan. That’s all I can handle.” And it was true. She was feeling overwhelmed. She hadn’t felt this way since Robert had betrayed her and she hated this feeling.

His eyes narrowed and he undid the buckle to his jeans. “Fine.”

Only she had a feeling by the way he’d said “Fine” that this wasn’t over and that this discussion was going to continue. He was persistent enough. It was something she’d admired about him. He was driven and that’s why he was the best there was in neurosurgery and why she’d striven to continue to rise in her chosen field.

There had been so many people who’d said she couldn’t be a surgeon when she struggled with Asperger’s, when she struggled with social anxieties, but she had risen above so much to get where she was. She worked longer hours. She worked hard.

To be perfect. To be the best.

Her pregnancy made her human and that had been a hard pill to swallow, but she’d never shied away from her mistakes, but to think that she and Ryan had something more than just a momentary attraction was silly.

It’s not momentary. You’re still attracted to him.

And her cheeks heated as he picked up the scrub pants. She cleared her throat and looked away. “I’ll be out in the hall and then we can head down to the OR.”

“Fine,” he said, but there was a devilish twinkle in his eyes as if he knew that he was affecting her and she hated that.

She slipped out of the attendings’ lounge and leaned against the wall, closing her eyes and trying to catch her breath. When she opened them again, she could see a few of the interns, nurses and even physicians watching her, whispering as they looked at her belly.

Dammit.

She hated being the center of attention when it came to gossip. She didn’t mind it when it was about her work, but when it involved her baby and now her supposed marriage to Ryan, it bothered her.

The door to the lounge opened up and Ryan stepped out wearing scrubs instead of his street clothes. He looked good in the dark blue of the SMFPC attending colors. The color brought out the intensity of his cerulean eyes.

“You okay?” he asked.

“Fine.”

Liar.

“You look a bit pale. Are you overdoing it?”

“No. I’m fine. Let’s go, they’re waiting for us in OR two and I don’t want that patient in therapeutic hypothermia any longer than he has to be.”

“Lead the way.”

Emily led Ryan down to the OR floor. They didn’t say anything to each other, but she could feel the stares as they passed through the halls. Gossip spread like wildfire in this hospital and she would have to have a word with Dr. Teal.

They stopped just outside the wide hall that led toward the many operating rooms. She pulled on her scrub cap and showed Ryan where to get a generic one. She hung up her white lab coat, changed her shoes. Ryan covered his shoes with booties. He’d have a pair of sneakers that would be just for the OR floor.

“You ready?” she asked.

“Always.” He smiled at her and it was full of confidence.

“Come on.” She punched in a code and opened the door. She always liked this walk down the hallway. It was calming. There were gurneys and equipment waiting in the wings, sometimes there would be a gurney roll by that was accompanied by a parent and a child life support person as SMFPC supported the parental presence at induction, and those cases always made her smile.

There was fear in the parents’ eyes, hidden behind their masks, but they were strong for their children and their presence really promoted the well-being and health of the children.

Then there were cases like this little boy they were attending.

Priority A, where a young life was on the line.

She ran a hand over her belly and glanced up at Ryan, whose gaze was on her belly, before he met her eyes briefly. There was pain in his eyes, but also fear.

“The scrub room is here,” she said, breaking the tension that fell between them.

He nodded and walked into the room before her. The scrub room overlooked the operating room where their young patient was lying. The rest of the operating room team was prepping him and the anesthesiologists were waiting.

Ryan was scrubbing, staring at his patient intently, as she often did herself. She would play out the surgery in her mind, like a playbook.

“Do you think you’ll be successful?” she asked, because she knew he was a great neurosurgeon but she’d never worked with him before and none of the neurosurgeons at SMFPC would ever attempt therapeutic hypothermia on a child younger than sixteen. Ryan was a bit of a maverick. Maybe that’s why she’d been so attracted to him in the first place. He was so different from Robert, who had always done things by the book.

So different from her.

“Of course.” He smiled confidently. “I’ve done this before.”

“Good, because I’ve never done this.”

“You’ve never done a spinal decompression and a repair of a fracture?”

“Yes. I’ve assisted with that, but I’ve never dealt with a child in hypothermia like this.”

“It’ll work, Emily,” Ryan said gently, before he shook off his hands and toweled them dry. “Trust me.”

Emily continued scrubbing as he headed into the operating room. He’d asked her to trust him and she wanted to do that, for their patient’s sake, but she had a hard time trusting someone she didn’t know.

She liked routine. She liked certain anesthesiologists, certain residents, certain scrub nurses in her operating room. The routine gave her a sense of calm, and she’d never worked with Ryan before.

He’s the best.

And that’s what she had to keep telling herself. She shook off her hands and then headed into the operating room. Her favorite scrub nurse, Nancy, helped her into her gown and gloves. Emily also had to remind herself that she was not lead surgeon here.

Ryan was.

She might be the head of pediatric surgery, but he was the neurosurgeon and she had to put her faith in him and what he thought was best. He’d been there when the accident had come in. He’d got all the permissions from the patient’s parents. He knew the chart best.

Emily looked up into the gallery and could see the chief of surgery watching, as well as a few of the interns and residents.

They’d come to see the show.

Ryan’s reputation preceded him.

She had to get a grip on all her self-doubt and focus on this moment, because soon there would be a set of babies on this table and it would be a team, led by her and Ryan, as they worked to separate the babies and give them a chance at life.

She approached the operating table and took the second position across from him. Dr. Sharipova was there, as well as Dr. Teal, but Dr. Teal would just be observing.

“Dr. Teal, would you read off the chart for the record?” Ryan said, totally ignoring the fact Dr. Sharipova was the resident and should be reading it out for the OR record.

Dr. Teal looked toward her and Emily nodded. “Go on, Dr. Teal.”

Amanda nodded. “Jason Klassen is a ten-year-old male patient with a break in the spine from the C7 to the T3. Patient was placed in a medicated coma and induced into therapeutic hypothermia in Portland for transfer. This surgery will reverse the hypothermia and we will attempt to repair the damage to the spine.”

“Not attempt, Dr. Teal,” Ryan said brightly. “We will.”

“Right,” Dr. Teal responded, her voice catching.

“Ready when you are, Dr. Gary,” Emily said.

Ryan nodded. “Scalpel.”

* * *

Emily might not want to admit that she was tired and hurting after hours in the operating room, but Ryan could tell that she was.

She was sitting on a bench just outside the OR and was hunched over. Her head was propped up by one arm and her eyes were closed. He could tell by the way her shoulders moved that she was taking deep breaths.

It had been a long surgery, but it had been successful. The tests on the nerves showed function in the patient’s legs. It was just a matter of time before they could bring him out of the coma and see what damage had been done to his brain, but Ryan didn’t believe that there would be any damage. Therapeutic hypothermia worked.

Right now, that wasn’t his concern. He was worried that Emily was pushing herself too hard and that she was putting herself and the baby in jeopardy.

He straddled the bench beside her. It took all his willpower not to reach out and touch her, but he thought the gesture would not be a welcome one. In fact, the moment he’d arrived he’d had the distinct feeling that his presence here was unwelcome.

And he aimed to change that. He’d give her the support she needed while he was here. He owed her that much. He was terrified about being a father and he wasn’t sure he knew how to be a good one.

His own father had abandoned him and his mother instead of ranching on his mother’s family’s land. He knew nothing about being there for a kid. He wasn’t sure he could.

Morgan never gave you the chance to decide.

Maybe that was for the best. His life was too transient. He liked it that way.

Do you?

He shook his head.

He was a fool.

“You okay?”

“Fine.” She sat up straight, but he could see that she was exhausted.

“It’s a long time on your feet.”

“I’m aware of that.”

“When did you eat last?” he asked.

Emily shook her head. “Lunch, just before I got the call from Dr. Ruchi about the conjoined twins and before you decided to grace me with your presence.”

He chuckled. “Come on, let’s get something to eat.”

“There’s no time. The patient’s parents have arrived and are in the waiting room. I think we have to go talk to them and take them to their son.”

“We can go talk to them, but one of the interns can take them to their son in the ICU. After we talk to them, you’re getting something to eat. Doctor’s orders.”

Emily sighed and stood up. “Fine.”

“You’re not going to argue with me?” he teased.

“No, because you’re right and I’m starving. Let’s go talk to the Klassens. Dr. Teal can take them up to see their son.” Emily stood up, but she closed her eyes and the blood drained from her face.

Ryan reached out and held her steady. “Whoa, you’re definitely not fine.”

“Just a bit dizzy. Okay, you’re right. Today I pushed it too far. I haven’t been present in a pediatric orthopedic or neurosurgery since I got pregnant.”

He helped her sit back down. “I want you to stay here. I’ll go speak with the parents and then I’ll be right back.”

She nodded. “Okay.”

“I’ll be right back. Don’t move.”

“I won’t.”

* * *

He didn’t want to leave her, but he had a duty to his patient’s parents. They were probably sick with worry. He took Dr. Teal with him so that the young intern could take Jason’s parents to the ICU, and because Dr. Teal was with him it didn’t take him long to find the waiting area.

He explained to Jason’s parents the procedure and the outcome. Jason’s family would be in Seattle for some time while Jason went through extensive physiotherapy after he healed.

At least with kids they bounced back.

After Dr. Teal had taken Jason’s parents up to the ICU, Ryan turned round and went back to the operating room floor, using Emily’s pass.

She’d stayed where he’d left her.

Only she was sitting on the floor, her back to the wall and her head between her knees. He rushed over to her and knelt down.

“Emily?”

“I really need to get something to eat.” A weak smile tugged at her lips and he couldn’t help but smile at her.

“Come on. I’ll take you to the nicest place in town.”

“Don’t you have to stay while your patient is in the ICU?” she asked as he helped her to her feet.

“I do, but the nicest place in town isn’t far.”

She laughed. “I hate to disappoint you, the cafeteria is not the nicest place in town.”

“Well, it will have to do until I can take you to the nicest place in town. Where is that, by the way?”

She chuckled again and shrugged as they began to walk slowly away from the OR. “I don’t know. I’ve been in Seattle for five years but I haven’t got out and done much.”

“You’re not from Seattle?” he asked.

“No, I’m from Salt Lake City and, no, before you ask, I’m not Mormon. My parents are, but I never connected with the religion or any religion, just science.”

Ryan nodded. He understood that. Science had exerted the same sort of pull on him. His mother had wanted him to farm her family’s land, but by the time he’d hit eighteen it had been apparent that he was not suited to a life of ranching. That was about the time his mother had stopped talking to him and when he’d learned to fend for himself.

“Well, asking about your religious affiliation was the furthest thing from my mind.”

“Sorry, it’s just when I tell people where I’m from, that’s the first thing I’m asked.” She glanced up at him. “Sorry I’m walking so slowly.”

“It’s fine. Take your time.” He couldn’t help but wonder why she was apologizing so much.

“It’s frustrating,” she admitted. “I would spend my time racing around this hospital. I could get from the ICU to the emergency room in five minutes and now I’m significantly slower.”

He felt like he should apologize, but he hadn’t been the only willing party the night they’d conceived their child. What he did feel bad about was missing the first six months of her pregnancy, for her doing this on her own.

He was ashamed about that and angry at himself. He might not be sure about being a father, but he’d never meant to leave her alone. If he’d only known...

“Let’s get you something to eat.”

They walked into the cafeteria and Emily sat down. Ryan went to the counter and grabbed a couple of sandwiches and some water. He brought it back to her and sat down next to her.

“Thanks for this,” Emily said. “They really do make good sandwiches.”

“Still, there’s probably somewhere better and I’m going to have to find it and take you to it.”

She raised her eyebrows. “Why?”

“Emily, we have a lot to talk about.”

“Other than work, we don’t. I meant what I said in those messages, I can raise this baby on my own. We both made a mistake—”

“I don’t walk away from my responsibilities.” He was annoyed that she was giving him an out. He didn’t want an out. Well, he did, but he didn’t either. Right now, he wasn’t sure what he wanted. But he was here now.

The last time that had happened, he’d lost a child and it had hurt. He was going to take responsibility for this one.

There wasn’t any way he was going to walk away. He was going to help Emily for as long as he could.

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