The Surgeon and the Cowgirl. Heidi Hormel

small horse for his therapy session. He was beaming. Obviously, sitting on a horse was better than anything that even Santa could’ve brought him. Payson had spoken with Karin about Alex’s comments and discovered the foundation that had been covering the cost of the therapy had to make some tough decisions about what they would fund. Alex and his riding hadn’t made the cut.

      While Payson may not have been completely convinced of riding’s therapeutic outcomes, he could see that there was a psychological benefit in Alex’s case. Recently, the little boy had been more positive about his limitations and even more willing to do his conventional therapy. Payson needed actual research before formally agreeing that Hope’s Ride made a difference for patients’ physical recovery and progress, but in some very specific cases, he could see that the therapy did influence outlook and attitude. The question was whether that improvement made the program worthy of affiliation with a hospital like Desert Valley. If it did, money situations such as Alex’s would likely go away.

      “Let me give the foundation a call,” Payson had finally told Karin as tears streaked down her face. “I’m not promising anything, but maybe I can give them the assurance they need.”

      “Dr. MacCormack, if you call them, I know they won’t say no.”

      “I don’t know about that, but I’ll certainly see what I can do,” he said, and then asked her questions about Alex’s recent regression to the wheelchair. He hadn’t seen anything on the X-rays after the boy’s fall and nearly getting run over by the horse, but Payson worried there was something that had not shown up immediately. Karin explained that Alex had insisted on the chair because he wanted to save all of his strength for the riding and for feeding Molly. Payson had to smile at Alex’s determination to figure out how to work around his illness with as little fuss as possible. Once again, he had to admit that his patient’s improved attitude could be attributed to Hope’s Ride.

      When the session ended, Alex broke into a song that he’d made up on the spot about feeding Molly her apples and getting pony kisses. Payson went to him, while Karin stayed in the arena talking with one of the therapists and another mother.

      “Dr. Mac,” Alex said. “Are you going to kiss Miss Jessie again?”

      “Not this time. And no kisses from Molly, either,” he said, hoping that would quiet the boy. He was pretty sure he heard Jessie chuckle.

      At the fence, the pony jammed her head between the rails, her lips smacking in anticipation of the apple in Alex’s hand. The adults stood a few steps away as Alex fed the pony and talked with her. He told her that he wouldn’t be back, but that she shouldn’t be sad. “There are other little boys and girls who will give you apples,” Alex told her, his voice quavering just a little. “Mommy said that someday we’ll come out to visit but that might not be for a little while.”

      Payson had learned not to react to emotion from his patients and their parents. With Alex, he felt his heart wrench with every tear. He desperately wanted to tell his young patient that everything would be fine and that he’d be coming to Hope’s Ride as usual. But Payson shouldn’t make that promise. If he were director of pediatrics, then he would have leverage to get a “yes” to this and a lot of other options for his patients.

      “Don’t worry, Alex,” he said, squatting beside the boy. “Mommy and I are working to see to it that you’ll be back soon. You can work hard on your therapy at the hospital, and I bet you’ll do even better the next time you’re here.”

      “Are you sure?” Alex asked.

      “Yep. No need for you to worry,” Payson said, avoiding looking at Jessie. He also didn’t think about the fact that he might just be lying to the boy, and what would happen if he couldn’t convince the foundation to pay for the treatment. “Do you think Molly’s done with her apple? Your mommy’s waiting for you.”

      “See you, Molly,” Alex said, and patted the pony. His smile reached ear to ear. “’Bye, Miss Jessie.” He raised his arms for a hug. Payson saw her eyes close as she lifted the boy off the ground and squeezed him tight. When she put him down, Payson was stunned by the pain on her face.

      As Alex made his way toward his mother, Payson stepped up to Jessie. “The foundation that helps pay for Alex’s therapy is withholding funds, according to Karin. I’ll give them a call. I’m sure that something can be worked out.”

      Turning from him, Jessie said, “He’s not the first child who’s had to stop coming. Unfortunately, I’m sure he won’t be the last. That’s why Desert Valley is so important. More places would help out if the hospital gave us its Good Doctoring Seal of Approval.”

      “I’m making the call to the foundation, Jessie.” His time at Hope’s Ride had totally messed with his schedule and now his brain was sorting through what he would face when he finally got back to his office. Helen had left six messages and sent him ten texts. The last said, Get your @ss in here.

      “You’ll make the call today. You won’t forgot once you get back to the hospital,” Jessie said when she caught him at his vehicle.

      “I said I’d do it,” he snapped, a little tired of her acting as if he was the bad guy around here.

      “Make sure that you do.”

      “What’s that supposed to mean?”

      “That you don’t believe in this program, and you’re just here so that you can get some meaningless title,” she said.

      “Meaningless? It will mean control over how the children at this hospital are treated. It will mean being able to help more children, being able to offer newer, more effective treatments. And, to do it, I’ve been scaling back on surgery, which I—” He shook his head before going on. “I’ve taken on more administrative roles at the hospital. Your program...has changed my plan.”

      “Of course. Can’t mess with the great doctor’s plans. Pushing papers is much more important than actually helping the kids.”

      What the hell? Didn’t she understand what it had been like for him to have to say no to children and their parents as he’d started to make the transition to administration? “I was told that this was a ‘good trial’ to see how I would do as a director because I’ll be more or less coordinating the different staffs coming out to the program. If I get this right, I’ll have control over all care in pediatrics.”

      “Now we get to the meat of it. You want to be in control, like always. Haven’t you learned anything? These are children, not science experiments.”

      “I won’t apologize for looking for empirical evidence that your program and therapies make a difference. And I’m sure as hell not going to apologize for being a scientist.”

      “Exactly how are you going to measure happiness, huh?” Jessie said.

      “By how well the children are doing on their physical tests and evaluations. The hospital can’t base treatments on unicorns and rainbows. There has to be hard data. Do you think that I can tell parents that this is a treatment that will make their child smile? We don’t know if it will help him walk again, but isn’t it more important that he’s smiling? Yes, that’s exactly what parents want to hear from their doctor.” She was really starting to tick him off.

      “You told me that medicine is as much an art as a science. When did you change your mind about that?”

      Of all of the things that she would remember from his time as a student, why was that it? He’d thought that way early in his studies, when he’d been full of himself. “I was wrong. It’s only about science. I’ve got to go. We can have this discussion another day when I have data to show you.”

      “I’ll hold you to that and I’ll expect an apology when you find out that I’m right. That the smiles are just as important as the positive MRIs.”

      “It’s a bet.”

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