her face, on a shovel that was lying on the ground partially buried by snow. It cut her cheek but, to tell the truth, it wasn’t that bad. It was actually the treatment that worked against her. Cameron took her to the emergency room—he wouldn’t dare try closing up such a large facial laceration on a child. But there was no plastic surgeon, the E.R. doctor wouldn’t call anyone in because Meg’s family is very poor and has limited insurance—certainly nothing that would cover plastics, and he stitched her up himself. It didn’t take too long to see scar contractures, which I can almost guarantee will only get worse. Megan is growing—the scar is tightening while the rest of her face and surrounding tissue is soft and elastic. It causes severe distortion. And then there’s ectropion, scar tissue pulling down her lower eyelid. She needs plastic surgery.”
“And why isn’t she getting it? Is she afraid?”
Mel shook her head. “It’s considered cosmetic. Elective. It would cost thousands of dollars, and that’s speaking conservatively. This is a struggling family. They’re doing well if they can keep the heat on all winter.”
“She’ll be disfigured for the rest of her life,” Angie said.
“I keep looking for a break. A friend of mine, a doctor in Grace Valley, managed to get a morbidly disfigured woman help several years ago—there was a plastic surgeon with a surgical team who took on some of the most challenging cases for free, but it goes without saying—he can’t operate on everyone with an ugly scar. Megan’s is hard to look at and very sad—she’s a beautiful girl—but it’s not the worst we’ve seen. I’d be so happy if we could just get that eye fixed. That’s going to give her problems. It could lead to vision trouble, if it hasn’t already.”
“But by the time she’s a teenager…”
Mel put a hand on Angie’s arm. “I’ll keep trying. It’s hard in places like this, Ange. This isn’t a rich place. People work hard, but most of them don’t work for employers that provide good benefits—we’re a lot of family ranches and farms out here. Most can’t afford hundreds of dollars a month for medical coverage. Lorraine is a waitress and puts in a long week, so they have some benefits—the bare minimum. But there’s no coverage for plastic surgery that isn’t considered a medical necessity. I’ve already argued with them about the eye.”
“Have they seen pictures? The insurance company?”
“Oh, of course. I’ve done my best so far and I won’t give up. But the hard reality is that the Thicksons will have trouble even with the deductible and twenty percent of the costs. Frank was a logger with a good job, but he lost his arm in a logging accident. He has a prosthesis now. Between his part-time work and a disability check, they get by, but there are four kids and it’s tough for them.”
“It’s wrong,” Angie said, shaking her head. “This shouldn’t be so impossible.”
“We do our best—we do as much as we possibly can. Let me update this chart now. You can go if you want to, Angie. I can manage.”
“Nah,” she said. “There’s a treatment room to clean up.”
Mel smiled. Then she pointed at the reddish brown stain on Angie’s pretty yellow sweater. “Hydrogen peroxide on that—takes blood right out. Grab a bottle out of the supply cabinet and take it home with you.”
* * *
It was nearly nine by the time they’d finished cleaning up and Angie was finally leaving the clinic with Mel. Megan had long since gone home with her parents and Cameron broke free to find his wife and twins. When Angie stepped outside the first thing she noticed was Patrick, sitting on the porch steps at the clinic. “Hey!” she said in surprise.
He stood up while Mel turned to lock the door. “I wanted to see how you were. I already know the little girl went home with some stitches.”
“You must be freezing,” she said, noting the collar on his jacket turned
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