Disclaimer: I own nothing you recognize, I have Kara on loan from the Forks Ambulance Service, but I'm not sure how they feel about moonlighting, so let's not tell them...

Author's note: This story could stand alone, but I hope to make it into a world of my own... But if life gets in the way and I don't continue it, please enjoy anyway. And please review... Please? Also, before you say how implausible it is, know first of all that it's amazing what a paramedic can accept in the line of duty and second that there is an odd relationship between a paramedic and an ER doctor. We may not agree on much, but in the end we usually agree that we're on the same side.

Looking back, Carlisle Cullen decided that it had to be the alcohol. That was the only excuse for screwing up so badly. He was so used to blood that it didn't really bother him anymore (especially not like it tortured poor Jasper), so he couldn't blame that. In the end, his mistake was simply the result of alcohol and tunnel vision.

All four walls of the trauma room were splattered with blood, and the stench of alcohol filled the air as Carlisle stared at the bloody chest cavity of the teenage boy. As many times as he had patched up drunks after car wrecks, or pulled the sheet over them and waited for the coroner, it never got easier. Or the smell less nauseating. He doubted even Jasper could be hungry with the smell of Kentucky whiskey so strong in the room. But this boy was not a regular drunk. He was just a boy who had made a disasterously bad decision. And because of it, the first time he had laid a hand on the bottle would be his last. Occasionally, drinking and driving carried a death sentence.

But it didn't have to be. Carlisle let the forbidden though linger in his mind. He could save this kid. No, not make him a vampire, literally save him. Allow him to walk out of this hospital and back to his mother's arms. He could do it. It was a huge risk, one that he shouldn't even be considering for his family's sake. But it could be done. He placed 2 more gauze pads over the clamped pulmonary vein that had been severed. The boy had maybe 20 minutes to live, and the helicopter coming for him was at least fifteen minutes out. He would never make it to the vascular surgeon. But Carlisle could fix it. He could move fast enough to sew the vein back together, could see well enough without the specialized equipment, could move his hands in a precise manner to stitch up the small vessel. It was a bad idea. But he could do it…

In the end, it was Esme's face in his mind that made the decision for him. How could he look her in the eye that night knowing that his hesitance to act had caused another woman the pain she went through, the pain that dove her to suicide. He simply couldn't.

It was only him and one nurse in the room, and there seemed to be nothing to do but wait. Only one other patient, a lonely old woman who fell at the nursing home earlier and had a bruise, so there was nothing pressing he needed to do. "Cheryl," he said gently to the nurse, "Would you care to go check the ETA on the helicopter?"

The young woman nodded. "Of course, Doctor." She turned to leave, then stopped. "Do you really think it will make a difference?"

He shook his head. "No, I think it will be a rather moot point."

She left the room, and he got to work quickly. After gathering the finest suturing material they carried, he moved with superhuman speed and precision as he reconnected the two severed ends of the vein. Quickly getting rid of the evidence, he was about to call for Cheryl, to tell her he had made a mistake, to cancel the helicopter. Everyone makes mistakes, and he would be his usual charming self, and explain that it obviously wasn't the pulmonary vein that had been cut… look, his blood pressure is rising as they spoke… when a flicker of movement caught his eye.

His unnecessary breath caught in his throat, and if his heart was beating it would have stopped as he saw the paramedic girl beside the cabinets, nearly hidden behind the curtain. Her clipboard and run sheet were hanging loosely in her hand, forgotten as she stared at him wide-eyed. Apparently the alcohol in the air had masked her scent, and she must have been standing there doing paperwork the whole time. She had seen everything.

"Um… oh, dear…" Carlisle had no idea what to say, but he knew he had to gather his temporarily scattered marbles before she bolted out of the room screaming. She had just witnessed him performing a surgery requiring several hours and a heart-lung bypass machine in a matter of minutes. There was no explanation. Her wide blue eyes were staring at him, yet not meeting his eyes. Short white-blond hair framed her face, and Carlisle realized who she was. He knew her vaguely, one of the few full-time paramedics Forks employeed. Kendra… Kathy… Kara! "Kara, it's-"

She cut him off, regaining control of her expression and raising the clipboard to clutch it to her chest. "He's going to make it now? You fixed him?"

"Yes." There was no use in lying about it.

She nodded. "I go to church with him and his family. Thank you."

"I-" Carlisle still had no idea how to respond. He couldn't believe that he had messed up this badly. He had let someone see him… not being human… And this girl was handling it… he shook his head to clear scattered thoughts. "Kara… What you saw…"

She nodded. "You're something different, right? Something… special?"

He nodded dumbly. "Well, I know you didn't mean for me to see that. And thank you for taking that kind of risk to save Derek. He's a good kid. Better than this. What are you going to tell Cheryl? That he had some kind of anomaly and blood is going through another way?"

"Um… that I was mistaken. That everything in here was such a mess that I saw something else and thought it was the pulmonary vein."

"Good plan. And cancel the helicopter?"

"Yeah."

"Okay. You ready?"

He managed a half-smile and nodded. Kara turned and hurried out of the room. He watched the girl walk up to the desk where Cheryl was on the phone. He saw Cheryl hurriedly hang up the phone, and the two rush back into the room. Carlisle made himself blush as much as possible as he explained that he was wrong, that the boy's blood pressure was coming up, probably as a result of the epinephrine that EMS had given during transport and the four units of blood that had pumped into him. And to get him an ICU bed immediately.

Cheryl went off to take care of that, and Kara stayed and assisted him as he sewed up the patient's chest. It wasn't unusual for a medic to help out when they brought in a bad case, and Kara's partner would probably think nothing of it. Carlisle welcomed the help, and the time it gave him to think of an explanation. It didn't help. He still had nothing. Finally, as they finished up, Kara looked at him. "Dr. Cullen… are you going to tell me what happened today?"

He shrugged. "Doctor's make mistakes. You just happened to witness one." And he wasn't lying. He had made a major mistake.

"I didn't witness anything," she said. "But if you ever feel like telling me what I didn't see, I'll be around."

Carlisle let his real smile shine through. "I know. And maybe sometime I will be able to explain." She headed for the door, then stopped in her tracks, debating. "What is it?" he asked. "Dr. Cullen, are you an angel?"

An undignified snort of laughter escaped him. "Good Lord, no! I'm just a person trying to do what I can to make this place a little better."

"But-"

He pulled off his gloves and put a gentle hand on her shoulder, guiding her out the door. "See you next trip, Kara."

She looked like she was going to protest, but was interrupted by the radio at her side. Carlisle was unable to understand most of the radio codes, but he was pretty sure one of them meant a drug overdose. "Gotta go, Doc," she said. Her voice lowered to a whisper, she said "Don't worry. You can trust me."

He smiled as he nodded. "Be careful out there." She nodded and was gone. He finally let out the breath he had been holding. The girl would need to be watched. She knew way more than he was comfortable with. But she was a good kid. He actually believed her. Maybe he could trust her…