Living Out Loud (Austen, #3)(25)

But I’d never been afraid. Because those hospitals would save me if something went wrong.

Being born with a congenital heart defect was scary, but I wasn’t scared. I could have been afraid, could have made myself even sicker from worrying, but I had faith. I believed the doctors who had treated me over the course of my life were as magical as fairies or wizards, but instead of using spells or magic dust, they used science.

I wasn’t even afraid of needles. I’d watch, wide-eyed, as the needle disappeared into my skin, watch my blood fill up the syringe, or feel the chill of fluids as they rushed up my arm, freezing me from the inside.

It just never bothered me, not the machines or the sterile smell or the needles or the hospital itself.

That was, until my new doctor walked through the door the next day.

It was something in his face that set my heart skipping, something in the tightness at the corners of his mouth and the almost invisible crease between his brows.

He took a seat on his rolling stool and began to type at the computer.

Mama took my hand.

“I’m sorry to have kept you here all day, but I’m glad you were able to stay for the MRI and results. After seeing your echocardiogram, I really wanted to get a better look and compare them to your scans done six months ago.” He turned the computer screen to face us, displaying two scans illuminated in blue-black and gray. “This is your heart six months ago, which matches the scans from six months before that almost identically. This,” he used his closed pen to draw a circle around my heart in the new scan, “is from today. Your tricuspid valve—the leaky one—is allowing too much blood into the right atrium, dilating it, and in turn shrinking the right ventricle. Notice the difference in size. It’s slight for now, but it’s very likely it will continue to expand. I think it’s time we talk about surgery.”

My palms were damp, my breath short.

“Has anything changed since your last scans, Annie? Are you still taking your medication regularly?”

“Yes, of course, but…my father died last month, and we moved here.”

He frowned, concerned. “That’s a lot of change at once. I’m very sorry for your loss.”

“Thank you,” I said quietly.

“Have you felt any different? Noticed any new symptoms?”

I considered it, my brows drawing together when I realized the truth. “Not new, but more frequent.”

Mama looked up at me from her chair. “Annie, you didn’t tell me.”

I tried to smile, squeezing her hand. “I didn’t realize. Mostly, I’ve felt fine, just little bursts of dizziness or shortness of breath. And my arrhythmia has been a bit more…vocal than usual.”

Dr. Mason’s frown deepened. “Annie, I want to see you immediately if you have any increase in symptoms or frequency. Without scanning you, your symptoms are the only way we know if something has changed, and your condition could escalate very quickly, too quickly for you to be able to act.”

I nodded dutifully.

“Truth be told, if I had been your physician all along, we would have done the surgery before now. My recommendation is to correct your valve using the cone procedure and repair the hole while we’re in there.” He grabbed a model of a heart off the counter and held it up in display, using his pen as a pointer again. “Your tricuspid valve is in the wrong spot. It’s here,” he pointed, “instead of here. In this procedure, we’ll separate this part of the valve from the wall of the heart, rotate, and reattach it.”

“Is there any reason not to do the surgery, Doctor?” Mama asked.

“Not one.” He set the model down and turned to me again, hands clasped in his lap. “And while I don’t see any reason to panic, I would like to schedule the surgery as soon as we can get the authorization from your insurance.”

Mama’s fingers were clammy in mine. “And how long will that take?”

“A couple of weeks, surgery scheduled a week or two after that. The mortality rate of the surgery is less than one percent, but it’s still open-heart surgery. The recovery will be long, so I’d like for you to plan for that. But, otherwise, it’s the gold-standard procedure for this condition, and our department at Columbia has a lot of experience with it. My colleague—the surgeon who will perform the procedure—has done more than just about any doctor in our field and was a pioneer in the research.” He said it all without saying anything truly comforting or scary, just with that distant, clinical tone that lends nothing but facts.

It was time. I’d known it was coming for years, knew that surgery wasn’t just possible but probable, not if but when. I should have had it at sixteen, but my old cardiologist seemed to think everything was fine, that we had plenty of time.

Regardless of knowing it was coming, I was shaken.

Mama looked afraid. The doctor looked professionally expectant. And so, I squeezed Mama’s hand and smiled as my heart skipped against my ribs.

“Let’s do it.”

We spent the next hour filling out paperwork for the insurance company in near silence. It wasn’t until we were in the backseat of the black Mercedes, which Susan had insisted drive us, when Mama took my hand again.

“I’m scared,” she said, the sound so small.

“I know. But we knew this was coming, Mama. And, when it’s all said and done, I’ll be healthier than ever. No more taking a thousand pills every day or checking my hands for oxygen depletion. No more dizziness. My heart will beat as steady as a metronome. It’s gonna be good. Don’t worry.”