The Queen of Hearts(57)
Charles Frank took an early retirement.
“Is Boyd suing the hospital too?”
“No.” In the background, I could see the boys, who had apparently tied all their shoelaces together, thudding en masse across the living room. They lurched drunkenly and fell over, shrieking with laughter. Betsy stood like a stone. “He says he’ll indemnify the hospital if they fire her. Our lawyer is screaming about it, but Boyd will get his way. He’s going to bring Nestor down on her like a ton of bricks. He wants her fired.”
I let out an involuntary squeak.
She broke from her lethargy enough to swivel toward me, still expressionless. Her lack of animation struck me—depending on how you looked at her, she could be mistaken for serene, or possibly lobotomized. I reached toward her, but she pivoted again and stared past me. “How is she?” she asked.
“Emma?” I said, surprised at the question. “She’s . . . she’s awful, actually. I’ve barely seen her.”
Betsy nodded. “Well,” she said. “I’m late getting the kids to school.”
We looked toward the front door, where a knotted pile of shoes sat heaped. Out of nowhere, Delaney appeared and clamped onto my pants leg. “Mom,” she puffed, “I am done with being human. I need you to buy me a tail.”
Betsy closed her eyes.
I dislodged Delaney and said quietly, “Delaney, go wait in my room. Okay?”
“Can I have a tail?”
“It’s possible,” I hissed. “Go.”
Betsy zombie-walked toward a torrent of sunshine pouring through the front doorframe. I followed her, scooping up the shoes as I went, hoping the boys hadn’t migrated to a mud puddle in the two minutes we’d stood talking. Just before we reached her new car—a Volvo station wagon, quite unlike the massive black Suburban she’d had before—Betsy turned to me. She whispered into the cuff of my shirt, so faint I could hardly hear her, “Will you talk to Boyd?”
“Of course. Of course I will. But what do you want me to say?”
She blinked, haggard-faced, the skin beneath her eyes so pale it was almost pearlescent, shot through with the faintest of violet undertones. “I don’t know,” she said. “I was hoping you could help me figure out the right thing to do. Should I ask him not to sue her?”
—
First patient of the day: referred for fainting. Second patient: referred for murmur. The third patient broke up the monotony only slightly—valve surgery follow-up—but the fourth one was interesting: a fourteen-year-old who had collapsed while playing soccer.
Shortly after he was born, Christian Kajowski’s delivery room nurses noticed a loud murmur when they auscultated his chest. They called the pediatrician, who ordered an echocardiogram—an ultrasound of the heart—which confirmed a problem: aortic stenosis. The vessel carrying blood from Chris’s heart was too small. A few weeks after birth, he had a temporary procedure to widen the stricture, followed by an aortic graft last year as we waited for him to reach his adult size so he could finally have a valve replacement. Meanwhile, he’d been an active, healthy kid.
But unbeknownst to anyone, a minor infection after Chris’s last surgery had created a small area of scarring in his heart. One afternoon in September, after a warm-up lap around his school’s track, he jogged to the soccer field, waved to his coach, and slow-motion crumpled to the ground.
I knocked on the exam room door, lugging my cumbersome COW (Computer on Wheels) behind me. “Hello there, Chris!” I said, smiling. “I’m happy to see you!”
Chris looked reasonably happy to see me too. He was an amiable kid with broad shoulders, wide gray eyes, and the kind of lush, curving eyelashes often unfairly bestowed on boys. “Hey, Dr. Anson,” he said, lounging in a slumped, knees-wide-apart posture reminiscent of a professional athlete. His mother elbowed him and he politely sat up. If he was feeling any angst related to the possibility that he could die at any moment, he hid it well.
Chris’s mother, Deborah, was not as successful in hiding her angst. Her eyes darted around the room in rabbity assessment, finally locking on me with unsettling intensity. But her voice, when she spoke, held a note of forced calm. “No shocks,” she said, motioning to her son’s chest.
“I know,” I said gently. “That’s good.” Chris had an implantable defibrillator in his chest, which meant he lived with the unsettling knowledge that if his heart rhythm deteriorated again, the device inside his chest would suddenly shock him. This paled in comparison, however, to what he faced next: tomorrow, the surgeons would slice out part of his heart and replace it with a hunk of manufactured pyrolytic carbon.
One of the reasons I love the heart so much is its immense complexity. On the surface, it’s a simple mechanical pump, taking in depleted blood and whooshing out rich, oxygenated red cells to all the nooks and crannies of the human form. But the physics underlying the pump are truly majestic. Every beat is precipitated by an electrical cascade, a subcellular chain of dominoes, alighting like fire along the fibers and muscles that bear the brunt of our bodies’ unceasing demand for fuel. When it works as it should, it’s spectacular.
After Chris collapsed on the soccer field, his heart spasming arrhythmically and uselessly, his cells screaming for oxygen that wasn’t coming, his teammates and his coaches reacted fast. They reached him in seconds, and his coach began CPR as his friend Billy took off in a desperate, all-out sprint to the football field, where the school kept a portable defibrillator. They shocked him three times before the paramedics arrived, and the paramedics shocked him twice more en route to the hospital. Had he been alone, or had he been somewhere without a defibrillator and people who knew CPR, he’d have stayed dead. But his schoolmates brought him back.