Authors: Hilary Norman
“Because I knew you’d make a fuss.” She started to get up.
“Don’t you dare move. Damn right I’ll make a fuss – and if you don’t tell me everything right this minute, I’ll call Doc Sheldon.”
“Okay, okay, I’ll tell you – and there’s no need to look so worried. It was just a little dizziness – it’s probably just some kind of virus.”
“Have you ever passed right out?” Hugo demanded.
“No.”
“Sure?”
“
No.
”
“How many times has it happened?”
“Hugo, will you please shut up and let me tell you.”
Five minutes later, he was on the phone to Charlie Sheldon anyway, insisting that Lally needed to be seen right away, and though Hugo was acting calm now, what worried him more than anything
else was that Lally wasn’t really arguing.
The nightmare began about fifteen minutes after Charlie Sheldon had started his examination. He was about sixty-three, perhaps older, wore ancient tweed suits, cut his own
wispy white hair and smelled of pipe tobacco, and he was always a quiet thoughtful man, not prone to making snap decisions or diagnoses. But it seemed to Lally this morning in his old,
companionable surgery, its walls lined with Rockwell prints, that Charlie was even more ruminative than usual, offering scarcely more than a grunt or two as he took her blood pressure, looked into
her eyes and ears, listened to her heart and lungs, checked her reflexes, weighed her, took a little blood and then sent her to the bathroom to produce some urine to accompany the other sample to
the laboratory.
The doctor was on the telephone when Lally came back into his office, and it was a moment before she realized that the appointment for tests he was setting up in less than an hour’s time
was for her.
“Charlie, what’s going on?” she asked as he put down the receiver.
“Just fixing up a few tests.” He took off his glasses, old as his suit and roughly mended with adhesive tape, and rubbed the bridge of his nose.
“I heard.” She looked right into his face. “Where’s the fire, Charlie? What are these tests?”
He looked right back at her. “I’m concerned, Lally. With another patient I might fool around with the notion that the dizzy spells were stress related, but I’ve known you too
many years for that.”
“They could be.”
“You believe that?”
She said nothing.
“Okay, let me be straight. I don’t much like the sound of your heart.”
She felt a sharp jab of fear. “What’s wrong with it?”
“I’m not sure, which is why I ordered the tests. Okay?”
“Not really.”
“But you’ll have them.”
She gave a small, helpless shrug. “You’re the doctor, Charlie.”
Hugo, still in the waiting room, blanched visibly when Lally told him, trying to sound calm, that she was going directly to the Taylor-Dunne Hospital in Holyoke for a few
tests.
“Right now?” Hugo looked at Charlie Sheldon standing in the doorway behind her. The doctor nodded.
“I think Charlie gets bored on Sundays,” Lally tried to joke.
“All that’s happening,” Sheldon told Hugo, “is me trying to do my job, just trying to rule a few things out.”
“What kind of things?” Hugo asked.
“He won’t tell you,” Lally said, and took his arm. “He’s a doctor, they study for years just for moments like this, so they can pretend they know stuff when they
don’t really know anything at all.”
“Doc?” Hugo looked back at Charlie again.
“Just get her over to Holyoke. Folks over there are busy enough without patients being late for their appointments.”
Walking out to the car, Lally recognized the barely concealed fear in Hugo’s eyes, and she remembered that he’d been a little phobic about hospitals ever since his own back injury.
“Why don’t I just get a cab?”
“Oh, sure.”
She pulled him to a stop. “Hugo, I’m sure there’s nothing to be worried about, and I think you’d be better off opening the café – I mean, what use is a
business partner if he doesn’t take care of business when you’re sick?”
“Nice try, Lally.” He started walking again.
“Maybe I’d rather be alone.”
“No, you wouldn’t.”
She leaned against his shoulder. “No,” she said, “I wouldn’t.”
She was examined more thoroughly than she’d ever been in her life, and asked about a hundred questions, before she gave more blood, underwent a brain scan and an EKG, in
which electrodes were applied to her chest, wrists and ankles. They took spinal and chest X-rays, and performed a calorific test in which the outer canals of her ears were briefly flooded with
water and her eyes then checked for normal reflex flickering to rule out labyrinthitis. The doctors, nurses and orderlies were all gentle, reassuring and efficient, but Lally had never felt so
terrified and alone. She’d made Hugo stay in a waiting room, but she thought now that she might have liked a familiar hand to hold, and when the sudden memory of Chris Webber’s face
flashed into her mind, she let herself grasp at it for just an instant, remembering the dark blue eyes and curly fair hair and strong straight nose. And then she let the image go again. She was on
her own, and that was okay. She was good on her own.
Her brain was just fine, so were her ears, and so was all the rest of her, except for her heartbeat, which was pretty much what Charlie Sheldon had thought. Against her will, Lally was ordered
into a wheelchair and pushed to the office of one Dr Lucas Ash, a cardiologist, where she waited for almost three-quarters of an hour, in pristine, pearl-grey leather and chrome silence, while he
completed his hospital rounds.
“I’m sorry,” he said, as he swept into the room.
“That’s okay.” Lally looked at him with fascination. He was about forty-five, blond and almost too handsome, with a Roman nose, violet-blue eyes and the kind of perfect skin
that looked as if it were scrubbed clean and moisturized on the hour.
“Excuse me while I flip through your notes?” He smiled at her disarmingly, then bent his head over the file. Every now and then, he picked up a pair of tiny fold-up spectacles from
his desk and put them on, almost, Lally felt, as if he needed to prove that he really was a doctor and not an actor in a medical soap.
He didn’t make her wait too much longer for his diagnosis. He listened to her heart for a while, took her pulse and blood pressure, double-checked her family history, and asked, loud and
clear, if she was perfectly sure she hadn’t taken any drugs whatsoever in the last week or so.
“Not even an aspirin,” Lally said.
“Okay.”
She waited, focusing on the window behind the doctor’s chair. It was snowing again outside, and the hospital gardens, the whole world, seemed closed off behind the veil of white.
“You have a condition called bradycardia. In lay language, that really just means an abnormally low rate of heartbeat. That’s what’s been causing your blood pressure to drop,
hence the loss of energy, weakness and dizzy spells.” Ash paused. “Have you heard of heart block?”
Lally shook her head. Her hands were very cold.
“In simple terms, it’s an interruption, or a blocking of the passage of impulses through the heart’s conducting system. The contractions of the upper and lower parts of the
heart are not properly synchronized, and though in some cases the problem can be partial, in your case, it’s what we call complete heart block.” He paused again, watching her face.
“Now that’s nowhere near so alarming as it might sound.”
“How serious is it?” Lally’s voice was very soft.
“Very serious, but only if left untreated. It could lead to a seizure, even a cardiac arrest.”
“You mean it could kill me?”
“Only if we did nothing about it.”
A sense of unreality and disbelief was making Lally feel as if she were floating somewhere above the room, looking down at herself sitting in the chair, facing the doctor.
“I don’t really see how this can be true,” she said, very slowly and still quietly. “I’m a dancer. I exercise all the time – I mean not just dance, I work out
every morning. I’ve always had more energy than I know what to do with. I’m a strong person.”
“Not quite so strong lately, though,” Lucas Ash suggested.
“No, that’s true, but couldn’t this just be one of those weird viruses you hear about?” Lally began to hear the suppressed terror in her voice. “Neither of my
parents ever had any kind of heart problem – no one in my family has, so far as I know.”
“Your mother and father died young, in an accident.” The doctor was kind, but matter-of-fact. “And I doubt if heart disease was exactly a regular topic of conversation in your
home. It never is, till something goes wrong.”
“And now it has.” A fist of dread was twisting itself around in Lally’s stomach. Suddenly she wanted to cry like a child, wanted someone to take her in their arms and tell her
that everything was going to be all right.
“There’s nothing for you to be afraid of, Lally,” Dr Ash said. “I told you that this would only be a problem if it was left untreated.”
Lally looked at him guardedly. “How can you treat it?”
“By fitting you with an artificial pacemaker.”
“A pacemaker?” The small relief at being told she could survive was instantly wiped away by images of artificial hearts, pictures of her lying on a bed with tubes and wires. She saw
herself being wheeled by Hugo to her dance studio, pale and fragile, heard herself tell her students that she couldn’t teach them any more, but that they weren’t to be afraid for her
–
“How much do you know about pacemakers?” The doctor’s question brought Lally back to earth.
“Very little, I guess.” She flushed pink. “I’ve heard about them, of course, but I’ve never knowingly met anyone who had one.”
“How big do you think they are?”
Lally shrugged, and held up her hands vaguely in the shape and size of an orange. “About so big? I don’t know.”
Dr Ash smiled and opened a drawer in his desk.
“This is a modern pacemaker.” He saw the surprise in her eyes. “Not much bigger than a matchbook, is it? Take it.” He offered it to her. “Light, too, isn’t
it?”
“It’s amazing.” The fear came back. “This would be attached to my heart? I know it’s small, but how could I move around with something like this inside
me?”
“Easily, believe me.” The cardiologist fished in his deep desk drawer for something else, then stood up and turned around to remove a book from one of his shelves. “Lally, come
and sit down over here.” He gestured to a grey settee and waited for her to settle. “In the old days, the early days of pacing, this was the kind of device patients had to put up
with.” He held out a large metal object. “Take it.”
Lally held it in her right hand. It was about seven times bigger than the first one he had shown her. “It’s so heavy,” she said, startled.
“Nevertheless, the first recipient of the first pacemaker in the late fifties is still alive today.”
“Really?” The first spark of genuine relief lifted her.
“And when you go on to learn how extraordinarily sophisticated pacemakers have become over the last thirty or so years, that information alone ought to be enough to wipe out most of your
fears.”
“I guess so.” Her lack of conviction showed in her voice.
Lucas Ash looked at her with genuine sympathy. “I’m not dismissing your anxieties, Lally. The symptoms you’ve been suffering would scare anyone, and in just the last few hours
you’ve had all kinds of tests, and then I come in – a complete stranger – and tell you that you have a serious heart condition.”
“But one that’s not going to kill me, right?”
“Absolutely right.” The doctor took the old pacemaker away from her. “But you’re still scared, aren’t you?”
Lally nodded.
“Then the best way to deal with that is to explain to you exactly what we’re going to do, and then to do it.”
“When?”
“Right away.”
“You mean today?”
“Absolutely today.” Lucas Ash smiled. “It’s a comparatively simple procedure, Lally, not really surgery at all. No general anaesthetic, just a few days in the hospital to
rest up, and then home and back to normal.”
“What do you mean by normal?” Lally asked.
“I mean just that, normal.”
“By whose standards?”
“Anyone’s.”
“What about a dancer’s?”
Dr Ash leaned forward. “Lally, listen to me. I’m not in the business of lying to my patients, okay?”
“Okay,” she said, tensely.
“For the first two or three days after the procedure you’ll feel a little sore from the small superficial wound on your chest, just above your left breast – you are
right-handed, aren’t you?” She nodded. “Then, for another week, you’ll be advised to take things gently, though with each passing day you’ll probably feel more and
more like doing pirouettes, or whatever it is that ballet dancers like doing.” He saw her manage a weak smile. “And after that, if things go well, you’ll be able to do exactly
what you’ve always done.”
“What might not go well?” Lally asked quickly.
“Nothing disastrous. Sometimes, adjustments have to be made at the post-implant stage, but all that means is that a piece of gadgetry gets waved over you, and everything gets put one
hundred per cent right without the slightest discomfort or risk.”
“Sounds like a piece of cake,” she said.
“It is.”
“But does it really have to be done today? I mean, I have responsibilities – my dance classes, the café. Hugo and I – Hugo’s the friend who brought me here –
we run a café in West Stockbridge together, and he needs me to do the baking, and – ”
“I’m sure Hugo will get by.”
“Maybe, but – ”
“But nothing.”
Lally stopped talking.
“We need to do this right away, Lally,” Lucas Ash said again, patiently. “Most probably, if we didn’t, you’d be okay, get away with it. But you’d be running
an unnecessary risk.”
“You mean I might have a seizure or something.”
“I mean, in theory, that you could die. Which would be an awful waste, don’t you think, considering that a pacemaker would take care of the problem completely.”
Lally was silent for another moment.