The woman had stopped walking. “I didn’t think you could. But my neighbor told me some people’d been cured of blindness. I thought I should come and ask.”
“I’m sorry,” Seri said, “I’m just learning. They can cure some people. Let’s get you upstairs and see whether you’re one of the ones they can treat.”
The woman paused, “I’m sure I’ll be wasting their time. How much are they going to charge me just to talk to them? I can’t afford much. If I’m going to be blind, I’ll need every copper.”
“Oh. They don’t charge unless they can make you better.”
“Unless they say they can make you better.”
“No, only after you’re actually better. You don’t have to pay until you’re better and then only what you think it’s worth.”
The woman stood for a moment, then snorted, “I don’t believe that, but I’ll come up to hear the healers tell me you misunderstood.”
As Seri led her on to the stairs, she wondered if she could tell if the woman had cataracts or needed glasses. She asked, “When you say you’re going blind, do you mean that your vision’s getting foggy or not as sharp?”
“No. It started with flashes of light in my right eye. Then this morning I noticed that if I close my left eye, I can’t see things to my right. It’s as if a curtain’s being drawn in from that side.”
“Oh,” Seri said, thinking furiously. That didn’t sound like something that could be cured by putting a lens in front of the eye. Maybe taking her upstairs really will be a waste of everyone’s time, hers included.
When they got upstairs, Vyrda, Kazy, and Rrica were all gathered around the gurney of their last patient. They looked worried. Kazy looked up and saw Seri entering with the woman. She pulled the curtain around the bed to hide their patient from the woman’s view.
Seri seated the woman at the little table where Kazy’d fitted a man with spectacles yesterday, then went over to see what was going on.
Vyrda was talking to a grey-looking older man who was lying on the gurney. The man had his hands clasped to his chest as if in pain. As Seri arrived Vyrda was saying, “… a blood vessel in your heart’s almost completely blocked off. That’s the cause of what people call a ‘heart attack.’ The pain in your chest’s similar to the pain in your arm if you cut off the circulation it by sleeping on it wrong. I can try to remove the blockage…” Vyrda gasped, “Oh God!”
Wondering what was wrong, Seri looked at the man. His eyes were rolling up. Why’s he doing that? she wondered. Is he trying to ignore her?
Vyrda seemed to faint, falling forward onto the patient.
Seri reached out to catch her, then realized Vyrda was actively putting her head on the man’s chest.
Rrica touched Seri’s arm and urgently whispered, “What happened?”
“I don’t know!” Seri answered, feeling frantic.
“Is his heart still beating?” Rrica asked.
“I don’t…” I should have my ghirit in there! Seri realized. She said, “Just a moment,” while she sent it in. Her ghirit showed her a heart that wasn’t squeezing and relaxing like they normally did. It was only quivering. She turned to Rrica, “His heart’s stopped beating. It’s just shuddering.”
“Ventricular fibrillation,” Rrica whispered. She obviously already knew something about the condition.
“Can we cure it?”
“I don’t know. The ancients used to shock the heart with electricity. It was kind of like striking them with a little lightning bolt. I’m pretty sure we don’t know how to do that.”
Seri turned back to Vyrda, “How can I help?”
Vyrda said nothing, evidently concentrating on what she was doing. Kazy was climbing up on the gurney. Vyrda leaned up away from the man.
To Seri’s astonishment, Kazy chopped her fist down onto the man’s chest. Hard. As if she were hitting someone in a fight. She waited a moment, then leaned forward, putting her hands on his breastbone and shoving. She didn’t wait this time, she just shoved again. And again, shoving over and over.
Vyrda was crying.
Seri said, “What…?”
Kazy kept shoving on the man’s chest, but she spoke between grunts as she did it. “The main coronary artery to the muscle of his heart blocked off while Vyrda was talking to him. Then the heart’s rhythm messed up, going into fibrillation like Rrica said. In fibrillation, it doesn’t have the kind of rhythm that’ll pump blood out to the rest of the body. Vyrda’s pulled out a little bit of the plaque that was blocking the artery and restored some blood flow, but it hasn’t fixed the rhythm.”
“Why are you shoving on his chest like that?!”
“Use your ghirit!” Kazy said, sounding frustrated and speaking between shoves. “Each push, squeezes the heart, pushing blood, out to the body, even though, the heart’s not, doing it itself.”
“Oh. Do you want me to do the pushing for a while?”
“No,” she said, continuing to speak between shoves, “Rrica could do that. You can push blood out of the heart and into the arteries while Vyrda tries to remove more of the blockage.”
“What? How?”
“With your ghirit!” Kazy said, sounding frustrated again. She looked at Vyrda. “You ready to work some more?”
Vyrda nodded and Kazy hopped down off the table, motioning Seri to take her place.
“You do want me to shove on his chest?” Seri asked.
“No! Lean your head down here and push as much blood through the heart as you can.”
“But, I don’t—”
“Mr. Milner’s going to die if you don’t do something!” Kazy barked. Then more softly, “Just do the best you can. That’s all any of us can ever do.”
Seri leaned her head down until it was touching Vyrda’s head and the man’s chest. Sending in her ghirit, she grabbed some blood within the heart’s chambers and pushed it out into a big vessel.
“You’re pushing it backward!” Kazy hissed. “Push it out into the thick-walled vessel on the other side!”
Face heating furiously, Seri nonetheless grabbed all the blood in the biggest chamber of the heart and forced it out into the thick-walled vessel she now recognized as the aorta she’d read about. Why, when it really matters, do I suddenly get so stupid?! she wondered.
Kazy leaned in again, “Now move some from the other chamber of the heart, out into the pulmonary artery.”
Seri began alternating from chamber to chamber.
While Seri kept moving surges of blood, she heard Kazy explaining chest compressions to Rrica. She was saying things like, “You’ll have to push hard,” and, “I’ll be monitoring to make sure you’re moving enough blood.” Then Kazy stepped over and put a hand on Seri’s shoulder, “You’re doing great! Don’t wear yourself out. If you start to feel a headache coming on, let me know so we can give you a break.”
Seri said, “I’m doing okay so far.” She tried to figure out what Vyrda was doing in the blocked artery but found it took almost all her focus to keep moving blood. She couldn’t seem to divert her ghirit over to see what was happening in the arteries of the heart without missing a surge.
Vyrda stood up with a groan. “I’ve got it cleared out pretty good. Not as good as Daussie could, but a lack of blood flow isn’t the problem anymore.”
Kazy patted Seri on the shoulder, saying, “Take a break. Rrica’s going to do chest compressions for a while.”
When Seri stood up, she saw tears still streamed down Vyrda’s face.
Kazy chopped her fist into Milner’s chest again, waited a moment, then shook her head exasperatedly. She helped Rrica up onto the gurney and coached her on the chest compressions until she was satisfied with the way they were being done. Then Kazy turned to Vyrda and Seri. “Do either of you have any ideas for how we might stop the fibrillation?”
Seri looked at Vyrda. The woman looked exhausted. She’d taken a seat on one of their stools and her head hung down. She slowly shook her head without lifting her eyes. Seri turned
her eyes to Kazy, waiting for Kazy to tell her what to do next, but Kazy was just staring at her. “What?” Seri protested, “I don’t have any ideas. I just started learning!”
Kazy said, “Neither do I.” She turned and looked up at Rrica, laboring over the man’s chest. “Rrica, do you have any ideas for how to stop the fibrillation?”
Still pumping, Rrica shook her head. “Not unless you have a machine that’ll deliver a lot of electricity. That’s what the ancients did.”
Kazy turned to Seri, “Try poking his heart with your ghirit.”
Seri drew back, “What?!”
“Hitting the patient on the chest like I’ve been doing is supposed to generate a little bit of electrical current. Apparently, in ancient times it’d occasionally reset the heart’s rhythm. If hitting the outside of the chest could do it, it seems to me that smacking the heart itself might work better.”
“But… I don’t know how!” Seri said, alarmed to hear the whiny tone in her own voice.
Kazy grabbed her by the shoulders and gave her a little shake. “Mr. Milner’s dying. If we don’t do something, he’s going to finish dying. No mistake you might make is going to make dead any worse. I don’t really think poking his heart’s going to fix his fibrillation, but if I was the one doing the dying, I’d sure as hell want someone to try!”
“Okay! Okay, I’ll try.” Seri stepped toward Milner’s left side since the heart was more on that side. She was surprised to see the man looked pinker than he had when she’d first seen him. After a moment, she realized it was because his blood flow had improved—even if that was entirely due to their pumping his heart for him, rather than his heart pumping itself. She glanced at his eyes. They remained partly open, though the pupils were hidden beneath his upper lids. She thought it a kindness for him to be unconscious through all the striking and compressions being applied to his chest.
She paused, realizing she had no idea whether she could generate a strike or thump with her ghirit. She turned to Kazy, “Are you wanting me to ‘poke’ his heart? Or are you looking for something more like the strikes or blows you’ve been hitting his chest with?”
Kazy shrugged, “No idea. Try poking at first. If poking doesn’t work, work your way up to smacking it. Just don’t poke a hole in it, that’d definitely be bad.” Kazy then turned and whispered, “Vyrda, while we’re trying these crazy ideas, can you look through the books in the cabinet? Try to see if you can find something we might do to treat fibrillation?”
Seri looked at her own arm, then tried poking it with her ghirit. As hoped, she felt a push as if someone had prodded it with a finger. With a little trial and error, she found herself able to administer something that felt like a slap. She sent her ghirit into Milner’s chest, then turned back to Kazy. “Where should I be poking and hitting? Down at the lower left end? Up where all the blood vessels attach?”
Kazy shook her head, “I don’t know. I do know that the longer it takes us to do something, the less likely it is to work. Poke at the bottom end, then up at the top. If that doesn’t work, hit it harder. Do something!”
Seri leaned down close. She poked the lower end of the ventricles near the semi-pointed apex of the heart, but the walls continued to quiver. She tried up near the top where the atria were. No change. She tried thumping it bottom and top, then smacking it harder, a blow she thought of as being something like a hard flick with a finger.
Nothing she did changed the quivering mass of muscle back into a rhythmically contracting engine of life. She turned back to Kazy, “No luck. What next?”
Kazy was patting Rrica on the shoulder, saying, “Climb down and take a break. I’ll pump for a while.” As she helped Rrica down, she turned to Seri, “I don’t know. Try poking it some other places. Try the section that had its circulation cut off when the blood vessel was blocked.”
Seri put her head back down so it almost touched the man’s chest as it began surging beneath Kazy’s compressions. She quickly followed the coronary arteries, looking for a blockage. She found a surprising amount of crud in the man’s vessels. One vessel had so much sludge in it that it was still significantly—though not completely—blocked. When she examined the heart muscle beyond the end of that vessel the tissue seemed different to her. She assumed it had to have been the area where the circulation had been cut off.
Seri poked that area gently, then more firmly. Then she snapped it with significant force. She wondered whether she should try to hit it even harder but decided that blows harder than that seemed unreasonable.
Minding Kazy’s admonition to “do something,” she tried thumping at different locations around the circumference of the heart now that she’d done both ends. Realizing she’d now thumped almost every part of the heart’s surface, she paused to explore the heart with her ghirit. Oh, she thought, I’ve ignored the wall of muscle between the two main chambers of the heart. She thumped her way from the apex of the heart, up the wall between the ventricles and into the wall that separated the two smaller atrial chambers. There she snapped a bit of tissue that suddenly seemed to send out a somewhat unified contraction. A contraction that shot down the interventricular muscle toward the apex of the heart.
Goosebumps erupted across Seri’s scalp.
Kazy abruptly stopped doing chest compressions. When Seri looked up at her she was giving Seri an astonished but excited look.
The unified contraction petered out and the confused twitching of the muscle resumed.
Kazy said, “You almost had it! Try it again!”
Seri tried again at the same location. She got a contraction but it didn’t spread as far as the first one. She tried it again in a slightly different location—that one less successful than the one before. She tried again, more anteriorly. This fourth one was almost as good as the second one, but not good enough. The fifth one, somewhat more superior, was almost as good as the first one, but still ultimately failed.
Seri tried again and again, in the same locations and in different ones all around that first one —every single time without success.
Rrica took the chest compressions back over from Kazy.
Vyrda came back. She said the large electrical shocks employed by the ancients seemed to stun the heart sufficiently that when a structure called the “sinoatrial node” up in the atria sent out a “wave of depolarization”—which was some kind of electrical event—the wave met quiescent muscle that could be stimulated to contract all at once.
Which obviously wasn’t happening. Kazy proposed the theory that Seri’s “thumps” in the atria were simulating or eliciting such a wave of depolarization, but that the wave was encountering twitching muscle that wasn’t ready to be stimulated.
“So, how do we make it quiescent?” Seri asked.
“I don’t know!” Kazy exploded. Then she closed her eyes and tilted her head back with a sigh. After a moment, she said wearily, “Do you think you could smack the entire heart at once, trying to make all the muscle twitch simultaneously? It sounds like that’s what the ancients’ electrical shocks did.”
“I don’t know,” Seri said. “I wouldn’t even know how to try to do it. But surely if it can be done, Vyrda could do it better than I can?” She glanced at Vyrda but the look on Vyrda’s face didn’t inspire confidence. When she looked at Kazy, she saw Kazy was looking at Vyrda as well. Suddenly she realized that Kazy, youngest amongst them, was the one leading their little team in its attempts to save the man. The elder—presumably most experienced and knowledgeable—Vyrda, seemed overwhelmed and exhausted by the ordeal.
Kazy softly said, “Vyrda, you want to give it a try?”
Vyrda shook her head, “I don’t know how to do it any better than Seri does. Since she has a lot more power than I do it’d just as well be her.”
I have more power?! Seri thought, turning wide eyes to Kazy.
Kazy, evidently recognizing the surprise in Seri’s eyes, said, “Vyrda’s telekinesis isn’t very strong. Yours is. I think you might be nearly as st
rong as Tarc after you’ve had more practice. So, if anyone’s going to have a chance at thumping the entire heart at once, it’d have to be you.”
After a moment, Seri lifted her arm up next to her head and tried slapping her mid-forearm from every direction at once. It didn’t work the first time, but by the seventh time she tried it, it felt like hands had clapped against her arm from all directions.
Now she had a headache.
Kazy seemed to recognize this. She said, “Stop using your talent for a few minutes. When you do too much with your talent it gives you a headache. If you try to do more anyway it gives you a much worse headache and you lose your ability for a while. You need to stop until the headache’s gone.” She got up and tapped Rrica on the shoulder, “My turn.”
Seri said, “But—”
Kazy’d already started pumping, but she interrupted Seri despite the physical effort she was exerting, “Better I do chest compressions for a while so you can try restarting the heart with a fresh head. If slapping the heart from all directions quiets the muscle, you’ll need to immediately try snapping the sinoatrial node. You need to be fresh when you give this a shot.”
Sitting and waiting for her headache to fade gave Seri plenty of time to get apprehensive about failure and dismayed about how unsuccessful all their efforts so far had been. When she’d decided she wanted to become a healer she’d visualized the triumphs. Despite the fact that she’d been intellectually aware that there had to be failures—in the long run, inevitably more failures than successes—she’d focused only on the glorious outcomes that left everyone joyously happy.
She hadn’t dreamed of days like this one.
Seri was deep into maudlin ruminations when Kazy grunted between compressions, “Your headache’s still there?”
“Oh, sorry, no,” Seri said getting up and stepping over to their patient.
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