Heart Stopper

by R J Samuel

  “And then I kissed you and Tara and the others left without me. So you took me to Daniel’s place.”

  “Yes. It was around 1 a.m. when we left the pub. I was surprised when you flirted with me. I thought it was because you were drunk so when the others left you there I thought taking you back to Daniel’s place was the right thing to do. I didn’t want to disturb Daniel so I put you in the guest room.”

  Reyna seemed to be spitting the last few words out and Priya saw what Catherine meant. The anger was self-directed.

  Priya asked, “Why did you leave?”

  “I didn’t want to be there in the morning. That would have been too weird. I assumed you and Daniel would spend the day together and I came back here.”

  “Was there anything different about the apartment?” Catherine asked and her quiet voice startled the two of them.

  “It was dark. I was trying to get Priya settled. I didn’t notice much.”

  Priya gathered her thoughts. “Okay, so we have a text from Daniel at around 8 o’clock on the Friday. I woke up just after 5 a.m. and found him. When I was leaving I heard a voice or voices from the lift..., elevator. Then I think someone looked through my stuff when I was away on the Thursday or Friday after and someone followed me yesterday.”

  Catherine said, “Daniel was worried for the last month about something to do with work. He went to New York at the beginning of July and worried Reyna enough that she flies here to see him. He doesn’t make it to the pub and he’s dead the next morning. The postmark on the envelope is 5 July and it was sent from New York; the day before he was to come back to Ireland. Why didn’t he keep a hold of the papers till he got here?” She paused. “I’m more confused now. The papers are obviously important. Will you look through them and see if there’s anything there that might explain any of this?”

  For the first time that evening, Catherine looked like a tired woman in her sixties. Her eyes were faded and the lines in her face stood deeper. She took a deep breath and stood up.

  “I’m sorry your first visit out here happened at this horrible time. And thank you for agreeing to look through the papers. I’m going to go to bed. You’ll both have to leave early to get to the clinic tomorrow so I’ll say goodbye for now. We’ll meet up as soon as you’ve read them, if that’s ok?”

  Priya got up and hugged Catherine. “Of course it is. I’ll look through it tonight but there’s a lot of stuff there so maybe at the end of the week.”

  Catherine held the hug tight for a long moment and then wandered into the house.

  CHAPTER THIRTEEN

  Priya’s chair was turned to face the view, but she had not looked at anything except the papers in front of her. After Catherine left, Reyna had finished clearing, brought them out coffees and then sat in a hammock chair that swung from an upright beam fixed to the patio. An hour had passed in silence.

  Priya’s head was starting to pound. She hadn’t slept well for the last few nights and had been up early as well. The graphs were beginning to blur. She’d done a quick scan and separated the papers containing notes on the design of the original Mark 1 Pacemaker from the results of trials on it. The notes and the testing of the Mark I Controller were also in two separate piles and she made a fifth pile with anything that didn’t fit into the other ones. The papers she could see were all densely packed with typing and graphs, figures and code. They looked like photocopies.

  She started with the Mark I Pacemaker. She had never been shown these details before. Her specific area of interest during her year with Fairer Research had been the security protocols used in the wireless communication between pacemakers and their program controllers. The Controller Home was being discussed and she had been given data to work with, but in a very restricted range.

  She found some of the sheets on the Mark I Pacemaker that were darker and were actually old carbon copies. Or copies of carbon copies.

  “It’s been a long time since I’ve seen carbon copies. Do you remember when they were being used, those purple sheets of stuff?” Priya said, and Reyna swung the hammock around with her feet.

  “That would have been the 80s, I think.”

  “These seem to be the notes your granddad made then for the first pacemaker he designed. He patented the use of a new and alternative way of powering the pacemaker.” Priya pointed to the second pile of papers. “They seem to be some of the results from the clinical trials on that pacemaker.”

  “What was the technology he patented?” Reyna asked. She got out of the hammock chair and sat down across the table from Priya.

  Priya laid out the copies of the older papers. She said, “I’ll try and explain. I know some of this from my studies in the field obviously; I just never had this kind of detail on it before now. Do you have the internet here? I could show you some pictures that would make it clearer.”

  Reyna shook her head. “I’m afraid not. Catherine didn’t get the place hooked up, we’re lucky to even have a phone line, there’s no cell phone signal out here.”

  “I don’t know how anyone could live without an internet connection! Okay, do you know what a pacemaker does, where it goes and stuff?”

  “Well, I helped my grandfather on the business and finance side not the medical bits. I manage the foundation he set up. I know that pacemakers are used when there are problems with the heart and I know the different product ranges. I need us to get to a point where we can figure out why Daniel gathered all this stuff. And why he didn’t give it to you.”

  Priya felt the anger rise. “So you still think I had something to do with this?”

  Reyna tapped one of the piles on the table. “I guess we’ll see how capable you are.”

  Priya glared at her. “You want me to explain all of this, but you don’t trust me. How can you trust anything I say then?”

  “I know you’re good at your job. And that you used to be some kind of genius when it came to coding. If you don’t have anything to do with whatever was worrying Daniel then you don’t have anything to hide, do you? You’ll be as eager as I am to figure all this out.”

  Reyna looked at her and the challenge in her eyes infuriated Priya. But Priya thrived on a challenge, at least she had. And, like Reyna, she couldn’t understand why Daniel hadn’t spoken to her about his worries, or sent these papers to her, why he’d sent them to Catherine when he’d given Priya the readings and code on the Controller II with no apparent reluctance. What was so important that he had gone to New York, called Reyna in, and sent the papers to his mother?

  Priya closed her eyes and stopped the questions crowding her mind. She tried to simplify and arrange the concepts instead. She was aware of Reyna’s eyes on her face.

  She opened her eyes and said, “Okay. I’ll start with the basics. Pacemakers can be used when there are problems with the heart’s normal rhythm. The heart has its own built-in electrical system that creates the signals that tell your heart when to beat. It has a group of cells called the SA node that creates the electricity. This SA node is called the natural pacemaker. It ‘self-fires’ at regular intervals to cause the heart to beat with a rhythm of about 60 to 70 beats per minute. There’s obviously a lot more to this, but problems can occur with the natural pacemaker or the rest of your heart’s electrical system, which could lead to a slower rhythm or a faster rhythm, and you get symptoms like fainting or shortness of breath or palpitations. When people say pacemakers, it’s actually a pacing system. It includes the bit that generates the pulse, the leads, and the programmer, what we call the controller. The pulse generator part is implanted in the upper chest; around here,” Priya pointed to the area just under her collarbone and then felt conscious of her heart beating as Reyna looked, “under the skin and fat, above the muscle. The leads are fed through the vein and into the correct area in the heart and then the other ends of the leads are hooked up to the pulse generator. All clear so far?”

  “Yes, keep going.”

  “Modern pulse generators are programmable with informati
on and settings and we can also get information by transmitting data from the pulse generator to a controller which is called telemetry. The telemetry and programming communication uses a wireless technology. We usually do this at the clinic, but some of the newer ones can even download their data to the internet or can be checked over the telephone.”

  “So you’re talking to a device that is inside somebody and it’s telling you stuff about itself?”

  “Yes. It can tell us how efficiently it’s working, how much energy it is using, whether any arrhythmias occurred. Now, normally we would be checking battery life with a view to replacing it if necessary, but that’s where the technology your granddad patented comes in.”

  “Right, you said it was a new way of powering the pacemaker.”

  “Yes, in the 50s Medtronic’s founder developed the first pacemaker that was wearable and it was powered by mercury batteries. In the 60s implantable pacemakers were produced. They’ve used nickel cadmium rechargeable batteries and zinc-mercury batteries. Each had problems. There has been work on biological batteries - biogalvanic cells, fuel cells utilizing oxygen from blood and hydrogen from body proteins, kinetic body energy. Even nuclear batteries. In the 60s there was a pacemaker that used Plutonium. The life of this type of pacemaker is around 14,000 years so these pacemakers would generally survive longer than the patient.”

  Priya laughed at Reyna’s expression. “I love dropping that fact in. Some use the ceramic plutonium oxide to reduce the possibility of spillage in the case of the accidental impact of a rifle bullet. Plutonium could be used for other dangerous stuff so they stopped making this type of pacemaker, the U.S. government closely monitors the few that still have them in, and they come to collect the material from the pacemakers when the patient died. Anyway, in the 70s they started using lithium batteries. These batteries would last from 5 years to 10 years depending on their usage. Your grandfather was very interested in alternative self-sustaining sources of energy for the pacemaker and he figured out a way to use the voltage changes from around the natural pacemaker, the SA Node, and feed that back through the leads in the heart to the pulse generator. Quite ingenious really.”

  “But the patient who has a pacemaker has a bad SA node, yes?”

  “That area of the heart has a lot of self-firing electrical activity. And the SA Node itself is not necessarily damaged; the arrhythmia might be due to a problem with the conduction system. The leads that are placed in the heart sense the electrical activity there, he just found a way to harness that energy and use it to run the pulse generator. The pulse generator senses when there is an abnormal rhythm and there are different types, some only discharge when they detect a problem, others give out a regular beat and others change their rate with the body’s activity.”

  “So the person’s natural pacemaker could still be working away.”

  “Yes.” Priya was impressed with Reyna’s grasp of the information. She was beginning to wish she hadn’t spent the last two years suppressing any intelligent thought.

  She continued, “There is a small lithium battery in the pulse generator just as a backup. We check its remaining battery power at the regular checks, but it is really just routine.”

  Priya said thoughtfully, “I just checked the battery on a patient with an implanted pacemaker and her lithium battery seems to have been used.”

  “But you said it was only a back-up.”

  “Yes, that’s why I found it strange. I need to go back over the battery readings for her and for the other patients. I should have caught it last week, but what with everything that’s been going on.”

  “So, what do the papers show?”

  “I have really just separated them out. I need to look at them properly. They developed the Controller Mark I to communicate with the Pacemaker Mark I. They used to use the Controller I in the clinic to check on the implanted pulse generators. The Controller II replaced it then, it works using wireless technology as well, but it incorporates the ability to communicate on the MICS channel as well as the older 175Hz frequency.”

  Reyna looked confused.

  Priya explained, “The older pacemakers communicate on the 175Hz band. The Pacemaker Mark I does too, despite the fact that the FCC in the U.S. brought in the new range in 1999. All implantable medical devices are now to communicate on the 402-405 Hz band. This will help for longer-range communication, for devices that can be controlled at a greater distance. Like the new Controller Home that the Research Company is just finishing. They are also going to launch the Pacemaker II which operates on the longer-range frequency.”

  “The Controller III or the Controller Home is almost ready, that will be used by patients or their carers in their own homes and the information can be sent over phone lines if necessary. The papers here relate to the Mark I pacemakers and controllers. Nothing that I can see on the Mark II controller.” She hesitated.

  “What?” Reyna asked.

  “I have the notes on the Mark II controller, that’s what I had in my briefcase when you invited me out here.” Priya made up her mind. “I took the research papers home a few weeks ago. Daniel gave them to me and I had a feeling something was out and I know the security issues and the rules, but I really wanted to continue working on them. I told James about it yesterday. I had to; whoever broke into my house probably saw the papers. I presume James will be talking to you about it at some point.”

  Reyna rubbed her forehead. She rested her chin on her palm and stared at Priya. A little line had appeared between her eyebrows and Priya had an urge to reach out and smooth it away.

  Priya said, “You’re thinking how come someone who appears to be bright enough can do so many stupid things, right?”

  Reyna gave a smile that seemed to come out against her will. “Well…”

  “I seem to have made it my mission in the last few years. I was probably right this time though. I mean Daniel wouldn’t have collected this stuff and he wouldn’t have sent it here if he hadn’t also felt something was wrong.”

  “Okay, we’ll have to deal with that particular mistake later. I’ll have to hear it from James and I should consult with him and see what he thinks should be the consequences of your taking the papers home and possibly exposing them to the wrong eyes. I think Gerry and Valerie will have to make that call, it is their research material really that you’ve potentially exposed. So I think the faster we can work out what’s going on, the better.”

  “I’d better get back to the papers then.” Priya picked up the second pile.

  Reyna sighed and got up from the table. She went back to the hammock chair and stared out at the view.

  ∞

  “Did we, you know...?” Priya’s voice ran out. She hadn’t been able to concentrate on the papers in front of her for the ten minutes since Reyna had left the table. She was too conscious of Reyna, of the gentle movement of the hammock.

  Reyna said in a softer voice than Priya had heard from her “You’re a very beautiful woman, Priya, and you were very charming... If it hadn’t been for the fact that I thought you were Daniel’s...” She paused. “No, we didn’t do anything, well... I lay beside you for a few hours because you said you didn’t want to be alone.”

  “And you undressed me? Or did I manage that myself?” Priya was finding her voice and it had a bitter tone.

  “I helped. And I lay on top of the covers.”

  ∞

  They were silent again and Priya tried to focus, but she gave up after a half hour of alternating looks between the papers on the table and the weave of the back of the hammock chair as it swung slowly. She had glanced through the clinical trials on the Mark I pacemaker and nothing had jumped out at her. The summer light was leaving the fjord and the air was darkening in minute degrees.

  “I’m going to take a walk. I need to clear my head.” Priya said as she got up from the table.

  “You don’t know the area, would you like me to come with you?” Reyna asked.

  Priya looked at the
forest lining the road leading from the front of the house down to the lake. The road was a dark pause before the brightness in the distance. She hesitated, not sure if she could relax with Reyna beside her, but the thought of walking through the gloom alone didn’t appeal. She accepted the offer.

  Reyna had gotten out of the chair and was standing waiting for her. They walked on the light stone driveway, the crunching of their feet magnified in the quiet that enveloped them as they entered the avenue of trees. In the distance ahead of them, the lake glowed vivid through the shadow frame. They emerged from the forest and stepped off the road onto a small path that wound around the lake. Priya stopped and stared at the interwoven layers of blues and whites and greens.

  “Don’t you find beauty sometimes to be so painful? I look at this amazing view and it almost hurts,” Priya said.

  “Yes, sometimes beauty can affect us in unexpected ways.” Reyna was looking at the mountains on the far shore, but her eyes focused closer as she spoke and Priya felt her breath catch as she met Reyna’s gaze. They were standing a few feet apart and Reyna moved nearer. Priya stood, fixed to the spot, unable to look away. Reyna rested her fingers under Priya’s chin and ran her thumb gently over Priya’s lower lip. Priya could see the faint black and blonde striations in the dark gold of Reyna’s eyes. She saw helplessness struggling with desire. From the little she knew of Reyna, weakness wasn’t characteristic, but Priya was struggling too.

  “I haven’t been able to look at you without remembering that kiss. And you didn’t even know what you were doing at the time.” Reyna’s voice was husky.

  Priya could hear the rustle of leaves and the gentle splash of the water beside her, the sounds dulled by the thud of her blood pulsing loud in her ears. She stared at Reyna’s lips and heard a gasp as Reyna lowered her head and replaced her thumb with her lips. She could hear moaning, but she didn’t know which one of them it was coming from. She hadn’t let a woman kiss her since Valerie. When she had slept with a woman in the last few months she’d been the one in control, never losing control, never feeling this overwhelming weakness, her legs trembling so she rested against Reyna, not just resting, pushing, straining to melt into Reyna’s warmth. She had her hands in Reyna’s hair, the thick strands worked loose from their restraint wrapping themselves around her fingers in bonds of brown silk.