Heart Failure

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Heart Failure Page 10

by Richard L Mabry


  By now, Adam executed avoidance maneuvers like a pro, ignoring repeated demands from the GPS to “when possible, make a legal U-turn.” When he was certain he wasn’t being followed, he got back on track to his destination. He had no idea what was ahead. He wasn’t even certain this was his best course of action. But it was the best he could do. Directions for the drive were coming from the GPS system, but Adam prayed that God would direct his actions.

  The first question came at noon.

  Carrie was sitting at her desk thumbing through a professional journal and munching on a sandwich Lila brought her from the food court. What was it? Tuna? Ham? It might as well be cardboard. But she had to eat.

  She had gone through the same thing after John’s death. She had no appetite. Food had no taste. Time dragged by, marked by painful memories of the past and fears of what the future might hold. Would Adam’s departure prove to be as hard as John’s death? Both almost killed her.

  Phil Rushton, a white coat covering his dress shirt and muted tie, tapped on the frame of her open door. “Got a sec?”

  Carrie washed down a bite of sandwich—it turned out to be grilled cheese—with a swallow of Diet Coke. She blotted her lips with a paper napkin. “Sure, come on in.”

  Phil eased into one of the chairs across the desk from Carrie. “You shouldn’t gulp your food like that. You’ll get an ulcer.”

  “I’ve been doing this since my second year of premed. If it hasn’t burned a hole in my duodenum by now, I don’t think it will.” She laid aside the remains of her sandwich. “What’s up?”

  Phil sat down and crossed his legs, revealing navy over-the-calf socks above black wingtip shoes. “Just checking on how you’re doing. I don’t want you to burn yourself out. It seems that every time I look up, you’re in the office or ER, even when you’re not on call. You need some time away.”

  Carrie decided to say what she was thinking. “Phil, how is that different from what you do? Both of us spend a lot of time practicing our profession, but I guess that’s our choice, isn’t it?”

  Phil nodded. “Touché. And I must admit that you’re not burying yourself in your work as much since you began going out with Adam.” He looked down at her hand. “I hadn’t noticed until now. You’re not wearing your ring anymore. Is something going on?”

  Carrie was acutely aware of her bare left hand. “I don’t want to discuss that.” She looked straight at Phil. “Adam’s left town. I don’t know whether he’s coming back or not.”

  “Why did he leave? Where has he gone?”

  “I don’t know,” Carrie said. She reached up to dab at the corner of her eyes, a gesture that wasn’t fake. Just the mention of Adam’s departure was enough to bring her to the verge of tears.

  Phil rose. “Well, I’m sorry to hear that. You know you’re very special to everyone here. If there’s anything I can do . . .” He let the words hang for a moment, then turned and left the room.

  Carrie leaned back and tried to ignore the urge to cry. She replayed Adam’s leaving once more. Was he in danger? Would he be back? Or had she lost the love of her life for yet a second time?

  For reasons she couldn’t fully explain, Carrie swiveled her chair and reached into the bookcase behind her desk to retrieve a dusty, leather-bound volume. She laid it on top of the journal she’d been reading and opened it to the front page. The ink was fading, but the words were still clear: “To Carrie. Let this be a lamp unto your feet, a light unto your path. Corrine Nichols.”

  Carrie hadn’t thought of that sweet lady in years. But maybe the gift she’d given to a medical student just starting on her Christian pilgrimage was what Carrie needed right now as she struggled to hold on to the spark of faith that flickered within her. She let the book fall open and ran her finger down the pages, looking for direction in a life that was rapidly sinking into despair.

  Adam squinted into the sun and reached into his pocket for his sunglasses. His journey took him eastward, and that meant each morning he had to drive into the sun. Couldn’t be helped. The quicker he reached his destination, the quicker he could start his search for the puzzle piece he needed. He planned to use every available hour of daylight.

  He’d spent last night in a Holiday Inn just west of the Texas-Arkansas border. Their “free buffet breakfast” of juice, Danish, and coffee was about all he could tolerate—not because it was so bad, but because the butterflies that took up residence in his stomach when he started the journey were still fluttering furiously.

  Adam intended to call Carrie last night, but by the time he arrived at the motel, he was too tired to do anything but shower and fall into bed. He didn’t want to try phoning her during the day—cell coverage was sometimes spotty where he was, and if he did get through, she was hard to reach between patients. Besides, leaving a message for her would be worse than no call at all. No, right now he’d concentrate on his driving. He’d phone her tonight for sure.

  The eighteen-wheelers speeding eastward on Interstate 20 made using his cruise control impossible. Instead, Adam guided his little SUV along, speeding up and slowing down, passing and being passed, always careful to stay under the speed limit. The last thing he needed was a traffic stop.

  As the driving became automatic, Adam let some of the thoughts he’d suppressed surface. Why had he thought this harebrained scheme would work anyway? The smart thing would have been to pack up and leave town for good, strike out for a new city and bury himself there. Leaving the relative security of the Witness Security Program had probably been a mistake. On the other hand, it had brought Carrie into his life. And for that, he was eternally grateful.

  Would this work? Could he—? No matter. Adam had to set short-term goals and not look beyond them. First, leave Jameson. Make sure the story got out, one that was believable but left him an option to return. Then make this drive. When he reached his final destination, call Dave and ask for his help in the last stage of the plan. Despite the promise he’d made, Adam hadn’t called Dave. Why? Because if he revealed the final step of this scheme too soon, he knew his brother would surely try to talk him out of it.

  And if this failed? He didn’t want to think about that possibility.

  The plan had to work.

  ELEVEN

  CARRIE WAS IN HER KITCHEN, ABOUT TO MICROWAVE A TV DINNER, when her cell phone rang. Once she recognized the caller, all thoughts of food left her. She dropped into a chair and breathed a silent “thank You” to God.

  “Adam, is that really you?”

  “Yes. It’s so good to hear your voice. You’ll never know how much I miss you.”

  “Oh, but I do, because I miss you even more.” Carrie had a million questions, but they all fled her brain like dandelion fluff in a strong wind. She asked the one that remained topmost in her thoughts. “Are you all right?”

  “Fine. Just tired. But only a few more days to go.”

  “Where are you?”

  “I’m just east of—” Static filled the line, then everything went quiet.

  Carrie looked at her phone display. “Call failed.” Was it the fault of her phone? No, she had good reception. The problem must be with Adam’s phone. Maybe a battery, perhaps poor cell phone reception where he was. She waited a couple of minutes for him to call back. When he didn’t, she dialed his number—first his regular cell phone, then the throwaway phone he’d bought—but all she got was a mechanical voice saying, “Your call cannot be completed.”

  At that moment, what Carried wanted most was to throw something, to vent her frustration with cell phones, cell phone towers, cell phone service providers, and everyone associated with the mass communication industry. Instead, she took a deep breath. It had been good to hear his voice and know he was doing well. That would have to be enough for now.

  Before she returned to her food preparation, she murmured a brief prayer. God, please keep him safe. Bring him back. Please . . .

  “Lila, I’ll be ready to start seeing patients in a few minutes.” Carrie scanned t
he list of morning appointments. Nothing unusual there. She decided that she might have time to finish reading the medical journal article that had caught her eye yesterday.

  She started digging through the stack on her desk, but before she could put her hands on the right one, her phone rang—not the primary number, but her back line. She didn’t give that number out to a lot of people, but one of them was Adam. Maybe . . .

  She lifted the receiver. “Hello?”

  “Dr. Markham?”

  The voice wasn’t Adam’s. It wasn’t even a man calling. Disappointment replaced hope in Carrie’s mind. “Yes. Who’s this?”

  “This is Doris, in the ER. Your patient, Mrs. Cartwright, is here, complaining of weakness, nausea, sweating. May be the flu—lot of that going around—but I thought I should give you a call. Do you want me to have the ER doctor look at her, or do you want to come over?”

  The fact that Shelly Cartwright had come to the ER in the first place worried Carrie. The woman wasn’t a complainer. Her husband was in Afghanistan. The couple had a three-year-old son, an unexpected blessing that came while they were in their late thirties, but as far as Carrie could tell, Shelly was doing a good job of handling the stress of being both mother and father during Todd’s deployment. This must be something bad if it sent her to the ER.

  “Dr. Markham?” Doris’s voice carried a hint of impatience.

  “I’ll come over to see her. In the meantime, let’s get some labs going.” She rattled off the tests she needed, including a blood count to look for anemia and a blood sugar to check for low or high values. She added potassium, since a deficiency could contribute to weakness. “I’m on my way.”

  When Carrie pulled back the curtains around the ER cubicle, she was taken aback by what she saw. The woman on the gurney looked nothing like the vivacious brunette with whom Carrie spoke at church only a few weeks ago.

  Doris moved to the other side of the gurney and reached down to pat Shelly’s hand. The nurse might have a gruff exterior, but Carrie knew better.

  “Shelly, what’s wrong?” Carrie asked.

  “I feel so silly being here, but I kept getting weaker and weaker.”

  The history Carrie obtained was of the fairly sudden onset of weakness, sweating, slight nausea. “When did this start?”

  “About an hour . . . maybe an hour and a half ago.”

  “Did you do anything for it?”

  “I lay down, drank some Coke, but nothing helped.”

  “Any pain?”

  “No, nothing. I just felt like I was going to pass out . . . still do.”

  Carrie looked across the gurney and checked the monitor again. Blood pressure had dropped a bit, pulse had gotten a little faster in the past few minutes. Cardiogram complex on the monitor didn’t look quite right—maybe hypokalemia?

  “Labs back yet?” Carrie asked.

  “Not yet,” Doris said. “I’ll see what’s holding them up.”

  “Just a sec.”

  Doris turned, a puzzled look on her face.

  “Let’s hook her up and do a full EKG.”

  Without question, Doris grabbed the apparatus and began attaching the leads.

  In a moment Carrie was looking at the paper strip spewing from the EKG machine. “That explains it.”

  “What?” Shelly asked.

  Carrie held up the wide strip with the full EKG tracing. “You were hooked up to a cardiac monitor that only gives a partial picture of your heart’s activity. This is a complete one, and it confirms my suspicion. You’re having a heart attack.”

  “But I don’t have chest pain,” Shelly said in a “this can’t be happening” tone.

  “Almost half of women who have heart attacks don’t have chest pain,” Carrie said. “But we know what the problem is, and we’ll take care of you.”

  And that’s what they did. Oxygen. Aspirin under the tongue. Amiodarone. A beta-blocker. A call to the interventional radiologist, and soon Shelly was on her way to the X-ray suite for a coronary angiogram.

  While Carrie waited for the results, she asked Doris if she knew who was caring for Shelly’s son. “Sorry, I don’t know. Why don’t you ask the EMTs who brought her in. Rob and Bill are still here. They’re on break in the cafeteria.”

  Carrie found the two EMTs in a corner, sipping coffee and swapping stories. She didn’t make the connection between name and person until the one with his back to her turned, and she saw it was Rob Cole. This might be awkward. Well, she needed the information.

  “Dr. Markham, come join us,” Rob called.

  Bill slapped Rob on the shoulder and grinned. “Yeah, I’m tired of this guy’s company.”

  Carrie pulled up a chair, declined their offer of something to drink, and got right to the reason for her visit. “You guys did the pickup on Shelly Cartwright?”

  “Yeah,” Bill said. “She was having second thoughts about calling 911 when we started to load her onto the gurney, but she was pale, her blood pressure was a little low, and the neighbor who was with her insisted that she should be seen by a doctor.”

  “So a neighbor was there,” Carrie said. “Do you know if she’s taking care of Shelly’s son?”

  “That’s right,” Rob said. “The woman’s sort of a grandmother type, and I got the impression she does that a lot when the mother has to go somewhere and can’t take her son.”

  Carrie pushed back her chair. “Thanks. I’ll have the social worker make contact with her. We need to be certain the little boy’s taken care of until his mom is released.”

  Carrie was a dozen steps away when she heard, “Dr. Markham?”

  Carrie turned to find Rob behind her. “Yes?”

  “I . . . I wonder if you’d like to have dinner with me while your boyfriend’s gone. I’ve been on my own before, and it’s no fun.”

  “Thanks anyway, Rob, but I’ll be fine until Adam gets back.”

  She turned to walk away, but apparently Rob wasn’t through.

  “So where did he go? How long is he going to be gone?”

  “Rob, I’m sorry. I have to get back to my patient.” She turned and hurried away before the young man could say anything else. Can’t he take no for an answer?

  Adam dropped his suitcases and flipped the switch to illuminate the bedside lamp of his motel room. After making sure the door was double locked, he closed the blinds and pulled the heavy drapes together. Then he slumped onto the bed.

  He closed his eyes and wondered how Carrie was doing. It frustrated him when his cell service failed earlier today, but at least he’d been able to tell her he was all right. In a bit, he’d call from the landline in his room, and they could talk as long as they wanted.

  It had been a disappointment, but not a surprise, when Carrie said she wasn’t ready to take back his ring. He wished she were wearing it now. On the other hand, if he did what might be necessary to protect her from Charlie DeLuca, there was a very real possibility Adam wouldn’t be able to keep a wedding date anytime soon.

  Well, it was too late to turn back. He should reach his destination tomorrow. Now there was another call to make, one that was critical to his mission. He dialed Dave’s cell number, but the call, like the one that preceded it earlier in the day, went unanswered. Adam had already left one message. No need to leave another. He’d try again later.

  Adam’s grumbling stomach reminded him that he hadn’t eaten since lunch. No problem—he’d seen signs for several fast food places nearby. One of them would probably be open late. He’d get a burger and malt, then call Carrie. After that, a shower and a good night’s sleep.

  He started to get up, then fell back onto the pillow. He was exhausted. He’d rest for a few minutes, maybe half an hour. Then he could be up and running.

  Adam heeled off his shoes, pulled the spread over him, turned off the bedside lamp, and closed his eyes. After what seemed like only a few minutes, the ring of the phone brought him awake. He grumbled as he sat up and turned on the lamp. Adam snatched his cell phone
from the bedside table, but the display was dark. His sleep-clouded mind finally cleared enough for him to realize that the ring came from the room’s telephone.

  Who could be calling? No one knew he was here. If this was a wrong number . . . He had to clear his throat twice before he could rasp out, “Hello?”

  “This is Jeremy at the front desk. We were wondering if you planned to spend another night with us.”

  Why was this nut calling? Adam had just checked in less than an hour ago. He glanced at his watch and was startled to see it was twelve o’clock. The phone cord barely stretched to allow Adam to pull aside the drapes and peek through the slatted blinds. When he looked out he did a double take. It wasn’t midnight-dark. It was noontime-bright. He’d slept for almost fourteen hours!

  “I’m sorry. Yes, my plans have changed. I’ll be staying one more day.”

  “Very good, sir. Fortunately we can accommodate you without your having to move. Have a good day.”

  Adam checked the display on his cell phone. No missed calls, no messages. A growling stomach reminded him that his last meal had been twenty-four hours ago. A cup of coffee brewed in the room’s pot, with all the sugar and creamer available, would have to hold him until he could make himself presentable. After twenty minutes, showered, clean-shaven, dressed in clean clothes, he headed for the Denny’s near the motel.

  An hour later Adam was back in his room, his hunger satisfied and his mind working at full throttle again. He microwaved the coffee that remained in the carafe and added sugar packets he’d picked up from the restaurant. Coffee in one hand, his cell phone in the other, he sat on the edge of his bed and punched in Dave’s number.

  What if his brother still didn’t answer? What if he was undercover, or somewhere with no cell reception, or . . . After the fifth ring Adam was about to end the call when he heard, “Branson here.”

 

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