Heart Trouble

by Jae

  A hospital. She had to be in the ER. Laleh remembered stepping through the sliding glass doors, then nothing. Had she passed out?

  When she lifted a hand, searching for a call button, she realized that she was hooked up to an IV. A small device clipped to her finger connected her to a monitor on the other side of the bed.

  “You’re awake.”

  The husky voice startled her, and then someone moved into her line of vision.

  A woman bent over her. Her gaze went from Laleh’s face to the monitor next to her and back. The only thing Laleh really registered about her was her intense eyes. Their color matched that of the woman’s light blue scrubs.

  Was she a nurse?

  But she was wearing a crisp white lab coat, which contrasted with her chin-length, wavy, dark brown hair. The name embroidered above the breast pocket in big blue letters was Hope Finlay, MD.

  “I’m Dr. Finlay,” the doctor said. “How are you feeling?”

  Laleh’s hands fluttered over her chest. Her blouse was gone. Instead, she was wearing a hospital gown. Her ribs were sore, but other than that, nothing hurt and her heart had stopped racing. She had to clear her dry throat before she could speak. “Like I’ve gone twelve rounds with a heavyweight champion and come out on the losing end.” She indicated her chest with the hand that didn’t have the IV.

  A faint smile curled the doctor’s lips. “That’s to be expected. We had to do chest compressions. Do you remember what happened?”

  Chest compressions… Laleh sucked in a breath. She couldn’t believe this was happening to her. After a moment, she nodded weakly. “My mother took me to the ER because my heart wouldn’t stop racing. I think I collapsed. What’s wrong with me?” She couldn’t stop the fear from creeping into her voice.

  “We’re still running tests, so we don’t know for sure.”

  “But if you’d have to take a guess…?” Laleh sent a pleading gaze up to the doctor. The not knowing what was wrong was driving her crazy.

  “My money would be on—”

  “Dr. Finlay!” A nurse called through the open sliding door. “We’ve got a multiple trauma coming in, and Dr. Wang is busy with a possible heart attack.”

  “How far out?” the doctor asked.

  “The ambulance just pulled in.”

  Hurried footsteps sounded in the hallway in front of Laleh’s room, and a patient screamed in agony.

  “I’m coming.” Dr. Finlay’s gaze went back to Laleh. Despite the chaos going on outside the door, she seemed calm and focused. “I’ll be back later. Try to get some rest.”

  Then she rushed from the room, her white lab coat swishing behind her.

  Laleh stared after her, still not quite able to grasp what was happening.

  * * *

  Boy, what a day! In addition to the two codes she had run tonight, people with sore throats, abdominal pain, and lacerations flooded the emergency department. Hope had lost count of how many patients she’d seen since her shift had started five hours ago. The ER was so busy that patients were lying on stretchers in the hallway, waiting for beds to open up on the regular floors. She hadn’t had time to eat anything or even go to the bathroom.

  Every time she passed treatment room four, she paused to glance through the open door and make sure Laleh Samadi was still doing okay. The monitor next to her bed showed normal sinus rhythm. The QRS complexes looked great, and Ms. Samadi’s pulse and blood pressure were stable. Even her IV had been removed. The patient was alert and oriented, talking to her mother.

  See? Everything was just fine. Her patient was young and, except for occasional episodes of tachycardia, healthy. Nothing indicated that there would be further problems tonight.

  So what was it that made her return to that room time and again to check up on this particular patient?

  “Dr. Finlay?” Paula called from the nurses’ station.

  Hope turned away from treatment room four and walked over to her.

  “You wanted me to let you know when the lab results on Ms. Samadi came in,” Paula said.

  “Finally.” The lab had been as backed up as the rest of the hospital. “Thanks.” Hope rejoiced as she took a seat at one of the workstations, happy to be off her feet for a few minutes while she logged in to a computer and pulled up the lab reports.

  Maybe they would give her an indication of what had caused Ms. Samadi’s ventricular fibrillation, so her mind could finally put the case to rest. Carefully, she reviewed each lab result.

  Normal potassium, calcium, and magnesium levels, so electrolyte abnormalities weren’t the cause for her arrhythmia. The repeat of the cardiac enzymes were just as normal as they had been when they had first checked them three hours ago. Clearly, her patient hadn’t suffered a heart attack—not that she had really expected it, considering the patient’s age. The echo hadn’t revealed any structural damage to the heart either, and the EKG showed no apparent irregularities. According to the blood work, Ms. Samadi didn’t even have a simple cold.

  Still, that niggling feeling that something wasn’t quite right wouldn’t go away.

  Oh, come on. Since when do you give much stock to baseless gut feelings?

  She closed the electronic chart, logged out of the computer, and got up. Time to give her patient the good news.

  Softly, she knocked on the open door of treatment room four and then entered.

  Mrs. Samadi had nodded off on a chair next to the bed, but her daughter was still awake. Her eyes—warm and dark brown like the coffee Hope had been craving for hours—were a little glassy.

  No reason for concern, Hope told herself. It was midnight already, and after everything Ms. Samadi had been through today, Hope would have been surprised if she weren’t exhausted.

  Ms. Samadi watched her, a line forming between her dark eyebrows. “Is something wrong? My EKG and the lab results…?”

  Great. Now she’d worried a patient. Usually, she kept a perfect poker face at work, but apparently, getting shocked had rattled her more than she wanted to admit. “They’re fine,” she said quickly. “In fact, all the tests we ran came back negative. Have you ever had an EKG before?”

  “Yes. When the episodes first started, about four years ago, I went to my general practitioner. But by the time I got there, my heart had long since stopped racing. The doctor said the EKG looked fine and it was just stress. But it’s more than that, isn’t it?”

  Hope pulled the exam stool next to the bed and sat. “Yes, it is. We can’t know for sure before we get you into the cath lab—a special examination room for diagnosing this kind of thing—but from the symptoms you were describing, it could be AVNRT, an arrhythmia caused by an abnormal electrical circuit in your heart.”

  Ms. Samadi put a hand on her chest, directly over her heart, and rubbed as if deep in thought. “If it really is AVNRT…” She repeated the abbreviation without stumbling. “Is there a medication I can take for it?”

  “That’s one option, but in your case, we could do even better than that. We could thread a catheter into your heart through a vein in your thigh and correct the issue once and for all. How does that sound?”

  In the chair next to the bed, Mrs. Samadi started to snore.

  “That sounds great—curing it once and for all, not the snoring,” Ms. Samadi added with a smile. “So, what will happen next?”

  “We’ll transfer you to the CCU. That’s the—”

  “Coronary care unit.”

  Hope gave her a curious look. Well, maybe a family member or a friend of Ms. Samadi’s had been in the CCU before, and that was how she knew. “Exactly. We’ll monitor you there for a day or two until we can get you on the schedule for a catheter ablation. If all goes well, you’ll be discharged the day after.”

  “Sounds even better. Nothing against your hospitality, of course, but, well, the hospital is not my idea of a fun place to stay.”

  Hope chuckled. “I understand.”

  Mrs. Samadi stopped snoring, sat up in her chair, and blinke
d owlishly. “Is there any news?” she asked when she saw Hope.

  “It’s all good,” her daughter said before Hope could speak. “Dr. Finlay thinks it might be something easily fixed.”

  Paula stuck her head into the room. “There’s finally an open bed in the CCU. We’ll take you upstairs, Ms. Samadi.”

  Paula and a nurse’s aide stepped into the room and unhooked the leads from the cardiac monitor. Within seconds, they had unlocked the stretcher’s wheels and were pushing Ms. Samadi into the hallway. Her mother followed behind.

  “Thank you, Dr. Finlay,” Ms. Samadi called back through the door.

  “You’re welcome.” Hope watched as they wheeled her to the elevator before giving herself a mental kick and getting up from the stool. Other patients and a lot of paperwork were waiting.

  CHAPTER 3

  “We scheduled your catheter ablation for tomorrow morning,” Dr. Myers said.

  Finally! All the waiting and lying around was driving Laleh crazy. Almost an entire day had gone by since she had been transferred to the CCU, and she was beyond ready to get out of the hospital.

  Her parents, who hovered next to her hospital bed, looked relieved too.

  “So,” Dr. Myers said, “what we will do is basically—”

  The ringing of Laleh’s phone interrupted the doctor in the middle of his explanation of the procedure.

  Her cheeks heating, she reached for the phone on the over-the-bed table. The staff didn’t like seeing cell phones being used, but she knew it was only because the constant ringing and beeping was annoying, not because they were actually interfering with the medical equipment. “I’m sorry.”

  Just as she was about to shut it off, her gaze fell on the small display.

  It was Jill calling.

  Damn. Had she gone by the restaurant and heard what had happened from Laleh’s aunt? If so, she was probably worried out of her mind. “I have to get this. Just a second.” Quickly, she accepted the call and lifted the phone to her ear. “Jill?”

  “Laleh! What happened? Your aunt said—”

  “I’m fine. Really.”

  “A heart problem is fine in your book?” Jill asked.

  “It wasn’t a heart attack or anything, just some arrhythmia,” Laleh said, trying to sound as soothing as possible. She knew Jill had an audition later today, and if she thought Laleh needed her, she would cancel to be at her bedside. “I’ll have to undergo an itty-bitty procedure tomorrow, and I’ll be as good as new.”

  “Are you sure?”

  “Of course I’m sure. Would they let me go home tomorrow if this were a big deal?”

  Jill took a deep breath, probably to tell her that she would be by anyway.

  “Jill, I need to go. I’m in the middle of talking to a doctor. I’ll call you as soon as I’m back in my room tomorrow. Good luck with the audition.” She hung up before Jill could protest and gave Dr. Myers an apologetic smile.

  Ten minutes later, she had nodded to his explanations and signed the required paperwork. The curtain closed behind the doctor.

  Her mother stared after him with a frown. “Why can’t doctors talk like normal people? I didn’t understand a word he said about what exactly is wrong with your heart.”

  “It’s easy, really, Maman. You know that each beat of the heart is set in motion by electrical signals, right?” She glanced from one parent to the other.

  “Of course.” Her father nodded, even though he looked as clueless as her mother. As a young man in Iran, he had planned on teaching engineering at the university one day, and he would never admit to not understanding an explanation.

  “There’s a cluster of cells in the middle of the heart that we call the AV node,” Laleh continued.

  “We?” her mother asked.

  “Uh, I mean the doctors.” Laleh had to laugh at herself. She’d been in the CCU for less than a day, and apparently, she was already considering herself part of the hospital world. “Anyway, the AV node acts like a traffic signal, slowing the electrical impulses to give the ventricles—the chambers of the heart—a chance to fill with blood before they contract. Well, the doctors think that I have an extra electrical pathway.”

  “Two traffic signals?” her father asked.

  “Yes. And the extra one is constantly turning green, so the electrical impulses are coming too fast. That’s what causes my heart to race. Tomorrow morning, the doctors are going to destroy the extra traffic signal.”

  Her father nodded as if he had known that all along.

  Laleh’s mother stared at her. “You got all that from that gobbledygook?” She pointed in the direction in which the doctor had disappeared.

  “Sure.” Laleh shrugged. “I guess I remember more of my biology classes than I thought.”

  “See?” Her father gently nudged her. “I always said you should have gone to medical school. You’re smart enough to become a doctor.”

  Laleh groaned. Great. She was in the hospital, about to undergo a procedure on her heart, and her father seized the opportunity to remind her of the potential she was wasting by not getting an MD or another degree.

  “Hush.” Her mother put a hand on his arm and leaned close to Laleh. “Aren’t you scared, Laleh joon?” she asked in a whisper.

  “A little,” Laleh said. Okay, a lot, if she was honest. After all, they would basically destroy part of her heart with a hot wire. Not exactly a pleasant thought, so she tried to ignore her fears and focus on the facts. “But I trust the doctors here. His inability to speak in nonmedical terms aside, Dr. Myers seemed very competent. There’s a ninety-five percent chance of the ablation curing my problem and only a three percent risk of anything going wrong. I like those odds.”

  Her mother frowned. “Did the doctor say that?”

  Laleh paused. She couldn’t remember his exact words. Had he quoted those numbers? “He must have. How else would I know it?”

  Before either of her parents could answer, a nurse pulled back the curtain surrounding Laleh’s bed. “I’m sorry, but visiting hours are over. We should let the patient get some rest. You can see her in the recovery room right after the procedure tomorrow morning.”

  Tears glittered in her mother’s eyes as she bent over Laleh and kissed her on each cheek. She held on as if never wanting to let go.

  “I’ll be fine, Maman. I promise. I have a good feeling about this.”

  Her mother clung to her a moment longer before releasing her. “I’ll bring you something to eat,” she whispered before stepping back. “Bita was in this hospital last year, and she says the food is horrible.”

  Laleh had to smile. Her mother, forever feeding people. She could imagine her smuggling in a dozen containers of food as if on a black-ops mission.

  Her father kissed her on each cheek too and then paused for a moment and gazed into her eyes. He looked as if he wanted to say something. Finally, he just squeezed Laleh’s hand and nodded at her.

  The last thing Laleh saw was her parents reaching out to each other for support before the curtain was drawn shut behind them.

  * * *

  Hope’s shift had ended an hour ago, but by the time she had brought the colleague who was relieving her up to speed on every patient in the ER and had finished her charting, it was already after eight. Even the night-shift nurses had left by now, eager to get home and into bed.

  Yawning, Hope put on her leather jacket over her scrubs and walked past the nurses’ station. But instead of heading straight for her car, she found herself in front of the elevator. It would take only a minute to go up to the CCU and check on how Ms. Samadi had fared during her catheter ablation.

  Are you crazy? Since when are you checking on patients once they’re out of the ER?

  Only once, after treating a little girl that had been run over by a drunk driver, had Hope allowed herself to head up to the PICU. Normally, her responsibility for her patients ended as soon as they left the emergency department—and she liked it that way. It was part of what had attracted h
er to emergency medicine. Some of her colleagues regretted not getting to follow up on patients beyond the end of a shift, but Hope was perfectly happy with the brief encounters. Instead of forming long-term relationships with her patients, as family practitioners did, she could either release them or hand them off to the OR or to one of the regular floors after she had stabilized them. If her childhood—and her relationships—had taught her one thing, it was that forming attachments was a bad idea. They never lasted anyway.

  Exactly. No emotional involvement, remember? Go home. Pick up some takeout, and catch some sleep.

  Resolutely, she strode past the elevator and toward the exit.

  But before she could even make it out of the hospital, a man stopped her. “Excuse me. Could you, by any chance, tell me where the CCU is?”

  “Sure.” She pointed back over her shoulder to the elevator she had just left behind. “You go up to the third floor and then turn right. You can’t miss it.”

  “Thank you.”

  “No problem, Mr. Samadi.”

  She wanted to walk past him, but he was still blocking her way, staring at her.

  “How do you know my name?” he asked.

  “Your name?” What the heck was he talking about?

  He nodded repeatedly, looking a bit like a bobblehead doll. “Yes. You called me Mr. Samadi.”

  Had she really?

  “Do we know each other?” he asked.

  Hope usually had a good memory for visual things such as faces. She was fairly sure she had never seen him before, but he did look familiar. With his black hair, large brown eyes, and his tan complexion, he could be mistaken for Italian, but his long, straight nose and his high cheek bones said something else. “No, but…you must be Laleh Samadi’s brother.” Somehow, there wasn’t a doubt in her mind.

  His eyes widened. “How do you know?”

  “I was the doctor who treated her in the emergency department the day before yesterday. The family resemblance is obvious.”

  “Really?” He ran his hands through his hair. “Huh.”

  “Well, that and you asked for directions to the CCU, so I put two and two together…”