Dean Koontz
Page 10
“Hypertrophic. That’s the kind I’ve got.”
“Yes. An abnormality of heart-muscle fibers. The heart cells themselves do not function properly.”
“And the cause?”
“Usually it’s an inherited disorder.”
“My parents don’t have it.”
“Perhaps a grandparent. Sometimes there are no symptoms, just sudden death, and it’s simply labeled a heart attack.”
Ryan’s paternal grandfather had died of a sudden heart attack at forty-six.
“What’s the treatment?”
The cardiologist seemed embarrassed to say, “It is incurable,” as if medical science’s failure to identify a cure was his personal failure.
Ryan focused on the golden retriever in the family portrait. He had long wanted a dog. He’d been too busy to make room for one in his life. There had always seemed to be plenty of time for a dog in the years to come.
“We can only treat the symptoms with diuretic drugs to control heart failure,” said Dr. Gupta, “and antiarrhythmic drugs to control abnormal rhythms.”
“I surf. I lead a fairly vigorous life. What restrictions are there going to be, how will things change?”
The cardiologist’s hesitation caused Ryan to look away from the golden retriever.
“The primary issue,” said Dr. Gupta, “is not how restricted your life will be…but how long.”
In the physician’s gentle eyes, as in a fortuneteller’s sphere, Ryan saw his future.
“Your condition is not static, Ryan. The symptoms…they can be ameliorated, but the underlying disease is not arrestable. Heart function will steadily deteriorate.”
“How long?”
Dr. Gupta looked away from Ryan, at another photo of his family that stood on his desk. “I think…no more than a year.”
Wednesday night, writhing in pain on the floor of his bedroom, Ryan had expected to die right there, right then. In the days since, he had anticipated being felled at any moment.
A year should, therefore, have seemed like a gift, but instead the prognosis was a psychic guillotine that cut through him, and his anguish was so intense that he could not speak.
“I could tell you about advances in adult stem-cell research,” said Dr. Gupta, “but there’s nothing coming within a year, perhaps nothing ever, and you aren’t a man who would take comfort in such wishful thinking. So there is only a transplant.”
Ryan looked up from the envelope containing Teresa’s photograph, which he gripped with both hands, as if it were a buoy keeping him afloat. “Heart transplant?”
“We’ll register you with UNOS immediately.”
“UNOS?”
“The United Network for Organ Sharing. They ensure equitable allocation of organs.”
“Then…there’s a chance.”
“Frequently the results of a heart transplant are quite good. I have a patient who has lived the fullest life for fifteen years with a new heart, and she’s still going strong.”
Instead of ameliorating Ryan’s anguish, the possibility that he might escape death through a transplant rendered him even more emotional.
He did not want to be reduced to tears in front of Samar Gupta, and in searching for something to say that would help him stave off that embarrassment, he returned to the central theme of the past few days: “Could I have been poisoned?”
Dr. Gupta frowned. “Surely not.”
“Dr. Stafford did mention it as a possible cause of an enlarged heart. Though he also did…dismiss it.”
“But in studying the biopsied tissue,” the cardiologist said, “I feel quite sure your case is familial.”
“Familial?”
“Inherited. The cell characteristics are classic for a familial attribution.”
“You’re quite sure,” Ryan said, “but not certain?”
“Perhaps nothing in life is certain, Ryan.”
Having successfully repressed his tears, Ryan smiled thinly and said, “Except death and taxes.”
Dr. Gupta received Ryan’s smile with gratitude, and smiled himself. “Although at least the IRS will give you your day in court.”
TWENTY-THREE
In the days following his appointment with Dr. Gupta, Ryan surrendered to fits of denial during which he spent hours obsessively searching medical sites on the Internet for the latest developments in the treatment of cardiomyopathy.
When he found no scientific news dramatic enough to lift his spirits, he switched to alternative-medicine sites. Eagerly he sought stories about patients cured with the bark of an exotic Brazilian tree or with a tea brewed from the leaves of a plant found only deep in the jungles of Thailand.
Again and again, he read a thick packet of material about heart transplants, provided by Dr. Gupta. On each reading, his admiration for the skill of contemporary surgeons gave way to frustration over the imbalance between the number of patients in need of transplants and the number of organ donors, and to impatience with the system established by the health-care bureaucracy that was authorized to address that imbalance.
As he struggled to adjust to his radically altered future—or lack of one—Ryan avoided Samantha by pretending still to be in Denver on business.
Before seeing her, he wanted to live with his diagnosis long enough to begin to accept it. He intended to be in control of himself when he shared the news with her, because regardless of what happened between them, the meeting would be perhaps the most important of his life. He needed to be sufficiently composed to remain alert to every nuance of what she said, to every subtlety of her expressions and her body language.
The photo of Teresa continued to intrigue Ryan.
On the flight home from Colorado, he had brought the photo-analysis workstation that Wilson Mott established for him in the Denver hotel. It now stood on the desk in the retreat off the master bedroom.
When he could not ascertain if in fact a foreign object was lodged in the dead woman’s mouth, he next divided the photograph into eighty one-inch squares, enhanced them one by one, and analyzed them exhaustively. Some revelatory item might be snagged in her lustrous golden hair or half folded in a pillow crease. Or perhaps in a way impossible to fully imagine, a faint mark on her face might provide a clue that linked Teresa’s death to Ryan’s current crisis.
After he had studied twenty squares over two days, however, he began to feel that he was engaged in a foolish quest, that the photo had electrified him solely because Teresa was Samantha’s twin, which made seeing her in this condition seem like a clairvoyant glimpse of Sam’s death, therefore a profound shock.
Eventually he switched off the computer, intending to abandon his analysis of the portrait.
Although the digitized photo on the monitor no longer held any fascination for him, though he was weary of it, the original eight-by-ten glossy still riveted him when he extracted it once more from the manila envelope. He was pierced again, as he had been pierced in Spencer Barghest’s study, by the conviction that with this photograph he was trembling on the brink of a discovery that would do more than explain all of the recent weirdness, that would also and literally save him.
In business, over the years, every hunch proved worth pursuing. But his recent moments of irrational speculation, his newly developed tendency to paranoia, might be the consequences of the compromised efficiency of his heart, the diminished oxygenation of his blood. In that case, his intuition could no longer be trusted, nor could he be sure that his thinking would always remain as clear as it had once been.
He did not for a moment dwell on the unfairness of receiving a death sentence at thirty-four. In this case, as with any negative turn in life, you could whine or you could act. Action offered the only hope.
Unlike in business, where courses of action in an emergency were constrained only by the sharpness of your wits and your willingness to work hard, options in a health crisis were more limited. But Ryan refused to be a victim. If a way existed to escape the grim prognosis that bound him, he w
ould discover how to slip the knot and cast off the ropes.
While he adjusted to his condition and rapidly educated himself about organ-sharing protocols and transplant-surgery techniques, he expected to be felled momentarily by another sudden seizure, but he wasn’t stricken. Dr. Gupta had prescribed three medications that apparently, for the time being, were repressing the symptoms that had recently plagued him.
Through Thursday, he remained in the master suite and did not once venture elsewhere in the house. He didn’t want to see anyone, because he worried that during even innocent conversation, he might imply—or someone might infer—that he had a serious health problem. He did not want a hint of his condition to reach Samantha before he was ready to break the news to her.
On Kay Ting’s voice mail, he recited a list of meals and snacks that he would prefer and the times at which he would like to receive them. These deliveries were made by food-service cart and left in the elevator alcove outside the master suite.
Sometimes, when he fell into a hypercreative flow state while writing a piece of software, Ryan passed days like a hermit, living in his pajamas and shaving only when his beard stubble began to itch. Therefore, this regimen would not strike the household staff as peculiar.
He didn’t worry much that what he ate and drank might be laced with poison or with hallucinogenic drugs. Since suspicion had led him to Rebecca Reach and then to Spencer Barghest in the house of the modern-day mummies, the Tings and other household employees seemed to be the least likely of the people in his life to be conspiring against him.
Besides, the damage to his heart had already been done. The poisoner, if one existed, would achieve nothing by administering superfluous doses but would risk revealing his identity.
The dreams of sunken cities, lonely lakes, and demon-populated palaces no longer troubled Ryan’s sleep. He heard no unexplainable tapping, no moth or bird or gloved hand rapping at any window, wall, or chamber door.
Perhaps receiving a precise diagnosis and a sobering prognosis had focused him so entirely on a real threat that his mind no longer needed to expend nervous energy on imaginary menaces, and in fact could not afford to do so if he were to concentrate on surviving until a heart became available for transplantation.
By Friday, he was prepared to share his dire news with Samantha. He called her to say that he was home from Denver, and that he hoped to see her for dinner.
“What if we try that new restaurant you were so hot about last week,” she suggested.
“These have been a busy few days, Sam. I’d rather we had a quiet evening, just us. Is your place okay?”
“I’m all cooked out, Dotcom. You bring deli, and it’s a deal.”
“See you at five-thirty,” he said, and hung up.
He considered bringing as well the death photo of Teresa, in case the evening took a turn that required cold questions and hard answers.
After looking once more at the dead woman’s portrait, Ryan decided that even if reason arose to be more suspicious of Samantha than he had yet allowed himself to be, using this picture to shake her confidence would constitute a cruelty of which he was not capable.
He returned the photo to the envelope, which he stowed in a desk drawer.
TWENTY-FOUR
In silk slippers and a blue-and-gold kimono, Samantha was so much lovelier than Ryan remembered her that he felt at once disarmed, and knifed by desire.
He had recently spent so much time staring at her lost twin, whose looks were weathered by suffering, that his memory of her exceptional face had been clouded.
As soon as Ryan put the deli bags on the kitchen counter, Sam came into his arms. She would have kissed him straightaway into the bedroom; and he almost allowed himself to be led there.
Crazily, in memory, he heard the voice of the young woman who spoke for the navigation system in the Cadillac Escalade, leading him back to his Denver hotel and away from the park full of aspens. This bizarre association lowered the flame of his desire, and he regained control of himself.
“I’m starving,” he said.
“You’re kidding.”
“Totally starving.”
“You must be.”
“Look,” he said, “corned beef sandwiches.”
“I really thought this kimono made me irresistible.”
“With that cheese you like and the special mustard.”
“Next time I’ll wear corned beef and cheese.”
“And the special mustard,” he said.
“With pickles for earrings.”
“That’s one fashion risk too many. Look, pepper slaw and potato salad and that three-bean-and-peppers-and-celery dish, whatever they call it.”
“Pepper slaw would have been enough. What’s this—custard cake?”
“And then, here, those fabulous cookies.”
“What’re you fattening me up for?”
“I just can’t control myself in that deli. I shouldn’t be allowed to go in there without a chaperone.”
They transferred everything from bags and plastic containers to dishes and bowls, and then carried the feast to the table on the deck.
“I’m surprised you didn’t bring a keg of beer,” she said.
“You don’t drink beer.”
“I don’t eat eight pounds of deli at one sitting, either, but that didn’t stop you.”
“I brought wine,” he said, pointing to the bottle that he had left on the table on arrival, before he’d gone into the kitchen. “An excellent Meritage.”
“I’ll get glasses.”
After he poured, before they sat at the table, they clinked wine-glasses, and a note as sweet as that from a silver bell rang through the surrounding pepper tree.
They sipped, they kissed, they sat, and Ryan was so instantly comfortable with her that he knew, whether this Sam was a lie or not, he loved her, and he would continue to love her even if there was another Sam who was a conniving bitch.
“It’s been a whole week,” she said.
If it turned out that he had been diagnosed with a bad ticker and this night discovered he was in love with Ms. Jekyll in spite of Ms. Hyde, it would perhaps be the most eventful week of his life.
A web of shadows and late sunshine seemed not to overlay them but instead to entwine them, as if they were embedded in it and it in them, a matrix of light and dark, known and unknown, a warp and woof of mystery from which their future would take shape.
“Why did we let a whole week go by?” she wondered.
He said, “The novel’s going especially well, isn’t it?”
“Good. I’ve had several good days in a row. How did you know?”
Ryan had no intention of telling her that when she was swept up in her writing, she thought less about his proposal of marriage, and that when marriage was not on her mind, she was less chaste than when it was.
Instead, he said, “Your eyes are shining with excitement, and your voice is full of delight.”
“Maybe that’s because you’re here.”
“No. If you were that glad to see me, you’d be wearing corned beef and cheese.”
“Okay, the book. Hard to explain. But text and subtext are coming together in ways I never could have anticipated.”
“That is exciting.”
“Well, it is for me.”
“How are you doing with the past participles?”
“I’ve got them under control.”
“And the semicolons, the gerunds, the whole who-whom thing?”
“If this wine weren’t so good, I’d pour it over your head.”
“Which is why I buy only the best. Self-defense.”
Quick footsteps ascended the stairs from the courtyard.
Ryan turned in time to see the ice-crown of white hair that, in the moonlight one week previous, had identified the tall man in the yard, conferring with Samantha, as Spencer Barghest.
Without the moon, the identification did not hold. This man was Barghest’s body type, but he was a decade
younger than Dr. Death, in his forties, and he lacked the rubbery facial features of a stand-up comic behind which Barghest hid.
“Oh,” he said upon seeing them at the table, halting one step below the deck. “I’m sorry. I don’t mean to interrupt.”
“Kevin,” she said, “please join us. I’ll get another glass.”
“No, no. Really. I only have a moment anyway. I’ve got to be off to the hospital, evening visiting hours.”
As Ryan rose from his chair, Samantha said, “Have you guys met?”
When Ryan regretted that they had not, Samantha introduced him to Kevin Spurlock, the son of Miriam Spurlock, who owned the house that came with the garage above which Sam lived.
“How is your mom?” Samantha asked.
“She’s doing well. Really well.”
For Ryan’s benefit, Samantha said, “Miriam had a very bad attack of angina a week ago—in fact a week ago this evening.”
“She was in a restaurant,” Kevin said. “Paramedics rushed her to a hospital. The worst for her was making a scene in a public place. She was mortified.”
“Heart attack?” Ryan asked.
“No, thank God. But tests revealed blocked arteries.”
“Critically blocked,” Samantha said. “The next morning, she had a quadruple bypass.”
“She loved your flowers,” Kevin told Samantha. “Calla lilies—they’re her favorite.”
“I’ll fill her bedroom with them when she gets home.”
After Kevin had gone, Samantha told a few stories about Miriam, one of which Ryan had heard before. The landlady was something of an eccentric, although unfailingly sweet and kind.
A week earlier, when Ryan thought he’d caught Samantha in a furtive conversation with Spencer Barghest, she evidently had been receiving the news about Miriam Spurlock’s hospitalization.
Seeing a light in the apartment, Kevin must have come to the door. The knock failed to stir Ryan from a postcoital nap. To avoid waking him, Sam had gone outside to talk with her landlady’s son.
Inspired by a paranoid interpretation of this innocent meeting, Ryan had flown to Las Vegas the following morning, seeking proof of a nonexistent conspiracy.