And then the chest pains began. This is it, he thought, I’m going to be one of those men who drop dead at forty.
He went to his GP, David Wang. ‘It could just be stress, Rick,’ David said, ‘although you do have a bit of a heart murmur. Did you know that?’
No, he didn’t.
‘It could be nothing to worry about. But then again, you do have chest pain.’
That night in bed he thought: I’m not ready to die.
But what would ‘ready’ mean?
He was over forty now, and any day death was a possibility. He might need to have a bypass, or a valve replaced. He had heard that any repairs to the heart could be more complicated than a transplant. Surely that couldn’t be true? For one thing, the aftereffects would be fewer. And what did the murmur sound like? A whisper? A slight rumble in the orthodox rhythm? A click? A trill? Was it some kind of electrical fault? And he drifted into sleep, alive to the thought of that murmur, that whispering sound. What am I panicking about? he thought. All I have is a murmur.
One wet Saturday afternoon he went with his son, Luke, to the university’s medical library, bent on doing his own research. But immediately he walked through the door of the Bosch building he was overcome by his old library claustrophobia with its memories of enforced tedium, of the brain in institutional harness. He had always felt an antipathy to books en masse; stolid, musty little rectangles of the arcane. Using the keyword ‘Murmur’ on the medical library data base, he scrolled through a bewildering array of titles: Clinical Disorders of the Heartbeat/The Disorders of Cardiac Rhythm, Vols I and II, Interpretation of Complex Arrhythmias, Electrosystoles and Allied Arrhythmias, Intraventricular Conduction Disturbances, Frontiers of Cardiac Electrophysiology and Ventricular Tachycardia. Proceeding on the intuitive principle that the right book would jump out at him from the shelves, he strolled through the rows of cardiac books while Luke rode his scooter up and down the parapet outside. The books were more dryly technical than he had anticipated and there seemed to be two hundred varieties of heartbeat, each characteristic of a different syndrome and carrying a different name, not one of which spelled out Dream-disoriented Systems Analysts in Mid-life Panic. And he knew his coming was absurd. After only a few frustrated and increasingly half-hearted minutes his eye was caught by the title of a slim black volume, Sudden Death of Athletes, written by a man with the improbable name of Jokl. Taking it from the shelf he slumped into a black vinyl reading chair and read a lurid chapter on ‘Collapse Syndromes’: hypothermia, effort migraine, mountain sickness and cataplectic loss of muscle tone (athletes collapsing of shock when informed of their win), the Mexico Olympics in ’68 proving to be of special interest.
This is absurd, he thought. He stood up, walked outside and whistled for Luke, who was careening down a long path into the trees. On the way home they stopped for pizza and a bag of movies on DVD.
A week later he presented himself for an echocardiogram. It was somewhere around six o’clock on a rainy Thursday evening and there he was, sitting in the antiseptic waiting room of one of those private pathology centres that smell of money and death.
He was the only one there. Waiting to be summoned. Within an hour, he was thinking, everything in my life could change.
It was a heavy old house, a Victorian mansion converted into medical suites with cheap chipboard partitions subdividing what were once grand and gloomy salons. After a time, a statuesque woman appeared and beckoned him over. ‘Richard?’ she asked.
‘Rick. It’s Rick.’
‘Hi, Rick, I’m Helga.’
Helga was a large Nordic-looking woman in her fifties, solidly built with cropped blonde hair streaked with grey.
‘Ever had an echocardiogram before?’
‘Never.’
She pointed to a cubicle. ‘Strip from the waist up.’
‘Shoes?’
‘No, you can leave your shoes on.’
For some reason this summoned up the notion, both comic and macabre, of dying with his boots on. Draped in a clinical wrap made of pale-green paper, he opened a padded door and entered a small, dim room where the ultrasound machine was waiting for him, a stolid block of gun-grey metal, six feet at its highest point, with two small video screens at the top. Helga, he realised, was the technician, or rather, the high priestess in charge.
Lying on the high white surgical bed, with his head resting on a small pillow, he felt as if he had been taken up into a spaceship by a benign alien.
He liked Helga. There was a certain warm gravitas about her; in her pale-olive track pants and grey ugg boots, which on anyone else would look shapeless and woolly, Helga looked stylish, like an astronaut in a lab. She had a comfortingly androgynous quality, like a hi-tech angel, a cross between Nordic hausfrau and goddess. It was clear she read the heart like an old letter, like the back of a cereal packet; there were no mysteries there for her, but nor was she jaded. There was a quality of concentration, of low-key command: rapid, efficient, absorbed. She worked the machine in the way that competent women cook, with the kind of familiarity and ease of those who’ve done it all before, but with the relaxed alertness of one who knows that at any minute it could all go wrong, something malignant and fatal could appear, some squiggle or smudge on the screen that could signify a death sentence for the hapless figure prone on the surgical bed. Some fatal flaw, some warp or blockage, or malformation; some enlargement, or tissue damage, or clot, or calcification; some startling arrhythmia like a code that’s been scrambled; some electrical fault running malign interference.
Ah, but here was another alien. A man in his sixties came in and introduced himself as Dr. Cullen. He was old, grey, thin and dry-looking and Helga called him ‘Doc’.
So there he was, Richard Kavanagh, lying in his green paper gown on a white surgical bed, reclining on his left arm, like a model sitting for a life class. On the wall opposite was a poster in the abstract style, a large red tube with smaller, thinner offshoots at one end. In this room everything was tubes, even the token artwork. Helga, meanwhile, was holding a small tube that looked like one half of a stethoscope and was rubbing one end of it with some gel.
‘What’s that?’ he asked.
‘That’s the traducer,’ she said, and he smiled, because the name itself conjured up trespass and violation. Meanwhile Helga was placing the traducer firmly against his chest, just under the left nipple, pressing hard against his rib cage so that it hurt.
Without fanfare his heart appeared on the top right-hand screen.
Just like that.
He was gobsmacked. There it was, in black and white, a slightly blurred image of heaving mass, working away with such ferocious energy that he was in awe. Even more in awe than he had been when he first saw his son’s foetal form in utero on the ultrasound screen. In awe of himself? Well, that made a change. Nothing, he thought, prepares you for the experience of seeing your own heart. He continued to gaze at it in frank arousal, almost expecting a round of applause.
Helga, of course, was disinterested. Sitting on her high stool, leaning in towards the machine, she began matter-of-factly to scan the image from different angles and cross sections, adjusting the dials to give close-ups of certain features, like the valves; reading off numbers to Cullen, who sat behind her on a low chair and repeated her observations, muttering comments in corroboration or dissent.
Helga was reeling off the numbers. ‘27, 28, 47 … good functioning of the left ventricle … 28, 40, 8 … 7, 21 … A good set of numbers there, Doc,’ she said, and winked at Rick, letting him know that she was mocking the words of the economic pundits.
Cullen looked up from his notes and peered at Rick over the top of his half-moon glasses. ‘It’s all numbers these days, isn’t it?’ he said dryly.
Rick smiled politely, thinking: It’s like watching the Keno machine on TV. This is my life’s lottery, my flesh-and-blood poker machine.
Suddenly there was a noise, and he realised with a start that Helga was adjusting the sou
nd dials on the machine and this, now, was the sound of his heart … whoosh-whoosh! it went, whoosh-whoosh! like a loud, emphatic washing machine. Look at that pump; that manic, heaving pump – rhythmic, implacable – could that really be him? All those times in his life when he had suffered from lassitude, from negativity, from doubt and despair, all that time this heart had been oblivious … whoosh-whoosh! … Here it is, he thought, the prosaic soundtrack of my self. Indifferent to the dreary thoughts of my brain, it pumps on regardless. And he was moved. Yes, he had been told about it, had had it described for him, seen other people’s hearts on TV in documentaries, but let me tell you, he will say to Zoë that night, it’s different when it’s yours.
Helga and the Doc were still muttering to one another, swift, matter-of-fact statistics and appraisals. By now, all fear had left him. He wanted to ask a dozen questions but he didn’t want to disturb their concentration in case they overlooked some tiny but fatal flaw. So he gazed at the wall opposite his feet, at another print in hazy patterns of blues and greens, soft and soothing. He heard Helga say: ‘17, 21, 28 … a murmur there …’
A murmur! He jerked his head up. This was it. This was the death sentence.
‘… but I’d say that was trivial, Doc. I wouldn’t say that constituted a prolapse.’
Cullen was gazing up at the screen, his glasses having slid down to the end of his beaky nose. There was a horrible pause, and then he said: ‘No, not a prolapse.’
‘What does that mean?’ asked Rick, sharply.
‘Nothing to worry about,’ said Helga, still staring up at the screen. ‘I’ll explain in a minute.’
Then Cullen left the room, unceremoniously, with only a dry nod at Rick who was no longer interesting, who had failed to produce an interesting set of numbers. Helga switched off the machine.
Just like that.
No more heart. Heart put away, back in its rib cage, back in its box.
Helga leaned forward on her stool and adjusted her glasses.
‘There is a murmur,’ she said, ‘which is what your GP heard, but it’s an innocent murmur.’ She said this quickly, so as not to cause him alarm. She called it ‘trivial’.
‘What does that mean?’
She brought her two index fingers together. ‘This is the normal valve’ – moving one finger up over the other an almost imperceptible fraction – ‘and this is yours. There’s just a very slight misfit, if you like, an infinitesimal gap or cusp. A slippage. If bacteria get in through this, into the bloodstream, they like to congregate there and breed.’
He had heard of this condition. He had heard (but didn’t like to say) that the bacteria eat away the valve and then you’re in big trouble. Yes, he would say it.
‘They can damage the valve?’
‘It’s rare. Very rare. That’s why you take antibiotics before dental treatment, just in case.’
‘That’s it?’
‘That’s it.’
The verdict: innocent. But still he couldn’t quite accept it, still he was holding his breath. ‘I just don’t understand,’ he said, ‘how any murmur, any deviation from the norm, can not mean something.’ How could a murmur be innocent?
At which point Helga put her large reassuring hands on his shoulders. ‘There is absolutely nothing,’ she said, ‘wrong with your heart.’
Back in the cubicle, he put on his clothes. He felt he would like to shake Helga’s hand, or kiss her on the cheek, but that would be inappropriate. It was all routine to Helga. Helga saw eight hearts a day.
Outside. He was outside and walking down the winter dark of Macquarie Street, past the Catholic shop with its sombre cruci-fixes, its painted statues of the Virgin, its gilt candles. He paused for a moment by the window and looked for a statue of the Sacred Heart. There wasn’t one. Perhaps it was out of fashion now, that lurid icon of blood and fire. There had been no blood and fire on the machine, just the blurred black-and-white smudges, the rhythmic pulsing, the whoosh-whoosh. And Helga the high priestess.
It was four blocks to the underground car park and he walked them in a kind of alert trance, breathing in the cool, damp smell of rain, taking in the world around him; the all-but-deserted city, the wet road, the traffic lights, the grey drizzle, and all the time in his mind’s eye that surging, inexorable mass of muscle and blood, his heart.
So long as the heart is doing its work, the murmur may be pardoned for its innocence. He had read that in a book in the Bosch Library and it had lodged in his brain: things may not always be perfect but that doesn’t mean they can’t do their job.
And it was nothing personal, not something he could take credit for. If they took it out of him and put it in someone else it would go on in exactly the same way; like the rhythm of the universe, like the movement of the tides. And he felt humbled: it did all this work for him, without pause or rest; twenty-four hours a day for forty-three years. Such a long time for a muscle to pump without missing a beat. Suddenly it seemed almost beyond being credible. No wonder they called it the miraculous pump. The cyclonic funnels, surging and throbbing, like mini-storm channels. Relentless – that was the word he was searching for, the quality he was awed by; the sheer relentlessness of it. He knew his other organs were working hard but not so dramatically, so noisily, not with the same unabated, day-into-night, night-into-day rhythm. And what he felt was gratitude. He was grateful and he must show his gratitude. He must not take this heart for granted. He must find a way to exercise more. And to relax. He had his heart, and his heart was good to him. Why wasn’t he good to his heart?
For some time after the ECG he existed in a state of simple-minded gratitude that was new to him. For a while he felt good, almost invincible. Small pleasures would ambush him; the simplest things. Spring arrived, and he began to feel that the worst of his anger was over.
It was a Wednesday morning. He was feeling off-colour and he rang the office to say he had the flu that was on the rampage that spring and he would not be coming into work. Zoë was late and frazzled and sharp-tongued with Luke. He hated it when she spoke to the boy like that, even though, increasingly, this was the way he, Rick, spoke to her. It was one of those hateful mornings of family dissonance, though he wouldn’t for a minute blame her for what was to come.
‘I’ll drive him to school,’ he said. ‘I’ll drop you off at the station first and you’ll save twenty minutes.’
She shot him a glance, almost of truce. ‘Thanks,’ she said.
By this time he had lost the knack of patient endurance in peak hour – if ever he’d had it. Cars banked up all down the highway like a line of moronic tin beetles, while the humidity, already rank by 8 a.m., seeped into the car like a noxious gas until he felt he was bumper to bumper in thick cotton wool.
Two blocks before the school he pulled into the kerb by a small park opposite a frantic intersection. Cautioning Luke to be careful crossing the road, he watched as the boy, nervously glancing from side to side, waited for the lights to change and then ambled across the road with his distinctive bobbing walk, his backpack dangling awkwardly from one shoulder.
He waited until Luke had disappeared through the school gates and then he turned the key in the ignition. Then he turned it off again. There was a small convenience store on the corner and he would get the paper and some milk. They were out of milk and he was looking forward to coffee. He walked to the edge of the corner and stepped out onto the kerb. At that moment a flash of white metal swerved with a screech of tyres around the corner on his blind side and almost ran over his foot. The car, a dilapidated hot rod with a gash in the driver’s side and a smashed headlight, stalled on the turn into the main road and suddenly he was standing there looking down through the driver’s window – it was rolled down as far as it would go – and into the glinting brown eyes of a young man. He leaned in and with his open hand he slapped the man across the face, registering in a split second that the face he was striking was black. The driver was a young Aboriginal guy, twenty-two, twenty-five, maybe, who s
tared back at him with eyes of molten rage. And next to him, another face, his friend, whose mouth was open in hostile shock, though only for a second, perhaps two, before it widened into a grimace of growling obscenities.
Not that he heard them. Or rather he heard them, but didn’t hear them because his attention was focused on the driver, who had flung open the door and was lurching towards him.
For a moment he considered turning to run, but his pride would not allow this. The first blow he felt against his upper right temple. The second caught him on the shoulder. Positioning his feet instinctively to maximise his balance, as he’d been taught in martial-arts class as a boy, he ducked from side to side as the blows came, one after another. Not for a second did he consider fighting back. For one thing, he was in the wrong, and his heart was a black hole of stupefying foolishness, a sunken galleon in his chest, and for another, if he managed to land even one halfway decent punch then the other guy in the passenger’s seat would get out and he’d really be done for: there was no way he could beat the two of them, and probably not even this one who was younger and fitter and heavily built. The blows came at him in a rush and any one of them might have smashed his jaw or broken his nose if he hadn’t been ducking and weaving so that they glanced off him in jolting grazes and he scarcely felt the lacerations of his skin, the bloody contusions on his scalp. But with the fifth blow he felt the hard bone of knuckle against his skull and he fell to the grass, almost in slow motion, for a moment on his knees and then keeling over, slowly, onto his side, so a green blade of grass was in his eye, the dank earth in his nostrils.
He lay there in a daze, thinking: Here it comes, the boot in the head. But it didn’t.
When eventually he sat up, shaking his head slowly from side to side, he looked around him. The hot rod was gone. A woman and her two small daughters were staring at him as if he might bite.
‘Are you alright?’ the woman asked. ‘Do you want me to call the police?’
Reading Madame Bovary Page 9
