Unspoken Words

by K. M. Golland

  Swallowing, I willed my eyes to open again, spectres of light filtering through, ghost-like and mystical.

  “Beth, I think she’s waking up again.”

  Chairs scraped linoleum and feet scuffled, grating my eardrums.

  I moaned.

  “It’s okay, sweetheart. You’re in hospital,” Mum said.

  “You’re safe, Elliephant.”

  “We’re all here for you,” Dad added.

  The hands clamped around mine softened but still taut, unrelenting, as if they’d never let go, and I knew beyond a shadow of a doubt they were Connor’s.

  “She just squeezed my hand,” he said.

  “Chris, go and get the nurse.”

  The creak of a swinging door vibrated through me, and I pushed harder to open my eyes.

  Mum, Dad, and Connor’s silhouettes hovered over me, all of them a blur at first, but the more I blinked, the clearer they became, all three of them smiling but not quite.

  The door creaked open once again, and a nurse entered the room. Her blonde hair was twisted into a bun, and she had an upside-down watch pinned to her baby blue shirt. Mum and Dad moved back to give her some room, and she leaned over me and smiled while checking the machine by my head.

  “Eloise, can you hear me?” she asked.

  I nodded.

  She touched my arm. “Good. Do you know where you are?”

  I opened my mouth to speak, but nothing came out.

  “Take your time,” she said, her tone kind and authoritative.

  “Hospital.” My voice was coarse and barely above a whisper.

  “Yes. Good. Do you remember what happened?”

  Straining my brain for a memory, some kind of clue, a vision of the concert flashed like lightning. “The concert,” I said.

  She nodded. “Yes, you were at a concert.”

  My eyes shot to Connor, and I let out a sob.

  “It’s okay, baby. I’m here.” He released one of his hands from around mine and stroked the side of my face, his eyes exploding with concern and unspoken words.

  “Your show,” I rasped. “I ruined your show.”

  “You ruined nothing.” He leaned forward and kissed my forehead, his lips damp but firm, and for a second I thought they’d glued themselves to my skin when he didn’t retract them straight away.

  “Can you remember what happened at the concert, Eloise?” The nurse pressed a button on the machine, and my arm all of sudden felt as if it were being squeezed.

  I winced.

  “It’s okay, I’m just taking your blood pressure.”

  “I … I fell … off the stool.”

  She nodded.

  “Did I hit my head?” I tried to lift my arm to touch my head, and to see what was stuck to my chest beneath my hospital gown, but my arm lacked strength, and my hand was sore where an intravenous drip had been inserted into a vein.

  “Yes, you did. But not too badly. Your head is fine.” She gave my arm a light pat.

  Another memory pecked at my mind, and I pressed my eyes shut, remembering how tight and painful my chest had felt, my struggle for air … the sheer terror as my vision blackened. “I … I couldn’t breathe. My chest—”

  The machine beside me beeped faster.

  “It’s okay, Ellie. You can breathe now. You’re safe. Just try to relax.” She pressed a button and the squeezing eased. “Would you like a drink? You must be thirsty.”

  I nodded.

  She smiled and lifted a glass of water with a pink straw to my mouth. “Nice and slow. Not too much, okay?”

  I took a small sip, the water icy cold. It was perfect.

  “I’ve paged Dr Webb. He’ll be here soon to answer all your questions, okay?”

  I nodded again.

  “Good.” She placed the glass back down, picked up my chart, and marked a few things on it before slotting it into the holder at the end of my bed. “I’ll be just outside your door. Press the yellow button on the bedside remote if you need me.”

  When she left the room, Mum and Dad swooped like birds, their hands on my face, their smiles wide, their eyes cautious.

  I searched them for answers. “Did I faint?”

  “Well, yes,” Mum answered.

  “Beth, I think it’s best we let Dr Webb explain the details. We still don’t know the full extent of her condition.”

  “My condition?”

  My eyes shot to Connor and he looked down at my hand.

  “What’s my condition?”

  No one would answer, so I stared at my brother, his expression noticeably different from everyone else’s. Nose scrunched, teeth gritting together.

  “Chris?”

  Just as he opened his mouth to speak, Dr Webb entered the room.

  “Hello, Eloise. I’m Dr Webb, a cardiologist here at South West.” He picked up my chart, glanced at it briefly then tucked it under his arm while moving to the side of my bed. “How are you feeling?”

  “Like a tack,” I croaked out.

  He chuckled, his blue eyes sparkling like ice crystals. “Flat?”

  “Yes. And weak.”

  “Well, that’s to be expected after suffering cardiac arrest.”

  My heart pulsed in my chest as if to punctuate that it was still there and beating.

  “What?”

  He slid a nearby chair underneath him and sat beside my bed, his head face level with mine. “You suffered a cardiac arrest due to Hypertrophic Cardiomyopathy. Have you heard of that condition before?”

  My body stiffened, but I did manage to shake my head.

  “Hypertrophic Cardiomyopathy, also known as HCM, is an inherited disease of the heart, which leads to abnormal thickening of the heart muscle, most often of the left ventricle—the main pumping chamber of your heart.” He flipped the pages of my chart to a blank sheet of paper at the back and quickly sketched a diagram. “This is a poorly drawn example of your heart, but see this side?” he asked, circling one half of the heart. “This side pumps blood out of the heart to the rest of the body bar the lungs.” He coloured a thick outline on part of the heart. “The walls of your left ventricle are much thicker than normal, which is problematic because it causes the heart to work less efficiently, thus pumping much less blood out of the heart and into the body than what is required. As a result, you can experience chest pain, shortness of breath, dizziness, fainting, palpitations and, sudden cardiac arrest.”

  “You died, Elliephant.”

  My eyes widened at my brother’s statement, and Mum whacked him on the arm.

  “I died?”

  “Unfortunately, your brother is correct; you were clinically dead for what we estimate to be four minutes before paramedics at the scene revived you.”

  Connor’s grip tightened on my hand, and I noticed the whites of his knuckles.

  “Your heart stopped, and the reason for that is because sufferers of HCM have an ejection fraction of less than 40%.”

  “What’s an ejection fraction?” I asked, confused.

  “It’s the measurement of how much blood inside your left ventricle is pumped out with each contraction. As I said, sufferers of HCM tend to have an ejection rate of 40% or less. A normal person would sustain between 55-65%. Your measurement, Eloise, is 25%, which is dangerously low in your condition.”

  “My condition?”

  “Yes, I’ll get to that in a minute.” He patted my hand again and then continued. “After consulting with your parents while you were in an induced coma, we’ve discovered a history of the disease on your paternal side of the family.”

  “Wait!” I croaked. My throat was getting sorer by the second. “I’ve been in an induced coma?”

  “Yes. We’ve been safely and slowly bringing you out of it for a couple of days now.”

  Tears stung my eyes and trailed down the sides of my face toward my ears. I tried again to raise my arm, but Connor wiped them for me.

  “Can we fix this HCM thing? Is there a cure?” he asked.

  “O
ther than a heart transplant, there’s no cure nor reversal of the thickened ventricle wall; however, there are some treatments both surgical and with medication that can prevent it from getting worse.”

  “I need heart surgery?”

  “Considering your ejection fraction and the deterioration to your left ventricle at present, yes, you will need heart surgery.”

  Dr Webb took in a deep breath just as the door to my room swung open and another doctor entered—a middle-aged woman with short, brunette hair and navy rimmed glasses perched on the end of her nose. She smiled at Dr Webb, my family, and then at me.

  “Eloise, this is Dr Goodman. She’s a Perinatologist—”

  Mum gasped and covered her mouth with her hand, her eyes wide as she turned to my father. He furrowed his brow, confused, as did the rest of us bar the doctors.

  “Wh … what’s a Perinatologist?”

  Dr Webb stood up and allowed Dr Goodman to take his place in the seat beside my bed.

  “Hello, Eloise, my name is Megan Goodman, and a Perinatologist is a fancy name for an obstetrician who specialises in high-risk pregnancies.”

  After shaking my head for what could have been seconds or minutes, I glanced at Connor who’d turned as white as his knuckles. “I’m sorry, what?”

  She sighed, smiled, and nodded to herself. “I take it you weren’t aware that you’re expecting?”

  “No,” I choked out.

  “Okay. I know this is a lot to take in, especially after what you’ve just been through, but blood tests were conducted while you were in the coma, and they tested positive to elevated levels of hCG, a pregnancy hormone. We also performed an ultrasound and estimate gestation to be nine weeks.”

  “I’m pregnant?”

  “Yes, Eloise. And baby is strong like his or her mum.”

  My hand moved to my stomach while Dr Goodman explained that pregnancy for sufferers of HCM was generally well tolerated; however, a subset of patients did experience significant complications and that I was part of that subset because my HCM was present before conceiving, but more so because of the extent the disease had deteriorated my heart muscle.

  “Hang on a minute,” Connor said, standing up. “So what you’re saying is that if Ellie goes through with the pregnancy without surgery, her risk of dying is far greater?”

  “Unfortunately, yes, that’s what we’re saying.” Dr Webb confirmed.

  “Is there anything we can do to minimise the risk?” Mum asked.

  “Because Eloise’s ejection fraction is so low, it puts her at a very high risk of arrhythmia and subsequent cardiac arrest—”

  “Which is what already happened, right?” Connor massaged his temples, and I could tell he was struggling.

  “Yes, but as the foetus grows, so, too, does the expectation of Ellie’s organs, namely her heart. It will work overtime—”

  “But it’s barely working at all,” Connor interrupted again.

  “Which is why, going forward, we see only two options, one of which would be a last resort.”

  “What are they?” Dad asked.

  “Long term: a heart transplant.”

  Mum burst into tears. “But she’s only twenty-three years old.”

  Dr Webb clutched my chart to his chest and offered Mum a sympathetic look. “HCM isn’t age sensitive, Mrs Mitchell.”

  “Connor,” I said, tugging his hand.

  Everyone stopped talking and looked my way, but I only had eyes for Connor. I only had words for Connor.

  “We’re having a baby,” I sobbed, my eyes filling with tears of joy. It was what we’d always wanted. A family, together. Him and I, not him and Lilah. I guided his hand to my belly. “That’s you and me in there.”

  He smiled, but it didn’t quite reach his foggy eyes.

  Dad hugged Mum to his side. “And what about short term?”

  “We would fit a pacemaker.”

  “When?” Connor asked.

  “We’d like to schedule surgery for the pacemaker as close as possible to the beginning of her second trimester.”

  Everyone’s voices became white noise as I honed my senses on the tiny life growing inside me. My baby. Connor’s baby … Our son or daughter. I’m going to be a mother. Me: Eloise Mitchell. I smiled and caressed my lower belly, completely blown away that Connor and I created something so pure of our love. A miracle. An angelic McCutesy Baby Head. The heart attack, my diagnosis and prognosis … none of it mattered, because I would protect this little life I created with everything I had. Every breath. Every fight. Every ounce of energy.

  “What threat does this surgery pose to my baby?” I asked, interrupting their conversation about me, my body, my life.

  “With any surgery during pregnancy, there is a risk of maternal and foetal mortality. But I must stress that—”

  “No!”

  “No?”

  Both Dr Webb and Dr Goodman exchanged a look that appeared to be resignation, as if they’d predicated my response, as if they weren’t strangers to it.

  “Eloise.” Dr Webb stepped forward and placed his hand on my leg. “If you don’t have this surgery as soon as possible, your risk of mortality increases substantially.”

  “I won’t put my baby at risk.”

  “But, Ellie—” Connor tried to move his hand but I held it there.

  “No,” I said, my eyes beseeching his. “We protect what’s inside here. No buts.”

  His eyes glazed over and his head drooped. “I can’t lose you. Not ever.”

  “You won’t.”

  “You don’t know that.”

  Dr Webb lifted his hand and nodded toward Dr Goodman. “This is all a lot to take in. No decisions need to be made right now. Let’s just focus on your initial recovery over the next week and revisit this discussion then, okay?” He scanned my chart one last time and scribbled down some notes.

  I didn’t answer him, and I didn’t argue, because I didn’t need to. My decision was final and it wasn’t going to change.

  Chapter Thirty-Nine

  Connor

  Ellie drifted off to sleep shortly after Dr Webb and Dr Goodman left the room. Both specialists asked to have a word with Beth, Roger, and me in the corridor, their advice, once again, to reaffirm that surgery was the best way forward but that keeping Ellie calm and stress-free was the priority. Anxiety and stress increased her chances of heart failure, so it was imperative we offered support and not resistance, which was easier said than done when walking a tight rope and Ellie and our baby were the only ones who could fall.

  Our baby …

  “Shit!” I said, my head in my hands as I sat on a wooden bench in the hospital garden, desperate for fresh air. The past forty-eight hours had been a vivid, horrific, blur, and I needed a moment to let it all sink in.

  Ellie died right in front of my eyes. She has a life-threatening disease. She’s carrying our baby. They can both die if she does or doesn’t have surgery.

  “Fuck!” I muttered, blinking back tears.

  “You can say that again.”

  Looking up, I wiped my eyes with the back of my hand to see Chris take a seat on the bench opposite me, his big muscled frame sagging.

  “You all right?” he asked.

  “No.”

  “I’d be worried if you weren’t.”

  “How ‘bout you? You all right?”

  Chris shook his head, leaned forward, and gazed down at his hands that were steepled between his knees. “No. That’s my sister in there. My Elliephant. I’ve never seen her so fragile and helpless, and there’s nothing I can do about it.”

  The leaves on the trees and shrubs dotting the garden rustled with the breeze. I closed my eyes and took in that much needed air.

  “She died, Chris. Twice. Right in front of my eyes.” I choked back a sob. “I can’t let that happen again.”

  “I know, mate. And it won’t.”

  “You don’t know that. Her heart is …” I paused then shook my head, “It’s not strong enoug
h for the rest of her. She’s gonna need surgery, and soon.”

  “I know, but this is Ellie we’re talking about. Stubborn, know-it-all, fierce, protective, Ellie. When she sets her mind to something, you’ll be arsed tryin’ to change it.”

  The glass door to the garden opened, and a middle-aged man in a leather jacket found a spot under a tree and lit up a smoke. I glared at the fucker. Why could he smoke and be fine when Ellie had never touched one and was dying? I bet the ungrateful jerk drank, didn’t exercise, and ate greasy shit all day every day as well. I bet he was fit as a fiddle and took it all for fucking granted.

  Dipping my head, I focussed on my boots before I lost my cool and did something stupid, like butt his smoke on his friggin’ head. None of what was happening made sense, and it sure as shit wasn’t fair.

  “You’re gonna be a dad again, mate, and I’m gonna be an uncle.”

  My chest tightened at Chris’s words, my eyes burning with tears. One slid from my cheek and dropped, a perfect dot dampening the leather of my boot. “I hope so,” I said, wiping my eyes. “But let’s not get ahead of ourselves.”

  Chris stood up, and his sneakers came into view as he stopped beside me, his hand landing on my shoulder, his grip firm and somewhat reassuring. I waited for him to speak, to say something wise—which he always somehow managed—but he didn’t say anything.

  He couldn’t. No one could. Because it was what it was.

  Later that night, the sound of Ellie’s ECG was a consistent rhythm, like the bounce of a ball, a bounce I kept hearing as if to remind me that we do lose the ones we love. I shifted in my seat by her bed, my body stiff, sore and restless. Beth, Roger, and Chris had left hours earlier and would be back bright and early in the morning, but I couldn’t leave—I wouldn’t. I’d attached myself to that damn ECG machine like glue. Alert. Ready. Prepared. For any skip, any pause, I’d hear it, and I’d take action and prevent Ellie’s heart from stopping again. She’d given it to me, twice, and I would protect it in every way possible.

  Bounce.

  Beep.