Irregular Heartbeat

by Chris Zett

  They perused the menus in silence. Emily searched for a safe topic. “What are you having? The burgers are good.”

  Diana nodded. “I know. I’m here too often for my own good. I’ve little energy for cooking lately.”

  The waitress interrupted them with their drinks and asked for their orders, and they both decided on the burgers.

  “You cook? From scratch, with real ingredients, or do you just microwave something?” Emily asked after the waitress had left.

  Diana snorted. “No, with real vegetables, spices, everything made from scratch. I grew tired of fast food during my residency and the first year on tour. I had a lot of time between rehearsals and songwriting. The property where we all lived when we didn’t tour used to be a farm, and Mel revived the kitchen garden for us. Someone was always around, so I experimented. After a few years, the food became edible.” She grinned. “But my kitchen never looked as clean as yours.”

  Emily loved how easily Diana now talked about her past. “So your mother must be proud of you.”

  “Well, she’d be really, really surprised if she knew how much I enjoy it. She always wanted to do mother-daughter bonding with cooking and baking. And I hated it. I preferred to play outside with my brothers. She loved gardening, but that was too boring for me. I was too impatient as a kid.” Diana’s voice held no bitterness, merely amusement. “Did your mother give you cooking lessons too?”

  Emily nodded. “And sewing, knitting, and anything else a good wife needs to know. She was very persistent.” The resentment for wasting her time had faded over the years but never completely left her. She fought to leave it out of her voice. “She’s very old-fashioned. Sometimes I think she got her ideals from the Victorian literature she reads.”

  The waitress brought their food, and they both took their time assembling their burgers without speaking.

  “What do you mean, Victorian ideals? I really can’t imagine what that could be.”

  Emily took a bite of her sweet potato fries to gain some time. “She has this image of a nice, pale, polite young lady in her mind. She always wanted to be like that and for me to be like her. She wanted me to read and study, but to keep my mouth shut when we were outside of the house. She had a never-ending list of correct things to say, to do, how to look.”

  Diana studied her for moment and frowned, but Emily couldn’t detect the usual immediate judgment she had received before. When she had started college, everything about her had been mousy and old-fashioned. Her braid, her clothes, her way of talking. Her first roommate had made endless fun of it. In the second year she had lived with Jen, who had helped her to break out of her shell.

  “Is that the reason you try so hard to cover up the cute freckles?” Diana’s observation was spot-on.

  “They’re not cute. I look much too young and immature with them. Appearances are as important as medical skills in our job.” Emily knew she sounded defensive. Heat rose in her cheeks, and she tried a big sip of the ice-cold water, hoping it would stop her blush from blooming.

  Diana shrugged and finished chewing her last bite. “I’m sorry, I didn’t want to make you uncomfortable. I just think you’d look great without makeup. But it’s definitely not my place to tell you that.” She smiled at Emily before she concentrated on her food again.

  The compliment thwarted any chance of containing her blush.

  Diana looked up. “I just remembered something. In the park, when we met the first time, you really meant what you said about not running in the sunshine. It was because of your freckles and not just a stupid excuse to get rid of a resident.”

  Emily shook her head. “No, no, it wasn’t. Did you think that?” She reached out to touch Diana’s hand. Wait, what are you doing? She detoured to her glass instead. “I’m sorry. I know intellectually that my upbringing was weird, but sometimes, especially when I’m nervous, I fall back on those habits.”

  And now she had admitted to being nervous about meeting Diana at the lake. She rearranged the slice of avocado that had nearly fallen off her chicken breast burger and tried to judge Diana’s expression from the corner of her eye.

  If Diana had noticed, she didn’t let on, but then again, she had a pretty good poker face.

  Emily decided to shift the focus away from herself. “I can’t imagine how it was to grow up with brothers. How many do you have?”

  Diana grinned. “Five.”

  “Five? That’s… Wow.” Emily had always wanted a brother or sister, but she would’ve been happy with one or two.

  “That’s probably four too many. I was the youngest and got tossed into a house full of chaos. It was loud. Dirty. Hungry. But so much fun.”

  She proceeded to tell funny anecdotes about all of them between bites of her burger. Sometimes she illustrated a point with her hands, and Emily tried hard not to stare too long at them.

  Slowly, the sunlight faded, and several lights placed strategically in the trees around the patio started to glow. The waitress delivered a lit candle in a glass jar and refilled their drinks.

  A comfortable warmth spread slowly from Emily’s middle to her chest. The just-two-colleagues mantra had ceased working somewhere between her admission about the freckles and Diana’s compliment. This felt dangerously close to a date, two women having a candlelight dinner and talking about their families. Since it probably was the only chance of getting one with Diana, she decided to pretend it was, in fact, a date. Nobody needed to know the truth. Her longtime fantasy of the shy girl who grew up in a library and the sexy drummer could be reality for one evening. Tomorrow they could be attending and resident again.

  Chapter 9

  Emily shrugged out of her protective gown, made a ball of the flimsy material, and threw it across the room into the big trash bag. Hitting the bag on her first try wasn’t satisfactory. At all.

  Her gloves followed with more force. They hit the wall, bounced back, and landed next to the gurney in the middle of the room.

  One of the nursing assistants picked them up and looked around for the culprit.

  Emily held up her hand, but her mumbled apology was drowned out by the beeping of the monitor as it came alive again. The shrill alarm hit her like a surprise attack.

  “Shit, I’m sorry. Wrong button.” Madison fumbled with the off switch.

  In the abrupt silence, nobody moved.

  Emily held her breath and took one last look at her patient. Gray pallor. Lifeless eyes. Remains of the fight for his life cluttered the gurney around him like a battlefield. Crumpled plastic wrappers, IV bags, and the now-useless defibrillator patches. Bloody footsteps led nowhere. Anger seeped into the pit in her stomach that had been caved by the futility of the last hour.

  Shaking her head, Emily squared her shoulders and strode to the corner of the room, where Diana was standing next to the computer terminal.

  She seemed frozen in midmotion, one hand clutching a few printouts with scribbled notes, the other hand hovering over the keyboard. As Emily came closer, she tore her gaze from the patient and looked at her instead. The hard green of her eyes softened into warm hazel as she held her gaze.

  Around them the cleanup continued, but Emily paid no attention to the hushed voices. She tried to gauge if Diana was as calm as she appeared to be. She had shown professional behavior, even when it became clear that nothing they did would lead to a positive outcome. Emily knew from her own experience that sometimes the image of composure you projected was in contradiction to the warring emotions beneath the surface.

  “Are you okay?” Emily put her fingers around Diana’s arm without thinking first. The skin was soft to the touch and nearly distracted her from her question.

  Diana smiled and covered Emily’s fingers with her own. “I’m fine. Thanks for asking. I hate when we can’t help anymore, but it’s unfortunately not the first time that happened.”

  Emily acknowle
dged that with another quick squeeze before letting go. Immediately, her hand went cold, and she stuck it into her pocket. “I’ll see if the family has arrived and tell them. Can you finish the paperwork?”

  Diana nodded and closed the computer program with a few clicks. Her hand didn’t shake. “I’ll follow you outside so the nurses have more room to work. They need to clean him up before the family sees him.”

  Turning toward the door, Emily looked at her reflection in the safety glass and straighten her clothes and hair. But nothing she could do would fortify her for the talk that had to come now.

  Emily scanned the waiting room with a practiced gaze and found the family immediately. A woman in her midforties and a teenage girl were holding hands without speaking. Both were elegantly dressed in evening gowns, matching the suit they had cut from their patient. The teenager stared at her smartphone and swiped hastily with her thumb over its surface, probably not seeing anything. The woman had closed her eyes and leaned her head back against the wall. But both turned toward Emily as she came closer, belying their seemingly disinterest in their surroundings. The woman looked anxious and guarded as though she suspected bad news, but the teenager’s face screamed hope. Emily hated to crush her expectations.

  “Are you with Michael Rennin?”

  The woman rose from her seat, pulling the girl up with her. “He’s my husband and this is our daughter, Chloe. Please, can you tell me what happened?”

  “I’m Dr. Barnes. If you come with me, we can talk in private.” Emily ushered them to a family room, where she could break the news without an audience.

  On the way, the daughter started asking questions, but the mother silenced her with a barely audible “Chloe!” and a firm grip on her arm.

  They all took seats around a small table, and Emily took her time to look both of them in the eyes.

  “Mrs. Rennin, Chloe, I’m one of the doctors who took care of Michael when he arrived. Were you with him when he collapsed?” Emily wanted to know how much they had seen before the paramedics had taken him away.

  Mrs. Rennin nodded. “We were at the restaurant. He had been silent for most of the meal and didn’t eat much. He said he might have caught a stomach bug or something. And when the cake came…” She stopped and struggled not to cry. “And when the cake came, he just looked so pale and green, as if he wanted to puke, and suddenly, his eyes rolled back and he didn’t speak anymore and…” Now she was crying, and Emily waited patiently. It was important for the family to share their story. After a minute Mrs. Rennin took a tissue from the box on the table, blew her nose, and then looked back at Emily.

  Chloe spoke for the first time, her voice pitched unnaturally high. “The paramedics, I think they performed CPR, right? It wasn’t a stomach bug, was it?” Both sets of eyes looked at Emily expectantly, the older even more anxious than before and the younger still carrying traces of hope.

  Emily shook her head. “No, it wasn’t a stomach bug. He had a heart attack, a major one. You’re right; the paramedics performed CPR and managed to regain a pulse for a short time. When he arrived here, his heart arrested again. We did everything we could, but in the end, we couldn’t help him. He never had a stable circulation, and he never regained consciousness. He died.” Emily felt her words hit both women like a tidal wave.

  They fell back in their seats. Mrs. Rennin only murmured, “No, no, no,” between sobs and held on to her daughter’s hand. Chloe stared at Emily unblinking, unbelieving, unseeing.

  Emily hated that part of her job, but she had done it often enough to know what to expect. In a minute the questions would start and sometimes the accusations. She didn’t know yet what would come from this family.

  Right on schedule, the wife asked questions, and Emily tried to answer as best as she could. Feeling empathy was natural for her, but expressing it had taken some training.

  She watched the daughter out of the corner of her eye and waited for her to catch up.

  The door opened, and Diana entered, probably to tell her they were now ready to let the family see him.

  Chloe turned from her to Diana and back. “It was a mistake, right? He’s not dead?” Her voice got louder with each word.

  Emily focused on her. “I’m sorry, Chloe. There was no mistake.”

  “No, no! That’s impossible. He can’t be… Not today. Today is my birthday, he can’t be dead. It’s my birthday!” Chloe jumped up and ran to the window.

  Her mother followed her, but Emily didn’t notice what they were doing. Her vision narrowed, and she couldn’t breathe. The tidal wave was back, now a tsunami washing over her. Today is my birthday, he can’t be dead! A rushing sound filled her ears, and the sentence repeated again and again. It wasn’t Chloe’s voice, but her own. She closed her eyes and tried to breathe but was afraid of drowning. Everything swirled around her; the ground beneath her slipped away, pulling her into an invisible abyss. She wanted to let herself be taken away, away from the pain, away from her own crying in her mind.

  A steady hand gripped her shoulder, and a warm voice talked to her. It took her several sentences until she was able to focus on the words and not only the sounds. The voice was pulling her back to safe land, anchoring her. Diana. Diana was talking to her. Slowly, she could discern words from the white noise.

  “Emily, are you okay? What happened?” Diana sounded concerned.

  Emily only stared at her, unable to form a coherent sentence.

  “Can you wait here for a moment? I’m taking the family to see him, and then I’ll be back for you.” Diana squeezed her shoulder. “Okay?”

  Emily nodded, still not trusting her voice. Her gaze followed Diana as she walked to the window to introduce herself and lead mother and daughter out of the room.

  On her way back, Diana detoured to the staff lounge to grab a water bottle and check if anyone else was there. Liz, the other attending tonight, had her feet up on the couch and was drinking coffee.

  “Hey, Liz, can you cover for Emily and me for fifteen minutes? We need to talk about the case.” Diana gestured vaguely toward the code room.

  Liz nodded. “Take thirty. I’m here all night.”

  “Thanks.”

  Diana hurried back to the family room, hoping Emily was still there. What had happened to her? She had looked even paler than usual and ready to faint. At first, she had stared straight ahead and had shown no reaction to anything Diana had said.

  Good, Emily was still sitting at the table. Her face showed traces of pain and maybe anger, but was no longer frozen in shock. She shivered, and Diana had to restrain her impulse to hug her.

  Diana placed the water in front of her and sat next to her. “Are you okay?”

  Emily looked at her with ice-cold gray eyes. “Of course. Why shouldn’t I be okay? I’m okay. Everything is fine.”

  The aggression simmering under the surface was completely unlike Emily. What had triggered that? “If you say so. Sure.”

  How could she get Emily to talk about it? The ED wasn’t the right place to inspire a heart-to-heart. She followed Emily’s gaze to the window. A few trees and bushes were cramped between the main building and a smaller maintenance building. The area would be deserted on a Thursday night. Perfect.

  Diana took a chance. “Emily, could you do me a favor and come with me for a minute?”

  Emily’s eyes widened, and her mouth half opened as if she wanted to say something. Instead, she followed Diana without questions, another sign that she wasn’t herself.

  Diana wanted to avoid other staff and led Emily through back doors and seldom-used side corridors. Soon they were hidden in the sad excuse for a park. She steered her toward a bench where the hospital employees liked to meet for smoking breaks without attracting the attention of the image-conscious administrators.

  Emily looked around. “What are we doing here?”

  Diana pulled her down
on the bench. “Taking a break. Sitting. Talking.”

  “There’s nothing to talk about.” Emily’s voice was as cold as her eyes, but both failed to intimidate Diana.

  “You froze in there. I don’t think the family noticed, but you were out of it for a few minutes.” Emily started to answer, probably to deny it, but Diana didn’t let her speak. “I’m concerned. You looked like you were about to faint.”

  Emily’s eyes grew larger, and tears glittered on her eyelashes.

  Diana took Emily’s hand and softened her voice. “Did the family say something to upset you?”

  “It’s her birthday. Today is her fucking birthday.” Emily sobbed.

  Diana didn’t know what she was talking about, but it didn’t matter. She pulled Emily into an embrace and slowly stroked her back. The sky turned from indigo to gray as Emily’s tears soaked through the shoulder of Diana’s scrub shirt.

  Finally, Emily pulled back and rubbed her eyes with both hands. “I’m sorry.”

  “Don’t be.” Diana burned to know what was going on but restrained herself from asking. They sat for another minute in the rapidly descending darkness.

  “My father died when I was seventeen, the summer before I started college.” Emily’s voice was low, and Diana strained to hear her. “He went to the ED late one evening with pain in his right shoulder and thorax. They did an EKG and cardiac enzymes. In the six hours it took them to get the lab results, nobody examined him. A first-year resident asked some standard questions, but nobody really looked at him. When they returned to congratulate him on not having a heart attack, they found him nearly unconscious.” Emily looked up, directly at Diana. “He had a ruptured gallbladder and died from septic shock.”

  They looked at each other without saying anything.

  “I’m sorry. That’s terrible.” The words were inadequate to convey Diana’s feelings. A surge of protectiveness flared, and she balled her hands into fists. Seeing Emily heartbroken but trying to put up a strong front made her want to hold her again, but she didn’t know if Emily would welcome it this time.