Heart Failure (9 page)

“I’m here,” Carrie said to the other doctor. “Fill me in.”

He did so in a few sentences, using the medical-speak only a professional would understand. “If you don’t need me, I’ve got an ER full of patients. But call if I can help.” He slid through the curtains and was gone.

As Carrie moved to her side, the woman on the stretcher opened her eyes, blinked, and squinted in recognition. “Dr. Markham. Am I dying?” Her voice was weak, and the effort of speaking seemed to exhaust her.

Carrie patted her hand. “Mrs. Lambert, you’ve had another heart attack—a pretty big one, according to what I see. We need to do a cardiac angiogram to see how to handle this.”

Mrs. Lambert breathed out through pursed lips, then took in a deep breath. “So, another stent?”

“I’m—”

“It depends on what the angiogram shows. You may need an operation to supply more blood to your heart.”

Carrie whirled to identify the speaker. Actually, his voice was easily identifiable to her—she’d heard it only minutes ago—but she couldn’t believe Phil Rushton would try to claim the case without speaking to her first. “Phil, what—”

At that moment a man and woman in hospital scrubs pushed into the already crowded space and positioned themselves at the head and foot of the gurney. The woman spoke to Mrs. Lambert. “We’re going to take you for an X-ray study of your heart.” They busied themselves with changing from the wall oxygen supply to a tank under the gurney. The male member of the team unplugged the monitors, and in a moment they wheeled Mrs. Lambert away.

Carrie glared at Phil. “Can you tell me what’s going on? And why you’re taking over my patient without consulting me?”

Phil made a palms-out gesture. “Carrie, this is Mrs. Lambert’s third infarction. I have no doubt that both her EKG and enzymes will confirm that it’s a major one. Her daughter called the clinic right after you left and asked if I’d take charge of her case if she needed surgery. She gave me most of the history I need. We’ll see what the angiogram shows, but I’m willing to bet that this time stents won’t do it. Your patient will need bypass surgery. Now, unless you want to try to talk her and her daughter into going somewhere else, I think you’ll agree I’m a good choice to do the operation. And the sooner we get to it, the better.”

He was right, of course. Mrs. Lambert was a prime candidate for what medical professionals called a “cabbage.” Not the leafy vegetable. She needed a coronary artery bypass graft, a procedure that bore the acronym CABG. Carrie had to admit the probable need for such surgery crossed her mind as she
hurried to the ER. Mrs. Lambert shouldn’t suffer because Carrie had her feelings ruffled. She shrugged. “Let’s head for the angiography suite. I want to see what the angio shows.”

“Are you sure you want to go back there?” Phil said. “After what happened to John—”

“I’ll be fine,” Carrie snapped. “I’ve been going to the angio suite since two weeks after John died. I’ll be the first to admit it wasn’t easy at first, but I did it.” She turned on her heel and said over her shoulder, “I promise I won’t break down, if that’s what’s bothering you. Now, are you coming?”

As Carrie hurried down the corridor, she wondered about the man matching her stride for stride. Professionally he was as competent as they came. She’d trust her life to Phil. Actually she’d trusted her husband’s life to him. She might have assigned some blame to Phil in John’s death, but now that some time had passed she realized he’d done all he could. The question that continued to plague her was whether she had done all she could as well.

SEVEN

PHIL WAS RIGHT, OF COURSE. THE ANGIOGRAM SHOWED ALMOST total blockage of Mrs. Lambert’s left anterior descending and left circumflex coronary arteries. In layman’s terms, blood flow to the major portion of the heart muscle was cut off. “I’ll talk with Mrs. Lambert and her daughter,” Phil said.

Carrie knew she’d been dismissed, but she couldn’t simply disappear. She’d cared for Mrs. Lambert through two other heart attacks and thought she’d formed a bond with the woman. Even if the daughter asked Phil Rushton to take over the case, Carrie felt an obligation to be there. “I want to go with you when you talk with them. She’s my patient too.”
At least for now
.

She stood by as Phil explained the procedure to Mrs. Lambert and obtained her permission for the surgery. No problem, the woman said. She knew how close to death she’d come—how close she still was. If surgery was what was needed, she was ready.

Carrie’s heart melted when Mrs. Lambert looked at her and said, “Dr. Markham, would you pray for me?” Carrie nodded her assent, afraid to speak.
I’ll try, but my prayers haven’t been too successful lately
. She squeezed Mrs. Lambert’s hand and followed Phil out of the room.

They found the daughter, Mrs. Stinson, in the waiting room. Despite her earlier frustration about the call to Phil Rushton, Carrie sympathized with this harried, middle-aged woman who wore worry lines on her face like a combat badge. Mildred Lambert had lived with her daughter and son-in-law since her husband died over a year ago.

Carrie and Phil took two vacant chairs that flanked Mrs. Stinson. There was no one else within earshot, so this was as good a place as any to have the talk. “Your mother has had another heart attack,” Carrie began. “And this was a big one—almost fatal. So Dr. Rushton needs to perform surgery.”

Phil explained that Mrs. Lambert needed more blood flow to the heart, so he’d take a vein from her leg and hook it up to take the place of the clogged arteries. “We call it a bypass graft.”

“Is it risky?” Mrs. Stinson’s voice was weak, and now tears flowed freely.

“Of course,” Phil said, and went on to explain the potential risks. “But it’s necessary surgery. Without it, your mother would almost certainly die.”

Mrs. Stinson turned for the first time to Carrie, an unspoken question in her eyes.

Carrie nodded. “I agree.”

A secretary came over to the group and handed Phil a clipboard. He glanced at it. “We have the op permit signed. Now I have to get ready.” He rose and hurried away.

“Is Mother strong enough . . . ?” Mrs. Stinson let the words trail off.

“We believe so. The anesthesiologist is excellent. Dr. Rushton is the best heart surgeon around. The whole team is extremely competent. Your mother is in good hands.” Carrie found herself reaching for Mrs. Stinson’s hand. “I have to get back to the clinic. Dr. Rushton will see you as soon as the surgery is over, and I’ll be back this evening. Is there anything I can do for you now?”

Mrs. Stinson blinked away tears. “Just keep us in your prayers.”

Carrie nodded and left the room. She looked at her watch and decided that if she hurried, she could finish seeing her patients and still be on time for lunch with Julie. In the hallway, she heard someone calling her name. Carrie turned to see Rob Cole trotting toward her. “Dr. Markham, I’m glad I caught you.”

“Rob, I really have to get back to the clinic. What’s so important?”

“I wondered about Mrs. Lambert.”

“Did you and your partner have that call?”

“Right. Her EKG showed a massive MI. Did she make it?”

“So far. And you were right—she had a myocardial infarction. Dr. Rushton is doing a CABG right now.”

“Well, she’s in good hands,” Rob said. He ducked his head, and Carrie thought he looked about fourteen years old when he did. “Um, I know that you’re a doctor and I’m only an EMT, but I was wondering if you’d like to have a cup of coffee together sometime.”

Carrie put her hand on his arm. “Rob, I’m flattered, but I’m involved with someone else. Thank you, though.”

Rob was a good-looking young man who’d just asked her out. And Phil, despite his usual demeanor, had sent some signals of interest as well. Some women probably would be thrilled to have that much attention, but Carrie wasn’t one of them. No matter what had happened, she wanted to honor her commitment to Adam.

She thought about the ring she’d given back. Did she regret that action? No. Although she was in love with Adam, Carrie didn’t think they could move forward until they were no longer in danger. She only wished she knew when that might be.

Carrie and Julie had decided to meet at a restaurant in the Galleria, a large shopping center north of Dallas. Julie was already at a table toward the back, and the sight of her friend made Carrie’s face light up.

Julie jumped up and met Carrie halfway to the table. The two friends hugged.

“I’m sorry I’m late,” Carrie said. “Things were crazy this morning.” She took the chair next to Julie and tossed her purse onto the vacant one beside her.

“No problem,” Julie said. “Catch your breath, get something to drink, and we can talk.” She sipped her iced tea. “Afterward, I have orders from Barry to check out the Nordstrom here. He agreed to pay for our lunch if I brought home something frilly.” She raised an eyebrow.

Carrie grinned. In a few minutes the two friends were chatting as though no time had passed since they were last together.

The waitress served salads, and for a moment the two women nibbled, although neither seemed as interested in eating
as talking. Finally Julie said, “Now for the reason we’re here, I guess. The last time we talked, someone had taken a shot at you, after which you discovered your fiancé wasn’t who you thought.”

“I’ve found out even more since then,” Carrie said. She leaned forward and laid out all she’d learned from Adam. “The real question isn’t whether I love him—despite everything, I still do—but what we’re going to do to get out of this mess.”

“I don’t suppose you’ve talked with anyone else about the situation,” Julie said.

“Who would I tell? My parents pretty much washed their hands of me when I became a Christian my first year in med school. I don’t have any siblings—you’re the sister I never had.” Carrie leaned across the table. “You’re my best friend.”

“Even though we were both in love with Billy Kiker in the third grade?”

“Even then,” Carrie said, and laughed for what seemed the first time in weeks.

Julie took a forkful of salad. “Why didn’t Adam tell you all this before he asked you to marry him?”

Carrie put down her fork. “He admits he probably should have, but he thought he’d made a clean start in Jameson and hoped he could get by without revealing his past.”

“And you can forgive him for that?”

“When I think about how supportive Adam’s been, when I realize how wonderful it’s been to have him in my life—yes. He taught me how to smile again, Julie. When he and I first met, I was a wreck, mainly because of what happened to John.”

“Stop it! John had a cardiac problem that no one, not even a great diagnostician like you, could have noticed. And even
though the odds of a complication like the one he experienced are slim, that doesn’t mean it can’t happen . . . even with the best possible medical care.” She reached to pat Carrie’s hand. “You have to accept that.”

Carrie inhaled, taking a moment to compose herself. “I know. And I’m making progress there.” She took a swallow of tea. “The guilt about John’s death isn’t as bad as it was, although there are still triggers. But now I’m really frightened for Adam. The shooting, the firebomb, someone trying to kill him—and my life is in danger as well.”

“Why doesn’t he go to the police?”

“He says there’s a possibility someone there might leak his true identity. I don’t think it matters anymore, but he won’t listen.” She drained the tea from her glass, but her throat remained dry. “It’s frustrating to feel so helpless. I don’t know what’s going to happen next.”

Julie rattled the ice cubes in her glass, and the waitress appeared with a pitcher for refills. After she left, both women added sweetener to their glasses and drank. Then Julie said, “How would you like this to end?”

Carrie didn’t answer at once. When she did, her voice was almost a whisper. “What do I want? I want all the danger to go away—right now, without our having to do anything. Just
poof
.” She opened her fist like a magician making a coin disappear.

“Neither possible nor realistic,” Julie said. “What is both possible and realistic is that you give Adam your support and help him find out who is after him.”

“Even if doing that puts me in danger?”

“Crossing the street puts you in danger. Driving to the grocery puts you in danger. Eating in the hospital cafeteria
puts you in danger. And the reward for any of those doesn’t approach what you’ll get from having Adam in your life. You love him. Period.”

Carrie shoved her plate aside. “And that’s it? That’s all I can do? Julie, I feel so helpless. I need to
do
something.”

“Isn’t that typical of a doctor? You always want to be in control.” Julie pointed her finger at her friend. “You can’t control this. You can brainstorm, you can do what Adam asks, but the main thing you can do is pray . . . for him, for you, for the whole situation.”

“I . . .” Carrie’s throat tightened. She couldn’t get the words out.

“I know, sometimes praying is hard, especially if you haven’t done it for a while. But there’s no magic formula. Just talk to God. He’s been listening all the time. All you have to do is make it a two-way conversation.”