Melissa Brayden: Heart Block

“Of course.” Sarah looked around the room wildly for her purse. “I’m leaving now. Thank you.” She hung up the phone just as her once-stable world seemed to tilt on its axis. She gripped the countertop tightly to steady herself against the onslaught, her heart ready to jump from her chest. After a few purposeful deep breaths, her vision once again cleared and the room righted itself.

As she made her way through the door of her apartment, she thought back to earlier in the day, scrutinizing Grace’s every move with new perspective. She’d been just fine a few hours before in the car on the way to school. They’d talked about their plans for the summer and the possibility of Grace attending the YMCA’s day camp now that she would be in the fourth grade and showing signs of responsibility. She’d been so excited. The image of Grace’s face lighting up at the news played like a movie in Sarah’s mind. So what had gone wrong? Her rational side understood that Grace could have fainted from something as simple as not having eaten a decent breakfast. They had been in a hurry and she hadn’t examined whether Grace had actually eaten the cereal and juice she’d set out for her. But the mother in Sarah feared the worst, conjuring up all sorts of terrifying scenarios. She put her key in the ignition and gunned the engine, doing eighty-five easy on the freeway.

*

It was raining outside. Hard. Emory Owen could hear it mercilessly pelt the roof and see the thick drops as they raced past the somewhat smudged window she stared out. It was the kind of rain that made her want to stay inside, snuggled up under the comfort of her favorite chenille blanket, a cup of hot mint tea in her hand. Instead, she sat amidst uncomfortable blue plastic chairs, harsh fluorescent lighting, and year-old magazines in the waiting room of Mercy General.

“Miss Owen?” A pause. “Excuse me, Miss Owen; did you hear what I said?”

She did and she didn’t. Emory turned fully to the older woman in the white coat who’d said her name. She blinked, trying in vain to clear her head. “I’m sorry. Would you mind repeating that?” Numb. With very good reason, she felt numb.

The woman’s tone softened. “My name is Dr. Turner and I’m in charge of your mother’s case.” Emory accepted the extended hand and stared at the woman, randomly noticing the patches of gray at her temples. “Why don’t we sit down?” Emory nodded her agreement, trying to read the doctor’s face. “We’ve run some tests on your mother. It was a massive stroke, just as we originally thought. Unfortunately, Ms. Owen, her prognosis at this point is not very promising and there are some things we need to discuss.”

Emory nodded her understanding, suddenly acutely aware of the sounds in the room—the hum of the lights overhead, the steady beep of an unidentified machine behind the nurse’s station, the squeak of the custodian’s sneaker on the vinyl floor just feet away. Everything seemed so much louder. Why?

“The stroke has caused her brain a great deal of trauma. What this comes down to, Ms. Owen, is a profound loss of brain function.”

“She’s brain dead? Is that what you’re saying?”

The doctor nodded. “It is. Her heart and lungs are currently sustained by artificial means, but—”

“I understand. Can I see her?” Emory asked.

“Of course. Is there someone we can call for you?”

“No, there’s no one. I’ll handle it.” And she would.

*

“A heart block?” Sarah repeated. “I’m not sure I understand. What does that mean, Doctor…?”

“Turner,” the woman supplied. She had kind eyes. “A heart block occurs when the electrical impulses that tell the heart to beat do not transmit properly. The EKG showed that the heart block in Grace’s case is producing a bradycardia, or very slow rhythm, which we believe was the cause of her loss of consciousness this morning.”

Sarah leaned against the wall for support. She didn’t like the implications of what she was hearing. “Is this a life-threatening condition?”

“No, not usually. Grace is lucky. She’s not dealing with a complete block but rather a block of the second degree. The impulses in her heart are delayed, slowing her rhythm, but they’re not blocked entirely.”

Sarah shook her head slowly. “Why didn’t I pick up that something was wrong?”

Dr. Turner placed a reassuring hand on Sarah’s shoulder, dipping her head to meet her eyes. “Don’t beat yourself up. Without an episode like this one to prompt an EKG, the block wouldn’t have presented itself on a normal checkup. Most likely, Grace was born with this condition. Often times with symptoms like fatigue, shortness of breath, a fluttering feeling in the chest, children don’t know how to describe what they’re feeling and assume they’re simply tired.”

It did make sense, but Sarah still felt as if her mother’s intuition had somehow failed her. She should have known something was wrong, should have picked up on the problem. “What do we do now?”

“Well, the first step is to get you set up with a pediatric cardiologist, who I imagine will want to run a few more tests. There’s a chance that Grace may require a pacemaker at some point, but that might be something the doctor will want to hold off on, as Grace hasn’t exhibited many symptoms up until this point.”

“What does she need in the meantime? Medication? How do we stop this from happening again?”

“For now, continue to monitor her physical activity. Children with heart blocks can still lead physically active lives, but their endurance is generally weaker. Grace informed me she had been running on the playground before school, and that could have contributed to the collapse during class. She may have to pull back a little.”

“You haven’t spent much time with my daughter.”

“I’ll leave the hard work to you then.” Dr. Turner patted Sarah’s shoulder and began walking down the hall. “The nurse will bring you some literature along with her discharge paperwork, and I’ll get you a list of referring cardiologists. Be back in a little while. And, Ms. Matamoros?”

Sarah straightened. “Yes.”

“Try not to worry.”

Sarah swallowed hard and nodded politely, knowing the impossibility of that request.

Once alone, she took a moment in the hallway and exhaled slowly before pushing open the door to the small hospital room. Grace turned her head on the pillow and smiled up at her. She’d worn her hair in a ponytail to school that day, but it was down now and framing her delicate face with soft waves. “So what’s going on in here, monster? Have you run the nurses ragged since I last saw you?”

“Nope. A perfect angel.” But the smile didn’t reach her eyes.

Sarah sat next to Grace and leaned across the space between them, kissing her forehead and smoothing her hair. “It was scary today, wasn’t it? When the paramedics came?”

Grace met her eyes. “A little. I didn’t know what had happened and I was confused. But…”

“But what, mija?”

“I just don’t want you to be upset anymore. You were crying when you came in before, and I hate it when I make you sad.”

Sarah’s heart ached at just the thought of Grace thinking more about her feelings in this scenario. She’d always been a sensitive, caring kid, and for that, Sarah was grateful. She didn’t know what she would do without Grace. The thought ran her over like a Mack truck. She pushed the gathering emotion aside, however, and focused on putting on a brave face. She was the adult, and it was up to her to get them through whatever might be ahead. “Well, I’m not upset anymore. See?” She crossed her eyes playfully and Grace giggled. “I talked to Dr. Turner and she says you’re going to be fine. You just have to take it easy until we sort this whole thing out. Deal?” Sarah extended her hand.