Lisa Stone - The Darkness Within - A heart-pounding thriller that will leave you reeling

Jacob sat in the passenger seat next to his mother as she drove, his gaze fixed rigidly ahead and earbuds in so he didn’t have to look at or talk to her. Elizabeth was grateful she didn’t have to make conversation or try to smooth over the last confrontation with her son, for her thoughts were full of what she would say to the doctor, diplomatically, so that Jacob didn’t become upset and angry again. Their disagreement this morning had been over his wish to drive them and he was clearly still in a bad mood. True, it was only a few days until the six-week post-operation milestone – when he could drive again – but Elizabeth had erred on the side of caution and had wanted to check with the doctor first that it was all right. Jacob had exploded into anger, swearing at her and kicking a chair. Thankfully Andrew had already left the house so hadn’t witnessed this last scene.

The bad atmosphere had been building over the weekend, Elizabeth admitted as what had promised to be a pleasant few days had quickly deteriorated into one angry scene after another. When Eloise had arrived on Saturday morning she’d received a frosty, offhand reception from Jacob. Then without giving a reason he’d refused to go to watch the wedding. Andrew was already at the church so she and Eloise had gone together, but Eloise had been very quiet and seemed to take little pleasure in the ceremony, presumably worrying about Jacob. When they’d returned to the rectory, Elizabeth had left them alone in the living room, believing they could do with some time together to repair their differences while she busied herself making lunch. Half an hour later Eloise had come to find her, looking as though she might have been crying, and said she was going now as her mother wasn’t well.

‘Oh dear, I am sorry. I expect she’s got what you had,’ Elizabeth sympathized, while suspecting it might be an excuse. But what could she say? She’d asked where Jacob was and Eloise had said he’d gone up to his room for a rest. Eloise couldn’t be persuaded to stay for lunch so Elizabeth had seen her off at the door, sending her mother, whom she had yet to meet, her best wishes for a speedy recovery.

Once she’d gone Jacob had appeared and taken his lunch up to his room, which had irritated Andrew who’d just come in and had expected them all to eat together.

Then on Sunday morning Andrew had made the mistake of saying that now Jacob was quite a bit better it would be nice if he started going to church again. Elizabeth and Jacob usually went together and if Eloise was staying with them for the weekend she came too. Elizabeth had been in the adjacent room when Andrew had broached the subject with Jacob and had heard every word of their heated exchange. It had culminated in Jacob shouting, ‘He’s your God, not mine! Stuff your religion. I never believed. I hate your fucking church.’ Which simply wasn’t true. For even if Jacob hadn’t had the strength of faith his father had, he’d never minded going to church before. And as the Reverend’s son there was a certain expectation – duty, even – for him to go, although Elizabeth would be the first to admit that duty was no longer a word in Jacob’s vocabulary.

‘It’ll be better once he can get out more,’ Elizabeth had said placatingly to Andrew after Jacob had stormed off. He was clearly badly shaken.

Andrew had nodded half-heartedly, not wholly convinced. ‘Just make sure you talk to the doctor about his medication. Something has to change.’

Jacob had spent the rest of the day in his room, only coming down to eat and take his pills, which Elizabeth no longer took up to him, but set out in the kitchen, calling up to her son when it was time.

She glanced at Jacob now as she parked in the hospital car park. Expressionless and unfazed by the bad atmosphere, he was head down, selecting music on his phone. He stayed in the car while she bought a ticket from the machine and placed it in the windscreen. Then with his earbuds still in and without acknowledging her at all, he got out and fell into step beside her as they walked to the main entrance. It wasn’t until they were in the department that he took out his earbuds, but then of course it wasn’t to talk to her, but to the nurses, some of whom were young and attractive. She saw him turn on the charm and thought of Eloise. Jacob had never overtly flirted with the nurses before.

The routine was similar and they’d attended so many of these check-ups that they knew what to expect. As usual it took nearly an hour to run all the tests, monitor his heart rate and weigh him, before they were called in to see the doctor.

Dr Shah, one of the implant team who they’d seen before, sat behind his desk going through the latest test results. He glanced up and greeted them as they entered, then continued reading as they took the two chairs opposite. Jacob strummed his fingers on his knee and fiddled with the wire of his earbuds, now looped around his neck. He began tapping his foot impatiently as Elizabeth sat perfectly still, her thoughts racing with what she had to say.

‘Well, young man,’ Dr Shah said, finally looking up. ‘You’re doing very well. All your test results are good. Spot on. Let me have a look at you.’

It was the usual routine and Jacob went over to the couch so Dr Shah could examine him. He admired the scar, felt his chest, and then listened to his heart.

‘Perfect. A wonderful strong beat. I’m very pleased. It’s behaving exactly as it should. Well done.’ The examination over, Jacob returned to his seat next to his mother. Dr Shah sat behind his desk again, making a few notes, then looked at Jacob.

‘So how are you feeling in yourself? Fit and raring to go?’ He smiled.

‘Can I start driving now?’ Jacob asked.

Dr Shah consulted his notes again. ‘You’re six weeks post-op next week and everything seems to be healing nicely so I don’t see why not. As long as you’re careful and don’t overdo it. I assume we’re talking about driving a car along a road and not racing?’ He laughed at his joke and Elizabeth smiled politely.

Jacob nodded.

‘You’re starting the cardiac rehab programme next week so there’s no reason why you shouldn’t drive yourself to and from your appointments if that’s what you’re thinking?’

‘Yes,’ Jacob agreed amicably.

‘Good. And no side effects from the medication? You seem to be tolerating it all well.’

‘I’m fine,’ Jacob said.

‘You may find that your new heart reacts slightly differently to your old one,’ Dr Shah said. ‘Especially when you start to exercise. That’s perfectly normal. During the transplant the nerves to the heart are cut. The medical term is denervation. They don’t grow back but that doesn’t matter. Your old heart rate was controlled by your nervous system but your new heart is controlled by adrenalin. It will make your new heart beat faster and take a little longer to slow down. Again, all perfectly normal and it won’t limit what you are able to do. The physiotherapist will talk to you more about this and show you how to warm up properly before exercise. The denervation also means that you will no longer feel chest pain related to your heart. The nerve connections that conducted pain are gone. Any chest pain you feel during activity is probably caused by the healing of your chest after surgery.’

‘I do get breathless if I exert myself,’ Jacob admitted. ‘And I seem to tire more easily.’

‘You will at this stage in your convalescence, but that isn’t because there is a problem with your heart, it’s just because you’ve been out of shape for a long time. As you exercise, your strength and stamina will improve. Another couple of months and you’ll be a new man.’ He smiled again. ‘Any more questions?’ He looked from Jacob to Elizabeth.