The Color of Hope (The Color of Heaven Series) (18 page)

He wrote that down. “Do you smoke?”

“I used to. I quit last year.”

“How many years were you a smoker?”

“Since I was fifteen,” I replied, “so that would make it... twelve years.”

“Any family history of heart disease?”

“I don’t know. I was adopted, so I never knew my real family.” I paused. “Except for a twin sister. She lives in Maine. But she never mentioned heart troubles.”

He nodded. “What about drugs. Cocaine, meth...?”

“God, no!” I shouted at him. “I’m pregnant! I’ve been taking folic acid pills, but that’s it.”

He held up a hand and gave me an intimidating stare over the tops of his glasses. “What did I tell you about getting worked up?”

I clenched my jaw to keep from losing my temper, because he was suddenly rubbing me the wrong way.

“How has your health been lately?” he asked.

“Not great,” I told him. “I was sick for the past few weeks.”

“Tell me about your symptoms.”

I described my sore throat, plugged sinuses, and the severe bronchitis. “I thought I had pneumonia,” I told him. “I went to see my doctor and he said it would go away on its own. Then I was short of breath and constantly tired. I could barely climb a flight of stairs.”

“Any trouble breathing at night?”

“Yes. That’s why I came to the ER.”

He wrote briskly in my chart while I spoke. Always in the background was the constant whirly sound of my baby’s heartbeat on the fetal monitor.

“Did you notice any swelling in your legs or hands?” he asked.

“Yes, in my legs, but I’m pregnant, so I didn’t think much of it.” I suddenly realized I didn’t know the man’s name. “Who are you?”

He looked up. “I’m Dr. Vaughn. I’m a cardiologist.”

“It’s nice to meet you,” I replied.

“Likewise.” He wrote down a few more things, then closed the chart.

I was still in shock, and part of me was certain this had to be some sort of mistake. “What does it all mean?”

“I’m not certain yet,” he said, “but I can tell you what we know so far. After we cleared the fluid out of your lungs to help you breathe, we did an Echocardiogram, which is an ultrasound of your heart. It told us that your heart function is down to about twenty-five percent.”

“Oh, my God.”

“Normal is around sixty percent,” he said. “And based on what you’ve just told me, it’s likely that you have a condition called myocarditis.”

I frowned. “What’s that?”

“It’s an infection that causes damage to the heart muscle. The most common cause is from a flu-like virus that usually goes away for most people, but sometimes it can affect the heart.”

“Are my arteries clogged?” I asked.

“No, that’s not the problem. It’s not because you ate too many potato chips, or didn’t exercise enough. You’ve just had some bad luck, I’m afraid.”

It made me feel sick to hear him say that, and I trembled with shock. “Will I get better?”

He paused. “I’m very sorry, but damage – as severe as you have endured – is usually permanent.”

He sounded so casual about it all.

I swallowed hard as a wave of terror swept through me. “What about my baby? Will she be okay? Will I be able to give birth?”

“That’s not my area of expertise,” he explained, “but someone from obstetrics will be down to see you soon.”

“But you must know something,” I insisted. “Surely you’ve talked to them, or you’ve dealt with this before.”

“Obstetrics will be down soon to answer your questions,” he said.

I clenched my jaw in frustration. “You still haven’t told me what’s going to happen,” I said. “Am I going to die? Or is this treatable?”

He removed his glasses. “We can treat it to some extent. We can keep clearing the fluid off your lungs enough so that you can function and feel better. As long as the condition doesn’t worsen, we may be able to discharge you in a week or two. The goal will be to keep you healthy so that your baby can continue to grow and mature.”

“And then what?” I asked. “Will I give birth?”

“I can’t speak to that,” he said. “The most I can tell you is that – at the level your heart is functioning now – you will likely need a heart transplant.”

A heart transplant?
This was too much for me to take in! I couldn’t absorb it all. It didn’t seem real.

Rather than suffering a complete nervous breakdown in the next five minutes, I tried to stay focused on the facts. “When would that happen?”

“Hard to say. First we need to get you on the transplant list. Then it will depend on how far down the list you are, and how soon a suitable donor can be found.”

“How long can I live without a new heart?” I asked. “And will my baby survive the transplant?”

He put his glasses back on and stared at me over the tops of the lenses. “First of all, it may take a while to find a donor, and even if we had one tomorrow, it’s impossible to predict the outcome of the surgery with a baby in the mix. But you should know that your baby is not helping you. It’s robbing you of energy and circulation. They say a baby in the womb is the most efficient parasite there is.”

“Are you serious?” I blurted out. “Did you just call my baby a parasite?”

He held up a hand. “I don’t mean to offend you, but you need to be aware of the danger you’re in. There are a lot of stresses on your heart right now.”

I took a few deep breaths from the oxygen mask, because this doctor needed a few commonsense lessons in bedside manner. I was tempted to biff my pillow at him. If only I had the strength.

I set the mask aside again. “Will I live long enough to have this baby?”

A dark-haired female doctor in a white lab coat walked in at that moment.

“Ah, Dr. Mills.” Dr. Vaughn turned to face her. “Follow me outside for a moment.”

I watched them leave together. Faintly, I could hear them discussing my case out in the hall. They returned to my bedside after a few minutes.

“The patient is wondering about whether or not she can give birth,” Dr. Vaughn said.

I turned to Dr. Mills, who was slim and attractive. I guessed she was about forty. She wore trendy black plastic rimmed glasses, and her long dark hair was pulled back in a sleek ponytail.

“The
patient’s
name is Nadia,” I pointed out.

Dr. Mills grinned at me and shook my hand. “It’s a pleasure to meet you, Nadia. Looks like you had a rough night.”

“That’s putting it mildly.”

She squeezed my shoulder. “Don’t worry. You’re in good hands. We’re doing our best to take care of you and your baby.”

Dr. Vaughn mentioned that he had other patients to see, and left me alone with Dr. Mills. I wasn’t sorry to see him go.

Dr. Mills pulled a chair closer to my bed. “Myocarditis, eh?”

“Yeah,” I replied. “Guess it’s my lucky day.”

She regarded me with compassion. “You want to know if you can give birth.”

“Yes.”

“Well...” She paused. “My professional opinion is that I wouldn’t advise it. With your heart in the condition it’s in, your body probably wouldn’t be strong enough. What I am going to recommend is that you take really good care of yourself for the next six weeks, until the baby is mature enough to survive on her own. Then we’ll do a C-section.”

I pondered this news, and wasted no time in mentally tossing out my previous birth plan, which included herbal tea and no drugs.

“What if my condition gets worse?” I asked. “Can we take her out sooner?”

I appreciated that Dr. Mills didn’t hold anything back or patronize me. She gave it to me straight.

“Statistically,” she said, “an infant at twenty-four weeks has only a sixty percent chance of survival, and a seventy percent chance of neurodevelopmental impairment. The longer she stays in your belly, the better off she’ll be. I’d like to try to reach at least thirty weeks, but if you’re doing well, we could even try to make it to full term.”

“What about the heart transplant?” I asked.

“That complicates things,” she said. “It’s more likely that the C-section will happen first.”

I tried to imagine having major surgery, feeling as weak as I did. “Will I survive the C-section with only twenty-five percent heart function?”

“It’ll be high risk, for sure,” she told me, “but you’ll be in excellent hands. Once the baby’s out, you’ll have more strength for the transplant.”

I put the oxygen mask back over my face and listened briefly to the calming rhythm of the fetal heart monitor.

“What if we find a donor right away?” I asked. “Would the baby survive a heart transplant? Dr. Vaughn wasn’t very clear about that.”

I got the sense he would have preferred to abort the baby just to save the heart.

Dr. Mills leaned back in the chair. “It would be better to put off the transplant until your baby is delivered.”

I felt tired all of a sudden, and needed to close my eyes. “All right,” I said. “Let’s plan for a C-section.”

Dr. Mills stood up. “Good. Do you have someone to help you over the next few weeks? You’ll need to get plenty of rest. Any family in the city?”

Family? Me?

I shook my head. “I don’t have anyone here, but I have a sister on the east coast.”

“Have you called her yet?”

“Not yet.” I was ashamed to admit that she wasn’t taking my calls because she had caught me making out with her would-be fiancé in a Las Vegas elevator last year.

After Dr. Mills left, I wondered if Diana would at least listen to a voicemail.

Diana

T
HERE WAS NOTHING
like a hot shower after yoga class on a Friday to help ease the stresses of the day.

Earlier in the afternoon, a client had walked into my office and wept for an hour. She came to me because she’d just lost custody of both her children in a prejudicial divorce settlement. The husband – who was physically abusive during their marriage – suggested that because she was in therapy (to help her cope with the breakdown of her marriage), she was emotionally unstable, therefore incapable of taking care of their children. Her lawyer had been so unprepared, he didn’t even know that half of the information presented by her husband’s more aggressive lawyer had been lies.

According to the woman, her husband didn’t even
want
the kids. All he cared about was finding a way to avoid paying child support, and to continue receiving government checks and tax breaks for dependents.

I took her on as a client and immediately began looking into ways to appeal the judge’s decision.

After shutting off the water in the yoga studio shower, I wrapped myself in a towel and returned to my locker. I pulled out my gym bag and decided to check my phone before getting dressed.

I sat down on the wooden bench and swiped my finger across the screen. There were a few emails from work – nothing urgent – and a text from my mother to let me know she and Dad would be arriving at my place in about an hour. They were on their way home to our house in Bar Harbor for a weeklong vacation, and were passing through Boston.

I texted her back and asked if she still had the extra key to my place, and if so, they should help themselves to anything in the fridge.

Then I checked my voicemail, and was surprised to discover a message from a Los Angeles phone number I didn’t recognize. I listened to it:

“Hi Diana. It’s Nadia...”

My stomach clenched.

Quickly, I hit the skip button and slipped my phone back into my bag. I would listen to it later, I decided, after I had a chance to put some clothes on.

I left the yoga studio and drove all the way home before I could even think about listening to the rest of Nadia’s message. Just the sound of her voice – so much like my own – caused all my muscles to tense. I should have opted for a second yoga class.

What she wanted, I had no idea. Maybe she simply called to tell me about her happy condition. Or maybe she’d spent all of Rick’s money already, and needed to be bailed out of a financial crisis.

There was no point speculating. I promised myself I would listen to the message as soon as I got home and had something to eat.

I arrived shortly after eight. My parents’ car was parked out front, and the lights were on in the front windows of my townhouse.

“Welcome,” I said to Mom as I entered the foyer. I wrapped my arms around her. “I missed you.”

“I missed you, too.”

Dad came to greet me as well. “Hey kiddo.” He gave me a quick peck on the cheek. “How’s the new practice?”

“It’s growing,” I replied, setting my purse and keys down on the table by the stairs. “Slow but sure.” I inhaled deeply through my nose. “What smells so good?”

“I’ve got a pot of chili on the stove,” Mom told me.

I smiled at her. “I love it when you come to visit.”

We moved into the kitchen, and I pushed Nadia’s voicemail message from my mind.