Heart Failure Read online

  Table Of Contents

  Other Books by Chris Zett

  Acknowledgments

  Dedication

  Chapter One

  Chapter Two

  Chapter Three

  Chapter Four

  Chapter Five

  Chapter Six

  Chapter Seven

  Chapter Eight

  Chapter Nine

  Chapter Ten

  Chapter Eleven

  Chapter Twelve

  Chapter Thirteen

  Chapter Fourteen

  Chapter Fifteen

  Chapter Sixteen

  Chapter Seventeen

  Chapter Eighteen

  Chapter Nineteen

  Chapter Twenty

  Chapter Twenty-One

  Chapter Twenty-Two

  Chapter Twenty-Three

  Chapter Twenty-Four

  About Chris Zett

  Other Books from Ylva Publishing

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  www.ylva-publishing.com

  Other Books by Chris Zett

  Irregular Heartbeat

  Acknowledgments

  Writing my second book was simultaneously easier and harder than the first. The knowledge that I could do it—that I had already successfully finished, edited, and published a novel—helped immensely. Unfortunately, my self-imposed expectations for perfection grew faster than my abilities, and I struggled in representing the characters on the page as I felt them in my heart. But even though writing might be a solitary experience, editing and publishing is a team effort.

  I’m very grateful for everyone who helped me to transform this story from an okayish first draft to this novel I’m proud to share with readers.

  My beta-readers—Trish and Bianca—gave me invaluable feedback in an amazingly short time. I promise to manage my deadlines better next time!

  My publisher Astrid shuffled around deadlines and publication dates so I could rewrite the whole novel, taking out unnecessary secondary characters and adding new scenes on her advice.

  My editors—Alissa, Miranda, and Amber—each improved different aspects of my writing. Special shout-out to Miranda for taking up the extra work last-minute and providing such insightful and detailed comments about my characters.

  And an extra-big-thank-you-with-ice-cream-on-top to Sandra, who switched roles from senior editor to writing mentor to friend seamlessly and always encouraged and supported me.

  And last but not least: Thank you, readers, for buying this book and maybe even my debut novel too. You help me sharing my stories around the globe.

  Dedication

  For Bianca—thank you for being courageous

  Chapter One

  “Riley! What the hell are you doing?”

  Dr. Jess Riley wrenched her foot off the fluoro pedal to stop the X-ray and inspected the intruder.

  Like a pit bull in green scrubs, Dr. Watts charged into the cath lab. He stopped only inches from her patient.

  Her team, decked out in full sterile garb, froze.

  Jess gave him an isn’t-it-obvious look and pointed at the patient and the big, illuminated X-ray in use sign that should have stopped him. “Whatever it is, now is not the right time.”

  “You stole my patient! Are you so desperate for lab time you troll the surgical floor and poach my patients? You bitch!” Spittle flew from his mouth, as he hadn’t even bothered to don the obligatory face mask.

  Jess squared her shoulders and rose to her full five-ten. Not an easy feat, as the protective lead apron that covered her body seemed to weigh a ton after the two-hour intervention. Sweat slid down her shoulder blades and soaked her scrubs. She ignored her fatigue and discomfort and fixed her iciest glare on Watts. “I have no idea where your accusation is coming from. But I won’t discuss this here in front of a patient during an intervention.” She didn’t remind him that as a senior attending in the cardiology department, she didn’t owe him or any other cardiac surgeon an explanation.

  He held her gaze, not backing down an inch. After what felt like an eternity, he growled. “Nothing to discuss. Your boss will hear from me. He’ll regret the day he decided to cave in to HR and hire a woman to do a man’s job.” He stabbed the door button repeatedly as if the electronic door would bend to his will and open any faster. As soon as the opening was wide enough, he stomped out.

  Was he trapped in the dark ages? Jess clenched her jaw shut beneath the mask. The threat he would talk to the head of the cardiology department didn’t faze her in the least. She trusted her boss to have her back, and she intended to have a word with him about Watts’s unacceptable behavior.

  But the insinuation stung. Did more colleagues think she’d been hired because of her gender? She’d thought she left this shit behind years ago.

  She shook her head to clear it from the emotional fog before tears started to rise. Recently, her protective barriers had been thin like early spring ice, ready to crack at any second. But she wouldn’t allow her hormones to reign and encourage the idiots who still thought women didn’t belong in medicine. Especially now.

  “Are you upset? Do you want me to continue?” Scott’s voice oozed with friendliness.

  Of course, the boy-scout image was a façade, and he was as eager as the next cardiology fellow to pounce on her territory as soon as she showed any signs of weakness. Sharks. All of them.

  Getting worked up over her young colleague helped her to pull herself together. “No.” He wasn’t so advanced in his training that she trusted him with her high-risk patient.

  “Hey, I was just asking.” Scott pouted. Not a cute look on him.

  There wasn’t a reason to be this short with him, but she wasn’t in the mood to coddle another male ego.

  Jess leaned over the sterile drape to check on her patient. He was still snoring softly from the sedative he’d received earlier. At least something was going according to plan.

  She met Kayla’s gaze over the face mask. The dark-brown eyes of the nurse showed support and not judgment. “Let’s finish him up and get a cup of coffee.”

  The idea of coffee sounded heavenly. Jess pushed the residual traces of anger, frustration, and annoyance to the back of her mind and continued with the angioplasty. The most difficult part had been over before the interruption, and the rest she could do in her sleep.

  Fifteen minutes later, Scott wheeled the patient to the recovery room.

  Jess peeled off the sterile paper gown and gloves. The draft from the air conditioning sent a trail of goose bumps over her arms. She opened the lead apron to let even more air in and stretched. She couldn’t wait to get off her feet for a short break.

  Kayla sorted the instruments from the table, discarding the sharps in the safety container. “Will I see you this Saturday at the free clinic?”

  “No, I swapped the shift. My mom’s birthday is this weekend.” And she couldn’t miss that for the second year in a row. Besides, she was long overdue for a personal visit and talk.

  “The patients will miss you, but your mom should come first.” Kayla crunched the sterile wrap into a big ball and stuffed it into the trash. “What did Watts mean, you stole his patient?”

  Jess shrugged. She honestly had no idea. She saw hundreds of patients each month and didn’t need to search for more.

  Before she could answer, Scott joined them, twirling his face mask in his hand. “We didn’t steal him; he didn’t want surgery. Really. Sheila said so.”

  “What? Who didn’t want surgery?” Jess frowned. “And who the fuck
is Sheila?”

  “Um, Sheila is my girlfriend. She’s a nurse on the cardiac surgery floor.” Scott beamed at the mention of her name. “I guess Dr. Watts meant our last patient. He was scheduled for coronary surgery, but he was afraid. His son and the surgeons pressured him, and Sheila asked me to take a look at him. And I talked to him, and…” He trailed off as if he only now noticed the twin sets of glares on him.

  “You mean, you really did poach on the surgery floor, and now Dr. Watts is blaming Jess?” Kayla’s voice hardened, and she crossed her arms over her chest.

  “Hey, I was right. Everything went well. No harm, no foul.” Scott tried his best boyish grin.

  That didn’t help his case at all. Jess clenched her fists and fought the urge to yell. “Yes, everything went well. But you don’t have a fucking clue what you did. You lied to me. You not only kept the backstory from me but told me an outright lie—that the cardiac surgeons had referred his case to us.”

  “But I just wanted—”

  Jess held up her hand. She wasn’t in the mood for whiny, entitled arguments. “No. I don’t want to hear any of your shit. You think about what you’ve done and apologize to Dr. Watts.” She held his gaze until he looked down.

  Jess was about to turn on her heels and leave as a wave of nausea rolled through her. Oh, fuck! Not now. She tore off the vest and the restricting skirt of her lead apron and flung them on the stool in the corner, but even that didn’t help.

  As if chased by a bear, she sprinted to the bathroom. Jess made it in time to lose her breakfast as well as her dignity.

  After retching for what felt like hours, she knelt on the cold tiles and tried to muster the energy to get back up again.

  “Jess?” Kayla’s voice came from outside the stall. “Are you okay?”

  “Just a minute.” Jess rose on weak knees and flushed. She wanted to pinch her cheeks for some color and straighten her hair, but she needed to wash her hands first. Ugh. Jess shook herself. Without intention, she had clutched the yucky toilet seat like a lifebelt.

  Jess squared her shoulders, opened the stall, and brushed past Kayla to the sink. She washed her hands twice and disinfected them, then rinsed out her mouth. The tap water tasted horrible, but it was cool and fresh. Finally, she finger-combed her short hair and risked a glance in the mirror. Yup, she looked like death warmed over, and no amount of cold water could help her there.

  Kayla’s concerned gaze met her in the mirror. Her skin seemed even darker than usual next to Jess’s unnatural paleness.

  With a sigh, Jess faced her and leaned against the sink. “I’m fine.”

  “Nuh-uh.” Kayla lifted the edge of her mouth in a half smile. “Didn’t you just lecture your puppy about telling lies?”

  Jess grinned against her will. “He’s not my puppy. I only took him for a walk today.”

  “Not the point. What’s wrong? Are you sick?” Her gaze raked Jess from head to toe. “Did the asshole surgeon and his comments get to you?”

  She could say yes and leave it at that. But Kayla was one of the few friends she had at work, and she was right. Telling lies was out of the question. But Jess hadn’t told the truth to anyone yet, not even her mom, and wasn’t sure she was ready.

  “If you were anyone else, I’d ask if you were pregnant. But I guess not.” Kayla chuckled. “You’re still a lesbian, right?”

  “Yeah, the last time I checked. But that’s got nothing to do with it.” The words slipped out before Jess could censor herself. Oops. She held her breath, waiting for Kayla’s reaction.

  “No! Are you…? You can’t be…” Kayla’s eyes widened as her gaze swept over Jess’s sweat-soaked scrub shirt that clung to her torso and revealed more curves than usual. “You’re pregnant? How? No—scratch that. Why? Was it planned?” She pressed both hands to her mouth but couldn’t hide the wide grin.

  “Yeah. Thirteen weeks pregnant. I’m due in July.” Saying it out loud was like coming out again. The weight lifting from her shoulders made her dizzy. “I thought it was past time. I turned thirty-seven last month. If I waited for the perfect relationship, I’d be too old.” At least that was the reason she was willing to admit to right now.

  “Congratulations!” Kayla enveloped her in a hug.

  “Thank you.” Jess soaked up the happiness emanating from her friend. All too soon, reality intruded, and Jess looked at Kayla. “Please don’t tell anyone yet.”

  “Sure. I won’t gossip. But sooner or later everyone will know.” Kayla gestured to Jess’s middle.

  Jess sighed. “Yeah, but you know the cath lab policy: no lab time for pregnant employees. The studies and recommendations all say it’s safe, but the chief of cardiology doesn’t care about that.”

  “My lips are sealed.” Kayla made a zipping motion. “But you better hope Scott isn’t too clever and connects the dots. You looked really green.”

  Jess slumped back against the sink. Time was running out, but she was determined to make the best use of her skills for as long as she could.

  Jess clenched her teeth and swallowed a groan as another contraction tore through her. No, not a contraction. Braxton Hicks. Damn inconvenient, but nothing she couldn’t handle. She’d been handling it all day.

  “And that’s why I called you.” When the emergency medicine resident finished prattling on about the EKG and handed her the printout, she beamed like a preschooler who had painted her first rainbow. With her perky blonde ponytail, she looked not much older and not much smarter.

  With one glance, Jess recognized the EKG pattern as a harmless atrial fibrillation with no sign of an acute heart attack. What a waste of time. She should have trusted her own resident to take this case, but she had always preferred her own judgment. Especially now since she had been banned from the cath lab for the last five months of her pregnancy—an eternity for an interventional cardiologist.

  Jess addressed the patient. “Ever had an irregular heartbeat?”

  “All the time. That’s why I take those yellow and white pills. Doesn’t bother me much.” The wrinkles in the woman’s face deepened. “What does this have to do with my pain?”

  “Pain? Where?” Maybe this was getting interesting.

  The woman pointed toward her lower abdomen. “Whenever I pee. Burns like hell.”

  Not interesting at all for a cardiologist. “Your irregular heartbeat has nothing to do with it.” Jess smiled at the patient, but it probably seemed more as if she bared her teeth because in that moment, another wave of pain ripped through her.

  The resident paled, and one of her eyelids twitched.

  Jess could almost smell the fear. Good. She wouldn’t dare to call the cardiology department for more of this nonsense without checking with her attending first. “Anything to add?” The question was rhetorical, but the resident didn’t seem to know that.

  It was comical to see her gather every ounce of courage she’d lost. She stood straighter, raised her chin, and balled her hands into fists until her knuckles whitened. “Um, Diana said she read a study that women were underdiagnosed because of atypical pain, and I thought—”

  Okay. She had a point there, but Jess wasn’t in the mood for a lecture from someone a dozen years younger who thought herself too smart to play by the rules. And besides, she had looked at the EKG. Her trip to the ED had been a waste of time. “Have you even been to med school? What is the most important rule? Horses! Look it up!” Another wave of pain robbed her breath. Jess shut her mouth with a snap.

  The kid’s upper lip trembled, and Jess regretted her words, especially in front of the patient.

  She could only hope that the nice old woman wouldn’t log a completely justifiable complaint about her.

  Since when had she turned into one of those yelling types who intimidated residents with the same old sayings? If you hear hoofbeats it’s always horses not zebras might have some truth i
n it, but that was no reason to attack the young doctor like this. Jess had been in the same position more than once during her residency, and the feeling of helplessness while someone undermined your authority was the worst.

  But she couldn’t handle an overly emotional resident on top of her pain at the moment. She would apologize or teach her something or do whatever to make it up to her—later. Much later.

  Jess turned on her heel as fast as she could with the grace of a beached whale. She had to get out of here and find a spot to calm down, to breathe. She flung the door open and stormed out of the room.

  And promptly collided with an obstacle. A living obstacle who touched her belly and arm.

  “Keep your hands off me. What are you doing here, standing in the way?” Jess stared at the dark-haired woman in scrubs. She seemed vaguely familiar.

  Whoever she was, she was clever enough to raise her hands in a peace offering and step out of the way.

  Jess hurried past her but didn’t go far before more pain stopped her. She pressed her hands to her middle as if that would help and panted until it was over.

  “Dr. Riley, are you okay? Can I help you?” The woman had followed her.

  “Okay? I haven’t been okay for nine fucking months.” Not since she’d had the clever idea of having a baby before she was too old. Her voice shook, and she clutched her belly again. “I don’t have time for this today.”

  “Do you want to lie down? Should I call your obstetrician?” The woman looked around as if she expected someone from ob/gyn to come around the corner.

  Jess shrugged in an effort to appear nonchalant. “Just Braxton Hicks. No need to call anyone. I’ve still got work to do.” She fought to steady her voice. No one needed to know about the pain. She was in control and knew what she was doing.

  The other woman studied her for a moment, then attempted a professional smile. “We could check you out real quick without signing you in. If you’re right, you can return to work anytime.”

  That smile sparked a memory. Kayla had shown her pictures when she’d told Jess about the scandal in the emergency department. One of their residents was a former rock star, a drummer, which had drawn publicity when it all had come out. “You’re the rock chick, right?” Jess pointed a finger at her. “What do you know?”