Heart Failure Read online

  That seemed to shut her up. She looked as if she’d swallowed a lemon and didn’t protest as Jess walked away.

  Jess knew she should return to her department, lay her feet up in the staff lounge, and drink one of those terrible herbal teas her mom was so fond of. But she needed ten minutes for herself and some fresh air. So she detoured to the back entrance and the small yard.

  She’d almost reached the bench when hurried footsteps caught up to her. “Dr. Riley, I’m sorry to disturb you out here, but I don’t think you should be alone right now.”

  Jess frowned. She opened her mouth to tell the rock chick what she thought about this disturbance, but no sound came out. Her pulse pounded faster and faster, echoing in her ears. Stars danced through her field of vision, and she didn’t know anymore where up and down were. She swayed, reaching out as if to balance on a log over a stream, then fell. Soft and fluffy darkness enveloped her, and finally, the pain in her abdomen was gone.

  And then the pain roared back and chased the darkness away. It was even worse now, and her back and chest hurt too.

  “Dr. Riley?” Someone shook her.

  As Jess opened her eyes, the blue sky loomed above her. “What…what happened? Why am I on the ground?” She clutched her belly and moaned. After a moment, the pain passed, and she looked from one side to the other to reorient herself. A familiar figure leaned over her. Why couldn’t the woman leave her alone? She needed a minute to breathe, and everything would be okay again. “You, Rock Chick! I said I didn’t need help!”

  A muscle twitched in the resident’s cheek. “That was before you fainted. Now, shut up and let me help. And that’s Dr. Rock Chick to you.” Her tone was even, direct, and full of authority.

  Before Jess knew what she was doing, she nodded. Maybe she had hit her head or something.

  “Can you sit up?” The woman offered her hand.

  The dizziness had receded, and she didn’t need the help of the persistent resident. “I didn’t faint,” Jess mumbled, more to herself. She used both hands to push herself into a sitting position.

  “Fainted, collapsed, call it what you want. You had a syncope and an irregular tachycardia.” Rock Chick played doctor, pulled gloves and a stethoscope from her pocket, and worked through a physical exam before Jess could think about protesting. Maybe she did know what she was doing. She’d seemed competent enough the last few times she’d called cardiology for a consult. What was her name again? Diana something or other?

  When Diana touched her belly, it hardened with another contraction.

  Oh shit, were practice contractions supposed to be this painful? How much worse would the real ones be? Instinctively, Jess gripped the hand resting on her belly, never minding Diana’s groan of protest. Served her right for barging in like this.

  Once the contraction had passed, the wimp extricated her fingers and stretched them, wincing.

  If she wasn’t so pissed off at everything at that moment, Jess would have laughed at her pained expression.

  Diana pressed her lips together and slung her stethoscope around her neck. “If I help, can you move to the bench?”

  As she tried to get up, Jess noted two things: her pants were wet, and her knees had softened to jelly. Had she slipped and landed in a puddle? That might explain her fall. Another possible explanation flickered through her mind, but it wasn’t something she wanted to consider now.

  First, she had to get up, and then she had to get away from the obnoxious resident. As she couldn’t do the latter without the former, she accepted Diana’s help. It wasn’t easy, and both gulped for air when Jess had settled onto the bench.

  Diana hovered over her, much too close, rocking back and forth on the balls of her feet as if she was preparing for a tennis match. The intense stare matched a professional athlete too. “No way you can walk back now.”

  Thank you for stating the obvious. But Jess didn’t want to give her the satisfaction of agreeing. “Just give me ten minutes, Rock Chick. I’ll be fine.” She lay down to rest and pushed her sweat-dampened hair from her forehead. She’d allow herself the short respite, and then she’d get up and face the rest of her workday.

  “What kind of denial are you in? You’re in labor, and I don’t know if we have ten minutes.”

  Labor? Was this really labor? It’s too soon. I’m not ready! First kids never came early. She was sure she’d heard that somewhere. She had meant to read up on the medical side of delivery but had thought she still had time. The C-section was scheduled in ten days.

  “Could you unlock your phone so I can call for a stretcher? I don’t have mine on me.” Diana’s voice barely broke through the thoughts that tumbled and crashed in Jess’s mind like a washing machine filled with broken parts.

  When and where had she gotten Jess’s phone? She unlocked it and handed it back. Never mind.

  How could she tell if she was in denial when the whole point of denial was to protect a mind from things it didn’t need or want to know? And why was she thinking about psychological defense mechanisms when her body was being ripped apart by one wave of pain after another?

  Whatever Diana said on the call, Jess couldn’t hear a word.

  Jess clutched her belly and tried to breathe the pain away as if that would suddenly work when it hadn’t done her any good during the last several hours.

  Heat shot to her cheeks. She had been too stubborn to accept the truth. Waves of pain. For hours. Dr. Rock Chick was right. This was happening. She was in labor, and her water had broken. Jess didn’t know if she should laugh, cry, or kick herself. Since she’d decided she needed a baby in her life, everything had fallen apart. Her work, her relationship with her mom, her body. It was fitting that her body betrayed her today by going into labor instead of sticking to the plan—a nice, pain-free C-section with all the professional medical attention a person could ask for.

  Instead, she got a dirty park bench and a former rock star turned emergency resident. Just perfect.

  “Dr. Riley, I need to get you undressed to see how far you are.”

  Jess let her head fall back and nodded. What else was there to do?

  Even though Diana’s movements were careful, she couldn’t help the fact that Jess’s wet scrub pants stuck to her legs like a second skin and caught on her ugly, swollen ankles.

  Jess bit her lip and looked away as Diana peeled them off the rest of the way. When another contraction started, much more painful than before, she couldn’t help pulling up her legs and groan.

  Diana looked back to the hospital entrance as if she’d rather flee than stay and help.

  Jess could relate. If she could, she’d be out of here faster than she could say delivery. The reality of the situation hit her like a punch in the solar plexus and robbed her of her last breath. She was here with this resident, who wasn’t even an obstetrician. Alone. Giving birth to her child. Her daughter. What if something happened to her baby? She gasped.

  Think, Jess. You’re a doctor too. What’s the best plan to keep her safe? No doubt, the safest place for her baby was her womb, and she needed to do anything she could to keep her daughter inside as long as possible. Delay until help arrives. Not a sophisticated plan but the best she could come up with now.

  Diana nodded with determination. But as she lowered her gaze between Jess’s legs, she paled. “You need to push.”

  Was she crazy? “I can’t. Not now. That’s not the plan.” Jess’s eyes filled with tears.

  “Are you kidding me? Fuck your plan. We don’t have time for this. The head is crowning, and you need to push—now!” Despite her harsh words, Diana’s movements were gentle. She pulled Jess’s legs apart, holding eye contact all the time.

  Jess wasn’t convinced that pushing was the best option, but she couldn’t come up with an alternative. Why hadn’t she prepared for such a scenario? She always prepared for every fucking thing.


  “Listen.” Diana lowered her voice and squeezed Jess’s knee. “I’m sorry that the birth is not going as you planned, but your child seems to be as stubborn as you are. We can do this but only with your help. So when the next contraction comes, you push. Okay?” Her expression was confident as if she’d done this a thousand times.

  Another contraction came, and Jess was out of time. “Fuck!” She screamed the word like a war cry and pushed.

  “Yeah, fuck!” Diana screamed back as if they were charging into battle together.

  Jess’s world reduced to a bloody fight, filled with pain, curses, and groans. She no longer knew or cared about the details. Her only clear thought was push, and so she did, until another cry pierced through the fog in her mind.

  A shrill cry, full of anger at the unfairness of the world, full of need to belong, full of hope for a better future.

  And when the crying bundle was placed in her arms, Jess’s pain evaporated in a surge of hormones and pure love.

  Chapter Two

  Lena leaned closer to study the curve of the new-formed leaf, and the sweet floral scent of the rose enveloped her like her grandma’s hugs. She hadn’t been the type to wear perfume but had always kept a few dried petals in her closet. Taking a deep breath as if she could store the scent, Lena smiled at the memory. She missed her every day. Grandma would have loved this garden.

  After another glance at the flower, Lena focused on her sketchbook and added a few fine black lines.

  “Beautiful. I love the detailed depiction of the petals and sepals.” Maggie’s voice came from directly behind her.

  If her pen had been on the paper, Lena would have ruined the sketch. She hadn’t heard Maggie approach or noticed the rhythmic snipping of the garden shears had stopped. “Thank you. But what’s a sepal?” Not used to compliments, her face flushed, probably as pink as the rose.

  “The small, green, leaf-like parts beneath the petals.” Maggie took a seat on the wooden chair next to the patch of grass Lena sat on. She removed her gardening gloves and wiped her forehead with a fabric handkerchief.

  “Do you want some water or tea? I can get something from my kitchen.” Lena gestured to the garden house.

  “Water would be lovely. But I can get it. If you don’t mind me rummaging around your kitchen.” She rose from the chair with an agility that belied her age.

  “No, stay, please. I feel bad enough that you won’t let me help you with the gardening.” Lena secured her sketchbook closed with a wide band and tucked the pen into one of the loops on the elastic. She placed the book on the side table next to Maggie’s chair and hurried into the house.

  It was just a few steps from front door to fridge, and she grabbed a large glass bottle she had filled earlier and left to chill. The fridge was pretty bare, but at the sight of the last bit of organic cheese, her stomach growled.

  Had Maggie stopped for lunch? Probably not. She had been as immersed in her work as Lena.

  Back outside, Lena placed two plates with cheese and apple slices on the small table and poured them both water. “Do you want something for the water? Mint?”

  “Lemon balm, thanks.”

  Maggie had planted dozens of different herbs in all parts of the garden, but Lena was sure she remembered where the lemon balm was hidden. She found it a few steps away and rubbed a leaf between her fingers to release the citrusy scent. She plucked a few leaves and held them up. “Is this enough for you?”

  Maggie nodded her approval and took half of the leaves into her glass. “Melissa officinalis.”

  Lena mentally repeated the name a few times. She’d sketch that one next and write down both names. “Is there anything I can help you with today? Carry something heavy?”

  Smiling, Maggie shook her head. “I need to work to stay flexible. You have tai chi and youth on your side. I’m battling old age with the help of my plants.”

  And the workout was certainly effective. Maggie had to be in her late sixties—judging by the soft, wrinkly skin and hair that was mostly gray-and-white with only a hint of brown—but she moved like a much younger woman. Lena hoped she would be that fit in forty years.

  They nibbled on their snack in companionable silence until a phone rang from the middle of the plant bed Maggie had been working in.

  “Let me get it.” Lena made her way between the roses, lavender, and half a dozen different green shrubs she couldn’t name. She followed the ringtone until it stopped. Where was that phone? After a short break, the ringing started again. “Someone really wants to talk to you.”

  “They always call to sell me things I don’t need. My name and number must be on a very gullible list somewhere.” Maggie chuckled.

  Lena snorted. Maggie might be the least gullible older woman she had ever met. “Ah, here it is.” She snatched the phone from its hiding place under a rose bush in amazing shades of tangerine and burnt orange. “Oh, the hospital. I hope it’s nothing serious.” She hurried to bring the phone to its owner.

  “It’ll be Jess. It’s Friday and time for her to cancel our monthly dinner. Again.” The resignation in her voice was nothing new.

  Lena pressed her lips together and swallowed a reply. She couldn’t understand Maggie’s daughter. If Lena had a mother as wonderful as Maggie, she wouldn’t stay away all the time. As far as Maggie had told her, they didn’t have any problems or disagreements; Jess was only too busy with work. Lena handed the phone over as it stopped ringing. “Oh, sorry.”

  Before Maggie could reply, it started again, and she answered it. “Riley. Yes. Oh. Oh.” She paled, and the phone shook in her hand. “Okay. How is she? Can I…? Tell her I’ll be with her as soon as possible. Emergency department. Thank you.” She hung up and stared at the phone as if it could provide more information or guidance.

  Lena reached over and took her hands, which trembled like a frightened bird. “Hey, what happened?”

  “Jess…she…” Maggie looked at her with wide eyes, tears clinging to their corners.

  Did she have an accident? “What happened?” She repeated the question in a soft tone.

  “She had her baby. I’m a grandma.” As if speaking the words out loud allowed Maggie to understand their meaning, her face transformed. A wide grin illuminated her face like the first rays of sunshine after a storm. “I’m a grandma!”

  Lena couldn’t help but grin with her. “Congratulations.” She squeezed the still-trembling hands, but it wasn’t enough to convey what she was feeling. Before she could question herself, she pulled Maggie in for a hug.

  Maggie returned the embrace as if they were friends or family and not landlady and tenant. The scent of crushed herbs and warm soil, like summer, enveloped her, and Lena never wanted to let go.

  Which was precisely why she retreated to a safe distance after another mumbled congratulations. She couldn’t allow herself the illusion of being part of a happy family if the reality was just the opposite.

  “Thank you.” Maggie brushed at her dirt-stained jeans. “I need to change and drive to the hospital.” But she remained rooted on the spot. “I don’t have a present. The quilt isn’t ready. Flowers? Maybe I should cut some flowers.” She reached for the roses and pricked herself on a thorn. “Ouch.”

  “Careful. Why don’t you go change, and I’ll get the flowers?” Lena had thought nothing could faze Maggie, who had shown grace and composure even when her neighbor had had a heart attack right here in the garden. She’d taken care of her friend and called the ambulance as if she’d prepared for such an event.

  Maggie hastened off toward the house, and Lena decided to pick the flowers quickly enough to have time to change herself. No way would she let Maggie drive herself to the hospital in Seattle and end up in a car crash.

  To her surprise, Maggie handed her the car key without discussion.

  Maggie’s car was a cute Prius that drove so smooth and
silent that Lena didn’t even mind the afternoon traffic. Such a difference from her old, dying Ford.

  Maggie looked at the small silver watch on her wrist. She didn’t say anything about driving faster but fidgeted in her seat.

  “You didn’t tell me, is it a boy or girl?” Lena tried to distract her. “Did your daughter decide on a name yet?”

  “A girl.” She sighed. “Jess was still undecided about the name, last I knew.” Maggie’s tone was very neutral.

  Lena glanced to her right.

  Maggie smiled, but it was laced with tension

  Uh-oh. She had wanted to redirect Maggie’s thoughts in a positive direction. “Were you hoping for a girl when you had Jess?”

  “When I was pregnant with Jess, I wished for a boy, not because I preferred boys but because I thought it would be easier for my husband to bond with a son.” She chuckled. “But those two did all right. Actually, more than all right. She always trailed after him, and he encouraged her. She loved to hide in his office when he had patients in there. I will never know what age-inappropriate things she learned by listening in on those conversations.”

  “So your husband was a doctor too?”

  “Yes, a cardiologist, same as Jess. He mainly worked in private practice, not in the hospital. More time for golf.” She said the last bit in a tone that suggested she was teasing.

  Lena had never met Maggie’s husband; he had died a few years ago.

  “What does Jess’s partner do? Is he a doctor too?”

  Maggie laughed. “No, there isn’t a he in the picture. Or a girlfriend. Jess decided to have a child on her own. I don’t know why she thinks that being a single mother is a wise decision with the work hours she keeps.”

  Lena agreed, but it wasn’t her place to say so. She’d never known her father either, and the short time she’d lived with her mother alone hadn’t been an advertisement for happy family life. For a moment, the reminder of what she’d missed itched like an old scar. But what was done was done.