Heart Failure Read online

  “Oh?” was all she could answer without betraying her thoughts.

  “I’m sorry, that was mean. But Jess is convinced that she can do anything she wants on her own. She’s too stubborn and independent for her own good. For her sake, I hope she’s right.”

  The more Lena learned about Jess, the more she wondered how she could be so different from her mother. But that wasn’t fair. She probably had lots of redeeming qualities.

  After twenty minutes, the fancy sat-nav in Maggie’s car announced that they had to leave the highway, and Lena concentrated on the unfamiliar roads until they arrived at the hospital. She stopped in front of the main entrance.

  “You go on in, and I’ll park the car. I’ll wait in the lobby until you’re finished.”

  “Nonsense. Come with me. I’ll introduce you. And who can resist a peek at a newborn baby?” Maggie talked rapidly in an uncharacteristically high voice.

  Honestly, Lena wasn’t eager to meet Jess, but she did love babies. And beneath the reasons Maggie had listed probably lurked the wish for backup. “You’re right, I can’t resist.”

  After lucking out with a parking spot close to the entrance, they made their way inside. The main hall was cool and empty, and their steps echoed on the stone floor. Lena followed Maggie to the admission desk, where a bored-looking young woman worked behind a glass wall.

  “Hello, I’m Mrs. Riley. I’m here to see my daughter, Dr. Jessica Riley.”

  “Oh my God! Yes!” The woman’s oversized bun wobbled as she nodded. “Diana…um, I mean Dr. Petrell delivered the baby all on her own in the garden. Half-naked! She tore off her scrub shirt to cover the baby, like a superhero. It was awesome! Come in!” She pressed a button, and a door opened. “They’re in room seven.”

  Garden? Maggie hadn’t said anything about that, and by the way she paled, maybe she hadn’t known. She stood frozen in front of the admission desk.

  “Room seven. Thank you,” Lena said to the woman.

  As Maggie hadn’t moved yet, Lena took her arm and led her through the door. The smell of disinfectant and fear assaulted her as soon as they entered the ER proper, reminding her of her grandma’s last day.

  She leaned into the roses she carried and breathed against the knot in her stomach until it dissolved. Concentrate! Signs with numbers and arrows led her in the right direction. They reached room seven without meeting anyone. Lena was unsure of the protocol but decided knocking was the polite thing to do.

  “What now?” A loud voice barked from the other side.

  That seemed to rouse Maggie from her shock. She opened the door. “Jessica Eleanor Riley. Is that the way to answer a knocking?” Her tone was more exasperated than angry.

  Suppressing a snicker, Lena followed Maggie inside. That was exactly the tone her grandma would have used on her. The last time she’d needed to, Lena hadn’t been older than fourteen.

  A woman in her late thirties rested on a gurney. The headrest was up so she was more sitting than lying, and she cradled a tightly wrapped bundle in her arms. Her dark-blue scrubs contrasted with her pale face. Short dark hair was curly where sweat had plastered it to the temples. Her frown faded as she recognized her visitor. “Oh. Mom. Hi.”

  And that sheepish tone was the same in which Lena would have answered fifteen years ago. Finally, something she could relate to.

  “Here’s Ella, your granddaughter.” A proud smile spread on Jess’s face, and she glowed with the joy of new motherhood. It transformed her completely. Now her natural attractiveness outshone her exhaustion, and the cornflower blue eyes sparkled with the same beauty as Maggie’s.

  Lena couldn’t help but smile with her.

  Carefully, Maggie hugged her daughter and grandchild at once. After a moment, she retreated and stroked Jess’s face. “Oh, Jessi, you look tired. Are you okay?”

  The love in her voice pricked Lena like the thorns of the roses she held. Her chest tightened until she had trouble breathing. She needed to get out of here. This was a private moment, and she had no right to intrude. She took a step back and collided with someone.

  Strong hands grabbed her shoulders and steadied her. “Whoa. Careful. Beautiful roses.”

  Lena turned around.

  The woman she had bumped into smiled down at her. She was clad in the same dark-blue scrubs as Jess. Her dark hair was fastened in a short ponytail, but several strands had escaped and gave her a slightly informal look. “Hi, I’m Dr. Petrell. You must be family.”

  Family? No amount of wishful thinking would make Lena part of a family again anytime soon. “No, no. I’m here as a friend to Maggie. She’s the family.”

  Maggie witnessed the exchange with arched eyebrows.

  “I have to leave now. Call me if you need anything. I’ll take the bus home.” Without meeting Maggie’s gaze, Lena held the flowers and the car key out to her.

  As soon as Maggie took them, Lena fled from the room. This is not your family. She was alone and that had been her decision. Now she needed to own it.

  All the way outside, she balled her fists and bit the inside of her cheek to keep the tears from falling.

  Chapter Three

  Jess stumbled over a stuffed penguin in her kitchen and nearly lost her precious cargo. If she hadn’t been so out of breath, she would have laughed at the absurdity of juggling half a dozen containers of breast milk.

  Shouldn’t it be easier to get ready for work now than during her pregnancy? She no longer resembled a whale about to beach, but instead of feeling rejuvenated, Jess was tired and weak like never before. Even in the worst times of her residency, she hadn’t felt as sleep deprived as she did now.

  Every time her mom had visited during the last four weeks, Jess had fallen asleep talking. She still hadn’t decided if she was embarrassed or grateful her mom had taken to sending her to bed like an overtired toddler.

  And that had made her too ashamed to even consider inviting Kayla.

  Admittedly, the maternity leave hadn’t helped with her circadian rhythm. Much like her residency, she was woken at all times of night and day to deal with emergencies. In this case, the emergency of her daughter believing she might die any second from starvation or loneliness. And the shift never ended and went on and on for a month.

  When her boss had called to ask her to cut the leave short because they were short staffed, she’d been delighted. Getting out of the house and leaving Ella’s care in professional hands for the day seemed like the perfect remedy for her exhaustion. In the last years, working as an attending had more fueled than drained her energy levels despite the long hours.

  Only she wasn’t ready. No professional help was in sight. The hospital daycare had changed their policy last month without warning and didn’t accept kids younger than one year anymore. The only halfway acceptable daycare out of the dozen she’d visited in the city didn’t have a free spot on short notice, no matter how much she offered to pay. If her mother hadn’t offered to step in, she wouldn’t be able to go to work. And that was the tip of the iceberg. She hadn’t lost her weight. She hadn’t read any of the articles she’d saved for her leave. She hadn’t even managed the simple task of getting a haircut.

  Jess picked up the penguin and set it on the kitchen counter next to her half-empty cup of coffee. She took a sip and winced. Tepid and bitter, it didn’t help to calm her churning stomach. She hadn’t felt so unprepared for her day since her first week of college.

  Stroking the soft fur of the penguin, she went through her mental checklist. Milk. Check. Stuffed animal. Check. Baby’s bag with diapers, wipes, and change of clothes. Check. Mom’s bag with keycard, money, phone, and the latest edition of Journal of Cardiology in case she was awake enough to read more than two lines. Check. What was missing? Just go. You’re running late already. Stop with your stupid lists.

  At the elevator, the vague feeling of having lost somethin
g remained. What was missing?

  When the doors opened with a ping, she entered and pressed the button for the parking deck.

  Ella.

  Jess jumped out through the closing doors and narrowly missed being squashed by the metal. Fuck, how can you forget your own child?

  It took three attempts to enter the code to her condo. Her racing heart wouldn’t slow down even when she’d reached the sleeping baby. She was dizzy with relief that Ella hadn’t noticed her absence.

  With shaking hands, Jess lifted her daughter from the cradle and held her close for a minute. The scent of freshness and innocence washed over her and calmed her nerves like magic, better than any checklist ever could.

  Loaded with both bags and the baby carrier, she resumed her journey to the car. Even when she had stowed everyone and everything safely in her BMW X5 and was on her way to her mom’s house, her heart rate was still elevated.

  Ella cooed in that adorable way to signal she was awake.

  Jess glanced in the mirror but couldn’t see her daughter’s expression. The thirty-minute drive to Shoreline passed in the blink of an eye, and Jess nearly missed her mom’s driveway because an ugly lump of junk—that might have qualified as a car fifteen or twenty years ago—was blocking most of the garage. Her mom’s tiny Prius might fit next to it, but there wasn’t enough space for her own SUV. She ran through a list of her mom’s friends, all of whom were either retired academics like her or old hippies or both. Neither group would drive such a piece of shit. Maybe someone was doing work at the house?

  Not that it mattered. She parked on the street, not caring that she blocked the driveway. That thing didn’t look as if it was able to go far anyway.

  Before she had again succeeded in juggling Ella, her bag, and the car keys, her mom appeared.

  “Jess, let me help.” Her mom took the baby carrier and peered inside. “Oh, Ella, look at you. How you’ve grown. Aren’t you sweet?”

  “Growing is all she’s doing for now.” Jess covered her mouth to hide a yawn. “But, yeah, she’s sweet.”

  Her mom looked up and studied Jess until she squirmed. “Do you want to come inside? You look tired. Have some coffee? Breakfast? You can meet Lena.”

  Who was Lena again? Jess looked at her watch and sighed. It wasn’t important. As much as she could have killed for another coffee, she needed to get going. Morning traffic was always difficult to predict. “I better head off now. Thank you so much for taking her on short notice. I’ll find a reliable babysitter or daycare soon.” Jess swallowed and looked down at her oversized sneakers that were the only shoes that fit her pregnancy-ridden feet.

  “Don’t worry about it. We’ll have much fun, Ella and I. Won’t we?” With the last words, she stuck her head into the carrier and said something in that tone reserved for babies and kittens. Or, in her mom’s case, more often than not, for rare plants. “Will you stay for dinner?” she added in her regular voice.

  “I don’t know yet. Let’s see how the day goes, okay?” Jess wasn’t looking forward to driving to her mom’s again in the evening when all she wanted to do was sleep. But she wouldn’t have gotten so far in her career with a habit of admitting weakness, not even to the person who should know her best.

  “Sure. Say goodbye to Mommy.” Her mom talked to Ella as if she expected her to do just that.

  Ridiculous but cute. “Bye.” Jess smiled and waved as she entered her car. No need to cuddle her daughter after she’d spent four weeks nonstop in her company. She should be happy to have some adult time, so why did her instincts make her want to cry or even grab the carrier from her mom? She clenched her jaw and forced herself to start the engine without hesitation. She gripped the steering wheel until her knuckles whitened. Missing her daughter might be normal, but this pain, as if she was stretched and stretched until something tore inside her, was absurd.

  With a shake of her head, she drove to work as fast as she could.

  Frantic beeping signaled an unnaturally high heartbeat. Some of her colleagues would mute the alarm in order to concentrate, but Jess flourished under the pressure. The monitor displaying the patient’s vital signs was probably flashing with all kinds of alarms as the blood pressure fell. She didn’t need to see it to know she had to act fast and finish the angioplasty to restore the oxygen supply to the heart.

  Her vision stayed fixed on the X-ray monitor showing her attempts to place the catheter in the correct position. Just a millimeter more. That’s it. She exhaled and gave the signal to inflate the balloon.

  Scott pressed the device and counted to five. He had been hovering behind her shoulder all day. Now that he had finished his regular cardiology fellowship and started the interventional cardiology one, Jess should have let him perform the procedure. But she was too damn happy to be back in the cath lab to care.

  As soon as he finished, Jess held out her hand.

  Wordlessly, Kayla offered her the right stent without being asked.

  With a grateful smile, Jess finished the procedure. She had missed working in perfect synchronicity with colleagues who read her mind.

  The patient’s heart rate dropped to normal levels, and the blood pressure rose again as blood flow in the most important coronary vessel was restored. Jess grinned. No matter how often she witnessed or performed the procedure, and no matter how well she understood the mechanism, this part still retained some of the magic she had felt the first time she’d seen it as a student. She had instantly decided that it would be her future.

  The most important work was done, and the rest was routine: closing the puncture wound and applying a pressure bandage. That was Scott’s job.

  With the knowledge of a job well done, Jess relaxed and her adrenaline level plummeted.

  Stars danced in her vision, and she blinked to remove them. She didn’t need clear vision to pull at a catheter, but steady hands would be nice. Hers shook like a student’s when they first drew blood. She attempted to take a deep breath but sucked the paper mask against her lips.

  “Everything okay? Jess?” Kayla’s voice was muffled as if through a thick wall.

  Jess nodded, unable to speak as her tongue stuck to the roof of her mouth. She stepped away from the table and ripped the mask from her face to gulp in some air. Her heart raced as if she was the patient on the table. What the fuck was happening?

  Maybe it had been a mistake to put on her prepregnancy lead vest that was too tight now. But she had been too proud and vain to ask for a larger size, and now she was paying the price for all those shallow breaths over the last few hours. Her breasts hurt like hell, especially her much-too-sensitive nipples.

  Sweat ran down her temples, along her neck, and under the lead vest and the sterile paper gown covering it. It stung her eyes like acid. She was cold and hot at the same time, and an uncontrollable tremor ran through her. She took a breath—not a deep one since her movement was still restricted as if a boa constrictor held her in its grasp.

  Out. I need to get out of this dammed vest.

  She dug deep inside her training to project calmness and confidence. “Scott, finish here, please. I’ll start on the report.”

  With her last shred of strength, she tore off her gloves and gown, then opened her vest. Each step was a struggle, but she held her head high, not losing sight of her destination, the door where she would be able to pull off the constricting vest and sit.

  Only the door swayed from side to side until it vanished from her view. “Not again,” she mumbled as the floor rushed up to meet her.

  The reassuring beep-beep-beep of a heartbeat monitor drifted in and out of her consciousness. Something grabbed her shoulder and shook her. A hand.

  “Dr. Riley, wake up!” The woman’s voice was warm and low but held so much authority that she wanted to comply.

  But why? The heartbeat was steady. No reason for her to get up and look at it. She was as
tired as if she’d run a marathon.

  Marathon? No, she had been at work. Cath lab. But why was she lying somewhere in the hospital? Jess blinked, then squeezed her eyes shut as a glaring light blinded her. But the glimpse had been enough to recognize the room as part of the emergency department. Why am I in the ED? Again? Is this a joke? She tried to get up for a better view of her surroundings, but strong hands stopped her.

  “Hey, Dr. Riley. Good to have you back. Stay down for a sec, okay?”

  That voice. “Rock Chick?” She opened her eyes again, and this time the light wasn’t unbearable. It was indeed the resident who had delivered Ella.

  “Haven’t we been over this already?” She chuckled. “It’s Dr. Rock Chick or even Dr. Petrell, but you might as well call me Diana, as we’ve already seen each other half-naked.”

  Jess nodded. She would never admit this out loud, but Diana’s presence alleviated her uneasiness. Jess trusted her, even though she barely knew her. “What happened?”

  “What do you remember?” The mirth vanished from Diana’s voice.

  Jess considered the question for a moment. “I had finished an intervention and was a bit dizzy and sweating. I guess I got dehydrated wearing the lead apron and fainted.”

  “Mmh. That might be possible. But you didn’t just faint.” Diana rolled a stool from the side of the room and sat at eye level. A faint line between her brows spoke of her concern.

  “What are you not telling me?” Had she hit her head? Broken something? Nothing hurt save for a faint ache in her breast and shoulder muscles, obviously from too many hours under the heavy protective garments.

  Diana looked to the other end of the room. “Madison, please give us a minute.”

  A nurse Jess hadn’t even noticed until now shrugged and left with a long glance back to her patient. It was rare that a doctor turned into a patient in her own hospital.