The Perfect Son

by Barbara Claypole White

  “I need a permission slip signed for a field trip to Barnes & Noble for AP Lit. And breakfast would be good.” Harry pasted on a smile. “Mom keeps chocolate croissants in the freezer.”

  For one whole moment, Harry truly believed Dad’s nostrils flared. “You know what, how about I take care of breakfast?”

  “Yes, how about you do just that.”

  SIX

  Voices hovered beyond her eyelids. A nurse muttered about preventing bedsores and then stuck her with a syringe; Katherine whispered into a cell phone.

  Sleep reached out, wrapping her close.

  Sit up, Ella. Sit up.

  An invisible force—a formless being—pinned her to the hospital bed. Sound shimmered into waves of light; lips moved through soundless words; a ghostly mirage leaned over to kiss her with icy breath.

  “Mom?”

  “Honey, you okay?” Katherine; it was Katherine’s voice.

  “I think I’m hallucinating.”

  “Seeing the dead mother again?”

  Ella nodded slowly. The only part of her that didn’t ache was her head. She planned to keep it that way.

  “Damn, you need to share those drugs,” Katherine said. “How do you feel? Like a gang of Hell’s Angels partied all night in your chest?”

  “Pretty much.” Ella stared at the breakfast tray. When did that arrive? “Water?”

  “On it.” Cradling Ella’s neck, Katherine raised her head and held a plastic cup to her lips.

  Ella sipped through the straw, then eased her head back onto the pillow. “Throat like sandpaper. On the positive side, I didn’t croak. If my breath would hold out, we could sing Gloria Gaynor’s ‘I Will Survive.’”

  “That’s my girl.” Katherine packed away her laptop and started winding up the cord.

  “Your deadline. God, I’m sorry, Kath.”

  “You’re kidding, right? I’ve been on my very own writer’s retreat for the last twelve hours. I should be thanking you.” Katherine smiled. “Felix will be here by nine thirty. Are you still sure you want to meet with the cardiologist alone?”

  “Positive. Thanks for covering for me.”

  “Hey, what are best friends for, if not to lie to husbands?”

  “I owe you.”

  “Honey, I owe you a thousand times more.” Katherine picked up her writer’s bag and headed toward the door. “I’m going home to shower and then I’ll be back.”

  “Wait. How did Felix sound—when you talked to him last night?”

  “Concerned about you, which won’t do him any harm. And Harry’s fine, so no worrying about him. Velcro Max is refusing to leave his side.”

  The ringing in Ella’s ears became a thunderous waterfall. She was tumbling into nothingness, falling into rapids. She grabbed the bed rail.

  “Should I call the nurse?”

  “No.” Ella closed her eyes and visualized the horizon. Nothing was moving; she was not moving.

  “I should text Harry. Say good morning.” Ella grappled for her cell phone, and it clattered to the floor.

  Katherine dove down to retrieve it. She placed the phone out of reach on the chair. “Harry’s fine. He’s in school with Velcro Max, and you, missy, need to rest and get your strength back. Your mission, should you wish to accept it, and you will, or else”—Katherine raised her eyebrows—“is to focus on no one but yourself. Got it?”

  “Yes, ma’am.” Ella adjusted the bed so she was sitting up.

  “Want me to help you freshen up? I hear the cardiologist is a hottie. Dr. Beau Carlton Beaubridge, what a heroic name.”

  “You spent last night eavesdropping by the nurses’ station, didn’t you?”

  “I couldn’t help myself. The CCU is fodder for character research. I may have to give my next heroine a heart attack. Okay, I’m outta here. Love ya.” Katherine paused in the doorway to greet the doctor. Not exactly a hottie, but he was good-looking in a bland, predictable way.

  “Good morning. May I come in? I’m Dr. Beaubridge, your cardiologist.” He closed the door and moved to her bedside with a confidence that stated, I own this place. A young nurse followed in his wake.

  “How are you feeling?” He whipped the stethoscope off from around his neck and warmed it on his hand.

  “Like I was run over by a freight train,” Ella said. “Possibly a whole battalion of them.”

  “Yes, it was a substantial heart attack.”

  Dr. Beaubridge began to examine her in efficient silence. When he pulled up her gown to inspect the site of the catheter insertion, she looked toward the nurse.

  “Nice work,” he muttered. “Dr. Wilson did this?”

  The nurse nodded.

  Dr. Beaubridge sat next to the bed and read Ella’s file. Her mind wandered to Harry in his dress-up scrubs, the ones he’d worn to kindergarten every day for a week—until a brute of a five-year-old had ripped them in a playground incident. Calhoun Junior, Cal for short. She’d memorized the names of all of Harry’s bullies.

  She would listen and obey; she would do whatever Dr. Beaubridge told her to do so she could get home to Harry. But first, she had to ask the question.

  “I have a disjointed memory from the plane. At least, I think it’s a memory, not a nightmare.” Ella stared up at the ceiling tiles, found a focal point, and kept staring, despite the prickling dryness of the air. “My heart stopped and I was shocked back to life. Is that true?”

  “Yes.” Dr. Beaubridge rustled papers. “It happened again in the ambulance.”

  “My husband won’t be able to handle this. He mustn’t know. Please don’t refer to it if he turns up before you leave.” Dr. Beaubridge had been late; Felix would be early. The chances were high that they would meet.

  “There’s no reason why he should know unless you choose to tell him. You’re of sound mind and able to make your own medical decisions. What your husband does or doesn’t know is between the two of you.”

  “I need to understand something.” She glanced at the door. Felix could walk in at any time. “Was this incident”—she couldn’t say the words heart attack; they belonged to her mother—“life-threatening?”

  “Yes, you dodged a bullet, Ella. The STEMI—or ST segment elevation myocardial infarction—had a proximal location such that the area of the heart muscle provided for by this artery was quite large. Maybe greater than fifty percent of the heart muscle of the left ventricle, which, as you probably know, is the pumping chamber of the heart.”

  Ella nodded.

  “When the blockage is very proximal—which means before any branches come off that artery—it’s sometimes called a widow-maker lesion. For good reason. A blockage at that site can be high risk.”

  Widow-maker, widower-maker.

  “But you were also extremely lucky. The plane was close to landing, and you were brought to one of the best heart centers in the country. I’m not sure if anyone has explained this to you, but not every hospital has a cath lab.” He paused. “Now we focus on healing.”

  “And I can assure you that I’ll do whatever it takes.” She stopped to catch her breath. “But I also have a high-maintenance family, which means I always need a plan B.”

  Her monitor bleeped with a slow, steady rhythm.

  “Am I at risk for another one, Doctor?”

  “There’s always a possibility, yes, but we’ll teach you how to aggressively manage your risk factors to lower the chance of a recurrence.” He glanced down at the file. “Losing weight isn’t an issue for you. Do you exercise?”

  “Every day.”

  “Smoke?”

  “I quit five years ago.”

  “And your cholesterol is fine,” he said with a frown. “I see your mother died of a heart attack at the same age.”

  The young nurse coughed.

  “Meaning I’m screwed?” Ella said.

  “Meaning we can likely blame a genetic condition.”

  Ella’s door was the only closed door in the section. Once he opened it, Felix would be a
step closer to the truth about her prognosis, to confirming or denying the terrifying statistics he’d gleaned from the Web. He tucked the yellow legal pad under his arm. From now on, he was compiling a written history. He didn’t trust this hospital—inner-city incompetence waiting to happen—and he didn’t trust his own memory to get the details right. Plus he was towing a U-Haul of questions. The cardiologist better be packing answers, because if he didn’t come with a wall of shiny plaques that bragged of his expertise, this man was not going to treat Ella.

  Braced for impact with Katherine, Felix opened the door and discovered his wife sitting up in bed. The oxygen mask was gone, replaced by a tube under her nostrils, and she was chatting to a blond, blue-eyed, all-American male doctor. A young nurse stood behind him.

  “Felix—” Ella blushed as if he’d caught her red-handed. “This is my cardiologist.”

  “Beau Carlton Beaubridge.” The doctor rose, shook his hand, sat back down.

  Felix flicked the “Mute” button on his phone. “I’m sorry if I’m late, but I was under the impression that you were due at nine thirty.”

  Dr. Beaubridge frowned. “I was explaining to your wife that it was a substantial infarct.”

  “A fart?” Felix said. Clearly, this man was not qualified to treat his wife.

  “A myocardial infarction, or MI. A heart attack to Joe Blow.”

  Did he, an Oxford man, look like a Joe Blow? Felix flexed his fingers.

  “I was also explaining that the angioplasty was successful.” Dr. Beaubridge checked his pager. Really, the man could have been discussing a picnic in the Hundred Acre Wood.

  “Can she be transferred to Duke or Memorial?” Felix asked. Can I confiscate your pager?

  “Felix, I’m not changing hospitals.”

  “Ella, please. Let me handle this. You need the best care available.”

  A muscle twitched in the doctor’s neck. “If Ella wants to move, that’s her prerogative, but if you’re concerned about the level of care, I can assure you that Raleigh Regional has the leading heart center in the state. I myself transferred here from Duke. Your wife is in excellent hands, Mr.—”

  “Felix,” Ella said.

  “Fitzwilliam,” Felix added. “Her prognosis?”

  “Your wife is relatively stable at this point, Mr. Fitzwilliam, but she’s still in critical condition. A normally functioning heart ejects about sixty percent of the blood in the pumping chamber with each contraction. Ella’s heart is operating at thirty percent. You see—” Dr. Beaubridge swung his chair round and pulled a small pad and a pen from his pocket. “The heart muscle provided for by the blocked artery lost its blood supply for a period of time.” He began drawing a diagram. Really? Did Felix look like someone who needed visual aids?

  “By the time the blockage was opened up with the stent, the damage had already been done. That heart muscle may recover in time; it may not. Obviously, we hope for the former.”

  “Yes, I did my Internet research last night.” Felix scowled. “Did your staff not get her to the cath lab quickly enough? Was the door-to-balloon time not up to par?”

  Dr. Beaubridge exchanged a glance with the nurse. “We don’t advise Internet research. In our experience, it generates misinformation and unnecessary distress. Door-to-balloon time, for example, is no longer relevant. These days we work directly with the EMS. They faxed us your wife’s EKG from the ambulance, and it revealed ST elevation. Since timing was an issue, we couldn’t treat her with thrombolytics—superstrong blood thinners—so my colleague arranged for her to go straight to the cath lab.”

  Dr. Beaubridge resumed his kindergarten sketch, this time angled toward Ella. “Your artery here got blocked, so we unblocked it with a stent, a small tube placed across the blockage. That opened up everything so blood could flow to the heart muscle again.” He drew something that looked like a bridge, then pulled back to admire his artwork. “Dr. Wilson, who treated you yesterday, managed to get a good look at the rest of the coronary arteries, and you do have severe blockages elsewhere. We’ll deal with those later, after the heart has healed some—”

  “Why didn’t he deal with the other blockages yesterday?” Felix said.

  “We need to do things step by step in an acute setting.” Dr. Beaubridge paused. “Outcomes are worse if we try to fix all the blockages at the time of the initial heart attack.”

  “No open-heart surgery?”

  “Not at the moment, no. The muscle is too compromised.”

  “Compromised?”

  “Mushy.”

  More Joe Blow definitions?

  “But it is likely that Ella could return after a recovery period of one to four weeks for a subsequent cardiac catheterization. Our goal right now is to stabilize Ella’s condition, and start her on medication that will take the load off her heart and enable her to breathe more easily.”

  Something attached to Ella bleeped.

  The doctor slapped his knees and stood. “We’ll educate you about managing your risk factors, Ella, and when we’re convinced you can handle basic self-care, you can recuperate at home. We’ll treat you with a statin to lower cholesterol—”

  “My wife has high cholesterol?”

  “No, but we need levels below normal. Less than seventy. And you’ll need a beta blocker, Ella, and Plavix to prevent clots from forming at the site of the stent. Plus aspirin. And we’ll refer you to a cardiac rehab program several weeks after discharge. No driving for a while.” Dr. Beaubridge checked his pager again. “You’ll probably be back to work in three to six weeks. Resume sexual relations in about four.”

  “It could be six weeks before she can return to work?” Felix said.

  “Is that a problem?”

  “Yes,” Ella said quietly.

  “What is it that you do?”

  “I’m a stay-at-home mom.”

  “Well, I’m sure friends and family can help out.”

  I’m sure they can’t.

  Ella gazed up at the ceiling. She didn’t move; she didn’t make a sound. And Felix knew what she was thinking, because he was thinking it, too. Life will never be the same again.

  “Ella needs to focus on building up her strength, recuperating, and, as I’ve said, learning to manage her stressors,” Dr. Beaubridge said.

  Manage her stressors. Was that a cardiologist’s get-out-of-jail-free card, the one that allowed him to blame everything on a patient’s failure to rein in her risk factors?

  “I’ll see you at the same time tomorrow, Ella.”

  “Thank you, Dr. Beaubridge,” she said.

  “Wait! You’re leaving her with a bunch of nurses?” Felix stood tall and put a hand on his hip.

  “Extremely well-qualified nurses, Mr. Fitzwilliam.”

  “You’re not coming back later today?”

  “I do my rounds in the morning, before patient office hours. Do you have any questions, Ella?”

  Felix moved to barricade the door. This guy was not leaving. They had barely scratched the surface of Ella’s diagnosis. “Are there any problems we should be aware of—with stents?”

  “Dissection, sometimes. It’s very rare.”

  “But it can happen.”

  “In less than one percent. And a small tear can heal itself.” Dr. America checked his pager again, and Felix imagined pulverizing it under the heel of his boot. “Mr. Fitzwilliam, I understand how frightening this situation is for you and your family, but I don’t think this conversation is helpful.”

  “When can she come home?”

  “That all depends on her condition and her recovery, but I’d say in a few days.”

  “So she can’t come home tomorrow?”

  “Definitely not, Mr. Fitzwilliam.”

  “The next day?”

  “Unlikely.”

  “The day after?”

  “Let’s wait and see, shall we?”

  But Felix needed answers, he needed solutions, he needed absolutes. He needed someone to say, “Yes, she’ll be home
in four days, and her chances of making a full recovery are ninety-five percent.” This man was not telling him what he needed to know.

  “Your wife is in excellent hands here at the Raleigh Regional CCU, Mr. Fitzwilliam.”

  Brilliant, so now Dr. Beau Carlton Beaubridge sounded like a cheap car salesman. Felix scribbled on his pad: check doc’s credentials.

  Dr. Beaubridge shook Felix’s hand. “I suggest running a Google search. That’s the easiest way to check my credentials. I think you’ll be impressed.” And he left. The nurse, eyes lowered, shuffled out behind him.

  Felix turned and stared at the blank television screen and the vase of flowers next to it. Unlike him, Katherine had thought to bring flowers. They were ridiculously gaudy and horribly inappropriate for January. Also far too sweet. He would bring ones that didn’t nauseate; ones Tom would have approved of. Was it too early for jonquilla?

  “How’s Harry?” Ella said.

  As Felix moved to her bedside, a memory ambushed him: holding Ella’s hand during labor. Drug-free labor at Ella’s insistence, although Felix, who’d believed he would die from the horror of watching her suffer, would gladly have taken any drug offered.

  “Harry’s in school. Max drove him.” He reached out and twisted her wedding ring round and round. It was warm and smooth. “Did you know that after two teenage boys share a bedroom, the stench is worse than when Saint John’s gun dog rolls in manure?”

  “Welcome to my life.” She gave a laugh that disintegrated into a cough. Felix poured water into the plastic cup and held the straw to her lips.

  She lay back on her pillow. “Is Max doing school pickup?”

  “No, I am.”

  “Good. Keep Harry on his normal routine as much as possible. He needs routine.” Ella looked up at him with huge brown eyes, eyes that normally reflected passion, humor, anger. This morning, they were dull and lifeless.

  Her mobile dinged with a text; she ignored it. “Felix, I need you to look after Harry.”

  “Harry doesn’t need looking after. He’s practically a man.”

  “He’s a sweet, all-over-the-place kid who needs help structuring his life and a lot of parenting.” Ella smoothed out the edge of her sheet. “Tag, you’re it.”