A Matter of Heart

by Amy Fellner Dominy

  Now, with Mom in bed and no one listening but the moon, I figure Dad and I can talk it all out. Make sense of it together.

  He sits on the edge of my bed and rubs his hands along his thighs, his dark blue sweats the same color as my ceiling. “How are you feeling?”

  “Fine. Really. I’ve felt perfect all day long.”

  He nods, and I can see the relief on his face. “So how did Coach take it? You having to go easy for a few days?”

  “Okay,” I say. “He didn’t act like it’s any big deal. He sent me to Admin for the interview.”

  “Because you’re the star of that team.”

  I work my hands around a stretch of the sheet. “I just hate missing a real practice.”

  “You’ll be fine. But you do need to be more responsible.” His voice is sharp. “Keep hydrated and take the vitamins your mother buys for you.”

  “I will.”

  He squeezes my arm. “I’m proud of you, honey. You stay strong and we’ll get through this.”

  “Two more days.”

  “That’s right,” he agrees. “We’ll see the cardiologist on Wednesday and get you back in the water on Thursday.”

  “Are you going to come?”

  “You kidding?” he says. “If I send you with your mother, you’ll come home wrapped in gauze.” He smiles to soften his words. “A little extra rest is all you need.”

  13

  At 5:30 the next morning it’s dark, and the air is cold enough that I’m wearing my swim parka over my one-piece. I’ve kicked off my flip-flops, and the pool deck feels so cold it burns my bare feet. I like it, though. It wakes me up and gets my muscles firing.

  It’s still quiet while everyone shuffles in, most of the team still half asleep. Horizon’s pool is nicer than most of the community pools. The facility was donated by a local family in honor of their grandmother, who competed in the Olympics in the sixties. It’s eight lanes wide, twenty-five yards long, with state-of-the-art mounting blocks. The locker rooms are inside the school gym, but there’s a covered walkway leading to the pool.

  Yawning, I stretch out my shoulders. The pool lights are on, so every ripple of water reflects a shade of blue. I drop my bag next to lane 1. Coach clears his throat and I look up. He points me to lane 8. Usually I’m in lane 1, group one. We swim three or four to a lane, and the first swimmer in each of the top lanes is the fastest. That means we race against each other, even during practices. Jen is in lane 1 and usually swims behind me in group two. Not today. Plenty of eyes follow me as I grab my stuff and move down the pool. Alec is already churning out laps in lane 2, but most everyone else is wetting goggles and lining up kickboards and hand paddles. Connor is practicing at the community pool with the Aqua Athletes this morning.

  “I have to take it easy,” I say as I walk. Bree is listening. Alicia. Tanner and Logan. Jen shoots me a thumbs-up, but the rest of them give me weird looks. It is weird. When have I ever taken anything easy?

  “We’ve got four thousand yards this morning,” Coach says. “Abby, no more than two.”

  I pretend I’m cool with it. But it’s hard to maintain a swagger past seven other lanes. I’m sharing with Hannah and Jessica. They’re both freshmen, and I don’t know much about them other than they’re slow. Then again, this is the slow lane. I wad my hair in a ball and shove it into my cap. I drop my coat behind my bag and jump in after Hannah. The cold steals my breath, but I’ll be warm by the time I finish my first fifty. I fit on my goggles, then push off from the wall.

  I stretch my arms in a slow glide, joining the smooth flow of the water. I was born in September, which makes me a Virgo. But I should be a Pisces, sign of the fish, because I belong in the pool.

  I want to push it. I want to feel the rush of water when I’m going fast. I want to swim right over the top of Hannah and Jessica just to prove I can. This feels like a punishment. As if I’ve been sent to swimming time-out. Two days, I remind myself. I can stand it for two days.

  Connor calls just as I finish dressing. His practice with the club team usually ends a few minutes ahead of ours.

  “Hey,” he says. “How’s it going?”

  “Crappy,” I tell him. “I had to swim slow.”

  His laugh rumbles. “A couple of days won’t kill you, Ab. I missed a week with pneumonia, remember? And I only had one slow meet.”

  One slow meet. Those were Alec’s words. I shift the phone to the other ear, disconnecting that thought. “Yeah, you’re right,” I say. “So how was practice?”

  “Lame. I wasn’t feeling it.”

  “Yeah?”

  “Legs were dead, like dragging bricks behind me. And you won’t believe what happened.” His voice lowers. “That asshole Ainley tried to move up on me. Thinks he can jump to group one.”

  “Seriously?” I shrug even though he can’t see me. “Who cares about Ainley. He can’t carry your swim bag.”

  “I know, right?”

  I can picture him smiling over that.

  “So how was your practice?” he asks.

  My breath catches in my throat, and there’s a second of silence on the line. “Oh, right,” he says. “Sorry. Forgot.”

  If only I could. I’m tempted to say more so he can reassure me and tell me I’m fine. My mouth opens and closes, but the words won’t come. I picture Connor on the other end of the line, lounging against a wall in a loose tee and worn jeans, grinning his way through a perfect senior year. I close my eyes and draw in a steadying breath. “Let’s talk about something else,” I say, keeping my voice light.

  “Yeah. Sure,” he says. “Anything.”

  And I hold my phone, knowing he’s holding his, and there’s silence on the line because I can’t think of anything else for us to talk about. My not swimming is screwing up everything.

  “You know what?” I say. “I’d better run. I’ll see you in the halls later.”

  14

  The colors in the cardiologist’s office remind me of Thanksgiving—rust chairs, pumpkin walls, and cranberry planters. Spaced between the chairs are fake leafy plants—are they supposed to make us feel like we’re alone? We are alone, except for an old couple with matching white hair.

  Mom and Dad are both here. Mom has canceled her Wednesday after-school group. Dad coaches the cross-country team at his middle school, and he’s missing a meet to be here. Not that they think anything is wrong.

  I’m trying to stay focused and positive. I’m not big on praying, but God and I talk sometimes. It never made sense that I should ask God for something that I could work to get on my own. Even now, I’m not asking him for favors so much as explaining how it’s going to be. I can’t be sick now. In a month, fine, but not now. I got slightly dizzy because I didn’t drink enough. It happens to me every winter. The Phoenix temperatures drop down to normal human levels and I forget to drink enough. Mom is always on me to take vitamins. I silently vow to take my potassium every day even if it does make me burp.

  Mom is sitting on my left, a clipboard with a stack of papers to fill out propped on her knee. Dad is on my right, trying to rearrange a plastic leaf that keeps poking his shoulder.

  I’ve got my math spread out on my lap, but I can’t concentrate. The air in here is musty. There are no windows, either. Why? So you can’t jump when you get bad news?

  I should be swimming right now. The back of my neck feels itchy just thinking about it. I know it’s only been two days, and Coach is beginning to taper down the workouts anyway. But I still have this stupid fear that everyone else is getting fast while I’m getting slow. After I’m done here, I’ll ask Connor to meet me at Lifeline for a swim. A swim will make everything right.

  After Mom finishes the paperwork, a lady wearing a cranberry smock leads us down a hall to one of the rooms.

  I sit on an examining table just like at Laney’s office. Only this room has a cart next to the bed with a monitor attached to some kind of machine.

  The assistant’s name is Maggie, and she does all the s
ame stuff they did to me at Laney’s: takes my medical history, blood pressure, temperature, pulse rate. Then she hands me a pink folded-up thing. “If you could put that on, please.”

  “What is it?” I ask.

  “A dressing gown. It opens in the front.”

  Dad clears his throat. “Maybe I ought to wait outside.”

  I crumple the material as I realize why his cheeks are suddenly pink.

  Mom squeezes his hand. “I’ll come get you as soon as we’re done.”

  I put on the gown, and it doesn’t take long for Maggie to attach the electrical leads to me. They’re flat sticky bits of tape that are held by clips and attached by wire to the machine. I expected a few—not ten. They’re on my chest, my arms, and my ankles.

  “Just relax,” she says.

  As if. I’m afraid to move so the lines don’t shift around. Also, the gown is barely hanging to the curve of my right boob and I don’t want it to slip and leave my nipple to the wind. Even worse, I have a nagging itch on the inside of my left ankle.

  “Mom,” I say. “Scratch for me.”

  She finds the spot and digs in with the tips of her short nails the way I like. In the meantime, I can see a line stretching across the computer monitor, spiking with every heartbeat. It’s just like Grey’s Anatomy. The screen looks like it’s full of pointy witch hats. Good thing Jen isn’t here. She’d get new ideas for Halloween.

  A few minutes later, a printer starts up. “You can get dressed now,” Maggie says as she takes a sheet off the printer. “The doctor will be in shortly.”

  I finish dressing and Dad comes back in. Nineteen minutes later we’re waiting so quietly I can hear a rustle on the other side of the door. My chart being lifted. A quick knock follows and then he comes in.

  “Hello,” he says. “I’m Dr. Danvers. And you must be the Lipmans.”

  Dr. Danvers is a good-looking guy about twenty years past hot. Dr. McDreamy for the parental crowd. His black hair is shot through with gray, but he has really nice blue eyes and an easy smile, and he even has a little beard-stubble thing going on.

  He works his way from Dad to Mom and then gets to me. He shakes my hand. I can see that he’d be a good doctor to have if you needed one. Which I don’t. I just need him to give the okay so I can get back in the pool.

  “Laney told me you’re a star swimmer,” he says.

  “Just broke a school record in the hundred free this past weekend,” Dad says.

  “Really?” His brows rise along with the edges of his smile. “And you’re how old?”

  “Sixteen,” I say.

  “Just turned sixteen in September,” Dad adds.

  “She’s never had any heart issues,” Mom says. “She passes a physical every year in perfect condition.”

  He nods and pulls out his stethoscope. “Mind if I have a listen?”

  He listens to me lying down and then standing up. “Breathe normally,” he says, which I’m getting really tired of hearing. When he finishes, he wraps the stethoscope around his neck. “I’d like to do one more test.”

  “What?” Dad blurts as Mom makes a noise like a dying bird.

  “The EKG shows the heart muscle is a little thickened, but I can’t determine the cause without also running an echocardiogram,” he explains. “It’s basically an ultrasound of the heart. It doesn’t hurt a bit. We can do it right now, if you like.”

  A nervous feeling rolls through me like a wave of seasickness. I want to tell Dr. Danvers that no, I don’t like. “I’m meeting Connor at the pool tonight. It’s already after five.”

  “Honey,” Mom says.

  Dad’s rubbing a hand over his mouth and chin. I can guess how he feels. The same way I do. Frustrated. Mad. Freaked out.

  “Dad?” I say.

  His eyes meet mine. “Let’s do the test and get out of here, Ab.”

  But it’s another hour before I get taken to a different room, and a lady with hair on her chin smears blue gel on my chest and rubs a cold metal knob over it. I try to breathe normally.

  When it’s over, there are three texts from Jen and one from Connor. STILL WAITING I text them both. Tomorrow I can tell them about the EKG and the echo. When the scare is over.

  But when Maggie leads us to Dr. Danvers’s office, it doesn’t feel like a false alarm.

  It feels like a funeral march. I shake off the feeling, but Mom rubs my shoulder as if she feels it too.

  Dr. Danvers’s office is all desk and bookcases and framed medical degrees. I can’t focus on anything except the file in front of him. My file. When we’re sitting down, me in the middle, Dr. Danvers tilts his computer screen so it faces us. “I’ve reviewed Abby’s echo,” he begins, “and I’m afraid there’s a problem.”

  A shiver ripples up my spine.

  Dr. Danvers gestures to the screen. “This is Abby’s echo. It measures the thickness of the chambers and walls of her heart. Abby has an asymmetrical, or irregular, thickening of the ventricular wall. This is indicative of a heart condition called hypertrophic cardiomyopathy.”

  “Heart condition?”

  “What?”

  Mom’s and Dad’s words overlap and twist together in disbelief and fear. Dr. Danvers pulls out a piece of paper and carefully writes out the words in block print as if we’re five years old: HYPERTROPHIC CARDIOMYOPATHY. He lays the paper on the desk facing us. “It’s sometimes called an enlarged heart.”

  “But her heart is fine,” Dad says. “It’s always been fine.”

  “Hypertrophic cardiomyopathy, or HCM, often doesn’t develop until adolescence,” Dr. Danvers says. “That’s one of the reasons this can be so deadly. Teenagers die from this without ever knowing they have it.”

  “Die?” Mom says with a gasp.

  “When it’s not discovered in time,” he adds quickly.

  “Then we caught it in time?” Mom asks. “Before it gets too serious?”

  “HCM is always serious, but Abby should be fine.” He pulls out another piece of paper and draws a picture of a heart. “These are the chambers of the heart, and this is the wall that separates them: the septal wall. With the measurements from Abby’s echo, I’d say she has a mild to moderate case.”

  I let out a breath at the same time Dad does. “So that’s not bad,” I say.

  “It’s not,” Dr. Danvers agrees. “But even at mild levels, HCM results in a strain on the heart’s function. Because of this thickened wall, the blood doesn’t flow out of the chamber as easily. There’s a great deal of pressure that builds up, which is why Abby experienced dizziness. Other typical symptoms include arrhythmia—an uneven heartbeat. This could lead to fainting and cardiac arrest.” He pauses, his gaze circling from Mom to Dad and then to me. “Unfortunately, when left untreated, HCM can result in death.”

  Mom’s fingers are white on the arm of her chair. Dad’s hands are fisted. I feel like I’m somewhere else. Like this is a movie and I’m watching from above.

  “You just said it was a mild case,” Dad snaps.

  “Mild to moderate,” Dr. Danvers says. “And I’m just trying to be clear about what we’re dealing with.”

  “Is it treatable?” Mom asks.

  “Absolutely.” He reaches for a prescription pad. “I want to start Abby on beta-blockers immediately. They’ll help control her heart rate.”

  “What does that mean?” Dad asks.

  “Beta-blockers will keep her heart rate low and in a safe range.”

  I’m shaking my head. As if from above, I see my head moving. I hear the words come from my lips. “But I can’t swim fast with my heart rate low.”

  “No,” Dr. Danvers says. “You can’t.”

  You can’t.

  I hear the words, but they don’t reach me. I’m still watching from above. This isn’t happening.

  “You’ll have to make some changes, Abby. You can still swim,” he says. “But not competitively. Not at the level you’re accustomed to.”

  My voice shakes. “For how long?”


  “You don’t understand,” Dr. Danvers answers, and his voice is so gentle, fear rises in my throat, squeezing until I can hardly breathe. “This condition is permanent, Abby.”

  “How long?” Dad growls as if he hasn’t heard this last bit.

  Dr. Danvers blinks and looks from Dad back to me. “Forever.”

  15

  I’m frozen. Numb, maybe. I heard Dr. Danvers, but it’s like my ears just closed up shop and nothing’s getting in or out. Then Mom gasps. Chokes on a sob. I feel her hand on my arm and something cracks inside me. A jagged crack like you see on the sidewalk, and if it spreads and deepens, then it will crumble. I’ll crumble.

  No! I won’t fall apart. I struggle for breath, needing to do the one thing I’m good at. Fight.

  I look up, and Dad is standing now. His jaw pulses and the veins in his neck stand out. “How can you say that? How can you sit there and say that to us?”

  “Please, Mr. Lipman, have a seat. Let’s talk calmly about this.”

  “I don’t want to sit,” Dad bites out.

  “David, please.” Mom’s voice is a tremble of air.

  I pull my arm from Mom’s hand and sit forward. “This doesn’t make sense. I just set a new school record on Saturday. How could I do that if my heart is as screwed up as you say?”

  He folds his hands together. “That’s a good question, Abby. But as I said, this condition develops over time. Up until now, your heart was able to withstand the pressures and do its job. But that’s changed now. The dizziness and loss of consciousness are signs. A warning.”

  “But I was dehydrated. Laney said that could have caused it.”

  “It was almost certainly a factor,” Dr. Danvers agrees. “Dehydration is an added risk factor for HCM.”

  “Then if I’m careful and drink more—”

  “It might alleviate symptoms, but it won’t change your condition.”

  “How did this happen?” Mom asks. “Is it some kind of virus?”

  “No, Mrs. Lipman. HCM is a genetic condition.”