Assignment- Baby

by Lynne Marshall

  Apprehension rose up like a brick barrier and he slammed into it. "What's wrong?"

  She was breathy and nervous, and her eyes grew wild as if she was in panic mode. "Heartbeat. Too fast."

  Hunter felt her pulse. Holy God! He could hardly count the beats. Surely it couldn't be that fast? Her skin felt cool, yet she was sweating.

  "I feel dizzy," she said, paling right before his eyes.

  "Are you having chest pain?"

  "No." She shook her head.

  "Sit down. No! Lie down." For a medical professional, he'd quickly unraveled into bumbling boyfriend. Think! "Bend your knees." Hunter slipped his cell phone from his pocket and dialed 911. "Try the Valsalva maneuver," he said, grasping at anything that might be remotely of benefit. Realizing he might be making her more nervous than she must already be, he schooled his voice. "That will help your heart slow down."

  He answered all the questions from the nine-eleven operator and dutifully waited. And prayed.

  What in the hell was happening to Mandy?

  He sat by her on the grass, holding her hand, all the while watching every twitch of her face and every change in her expression. She was young and fit. This was a fluke. Surely nothing could be life-threatening? He felt her pulse again. It was still thready, and over two hundred beats a minute. He couldn't believe it. Thankfully the rhythm wasn't irregular, as in atrial fibrillation, it was just ultrafast. Since the Valsalva maneuver hadn't worked, he rapidly rubbed over the vein in her neck, giving her a carotid artery massage in another attempt to slow down her pulse.

  "Mandy, stay with me."

  "I'm here."

  He worried that her blood pressure would drop too low and she'd pass out. He elevated her legs by propping them on his shoulder, and didn't take his eyes off her until the ambulance arrived ten minutes later, along with a fire truck. The EMTs began their intake. Mandy's blood pressure was only eighty-five over forty while her heart rate remained alarmingly rapid. On the portable monitor, the rhythm looked like supraventricular tachycardia.

  "You're going to be all right, sweetheart. Your heart is young and strong. They'll straighten this out in no time."

  The oxygen helped her breathe easier. They started an IV to give her fluids to help bring up her blood pressure, and to give access in case she needed emergency drugs. They called ahead and warned the local hospital they were on their way.

  Hunter rode in the back of the RA unit, fearing he might lose the woman he'd come to love all over again. He held her hands and bent close, looking into her eyes. Fear still occupied her gaze.

  "Everything will be all right. They'll give you medicine to slow your heart. I won't let anything happen to you." He squeezed her cold hands tighter.

  The hint of a smile crossed her lips. He glanced at the monitor. Her heart rate was unchanged.

  A weak tap on his hand drew his attention back to the woman he loved. Her nostrils flared as she tried to catch her breath. He knew she wanted to tell him something, but she couldn't manage to utter a sound.

  CHAPTER TEN

  THE EMTs rolled Amanda through the double doors at the back of the small ER at the local Serena Vista hospital. Ceilings and lights whirled past, making her squint. The blare of voices assaulted her ears and made her flinch. Though her heart galloped in her chest, and it was hard to catch her breath, she tried to relax in the knowledge that soon her condition would be treated and she'd be back to normal.

  And Hunter was by her side. He'd finally told her everything she'd dreamed. He wanted a second chance and was open to her dreams. Hell, he'd stopped short of asking her to marry him again. But she'd withheld the biggest secret of all: her heart condition. She'd never meant for him to find out like this.

  She was placed in a vacant room in front of the nurses' and doctors' station. Everywhere she looked people were crowded together, reaching over, bumping into and dancing around each other. Someone nearby had recently used a bedpan, and the institutional air freshener was doing a poor job of covering the odor.

  The tiny emergency department had clearly outgrown itself. Outside the rooms, gurneys lined the walls, surrounded by drapes resembling shower curtains around a bathtub to accommodate extra patients. From her vantage point, every room and gurney in sight was filled.

  She heard Hunter answering questions and discussing her with the attending doctor and nurse by the bedside. No, she didn't use drugs. No, she wasn't taking any type of weight-loss aid. No, to his knowledge she wasn't using any herbal supplements. No, she didn't have any preexisting heart condition.

  She raised her hand to say something, but the nurse had hooked her up to a heart monitor and a blood pressure cuff. Her oxygen level was checked by pulse oximetry. They placed a nasal cannula inside her nostrils and weird-smelling air blew up her nose. Her heart rate registered two hundred and forty-eight beats per minute, and her realizing that made the rate increase a few beats more.

  Amanda needed to tell the doctor about her Wolff-Parkinson-White condition, but Hunter was intently monopolizing the conversation.

  A tall doctor named Rodriguez squinted and studied the heart monitor. "It almost looks like a circus movement tachycardia," he mumbled to himself. "Let's get an EKG. Stat."

  Five minutes later, two doctors were poring over the EKG. "The QRS interval is narrow. I'm not a cardiologist, but it looks like orthodromic conduction."

  She could only pick up bits and pieces of their conversation over the racket from equipment being rolled into and out of the room, and the piercing voices competing with each other in the hallway. As the patient, she felt left out of the equation.

  The black-haired Dr. Rodriguez appeared at her bedside and looked down at her with concern in his midnight-colored eyes. Hunter stood on the other side of the gurney. "Dr. Phillips tells me you're a nurse?"

  She nodded.

  "Your heart is in a tachydysrhythmia known as circus movement, and we need to break the cycle. We don't know why this has happened, but since you're having symptoms with this pre-excitation, we need to treat you." Dr. Rodriquez pointed toward her monitor unit. "As you can see, your blood pressure is quite low, and you're short of breath and dizzy, so we'll start with a calcium channel blocker and go from there. If necessary, we will cardiovert you chemically with Adenosine, and if that doesn't help we'll use direct current."

  She tried to get a word in, but he kept on telling her how he intended to treat her heart problem. Amanda cursed herself for not buying the medical alert necklace her doctor had suggested when he'd first diagnosed her. But she'd been in total denial, and eventually had forgotten about it. Some educator she'd turned out to be.

  She tried to catch her breath and say Wolff-Parkinson-White, but she kept getting cut off. If they chose the wrong treatment, or if they treated her for atrial fibrillation instead of WPW, they could make matters worse.

  "Is there any chance you might be pregnant, Ms. Dunlap?" Dr. Rodriquez asked.

  Her eyes darted to Hunter, who looked as surprised as she felt. She shook her head.

  "I ask because Adenosine's safety for use during pregnancy hasn't been established."

  "Give me the shock," she finally managed to say.

  "But we may be able to slow down the heart rate with the drug."

  No. She shook her head, knowing it was the more extreme of the two treatments, but was fail-safe. "The shock." She just wanted to get this over with so she could move on with her life. A new life she hoped to share with Hunter.

  "The shock's safety during pregnancy is questionable, too." The doctor persisted in his one-note samba.

  "Not pregnant. Shock me."

  Hunter leaned forward. "Are you sure you want to go that route?"

  "I've got Wolff-Parkinson-White syndrome," she said, though she had to take a couple breaths between words. "I need the shock."

  Hunter's brows shot up, then furrowed. "Why didn't you tell me this—"

  Dr. Rodriguez broke in. "Were you officially diagnosed?"

  "Y
es. Last year."

  "In that case, I'll have a nurse give you a sedative and I'll call Anesthesiology to prepare you for electrical cardioversion. The nurse will have you sign a consent." Before Dr. Rodriquez left the room, he turned back. "If you know you have WPW then you should also know there is a way to fix it with cardiac ablation. You don't ever have to have one of these episodes again."

  "I know," she said.

  Hunter looked at her in total confusion. "Why haven't you taken care of this?"

  She felt too exhausted to explain all her reasons for putting the procedure off. Number one being fear. Deep primal memories of being helpless and poked and probed, of feeling cold and alone in hospital after hospital as an infant and toddler, came to mind. And fear that she'd wind up like her twenty-one-year-old patient—dead on the table. Number two: denial. She'd spent enough time being a weakling as a child. She'd survived. She could handle this one last flaw if she monitored herself.

  She could also throw in the fact that she'd weighed the odds of dealing with occasional bouts of SVT versus going through an invasive heart procedure and had erred on the side of conservative treatment. She'd even bargained with herself that if she taught other people to care for their hearts then maybe she'd be cut some slack on her own condition. That approach seemed the opposite of scientific, but hope and faith went beyond science.

  Obviously nothing had panned out.

  Fighting the machine gun rhythm in her chest, and Hunter's incredulous stare, she started to feel overwhelmed. Pins pricked behind her eyes and she bit her lip. Instead of giving in, she shut an emotional gate and clamped her jaw. She'd handle this in her own way. If he loved her, he'd understand.

  Dr. Rodriguez started to usher Hunter out of the room as the anesthetist arrived. "Time for us to go."

  Hunter quickly bent and kissed her forehead. "I'll be outside."

  Knowing he'd be there comforted her, but she worried what he must think about her never mentioning her condition. The trust pendulum swung both ways.

  An anesthetist wearing teal-colored scrubs and a flowery surgical cap leaned over the gurney and introduced herself. She had small green eyes that matched the scrubs, and she smiled while she placed large adhesive electrode patches over Amanda's chest and behind her back.

  Not knowing that Amanda was a nurse, the anesthetist continued using layman's terms. "The electrical shock causes all the heart cells to contract simultaneously, and that split-second interruption allows the heart to regroup and return to its normal heartbeat." As the IV had been placed by the EMT before their drive in, the woman cleaned one of the access ports and said, "I'm going to inject a quick-acting sedative, and when you wake up you won't remember a thing."

  Amanda knew that the electrical shock was painful, and welcomed the sedation. The procedure had left two large red marks on her chest and back last year. Feeling the effects of the medicine almost simultaneously as the nurse injected it, Amanda's head began to swim. A quick thought sped past, about her world being like a roller-coaster ride with Hunter around, and how much more beautiful life was with him in it. She felt separated from her body, as though it was floating on a soft raft out to sea.

  More quick notions danced on the horizon of her mind. Hunter's love was a gift. Drifting deeper and further away from consciousness, she held on to the thread of one last thought. If she loved him, she needed to trust that he'd accept her exactly the way she was.

  And then there was nothing.

  * * *

  Hunter paced the crowded ER waiting room from end to end while Mandy was being cardioverted. He fished out his cell phone and walked outside, past the "No Cell Phones" sign on the other side of the hospital doors. Several other people were there, elbows bent, phone to ear, presumably explaining their loved ones' circumstances into their mobile devices.

  Hunter dialed a number he hadn't realized he still remembered until right now. "Hello? Chloe? This is Hunter Phillips." Your ex-son-in-law. "I thought you'd want to know that Amanda is in the hospital. It's her heart…again."

  Wolff-Parkinson-White? Why the hell hadn't she told him? He'd known she'd changed. His gut had warned him she'd been holding something back. No wonder she'd put herself on a cardiac care diet and was so passionate about the Mending Hearts Club. He'd been right, something had knocked her world sideways, but never in a million years would he have guessed what.

  Sure, she'd done her best to cover it. Once he'd broken down her early barriers, she'd kept things aloof or playful whenever they got too close. Not that he hadn't enjoyed their carefree romps. And she'd been professional to a fault, kept him at an arm's distance. He'd made it past that hurdle, too. Once they'd made love, he'd thought it would all be smooth sailing—until she'd dropped the bomb with her final ultimatum.

  And now she'd managed to astonish him again, with this surprise condition.

  He'd finally opened up and shared his every thought with Mandy. He'd given opportunity after opportunity for her to do the same, only to find out she'd hoarded a huge secret.

  How could she love him if she didn't trust him? Disappointment draped him like a heavy curtain. His shoulders drooped under the weight. Finishing his brief call with Amanda's mother, he switched off the phone and went back inside to the waiting room.

  After several more minutes of pacing, he approached the middle-aged woman wearing a blue smock with a volunteer badge at the hospital front desk.

  "Can you check how much longer before I can go back in to see Amanda Dunlap?"

  The deeply creased woman, with youthful blond weaves throughout her graying hair, picked up the phone and dialed the emergency department ward clerk. "This is Janet at the front desk. I've got a Mr…" She looked up at Hunter.

  "I'm Dr. Phillips. Amanda's ex-husband."

  "I've got Ms. Dunlap's ex-husband here, a Dr. Phillips, and he's wondering when he can come back." She listened for a moment and replaced the receiver in the cradle. "They'll call you as soon as possible, Dr. Phillips."

  Frustration had him gritting his teeth. The thought of Mandy going into complications sent his heart speeding. He couldn't bear to lose her now that he'd found her again. Even if he was no longer sure who the hell she was.

  Here she was, running a preventive heart care program, when all along she was the one who needed to have her heart fixed. When had she been planning to tell him? And, more importantly, could he ever trust her again?

  Hunter loved her and believed in her, but she had to be honest with him for their relationship to work.

  Finally, after several more minutes, the blond volunteer waved him over and led him to the ER doors, where she punched in a code to open them. "She's in room five."

  "Thank you."

  He entered anxiously to find Mandy resting comfortably, though looking drowsy. He bent to kiss her forehead. She moaned. Once he'd established she was okay, his gaze shifted to the heart monitor. Normal sinus rhythm. Thankfully.

  After a reassuring conversation with the ER doctor, he took one last look at Mandy and walked away. Until she could be completely honest with him, there was no point in proceeding with his plans.

  What kind of man ran out on a woman in the ER, leaving her to go home to the parents who'd never thought she'd thrive? A man who needed more time to think.

  He'd give her a few days to recover, and then because he loved her, he'd convince Mandy to have the heart procedure. In the meantime, as far as their relationship went, he'd demand nothing less than honesty—which meant she'd have to approach him. Right about now, the thought of waiting for her to see the light and come to him felt worse than open-heart surgery.

  * * *

  The last thing Amanda remembered at the hospital, besides the small green eyes of her anesthetist, was Hunter's shocked and hurt expression before he kissed her and left the room. Had that been before or after the procedure?

  Her hand rose to her chest and gently massaged the tender spot on her skin. A loud purring noise alerted her to Jinx, nestled inside the c
rook of her other arm. She was home. "Hey, buddy."

  How had she gotten here?

  Still dazed, she stared at the bedroom ceiling, comforted by the slow and perfect rhythm of her heart. But it didn't last for long. A whooshing sound drew her attention to her bedside.

  "I've brought you some herbal tea," her mother said. She set it on the nearby table and helped her sit up, then propped her with several pillows. These were the tender touches of someone who cared about her. Something she hadn't felt from her mother in ages.

  "Mom? What are you doing here?" Her mother handed her the cup. She took it and sipped.

  "Hunter called us. We rushed over to the ER as soon as we heard."

  Amazed by her mother's sudden appearance and obvious concern, she glanced beyond Chloe's shoulder to find something more astounding. Her father. An expression of equal attentiveness softened his usually intense gray eyes.

  "You had us worried, sweet pea," he said.

  Putting on a cheery facade, she blew on her tea and said, "No worries. They fixed me." She took another sip.

  Her father sat at the bottom of her bed and massaged her foot with a knobby hand. "Until the next time. You know you've got to be careful. Why were you out there running like an athlete?"

  "Dad, nothing in particular sets this condition off. Stress, maybe. No one knows for sure. I could be sitting at my desk all day and have the same thing happen. Haven't we had this argument enough? I was born a preemie, but I'm a strong adult woman now. Jogging is good for me."

  "Maybe you should tell your heart that," her mother mumbled.

  Amanda felt her blood pressure rise as she handed the teacup back to her mother. Was this some cruel joke Hunter had played on her for not being honest? Okay, so she hadn't been straight with him about her condition, but she had it under control. She hadn't thought he needed to know because once he did, he'd treat her just as they did—like an invalid. She couldn't bear him treating her like that. And she really didn't need the aggravation of dealing with her parents right now.