Cordelia threaded the dilator into the catheter, attaching it to the needle and inserting it, waiting for the flash of blood, before continuing. She held the needle steady while advancing the wire into the vein. She then removed the needle, made a little cut with the scalpel and inserted the sheath, with the dilator in place, over the wire.
‘Almost done,’ she said quietly to Aryssa. ‘I’m just removing the wire and testing the balloon on the pacing wire.’ That only took a few minutes then she completed the procedure by inserting the wire into Aryssa. The wire was attached to the pacing box and it turned on. They watched on the screen as the balloon allowed the wire to be positioned. A few seconds later the pacing spikes appeared on the monitor, showing them that the wire was in the correct position.
Cordelia still marvelled at the technology they had these days that allowed them to do relatively complicated procedures in such a quiet and controlled environment. They waited another few minutes, watching the monitor for any potential changes. It only took a few seconds for Gene to smile and nod and for Aryssa’s cheeks to start to pink up. Her heart rate was now sitting at around seventy beats per minute. The pacing wire was doing its job.
They held steady. Waiting to ensure that everything was in place.
That was when it started. The noise like horses’ hooves in her ears. That feeling of a runaway train in her chest.
No. Please, no.
She stared down at her gloved hands, wanting to lift one to her neck. But she couldn’t. This was a sterile procedure.
She tried to take some long, slow, steadying breaths. But it was useless. She knew that. She’d dealt with this condition too long.
She kept her voice as steady as it could be. ‘Dr Du Bois, would it be possible for you to stitch the line in place for me, please?’
The nurse next to her turned her head in surprise, and Gene looked up. He gave her the strangest look. Stitching only took a matter of minutes—minutes that she didn’t feel like she had right now. It seemed odd to ask another doctor to scrub and get sterile. It would take him longer to do that than it would for her to do the stitching. But her head was starting to swim. She had to get out of here. Now.
She didn’t wait for his answer. She just turned to the nurse next to her, who was already gowned and wearing sterile gloves. ‘Could you hold this for me until Dr Du Bois is ready, please? I need to get a little air.’
The nurse moved swiftly, sliding her hands over Cordelia’s so there was no change in position. Cordelia didn’t hesitate. She turned and left as the thudding in her chest threatened to overtake her. She heard someone call her name. But she couldn’t afford to wait.
Her legs were shaking almost as much as her head. Heat swamped her and she tugged the sterile gown from her throat and sterile gloves from her hands as she staggered the last few steps to her office.
It was like a sanctuary. She didn’t even have time to close the door but slid down the wall, automatically putting her fingers to her neck to start massaging.
It was all she could think about. All she could concentrate on. Every molecule in her body had to think about those fingers. It was her own fault. She’d never left it this long before. She always dealt with the arrhythmia as soon as she’d felt it. As soon as she’d had symptoms.
She counted in her head. Slowly. One...two...three. It was impossible. Counting wouldn’t slow her heart rate. Or stop the wooziness in her head. Or the tightness in her chest.
She pictured something else. Green meadows. For as far as the eye could see. Flat green meadows. Dotted with daisies and dandelions. She sucked in a long, slow breath.
This was the place she liked to see when she needed to. It normally helped to centre her. Keep her calm. Keep her feeling in control, even though her body revolted. But this time there was a difference. This time something else was in her place. A blond-haired kid. And a broad-chested father. Smiling, laughing together. The father picking the kid up and swinging him in the air and the little guy screaming with joy.
It startled her. She’d never visualised things like this before. Her hands slid from her neck.
Her heart rate had slowed and she hadn’t even noticed. She put her fingers on her wrist and counted her pulse. Old-fashioned but effective.
She let her head sag back against the wall. The tightness in her chest eased. Thank goodness. She pulled her shirt from her body. Cold sweat was uncomfortable. She’d need to change. Just as soon as she checked on Aryssa.
Her stomach clenched.
Patient. She had to check on her patient.
* * *
Gene was dumbfounded. Had she really just left?
The nurse met his gaze. ‘She was paler than Aryssa,’ she whispered in a voice only he could hear.
He nodded and swapped sides, moving to the sink to scrub. Another nurse appeared, holding out a disposable gown for him. Within a matter of minutes he was scrubbed and gloved and talking away to a much more alert Aryssa as he placed a couple of stitches to hold the pacing wire in situ.
If the rest of the staff thought it strange that Cordelia had left in mid-procedure they didn’t say anything. But she hadn’t really left in mid-procedure. He was being hard on her. She’d completed about ninety per cent before she’d bailed. But it still didn’t make him feel any easier.
He kept talking, finished up, all the while keeping an eye on Aryssa’s ECG readouts before asking the nurse to keep her on the monitor for the next few hours. It was routine after a procedure like this and Aryssa already looked better. They would transfer her to another facility later. The pacing wire was only a temporary measure. She’d need a new permanent pacemaker in the next few days.
She reached over and touched his arm. ‘Thank you, Dr Du Bois. I feel much better. But I can’t pretend to be happy about getting flung off the trial. I’d finally found a drug that had actually improved my other systems, and probably my heart function. I feel as if—even though you’ve given me a new pacing wire—it will go downhill from here. I’ll miss the effects of that drug.’
He understood exactly what she was saying. ‘Cardiomyopathy is a complicated disease. Even when you have the gene, things can be different for every patient. You think the drug might already have helped. And those effects might last.’
Aryssa shook her head sadly. ‘I don’t think so, Doc.’ She sighed and leaned her head back against the pillows. ‘I’m just sorry this happened. All because some stray cat ran on the road in front of us.’
He wanted to tell her she could stay on the trial. He wanted to tell her there was a way around this. She’d had a pacing wire from the start. Who needed to know it had been replaced?
But Gene was far too ethical for that. The trial conditions had to be strictly adhered to. Trials were always strict—for good reason. They had to be absolutely crystal clear that any side effects or changes in a patient’s condition were caused by the new trial drug and not by anything else.
He put his hand over Aryssa’s. ‘I’m sorry, Aryssa. You know there’s nothing we can do about the rules of the trial. We have to follow them.’
A million thoughts were racing through his brain. This could be a drug that could help thousands of cardiomyopathy sufferers throughout the world. This could be the drug that could one day make a difference for his child.
He had to push all his personal feelings aside and think purely like a doctor, purely like a researcher. It was like being a coin, balancing on its edge. One tiny push could see him campaigning to keep Aryssa on the trial. And even though every professional bone in his body knew that was the wrong thing to do, the parent in him would always wonder if he should.
Aryssa was wheeled out to Recovery and Gene pulled off his gown and washed his hands again, running his fingers through his hair.
Cordelia.