A Matter of the Heart. Patricia Davids
opened another door and strode out onto the pediatric floor. Unlike the rest of the hospital, the walls here were brightly colored and decorated with oversized cutouts of cartoon characters.
Rob noticed she didn’t seem winded by the rapid climb. “So you don’t get many injures like Ali’s?”
“To be perfectly honest, I have never seen a case like Ali’s and I’ve only read about a very few in the literature. Most of them were adults involved in motor vehicle accidents. The vast majority of people who sustain enough trauma to tear apart an internal structure of the heart don’t survive.
“The fact that Ali has is amazing. Two of the cases I studied healed on their own. Two required surgery to repair the tear when they began to show signs of fluid buildup in the lung. Three others died due to heart tissue death after approximately four days. However, Ali’s operation will be the same as for a simple VSD repair.”
“How can you operate on the kid if you haven’t had a case like this before? What’s a VSD?”
Nora paused outside a pair of wide double doors marked with PICU in large letters. “A VSD is a congenital cardiac defect.”
“You said that before.”
“And my answer was correct both times. We have several good handouts that we give to parents explaining the defects in detail and how they are repaired. I’ll make sure Carmen gets you some to study.”
“When do you see patients in your office?”
“Consults and a few follow-ups are scheduled once a week on Mondays. Ninety-five percent of my patients are direct admits to the PICU. Heart defects in children often go undetected until they are in crisis. Unless they have need of a second surgery in the future, I don’t normally see them after they leave the hospital.”
“Doesn’t that make it hard to get to know the families?”
“My focus is on my patients, not the families. There are social workers and others who deal with any issues that arise with them.”
Pushing open the doors, Nora entered the unit and walked to the nursing desk. Theresa Mabley, a stout woman with short salt-and-pepper hair was dressed in her usual blue scrubs. Standing behind her were a collection of residents and nurses, all waiting to begin reporting to Nora on the patients.
“Good morning, Theresa. Mr. Dale, this is the head nurse in our PICU. Mr. Dale is a reporter, and he’ll be rounding with me for the next several days. You may answer any questions he has.”
Theresa nodded in his direction. “Nice to meet you, Mr. Dale.”
He extended his hand. “Call me Rob. I promise not to get underfoot more than fifty times a day, Theresa.”
His lopsided grin gave him the look of a charming rogue, and it was painfully clear to Nora that even the stalwart charge nurse wasn’t immune as Theresa shook his hand and smiled back at him. “I doubt you’ll be underfoot at all, Rob. Is this your first visit to a PICU?”
“My very first. Be kind to me.”
Theresa chuckled. “Let me give you the tour. We currently have an eight-bed unit. However, thanks to a recent quarter-million-dollar gift made to the hospital in our name, we’ll soon be resuming construction to expand to a fifteen-bed unit with all new, state-of-the-art equipment.”
Nora held her breath thinking he would ask questions about the money, but Theresa was already on to her favorite topics—the need for more nurses and her grandchildren.
Nora stared at the two of them. How did he do it? How did he connect with people so easily? She didn’t get it. It had taken months for Theresa to warm up to Nora, and even now they were far from friends. Yet Theresa was chatting away with this reporter like she had known him for ages.
Suddenly, the code-blue alarm rang. Glancing down the hallway, she saw the light flashing over Cara Dempsey’s doorway. Rob Dale was completely forgotten as Nora raced toward the room.
Chapter Three
R ob watched Nora bolt down the hallway. Several people in lab coats came running into the unit and rushed passed him, closely followed by a security officer. Rob had no idea what was going on, but it didn’t look good.
He moved to where he could look through the door and yet be out of the way. All he could see was a ring of people crowding around a warming bed. Theresa entered the room, but she didn’t join the crowd. Instead, she went to stand beside a young couple huddled together watching the activity with wide frightened eyes.
Draping an arm around the young woman’s shoulder, the nurse gently explained to them what was going on. Rob couldn’t hear everything over the noise of the alarms, but it was clear that their baby was in serious trouble.
The young mother burst into tears and pressed her hands to her mouth, then shouted, “Don’t let her die! Please, God, I’ll do anything, just don’t let her die!”
Nora, at the side of the bed, looked up and motioned with her head toward the door. “Take them out of here, and someone silence that alarm!”
Theresa gently but firmly herded the couple out of the room. A tall, thin, young man with blond hair and dressed in a dark suit met them at the unit door and led them away. Rob noticed he was holding a Bible in one hand.
Theresa came back and stopped beside Rob. In a weary voice, she said, “That little one has been looking for the light ever since her surgery.”
Sending her a puzzled glance, Rob asked, “What do you mean?”
“Her condition has been getting worse instead of better.”
His heart dropped like a stone. “Can they save her?”
“They are doing everything they can.”
The alarm stopped, and in the sudden silence he heard Nora calling out orders for medication and asking for a stat blood gas. Her face was calm, but her voice vibrated with intensity. After the requested drugs had been given, Nora studied the monitor intently, then turned to one of the nurses. “Why wasn’t I paged?”
“I was told Dr. Kent was covering for you. I’ve paged him three times, but he hasn’t answered.”
“I want to be paged every time one of my patients is in trouble. It doesn’t matter if Dr. Kent is covering or not. You call me. Is that clear?”
Meekly, the nurse nodded and said, “Yes, Doctor.”
Leaning toward Theresa, Rob asked, “What’s wrong with the baby?”
“She had what we call transposition of the great arteries. Think of the heart as two separate pumps fused together. The right side of the heart collects blood from the body and sends it to the lungs for oxygen. The left side of the heart collects blood from the lungs and sends it to the rest of the body.”
“Okay, I get that.”
“Early on, the blood vessels coming out of the top of Cara’s heart began to grow incorrectly. The right side of her heart collects blood from the body but the blood vessel that should take it to the lungs lead out to the body instead. So blood leaves the heart without oxygen. The left side still collects blood from the lungs but then sends it back to the lungs again.”
“Wait a minute. You can’t live if your body isn’t getting oxygen. How did she survive until now?”
“The same way all babies do. In the womb. Cara got her oxygen from her mother’s blood. It wasn’t until after Cara was born and had to breathe on her own that the trouble began.”
“I take it Dr. Blake couldn’t fix her heart?”
“From what I understand, Dr. Blake did a beautiful switch of the arteries. Cara’s blood is now going exactly where it should.”
He shook his head. “Then why isn’t she getting better?”
“Because