“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.”