print previewback E.L. TREMBLAY
The Language of the Heart
The third time it happens, it scares me enough that I tell my mother, but she dismisses it offhand as asthma and I am willing to believe her because I am nine.
That was the fall. I pretend to ignore it until I know spring is over because I don’t have to wear tights anymore, until the day it doesn’t stop like it always has when P.E. ends and I change back into my bright red sweater and MacDonald plaid, pleated uniform skirt. It continues through two classes before Stephanie notices I’m shaking so badly our two desks are shaking with me, and Mrs. Yorkie sends me, pale and sweating, to the office, where my mother pulls me into her lap even though she hasn’t done that in years. Her cool hands move a little too fast over my forehead, pull a little too hard at the tiny buttons of my shirt to touch my chest.
It isn’t asthma. I don’t go back to class.
~
I spend two years in and out of the cardiology wing of the ocean-themed children’s hospital, a huge, open, oddly quiet building of blue lights, fish tanks, undersea murals, marine mammal mobiles, and a centerpiece hanging from the lobby ceiling: a life-sized whale sculpture painted with thick lines and a boldly staring eye in the local Native American style we’ve been studying in language arts class. My parents do paperwork while I wander and stare.
Nothing ever happens here except for changing doors, names, nurses, sea creatures. Kirk Billett, MD. Delphine Yung, MD. Terrence U.H. Chun, MD. They watch me quietly and, without comment, take extensive notes on everything I say—episodes have only occurred on Mondays; has an excellent appetite; normal-appearing, very gregarious young lady. When they do talk, they use phrases like SA node, palpitations,and sinus rhythm, so I pay more attention to EKG printouts and the queen crown sticker on the Holter monitors wired to my chest.
Sometimes I ask questions. I try to understand.
EKG: electrocardiogram. The doctor doesn’t know why the acronym has a K, but he thinks it might have something to do with a German inventor.
Holter monitor (he pronounces it halter and thinks it also might be German): little black box, continually records a heartbeat via two wired electrodes. Hit the record button and it retains the past thirty seconds and following sixty seconds.
“Don’t forget that,” he says. “Press the button and hold until you hear it make the noise.”
“What will it sound like?”
“Just beeps.”
The wires protrude from my torso at odd intervals: a special examining table, for an hour, mid-May; that night, in bed, 9 p.m. to 7 a.m.; all day, two weeks, May to June; on a beach in August; after the fire trucks come for me in the fall; that same fall again; fall a third time, almost winter. My body shows red patches where my mom presses down stickers for the electrodes every morning and then pulls as hard and fast as she can to rip them off at night. She screws her face up every time and I joke to make it seem like it doesn’t hurt: “Worst sticker I ever got from the doctor’s office.” “It’s the medical version of Super Glue!”
~
The doctors talk at my parents mostly, and my mother asks me one day if I might be mistaken, if I’m maybe making it up for attention, because it never comes when I have a monitor, and the surgeons are beginning to wonder. I try not to think about being crazy as I watch envelopes with blue crosses marked BILL pile up on the kitchen counter my dad built.
My friends silently resent that they have to take me to the office, again, because I jumped from the bars on the playground. Teachers and supervisors flutter anxiously when suddenly my heart slams my chest as if it is no longer a part of my body, as if it has solidified to diamond or a metal machine for spite, as if trying to crack me open. When it is no longer an organ under my control, but a magnet drawing me to the earth, a separate being stealing my breath and my balance and my body for its own, I lose track of the people running around me. Instead I try to keep up with my heart’s pace until it’s over and I’m left panting in silence, everyone staring, sirens approaching, feeling as if I’ve been bruised on the wrong side of my skin. It might not come again for months, but it might restart in minutes.
Years of recesses, sports teams, and hikes go by this way: cycles of arrhythmia, monitor, no monitor, arrhythmia. Until. Sixth-grade environmental camp, a little luck, a simple tag team relay race and I’m caught. I sit on the cold rocks at the side of the path and listen to my heartbeat translated into blips and beeps and blanks by the black box at my hip.
~
“Supraventricular tachycardia. It’s when a specific adrenaline level sets off an electric pulse that shouldn’t exist and starts a loop . . . ”
I stare at a sea star and don’t understand much except it’s what the doctors thought all along. My parents never ask what we wondered at home: Why, as experts understanding this condition, did they doubt my honesty? Why couldn’t they reassure my parents I wasn’t dying, these brilliant surgeons and physicians, so my mom didn’t have to cry at soccer games? Why was it so hard to tell me that the feeling of boulders rolling inside my sternum did not mean that my heart was going to explode, even if it felt that way? Why couldn’t they figure out how fast my heart beat?
Instead, a doctor tells us the medicine: lifelong attacks, pills that may make me morbidly obese, or a procedure called a “radio catheter ablation,” and for the first time I’m scared.
He tries to simplify.
“We’ll freeze or burn the section of misfiring electric pulses with a noodle that goes in through your leg . . . four-hour procedure . . . extremely low death rate . . . one in one thousand . . . go home the same day.”
We go home to “think about it” but I can’t see a choice. I am now thirteen. I write a will in secret.
~
Grandma comes early from Wisconsin for Thanksgiving so she can be there for the procedure. It’s on a Friday. The kids I’ve just met at my new school give me a green good luck card with a horseshoe on it on Thursday before I go home and I don’t eat and I don’t sleep much because I’m at the hospital at 4:30 a.m. Dawn on the ocean.
The small room they’ve set up for us has two doors: one where we came in, and one for everyone else. An overweight, older nurse asks me pages of questions I’ve already answered for the three different doctors while my dad, sitting next to me, uncomfortably pretends not to listen.
By the time the anesthesiologist comes in an hour later everything seems hysterically funny, and he has such a strong Cockney accent that I can’t understand his questions even though they’re identical to those the last nurse asked, and the doctors before her, and their nurses before them, and I’m reduced to giggled blushes articulated to the floor.
Before leaving, the anesthesiologist hands me a paper robe with a single drawstring at the neck. He glances back through the door.
“You can leave your underwear on, if you want,” he says, the first time I know what he’s saying without my mom translating.
I don’t tell him how cold his hospital is.
I have a book but I can’t focus on it. When the doors open again, it’s someone come to take me, and I freeze for an awkward second but pretend I am lost in the book, and everyone laughs, what a bookworm forgetting her surgery, and I hug my parents goodbye, lightly (I’m not scared), and walk barefoot through the other door, down a wide hallway, through double doors with a thick, yellow DO NOT CROSS line in front of them (I’m not scared) and then somehow I’m in a tiny room that’s crammed so full with huge machines, tangled wires, blinking lights, and looming medical people that I don’t realize I’m supposed to go to the rectangular slab with the pristine, white blanket in the middle of it all (I will not be scared) and I have to hop a little to get up, the people laugh, but the blanket is warm now that I’m lying under it, and someone is asking which hand I use and, confused, I say “Both. Oh. I’m right-handed.” She picks up my left arm, slapping my wrist.
“You have very nice veins!”
I don’t understand that. The nurses talk, joke, not convinced I’m not scared. “You get to sleep, I have to deal with these people!” says one. I have to reply quickly; my last words are “Good luck with that?” as they set a plastic mask on my face that doesn’t smell like anything but it scares me it scares me because it means I’m dying don’t sleep count backwards 10 9 8 I can’t
~
I wake up in a long room filled with gurneys, all empty except for mine; yet another nurse sits next to me doing paperwork.
“Did they get it?”
“Get what?”
“The SVT. Did they get it?”
She has no idea what I’m talking about.
Waiting with my parents for the surgeons I realize: the nurses know nothing about me; there’s a needle stuck in my arm; it’s hard to read without noticing the needle in my arm; the catheter that was supposed to go in through my “leg” actually went into my groin; I have a splitting headache—“sugar low”—but I can walk just fine; the book isn’t long enough; I have to wait more; the surgeons don’t care about me; I’m alive.
Finally the surgeon I’ve met comes in. “We got it,” he says triumphantly. “All of it. And yours was quite big, too, we had to freeze and burn, and . . .”
I only pay attention to the important things: tachycardia for my age meant a heart rate over 130 beats per minute.
The average heart rate of a hummingbird is 250 beats per minute.
My heart rate was measured during the procedure at close to 400 beats per minute.
It’s all gone.
It’s over.
~
The first few times it happens, I think nothing of it, because it happens over a period of years and it isn’t a big deal and I had a procedure so there can’t possibly be anything wrong with me. So I don’t mention it offhand to my mother. I don’t tell my friends why I hate roller coasters and surprises. I don’t explain to my dad why I don’t want to play sports anymore.
Then it’s fall of junior year, the most important year of high school, and the AP Spanish homework I worked on so meticulously disappears after I turn it in. Señora calls me a liar and a cheater and just like before, it starts and doesn’t stop.
It’s so cliché to talk about hearts, there are almost no words left in English to describe what literally happens. If you notice your breathing—but don’t change it—when you next finish exhaling, don’t try to push all the air out of your lungs, just stop. Wait. Aim for fifteen seconds before inhaling.
Now imagine that your heart breathes instead of beats. It’s this feeling of smothering, of emptiness, emanating from my chest.
“It didn’t work,” I tell my mom. “I need to go back.”
It’s odd to be seventeen years old and sitting in the children’s hospital, seventeen staring at the ugly plastic rocks at the bottom of murky fish tanks, seventeen and again carrying around the little black box that looks like a cell phone but isn’t, seventeen ripping the electrodes off my own skin every night. My friends think I’m doing it for the attention. I ask them to scare me to trigger the episodes, try make it into a game that has as little to do with medical problems as possible, but they’re busy with their own problems, and grades, and classes.
In biology we’re learning about the heart. I’ve always understood heartbeats as my metronome, dividing my life by the two halves of a thump: propelling my excitement, falling into my sleep, keeping time with what I do. Now I’m supposed to understand that they’re somehow, crucially, literally, electric; a node initiates an electric signal that runs through the top part of the heart, shocking it into movement before it hits the lower part, thump-thump.
At home, I look up heart conditions, scaring myself as I compare symptom lists and hit the RECORD button again and again. This new problem of mine makes no sense: sitting by the heater with a book and a blanket, sleepily sipping hot cocoa; watching a documentary about great blue whales; eating dinner when my dad gives me a funny look. My heart forgets to beat and then, overcompensating, races to catch up with what it missed: stuttering, running jaggedly along, stopping altogether again, trying harder.
I fax recording after recording to the hospital and hear nothing back until time expires and I have to return the monitor. It’s received without comment, my arrhythmia not serious enough to be worthy of explanation. I apply to colleges, graduate, move to New York, transfer all my medical documents to a new doctor. When she finds out I have had a heart condition, she asks for the records, so I fill out the release form and call the surgeon and send emails and go in to review the files with her.
No diagnosable condition.
“I have a heart condition,” I had told people confidently, pausing to tread water and breathe deeply. “Not a big deal.”
~
The bird incident. I’m walking back to my dorm, thinking about the files, wondering why I never got to talk to someone, wondering what’s normal about arrhythmic palpitations. But that’s what the doctors said, through these papers: normal arrhythmic palpitations.
It’s a chickadee. The feathers are sharp against the gray of the pavement, and it doesn’t move when I put down my backpack, crouch, extend my hand. It flicks its head this way and that, and I’m sure it must be dying if it’s letting me get this close. I start making plans: I’ll bring it back to my room, make a bed in a box, keep it safe from predators. Slowly, carefully, I put my hand on its back, feel the warmth of its body and the quick pulse of its heart; five silent beats go by in a blink and the bird suddenly explodes into movement, feathers everywhere, then reappears in a nearby tree, warbling vivaciously.
I pick up my papers and walk away. 