CHAPTER 6 : THE FAMILY HEART

The first thing I notice when I put on my clothes is the wire under my shirt.

The second is how much I hate it.

The rhythm monitor is small enough to hide under my clothes, but it’s been a focus of more of my attention than I want to admit. And with every move I make, I feel the electrodes on my skin. And as I think of the reason I'm wearing it, the mood gets worse.

Seven days.

Dr. Carter could have asked me to do just about anything else for a week and gotten less resistance.

I straighten my cuff, and I look at my reflection. My suit is clean, my tie is straight and there is nothing in my appearance that would indicate a medical device is tracking my heart’s activity.

Nice.

I have no desire to make my health the subject of office gossip.

I walk into the dining room. Adrian is waiting with his tablet already. "You're late," he says. "It's seven forty." ""Your car was supposed to leave at half past seven."

“Then the car can go now.”

His eyes flick to my chest for a second.

I squint mine. "Don't."

"I haven't said nothing.

"You were going to." "I was going to ask if you remembered the monitor instructions." "I do." "And if you brought the symptom diary."

I look to him.

He knocks my book away. "You left it on the table.

I take it off him. "Anything else?" "No. I did move your eleven o'clock meeting to eleven-thirty though."

''Why?

"Because you have a medical condition Damian. Sometimes the world will make it if you give yourself another half hour." "This meeting has nothing to do with my health.

"Your health disagrees with you."

I walk past him before he can go on.

The problem with Adrian is he's known me too long. He knows when I’m avoiding something – he’s seen enough of my life to know – and he’s never had the good sense to pretend otherwise.

Back at the office, I’m in familiar territory.

Numbers. Contracts. Determinations.

The financial report has discrepancies that should have been caught before it hit my desk. I want the corrected figures before the afternoon review. I question the director responsible, reject his explanation.

Twenty minutes the matter takes.

I forget about the monitor for twenty minutes.

Then I reach for a document, feel the tug under my shirt, remember.

My heart is under surveillance.

You can think this is stupid. The device isn't watching me in any serious personal manner. It’s logging information for my doctors to assess how I’m doing.

I understand what you mean.

But what fun is knowing something?

I adjust the monitor’s position twice before lunch. I've also caught myself wondering if a really stressful meeting might spit out something worth writing down.

That is what I hate the most.

 I have devoted years of my life building a life on the principle of anticipating and controlling problems before they become serious. I base my decisions on facts, I prepare for the consequences and I don't leave important things to chance.

But my heart refused to accept these rules.

Nor did my father's.

That evening I'm at home, looking through an old company report when the memory comes.

One sentence on the page reminds me of a conversation I overheard once between my father and one of his doctors. I don't remember the words, but I remember the tone. The doctor explaining something, my dad asking a question, and the conversation coming to a halt when I walked through the doorway.

I was a younger man then.

Old enough to know there was something wrong. Too young, I didn’t know why no one would tell me what it was.

My father suffered from hypertrophic cardiomyopathy. I knew the name of the condition before I knew what it was like to live with it. I knew about appointments, medication, and days when he seemed more tired than usual.

I didn't realise how serious things had become.

When I asked a question, somebody would find a way to reassure me, without answering the question.

Your father is being taken care of.

The doctors know what they are doing.

Nothing for you to worry about.

They were meant to make me feel safe.

Instead, they taught me that those with the information got to decide what portion of the truth I was allowed to have.

I shut the report.

My dad is dead. The questions that remain unanswered.

I have told myself for years that I was too young to understand it all and that there was nothing I could have done differently. Both statements could be correct.

They don't explain why the memory still bothers me.

Maybe because I understand now what I couldn’t understand then. Information is important. You should know what is going on with your own body. You’re protected from the truth. You’re not protected from the consequences of the truth.

I glance down at the monitor taped under my shirt.

I’ve become very adept at ensuring no one makes decisions about my life without my knowledge.

Except, it seems, when the topic is my health.

I grab my phone and look at the text from St. Vincent’s confirming my next appointment.

The review is planned for a few days time.

I could request an earlier one. I could have Adrian call the department and explain that I need the results as soon as they are available.

Instead I put the phone away.

There’s a process to the assessment. I said I would follow it up.

I ought to wait for the evidence before deciding what it means for once.

 By day four, the monitor has become an annoying friend.

I remember it when I dress, when I move from meeting to meeting, when I lie down in bed at night. Sometimes I forget it for hours. I prefer those moments, because they let me revert to the comfortable assumption that my body will keep on functioning without demanding anything from me.

Then something moves under my shirt, and the assumption is gone.

I go about my usual business. I attend meetings, I review contracts and I make decisions that impact hundreds of people. I'm being monitored and nothing about the business changes.

It does make me conscious of myself.

In one meeting a director will spend 15 minutes defending a proposal that does not solve the problem it was meant to solve.

I interrupted him. If the numbers back up your suggestion, lay it out. If they do not, revise the proposal. “I’m not interested in hearing you defend a conclusion the evidence doesn’t support.

The room becomes silent.

The director consults his papers.

Adrian sits beside me, writing a note without looking up.

I look at the next thing.

Only later do I realise that all through the exchange I had forgotten the monitor.

For a few minutes I had been quite myself; concentrated, resolved, and indifferent to what my heart might be doing.

The relief I feel at that realisation is almost insulting.

I shouldn’t have to be grateful that I forgot I have a medical condition.”

But I'm not.

That night, after most of the staff has gone home, Adrian finds me in my office. "You should go home.

“I have to work.

"There's always work."

"Then you understand the problem.

He leans against the door frame. "How's the feeling?"

"Alright.

I didn't ask that one.

I put down my pen. "Is there some reason everyone has suddenly become interested in my feelings?

Nobody cares about your feelings. We want to know if you’re being truthful with your doctors.”

I look at him.

He doesn't look down.

"I'm just following orders," I say. "That's not the same as telling them everything."

What do you think I'm hiding, huh?

“I don’t know, Damian. That’s sort of the point.”

Neither of us speaks for a moment.

Adrian has always known the difference between respecting my privacy and pretending that my decisions have no impact on the people around me. Usually, I like to make that distinction.

Tonight doesn’t work for me. “I’m having my medical history taken by a cardiologist,” I tell him. “I don’t want you to do a second consultation.

"Right. "Cos I ain't qualified to do that.

"Then we're done."

He sits up straight. "One thing though.

I shut my eyes momentarily. “What?”

“You can’t run away from a problem by not looking at a problem.”

Before I can reply he's gone.

I return to my work, but the words linger longer than I want.

My appointment with Dr. Carter is after the period of monitoring.

I walk into her office and see her looking through a file. She looks up, nods to me, and gestures to the chair.

“How was the monitoring period?”

"Nothing to record." "Do you have any symptoms that you recorded?" "Nothing to record."

“Any issues with the device?”

"No."

She makes a note. "Well. The information will be reviewed in conjunction with your other results. Before that, I want to discuss some things about your family history.

I lean back in the chair. "What details?

“Your dad’s diagnosis and treatment he received. I know we have talked about this before but I want to make sure we have a good record.

I’m giving her the details I remember.

My dad had hypertrophic cardiomyopathy. He received specialist treatment, took medication and attended appointments. His condition worsened and he died because of complications arising from it.

I do not know all the decisions during the last period of his illness.

Dr. Carter listens without comment.

"Have any other members of your family been diagnosed with the same condition, do you know?" "Not that I know of.

"Have you been informed about genetic assessment?

I know it is possible to inherit it.

"That's not exactly what I wanted."

I look into her eyes.

“No. No one has gone into it with me in detail."

She makes a note of the answer. “Considering your family history, it’s worth talking about what further assessment might be appropriate. "We'll see that with what you know already." "Will it make any difference?"

This may help us understand your risk and guide your care. “I can’t say what the outcome will be until we see the information.

At least she doesn't pretend to know the unknowable. "You're very careful with your answers, Dr. Carter." "I'm a cardiologist. I like evidence better than assumptions . " " Even if an assumption would be more reassuring ?

"Especially then."

I turn away and almost smile against my will.

She flips another page. “Did your father ever speak frankly to you about his illness?”

The question stuns me. "He spoke about what he thought I needed to know.

Was that enough?

I look over at her.

For a second I think of giving her the same answer as I gave everyone else. It'd be simple. It would stop the conversation without my having to tell them anything personal.

 Instead, I say, 'I don't know.'

She waits. "I was young," I go on.The grownups around me thought it best that I not know how serious things were. They thought they were protecting me, I guess.”

And how did that affect you?"

The question is simple:

My answer is not.

I remember the questions that went unanswered, the conversations that stopped when I walked into a room, and how reassurance became something I learned to distrust.

I don’t tell her any of that. “It was a long time ago,” I say.

I am not tested by Dr. Carter. We don’t need to get into the emotional side today. But if you think of any additional medical history, please share with us.”

“I will.”

She looks at me briefly, then back at the file. “We'll let you know once the results have been reviewed. And in the meantime, continue to follow the medical advice you've been given. “If you have symptoms that match what your team told you to watch for, call them. Don’t wait until your next appointment.”

"I understand.

I get up, relieved the conversation is over.

I stop at the door though. "Dr. Carter?" "Yes?

“I expect to be told straight if the results are concerning.”

Her expression remains the same. "Of course. You have a right to know about your own medical care.

No gap. No degree.

I nod once, and I go.

I go back to Blackwood Industries to complete the work I have postponed because of the appointment.

Adrian left a new schedule on my desk. I have three messages on my phone from finance and a reminder about the board meeting on Monday.

Everything is the same.

I respond to the messages, look at the schedule and begin to sift through the documents.

Then my phone buzzes.

It’s a message from St Vincent’s.

I opened it, anticipating some routine update about the monitoring period being completed.

Instead I have a short notification saying the recorded results have been received and need closer clinical review. I will hear from the team about the next steps.

I read it over again.

There’s no diagnosis. No explanation is given as to what has been found. Nothing to tell me if the review is precautionary or something in the recording has raised a concern.

Just the instruction to wait to be called.

I dial the number in the listing.

The receptionist also said that the message was added to my record, but they could not tell me what it meant. The clinical team will look at the information and get in touch with me as they see fit.

Say thank you and hang up.

I hold still for a few seconds.

My first instinct is to ask for the report. My second is to get Adrian to talk to someone to get me an answer before the hospital's scheduled follow-up.

One or the other I could do.

I have spent years ensuring that waiting is what other people do.

But the results have not been explained and I will not pretend to understand them from a notification.

I placed the phone down on the desk next to the folder.

My father once lived in the in-between of diagnosis and answer. I remember the adults who filled that space with reassurances, and left me to discover how little those words could tell me.

I am not going to do that to myself.

I will hear what the people who are responsible for my care have to say. I will ask all the questions I need to ask and I will make decisions when I know what I am deciding.

Until then, I won’t let a message without an explanation define the rest of my life.

I went back to my work.

The first page is still there, waiting for me to turn it.

I read the same paragraph three times and did not understand a single word.

Then my phone buzzes again.

This time it’s a text from Adrian.

Damian, we’ve been trying to reach you at the hospital. Dr. Carter wants to talk to you as soon as he can.

I look at the screen.

The first message didn’t have a conclusion, only a promise that someone would get in touch.

Now my cardiologist wants to speak to me face-to-face.

I pick up the phone and dial her office.

The phone rings.

One time.

Two times.

I hear movement on the other end, then a familiar voice answers. “Mr. Blackwood,” Dr. Carter says. “Happy you called.

There's something in her voice that makes me sit up straighter. "Have the results been reviewed?"

“Some of them. I have to go over the results with you before we can decide what to do next.”

I look down at the empty space on the monitor under my shirt. For the first time in seven days, nothing is attached to me, nothing is recording the quiet rhythm I have been trying to ignore all week.

Still, I don't think I've ever been more aware of my heart. "What's wrong?" I ask.

A pause. "I don't want to jump to conclusions over the phone without going through the findings with you," she says. Can you come in tomorrow morning?

I look at my calendar. "I have a board meeting."

Then you’ll have to decide which appointment is more important.

She's not exaggerating. She does not shout. She does not give a warning she cannot fulfil.

So they’re impossible to dismiss.

I check the time. And the message from the hospital.

For years I have believed that if I control enough things, I can keep uncertainty at a safe distance.

Now, for the first time in a long time, I don’t know whether the next conversation will prove what I fear, or make me face something I haven’t yet considered. “Tomorrow morning,” I say. “Will be there.”

"Fine. We’ll read it all together.”

The call drops.

I sit there, holding my phone.

The board meeting is open-ended. Contracts can wait. The company will keep running for a

few hours without my attention.

But my heart has never respected my schedule.

Tomorrow I will have the results.

And whatever they show me, I will not let them tell me how much truth I am allowed to know