Heart Failure (23 page)

Carrie heard keys clack, then Marie’s voice back on the line. “Um, we have you marked out until tomorrow. Was that a mistake?”

“No, it’s perfect,” Carrie said. “I’ll see you Thursday.”

She needed today off—not necessarily because of her head wound but because of the stress of the situation. Carrie puttered around in the kitchen, deciding which dish she’d choose for her leisurely breakfast. But in the end she came back to what she had most days—juice, a toasted English muffin, and coffee. She flinched only a bit at the pounding in her head when she bent down to retrieve the newspaper from her porch. A second cup of coffee, a run through the headlines, and Carrie was ready to move on.

She took a long shower, careful to keep her head wound dry, followed by time in front of the mirror styling her blond hair to cover the crease left by the bullet. Makeup supplied the final touch. She slipped on a simple white tee and black
slacks, slid her feet into cordovan loafers, and was ready for the day. But what was she going to do? Right now she was the embodiment of the phrase “All dressed up and no place to go.”

Carrie brought the remainder of her second cup of coffee to her desk and found the T-chart she’d started last night. She couldn’t do much about Adam’s side of the list. She had suspicions about a couple of people whose names she knew, but some unknown, unnamed person with a connection to Charlie DeLuca could also be the shooter. But she could whittle hers down pretty quickly. The question was whether she was willing to do it.

Lord, if I do this I’ll need more strength and wisdom than I have. And, truth be told, I’m scared
.

She shoved the list aside and picked up her Bible off the end table. Carrie thumbed through it randomly, hoping to find direction, but nothing spoke to her. She reached to replace it on the table, when it slipped from her hands and fell, open, onto the floor. When Mrs. Nichols gave it to her, she mentioned highlighting a few passages. “These may be helpful for you,” she’d said.

The open page was in the book of Psalms, and a passage marked in yellow caught Carrie’s eye. “The Lord will protect you from all evil; He will keep your soul. The Lord will guard your going out and your coming in, from this time forth and forever.”

Carrie nodded, as though in answer to an unasked question. She picked up the phone and punched Redial. “Marie, this is Dr. Markham again. Would you give me the home address for Calvin McDonald?”

Adam’s first day back at the law offices of Hartley and Evans was actually easier than he feared. He came in early, as was his custom. A desk, bookcase, chairs, computer, and all the contents of his old office had been moved into the new one. The only clue that it had once been a storeroom was a stray legal journal in one corner, left behind by whoever had done the moving.

When Brittany arrived, the coffee was already made. Adam was in his office digging through the files he’d found waiting for him when she stuck her head through his open door. “The coffee smells wonderful. Thanks. Her Ladyship never comes in early enough to brew coffee, much less offer to do it. Guess she thinks she’s too good.”

Adam didn’t want to get into a gossip-fest with the receptionist, so he made some noncommittal remark and returned to his apparent study of the open law book on his desk. In a moment he heard Brittany’s voice back at her desk, answering the phone.

Greetings from Janice Evans came next, then Bruce Hartley. Mary Delkus was the last one in. Apparently good looks granted certain privileges. As soon as Adam felt sure that everyone was busy, he called up an Internet search engine on his computer and typed in a name. It was a name he hadn’t thought of since his second year in law school. But it was the name of a person who might help him with one of the most important problems he’d ever faced.

Finally he was able to secure an address, which led him, after more digging, to a phone number. He scribbled it on a yellow Post-it and shoved it deep into his briefcase. When he
was at lunch, he’d make the call. Meanwhile, he had some catching up to do, if he wanted his current “temporary” position to become permanent.

As soon as Carrie got into her car she realized she’d forgotten one detail: the two front windows were missing. Dealing with that was now her first order of business. Fortunately the dealer from whom she’d purchased her car was not only a patient but also a friend. He took her to his service manager and explained Carrie’s situation. “I’d appreciate it if you could help the doctor get underway. She’s in sort of a hurry.”

After completing the paperwork, the service manager pointed to a silver Prius, identical to Carrie’s, just pulling into the service drive. “That’s your loan car. I’ll call you when we get the new windows installed.”

“Thanks so much,” Carrie said as she drove away. Thank goodness the vast majority of her patients not only liked her, but some were willing to go the extra mile to help her when she needed it.

The house certainly wasn’t what Carrie expected. Every time she’d seen Calvin McDonald, the man was dressed in jeans and a nondescript shirt—sometimes plaid, sometimes denim. The clothes showed evidence of frequent laundering but were always clean. Somehow Carrie’s mental picture of McDonald was of a man scratching out a living on one of the black-dirt farms outside of Jameson. But the man’s home forced her to revise that image.

The house wasn’t outside Jameson’s city limits. As a matter of fact, it was in one of the nicer sections of town. Rather
than the small white clapboard house with a composition shingle roof Carrie visualized, McDonald lived in a two-story red brick home, set in the middle of a well-maintained yard surrounded by a recently painted white picket fence. A black Buick, its surface unmarred by dirt or dust, sat in the driveway in front of a two-car garage.

Carrie screwed up her courage and gave the button beside the front door a tentative push. She waited, her ears straining to pick up any sound from inside. As she was about to ring the doorbell again, the door opened wide, and she was face-to-face with Calvin McDonald.

He gave her the same squinty-eyed glare she’d come to expect, but although the expression was somewhere between disdain and dislike, the voice was surprisingly soft. “Help you?”

“Mr. McDonald. I’m Dr. Carrie Markham. I’m sorry to intrude like this, but I’d like a few minutes of your time.”

McDonald’s look of surprise lasted only a second. “Come in.” He gestured her inside. Carrie wondered if she’d ever pass back out the door again. After all, this man topped her list of people who’d like to kill her. Of course, even if he did, maybe Adam would be out of danger.
Lord, protect me
. She took a tentative step inside, and McDonald closed the door behind her. Then she heard the click of a lock, and a chill ran down her spine.

Carrie was poised to bolt for the door, hoping she could reach it before McDonald intercepted her, when he spoke. “Would you like to have a seat?” He escorted her to what, in an earlier day, would have been called a parlor. Two easy chairs, a sofa, some tables and lamps, and a couple of throw rugs. There was no TV set. Instead, an upright piano sat against one wall.
Apparently this was the room for “entertaining company,” as her grandmother might have said.

As she eased into a chair, Carrie noticed that although the room was neat, a faint patina of dust covered some of the furniture. “I apologize for the dust,” McDonald said, as though reading her thoughts. “My wife always kept the place spotless, but since . . . since I lost her, I haven’t paid as much attention as I should. I have a woman who comes in and cleans, but I’ve asked her to leave this room alone. It’s . . . it’s where Bess and I used to sit and talk.”

Carrie decided to plunge right in. “Mr. McDonald, I’m sorry for your loss. I tried to tell you that at the time your wife . . . your wife passed away. And I hope you realize I and the rest of the hospital staff did everything we could to save her.”

McDonald sat unmoving. No response.

Carrie took a deep breath and went on. “As soon as I saw your wife in the Emergency Room, I made the diagnosis of a perforated ulcer. That’s outside my specialty, so I called in a general surgeon. He rushed her to surgery, and I stood by in the operating room in case I could help. Unfortunately, her heart was too weak to tolerate the procedure. The anesthesiologist and I did everything we could to save her, but we were unsuccessful.”

Carrie swallowed, remembering the frustration she felt at losing that patient. “I’m not sure anything could have been done differently, but believe me, we gave it our best effort. I’m sorry it happened.” She paused, trying to read his expression. It was the same squint-eyed glare she was used to seeing from him. “Now I’m here to make certain you’re not carrying a grudge toward me. And if you are, I want to ask your forgiveness.”

There, it was out. She held her breath, waiting to see what came next.

“Grudge toward you?” McDonald’s glare softened. He wiped a tear from his eye. “The only person I’m angry with is myself. I tried to get Bess to go to the doctor, but she wouldn’t budge. I watched her take antacids and sodium bicarbonate, urged her to get her stomach pains checked, but she refused. And when she finally had so much pain she couldn’t stand it, I took her to the Emergency Room. I was afraid it might be too late. I prayed it wasn’t—but it was.” He pulled a handkerchief from his hip pocket and wiped his eyes. “But I don’t blame you, Doctor. I blame myself.”

Carrie’s next words came out without conscious thought. “Then why do you always glare at me when we pass in the halls?”

McDonald reached into his shirt pocket and pulled out a somewhat worn black clamshell glasses case. He withdrew a pair of wire-framed spectacles, hooked them over his ears, and settled them on his nose. “Bess was always after me to wear these, but I hate them. I’d rather squint. Is that better?”

Actually, it was. What Carrie had interpreted as a scowl was gone. McDonald was no longer someone sending a glare of hate her way. Now Carrie realized he was just a lonely old man, sitting day after day in an empty house, missing his late wife.

Carrie started to get up, but something kept her seated. Should she? Maybe it would help him. Maybe it would even help her. “Mr. McDonald, I know something about survivor guilt, and that’s what you’re feeling. I’ve been there. If you keep hanging on to it, you’ll never move forward. I know from personal experience. Lots of people suffer from it, and they’re almost always wrong to do so. Let me tell you a story.”

She took his nod for permission. “It’s about two doctors. They’d been married since graduating from medical school. It wasn’t always easy to make a marriage between doctors work, but they did . . . and they were happy. She found that she couldn’t have children, but they decided God had a child out there for them somewhere, so they’d adopt.

“They barely had begun the process when he started noticing fatigue. He was a general surgeon, and he passed it off as working too hard. But the symptoms worsened. She insisted that he see one of her colleagues for a workup. He put it off and put it off, but finally he relented.

“The workup showed an unusual congenital heart problem—it’s called Ebstein’s anomaly, but the name isn’t important. One danger it poses is a potentially deadly rhythm disturbance of the heart. He developed more problems. Medications weren’t working. So a specialist proposed a procedure called transvenous radiofrequency ablation.”

She saw McDonald’s eyebrows rise, so she hurried to explain. “Call it RFA. In it, a doctor inserts a fine plastic tube through a vein in the leg and runs it all the way up to the heart. A wire inside the catheter delivers current to cauterize the abnormal areas responsible for the rhythm problems. It’s an accepted procedure, and it’s generally safe.”

Carrie paused and tried to clear the lump in her throat, but it wouldn’t budge. “The risks of something going bad during such a process are small, but they exist. But in this case the wire got into a coronary artery and opened a tiny hole in it. The only chance to save such a patient is immediate heart surgery to repair the damage. In this case, one of the best cardiothoracic surgeons in the state was in that hospital right
then. They took the patient immediately to the operating room . . . but he died.”