Love, Rosie (175 page)

the
little
boy
working
in
Dad’s
office
again.
And
just
think,
if
it

wasn’t
for
you
getting
so
drunk
on
your
sixteenth
birthday
that
you

had
to
get
your
stomach
pumped,
we
never
would
have
been

caught,
we
wouldn’t
have
been
suspended,
and
I
wouldn’t
have

been
punished
so
severely
by
having
to
file
every
piece
of
paper
in

the
world
in
Dad’s
office
where
I
might
add,
I
would
never
have
met

Bethany.
So
it’s
all
down
to
you
my
dear
friend!

Rosie:

Alex:

Rosie:

Alex:

OH
WHYYYYYY???
Dear
god,
oh
why?

Ha
ha.
I
better
go
now
because
I’ve
got
surgery
in
a
few
hours.

Why?

Because
I
happen
to
be
a
cardiac
surgeon
and
there’s
a
poor
man,

266

Cecelia
Ahern

called
Mr.
Jackson
if
you
really
must
no,
who
needs
aortic
valve

surgery.

Rosie:

Alex:

Rosie:

Alex:

Rosie:

Alex:

Why?

Because
he
has
aortic
stenosis.

Why?

Well
the
reasons
behind
aortic
incompetence
in
general
are
rheu-

matic.

Why?

It’s
due
to
annulo-aorto
ectasia,
endocarditis,
and
aortitis
among

others.
But
don’t
worry
(because
I
no
that
you
are),
Mr.
Jackson

will
be
fine.

Rosie:

Alex:

Rosie:

Alex:

Why?

Because
thankfully
due
to
75
years
of
studying
I
have
learned
an

operation
involving
the
ball
valve
prosthesis
which
will
help
him.

Why?

Oh
Rosie
.
.
.
OK
but
you
asked
.
.
.
it
will
help
him
because
after

induction
of
circulatory
support
by
extra
corporeal
circulation,

cooling
of
the
patient
and
heart,
the
aorta
is
x-clamped
and
the

aorta
valve
exposed
after
the
aorta
is
opened.

Rosie:

Alex:

Why?

So
the
aorta
valve
can
be
examined
and
excised
for
the
aortic
valve

replacement.
So
then
the
sizing
of
the
aortic
annulus
is
done
by
a

valve
sizer.

Rosie:

Alex:

Why?

To
help
select
the
size
of
the
aortic
valve
prosthesis.
Then
the
valve

sutures
are
placed
into
the
aortic
valve
annulus
and
into
the
heart

valve
prosthesis.

Rosie:

Alex:

Why?

To
tie
the
valve
prosthesis
secure
into
the
valve
annulus
of
course
.

So
then
the
artificial
heart
valve
is
in
place,
the
aorta
is
closed
by
a

running
suture,
the
heart
is
de-aired
and
the
operation
is
finished.

And
Mr.
Jackson
will
be
a
healthy
man.
Any
more
questions?

Rosie:

Alex:

The
aorta,
it’s
in,
like,
the
heart,
right?

Very
funny
Rosie.
OK
I’m
really
going
this
time;
I’m
really
glad
we

love,
rosie

267

had
this
discussion
and
that
we’ve
cleared
the
whole
Bethany
thing