The Results Are In

So throughout Adventures in Cardiology, the Matron has hung her diagnostic hat on the following words that fell from the (shockingly young, beautiful and, of course, fashionable) pediatric cardiologist:   "Two to three percent of everyone's heartbeats are irregular.  We only call this irregularity a disorder, disease or problem if the irregularity is as high as 10%.   If Merrick's irregularities are less than 10% of his total beats, we'll just monitor him annually and not worry one bit.  If the number is 10%, we'll have a conversation and discuss how to proceed."

Let's be clear.   Creative License and Reality frequently collide in the Matron's world (offline too) and License wins, every time.  Unreliable narrator!   Get thee to a nunnery!  But really and truly, the whole Cardiological Discourse hung on that 10%.  So the Matron has spent the past 48 hours fixated on that number:  "Please let the beats be less than 10%.   Less than 10%.  Less than 10%."

First thing in the morning, the Matron calls the clinic and points out that she got an initial (unheard, thanks honey) message around 1 on Monday but didn't get a call at all Tuesday --and she is a mama who is WAITING.  She was polite about this, but made note, hoping to impress upon the secretaries that she wanted the Word.

Within two minutes, the cardiologist called her.

First there was a long period of explaining how incredibly busy she had been the day before -- bombarded with the decaying, malfunctioning, pathetic hearts of children---urchins frail enough to require hospitalization.  Unlike your son, who is Just Fine which is why I didn't take time away from the limpid and pale to return your call.  The cardiologist very carefully explained to the Matron that when doctors don't call or leave multiple messages, you get to rest easy.   

Truly.   The Matron is an educated woman with lots of degrees.  Many of her friends are doctors.  A simple "I genuinely didn't have a minute and I'm sorry" would've sufficed, without that fine, fine line of shame.  Indeed, the Screenplay the Matron wrote yesterday when the doctor didn't call reflected that sentiment:  he's fine!  She liked that narrative.  

Duly chastened, the Matron thanked the doctor (because that's what you do) and inquired: "I'm so relieved he's all right!  But what was the exact percentage of irregular heartbeats out of all total?"

Here's where there was a good long pause.  And a breath.  

"I believe the number was 9.9%."

Matron, absorbing how completely arbitrary that .1% feels, in either direction.

Doctor:  "So good news!   His irregularities did subsist when his heart rate went up.    He looks terrific.  Kids outgrow this, sometimes.  So let's see him next year for another monitor.  Ta-ta!"

She couldn't get off the phone quickly enough.  

The Matron went along with the whole deal, pondering second opinion,  until the mail arrived.  The report must have been sent yesterday, along with the missed phone call.

And the official, documented results:   "Holter over 24 hours showed HR range from 61-194/min.  Average HR of 109 min.  10% Unifocal monomorphic PCV's."

That doctor did not want to have an honest, genuine heart to heart with the Matron.  She did not want to say:  "Look, he's at 10%.  But given all the rest--he's not symptomatic, his skin color is good, he's not complaining -- and that children generally outgrow this, let's monitor and not worry.  Should we talk about what to do when you're on the fence and it's a matter of judgment?"

No.  She didn't want to enter that color Gray into the conversatioin - where it belonged.  And that makes the Matron?  

Angry.  

You should put your ear to Merrick's bony chest.    Imagine you're his mama, hearing the beats that go bump  in the night, in a million weird ways, the new musical backdrop to your own heart.  

Don't you think that woman deserves a genuine conversation?