A mother brought her infant for a well-baby visit, and my heart leaped. Last I heard, she had such bad postpartum heart failure that the word "transplant" was being mentioned. Her heart "ejection fraction" (how well her heart was pumping) was reported as an impossibly low number - one not generally associated with being out of the hospital, much less bringing your child to the pediatrician.
She was standing up, holding her baby when I entered the room. She smiled at me and I grinned back. She knew I knew the significance of that.
"You look wonderful," I said, broadening my smile.
She looked up from her baby with a tear barely appearing in her eye. "Thanks."
Nothing more had to be said. We both left with hearts lifted.
I got an urgent call from a radiologist earlier in the week. One of my patients had a very high "calcium score" on a CT scan of the heart - meaning that there was a large amount of atherosclerosis (plaque) in her coronary arteries. It was unexpected, as the patient was moderate risk and had generally been in good shape. "There's a large deposit in the LAD," said the worried radiologist. My heart sank. I had to call the patient and explain this unexpected bad news to her.
I called, trying to emphasize the importance and seriousness of the finding without getting her overly panicked. "This is exactly why I ordered the test," I explained calmly, belying my pounding heart. "It's far better to be surprised in this way than to learn about it in the emergency room."
This seemed to help her, but the tone of my voice clearly had her worried. She asked me if she needed to do anything different. I told her to take aspirin, and then, pausing, said, "You might also want to take it easy until I can get you into a cardiologist. Maybe you shouldn't go jogging for now."
There was silence. I had just sent a message that this was not "no big deal," it was serious. I debated about saying it, since she had undoubtedly been living with this plaque build-up for a long time. Things were no different in her body today than they had been yesterday. But things were totally different.
I told her that I would make sure she got in to see the cardiologist as soon as possible. I hate it when people have to wait with a potentially deadly diagnosis looming. I hate to leave people hanging.
"Thank you. Thanks so much for calling," she said, sounding sincerely grateful I took the time to call.
I smiled to myself. When you drop a bomb on someone's life, the last thing you expect is gratitude. I sighed and my heart rate slowed down. "No problem," I responded. "I'm just glad we found this before it caused any trouble."
I also saw Collin's mother this week. Collin is a boy with Asperger's syndrome (mild autism) who has my heart wrapped around his little finger. He is as sweet as a boy can be, with huge eyes, a sing-song way of speaking, and an innocence in outlook that leaves my heart longing for something I once had but lost.
He also is the head of my fan club. Every time I see his name on the schedule, my heart skips a few beats. I know I will be met with those huge eyes, that sweet voice, a hug around my waist, and lots of laughs as I playfully banter with him. His mother sits across the room and smiles, knowing just how incredibly sweet he is and happy to see him pouring that sweetness out on me. I should probably install a button in my office that I can press to have Collin added to the end of my schedule when I have a particularly bad day. Walking into the room to see him evaporates any stress I carry, heals any aches in my heart, and cures any self-pity I hide. He heals me.
His mother was seeing me today, however, and Collin wasn't there with him.
"I had to hide the fact that I had this visit from him," she explained. "He needs to go to school, and he would have been hard to get out the door if I gave him time to think about it."
I laughed. "He's about the sweetest kid I know."
"Yeah," she replied, not hiding the pride in her voice, "he sure is. When I finally told him this morning, he said 'Mom! You mean you are going to see Dr. Lamberts without me??'"
I shook my head. "Yeah, he's really got something for me. I am always thrilled when his name comes up on my schedule."
"You've got a special place in his heart, that's for sure." She said, her pride growing in her expression. "After I told him, he went to his room and then came back to me and said, 'Mom! Why didn't you tell me sooner? You didn't give me enough time to draw a picture for him!'"
"He's got a special place in my heart too, that's for sure." I said.
I paused, and then said, "it's amazing."
"What?" she asked.
"It's amazing how he can melt my heart and heal it at the same time."
She smiled. She knew that same feeling.