Brian (IV)
In his dreams, a baby cried. The shrill sound roused him from the fog of sleep, and he struggled to sit up. It felt like there were invisible chains hooked to his ribcage, and if he pulled too hard, he would rip himself in half, right down the middle. Still, Calhan was crying, and he had to get to his son. He rolled slowly out of bed, swaying a little as he tried to stand. Nausea and vertigo made his head spin, but the sound of Calhan’s cries quickly cleared it.
“I’m coming, Cal!” he cried hoarsely, stumbling across the room. In his dreamscape, the darkened bedroom looked nothing like the one he shared with Becci, yet somehow, he knew exactly where to go. He followed the frantic cries down the hallway and into a beautifully-painted nursery, illuminated by a carousel lamp that cast colorful patterns on the walls and ceilings as its scenes spun slowly by.
The crib was in the corner. He staggered toward it, his hand pressed against a spot just below his breastbone, where the end of an angry red seam threatened to split open and spill his insides onto the floor. His heart hammered against his ribs as he reached out and clutched the crib rail, holding onto it until the second wave of dizziness had passed. But when he leaned over the rail and looked down into the crib, his heart sputtered and nearly stopped, and he swayed unsteadily again.
The crib was empty.
Brian awoke, gasping for breath. Panic-stricken, he tried to sit up, but the crushing pain in his chest prevented any sudden movements. His eyes darted around the room, and he felt some relief as he recognized his surroundings, different from those in what he now understood to be a dream. He was still in the hospital, recovering from heart transplant surgery. Calhan was at home in his crib, sleeping soundly. If he woke up crying in the night, Becci would be there to comfort him.
Alone in his hospital bed, Brian greedily sucked oxygen through the canula in his nostrils. The thin tubes didn’t seem capable of delivering it fast enough; his lungs were screaming in protest, pleading for air. He didn’t stop to wonder why his new heart wasn’t pounding, as it had been in the dream, until it suddenly started to race. Only then did he become aware of the familiar, fluttery feeling in his chest. Frightened, he turned his head until his eyes found the monitor that displayed his vital signs. He watched his heart rate shoot up from a normal one hundred beats a minute to a shocking one hundred fifty.
Just as he was fumbling for his call button, his night nurse, Rita, appeared at his bedside. “How are you feeling, Brian?” she asked, slipping the bell of her stethoscope under his gown to listen to his heart. “Any pain?”
He started to nod, then reconsidered, as he realized the only real pain he felt radiated from the incision that ran down the center of his chest, not from the heart racing inside it. It was different from the squeezing sensation he’d felt whenever his old heart acted up, but the other symptoms that accompanied it – the sweating, the shortness of breath – were the same. He slowly shook his head, then tried to explain what he was feeling: not so much pain as panic.
“You’re clammy,” Rita observed, wiping his forehead. “Did you just wake up?”
She had turned up the flow of his oxygen, and even though it hurt, he closed his eyes and took a deep breath before exhaling, “Yeah… a few minutes ago…”
“Do you think you might’ve had a nightmare?”
His eyes flew open. How could she have known that? “Yeah,” he breathed, “that was what woke me up.”
The nurse nodded knowingly. “Try to relax,” she said. “It’s just an adrenaline rush that’s making your heart race. The monitor’s showing sinus tach – fast rate, but normal rhythm. It may take it a little while to calm down, but that’s normal, too.” When he frowned, unsatisfied with this explanation, she added, “You may not have realized, but in a heart transplant, all the nerves that connect your heart to the central nervous system are cut. The heart has its own electrical system that keeps it beating, but your brain can’t send it messages anymore that tell it to speed up or slow down. It has to wait for hormones in the bloodstream, like adrenaline, to give it that signal, which takes a lot longer. Consider it a delayed reaction to your dream.”
“That’s weird,” whispered Brian. He supposed it made sense, but it was strange to think that, while he had realized right away that what he’d dreamt wasn’t real, his new heart had yet to receive the news. It was still racing away, as if he were trapped in the middle of a living nightmare. Rita said there was no reason to worry, but he couldn’t calm down while his heart was hammering so hard.
“When you start exercising again, you’ll need to incorporate longer warm-ups and cool-downs into your routine, just for this reason,” said Rita. “It takes some getting used to. I’ll check with your doctor about giving you something to help you relax.” She patted his arm and made a few notes on his chart before she walked away.
Brian lay in a heightened state of panic for several more minutes until Rita returned, a syringe in her hand. “This is just a mild sedative,” she said, injecting it into his IV line. It only took a matter of minutes for the drug to work its magic. As his heart started to slow down, Brian drifted back into a dreamless sleep.
***
“I heard you had a bad night,” was the first thing out of Becci’s mouth when she came to visit the next morning. She gave Brian a look of sympathy and smoothed his hair back off his forehead, as if he were a small child, Calhan’s age again.
He forced himself to smile up at his wife. “It was nothing. Just a nightmare.” He explained to her what the nurse had told him about his heart needing more time to react to being startled.
Deep furrows appeared in Becci’s forehead as she frowned. “Well, what did you dream that got you so worked up, hon?” she wondered. “Something about the surgery?”
“No…” Now it was Brian’s turn to frown. “It was about Calhan.”
“Calhan?” Becci cocked her head, looking concerned. “What about Calhan?”
“I dunno, it was weird. It was like one of those dreams you used to have right after we brought him home from the hospital as a baby – you know, the ones where you could hear him crying, but couldn’t find him?” Brian remembered many a night spent holding Becci as she sobbed on his shoulder, distraught after another one of the disturbing dreams.
“Ohh, I hated those!” Becci shuddered. “So that’s what you dreamed? Calhan was crying, and you couldn’t find him?”
“Yeah…” Even after the sedative, Brian found it wasn’t difficult to remember his nightmare. It still stood out vividly in his mind. “I could hear him crying, so I got out of bed and went to his room – only it didn’t look like his room; you know how things are always different in dreams – and the crib was empty. Then I woke up, and I couldn’t breathe.”
“My OB always said those nightmares were caused by anxiety. I bet that’s all it was… just anxiety about everything that’s happened in the last few days.” Becci sounded confident, but something in her eyes told Brian she was more concerned about him than she wanted to let on.
“Yeah, you’re probably right,” he agreed. He wasn’t worried. He’d been feeling better every day, and if there was anything wrong with his new heart, it would show up in the bloodwork and chest X-rays he underwent daily. As Rita’s prompt appearance the previous night had proven, every function of his body was being closely monitored, and so far, all signs pointed to a successful transplant. He couldn’t wait until he was well enough to be released from the ICU. “As soon as I’m in a regular room, I’d love it if you’d bring Cal up,” he told Becci. “I’m dyin’ to see him, especially after that dream last night.”
Becci nodded. “You bet,” she said, and he could tell she was smiling behind her mask. “He’ll be glad to see you, too. He misses you.”
Brian felt a pang in his new heart that had nothing to do with the surgery. “I miss him, too.”
***
When the results of his latest round of tests came back clear, Brian was released to a private room. There were fewer restrictions in this part of the heart institute, so Calhan came to visit the very next day. Becci beamed as she brought him in, and as grateful as Brian was to see his son, he was just as glad to see his wife’s smile again. For the past three days, she’d had to hide half her face behind a surgical mask to protect him from germs. Now it was his turn to wear one.
“C’mere, Cal!” he cried, his voice muffled by the mask, as he extended his arms toward the toddler. For the first time since his admission, Brian found himself free of most of the tubes that had tied him down. He could sit up, even walk around without worrying he was going to tangle his oxygen line or tear out his chest drains. The IV in his arm and the ECG leads attached to his chest were the only leashes left to contend with, and they couldn’t hold him back from hugging his son. But when Becci set Calhan down on the bed, the little boy stared at Brian, screwed up his face, and started to cry.
“Oh no,” Becci groaned and quickly went into consolation mode. “It’s okay, Cal, look – it’s Daddy!”
But Calhan just clung to her until he could get down from the bed, wanting nothing to do with the stranger sitting in it. His reaction stung, but Brian tried not to let it show. It must have been the mask, he thought. Cal just didn’t recognize Brian behind it. To a one-year-old in an unfamiliar place, he must have looked different with half his face hidden. So he lowered the mask, despite Becci’s squawk of protest, and put on his biggest smile. “Look, bud, it’s me!”
Sniffling, Calhan warily lifted his face from Becci’s leg and turned to look at Brian, who took it as a good sign when he didn’t immediately burst back into tears. “See, Calhan?” Becci cooed softly, squatting down to Calhan’s level and pointing up at Brian. “Daddy’s all better now. Don’t you want to give him a hug? He’s missed you!”
Teardrops stained his chubby cheeks and sparkled in his long lashes, but at the word “hug,” the toddler opened his arms wide. Smiling, Becci scooped him up again and brought him back over to Brian’s bedside. She perched on the edge of the mattress, holding him on her lap, and leaned in so Brian could hug them both. “Be gentle,” she warned Calhan, who was sandwiched in the middle, but Brian knew nothing could make him feel better than a big family hug. He ignored the tenderness in his chest as he held his son, the nightmare of losing him a mere memory.
***
Brian spent another week in the hospital, during which Becci brought Calhan by every day. Brian always looked forward to seeing his family, but found that their visits left him exhausted. Calhan was a bundle of boundless energy, with an equally endless need to be entertained. Just watching Becci chase him around the room left Brian feeling tired, and he worried about what it would be like when he came home from the hospital.
He confided in the hospital social worker, Joan, who assured him his fears were perfectly normal. She was one of the many members of his transplant team, whose job it was to oversee every aspect of his recovery, including the transition from hospital to home. “Of course, you’ll need to take it easy at first,” she said, during one of their sessions. “It’s going to take three to six months for you to fully recover, but in that time, you’ll slowly build back your strength. Just remember, moderate exercise is good for you and healthy for your heart. Playing with your son won’t make you pass out, like it might have before the transplant. Your new heart can handle it.”
Brian couldn’t wait for the day when he’d be up to running around and roughhousing with Calhan. He’d never been physically able to before. But even though he could feel himself gradually getting stronger, that day still seemed far away. Just walking the halls of the hospital sapped him of the little strength he’d regained. It felt good to be up and moving again, though, so he followed his doctor’s orders and completed his daily exercise routine without complaint.
His goal was to be home by Thanksgiving, and he made it with two days to spare. He was released from the hospital on a Tuesday, and that Thursday, he was treated to a homecooked Thanksgiving dinner with all the trimmings and, more importantly, the people he loved most.
He had a lot to be thankful for, this year more than ever, but as he looked around the table at the smiling faces of his family – his mother and father, his wife and son – Brian realized that something was missing. Somewhere, there was another family with an empty place at their Thanksgiving table, a family who was mourning the loss of their loved one, whose heart beat inside his chest. They had given him a priceless gift, and Brian was grateful. But he also felt guilty, guilty because while he and his family were celebrating, his donor’s family must be grieving.
That thought would have made his old heart skip a beat, but the denervated donor heart was much slower to react. His father was in the middle of saying the blessing when Brian’s heart finally responded to the flood of emotions he’d felt. As he listened to his father thank God for the family whose generous gift had saved his son’s life, Brian could feel his pulse pounding in his throat. He took a deep breath and swallowed hard, trying to relax and willing his new heart to follow.
***
