Chapter 30
The sirens are the first thing I remember. The sound I hate more than anything in the world.
Then comes the pain in waves.
The paramedics try to keep me awake as they load me into the ambulance. I’m vaguely aware of Talia sobbing off to the side. I want to tell them she can ride with us, but they’ve put an oxygen mask over my mouth and nose and are starting an IV. I think my shirt is cut open, my bra exposed.
What happened? What did they do?
The doors slam shut with her still outside in the rain.
My heart is still thrashing, struggling, wrong, wrong, wrong—
I slide backward into the dark.
When I resurface again, the gurney is bouncing over the breaks in the cement of the hospital ambulance bay. A doctor is running alongside me while the paramedics read off my vitals. They’re not great—but not as bad as they could be.
And my heart is no longer flopping like a fish out of water in my chest, gasping for some way to live, to survive when everything is wrong.
I’m rushed into a trauma room, where a steady stream of doctors and nurses go to work on me, strapping on a blood--pressure cuff, attaching leads all over my upper body, drawing blood for myriad tests.
I can hear the alarm going off over and over again because my heart is beating too fast, some of the rhythms are still off, and my blood pressure is too low.
“We need to get her up to echo, and schedule her for a chest x-ray. And page cardio!”
“Someone get me a stand to hang this saline bag!”
“This is going to pinch.”
“Can you rate your pain for me on a scale of one to ten?”
All around me is a flurry of activity and urgency, but I stare at the steady drip, drip, drip of the saline into the thin tube that snakes down to the needle that has been placed into my vein. I watch those drops of saline and think of rain.
The rain I danced in seven years ago.
The rain that Talia got left in.
“Where is she? Where’s my daughter?”
I hear my mom’s frantic voice seconds before she rounds the corner into the trauma bay.
When she sees me lying on the gurney, attached to all the things, but my eyes open, she crumples, her shoulders shaking.
“Mom,” I say, but my voice is muffled by the oxygen mask. “I’m sorry.”
“What happened?” Now that she’s ascertained I’m awake and alert, she turns on the medical staff, practically yelling.
“She’s experiencing significant arrhythmias, including runs of PVCs, along with chest pain and intermittent loss of consciousness,” the doctor tells my mom, his voice calm but serious.
“We’re running every test we can to find the cause.
We’re just waiting on lab results and an echocardiogram room to become available.
Once it is, we’ll take her straight up.”
He gestures toward a chair in the corner. “If you don’t mind waiting there, we’ll update you as soon as we know more.”
My mom’s face is bloodless as she reluctantly does as he asks.
Another PVC hits, making me gasp.
“Olivia, is it? We’re going to give you some morphine for the pain, okay? It should start to help right away.”
They push the morphine through my IV. My mouth fills with the strange metallic taste that always accompanies anything injected straight into my veins. The drug begins to take immediate effect, and as I’m falling into it, there’s another commotion out in the hallway.
“She’s our sister. Haven’t you ever heard of adoption?” Talia’s shout is accompanied by the click of Lou’s heels, and suddenly, they’re both there, pale and terrified and shaky and furious.
A CNA trots behind them, feebly protesting that only immediate family can be in the trauma bay.
“These are my daughters!” my mom immediately declares, jumping to her feet. “Are you keeping them from their sister?” She glares icily at the man, daring him to question her.
He stutters something about “not knowing for sure,” and, “I’m so sorry,” and then he’s gone.
Talia rushes to one side of my bed while Lou hurries to the other—but not before grabbing my mom in a swift hug and thanking her profusely.
Then they both have one of my hands, talking over each other.
“Talia called me. She said you collapsed—”
“You can’t keep doing this!”
“She said it felt like forever before the ambulance got there—”
“Are you okay? What’s happening?”
“Is it your heart?”
“Girls!” My mom’s voice lifts over theirs, and they finally—-mercifully, for my headache—go quiet. “We don’t know much yet. They’ve given her some morphine while we’re waiting on labs, and they’re going to take her up for an echocardiogram as soon as the room is available.”
Talia nods, all too familiar with all the medical jargon, while Lou’s forehead scrunches.
“We’ll know more soon,” I say, the nasal cannula pumping oxygen straight into my nose, lifting and falling with the movement of my mouth.
A phone buzzes, and Lou pulls hers out of the small purse slung over her shoulder. She glances at the screen, quickly types something out, then shoves it back away. “I have to go take care of something real quick,” she says, looking reluctant.
“It’s okay,” I assure her, joking feebly, “I’m not going anywhere.”
She blinks a few times but nods. “I’ll be right back.”
My mom stands up to take her place at my side, across from Talia. “I’m so grateful you were there with her, Tal. If you hadn’t been—I don’t even want to think about what might have . . .” She gets choked up and has to stop.
Someone I haven’t seen before strides into the bay.
“Hi, my name’s Diego. I’m here to transport Olivia up to echo,” he announces.
After cross-checking the name band on my wrist with his chart and connecting my nasal cannula to a portable oxygen tank, he unlocks the wheels of my gurney.
“You can both wait here. I’ll bring her back after we finish. It’ll probably be about a half hour.”
My mom leans over to press a kiss against my temple, and Talia clasps my hand tighter before letting go.
He’s wheeling me through the ER hallways toward imaging when I hear a familiar voice somewhere nearby. I strain to make out the words. Then, when a second familiar voice joins the first—here, in person—my heart lurches, another sharp pain shooting through my chest.
“Wait—stop.” I reach out and grab Diego’s arm.
He jerks the bed to a halt. “What is it? Are you okay? Do I need to page a doctor?”
“No. Just—wait a second.” I struggle to hear what they’re saying over his voice.
“It is always going to hurt that Lyla is gone,” Lou is saying. “I know you wish you could change what happened to her. But because of that tragedy, one of the best people I know got to live!”
“You think I don’t know all this?” The words scrape out of Hunter’s throat.
My breath snags as another stabbing pain hits me beneath my ribs—but this one isn’t from an arrhythmia.
“You came here because you didn’t know how bad it was. Shouldn’t that tell you something? What if something does happen to her, and you never told her the truth?”
“Of course I’ve thought about that!”
“Then do something about it—go to her!”
“I . . . I can’t. You have no idea what I’m going through—how much this hurts,” Hunter rasps.
“Olivia, are you okay?” Diego looks a little pale beneath his olive complexion. “I’m going to page the—”
“No,” I cut him off. I’ve heard enough. The ache of knowing Hunter came—that he’s here, within hearing -distance—but didn’t come to actually see me is worse than the agony that sent me here in the first place. “I’m sorry. I needed to catch my breath. We can keep going.”
But instead of continuing on straight, Diego pushes the gurney around a corner, and suddenly, I’m face-to-face with Lou and Hunter frowning at each other—until they step out of the way and see it’s me lying on the bed.
I can’t even draw breath when Hunter’s red-rimmed eyes meet mine. I blink to clear my vision—I need to see him without obstruction.
Hunter stares at me, lying on the bed, on oxygen, most likely pale, lips rimmed with blue, hooked up to all sorts of machines and IVs. His jaw clenches. He looks tortured, like he hasn’t slept, his eyes shadowed by deep-purple bruises and his jaw lined with scruff.
“Hunter . . .” I whisper, lifting trembling fingers toward him.
He shakes his head and backs away, eyes glistening, the green in his hazel irises more prominent than I’ve ever seen. “I’m sorry,” he says, low and anguished. Then he turns and strides away, leaving Lou standing there, her shoulders slumped, her head bowed in defeat.
Neither of us says anything.
There’s nothing to say.
Diego wheels me away.
About thirty minutes later, I’ve been taken back to the trauma bay where my mom, Talia, and Lou wait, along with Cameron, who apparently showed up while I was having the echo done.
“I’m not going to miss being here for you—not this time,” Cameron says when he comes over to give me a hug. I squeeze him back as tightly as I can.
We turn on the TV while we wait for results, but I can’t focus on anything they try to watch. Finally, about fifteen minutes later, Dr. Thorup walks in.
“Your blood work is back, and I’ve reviewed the echo results,” he says without preamble. “You’re severely dehydrated, and your electrolytes are significantly out of range. Your heart function is mildly diminished, and there are some arrhythmias, specifically frequent PVCs.
“My clinical impression is that these are likely secondary to the electrolyte imbalance rather than a primary cardiac issue. Even though you’re having chest pain and irregular rhythms, I don’t believe this is a structural heart problem—as long as we’ve caught it in time to correct the underlying cause. ”
I exhale in relief.
“Have you been ill? What’s going on that you are so severely dehydrated and your labs are so off?” He looks up from my chart on the iPad he holds.
“I, uh . . . kind of?” I offer weakly.
“She’s going through a very hard time right now and has been dealing with elevated anxiety and panic attacks. Her appetite has suffered for the last few days.” My mom sends me an apologetic look.
“You haven’t been eating—intentionally? When you know how critical proper nutrition and hydration are to heart function?” Dr. Thorup’s voice sharpens, his eyes narrowing with concern.
I wince. “I’m trying to eat and drink what I can. I—I feel like I’m going to throw up whenever I do. And if I can keep anything down, it goes right through me.”
“You mean you have diarrhea as well?”
I nod, miserable.
Dr. Thorup taps on the screen a few times, then shakes his head. “I’m going to admit you. We need to start IV fluids right away and correct your electrolyte imbalance. The arrhythmias I saw on your ECG are likely what’s causing your chest discomfort.”
He swipes to another screen, squinting slightly. “Again, my clinical impression is that this is secondary to dehydration and nutritional deficiency—not a primary cardiac -issue—but we’re going to monitor you closely to be sure.”
“We’ll also get you something to help manage the anxiety so you can eat some dinner, and then we’ll repeat a few tests.
Hopefully, once you’re rehydrated and have some food in you, your levels will stabilize, and you’ll be able to go home tomorrow.
But we’ll take it one step at a time.” He looks at me over the top of his glasses, his expression firm.
“And next time it gets this hard to eat or drink, you’ll call me, right? ”
I nod again, properly chastised.
Dr. Thorup turns abruptly and strides away.
I sink deeper into the thin pillow on the gurney. “I’m such an idiot.”
“You’re not an idiot,” Talia immediately protests.
“Yeah,” Cameron agrees. “You found out you have your boyfriend’s dead sister’s heart. Anyone would be struggling to keep food down for a day or two.”
“Cameron!” My mom smacks him in the arm.
But for some reason, the completely matter-of-fact way he announced it shocks a laugh out of me—although it verges on hysterical.
He looks alarmed. “I’m sorry, Liv.”
“No, you’re right.” I’m laughing even harder now. “I have my boyfriend’s dead sister’s heart in my chest. How can anyone expect me to eat normally after finding that out?”
“Liv . . .” Talia reaches for my hand.
I laugh so hard it makes me cry. And then I’m just crying. Shoulder-shaking, breath-stealing, gut-wrenching sobs.
“I’m sorry, Liv,” Cameron mumbles.
Dimly, I hear alarms going off on my monitors. I’m sure my heart rate is elevated, and maybe my oxygen has dropped. A nurse is there within moments, and when she sees me crying uncontrollably, her expression softens.
“Dr. Thorup just sent an order for some diazepam. I’m going to go get that for you. Hang on for a minute, okay? You’ll feel better soon.”
I merely continue to cry.
Talia holds my hand, and my mom gently strokes my face, telling me to “breathe, honey, take a breath.” Lou and Cameron huddle in the corner of the trauma bay, both of their expressions twisted with worry.
“My boyfriend’s dead sister’s heart,” I gasp. (Though I should probably start inserting ex before boyfriend.)
The nurse bustles back in with a syringe that she screws onto the port of my IV. “Here you go, hon.”
As the medicine hits my veins, a blessed calm sweeps over me, repressing my panic into submission. I sigh with relief as the waves of anguish ebb away, leaving me drained but pleasantly sleepy.
“This should help her calm down and maybe get some rest. We’re going to transport her up to the cardiac floor here in a minute.”
I barely even hear the nurse’s words through the lovely quiet of the diazepam. It even soothes away the pain in my chest. My eyes close, and I let myself drift off into the release of a dreamless sleep.