Heart Song

CW: mention of death

HeartSong 

Marci’s pulse hammers in her throat — WHOOMPwhoomp! WHOOMPwhoomp! WHOOMPwhoomp! — so fervently that it’s painful. After one sharp intake, her breath catches in her throat so she can’t speak. Can’t swallow.

Her knuckles are white, one hand gripping Aaron’s and the other clenched on her lap. 

Had they heard correctly?

Distantly, through layers of cotton batting in her head, Aaron’s question filters.

“She - she has… what?” 

His voice is hoarse, ragged.

Dr. Greenberg repeats, gently, what they hoped they hadn’t heard.

❤️‍🩹♥️

“Lark, you’re off-key!” 

Mrs. Orejas stopped the class. What was she going to do about this child? The end of the school year was almost here; the traditional school-wide concert would be presented in just a few days.

Most of the children were able to at least blend in with the others. The voices of less confident singers fluted softly, while Lark’s brassy pitch slid about wildly like an out-of-key trombone.

Poor girl… 

No, Mrs. Orejas corrected herself, the child was blissfully unaware of her lack of musicality. Poor everyone else, subjected to her clashing vocal endeavors. She was delightful in every way — except for her singing voice. 

“But she has such a big heart!” the teacher declared to her colleagues in the staff room. “I just can’t discourage her. That mark on the report cards — ‘Pleasure to have in class’— I can honestly give her that!”

On the day of the concert, Lark stood in her assigned place — in the back row of her fifth grade class, farthest from the microphone — and happily sang her big heart out.

❤️‍🩹♥️

Four years later —

“You didn’t eat your lunch!” Marci exclaimed in surprise. “Are you sick?”

Lark always had a good appetite, usually bouncing into the house with an empty lunch bag and an empty stomach. 

Today, she had plodded into the kitchen and flopped down silently on a chair. She sat slumped with her chin propped on her hand, eyes dull.

”Do you have a fever?” 

She didn’t look flushed; rather, she appeared pale and listless.

“Mm.” She shrugged slightly.

Her mother crossed the room and did a quick check with her hand.

“Hmm. You don’t feel feverish… but you don’t look well.”

“Mm…tired,” mumbled Lark, putting her head down on crossed arms.

Marci wasn’t alarmed; it was the beginning of the school year, and bugs were bound to spread among the students. 

“Here, I’ll help you to your room. Take a nap,” she suggested. 

Lark was never a napper. But now — 

Sleep… was all she wanted. She felt so disconnected that she couldn’t even… think. Sound faded, receded, and she drifted off to sleep in the darkened room.

She slept all night, and was still sleeping when breakfast was ready the next morning. Marci called the school to report that her daughter was ill, and received perfunctory well-wishes from the secretary.

“Oh, I’m sure she’ll be better by Monday,” Marci replied. “That gives her a weekend.”

Aaron thought she should call the doctor.

“Because the weekend is coming — and if she needs to see the doctor, better do it today.”

❤️‍🩹♥️

“Good morning, sweetie. How do you feel?” It was late morning, and Marci had decided she’d better wake her daughter.

“Unh.” Lark’s groggy voice was inarticulate. “Sa…taard…(aaahhmm).” She moved her head fractionally and yawned, not opening her eyes.

“Do you want breakfast? You haven’t eaten since yesterday morning!”

“Mm. Nah…”

Marci’s face scrunched in concern, and she felt her daughter’s forehead again. Hmm… still didn’t feel feverish. The grogginess and lack of appetite were alarming though. She called the doctor.

❤️‍🩹♥️

“You need liquid, honey. Doctor said to keep you hydrated and try to get some bland food in you. Water, or tea?

…Lark?”

After several seconds, Lark slurred groggily,

“Jus’wat’r.”

“All right, here you go.”

She picked at a piece of toast and managed a few swallows of applesauce before leaning back against the pillows with her eyes closed. 

“Is that all you want?”

“…Ynh…”

Marci carried the tray out to the kitchen and picked up her phone to call the doctor’s office again. Before she completed dialing, she heard retching sounds from Lark’s room. 

❤️‍🩹♥️

“Likely a virus,” Dr. Williams surmised, rubbing a hand over his chin. He peered at Lark over his glasses. “There are a few making the rounds… Not our usual spunky girl, are you?” He patted Lark’s shoulder kindly and turned to her mother.

“Get her some electrolytes.” Scribbling on a sticky note, he handed it to Marci. “This is the good kind. If she doesn’t get any better, you call me. I’m the on-call physician tomorrow.”

❤️‍🩹♥️

Marci had to put a straw in the glass and hold it up for Lark to suck. After a few swallows, she turned her head away. 

“Nnh…”

“But that’s only two ounces! You need more liquid. Another sip?”

Ten minutes later, it came back up. Marci had given her daughter a hospital-issued emesis basin she kept under the bathroom sink, but Lark was so muddled that she didn’t grab it in time.

“Oh, honey — you’ll have to get out of the bed so I can change it for you.” 

Aaron and Marci were up most of the night. Their daughter slipped into exhausted slumber between episodes of vomiting. While she slept, her breathing was heavy, labored. She seemed to be deteriorating.

At first light, their eyes met as they stood beside Lark’s bed.

“I’ll call Dr. Williams,” Marci almost whispered.

“Bring her in as soon as you can!” The pediatrician’s rumbly voice, urgent but reassuring, tamped down their anxiety. He would fix the problem.

❤️‍🩹♥️

He couldn’t fix it. He examined her quickly, noting her struggle to breathe, and pointed out something else.

“Her legs are swelling. This is something more than a virus. Get her to emergency! I’ll call in while you head over!”

The hospital was across the street.   Aaron lifted his daughter — fourteen years old, but limp as a baby in his arms — and they rushed out to the car.

❤️‍🩹♥️

Now they sit across from Dr. Greenberg in his hospital office, listening to him explain the implications of congestive heart failure in a teenage patient.

“But — how can that be? There’s no history of heart disease…” 

Marci’s hand goes to her throat, feeling her own strong pulse still pounding, then slips down to cover her heart. Perhaps it’s a subconscious attempt to defend her genetic history.

Aaron places his free hand over their clasped ones. It feels clammy.

“Her condition is dilated cardiomyopathy,” Dr. Greenberg informs them. “It causes the heart muscle to enlarge and stretch. It isn’t necessarily genetic; it can also be caused by viral infections or toxins. We’ve ordered genetic testing to determine the cause.”

He further explains that it’s a progressive form of heart disease that weakens the heart, making it unable to pump blood sufficiently to the lungs and body.

They listen numbly as he tells them that their daughter must undergo surgery as soon as possible. She will have an artificial heart pump implanted. Ultimately, she needs a heart transplant. 

❤️‍🩹♥️

The last thing Lark remembered was feeling increasingly tired. 

Now, gradually surfacing from… where?… she heard murmuring voices. They were distant, muffled, but getting more distinct. Her eyelids fluttered.

When, at last, her parents and Dr. Greenberg appeared at her bedside, she was bewildered by the words bombarding her.

Heart problem. Heart failure? Artificial heart pump. Heart transplant!? She was only fourteen!

❤️‍🩹♥️

She was only fourteen, and she was adaptable. She got used to it, and life went on. There were things she couldn’t do, because of the heart pump — but there were lots of things she could do, because of the heart pump. The best thing was that she could live.

When the test had come back, it showed that the cause of her condition was genetic, but not a hereditary condition. It was a gene mutation, completely unsuspected.

“You know what?” Marci grimaced. “Mrs. Orejas was right. On your report card in fifth grade, she wrote: ‘Of all my students, Lark has the biggest heart!’”

❤️‍🩹♥️

Eva was a little nervous about the concert. She chewed on her lip as they drove to the auditorium. She knew the song. She felt the song. She knew her own voice, and knew it fit the song. She had sung it with the choir — but this was to be her first solo.

“You’ll do great!” her dad assured her, grinning. “Eva the songbird. You just get up there and pour your heart out!” 

She did. She sang for her parents, her brothers, her friends in the audience — her pure, clear voice ascending to the rafters.

❤️‍🩹♥️

On the way home, tragedy struck.

A vehicle, crossing the center line into oncoming traffic, slammed into their car and sent it spinning across the roadway into another car.

Eva, her parents, and her two brothers were taken to the hospital, along with occupants of the other vehicles.

❤️‍🩹♥️

Maria’s knuckles are white, one hand gripping Ted’s and the other clenched on her lap. 

Her pulse hammers in her throat — WHOOMPwhoomp! WHOOMPwhoomp! WHOOMPwhoomp! — so fervently that it’s painful. After one sharp intake, her breath catches in her throat so she can’t speak. Can’t swallow.

Had they heard correctly?

Distantly, through layers of cotton batting in her head, Ted’s question filters.

“She - she’s… what?” 

His voice is hoarse, ragged.

Dr. Stanley repeats, gently, what they hoped they hadn’t heard.

They listen numbly as he tells them that Eva is on life support. She’s brain dead, no hope of recovery.

❤️‍🩹♥️

(to be continued)