Part 32
Cameron was about to turn the page to peruse this second paternity test report more closely, when he looked up to see David Hayward.
"What are you doing here?" Cameron asked Hayward.
"Looking in on Alexander."
"Why?"
"Donna called me."
"What for?"
"I'm her friend."
"So you come all the way here from Pine Valley to see a friend's son when he's in a hospital with perfectly good cardiologists and his own father is one?"
"Yes, when the father is on speaking terms with neither the friend nor her son. How did you alienate them to such degree, Cam?"
"Are you trying to be arbitrator again?" Cameron said, sarcastically. "Why the interest?"
"I already told you, Cameron."
Cameron watched David walk off.
Dr. Monica Quartermaine went to talk to her patient about his diagnosis, and found that there were too many cardiologists around.
First there was Dr. Cameron Lewis. The patient refused to see him. The patient became upset at the very idea of seeing him. Dr. Lewis had no choice but to bow out.
The patient was less excitable about Dr. Hayward's consultation on his case and said it was fine with him if Dr. Hayward came in on the matter.
Dr. Quartermaine went in to the patient, knowing it was now a delicate matter indeed. Dr. Hayward went with her.
"So what do you big shot heart doctors think this is?" asked the patient, as if expecting the answer to be only mildly interesting.
"A disturbance the electrical system in your heart," Monica began to explain. "That can suddenly manifest itself without any prior symptoms. Had you ever fainted before?"
"No."
"With ordinary syncope – fainting - there is usually some warning: dizziness, blurring or blackening of vision, tingling or sweating. With this, it just happens precipitously - without warning."
"Yeah. Yeah it did. No warning. I can't even remember it now."
"You were playing tennis?" Monica asked.
"Not really. Teaching it isn't like playing a game."
"So you wouldn't say you had just been finished with a strenuous physical activity."
"No."
"An emotionally stressful event?" she asked.
"Dad showed up."
"Did you have words?"
"As usual."
"You got into an argument."
"I think I told him not to look for me again. I forget. I was annoyed to see him there."
"Was it stressful?"
"Not any more than usual. It's always stressful to talk to him."
"Does your heart flip-flop in your chest much?" David asked. "Skip a beat, feel like it flutters?"
"N-no," Zander said. "I don't think that has ever happened."
"Not often, anyway?"
"No, not often."
"OK," Monica said. When I decide you're up to it, I'm going to have you sent down for an EKG. When we discussed this before, you said there was no family history of sudden and unexplained deaths under the age of 40."
"Can I talk to you alone?" Zander asked David.
"Sure," Monica said, getting up, glancing at David, before she walked out.
"That history you gave me," Zander said. "Didn't something like that happen to your father?"
"She ought to know that, Alexander."
"Zander."
"OK. Zander. We ought to tell her, and as a professional person, she'll keep it in confidence."
"Even from her family?"
"Yes. Your Dad didn't talk to you about his patients, right? So those are the ethics of the medical profession. You don't discuss your patient's condition with anyone unless they say you can."
"This isn't really my condition, though," Zander said. "It's just a fact."
"That's smart of you to see that," David said. "It's really important for her to know it, though. There's an inherited condition I suspect, but she won't suspect it enough, if she doesn't get this part of your family history. I think she'll respect your confidence."
"OK. I have to risk it, then."
"It'll be fine."
"How much do you know about your father's death?" Monica asked David, when he had come out into the hall.
"Not much," he said. "But it was sudden, and unexplained, and when he was 36. It was too long ago for me to be able to get any good records. I tried when I first found out about this paternity thing. But in those days they weren't so particular. They shrugged and went on."
"And buried them," Monica said, grimly. "What did Zander want to talk to you about?"
"My father's death. I gave him a family history medical report when we found out. Anyway, he knows you have to know. I reassured him you will keep it confidential."
"I suppose I thought him indestructible," Cameron said to Monica. "This is so unexpected."
They were looking at Zander's EKG.
"If QTc squared is 470 msec, he gets two points, and he gets another 2 points for fainting under stress, that's four. Four is enough to diagnose the syndrome, so we have to treat him for it," Monica said. She was looking at a point chart that was a general guide to diagnosing Long Q-T syndrome.
"He'd only have three points if you decided that the fainting was not under stress," said Cameron.
"You were there. Was he under stress?"
"Nothing unusual."
"That's what he said. But it doesn't have to be unusual. Just stressful."
"It's usual for him to be under stress, you mean?"
"No, he told me that when you are around, he is under stress." Monica wanted to prevail on this point, so as to convince Cameron of the diagnosis without having to say anything about adding .5 point for the sudden and unexplained early death of David's father.
"Would you treat him for it if it were three points?" Cameron asked.
"Yes," Monica said. "The way he described the fainting fell right in with the classic descriptions. I wouldn't want to risk it. Granted he could live to be 90 with nothing happening, but with a risk it could suddenly kill him one day when he's much, much younger than that – well, if it were my son I wouldn't risk it. You think it might not be necessary to treat him for it?"
"No, no. I want to, but you are more objective and might see it as overreaction."
"No. The EKG reading is at the low end of where we'd conclude he has it, but the description of the fainting convinces me. I'm taking it to be under stress. I don't have an issue with that."
"Right after he shot his brother," Cameron said. "Then, under that stress, nothing happened to give us any indication of this. The run-in we had in the locker room was nothing."
"That's the way this can be," Monica said. "Just stress. Not the biggest possible stress."
"I suppose I should have my son Peter checked."
"It couldn't hurt," Monica said, looking away.
"I wish I had known this," Cameron said.
"How could you have?"
"I thought it would do him good to be on his own like he was. But that presumed that he was as healthy as I thought."
"You mean you let him be on his own?"
"I knew he would survive," Cameron said. "I didn't worry about him. But," he added, remembering she was Emily's mother, "I should have worried about other people and what could happen to them, and so I apologize to you. After what he did to your daughter, I understand if you blame me."
"It wasn't that simple. I liked Zander after a while. Emily did too."
"Peter does, too. But people like that can end up really getting badly hurt when they are within the range of Alexander's actions."
"He's not doing much action now," Monica said. "Let's worry about that."