I am very sorry for the delay in getting this chapter out, but I hit a little bit of writer's block. I had the chapter partway done, but I couldn't get it to go anywhere. So I ended up deleting the whole thing, and coming at it from a completely different angle, and that worked. Thanks so much for your continuing enthusiasm for this story and all of the wonderful reviews.
This chapter has no spoilers.
March 1996
The day of Blair's appointment dawned cold, wet and windy; the kind of day when it was hard to even get out of bed. The blaring of the alarm woke him with a start, and his heart pounded, ridiculously out of control. Not even his drastically increased medication could control his natural reaction to the excitement of the coming day. This was the day he had been waiting for; the day when he might actually get some answers to the mysterious heart condition that had been plaguing him for the past 18 months.
He had barely managed to struggle to a seated position when Jim appeared in his doorway with a steaming mug. "Here you go, Chief. I made you some Chamomile tea. Your heart rate tells me you need to calm down!"
Blair smiled sheepishly as he accepted the warm mug. "Thanks, man. I can't help it! I just keep thinking today's the day I find out what's wrong. And then I start thinking what if this new doctor can't help me either? Or what if it takes a long time? He probably has a bunch of other tests to run, and it might take a while. There's just so much to think about!"
Jim chuckled. "Well, why don't you drink your tea and take a shower while you're thinking? We have to leave for your appointment in an hour."
Blair paused with the mug halfway to his lips, the steam wafting into his face. "We?"
"Yes, we." Ellison headed back out to the kitchen. "I took the morning off so I can go with you." He held up a hand as Blair opened his mouth to protest. "Don't worry, I promise I'll stay in the waiting room this time. I don't want to make another one of your doctors mad at me."
Blair hid his grin behind his mug as he took a cautious sip of the hot liquid. "Okay, Jim. You can come with me. Thanks for the tea."
He dragged himself out of bed after another few sips of the comforting brew and grabbed some clothes, heading into the bathroom to take a shower and get ready. He adjusted the water temperature so that it was as warm as he could handle without aggravating his heart rate and stood under the spray. He would rather have had a steaming hot shower, but he had learned through experience that this was no longer an option with his condition. Twice in the past two months he had passed out in the shower, waking up when he hit the floor of the tub. Fortunately, Jim had not been home on either occasion, so he had been able to conceal the embarrassing incidents.
He had also been fortunate in that he had not needed to slow down on his guide duties with Jim. After the first week on his new dosage of medication, his body had adjusted and he had been able to keep up with his partner fairly well, although Jim had insisted that he take it easy.
"Sandburg, are you sleeping in there?" Ellison's voice startled Blair from his thoughts. "Now we only have 30 minutes until we leave. Get a move on!"
Blair moved into action, washing his hair as quickly as he could. How could he have been standing there under the warm water daydreaming for thirty minutes already? The last thing he wanted was to be late for his appointment, now that he had made it through a full eight weeks of waiting just to get to this point.
Finishing with his shower, he wrapped a towel around his waist and stepped out of the tub. Swiftly dressing, he contemplated pulling his hair back into a ponytail, but discarded that idea when he considered that he may end up having tests that required him lying flat on a table somewhere. Five minutes later he appeared in the living room, completely dressed, hair down and dry.
"Okay, Jim. I'm ready."
"Hold your horses, Chief. Your breakfast is on the table. We're not going anywhere until you eat something." Jim looked up from the newspaper he was reading over his coffee to fix his partner with a stern look.
"Fine." Blair sat down at the table and ate the breakfast Jim had laid out for him, which consisted of a bowl of oatmeal, a slice of buttered toast and a banana. He drank his orange juice, and then grinned at Jim. "There, are you happy, Dad?"
Jim smiled back. "Very. Now brush your teeth and let's go." He folded his paper neatly and stood up. "I'll go start my truck. I'll see you down there."
Blair hurriedly brushed his teeth, grimacing at the taste of orange juice mixed with toothpaste, grabbed his backpack and took the elevator downstairs, having learned from experience that walking down all those stairs would merely exhaust him. Jim was already in the truck, and the engine was running. Blair quickly got in on the passenger side, and as soon as he was settled, Jim put his vehicle into gear and they began the ten minute drive to the cardiology complex.
"So, how do you feel?" Jim glanced at his partner curiously.
"Nervous!" Blair blurted. He grinned wryly at Jim. "I've got my hopes up so much, I'm just afraid I'm going to find out they can't help me."
Ellison smiled at him sympathetically. "Well, it's always a good idea to be realistic, but don't count this doctor out before you even see him."
Blair nodded, then leaned back to look out the window. Silence reigned for the rest of the drive, Jim concentrating on driving and Blair thinking about his appointment. As they pulled into the complex, Jim noticed the full parking lot and groaned.
"I'm going to drop you off at the front door and go park the truck. Just save me a seat in the waiting room."
Blair nodded, grabbed his backpack and got out at the door, watching as Jim's truck pulled away toward the other end of the parking lot. This place was always full. The practice was large, consisting of seventeen cardiologists in several specialized areas. Between them, the doctors usually kept the parking lot and the waiting room full.
Inside the building, Blair let his eyes adjust to the dimmer light. The waiting room was laid out in two groups of chairs, one group on either side of the main doors. In the middle of the room was the reception area, where two women in scrubs were busily working. A line stretched almost to the door, waiting to check in. Blair got in line, ruefully thinking that if nothing else, this whole ordeal had taught him patience. Other than his ambulance ride and the emergency room visit, nothing had been done in a hurry throughout this whole lengthy process.
He had only been standing in line for thirty seconds or so when he was no longer the last one in line. By the time Jim entered the building, Blair had moved about halfway to the desk, and there were seven people behind him. He grinned at Jim.
"Guess you'll have to save me a seat, man."
Jim grinned back, shaking his head. "I'll just be over here looking at a magazine…"
Blair chuckled, watching him walk away, and then settled in to wait until it was his turn to check in. Finally he made it to the front of the line, and one of the receptionists motioned for him to approach.
"Hi, how's it going?" Not much could keep Blair's irrepressible flirting down, and the woman was definitely worth a second look. "Blair Sandburg. I have an appointment with Doctor Simmons." He handed her his driver's license.
The receptionist took the license and began to type the information from it into her computer, sparing a moment to smile at Blair. "Hi, Blair. It's been insane in here today. I'm afraid you might have a bit of a wait. Doctor Simmons had an emergency this morning, and his patients have gotten backed up a little." She handed the license back to him. "You can have a seat in the chairs to the left and someone will call you back when they're ready for you. I'm sorry for the wait."
Blair put his license back in his wallet, smiling ruefully. "Don't worry, I'm getting used to waiting." He turned and gestured to Jim, who had already taken a seat in the chairs to the right. "Come on, Jim. We're over on the other side today."
Jim put his magazine back on the table and crossed to the other grouping of chairs. "You've never been on this side before."
"No," Blair agreed. "This is the side where they have the specialists. I've always been on the side for the general cardiologists before."
Jim shrugged, settling into a chair next to Blair. He grabbed a Newsweek magazine from the table beside them and started to read. Blair pulled a book out of his backpack and settled back to do some homework. He had gotten to be quite the professional at handling long stays in waiting rooms.
*****
"Blair Sandburg?"
Blair looked up in relief, spotting a young woman in green scrubs just inside the door holding a clipboard. His wait had seemed extra long today. He shoved his book back in the backpack, which he handed to Jim. "Keep an eye on this for me, okay, man?"
Jim nodded, meeting Blair's eyes seriously. "Deep breaths, buddy. It's going to be okay."
Blair nodded as he followed the nurse through the door into the restricted area of the office. He followed her through winding halls into a section with several examination rooms surrounding a central area with a scale and a desk. Several of the rooms had a chair just outside the door. He wondered what those were for but didn't ask. His stress level had risen as soon as his name had been called, and he didn't even bother to flirt with the pretty woman, preferring to remain quiet but cooperative as she recorded his weight and then led him into one of the examination rooms.
"Please sit up on the table," she said crisply, closing the door behind her.
Blair complied and sat patiently through the usual round of pulse and blood pressure checks, then sighed as she pulled out the equipment to do an EKG. This seemed to be as standard in a cardiologist's office as checking blood pressure. Without being asked, he began to remove his shirt; he knew the drill by now.
Once the test was complete, the nurse instructed him to put his shirt back on. "Doctor Simmons is still running behind, but he should be with you shortly." She smiled at him and left, again closing the door behind her.
Blair sighed; he should have brought his book back with him. He climbed down off the table to sit in the chair beside it; if he had to wait he could at least be more comfortable. Leaning back in his chair, he started to read the framed posters on the wall, all cutaway depictions of a human heart. Once he had finished reading the posters, most of which he had seen before in other examination rooms here, he leaned his head back against the wall and closed his eyes. At least this was giving his heart a chance to settle down before he saw the doctor, although he actually wasn't sure that was a good thing. He wanted it to act up when he saw the doctor so that it might be easier to diagnose.
Comfortable now, he let his mind wander. I wonder how long I'll have to wait. I bet Jim could just listen and figure out where the doctor is now and how long it will take him to get in here. I wonder what Jim's doing? I wonder if he found any interesting magazines. Or maybe he found a pretty woman to talk to. Man, I'm such a wimp, being too nervous to even talk to that poor nurse. She was really hot. Is it hot in here, or is it my heart? I wonder why they have those posters on the wall? They're kind of disgusting when you think about it.
Man, I wonder if the doctor is going to have any clue what's going on, or if he's going to tell me the same thing all the other doctors have. I gotta stop thinking about this. I wonder how long I'll have to wait…
His musings were interrupted when he heard a noise outside the room. He may not have Sentinel hearing, but he could hear paper rustling and then a squeaking noise. His guess was that someone was sitting in the chair outside the door and looking through his file. He opened his eyes and sat up straighter. This could be it. The doctor was outside his door. Finally!
The rustling noises and the occasional squeak continued for the next fifteen minutes, and Blair was beginning to think that he had been wrong about the reason for the noises when a sharp knock sounded at the door and a young man in a white coat entered the room.
"Hi Blair, I'm Jonathan Simmons."
The doctor held out his hand and Blair shook it, thinking this doctor didn't look any older than Blair himself. Maybe he wasn't. He was a tall man with close cropped blonde hair and sharp blue eyes. The doctor pulled a stool from the other side of the room and sat down in front of his patient.
"So I understand you've been having a hard time getting a diagnosis." Simmons looked down at the thick chart on his lap absently.
Blair laughed mirthlessly. "Yeah. I've been dealing with this for a year and a half, and so far all they know is that there's nothing wrong with my heart. And yet I'm on heavy doses of medication to control it. I really don't want to spend the rest of my life living on medication."
The doctor smiled. "Then we'll just have to make sure you don't have to. I know what's wrong, and I can fix it."
Blair found himself speechless for a moment, his mouth opening but nothing coming out. Finally he regained control of his faculties. "You … know what's wrong?" His brow creased in a puzzled frown and he could tell his heart had sped up again. "How could you know what's wrong? You haven't even examined me! Aren't you going to order tests or something?"
Simmons grinned at him smugly. "I get that a lot. Blair, I don't need to examine you or to order any tests. I have everything I need in your file. You've already had every test I would have ordered, and your diagnosis is obvious because of the results. Doctor Aaron didn't catch it because it's not in his area of expertise, it's in mine."
Blair, still reeling, leaned forward in his chair. "So what's wrong with me, and how can you fix it?"
Simmons pulled a colorful pamphlet from his coat pocket. "You have an arrhythmia. Doctor Aaron was correct in that there is nothing physically wrong with your heart; it's all in the electrical system, which until recently nobody understood. This pamphlet will help you understand what I'm talking about." He opened the booklet and flattened it against Blair's file, gesturing to his patient. "Here's what I mean."
Blair found himself having a hard time following the doctor, his mind continuously playing back the words he had spoken only moments before. I know what's wrong, and I can fix it. He had hoped the doctor could help him, but it was almost impossible to fathom that it was this easy. After eighteen months of wondering, it was mind boggling.
Blair pulled his thoughts together and focused in on the doctor, who was now sitting back on his stool, observing him with an amused smile. "Are you with me? I completely understand your response, because I see it a lot. Are you ready to continue now?"
Blair nodded sheepishly. "Sure. Sorry about that. So I have an arrhythmia? What does that mean?"
Simmons gestured to the pamphlet again. "Take a look at this diagram of a heart. The two chambers at the top are called the atria, and the two at the bottom are the ventricles. The blood enters your right atrium, passes through the right ventricle into your lungs, then back into the left atrium, down to the left ventricle and back to your body. I'm sure you learned that in biology class when you were in school. But let me explain how the heart actually works."
Blair looked up at him attentively. This was kind of like being in a lecture at Rainier. He was more in his element now. "Should I be taking notes?"
Simmons grinned. "No, I'll give this pamphlet to you, and it explains everything. So . . . now you know how the blood moves through the heart, and that part of your heart is working fine. The thing you are having an issue with is the actual electrical impulse that causes the heart to beat to begin with." He drew a circle over the right atrium on the diagram. "This is where your heartbeat originates, in a part of the heart called the sinus node. The electrical current is supposed to start there and then direct both atria to contract, letting the electrical current spread to the rest of the heart.
"But your heart is not doing that. The technical term for your condition is Paroxysmal Supraventricular Tachycardia, specifically Atrial Flutter." The doctor chuckled at the blank look on Blair's face. "I know, that's a mouthful. Let me explain what that means. I just told you how your heart is supposed to beat. Now let me tell you what your heart is actually doing."
Doctor Simmons opened Blair's fat file folder and flipped through several pages until he came to what he was looking for. He turned the file so that Blair could see a page of EKG printouts. To Blair, it just looked like a bunch of squiggly lines.
"Instead of the sinus node originating the electrical current and passing it along to the rest of your heart, you have an extra electrical pathway in your right atrium that is causing the electrical impulse to get caught in a loop. It's just circling around in your right atrium. So that one part of your heart is beating at about 300 beats a minute, and only some of those beats are getting through to the rest of your heart, which is what is causing your heart rate to beat between 120 and 150 beats a minute.
"Don't worry, there's very little threat of death from this type of arrhythmia," Simmons continued, seeing the panicked look on Blair's face, "unless you were to pass out while driving a car or walking across a street or something. But there's no reason for you to have to continue to live like this. We could put you on medication, which you've already told me you don't want, or we can fix it."
"And how would you do that? Are you talking surgery?" Blair was still struggling to take everything in, but he was determined to keep up and ask intelligent questions.
Doctor Simmons pulled a second pamphlet from his pocket. "There is a procedure we can do called cardiac ablation. It involves catheterizing the heart, which means we'll insert catheters into your heart through blood vessels at the groin area and possibly through your arm or neck. You won't be anesthetized for the procedure, but we'll give you something to help you relax. You might even fall asleep.
"Once the catheters are in place, we can induce the arrhythmia, and special electrodes at the end of the catheters can help us pinpoint the exact location of the bad electrical pathways. Then we use something called radiofrequency energy to destroy the bad pathways. It will take four to six hours, and then you'll have to lay flat for another four to six hours after that. We'll probably keep you in the hospital overnight. It's not surgery, so it's considered non-invasive, and there's little pain associated with the procedure. You'll be back to your old self in a week or two. So what do you think?"
It took Blair a moment to realize that the doctor had stopped speaking and was waiting for a response. "Um, well it doesn't sound too bad," he began, head spinning from the onslaught of information he had just received. "So it's not too risky?"
"Well, there's always a risk involved with any procedure, but it's not a large one." Simmons studied Blair closely. "So would you like to go ahead with it?"
It was all happening too fast, and Blair needed to slow down for a minute. "Um, could I have a couple of minutes to think about it?" he asked desperately.
Simmons stood up. "Sure. You think about it, and I'll be back in a few minutes. In case you decide to go forward with the ablation, I'll check for openings in the electrophysiology lab. That's where we do the procedure." He turned and left the room, still clutching Blair's folder.
Blair was left alone in the room with two colorful pamphlets, an overload of information and a big decision.
To be continued . . .
Thanks again for reading this! I will try to get the next chapter out more quickly. As always, I appreciate your reviewing and letting me know what you think!
