4

Anna Westbrook v. The Heart

"I saw the way my love letter made you swoon. I knew you had feelings for me."

Exhibit number 69: excerpt from a letter sent from the defendant, Noah Hall, to Anna Westbrook's new address.

-o-

Anna woke to someone weeping. Melissa, she realised a second later. Her fingers twitched, seeking out her sister's hand or the top of her head, wanting to comfort her. Her eyes fluttered with the exertion of opening them before they finally obeyed.

Light flooded her. She looked around the small room. The walls were pale yellow, like their little bathroom back in their childhood home, and adorned with posters and medical equipment. This made her uneasy. Her eyes shifted down to her hands, resting on top of seafoam green sheets. A pulse oximeter clamped onto a forefinger. A long plastic tube sprouted from the back of one hand.

Anna drew a deep breath. Her chest hurt, and her throat ached with thirst. She felt like she had been hit by a truck. She had spent enough of her childhood in hospital to realise that was where she was. Though, she was unsure with which part of the Forks Community Hospital she was in; the paediatric ward was aquatic-themed, and this room clearly was not.

She looked over to her right. A head of shiny orange hair, flipped over, greeted her. Melissa's face pressed into part of Anna's bed. Her sister's shoulders shook with muffled sobs, the gasping kind that made her worry about her asthma.

"Mel."

Her sister's head snapped up, and she looked at Anna with wide teary eyes. Her face was bright red, her cheeks wet, her lips swollen.

"Anna? Oh my God, wait here. I'll call for someone." She rushed to her feet, wiping her nose with the back of her hand. Disappeared out of sight for a handful of seconds before she was back by her side, picking up her hand and cradling it. "Don't ever do that again. You scared the crap out of me."

"Don't swear," Anna murmured.

A doctor stepped into view. Anna blinked at him, trying to recall the name of the blond man. One of the Cullens. Carlisle. Yes, Dr. Carlisle Cullen.

She frowned. He was an Emergency Medicine specialist, wasn't he? But this wasn't the emergency room. She peered at his white coat. His name was embroidered neatly, and beneath it Chief of Emergency Medicine.

He seemed to notice her confusion. "Anna, can you tell me when your birthday is?"

"May third."

"Very good."

"This isn't-" She swallowed- "the ER."

"No," he said. "We've moved you to the cardiac care unit."

Cardiac care unit? There was a mistake. She needed to talk to someone. "Where's the cardiologist?"

"I'm your doctor," he said gently. "This is a community hospital; we're short-staffed. We all help out across departments and do what we can. I assure you, you're in good hands. I have a lot of experience across different specialties, and I've had someone consult from Seattle."

Anna nodded slowly. Still, it was odd, she thought, that he seemed so confident.

"Do you know why you were brought in?"

She shook her head.

"You had a heart attack."

Her brow lowered. A heart attack? She was twenty-six. She was too young for heart problems.

"I'm sure this is a confronting thing to hear," he said. "Your sister told me you were experiencing some health concerns leading up to it?"

Anna said nothing.

Whatever Melissa thought she'd seen was wrong. So what if she was pale? That was because she only went outside to travel from the unit to Westbrook's. So what if she struggled on their hike? That didn't mean she was sick. Her body was deconditioned and she wasn't used to high intensity exercise, that was all. Her fast heartbeat, her breathlessness, her pallor - these were all just side effects of her lifestyle, not of anything serious.

Realising Anna wasn't going to answer, Dr. Cullen tried again. "Melissa said you've been unusually pale, and you've been having some chest pain and trouble breathing."

Anna shrugged. "I guess."

He nodded. "When you came in, we did a few tests, including an echocardiogram and an EKG. The results revealed that you were having a heart attack, but also that you have something called hypertrophic cardiomyopathy. That means that the muscles of your heart are abnormally thick, making it harder for your heart to work."

"How do you fix it?"

"Unfortunately we can't fix it, but we can manage your symptoms. I've prescribed some medication to help regulate your heart rate." He paused for a moment, flicking through her patient file. "The echo also revealed that part of your heart was damaged. It's quite possible that you've had a heart attack before without knowing. We'll need to do further tests to determine if scarring will be an issue."

"When can I leave?"

"Not for a while. We need to monitor you and make sure you're alright." Dr. Cullen smiled apologetically. "Melissa said that when she found you, you were unconscious. Have you had any instances of unexplained fainting?"

Anna blinked at the doctor, silent, unable to answer him. Melissa was the one to find her. A lump formed in her throat. How scared she must have been, climbing out of the bathtub, relaxed and content. Not finding her in the unit. Wandering outside in search of her. Finding her collapsed on the concrete.

Anna tried so hard to protect her. She tried so hard to pretend everything was fine to keep Melissa from finding out she was just as fragile as everyone else. Melissa needed her to be strong for her, someone she knew she could turn to for help. And Anna needed to be there for herself, too. She needed to protect herself. She needed to be strong. Bad things happened when she wasn't.

Anna shook her head. Then, after a long moment, she dared to ask, "Is it my fault?"

"What do you mean?"

"Did I do it?" she asked. "Did it happen because of something I did?"

"Melissa informed me that you have some lifestyle risk factors for heart failure but it is likely that your heart attack was caused by your cardiomyopathy, which is typically genetic."

Anna let out a sigh. It wasn't her fault. She didn't have to blame herself for her weakness, for scaring Melissa. Someone else was to blame, something else entirely out of her control. This was down to genes. This was just one more thing she was all too willing to blame her father for.

Soon after, Dr. Cullen left the room with a promise that a technician would be in later to run more diagnostic tests. The second he left, Melissa turned to her.

"I read the letter," she said.

Anna's heartbeat rocketed. "W-What?"

"You were holding a letter," she said. "I read it."

The air rushed from her lungs. She had no idea what the letter read. She hadn't managed to read it before her legs gave out, before her heart gave out. Speaking of, that pain was back, nestled between her breasts.

"Why wouldn't you tell me?"

Anna frowned. Her pulse was in her ears, her temples. Her heart fluttered uncomfortably. A machine nearby beeped. "What?"

"So you get to ask me all about Jasper, but you won't even tell me about your own love life?" She narrowed her eyes. "You weren't even going to tell me he was coming to visit!"

The air rushed from Anna's lungs. A terrible pressure formed in her chest, painful when she breathed. Crushed by the weight of Melissa's words. She didn't understand. Melissa didn't understand. She needed to make her understand.

"Show me." She reached out to her, fingers shaking. She needed to see the letter. She needed to know exactly what Melissa knew, what nonsense Noah had written.

Her sister ignored her, and failed to produce the letter.

"Show me now," she hissed through clenched teeth.

Melissa didn't. She was eying her now, face twisted still in anger, but fear lurked in her eyes.

She was scared of her.

God, she was scared of her. Was she acting like their father? Was she being cruel? She was desperate now. She needed to protect her sister. She didn't understand. She thought she lied, but she hadn't. She hadn't lied. And God, her chest hurt. But that could wait. She needed Melissa to understand.

"Anna?"

She read the words on her lips but the sound of her name came to her too late. The pain intensified. Burning pressure. She kneaded her chest with the palm of her hand. Grimaced.

Melissa scampered off, her orange hair floating behind her. She was out in the hall, screaming. The hospital was no place for behaviour like that. Footsteps rushed towards her. She'd gotten them both in trouble.

"Anna?"

Dr. Cullen's face bobbed before her eyes, an uncertain thing, hazy. His voice came from somewhere far away. Still, the pain burrowing away at her chest. She winced, on the verge of tears. Last time she was lucky. Last time she was too frightened to feel anything.

He turned to face someone behind him. "Get Melissa out of the room."

Anna stared at her sister as she was herded outside. Her eyes bore into her, wide and scared and angry with her all at once from the doorway. And as the doctors and nurses rushed around her bed, all she could think was that she must survive this. She must live through this so she could set things right. So if Noah was coming to the house, Melissa wouldn't be there alone when he arrived.

She had to live to protect her.

-o-

The weeks passed slowly in the hospital, interrupted only by more tests, new drugs when the old drugs weren't working. Anna was too unstable to release, they said, but all she could think about was the waste, the money, the days Melissa was spending alone at home.

Melissa barely visited her, drifting into the room only for short lengths of time before disappearing again. Sometimes, she brought flowers from the florist next to Westbrook's, or a copy of a new horror comic from the shop, but never what Anna really wanted: the letter, or else news that she could go back home. The thought of her stalker coming to the unit when Melissa was there by herself terrified her.

Then, one day, Dr. Cullen entered the room with a very serious expression. Melissa wasn't there. Anna was thankful.

"The drugs aren't working," he said. "The tests have revealed that you have excessive scarring in your heart. We need to consider the possibility of surgery."

"What kind of surgery?"

"There are some procedures we could do to help manage your condition," he said, "but ideally a transplant."

Anna's eyes widened. "A heart transplant?"

He nodded. "I'll be honest with you. The wait list is very long. Most patients in major cities wait up to a year for a heart. In rural areas, the wait can be longer. A heart is only viable for transplant for four to six hours. Organs usually go to whoever is closest to the donor."

She looked at him. "Then…"

"If you received a transplant here, it would likely be from somebody you knew," he said.

The air stalled in her lungs.

"Anna, it is very unlikely that you will receive a match here. The surrounding population is very small, and the travel time to and from major cities is long enough to complicate the surgery," he said. "Even if there was a heart available there is no guarantee it would be a match."

Anna swallowed. "What happens if I don't get a heart?"

He looked at her with solemn eyes. "It is likely that the walls of your heart would continue to thicken, and the function of the organ would decline further. There is significant risk of further complications, like stroke."

This was serious. This wasn't the tiny blip in her life she thought this hospital visit would be, the way all hospital visits had been her entire life. Anna glanced down at her chest, the spot between her breasts. She felt betrayed. How could something she had grown herself do this to her?

"The next step would be a HLA panel to determine the compatibility of your body and any possible donation," he said. "After that, I strongly recommend moving to a larger city to increase your odds of finding a match."

Moving. She'd just done that. Packed everything away in cardboard boxes. Secured a cosy unit in a neighbourhood she loved. Picked up her whole life and threw it off into the distance. She didn't want to do that again. And what about Melissa? She was so close to graduating. She had friends here. She had friends and a life she loved. Anna had promised her things would be easy now. She promised her they would stay in their little unit away from their father and they would be happy. How could Anna take all of that away from her?

And there was the shop, too. Anna's business. She had renovation plans. She was going to swap out all the lights, buy nicer shelves and things for the kitchenette in the back. A new coat of paint had been on her mind. How could she paint if she was in Seattle?

"You don't have to decide on everything now." Dr. Cullen smiled reassuringly at her. His pager beeped, and he glanced down at it. His expression changed into something far more grim. "Someone will be in to do the HLA soon. Excuse me."

He left the room.

-o-

Her blood was drawn without issue and sent off to the hospital's laboratory. A few hours later, a nurse was in her room. She perched on a rolling stool and went over all the ways Anna's life was about to change.

No more energy drinks. Eight hours of quality sleep every night. Daily walks to get her cardio in. Less salt, less deep-fried food. She'd hadn't expected the bit about eating less canned food, less cured and smoked meat. The whole time Melissa sat in the corner, bobbing her head along, agreeing with it all.

"Overweight and obesity put additional strain on your heart," the nurse said.

Anna zoned out after that. Her heart condition was genetic. Didn't the nurse know that? She knew her lifestyle choices certainly weren't helping, but talking about her daily habits was less offensive than talking about her shape.

She turned her attention to the monitor next to her bed. Irregular lines jumped over the screen with each beat of her heart. The lack of a pattern irritated her. Her fingers twitched with the desire to reach out and pull at the peaks and throughs so each pulse was the same.

Thankfully, the nurse's comments on her body were quickly interrupted. Dr. Cullen entered the room. He didn't even apologise for his harsh entrance, the way he cut off the nurse.

"A heart has become available," he said. "It's a match. It's yours if you consent to surgery."

Her eyes widened. So soon? So quickly? Just like that, a heart was falling into her lap? A blessing she was certain she didn't deserve. She stared dumbly at the doctor, wondering what the catch was. There had to be one. There always was.

"Anna?"

She blinked, and drew a stuttering breath. Nodded numbly.

Dr. Cullen turned to the nurse. "Prep her for surgery in Theatre Two."

He looked back at her before he left the room. His expression nearly crushed her. Anna understood. Someone had passed. Her hope could only come from another's grief. If she was to live, it meant someone else was to die.

The air shook in her lungs as she exhaled. Under her breath, she whispered her gratitude.

-o-

Apologies for any medical inaccuracies. More Paul in the next chapter :)