(2006) When Crickets Cry (17 page)

We had stepped onto the stone walkway that led up to the house when Charlie called out from across the lake, "Stitch? That you?"

"Yeah," I hollered back. "Brought my little cruise in for a tour of home. Charlie, meet Cindy McReedy and Annie Stephens."

Charlie waved his white stick while Georgia sat ready at his side. "Hi, ladies. You two look lovely. Just lovely."

Cindy looked at me, a little confused.

Charlie then turned side to side to show off his suit. He buttoned the top button and snugged up his tie. "I'm off to my dancing lesson. How do I look?" He wore a blue and white, threebutton seersucker suit with white and black penguin wingtips. Add a top hat, and he'd have looked like Chaplin.

"Charlie, you look ..." I smirked at Annie. `Just great."

"I know it," Charlie said, dusting his shirtsleeve with the back of his palm. "Let's just hope the ladies do too. Preferably, ones that smell good." He smiled, grabbed the cable that acted as a guide wire up the steps and into his house, said, "Ladies!" and then disappeared beneath the trees.

"Who is that?" Cindy said with a smile.

I took Annie's hand and began leading her up toward the house. "Oh, that's my brother-in-law, Charlie. He's ..."

I heard Cindy stop and take a short, quick breath that sounded like the end of it was squeezed off due to a constricted airway. Then I thought about what I'd just said.

I turned and held up my hands. "My wife, Emma, was Charlie's sister. She died almost five years ago."

Annie's hand tensed in mine, and the questions in Cindy's eyes disappeared, only to be replaced by twice as many more colored by shades of shared pain.

"I'm sorry," I said. "I ... Charlie will always be my brotherin-law."

Cindy's chest rose and fell as another deep breath filled her lungs, and the muscles in her face relaxed.

"We work on boats together, and he helped me build this house."

Annie was now holding my hand with both of hers. She pointed behind her. "But he's blind."

"I know," I said, my eyes following Charlie's suit up through the tree line. `Just don't tell him that."

She smiled and followed me up the steps. Halfway up she said, "Did he call you Stitch?"

I nodded and, opening the door and letting them into the back porch, told her the story of Charlie swinging like Tarzan with his Stretch Armstrong rope. Cindy turned her head as though she'd caught a whiff of something she liked to smell. "What's that?" she said, pointing her nose in the air.

"One of three things." I pointed at the green shoots sprouting up between the house and the lake that covered the underside of the trees like a bed of tall grass. "That's mint. Emma planted it here when we bought this place about seven years ago, and it spreads like kudzu. No weed whacker in the world can tame it."

They smiled.

"Or second, it's that rose-scented geranium at your feet. I bought it at your hardware store a few weeks ago because I liked the smell."

Cindy rubbed the leaves to activate the scent and then smelled her fingers.

"Or third"-I pointed toward the open window of my secondstory bedroom-"bachelors don't always do their laundry on time. Please tell me it's one of the first two."

Cindy smelled again. "Mint. It's the mint."

"Pick some, and I'll make tea," I said.

Cindy picked a few shoots while Annie and I put on a kettle to boil.

While the tea steeped, I gave them a tour. Annie noticed the many charcoal sketches and oil paintings decorating most every square inch of wall space in my home and asked, "You like art?"

"Some."

"These are really good."

I nodded.

"Is this somebody in New York or L.A.?" Cindy asked.

"No." I shook my head. "My wife."

Cindy folded her arms, looking cold again, while Annie examined everything. I gave them a tour including every room in the house save one: my office. I keep it locked and seldom go in except when necessity requires.

Cindy noticed one of Emma's early sketches of the lake and said, "That early morning, swirling-tornado look that spins across the lake just after sunup is one of my favorite times of day out here." She studied the painting some more. "She was talented."

I grabbed three glasses and began filling them with ice, then pointed a glass toward the shop. "Would you like to see the workshop?"

Annie nodded while Cindy poured tea and gave everyone a sprig of mint. We walked to the workshop, I turned on all the lights and punched Play on the CD player-Mozart.

"This is where you work?" Cindy asked incredulously.

I nodded. "Pretty nice, huh?"

"I'll say so." Annie looked over the tools while I explained how Charlie and I worked.

"And Charlie really helps you?" Cindy asked.

"You ought to see his chain-saw carvings. He's really pretty good."

"You're kidding."

"I promise," I said, pointing to the beam and hoist in the ceiling. "Charlie has great hands. He'd have made a great surgeon except for the fact that he liked working with wood."

Cindy looked at me and stepped closer, letting out one of the questions that had first pricked her fancy in the hospital. "You know a thing or two about surgeons?"

I smiled. "Only what I've read."

Cindy looked around her at the tools, the organization, the cleanliness. "This looks more like an operating room than a woodshop."

he human heart is remarkable in that it is designed to pump continuously for a hundred and twenty years without ever needing to be reminded what it was meant to do. It just does it. In all my reading and study, I have come to know one thing without any shadow of doubt: if anything in this universe reflects the fingerprint of God, it is the human heart.

While it pumps more than a hundred thousand times a day without stopping, funneling hundreds of gallons of fluid around the body, it derives no benefit from the blood it pumps, making it the most unselfish of organs. In order to feed itself, it siphons from its own flow then reroutes it through three main arteries that loop back around the outside of the muscle to feed itself. Two of these arteries feed approximately half the heart, and the third, largest artery-also known as "the widowmaker"-feeds the other half. If it becomes blocked with plaque, a condition known as coronary artery disease, the heart stops.

If caught early, this condition can be corrected with a stent or a bypass-taking an artery from another place in the body, like the leg or inside the chest wall, and rerouting the siphon.

If you've ever bought an old house with iron plumbing, you have some idea of how this works. Rather than remove all the old, you simply snake it to dislodge the clog-a temporary fix-or add new pipe to bypass it altogether-much more permanent. Following such surgery, it is not uncommon for an individual to leave the operating room with four or five bypasses and a rather expensive medical bill.

In the womb, a baby gains oxygen through its mother's lungs, which she sends, along with everything else the baby needs, via the umbilical cord. Baby's heart doesn't need to send blood out to the lungs to be reoxygenated; Mom has already taken care of that. To prevent the needless flow of blood through those tender, developing lungs, God created a small hole between the right and left atria-the top portions of the heart-that allows it, in utero, to bypass the lungs. At birth, a hormone called prostaglandin causes the hole to close and begins routing the blood into and out of the lungs. When that doesn't happen, and the hole doesn't close, it's called an atrial septal defect.

For most of us, things work pretty well until genetics, what we've eaten, or how we've lived catches up with us. Usually, that "catching up" is called a heart attack, which is nothing more than plaque clogging an artery and stopping blood flow to a portion of the heart. Anyone who's ever run the quarter mile knows what I mean. The first three hundred yards can be relatively fun, but by the last turn and final straightaway, the human body is so oxygendeprived the muscles are beginning to lock up, making the runner feel as if rigor mortis has set in. Experienced runners call the last fifty yards "the bear" because it often feels as if one has jumped on your back.

In truth, the muscles in the runner's legs have burned far more oxygen than the heart and lungs can supply. Extremely fit sprinters can minimize this through aggressive training, as can rowers, cyclists, marathoners, and others, but training has its limits. It cannot overcome genetics. The physical limitations of aerobic exercise are established by the volume of oxygen and blood the heart and lungs can send throughout the body.

God gives most of us mortals normal hearts and lungs. To others, He gives a little more. A slightly larger heart and lungs. Studies of long-distance athletes confirm this. And yet to other people, like Emma, He gives a little less. One thing my education never taught me was the reason for this.

When the human heart has suffered an attack, often the area that's been shut off from blood flow will die. Amazingly, even halfdead, the human heart still pumps. People can survive and live somewhat normal lives with only part of their hearts functioning, though it changes their lifestyles substantially. The heart is not only the most unselfish of organs, it is also the most courageous and faithful.

Emma's problem was not the buildup of plaque, but that her embryonic hole had never closed, causing a continual partial bypass of blood to her lungs. Many people walking around the planet right now suffer from the same problem, have no idea of its existence, and will never suffer a day for it. It's almost as common as a mitral valve prolapse-a common heart condition in which the last valve of the heart doesn't close all the way, allowing something of a backwash into the heart. Emma would have continued to lead a completely normal life had one thing not occurred. Her hole enlarged, resulting in a continual flow of oxygendepleted blood coursing through her veins.

As the hole enlarged, it further crippled her heart, causing the onset of the disease that would further enlarge it-a natural result of a muscle working overtime. The enlarged muscle fills up the cavity in which it lives and works, creating more pressure against the walls that house it, thereby decreasing the space it has to work in and, once again, causing itself to work that much harder and that much less efficiently. It's called dilated cardiomyopathy and is often described as increased volume in the heart, causing the muscles to dilate like an overinflated balloon. It's a problem that worsens exponentially rather than incrementally. It's like gaining forty pounds at the waistline while trying to wear a belt with only one hole. You can buy a bigger belt, but you can't enlarge your chest.

From the moment we are born, every human on the planet is dying. Emma was just dying at about six times the rate as the rest of us. And if during that slow death she looked perpetually tired, she was. Emma lived her entire life feeling as if she were running the last hundred yards of the quarter mile, always behind and never able to catch her breath.

My reading had taught me that Emma's heart was diseased, big and flabby, inefficient, and inherently weak. Nothing anyone could do to her present heart would do her any good. It was beyond repair and, after so much deterioration, had lost most of its elasticity. The very real danger that Emma faced was the popping of her balloon.

The heart, brittle, inelastic, and frail, will pop or tear, causing a hole in the side of the ventricle, through which blood will pour out into the pericardium, the nearly bulletproof sac surrounding the heart. The blood, now on the outside of the heart, fills up this sac, which is so tough it won't bust. This, in turn, places increased pressure on the heart, in effect suffocating it. In doing so, it places more pressure on the heart than it can pump, a condition known as pericardial tamponade.

In emergency situations, when there is no time to open the chest, the only way to alleviate the pressure is through pericardiocentesis- a doctor inserts a heavy-gauge needle through the sternum at about a thirty-degree angle to the patient, trying to avoid the lungs and pierce the pericardium to allow the blood to exit through the needle and decrease pressure on the heart. The problem now is that the patient has a hole in both the heart and the pericardium and is losing body fluids at a fantastic rate, which is dropping the blood pressure and further compounding the stress on the heart. It's a downward fall that can quickly spiral out of control.

The good news is that the heart is still able to pump. The bad news is that the heart is a lot like an old well pump; it works great as long as the prime is retained, but once that prime is lost, it's a devil to get going again. So, following the pericardiocentesis, the trick is getting the patient open and sewing up the holes while keeping the blood pumping and the body's fluid levels up.

And if I had known all this about the heart as a kid, I would have ripped open my chest, severed my own arteries, and given Emma mine.

t was nearly dark when we made it back to the dock. I had probably kept them out too late. Annie had dozed again, so while Cindy tied off the boat, I lifted Annie into my arms and she wrapped hers around my neck-a familiar sensation. One I missed. I walked slowly up to the house. As we neared the cricket box, raucous with noise and nighttime chatter, Annie raised her head.