“Do you have some time?” he asked. “Because I’d like to call Dr. Wanschu in pediatric cardiology to take a look at her.”
“What is it?” I said.
“I hear a murmur and her heart rate is too fast right now. If she were crawling or trying to walk the heart would be more active but she’s not involved with any activity right now. It shouldn’t be this fast.” He walked out of the room and I held Mia close to me. What could possibly be wrong?
“Can I hold her?” Emily asked, trying to wrangle Mia from my arms. I asked Emily to sit on a chair and handed Mia to her. She wrapped her arms around her as if she were carrying a load of firewood. We sat in the room for several minutes before the doctor came to see us.
“Hi, I’m Dr. Andrews,” he said, extending his hand to me. He looked too young to be a doctor.
“We’re waiting for Dr. Wanschu,” I said, assuming he had the wrong room.
“He’s unable to be here today,” the doctor said, taking a seat in front of Emily and Mia. “He seems to have caught some sort of virus.” First Sandra’s son and now the doctor. “Well, what’s wrong with your little sister?” Dr. Andrews asked Emily. I opened my mouth to explain the situation but Emily beat me to it.
“She’s not my sister.”
“She’s not?” the doctor asked, surprised. “Well, I just assumed she was because she’s just as pretty as you and looks a lot like your mommy.”
I groaned inside but still couldn’t get the words out fast enough. Mia was slipping from Emily’s lap and I picked her up.
“She’s not my mom,” Emily said, looking around me. “My mom died.” Dr. Andrews looked at her.
“I’m really sorry,” he said. “My mom died when I was a little boy.”
“Were you sad?” Emily asked.
“Yes. I was very sad.”
“Did you cry?”
“I cried a lot.”
She looked down at her shoes and thought for a moment. “Do you still cry?”
“Sometimes.”
Emily stood and put her arms around Dr. Andrews’s neck. She was comforting him. I knew then why Emily was supposed to go to the hospital with me. She sat back down in her seat and reached for Mia.
“I’m Patricia,” I said, handing Mia to Emily. “I’m a social worker and—”
“I realize that now,” Dr. Andrews said. “I’m sorry. It’s here on the chart and I should have read through it when I came into the room.”
“It’s okay,” I said, recalling Emily’s hug around his neck. He put Mia on the examining table and she began to cry. I watched as he worked with her, making her laugh as he ran his stethoscope over her chest and back. He was a good doctor. Emily stood close to his side and watched every move he made. When he finished his exam Emily reached her arms for Mia and Dr. Andrews handed Mia to her.
“Do you know if she’s ever seen a cardiologist?” he asked.
“I don’t know but I doubt it.” He was careful as he chose his words because Emily was in the room.
“How long has she been in the foster system?”
“We just took her to a home on Friday. The foster mother was concerned about her breathing this morning.”
He nodded. “I don’t think this is the first time Mia’s exhibited these symptoms but I do think you got her to us in time.” I wondered what would have happened to Mia if her mother had left her alone for another fifteen hours?
“What’s wrong with her?”
“She has a condition that’s called incessant atrial tachycardia.”
“The other doctor said she had a murmur.”
“A murmur is part of it. People can live their whole lives with a murmur. But when I put my hand on Mia’s chest I can feel the force of the heart striking the chest and when I listen I can hear an additional sound when the heart beats. A gallop.”
“What is that?”
“It’s an abnormal beat caused by an enlarged heart. That’s why she’s been sleeping so much but still seems tired and out of breath.”
I put my hand on Mia’s head. She was poking Emily and laughing. Mia had no idea she was so sick.
“What does all that mean?”
Dr. Andrews leaned against the examining table and crossed his arms. “We need to set her up in a step-down unit of the ICU for an electrophysiology study. That’s a test where we’ll put catheters into the heart that will deliver electrical impulses so we can map where the abnormal heartbeat is coming from. Once we determine where the abnormal beat is we’ll use one of the catheters to deliver a short controlled ‘burn’ to the heart tissue to eliminate the source of the irregular heartbeat.” I looked down at Mia in Emily’s arms. She was so tiny. How could her heart take all of that?