Heart's A Mess: Chapter Eleven

“Do I see a carrot in your hand?” her voice barely concealed her incredulity.

“Desperate times J…desperate times.” Khushi sighed, munching on the end of the nauseatingly orange root vegetable.

“It must have been the only thing left in the fridge.” Shagun remarked slyly.

Using the carrot as an extensor of her middle finger, Khushi let Shagun know just how she felt. With 

her feet up on the desk and crossed at her ankles, she leaned back into the plush leather of her chair and took a few minutes to eat lunch with the girls.

“Where’s Meg?”

“She’s been rostered to Parker’s valve repair this afternoon.”

Jahnvi and Khushi barely concealed their grins. Waggling her eyebrows devilishly Khushi plotted. 

“A whole afternoon with Parker? Remind me to give her hell about it later yeah?”

“Why would you need reminding?”

She shrugged, munching on her ridiculously healthy salad mix. “I usually forget these kind of things. Blech! This literally tastes like it’s come from the rear end of a horse.” Making a face she tried to chase down the taste with a green organic juice mix. The disgust on her face became even more pronounced as she tried desperately not to hurl the entire thing. “I didn’t think it could get any worse.”

Shagun shook her head. “Khushi you always start these health kicks only to go back to eating Mcdonalds the next day. I don’t know why you even bother anymore.”

“Danes has been on my back about the whole healthy eating thing and I stick around in the hope that one day it won’t be a kick and I can make it my lifestyle. ”

Jahnvi and Shagun looked at one another and rolled their eyes. They wouldn’t be holding their breath.

“Did you hear about Linda?” Jahnvi whispered conspiratorially.

Khushi frowned… “The nurse on night duty? No…why? What happened?”

“Oh it was so romantic…” Jahnvi sighed.

Shagun couldn’t help but smile at her friends hopeless romanticism. “A patient who had come in to the ED the night before came back the next day with a big bunch of flowers to ask her out.” 

She filled Khushi in.

“He got down on one knee and everything in front of everyone.” Jahnvi extrapolated on the details unsatisfied with Shagun’s somewhat clinical explanation.

Ordinarily such incidents would wash over Khushi as she remained caught up in the latest medical journal or patient labs. Today however she couldn’t help but smile as she remembered how one particular man had slept on the uncomfortable chairs of the waiting room …flowers in hand.

“Good god…hell must have frozen over. Gupta’s smiling at a soppy romance.” Shagun teased.

Khushi rolled her eyes as Jahnvi giggled asking… “How are you and dream boat going? You never tell us anything!”

“There’s nothing to tell.”

Shagun snorted ungracefully. “Oh come on. J can have all the soppy details just tell me…is he a good kisser?” Waggling her eyebrows she enjoyed the horrified look on Khushi’s face.

“That is personal!”

“Oooooooh” Jahnvi squealed and clapped like an excited seal. “That means you have kissed.”

Khushi blushed bright red as they laughed and stood up. “Just…just go away!”

Pulling her back down into the chair, it took a few minutes before their laughter slowly subsided.

“It’s just funny seeing you like this. You’re a kick ass surgeon who doesn’t take crap so to see you like the rest of us is humbling and makes us feel better about ourselves.” Shagun explained to an annoyed Khushi. After a moment of contemplative silence Shagun grinned again… “So tell me…is he?”

Relenting with a frustrated huff she tried to look as nonchalant as possible… “Earth shattering.”

All three girls looked down at their lunch grinning away. “I take it things between you guys are good then?”

Khushi munched away thoughtfully. “They are but I’m scared that its too perfect. Guy’s aren’t supposed to be so….so interested? Are they? From what I’ve heard and my experience the end game seems to be sex but he…he keeps talking about our future children.”

Shagun dropped her lunch.

Jahnvi and Khushi turned to look at her. “You ok?”

“Uh…yeah. It’s just um….god you’re a lucky cow. You know that Khushi? Do you know how many guys I had to date before I found one that would say that to me?”

“I don’t understand…”

“When Gaurav and I were dating he would drop casual jokes about kids all the time." Her voice dropped down to a whisper as her eyes faded to a distant place. "And now...now no matter how hard we try I can't get pregnant. Us having kids has literally become a joke." Her voice was dripping with bitterness. 

Khushi and Jahnvi rushed to console Shagun who was now crying into her hands. Jahnvi hugged her tightly... "Why didn't you say anything?"

Not a person to advertise her problem, Shagun quickly wiped her tears. "I...I became overly emotional. It's not that bad. We still have to try IVF and adoption is always an option. It's just that sometimes it's all a bit much."

Khushi not knowing what to say nodded in support. 

"Am I interrupting?" a familiar voice called out.

Arnav stood on the other side of the nurses station looking at the girls curiously. Shagun sat up and smiled, her voice still a little hoarse. "Nothing....what are you doing here hot shot? Don't you have a business to run?"

He let out a lazy grin to which Jahnvi giggled. "I'm my own boss. It's handy. Gupta and I are on for dinner tonight but if she's busy I could always take you." He winked.

Shagun put up her hand. "Someone already put a ring on it dreamboat."

He sighed dramatically, flinging his arms up to then heaven. "Why GOD!? Why!? Well... I guess I'll just have to settle for Gupta then won't I?"

Khushi rolled her eyes at the two of them. "Dinner? We just started lunch."

Arnav looked at his watch just to be sure. "Uh Gupta...It's 5.00 pm."

"So? I've had a busy..." She began to argue.

Jahnvi who was still flustered around Arnav turned to Khushi..."As if you've eaten more than two bites of that anyway. Go have an early dinner. I'll get Morrissey to do your ward cover."

Feeling particularly exhausted she threw her salad in the bin and grabbed her stuff. Giving Shagun a quick hug she whispered..."Call me anytime. We'll talk ok?"

"Yes...yes. Now go!" Shagun nodded shoving her toward Arnav. 

Slinging his arm around her shoulder, he walked her down the corridor toward the lifts. Their conversation filtered down the hall...

"Where are we going for dinner?"

"Your place."

"Raziada...I'm not cooking."she grumbled. 

"Don't flatter yourself Gupta. You're not that good a cook."

"I can't have take out either. I'm on a health kick."

Arnav snorted. "Uhhh...sure....I believe you."

"Why is everyone saying that?" she complained like a child.

Squeezing his arm around her shoulder tight he dropped a kiss on her temple. "That's because you eat like a horse Gupta."

"What!"

"You do. Don't worry though, I'll make something tonight that will be healthy and delicious."

The doors to the lift pinged open and they stepped. "But you can't cook!"

"No... you just presumed...I didn't correct you. I liked it when you taught me anyway."

"What the fu...." 

The doors pinged closed.

***************************************************************************** 

"Hey Khushi!" Matt grinned at her widely. 

Khushi looked at him sceptically. "What do you want?"

Pretending to be wounded he looked at her with doleful eyes. "Can't I just say hi without wanting something."

Raising her eyebrows she resumed the mundane process of charting. She counted in her head to see how long he could last...1...2...3...

"Ok so I need a favour."

Khushi grinned up at him. "Three seconds Parker. Pathetic. Have a little more will power will you?" Leaning back, Khushi pretended to give the idea much thought, tapping her pen against her chin. "Hmmmmm fine....but only if you do me one."

Matt hit his head against the desk. "Ugghhh....what do you want?"

"Do us all a favour and just ask Meg out! We're sick of watching you two stare at each other like love sick puppies."

Matt stood up lightening fast. "Each other? You mean she looks at me too?"

"As if you didn't know it."

"Ummm I wasn't sure. You think she'll say yes?" he held his breath waiting for her answer.

"If she doesn't I'll twist her arm until she does. Okay?"

Shrugging as it were nothing he replied..."Yeah I'll do it. Only because you asked though."

Khushi shook her head. Men. They thought they were soooo cool. "I don't have all day sunshine. What do you need?"

"A consult."

"From me? Why don't you go to Danes?"

"See that's the thing. I want to present a recommendation to the board. In my opinion this patient deserves to go on the recipient list for a heart transplant. But the situation is a little complicated..."

"Complicated?"

"I'm getting to that part. I know you have Danes's ear. He listens to you."

"Woah...I'm not taking advantage. You can forget it. It's not happening." Khushi said with finality.

"Look I'm not asking you to take advantage...just...just listen ok? Then make up your mind."

Khushi looked at Parker. He almost looked desperate. Giving in she decided that listening to him wouldn't hurt. 

"Ok I'm listening but I'm not promising anything else. Hit me with it."

"The patient is in their thirties with a history of Rheumatic Fever and RHD. Subsequently developed undetected mitral regurgitation. By the time it was detected the transitional phase was favouring decompensation."

"Can I have a look at the file?"

Parker handed over the thick folder. Khushi skimmed still listening..."The regurgitant fraction is 54% but the patient is currently exhibiting no real symptoms. There are signs of fatigue and light headedness with excessive activity but nothing more than that."

"Pulmonary hypertension..."

"Not as yet but likely to develop."

"Oh come on Parker" Khushi laughed "...that's a stretch isn't it?"

"I don't think it is. Look at the ECHO. That's congestive heart failure right there."

Khushi had a look at the latest report. Matt was right.

"What I don't understand is how the regurgitation managed to progress that fast?"

"For a time in the patient was subject to abject poverty. The living conditions were unsanitary...they didn't have access to the proper kind of prophylaxis. So the fever was recurrent compromising the valve."

"Well it all seems legit. I don't know why you need me. Danes would take it to the board. Obviously it would take time before..."

"There is a slight problem." Matt said looking everywhere but at Khushi.

"Spit it out Parker." her tone was dangerously even.

"I've never done a physical on the patient neither has anybody at the hospital. And they've never been admitted either."

Khushi opened and closed her mouth in shock. "So you're telling me no one in this hospital has done a work up?"

Matt shook his head in the negative holding his breath. 

She burst out laughing shoving the file back in his hands. "Great joke."

"I'm not joking Gupta."

Immediately she stopped laughing and scowled. "Neither am I. Are you crazy. You want me to loose my job? Do it yourself."

"Look I wouldn't ask if I wasn't desperate."

Khushi looked at the despondency splashed across his face and rubbed her head tiredly. "Can't you get the patient in for a physcial one time."

"There are privacy issues. They don't want to be recognised. It could have negative effect on their career if they were to be recognised by anyone here."

"Do the physical off site if you have to."

"Do you reckon that will hold up?"

"Why not? If you can do that I'll take this to Danes. Let me read through this in more detail tonight though."

Parker smiled in relief, sagging against the counter. "Your a champion Gupta."

"Yeah yeah....whatever..."

He smiled. "Seriously I appreciate." Walking away he had a skip in his step. Stopping he turned around and yelled..."I forgot to mention the patient's a Type 1 Diabetic...it might help with the UNOS registry."

Khushi shooed him away. Her pager beeped. Pushing herself back from the swivel chair she stood up. The tab on the file caught her attention.

Presenting PATIENT: Anjali Singh Raizada

Referring Doctor: Dr. A. Mathur

******************************************************************************

N/B: One of the non-modifable risk factors for Diabetes Mellitus Type 1 is having genetic susceptibility.

I know this update was very technical but it is important. All you need to know is that a heart transplant is required. All doc's out there reading this...I am not a cardiac specialist please grant me leave to screw this up.

Oh and I just re-read chapter 49 and 50 of YLME and fell in love with myself. Ok....exaggeration but I loved it. GO read it! It will make you smile!