Page 2 of The Don’s Omega

I move toward the chairs, but I can’t sit. I’m way too wound up. I stand near the doors with my arms crossed and my fingers digging into my own biceps. I’m trying to keep it together, but no info is literally torture. I watch every person in scrubs who passes through like I can will one of them to stop and talk to me. But it’s not working because no one tells me shit.

Twenty minutes pass and it feels like an hour. Then a doctor pushes through the double doors and says my name. When I meet her gaze, she waves me over, and I’m following her down a hallway.

“Your brother was conscious when the paramedics brought him here.” The doctor is walking fast and talking faster. She’s an alpha, maybe my age, dark hair pulled back, and she has the kind of calm that I recognize as professional. She’s not calm because things are fine. She’s calm because she’s looking at things analytically and not emotionally, like me. “He was experiencing significant chest pain, shortness of breath, and a rapid, irregular heartbeat.”

“Is he okay?” Because, let’s face it, that’s all I care about.

“He’s stable,” she says emotionlessly. “We’ve run an EKG, blood work, a chest X-ray, and an echocardiogram. The EKG shows an abnormal rhythm, and the echo shows significant thickening of the heart muscle with obstruction to blood flow.”

My anxiety grows. She said he’s stable, and that word should make me feel better, but it doesn’t. I can tell from her face and her tone of voice that there are bad things coming. My gut is churning so hard, I’m surprised I don’t puke from the stress.

“So, what’s actually wrong with him?”

She grimaces. “Let’s talk in private.”

Yeah, that’s not good.

Things must be dire if she doesn’t want to tell me out in the hallway. She takes me to a small room that has two chairs and a box of tissues on a side table. The fact that they have a room set aside specifically for conversations like this makes my stress levels rise.

“What’s going on?” I ask, trying not to freak out.

She clasps her hands in her lap. “Well, your brother collapsed because he has a condition.”

“Okay.” I swallow hard. “What kind of condition?”

She grimaces. “It’s called hypertrophic obstructive cardiomyopathy,” she says. “HOCM for short.”

Just the name alone gives me anxiety. I know it’s really bad just because there are so many words and syllables. “I’m sorry, I don’t know what any of this means. Can you please just tell me what’s happening in normal words?”

Her cheek twitches. “Sorry. HOCM means that the muscle of his heart, specifically the septum, the wall between the two lower chambers, has thickened significantly. It’s obstructing the blood flow out of his left ventricle.”

I’m listening. I’m hearing the words. But I’m not understanding the meaning.

“Is that why he collapsed?”

“Almost certainly. The obstruction can cause arrhythmias, which is what we saw on his EKG. In a case like your brother’s, where the thickening is this pronounced, the risk of sudden cardiac events is real.”

Sudden cardiac events. I know what that means. She means his heart could stop.

“What do we do?” I ask, because that’s the real issue. I don’t ask why him or how it could have happened to such a nice kid. None of that matters. All that matters now is how do we fix this? Because the answer to that is always the same for me when it comes to my brother: Whatever it takes. I’ll do that.

“He needs surgery.”

“All right.” I grit my teeth.

She sighs watching me. “It’s a procedure called a septal myectomy. A surgeon removes a portion of the thickened septum to open up the outflow tract and restore normal blood flow. It’s an open-heart procedure, so it’s significant, but for patients Fabio’s age with his level of obstruction, the outcomes are very good.”

“Okay. Let’s do it.”

She hesitates. That hesitation is where my anxiety spikes yet again. I can tell from her expression that there’s a roadblock.

“The surgery is highly specialized. There are only a small number of cardiac surgeons in the country who perform it regularly. The closest one to us is at Penn Medicine in Philadelphia. We’d need to transfer Fabio’s care, coordinate pre-operative testing, schedule the surgery itself, and then plan for several months of cardiac rehabilitation afterward.”

“Okay,” I say again, slower this time, because I can feel where this is going.

“I want to be straightforward with you about the financial picture. This is not a routine procedure at a local hospital. Between the surgeon’s fee, the facility costs, anesthesia, the ICU stay, the pre-op workup, and the cardiac rehab program, the billed charges could easily exceed two hundred thousand dollars. Possibly more, depending on how the recovery goes.”

Her terrifying number just hangs in the air between us. I made twenty-six thousand last year. Two hundred thousand dollars might as well be two hundred million.