Your Heart Belongs to Me

could do nothing, perhaps he had busied himself seeking a bogeyman whom he could more readily engage in battle.
    When they arrived at the medical building in which Dr. Gupta had his offices, the limo curbed in a no-parking zone.
    Ryan slid Teresa’s photograph into the manila envelope.
    The chauffeur got out from behind the wheel and stepped to the rear of the car to open Ryan’s door.
    In the grip of unreason, Ryan took the dead woman’s photograph with him, not to show it to the cardiologist, merely to be able to hold it, as if it were a talisman, the power of which might prevent him from descending the final steep step between resignation and despair.
     

 
    TWENTY-TWO

    C ardiomyopathy,” said Dr. Gupta.
    He sat with Ryan not in an examination room but in his private office, as though he felt the need to deliver this news in a less clinical, more reassuring environment.
    On a shelf behind the desk, in silver frames, were photos of the physician’s family. His wife was lovely. They had two daughters and a son, all good-looking kids, and a golden retriever.
    Also on the shelf stood a model of a sailboat, and two photos of the Gupta family—dog included—taken aboard the real vessel.
    Listening to his diagnosis, Ryan Perry envied the cardiologist for his family and for the evident richness of his life, which was a blessing quite different from—and superior to—riches.
    “A disease of the heart muscle,” said Samar Gupta. “It causes a reduction in the force of contractions, a decrease in the efficiency of circulation.”
    Ryan wanted to ask about cause, the possibility of poisoning that Forry Stafford had mentioned, but he waited.
    Dr. Gupta’s diction was as precise as ever, but the musicality of his voice was tempered now by a compassion that imposed on him a measured solemnity: “Cardiomyopathies fall into three main groups—restrictive cardiomyopathy, dilated, and hypertrophic.”
    “Hypertrophic. That’s the kind I’ve got.”
    “Yes. An abnormality of heart-muscle fibers. The heart cells themselves do not function properly.”
    “And the cause?”
    “Usually it’s an inherited disorder.”
    “My parents don’t have it.”
    “Perhaps a grandparent. Sometimes there are no symptoms, just sudden death, and it’s simply labeled a heart attack.”
    Ryan’s paternal grandfather had died of a sudden heart attack at forty-six.
    “What’s the treatment?”
    The cardiologist seemed embarrassed to say, “It is incurable,” as if medical science’s failure to identify a cure was his personal failure.
    Ryan focused on the golden retriever in the family portrait. He had long wanted a dog. He’d been too busy to make room for one in his life. There had always seemed to be plenty of time for a dog in the years to come.
    “We can only treat the symptoms with diuretic drugs to control heart failure,” said Dr. Gupta, “and antiarrhythmic drugs to control abnormal rhythms.”
    “I surf. I lead a fairly vigorous life. What restrictions are there going to be, how will things change?”
    The cardiologist’s hesitation caused Ryan to look away from the golden retriever.
    “The primary issue,” said Dr. Gupta, “is not how restricted your life will be…but how long.”
    In the physician’s gentle eyes, as in a fortuneteller’s sphere, Ryan saw his future.
    “Your condition is not static, Ryan. The symptoms…they can be ameliorated, but the underlying disease is not arrestable. Heart function will steadily deteriorate.”
    “How long?”
    Dr. Gupta looked away from Ryan, at another photo of his family that stood on his desk. “I think…no more than a year.”
    Wednesday night, writhing in pain on the floor of his bedroom, Ryan had expected to die right there, right then. In the days since, he had anticipated being felled at any moment.
    A year should, therefore, have seemed like a gift, but instead the prognosis was a psychic guillotine that cut through him, and his anguish was so intense that he could not speak.
    “I could tell you about advances in adult stem-cell research,” said Dr. Gupta, “but there’s nothing coming within a year, perhaps nothing ever, and you aren’t a man who would take comfort in such wishful thinking. So there is only a transplant.”
    Ryan looked up from the envelope containing Teresa’s photograph, which he gripped with both hands, as if it were a buoy keeping him afloat. “Heart transplant?”
    “We’ll register you with UNOS