“He won’t take his bottle,” said the maternal Duchess, ignoring my compliment. “Channy always took her bottle. Carter won’t.”
Just then a nurse walked into the room. She took Carter from the Duchess and started to give him his exit exam. I was still packing the bags when I heard the nurse say, “My, my, my, what wonderful eyelashes he has! I don’t think I’ve ever seen such beautiful ones on a baby. Wait until he unfolds a bit. He’s gonna be awfully handsome, I bet.”
The proud Duchess replied, “I know. There’s something very special about him.”
And then I heard the nurse say, “That’s strange!”
I spun on my heel and looked at the nurse. She was sitting in a chair, holding Carter—pressing a stethoscope against the left side of his chest.
“What’s wrong?” I asked.
“I’m not sure,” replied the nurse, “but his heart doesn’t sound right.” She seemed very nervous now, compressing her lips as she listened.
I looked over at the Duchess, and she looked like she’d just taken a bullet in her gut. She was standing, holding on to the side of the bedpost. I walked over and put my arm around her. No words were exchanged.
Finally the nurse said in a very annoyed tone: “I can’t believe no one’s picked this up. Your son has a hole in his heart! I’m certain of it. I can hear the backflow right now. It’s either a hole or some sort of defect with one of the valves. I’m sorry, but you can’t take him home yet. We need to get a pediatric cardiologist up here right now.”
I took a deep breath and nodded slowly, vacantly. Then I looked at the Duchess, who was in tears—crying silently. In that very instant we both knew our lives would never be the same again.
Fifteen minutes later we were in the lower bowels of the hospital, standing in a small room filled with advanced medical equipment—banks of computers, monitors of various shapes and sizes, IV stands, and a tiny examining table, on which Carter was now lying naked. The lights had been dimmed and a tall, thin doctor was now in charge.
“There, you see it?” said the doctor. He was pointing his left index finger at a black computer screen, which had four amoebalike swaths in the center of it, two of them red, two of them blue. Each swath was the size of a silver dollar. They were interconnected and seemed to be draining into one another in a slow, rhythmic fashion. In his right hand he was holding a small device, shaped like a microphone, and he was pressing it against Carter’s chest and moving it in slow, concentric circles. The red and blue pools were echoes of Carter’s blood as it flowed through the four chambers of his heart.
“And there,” he added. “The second hole—it’s a bit smaller, but it’s definitely there, between the atria.”
Then he turned off the echocardiogram apparatus and said, “I’m surprised your son hasn’t gone into congestive heart failure. The hole between his ventricles is large. There’s a strong likelihood he’ll need open-heart surgery in the next few days. How’s he doing with his bottle? Is he taking it?”
“Not really,” said the Duchess sadly. “Not like our daughter did.”
“Has he been sweating when he feeds?”
The Duchess shook her head. “Not that I’ve noticed. He’s just not that interested in feeding.”
The doctor nodded. “The problem is that oxygenated blood is mixing with deoxygenated blood. When he tries to feed it puts a great strain on him. Sweating during feeding is one of the first signs of congestive heart failure in an infant. However, there’s still a chance he might be okay. The holes are large, but they seem to be balancing each other out. They’re creating a pressure gradient, minimizing backflow. If it weren’t for that, he’d be exhibiting symptoms already. Only time can tell, though. If he doesn’t go into heart failure in the next ten days, he’ll probably be okay.”
“What are the chances of him going into heart failure?” I asked.
The doctor shrugged. “About fifty–fifty.”
The Duchess: “And if he does go into heart failure? Then what?”
“We’ll start by giving him diuretics to keep fluid from building up in his lungs. There are other medications too, but let’s not put the cart before the horse. But if none of the medications work, we’ll need to perform open-heart surgery to patch the hole.” The doctor smiled sympathetically. “I’m sorry to give you such bad news; we’ll just have to wait and see. You can take your son home, but watch him carefully. At the first sign of sweating or labored breathing—or even a refusal to take his bottle—call me immediately. Either way, I’ll need to see you again in a week”— I don’t think so, pal! My next stop is Columbia-Presbyterian, with a doctor who graduated from Harvard!—“to take another echocardiogram. Hopefully, the hole will have started to close by then.”
The Duchess and I immediately perked up. Sensing a ray of hope, I asked, “Do you mean it’s possible that the hole could close on its own?”
“Oh, yes. I must have forgotten to mention that”— Nice detail to leave out, slime bucket!—“but if he doesn’t have any symptoms in the first ten days, then that’s most likely what’ll happen. You see, as your son grows, his heart will also grow, and it’ll slowly envelop the hole. By his fifth birthday it should be completely closed. And even if it doesn’t close completely, it’ll be so small that it won’t give him a problem. So, again, it comes down to the first ten days. I can’t stress it enough—watch him carefully! In fact, I wouldn’t take my eyes off him for more than a few minutes.”
“You don’t have to worry about that,” said a confident Duchess. “There’s gonna be at least three people watching him at all times, and one of them is gonna be a registered nurse.”
Rather than going to Westhampton, which was a good seventy miles to the east, we headed straight to Old Brookville, which was only fifteen minutes from the hospital. Once there, our families quickly joined us. Even the Duchess’s father, Tony Caridi, the world’s most lovable loser, showed up—still looking like Warren Beatty, and still looking to borrow money, I figured, once all the commotion died down.
Mad Max led the vigil, quickly turning into Sir Max—assuring the Duchess and me that everything would work out fine; then he went about making phone calls to various doctors and hospitals without losing his temper once. In fact, there would be no sign of Mad Max until the crisis resolved itself, at which point Mad Max would magically reappear—making up for lost time with vicious verbal tirades and belligerent smoking strategies. My mother was her usual self—a saintly woman who prayed Jewish prayers for Carter and offered moral support to the Duchess and me. Suzanne, the closet anarchist, chalked Carter’s holes up to a government conspiracy, which included the doctors, who, for some inexplicable reason, were in on it.
We explained to Chandler that her brother was sick, and she told us that she loved him and that she was glad we decided to bring him home from the hospital. Then she went back to playing with her blocks. Gwynne and Janet stood vigil, too, but only after they’d recovered from six hours of hysterical crying. Even Sally, my lovable chocolate brown Lab, got into the act—setting up camp at the base of Carter’s crib, leaving only for bathroom breaks and an occasional meal. However, the Duchess’s dog, Rocky, evil little bastard that he was, couldn’t have cared less about Carter. He pretended nothing was wrong and continued to annoy every person in the house—barking incessantly, peeing on the carpet, pooping on the floor, and stealing Sally’s food from her dog bowl, while she was busy sitting vigil and praying with us like a good dog.
But the biggest disappointment was the baby nurse, Ruby, who came highly recommended from one of those WASPy employment agencies that specialize in providing wealthy families with Jamaican baby nurses. The problem started when Rocco Night picked her up from the train station, and he thought he smelled alcohol on her breath. After she’d finished unpacking her bags, he took it upon himself to search her room. Fifteen minutes later she was in the backseat of his car, being led away, never to be heard from again, at least by us. The only fringe benefit was the five bottles of Jack Daniel’s that Rocco had confiscated from her, which were now in my downstairs liquor cabinet.