Maria Delgado has worked for the chamber of commerce for five years but this is the first year she has been in charge of the annual Christmas parade. She wants everything from the floats to the food trucks to the games and booths to be exceptional. Normally, a man or woman is chosen by chamber members to sit atop the lead carriage in the processional and to host the day’s festivities as the grand marshal, but it was her idea to have the residents of Grandon vote for the GM this year. As she gathers her purse and coat, Maria sticks her head into the office of Jessie Klein, the chamber president. “Just wanted to remind you that I’m taking Cassondra to the doctor.”
Jessie looks up from her computer. “Is this just a follow-up or is there more going on that I don’t know about?”
Maria smiles. “Just a follow-up. Dr. Andrews assured us that her heart is ticking right along like it’s supposed to.”
A year earlier, Maria and her husband, Craig, were at home with Cassondra and her older brother, Aidan, who were running and chasing each other in the back yard, when Cassondra collapsed, her body seizing. Aidan screamed for his parents, and as they ran across the deck and down the stairs they could see her crumpled in the grass. When Craig scooped her into his arms, her eyes fluttered open.
They raced her to the emergency room where a doctor assumed it was something neurological but could not say that with certainty, and issued a transfer to the nearby Children’s Hospital. One test after another was performed with nothing definitive revealed. A seizure two weeks later led them to a neurologist named Dr. Leonard Craig. Antiseizure medication was prescribed and months went by without another episode, until six months ago when Cassondra seized again.
Dr. Craig recommended that Cassondra see Dr. Nathan Andrews, a pediatric cardiologist. “Sometimes,” Dr. Craig said, “seizures aren’t related to the brain after all but to the heart. I’d like to send you to Dr. Andrews for further tests.”
Dr. Andrews looked to be in his thirties with short, sandy-brown hair and blue eyes when he entered the hospital room where Cassondra and Maria and Craig waited. They were anxious as he stuck out his hand. “I’m Dr. Andrews,” he said, shaking each of their hands. When he got to Cassondra he stood by the hospital bed and said, “Well! You are just the prettiest thing I’ve seen all day!” She grinned and folded her hands in her lap. “Don’t tell my wife I said that. She can be insanely jealous.”
Maria and Craig never sensed that he was in a hurry to get to another patient. He had a file with him but it was closed. “Are you in school yet?” Cassondra nodded. “Let me guess. You are in seventh grade.” She shook her head. “Twelfth grade!” She laughed and shook her head again. “Don’t tell me you’re already in college.”
“Kindergarten!” she said, laughing.
“Kindergarten! You mean with ABCs and 1,2,3, and crisscross applesauce?” She nodded, smiling. “What is your favorite part about kindergarten?”
She thought, resting her chin on her index finger. “I like math tubs.”
He crossed his arms, looking impressed. “Math tubs? Is that like a bathtub but instead of water it’s filled with numbers?”
“They’re filled with math games!”
He nodded. “And you get this love of math from which parent?”
“Neither,” Maria said, smiling.
“They don’t like math,” Cassondra said.
“So you are going to have to be the one at the grocery store figuring out the best price for the macaroni and cheese when your mom buys it or at the dealership when your dad goes to buy a new car, right?” She nodded and Maria and Craig relaxed. Dr. Andrews was not in a hurry. He was going to take the time that he needed to get to know his newest patient. “From what I understand, you have a big brother. What’s he like?”
“He’s good,” Cassondra said.
“He’s good? When I was a kid I don’t think I would’ve described my sister as being good.” He leaned in, whispering to her. “Did he tell you to say that in front of your parents? Is he holding something over your head?”
She laughed, opening her hands on her lap. “No! I’m serious. He’s good. He’s okay. He can be mean sometimes but not all the time.”
Dr. Andrews nodded. “Ah! That sounds more like it. I could be mean sometimes, too. What’s your brother’s name?”
“Aidan.”
“You were playing with Aidan outside one day when you fell in the yard. Is that right?” She nodded. “What were you and Aidan doing?”
“We were playing Star Wars with our dog.”
He looked captivated. “And who were you and Aidan?”
She shrugged. “He was a storm trooper and I was a Jedi.”
“Just as I assumed! And who was the dog?” Maria and Craig smiled, listening to them.
“He didn’t have a name. Just a bad guy with the dark force that I was fighting.”
“So you were running around the yard, chasing each other?” She nodded. “And two weeks later when you had another seizure, what were you doing?”
Cassondra looked at her parents. “She was at a birthday party,” Maria said.
“What was she doing at that time? Eating cake? Playing a game?”
“It was at a place where there are trampolines and big pits filled with foam balls. Things like that. She had just gotten off a trampoline with a friend.”
Dr. Andrews was still not referring to the folder in his hand, but it was obvious he had already read through it. “And when she got off was that the moment she began to seize?” Maria nodded. “The next few months brought no other seizures but then what happened late yesterday?” He looked at Cassondra, wanting to hear it from her.
“I was swimming at our community pool and a bunch of us were playing mermaids and we were swimming to get away from the sea witch.”
“And who was the sea witch? The dog again?”
“No! Dogs aren’t allowed in the pool! Katrina was the sea witch because she can swim fast.”
“So the faster Katrina swam the faster you swam?” She nodded.
It was here that Dr. Andrews finally opened the folder and looked at Maria and Craig. “Were you with her?”
“I was,” Maria said. “Craig was at a job interview. His company downsized and he’s been…” Dr. Andrews can see on their faces that the last few months have been stressful and nods for her to continue. “One of the kids saw her immediately and started screaming. I jumped in along with some other adults and the lifeguard and we got her out.” Maria wiped her face and cleared her throat, reminding herself not to get too emotional in front of Cassondra. She didn’t want her to be afraid.
“And there has been no major illness or heart surgery prior to this?” Maria and Craig both shook their heads. Dr. Andrews looked at Cassondra and asked, “How do you feel right now?”
“Good.”
He smiled, placing his hand on her head. “Well, let’s make sure that you stay feeling good, okay?” She nodded and he closed the file. “I’m going to take a listen to your heart, all right?” She leaned forward and he put his stethoscope first on her chest and then her back. “You know you have a heart that sits right about here,” he said, touching her chest. “And it is an amazing organ! When it works right it’s wonderful but when there’s a glitch in it things aren’t so wonderful and somebody might not feel so good.” He crossed his arms and looked directly into Cassondra’s eyes. “Now, I want to try to explain this to you in a way that you can understand. So if you don’t understand I want you to tell me, okay?” She nodded. He pulled a cartoon picture of a heart out of the folder, pointing to it as he spoke. “Everybody is born with their own natural pacemaker inside their heart. The upper chamber sends out a signal and that moves to the lower chamber and the ventricles squeeze and blood gets pumped all through your body. All the way down to your toes and back. Isn’t that awesome?”
She nodded and he continued. “The cells inside your heart are called pacemakers because if you’re exercising they need to work faster, and if you’re sitting around and watching TV with your dog, then they work slower. Those cells send out little electrical pulses and regulate the pace of your heart. Make sense?”
She shrugged. “Sometimes, babies are born with a glitch somewhere in that system. A glitch means that there is some sort of little issue that might be causing a roadblock, which means that the little electrical impulse isn’t working right and blood can’t get all the way to your toes after all and that’s called an arrhythmia, a doctor’s word for a heartbeat that’s too fast or too slow or irregular. So!” He patted her on the leg. “When I listened to your heart with this,” he said, indicating his stethoscope, “I didn’t hear anything unusual, but your history clearly tells me that we need to test your heart so we can get to the bottom of all this seizure stuff. Does that sound all right?”
“Do the tests hurt?”
He opened his arms wide. “Do I look like the kind of guy who would put my patients through tests that hurt? I’ll tell you who that hurts … It hurts me that you would even think that!”
“So they don’t hurt?”
Dr. Andrews laughed. “No, they don’t, but you can pretend that they do so that the nurses feel sorry for you and give you a handful of candy. How does that sound?”
It sounded just fine to Cassondra, and after she’d had the tests she was happy to relay back to him that they indeed did not hurt!
Two days later Dr. Andrews implanted a pacemaker inside Cassondra’s chest. If the length of time stretched too long between heartbeats, the pacemaker would send out an electrical impulse to make her heart contract and beat. “When can it come out?” Cassondra asked prior to the surgery.
“More than likely it will be there for the rest of your life,” Dr. Andrews said. “The battery can last for years and you’ll just get that changed out when needed, and as you grow and get bigger we’ll need to change out the wires to longer ones.”
“Can I still play Star Wars and mermaid?”
“Absolutely! But I would advise against boxing or football.”
When Cassondra and Maria followed up with Dr. Andrews two weeks later it was inside his medical office. A nurse led them to the office and they looked at pictures on his wall and his desk of his wife and two children as they waited. Cassondra noticed a wooden box on the bookshelves behind Dr. Andrew’s desk and walked to it, opening the lid, noticing an L scratched into the underside. “Cassondra,” Maria said. “Don’t touch his things. Come back on this side of the desk.”
“It’s so beautiful,” Cassondra said. “I could pretend it held dreams and when I opened it I could be right in the middle of them!” She traced her fingers over words engraved on the top. “What does this say?”
“It says,” Dr. Andrews said, entering the room, walking behind the desk and reading the words, “‘The Lord says, “I will guide you along the best pathway for your life. I will advise you and watch over you.” Psalm 32:8.’”
“We’re so sorry, Dr. Andrews,” Maria said. “Cassondra, come over here please.”
“Don’t be,” Dr. Andrews said. “She wasn’t hurting anything. I think it’s beautiful, too.” He picked up the box and held it in front of him. “My wife found this at a garage sale a year or so ago and thought it’d look good sitting in my office. She loved what it said because it’s kind of like both of our lives: how I became a doctor and how she survived a heart defect of her own and a liver transplant when she was a young woman.” Cassondra’s eyes widened as she listened. “But you know what? I never knew what to put inside of it. That’s why it’s still empty. You, however, saw it and immediately knew that it could hold dreams, so why don’t you have it?” He held it out and Maria leaned forward in her chair.
“Oh, no, Dr. Andrews! She couldn’t take that.”
“Why not? I completely missed its purpose and Cassondra took one look at it and knew what it was for. I’d like her to have it. Would you like it?” Cassondra smiled and he put the box in her hands. “There you go, pretty lady! I hope all your dreams come true!”