Witches of Rascar Pablo: Part I

Chapter 3: Electrophysiology

2:42 pm Thursday, May 18, 1984 (PDT)
Grants Pass, Oregon

Rachel never got grades as low as a B-. She sat in her English lit class – the last class of the day – looking at an essay handed back to her and loathing what her father might say. In her peripherals she could see that Jessica had an A-. It didn’t make sense. Her grades seemed to be falling.

She decided to stay after class to ask Mr. Fredericks, her English lit teacher who also happened to be her tennis coach, about the grade.

“Why don’t we talk about it tomorrow,” he told her, impatiently. “I have a parent-teacher appointment in a few minutes.”

Wrecked, Rachel’s throat swelled up with emotion. The hallways burst into a frenzy of departing students. Unable to hold back her tears, she ducked into the girls’ restroom. She looked on herself with disdain in the mirror.

“Weak,” she whispered, glaring at herself. “You’re so fucking weak!”

She washed her face and composed herself, and then headed down the now empty hallway. She had to walk by Mr. Fredericks’s classroom again on her way out, and she heard giggling coming from within. She snuck up to the little window on the door and peered in. She watched as Mr. Fredericks, in a more-than-friendly embrace with Jessica, slid his hand down her plaid miniskirt.

A wave of confusion overwhelmed her. Jessica and Mr. Fredericks?

Rachel ran out to her sedan, climbed in, slammed the door shut and, still fighting back the tears, peeled out of the parking lot.

* * *

7:26 pm Thursday, May 18, 1984 (PDT)
Grants Pass, Oregon

Lucas had endured two more sudden losses of consciousness since the incident in the cafeteria, both of which occurred at home in the evening. Neither episode lasted more than a minute, or so. His grandmother, on witnessing the second, brought him to the emergency room of Three Rivers Community Hospital where she was told that, since Lucas’s situation was not life-threatening at the time, all they could do was give him a medical screening exam. The exam consisted of checking his vital statistics, such as blood pressure and blood sugar, a urine analysis, and an EKG. When the screening came back normal, the consulting physician told Lucas’s grandmother that, although Lucas showed no signs of any condition that might cause him to suddenly blackout, it is still possible that he may have some kind of arrhythmia, or heart irregularity, and that, to be on the safe side, she may want to see if that possibility can be ruled out. She agreed, and the physician arranged for a cardiologist to take a look at Lucas.

Lucas was lain onto a cot in the hallway, and hooked up to a cardiac monitor that a nurse would come by to check from time to time while they waited, and Lucas’s grandmother was asked to sign several forms stating that she agreed to the various tests being administered. Lucas scanned the hallway with wide-open, unblinking eyes. Once all of the forms were signed, the cardiologist, Dr. Xu, appeared – he had a nasally voice, an accent heavier than Jon’s dad’s, and a big brown mole on his chin with three long hairs growing out of it. He had Lucas’s EKG results in his hand, and told Lucas’s grandmother that he thought it was possible Lucas might have some kind of arrhythmia.

“But why do you think he has arrhythmia?” she asked. “The other physician said that his EKG was normal, and you haven’t done any tests yet.”

“Well,” said the doctor, “we will certainly do tests. We will do a tilt-table test, another EKG, and an EP exam, but when an otherwise healthy adolescent experiences sudden loss of consciousness as your grandson has, it is sometimes due to a heart irregularity.”

“Lucas is young and healthy, and he never had any problem with his heart before.”

“The fact that he is young and healthy when experiencing these syncopes is exactly what makes me think it might be something with his heart. Some people are born with heart conditions whose symptoms don’t appear until they are well into adulthood.”

Lucas’s grandmother became teary-eyed.

“Don’t worry so much, Grandma,” said Lucas, “I’m sure it’s not that.”

The doctor left the room and returned five minutes later with some brochures on pacemakers and implantable cardioverter defibrillators, and proceeded to explain to Lucas’s grandmother the price differences between the various models, as well as whether or not her insurance would fully cover any of them.

“But you still haven’t done any tests?” she asked in protest, wiping tears from her eyes.

Lucas caught a glimpse of one of the brochures that showed a pacemaker situated in a person’s chest. The thought of having one in his own chest caused his heart rate to climb, which subsequently showed on the heart monitor he was hooked up to. The monitor made a beeping noise, and the nurse reappeared and asked Lucas if he was nervous.

“Do I have to get one of those?” asked Lucas, beginning to see how serious the problem might be. “Do I have to get that machine in my heart?”

“No,” said his grandmother. “For now they just want to do some tests.”

“Possibly,” said the doctor, holding up one of the brochures. “And, as you can see, the higher quality ICD’s can be expensive.”

Lucas’s grandmother broke into tears.

Benny appeared and walked up to the cot where Lucas was lying. He looked at his grandmother. When he saw her tears his spine straightened and a ward of testosterone filled the room. “What happened? Grandma?”

“Umm…ghhgm…Only family is allowed in here.”

“He’s Lucas’s brother,” said their grandmother.

“Umm…” the doctor stuttered, and proceeded to explain what was in the brochures. Benny took the brochure from the doctor.

“Lucas needs this?” asked Benny.

“We will do some more tests…but…it’s very possible.”

“So… I mean… is he already diagnosed with this? He needs one of these… devices?”

“It’s called an ‘ICD’,” said the doctor, holding the brochure up for Benny to see.

“What does he have?” asked Benny. He took the rest of the brochures from the doctor’s hand. “What’s the actual problem he has?”

“Like I said, we still need to do more tests. But quite possibly awhyssmia.”

“Arhythmia?”

“Yes, awhyssmia.”

The doctor left the room. Shortly after, two nurses arrived and instructed Lucas to put on a hospital gown as one of them fastened an in-patient bracelet to his wrist. They put him onto a stretcher and carted him out. When she asked, they told his grandmother they were moving him to the cardiology ward for the tests, and that he might need to stay the night.

“Why are you taking him to the cardiology ward if you’re not sure if he has a heart problem?” asked Benny.

“A heart condition is the worst case scenario,” said the nurse, “we want to rule that possibility out first.”

She sounded sincere, and her words calmed him bit.

The hallways of the ward bustled with emergency. Patients were being rushed from room to room. One doctor was frantic, shouting orders at the nurses and other staff. They passed by a room where Lucas could see a nurse using a defibrillator on a man. She shouted, “Clear!” and the body convulsed under the paddles.

Lucas was carted through a doorway that read ‘Electrophysiology’. Dr. Xu was already in the room, accompanied by another younger doctor. The nurses placed Lucas onto the operating table and fastened two metal electrode sheets to his back. Lucas looked wide-eyed around the room. He could see that the computer monitors overhead already showed real-time X-ray images of his rapidly beating heart. The younger doctor began attaching electrodes to his chest.

“We are going to give you an EP exam,” said Dr. Xu as he pulled latex gloves over his hands.

One of the nurses began shaving Lucas’s femoral artery area.

“You are going to feel a slight pain in your groin,” said the younger doctor.

The sting was not so bad.

“We are now going to put a catheter into your femoral artery, but you won’t feel a thing.”

The pain was excruciating. Not only could Lucas feel the entire length of the catheter as it crept up his femoral toward his heart, but he could watch its progress on the x-ray monitors overhead.

“You can feel that?” asked Dr. Xu. “You should not be able to feel that.”

“It feels like you’re stabbing me with a wire, or something,” cried Lucas. “It feels too weird! Please!… Stop!… No!… Don’t!”

Lucas’s surroundings blackened. The harder he clung to consciousness, the faster it flew from him.

He awoke amid a copse of pine trees which he did not recognize. He tried to stand but felt a sharp pain in his groin. He was barefoot and had on a hospital gown. When he lifted it to examine his groin, and saw the bandaged wound, the terrifying memory of the electrophysiology exam came flooding back. The earth felt moist under his bare feet. The pain in his groin made walking a painful venture, but every few steps he was able to take some weight off his right leg by leaning against a tree. Lucas knew many of the woods that surrounded Grants Pass, but here there was no landmark – nothing he recognized. All he could see were endless thickets of manzanita, ferns and blackberries under a never-ending canopy of evergreens.

Is this something mental? Am I losing my mind? He thought of his father and of the prospect of hospitalization. He thought of all the newly disabled kids at school and felt a sudden churn of his stomach. He leaned onto the pitch-covered trunk of an old pine and vomited onto its roots.

“Breath little amigo,” came the voice of a man.

“Huh?” Lucas probed about for the source.

“Don’t be afraid little amigo… you can’t see me… but I’m real… I promise.”
The voice seemed to come from all directions.

“Where are you?”

“I told you. You can’t see me. I’m in your… cómo se dice… mind.”

“What?!”

“Oh… don’t worry little amigo… you are not loco.”