Free A Matter of Heart by Amy Fellner Dominy

pad. “I want to start Abby on beta-blockers immediately. They’ll help control her heart rate.”
    “What does that mean?” Dad asks.
    “Beta-blockers will keep her heart rate low and in a safe range.”
    I’m shaking my head. As if from above, I see my head moving. I hear the words come from my lips. “But I can’t swim fast with my heart rate low.”
    “No,” Dr. Danvers says. “You can’t.”
    You can’t
.
    I hear the words, but they don’t reach me. I’m still watching from above. This isn’t happening.
    “You’ll have to make some changes, Abby. You can still swim,” he says. “But not competitively. Not at the level you’re accustomed to.”
    My voice shakes. “For how long?”
    “You don’t understand,” Dr. Danvers answers, and his voice is so gentle, fear rises in my throat, squeezing until I can hardly breathe. “This condition is permanent, Abby.”
    “How long?” Dad growls as if he hasn’t heard this last bit.
    Dr. Danvers blinks and looks from Dad back to me. “Forever.”

15

    I ’m frozen. Numb, maybe. I heard Dr. Danvers, but it’s like my ears just closed up shop and nothing’s getting in or out. Then Mom gasps. Chokes on a sob. I feel her hand on my arm and something cracks inside me. A jagged crack like you see on the sidewalk, and if it spreads and deepens, then it will crumble. I’ll crumble.
    No!
I won’t fall apart. I struggle for breath, needing to do the one thing I’m good at. Fight.
    I look up, and Dad is standing now. His jaw pulses and the veins in his neck stand out. “How can you say that? How can you sit there and say that to us?”
    “Please, Mr. Lipman, have a seat. Let’s talk calmly about this.”
    “I don’t want to sit,” Dad bites out.
    “David, please.” Mom’s voice is a tremble of air.
    I pull my arm from Mom’s hand and sit forward. “This doesn’t make sense. I just set a new school record on Saturday. How could I do that if my heart is as screwed up as you say?”
    He folds his hands together. “That’s a good question, Abby. But as I said, this condition develops over time. Up until now, your heart was able to withstand the pressures and do its job. But that’s changed now. The dizziness and loss of consciousness are signs. A warning.”
    “But I was dehydrated. Laney said that could have caused it.”
    “It was almost certainly a factor,” Dr. Danvers agrees. “Dehydration is an added risk factor for HCM.”
    “Then if I’m careful and drink more—”
    “It might alleviate symptoms, but it won’t change your condition.”
    “How did this happen?” Mom asks. “Is it some kind of virus?”
    “No, Mrs. Lipman. HCM is a genetic condition.”
    “Genetic?” I blink, surprised. “I was born with it?”
    “Technically,” Dr. Danvers says, “you were born with the genes to develop this. But HCM doesn’t always appear right away. And in many cases, there are no symptoms, which is why it’s often missed during school physicals. In fact, you’re quite lucky, Abby. In many cases, the first time it presents itself is at death.”
    Mom cries out and covers her mouth.
    I want to laugh and be sick at the same time. Dr. Danvers has just called me lucky?
    “The important thing to remember is that HCM is treatable, and Abby can live a full and active life. We’ll start her on a low dose, twenty-five milligrams of a beta-blocker a day. That’sjust one pill every morning. The goal is to keep her from overexertion. We want her peak heart rate around one hundred fifty beats per minute.”
    One hundred fifty?
    Dad is asking more questions but I can’t listen.
One hundred fifty?
When I’m racing, my heart rate peaks between one eighty and one eighty-five. How can I jet through the water at that rate? How can I swim fast enough to make tidal waves?
    I look at the desk and I see the words staring up at me from the piece of paper.
HYPERTROPHIC CARDIOMYOPATHY
    I guess doctors can write neat enough when they want to. Anger swells