Raul had fallen asleep again. He slept almost all the time. He had to. He needed all of his strength just to stay alive.
Clovis couldn’t bear to watch him anymore. He turned his back on his son, walked to the window, and leaned his fore-head against glass cooled by rainfall lashing the other side of the panes. It was coming down hard, the kind of rain that drenched Sao Paulo almost every day in summer, but rare in this month of June.
Morumbi Stadium, the skyscrapers of Avenida Paulista, the blue-gray bulk of the Serra da Cantareira, all were gone, van-ished behind a veil of falling water. On the street below, cars were creeping by, immersed to their hubcaps by the sudden flood. A long roll of thunder momentarily overpowered Ana Carmen’s voice. Then the thunder was gone, and he could hear her saying the same words over and over again as she fin-gered the beads of her rosary. She lay on the bed, covers tossed aside, her hair in disarray, staring at the ceiling. The grief on her face made her look far older than her twenty-eight years.
Clovis leaned back from the glass, took out the paper Dr. Levy had given him, and stared at it. There was a telephone number, nothing more. No name, no address. He took his cell phone from his pocket and walked out into the hallway to make the call.
By that time, the nightmare was sixty-two hours old. A nightmare that weakened when he snatched a few hours of sleep, returned with renewed force when he awoke. It had begun in the delivery room, just after Ana Carmen had given birth. It had begun, more properly, with the arrival of Dr. Dirceu Amaral, one of the house pediatricians.
Amaral, an outgoing fellow in his early forties, had arrived to examine the new baby, Clovis and Ana Carmen’s first. He gave Clovis a firm handshake and smiled at a weakened but beaming Ana Carmen. He was still smiling when he applied his stethoscope to the baby’s chest, the disk huge against Raul’s tiny rib cage.
But then the smile disappeared. He whipped the earpieces from his head, ordered an immediate electrocardiogram, and paged Dr. Jacob Levy, a cardiovascular specialist.
Levy arrived within three minutes, even before they had the electrodes in place. He hung over the machine, analyzing the results as the paper emerged. Then he and the pediatri-cian went into a corner and started conferring in low tones.
After that, things happened fast. Raul was carried off. Ana Carmen was given a sedative and wheeled to her room. Clovis was shown to Dr. Levy’s office and asked to wait. He took a seat on a couch between two end tables. Ten minutes later, a middle-aged woman in a blue pants suit came in with a stack of forms.
“What’s this?” Clovis said.
“Just some authorizations,” she said. “You sign here, here, and here.”
Clovis read the paper on the top of the stack and balked.
“You’re asking me to authorize you to cut his chest open?” he asked in disbelief.
The woman shook her head and put a motherly hand on his shoulder. “Only a precaution,” she said. “In very rare cases, something goes wrong. And if it does, we have to get at the heart quickly. There’s little chance of that. Dr. Levy’s the best, but the insurance people insist-”
“What’s going on? What’s wrong with him?”
She extended a pen. “Dr. Levy will come and talk to you as soon as he’s finished.”
“No. Now. I want to talk to him now.”
“You can’t. He’s with your son. Please, sign the papers.”
Clovis shook his head.
The edges of the woman’s mouth took on a stubborn set.
“We have no time for this,” she said.
“But-”
“Doctor has to do a cardiocath, and he has to do it now.
What’s a cardiocath?”
“It’s no big deal. We do it all the time. Now if you’ll just-”
“What is it? I have a right to know.”
She gave an exasperated sigh. “It’s a procedure,” she said. “Doctor makes a small incision in his leg, then slides a tiny tube, called a catheter, through his veins until it reaches his heart.”
“Through his
“Through his veins. That way it isn’t necessary to open his chest to have a look.”
“A look at what?”
“After the catheter is in place, doctor injects a dye. He uses the catheter to take samples and blood pressure meas-urements and uses a fluoroscope to photograph the dye as it moves through your baby’s circulatory system. The sooner he has the results, the sooner he’ll be able to come back here and give you his diagnosis.”
“But he must already have some idea. What does he think the problem is?”
“I couldn’t say.”
“Can’t or won’t?”
Again, she shook her head. Again, she held out the pen. This time, Clovis took it.
“Here, here, and here,” she said.
When he’d finished scrawling his signatures, she gathered up the papers and hurried away without another word.
There were magazines on the end tables. One of them was
He moved closer to the light and read the first paragraph without absorbing a thing.
He started again at the beginning and finished with the same result.
After that, he just sat there, the magazine on his lap. He wasn’t a religious man, but once or twice in the course of the next two hours he prayed.
When the door finally opened again, he sprang to his feet. It wasn’t Dr. Levy. It was the same middle-aged woman.
“He’s with your wife,” she said. “You’re to go upstairs and meet him there.”
Clovis brushed past her, hurried to the elevator, pushed the button, got tired of waiting, bolted up the stairs.
Dr. Levy’s diagnosis was dilated cardiomyopathy.
When he gave it to them, Ana Carmen, despite the fact that she’d been mellowed by the sedative, bit her lip so hard it turned white.
Clovis asked the question, “Dilated cardio what?”
“Myopathy,” Levy said. “The myocardium is the heart muscle. Cardiomyopathy is when the actual muscle cells are sick.”
Ana Carmen clenched a hand in front of her mouth, as if she were about to stifle a cough.
“Is it. . life threatening?” Clovis asked, glancing at his wife, then back at Levy.
“I’m sorry,” Levy said.
Ana Carmen started to cry. She’d apparently been doing a lot of that in the course of the last two hours. The area around her nostrils was red and raw. She snatched up a crum-pled paper handkerchief from the bedside table, gently blot-ted her nose, and studied the tissue for signs of blood as the tears rolled down her cheeks.
“I have him on four medications,” Levy said. “Captopril, digoxin, Lasix, and atenolol. The captopril will dilate his arteries and reduce the strain on his heart. The digoxin will improve the pumping function and combat arrhythmia. Lasix is a diuretic, to reduce fluid buildup in his lungs. The atenolol will help to control his blood pressure.”
Clovis didn’t care about any of the medical mumbo jumbo. He cut to the chase. “Will any of that stuff cure him?”
Levy took a deep breath. “No,” he said, “but it will help to keep him alive.” He didn’t add the words
