a place at college to study medicine.
He’d drunk a lot of cups of masala chai with his gran over the years so he waited, clamping down his impatience as she went through the ritual of boiling tea leaves with cloves, cinnamon, cardamom, a pinch of pepper, and ginger, adding milk and way too much sugar before pouring the steaming concoction into chipped glasses.
When she placed the glass in front of him and pulled up a seat, the scent of the spices made his throat clog with emotion. The smell of comfort. Of home.
He reached for the tea and took a sip to ease the tightness in his throat, the milky sweetness evoking so many treasured memories.
Izzy waited until he’d drunk half his tea before speaking.
“The doctor suspected endocarditis when I first saw him, and the blood tests and the transthoracic echocardiogram I had yesterday confirmed it.”
Manny returned his glass to the table, his hand trembling, as every snippet of information about inflammation of the heart’s inner lining flooded his brain.
Usually caused by bacteria. Uncommon in people with healthy hearts, which meant Izzy’s wasn’t. Symptoms could develop slowly over time, so could go undiagnosed too long.
“Stop imagining the worst,” Izzy said, poking him in the chest. “It’s not the end of the world.”
“Endocarditis can be fatal,” he blurted, immediately ashamed those were the first words he uttered after his gran revealed her diagnosis.
He should be comforting her, offering her pragmatic advice, not scaring her. Then again, Izzy was too stoic for her own good, and he needed to ensure she knew how serious her condition was.
“I’m well aware of that,” she said. “I may call my doctor a quack, but he’s far from it.”
“What symptoms have you had?”
Her gaze slid away, furtive, guilty. “You were right: I have lost weight. And I’ve had night sweats, joint pain, with occasional nausea. I thought I’d lost weight because I haven’t felt like eating much the last few weeks.” She shrugged, fatalistic. “Then my heart started doing some weird jumpy thing, so I thought I better get it checked out.”
“It’s bacterial, so it will be treated with antibiotics for a start—”
“The echocardiogram showed I have heart valve damage and a lot of scarring around it, which allowed a buildup of bacteria.”
Manny was pretty sure his heart skipped a beat. Valve damage in itself could be fatal too.
“How bad are the valves?”
Izzy’s nose wrinkled. “Bad. Apparently, I have prolonged infective endocarditis, so there’s a lot of damage. Dead tissue around the valves, fluid buildup, debris from the infected tissue. I need the valves replaced.”
Manny felt the blood drain from his face. “All of them?”
“They’ve booked me in for surgery in two days.”
Fuck. This was serious, and he knew enough that if Izzy had a case of prolonged infective endocarditis, replacing the heart valves wouldn’t mean she’d be fine.
Complications from sustained damage were common: blood clots, atrial fibrillation, kidney inflammation, and the more severe stroke and heart failure.
“Please get that look off your face.” Izzy sighed and reached out to clasp his hand between hers. “I’m old. I’ve lived a good life. What will be will be.”
Tears burned the back of his eyes as he searched for something to say other than curse the injustice of this. He had nobody, apart from Izzy.
Though that wasn’t entirely true. He had Harper now. And the thought of having someone to confide in, to vent to, went some way to alleviating the pressure in his chest.
“But you know what this means, don’t you?” Izzy squeezed his hand before releasing it, the old twinkle in her eyes.
“What?”
“You’ll have to get married before I die. It will be my deathbed wish, and I’ll haunt you forever if you don’t.”
“Stop this talk about dying,” he muttered, harsher than intended as her eyebrow rose.
“You of all people know what I’m dealing with, Manish, so please don’t patronize me or sugarcoat the truth. My doctor clearly outlined the seriousness of my condition, so I’m under no illusions.”
She clutched at her chest, and Manny could’ve sworn his heart stopped. “Are you okay?”
“I’m fine, but seeing you married would be the best medicine.”
He managed a laugh. “You’re incorrigible.”
“Made you smile though.”
He shook his head and pulled her in for a hug. She clung to him, and as he pressed his cheek to the top of her head, he wished he could impart his strength to her.
His beloved grandmother would need it for what she had to face.
49
Harper had received a text from Manny yesterday afternoon, saying