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“Forgive me, father, for I have sinned.”
There’s a long pause.
“Take your time. How long has it been since your last confession?”
Vasch doesn’t reply to his question. “I have killed a man.”
The priest is silent for what seems like an eternity. “You took another’s life?”
“I handed my colleague a death sentence. I’m a doctor. I couldn’t save my friend.”
“Did you do all that was in your power to do so?”
“Yes. But it wasn’t enough. He has a lover, and a brother he is a father to. I couldn’t repair the damage to his heart that will one day kill him.”
“If you did all that you could, your only sin is unfounded guilt. There’s no penance for that.”
Vasch laughs bitterly. “My only sin is letting my friend die.”
“My son, life takes its own course, as does death. If you are looking for forgiveness, the Lord has nothing to forgive you for.”
“That’s not how it feels.”
“Your friend doesn’t resent you, either,” says the priest. “Rest, my son. It’s been a while since you’ve been to confession, hasn’t it? Your thoughts are muddled. Go in peace, and may God bless you.”
Roderich is playing the piano when he walks in, a dramatic piece that just about fits Vasch’s mood.
“Beethoven?” he guesses wildly, kissing his soft, dark hair.
“Brahms,” says Roderich, letting his fingers fall still on the keys and turning to face Vasch. “I missed you this morning.”
“Sorry, I went for a bit of a stroll after my run,” says Vasch. “Wanted to check the dates on an exhibition at the Imperial War Museum. Have you had breakfast?”
“I tried to make French toast, but it didn’t go very well. Do you want to go to the patisserie on the corner?”
“Sure,” says Vasch. “Let me change quickly and I’ll be with you.”
“Okay,” says Roderich, turning back to the piano.
It’s killing Vasch not to tell him. He knows that Roderich cares enough about Thomassen to want to support him, and he knows that he cares enough about Vasch to be ready to share some of the weight that comes with telling a colleague — a friend that they’re going to die. Ten years is a long time, Thomassen told him. In ten years, Vasch hopes to maybe have paid off his student loan and to actually be able to finally buy a house in London instead of renting. In ten years, Thomassen will be dead.
Vasch can’t even guarantee that Thomassen will be able to see his younger brother settle down. Vasch can’t even guarantee that Thomassen himself will settle down.
And then there’s Andersen. Andersen has a right to know. Andersen needs to know that the man he loves won’t make it to forty, that they won’t grow old together, that they’ll never be able make future plans together as he does with Roderich — no children, no grandchildren, no retiring to a little house in a quiet village outside of Bern.
But Vasch can’t tell him, because Thomassen is an insufferable arse and Vasch can’t abide his selfish desire to let his death be a shock to the people who care about him, and Vasch knows that Thomassen’s dying is on him.
What kind of doctor is he if he can’t save his patient? What kind of man is he if he can’t save his friend?
“Vasch, are you okay?” asks Roderich, and Vasch realises that he’s been standing in their bedroom staring vacantly at his wardrobe for the last ten minutes.
“Euh — yeah. Yes. Indecisive. Brown chinos with a white shirt, or green chinos with a blue shirt?”
Roderich looks him up and down. “Mmm — why don’t you go for charcoal with a white shirt? That way, you can wear those nice suspenders without them clashing. And your coat will set it off, too.”
“I’ll be wearing fifty shades of grey, though.”
“Darling,” says Roderich, adjusting his glasses, “with all due respect, I’m not sure I can think of anything more fitting for you.”
Well, Vasch can’t argue with that.
Vasch pushes himself for a six-mile run before work today. He gets in at six-fifteen, feels guilty about being late to wake up Roderich with his black coffee but can feel the extra mile in his veins, feels the sheer exhilaration of the challenge.
“Vasch,” Roderich says sleepily, blinking in the morning light as he hands him his coffee. “I love you.”
“Good morning, sleepyhead. I love you too.”
His phone rings then, loud and blaring and Roderich flinches at the noise. It’s Beilschmidt, head of cardiology — Vasch’s version of Roderich’s escapism into music.
“Sorry, Roderich,” he says. “I’ll take it outside, take your time.”
Roderich nods, sipping his coffee, still in a sleepy haze. He’s not much of a morning person.
“Zwingli, we need you,” says Beilschmidt. “I’ve got a patient who inexplicably went into cardiac arrest around eleven hours ago, otherwise healthy. Male, twenty-five, normal left ventricular function, coronary arteries look fine. Can’t treat until we have a diagnosis, no idea how much time we have here.”
“Anaphylaxis?” Vasch suggests, watching Roderich dress through the window on their balcony. “I’ll be in in five.”
Roderich yawns, cat-like, and fumbles tying his tie.
“I’m so sorry, Roderich, I’ve been called in. Cardiology need an extra hand, apparently.”
“Mmm, don’t worry. I’ll see you later, then?”
“Indeed you will. Try not to forget to eat breakfast, there’s some yoghurt and some fruit in the fridge.”
“Good luck,” Roderich calls after him as he pulls a coat on and shuts their front door behind him.
Beilschmidt is up to his eyes in files when Vasch enters his office. Vasch can understand why he was called in. He really doesn’t miss the paperwork of being a regular cardiologist.
“Patient’s in ward five,” says Beilschmidt, not looking up from his desk. “File’s on the chair. I’ll discuss with you once I’ve finished this set of papers.”
Vasch takes the file, thanks him and heads to the ward as he reads it. Guillaume Schauss, born nineteen-ninety-two, in Bastogne, Belgium. CPR administered immediately by a doctor in the area; returned to normal heart rhythm soon after defibrillation. No previous cardiac distress, no family history of early-onset heart disease, no known allergies, exercises regularly and follows a ‘plant-based’ diet.
“Mr Schauss,” he greets the patient, who is sitting upright in his bed, reading. “I’m Dr. Zwingli, one of the cardiologists here.”
The patient looks up and smiles sweetly at him. “Hi. I take it I’m not being discharged yet?”
“I’m afraid not. It was fortunate you were in such a public place when you went into cardiac arrest; we can’t risk it happening again somewhere less safe.”
“It couldn’t have been worse timing, really, I was just about to go into the opera,” the patient says with a grin. “I was really looking forward to that.”
“If it was at the National Theatre, you weren’t missing much,” says Vasch. “My colleague went to see it and regretted it, said it made him long for a good Italian one.”
The patient laughs. “That does make me feel a bit better. I’ll just have to go to the Royal Opera House when I’m out.”
“I’ve been to a couple there, they’re always good. Have you noticed any chest pain recently?”
“I’ll look forward to that, then. No, nothing. I had some chest pain last year, but my therapist said it was stress and anxiety-related.”
“Your therapist was probably right. Are you generally under a lot of strain, then?”
“Quite a bit. At the time, my company was going through some difficulties — I’m the head of the family business, you see.”
“At twenty-five? Impressive.”
The patient smiles, almost wistfully. “My parents retired early to the Côte d’Azur, and neither of my siblings were really interested in it. My brother is an art lecturer in the Netherlands, you see, and my sister has a little tearoom-bookshop sort of thing back in Belgium. Someone had to carry on the business.”
Young, ambitious to a fault, precociously successful, family-oriented. It’s not Thomassen but — by god, it could be. Schauss even has the same rich-boy shiny blonde hair. Of course, he’s a damn sight nicer than Thomassen, far less bitter and generally less insufferable. But still, Vasch has to mentally shake himself to get rid of the vision of his colleague bleeding out on the floor.
“Well, it’s highly unlikely that stress alone would have caused the arrest, but you shouldn’t push yourself. Are you taking any antidepressants?”
“None. I’m only seeing the therapist because my sister was worried about me.”
Vasch can understand why. “Are you taking any medications not listed in your file?”
The patient shakes his head. “I don’t get sick very easily.”
“Okay,” says Vasch. “I’m going to refer you for an echocardiogram and an exercise test, since I can’t see any abnormalities while resting. In the meantime, if you get any — and I mean any — other kinds of symptoms, notify someone.”
“You’re dedicated,” says the patient.
Vasch tries not to flinch. “I’ve seen the consequences of a misdiagnosis,” he says, and immediately regrets it. “Not that the situations are really comparable, of course — I mean — I’m a doctor, I’m meant to be dedicated.”
The patient looks amused by his floundering. “Right.”
“You know, we don’t usually get other people to do our tests for us in Cardiology,” says Beilschmidt, looking over his request for an echocardiogram and a stress test. “I’m not sure how Kirkland runs things, though.”
“We’ve started looking for a second opinion on things after Thomassen was stabbed,” Vasch replies.
Beilschmidt raises his eyebrows. “You’re worried our patient will deteriorate straight from cardiac arrest to a psychotic break?”
“We should always exercise caution, Beilschmidt.”
“So this doesn’t have anything to do with any personal feelings of yours?”
“My objectivity has not been affected, no.”
Beilschmidt obviously doesn’t believe him, but accepts it anyway. “Fine, I’ll get Bonnefois to run the test, and I’ll let you know when we have the results.”
“I appreciate it.”
Vasch is sure Beilschmidt is putting two and two together, even if he only has half the story. He doesn’t care, though. He just needs to get out of there, and for once he welcomes the file that Kirkland throws at him.
“We missed you this morning,” says Kirkland. “Edelstein was positively distraught.”
“I was not,” say Roderich.
“Sounds like leukaemia,” Vasch says, ignoring Kirkland.
“It’s not,” says Thomassen. “Bloodwork is fine, marrow biopsy is fine.”
“Gonorrhoea?”
“Zwingli, the patient is ten,” says Héderváry. “Are you alright? You seem—“
“I’m fine,” Vasch says quickly, before Héderváry can finish the sentence with shaken or off and worry Roderich. “Beilschmidt’s got me on another case, I suppose my mind is preoccupied.”
“A thrilling tale,” says Kirkland. “Thomassen, check the patient for tick bites, this could be Lyme disease. And take Zwingli with you, he’s no use to us here.”
Thomassen raises an eyebrow but gets up anyway, holding the door open for Vasch. Neither speaks as they walk to the patient’s room, and Thomassen barely acknowledges him as he examines the patient.
“Do you play outside frequently? In the woods, for example?” he asks, and the boy shakes his head.
“This is London, Thomassen, there aren’t any woods,” says Vasch.
Thomassen glares at him as he checks under the boy’s collar. “I know that, Zwingli, thank you very much. Maybe your parents take you to the countryside sometimes?” he asks, addressing the patient again.
“No, Mummy doesn’t like leaving London,” says the little boy. “She says there’s nothing to do.”
Vasch can practically feel Thomassen’s disdain. He supposes it makes sense that he spent his childhood running around on Daddy’s estate.
“You know,” he says as they leave the room with no further ideas, “for someone who raised their younger sibling, you’re awful at talking to children.”
“I only looked after Emil from when he was eight,” says Thomassen. “He didn’t need baby talk then. When children still need things oversimplified, it shows parental incompetence.”
Vasch raises his eyebrows. He’s sure those numbers don’t add up. “You took care of your younger brother while you were in med school?”
Thomassen shrugs. “I’d already done a year, I started when I was seventeen. And I had my own flat, which made it easier.”
Vasch still doesn’t have his own flat. “And your brother still doesn’t — know?”
“No. And I don’t intend to tell him.”
“But you must be close.”
“Very. That’s why I can’t tell him.”
Vasch shakes his head. “And you’re applying the same logic to Andersen?”
“Of course.”
“Even though they both deserve to know?”
“They’d both suffer needlessly. I want to die quietly, Zwingli, I’m sure you’d understand.”
Vasch thinks about his younger sister back in Switzerland. Elise is the first to check up on him if gets so much as a cold. “I’d tell my sister, and I’d tell Roderich, instead of letting them think I’m fine. You’re essentially lying to them.”
“I’m sure you’ve heard the term ‘greater good’.”
“You’re a prick, Thomassen.”
Bonnefois, instead of paging him, decides to give Vasch the results personally. Héderváry is in the middle of explaining why exactly it’s not an osteoid osteoma that they missed on the CT when Kirkland looks up, jumps up and points accusingly at the man standing in the doorway.
“I told you never to come within ten feet of me again!” he cries.
“But how, then,” says Bonnefois, “am I supposed to kiss you, petit?”
Vasch regrets not running the tests himself.
“Don’t you fucking dare call me little, you shit. I waited for you to call me back, and all I got was a message passed on through about five different people — “Oh, sorry, François can’t make it tonight, he’s too busy!” — I'm sure you were very busy with that girl—”
“Arthur, little Adelise is my cousin.”
“That’s actually illegal here, you know. And it’s Dr. Kirkland to you.”
Bonnefois has trouble suppressing a laugh. “It is you who ran around with Adelise — no, you cannot deny it — but to know you did it out of jealousy, well. Now that is interesting.”
“Well, if you weren’t off with her, why didn’t you call me back?”
“Because you never gave me your phone number, petit. And I really was busy, I was called in to assist with a surgery, but I couldn’t exactly call you to rearrange.”
Kirkland is stunned into a humiliated silence, and Vasch takes the opportunity to remind Bonnefois of why he’s actually here.
“Since you’re in no hurry, I take it the echo and the exercise test didn’t turn anything up.”
“No, but Beilschmidt wanted you to know that we can’t keep him here much longer if there’s nothing physically wrong with him.”
Vasch questions the use of the phrase ‘nothing physically wrong’ in conjunction with cardiac arrest. “Does he have any fresh ideas?”
“None, the boy is in perfect health.“
“I’m going to check on him,” Vasch says, pushing away the ten-year-old’s file as Kirkland and Bonnefois start bickering again.
Schauss is on his laptop when he visits him, and barely looks up, presumably working.
“You know, stress really isn’t good for the heart,” says Vasch.
“There’s nothing wrong with my heart,” says his patient, still looking at the screen. “My brother, however, poses a problem.”
“Your brother?”
“The art lecturer. He’s emailed to tell me he’s flying over from Amsterdam even though I told him I’m fine.”
“Family members do tend to care about one another.”
“He has students who need him. I don’t.”
Vasch can’t stop seeing Thomassen. “He’s just worried about you.”
“I don’t want him to be,” Schauss says, and then takes a shaky breath. “Fuck — my chest hurts.”
His heart rate is elevated and rising, and even as Vasch adjusts the beta blockers in his IV, his eyes close slowly and his grip on his laptop weakens.
Vasch grabs the paddles and yells for help. A nurse comes running in, lies Schauss flat on his back and clears everything else off the bed.
“He’s in V-fib — get an oxygen mask.” He places the paddles on Schauss’ chest. ”Charging — clear.” Vasch pauses. “Nothing, again. Charging — clear.” Another pause. “We’ve got a pulse.”
As the nurse fusses around Schauss, Vasch pulls out the ECG printout from the monitor beside his bed. It’s perfectly normal, right up until the arrest. “Fuck,” he says to himself as Beilschmidt walks in.
“One of the nurses alerted me,” he says. “Perhaps we ought to hand the patient over to Kirkland.”
“Kirkland is a neurologist, you think he can help?”
“Perhaps more than we have here. The patient is clearly at risk.”
“You were going to discharge him.”
“And evidently, I no longer intend to do so.”
Vasch sighs, and rubs a hand over his face. “I’m not letting Kirkland near this.”
“It’s possible our only option is to put in an ICD and make sure he’s carefully monitored.”
“Surgery, when we don’t know what’s throwing him into cardiac arrest? Yes, that definitely seems like a good decision.”
Beilschmidt furrows his brow. “I don’t appreciate your sarcasm, Zwingli. We need to act fast.”
“We need to diagnose fast. Recheck the patient history, this must be genetic.” An image of an eighteen-year-old Thomassen flashes in the back of his mind. He wonders, for a second, if he was really resuscitating a twenty-five-year-old businessmen from Belgium, or if his mind had already replaced Schauss with a young, scared Thomassen.
“We already know it can’t be,” Beilschmidt says after Vasch as he picks up his file and turns to leave. “Where are you going?”
“Home,” says Vasch. “I’m going to work on this at home, where I can actually think. Make sure there’s someone on hand for the patient. And his brother is supposedly going to turn up at some point, so make sure to ask him about the patient history, too.”
“You’re not my superior, you know,” Beilschmidt calls.
“And nor are you mine.”
“You’re home early.”
“Needed to think.”
“About Beilschmidt’s patient?”
“He went into cardiac arrest again. No abnormal heart rhythm leading up to it. Perfect health.”
“It wasn’t anaphylaxis?”
“Doesn’t match. Patient doesn’t have any allergies, either.”
“How’s Thomassen doing?”
Vasch looks up from the notes and files spread over their kitchen table and stares at Roderich. “He’s not my patient anymore.”
“It’s been nearly six months, he should be seeing a cardiologist soon.”
“He can do it himself, he’s as good as anyone in Cardiology.”
“Vasch. You’re his doctor.”
“I was his surgeon. He’d rather do it himself. He’d know if something was off more quickly than anyone else.”
“Why don’t you want to treat him?”
“Well, hopefully, there’s nothing to treat.”
“What is up with you?” Roderich asks, pulling out the chair opposite Vasch’s, sitting, and fixing him with a hard stare. “You’re barely talking to me, spacing out during meetings with Kirkland, throwing yourself into a case that Beilschmidt threw at you out of the blue — which you know you wouldn’t even look at, usually — and you’re acting weird around Thomassen ever since he was injured. What’s going on, Vasch?”
“Nothing is going on, Roderich, I’m fine. Sometimes I just need to get away from Kirkland, you know how it is. He’s been particularly insufferable lately.”
Roderich shakes his head. “That’s not it, I know that’s not it, you can tolerate Kirkland better than anyone else. Vasch, talk to me. Please.”
“There’s nothing to talk about.”
“Is it Thomassen? Are you — seeing Thomassen?”
Vasch frowns at that. “No, of course not. God, no. It’s not — it’s nothing to do with any sort of relationship.”
“Then for goodness’ sake, Vasch, what the fuck is it?”
“I don’t want to talk about it.”
Roderich slams his hand down on the table, as if slamming out an angry chord on a piano. “And I don’t want my conversations with my boyfriend to be monosyllabic answers to tentative questions! It’s been six months, Vasch. I know this is related to Thomassen, and if you’re not sleeping with him then surely it can’t be that hard to just tell me what’s going on.”
Vasch bites his lip. “It’s — it’s not really that simple.”
“What, you’re not allowed to talk about it to your own boyfriend?” When Vasch doesn’t reply, Roderich raises an eyebrow. “You’re actually not allowed to talk about it. Thomassen has forbidden you. That wouldn’t usually stop you.”
“Patient confidentiality.” There. Vasch has said it. It — it doesn’t feel much better.
“You said he’s not your patient anymore.”
“I lied.”
“What is there to hide? Is this related to the accident?”
Vasch closes his eyes, and rests his head in his hands. “Yes,” he says, “but I can’t tell you. Only Kirkland and I know anything about it, and Kirkland only because he’s known Thomassen since they were in med school together.”
“Vasch, whatever it is, it’s clearly affecting you, you need to talk about it.” Roderich takes his hand across their tiny, messy kitchen table and squeezes it. “You can talk to me, you know I won’t tell anyone. I don’t even like Thomassen, he's a self-righteous arse.”
“Everyone we know is a self-righteous arse,” Vasch says with a forced laugh. “I don’t like him either, but — but god, Roderich, I had to — I had to tell him he was going to die.”
He realises, as soon as he says it outright, that while it’s not better, it really fucking helps to actually share what’s on his mind rather than bottle it up. He realises, suddenly, that he’s just been doing the same as Thomassen — keeping his thoughts so close to his chest that he’s suffocating in them, with only the greater good in mind, or some other bullshit. He’s absolutely no better.
Roderich is shocked into silence by his words, but the grip on his hand tightens, and Vasch can't now stop talking.
“His heart tissue was damaged even before he was stabbed, and he went into cardiogenic shock. Unless he gets a transplant — which isn’t likely, he's technically non-urgent and honestly, chances of surviving the surgery are slim — it’ll just give out in ten years, maximum. I — I couldn’t do anything. There was too much damage for me to repair and I’m just letting him die, Roderich.”
Vasch is pretty sure he’s crying now, but he carries on. “Neither Andersen nor his brother have any idea. He’s refusing to tell them, and I just keep — I just keep imagining myself in the same situation. I don’t know what would happen to Elise if I were to die. I don’t want to imagine leaving you alone. And — and this patient of Beilschmidt’s — he’s just like Thomassen. Much less of a brat, but he’s twenty-five and running his own business and even though he's gone into arrest twice now, he doesn’t want to see his family because he doesn’t want to inconvenience them, or some shit. And I have to solve it, Roderich, I have to, because if I don’t I’ll be killing Thomassen all over again.”
“That’s awful,” Roderich says quietly. “That’s awful. Fuck, Thomassen doesn’t deserve that. He’s so young, too, he’s what—?”
“Twenty-eight.”
“Twenty-eight,” Roderich repeats. “Shit. But Vasch, you can’t blame yourself for it. It’s awful, but he’d be a lot worse off if it weren’t for you.”
“I should’ve been able to fix it, Roderich.”
“You said there was already damaged tissue, there’s nothing you could have done about that. You’re the best cardiologist we have — that’s why Kirkland snatched you. You saved his life, Vasch.”
“I could have done more.”
Roderich stands up, walks round the other side of the table and gives him a bone-crushing hug. He hadn’t quite realised that this is what he’s needed for the past six months but — Roderich knows Vasch better than Vasch knows Vasch, so it makes sense.
“You’re the only one blaming you, darling.”
Vasch sighs shakily into his boyfriend’s chest. “Thank you,” he says quietly. “I think I needed to hear that.”
Vasch wakes up at five, as usual, and goes for a run, as usual. He makes Roderich coffee, as usual, and drinks a pint of milk, as usual. Then, he sits at the kitchen table, poring over the files now migrating to every available surface in the flat, and doesn’t move for another three hours, until Beilschmidt calls him.
“The patient’s brother wants to know why his physician isn’t here,” he says. “As do I.”
“I know, Beilschmidt, but I need to think. Have you got any more of a history from the brother?”
“He’s not exactly the talkative type. It’s not genetic, Zwingli.”
Vasch sighs. His files are saying the same thing, but the symptoms — and his instinct — beg to differ. “I’ll come in and ask him myself. But I’m going to recheck everything first.”
“Just be in. You chose to take this patient, you’re the one who has to see it through.”
“Fine.”
Vasch hangs up, and Roderich — underdressed, overslept — slides into the seat next to him, yawning. “Can I help?”
“Not unless you specialised in cardiology overnight. Sorry.”
Roderich smiles. “I’m afraid I’m of no use, then. Are you going to speak to Thomassen?”
“About telling Andersen and his brother? God knows I’ve tried. He’s so stubborn. I can’t change his mind. Is Kirkland going to hunt you down for not being there?”
“He won’t miss me, I needed that sleep. I haven't been able to get a decent night since Thomassen was injured.”
Since you started to withdraw yourself remains unsaid. Guilt twists in Vasch’s stomach. “I’m sorry,” he says, and he means it. “Don’t hesitate to wake me if you can’t sleep in the future, okay? We’ll talk things through, I’ll make you some hot chocolate or something.”
“Thanks," says Roderich. “I'm surprised I don't wake you anyway, though, you’re such a light sleeper.”
Vasch raises an eyebrow, amused. “I’m not a light sleeper, you just sleep more deeply than anyone I’ve ever known.”
“I do not,” Roderich says, with an indignant sniff. “I think I’m going to go back to bed, though, I’m so tired.”
“Okay. Sleep well,” says Vasch, then looks again at the messy hair, the clumsily-tied bathrobe, the vaguely crooked glasses. He’s never seen anything more beautiful. “Wait a sec,” he adds, and pulls Roderich towards him into a kiss.
“Go save a life,” Roderich says as they pull apart, smiling.
The taste of his lips is still on Vasch’s as he gathers all his papers and Vasch feels — optimistic. He's got nothing to go on, and there's still a ghost of Thomassen following his every move — because no matter what happens, Thomassen’s dying will always be on him, on his incompetence, because that’s what it means to perform surgery on someone you actually care about — but he will do this.
Schauss is looking worse for wear, now. He clearly hasn’t slept properly since his second arrest, and when Vasch greets him, there’s none of the charm and vitality he showed upon their first meeting.
“My brother, Lars,” he says, gesturing to the tall man beside his bed. “Lars, Dr. Zwingli.”
“Pleasure’s mine,” says Lars. “What is wrong with my brother?”
“Lars, please,” Schauss sighs.
Vasch doesn’t reply to his question. He’s distracted — Schauss’ files say that he shares only a mother with his two siblings, yet the birthmark on the elder brother’s left hand is identical to that on the younger brother, but it’s certainly missing from the mother in the family photo that Schauss keeps as his laptop homescreen. Birthmarks aren’t usually inherited, Zwingli, says his inner Kirkland, but Vasch ignores it — it’s genetic. It has to be genetic.
“I’ve been researching the wrong father,” he breathes.
“I’m sorry?”
Vasch addresses Lars. “Your father — does he suffer from any type of heart condition?”
“My father is dead. He was in a car accident five years ago — how is this relevant, exactly?”
Loss of muscle strength would lead to loss of control over the vehicle — and syncope as a result of an undiagnosed hereditary disease would account for everything. Vasch realises now that neither cardiac arrest was, in fact, unprovoked; the first time, Schauss was on his way to the opera on a Monday afternoon, meaning that he was taking time out of work — meaning that he was stressed. The second, his brother had just emailed to inform him of his arrival in the U.K., and Schauss, being family-oriented to a fault, felt guilty. Stress alone is unlikely to have caused the arrest, as he told Schauss, but stress with a pre-existing disease?
“Your brother has CPVT, it’s a rare genetic condition — while it is uncommon that it would start manifesting at twenty-five, if it manifested so late in your father, too—”
“We have different fathers,” Schauss cuts in. “It’s in my file.”
Vasch bites his lip. “I think you might have to ask your mother about that.”
“So you can cure it?” asks Lars, before Schauss can argue about it.
“I can treat it,” says Vasch. “I’ll schedule the surgery — you’ll need an ICD, which is our best shot for preventing cardiac arrest, and medication after that.”
“But I’ll be fine?”
“As long as you avoid exercises which could damage the ICD, you should be fine. And you should try to avoid too much stress, too.”
Lars raises an eyebrow at the mention of stress. “Guillaume, Emma and I keep telling you—”
“Lars, stop meddling. I’ll — hire someone to help me, I suppose.”
“That sounds like a good plan,” says Vasch.
“CPVT from a birthmark is a Kirkland-worthy diagnosis,” says Beilschmidt, looking over the file. “You’re sure about this?”
“It fits,” Vasch says simply.
“Will you be doing the surgery?”
Vasch shakes his head. “I’d suggest Bonnefois.”
“This is about Thomassen.” It’s not a question — Beilschmidt knows, has known, perhaps, the whole time. Any cardiologist to glance the file would guess, would conclude Thomassen’s situation.
“There are — parallels.”
“Zwingli, you're the best cardiologist we have, and the second best surgeon after Thomassen himself. I do hope there are no ridiculous notions of guilt or self-blame surrounding his situation.”
“Simply a sense of responsibility,” Vasch replies.
Beilschmidt sighs. “I’ll tell Bonnefois,” he says.
“Thank you.”
There’s a sense of liberation that surrounds the resolution of Schauss’ case. Vasch rejoins Kirkland and the others, who conclude that the ten-year-old is in fact zinc-deficient, and turn their attention instead to Roderich’s absence. Vasch refuses to participate until Héderváry begins speculating about their sex life, which is when he finally shoots them down with a cutting remark or two. The team, with no diagnostic work left, disperses to their various departments, and Vasch takes the opportunity to speak to Thomassen as they head to the ICU.
“I know I’ve said this before, but—”
“I need to tell Søren and Emil, I know. Kirkland’s been saying the same thing. I’m not going to, you might as well give up.”
“This is the last time I’ll say it. Just — imagine if it was your brother who was keeping it from you, or Andersen. And one day their started heart giving out, and you’d never properly said your goodbyes.”
“Zwingli, I do not need your guilt-tripping.”
“Fine.” Vasch recognises a lost cause when he sees one. “I just hope you’ll do it eventually. How are you feeling?”
"Like shit. Just not as shit as I'll feel in, say, nine and a half years."
"I am sorry, Thomassen."
Thomassen gives him a long-suffering look. "Not you, too. Kirkland has spent the last six months trying to avoid eye contact with me because he's too consumed with guilt, or something. Everyone seems to forget that I chose to take a biopsy from an unstable patient."
Well, when he puts it like that, Vasch feels considerably better.