“I’ll stay with you, Matt,” said Greg Gahn. “It’s my job as...”
“No fuckin’ way!” Matt said. “The last thing in the world I want to deal with now is a hypocrite Mormon tour manager. You stay on the plane with everyone else.”
“But who is going to arrange for hotel rooms and travel for you?” Greg asked.
“I can do that shit myself,” Matt said.
“But...”
“Don’t worry, Greg,” Jim said. “I’m going to stay with Matt through this.”
Greg looked at him. “You are?”
“I am,” Jim said. “It’s my job.”
“You don’t have to stay with me, dude,” Matt told Jim, though he seemed rather touched that the paramedic had made the offer.
“I know I don’t,” Jim said, “but I’m going to. It’s what you pay me for, right?”
Matt smiled. “Right,” he said.
The ambulance took him to Houston Methodist Hospital, the same facility he had been taken to after his first bout of SVT during the Next Phase tour. The trip took a little over thirty minutes. Jim rode in the back, in the airway seat behind the driver’s compartment, but offered no contributions to the care being given by the Houston Fire medic. It would have been uncouth. Instead, they talked mostly about their jobs, the Houston medic giving Jim a rundown on how their department and the Houston EMS system worked and Jim giving the Houston medic a rundown on how it worked in his little corner of southern California. He then told a few anecdotes of his travels with Matt Tisdale. The Houston medic was much more interested in these tales—in which he was told why you should never kiss a groupie and what exactly a two by four or a three by six entailed.
As fate would have it, the same doctor who had treated him before—Dr. Goldstein—was on duty in the emergency room when they wheeled Matt in.
“Hey, doc,” Matt greeted him. “Bet you never thought you’d see me again, huh?”
“As a matter of fact, Mr. Tisdale,” Goldstein said, “I’m amazed it took so long.”
They went through a standard cardiac workup. An EKG was done. Matt’s complete blood count, electrolytes, and a dozen other labs were checked. They checked his urine for infection and drugs of abuse. His labs came back remarkably similar to the last time he had been there. Red blood cells, white blood cells, and electrolytes were all normal. His hepatic enzymes were elevated to a level that indicated Matt’s liver was not particularly happy with him. His drugs of abuse screen came back positive for marijuana and cocaine. His cardiac enzymes were just a point below what would be considered positive for heart damage. His chest x-ray, however, revealed something quite significant.
“You have cardiomegaly,” Goldstein told him.
“What the fuck’s that?” Matt asked.
“It means your heart is enlarged,” the doctor clarified. “It is quite apparent on the chest x-ray.”
“What’s wrong with having a big heart?” asked Matt. “The more the better, right?”
“Wrong,” Goldstein told him. “A big heart is a less efficient heart. It doesn’t pump blood as well as a normal heart. The condition, if allowed to continue, will eventually lead to heart failure and more than triples your risk of sudden cardiac death; particularly when you add in your correctable risk factors.”
“My correctable risk factors?”
“That would be your cocaine use primarily, but also your smoking of cigarettes, your alcoholism, and your poor diet.”
“Oh ... I see,” Matt said. “Well ... how did my heart get so big in the first place?”
Goldstein looked at him pointedly. “Again, that would be your cocaine use, primarily, but also your smoking of cigarettes, your alcoholism, and your poor diet.”
“No shit?” Matt asked.
“No shit,” Goldstein assured him. “In effect, you have aged your heart decades past your physical age. The constant use of stimulants and tobacco have caused your heart to have to work harder than it was designed for. This causes gradual and cumulative stretching in the cardiac fibers and enlargement of the heart.”
“What a rip,” Matt said, dejected.
“Rip or not,” the doctor said, “that is the situation you are now facing. Last time you were here, you refused admission and cardiac workup.”
“I had a show to do in Dallas,” Matt said.
“I remember the conversation,” Goldstein said. “Will you allow me to admit you this time? I really think a complete cardiac evaluation is warranted so we can tell you exactly how bad the damage is.”
“Well ... I was planning to catch a plane home tonight,” Matt said. “I’ve been away for a few months now and Kim—that’s the bitch I fuck—is expecting me to come home and slip her some schlong for Christmas.”
“Slip her some ... schlong,” Goldstein said slowly, as if pondering the meaning of the phrase.
“He’ll stay,” said Jim, who was sitting in the visitor’s chair next to the bed.
Matt gave him a dirty look but did not contradict him. “All right,” he sighed. “I’ll stay.”
“Very good,” Goldstein said. “I’ll get our cardiologist involved and we’ll get you tucked in for the night.”
The cardiologist was a balding man in his late thirties, fit, handsome, with skin that was almost, but not quite, olive colored. He had a strange accent but spoke English flawlessly. He wore a shirt and tie underneath his sparkling while doctor’s coat and had an expensive looking stethoscope hung around his neck. He introduced himself to Matt and Jim as Doctor Rostami.
“Rostami?” Matt said, repeating the name back. “You a wop?”
“I beg your pardon?” the doctor said.
“Italian,” Matt clarified. “Rostami sounds like a wop name.”
“Uh ... no,” Rostami said. “I am from Iran originally.”
Matt’s expression darkened. “Iran? Home of the ayatollahs and the jihads and death to America and all that?”
“My family are Christians,” Rostami told him. “We fled Iran after the Islamic Revolution and I was educated here in the United States.”
“Oh,” Matt said. “I guess that’s okay then.”
“I’m glad you approve,” Rostami said blandly. “Now then ... how about we discuss your heart?”
They discussed his heart, and his cocaine use, and how the latter had undoubtedly led to the problems he was now having with the former. Matt did not really want to hear this.
“All you doctors keep trying to tell me that the coke is what causes all this,” he grumbled.
“Do you think, perhaps, the fact that we’re all telling you that might be meaningful?” Rostami asked.
“Well ... maybe,” Matt allowed.
“Here’s what is going to happen,” Rostami said. “You’ll spend the night in the telemetry unit and the first thing in the morning, we’re going to give you a nuclear stress-echo exam. That’s a test where we inject you with some mildly radioactive dye and then have you exert yourself on a treadmill until we get your heart rate up above one hundred and fifty beats per minute. We will then put you in a machine that will measure your cardiac output and blood flow so we can determine how bad the damage is.”
“That doesn’t sound like a lot of fun,” Matt said.
“You’re here to have your cardiac function evaluated,” Rostami told him, “not to have fun.”
Rostami left to go make the admission arrangements. Matt, now wearing a hospital gown and hooked up to a beeping monitor, sulked and grumbled for a bit and then seemed to return to at least a shadow of his former self.
“Well, you might as well get out of here, dude,” he told Jim. “Find yourself a nice hotel and use the credit card in my wallet to pay for it. Book a suite. That’s what you’re used to.”
“Uh ... okay, sure,” Jim said. “I’m sure there’s something near the hospital.”
“One other thing,” Matt said, lowering his voice to a whisper.
“What’s that?”
“There’s a couple hundred dollars in my wallet. Take it and see if you can score me some coke.”