Dr. Breit comes in Sunday morning and tells him, "Harold, you're looking A?1. Ray does beautiful work. They say around the OR, `He could tickle a tapeworm under the chin with that catheter."' Breit looks up through his furry eyelashes for the expected laugh, doesn't get it, and perches on the edge of the bed for extra intimacy. "I've been reviewing our own films plus the stuff the jerks down at Deleon Community finally got around to sending us. Your lumen in the LAD has gone up from fifteen per cent of normal to sixty. But I can't say I'm crazy about your RCA, the right coronary artery; it shows I'd put it at about eightyper?cent blockage, which is fine and dandy as long as the welldeveloped collateral is supplying the right ventricle from the circumflex. But a lesion is developing at the bifurcation of the circumflex and the LAD, and a lesion at a bifurcation is tougher to treat with angioplasty. Same thing ? I assume you're interested in this ? if the lesion is too long, or in a hyperkinetic AV groove, or in a situation where in the middle of the procedure you might get stranded without enough collateral circulation. In those kinds of cases, it can get hairy."

His legs are a little short for sitting on the bed comfortably; he bounces his ham a little closer to Harry's legs, and Harry feels the blood inside his supine body sway. Breit smiles and his voice grows confidential, like when he was murmuring over Dr. Raymond's shoulders. "The fact is, Harold, PTCA is a pretty Mickey Mouse treatment, and what I want you to seriously consider as you lie here these few days, even though as I say this procedure appears to have produced good results for the time being, is, now that you've tested the waters, going ahead with a CABG. Not right away. We're talking four, six months down the road before we go in again. We'd bypass both the RCA and the CFX, and the LAD depending on the restenosis, and you'll be a new man, with damn close to a brand?new heart. While we're in there we might want to look at that leaky aortic valve and think about a pacemaker. Frankly, we may have had a little postoperative MI; your electrocardiogram shows some new Q waves and there's been an elevation of the CPK isoenzyme, with positive MB bands."

"You mean," Harry says, not totally snowed, "I've been having a heart attack just lying here?"

Dr. Breit shrugs daintily. All his gestures have a daintiness that goes with his milky?pink skin. His voice is a bit squeaky, piped through his blistered?looking lips. He says, "PTCA is an invasive procedure, nobody said it wasn't. A little trauma is to be expected. Your heart shows myocardial scarring from way back. All a heart attack is is some heart muscle dying. A little can die without your noticing. It happens to all of us, just as everybody over a certain age has some emphysema. It's called the aging process and there's no escaping it. Not in this life."

Harry wonders about the next life, but decides not to ask. He doubts that Breit knows more than The National Enquirer. "You're telling me I've come into this hospital for I don't............