If Only She Could Speak
"I'll try to get in touch, but I honestly don't know whether Bokshil will be able to undergo the surgery."
"Yes, yes."
Na Haram nodded hard as she answered. When hope had been nowhere to be found, the mere fact that there was now a door left to knock on meant something. A faint flush of color rose to her cheeks as she spoke.
The director placed the call right there in front of Na Haram, and it connected almost at once. She couldn't hear what was being said on the other end, but the director nodded along while answering.
"Then please have Director Lee call me back once he's out of the operating room. I'd like to put in a surgical referral."
After hanging up, the director turned to Na Haram.
"The director of Mongmong Animal Hospital is in surgery right now. I asked them to have him call, so he'll reach us once the operation is over."
"Ah, yes."
"I'll let you know the moment we connect. You'll be in the waiting room, I assume?"
"Yes. I was going to leave once Bokshil is doing a bit better."
"All right. Then I'll go check on Bokshil."
About an hour after Na Haram had settled into the waiting room, the director came back in.
"I've got the director of Mongmong on the line."
The director gave the phone a brief shake to show her, then immediately continued the call. Na Haram was grateful it was happening right there in front of her.
She knows exactly how worried I am, how badly I want to hear this. That's why she's taking the call here.
The director's voice, speaking just a few feet away, sank straight into her ears. After a brief exchange of greetings, they got down to business.
"We have a Maltese named Bokshil at our hospital, MMVD Stage C. We estimate she's between ten and twelve years old. She developed pulmonary edema a month ago, and today is the second episode..."
The person on the other end said something in response to the director explaining that this was the second time the heart condition had filled the lungs with fluid. The director nodded, then stated the reason for the call.
"The reason I'm calling is that Bokshil's guardian mentioned mitral valvuloplasty."
"I haven't discussed it with her that far yet, but she said she'd at least like to have her examined."
The director nodded for a moment, then took the reply.
"Then I'll let her know that. As for the appointment... hang on a moment."
The director turned to Na Haram.
"Bokshil's guardian — we'll set the exam date after we see how she's doing, but Director Lee is asking if you'd like to come in first and hear about what the surgery actually involves."
"Yes, yes. I'll do that."
"Then I'll send Bokshil's chart over to their hospital in advance."
Right then and there, Na Haram booked a consultation at Mongmong Animal Hospital — for that very evening. They set it for half past eight. When she was told a daytime slot wouldn't open up for another two weeks, she was actually glad. It would be the perfect time: go into work, come back to see Bokshil, then head over.
Because she'd taken the morning as a half-day, she stayed at the clinic a little longer. Then, just as planned, she went to the office, came back to see Bokshil, and set out for Mongmong Animal Hospital.
It was a neighborhood she'd never visited, but she found Mongmong Animal Hospital at once. High on the side of the six-story building, a sign in blazing red letters glowed through the dark.
24-HOUR NIGHT EMERGENCY CARE
A sign you couldn't miss, whether you were driving past or on foot. For guardians racing through the night in search of an animal hospital, it must have been a beacon of hope. There was probably an identical sign on the other side of the building, too. Holding that thought, Na Haram stepped inside.
Ding-a-ling.
A clear, bright chime rang out, and a voice every bit as bright came to meet her.
"Welcome."
"...Ah, yes. I'm here to see the director."
"Ah, you must be Bokshil's guardian. Please have a seat over there for a moment. The director is in the inpatient ward right now. He'll be right out once he's finished treating the patients."
"Ah, yes."
Na Haram tilted her head as she walked toward the chair the staff member had indicated. How did they know?
The other person had recognized her before she'd even said a word. Thanks to that, she sat down in the waiting chair with a slightly easier heart. There was a large cat tower right beside her, but it never registered. Nor did she look for Mongmong Animal Hospital's famous trio — Hoesaegi, Gkamnyangi, and Sapsaree — the three that first-time visitors almost always sought out. For Na Haram, whose mind was filled with nothing but how to save Bokshil, such things were of no interest at all.
Five minutes of waiting, and she heard someone calling her.
"Hello. You're Bokshil's guardian, aren't you?"
Director Lee Jun, whom she'd seen on television, was standing there, greeting her.
"Ah, yes. Hello, Director."
"How is Bokshil doing right now? Is her breathing a little easier?"
Na Haram was startled. A hospital director she'd never met, asking about Bokshil's condition right off the bat. If that had been all, she might have taken it as a routine greeting and let it pass. She couldn't. Worry was woven into the voice that asked, into the eyes that looked at her. She felt, somehow, comforted.
"She seems a little better than this morning..."
"You must be so worried. Would you come into that room with me, so I can hear a bit more about Bokshil?"
"Yes."
As she followed him into the director's office, a simple feeling settled over her — that Bokshil would love this place, Mongmong Animal Hospital. And that she would love this director walking ahead of her, too.
"Please, have a seat. I looked over Bokshil's chart before you arrived. And thankfully, the director at Onmaum sent over footage of her as well."
Onmaum Animal Hospital was the clinic where Bokshil was currently hospitalized.
"...She did?"
"Yes. The open-mouth breathing is quite severe, but she's enduring it with everything she has."
Tears simply rolled down Na Haram's face. The director sitting across from her hadn't said anything particularly special, and yet they came. Was it because of the words enduring it?
"Ah, I'm sorry. I shouldn't have said that..."
"No, no. It's not that."
Na Haram shook her head as she answered. In that brief moment, a box of tissues had been set in front of her. She wiped her eyes and spoke.
"It's just... our Bokshil seems to be in so much pain. I keep worrying whether I'm even doing the right thing... And when I think of her, I want to make her a little happier, but she's hurting like that..."
She had come to Mongmong Animal Hospital because she desperately wanted Bokshil to have the surgery. But the moment she saw Lee Jun, the worries she'd been carrying spilled out on their own.
"I see."
"Ah, no — I'm sorry. That's not what I came here to say..."
"Every guardian who loves their companion animal has those same worries. I did too. Everyone does. How far should I take the treatment? Is what I'm doing right now the right thing?"
Yes. It was always the question. Even when you did everything you could, regret lingered. Attachment lingered. And the biggest worry of all...
"I'm afraid I'll keep the treatment going out of my own stubbornness. Bokshil might not even understand what the treatment is, and just be in pain. She already hates the medicine that tastes bad, and she'd have to force it down."
"I hope that's true."
Despite her reply, Na Haram's heart eased a little. Because she thought maybe, just as the director in front of her had said, Bokshil might understand.
"The director at Onmaum mentioned that you'd like Bokshil to have the surgery?"
"Yes. I didn't even know a surgery like this existed. Now that I know, I want her to have it. No matter what."
"Well... this is a very difficult surgery."
"I'm sure it is. It's heart surgery. Ah — I know it costs a lot, too."
Na Haram fell silent. It felt nothing like the vague picture she had been carrying in her head. She sat there, dazed, for a long moment.
What if you sent her into surgery to save her — to let her live more comfortably — and that was the last time? What if it actually turned out that way?
She had come here to save Bokshil. She had come carrying hope, because she'd been told there was a way. And yet...
The image of Bokshil, panting hard, struggling for every breath, and still smiling up at her, overlapped with Dodam's face after she had stopped breathing. In the end, Na Haram let out a long sigh.
"Hahh..."
"The surgery Bokshil would need is called mitral valvuloplasty. Ah — the mitral valve. The heart is divided into atria and ventricles. Before I go further, has anyone around you had heart surgery?"
"Ah, no. No one."
"I see. It's a surgery that requires a heart-lung machine. Because it's performed by opening the heart."
"A heart-lung machine?"
"Exactly what it sounds like — a machine that takes over the work of the heart and lungs. Since it's open-heart surgery, the heart has to be stopped."
Na Haram's eyes went wide. She had thought of it as heart surgery, but she hadn't imagined they would actually open the heart. If you cut the heart open, doesn't that mean you die? That thought was running through her when Lee Jun continued, showing her a model of the heart's structure.
"There's something like a door attached so that blood only flows in one direction. That's called a valve. The door between the left atrium and the left ventricle is the mitral valve."
"Ah, yes."
"Unfortunately, as they age, the valve thickens, and the chordae tendineae that hold it in place can tear. When that happens, the valve doesn't close properly."
When the valve failed to close, blood leaked back in, and because it couldn't flow out the way it should, the left atrium gradually enlarged. Going further, the pressure in the pulmonary veins and capillaries rose, and pulmonary edema developed. Lee Jun explained Bokshil's condition in great detail, and in language that was easy to understand.
"So the surgery is to replace the defective valve?"
"That's right. We repair the valve, and we reconstruct and reattach the torn chordae. That's the procedure."
"My god... Is that even possible on a dog that only weighs three kilograms?"
Simply thinking of it as "surgery" and hearing it explained while looking at a model of the heart were two entirely different things. Na Haram's hands trembled. To think she had considered putting their Bokshil through something like this.
"It is a possible surgery. But it's an equally dangerous one. It's a surgery we veterinarians have to decide on with extreme caution as well."
She had come carrying hope, and despair was trying to take root. Should she just keep giving the medication as it was, and if fluid filled the lungs, hospitalize her and drain it? Those thoughts swirled chaotically through her mind. Then she asked,
"The ones who made it through the surgery... how are they doing now?"
What she actually wanted to ask was whether any of them had succeeded at all, but she couldn't quite bring herself to say that to his face. So she asked it indirectly.
"They're doing well. There are children we lost, unfortunately. But among the successful cases, there are quite a few like Bokshil's. Some have been able to come off medication entirely. Some have stopped the diuretics but are still on cardiac stimulants because their myocardial contractility has declined significantly. For most of them, though, their overall condition has improved dramatically."
"I... see?"
"Yes. The ones who made it through are living lives completely different from what they had before. Breathing easily. Going on walks. That said, given how difficult the surgery is, I can't give you a hundred percent guarantee."
It was strange. Hearing those last words, Na Haram's mind was made up.
All right. Let's do the surgery. Bokshil wouldn't want to live like this either. They say fluid in the lungs is like drowning.
Then another thought occurred to her. What was Bokshil thinking, really? If she was thinking the same thing, Na Haram wanted she could put her into surgery this very moment. But if she wasn't...
Ah, that's right. They said the director is good at reading animals' hearts.
Na Haram drew a deep breath, then spoke to Lee Jun.
"I understand."
"So I'd like you to take a look, Director. At what our Bokshil is feeling. I want her to have the surgery, even though it's dangerous, so she can live comfortably. If it were me — whether I got one more month or two more months — I'd want to live them breathing easily."
"I feel the same way. But what matters most is what Bokshil herself thinks. We may feel this way, but Bokshil might not want a surgery that could mean she never sees you again. She might just want to stay by your side."
"That's possible, isn't it."
"It is. We don't know everything that's in their hearts, after all. There's still time until Bokshil's condition stabilizes. Think it over carefully before you decide. As for what Bokshil wants — we can look into that when we examine her."
Leaving Mongmong Animal Hospital, Na Haram's heart was heavy. She wanted to give her the surgery — but what if Bokshil just wanted to stay as she was?