The timeline matched what I already suspected. Three of the spikes were post-exertion, during walk-through and drills. One was post-meeting, no activity logged. The lowest dip occurred the night after the administrative confrontation. The inconsistency, paired with the resting range swings, fit the clinical presentation.
The diagnosis sat on the page, not written out, but visible in every number.
“SVT?” I asked, voice steady despite my heart racing.
William didn’t pause. “Paroxysmal. Most likely. No visible reentrant pathway on surface ECG, but the rhythm irregularities match narrow-complex tachycardia patterns. We need EP confirmation.”
“What’s the differential?”
He pulled the vitals up on the monitor. “It’s not sinus arrhythmia. Not atrial fibrillation. Not PVCs. No skipped beats, no irregular pauses. He’s not symptomatic between episodes, but the spikes are too consistent to ignore.”
“And the referral?”
“Sent to Cardiology last night. Electrophysiologist is on Thursday rotation. If they can fit him in, we’ll have confirmation by the end of the week. Otherwise, we push him to Monday and pull him from practice through the weekend.”
I gripped the edge of the counter. “What’s your read?”
William turned to face me. “If this is SVT, it’s early-stage, manageable, and treatment-responsive. But he’s in a high-risk environment. Intensity spikes during practice, altitude travel, inconsistent recovery. Those factors make it unpredictable.”
He paused, then added, “You know what’s next. We start documentation for cumulative stress interaction and determine how often he’s red-zoning.”
“He doesn’t know,” I said.
He gave me a look but didn’t challenge it. “Not until it’s confirmed?”
“Correct.”
“I support that,” he said. “But we’re on a clock now. One more sustained spike, and I’m required to flag it to Booth.”
I nodded once. “Understood.”
He pulled the performance overlay onto the screen. We watched it loop silently for a few seconds.
“I saw the field footage,” William said. “Sunday. He was compensating.”
“He’s scheduled for neuro at noon,” I said, opening his chart on my tablet. “We’ll reassess fatigue and executive function.”
“I’ll flag Ivy to monitor his hydration post-screening. We don’t need another episode.”
I added a new note to the internal file:Pending specialist confirmation. Monitor for continued HR variance. Patient stable. Emotional stressor ongoing.
William stepped back slightly, watching me enter the data. “You’re documenting it cleanly.”
“I always do.”
He leaned against the cabinet. “I know you’re managing this professionally. I also know this is personal.”
All my blood drained from my face. He knew. He found out the truth. I was going to get fired. My fingers numbed as I remained there, frozen, unable to speak.
“You’ve been running interference for months. Balancing medical, mental health, and performance outcomes without blowing up the room. That’s not easy, and most of them don’t see it.”
Wait. What?
“Hm?” I replied, digging my nails into my palm to hide my freakout.
“I see all that you do,” he said. “And so does Ivy. If this escalates, we back your call. Every part of it.”
I met his gaze, throat tight as reality hit me. He was complimenting my work, not outing my secret. There was no bullshit in his voice, and guilt clawed at my gut. They wouldn’t think this about me if they knew the truth about Oliver and me.All this trust would evaporate. I cleared my throat, looking away from him. “Thank you.”
