The amber vial clinked against the pills within, dice shouting out another losing hand. Meir Amsel shook them out—fourteen left until his next appointment with Dr. Harrison, the cardiologist who dispensed death warrants in the dispassionate tone of a weather forecast. "Your ejection fraction has dropped to thirty percent, Meir. We're dealing with end-stage cardiomyopathy."
Twenty-six years old, and his heart was penning its resignation letter.
He slapped his hand against his chest, and the old fluttering, which had tormented him as a child, returned. The genetic lottery had been particularly cruel to the Amsel line—his father was dead at thirty-two, clutching his chest in a supermarket checkout line. His grandfather at twenty-eight, dropping in a factory that no longer existed. The men in his family didn't live long enough to collect gray hair or grandchildren.
Beyond his rain-spattered window, London lay out beneath a bruised sky. Couples walked hand in hand along the Thames, their bodies swaying in unconscious synchrony—heartbeats regular, lungs filling with the confidence of people who had no doubt of waking up the following morning. Meir watched them with the detached curiosity of an anthropologist studying a distant tribe.
When had he last been touched by anyone with anything other than need? Dr. Harrison's cold stethoscope on his chest. The rubber gloves of the phlebotomist during his twice-monthly blood draws. The pharmacist's respect for not touching him when she gave him his medications. He was twenty-six and had never been kissed by anyone who wanted him, not felt sorry for him.
His face in the window captured the joy women instinctively understood—the graying to flesh starved of oxygen, the dark circles under eyes which had gazed too long at hospital charts, the wary way he traversed as if his body were glass spun thin. He was a ghost within his own existence, and everyone was aware of it.
The apartment felt smaller each day, walls closing in like the chambers of his sick heart. His neighbors no longer inquired as to how he was doing; the answer was always the same, conveyed in the slow way he climbed stairs and in the pharmacy bags that accumulated by his door. Mrs. Chen of 4B left him soup that she had prepared herself from time to time, her eyes aglow with the kind of pity that made his chest clench up for reasons outside of his sickness.
He'd tried online dating once—a brief burst of optimistic desperation that had lasted exactly three conversations. The first woman had ghosted him the moment he'd mentioned his heart condition. The second had talked to him as if he were a charity patient, in the overly gentle voice reserved for terminal patients and wounded animals. The third had suggested "taking things slow" with such obvious reluctance that he'd shut down his profile that very night.
Now he lived on the scraps of human contact—fast exchanges with store clerks, obligatory small talk with hospital workers, occasional nods from neighbors who sympathized enough to nod at him. He was becoming invisible, a pale photograph left out in sunlight.
The loneliness had been a physical weight this evening, pressing down on his ribcage with an intensity more than his wild heartbeat. He'd wasted the day watching over a romantic comedy that did nothing for him, seething at fictional couples their easy intimacy. At the end of the credits at last, the silence of his flat had been so complete he'd checked his wrist to make sure his heart kept pumping.
His pill routine covered the kitchen counter—seven scripts in a delicate dance of time and dose. Beta-blockers to slow his hyper-speed heart. ACE inhibitors to stabilize pressure on his compromised ventricles. Diuretics to manage the fluid that had accumulated in his lungs. Each pill a reluctant surrender, a concession that his body was a rebellion against life.
But now, however, the thought of taking another handful of pills and going back to his routine—documentaries until his eyes grew heavy, then the clever positioning of pillows to help him catch his breath—was unbearable. Tonight, for the first time, he wanted to be alive before his heart finished its slow process of giving up.
The decision shocked him: he would take a walk. Not the careful, cautious circuit around his block that Dr. Harrison had approved, but an honest-to-goodness walk in the London night. If his heart was going to kill him anyway, then why not let it kill him somewhere other than his tomb-like apartment?
He pulled on his jacket, now too large, his body shrinking along with the functioning of his heart, and he went out into the evening. Cold stabbed his lungs, but for the first time in a long time, he didn't automatically have to calculate how much work he could do before the tightness in his chest started.
London at midnight was a different world. The tourists and families had retired, leaving the only the night workers, the insomniacs, and lost souls who traveled the night like him—souls whose stories were written in darkness and quiet desperation. He walked aimlessly, his dying heart beating its erratic rhythm against his chest, and for the first time in years, felt as if he were living rather than merely surviving.
He did not know that somewhere in the city, another shattered heart was racing toward a collision that would change their lives.