As Dr. Meymandi typed an email to the pediatrician in Kansas, I thought about the fact that this young patient had a one-in-three chance of waking up one day with a heart, a corazón, that would feel too heavy and big for her body. A heart whose walls would thin, develop scar tissue, and perhaps eventually even need to be replaced with a transplant. I thought about how startled the mother must be and wondered how much she understood about her daughter’s prognosis: Any heart failure would not come this year or next, but in ten or twenty or even thirty years.
I thought, too, about how most people with Chagas do not have email. They are poor. They are immigrants. They don’t even know that Dr. Meymandi is here in the San Fernando Valley.