Diversity of Life

9. The Stress ECG

Amber wasn't sure how to sit down on the sports equipment. She seemed a bit helpless, which Dr. Karmann quickly registered. "I'll help you," she said, removing the clamps on Amber's ankles. So carefully straightened up. All the cables tickled her. There are quite a few, she thought. Dr. Karmann grabbed a few, put them in order and held them in her hand. Meanwhile, Dr. Winkelmann put her bag on the table. She had now straightened up, took it and pulled out her sneakers. Dr. Karmann took one and laid it on the floor while Amber pulled the first one over her bare right foot. Dr. Winkelmann put the bag aside again and went back to the ergometer. Amber felt electrodes interfering with putting on the shoes. Something tugged as something stretched and stretched.

Once she had pulled the first one over, Dr. Karmann gave her the second, which she also pulled over and quickly tied a bow. Pretty stubborn, she thought to herself as she put on her left shoe. She felt each one of the electrodes under her left breast. They weren't exactly small either. Then she was ready and looked at Dr. Karmann. "Ok, then please come on the ergometer here," she said, holding the cables. Amber put her feet down and stood up cautiously. With her shoes on, she quickly made contact with the floor and noticed that the table wasn't that high after all. She carefully walked onto the nearby piece of sports equipment while Mrs. Karmann made sure that the cables were long enough. But it seemed to work. Fully wired, she gripped the upturned handles, which were covered in soft foam rubber. She struggled to carefully grab an empty spot because the black stethoscope was still dangling from it, so she grabbed the ends of the handlebars. The doctors didn't seem to care.

Holding on, Amber put one foot on the pedals and shifted her weight onto them. With a little swing she sat down on the cool saddle and put her second foot in the strap of the pedals. She was now ready and looked at the two doctors one after the other with both hands on the handles. Dr. Winkelmann was now back at the monitor. "Very good," said Dr. Karmann and put both hands on the metal tubes of her stethoscope, which was still around her neck. She took it off in one swift motion, then, holding the chestpiece in her right hand, grasped the ear plugs. She cocked them and put the stethoscope in her ears again. Wasn't that enough before, Amber thought, taking her hands off the handles and straightening her body. Determined and without any explanations, Dr. Karmann approached Amber. She placed the diaphragm of her stethoscope again on an empty spot on Amber's left breast. "Would you please bend over slightly?" she said and looked briefly at Amber. She obeyed immediately and leaned forward slightly. To support herself, she grabbed the handles with her right hand. Dr. Karmann moved the stethoscope once and placed it on a free spot on the underside of Amber's breasts, which she slightly lifted for it. Then, two seconds later, Dr. Karmann took down the membrane. She clamped the stethoscope around her neck and turned to Dr. Winkelman. "Would you turn on the ECG, please?" No sooner had this sentence been said than it beeped audibly in the room again. The doctor turned back to Amber. "Please pedal once, yes?"

Amber started to pedal. No problem, she thought. The resistance was very low. And boldly she began to pedal. Her pulse quickened, as did the beeping. Amber looked at the display of the ergometer. But her focus was more on her leg strength. Ignoring the display of the ergometer, she looked down at her thighs. She noticed all the cables swinging left, then right, and so on with every leg movement. They now hung down and rested on her left leg before leading away from her to the machines. Meanwhile, Karmann stood next to her the whole time and observed what was happening. Amber was busy with the ergometers, so didn't notice that Dr. Winkelmann also came along. He had a blood pressure cuff in his hand, which was already completely open, and he carefully placed it around Amber's upper left arm, who kept pedaling without pausing. She glanced to the left and saw the doctor tightening the cuff, but then back to the ergometer reading. There were also several hoses attached to the cuff. One belonged to the pump ball, which Mr. Winkelmann controlled and allowed to dangle down the outside of Amber's left arm. Another hose was connected to the display that hung on the wall. Amber couldn't see the display, but the hose must have been quite long. She looked briefly at the arm. As she did so, she saw that the hose had a spiral shape, like a telephone receiver cord, and had to be quite long. It stretched, but it got a little warm under the cuff.

Dr. Winkelmann took the stethoscope off the handles and held it briefly in his hand while he looked at the display of the ergometer. Then he put it away. Amber changed the position of her hands. Because the stethoscope was no longer attached to the handle, she could now also hold on to the horizontal points. This caused her body to lean a little further forward. The electrodes on the abdomen tugged a little. But she felt the rest of them too.

Due to the constant movements, the audible beeping in the room became faster. She noticed how pedaling now slowly becoming more strenuous. She got a little warm. With the stickers on her body, the feeling didn't want to get any better. The physical exertion was not a problem for Amber. But the surroundings made her uncomfortable. In addition, both doctors stood by her with interest, observed what was happening and the monitors very attentively or busy themselves with changing something on the devices. Amber didn't have time to look around. She concentrated too much on pedaling and tried to suppress the shame. How long is this going to be topless, she thought as she caught a glimpse of Dr. Karmann took her stethoscope off her neck and put the eartips in her ears. Not again, Amber thought and pretended not to notice what had happened.

Mrs. Karmann took a step closer to Amber, pressed the chestpiece into Amber's armpit and took the pump ball with her free hand. Then she looked past Amber at the wall and started to pump. Immediately the cuff tightened around Amber's upper arm and became tighter. She felt an uncomfortable feeling. Now it feels like I'm still under control, Amber thought. In addition, the stickers on her chest tugged a little, and the constant but rapid beeping filled the examination room the whole time. Now there was no more secret she carried to hide. Her body belonged to the medical team, she gave herself completely. All that's missing is a gynecologist, she thought and noticed that the sweat was forming under the cuff. But she also felt the pores on her body move and begin to moisten the skin. Amber could not be further interested in it. Because Dr. Winkelmann operated the control panel of the ergometer while Mrs. Karmann measured Amber's blood pressure. Pedaling became harder.

Amber's breathing became shallow. She breathed faster and realized the effort she had to muster. She breathed in the air through her mouth now. Without hoping it, she suspected that Mrs. Karmann would put the stethoscope on her chest again soon. She only seemed interested in her heart. And indeed. The doctor took the chestpiece out of the crook of her arm, carefully let the pump ball dangle down again and led the chestpiece, which she was holding with her hand, under Amber's left arm to her body. At least the pressure of the cuff had eased noticeably. Amber briefly looked in amazement at the doctor's hand between her body and her left arm, but then back at the display of the ergometer. To make Karmann a little easier, she grabbed the upper extremities of the handles and for a split second wondered herself at the politeness of making it as easy as possible for the doctor.

Shortly thereafter, Amber felt the doctor place the stethoscope on her left breast. She doesn't need to ask me to take a deep breath while she’s listening, thought Amber, since she was almost panting anyway from the physical exertion. Not long did Dr. Karmann the chestpiece on this spot. Is the beeping in the room not enough? Amber thought to herself. And as she already knew from Mrs. Karmann, she moved the chest piece very quickly and then felt it on a lower part of the left breast. After a few seconds she took it down again. "Everything sounds very good so far." said Mrs. Karmann and gave Amber a short smile.

During that time, Amber didn't realize that Dr. Winkelmann fetched something. After Dr. Karmann took the stethoscope down again, he spoke. “We will now carry out a lactate measurement. Just a small, short prick in the ear. Please continue pedaling normally, you will hardly feel anything.” Amber noticed that Dr. Winkelmann had put on white latex gloves. She was surprised that she hadn't seen or heard that at all. She plucked up courage and turned her attention to Dr. Winkelman. "What are you going to do now exactly?" As she pedaled, she glanced sideways at the doctor. Now that she could feel the sweat under the cuff and between the stickers on her body, the procedures seemed to be getting a bit too much. And for a moment it seemed like sanity took hold of her and it gave her back control of her body. dr Winkelmann looked friendly at Amber. “We will briefly check the lactate value. Lactate occurs when you exert force like you are doing right now. We can detect lactate in the blood, so I take a drop for a moment. If too much of it is in your blood, it affects your performance. But if the quantities are below the threshold, everything is ok. We're going to do that a few times now, maybe two or three times. This way you can say exactly whether a certain training is good for your body or maybe even harmful. Winkelmann looked at Amber briefly and smiled. "OK?"

Amber was satisfied and nodded. She liked that the doctor stopped his examination to explain the process to her. It gave her some reassurance, but also a sense of taking back some more control. He's actually quite likeable, she thought, and kept pedaling. The doctor put an object to Amber's ear. She felt the touch on the lobe of her ear and a second later a small sting that hurt a little. Mrs. Karmann stood by and watched the displays. “I will now increase the intensity again. It's getting a little harder now, isn't it?” she said.

What awaits her and what's to come, thought Amber. It was getting uncomfortable. Isn't it like that all the time, Amber thought briefly. She observed Mrs. Karmann adjusting something on the display of the ergometer. She hasn't taken off her stethoscope yet. Well, if she wants to use it again, then she has to put it on my damp skin, thought Amber, who quickly felt the higher resistance in the pedals. Much more strength was now required than at the beginning. Amber closed her eyes. It almost felt like climbing a mountain on a bike. But the electrodes on her chest wouldn't let her imagine it. Will they hold up? Amber wasn't sure, opened her eyes and looked down at herself for a moment. Beads of sweat were already forming on her chest. She couldn't see all the electrodes. Especially not the ones stuck under her chest. Still, it felt like they were already coming loose at the edges. But slowly I'm out of breath, Amber realized. Her heart was beating wildly. She felt it pounding in her throat, and the beeping in the room also indicated this.

While Amber was pedaling, she noticed again how the blood pressure cuff was getting tighter and tighter. So busy with the effort, Amber was no longer really interested that Mrs. Karmann had put the stethoscope in her ears again and was measuring Amber's blood pressure. And anyway, nothing seemed to interest her more than the effort and her own body. She didn't care what the doctors were doing now. Amber longed for the end. Even that Dr. Winkelmann approached her again, she was initially not interested.

"Would you please take a short break?" This sentence sounded like a salvation. Amber couldn't believe what Dr. Winkelmann said. But she quickly realized. Resting her legs, she pushed off the handles and straightened up. Finally, she thought. She didn't even notice that Mrs. Karmann was still holding the membrane of her stethoscope in the crook of her arm. Remembering this, she glanced to her left for a moment. Dr. Karmann slowly took the chestpiece down. The jolt didn't seem to have bothered her. "Fine," she said. Again she applied the chestpiece above the left breast. "How are you feeling, Amber?" she asked while listening to the heart again at that point. Amber breathed quickly through her open mouth. She felt the stethoscope on her chest trying not to breathe in the doctor's direction and looked down. "Everything ok, but exhausting," she breathed and looked back at Dr. Karmann, who moved the stethoscope again. "It's good. Heart sounds are fine too.” Amber now felt the membrane on the inside of her left breast. Unusual spot, she thought, no doctor has ever put the stethoscope on here. Meanwhile, Dr. Winkelmann again a blood sample from the ear.

"I think that's it for now." Dr. Karmann took the eartips out of her ear and put the stethoscope around her neck again. "Well done, Amber!" She put her hand on her shoulder. "We will now remove the electrodes and release you." Finally! Amber thought and felt Dr. Winkelmann removed the cuff from her arm. The skin underneath was soaking wet. The breeze she felt on it felt really good. Dr. Karmann began to remove the electrodes and the cables. It wasn't pleasant, because some of them still stuck quite well. But the feeling of finally being free was irreplaceable. As soon as the beeping stopped, she felt her body and her emotions regain her possession. Now she could be herself again and was really looking forward to a shower.