The doctor nods as if I’m making perfect sense. “I’m Doctor Lewis. Your uncle has pulmonary valve stenosis. The valve in his heart that allows blood to flow into the pulmonary artery and then the lungs is not working. We inserted a balloon through a catheter to keep the valve open for now, but the valve needs to be replaced. Your uncle needs surgery.”

“Okay,” I say.

“Wait a minute,” Ethan says at the same time.

I turn to Ethan. “What?”

“What’s this surgery mean?” Ethan asks Dr. Lewis. “Did something happen to the valve? Was it damaged?”

“It’s congenital,” Dr. Lewis says. He sways on his feet, as if sheer willpower is the only thing keeping him from curling up in a nearby chair for a nap. But his eyes are alert and trained on us. “The pulmonary valve opens and shuts to regulate blood flowing out of the heart to the lungs. Today it just shut and wouldn’t reopen.”

“So he needs it replaced,” I say. “Problem solved. Right?”

Dr. Lewis looks from Ethan to me and back to Ethan. “You would need to decide what kind of valve your uncle wants,” he says. “There’s a mechanical one or a tissue valve, usually taken from a pig. We can go over the pros and cons of each.”

“But then he’d be fine, right?” I say.

The doctor tilts his head slightly, a man looking at an unbalanced scale. “It’s open-heart surgery, which is serious for anyone, and your uncle is in his sixties. But otherwise he’s in good health, and he’s stable right now. With a little luck and some rehab, your uncle should be fine.”

“Can we see him?” Ethan asks.

Dr. Lewis nods, his head wobbling on his neck. “It will have to be brief, though. You can come back tomorrow to talk with him about his options.” He looks at a chart in his hand. “Do either of you have authorization to make medical decisions for your uncle?”

“I do,” Ethan says.

“You do?” I hate the surprise and the squeaky resentment in my own voice.

Ethan shrugs. “I’m the one who lives here.”

I know he doesn’t mean anything by it and is just stating a fact, but his words hit me like a gut punch. I’m still thinking of a reply when he reaches for his back pocket and pulls out an envelope that’s creased like he’s sat on it. He tries to straighten out the crease and then holds it out to Dr. Lewis. “I’ve got medical power of attorney for my uncle. It’s notarized if you need to see it.”

“That’s not necessary right now,” Dr. Lewis says. “If you’ll follow me.” He turns and heads down the hallway, the four of us trailing him.