Chapter 45 The Projection of Fear She secretly read the diagnostic manual…

"The good news is that no structural problems or signs of malignant arrhythmias were found."

"That was probably an isolated case of vasovagal syncope. If you're worried, you could consider a tilt table test, but since it only happened once, it's not really necessary."

Xu Aida held Liang Siyu's hand and gently exhaled. Although she believed she was alright, a professional diagnosis always brought her more peace of mind.

The doctor continued to smile at her, “Ms. Xu, your average resting heart rate is high, generally around 90-100 during the day. Considering all factors, the current diagnosis is IST (inappropriate sinus tachycardia).

“IST?” she responded quickly. “I’ve looked it up, it’s a common benign condition, right? It basically doesn’t require treatment.”

In her past life, when she was in her thirties, her resting heart rate was also high, but doing yoga or something similar helped to improve it.

The doctor was a little surprised, but after looking at her educational background—a PhD candidate in Computer Science at Johns Hopkins University—he immediately understood.

"Yes, IST is a benign outcome with a very good prognosis. In your current situation, first adjust your lifestyle, reduce staying up late, maintain a regular schedule, ensure sufficient sleep, and engage in light exercise."

“For the past two weeks, I’ve been going to bed before 10 p.m. every day,” Xu Aida said with a “good student” smile.

"Good job, keep it up," the doctor encouraged.

"Hello, could you please take a look at the report regarding heart rate during sleep?" Liang Siyu, who had been silent until now, suddenly asked.

"Of course." The doctor scrolled through the report, turned the monitor toward them, and thought to himself, "The family members are well-prepared; they're very professional."

He pointed to the chart on the screen, "This is the data from the last day. In this segment, around three or four in the morning, during deep sleep, the heart rate drops to around 80."

"What about the past few days? Were there any periods when your heart rate was below 80?" Liang Siyu quickly asked, her fingers unconsciously tapping her knee.

The doctor scrolled up the data from the previous few days: "It was basically around 83-85."

Looking at the slightly furrowed brow on the other side, the doctor emphasized, "Her heart regulation function is still okay."

IST is not a big deal in cardiology, and the patients are highly educated and cooperative. For the first examination, they tend to be encouraging and not increase anxiety.

Liang Siyu felt a little heavy-hearted. If her parasympathetic nervous system were working properly, her resting heart rate should be around 50-60 during deep sleep.

Moreover, she used to have very good exercise habits, swimming and running regularly, but she has stopped exercising recently due to health issues.

They thanked the doctor and left the hospital.

It was afternoon, and the New York sun was still glaring, but Xu Aida felt that today was not so hot and humid, and the weather was not bad.

“Ned, isn’t this great?” She grabbed his arm and shook it gently. “Since there’s nothing wrong, how about we go relax? I found a pretty nice bar where we can listen to jazz.”

This lighthearted tone, however, stung his nerves.

"A bar? Ada, you know perfectly well that alcohol affects the central nervous system and directly causes an increase in heart rate."

He didn't give her a chance to argue, took her hand, and walked straight to the parking lot.

"Let's go home first. There are some things we need to talk about seriously."

He walked faster than usual, and Xu Aida stumbled a couple of steps before barely keeping up.

When they reached the car, she shook off his hand for the first time in public: "I'm not getting in the car."

Her voice wasn't loud, but it was firm: "Ned, if you want to talk, you can. We'll talk right here."

“I used to have a cocktail occasionally, and you never thought it was a problem. Now that my cardiologist has confirmed I'm healthy, what's wrong with going to a bar to relax?”

The asphalt surface was scorching hot from the sun, and a surge of irritation rose in my chest.

“Not sick? What’s wrong with relaxing?” Liang Siyu narrowed his eyes. “Ada, you have to understand that ‘benign’ in IST is a relative concept. It’s in contrast to malignant conditions that can lead to sudden death.”

Hearing words like "malignant" and "sudden death," Hsu Ai-ta's heart skipped a beat.

He was using this tactic to intimidate her again, as if he held the final say whenever health issues were involved.

He said in a serious tone: "This term, 'inappropriate sinus tachycardia,' clearly tells you that this is not a healthy condition."

Looking at his furrowed brow, she felt a surge of irritation. She had been adjusting her sleep schedule and reducing her caffeine intake as he had requested for a month now.

The doctor brought good news today, wouldn't it be nice to go and relax together?

"Don't exaggerate. I've read the information, and the doctor said that it doesn't even require medication."

He immediately retorted, "Because it's not a disease of the heart itself, but a core symptom of autonomic nervous system dysfunction!"

"You've studied cognitive neuroscience; stress activates the 'fight-or-flight' response, and the sympathetic nervous system is awakened..."

"Stop talking!" she interrupted him sharply. She vaguely realized what he was saying; he was referring to IST as a psychosomatic illness.

She unconsciously pressed her right hand against her chest, her breathing quickened, and the white light reflected from the concrete floor made her feel a little dizzy.

Liang Siyu immediately regretted it. He had clearly planned to go home and explain things to her properly, trying to present the situation objectively, so that she wouldn't underestimate her situation or become too anxious.

He immediately moved closer and put his hand on her shoulder: "I'm sorry, Ada, it's my problem. Let's get in the car and rest for a bit, then we can go home, okay?"

"Don't touch me!" She quickly backed away.

He clearly lit the fuse and detonated the explosives, turning her into a pile of rubble, yet he acted all magnanimous.

A car drove out from behind her!

"Don't move!" Liang Siyu shouted, pulling her back into his arms.

She froze for a few seconds, then saw a car turn and drive away out of the corner of her eye. Only then did she realize that the car had just passed behind her, and if she had taken a few more steps back, she might have been hit.

The tendon on the left side throbbed, and the already heavy head felt a dull ache, as if a steel bar was tightening around it.

He looked down at her face, feeling both pain and regret. He gently patted her back and said, "Ada, really, I didn't mean to. Let's go home, okay?"

She opened the back door and climbed in. The familiar blanket was still on the back seat, which she clutched tightly and covered her knees.

When they got home, they sat side by side on the sofa. Xu Aida held a cup of chamomile tea, but didn't drink a drop.

“Ada, you know what? I’ve been a little worried lately, you’ve been feeling unwell quite often.” Liang Siyu said, gently taking her left hand in his.

She immediately retorted, "Then I've adjusted my schedule too, and I've listened to all the reasonable suggestions."

"Take today's events for example, the doctor didn't even give me a no-alcohol order. If you're nice to me, I might order a non-alcoholic cocktail."

“But you can’t do this, using your anxiety to hold me hostage every day.” She pulled her hand away.

Hearing about "non-alcoholic cocktails," Liang Siyu was initially quite relieved, but the last sentence used anxiety to bind her.

She's so stubborn; once she's made up her mind, he has to be extremely careful even if he tries to persuade her. Kidnapping? When will he ever have that kind of influence over her?

He was also a little uncomfortable: "When can I force you to do something you don't want to do? Can I kidnap you?"

She had promised to see a therapist, but she never made an appointment. He had a hunch, but didn't dare to confront her. He was helpless except for worrying silently.

Xu Aida looked up in disbelief: "Fine, everything I did was of my own free will, and has nothing to do with you. That's what you think, that I'm a cold and heartless robot, right?"

She slammed the cup down on the coffee table and rushed toward the elevator.

The mathematical derivation of the new algorithm was particularly complicated, but to ease his worries, she interrupted her train of thought countless times, preferring to redo it the next day rather than leave him alone, just to get back to her room on time.

She was afraid he would be upset; hadn't she even stopped renewing her apartment lease?

But if all of these things need to be discussed one by one, then what self-respect is left?

The crisp sound of a teacup hitting the marble coffee table startled Liang Siyu. Her words, "cold and heartless robot," stung him, leaving him both pained and chilled.

He caught her in the elevator: "Ada, Ada, it was my fault, I spoke without thinking."

He knew, of course, that she had compromised and changed so much for him. She had always been a gentle and delicate girl, but she was too proud to recount all her sacrifices.

He held her in his arms, and the person in his arms was trembling all over, her teeth chattering.

He held her tightly to his chest, looking at her slightly reddened eyes. "Ada, it's my fault. I'm an idiot. Don't be sad, okay?"

He carried her back to the bedroom, gently stroking her back and cheek, waiting for her to slowly calm down.

Her voice was still trembling, and her words were unclear, but her tone was firm: "There is no such thing as speaking recklessly."

To some extent, what people say is the truth.

He immediately understood, grabbed her hand, and insisted on intertwining his fingers with hers: "I was too hasty, okay?"

He dared not continue, for if he did, he would touch upon sensitive topics again. He couldn't talk about physical and mental illnesses, and he certainly couldn't mention counseling.

He hesitated for a few seconds before reluctantly admitting, "I'm afraid that one day you'll find me annoying and stop talking to me."

Upon hearing this, Xu Aida's expression softened somewhat. She snorted and said, "You're getting a good deal and still acting innocent. I haven't had a normal cup of coffee in three weeks."

He hugged her tighter: "I tried to find several different kinds of decaf beans. Didn't you say that the beans are still okay to drink?"

She rolled her eyes at him, and he gently pressed his lips to hers. "I know, I know. It's not just about coffee. You've been very accommodating to me in terms of diet, sleep schedule, and apartment."

That's more like it. Xu Aida relaxed a little, but still moved back a bit.

He stroked her cheek, hesitated for a moment, and then couldn't help but ask, "Did your heart race again just now? Is there anything else that's bothering you?"

"My heart is fine." Since you're not feeling unwell now, there's no need to bring it up again.

She pointed to her temple, "There's a nerve here that keeps throbbing, it's so tense and uncomfortable."

His fingers pressed gently against the surface, and his voice became low and soft: "When did this happen?"

“The parking lot,” she said softly, her eyes closed, “and you keep scaring me.”

She was the one who scared him to death; when that car came, his heart almost stopped.

He sighed softly, his fingers tracing back along his temples. The scalp fascia below the left temporalis muscle was particularly taut, and even felt somewhat swollen to the touch.

"Does it hurt a lot? Should you take an ibuprofen?"

She opened her eyes, nodded, and took the medicine from his hand.

He knew the massage was just a placebo, but he still gently pressed around his temples, waiting for the painkillers to take effect.

In the evening, he ate a light meal with her and suggested that they sit in the garden for a while, but she said she wanted to go back to her room to rest.

Meeting his worried gaze, she explained softly, "I'm not feeling unwell, I just want to be quiet for a while."

"Of course." He nodded, understanding her unspoken message: she wanted some space of her own.

The elevator doors slowly closed, and she lowered her head slightly, lost in thought.

Back in the bedroom, Xu Aida did not go to bed to rest, but instead stood in front of the bookshelf searching.

He habitually keeps an important medical manual in various places so he can refer to it at any time; perhaps there is a DSM-5 here as well.

Sure enough, she found it in the middle of the bookshelf, thick and placed horizontally on top of this shelf along with several other books.

She took a deep breath and looked at the table of contents to find the relevant chapters on PTSD.

She turned the page and suddenly saw a sticky note on the page for "Other specific trauma and stress-related disorders" that read, "CPTSD, see ICD-11".

Inside the restaurant, Liang Siyu paced back and forth, glancing at the clock. An hour had passed. Was it alright for him to go back now? Would he be seen as chasing after someone too closely?

What if she has a headache and feels unwell again? We should go up and check on her as soon as possible.