Like Nick, I felt a foreboding sense of déjà vu as we pulled up in front of Florida Hospital, but for different reasons. This was where Holden had been diagnosed six months ago. I remembered the fear I’d felt as I arrived at the hospital to find my son in ICU, on a ventilator, sedated, and sicker than either Leigh or I could have ever imagined. Life could change in an instant there.
I saw the falsely cheerful facade of the children’s hospital in the background as Nick followed the signs to the emergency department. There, he handed my keys off to the valet to park the car so he could come inside with me.
Dr. Parker must have fulfilled his promise to call ahead because, once we’d checked in, we didn’t have to wait long before a nurse named Colleen led us back to a private room. She took my vitals, made a few notes on my chart, and then handed me a hospital gown. “Go ahead and get changed and hop into bed. I’ll be back to check on you in a bit,” she said briskly before she left.
Nick looked at me awkwardly. “Do you want me to wait in the hall while you change?”
I shrugged. “I don’t care if you stay. Nothing you haven’t seen before.”
But that wasn’t exactly true. When I took off my t-shirt, his jaw dropped. “Holy shit!”
“Yeah, I know… it’s everywhere,” I said miserably, assuming he was talking about the rash.
“No… your scar.” Nick suddenly looked embarrassed, like he’d blurted out something he shouldn’t have. “I’m sorry,” he said, shaking his head. “But… shit, dude, they really sliced you up.” He couldn’t hide the look of horror on his face, nor could he seem to stop himself from staring.
“Well, yeah, your liver’s the biggest organ in your body,” I said, feeling my face flush as I self-consciously followed his line of sight down to the Y-shaped scar that stretched from the center of my chest to the top of my belly button and out to both sides of my torso. It was fully healed now and had faded a lot over the last few months, but I supposed it was still pretty shocking to someone who hadn’t seen it without the bandages before. I wasn’t a big fan of it either, but I told Nick, “It looks worse than it is.”
He let out his breath in a low whoosh. “I’d say you’ve definitely got Brian beat,” he said with a nervous laugh. “He’s gonna have some competition now for which Backstreet Boy the girls wanna see without a shirt the most. Chicks dig scars.”
I made a face. It was hard for me to imagine feeling comfortable enough to go shirtless on the next cruise. Then again, after what had happened on the last one, I somehow doubted Nick would even agree to another cruise. We still had a couple more on our contract, but I was sure we could cancel that on the basis of my health concerns, if it came down to it. It was just one of the many career moves we would have to consider, sooner or later. Until we had that conversation, everything with the group seemed to be on hold. And until I found out what was causing my symptoms, everything in my life seemed to be on hold, too.
Nick sat with me as I waited to be seen by a doctor. Finally, a woman in a white coat came in and introduced herself as Dr. Webber. She spoke in a British accent and had a pretty, dimpled smile that put me at ease. “I hear you’re feeling a bit poorly, Mr. Dorough,” she said. “Can you tell me more about the symptoms you’ve been experiencing?”
“Call me Howie,” I replied, “and yeah, sure.”
As I started describing the symptoms that had developed over the last couple of days, Nick suddenly cleared his throat and stood up. “Um, I should probably step out, huh?”
“You don’t have to,” I said quickly. I could tell he was uncomfortable, but, selfishly, I wanted him to stay. It had helped, having him there to wait with me, and now that the doctor was there, I felt like I needed him even more. “My friend Nick can stay in the room, right?” I asked Dr. Webber.
“Of course, if you’re comfortable with that.”
I looked at Nick, silently begging him to sit back down. I was worried about what the doctor would say; if something was seriously wrong, I didn’t want to be alone when I found out.
Nick shrugged. “I guess if it’s cool with everyone, then okay,” he said, taking his seat again. I shot him a grateful smile, then got back to telling Dr. Webber about the way I’d been feeling.
When I was done talking, she said, “Well, Howie, given your history, your symptoms could be indicative of several different issues – some quite serious, others not so much. We won’t know exactly what we’re dealing with until we do some further investigation, so I’d like to start with a physical exam and then order a few tests. Does that sound alright?”
I nodded, knowing I didn’t have much of a choice in the matter. I was so used to being poked and prodded by that point, it wasn’t a big deal. I let her look at my rash, listen to my chest, and feel my belly.
“There doesn’t seem to be any swelling or tenderness around your liver,” she said, as she pressed her fingers into a few places on my right side, just under my ribcage. “That’s a good sign. I still want to test your liver function, just to be sure you’re not experiencing an episode of rejection, and do some additional bloodwork as well. I’ll send Colleen in to collect some samples, and I’ll be back to check on you once we have the lab results.”
After the doctor left, the nurse came back to draw my blood. Nick, I noticed, stared determinedly at the floor as she inserted the syringe into my arm. After she had gone, I smirked at him and said, “How can you have so many tattoos and still be afraid of needles?”
Nick shuddered. “I swear, it’s even worse watching someone else get stuck.”
“Aww, it wasn’t that bad,” I said, touching the Band-aid that was holding a cotton ball against the tiny hole in the crook of my arm. But beneath my bravado, I was touched by his sympathy. “I know what you mean, though; I hate watching James and Holden get shots. It is worse when it’s someone you love, and all you can do is hold them and wipe their tears away when it’s all done. You feel so helpless…”
I glanced over at him hopefully, wondering if my use of the word “love” would get a reaction out of him, but Nick had gone back to looking at the floor. I wished I could read his mind and understand what was going on in there. Nick had always worn his heart on his sleeve, but these days, his feelings were hard to decipher. Then again, the fact that he had stayed with me, even though I knew it made him uncomfortable, spoke volumes. Maybe he wasn’t offering to hold my hand, but at least he didn’t hate me anymore – that much I was sure of.
“You want me to call anyone?” Nick offered, after we’d been waiting around for awhile. “Or step out so you can call your family?”
I shook my head. “Nah… no sense in worrying anyone when it could be nothing. Let’s wait until the test results come back.” And see how bad it is first, I added in my head. I wasn’t usually so pessimistic, but seeing as how nothing had gone my way in the last six months, I was getting used to bad news. Waiting for it, though… that was the worst.
“Okay,” said Nick, both hands tapping out a random beat on the tops of his thighs as he looked around the room. I could tell he was getting restless. There was no TV or anything in the room to keep us occupied, and we’d run out of conversation. It wasn’t the right time or place to try to talk to him about our relationship. The kiss in the car felt like it had taken place a lifetime ago, though it had only been two days. Watching Nick nervously lick his lips, I couldn’t help but wonder if it had even happened at all, or if it was only a fantasy.
“Hey, I heard there’s gonna be another rocket launch this Thursday,” I said randomly, wanting to see how he would react. When his face turned red, I knew for sure I hadn’t been dreaming. “Maybe,” I added, trying to feel him out some more, “if I’m outta here by then and you’re still in town, we could go watch it together.”
Nick met my eyes for just a second, long enough for me to see a flash of something in his before they seemed to settle on my forehead. “Yeah, sure… sounds good,” he said, and I felt a flicker of hope.
Then Dr. Webber came back. This time, she was accompanied by another woman in a white coat, whom she introduced as Dr. Charnell. “Dr. Charnell is a hepatologist. I’ve asked her to consult on your case because, while your lab results haven’t confirmed an episode of rejection, we can’t rule it out until we run some more tests. I’ll let Dr. Charnell explain.”
The second doctor stepped forward, clearing her throat. “Yes, unfortunately, Mr. Dorough, there are some findings in your blood work that are cause for concern,” she said, and my mouth went dry. “First of all, your liver enzymes are slightly elevated, which, as I’m sure you know, could be an early sign of rejection or failure of your liver graft. Like Dr. Webber said, we’ll need to do more tests, including a CT scan of your abdomen and a liver biopsy.”
I nodded, thinking that didn’t sound so bad. I’d been through both of those tests before and after my transplant.
“You’re also anemic,” added Dr. Charnell. “Your red blood cell count is low, which explains why you’ve been feeling tired. It’s not uncommon after a liver transplant and could just be a side effect of the immunosuppressant drugs you’re taking. That said, the anemia coupled with a fever and rash have us both concerned that it could something more serious. These are all symptoms of a rare complication called graft-versus-host disease, which occurs when cells from the donor liver attack the transplant recipient’s tissues and trigger an immune response.”
I swallowed with difficulty, wishing I had some water. “That doesn’t sound good. How, um… how serious are we talking here?”
Dr. Charnell and Dr. Webber exchanged glances. Even before the answer came, I could tell, more or less, what it was going to be by the looks on their faces.
“Unfortunately, graft-versus-host disease does have a high fatality rate in liver transplant recipients,” said Dr. Charnell. “However-”
“How high?” I asked hoarsely.
Dr. Charnell shifted her weight uncomfortably. “I don’t put much stock into statistics; every case is different, and we don’t even know-”
“How high?” I repeated, louder this time.
Dr. Charnell paused to take a deep breath. “Over seventy-five percent.”
I suddenly felt woozy. Next to me, I heard Nick’s sharp intake of breath. I’d almost forgotten he was even in the room. I chanced a glance his way; he was staring at the doctor with a horrified look on his face, his blue eyes wide.
“But Howie, we don’t even know if that’s what this is,” said Dr. Webber quickly, “so let’s focus on the next steps and not get too far ahead of ourselves. Here’s what’s going to happen next: We’re going to admit you to the hospital for a blood transfusion, which will replenish your red blood cells and hopefully help you feel a bit better. You’ll undergo some diagnostic tests, like the CT scan and liver biopsy I mentioned earlier, and Dr. Charnell will get to the bottom of what’s causing your symptoms.” She offered me an encouraging smile and added, “You really needn’t worry until we know more.”
But of course I was worried. How could I not be?
When the two doctors left me with a packet of admission paperwork to fill out before I could be moved to a new room, I looked again at Nick. He was now staring at me, and when he saw me looking, he shook his head slowly. “Damn, Howie… you gotta quit doing this to me, man.”
I laughed shakily. “Just trying to keep things interesting.”
Nick cracked a smile. “Yeah, well, that’s one way to put it.” Then suddenly he sat forward, leaning toward my bed. “Listen, though – those doctors are right. Don’t start freaking out about something you don’t even know if you have. Trust me, I’ve been there, and it ain’t fun. And if it turns out that you do have that graft-verse-whatever thingy, well… if you can survive everything else you’ve been through in the last six months, you can survive that, too. I mean, I’m beginning to think you’re immortal or something… The Indestructible Howie D!”
I smiled at his attempt to ease my mind. “Thanks, Nicky. I really appreciate you being here with me.”
He nodded. “No problem.” Then he reached out and grabbed my hand. Reassuringly, he squeezed it and said, “I’m not going anywhere.”
As I gave his hand a grateful squeeze back, I couldn’t help but feel more hopeful. About everything.