Nick
My heart raced as the orderly rolled me down a long hallway. Bright lights flickered over my head as I lay on my back, looking up at the ceiling. I closed my eyes to block them out and concentrated on taking deep breaths, trying to slow down my heart and help my body relax. But I couldn’t help feeling anxious about the tests I was about to undergo.
The nurse had told me I was on my way to the noninvasive cardiac lab. I wasn’t too good with words, but I was pretty sure “noninvasive” meant they wouldn’t be putting anything inside my body. Hopefully it also meant there wouldn’t be any pain involved. That made me feel a little bit better, a little less nervous.
“Here we are,” the orderly announced.
I opened my eyes to find myself in a small room. A young woman with black hair was waiting for me. “Hi, Mr. Carter,” she said with a smile. “My name is Vanessa, and I’m going to be doing your echocardiogram today. Has your doctor talked to you about what this procedure entails?”
I shook my head. “I don’t think so.” If she had, I didn’t remember. The morning was a blur.
“Okay, well, an echo is basically an ultrasound of your heart. What I’m going to do is place a transducer probe on your chest that will send sound waves through your body.” She showed me a small, white device that looked like a cross between a microphone and an electric razor. “When the waves bounce off your heart, they’ll create moving images on my computer that your doctor will use to evaluate its structures and function. In other words, it shows us the shape of your heart,” she added, winking at me.
I forced a weak chuckle. I’m sure she was just trying to lighten the mood, but her little BSB joke only increased my anxiety. The fact that she knew who I was – and may have been a fan – made me feel even more uncomfortable. I knew there were privacy laws that prevented her from sharing any of my medical information publicly; I just had to hope she would follow them.
Vanessa parked my gurney right next to a padded table. “Go ahead and scoot over here,” she said, lowering the side rail so I could slide myself onto the table while she kept my tubes and wires from getting tangled. “I’m going to have you take off your gown now.” She helped me out of the hospital gown, easing my IV bag through one of the arm holes before she hung it on a pole. Then she plugged the cable that connected the wires on my chest into a white cart that sat next to the table. It had a large monitor mounted on top with what looked like a built-in laptop beneath it. I assumed this was the echocardiogram machine.
I cringed when she squirted some cold gel onto my chest. “This will help conduct the sound waves to give us a clearer image,” she explained as she pressed the probe into the pile of gel on my bare skin.
I glanced up at the monitor to see a ghostly gray and white image flickering on the black screen. “That’s my heart?” I asked, watching it with fascination.
Vanessa nodded. “This is your left ventricle,” she said, tracing part of the picture with finger. “And this is the right ventricle… right atrium… and left atrium.” She pointed out each chamber. “The little flaps you see between them are the valves.”
I watched the valves flutter back and forth with each beat of my heart, opening and closing to control the flow of blood. They were moving really fast. “Does everything look okay so far?” I asked anxiously.
“Oh, I couldn’t say; I’m only the sonographer,” Vanessa was quick to reply. “My job is just to take some images and measurements and report them to your doctor, who will interpret the results.”
I didn’t question her further, but I was willing to bet she could say if she wanted to. She just wasn’t allowed to tell me anything. I watched her face carefully, looking for clues that she saw something wrong with my heart. But she wore an unreadable expression as she went to work, repositioning the probe over my chest with one hand while she pushed buttons on her computer with the other. At different points during the procedure, she asked me to hold my breath or change positions.
“I need you to lie on your left side now,” she announced after a while. As I rolled onto my side, she placed a wedge pillow behind my back to help me stay in that position. “Let me know if you get too uncomfortable.”
“I’ll be all right,” I replied, trying to be tough. So far, the test wasn’t too bad, but I would be glad when it was over. My chest felt tender from how firmly she had to push the probe into it to get a clear picture, and I was tired of lying perfectly still.
“All done, Mr. Carter,” Vanessa said, finally removing the probe from my chest. I sighed with relief, feeling my body relax. She wiped off the gel and helped me put my hospital gown back on before I shifted over to the gurney again.
An orderly brought me back to my room to rest. “How’d it go, man?” Kevin asked after I had gotten settled into bed again.
“Not too bad,” I answered with a shrug, describing what had happened during the test. I just hoped the results wouldn’t be too bad either.
***
The next morning, Dr. Richards came by my room bright and early. She listened to my chest with her stethoscope again and asked how I was feeling. By then, my hangover had worn off, and I felt fine. “Ready to go home,” I answered hopefully.
She returned my smile briefly before ruining the rest of my day. “I’m afraid that won’t happen today,” she said, and my heart sank. “After looking at the results of the echo you had done yesterday, I’d like for you to undergo a nuclear stress test. This will allow us to see how well your heart is working when you’re active compared to when you’re at rest. The test takes a few hours to complete.”
As another long day in the hospital loomed ahead of me, I let out a sigh. “What did the echo show?” I asked her. “Is there something wrong with my heart?”
“I’d rather wait until I’ve had a chance to review all your test results to talk about that,” Dr. Richards replied dismissively. “We’ll discuss everything in more detail tomorrow. But no matter what the results show, I hope this will serve as a wake-up call for you.” She gave me a stern look.
I only half-listened as she lectured me about changing my lifestyle – drinking less, staying off drugs, losing weight, exercising, and eating healthier foods. I had heard it all before, but, as the tattoo on my wrist reminded me, old habits die hard.
She finished by saying, “I should have something more definitive to tell you by tomorrow morning. Until then, try not to worry.”
But, of course, hearing that just made me worry more.
“It’ll be okay, Nick,” Kevin tried to reassure me after she left. “Whatever’s going on, you’ll get through it.”
I gave him a grateful smile. As I looked over at him lying in his hospital bed, I felt bad because, in many ways, he had it so much worse than me. At least I would walk out of here on my own two feet. When he left, it would be in a wheelchair. And, by the sound of it, that wouldn’t happen for another day. According to his doctor, they were still waiting for the results of a test called a urine culture to identify the specific strain of bacteria that had caused his infection. Once they knew what it was, he would be able to go home with a prescription of pills to treat that type of bacteria, but until then, he had to continue his course of IV antibiotics in the hospital. But in spite of getting bad news himself, Kevin still found a way to comfort me.
I knew I didn’t deserve his compassion. Whatever was wrong with me, I had likely brought it on myself. While Kevin had been working so hard to build back his strength, I had been abusing my own body. I should have taken better care of myself. Instead, I had taken my health for granted, never expecting it to fail me before I turned thirty. But if Kevin’s accident had taught me anything, it was that none of us were invincible. Life could change in a heartbeat.
Later that morning, I was whisked away to another part of the hospital for the stress test Dr. Richards had told me about. “Welcome to the imaging center,” said the man who met me there. He was a young, white guy with all-American good looks and a winning smile. “My name’s Jason. I’m going to administer your nuclear stress test today.”
He seemed friendly, but I immediately felt self-conscious lying on the gurney in front of him in my ugly hospital gown. I was supposed to be the heartthrob, not the heart patient.
Appearing to be about my age, Jason must have known who I was, but thankfully, he stayed professional and didn’t make any Backstreet Boys jokes as he talked me through the procedure. “There are two parts to this test,” he told me. “We’ll start with the exercise portion. You’ll walk on a treadmill while I monitor your heart rate, blood pressure, and breathing. Once you reach your target heart rate, I’ll inject a small amount of radioactive tracer into your IV.”
“Radioactive?” I repeated, my eyes widening.
Jason smiled. “I know, right? But no worries – it won’t hurt you. You may glow in the dark for a while afterward, though.” He winked to let me know he was kidding. Was everyone an aspiring comedian around this place?
“After you finish exercising, you’ll lie on a table under a special camera that can detect the radiation in your bloodstream,” he continued. “It’ll take pictures of your heart so your doctor can see how well it’s pumping while it’s under stress from physical exertion. Then you’ll get to relax for a while before the second part of the test, where I’ll inject you with more tracer and take another scan of your heart while it’s at rest so your doctor can compare it to the first set of scans. Sound good?”
No, I thought, but I nodded anyway, not wanting him to know how nervous I was.
Jason lowered the rail and helped me sit up on the side of the gurney. He gave me a pair of non-skid slipper socks to put on my feet. Then he hooked me up to a bunch of monitoring equipment. He taped more wires to my chest, clipped a probe to my finger that measured my oxygen level, wrapped a blood pressure cuff around my arm, and strapped a blue mask to my face that I was supposed to breathe into. By the time I got off the gurney and onto the treadmill, I felt more like the Bionic Man than a Backstreet Boy. I was sure glad none of my fans could see me now, plodding along with my gown flapping open in the back and my ass hanging out.
“We’ll start off with a nice slow pace to get you warmed up,” Jason said as I walked, “but the speed and incline will gradually increase so your heart has to work harder. You’ll probably break a sweat and get winded at some point, but please let me know if you experience any chest pain or start to feel light-headed, dizzy, nauseous, or extremely short of breath.”
“Okay.” Considering I could have been outstripped by a snail at my current pace, I wasn’t worried about the treadmill going too fast. Clearly, this test had been designed for fat old people with clogged arteries and failing hearts, not twenty-eight-year-old guys who were still in their prime. I would be fine.
My confidence grew as the test continued, taking me from a casual stroll to a brisk walk. Once I felt the pace pick up, it became easier to ignore all the medical equipment and concentrate on each footstep. If I closed my eyes, I could almost pretend I was working out at the gym instead of the hospital. When Jason came up alongside me to measure my blood pressure, I told myself he was just my personal trainer. Built like a quarterback, he already looked the part, and he played his role well. “You’re doing great, Nick,” he said, placing the end of his stethoscope in the crook of my arm as he pumped up the cuff. “Keep it up.” He must not have seen many young men like me in his line of work; I was probably in a lot better shape than most of his patients.
At first, it felt good to stretch my legs and get my blood flowing. But after about fifteen minutes, my stamina began to fade. By that point, I was running uphill. The backs of my thighs burned, and so did my chest. My heart raced even faster than my feet, pounding rapidly against my ribs as my lungs strained for oxygen. The mask over my mouth and nose felt like it was suffocating me; I couldn’t get enough air. I sounded like Darth Vader as I huffed and puffed, my breath coming in short gasps despite my effort to control it. I didn’t want to admit I had already reached the peak of my endurance, but I couldn’t really hide it either, not while every beat of my heart was being recorded. The electrodes attached to my chest didn’t lie.
“How you feeling, Nick?” Jason asked as he approached me again, his encouraging tone turning into one of mild concern.
“Fine,” I panted, my slimy palms slipping over the handlebar as I tried to tighten my grip on it. I could feel beads of sweat pouring down my flushed face and between my shoulder blades, but that was nothing new – I always sweated like a pig when I worked out. I must have smelled pretty bad, too, considering I hadn’t had a proper shower in two days. The sponge bath I’d given myself in bed that morning hadn’t cut it. “Sorry,” I added, my voice muffled by the mask. “I probably stink.”
Jason just smiled as he finished taking another blood pressure reading. “No worries, man,” he replied, removing his stethoscope from my arm and slipping it down the front of my gown to rest against my heaving chest. After listening for a few seconds, he said, “All right, you’ve reached your target heart rate, so I’m gonna go ahead and inject you with the tracer now. Then I’ll have you walk for a few more minutes to cool down.”
I nodded with relief, struggling to keep up with the pace of the treadmill as he replaced the stethoscope around his neck and got the injection ready.
“This may feel a little cold at first, but it won’t hurt,” he said as he stuck a syringe into my IV and pushed down on the plunger. I did feel a shivery sort of tingle, like ice flowing through my veins, followed by a bitter taste in my mouth, but by the time I finished on the treadmill, the strange sensations had faded away.
Jason took the mask off my face, which made it easier for me to breathe. He let me lie back down on the gurney for a while to give the tracer time to be absorbed by my heart tissue. Then he had me transfer to a table in front of a large machine. I lay on my back with my arms over my head and a pillow wedged under my knees as the table slid me slowly forward into a tube. I had to hold perfectly still while the scanning part of the machine moved over my chest, taking pictures of my heart.
“How did it look?” I asked Jason afterwards as he helped me back onto the gurney.
“Your doctor will discuss the results with you once she’s gotten a chance to go over all the scans,” he said, sounding just like the girl who had done my echocardiogram the previous day.
Still without any real answers, I was taken to a waiting area to rest and bring my heart rate back down before I underwent the second set of scans.
By the time I was finally brought back to my room, I was tired and hungry. It was after noon, and I hadn’t been allowed to eat or drink anything except water all day. I had a headache from the lack of caffeine. No wonder I didn’t have any energy. I couldn’t wait for dinner.
When the orderly wheeled me in, Kevin was working with a physical therapist. He still took the time to ask, “How was your stress test?”
I felt another wave of guilt wash over me as I watched the therapist bend and flex his knees. There was no way I could complain about having to run on a treadmill with all that stuff attached to me while Kevin lay there with legs that no longer worked. He probably wished he was still capable of running, period. Compared to him, I had it easy. “It was okay,” I said. “The guy did have to inject me with radioactive stuff, though. So if I glow in the dark tonight, I apologize.”
Kevin smiled at my stolen joke. “Hey, maybe you’ll walk out of here with superpowers.”
“That’d be sweet,” I replied, smiling back. But I didn’t really care about having superpowers. I just wanted to walk out of there.
I’m sure he wanted the same thing.
***
I had a hard time sleeping that night. I lay awake long after Kevin fell asleep, listening to his soft snores and the steady beeping of the heart monitor behind my bed. Dr. Richards had said we would discuss my test results in the morning. I assumed that meant she had a diagnosis for me.
Part of me just wanted to fast forward a few hours and get that conversation over with so I wouldn’t have to worry about it anymore. But there was another part of me that dreaded the next day, so afraid of hearing what the doctor had to say that I wished the night would last forever.
In hindsight, it was probably a good thing Dr. Richards had admitted me to the hospital. Had she allowed me to do the two days of testing as an outpatient, there was no doubt in my mind that I would have gone out again and partied like it was my last night on Earth. I would have hit all my favorite haunts and drunk enough to drown the demons inside my body.
Instead, I stayed in my dark hospital room, fighting the demons that filled my head with equally dark thoughts. What if it was cancer? Or something worse? What if I found out I was dying?
I slid my hand down the front of my gown and pressed it flat against my chest until I felt my heartbeat fluttering against my palm. My heart wasn’t pounding the way it had two nights ago, when the pain in my chest had woken me up. If it wasn’t for the fact that I was lying in a hospital bed, it might have been possible for me to pretend I had imagined the whole thing – talk myself into believing my symptoms were all in my head, that I was just being a paranoid hypochondriac again. But the feel of the patches still stuck to my skin as my fingers brushed over them and the sound of the monitor beeping steadily in the background prevented me from deluding myself any further into the fantasyland of denial.
Deep down, I already knew I was going to get bad news the next day. I just didn’t know how bad it would be.
***
Dr. Richards came to see me first thing in the morning. I had barely slept, but when she walked into the room, I snapped right out of my groggy stupor and sat up straight in my bed.
“Good morning, Nick.” Dr. Richards didn’t beat around the bush. “I’ve gone over all your test results from the past two days, and I believe I have a diagnosis for you.”
She started to pull the privacy curtain around my bed, but I shook my head. “You can leave that open. I don’t care if Kevin hears.” It wasn’t like Kevin wouldn’t be listening through the flimsy fabric anyway as he lay five feet away in the next bed. As I glanced over at him, he gave me a small smile of gratitude. Truth be told, I was equally grateful to have him there. I couldn’t imagine going through this alone.
“Okay.” The cardiologist left the curtain open and pulled a chair up next to my bed. Sitting down, she looked me in the eye and said, “Nick, you have a condition known as cardiomyopathy. It’s the result of a buildup of toxins in your heart, which have weakened it to the point where it’s having difficulty pumping blood.”
As I processed her words, my heart began to pound, which made me feel light-headed. I lay back against my pillow and closed my eyes for a second, struggling to come to terms with what she had told me. Toxins in your heart… weakened it… difficulty pumping blood. The frightening phrases tumbled around in my brain, sounding like a death sentence. My worst fear was coming true.
When I opened my eyes again, they were full of tears. Trying to blink them back, I looked down at my lap and asked, “Am I gonna die from this?”
“Not if you take it seriously and make immediate changes to your lifestyle,” she replied. “Cardiomyopathy can be caused by a number of things, including chronic substance abuse. Alcohol and cocaine are especially hard on the heart. Your history of drinking and drug use has no doubt contributed to this condition.”
It was hard to hear her confirm my suspicions that I had done this to myself. Yet, even as I hung my head in shame, I couldn’t help thinking, At least it’s not cancer. But, for all I knew, this could be worse.
“Cardiomyopathy can be fatal,” Dr. Richards continued. “It’s killed plenty of famous people who partied hard like you – the singer Andy Gibb and the actor Chris Penn, just to name two.”
I recognized both of those names. Andy Gibb was the Bee-Gees’ youngest brother, while Chris Penn was the younger brother of Sean Penn. Neither of them had been very old. Chris Penn had just passed away a couple years ago; I remembered hearing about it on the news. From what I recalled, he had been found dead in his home.
“We don’t want that to happen to you,” the doctor added. When I dared to glance up again, I saw Kevin nodding in agreement. He was frowning, his brow furrowed, his sharp green eyes narrowed with concern.
“I don’t wanna end up like them either,” I mumbled, my heart skipping a beat as I imagined myself being next in the line of celebrity little brothers lost to this disease. I couldn’t do that to Kevin, who had already lost so much, or leave my other Backstreet brothers behind. My eyes filled with fresh tears as I thought about how heartbroken my friends, family, and fans would be if I allowed that to happen.
“Fortunately for you, yours isn’t a full-blown case yet. We caught it at an early stage, so the damage done to your heart muscle can still be reversed if you stop drinking and using drugs,” Dr. Richards said, offering me some reassurance. But her tone turned stern again as she added, “If you don’t, the toxins will continue to weaken your heart until there’s no turning back. Cardiomyopathy is a progressive condition that can lead to heart failure and death. In some cases, people drop dead from a form of cardiac arrest brought on by a fatal arrhythmia – an irregular heartbeat. We call that ‘sudden death syndrome.’ In other cases, heart function gradually declines until the heart can no longer pump blood effectively. At that point, the patient would need a new heart – but abusing alcohol or drugs typically disqualifies someone from receiving a transplant.” Raising her eyebrows, she gave me a long, hard look. “In other words, Nick, you need to change your ways or risk dying young.”
If she was trying to scare me, she had succeeded. My heart was hammering inside my chest. I could hardly breathe. I inhaled shakily, trying to take a deep breath, and swallowed hard. My mouth felt bone dry. “I don’t wanna die,” I said hoarsely as tears trickled down my face.
She nodded. “I know you don’t. And that’s why you’re going to abstain from drugs and alcohol altogether from now on. If you need help doing that, I can get you into a treatment program.”
I took another breath, letting it out slowly before I shook my head. “No, that’s okay. I’d rather do it by myself.” I had tried rehab and twelve-step programs before, but that stuff didn’t really work for me. The only way I had been able to stay clean and sober in the past was to cut the toxic people out of my life, get away from the Hollywood party scene, and go to my own private sanctuary in Tennessee. I called it “Cool Springs Rehab.” It had worked for me before, but as I glanced over at Kevin again, I realized it wouldn’t work this time. I had other responsibilities now; I couldn’t just hop on a plane and leave him behind.
Kevin cleared his throat. “You don’t have to do it by yourself, Nick,” he said. “AJ and I are here for you, and we’re gonna help you get through this. All right?” He offered me a reassuring smile, which I returned, wiping the tears from my eyes.
“It sounds like you have a good support system,” Dr. Richards said approvingly. “I’m going to release you from the hospital, but I want to see you for a follow-up appointment in one week.”
“Okay.” I was so relieved to hear I could go home, I would have agreed to anything at that point.
After Dr. Richards left, promising to have my discharge papers ready soon, I looked awkwardly over at Kevin again, expecting another lecture. But all he said was, “You okay, Nick?”
I shrugged, not really sure how I felt. Dr. Richards’ dire warnings about heart failure and sudden death had definitely freaked me out, but after hearing her say I could reverse the damage if I quit drinking and doing drugs, I felt better. Maybe this wasn’t a death sentence after all.
“I dunno,” I replied, still struggling to process my own feelings, let alone put them into words. “Not really… but hopefully I will be.”
There was a faraway look in Kevin’s eyes. After a pause, he asked, “Remember the day I found out my injury was complete? That my paralysis was permanent?”
I nodded. How could I forget that day? I had shown up in his hospital room hungover and worried about how he would react when he heard what I’d said in front of the paparazzi the previous night. I’d put my foot in my mouth and told the world that Kevin would walk again, only to learn that he would most likely spend the rest of his life in a wheelchair.
“You had faith in me that day,” he went on, his eyes focusing on my face. “You told me that, even if I never took another step, I would get better… and I have. I’m a lot better than I was then. Being in the hospital again sucks, but I know this is just a temporary setback – for both me and you. Because I have the same faith in you, brother. I know you’ll do what you need to do to get better. You have a long, hard road ahead of you, but I’m gonna be right behind you every step of the way, just like you were for me. And in the long run, the struggle will make you stronger. You’re gonna be just fine.”
As I listened to his soothing voice say those words, I felt like the weight of worry was being lifted off my chest. The worst was over now. After months of feeling crappy, I finally knew what was wrong with me, and I was ready to move forward and face the music instead of trying to hide from it. My heart rate had started to come back down, seeming to calm the battering ram inside my chest. Without it slamming relentlessly against my rib cage, I could finally breathe again.
***