“Nice to see you, Kevin. How’ve you been?”
I smiled at the dark-haired man who breezed into the small room, his white coat billowing over his blue scrubs. “Hey, Dr. Collins. I’m doin’ real good, thanks. How ‘bout you?”
“Can’t complain,” he replied, smiling back. Even when he tried to sound casual, he couldn’t hide his Yankee accent. When I’d first met him shortly after moving back to Lexington, I could tell right away that he wasn’t from Kentucky or anywhere further south. He had grown up near Minneapolis, he’d told me once – or maybe it was Milwaukee. I couldn’t remember for sure. Somewhere in the Midwest, anyway. “So, what’s new with you?” he asked as he wheeled a stool over to the exam table and sat down across from me.
“A lot, actually.” Leaning back against the raised head of the table, I chuckled. “I just got back from a three-week trip to London about a week ago.” The past week had been a busy one, full of errands and appointments: grocery shopping, back-to-school shopping, physical therapy, and a kindergarten physical for Mason. Now it was my turn for a check-up with my physiatrist, a doctor who specialized in treating people with spinal cord injuries and other physical disabilities.
“Wow!” Dr. Collins raised his eyebrows. “Business or pleasure?”
“Business,” I replied. “I dunno if you heard, but I’m back with my band – the Backstreet Boys.”
“No kidding? I must have missed that, but good for you!”
“Thanks. We just started working on a new album, which we’re hoping to release sometime next year.”
“Nice! You’ll have to let me know when it comes out so I can give it a listen.” Dr. Collins paused, then asked, “Does that mean you’ll be moving back to California?”
I shook my head. “Probably not. I’ve been thinking about buying another place in L.A. so I have somewhere to stay while we’re recording out there, but it would break my momma’s heart if Mason and I moved back there permanently.”
“Well, I’m happy to hear that,” he admitted. “I’d hate to lose you as a patient.”
“Don’t worry – I’m not going anywhere,” I assured him. “Mason’s about to start kindergarten, so I don’t wanna completely uproot him.”
“Wow, kindergarten already?”
I nodded. “Next week. I can’t believe it either,” I said, my throat tightening. “Seems like just yesterday he was a baby learning to walk, but he turned five last month. Now he’s learning how to read and write and ride a bike.”
“It goes by fast,” Dr. Collins agreed knowingly. “We just took the training wheels off my oldest daughter’s bike last weekend. She’s six, going on seven.”
I smiled as I imagined him running alongside his little girl’s bike, holding it steady until she gained enough speed and self-confidence to keep it upright without his help. Secretly, I envied him for being able to do so.
Wrapping up the small talk, Dr. Collins got right down to business. “So, how have you been doing, healthwise?” he asked. “Any problems or changes since your last visit?”
“No, not really. Well, I did fall out of my wheelchair once while I was in London,” I said, suddenly remembering my most recent trip to the hospital. “Banged up my right knee and elbow pretty bad, but they seem to have healed by now.”
“Let’s take a look.” He stood up and raised the foot of the exam table, elevating my legs until they stuck straight out in front of me. I watched as he palpated my right knee, forcing it to flex and extend as he lifted my leg and then lowered it onto the table again. Even after four years of being paralyzed, it was still a little weird to see someone touching me and not feel it. My foot twitched with spasms, reminding me that the nerves in my lower extremities were still intact. My leg could tell it was being touched, even if my brain wasn’t getting the message.
“I know I’ve lost some range of motion from missing P.T. for the last three weeks,” I admitted. “I tried to at least do my daily stretches, but it was hard to find time to work out while I was in London.”
Dr. Collins nodded. “Your leg muscles do feel tighter than last time,” he said, now running his fingers along my calf.
Corey had told me the same thing at my first physical therapy session since returning from London. “Well, I’m back to doing P.T. three times a week, so that should help to loosen them up again, right?” I replied hopefully.
“That’s the goal. We want to reduce the risk of developing contractures, which can really affect your overall function, mobility, and quality of life.” As he spoke, the doctor worked his way down my leg. “Your feet and ankles are swollen,” he said with a frown, slowly rotating my right foot at the ankle joint. “Have you been wearing compression stockings during the day?”
I shook my head. “Not when it’s ninety degrees out. Sorry, I know I should, but I don’t wanna die of heat stroke.”
“You don’t want to die of a pulmonary embolism either,” he warned me, suddenly stern. “When you sit down all day, the blood pools in your legs, which can cause blood clots to form. If part of a clot were to break off and travel to your lungs, it could be fatal. Compression stockings improve your circulation by helping to push the blood back up to your heart. If you’re not going to wear them during the day, you should at least elevate your legs whenever you can to let gravity drain the excess fluid from them. And I don’t just mean propping them up when you sit on the couch – I mean lying on your back with your legs in the air, higher than your heart.”
I nodded. This wasn’t news to me; my doctors had been telling me the same thing since I was first injured. In the beginning, I’d worn my prescribed compression stockings religiously, but as time passed, I became less compliant. The long, tight-fitting socks were hard to put on, and I hated the way I looked wearing them with shorts in the summer. But I left that part out, knowing Dr. Collins would scold me for prioritizing my own vanity over my health. “I’ll try to do better with that,” I promised him.
“Good.” Now examining my left leg, he continued, “I don’t want to scare you, Kevin, but edema in the lower legs like this can also be a sign of kidney damage or cardiovascular disease, which tends to develop more frequently and earlier in life in people with spinal cord injuries compared to the general population. Unfortunately, being paralyzed leads to a lot of the risk factors we associate with heart and kidney problems: a sedentary lifestyle, weight gain, abnormal blood pressure, bladder dysfunction, and metabolic disorders such as high cholesterol, glucose intolerance, or insulin resistance.” He set my leg down and returned to his perch on the rolling stool. “Are you still seeing your urologist regularly?”
My mouth had gone dry. Swallowing, I said, “Yeah, I just saw him about a month ago. He didn’t do the full workup he usually does at my annual visits since I was just there to get some help with… well, my, uh, sexual function.” I felt my face heat up.
Dr. Collins raised his eyebrows. “Does that mean you’re sexually active again – or planning to be?”
“Well, I dunno if ‘sexually active’ is the best way to describe it, considering I mostly just lie there while she does her thing,” I said, letting out an awkward laugh. “But, yes… I have been seeing someone, and we’ve been intimate.”
He smiled. “Good for you. If you have any questions or need advice about the physical aspect of intimacy, don’t hesitate to ask. I’m always here to help.”
“Thanks.” I almost left it at that but added on sudden impulse, “The urologist gave me Viagra, but so far, it hasn’t worked very well. I can get an erection, but I can’t maintain it long enough to finish, if you know what I mean.”
Dr. Collins nodded. “Of course. What dosage did he prescribe?”
“Fifty milligrams, I think?” I shrugged. “I don’t remember for sure.”
“Fifty milligrams is most common for a first-time user, but I believe it also comes in a twenty-five milligram or one hundred milligram tablet. Maybe you can talk to him about trying a higher dosage.”
“That’s a good idea. Thanks,” I said, wishing I had thought to call my urologist sooner. Natalie was flying up from Atlanta that afternoon. It would be the first time I’d seen her since she had surprised me in London, so I assumed we would be sleeping together that night.
“You’re welcome.” Dr. Collins cleared his throat. “While you’re here, I want to run a urinalysis to make sure your kidneys are working the way they should.”
I nodded. “Okay.”
“We’ll also do some routine blood work,” he went on. “I’d like to get a complete blood count and a basic metabolic panel, which will check your blood glucose and electrolytes along with your kidney function. We’ll run a lipid panel to check your cholesterol levels as well.”
I cringed. “They’re probably not gonna be too good. I’ve been eating a lot of bacon lately,” I confessed. While Dawn and I hadn’t actually included bacon in every meal since we’d gotten back from London, I had eaten a couple of pieces for breakfast that morning and put some on my cheeseburger the night before. “I guess I missed American food while I was gone.”
The doctor laughed. “Well, all that sodium certainly could have contributed to the swelling in your legs,” he said, giving me a reproachful look. “I know it sounds counterintuitive, but be sure to drink plenty of water – at least eight glasses a day. Dehydration will only make your body retain more fluid. And I’m sure I don’t have to tell you how important it is to eat a healthy diet.”
I shook my head. “No, I know. Don’t worry; I’m gonna get back on track with everything – eating right, drinking enough water, and exercising more. I’m already the crippled Backstreet Boy; I don’t wanna be the overweight one, too. I’ve gotta be in the best shape I can possibly be in by the time we go back on tour.”
Dr. Collins cracked another smile. “Well, there you go. That sounds like a good goal.” But his expression quickly turned serious again as he rose from his stool, reaching for the stethoscope he wore draped around his neck. “You know, now that you’re over forty, you really do need to focus more on maintaining your heart health. Heart disease often goes undetected in quadriplegics because of decreased sensitivity to symptoms such as chest pain and palpitations that would signal a problem.” He slipped the ends of his stethoscope into his ears. “Mind if I take a listen?”
“No, go right ahead.” Reclining against the padded surface, I tried to relax as he leaned over and slid the chestpiece down the front of my paper gown. I didn’t really think there was anything wrong with my heart, but, as Dr. Collins had pointed out, I might not have noticed if there was. I couldn’t even feel the cold, hard disc moving over my bare skin. I only remembered what it had felt like before I’d lost all sensation from the chest down.
“Deep breath in, please.” Inhaling as deeply as I could, I held my breath and studied the doctor’s face closely as he listened, frowning in concentration. “And out.” I exhaled, letting the air out of my lungs with a low sigh. “Again, please,” Dr. Collins said as he repositioned the stethoscope, sliding it from the left side of my chest to the right. He listened for a few more seconds, then helped me lean forward, keeping one hand pressed firmly to my chest to prevent me from flopping facedown into my lap while he applied the stethoscope to my back with the other. “Another deep breath in… and out.” I could no longer see his face as I followed his directions. “And one more time… good.” He pulled me back into an upright position, propping my upper body against the head of the table again before he let go of me.
“Well, Doc?” I asked nervously, looking up at him. “How does everything sound?”
“Just fine,” he replied, his face relaxing into an easy smile. “I didn’t hear anything to be concerned about.”
He finished examining me, then sent in a nurse to draw my blood and drain my bladder for the labs he had ordered. Once she was done collecting the necessary samples, she went to get Dawn from the waiting room to help me dress and transfer back to my wheelchair. After that, I was free to leave. “We’ll call you if anything comes up in your test results,” the nurse promised as she escorted us to the exit. “Have a good rest of your day, Mr. Richardson!”
I will, I thought with a smile as I rolled toward my truck, eager to put the outpatient clinic behind me. Soon, I would be on my way to the airport, where Natalie’s plane would be landing in less than two hours.
“So, how was your appointment?” Dawn finally asked as she buckled herself into the passenger seat beside me.
I shrugged. “Fine, I guess. I got a lecture about diet and exercise – typical doctor stuff,” I said, starting the engine. “He wants me to start wearing compression stockings again. I told him it’s too hot.”
“Well, you should probably listen to him. He’s the expert,” she replied matter-of-factly.
“He also said I should elevate my legs more. Maybe Natalie and I will try out some new positions tonight.”
“Okay, that was more than I needed to know.” Dawn shook her head as she reached for the dial to turn up the radio.
I just laughed and let her blast rock music as I drove to my mom’s house, where we’d dropped Mason off earlier that morning. My mom was in the middle of making lunch, so, at her insistence, we ate there before heading to the airport to pick up Natalie.
“Wow, you brought the whole crew with you!” Natalie exclaimed, looking surprised to see Mason and Dawn standing next to me when she came down the escalator. She smiled, but it didn’t quite reach her eyes. I could tell she had expected me to be alone.
“Sorry,” I whispered in her ear as she leaned over to hug me. “I had a doctor’s appointment this morning. I didn’t have time to drop everybody off at home afterwards.”
“That’s all right,” she murmured back, stealing a kiss before she straightened up. “So, how did it go?”
“My appointment? Oh, it was fine. Just a routine check-up,” I said with a shrug. “How you doin’?”
If Natalie had been disappointed to see Dawn and Mason with me, she recovered quickly. “I’m great now that I’m here!” she replied, beaming. “And how are you, Mason? It’s so good to see you again!” She bent down in front of him, opening her arms for a hug.
“Fine,” he replied, giving her one somewhat reluctantly. I wished he would have responded to her with a bit more enthusiasm, but I knew it would take time for him to warm up to her. He hadn’t seen her in a month, I reminded myself, and he had only been around her for a few days before that.
“Tell Natalie what you’re doing next week,” I prompted him. When he gave me a blank look, I added, “Remember? You’re going to…”
“Kindergarten,” Mason mumbled, looking down at the ground.
Natalie already knew this, of course, as we’d talked nearly every day on the phone, but she pretended to be blown away by this big news. “Kindergarten?! Oh my goodness, you’re gonna have so much fun! Kindergarten’s the best!”
“He’ll have to show you his brand new bookbag and lunch box when we get home,” I said, reaching out to ruffle Mason’s hair.
Natalie smiled and nodded. “I can’t wait to see what you picked out!”
She hugged Dawn as well, asking how she’d liked her last week in London. As I led the way out to my truck, I listened to the two women talk about their travels. At least they seemed to be getting along well. I hoped that meant Natalie had let go of whatever hangup she had about me having a woman as my full-time caregiver.
When we got back to the house, I had Mason take Natalie upstairs to drop off her bag and see his new school supplies while Dawn and I went into the kitchen to get drinks for everyone.
“Dad, can I have some cake?” Mason asked the minute he came back downstairs.
His question caught me off-guard. “What? No, buddy, not until after dinner.”
“Wow, did y’all bake a cake for dessert?” Natalie asked as she followed Mason into the kitchen.
“No, he’s talking about leftover cake from last weekend,” I told her, picturing the large piece of pink-frosted funfetti cake sitting on a plate inside the fridge.
“For my mom’s birthday,” Mason added, opening the fridge to show her.
I caught the look of surprise and confusion that flickered across Natalie’s face when she saw it. “Kristin’s birthday was on the fourth,” I explained. “We still celebrate it every year, even though she’s in Heaven.”
“I got to blow out the candles,” Mason added. “A four and a two. That’s how old Mommy is.”
I nodded. “She would have turned forty-two,” I said hoarsely, a hard lump filling my throat. I quickly cleared it. “Close the door, Mason. You’re gonna let all the cold air out.”
“Here, Mason.” Dawn handed him a cup of apple juice. “Let’s go outside and play.”
As she led him out the back door, I offered Natalie an apologetic look. “You probably think it’s weird that we baked a birthday cake for my dead wife, huh?”
She shrugged. “Not really. My dad always has a glass of whiskey on his dad’s – my late grandfather’s – birthday. He’s not normally a whiskey drinker; he’s always been more of a beer guy. But my grandpa loved a good Scotch, so he drinks it in his memory.”
I nodded, relieved that she understood. “That’s exactly it. We do it to keep Kristin’s memory alive – especially for Mason, who has no real memories of her.” But for me, too, I admitted to myself. Mason wouldn’t have even noticed if August fourth had passed without any acknowledgment of his mother, but I would have agonized over it all day. Birthdays and anniversaries were still hard for me. And so, we baked a birthday cake and put candles on top and sang, “Happy birthday, dear Mommy,” before Mason blew them out. And while he clapped and bounced up and down with excitement while he waited for Dawn cut the cake, I watched the thin curls of smoke swirling up from the candles with tears in my eyes, wishing Kristin had been there to blow them out herself, mourning a beautiful life that had been extinguished long before it was time.
Natalie gave me a sympathetic smile. “Well, I think it’s sweet,” she said.
“Thanks.” I smiled back gratefully, glad to see that she seemed to have gotten over her jealousy or whatever it was she’d felt during her last visit to Lexington. I hadn’t told her about Kristin’s birthday because I was afraid of hurting her feelings or starting another fight. “Hey, speaking of sweet, there’s a glass of sweet tea on the table for you,” I added, tipping my head toward it.
“Thanks!” Natalie sat down on one side of the kitchen table, and I pulled my chair up to the open space at the end.
“So,” I said as she took a sip of her tea. “What do you wanna do tonight? I was thinking something lowkey – dinner and a movie, maybe?”
She pursed her lips. “Hm… maybe. Honestly, though, I wouldn’t mind just staying in and watching the Olympics. It’s the last night of gymnastics.”
I chuckled. “Works for me. We’ve been watching every night anyway. Mason got into the swimming, and I’ve been loving beach volleyball.”
“Oh, I bet. You’ve been loving those little bikinis they wear to play beach volleyball,” Natalie said with a knowing smirk.
“I’ve always appreciated an athletic woman,” I said, nodding.
“Uh-huh. I’m sure it’s their ‘athleticism’ you appreciate.” She rolled her eyes and grinned.
“I wouldn’t mind seeing you in one of those little bikinis…” I winked at her.
“Well, maybe you should put in that pool you talked about so I have a reason to wear one,” she replied, waggling her eyebrows.
“I do miss having a pool,” I admitted, glancing wistfully out the window to the backyard, where I could see Dawn playing catch with Mason. “Hopefully I can find an accessible place in L.A. that has one.”
“It shouldn’t be hard to find a house with a pool in L.A.”
“No… it’s the accessibility part I’m worried about.” I sighed. “I just don’t wanna have to renovate yet another house, you know?”
She nodded. “Sounds like a hassle… but I bet it’s worth it once you have everything exactly the way you want it.”
“Yeah… I’m just hoping to find something that works for me the way it is.” I had hired a realtor, the same one I’d used to help me sell my old house four years earlier, to keep an eye out for available properties that met my requirements: one level, at least three bedrooms and two bathrooms, a roll-in shower, wide hallways and doors, low thresholds, and no carpet or stairs. She had already sent me links to a few properties to look at online, but so far, none of them checked every box on the list. “Maybe I’m being too picky and expecting too much, but it’s not like I’m the only wheelchair user in the world. You would think there’d be other disabled people or elderly folks wanting to sell their homes.”
“Well, you just started looking, right?” Natalie reasoned. “It may take time to find the perfect place, but I’m sure something will come along. Try to be patient. For all you know, they could be getting ready to put their house on the market right now.”
“You’re right.” I smiled at her. “Thanks for letting me vent.”
“Anytime!” she replied, smiling back.
As the afternoon turned to evening, we ordered takeout for dinner and gathered in the family room to watch that night’s primetime coverage of the summer Olympic Games, which had kicked off in London the day before we left. “Daddy was just there a couple weeks ago,” I told Mason as an aerial shot of the London Eye turning next to the River Thames filled the TV screen. “Natalie and I rode that giant Ferris wheel. I showed you pictures, remember?”
He nodded. “Was it fun?”
“Very fun.” I looked at Natalie, who was cuddled up next to me on the couch, and smiled. She beamed back, burrowing closer to my side.
Mason sat on the floor in front of the TV, his legs bent on either side of him in the W position. “I wanna go on it.”
“Someday, I’ll take you with me,” I promised him. “When we go on tour with the Backstreet Boys, you’ll get to see a lot of cool places.” I couldn’t wait to show my son the world and watch him experience its wonders.
“Sign us up – right, Mason?” Dawn said, smiling at him as she raised her hand. “It’s pretty cool being part of a Backstreet Boy’s entourage.”
I laughed. “Just remember that next time you have to wash my sheets in a hotel room shower.”
She and Natalie both laughed along with me, although Natalie wrapped her arm around me afterward, looking sympathetic. But I didn’t care; my sense of humor had become more self-deprecating since I’d become disabled. If I hadn’t learned to laugh about the less dignified parts of my life, I would cry. I’d already shed enough tears over the last four years to fill the swimming pool Natalie wanted me to put in.
We finished off the last of Kristin’s birthday cake while watching the apparatus finals in gymnastics. “That looks fun,” Mason said, mesmerized by the men flipping around and around the high bar.
“Think you could swing from the top of your swing set like that?” Natalie asked him.
“Don’t give him ideas,” I muttered out of the side of my mouth, cringing at the thought of my son starting kindergarten with a broken arm from falling off his swing set.
She laughed. “I’m just kidding, Mason. Don’t try this at home.”
“You could do it, Dad.” Mason turned around to look at me, totally serious. “He doesn’t use his legs, just his arms.”
“I dunno about that, buddy.” I chuckled. “I bet it’s a lot harder than it looks – and it looks pretty hard to me. He has to have really strong arms and hands to be able to hold on tight to that bar,” I pointed out. “And look at his legs – see how he keeps them so straight and close together? That takes strength and muscle control, too. And, watch, he’s gotta land on his feet.” I held my breath as the gymnast went into his dismount, but he didn’t even stumble on the landing.
“Stuck it!” Natalie cried as the crowd on TV cheered. Of the four of us, she was by far the most knowledgeable about the sport. “I did gymnastics as a kid,” she told us during the women’s floor exercise finals. “Floor was always my favorite.”
“Can you do flips like that?” Mason asked her, pointing to the TV as American gymnast Aly Raisman performed an elaborate series of flips across the floor.
Natalie laughed. “Not like that, no. These are elite gymnasts; I never got anywhere near that level. But I bet I can still do a back handspring.”
Mason’s eyes lit up. “I wanna see!”
She smiled. “Okay. But I better stretch first. This thirty-year-old body isn’t quite as limber as it was at thirteen.”
After watching Raisman win the gold medal, we all went out to the backyard, where there was more room to tumble. I parked my wheelchair on the patio to watch Natalie warm up in the grass, admiring the way she looked in her shorts and tank top. She raised her arms over her head, her shirt riding up to expose her toned stomach as she slowly arched her body into a backbend. “Wow,” I said, impressed, as she pulled herself back up to a standing position. “That takes some serious flexibility and core strength.”
“Thank you, yoga,” Natalie replied, smiling as she tucked the front of her tank top into the hem of her shorts.
At that moment, she reminded me of Kristin, whose years of dance training had also made her incredibly limber. A lump rose in my throat as I recalled how Kristin could raise one of her long, slender legs high over her head, her toes perfectly pointed. Natalie wasn’t as tall or willowy, but I found her flexibility equally attractive. I wasn’t lying earlier when I’d told her I liked an athletic woman. I guess I had a type.
“All right,” Natalie said finally, swinging her arms out in front of her. “Are you ready for this, Mason?”
“Ready!” he replied, his face shining with anticipation.
“Please don’t land on your head,” Dawn said, looking slightly anxious. “We’ve already got one quadriplegic in this house.”
“Jesus, Dawn…” I snorted and shook my head.
Natalie raised her eyebrows. “Well, on that encouraging note… here goes nothing!” Her shoulders rose and fell as she sucked in a deep breath. Then she took off at a run, picking up speed before she launched her body into a roundoff that led into a bouncy back handspring, which she landed on her feet.
While Mason clapped and cheered, Dawn wiped her forehead with relief. “Dang, girl… I gotta say, I’m impressed!” she told Natalie when she walked back over to us, wearing a triumphant grin. “I can’t even do a somersault.”
“I can!” Mason shouted, jumping up and down. “Watch!” We all pretended to be equally amazed by his acrobatic skills as he rolled head over heels in the recently mown grass.
“He’s gonna need a bath tonight,” Dawn muttered to me as Mason came up covered in grass clippings.
“Make sure he takes one, would ya?” I replied with a grin. “You do Mason’s bedtime routine, and Natalie will do mine.”
Smiling back, Dawn nodded. “Deal.”
We watched from the patio as Natalie played with Mason in the yard. “Natalie, c’mere!” he cried, taking her by the hand and tugging her toward his swing set. I was glad to see that he’d warmed up to her since the afternoon.
“Careful, Mason!” I called in a warning tone as Natalie picked him up and hoisted him high into the air, letting him hang from the top bar of the swing set while she held onto his legs. Even with her standing right there, ready to catch him if he fell, it made me nervous. But I knew I was probably just being overprotective. I had climbed plenty of trees and playground equipment as a kid without killing myself, and I didn’t want my adult anxiety to prevent my son from having those same experiences.
“Don’t worry, Dad,” Dawn said, giving my shoulder a reassuring squeeze as she stood beside me. “He’s in good hands.”
I nodded, smiling as Natalie helped him down and sat next to him on the swings. “I know.” She started to swing back and forth, stretching her legs out straight in front of her so her feet wouldn’t touch the ground. Her long ponytail streamed behind her as she threw back her head and laughed at something Mason said that I couldn’t hear. Mason grinned and pumped his legs, making his own swing go higher and higher. I was glad he had other people in his life who could play with him like that. Watching the way Natalie interacted with him, I felt even more attracted to her. Clearing my throat, I leaned closer to Dawn and said, “I’m gonna use the bathroom. Be back in a bit.”
I wheeled myself into the house and took the elevator upstairs to my bathroom, where I kept my catheters and the supplies to go with them. But before I began the process of draining my bladder, I opened the top drawer of my bedside table and took out the prescription bottle of Viagra. I fumbled with it for a few minutes before I finally managed to open the childproof cap by pressing it between the heels of my hands and rotating my wrists until it popped off. As I turned the bottle upright to prevent the pills inside from spilling out, I took a look at the label on the front. Sildenafil citrate, 50 mg. Remembering what Dr. Collins had said about it coming in one hundred milligram tablets as well, I carefully shook two of the little blue pills out onto the tabletop and scooped them into the palm of my hand. If one wasn’t enough for me, maybe a double dose would work to get the job done. I popped the pills into my mouth and washed them down my throat with a swig from my water bottle. Then I wheeled myself back into the bathroom to do my other business. “C’mon, buddy. Don’t let me down this time,” I muttered, giving my penis a pep talk as I pushed the catheter into its tip.
By the time I made it back downstairs, it was getting dark outside. “Time to come in now, Mason!” I called from the doorway.
“Aw, Dad, do I have to?” he whined. “We were gonna play hide-and-seek!”
“Yup,” I replied firmly. “You need to take a bath, and then it’s bedtime.” With school starting in one week, Dawn and I were trying to wean Mason off his summer schedule and get him to bed at a reasonable hour, knowing we’d have to wake up early to get ready on school days. In the meantime, I was eager to spend some time alone with my girlfriend.
Once we’d told Mason goodnight, Natalie and I let Dawn take over while we retreated to the privacy of my bedroom. “I’m locking the door this time,” Natalie said as she closed the door behind us, turning the lock with a click.
I chuckled, my cheeks reddening as I remembered Mason barging in on us during her last visit. “Good call.”
She climbed onto my lap, sitting astride my legs as she leaned in to kiss me. “I’ve missed you,” she murmured, her lips moving against mine.
“Me too,” I replied, wrapping my arms around her waist.
We made out in my wheelchair for a while before we moved to the bed, where she began undressing me at once. “You really did miss me, huh?” I said, laughing as she hurried to remove my basketball shorts.
“Uh-huh.” She shot me a seductive smile as she slid the slinky fabric down over my hips. I reached for the remote for my bed and, with the push of a button, raised the head to an upright position so I could peel off my own t-shirt while she shimmied out of her clothes. Then she climbed back onto the bed to continue the foreplay, kissing and caressing me above my level of injury before she worked her way down.
As she started stroking me below the belt, I began to feel slightly lightheaded. It didn’t seem like a big deal at first; I was used to the dizzy sensation I had always attributed to my dysfunctional nervous system. Watching her work me to the point of erection, I envisioned the blood rushing from my head to my penis, despite the impasse my nerve impulses reached at the damaged part of my spinal cord when they tried to do the same. The physical stimulation had probably triggered a mild form of autonomic dysreflexia, which would go away once she stopped tugging and squeezing or I climaxed, whichever came first. I was hoping for the latter, so I didn’t complain when she climbed on top of me.
She let out a small moan as she began to rock back and forth, rhythmically thrusting her hips against mine. I couldn’t feel myself inside her, but I felt my body react, my face flushing with warmth before it broke out in cold sweat to combat the hot flash. My throat tightened, making it harder for me to breathe. I felt pressure in my chest and shoulders as she pinned me to the bed, using both hands to brace herself. “Don’t push so hard, babe,” I gasped, my sense of discomfort growing as she quickened her pace. “I can’t breathe.”
“What?” Lifting her hands off my shoulders, Natalie looked at me in concern. “Are you okay?”
“I… I dunno…” I still felt strange. My dizziness had increased, and my vision had begun to blur, darkness closing in from the corners of my eyes as if I was about to black out. “I think maybe I need to lie down…” But in the back of my mind, I remembered that lying down would only raise my blood pressure, which was the exact opposite of what was recommended when dealing with autonomic dysreflexia. “No, wait,” I said as she leaned forward, reaching for the remote.
“What is it?” she asked. “AD?”
“Maybe… but I dunno. It feels different.” I struggled to describe the way I was feeling. My head felt foggy; I couldn’t think straight.
Carefully, she climbed off of me and came to stand next to the head of my bed. “You’re all clammy,” she observed, frowning as she stroked the side of my face with one hand. “What do you want me to do? Should I go get Dawn?”
I didn’t want to involve Dawn, but by that point, I felt distinctly unwell. “Yeah,” I managed to say. “Get her.”
Natalie hastily pulled on her panties and my baggy t-shirt before she hurried half-dressed down the hall to find Dawn. Left alone, I lay my head back against my pillow and closed my eyes, concentrating on taking deep breaths. It felt like there was an elephant sitting on my chest, preventing my lungs from inflating.
In my mind’s eye, I saw Dr. Collins’ face. “Heart disease often goes undetected in quadriplegics because of decreased sensitivity to symptoms such as chest pain and palpitations that would signal a problem,” I heard him say as his expression turned serious. Was I having a heart attack? Or was it a pulmonary embolism? I wondered, recalling his warning at my appointment earlier that day: “When you sit down all day, the blood pools in your legs, which can cause blood clots to form. If part of a clot were to break off and travel to your lungs, it could be fatal.”
My eyes flew open when Natalie burst back into the bedroom with Dawn. “I think it’s a pulmonary embolism,” I blurted as Dawn came over to my bed, Natalie closing the door behind her to keep Mason out.
“What makes you say that?” Dawn asked, frowning as she perched on the side of my bed. She didn’t acknowledge the fact that I was naked, but even if Natalie hadn’t told her the details of what we’d been doing, I knew she could figure it out for herself. “Do you have chest pain? Shortness of breath?”
I nodded, now in full panic mode. “Both.”
“Okay… hang on…” She hurried into the bathroom and came out carrying the small black case that contained my portable blood pressure monitor. “Let’s check your BP,” she said, wrapping the cuff around my left arm. “Just relax and breathe.”
I tried to follow her advice as I felt the cuff inflate, listening to the low hum of the machine. After a few seconds, it stopped filling with air and slowly began to deflate again until it beeped to signal that it was done.
“Seventy over forty-five,” Dawn said, frowning at the reading on its screen. “That’s really low, even for you. This doesn’t look like AD. You better lie down before you faint.” She pushed a button on my remote, lowering the head of the bed until I was lying flat. Lifting my legs in the air, she added, “Natalie, come here and hold his feet up like this. They have to be higher than his heart to get more blood flowing to his brain.”
“Should we call an ambulance?” Natalie asked, her voice small and shaky.
Dawn looked down at me. “It’s your call, Kevin. What do you think?”
I appreciated her asking for my consent before calling 911, but at that moment, I didn’t know if I was capable of making the right decision. I didn’t want to go to the emergency room, but if I really did have a pulmonary embolism or heart problem, I knew delaying treatment could make the difference between life and death – and I didn’t want to die either. Taking the deepest breath I could, I nodded. “Yeah… I think you better.”
I saw Dawn and Natalie exchange glances. “Hand me my phone. It’s over there,” Natalie said as she held my legs in the air, tipping her head toward the table on the other side of my bed. Dawn fetched it for her, and for the second time since we’d started dating, Natalie dialed 911.
Lying buck naked on the bed with my legs sticking straight up and my penis going limp, I stared up at the ceiling and tried not to listen as she talked to the dispatcher. “When I said we might try out new positions tonight, this wasn’t what I had in mind,” I muttered miserably to Dawn as she helped me get dressed, working around Natalie to put my underwear and shorts back on.
Dawn laughed. “Where’s your shirt?” she asked as she looked around the room.
I nodded at Natalie. “Nat’s wearing it.”
“Oh! Duh. Well, I guess you don’t really need one right now anyway,” Dawn said with a shrug. “The EMTs will probably hook you up to a heart monitor when they get here.”
“They’re on their way,” Natalie said, lowering the phone from her ear.
“One of you needs to go down to the end of the driveway and open the gate,” I said, realizing the ambulance wouldn’t be able to make it all the way up to the house.
Dawn and Natalie looked at each other again. “I’ll go,” Dawn volunteered. “You stay here with him. Better put on some pants while you’re at it.”
Natalie’s cheeks turned pink. As soon as Dawn left the room, she propped my legs up on a pile of pillows and put on the shorts and tank top she’d taken off earlier. “How ya feelin’?” she asked, perching on the edge of my bed.
“Humiliated,” I said, shaking my head as tears prickled my eyes. “Why does this shit always happen to me?”
“You poor baby,” she replied sympathetically, resting her hand on my bare chest. “Your heart’s racing. Does it still hurt?”
“Not really.” I felt a little less dizzy now that I was lying down, but I was still having difficulty taking a deep breath. “It’s just hard to breathe.” My chest rose and fell rapidly beneath her hand as the air hitched in and out of my lungs in short, shallow breaths.
“You’re hyperventilating. Try to inhale slowly through your nose and exhale through your mouth, like this.” She modeled taking a slow, deep breath, holding it for a few seconds before she let it out with a long sigh. “C’mon, breathe with me. In… and out,” she coached me. “Again. In… and out.” Leaving one hand on my chest, she put her other hand on my abdomen and pushed down gently as I inhaled, making it easier for me to fully inflate my lungs. “That’s it. In… and out.”
I looked into her brown eyes as I concentrated on my breathing, listening to the soothing sound of her voice until I heard the approaching sound of a siren. It helped. By the time Dawn led the EMTs into my bedroom, I felt a lot calmer than before.
“What’s going on?” I heard Mason ask from the hallway, his voice high and scared. The siren must have woken him up.
“Your daddy doesn’t feel well,” Dawn told him. “He may have to go to the hospital for a little bit till he feels better. But he’ll be okay. You can see him in the morning. C’mon now, back to bed…” As her voice grew fainter, I imagined her taking Mason by the hand and walking him back to his own bedroom. Fresh tears filled my eyes as fear wrapped its icy fingers around my throat. Despite Dawn’s words of comfort, I couldn’t stop myself from worrying about the worst-case scenario. What if I never saw my son again?
Blinking back tears, I tried to focus my attention on the two medics who stood on either side of my bed. One of them asked me a bunch of questions while the other one examined me, wrapping a blood pressure cuff around my arm and attaching sticky patches to my chest to monitor my vital signs. While most of the numbers were within the normal ranges, my blood pressure remained low, so they transferred me to a stretcher and took me out to the ambulance that was waiting in the driveway. Its blue lights flashed, flickering eerily across the black sky. I felt a wave of deja vu wash over me as I recalled the scene of my car crash four years earlier. Tears flooded my eyes. I reached toward my face, trying to discreetly wipe them away.
“We’ve got room for one of you to ride with him if you want,” one of the EMTs offered as she and her partner prepared to load me into the back of the ambulance. She looked from Natalie to Dawn, who had followed us downstairs.
Dawn didn’t hesitate. “You go with him,” she told Natalie, nudging her toward the ambulance. “I’ll stay here with Mason. Oh, and take this.” She handed her a gallon-size freezer bag full of prescription pill bottles. “They’re gonna wanna know what meds he’s on.”
Natalie’s eyes widened when she saw how much medication she was holding. “Are you sure?” she asked uncertainly. “Maybe you should go while I watch Mason. You’re better with the medical stuff; you know more than me.”
“But you’re his girlfriend.” Dawn’s voice was firm. “Go on; get in the ambulance. Give me a call when you find out what’s going on.”
“I will,” Natalie promised and scrambled in after me.
“You can sit there,” the medic said, pointing to a padded bench on one side. “Buckle up, please.”
Natalie sat down and fastened her seatbelt, then leaned forward to reach for my hand. “I’m here,” she said, lacing her fingers through mine. I wished I could feel the warmth of her touch, but I still appreciated the reassuring gesture.
“Thanks,” I whispered, flashing her a grateful smile.
She held my hand the whole way to the hospital.
***