The symptoms started overseas.
At first, it was just minor shit - coughs, fevers, fatigue. I thought I had a cold I couldn’t shake or some European strain of the flu that my flu shot hadn’t covered. We were all paranoid about the flu, ever since Brian got the H1N1, and we’d been acting like total germaphobes, dousing our hands in hand sanitizer after soundcheck parties, but we knew there was no surefire way to keep ourselves from catching some bug. It’s just an inevitable part of touring. When you’re on the road, always on the go, traveling different places and shaking hands with hundreds of people a day, you’re bound to come down with something. I don’t think a tour’s gone by where I haven’t gotten sick at least once. I usually just grin and bear it and soldier on through until it runs its course.
This one never did, though, and I went home for Christmas still feeling crappy. I thought I was just run down from two months of touring and was sure that a few weeks at home were all I needed to get my energy back. I did feel less tired when I wasn’t constantly traveling and performing almost every night, but the other symptoms didn’t go away. Looking back, I guess I was stupid not to go to the doctor then, but you know how busy the holidays are. I had so much other stuff going on between Christmas, New Year’s, and my thirtieth birthday, I didn’t make it a priority, and then I just ran out of time. Before I knew it, I was on a plane to Tokyo for the Asian leg of our This Is Us tour.
It was in Asia that I realized something was seriously wrong with me. I would run fevers even at night and wake up drenched in sweat, my chest heaving, like I’d had a nightmare, except I couldn’t ever remember having one. My cough had never really gone away, and lying down, I could hear myself wheezing, gunk rattling around in my lungs. When I was onstage, I would get short of breath way more easily than I ever had before, even when I was sixty pounds heavier. But the scariest symptom was the chest pain.
I knew it had to be my heart. Besides the obvious symptoms, I had two personal experiences to back up my self-diagnosis. First, I remembered Brian saying how tired he’d felt before his heart surgery, when his heart was enlarged. Second, I remembered the way I’d felt, myself, at the end of the European leg of the Unbreakable tour, when I’d made the doctor’s appointment that led to my diagnosis of cardiomyopathy. My cardiologist had said it was a condition that could worsen, but could also improve if I cleaned up my act and started living healthy. I’d done that! It really sucked to think that, despite everything I had done to take care of myself the past two years, this problem had gotten worse.
I placed a long-distance call from China to schedule an appointment with my cardiologist in Fort Lauderdale for the day after I got back to the States, and when the guys wondered why I was flying to Florida, instead of home to California or Tennessee, I told them it was just a routine check-up and a chance to catch up with some of my family. It was Brian who asked if I’d been feeling alright, Brian I had to lie to when I answered yes. I know I should have opened up to them about what was really going on - I could have used the support - but I wanted to find out what I was dealing with and how bad it was before I told anyone else. Maybe it’s nothing, I told myself. No point making them worry if it’s nothing. But I wasn’t just being a hypochondriac. I was in denial.
Still jet-lagged from the long trip back from Beijing, I dragged myself to the private practice of my cardiologist, Dr. Richard Polakoff. I was his last appointment of the day. A nurse made me get on a scale on the way back to the exam room, and I was pleasantly surprised to find that I’d lost a few pounds since the last time I had weighed myself, despite having been too tired to work out much. I just figured all the dancing I did on stage was keeping me in shape, and besides, I was still following my diet.
After the nurse had taken my temperature and blood pressure and all that preliminary stuff, Dr. Polakoff came in. I had a lot of respect for him. He was in his mid-fifties and treated me like I was his son. I would never forget the way he had lectured me the day he’d called me in to his office to discuss the test results that showed I had cardiomyopathy. “You need to change your lifestyle,” he had said sternly, scaring me with stories of other celebrities who had died young from the same heart disease. Then he’d added, “I don’t want you to end up like that.” It had stung to hear that, but I knew he was just looking out for my best interest. It was tough love.
I thought it was obvious that I had taken his advice, but after listening to me describe my symptoms, he still asked me lots of questions about my diet, alcohol intake, drug use, and exercise regimen. I’d fessed up to slipping a few times before, but this time, I swore up and down that I was living clean and trying my hardest to stay healthy.
“Well, let me take a listen, and we’ll find out what’s going on inside there,” said Dr. Polakoff finally, slipping his stethoscope into his ears. “Take off your shirt, please.”
I pulled my t-shirt over my head and wadded it into a ball in my lap. I winced when he pressed the end of the stethoscope to the center of my chest. Why do those things always have to be so fucking cold?
“Take a deep breath in,” Dr. Polakoff ordered. “And out.” I could feel the dull ache deep in my chest as it expanded, but when I mentioned it to the doctor, all he did was nod. “Another deep breath, please.” He moved the stethoscope over my chest and around to my back, listening to my heart and lungs. Then he lowered the head of the padded table I was sitting on and asked me to lie down. He listened to my chest again while I was lying flat on my back, then tapped along my rib cage with two fingers. The whole time, he had a frown on his face. I hoped it was just because he was concentrating, but deep down, I already knew it was because he was hearing something he didn’t want to hear.
After a few minutes, he removed the stethoscope from his ears and slung it around his neck. Then he used his hands to examine me, his fingers poking along my jawline, down my neck, under my arms, and across my chest. I wondered what he was feeling for, but he didn’t say. Finally, he told me to sit up and put my shirt back on. When I did, he sat down on his stool in front of me, looked up at me, and said, “I hear fluid in your lungs. That’s why you’ve been short of breath.”
“What does that mean?” I asked. When I heard “fluid in your lungs,” I thought of someone drowning, like the time my brother fell in the pool when he was little. I couldn’t imagine how mine had gotten that way.
“It might just be an infection, like pneumonia. Your glands are swollen, and your history of fevers suggest your body’s been trying to fight off something. But I do want to warn you, given your diagnosis of cardiomyopathy, it could be indicative of something much more serious.”
My heart responded to his grave tone of voice, skipping a beat and then racing to catch up. “Like?”
“Pleural effusion - a build-up of fluid in the lungs - is a major symptom of congestive heart failure.”
It took me a minute to comprehend what he was saying. Congestive heart failure? I’d only heard the term used for old people. I was only thirty years old! How could I be in heart failure? I looked at him, feeling betrayed. “How could I have that?” I demanded. “I did everything you told me to! I stopped drinking, stopped doing drugs, started exercising and eating right. You told me my heart would go back to normal if I did all that!”
“I told you I hoped it wouldn’t deteriorate any further if you changed your lifestyle. And it might not have. Like I said, it’s only a possibility I wanted you to be aware of, a worst-case scenario. Chances are, you just have an infection. I want to run some blood work and get a chest x-ray. We’ll know more after that.”
He called ahead to University Hospital and ordered the tests, then told me to drive straight over. I had déjà vu the whole way to the hospital, remembering the two days of testing he’d put me through before diagnosing me the first time. The blood draw and chest x-ray were pretty painless, but it wasn’t the tests themselves I was worried about. It was the results.
***
The next day, I was back in Dr. Polakoff’s office, staring at an x-ray film of my chest. It was all pretty much a black and white blur to me. I could make out the bones of my shoulders, spine, and ribs, along with a big white blob in the middle that had to be my heart. But I couldn’t tell if it was normal-looking or not.
“Well Nick, I have good news and bad news for you,” said Dr. Polakoff, referring to the x-ray. “The good news is that your heart looks fine.”
I blinked in surprise. “Really? So it’s not...” I didn’t want to say the words that had raced through my thoughts all night, keeping me awake.
“Not in failure, no. In fact, it looks in better shape than it did when you were first here two years ago. So that’s the good news.”
“Okay...” I said, trying to prepare myself. “So what’s the bad?” Something told me it was still more serious than pneumonia.
Dr. Polakoff took a deep breath and used his finger to trace around a foggy section of the big white blob as he spoke. “The x-ray shows a mass in your chest.”
“A mass?” I repeated, my voice going higher. “You mean like a tumor?”
He nodded. “That’s what it appears to be. An x-ray doesn’t tell us everything, though, so you’ll need to undergo more tests to get a better picture of it. There’s no way to know, for instance, if it’s benign or malignant. All I can tell is that there’s something there, compressing your lungs, which explains your chest pain and shortness of breath, as well as the fluid build-up.”
“I thought that was my heart,” I admitted, staring at the x-ray.
“The mass is near your heart,” he said. “Your heart is down here.” He lowered his finger to the bottom of the blob, which was brighter white, more opaque than the supposed tumor. Still, the two looked so close, it was impossible to tell where one ended and the other began.
My short-lived relief over hearing that it wasn’t my heart went away, and I was scared again. “Is it cancer?” I asked in a whisper.
Dr. Polakoff offered a reassuring smile. “Like I said, it’s impossible to know for sure without further testing. Since it doesn’t appear to be cardiac-related, I’d like to refer you to a specialist. You’ll need a biopsy for an official diagnosis.”
Biopsy... I didn’t know exactly what that entailed, but I’d heard the word before, and it never sounded good. I stared at the x-ray, long after Dr. Polakoff left to place a call to a doctor he knew in Los Angeles, the specialist who would be able to diagnose me for sure. I couldn’t stop looking at the shadowy blob between the two black spaces that were my lungs.
Alone in the room, I pressed my hand to the left side of my chest and moved it around until I could feel my own heart, pulsing beneath my palm. Then I moved it up and to the right, to the spot where the tumor appeared to be on the x-ray. My hand was right in the center of my chest. I pictured a tumor that looked like Slimer from Ghostbusters, buried deep beneath my skin, slowly engulfing my heart and lungs. The mental image alone made me feel light-headed and sick.
I left Dr. Polakoff’s office that day with a manila envelope containing copies of my x-rays and blood work to take with me to my appointment with the specialist in Los Angeles. He had written down her name on an index card, along with the day, time, and location of my appointment with her. Though he wished me luck and told me again that the diagnosis might not be cancer, I couldn’t help but notice the name of the clinic he was sending me to: UCLA Santa Monica Hematology and Oncology.
I didn’t have a clue what was in store for me at that point, but I knew one thing: oncology was the branch of medicine that dealt with cancer.
***
