“So how have you been feeling, Nick?” Dr. Usako asked at my four-week follow-up appointment.
“Better, actually,” I answered. In spite of how screwed-up the last ten days had been, at least one thing in my life was going right. “Those Compazine tablets have really helped so I’m not sick to my stomach all the time.”
“No more nausea - that’s good to hear,” said the doctor, making a note on my chart. “How about your other symptoms? Are you still having headaches? Body aches? Fevers? Fatigue?”
“Not as bad as before. I’ve been pretty tired lately,” I admitted, looking over at Lauren, “but I’ve also had a lot going on. A friend of mine has been in the hospital, and... yeah.” I stopped there, not wanting to get into personal stuff with this woman I hardly knew.
“I’m sorry to hear that,” said Dr. Usako politely, as she added another note. “How well would you say you’ve been following your medication regimen? Have you been taking all of your pills at the proper time each day?”
I felt kind of like a kid in school, being tested by the teacher. “Yeah... I mean, for the most part. I’m not used to taking so many pills, but my girlfriend helps me organize them and makes sure I take them at the right time-” I glanced at Lauren again, and she gave an emphatic nod. “-so I guess it’s been going pretty well.”
“Good,” Dr. Usako said again. “I’m sure I told you when you started how important it is to stick to your treatment plan. It sounds like your side effects are under control, so our next step is to find out how well the medications have been working. I’m just going to give you a quick physical exam, and then I’ll go see if the lab has the results of your blood work ready.”
I nodded, massaging the tender spot on the inside of my arm where a lab tech had taken blood for testing right after I’d arrived at the AIDS clinic that morning. I was nervous, wondering what would happen if we found out the medication wasn’t working.
Dr. Usako listened to my heart and lungs, looked in my mouth, felt around for swollen lymph nodes, and tapped on my belly. When she was finished poking and prodding, she said, “Well, Nick, everything seems fine so far. Sit tight for a few minutes, and I’ll be back after I check your labs.”
I sat up again and looked at Lauren, who had insisted on accompanying me to the appointment. She had sat quietly in a corner of the room while Dr. Usako was examining me, but now that we were alone, she let out a little sigh of relief. “So far, so good,” she said, smiling at me.
I shrugged. “Yeah, I guess.”
“Think positive, babe. You have been feeling better; that’s gotta be a good sign that something’s working.”
“I hope so.” I didn’t want to keep talking about it until we knew something for sure, so I shifted my weight until I could slip my phone out of my back pocket. When I checked it, I saw that I had a text from Howie.
Hey Nick. I know I’m probably the last person you want to see, but is there any way you could come to the hospital? I need to talk to you, it said.
I frowned. “Howie texted me.”
Lauren looked up from her own phone. “What’d he say? Is he okay?”
“He wants me to go see him... said he needs to talk to me about something.”
“Oh. So he’s up for visitors? That’s a good sign.” As far as I knew, none of the guys had gone to see Howie in the four days since his transplant. Apparently, only his immediate family could visit because of the risk of infection. “Are you going to go?”
“I dunno. I don’t really want to, but... I guess I should.”
She nodded encouragingly. “We can swing by Cedars-Sinai on our way home.”
I sighed. “Yeah... we’ll see.” I wasn’t ready to commit to anything yet, so I tucked my phone back into my pocket without texting Howie back.
Dr. Usako came back about ten minutes later. “Sorry to keep you waiting,” she apologized. “I just got your lab work, and everything looks good!”
“Really?” I said, my heart lifting with relief.
“Yes, the results are exactly what we were hoping for. Your viral load has dropped from over 100,000 to about 10,000, which, although it still sounds high, is certainly much lower than it was four weeks ago. If it continues to go down, the virus could be undetectable in your bloodstream in another few months - which, of course, is the ultimate goal of treatment,” Dr. Usako explained.
“Oh, thank God,” said Lauren, grinning at me. “That’s great news, Nick!”
“And it keeps on coming,” added Dr. Usako with a smile. “Your CD4 count is up to 550, which puts it just within the normal range, meaning your immune system is making enough T-cells to keep you healthy. CD4 counts can fluctuate quite a bit, so we’ll continue to test your blood every three months to make sure the medication is still working.”
“Sounds good,” I said, feeling encouraged. For once, something seemed to be going right.
“One last bit of good news: your liver enzymes are about the same as they were last time you were tested, before you started treatment, which tells us the drugs haven’t done any damage to your liver.”
Thank god, I thought. I never wanted to go through what Howie had. Liver failure... not fun.
“That’s something else we’ll need to keep a close eye on, but for now, I don’t think we need to make any changes to your meds. Just make sure you keep taking them as prescribed, and call the office if you experience any other severe side effects,” said my doctor. “Do you have any questions or concerns?”
I shook my head slowly. “No, I don’t think so.”
I looked to Lauren, who shrugged and said, “It sounds like everything’s going as well as we can expect, at this point. I’ve been trying to make sure he eats right and exercises when he feels up to it, although with him not touring right now, we probably need to get to the gym more.”
Dr. Usako nodded. “A healthy lifestyle can only help. You’re lucky to have such a strong support system,” she added, smiling, as she looked from Lauren to me. In the background, my fiancée beamed.
“Yes, I sure am,” I said, smiling back, but on the inside, I groaned. It looked like I’d be stuck eating off Lauren’s list of immune-boosting superfoods for a long time.
“Baby, I’m so relieved!” Lauren gushed, once we’d left the clinic and were back in our car. “You couldn’t have gotten better news.”
“Yeah... unless it was that the lab fucked up the first time, and I don’t really have HIV,” I replied, causing her to roll her eyes at me.
“Oh, come on, Nick, you know what I mean. Under the circumstances, this is the best news we could have hoped for. We need to celebrate the good stuff and be grateful the treatment is working,” she said, reaching for my hand across the center console and giving it a squeeze. “You’re healthy, and that’s what matters most.”
I didn’t know how she could consider me “healthy” when I had an incurable virus, one that could still kill me someday, but I appreciated her positive outlook on it. Even I had to admit, the clinic visit couldn’t have gone much better. Maybe this wasn’t the death sentence I’d assumed it would be.
I was feeling a lot better about life by that point, so when Lauren suggested stopping by Cedars-Sinai again, I was game. Bring it, I thought. The worst part of my day was over, and if I could handle having my blood drawn, I could definitely deal with Howie. These days, he had it much worse than me.
Lauren drove us to the hospital. We walked into the main building and asked at the front desk where we could find Howie. I’d heard from AJ that he had finally been moved out of ICU, but wasn’t sure what ward he was in. The woman at the desk gave us directions, and we went up to Howie’s floor.
When we got to the transplant wing, we gave Howie’s name to a different woman at a different desk. “Are you family?” she asked, after she’d typed it into her computer. “It says here he can only have visits from immediate family members for now.”
“I’m his brother,” I said quickly, “and this is our sister.” I slung my arm around Lauren’s shoulders.
The woman looked at us suspiciously. “Big family,” she said.
I nodded. “Blame our parents. Catholic.”
I don’t know if she really believed me or not, but she got a kick out of that comment and called over a nurse to escort us to Howie’s room.
“Have you visited before?” she asked, as we walked down a hallway.
“Not since his surgery,” I said.
“Okay. Well, Howie’s immune system is suppressed so that his body won’t reject the new organ, so you’ll both need to wash your hands thoroughly before you go in, and you’ll need to wear a mask when you’re in his room. We don’t want him catching any germs,” she explained. Then she gave us each a surgical mask and showed us where we could wash our hands.
“You know, Nick, I think you should go in and see him by yourself first,” said Lauren. “You’re the one he wanted to talk to. I’ll find a waiting room for now, and if he’s feeling up to it, I’ll stop in and see him a little later. Okay?”
I sighed. “Yeah, all right.” I felt like she was abandoning me at the last second, but I knew she was probably right about Howie wanting to see me more than her.
When I was properly disinfected and wearing my doctor’s mask, the nurse took me to Howie’s room. “Knock, knock!” she called, as she opened the door a crack and peeked in. “Don’t worry, he’s decent,” she said to me, smiling. “You can go on in.”
“Thanks.” I sucked in a deep breath, steeling myself for another awkward visit, and opened the door all the way. When I walked in, I heard the nurse close it again behind me, and for a second, I felt almost claustrophobic, like the walls were closing in on me.
I took another deep breath before I dared to look at Howie. His voice sounded a lot stronger than it had the last time I’d actually talked to him, but I was remembering how bad he had looked, with all those tubes hanging out of him. I never wanted to see him that way again.
“Come over here, bro. Lemme get a good look at you in that mask,” he said, with a laugh.
I cracked a smile, though I knew he couldn’t see it behind the mask. “Why, does it make me look like a doctor?” I asked, as I walked slowly over to his bed.
He was sitting up, looking a hell of a lot better than he had the last time I’d seen him. Most of the tubes were gone, including the medieval torture device he’d had implanted his head. Some of the swelling in his face had gone down, and his color was back to normal.
“Paging Dr. Carter? Psh... in your dreams.” He grinned up at me. “Hey, thanks for coming, man.”
I nodded. “How ya feelin’? You look... well, I wouldn’t say good, but definitely better than the whole ‘death-warmed-over’ look you had goin’ on a few days ago.”
“So I hear,” said Howie. “I’m feeling a lot better, too. Look, I know things were pretty bad for a while there, and I wanna apologize again for putting you guys through all of this. You especially.”
“Dude... stop it.” I was getting sick of all the apologies. Maybe that meant I really had forgiven him. “You don’t have to keep saying you’re sorry. It’s done, all right? Apology accepted.”
He raised his eyebrows, looking at me with skepticism in his eyes. “Seriously?”
“Seriously.” I held out my hand to him. “Swear to god, I just scrubbed my hands with antibacterial soap for like three solid minutes so I wouldn’t spread any cooties, so we can shake on it if you want.”
“You actually washed your hands? I’m impressed.” I rolled my eyes, and he smiled as he reached out to take my hand. “Thanks, Nicky,” he whispered, squeezing it tightly.
I cleared my throat. “So,” I said, looking around the room, “when do you get to bust out of here?”
“Actually, that’s what I wanted to talk to you about. It won’t be for at least another ten days or so, but according to Angie, when I do get out of here, I’m going to your place?” He looked at me like he thought his sister must have misunderstood.
I forced a smile onto my face and hoped it would reach my eyes, knowing I couldn’t show my true feelings about the matter. He may have been better, physically, but I could tell he was still a little fragile in the emotional department, and I didn’t want to say or do anything that would cause a setback.
“That’s right,” I said. “Lo and I thought this way your family could get back to Florida sooner. Obviously they would have stayed, but since we already live here, it just makes more sense for you to stay with us.”
“Wow... that’s really nice of you, Nick, but... are you sure? I mean, after everything?”
I swallowed hard, trying to decide how I should answer that. I settled for the truth - or something close to it, anyway. “I’m not gonna lie to you, Howie. It was Lauren’s idea, and at first, I didn’t like it at all. But it really does make the most sense... and like she said, it’ll force us to face this thing head on so we can start to work through it. You want that, right?”
“Of course I do.” I heard a tremor in his voice and suddenly realized he was blinking back tears. “I just wasn’t sure you did.”
I shifted my weight uncomfortably. “Listen, we’ve been friends for a long time. I don’t know if I’m totally ready to forgive you... but I also don’t wanna just wash twenty years of friendship down the drain. Seeing you so close to dying made me realize that. So yeah... I do wanna try and work through it.” Shaking my head, I added, “Between the two of us, I think we’ve gone through just about every stage of grief there is over the last few weeks. Anger...” I gestured to myself. “Depression...” I tilted my head toward him. “All that’s missing is acceptance. I know nothing can change what’s already happened, so I guess we both need to find a way to accept it so we can move on with our lives.”
He nodded. “Those are some wise words, Nicky. I appreciate everything you said... especially your honesty. I know how hard this has been for you.”
“Yeah... but it’s not just about me,” I admitted, acknowledging how self-centered I had been. “It’s been hard for you, too. I see that now.”
Howie smiled sadly. “Thanks for saying that.” Then he sighed and looked at the ceiling. “I’ve sure made it a hell of a lot harder for myself.” That was when he started telling me about all the new medications he was taking, the daily measuring and monitoring he was expected to do, the weekly blood draws and doctor’s appointments he had to look forward to after leaving the hospital, and I realized I really didn’t have it that bad at all. My own medication regimen was no picnic, but now that I’d adjusted to it, at least I didn’t have to go back to the doctor for another three months.
“Hey,” I said, “don’t worry about all that. That’s why you’ve got Lauren and me. Trust me, she’s on top of med schedules and healthy meals and all of that stuff, and I... well, I definitely know my way to the hospital by now, so if nothing else, I can drive you to your appointments.” I smiled, and he smiled back. “Between the two of us, we’ve got you covered. You just worry about getting better, and we’ll help you with the rest, all right?”
“Frankly, Nick, the thought of trusting you to take care of me is frightening,” Howie joked, shaking his head. “But if you say so, then all right.”