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Nick took another nap that afternoon. Along with the nap came another nightmare.

This time, he was asleep in bed when he woke to a sudden, stabbing pain in his back. As he tried to sit up, he saw a pair of sharp knives protruding from his chest. Their blades pointed toward the ceiling, having slashed straight through his body from the bed underneath him. Screaming in agony, he tried again to pull himself up, but being impaled upon the knives meant that the slightest movement resulted in unbearable pain, as their razor-edged blades ripped into the internal structures of his body. He gagged and choked as blood gurgled up his throat, leaving the taste of metal in his mouth. Unable to breathe, he began to thrash around, but in spite of his painful struggle, he remained pinned to his hospital bed, unable to free himself from Freddy Krueger’s clutches.

He woke with a start, breathing hard, to find both Dani and Dr. Elizabeth standing beside his bed. “Holy shit!” he gasped, his hand going to his chest. He could feel his heart hammering against his rib cage, but his skin was unharmed. Of course there were no stab wounds, he told himself, as reason sank in. It had all been another bad dream.

“What is it? Are you having chest pain?” asked Elizabeth, her stethoscope already halfway to her ears.

“No,” said Nick, shaking his head. “No, I’m okay. I just had a nightmare.”

“Another one?” Dani asked sympathetically. “I’m sorry.”

He snorted as he remembered their earlier conversation. “You should be. You’re the one who got me thinking about Freddy Krueger.”

Dani raised her eyebrows. “You had a dream about Freddy Krueger?” When he nodded, she started to snicker. “Sorry... I shouldn’t be laughing, but that is seriously so cute. It’s like a little kid’s nightmare.”

Nick shook his head. “If I’d had nightmares like that as a kid, I would have never gone to sleep again.”

“Aww… that scary, huh?” He nodded. “Well, no need to worry. You’re in safe hands here. I promise we won’t let Freddy come for you,” said Dani with a wink. Nick smiled sheepishly.

Dr. Elizabeth cleared her throat. “If you’re feeling up to it, Nick, we need to run another diagnostic test, and I’d rather get it done this afternoon than wait until tomorrow.”

“What is it?” Nick asked warily, rubbing the place on his chest where the pacer pad had been earlier. The skin there was slightly red and sore, as if it were sunburned.

“It’s called a stress echocardiogram,” said Dr. Elizabeth. “It will show us how your heart responds to stress, such as exercise. From what we’ve seen so far, it seems like your arrhythmias are being triggered by physical activity. If that’s the case, this test can prove it. It’s painless, I promise.”

“Okay,” Nick reluctantly agreed.

Elizabeth wheeled a new cart of equipment into the room, leaving the red crash cart sitting ominously in the corner. “What we’re going to do is use ultrasound technology to take a picture of your heart while it’s pumping,” she explained. “Once we get a good look at your heart at rest, we’ll give you a drug called dobutamine, which simulates the effects of exercise by making the heart work harder, and see how it reacts.”

“What if it freaks out the way it did earlier?” Nick asked nervously.

“If you were to develop another arrhythmia, it should resolve once we discontinue the dobutamine drip. This is really a pretty low-risk procedure,” Dr. Elizabeth assured him. “Now let us show you the shape of your heart.”

Nick snorted with laughter when he realized she was quoting his own lyrics at him. “Nice one, Doc,” he said, appreciating that the seemingly straight-laced Dr. Elizabeth did, in fact, have a sense of humor.

“She’s a big BSB fan too, you know,” said Dani, tilting her head toward Elizabeth.

Nick raised his eyebrows. “Really?”

Elizabeth blushed. “I may have listened to your music back in the day,” she admitted.

“But not anymore?” he asked, smiling.

“Oh, please!” Dani exclaimed, rolling her eyes at Elizabeth. “She’s trying to play it cool, but she told me once she had posters of you guys hanging in her dorm room at college.”

“Wow… bet you never thought you’d be taking care of one of us someday,” said Nick. It was a little awkward, knowing his doctor was a fan. His last cardiologist had been a middle-aged man who couldn’t have cared less about him being a Backstreet Boy. But to Dr. Elizabeth’s credit, she had kept her interactions with him incredibly professional, never treating him as anything other than her patient.

“Not in my wildest dreams,” said Elizabeth with a smile. After a pause, she added, “Actually, it was Brian who inspired me to specialize in cardiology.”

“Oh yeah? That’s really cool,” Nick replied. “I’m sure he’d be honored to know that.”

“Well, you’ll just have to tell him next time you see him then,” said Dani, smiling at Elizabeth.

“Yeah, sure.” Nick wondered when that would be. With a sickening feeling, he realized he wouldn’t be able to finish the world tour with the group. He needed to let the guys know that. “You think I could borrow one of your cell phones when we’re done here?” he asked, taking advantage of the fact that he was talking to two fans. “I really need to call Brian and the other fellas, fill ‘em in on what’s going on with me.”

Dani and Dr. Elizabeth looked at each other. “I’m sorry, but we can’t allow cell phones to be used in the intensive care unit,” said Elizabeth. “There are too many important pieces of equipment the signals could interfere with. But one of us can call whoever you’d like us to.”

Nick sighed. “No, that’s okay. I don’t know any of their numbers, anyway.” Without his phone, he was starting to feel strangely disconnected from the outside world. It had been a long time since he’d gone more than a day without texting someone or getting on social media.

“I’ll try calling Lauren again later,” Dani offered. “I’m sure she could help with that.”

“Good idea, Dani. Now let’s get started with the procedure,” said Dr. Elizabeth, back to her usual businesslike manner. “Nick, we’re going to take off your gown and have you lie on your left side…”

Sorry, Dani mouthed at Nick as she helped him get undressed and into position.

“I’m just going to darken the room so I can see the ultrasound screen better,” Dr. Elizabeth added, as she dimmed the bright fluorescent lights.

“If I didn’t know better, I’d think you were trying to seduce me,” Nick joked, waggling his eyebrows. He couldn’t be sure, but he thought Elizabeth was blushing again.

Dani laughed. “She’s just trying to find a way back to your heart,” she told him with another wink.

He groaned. “How many heart jokes are you guys going to make with my song lyrics?” he asked, amused.

Dani shrugged. “I dunno, how many songs do you have with the word ‘heart’ in the title?”

“A lot,” said Elizabeth, as she adjusted the settings on her screen.

“A lot,” agreed Nick, laughing.

“Let’s see... so we’ve already mentioned ‘Shape of My Heart’ and ‘Back to Your Heart,’” said Dani. “There’s also ‘Straight Through My Heart.’”

“‘Don’t Go Breaking My Heart,’” Nick added, arching an eyebrow.

“‘I’ll Never Break Your Heart,’” Elizabeth replied without missing a beat.

Dani laughed. “Don’t forget my personal favorite, ‘Quit Playing Games (With My Heart).’”

“Oh yeah, that’s her CPR song,” said Elizabeth, smirking at Dani.

Dani’s mouth dropped open. “Don’t tell him that!”

“Well, it’s true, isn’t it”

“Wait, what?” asked Nick, laughing as he looked between them. “What does that mean, her CPR song?”

Dani rolled her eyes. “Okay, so this may sound weird to someone who’s not in the medical field, but when you learn CPR, some instructors will suggest singing a song in your head to help you stay at the right pace of a hundred compressions per minute. Most people use ‘Stayin’ Alive’ by the Bee Gees because both the beat and the title are perfect, but I happen to prefer ‘Quit Playing Games’.”

Nick narrowed his eyes at her. “Wait, so let me get this straight: while you were giving me CPR… you were singing one of my songs?”

“Of course not, because that would’ve made an already weird situation even weirder,” she replied quickly, though even in the dark, Nick thought he saw her face redden.

“Hey, what about ‘Welcome to My Heart’?” Elizabeth interjected, holding up the ultrasound wand. “Now, Nick, I’m going to need you to lie perfectly still while I move this transducer around on your chest. It’s covered in a conductive gel, so it may feel a little cold at first.”

Their light-hearted conversation came to a sudden halt. Nick flinched when the transducer touched his skin - it was cold. Dr. Elizabeth circled the left side of his chest for a few seconds before she found the right spot. Once she had centered the wand over his heart, Nick could hear a ‘whoosh, whoosh’ sound coming from the machine. He looked up at the monitor, watching the blurry white shape of his heart beating on the black screen. Both the sight and the sound reminded him of being with Lauren in the sonogram room when she was pregnant.

He remembered the first sonogram photos they’d gotten to share with their family and friends when they’d announced they were pregnant… seeing the progression of their babies’ alien-like bodies transforming into tiny humans as they grew bigger… and hearing each one’s heartbeat for the first time. He also remembered the last time, when they’d been told there was no longer a heartbeat, no more movement from the perfectly-formed fetus on the black screen.

They had been through two painful miscarriages before, but this one was different. Doctors don't call it a miscarriage after twenty weeks, and Nick and Lauren had made it all the way to the third trimester. They’d thought they were out of the woods - even if Lauren went into preterm labor, the baby would be viable by that point. They had the nursery almost finished, the name already picked out, and a small “sprinkle” shower planned for the following week when they’d found out their daughter was dead.

Numb with shock, Nick had driven Lauren straight to the hospital to have her labor induced. The whole way, he’d wondered how they were going to explain what had happened to Odin, who had only just started to understand what it meant to become a big brother. Nick didn’t understand it himself. At times, he was in denial. All throughout Lauren’s labor, he had hoped and prayed for a miracle. Maybe there had been some mistake, his mind reasoned. Maybe the doctors were all wrong. Maybe they could still do something to save the baby once she was born. But after the delivery, as he’d held her for the first and final time, he had been forced to face the reality of his daughter’s death.

They’d given her the name they had thoughtfully chosen: Arya, after their love of music and the show Game of Thrones. Instead of hanging above her crib, it was engraved on the tiny, gold urn they had picked out to hold her ashes.

“Take a deep breath and hold it, please.” Dr. Elizabeth’s voice brought Nick back to the present, back to the hospital bed in which he lay on his side, letting her examine his heart. He inhaled a breath of oxygen through the cannula in his nose and held it in his lungs until he heard her say, “Perfect. You can exhale now.” Then he let the air out slowly, struggling to keep his composure.

“You okay?” Dani asked, putting her hand on his shoulder.

“Yeah,” he lied. “It’s just getting uncomfortable, laying on my side like this.”

“Go ahead and change positions if you’d like. You can lie any way you want for a little while; the first part of the test is finished,” said Dr. Elizabeth.

“How’d I do?” Nick asked, as he rolled over onto his back, stretching out his legs with relief.

Elizabeth shrugged. “About like I expected. Your left ventricle is enlarged, and your ejection fraction is low. In layman’s terms, that means your heart isn’t able to pump blood as effectively as it should, hence the diagnosis of heart failure. But we already knew that,” she said matter-of-factly. “What we want to find out with the second phase of the test is how much your heart function is affected by physical activity. Usually we have people walk on a treadmill or ride a stationary bike for this part, but since you haven’t been able to get out of bed without experiencing symptoms, we’ll raise your heart rate with medication instead. Dani’s going to start the dobutamine drip now. As it takes effect, you may notice your heart pounding faster and harder - that’s normal. If you feel light-headed or have any chest pain, palpitations, or shortness of breath, let us know right away, okay?”

Nick nodded. He realized he’d been through a stress test before, remembering how Dr. Polakoff had made him run on a treadmill with wires taped to his chest to record what his heart was doing while he exercised. It had sucked then, but at least he’d been able to do everything that was asked of him. Now he could barely get out of bed. He still didn’t understand how his heart had gotten so bad so quickly. It must have suffered some serious damage during his episode of sudden cardiac death, he decided. Dani had saved his brain, but not his heart - and by doing so, she had doomed him to a slow, drawn-out death instead of an instant one.

On one hand, he was grateful to have been given a second chance at life - a chance to see his son again and make amends with his wife. But on the other hand, he dreaded the long, boring days that lay ahead of him - days he would almost certainly spend lying in bed, subjected to more painful procedures intended to prolong his life as he waited for a new heart. In some ways, he thought it would be better if he had just died on Halloween night.

Then he would be with Arya.

Depressed, Nick pretended to doze while Dani set up the dobutamine drip, plugging it into one of the ports of his central line. As the drug began to circulate through his bloodstream, his heartbeat accelerated. Although they had both told him this was to be expected, it still filled him with anxiety to feel his heart beating so fast without the slightest bit of physical activity.

“All right, Nick, I’d like you to roll onto your left side again so I can get another look at your heart,” said Dr. Elizabeth. Dani helped Nick get back into the correct position without disturbing any of the electrode wires. She checked his pulse and blood pressure as Elizabeth placed the transducer on his chest. After a few minutes, Elizabeth said, “We’re going to increase the infusion rate of the dobutamine now, which will raise your heart rate. Let us know if you experience any of the symptoms I mentioned earlier.”

Nick nodded. As more of the drug flowed through his IV, he felt a fullness in his neck and a fluttery feeling in his chest.

“PVCs on the monitor,” Dani warned Dr. Elizabeth in a low voice.

“What does that mean?” Nick asked anxiously.

“It stands for premature ventricular contractions - extra heartbeats that begin in one of the ventricles of your heart,” Elizabeth explained, as she studied the screen. “Are you feeling any chest pain or palpitations?”

“Not really pain, but… palpitations, yeah, I guess you could call it,” said Nick. His heart was pounding as hard as if he had just finished performing one of the fast songs on stage. “Is that bad?”

“Let’s go ahead and stop the infusion,” Dr. Elizabeth said to Dani, dodging his question.

As Dani disconnected the IV and flushed out the tubing, Nick felt what could only be described as a hot flash. Suddenly, his face felt flushed and sweaty. His heart was still racing like he was in the middle of a show, making it hard to catch his breath. “I don’t feel right,” he blurted out, abruptly rolling away from Dr. Elizabeth and her equipment. Lying flat on his back didn’t help; in fact, it only made it harder to breathe. He sat up and leaned forward, holding his hand against his heaving chest.

“He’s diaphoretic and tachy at one twenty,” Dani said. “Pressure’s dropping: ninety over sixty.”

“Are you short of breath, Nick?” asked Dr. Elizabeth, pressing her stethoscope to his back. Nick nodded. “Bilateral rales at the base of the lungs,” he heard her say to Dani, as she moved the stethoscope from one side to the other. “What’s his pulse ox?”

“Down to 93 percent,” Dani replied.

“Put him on one hundred percent O2, non-rebreather,” Elizabeth ordered. To Nick, she said, “We’re going to give you some extra oxygen through a mask to help you breathe. Try to relax and take deep breaths while your heart rate comes back down.”

Nick nodded again, feeling light-headed. As Dani took the oxygen cannula out of his nostrils and replaced it with a mask that covered his mouth and nose, a wave of dizziness washed over him. He started to slump sideways, but Dani caught him under the arm and eased him back down before he blacked out completely.

“Run of V-tach,” he heard Dr. Elizabeth say, as his vision blurred in and out. He could hear an alarm going off on the heart monitor in the background. “Let’s try eighty of lidocaine.” She turned the overhead lights back on, giving the room a strange, chartreuse tone. When she leaned over him, it looked like she had a flourescent green halo glowing around her head. “Nick, your heart is beating too fast. We’re going to give you another drug to get it back into a normal sinus rhythm. Just relax and breathe, okay?”

It was hard to relax and breathe when his heart was racing, but after a few minutes, Nick felt it start to slow down. “Back in sinus,” said Dr. Elizabeth, looking at the monitor. As the fluttery feeling in his chest went away, Nick breathed a sigh of relief. “Are you feeling better now?” she asked him.

“Much,” he replied, his breath fogging up the oxygen mask over his face. Dani removed the mask and slipped the tubes back into his nose so he could speak more easily.

“Good,” Dr. Elizabeth said, patting the back of his hand. “Unfortunately, you failed the stress test. It didn’t take much to trigger another arrhythmia, which tells me your heart isn’t able to withstand any extra physical demands placed upon it. That means your heart failure is progressing rapidly.

Nick felt a sinking feeling in his stomach, as the implications of what she was saying became clear. Despite Dani’s and her assurances that they wouldn’t let him die, he was dying, perhaps faster than Dr. Elizabeth had initially predicted.

“I’m recommending you have an ICD placed before you can be discharged,” Dr. Elizabeth continued. “That stands for implantable cardioverter-defibrillator - it’s a small device inserted into your chest that connects to your heart. It can detect an abnormal heart rhythm and either act as a pacemaker to help regulate your heartbeat or, in the case of a particularly dangerous arrhythmia, deliver a small shock to your heart to get it beating correctly again.”

Remembering the painful experience of being paced, Nick shook his head. “I don’t want one,” he mumbled. “I’d rather die than go through that again.”

Dr. Elizabeth gave him a sympathetic smile. “It’s not anywhere near as unpleasant as the external pacing you endured earlier, I promise. Because the internal pacemaker is wired directly to your heart, the electrical impulses it sends are much smaller - you won’t even feel them.”

Nick was not convinced. “What if it shocked me?”

“Now that you would feel - most people describe it as being like a punch to the chest - but it’s a small price to pay for saving your life, don’t you think?”

“What’s the point if I’m just going to die anyway?” Nick asked with a shrug.

“This device can help keep you alive until a donor heart is found,” said Dr. Elizabeth. “It can even improve your quality of life while you wait for a transplant. You don’t have to decide anything today, though. We can talk about it more tomorrow, after you’ve had some time to think about it, okay?”

Nick nodded.

“Try to get some rest. You’ve had quite a day,” she added, patting his arm. “Dani’s going to continue to monitor you while I make some calls. I’ll be back to check on you later.”

After she had left, Nick looked at Dani. “Do you think I should do it?”

Dani nodded. “Without a doubt,” she replied. “A lot of people end up with ICDs, and they really do help. It’s not as big of a deal as it sounds. But it’s your decision.”

Nick sighed. “I guess I should do it, if that’s what it takes to get out of here. No offense.”

“None taken,” she said, smiling. “No one wants to stay in the ICU. Hopefully we’ll get you stable enough to go home soon.”

Home. The word made Nick feel like Dorothy in The Wizard of Oz, stuck in a strange land and desperate to find her way back to Kansas. If only he could click his heels and wake up in his own bed with Lauren beside him.

But this time, Nick wasn’t dreaming. He was trapped in a nightmare that was all too real.

***