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Chapter 114

“This is your captain speaking. We’re now going to begin our descent into New York. The local time is 1:14 p.m., and the temperature is 33 degrees Fahrenheit. Yes, it’s a cold day in the Big Apple today, folks. There is snow on the ground, but conditions for landing are good. So sit tight and prepare for landing.”

Nick looked out his window as the pilot got off the intercom. He could see patches of ground starting to appear through the thinning clouds as the plane drifted lower in the sky. Taking a shaky breath, he gripped the armrests on his seat as he felt the plane shudder with turbulence.

After a month and a half, the European tour had come to a close, and he and the guys were on their way home again for a nice, long break. For Nick, it was much-needed. The tour had left him run-down and exhausted. He’d had a constant headache from lack of sleep, his sinuses were clogged from the changing weather, and he could feel a cold coming on – he’d had a cough for the last few days, and he had a feeling it was going to get worse before it got better.

And yet, he was exhilarated. Being on tour again had been amazing, and he was relieved and thrilled that both legs had gone well. After two months in the U.S. and almost two more months in Europe, Nick didn’t doubt himself as a performer anymore. He’d done it.

The last half of the European leg had been good. He had celebrated his birthday in Milan, which had been nice because of the nice big Italian feast of a birthday dinner he’d been given. Valentine’s Day had been spent in Dublin, so it had been easy for him to commemorate the fact that he was single again by going pub-crawling with Howie and getting completely trashed on Irish whiskey and Guinness.

Now it was the end of February, and he was on his way home at last. He couldn’t wait for the traveling part to be over. He hated flying with a passion, and he still had one more flight to go; after the guys landed together in New York, they would part ways, and he would board a connecting flight to Tampa. After the long flight from Portugal, where they’d wrapped up the tour two nights ago, the last thing he wanted to do was get on another plane.

When the transatlantic flight landed, Nick hauled up his backpack and made his way stiffly up the aisle. Once inside the airport, the five Backstreet Boys congregated to say their goodbyes before they continued on to different gates to catch their connecting flights. Kevin and AJ were headed back to LA, Brian to Atlanta, and Howie to Orlando. Nick had decided to spend a few weeks at his home in Tampa; with the tour over, Veronica out of his life, and most of his family now in Florida, there was really no reason to go back to Los Angeles right then.

“Take care, buddy,” Brian said, pulling Nick into a tight hug. “Have a safe flight home.”

“You too, bro,” replied Nick, patting his best friend on the back.

“Call me when you get home, alright, Nicky? We should get together sometime while you’re still in Florida,” added Howie as they hugged.

“Sure, D. You should come and go boating with me or somethin’,” Nick suggested. His words caught in his throat as he started to cough, and he put his mouth over his hand, trying to stifle the hacking.

“I’d hug ya, bro, but whatever you’re gettin’, I don’t want,” said AJ with a good-natured smile and thwacked Nick on the back before stepping away. Nick coughed in his direction on purpose and flashed him an impish grin.

“Very mature, Nickolas,” Kevin teased, pulling Nick into a rough hug. “Watch that cough, alright?” he warned quietly when he had Nick temporarily immobilized. “If it doesn’t clear up in the next few days, go see your doctor. You got that?” He gave Nick a firm look as he released him.

Nick only smiled and rolled his eyes. “Yes, Dad,” he begrudged jokingly, but he knew Kevin was right. He’d already learned the dangers of waiting too long to see a doctor; he wasn’t going to repeat that mistake again.

***

Nick spent his first few days home catching up on much-needed rest. His house had been well-taken care of while he was gone, so there wasn’t much for him to do when he got home. That was a relief, for in addition to simply being drained from the tour, he was also still sick.

What he’d thought was a cold was now seeming more like the flu. He’d been running a low-grade fever every day and woke up feeling tired and achy, like he’d been hit by a truck. He still had a nagging cough that seemed to be getting worse, and his chest felt tight when he breathed.

The latter two symptoms worried him the most because they were reminiscent of the symptoms he’d experienced in the weeks before he’d ended up in the hospital with a tumor in his lung. It can’t be that again; it’s just the flu, he told himself, but it was hard not to think of the worse-case scenario. Cancer was sneaky; it could hide out and pop up again just when you least expected it. Past experience had taught him that much.

Still, he tried to keep himself calm and wait it out. If he wasn’t feeling better in a few days, he told himself, he would call Dr. Kingsbury.

On his fourth day back, Claire called. “Hey!” she exclaimed brightly. “Aren’t you proud of me for keeping tabs on where you are? I knew you had to be home by now.”

“Yep,” he rasped from his bed, smiling, despite the fact that her voice was making his head pound.

“Are you home in Tampa or home in LA?”

“Tampa,” he answered, his voice still hoarse.

There was a pause, and then she asked, “You don’t sound very good. Lose your voice from all that singing?”

“Nah, I’m sick,” Nick croaked. “I think it’s the flu.”

“Oooh, nasty,” she sympathized. “How long have you had it?”

“Eh, it was starting before I left Europe, but it’s only been bad since I got home.” He paused, then added, “I’ll probably go see a doc if it doesn’t clear up soon.”

“Yeah, that’s probably a good idea. Better safe than sorry. There’s probably something your doc can give you to make you feel better too.”

“Yeah,” Nick nodded, groaning inwardly. He’d just had his usual check-up back in December and was not thrilled about the idea of going back. He’d gotten used to the regular appointments over the last few years, but even so, he still hated hospitals and doctor’s offices. Every time he went, he was accompanied by the fear that he was in for bad news, that the cancer would be back. He always tried to reassure himself that the cancer was gone – it had been cut out once and for all and couldn’t possibly come back. But he knew better. It had come back for Casey after almost five years of remission. It could always come back.

“Well, I won’t keep you if you’re not feeling well,” said Claire. “I just wanted to call and say hi. I’ll check up on you in a few days; maybe I’ll bring you some chicken soup or something.” There was laughter in her tone, and he smiled, imagining her slaving over a pot of homemade chicken soup.

“Sounds good,” he replied, wishing he felt more up for a conversation. But all he wanted to do was sleep, so instead he said, “Thanks for calling, Claire. I’ll talk to ya later, alright?”

“Okay. Feel better soon! Bye, Nick,” said Claire, and they hung up.

Nick coughed harshly and then fell back against his pillows, chest heaving. Every arduous breath seared with pain, and he balled his covers up in his fists and squeezed his eyes shut, waiting for it to pass. When it did, he let his body relax and looked up at the ceiling through watering eyes.

Please God, he pleaded weakly, please don’t let it be back.

***

A few more days passed, and when Nick found himself feeling worse instead of better, he reluctantly called the cancer clinic. He had no idea if his symptoms were cancer-related or not (for all he knew, it really was just a bad case of the flu), but he knew and trusted Dr. Kingsbury better than any other doctor, and he wasn’t going to take any chances. He wanted to be reassured without a doubt that this wasn’t a recurrence.

The oncology clinic was very accommodating and found him an appointment slot for early the next day. And so, at nine a.m. the following morning, he found himself sitting in the all-too-familiar waiting room on the fifth floor of Tampa General.

“Nick?” called Bobbi-Jo, one of the clinic nurses, and Nick stood, walking slowly over to her. His prosthesis felt like a lead weight today; he barely had the energy to walk on it. Just making his way from his car to the clinic had about killed him. “So, you’ve not been feeling well?” Bobbi-Jo asked, looking at him sympathetically as she helped him onto the scale to chart his weight.

“No, I’ve had the flu for the last week or so,” replied Nick wearily. He counted back the days in his head and realized it had been closer to two weeks since the symptoms had really started. He’d had a cough since their last concert in Lisbon.

“You’ve lost some weight since you were here in December,” the nurse remarked, checking his chart.

Nick smiled briefly. “Yeah, I’ve been on tour,” he said. “I always lose a few pounds when I’m touring.” This had always been an added bonus of performing every night, though nowadays he couldn’t afford to let his weight fluctuate too much – if it did, his prosthetic leg wouldn’t fit as well, which could cause all sorts of difficulties. He’d already noticed it felt slightly looser than usual, but wasn’t too concerned; he was due to be fitted for a new one soon anyway.

Bobbi-Jo led him back to an examining room and gave him a gown to change into. Once he had changed, she came back in to run through the usual list of questions about his symptoms and medical history and take his vitals. “Dr. Kingsbury will be in to see you in a few minutes,” she said when she was finished.

Nick sat and waited, reading the medical posters on the walls of the exam room until the doctor came in. “Well, I didn’t expect to see you back here so soon, Nick,” she said as she walked in, giving him a thin-lipped smile. She sat down on her wheeled chair and looked up at him. “Bobbi tells me you’ve had a bad cough and some shortness of breath?”

Nick nodded. “I think it’s just the flu,” he said. “It feels like the flu or a bad chest cold or something, but… I… I just wanted to be sure.”

Dr. Kingsbury smiled knowingly. “I understand, and you were right to come in.” She glanced down at his chart, reading the notes the nurse had made earlier. “So you’ve been feeling this way for about week?”

“About a week-and-a-half, I think,” confessed Nick.

Dr. Kingsbury nodded, scratching out something on his chart and jotting down something else. “Alright,” she said, setting his chart down, and stood up. She whipped off the stethoscope she wore around her neck and placed it in her ears. “I’m just going to listen to your lungs,” she explained as she slid the other end of the stethoscope inside the front of his hospital gown. “Take a deep breath in… and out… in… and out…” she instructed slowly, looking towards the ceiling she listened. Then she moved the stethoscope around to his back and repeated the process.

“You’ve definitely got some junk in your lungs,” she said when she was finished, slipping the stethoscope back around her neck. “I heard crackles on both sides. I’m concerned that you might have pneumonia.”

Nick’s heart flip-flopped and his hands grew cold as he remembered the last time he’d gotten pneumonia. It had been during his first round of chemo three years ago, and he’d ended up unconscious in ICU with a tube down his throat for a full week. “Shit, that’s bad, isn’t it?” he asked miserably, resting his head against his hand.

“It can be more serious for you than for the average person,” Dr. Kingsbury admitted. “Pneumonia causes fluid to build up in the lungs, and because your lung capacity is already slightly decreased from the lobectomy you had two years ago, you have less room to spare. If it’s pneumonia, we’ll need to keep a close eye on you.”

Nick swallowed hard, nodding.

“I want to get you in for a chest X-ray right now, and we’ll see if the film shows anything conclusive,” said Dr. Kingsbury, and Nick nodded resignedly again.

The chest x-ray was part of his usual routine, and it was painless, so he didn’t mind. Once it was over, he was taken back to the exam room to wait while the technician and his doctor examined the results. It was a long wait, but finally, Dr. Kingsbury came back, x-ray slides in hand. She slapped them up onto the light board in the room and turned it on so that the bright white light illuminated the dark films.

Nick studied the series of x-rays with an experienced eye. He’d had enough of them done to have an idea of what they should and shouldn’t look like. “Do you see these cloudy patches?” Dr. Kingsbury asked, her finger drifting over one of the x-rays, pointing out a trail of semi-transparent white blobs in spaces where Nick knew there should have been black.

He nodded, nervously licking his dry lips.

“These have me concerned,” the doctor went on, pursing her lips as she narrowed her eyes at the x-rays. “There’s definitely something building up in your lungs; it’s just very hard to tell what just from these films. It very well could be pneumonia, but a lot of things can disguise themselves as pneumonia in an x-ray. I’d like to get a CT scan too, to get a better picture of what we’re dealing with. Because of your history, I don’t want to rule out any other possibilities.”

Noticing the way she said the word possibilities, Nick felt the old, familiar, icy hands of fear creeping down his throat, squeezing his heart. “You mean like a relapse, don’t you,” he said flatly. It was not a question.

Dr. Kingsbury took a few seconds before answering. “I think it’s unlikely that this is a recurrence of the cancer you had in your lung,” she said, in measured tones. “Your last chest x-ray and CT scan in December looked clean. However, it is possible. That’s why I want to run most tests, just to be sure.”

Nick nodded, trying to take a deep breath. The effort just made his chest ache, and his heart started to race. “Can we do them today?” he asked anxiously, trying in vain to keep himself calm.

“The sooner, the better.” Dr. Kingsbury offered him a gentle smile and put a comforting hand on his back. “The sooner we know what we’re dealing with, the sooner we can start treating you and get you feeling better.”

Nick smiled at her maternal touch and nodded again, feeling slightly reassured.

“I know you’re not going to like this, but I’d like to admit you,” she said. “It could take a few days to get the test results back and analyzed, and in the meantime, I’d like to monitor you and start you on antibiotics to see how your body responds.”

Somehow, Nick had known that was going to happen. In the past, he might have protested, but this time, he merely nodded compliantly. He hated being in the hospital, but he would feel more secure there, knowing he was being taken care of. And Dr. Kingsbury was right. The sooner they got to the bottom of what he was sick with this time, the sooner he could get better.

At least that’s what he hoped.

***

As darkness fell that evening, Nick lay alone in the artificial twilight of his private room on the fifth floor of Tampa General. All of the lights were off, except a small one above his bed, and he’d hoped the soft glow and low drone of the TV in the corner would help lull him to sleep, but no such luck – no matter how weary he felt, sleep would not come. Instead, his mind was alert and filled with worries that kept him awake.

He was plagued by déjà vu of all the times he had spent the night in the hospital like this, but the one that stood out most vividly was the night of his collapse after the charity concert, when he’d lain in a hospital bed in the early hours of morning, burdened by the decision to have surgery to remove the tumor in his lung or not. This time, he didn’t know for sure what he was facing… but he couldn’t stop thinking about the worst possible scenario, that the cancer had flared up in his lungs again and that, this time, he wouldn’t have an option for how to get rid of it.

The worry kept him awake, despite the fact that he was exhausted. It wasn’t late, but he’d been up early and subjected to several different tests over the course of the afternoon. First, a nurse had come to take a blood sample so that they could measure his blood counts. Then it had been time for the CT scan, followed by a series of lung tests. He’d had to breathe into a special device called a spirometer, which measure his lung function, according to the tech who had administered the test. Not long after that, he’d been taken to a special airtight booth and forced to breathe into a different kind of mouthpiece that would measure his total lung capacity. The breathing tests had left him fatigued and out of breath, and he had been relieved when he’d finally been allowed to go back to his room.

He’d been trying to sleep ever since, but to no avail. If his fears were not enough to keep him awake, the nurses who kept coming in to check on him were. For the latter part of the afternoon, he’d had an older nurse doing his vital checks, but at seven o’clock, a younger nurse came in. Even in the dim light, Nick recognized her instantly as Samantha, who had always been one of his favorite nurses on the floor. She’d cared for him often when he was in and out of the hospital the year he’d been diagnosed, and he liked her because she was young and cute and sweet and more laidback than some of the other nurses. She was a fan, too, but not the kind who pestered him.

“Nick Carter,” the auburn-haired nurse drawled his name in a teasing voice, smiling as she came up to his bed. “Haven’t seen you up here in awhile.”

Nick gave her a wry smile. “No offense, but I’d rather not be up here now.”

Samantha laughed. “I certainly understand,” she said with a smirk. “How are you feeling?”

“Alright, I guess,” Nick replied tiredly. “The oxygen’s helping a little.” He fingered the thin, clear line of the nasal canula he’d been given. He hated wearing the thing, but the oxygen was making it easier to breathe, so he tried to grin and bear it.

“Good,” said the nurse, as she wrote something down on the clipboard in her hand. “You know, I just have to tell you – I came to your concert back in October, and you guys were so good!” She giggled, looking girlish.

Nick smiled. “Aw, really, you were there? I didn’t know. Thanks for coming; I’m glad you liked it.”

“Oh, believe me, I wouldn’t have missed it!” she exclaimed with a laugh. “I had my tickets bought the day they came out.” She chattered on in her lively Southern twang as she looked over the readings on his monitors, jotting down notes on his chart. “Your sats are a little low,” she commented, checking the little pulse ox monitor clipped to the end of one of his fingers. “I’m going to turn up your O2 a bit more; that should help.” He watched as she adjusted a gauge on the oxygen tank and made another note on his chart.

“Any pain from the IVs, or are they okay?” she asked, turning around the two bags hanging on the IV stand next to his bed. They were each connected to a line that ran into a vein on the inside of his elbow, one dripping saline to keep him hydrated, the other pumping him with antibiotics.

“They’re fine,” replied Nick, marveling over how used to IVs he was by now. He’d developed small calluses on the inside of his arms from all the needles that had been threaded into the veins there over the years; it was all routine to him by now.

“Good.” She wrote one more thing on the chart and then asked, “Is there anything I can get you before I go?”

He was about to say no, but then changed his mind. “You think I could get a sleeping pill or something? Nothin’ too strong, just something so I can get some sleep?”

“Sure!” said Samantha. “I’ll just run it by Dr. K first to make sure it’s okay, and I’ll be back in a jiff. I don’t blame you for not being able to sleep in this place,” she added with a chuckle. “It’s gotta be tough, with all of us coming in and fiddling with things all the time.” She smiled knowingly, and Nick laughed wheezily, then coughed.

Samantha watched him carefully, waiting for the coughing spell to pass, and then gave him another gentle smile. “I’ll be back soon with something to help you sleep,” she assured him. “Just hit your call button if you need somethin’ before then.”

“Okay. Thanks,” Nick replied, managing a smile back before she left the room. Then he relaxed against his pillows, inhaling the oxygen that flowed into his nostrils as deeply as he could.

As promised, Samantha was back within a few minutes with a large pill in a small paper cup. She poured a glass of water for him from the pitcher on his bed tray and handed him the cup. “This should help you get to sleep,” she said sweetly.

Nick thanked her and gratefully took the pill. Within half an hour, he had drifted off into a dreamless sleep.

***

It was the following evening before Dr. Kingsbury came to talk to Nick about the results of his tests from the day before. He’d spent the day resting, watching TV, and worrying because he didn’t seem to be feeling any better, despite the antibiotics. And Dr. Kingsbury didn’t do much to quash his fears.

“How have you been feeling today, Nick?” she asked when she came in to his room.

He pressed the mute button on the TV remote before turning to her. “Eh,” he grunted honestly, “about the same.”

The middle-aged doctor nodded, pursing her lips. “Well, I’ve been going over your test results with the pulmonology department, and I’m afraid they’re still not giving us the diagnosis we’re looking for. Your bloodwork showed that your white count is high, which usually means you have an infection. With the way you’ve been feeling, that’s no surprise. The lung function tests showed that your lung capacity is only 60% of what it should be, even taking into account the lobectomy you had. That means something’s building up in your lungs, taking up space, which, again, is not a surprise – we could already tell that from the x-ray.”

“What about the CT scan?” asked Nick, wanting to know what that “something” that was building up in his lungs was. Was is cancer, or was it just fluid from pneumonia?

Dr. Kingsbury smiled briefly at his question. “CT scans are a lot clearer than x-rays, but in your case, the scan didn’t tell us much more than the x-ray did. The same white infiltrates I pointed out to you on the x-ray yesterday showed up, but unfortunately, a lot of different lung diseases look that way in a scan,” she explained. “I won’t be able to make a clear diagnosis until I know exactly what those patchy spots are, what they’re made of. I want to schedule you for a lung biopsy tomorrow.”

Nick’s heart flip-flopped at the word biopsy. He’d had a biopsy done on his leg three years ago, when he’d checked into the hospital for further tests on what he’d thought was just a simple fracture. It was the biopsy that had given Dr. Kingsbury his diagnosis of Ewing’s Sarcoma.

Biopsies diagnosed cancer.

“Are you looking for cancer cells? Is that why you want to do a biopsy?” he asked, his voice catching.

Dr. Kingsbury smiled again. “I’m looking to rule out cancer. The doctor who does the biopsy will take a small sample of tissue from an area where we see the patches on your scans, and if no cancer cells show up, we can rule out metastasis. We’ll also be able to analyze the tissue sample to see what is in those patches. Does that make sense?”

Nick nodded, but he still didn’t feel much better about the whole thing. Another biopsy… The last time, he’d been more afraid about the procedure itself than what it might reveal. He’d been too naïve to know any better; he’d never even considered the possibility of cancer. But now he was wiser. This time, it was the results he feared.

***