"It was like God's hand was orchestrating the whole thing," Natalie says, "and all we could do was watch."
Which isn't to say she wasn't filled with guilt—even feelings of unworthiness. "Natalie's attitude throughout her illness was always 'I'm going to battle this thing with everything I have,' " says her manager, Barbara Rose. "The only time she said 'Why me?' was when the kidney became available, and she asked why she got chosen to have this miracle happen to her."
Natalie's Hepatitis C diagnosis was made in February 2008 by Joel Mittleman, M.D., a Los Angeles nephrologist she saw after a routine physical showed abnormal kidney function. "My response was, 'How come I don't feel bad?'" says Natalie, who likely contracted the virus during her days as an IV drug user. "It was just extraordinary to me that this had been dormant in my body for something like 25 years."
Natalie's closest friend, Tammy Engelstein, was equally shocked. "She was a gym rat," says Engelstein, who had met Natalie in Lamaze classes during Natalie's pregnancy with Robbie and Engelstein's with her daughter Meredith. "She was always very healthy."
Natalie accepted the diagnosis as "God's will." She told Robbie the news in a matter-of-fact manner, he recalls: "I think she was ready to take it on. My mother is not afraid of a challenge."
In May of 2008 Natalie's hematologist started her on weekly injections of interferon to help reduce the likelihood of liver failure, which hepatitis C frequently causes. He told her that typical side effects from the drug include fatigue and flulike symptoms.
Engelstein, who routinely spent nights at her girlfriend's house, where the two of them would eat sushi and watch "Law & Order," says that about 12 hours after the initial shot "it hit both of us that, hey, she was sick."
"It just felt like I was dying," says Natalie, who was practically knocked flat by the treatments. She lost more than 20 pounds in a matter of weeks.
"She was just skin and bones," Robbie says. "It was tough to watch."
She was, however, determined to continue working, and in June 2008, despite pleas from Engelstein and Cookie to cancel the trip, she flew to Tokyo, where she was scheduled to perform 14 shows in eight days. "I love it there," Natalie says, "and I didn't want to let my Japanese fans down." A tour doctor who'd met Natalie on previous visits to Japan took one look at her and said, "You need to go home." She refused.
Natalie received IV fluids in her dressing room to keep her hydrated, and she traveled to the stage in a wheelchair. "As miserable as I was, once I started singing, I felt better," she says.
Many of her Japanese fans, watching her perform, applauded and wept. But crew members kept asking, "Why are you doing this? We shouldn't be here."
"Natalie loves her audience and doesn't want to disappoint them," Engelstein explains. "If you've never seen her perform, go. You'll walk away with everything she is about."
"It was tough," Natalie admits, "but I felt if I didn't push myself, I would probably either die or just crumble." She performed ten shows before finally heading back to the United States.
"Still Unforgettable" was released in early September 2008, and once again Natalie rallied, flying to New York City for a series of interviews. When the cameras were rolling, she struggled to appear healthy and animated. But in between, she was experiencing shortness of breath, a result of fluid buildup caused by poor kidney function. On the morning of September 12 she spoke by phone to a New York friend, the songwriter and socialite Denise Rich. Alarmed by Natalie's gasps, Rich sent her own physician to check on her. He did a quick examination and said, "You have to go into the hospital right now."
"Had Denise not called her doctor," Natalie says, "I might have died that day, alone in my hotel room. I owe so much to her."