At Lenox Hill Hospital in Manhattan, tests showed that Natalie's kidneys were barely functioning, and she soon began dialysis. While her liver function remained healthy—thanks, most likely, to the interferon—it is possible, according to Mittleman, that the same drug hastened the failure of her kidneys, already compromised by years of high blood pressure. Her doctors stopped the interferon treatments.
Ten days later Natalie returned to Los Angeles. After a few more trips to the hospital, she was placed on a list for a donor kidney and began a three-hours-per-session, three-times-weekly outpatient dialysis regimen.
"They told me the average wait for a kidney was three years," Natalie says. "At first I thought, 'There goes my life.' " But after determining that she could tour as long as she received dialysis at each stop, she got back on the road.
Says Engelstein: "She'd go into the dialysis center with her books, her cell phone, and her leopard blanket, and she was the belle of the ball." Those centers were in places such as Turkey, Italy, the Philippines—wherever she was performing.
"I'd sometimes fly for 14 hours, then go straight to dialysis," Natalie says. "I spent a little time being tired, but we managed. I'm not a pity-party person."
Before the sun came up on May 19, with Cookie still unconscious, Natalie kissed her sister goodbye and headed home to pack a bag for her stay at Cedars-Sinai. Engelstein met Natalie at her condominium. "Two sisters couldn't have been closer than Natalie and Cookie," Engelstein says, so it came as no surprise that Natalie, while getting ready, kept muttering, "How can I do this? Cookie is in a coma."
Engelstein looked her in the eye and said, "Cookie would want you to do this. This is a chance of a lifetime."
Cookie Cole, who ran Nat King Cole's estate for the family, died at 8:30 A.M. that morning, just as Natalie, unaware, was being prepped for surgery. Many of the Cole family members, including Natalie's mother—who had reconnected with her daughter after her hepatitis C diagnosis—and her twin sisters, convoyed from the Tarzana hospital to Cedars-Sinai, rushing from one bedside to the other.
When Mittleman and Natalie's transplant surgeon learned that Cookie had died, they advised the family to withhold the information from Natalie until after the transplant.
As the surgical team wheeled her into the OR, Natalie kept saying, "I wonder how Cookie's doing."
Engelstein's only response: "We haven't heard anything yet."
A fierce believer in the power of prayer, Natalie went under the knife confident that Cookie would survive until she could see her again.
The transplant, which began at 3:00 P.M., was casebook perfect.
That night, when she woke in recovery, Natalie asked for Engelstein. When she got to her friend's side, Engelstein was astonished. "Her face had changed," she says. "She had this glow about her. All the pain was gone. She was, like, reborn."
The following morning, Natalie's family gathered around her hospital bed, some offering encouraging words about how well the surgery had gone, others telling her, bit by bit, of Cookie's death. Natalie processed the news, then looked over at Engelstein, who was standing in the corner. "I couldn't tell you, Sweetie," Engelstein said. "Dr. Mittleman said we couldn't tell you."
"I was getting good news and very bad news at the same time," remembers Natalie, wiping away tears. "This was a very joyous moment where I've got new life. It was also a very sorrowful moment, where my sister had gone on, and the family that donated the kidney had lost their daughter as well. My first reaction was that I wished I were back on dialysis to have my sister. These two people had left this earth—and I was here. Why? I feel like I don't deserve it."
The grieving process has been excruciating. "I've lost some very special people," Natalie says, "but Cookie is the toughest. There's a part of me that's missing now. I don't expect that I will ever totally get over it."