Editor's note: After publication, Nate Archibald clarified that he misspoke on a detail of the transplant. This story has been updated to reflect that correction.
Last December, Nate "Tiny" Archibald took it all in: the lights, the tree, the holiday tunes, the look of wonder on the faces of his great-grandchildren.
In the process, he tried desperately not to think about the fact that it could very well be his final Christmas.
Archibald, a Hall of Fame point guard who dazzled NBA fans in the 1970s and early '80s with his innate ability to penetrate and score over players nearly a foot taller than him, was diagnosed with amyloidosis, an incurable condition that occurs when a substance called amyloid builds up in organs. Amyloid, according to the Mayo Clinic, is an abnormal protein produced in bone marrow, and Dr. Michael Emery, a cardiologist at Indiana School of Medicine who serves as a consultant for the National Basketball Players Association, explained that it reduced the ability of Archibald's heart to fill with blood in between heartbeats.
Archibald learned of his condition following a free screening run by the players association. The screening detected an irregular heartbeat, which led to further tests -- and his rare diagnosis. There were no treatments available; a heart transplant was an option, but Archibald, who was 68 at the time, was told he might be too old.
A devastated Archibald implored his fellow retired NBA players to take advantage of the free screenings, which have unearthed heart conditions, diabetes and hypertension among former players. Tiny's message to NBA alums was heartbreaking: The screening may not save my life, but it could save yours.
"My doctor was pretty direct about it,'' Archibald tells ESPN. "He told me, 'You could go at any time.'''
One year later, Tiny Archibald is strolling the streets of his native New York, enjoying the season. He can't walk quite as fast or as far as he'd like, but he's taking that in stride. His medical odyssey, which entailed blackouts, deep depression and bleeding arteries, has left him with a new heart -- and a new lease on life.
Long after Nate Archibald retired, old friends who ran into him would often remark that he looked so fit, he could probably still suit up and play. Tiny loved to ride his bicycle and put in endless miles on the treadmill. He felt vibrant and healthy -- until the amyloidosis diagnosis in 2016 began sapping him of his strength and his confidence. By the spring of 2018, his condition had worsened noticeably. A routine trip to the grocery store often left him winded, dizzy. Once, he blacked out, eventually regaining consciousness on the floor of the produce section. It was not the first time such an episode occurred. In fact, it was becoming alarmingly frequent.
His cardiologist suggested a heart transplant and recommended that Archibald check himself into Columbia Presbyterian Hospital to prepare for the procedure. "The doc told me, 'Your heart can't take much more,''' Tiny recalls.
Tiny wanted to know how long he'd have to stay in the hospital. The answer was sobering; it could be three months, three years, seven years, all depending on his position on the waiting list and the number of donors. Archibald's health was deteriorating and he would need to remain hospitalized until a donor came through. Tiny informed his medical team that he refused to stay cooped up in a hospital not knowing how long he would be there. "But then the docs warned me, 'If you leave here, I don't know how long you will last,''' Tiny says.
He asked around and talked to a guy he knew who worked in the Bronx and who had a successful transplant.
"He told me, 'Nate, I waited too long,''' Archibald says. "I said, 'But you got a new heart.' He said, 'I did, but I waited so long, now I'm on the waiting list for a new liver.' When I heard that, I decided to check myself in.''
Archibald entered the hospital in April and began a cardiac rehabilitation program to prepare him for the surgery. He listened as they spelled out the potential complications of a transplant: bleeding, blood clots, stroke, heart attack, infection, rejection of the donor heart. As the days and weeks and months dragged on, Archibald chafed at his new life. He missed riding his bicycle. He missed walking to the grocery in the Bronx. He missed his freedom.
"You are in their custody,'' Tiny explains. "I couldn't do anything I wanted to do. I'd see people walking the halls, but I wasn't allowed to do that. I was all tubed up. They have to make your body stronger for what is going to happen [during the transplant]. I wasn't ready to be stuck in the hospital all that time.''
The isolation and the uncertainty left Archibald in a deep funk. When his doctor asked him how many people he wanted on his visitors list, Tiny answered, "Zero.'' He instructed his wife, Tina, to stay away and relayed the same message to his children and his close friends. None of them listened, but when they came to see him, he was distant, detached.
"At that point I'm thinking about what might happen,'' Archibald says. "I'm thinking about whether I'm going to be here tomorrow. I didn't want to leave this earth. I didn't want people to be sad. The doctor said to me, 'I think you're a little depressed.' I told him, 'It's OK. I've been a little depressed my whole life.'''
The medical team put Archibald on a strict diet. He had long ago limited the salt and sugar in his meals, but it hurt not to be able to have a sip of his beloved ice tea. He had always prided himself on the fact he didn't need to take any pills, but now they were waiting for him every morning in a tiny plastic cup. He retreated from everyone around him, clicking on his headphones and attempting to get lost in his music. He found himself reminiscing about the days when he was young, and a little lost, and how blessed he was to be mentored by Tom Hoover, Floyd Lane and Hilton White, who forced a brash young point guard to recognize his education was just as important as his basketball wizardry. Decades later, Archibald would return to New York to impart that same message to the young ballers of his city. "I was never happier,'' he says, "than when I was doing those free clinics, counseling those kids.'' The thought of never stepping foot in a gymnasium again steeled him when the boredom, loneliness and fear threatened to overtake him.
"I tried to do what I was told,'' Tiny says. "I took their horse pills, I ate their nasty food. It was like playing hoops to me. I was trying to get in a zone. I wanted to be left alone.''
The nurses gently cajoled him to eat his meals. "There's the fork and knife,'' Tiny would grouse. "You eat it.''
Tina and friend Tom Hoover spent hours trying to convince Tiny he needed to follow the regimen and stay positive.
"But he blocked everybody,'' Hoover says. "You can understand. He's a Hall of Famer that's used to doing things his way. When he had a broken ankle, he knew it took six weeks to heal and he knew what he had to do to make that happen. But now he's in this area that's unknown. We tried to get him to engage with us. But no matter how many times we said, 'We need to talk about this,' he'd just lay in bed and say, 'Yeah, yeah, yeah.'''
As April slogged into May and then into June, Tiny became friendly with other patients waiting for a transplant. Some were determined to wait for what was called a "clean heart" -- one without complications. Archibald informed the doctors he'd take the first heart that was available to him. "I was born and raised in the projects of New York,'' Tiny told them. "I grew up with complications.''
On June 21, just as the evening sun was waning, the head of the cardiology department walked in with some news. There was a heart available, but it was most certainly not "clean.'' It belonged to a 20-year-old man from New Jersey who was a drug user and had contracted the hepatitis C virus. The young man had taken his own life. Other patients had passed on the heart, but Archibald, who was now 70 years old, jumped at the opportunity.
"How soon will we do this?" he asked.
"In a few hours,'' came the answer.
Because of the donor's hepatitis C status, hospital personnel explained, this heart came with risks. Archibald would need to take the drug Harvoni, which is used to curb hepatitis C symptoms.
Tiny decided not to tell anyone about the transplant. "My thing was, 'Let me come out of recovery and say I made it.'"
The hospital called Tina to let her know about the surgery. Hoover, who knew other cardiologists at the hospital, was also informed. On June 22, 2018, Dr. Koji Takeda performed the successful transplant. Two days afterward, Tiny astonished doctors by walking a quarter-mile on the treadmill.
His recovery was remarkable, yet Archibald remained in the hospital for an additional 26 days undergoing rehab. On July 4, he sat by his window, watching the sailboats, shifting uncomfortably as the pain in his right side worsened.
The morning nurse walked in to help him wash up. "Are you ready, Mr. Archibald?" she asked.
"Yes,'' Tiny answered, "except I can't get up.''
The next thing he remembers he was in surgery, in a semiconscious haze that enabled him to hear everything the doctors were saying but unable to speak. Later, Archibald says, he was told he'd suffered a ruptured artery that required surgeons to drain nearly two liters of blood. "Thank God I was still in the hospital,'' Tiny says, "or I'd be dead.''
He was finally released from Columbia Presbyterian on July 18. A home health aide visited and supervised his daily walks, which were to be limited to two blocks. Tiny took him eight blocks the first time, then 10 blocks the next. The aide protested, explaining it was imperative to keep Archibald's heart on a steady beat. "I've been doing this my whole life," Tiny shot back. "I'm going to walk the way I want to walk.''
"He finally just stopped coming,'' Tiny says.
Archibald is now walking a mile a day, though he usually waits until his wife goes to work so he won't get a lecture. He attended the Naismith Basketball Hall of Fame induction ceremonies in September in Springfield, and he's itching to get back into the gym to do some clinics, but he hasn't been authorized to do that just yet. He would love to hop on his bicycle, but now that winter has settled in, that will have to wait until spring.
Just two weeks ago, on Dec. 14, Tiny showed up at the free screenings held by the players association at its New York City offices, hobnobbing with his peers and being examined by the doctors. He must undergo frequent biopsies to check the condition of his heart and will have to take immunosuppressants for the rest of his life, but, he says, that's a small price to pay.
"The players association saved my life,'' he says.
He was there when legends Oscar Robertson, Dave Bing, Dave Cowens and others fought to get retired players benefits. He will be forever grateful to the current leadership of the union, which includes Chris Paul, Dwyane Wade and LeBron James, for setting aside the funds to make sure every retired player with a minimum of three years of service can be screened.
Tiny says his new slogan is to enjoy one day at a time, and consider each day a blessing. He will continue to lead the charge, he says, to encourage as many retired players as possible to take advantage of the opportunity to get a complete picture of their health.
"You may look OK on the outside, but you never know what's going on from the inside,'' says Nate "Tiny" Archibald. "Trust me, I know.''