“I just got offered the biggest role of my life,” I said.

“Are you insane?” she shouted at me. “You can’t do this movie!”

She wasn’t entirely wrong. There was a Gremlin in the control room of my body that had locked the door so no one could stop it and was madly flipping the control switches. It was against all odds that I was still breathing. My doctors were scrambling to find out which medication designed for rheumatoid arthritis and other conditions that I didn’t specifically have would mitigate my symptoms. They were unsuccessfully trying to solve one part of a many part problem, pumping me full of these drugs, one after the other, all of which had horrific side effects. Sofia had every reason to say what she did, but the way I saw it, I had one job now: to prepare for this role. It was just the carrot I needed dangled in front of me, the one that would lead me out of this nightmare that had become my life. I needed to believe, even if it turned out to be a delusion, that one year from now I could handle the rigors of shooting a superhero movie for six months.

This would be my trial by fire. The operation had left me with scars: the long one below my belly button that looked like I’d been split open with a survival knife, plus two smaller ones on the right side of my abdomen where the catheters had been inserted. They were very fresh, and while they might raise eyebrows if they were seen, they were nothing compared to the golf ballsized hole the doctors had drilled through my stomach wall to pull out the end of my fleshy, pink small intestine that was now covered by a large plastic ostomy bag.

Adjusting to life without a large intestine was like waking up in someone else’s body. Without the storage capacity of a colon, within minutes of eating anything, my body would immediately output waste through the stoma. There was no real way to feel when it was going to start or stop. Sometimes it began thirty minutes after eating, some-times sooner. Since I was trying to gain all that weight back, eating steadily all day long, my digestive system worked around the clock, which meant I changed bags constantly and got no rest, even over-night.

I had the routine down though. I’d take an adhesive putty, work a piece of it in my fingers until it was pliable and sticky, and spread it in a circle around the protruding hole. I’d then adhere a plastic ring to the putty, making sure it was airtight, before snapping an ostomy bag to the ring. When applied perfectly, the stoma emptied directly into the bag and didn’t leak.

To make matters more complicated, I’d always been a stomach sleeper. My whole life I’d slept face down, with a pillow under my chest and my arms splayed out above my head. I was now forced to sleep on my left side only because of how the bag sagged and hung once it started filling up. Lying on my back was out of the question because at that angle, the stoma fired straight up like a geyser and compromised the adhesive seal, causing it to leak down my abdomen.

This had resulted in several nervous breakdowns during my first few weeks back home. I’d wake up in the middle of the night gasping for air, lying in a puddle of sweat, my hair drenched. I’d reach down to discover that the bag was leaking through my pajamas and quietly get out of bed to dispose of the waste, hoping I didn’t wake Sofia. Because I couldn’t control the output, I would often have no other choice but to stand in the shower, lean against the wall, and close my eyes until my body ran out of sludge. The complete loss of muscle mass in my lats and back, as well as the rest of my body, compounded my sleep issues.

Having muscle mass was like having pillows attached to my skeleton: Not only did it make lying down more comfortable, it held my spine in place. Since I’d lost so much of it and was sleeping in unnatural positions, I began to have neck and spinal problems. And since my body was suffering from all manner of internal and external inflammation, I’d wake up at night shivering cold in a pool of sweat. I learned to lay towels down beneath me and change them out each time I woke up.

Sofia couldn’t bring herself to congratulate me on landing the biggest role of my career. She’d just watched me die and come back to life through the marvel of modern science, and I think during my illness part of her had begun to adapt to the traumatic thought of living her life without me. Now here I was packing to leave her for an unbelievably high-stakes job that I was in no shape to take. Hard as it was for her to understand, I needed it to survive. The role contained the shred of hope that I might get my life back in some capacity, and I had to believe it was possible.

My job was simple: Be a warrior. When I looked into my eyes in the mirror, there was no fear, just determination. In them, I saw a gaze like Clint Eastwood’s when he played the Man with No Name in Sergio Leone’s Dollars Trilogy or Dirty Harry. That look that told other men that he’d pull the trigger with no hesitation or remorse, the look that always made them back down. I was not afraid to die anymore; death already knew who I was, and that look was in my eyes now. I had fought my illness with every fiber of my being—and then fought some more. I had discovered extra gears within me. I’d gain the weight back, get my digestive system reconnected, lose the bag, and get back to my life. The role was my destiny. I had been removed from one set because of my health, but it wouldn’t happen again.

I hated the pity I saw in Sofia’s eyes when she looked at me now. When we first met, she looked up at me with such pride; I would have gone to war and taken over the world for that look. Now all I could see reflected back at me was this sick, pitiful patient. I was determined to see Sofia’s eyes flicker for me the way they used to once again—even if it killed me.

I boarded my flight to Heathrow and tried my best to sleep on my side in the pod. I had my blanket pulled up and was starting to doze when I reached down and felt moisture. There was a fucking leak in my ostomy bag, and shit had started to soak my underwear. I got up, carefully holding my shirt away from my body, praying none of the waste got on it, leaving a stain that would smell for the entire flight. I got my backpack from the overhead full of my supplies: a spare ring, the putty, a waste bag to hold the used bag, a fresh ostomy bag, and clean underwear. I’d learned pretty quickly that it was wise to keep clean underwear on hand at all times. I got to the bathroom, peeled my shirt off carefully, and started swapping out the bag. As I removed it, the stoma shot like a cannon, spraying onto the mirror and counter. With lightning reflexes, I grabbed a wad of tissues and plugged it, slowing the flow for the time being. I emptied the full bag into the toilet, then folded it up and put it into the waste bag. While the tissues stuffed into my stoma soaked through, I got the pieces ready and did my best to attach the new bag. Once it was secure, I cleaned the bathroom using the hand soap and paper towels. By the time I was done, I was sweating from the stress and embarrassment even though I was alone in the middle of the night with most of my fellow passengers asleep. Once I had things under control, I changed my underwear, which thankfully was the only article of clothing compromised. Then I took a deep breath and looked in the mirror. “You’re a tough son of a bitch,” I said. “You’re a bad dude. I love you.” I nodded silently to myself in affirmation, then headed back to my seat to try to sleep. I was going to need it.

I got to my hotel the next morning and had the entire day to get settled. I thought long and hard about how to get through the fitting. I planned to stop eating in the late afternoon and not eat again until after it was over, giving me about eighteen hours to allow my digestive system to clear. I knew the suits DC used for their superheroes were three to four layers, starting with a skintight spandex bodysuit, a second layer of heavier latex material, a layer of armor, and sometimes another layer over that. I had to be absolutely sure nothing would come out in the bag while I wore the suit because under that degree of compression it would probably explode. I was appropriately empty by morning when I met with the wardrobe staff. They handed me the tight spandex base layer and just stood there. This was not unusual for a fitting, but I couldn’t undress for an audience without revealing my scars and the bag. I acted demure, which, given their expressions, clearly seemed a little curious coming from Alcide the naked werewolf and Big Dick Richie the stripper. I smiled, shrugged my shoulders, and held up the spandex, as if to say, “Are you all just going to stand there?” They snapped to attention, embarrassed, and filed out. I took off my sweatpants, which I’d gotten used to wearing exclusively because it was impossible to wear jeans or pants with stiff waistbands due to the location of the ostomy bag. I confirmed that it was still empty—so far, so good—then I slipped into the bodysuit and called everyone back in. They helped me into the next layer, made of thick, heavy, contoured latex, and began strapping shiny chrome armor on me. They tried a number of different knee pieces, arm pieces, you name it, to replicate Deathstroke’s look in the video game. Once we settled on the configuration, the pieces would be painted the character’s trademark navy blue and orange.

The fitting went as smoothly as could be, but apparently that wasn’t the end of the day’s journey. They informed me that they also needed to create a full 3D body scan image of me using 256 cameras mounted around a podium. The scan would be used to make a replica mannequin of my body, which they’d use like a dress form to tailor and fit my suit over the next month before we shot my scene. There was just one problem: “We noticed you’re wearing black underwear,” one of them said. “The cameras don’t like black, so we found these for you.” They handed me a pair of tiny bright blue briefs sized for a man much smaller than me with, shall we say, a very different personal style from my own. I stared at them and began to panic. There was no way in hell that little thing would fit me, let alone hide the bag.

From BLOODLINES: A Memoir by Joe Manganiello. Copyright © 2026. Reprinted by permission of Avid Reader Press, an Imprint of Simon & Schuster, Inc. Printed by permission.