In 1936, Walden Cassotto was born into a poor Italian-American family in East Harlem, a neighborhood in New York City. Shortly thereafter, Walden’s family, which consisted of his sister, Vanina “Nina” Cassotto, and mother, Paula “Polly” Cassotto, moved to an Italian Catholic neighborhood in the Bronx, one of the five boroughs of New York City. Polly’s husband, Sam, a petty criminal and drug addict, died in prison before Walden was born. Walden’s family had a secret.

In 1944, when Walden was 8 years old, he began suffering from a sore throat and fever. Unbeknownst to Polly and Nina, Walden had a bacterial infection called streptococcus, commonly called strep throat. They treated Walden’s sore throat and fever as well as they knew how, but it was far from enough. Lacking proper medical attention, Walden developed an inflammatory disease known as rheumatic fever which severely damaged his heart.