Former mobster, Nathan Hastings, was a detective with the Paul Williams Detective Agency. Nathan fell in love with Dr. Olivia Barber. Nathan and Olivia married. Olivia's sister Drucilla was her reluctant maid of honor, since Dru had a crush on Nathan herself. Dru commiserated with Neil Winters, who also was secretly in love with Olivia, but Dru and Neil ended up falling in love. It was obvious both couples were mismatched. The scholarly Olivia was married to the former criminal Nathan, and the former criminal Dru was with the well-educated Neil.
A pregnant Olivia was diagnosed with ovarian cancer, but refused to abort the baby to save her own life. Nathan Jr., known from birth as Nate, was delivered early to save Olivia's life. Liv had been planning to have a hysterectomy afterward, but the subject of her surgery and her cancer was never addressed further. A few years later, Drucilla had a daughter, Lily, and through the years, Lily and Nate were always best friends.
Years later Nathan and Olivia were not getting along because Olivia took her mentally ill mother's side against Nathan. So Nathan had an affair with the beautiful Keesha Monroe. Olivia became suspicious, and both Dru and Neil cautioned Nathan after they caught him with Keesha. Each time Nathan tried to end the affair, Olivia did something to drive Nathan back into Keesha's arms. But Nathan finally ended the affair, and he and Liv began trying to have another child. Just as Keesha was falling in love with Malcolm, he found out about the affair with Nathan and dumped her. Then Keesha began getting persistent calls from old boyfriend, Stan, who later died of AIDS. Keesha went to Dr. Liv, turned out to be HIV-positive, and had to tell Nathan. Dru decided to tell Olivia about Nathan's affair with Keesha. Liv was furious that Nathan had betrayed her, and had also endangered her and their son Nate with HIV. Liv kicked Nathan out and forbade him to ever see their son again. All three of them tested HIV-negative, but Keesha was doomed with full-blown AIDS and later died. Nathan became desperate to see his son, and kidnapped Nate. Life on the run was rough on Nate, so Nathan finally did the right thing, and was returning Nate to Olivia when he was struck by a car and killed.
Neil's brother, Malcolm, and Olivia were married a couple years later, and Nate was thrilled to have the exciting and fun-loving Malcolm as his new daddy. But eventually Liv began spending too much time at the hospital and not enough time on her marriage. Malcolm and Nate's nanny, Julia, were raising Nate. Olivia suddenly began being suspicious of Malcolm over nothing and ended up driving him into another woman's arms. Malcolm tried to patch things up with Liv and convince her she was wrong about him, but Liv suddenly couldn't decide if she wanted Malcolm back or not. Her mind was on Neil, the man to whom she was always drawn and much more suited. Much to Nate's disappointment, Malcolm asked Liv for a divorce and moved out.
Then the always work-obsessed Olivia started getting symptoms she refused to recognize and ended up on her deathbed with aplastic anemia. She further alienated Malcolm when she changed her will allowing Neil to raise Nate if she died. Dru returned to Genoa City with Lily in tow and donated bone marrow to save Olivia's life. Olivia's near-death changed her holier-than-thou attitude, but it was short-lived. Olivia decided that Malcolm was not a fit role model for her son, refused to let them see each other, and again set her sights on Neil. Malcolm sued for visitation and won. Nate loved Malcolm and still thought of him as his daddy, although it was never made legal. Then Malcolm disappeared in an accident on a photo shoot in Kenya, and was presumed dead.
Nate began getting close to his "Uncle" Neil then, but Neil was drowning his guilt over Malcolm's death in alcohol. So Olivia banned Nate from seeing Neil, too. Brad Carlton, husband of Olivia's best friend, Ashley, tried to step into the void. Later, Nate was happy to see his cousin Lily return to Genoa City from years living in Paris. Neil went on the wagon, and he and Drucilla were remarried.
Three years after he was declared dead, Malcolm showed up in Genoa City, very much alive, sporting cornrows and a bad attitude. Malcolm as out for revenge against the brother who he thought had stole his fiancée and left him for dead in Kenya. But mostly he returned to see Nate again. Olivia was resentful that Malcolm didn't make himself known to Nate as soon as possible, and made him wait to reveal himself until the 15-year-old Nate returned from boarding school at the end of the semester. Nate never returned, and Malcolm disappeared once again.
In November 2008, Olivia returned to Genoa City and mentioned that Nate was now in Medical School in Baltimore at Johns Hopkins University.
In February 2011, Nate, a Rheumatology specialist practicing in Boston, returned to Genoa City to perform a partial liver transplant on undercover FBI agent, Ronan Malloy, using the liver of his half-brother Chance Chancellor. Chance had been called in from witness protection when he was found to be a donor match for Ronan. Chance came through the surgery fine, but as soon as Ronan's surgery was finished, Ronan was taken away by an unmarked helicopter under orders from the FBI. Nate was shocked and very concerned for his patient, saying it was very dangerous for Ronan in his condition.
After surgery, Malcolm was there when Nate visited his cousin Lily to give condolences on the murder of her husband Cane. Neither Nate nor Malcolm was surprised to see each other, so viewers were left to assume that they have been in contact since Malcolm returned from the dead.
Dr. Nate has appeared sporadically since then, most recently at the wedding of Malcolm and Sofia.