Chapter 10
When Remus comes too, his chest is on fire. His throat is burning and his arms and legs are so painful that he finds he can’t even flex his fingers.
There is an unusual sensation on his belly and he tries to raise his head up to look down but finds that he doesn’t have the strength.
Remus tries to turn his head to find Sirius but he finds that he’s too weak to roll his neck the way he wants to. And then suddenly, Remus feels a flash of anger, then frustration, then pure, abject terror. He’s crying now, his arms are straining against the restraints weakly and he tries to talk but he can’t find his voice.
Why can’t he find his voice? Why can’t he find Sirius and why can’t he find his voice?
Sirius? He tries again.
Sirius? He doesn’t understand what’s happening.
Sirius! He needs Sirius, where is Sirius?
He’s shouting and begging and his voice isn’t coming and Sirius is missing and- and…
“Hey, Hey!” it’s Sirius’ voice, he’s right there now. Remus can see him now.
Where did he come from?
He wasn’t there just a moment ago.
“Take it easy, love,” Sirius’ voice is worried and his face is pale, the corners of his eyes and lips are drawn tight with tension. “You’re okay, I’m right here.”
Remus is sobbing and he’s trying to tell Sirius that he’s scared, that he doesn’t know what’s happening and he’s scared and it hurts and he’s scared. So, so scared.
What’s happening? Remus asks, his voice is still missing but maybe Sirius can actually hear it because he answers.
“They’re just changing out your PEG tube, Rem,” Sirius says, his voice soft.
PEG tube? Remus tries to remember but he can’t quite… can’t quite remember what that means.
Then, suddenly, his attention is drawn back to the original source of his curiosity and Remus sees them now. The nurses are standing on either side of the bed, he recognizes one of them vaguely but the name isn’t coming to him. God, his thoughts feel like mud and he’s struggling to even focus on one thing for longer than a few seconds.
Then, there’s a sharp pressure and a small flash of pain on his belly and he flinches, his hands drawing upward instinctivly, before being stopped by some sort of resistance, his face turning into a grimace.
“Almost done, Remus,” the male nurse, the one Remus feels like he should definitely know the name of, speaks in a calm, sure voice.
He feels the sensation of something soft being wiped across his belly and then there’s the feeling of wet coolness, the unfamiliar nurse waves her hand over the cool spot for a few seconds and then the male nurse is talking again.
“New tube going in now,” the nurse says and then there’s another spark of pain and a few moments of painful pressure, then it’s gone.
The nurses are talking again but Remus’ attention has been drawn away by the feeling of Sirius’ lips on his temple.
“All done,” Sirius coos, a hand in Remus' hand. “All done, no more.”
No more what?
No more pain?
No, that can’t be true because Remus is still hurting. His throat and lungs are burning and there’s a sharp pain and pressure in his chest that radiates up to his jaw as his failing heart does its best to keep working and his body is aching so terribly, he wants to stretch his limbs but they’re like lead. He begins shifting uncomfortably, trying to do anything to relieve the discomfort in his body.
“Are you in pain, sweetheart?” Sirius asks, placing a hand on Remus’ shoulder that stills his movement just a bit.
Owww. Remus tries to speak and it’s still not coming. Hurts, Pads. Hurts.
And again, magically, Sirius seems to be able to hear him even though Remus can’t hear himself or feel his voice vibrate in his throat. Sirius has got a hand in Remus’ hair again.
“Okay baby, Karl is going to get you some more medicine. The medicine will make it all better. All better, I promise,” Sirius says, his hand stroking Remus’ scalp rhythmically in a way that helps even if it doesn’t do anything about the pain.
Karl! It dawns on Remus, that’s the male nurse. He knows Karl, he knows he knows but his brain is too muddy to really think now, to really remember how he knows Karl.
There’s a burning in his arm and then everything seems to grow a bit hazy around the edges. The pain dulls little by little and then, there’s another burning in his arm and a feeling of pleasant warmth and the sensation of floating and then his eyes are closing.
His hearing stays on-line a bit longer than his vision and the last thing he registers before falling back into oblivion is the comforting sound of Sirius’ voice. It’s soft and sweet and he’s singing a song, one of Remus’ favorites, his breath ghosting over Remus’ cheek.
Three weeks into this ICU stay and, instead of things getting better, they just seem to keep getting worse. It’s always feeling like they’re one step forward only to immediately take three steps back. Everytime Sirius, Lily, and James get good news it’s followed up by two or three other bad things.
In the middle of the night, two days ago, Remus suddenly spiked a fever again after having gone several days with no signs of fever at all, the nurses sent off lung, blood, and urine cultures to try and pinpoint the culprit. It turned out to be a raging urinary tract infection caused by his urinary catheter.
They’ve removed the catheter and started treatment for the new infection but they've struggled to keep Remus’ fever down and he’s showing signs of increased water retention as evidenced by the way his poor feet and hands have seemed to quadrupled in size, the skin stretched to its limits.
Dr. Dearborn has begun gently suggesting to Sirius, James, and Lily that perhaps it’s time to consider other options, like hospice. To consider that perhaps it’s better to make Remus as comfortable as possible and allow him to go peacefully.
And, really, James can understand the doctor’s perspective and so does Lily. It’s getting harder and harder to keep Remus comfortable as they continue with extraordinary life saving measures. As expected, Remus has begun suffering bouts of delirium, fighting against the sedatives. His eyes opening, wide and searching, always searching , for Sirius.
James finds it kind of beautiful, in a very tragic, heartbreaking way, that no matter how long Remus has been sedated, how confused he is, or how much pain he’s in, his first instinct is to always look to find Sirius.
But Sirius had lost his mind, crying hysterically when the doctor suggested that. Telling Dr. Dearborn that he’d said the heart transplant would help Remus, that if he could just help Remus get a heart transplant that this would all be better. That Remus would get better; that he had to get better.
The doctor had just looked on sadly and reiterated that sometimes the body just becomes too weak to continue, no matter what medical interventions it’s given. He reminds them gently that sometimes death is a kindness and that, at some point, Remus would let them know what he needs, whether that’s to keep fighting or to be allowed to go.
“Sweetheart, it’s okay,” James is pulled back to the present as he hears Sirius murmuring to Remus again, his voice steady and sure. Comforting. “Hey, shhh, shhh, I’m right here baby. I’m right here.”
He watches as Sirius sits beside Remus on the bed, hip to hip. He’s placing cool compresses over the hot, feverish skin of Remus’ chest. James is pretty sure Sirius doesn’t know that James is awake as he was asleep just a few minutes ago.
So James watches on silently, not wanting to interrupt Sirius' quiet moment with his husband.
Remus’ eyes find Sirius’ once again. It strikes Sirius now, after the discussion with Dr. Dearborn this morning about hospice, just how beaten down Remus looks these days.
Obviously, he’s been weak and sickly for months but now, looking into Remus’ eyes as his skin blazes like fire under Sirius’ hand, fever raging, he can see a certain weariness that wasn’t ever there before, the frailty in his frame that gives the illusion that Remus could fall apart at the lightest touch. Remus can hardly even squeeze Sirius’ hand back these days.
Remus is crying, tears gathering in his eyes and falling down his temples when his eyelids and lashes can’t contain them any longer. Sirius wants to look away, Remus never used to cry and now he cries all the time. Just one more way that his terminal diagnosis is changing him. He looks like he’s in so much pain and Sirius, not for the first time, wishes he could just swap his body for Remus’, take Remus’ pain on for himself.
“Sweetheart, it’s okay,” Sirius reaches a hand up to wipe Remus’ tears away with the pads of his thumb. “Hey, shhh, shhh, I’m right here baby. I’m right here.”
Sirius’ heart tugs at the way Remus pushes his head instinctively into Sirius’ hand, begging for more contact. Sirius obliges, of course, pushing his hand up into his husband’s curls, massaging his scalp. Remus’ curls are soft and sweet smelling, Sirius having washed Remus’ hair only a couple hours prior, using Remus' favorite cherry scented shampoo.
“Baby?” Sirius asks, waiting for Remus’ eyes to find him again. It’s slow but Remus does eventually make eye contact. “Can you hear me, love?”
Remus nods minutely, the movement of his head just barely noticeable.
Sirius takes a deep breath because he’s just not sure at all how to say what he’s been trying to find the courage to say all day. He doesn’t even really want to say it but he knows that Remus deserves his consideration, he deserves the autonomy. And, Remus is having a rare moment of what Sirius believes is true lucidity. Most of the time Remus is confused and only half conscious, if at all, but right now, in his husbands’ eyes Sirius can see the life there, the real Remus. Sirius doesn’t know the next time he’ll see that, if he’ll ever see it again, even.
“Rem, baby, I-” Sirius feels his eyes heat with tears and he does his best to blink them away. “I just want you to know that if-if you ever feel like you’re done fighting this, if you ever decide you want to stop fighting and just let your body rest, I will support you in that decision.”
The tears are coming now and Sirius has no choice but to just let them fall. He doesn’t like crying in front of Remus but he isn’t sure that he’s capable of saying these words without crying. And he needs to say them before he loses his nerve.
“I want you to know that I’ll never make that decision without your consent, I will NEVER give up on you. But I also won’t ever begrudge you if you decide you want to stop treatment,” Sirius’ voice is thick and he clears his throat so that Remus can easily understand him. “You can go if you want to, if it ever just hurts too much or if you’re just too tired to stay. I’d miss you like crazy but you can rest when you're ready. And I’ll-I’ll be okay.”
Sirius is pretty sure that last part is a lie and he’s sure Remus knows that too but he feels like he can’t possibly tell Remus he would grieve forever without it sounding like a guilt trip to make Remus stay longer than he wants to.
Sirius’ tears are falling in quickly now, and one of Remus’ hands struggles against the restraint a bit and Sirius looks down at the hand and back up to Remus’ face.
Sirius expects to see anger or hurt but instead he sees love radiating off of Remus like sunshine.
Hug, Remus mouths and Sirius unrestrains on of his husbands’ arms and crawls into the bed, letting Remus attempt to wrap Sirius up, holding him. Remus’ swollen hand attempts a weak squeeze of reassurance and Sirius squeezes back.
“You’ll tell me, right Re?” Sirius asks, looking back up to his love’s face again. “You’ll tell me if you’re ever ready to stop fighting, so that we can make sure you’re comfortable?”
Remus’ lips purse slightly in a sign of sadness but he nods his head weakly.
Yes, he mouths. I’ll tell you.
Sirius lets Remus hold him a bit more but eventually he sits up and straps the padded blue cuffs back to his love’s wrists. Remus is shivering again with fever and Sirius removes the cold compresses, pulling up the thin blanket, knowing he’s not supposed to allow Remus to shiver like that. It’s a delicate balance of not allowing Remus to become too hot but also not allowing him to become too cold.
Remus’ eyes have gone glassy again and Sirius can tell that he’s sunk back into delirium, the confusion and anxiety brought on by fever and intense pain.
It hurts, Remus mouths frantically. Medicine. Suction. Please, Suction!
Remus is so frantic now that Sirius can tell that if he were able to vocalize that his pleas would be coming in shouts, voice breaking with anguish.
Sirius shouts over to James who is asleep on the couch to please, “Go get a nurse.”
James is up in an instant, leaving through the door without a word.
“Okay baby, we’ll get you some medicine and some suctioning, okay?” Sirius soothes, a hand in Remus’ hair. “I’ll get the respiratory team to come do some coughs okay? Coughs will make it feel better.”
Remus makes the slightest movement of acknowledgement and then he’s staring at Sirius again, mouthing something that Sirius can’t quite make out. He asks Remus to repeat himself and he finally understands after watching his lips a couple of times that Remus is mouthing, Too loud.
“Do you want me to take your hearing aids out, baby?” Remus nods and Sirius reaches up to Remus’ ears saying a quick “I love you, Rem.” and then he’s gently pulling his hearing aids out, popping the battery doors open and setting them safely in their case on the table.
The nurse comes in quickly and delivers some fever reducer and some more pain and anxiety medications into Remus' IV.
Remus is calmer but still crying in pain, struggling to breathe when the respiratory team arrives to do his nebulizer and cough assist. By the time they’ve finished clearing his airway, Remus has stopped crying and is now allowing James, Sirius, and the nurse to change him and reposition his body without protest. He's allowing himself to finally sink back into the cottony wool lightness of the sedatives.
He falls asleep quickly with Sirius’ loving hand stroking through his hair.
And when Sirius is sure that Remus has truly fallen asleep, only then, does Sirius allow himself to cry as hard as he wants. His shoulders shaking with silent sobs as he attempts not to wake Remus.
After a few minutes, James is there, gathering Sirius into his arms and squeezing him so tight Sirius is sure he might fall apart completely if James were to let go.