Chapter 13
Sirius is holding Remus’ hand, a gentle thumb rubbing back and forth across the back of Remus’ hand. Remus is grateful for it because his anxiety is at an all time high.
Out of all of the surgeries he’s ever had, these moments as he’s waiting for the nurses to come in and prep him are the scariest moments of his life.
Remus’ body is beaten down, his muscles wasted away, his heart just about ready to give up. He looks up into Sirius’ eyes, he desperately wants to talk to him but his voice is still stolen from him. He tries anyway.
I love you, he mouths to Sirius and weakly squeezes husband’s hand.
“I love you too, Moons,” Sirius assures him and leans down to kiss Remus’ forehead.
I’m scared. Remus admits, his lower lip beginning to tremble. He knows the risks and dying on the table is a very real possibility. He might never wake up once they put him to sleep today and he’s just not ready to say goodbye to Sirius. He’s not ready to say goodbye to life and his dreams for the future and his friends and family, baby Emma who has no memories of him yet and Harry who is still so young. And Sirius. Sirius who needs him, whom he loves more than anything in the entire world.
“I know baby,” Sirius says as the tears begin to roll down Remus’ cheeks, Sirius’ thumbs wiping them gently away. “I know baby, but I’ll be here until you’re asleep and I’ll be right there when you wake up.”
Remus just continues to cry and tremble, Sirius holding him tightly, feathering sweet kisses onto his cheeks and lips and the backs of his hands until the nurses arrive to get him ready.
Sirius insists on being allowed to help change Remus’ diaper for a fresh one and then helps him with a round of cough assist and suctioning to get ready for anesthesia.
The two exchange so many I love yous and see you soons and you’re the best person in my lifes.
And then, too soon, the anesthesiologist is there and he’s injecting something into Remus’ central line that makes his eyes grow so heavy and the last thing he hears is Sirius’ sweet voice saying “I love you so much, Remus. So much, sweetheart. I love you, baby.”
The last things he feels are Sirius’ gentle fingers removing his hearing aids from his ears and a light, sweet kiss on his forehead.
For the entire first two hours after Remus was taken back to surgery, Sirius paced. He paced nonstop, to the wall and back, to the wall and back, to the wall… and back.
Each of his friends and family took turns pacing with him. Some, like James, put a loving hand on his shoulder, others, like Reg, pace with him in silence, and others, like Marlene, attempt to make him smile or laugh.
Eventually, the doctors emerge to give their first update on Remus and Lily is able to coax Sirius over to the waiting room sofa where they sit together and listen to the doctor, Lily drawing soothing circles on the back of Sirius’s hand.
“We’ve disconnected him from the LVAD and he is now fully on the heart-lung bypass machine,” Dr. Dearborn explains. “We will now begin the actual transplant portion of the surgery.”
Sirius nods silently and watches as Dr. Dearborn retreats back to the OR. Sirius tries not to think about how, at this very moment, Remus’ heart is completely still. Not beating at all, his entire survival left up to the proper functioning of the bypass machine.
Sirius tries not to think about it but eventually it catches up to him and then he’s hyperventilating, tears falling down his cheeks in rivers, his hands shaking violently as James pulls him in close.
James holds him there, tightly and it’s not long before Regulus is there too, crouching in front of the two of them.
Regulus instructs Sirius to open his mouth and, when he complies, Regulus sets two Xanax tablets onto Sirius’ tongue. The chalky taste of them is familiar and already a bit comforting.
Sirius swallows them with a gulp of water, Regulus tipping the water bottle up for Sirius who can’t manage it himself because of his shaking hands.
It’s not long before Sirius’ eyes are growing heavy and James is coaxing Sirius’ head down into his lap, Regulus sitting at the other end of the couch, pulling Sirius’ feet into his own lap.
Sirius sleeps fitfully but enough for time to move a bit quicker and before he knows it, the doctor is coming out with another update.
This time, it is a different doctor, a severe looking woman he’s never met.
“Dr. Dearborn has successfully transplanted the donor heart, the next step will be starting the new heart, testing its function and removing Mr. Lupin from the bypass machine,” the woman, Dr. McGonagall, explains. “Dr. Dearborn will be out to speak with you once Mr. Lupin is all stitched up and on his way to the recovery room.”
Sirius is only half conscious thanks to the benzodiazepines circulating in his bloodstream but he vaguely registers a squeeze on his shoulder and James’ voice in his ear, “He’s almost done Pads, almost time to go see him.”
Sirius nods tiredly but lets himself be lulled back to sleep by Lily’s hand rhythmically petting his hair.
One minute or one hour or one day later, Sirius is having a hard time keeping track of time, Sirius is being awoken again by Dr. Dearborn, this time.
“Remus did so well and he’s in recovery right now, you can see him once he’s been stabilized and transferred to CICU,” Dr. Dearborn assures Sirius, leaning forward and putting a comforting hand on Sirius’ knee. “Now, his condition is still very delicate. We will keep him sedated for several days at least. This will allow him to begin healing and will allow us to care for his airway without being concerned about him coughing and gagging, putting pressure on his brand new incision.”
Sirius nods, feeling alert despite having just been awoken only several minutes prior. He expected that they’d keep Remus sedated, of course he does, this is Remus’ second open heart surgery in less than a year. But he just nods because, what else should he do?
Dr. Dearborn leaves them and then they all get her their belongings and wait for the all clear to join Remus in his ICU suite.
They all end up waiting an hour more, then they’re all making their way slowly to the CICU and its waiting room. James and Regulus walk on either side of Sirius, each keeping a hand on their brother.
Sirius breathes as evenly as he can manage, focusing on putting one foot in front of the other. He’s going to see Remus now. He just wants to be able to put a hand on Remus, feel him still warm and alive under his finger tips.
He vaguely realizes that this will be his first time seeing Remus with his new heart, maybe this is the first day of the rest of their lives. Maybe, just maybe, this is the beginning of happier times.
The CICU staff only allow Sirius, Lily, and James back to begin with. The others are left behind, banished to yet another waiting room. But nobody complains, only too happy to allow Sirius and Lily to be the first ones at Remus’ side, James there to support both of them.
Remus’ ICU suite is large this time, much larger than usual. The nurses have kept the room lowly lit, the only light coming from the glow of the monitors and medication pumps surrounding his bed.
Remus is lying so still in the bed, his long limbs cushioned and propped up by various pillows and wedges. His long legs, encased in air compression booties which occasionally inflate with air to encourage circulation.
He’s naked save for his diaper and a new urinary catheter snaking out from underneath it. The bandages on his chest do their best to hide the gruesome incision but the bruising spans much of his torso, far beyond the edges of the bandages that hide his fresh incisions and the wounds where the LVAD wires once protruded.
He breathes steadily thanks to the ventilator and Sirius notices that the nurses must have given him a fresh trach collar as it looks much newer than the one Remus had on earlier this afternoon when the ambulance took him to the hospital.
He wants to crawl into the bed, he wants to snuggle closely to Remus but he does understand that he can’t do that. He understands that Remus’ condition is still delicate, his new heart is still just as fragile as his old one just in a different way.
Instead, Sirius just assumes his position in the comfy-but-not-special hospital chair at Remus’s bedside and takes one of his love’s hands in his own, trying not to burst into tears at the reemergence of the blue, padded wrist restraints.
“Hi baby,” Sirius says, his voice a whisper. “Dr. Dearborn says you did amazing, your new heart seems really, really promising.”
Lily is sat on the other side of Remus’, his other oversized hand firmly grasped in both of hers. She is kissing the back of his hand over and over and over again.
“I’m so proud of you, Rem,” Sirius whispers to him again. “I know this has been so hard and so scary but… thanks for trying, for me and for Lily. Thanks for giving this new heart a try.”
Sirius falls silent after that having said all of the things he’s wanted to say all afternoon. He lets Lily talk and right now, she’s just murmuring sweet little things to Remus but Sirius isn’t really paying attention to what she’s actually saying.
All he’s thinking about is how grateful he is that Remus survived the surgery, how scared he is for when Remus wakes up knowing he’s going to be in extreme pain. He examines Remus’s hands and feet with his gaze, noting how his extremities are still extremely swollen and wondering how long it will be before his new heart makes the edema go away. He wonders if Remus will now, finally, be strong enough to begin the process of weaning off of the ventilator.
Dr. Dearborn has explained that even with the heart transplant, Remus’ lungs have been damaged from the long-term ventilator use and the long-term pulmonary edema. However, there is still hope that Remus will eventually grow strong enough to wean from the ventilator and that's what Sirius clings to now.
The three of them settle into a long, uncertain night. None of them sleep, all keeping an eye on Remus’ still body, Sirius helping with what he can when the nurses come in to care for Remus.
They are mostly silent but occasionally one of them will speak to Remus, usually it’s Sirius. Leaning forward again to press gentle kisses into his love’s hair and onto his cheeks reminding him of how much he loves him and how proud he is.
Oh, how Sirius Black loves and admires Remus Lupin. He can’t wait for his Moony to wake up once again but he’s patient, knowing he needs to allow Remus’ body to heal so he just watches and talks to and soothes his lover all night long.