The hanahaki disease is an illness where a flower plant grows inside the patient's body when they suffer from one-sided love. If left unchecked, hanahaki can prove fatal, as the flowers eventually fill the lungs and stomach. Hanahaki disease will be cured when the love is returned, or when the patient's feelings of love die. The infection can also be removed through surgery, but the patient's emotions disappear along with the petals.

Principles of Internal Medicine, Page 578, Hanahaki Disease

. . .

Midorima Shintarou is thirteen when he coughs the first petal out of his lungs. He stares at it in his palm- it's blue and round and it looks like a piece of the sky flew from his chest. He throws the petal to the ground.

Who?

Shintarou knows what this means, he is going to be a doctor (but maybe not, if this progresses, a treacherous voice in his head whispers). It's hanahaki disease- born of unrequited love. Shintarou recalls the passage on hanahaki disease in his father's medical textbook. (If left for too long, hanahaki can prove fatal, as the flowers eventually fill the lungs and stomach.)

Death is not an option, and Shintarou does not want to lose his emotions, so he will have to dispel whatever romantic feelings he may have. Man proposes, God disposes. Shintarou will fix this.

. . .

The next day, Shintarou wakes at precisely seven in the morning. He watches Oha Asa at seven fifteen, as usual- Cancer is in ninth place, lucky item soy milk, lucky color grey. Shintarou reminds himself to stop by the convenience store before school. Everything is normal and Shintarou almost (almost) forgets about the garden growing in his lungs.

…

As he searches in the convenience store coolers, Shintarou feels an itch in the back of his throat. He coughs and spits three blue petals (they appear to be hydrangea: frigidity and heartlessness) into his palm. A lady looks at him with pity, and he crushes the petals in his fist.

Stop, he wants to say. Don't look at me like that- like I'm already dead. He offers the lady a tight smile and selects a carton of soy milk off the shelf.

…

On the way to school, Shintarou expels thirteen more flower petals. He wraps them in a tissue and throws them into the nearest garbage can.

…

Akashi is watching Shintarou. They're in class- the teacher is droning on and on- something about allusions to Homer's Iliad. Shintarou coughs; he tries to subtly stuff the resulting petals into his bag. They're tinted red with blood, and they seem larger than before.

Akashi raises an eyebrow. Shit. Akashi noticed. (Of course he did, one cannot hide from Akashi, and furthermore, Sagittarius was third today.) Shintarou stifles another cough.

When the patient sees the object of their affection, the symptoms of the infection may be exacerbated.

Shintarou freezes. The line from the textbook runs through his head. The flowers swell in his throat, and Shintarou suddenly finds it hard to breathe. He retches again and raises his hand.

"May I go to the restroom?"

…

Shintarou all but sprints to the restroom, locking himself into a stall. He drops to his knees and places his hands on the sides of the toilet. Petals and blood pour out of his mouth into the bowl- the plants rip at his throat on their way out.

When the flood of petals expelled from Shintarou's lungs slows, he relaxes against the toilet (part of him is positively screaming about how unsanitary this is, but he has far more pressing problems to address). Shintarou drops his head into his hands as he tries to come to terms with the revelation he just had.

He's in love with Akashi Seijuuro. God help him.

…

Basketball practice is hell. Shintarou is constantly aching to cough, however, he cannot do so without his… infection being discovered. He takes an unusual number of restroom breaks to expel the petals from his lungs. The stems have started regularly drawing blood- when he washes his hands after hacking up more petals (they're large enough to be flowers now, the disease is progressing unusually fast) the sink fills with a mixture of saliva, petals, and pink-tinted water. He spares the sink a look of disgust before walking out of the bathroom and rejoining the practice.

Every time Akashi as much as glances at him, Shintarou's throat fills with velvety flowers and his breath shortens to a pant. His mouth tastes of hydrangeas and his chest aches far more than it should after a standard Teikou practice. He gags again- a stem is pressing on the inside of his throat.

Kuroko is looking at Shintarou strangely; the others, as usual, notice nothing. How did it come to this? He pretends not to see Kuroko's stare, turning around and reaching for another ball.

…

After practice, despite Shintarou's determination to avoid Akashi as much as possible, Akashi manages to persuade Shintarou to play a game of shogi. The club room fades to silence as Akashi sets up the board and pieces. There's a tension in the air- they both know what it's about.

Akashi breaks the silence first. "Shintarou, you were coughing irregularly today."

Shintarou gazes at the shogi board and selects a tile. "Yes." He pauses. "It's nothing to be concerned about."

Akashi audibly scoffs. "Don't lie, Shintarou. It's unbecoming." He captures one of Shintarou's pieces and places it to the side. Shintarou suppresses a cough; the flowers are rising in his chest, responding to Akashi's presence. Akashi continues. "You have hanahaki."

Shintarou winces- he can feel the stems ripping at his throat. "Yes."

"Who is it?"

It's you, Shintarou thinks. It's always been you. He finally coughs. A handful of petals float to the floor- Shintarou watches Akashi's eyes track the petals' descent. Shintarou shifts in his chair. He reaches out to take one of Akashi's pieces, pointedly staring at the board. "I don't know."

…

When Shintarou gets home, his parents are waiting for him. His father looks nauseous, and his mother has tears in her eyes. She holds out her hand- three blue petals lay in her palm. Shit.

"Shintarou, what's this?" His father's voice is shaking. "Do you…" his voice cracks. "Do you have hanahaki?"

"Father…" Shintarou's voice trails off. He doesn't know what to say; the flowers surge in his throat, reacting to his emotions. Shintarou coughs, and flowers drop from his mouth. His mother begins to cry, and his father looks stunned.

Shintarou hangs his head and runs to his room. Father, Mother… I'm sorry.

…

Shintarou wakes early the next morning. Cancer is eleventh, lucky item glasses, lucky color blue. The damn flowers will do for the lucky color, they might as well be useful for something. Shintarou eats his breakfast quickly, placing the bowl in the sink when he is done. Shintarou coughs once, twice, and throws a handful of flowers into the trash can, covering them with a tissue.

He rushes out of the door before his parents can stop him.

…

The day passes slowly. His throat is raw from coughing; he's short of breath and tired from nights spent hacking up flowers. Shintarou is certain he must smell of hydrangeas. He dodges Kise at lunch to run to the restroom. He spits flowers into the toilet- the water turns pink with blood.

At practice, Shintarou claims a half court to himself. He's winded far too soon; he can't keep his eyes off Akashi and it feels as if the plants are trying to escape from his chest. Shintarou decides to skip shooting practice.

He hurries home and locks himself in his room, finally expelling the petals he's kept in his lungs all day. They fall to the floor like a bloodstained waterfall- there's enough to fill his garbage can.

Shintarou goes to bed with the taste of hydrangeas on his tongue.

…

Life drags on. Shintarou is growing weaker; it's a struggle just to get through basic drills. He hates this, hates how everything smells of greenery, hates how he can't stop loving Akashi. His chest aches constantly.

Shintarou begins to wonder what death is like.

…

When Shintarou walks into the gym, he can tell something is wrong. The air is tense, and everyone in the room is watching Akashi and Murasakibara. Shintarou elbows his way to the front of the crowd.

"If it's okay not to practice as long as we win the games, I don't wanna practice." Murasakibara looks at Akashi.

Akashi glares. "Don't be stupid. I can't possibly allow that."

"I at least listened to you till now, Aka-chin," Murasakibara drawls. " 'cause I felt like I'd never be able to win against you."

Shintarou stiffens. Is Murasakibara insane? The hydrangeas rise in his throat.

Akashi looks up at Murasakibara with wrath in his eyes. "If I have to pin you down by force, then that is what I will do." He bounces a basketball off the floor. "One on one. Five scores to win."

…

Akashi is losing. Murasakibara is not holding back- the score is four to zero. Akashi slumps over, panting.

"Honestly, this is a bit… no, quite disappointing." Murasakibara looms over Akashi. "I make this shot, and I'll do whatever I want."

Shintarou can hardly breathe; the hydrangeas are clawing at his throat, begging for freedom. He watches Akashi's face contort- it seems as if Akashi is having some sort of internal struggle. A chill runs through Shintarou's body. He watches Akashi breathe in and out, slowing his breath.

Akashi speaks almost to himself. "Because I am victorious over all, I am always the just." He raises his head- his eyes are crazed. Murasakibara grits his teeth and charges.

Akashi knocks the ball out of Murasakibara's hands. It looks impossible- the speed at which Akashi moves is terrifying, and the precision with which he hits the ball is unimaginable. The gym freezes. How?

Kise leans forward, shocked. "Hold it… what happened just now?"

"I have no idea, in fact… " Shintarou's chest aches; his throat burns with the effort of keeping the flowers in.

Momoi stares at Akashi, eyes wide and fearful. "Something's different… this isn't the Akashi we've known until now."

…

Within five minutes, Akashi has won. Murasakibara couldn't keep up; it's as if Akashi could see the future. Akashi stands victorious.

Murasakibara turns to leave. "I'm done for the day. It's fine if I show up to practice like usual tomorrow, right?"

Akashi steps forward. His voice is cold. "No, I am calling that off. Do as you like. As long as we win our games."

"Huh?" Murasakibara turns.

Shintarou swallows and steps forward, disbelief coloring his words. "What are you talking about? You just said…"

Akashi turns. "The same goes for both Midorima and Kise. All actions will be glossed over as long as we win our games."

The entire gym gasps as one. Shintarou can feel a cloud descending, smothering the room in a thick, oppressive blanket.

Akashi walks to the door. "Dismissed."

…

After changing, Shintarou finds Akashi staring out of a window in the main building. Akashi's still in his practice clothes. He speaks icily. "Shintarou."

This is not Akashi. Shintarou is suddenly certain of this. "Who- who are you?"

Akashi smiles, a slow, sharp smile. Shintarou suddenly feels microscopic. "Whatever do you mean, Shintarou? I am Akashi Seijuuro. Who else would I be?"

Shintarou feels the familiar itch in his throat. He turns his head to cough into his hand- it fills with petals and blood. He stuffs them into his pocket and changes the subject- any argument he could formulate would sound ridiculous. "You did well against Murasakibara, Akashi."

"Of course I did. I am absolute. My orders will be obeyed." Akashi turns his back. "Shintarou."

"Yes, Akashi?"

"I expected better."

Shintarou stiffens. His lungs and stomach ache; as if the hydrangea plants are growing and stretching his chest open. Akashi walks down the hallway. Shintarou watches him as he leaves; his stride is heavy and purposeful, as if he's crushing insects beneath his shoes.

This is not Akashi.

The ache in his chest intensifies. Shintarou gasps for breath; he drops to his knees and gags. Flowers pour from his mouth, scratching his throat and drawing blood.

He kneels there until he has the strength to clean the blood and petals from the ground.

…

Akashi is different-there's a coldness to his actions. Akashi no longer attends practice; Shintarou and Kuroko are the only two of the Generation of Miracles still going. In games, Akashi's passes feel stiff and unfamiliar in Shintarou's hands.

Shintarou keeps quiet and observes: how Akashi's smiles have lost their warmth, how Akashi stares into space for minutes on end, how Akashi's left eye looks almost gold in the light (how the pain in Shintarou's own chest eases every day).

Shintarou notices how Akashi looks at everyone as if they are lesser beings.

Shintarou still hacks up hydrangeas, but the flood of flowers seems to be slowing. He tries not to think about what this means, tries not to hope (a mixture of relief and fear; relief that he may not be dying, fear that Akashi will never be the same again).

…

"Shintarou." Akashi approaches him at lunch. Shintarou stifles a slight cough. "Play shogi with me." It's not a request.

They make their way an unused classroom. Shintarou shuts the door behind them. "We will need to keep this game short." He clears his throat. "Lunch is not long enough for a drawn-out game."

Akashi doesn't react. "Don't worry, Shintarou. I assure you, this won't take long."

Shintarou stiffens at the jab. "Very well. Shall we begin?" He arranges the tiles on the board Akashi brought, and shifts a piece. "Your move."

Akashi reaches for a tile, and for a moment, Shintarou sees a hint of his Akashi. Then Akashi smiles, cruel and cold. He captures one of Shintarou's pieces. "Go, Shintarou."

Shintarou moves another tile. "Akashi."

Akashi sighs. "Really, Shintarou?" He picks up another of his tiles, and moves it. "Checkmate." Akashi stands. "How disappointing. I suppose I have been wasting my time." He walks over to the door, opens it, and looks at Shintarou. "Return to class, Shintarou."

He leaves Shintarou in the silent classroom, striding away like he didn't just crush Shintarou's heart beneath his shoes.

…

When Shintarou gets home, he runs to his room and locks the door. He climbs into bed with his school clothes still on- his throat feels strangely dry. Shintarou coughs. All that comes out are withered, dry petals.

The plants are gone.

Shintarou cannot bring himself to celebrate. He curls up in his bed, ignoring his dry throat, and cries for the first time during this entire ordeal. Akashi, I'm sorry. It wasn't enough. Shintarou falls asleep with a heavy heart and a chest that no longer bears fruit.

He never coughs up flowers again.