Chapter 13: Sweet 16

Her friends come over on Sunday. They party with her to give her the celebration she deserved but missed the day before. Since she slept through Blaine's performance, they showed her the video of it first. She immediately called Blaine to praise him, telling him how wonderful he was. Blaine got emotional, apologizing for the song he gave her. She reassured him she was fine and that she could have told him no, but chose to sing it instead. Once she started talking about how much fun she had singing it, he finally calmed down. After they hung up, the New Directions began their celebration….Take 2, now that Rachel was with them. Despite the cold, and her health, she convinced them (after convincing her mother) to take her to their spot. Not for long, she promised. She just hadn't been there in a while and really wanted to go. Rachel knew she was taking full advantage of their inability to say no to her, as well as their guilt over her leading them to victory at great cost to herself. She felt only mildly guilty about it. That guilt faded away while she sat bundled up in front of the bonfire, leaning into her brather, and listening to her friends happily talk. If anyone noticed that she didn't talk much, no one commented on it. She was too busy taking it all in and committing it all to memory. Every scent, every sound, every sight, everything. Another happy memory to add to her collection. Like cocoons she can crawl inside of when the pain gets too bad or she gets too upset or starts panicking. These cocoons were Renee's idea. Her therapist suggested she try to go to a "happy place" when things were bad.

Xxxxxxxxxxxxxxxxxxx

The following week, in the days leading up to her birthday, she only went to school once. This was not lost on anyone. It worried everyone. She was tiring even faster now. Struggling to wake even more than before. The one day she had gone, she hadn't been able to finish climbing the stairs. She'd been leaning on the railing with Holly holding her arm to keep her upright, her legs shaking. Mike had come running up to them and scooped Rachel into his arms. She was supposed to be heading to class, but after that Holly insisted they go home. Rachel hadn't argued. Not that she could. Mike carried her to Holly's car. Unsurprisingly, her mom had come home early. Rachel doubts she'll ever forget the look on her mom's face. The one laced with a fear that said "she's getting worse" that she hadn't managed to hide fast enough.

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When she woke up on her birthday, it was late morning. Her mom was curled around her and humming softly. Like the year before, her mom had made her a delicious omelette. Being a Saturday, Rachel fully expected to spend the day lazing about the house. She was surprised, then, when her mom suggested she shower and laid out a nice outfit for her.

"Are we going somewhere?"

"Yes, my sweet 16 year-old, we are."

"Where?"

"You'll see."

No amount of wheedling had gotten her any additional information. Her mother remained tight lipped, but smiling happily. She was confused when her mother drove her to an old movie theater.

"Are we seeing a movie?" It's not a bad idea. Fun and not physically taxing.

Her mother had merely kissed her cheek and led her inside. They were handed a bag of popcorn and sodas, then led into a small theater.

"Surprise!"

Rachel jumped slightly, grateful that her mother was holding the popcorn and sodas. Her friends and family were filling the theater. Even friends from the Warblers and Vocal Adrenaline. Jesse St. James, home for the holidays, was there as well. So were Mr. Schuester, Ms. Pillsbury, Holly, Sue, and even Coach Beiste.

"Um, hi!"

With much laughter and many happy smiles, she was eventually greeted by everyone. Once she had been wished a happy birthday many, many times over, she was finally sitting in the center, in the best seat in the house.

"What are we seeing?"

Uncle Burt turned and shouted up to the booth above them. "We're ready, Joe!"

Very confused, the lights went down and the screen lit up. A very familiar woman sat before her on the screen.

"Hi, Rachel! And Rachel's family and friends!" April Rhodes crowed. Rachel's jaw dropped. "We've been thinking of you and Kurt since we met over the summer. Also, I have a bit of a confession. You see, once I learned about Kurt's vlog, I started watching it. We've been following your health as well as your performances and hot damn you guys are good! Anywho, between some of the recent videos he has posted, as well as my chats with Will Schuester, I discovered that everyone wanted to do something special for your birthday. But, since you're still sick, they knew it couldn't be anything physically taxing. They still wanted it to be extra special, though. So I figured I'd offer up an idea. We know how much you love Broadway, so I got permission to share a professionally recorded production of 'Promises, Promises' with you for one night only. For those who don't know, that's the show I was in right before I came to Wicked. Having starred in it, I could lean a little more weight on the producers to get permission to make this happen." April giggles happily. "You're welcome!"

Rachel laughs. There's a scene change and suddenly the cast of Wicked is singing happy birthday to her. Despite it being a recording, she can't help but blush. Her mom wraps an arm around her shoulders and kisses the side of her head. Rachel sits back and enjoys "Promises, Promises" as if she were there watching it live. When a mild attack strikes, she grips her mom's hand but keeps any other reaction minimal. After the show was over, everyone mingled and talked about their favorite numbers. Rachel was sure to thank everyone. Not just for coming, but for arranging this.

"It was perfect." She grinned happily at everyone, receiving smiles back.

"It's not over yet." Puck said, smirking.

Rachel followed the crowd as everyone walked to the diner next door, her arm around Brittany's waist and leaning on her. Brittany yammered on happily, but she caught a few tense looks sent her way. She's tired. After sitting and watching a show. She knows it's not a good sign. Once they were seated in a private room, cake and ice cream were brought out and a table of presents revealed. She smiled brightly as they all sang "Happy Birthday" to her. Someone had thought ahead and put two candles on her cake; one that was a big number one and the other a big number 6 to make 16 rather than put sixteen individual candles on it. This meant she was able to blow out "all" of her candles when she made her birthday wish. Rachel laughed happily, truly enjoying her party, but quietly admitting to herself that she'd like to go home and go to sleep. About an hour after they arrived, she knows she can't keep up any pretense anymore. She's been sitting at the head of a long table. Her guests keep swapping seats so they could all take turns chatting with her without making her have to move. Like a princess holding court, Santana had teased her. At the moment, Quinn and Jesse are closest to her. She leans towards Jesse, figuring he has the best show face.

"Do me a favor?" She whispers, smiling.

He smiles back, but she can tell it's a show-smile. He knows somethings up. "Anything."

"Can you….quietly….let my mom know I want to go home?"

"Sure. Just tired or something else?"

"Very tired. I'm starting to feel heavy."

Jesse surprises her by kissing her cheek. "You still refuse to leave Hudson for me? Fine, whatever."

He throws a playful glare at Finn, winks, and "stalks" off. Rachel laughs. Quinn gives her a slightly suspicious look. She can tell something is going on, but clearly isn't sure what just yet. As Rachel (and apparently Jesse) expected, Finn heads over to take Jesse's spot.

"What was that about?" He's smiling and calm, so she knows he's aware it was a joke.

She grins and curls her finger, silently asking him to come closer. When he's close enough, she kisses him, then whispers "I need to go home. I asked Jesse to quietly get my mom. I don't want to bring it to everyone's attention, though. I just want to slip out unobtrusively."

Finn pulls back. For a moment, she's afraid he'll make a scene or at least make it obvious. Instead, he kisses her. Then it's his turn to surprise her. He stands and picks her up.

"My girl, St. James. Mine! And don't you forget it!" He playfully shouts at the older boy.

Rachel wraps her arms around his neck and kisses his cheek, hearing chuckles from the other guests. So he is going to make a scene, but a funny one. She's okay with that. She sees Jesse stand up from where he'd just been whispering to her mother. Her mom's eyes meet hers. They say eyes are the windows into the soul. If that's true, Rachel knows exactly how worried her mother is feeling right now.

"Oh, stop rubbing it in, Hudson."

"Never. I'm far too proud to have her as my girlfriend."

"Well, you know, I'm not the only one who knows what a catch she is."

Finn nods seriously. "Yeah. Maybe I should just take her away from here before anyone else tries to steal her from me."

"For the last time, I never tried to steal her from you!"

This goes ignored by Rachel and Finn, who are giggling as Finn hurriedly carries her out of the room. He shouts over his shoulder. "I'm not taking any chances!"

Finn carries her towards the door of the diner, but then stops. His smile is gone. It's too cold for her to be outside without a coat. She gets cold easily as it is. Thankfully, it's only a moment later that their mothers are hurrying towards them with their coats. Without a word, Finn sets her down on a chair by the door so she can put her coat on. She works hard to keep her face calm. Now that she's actually leaving her own birthday party, it's sinking in just how bad things have gotten. The other three put their coats on as well.

"I'll follow you in my own car so that I can drive Finn home." Carole tells her mom.

She assumes her mother nods, because she doesn't hear a verbal response. Finn picks her up again and carries her to her mother's car. Instead of putting her in the front seat, he puts her in the back and joins her. She buckles in, then leans against him. No one speaks. Her mother's knuckles are white where they grip the steering wheel. The heaviness is getting stronger and she leans further into her boyfriend. His grip tightens.

"Hey, you alright?" It's a whisper, but her mother turns quickly to look at them.

"M-hm."

He kisses her forehead. She manages to stay awake the entire drive, though everything's a little foggy. Her heart feels like it's racing and she's not sure why. They pull into the garage. Finn is lifting her out of the car before her mother is even out of the driver's seat. Inside, he starts to set her on the couch but her mother stops him.

"No. Bed." Her voice is low.

Finn nods and carries her up to her room. She sits on the edge of her bed and lets them help her remove her coat and shoes. She can barely lift her arms. Finally, her mother holds her face and looks her in the eye.

"What're you feeling, Rachel?"

"Heavy. Heart racing." She's slurring her words. Her mother's face tightens.

"Okay. Okay." Her mom presses her forehead against hers. "When did it start?"

Her eyelids are starting to drop. "At the diner."

Her mom's lips tremble for just a moment. "You did good letting me know right away."

Rachel tries to nod. "Sleep?"

Her mom's expression falls further. "Yeah, baby. You can sleep."

Her mom, Finn, and Mrs. Hudson ease her down onto the bed, then tuck her in. She's on the edge of consciousness, waiting to drop off. Suddenly she hears muffled crying. Prying her eyes open just a smidge reveals her mother, with her hands pressed over her face, crying in Mrs. Hudson's arms. Rachel can't keep her eyes open for more than a few seconds. They close again of their own volition.

"She's getting worse." The desperate cry sounds like it was pulled from her mother's lips against her will.

Someone has said the words aloud. Finally. It has obviously been on everyone's minds. There's really no denying it. She has seen it on their faces. Heard it in their tone. But until now, no one has said the words aloud.

I'm getting worse.

She plummets over the edge and into oblivion.

Xxxxxxxxxxxxxxxxxxxxxxxx

Fingers press on the inside of her wrist.

"…..has slowed down, so….."

"….don't think she…."

"…..reason…stay here….."

The words float in and out of her consciousness. She feels herself being rolled onto her back. Cold hands press lightly on her chest and abdomen. She shivers. The hands move.

"Rachel?"

She opens her eyes halfway. "Hm."

She swears she recognizes the man at her bedside. "Rachel, are you awake?"

It takes her a moment to respond. "Yes." It comes out a murmur.

"Do you still feel like your heart is racing?"

She focuses on it for a moment. "No."

"Good." The man, Dr. Lopez she realizes belatedly, presses a stethoscope to her chest. "I didn't really think so, but wanted to check."

Rachel tries to focus, but her eyes roll when she tries to move them to scan the room. When they re-focus, she sees Santana standing a few feet from her bed, arms crossed, and frowning. She looks worried. And sad. "San…."

Santana jumps to attention and comes closer, taking her hand. "Hey, Berry. Way to run out on yet another party."

The corner of her mouth rises slightly. "Sry."

Santana's face falters before she puts on a calm mask. "Whatever. There'll be other parties."

Now the other corner rises a little. She doesn't laugh so much as breathe out more air from her nose, but it's enough to make Santana smile a little. Her mother steps up beside Santana, placing a gentle hand on her friend's arm as she moves closer.

"Honey, why don't we get you changed into pajamas and you can go back to sleep?"

It must still be Saturday, then. It's still her birthday. "Kay."

She doesn't know how long she was asleep, but she guesses it was long enough for her mother to let out her emotions and put on a firm mask. She appears to remain calm when faced with Rachel's monosyllabic responses. But there's still a look in her eye that she can't completely hide, telling Rachel that she's not as calm as she's acting. Dr. Lopez and Santana leave the room. Rachel is surprised, expecting San to help her mom, but then realizes her grandmother is there as well. Her mother slides a hand behind her head and pulls her up. Once she's sitting, she keeps hold of her while the two women work to remove her top and bra. Rachel is so tired that she is beyond embarrassment or modesty at this point. They slide her arms through the holes in a warm pajama top and pull it over her head and down. Before helping her lie back down, her mother takes a moment to just hold her.

"What happened?" Still a murmur, but less slurred than before.

No one responds right away. Her mother rocks her and kisses her head. When she does get a response, it's whispered into her hair.

"Dr. Lopez thinks it's a reaction to the increase in treatments. We'll call Dr. Reed on Monday to confirm."

She still feels heavy and sluggish. Her arm, which had been wrapped loosely around her mom, starts sliding down. Her mother's hold briefly tightens and she feels more than hears the ragged breath her mother takes in before she lays her down. Once she's on her back, they pull off her jeggins and slide on the matching pajama bottoms. Her mom tucks her in again. By the time she leans close to look Rachel in the eye, she has regained her composure and once again looks calm and collected. She manages a smile. If you're not looking at her eyes, it'd even be believable.

"I love you, Rachel. Happy birthday."

Rachel uses the last of her energy to respond with her own smile. "Love you, too, Mom."

She falls asleep feeling Nana's hand rubbing her arm and her Mom kissing her temple.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Debra isn't surprised when Shelby joins Rachel in her bed instead of going to her own. Not surprised, but worried. Rachel is getting worse and Shelby needs a way to release her fear and stress. She and Christopher spend a while coming up with ideas for how to convince Shelby to leave Rachel for long enough to deal with her own emotions.

Almost everyone at the party had seen Rachel getting paler and seeming more tired as the night wore on. But no one expected her to request to leave early. Debra's first indication that something was really wrong was when that Jesse kid started whispering to Shelby and her daughter blanched, hands clenching the edge of the table before her eyes jumped to Rachel's. The second was the look on Finn's face as he carried Rachel out of the room. Oh, he was good, he was very good. He appeared playful. A goofy teenage boy. However, his smile didn't reach his eyes and his movements were playful on the surface, but had an undercurrent of anxiousness. Finn's mother noticed as well, because as soon as Shelby stood and grabbed both her and Rachel's coats, Carole did the same with hers and Finn's.

By that time, the rest of the party goers were aware of something being wrong. All eyes swung to Jesse. His show-face broke, but he held up a hand, silently asking them to wait. After a moment, it was clear that the four who had left would not be returning. The silence turned heavy and Jesse spoke.

"She asked to go home. She isn't feeling well."

Debra is quite proud of her granddaughter. She's being honest and putting her health first. It seems she has learned her lesson. Or maybe she is starting to feel so poorly that she doesn't have the strength to pretend anymore. The thought chills her.

Burt Hummel had stood, hand on his son's shoulder, and insisted everyone stay as long as they'd like. As kind as the offer was, the cheerful mood had dissipated. Despite this, everyone stayed. At first, Debra wasn't sure why. Then it dawned on her. They were waiting to get word that Rachel was okay and home sleeping. Instead, Santana got a call from Finn asking her to ask her dad to come to the house to examine Rachel. Something about her heart racing and slurring her words. Santana immediately called her father and spoke in rapid-fire Spanish. Brittany held her hand. Waiters, having picked up on something being wrong, starting packing up the remaining cake for people to take home. Several people helped Burt carry the gifts to his car. Debra and Christopher offered to drive Santana to Rachel's house. Her father could drive her home from there. She accepted instantly. When they arrived, they hadn't expected to see Rachel looking like death warmed over. They'd listened anxiously as Dr. Lopez shared his assessment. If he's right, then either they need to reduce her medication (and risk her numbers dropping further) or Rachel will have to deal with episodes like this periodically.

While helping change Rachel into pajamas, her granddaughter too weak to move her own limbs, Debra prays. Watching her daughter struggle to hold herself together as she cradles her half-conscious child, she prays harder. There's nothing else she can do, but pray. Which makes the fact that Rachel is getting worse all the more distressing. Praying, the only thing she can do, doesn't seem to be working.

Despite this, she refuses to abandon all hope.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

On Sunday, Kurt made a vlog thanking the cast of Wicked, especially April Rhodes, for helping make Rachel's 16th birthday wonderful. He promised them Rachel would be on soon to give her own thanks, but briefly, haltingly, explained that she'd had to leave her own party early.

"She, uh, felt tired. And heavy. And like her heart was racing. She started slurring her words." Kurt brushes his hair to the side distractedly. "She's better today, but still not feeling well enough to make a video. She asked me to share her appreciation in the meantime."

He showed a clip of her walking into the theater and being surprised. He showed another of the look on her face when April Rhodes came on screen and when the cast sang Happy Birthday to her.

"She really did have a wonderful time and thoroughly enjoyed the show." He promised his viewers.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

She recorded a video with Kurt on Monday evening, personally thanking April Rhodes and the cast of Wicked and anyone else involved in allowing her to see "Promises, Promises" on her birthday. She didn't talk about leaving her party early, but did rave about how great the show was and how much she enjoyed it. She also thanked the viewers who had sent kind birthday messages.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Shelby woke up in the dim light of the very early morning, instantly on alert. Beside her, Rachel was sitting up. However, she was leaning forward and gasping. In a flash, she had her arms around her.

"Breathe, Rachel."

"C-can-n't.." Rachel stuttered out.

Shelby's already alert mind shot into overdrive. "What?"

"Not….a-at-taa-ck."

"It's not an attack?" What the hell is going on?

"Nooo…" Her daughter moans, tears leaking from behind her clenched eyelids.

"What's going on? What's wrong?"

"Ca—nn-n't…br-rea-the…"

"You're not getting in enough air?"

Rachel shakes her head and continues to gasp for breath. Shelby jumps off the bed, scared and confused. Oxygen tank in hand, she hurriedly places the mask over Rachel's mouth and nose. Once it's on, she climbs back onto the bed and holds her daughter.

"Easy, slow your breaths. You're alright."

After a couple minutes, Rachel's breaths start coming easier and fuller. She relaxes, falling back fully into her mother's embrace. Shelby cradles her, hands on her torso so she can feel her breathing.

"Breathing better, now?" Rachel nods tiredly. "Did you have an attack before this began?"

"No."

"Were you in any pain at all?"

"No. Just….couldn't breathe."

"But you can breathe now."

"Yes."

"Okay. That's good." Shelby's racing heart finally slows, but her mind does not. What the hell happened? What was this? She looks down at her child, noting her pale complexion. She's already asleep again. Shelby is torn. It wasn't an attack, she wasn't in pain, she's breathing fine now. So she doesn't need to go to the emergency room, right? But…..this was new. This has never happened before. What the hell does it mean? Should she wait until later and call the doctor? Just take her in? Call an ambulance now? Looking at a clock, she sees that it's almost 4am. She doesn't know what to do. She hates not knowing what to do. She reaches over to her nightstand and grabs her phone.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Carole sits up in bed, watching her fiancé hurriedly pull on clothes while trying to simultaneously get more information out of Shelby and keep her calm. She's not sure who she feels worse for; Rachel or Shelby. The child suffering through it or the mother forced to watch helplessly. He hangs up and turns to her.

"Rachel woke up a few minutes ago unable to breathe."

"Was it an attack?"

"No. It wasn't. She just couldn't get in enough air. She's breathing fine now, but Shelby doesn't want to wait until the doctor's office opens to bring her in. Neither do I."

Carole nods. Of course. "What do you need me to do?"

Burt pauses, his expression full of gratitude and love. He kisses her. "Keep our boys calm and here."

"What should I tell them?"

"Up to you. I'll call or text when I have more information."

She nods again, but he's already out the door. Knowing she won't be able to go back to sleep, she decides on an early start to her day.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Burt sits in the waiting room. He has done this multiple times in the past year. However, he has never had Rachel in his arms while sitting here. Normally, she's brought back immediately and he sits and waits for information. But because she didn't have an attack and she's breathing fine, they were told to just sit tight. Shelby's head is in her hands. After what felt like too long, Nurse Hunter hurries towards them. He's relieved to see a familiar face. He knows Hunter is a good nurse and is already familiar with Rachel's condition. The young man kneels down in front of him and immediately starts checking Rachel's vitals. Then he smiles up at them.

"Vitals are good. Give me like 5 more minutes to get a room ready for her, alright?"

They nod, because, really, what choice do they have. But he'd already managed to calm them both down, so they smile. Burt notices an older couple watching them curiously, eyeing Rachel's oxygen mask. He sighs and shifts Rachel slightly. She's not going to be happy. When he'd arrived at their house, she'd been half awake. Shelby had been trying to help her put on her coat, but Rachel was fighting her. She didn't want to go to the hospital and was whining and pulling away. It was almost a relief to Burt, to be honest. Not just that she was well enough to try to argue, but that she's now giving in and whining. He hasn't really heard her whine much in the past year. Even when he and Shelby were practically begging her to whine and complain, she really didn't. She started complaining about little things, then bigger things, but this is the first real whine he has heard. Good. He wants her to be completely open and honest about how she feels; both physically and emotionally.

Nurse Hunter returns and lets Burt carry her to a bed. Then they're both kicked out while the nurses change her into a gown. They both smile slightly when they hear Rachel wake up and start fussing about being cold. When they catch each other's eyes, their smiles turn to chuckles. Relief. She's awake and complaining. She's okay. They're let back in in time to hear Rachel teasingly berate Nurse Hunter for not having a warmed blanket ready for her.

"You should know better by now." She smirks.

She sounds tired, but she's talking and breathing just fine. Burt feels like he can breathe normally.

"Well, next time bring me some Sour Patch Kids and I'll have your blanket ready." He teases right back.

Rachel snorts.

"Hunter, stop antagonizing the girl." Dr. Abdallah says, walking in.

They don't know her as well as they do Dr. Morgan, but they like her well enough. The woman smiles at them all, but focuses on Rachel. She listens to her breathe for a minute, then checks her blood oxygen levels.

"Okay, I think we'll put you on a nasal cannula for a while. How does that sound?"

Rachel shrugs. "Can I go home, then?"

Dr. Abdallah smiles sympathetically. "Not yet. We'll give you a more thorough exam later. For now, we'll get you on oxygen and some IV fluids, warm you up a bit, and let you sleep."

Burt realizes that without her coat and his body warmth, she's shivering lightly. It wasn't obvious but now that the doctor pointed it out, he feels like a moron. Of course she's cold. The doctor checks her port, then connects an IV. They draw blood, of course. That's standard practice. Especially in Rachel's case. Nurse Hunter returns with a warmed blanket. He places it over Rachel and she sighs happily, making them all chuckle. The nurse dims the lights on his way out. Shelby sits beside her and strokes her hair.

"Comfortable?"

"I'd be more comfortable at home." Rachel mumbles.

Shelby smiles sadly. "I know. But I really didn't like how much you were struggling to breathe."

Rachel nods. "I know. I just hate being here."

Shelby kisses her cheek. "I know."

Burt kisses her head and sits on her other side. Rachel reaches for his hand, but makes sure her arm is still covered by the warm blanket. He smiles softly. She's asleep in minutes. Shelby looks at him, her expression exhausted.

"Did I overreact? Should I have waited to bring her to the doctor?"

"No. I think bringing her to the hospital was the best choice. If it had happened later in the day, maybe calling Dr. Reed or bringing her to the office would have been a better option. But at 4 in the morning? After she woke up unable to breathe? I'd have brought her in."

Shelby nods slowly. "Thank you, Burt."

He knows she means for more than just answering her question. "Anytime."

He really hopes she knows that.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Finn is half asleep at the kitchen table, yet managing to scarf down a bowl of cereal. Kurt rolls his eyes. He sits daintily and pours his own, normal sized, bowl of cereal and eats at a normal pace. Carole sits down with a fresh cup of coffee. Looking around, Kurt realizes who is missing.

"Where's Dad?"

Slowly, Finn looks up. Carole doesn't answer right away.

"He got a call around 4 this morning." Kurt's stomach sinks. He's pretty sure he knows what he's about to be told. He trades glances with Finn, seeing the same look on his face. They brace themselves. "From Shelby."

Both boys freeze, waiting for more. Finn sets his spoon down.

"I don't know much. Just that Rachel woke up struggling to breathe, but she didn't have an attack."

The boys frown. "What does that mean?"

"We don't know. That's why Shelby wanted Burt to help her get Rachel to the hospital. Even though Rachel had started breathing normally, she didn't want to wait until office hours began to call Dr. Reed."

They sit quietly, digesting this.

"Finish up," Carole prompts gently, "You have school soon."

Finn looks at her in bewilderment. "I'm not going to school."

Carole's eyebrows shoot up. "Excuse me?"

Finn fixes his expression, trying to look contrite. "It's the last of school before winter break. It's half a day, Mom. We don't do any actual work."

"Don't you have a paper to turn in?"

Finn pushes his bowl away. "I'll drop it off on the way to the hospital."

"Finn, we don't know how long she'll be in the hospital."

"We could wait until we hear from Dad. Finn's right, we don't do anything productive today. We won't miss anything."

Carole sighs. "Alright. He texted not long ago, saying he was heading home."

So they wait. They prepare for both, a day at school and a day in the hospital. Carole has work, but said she already called to say she'd be late. When his dad arrives, he says Dr. Reed will be meeting with them later. For now, Rachel has been admitted to the hospital. While she's fine, they decided it'd be easier to keep her there since Dr. Reed already had hospital rounds scheduled for today. Besides, it's a treatment day. They'll do her treatment while she's in the hospital and that'll be one less trip to make. The parents agree to let the boys skip school and go to the hospital instead. The stop by the school long enough to drop off assignments. Or really, they quickly toss everything into Kurt's locker because it's closer. Then they text their friends, explaining the situation and asking them to turn in the assignments for them.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

The early afternoon light casts an orangey glow just inside the window. It's pretty. Shelby watches the soft natural light stretch into the room before being washed out by the iridescent light of the hospital room. A giggle captures her attention. Kurt, Rachel, and Finn are playing a card game. Rachel has been seeing just how obvious she can be with her cheating to see if they'll call her out on it or not. The boys finally realized what she was doing and are now trying to out cheat her. Shelby and Burt share a smile. Her smile slips when Dr. Reed walks in. The boys clear off the cards and sit in their own seats. Burt sits up, eyes on the doctor. The older man looks stiff. It sets her on edge.

"How're you doing, Rachel?" The doctor asks.

Her daughter shrugs and gives him a half-grin. "I'm alive and breathing on my own. So….pretty good?"

Shelby's heart hurts. The fact that those two things are what Rachel counts as "pretty good" is a hard pill to swallow. The doctor smiles at her, but it doesn't reach his eyes.

"I understand. Compared to how you've been normally, you're not in very good shape. But compared to how you were just a few weeks ago, you're doing pretty well. While you were sleeping we drew some blood to test your progress. It's common practice."

Rachel's face takes on a tense, yet knowing, look. She smiles humorlessly. "Let me guess. Stage 4."

Shelby opens her mouth to reprimand Rachel for being pessimistic. The look on Dr. Reed's face stills the words in her throat. Her stomach plummets. No. Finn and Kurt both pale dramatically. Shelby assumes she does as well.

The doctor sighs and sits by the bed. "How did you know?"

Another half-shrug. "Just how I've been feeling."

Shelby and Burt trade glances, eyes narrowed.

"And how is that?"

Her daughter's eyes slide over each of them before responding. "Like an old phone. No matter how long you leave it plugged in, the battery can't reach a full charge. And the battery levels drop quickly, even when it's not doing a lot."

Shelby's eyes close. A hand clasps hers. She grips it like its a lifeline. Thank God Burt is here to support her.

"You've always had an interesting way of describing things so that we can understand how you're feeling." The doctor tells Rachel, a small smile on his face.

"So….she's really in stage 4 now?" Kurt asks hesitantly, sounding like every word pained him.

Dr. Reed nods sadly. "Rachel is in stage 4. I'm so sorry."

Finn leans forward and wraps his large hand around Rachel's. Kurt once again looks like a scared little boy. Burt covers his mouth and seems to be trying to get control of his emotions. Shelby expected herself to be hysterical, but she feels…..oddly hollow. A shell of her normal self. Oh, she's in pain. She's terrified and furious and hurting. However, it feels like those emotions are clothing on her skin. They're not settling into her yet.

"What does it mean?"

"It means that we'll be increasing the dose of her medications. What happened on Saturday was mostly likely a result of us increasing her treatments to twice a week. While its possible that episode will repeat, it's safer to increase the dosage to stop her numbers from falling further. And Rachel, you really and truly need to take it easy from now on. I really don't think you should be going to school at all anymore. I know you've been limiting your physical activity and have reduced how frequently you go to school, but…it all needs to stop now."

Shelby watches her daughter roll her lips between her teeth and knows she's about to voice a question she's hesitant to ask. "But….I'm not on bedrest, right?"

"Right. You can still be up and walking around. In fact, I'd like you to. Just….not for long periods of time."

"Okay." Rachel's voice sounds small. "Um…..does this mean…am I dying?"

Shelby can't breathe. Each word is tearing her heart to shreds. The pause before the doctor answers her is crushing.

"In a manner of speaking, yes."

"What does that mean?" Finn's voice is rough.

Dr. Reed looks down, tapping his fingers on his clipboard before lifting his eyes. "It means that Rachel's condition is perilous. The aplastic anemia and even the treatments have been wearing her body down for over a year now. They've been progressively weakening her. At this point, a severe attack or flu could kill her. Could. It's not definite. Based on her symptoms, her numbers, and where she is in stage four, she's not yet terminal. There's still time for her body to start responding to the treatment better and start getting stronger."

"But if it doesn't…..how long would I have?"

Dr. Reed clearly doesn't want to answer, but he has never lied, never sugar coated anything, and has always answered all of their questions. "Perhaps two months. Three at the most."

The air is sucked from the room. The edges of her vision are starting to go dark when Burt squeezes her hand hard and presses his other hand against her back. It reminds her to breathe. She does so shakily. No one speaks. No one can. Dr. Reed sighs heavily.

"If the treatment continues to have the same effect on your body as it's been having, you have approximately two to three months left, Rachel. If the treatments were to stop working entirely, you would have less than that. Maybe days. If the treatment starts working to its fullest effect, you'll have many years left."

Tears stream down her daughter's pale face. Shelby wants to go to her, but can't move. The weight of this conversation is keeping her rooted to this chair. Finn and Kurt continue to hold her hands.

"Okay. Thank you."

"Rest. Take it easy. Stay hydrated. Eat as much as you're able. We will increase the dosage of your medications. Of course, that means the side effects may become worse."

Rachel snorts. "Of course."

"We may also increase your treatments to three times a week."

Rachel gives him a despondent look. "Three?"

"I said 'may'. If we decide to do that, it probably won't be for a few weeks. We want to give the increased dosage a chance first."

When no one else comments or asks any questions, Dr. Reed reiterates that he's available any time for questions. Then he leaves. Shelby shakily pushes herself up. With a gentle hand on Finn's shoulder, she silently requests that he back up. He does. She climbs onto the hospital bed and pulls Rachel into her arms. As soon as her head hits her shoulder, Rachel begins sobbing. So does everyone else.

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

The first treatment with the higher dosage has an immediate and obvious difference. Dr. Reed wasn't kidding. The side effects are worse. Stronger. As the treatment winds down, Rachel is shaking uncontrollably, a new side effect. The nausea is nothing new, but the intensity of her vomiting is. Burt holds her steady, Shelby holds her hair back, and Finn holds the basin under her chin. Kurt, who can't handle vomit, is standing in the hall. Between bouts of vomiting, Rachel is left gasping for breath. When it finally ends, she is shaking and weak, her forehead speckled with sweat despite her apparent chills, and she's slumped back against Burt. Shelby carefully wipes her face and neck with a warm towelette. Once he's sure its safe to enter, Kurt comes in with a newly heated blanket. Burt smirks at his son.

"See? Not entirely useless." Kurt mutters to Finn, in response to his earlier jab when the squeamish boy had walked out.

"Whatever, dude." Finn's grin is easy, but Burt notices his eyes are still heavy. Everyone's are.

Stage 4. Two to three months left to live if treatments don't start working. She turned 16 just four days ago. Burt leans back as comfortably as he can, wanting to keep holding Rachel. Shelby sits next to the bed and takes Rachel's hand. The girl is so exhausted and feeling so miserable that no one tries to talk more for a few minutes, giving her peace and quiet. The door opens and both Dr. Morgan and Dr. Reed enter the room.

"Sure, when the vomiting stops, you enter." Finn teases.

"It's a gift." Dr. Reed agrees with a smirk. Dr. Morgan rolls her eyes fondly.

"We wanted to discuss Rachel's care a bit more before you leave." Dr. Morgan begins.

"What else is there to discuss?" Shelby asks. There's an edge to her voice. Burt doesn't blame her. He knows the doctors have done everything they can for Rachel. He even understands why Dr. Reed suggested holding off on a bone marrow transplant. He'd agreed at the time. But now….now that Rachel is in fucking stage four, he's rethinking everything, just as he's sure Shelby is.

"As I explained before, we will continue her treatments, now with the higher dosage of medication, and may increase her to three times a week. We are going to continue doing whatever we can to make her better."

"I take it bone marrow transplant is still out?" Burt can't help but ask.

"Correct."

"We will continue working hard towards her improved health. However, now that she's stage 4, there is another element to her care. End of life care."

The room is suddenly very cold. Everyone shivers, but no one speaks. The last time Burt heard this conversation, it was his wife he was holding. He'd been furious and broken. Now, he keeps his mouth shut and lets Shelby respond.

"End….end of life….care." Her words are a whisper.

"We're not saying she is definitely at the end of her life. We're still working towards, and expecting her, to improve. We will get her to remission. However, the fact remains that the treatments, to this point, have not been working to their fullest extent. Rachel's body has not been responding to the treatment as well as we had hoped." Dr. Reed goes on.

Dr. Morgan takes over. "So while three-quarters of our focus will be on improving her health, one-quarter of our focus will be improving her current standard of living. Making her as comfortable as we can."

Shelby breathes hard for a minute. No one rushes her. She presses Rachel's hand to her lips while she composes herself. "How?" Her voice is hoarse.

Dr. Morgan opens the small box she had carried in. "We're prescribing a few new medications for her that are designed purely for her comfort. One is a mild anti-nausea medication. It's stronger than over the counter medications and good for any day to day nausea she may experience. This next one is the strongest anti-nausea medication that we can prescribe in pill form. This would be for times like minutes ago, when she is vomiting a lot or intensely. It's a pill, so the hard part will be helping her keep it down. Unfortunately, you may have to wait until the worst of the vomiting is over before giving it to her."

"Unless intense vomiting becomes a regular occurrence, especially after treatments. In that case, you can give it to her preemptively." Dr. Reed interjects.

Dr. Morgan nods, then goes on, holding up a third bottle. "We know you have the very strong pain medication at home for when she has a severe attack but doesn't come to the hospital. Keep those for those situations. This is a slightly weaker version of that, but still strong. It is not only a pain reliever, but a muscle relaxer. It'll help her relax tense muscles after attacks. This can be used for after moderate attacks, after double mild attacks, or severe headaches. In essence, it is for any pain that's more than mild but less than severe." She holds up a new bottle. "This other one is 800mg ibuprofen. This can be used for mild headaches, general soreness, if her bruises are bothering her, or anything mild." She grabs a fourth bottle. "This one I prescribed to Rachel, but it can be for any of you. It is a sleep aid. If any of you, or she, are struggling to sleep for whatever reason, this is a mild sedative. It'll knock you out. It's the same one I prescribed after her double attack."

"Last but not least," Dr. Reed takes over, "is an anti-anxiety pill. If Rachel becomes very anxious, if she's having an anxiety attack or panic attack, this will help her calm down. This one is technically just for Rachel. If any of you end up needing it, I'd suggest reaching out to your own doctors."

"That being said," Dr. Morgan jumps in, "we don't want you to not take it if you're having a panic attack or anxiety attack. Rachel is going to need all of you to be strong and calm for her. So if you're in distress, we'd rather you take it so you can be calm for her, than not take it."

"Any questions?"

They all shake their heads. Reading their expressions, Dr. Reed speaks reassuringly. "You don't need to be overwhelmed by this. All of these medications are clearly labeled and color coded to make it easy for you, and her, to be able to quickly find the correct meds. Their descriptions and details are also included. And of course, you can reach out to either of us at any time for any questions or concerns."

"That's nice, doc, but I don't think that's what we're overwhelmed about." Kurt says softly.

The two doctors nod. "You need to time to let this all sink in. You only found out a couple hours ago."

"Can I ask…" Finn begins, "I mean…..she was told today that she's stage 4. But, that doesn't mean she hit stage 4 today, right? Has she….technically been in stage 4 for a few days? Or like a week?"

Kurt nods, his eyes bloodshot. "For the past like week or two, we've all noticed her getting worse. The past week especially. It's been pretty obvious."

"Chances are, yes. She probably entered stage 4 some time last week. That would be our best guess."

"So she was already stage 4 when she had her birthday on Saturday." Shelby says.

Dr. Morgan nods. "Yes. From what you described about how she was, I'd say with a decent amount of certainty that she was already stage 4."

"Can we do anything for her that doesn't involve more medication?" Burt asks, keeping his voice low.

"Of course. Rachel is bound to become upset, angry, scared, or any other intense emotions. Do your best to let her express herself, but also keep her calm. A fit of rage where she is throwing things may be cathartic, but could wear her out or exasperate her symptoms. It will be challenging, but try to adjust to her moods and help her through them. She may not be able to do anything physical, but try to make sure she does fun things. I know she still gets monthly massages. Perhaps increase those to twice a month. It'll be hard for you all as well, but try to keep things as normal as possible while also helping her adjust to necessary changes. Just…keep her comfortable, calm, and as happy as possible."

"The state of her mind is just as important at this stage as the state of her body. We need to try to keep her spirits up. It would be very easy for her to slip into a depression at this time. If you think she's becoming depressed, reach out. That goes for you four as well. It is easy, and normal, for the immediate family and caregivers to experience depression in stage 4. Keep yourselves as positive as you can, while still preparing for any potential outcome."

Shelby wipes new tears away. They all take a moment to look at the girl on the bed. Rachel is still in Burt's arms, her eyes closed, and her face is tinged gray. Burt's not sure if she's awake or how much of this conversation she has heard. He nudges her gently.

"Rachel. Do you have any questions for the doctors?"

Rachel opens her eyes. "Hm?"

"Do you have any questions for the doctors?"

Rachel blinks and looks around the room. Her eyes land on the doctors. "No."

"Rachel," Dr. Morgan smiles, "you were incredible at Sectionals. Truly."

Rachel gives them a small smile. "Thanks."

Dr. Reed leans forward, a serious look on his face. "Yes, I was blown away by your talent. Dr. Morgan and I had a serious talk after we left your performance. We came to the conclusion that your voice belongs on Broadway. So we're going to keep working hard so that you can get there."

Rachel's smile brightens. "Sounds good to me."

Xxxxxxx

A/N: Please remember that I am only using accurate medical stuff as it suits me. 90% of the time I'm just making it up or changing it to fit my story. I'm trying to keep it believable and not completely unrealistic, but I'm also following my predetermined story timeline and dramatic plot. So when it comes to "terminal" and "end of life care" and "realistic" timeline…..just keep in mind that its a fiction story. Anyone who has been through this personally or with a loved one, my heart goes out to you. I hope you enjoyed this chapter and please review!