Chapter 24: The Tumor
Steve didn't particularly like leaving the hospital at the end of the day. He was one of the lucky few to have a job that he genuinely enjoyed nearly every second of, and it left a bad taste in his mouth to leave when he knew the kids that he worked with had no choice but to stay. Plus, his commute wasn't his favorite thing in the world. It had nothing to do with traffic or anything like that, he just didn't take much pleasure in listening to the radio by himself. But today was Wednesday, which was way better than most days, because today, instead of driving home alone, he got to pick up Bucky from practice.
He texted Bucky when he arrived to let him know he was waiting, but got no response. Steve thought nothing of it until Josiah walked out alone, carrying his soccer bag on the end of one of the crutches slung over his shoulder like a hobo bag. "Hey Josiah, is Bucky on his way?" Steve asked after rolling down his window.
"I think so," Josiah replied. "He told me he needed a few minutes and to just leave without him."
"Okay." Steve waited five minutes, and then ten. At that point he started to worry. Just as he considered getting out of the car to go and find him, Bucky arrived. Steve immediately noticed the tightness in his face and his posture, but he didn't say a word as he threw his bag in the trunk and slid into the passenger seat. "You okay?" Steve asked.
"Yeah," Bucky said curtly.
"You sure?"
"Just tired."
Steve shrugged and turned to leave the parking lot. Bucky closed his eyes and breathed forcibly through his teeth as the car started moving, but when Steve asked him again what was wrong, he said nothing. He decided an interrogation could wait until they got home. However, Bucky had other ideas. With nothing more than a curt, "I need a shower," he disappeared into their room. Steve knew better than to try and follow.
Half an hour passed. At some point Steve heard the shower turn on and then shut off a while later, but Bucky had not emerged yet. He set the table on his own, but when it came time to actually eat and he still hadn't heard so much as a peep, he decided to investigate. Steve paused outside the closed door to their room and knocked. "Bucky?" No answer. Now thoroughly worried, Steve threw open the door. He waltzed in, headed for the bathroom, and nearly tripped over Bucky. "Shit!" Steve exclaimed. No amount of worrying could have prepared him for the sight of Bucky curled up on the floor with his index finger clamped so strongly between his teeth it was bleeding. "Bucky stop, you're gonna hurt yourself!" he said. Steve threw himself to the floor in front of him and tried to gently extricate his finger from his mouth. Bucky only bit down harder and drew his knees as far into his chest as they would go.
"It already hurts," he squeaked.
"What? What hurts?"
"My hand." His words were garbled by the fact he was speaking without unclamping his jaw from his knuckle, but Steve was pretty sure he heard correctly.
"That's because you're biting the hell out of it," Steve said as calmly as he could manage. "You need to let go."
"No!" Bucky whimpered. "The other one."
The other one? Oh. The realization hit Steve like a fastball to the head. Phantom pain. Bucky had mentioned offhandedly a few times that it had been bad right after his amputation, but not since. Had it gotten that bad again? Or had it been this bad the entire time and he'd just quashed it down so much that today he finally snapped?
"Is there anything I can do?" he asked, hands hovering uselessly above Bucky's exposed flank.
Bucky finally relinquished his grip on his finger and instead clenched his bleeding hand into a fist. "Don't touch it," he said hopelessly.
"Okay, okay," Steve said. Instead, he grabbed a towel from the bathroom and wrapped the bite wound to stop the bleeding.
"You'll ruin it," Bucky said half-heartedly.
"I know how to get bloodstains out," Steve assured him.
"S'spicious."
As freaked out as he was about this whole situation, Steve couldn't help but laugh. Even so debilitated by pain, Bucky still managed to crack a joke. He forced his tone back to serious, "How long has this been going on?"
Bucky shrugged and immediately cried out. Steve did the only thing he could think to do, which was run his fingers gently over Bucky's forearm in the hopes that the gentle sensation would help him ride out the wave of pain. It took two minutes of deep breaths for Bucky to bring himself to speak again. "I don't know. 'S been getting worse for so long I can't remember when it started."
"Does anything make it better?"
"No," Bucky sighed despondently. "I tried massaging my stump like they taught me but any pressure just makes it worse."
"Okay. Have you seen a doctor about it?" Steve asked, even though he knew the answer was no.
"No. Nothing helped last time so I dunno what they could do now."
"If it was better and then got worse maybe something else happened to cause it. It couldn't hurt to get it looked at."
Bucky sounded so defeated when he admitted, "I guess so."
"I don't think I can handle watching you in pain without at least trying to do something about it," Steve said.
"Okay," Bucky relented, sounding marginally more confident this time. "Help me up?"
Careful not to touch anywhere near his left shoulder, Steve helped him sit up and then get shakily to his feet. Bucky sat down on the edge of the bed and stared forlornly at the bloody towel wrapped around his finger. "I cracked a tooth, you know," he said so quietly Steve almost didn't hear him.
"What? Just now?"
"No. After my amputation. Apparently I've always been a jaw clencher when it comes to pain. Cracked a tooth. They gave me a mouthguard after that. 'S why I bit my finger this time."
Steve didn't want to think about how badly something would have to hurt for him to bite down that hard. He was no stranger to pain, but it must've been infinitely more frustrating for it to occur in a part of his body that wasn't even there.
~0~
Bucky remembered a time when his phantom arm didn't hurt. The only problem was, he couldn't remember when that blissful period ended. He was pretty sure it didn't bother him the day of their wedding or in the weeks after, but he could've just been so overjoyed that he didn't pay attention to it. His first memory of it really coming back to bite him was Parker's twenty-first birthday. During that volleyball game, he made one spectacular dive that ended with him crashing into the sand left-side first. He'd had plenty of worse falls in his soccer career, and he expected the sand to be a more forgiving surface than turf or grass. Instead, the contact between his stump and the ground sent lightning bolts of white-hot agony ricocheting up and down his nonexistent arm. At the time, he'd hidden it well and figured it was just the force and angle of his landing.
And then it got worse.
The level of pain didn't worsen perse, but its frequency sure did. Needle prick sensations would race across his forearm and bicep even when standing or sitting still, or his hand would cramp up, or sometimes he'd just feel like he needed to crack his damn knuckles. It was annoying more so than painful most of the time, but as the months wore on it started to wear him down.
Bucky kept it from Steve because he knew he'd want to help, and it would frustrate him that he couldn't. If it could be helped, Bucky would have admitted it, but he knew from experience that not even narcotics could make his confused brain shut up about this imaginary pain. During practice that day, it had plagued him worse than ever. He would've powered through it no problem, but when they finished and headed to the locker room, John Walker started reminiscing about their World Cup victory last summer. In a congratulatory salute, he clapped Bucky on the shoulder. The bad shoulder. He might as well have drenched his arm in kerosene and dropped a match on it, for all the pain it caused. Bucky forcibly swallowed and kept the pain off his face, but immediately excused himself to the bathroom to curl up in front of the toilet. He expected to vomit any second from the agonized twisting of his gut and continued licking flame sensation of his arm, but nothing came up. Still, he didn't trust himself to leave this safe isolation until the pain died down, however long that might take.
"Bucky? Are you coming out?" Josiah asked. "I'll bet Steve's waiting for you."
"Need a few minutes," he choked out. "Go ahead without me."
"Okay."
He took ten minutes, the maximum amount of time he could without worrying Steve, and then headed out. Of course, his husband recognized that something was wrong, but Bucky told him nothing. The pain would fade again soon enough, and Steve knowing about it wouldn't change anything. Bucky retreated to their room as soon as possible and hoped a hot shower would help distract him. Instead, the water hitting his stump reignited the sensation. He stifled a scream and dove out of the spray. He sat on the floor of the bathroom for who knows how long, just catching his breath. When he was fairly confident that he could move without screaming, he shut off the shower and managed to get dressed. Exhausted, Bucky sat on the floor outside the bathroom door and tried to work up the strength to stand up and return to the kitchen.
This time, there wasn't even any trigger for the spike in agony. Bucky clenched his jaw so tightly he felt a zing of pain in the tooth he'd cracked nearly a decade ago. Not willing to risk another crack, he curled up on his right side and bit down on the knuckle of his index finger. The new pain was just distracting enough that he wasn't overwhelmed by the old pain. That's where Steve found him.
Despite knowing there was nothing he could do to fix it, Bucky felt better now that Steve knew. He was still in pain, but he wasn't enduring it all by himself. When Steve proposed consulting a doctor, Bucky tried not to sound as hopeless as he felt. How could they possibly fix pain in a part of his body that wasn't even there?
~0~
Bucky agreed to the appointment under the condition that they had it at Gravesen. Even though it was two hours away, he refused to be treated by anyone else, and it helped that they'd have much easier access to his medical history. Though he expected to be poked and prodded, he still got nauseous in anticipation of the pain he knew would accompany any contact. He also expected this appointment to be fruitless, despite Steve's encouragement.
The doctor, a Gravesen specialist he hadn't met before named Dr. Woo, listened to his explanation of the timeline of his symptoms and then touched his stump in a few different ways while asking how it felt. Bucky told him in no uncertain terms that it hurt like a motherfucker. Dr. Woo almost immediately proposed, "I think you have a tumor."
All the color instantly drained from his face and he felt his breath hitch in his chest. He'd just had his eight-year follow-up oncology appointment last year and there had been no signs of his cancer returning. How was it possible he'd come this far only to relapse?
Dr. Woo noticed his obvious distress and sheepishly backtracked, "A benign tumor, I'm so sorry. I didn't mean to scare you."
Bucky heaved a sigh of relief.
"I'd need an MRI to confirm, but I'm fairly certain this is a neuroma."
Even though Dr. Woo had already clarified it was benign, Bucky didn't like the sound of anything that had -oma in it.
"What's that?" Steve asked.
"It's a type of benign nerve tumor. Basically, when nerves are damaged—in your case, when they were cut during your amputation—they try to heal. Nerves grow very slowly, but they do grow. But since there's nowhere for them to grow, they're just growing in on themselves and forming little bundles."
"Can you get rid of them?" Bucky asked.
"Yes."
For the first time in over a year, he considered the possibility that he might actually be able to cure, or at least reduce, his phantom pain. Bucky wanted to cry in relief. Dr. Woo scheduled him for an MRI at the hospital nearest their home and told him that, if the scans confirmed neuromas, he should seek a surgical consult for something called TMR, targeted muscle reinnervation.
"In the meantime, I'd like to start you on a nerve pain medication. It should at least reduce your pain until we find a more permanent solution."
"Okay." Bucky had little faith in this type of medication since it hadn't really worked after his amputation, but it couldn't hurt to try. Dr. Woo sent them off with a prescription, a TMR pamphlet, and another apology for freaking them out about the word "tumor." Bucky decided he liked Dr. Woo.
While Steve drove, Bucky scanned the pamphlet cover to cover. This was a relatively new surgical technique, first used to give upper limb amputees better control over a prosthesis, but it had since been adapted as a treatment for phantom pain. If Bucky were reading about it for purely academic purposes, he would've been fascinated, but considering he would possibly be subjecting himself to this, it was more on the terrifying side. After his port came out, he'd hoped to be done with surgery for the rest of his life, and this was no small procedure. Then he glanced over at Steve, who was only alive because he'd allowed surgeons to crack his chest open and replace vital organs, and it suddenly seemed less scary.
Steve noticed him staring and took his eyes off the road just long enough to shoot him a reassuring smile. "You okay?" he asked.
"Yeah," Bucky sighed. "This just seems really daunting."
"I'll bet. But if it turns out to be a neuroma, do you want to do it?"
Bucky weighed his options. Continue experiencing this level of pain—or possibly worsening levels—for the rest of his life, or have this surgery in the hopes that it fixed it forever. All things considered, it wasn't even up for debate. He wanted to stop hurting. Whatever it took.
~0~
Steve read the TMR pamphlet while Bucky was off getting his MRI. He'd offered to accompany him to the appointment, but Bucky insisted he go alone so Steve didn't have to leave work early. For whatever reason, it scared him more than any lung transplant information ever had. Maybe that was because it was Bucky's body instead of his own. Steve had always been better at suffering gracefully than watching others do the same.
He was afraid, and he was angry. Not at Bucky, of course, but at the circumstances and also at himself. Bucky had been cancer free for over eight years now, just long enough for the possibility of relapse or the onset of long-term side effects to diminish enough that he maybe didn't think about them every single day. Steve still vividly remembered the night of their wedding—for many reasons, but mostly for this: Bucky had laid down next to him and whispered reverently, "For the first time since it happened, I didn't think about cancer today." The smile didn't disappear from Steve's face even as he drifted off to sleep. There was nothing he loved more than seeing Bucky healthy. But his own body, in trying to heal itself, was only causing more problems. It just wasn't fair.
Not only that, but Bucky had been suffering for months, and Steve did nothing. Bucky was so good at hiding his pain that his husband didn't even realize something was wrong. What kind of husband was he that he couldn't tell Bucky was suffering until he practically tried to bite his own finger off? As distressed as Steve was over this neuroma situation, he knew it had to be affecting Bucky all the more. After all the times Bucky had been there for him, it was his turn to be the support system in a time of faltering health.
The results of Bucky's MRI proved Dr. Woo's suspicions. His amputation had severed all the nerves in his arm, and the loose ends had all grown in on each other into one painful bundle of nerves. Bucky (also a bundle of nerves, figuratively speaking) sheepishly asked Steve to come with him to the TMR consultation. Steve accepted, heartbroken that Bucky felt the need to be shy about asking such a simple favor. Once again, they made the trek to Gravesen, to meet with the surgeon. For reasons Steve didn't quite understand, TMR fell under the category of plastic surgery, and there were only a few surgeons in New York that knew how to conduct it. Their consult was with a Dr. Raven Darkhölme.
Darkhölme was more professional than any doctor Steve had ever interacted with during an appointment, explaining the procedure with tactical precision. The pamphlet had explained all of this, but Darkhölme could go into more detail regarding Bucky's specific case. She'd make an S-shaped incision across the top of his pectoral, resever the nerves of the brachial plexus to eliminate the neuroma, and then take each end and integrate it into different sections of his chest muscles. Instead of growing in on themselves, over the next months the nerves would grow into the muscle and provide feedback to the brain so it stopped "freaking out over missing signal," so to speak.
Dr. Darkhölme concluded with, "If it's successful, within a few months you'll be able to flex your pec by thinking about moving your arm."
"I've always wanted to be able to pec pop," Bucky chuckled. Steve could tell he was terrified, because the joke came out hollow.
Darkhölme smiled. "Do you have any questions?"
Bucky shook his head, though Steve was surprised he didn't have anything to say. Darkhölme reminded Bucky that he could ask anything at any point, and then took him back to a procedure room for a temporary nerve block. When he made the appointment, they'd explained that this was a part of assessing his candidacy for TMR. Just to double check that the pain was actually coming from those specific nerves and nowhere else, they'd inject anesthetic to shut off impulses from the affected nerves. Steve didn't get to go with him, but he was secretly glad for that because he didn't want to have to watch.
When Bucky returned, Steve could see in his eyes that the phantom pain was all but gone. He smiled, and there was more genuine happiness behind it than Steve had seen in a long time. Bucky announced on the way home, "I can't wait for this to be over." Steve couldn't either, though he remained apprehensive of what the first few weeks after surgery would be like. Having nerves recut and repositioned didn't sound like a particularly pleasant experience.
I've trained you too well, it seems. Some of you were nervous about Bucky way back in chapter 12. I actually went back and reinserted those 3 sentences of foreshadowing after finishing off the first draft of the story because I didn't want anyone to complain that it came out of nowhere. But I didn't expect for readers to pay so much attention to those 3 sentences. So, I guess this chapter is for those who thought they worried over nothing way back then. It wasn't nothing, it just took another 12 chapters to pay off that foreshadowing. In conclusion, I'm impressed!
