Fair warning, things get pretty intense in this chapter. There is discussion of depression and (past) suicidal ideation. The effects of chronic illness are often more than just physical.

Chapter 35: Life Expiring

Last time he marched toward death, Steve didn't monitor his lung function on the daily. He'd had nothing but his disappearing abilities and increasing malaise to mark his decline. This time around, he had both, and he matched his physical losses to the plummeting numbers of his lung function tests in real time with a sort of morbid fascination. His mile time and his PFT had an almost perfectly proportional inverse relationship. It didn't bother him until he noticed Bucky hanging back to keep pace with him. They argued about it for a solid two weeks before Steve convinced him that his training exceeded the importance of togetherness when it came to morning workouts.

Though inevitable and irreversible, his decline was anything but linear. Sometimes, he'd go weeks or months without his numbers dropping and he convinced himself he'd outlive the doctors' estimates. Other times, he lost an entire ten percent in a month and feared he'd succumb before the end of the year. Some mornings he could barely bring himself to look at the numbers. Whenever anyone asked him how he was doing (which was every single time he saw friends or family) his answer was always the same, no matter how great or shitty he'd felt the past week. Surviving. That's all he was doing. And he'd do it for as long as humanly possible.

He developed a dry cough about nine months after diagnosis. Having lived his entire life prior to transplant with a never-ending supply of mucus buildup in his lungs, it felt beyond strange to cough without anything coming up. It both annoyed and hurt him in ways his CF cough never had, and it only got worse as time wore on.

Three months after that, he found his runs always ended with a period of wheezing not dissimilar to an asthma attack. The first time it happened, he frantically searched for his inhaler fearing an attack, only to discover that his airways weren't suddenly closing off as his immune system freaked out over an allergen; they'd merely been gradually closing off for the past year and only now reached this level of severity. He took a puff of the inhaler anyway. It did help some. The disease progression felt almost exactly the same as the destruction of his first lungs, like someone was slowly pouring cement into his bronchioles and it began to harden, creeping ever higher until it filled his lungs entirely and drowned him. Steve didn't look forward to drowning.

A year and a half on, he started dropping weight. Breathing reached that threshold degree of difficulty where it cost him more calories than he took in. Steve upped his daily intake and shortened his Tuesday and Thursday morning runs, replacing the back half with strength training. He dropped pounds more slowly after that, but it didn't stall his loss entirely. Nothing could grind his decaying body to a halt. Steve could only take each blow in stride and resist the urge to curl up and sob beneath Carol's American flag blanket. Actually, he did do that a few times, but only when he knew Bucky wasn't home.

He never looked at his oxygen sats right after working out. Steve didn't need an oximeter to tell him; the impending lightheadedness was all the proof he needed. A voice of reason in the back of his head told him he should probably stop, but to admit he couldn't safely exercise was to admit he was growing frail. Steve wanted to stave off that acceptance of defeat for as long as he possibly could.

His sats began tending toward the low side of normal every morning. Sleeping slowed the respiratory rate, and evidently, he wasn't exchanging quite as much gas at night as he was during the day when he consciously controlled his breathing. His doctors told him not to worry about it until his sats dropped below ninety or he experienced concerning symptoms like dizziness or an elevated heart rate.

No longer could he take advantage of every weekend in the same way he'd been doing before. A full week at work exhausted him. It broke his heart to tell his friends no when they invited him to do things, but a lifetime of chronic illness had made him a master at rationing energy and he knew if he did anything too adventurous, he'd be dead on his feet through the entire first half of the following week, and he couldn't bear to do that to his patients or to himself.

Instead, he spent his weekends reading or drawing or playing board games with Bucky. They both upped their Scrabble game and, per Parker's suggestion, took to playing Catan blind by setting up the numbers upside down and only revealing them after placing their settlements. While he missed all the other friends they used to see so often, Steve had to admit it was nice to spend this quality time with his husband. They had some of their deepest conversations over a game board or just curled up beside each other on the couch.

"Do you ever wish you'd been born healthy?" Bucky asked.

The inquiry caught Steve completely off guard, despite being a perfectly reasonable, albeit deep, question. "Yeah, sometimes," he admitted. "More so when I was younger and, you know, thought the world was supposed to be a fair place."

"That makes sense."

"But whenever I start to go down that path, I remember that I only moved to Brooklyn to be close to Gravesen and if I wasn't sick, that probably never would have happened." Sometimes, that was quite literally the only thing keeping Steve from driving his fist through a wall and cursing his genetic code. For him, no CF would have meant no Bucky, and that was a trade he was more than willing to make. But every so often, his imagination escaped the fences of realism that he set around it and he dreamed of a life that included both Bucky and healthy lungs. The mere notion made him positively ravenous, and his heart howled emptily every time he reminded himself that it could never be. Hence why he actively prevented his train of thought from traveling that route.

Bucky smiled a sweet yet timid smile.

"Do you ever wish you hadn't had cancer?"

That smile turned grim. "Only when I have to schedule oncology follow-ups. Other than that, I don't even think about it very often anymore, which is crazy. I used to think about it every goddamn day. But I'm one of the lucky ones who escaped physically unscathed. There's a lot of people, like Nick and Nat, who have to deal with the long-term effects of it every day."

Steve wasn't sure if he was joking or if he genuinely thought his disability didn't count as a long-term effect compared to Nick's or Natasha's. "Bucky?" He glanced across the Catan board, where Bucky had his hand of cards stuck in an upside-down box from another game since he couldn't fan them out and handle any other pieces at the same time. "Aren't you forgetting something?"

"What?"

"You are…not physically unscathed by cancer."

"Oh yeah," he said nonchalantly. Bucky gazed towards his left side and Steve saw his pectoral muscle flex through his shirt. He must've been moving his phantom hand. "I'm so used to it, sometimes I forget that I used to be different."

"You're well-adjusted. That's great."

"So are you. I can't imagine having to keep track of everything you have to do every day, but you make it seem easy."

Steve shrugged. "It's been my daily life for so long that I barely remember anything different. Same as you."

"Yeah, I guess so. Now do you have any brick?"

~0~

Bucky finished his Monday morning run and took a few walking laps around the house to cool down. He'd always been in charge of breakfast, but now that he always got home before Steve—the stubborn punk insisting on going the full distance even though it took him longer every month—he usually had it ready and waiting by the time his husband arrived. Bucky fished a Gatorade out of the fridge, set a dose of enzymes on a napkin beside it, and set up the blender to make their usual post-workout smoothie. He usually made two separate batches, enough for each of them to have one today and another later in the week.

Bucky made his own first, with oat milk—he wasn't lactose intolerant, he just liked it better than regular—and then Steve's with whole milk and extra protein powder. He set their glasses on the table and checked the time. Steve should have gotten home by now. Just as the first lance of worry drove itself through his gut, his phone rang.

Bucky glanced at the name. It was their neighbor, Mr. Hodge. He picked up the phone with increased urgency. "Hello?"

He wasted no time explaining the situation. "Steve passed out on my driveway."

"What?!"

Bucky tore out the door and sprinted towards Mr. Hodge's house, abandoning the phone on the counter without even bothering to hang up. Mr. Hodge crouched where his driveway intersected the sidewalk, one hand on Steve's shoulder. He was conscious and sitting up, but panting desperately with a hand fisted in his shirt as if to tear it off. His knees and elbows were peppered with road rash from hitting the ground, but none appeared to be bleeding too badly. His blue eyes, glimmering with panic and—was that shame?met Bucky's for half a second before they skittered away to stare at the pavement beneath him.

"Hey, hey," Bucky coaxed, kneeling down before him. He took Steve's free hand in his and rubbed his thumb in circles over his palm.

"I walked out the door to head to work and I just saw him drop," Mr. Hodge explained. "By the time I got here from the porch, he'd already come to. I asked him if I should call nine-one-one and he said no. But his heartrate is through the roof."

Bucky grunted in frustration. The situation before him looked very much like a nine-one-one type of situation, but of course Steve would never admit that. He once told his mom he was okay when he had a fucking collapsed lung, and then he nearly fucking died. "Was he running or walking?"

"Jogging."

"You idiot," Bucky scolded. An aborted hiccup interrupted Steve's shallow breathing. Bucky looked into his eyes more closely and notice they shimmered with unshed tears. He took a deep breath and reprioritized. The conversation about knowing one's limits could wait until Steve wasn't gasping like a fish and pulling at his shirt collar as if it had tightened enough to suffocate.

"Should I call anyway?" Mr. Hodge asked.

Steve, with breath he didn't have to spare, began murmuring, "No, no, no, no."

"Let me try something first." Bucky let go of Steve's hand to reach into his pocket, and the other man let out a whine and collapsed forward to rest his forehead on Bucky's stump. He could feel Steve's every frantic inhale reverberate through his body and grabbed more urgently for the object he knew he always carried. Ever since they got married and developed this routine of running together, Bucky kept a rescue inhaler in the pocket of his exercise clothes. He never knew when they might encounter a dog in a suburban neighborhood. This probably wasn't an asthma attack, just overexertion, but the symptoms were similar enough and he knew Steve could benefit from having his airways opened up.

He shook the device and ripped the cap off with his teeth, reminding himself to sanitize it later. Steve glanced up long enough to see what he was doing and visibly steeled himself, taking as deep a breath as he could manage. Bucky held it up and let Steve wrap his lips around the mouth piece. "Okay, deep breath on three," he instructed. "One, two, three." Bucky pressed down on the canister as Steve wrenched in a shaky inhale. "Hold it." Steve's chest visibly trembled with the urge to cough. "Come on Steve, you can do it. Five, four, three, two…one."

The air left his lungs in a frantic rush and he switched from clawing at his shirt to grasping at Bucky, trying to pull him in closer. "It's okay," Bucky encouraged. He didn't have a spare hand, so he relied on his words to comfort his husband. "I've got you." Steve looked at him once again. The threat of tears remained, but the panic had faded. Gradually, his breaths grew deeper and slower. Bucky recapped the inhaler and shoved it back in his pocket.

"'M sorry," Steve spluttered.

Bucky rested a hand on his shoulder and squeezed. "Not now."

"Mr. Hodge…late…for work."

"It's okay. My first period class is usually more than half asleep," he said good-naturedly. Bucky gauged the distance from here to their front door and decided Steve could probably attempt it. He helped him to his feet and, keeping his arm around Steve's shoulders, his eyes on his face, and his ears on his breathing pattern, they hobbled two houses over. The seven stairs up to their porch took almost as long as the trek from Mr. Hodge's. Bucky planted Steve on the couch and fetched the oximeter from their bedroom. He clipped it onto Steve's finger and waited for the reading. Eighty-four. If it was this low now, Bucky knew it must've been even lower when Steve blacked out.

"'M sorry," Steve repeated, voice shaky and hoarse.

"Yeah, apology accepted," Bucky said. He'd be angry later, when the stress of seeing Steve in such physical distress wore off. For now, he was just relieved that his plan worked. "Get those sats above ninety, then we can talk."

"Okay." Steve closed his eyes. Bucky imagined him mentally yelling at his lungs to get their shit in gear, as if oxygen sats were something that could actually be improved through willpower alone. If that were the case, Steve's would never dip below two hundred. Bucky stuck a straw in the Gatorade and offered it to Steve, figuring dehydration certainly wouldn't help his situation. Steve sipped at it slowly, resolutely. Bucky grabbed some first aid supplies and got to work on the worst patches of road rash. He also called both Steve's boss and Lamberg to explain why they wouldn't be coming in today, citing an unspecified medical emergency. Steve stayed on the sofa breathing intently. He finished his Gatorade, took his morning meds, and managed a third of the smoothie. It took over an hour, but his sats climbed back up out of the danger zone.

"So, do you want to tell me what happened?" Bucky asked cautiously. The maelstrom of emotions he'd seen hidden beneath the thick veneer of panic in Steve's eyes during the incident had vanished, but not from Bucky's memory.

"I guess I…passed out." Steve shrugged. "That's what Mr. Hodge…said he saw."

Bucky smelled a lie. "If that's true, you need to see a doctor immediately. Suddenly passing out, especially for reasons you don't know, is really dangerous. But something tells me you know a lot more about what happened than just, 'I guess I passed out.'"

Steve mumbled, "Until today I've always been able to power through it."

"Power through what exactly?" Bucky suspected the answer to this question would probably make him both concerned and extremely angry.

Steve's muttered answer was indecipherable.

"What was that?"

"Dizziness."

"And for how long have you felt dizzy on runs?"

"Just the last couple minutes of it."

"That doesn't answer my question."

Steve bit his lip and admitted, "A few weeks maybe."

Bucky ran a hand through his hair and tried to massage away a budding headache behind his eyes. "Steve, I say this with love, but you are possibly the most stubborn idiot I've ever met in my entire life."

Steve's ears flushed red with shame and he lowered his head even more, until his chin nearly rested against his chest. "I said 'm sorry."

"And you should be. What if Mr. Hodge hadn't called me? What if he'd already left for work and didn't even find you in the first place? What if you passed out somewhere more dangerous than the sidewalk?"

Steve offered no response.

"I thought you were more responsible than this. Steve, dizziness from low oxygenation is not something to just power through, Jesus Christ, you could die! How do you think I'd feel if someone called me to say they found you dead because you just didn't know when to quit? Would that be worth it for whatever sense of gratification you get from runner's high, or whatever the hell it is that gets you going out there when you clearly shouldn't be?"

Now Bucky was out of breath and seeing red. They went through this after the whole not-breathing incident with his TMR surgery: do not let a false sense of obligate stoicism prevent you from speaking up when you're suffering. Bucky trusted Steve enough to confide in him, and Steve was supposed to trust him in return, trust him with anything. To learn that for weeks Steve had been forcing himself to keep running as his body burned for oxygen it couldn't get while Bucky was home cooking breakfast enraged him to the point where he could barely think straight.

He simmered while waiting for Steve to devise a retort. The look in his eyes was that of someone faced with his worst nightmare. "I don't want to stop," he keened. "Because I know running's only the first, and once it goes…everything follows. I've done this whole lung failure thing before, Bucky, and I lost everything." He ran a hand into his hair, grabbed, and pulled as if to wrench the memories from his brain. "You were away at school, so you didn't see much of it, but that year before transplant? I woke up every day coughing my brains out and my first coherent thought was always, 'I just wanna go back to sleep because I can't fathom the thought of another day trapped in this fucked up body that's just waiting to die.' That transplant set me free, Buck, but I'm heading right back to the prison of not being able to so much as shave because it costs more energy than I have to give. And the truth is I don't wanna go back there, because this time there's no hope of freedom except literally dying, and I'm so fucking scared."

Bucky cut him off by wrapping him up in as strong a hug as he could possibly offer. He didn't often miss his other arm anymore, but if he wanted it back for any purpose, it would be this. Comforting his weeping husband as he contemplated the inexorable progression of this wretched disease that would strip him of his abilities little by little until just breathing became a feat that defied God. That one comment positively screamed suicidal ideation and Bucky should have realized that such a devastating chronic illness had more than just physical effects. Hell, on some of his worst chemo days he had pondered how desperately he wished he could just sleep through it, but that was a small proportion of days from a nine-month period of his life. When he thought about relapse, about doing all of that again, he grew sick to his stomach. Steve had lived that level of misery every day for years, and now, faced with his own version of a relapse, he'd have to do it all over again. He knew exactly what to expect, knew just how much suffering awaited him, and he was doing everything in his power to keep it at bay for as long as possible. Even if that meant simply pretending it wasn't happening.

"Steve, are you…are you depressed?" Bucky asked genuinely. Given everything Steve just told him, he already knew the answer, but he didn't know if Steve had yet acknowledged that within himself, and that needed to happen.

He shuddered in Bucky's embrace. "I…I don't know. I was…last time. After the collapsed lung, until transplant."

"Did you get help?"

"They medicated me for it."

God, Bucky wished he'd known that at the time. But Steve probably had a reason for not telling him—a stupidly noble reason. "And did that help?"

"Yeah."

"Do you think it would help now?"

"I don't know. Maybe."

"Then that's something you need to consider."

Steve said nothing for a long while. Then whispered, "Okay."