I know this story has already spiraled into really heavy material, so I just want to remind everybody reading to please take care of yourselves! Some of the topics here can be triggering. I will be sure to put specific warnings at the beginning of each chapter. If you skip a chapter and would like an angst-lite summary, please let me know.
Warning in this chapter for graphic depictions of illness and discussion of end-of-life care
Chapter 39: 103
Bucky awoke to the sound of Steve's oximeter alarm. As he raced down the hall into the second bedroom, he thanked his past self for fighting so hard to get Steve to agree to the monitoring. He tore open the door and approached his husband. The first thing he saw was the sheen of sweat on the back of his neck. His hair was so wet it looked like he'd just gotten out of the shower. Bucky reached out a hand to check his temperature and recoiled from the sheer amount of heat pouring from his husband's body. Fever. No doubt. Bucky's heart began racing away in his chest.
"Steve." He shook him by the shoulder to wake him up. No reaction. "Steve." Bucky tried again, more urgently this time. Steve awoke with a shudder and a raucous coughing fit. "I think you have a fever," Bucky told him. "We need to go to the hospital."
Steve didn't answer. He couldn't; he was too busy coughing and now violently shivering. Bucky grabbed the thermometer from Steve's pile of monitoring equipment. 103.1. He took it again just to be sure and got 103.2. Crisis mode activated. Bucky threw shoes on both of them and switched Steve's oxygen from the home concentrator to a portable tank. "Let's go," he prompted. Steve was barely coherent, but he listened. Bucky put the oxygen on like a backpack and used his arm to support Steve on the way to the car. When he turned it on, he checked the clock and found it was two thirty in the morning.
On the way to the hospital, Steve started mumbling, but Bucky couldn't make out any of the words. Even if he could, he had a sinking suspicion they wouldn't make sense anyway. One hundred three-degree fever and incoherent rambling. Bucky bit down on the fear that this could be it. Steve had been slowly declining for months—years, actually—and at this point it wouldn't take much to knock him all the way down. But he couldn't let that happen. Carol May wasn't here yet, and Steve had asked Bucky not to let him die until he met her. Bucky hadn't promised him anything, but this right here could be Bucky breaking that promise he never made.
They made it to the ER in record time and Steve was no longer mumbling. He stared blankly ahead, blinking slowly. "Bucky?" his voice, hopelessly small, called out.
"Yeah Steve, I'm right here," he assured.
"S'm'th'ng's…wrong."
"I know, Stevie, I know. But we're at the hospital and we're gonna fix it, okay? You just have to stay awake for me, can you do that?"
"Uh-huh."
"Good." Bucky planted a kiss on his temple and his lips puckered from the extreme saltiness, contained in the sweat still pouring from seemingly Steve's every pore. He informed the ER docs of the situation, and Steve was seen immediately. Apparently immunocompromised with a one-oh-three-degree fever put you pretty high on the triage list. They drew blood and started him on fluids as soon as they got their hands on him, then switched out his cannula for a full oxygen mask once they got a look at his sats. Bucky clung to Steve's hand and watched his eyelids flutter, whispering, "It's okay. You can beat this. They're gonna figure it out. You're not going anywhere until you meet her, Steve," and anything else he wanted to believe. Steve finally conked out after ten minutes, and Bucky watched the fogging of the mask and listened to the beep of the heart monitor to remind himself that Steve was still here. Still here and still fighting.
His chest x-ray showed both the extensive BOS that had ravaged his lungs for years, and the beginnings of pneumonia. Bucky swallowed down his dread. Pneumonia could kill healthy people. What it could do to someone like Steve? He didn't want to imagine it. And he didn't have to. He didn't have to imagine it, because he got to witness it in real time.
Steve coughed in his sleep and afterwards his breaths remained so shallow that his sats plummeted. They switched him from oxygen to BiPAP in the hopes that the pressure would help keep his breaths deeper. His chest x-ray seemed to worsen overnight. The sputum culture they took revealed two types of bacteria, each resistant to a different set of antibiotics. That left only a few options, and Steve was allergic to almost all of them after having used them copiously for CF exacerbations. Bucky hadn't known this, but when it came to CF and antibiotics, an allergy didn't stop someone from receiving them. All it meant was they pumped him full of IV Benadryl before infusing them. The meds also fell into the category of venous irritants, so they required some form of central line. Steve didn't have a port anymore, so they put a PICC line in his right arm. All of this seemingly happened within hours, but Bucky had no clue how much time had actually passed.
Steve slept through most of it, between the fever exhaustion and Benadryl-associated drowsiness. With nothing else to do, Bucky realized he should probably inform some people of the situation. He called Sarah first, not even bothering to look at the time.
"Bucky?" The urgency in her voice indicated it was probably not normal phone call hours.
"It's bad," was the first thing he could think to say. "Steve…pneumonia." That wasn't even a coherent sentence, but at least it got the point across.
"Oh no."
"I don't know how this is gonna go."
"Oh Bucky, I…I don't know what to say. Do you need company?"
He honestly didn't know. Months ago, Steve told him that he wanted to die with just the two of them, and if that ended up being the conclusion of this hospital stay, he didn't want to ruin that. But he couldn't do this by himself. "I—yeah, I need help."
"Okay. You're at Steve's hospital, right?"
"Uh-huh."
"Joseph and I will be there as soon as we can. Do you want me to bring your parents into this too?"
"No." He was already invading Steve's privacy by inviting the Rogers without his permission, and he didn't want to infringe further. Besides, his mother wouldn't handle the situation very well. Bucky put the phone back in his pocket and returned his attention to Steve. Fever sweat still clung to his brow, and the monitor displayed his temp at 102.9. Lower than it was, but still frighteningly high.
Bucky laced their fingers together, and Steve's eyes drifted open. They were glassy with fever but focusing, and they focused on Bucky. "Hey," Bucky said quietly. Steve couldn't speak through the BiPAP mask, but he ran his thumb across the back of Bucky's hand and squeezed. "I know, you're not going down without a fight. I expect nothing less of you."
Steve nodded weakly and drifted off again. Bucky sighed. He feared even Steve's fight would be no match for this.
~0~
By the time the Rogers came, Steve's breaths had grown more labored and each contained an audible gurgle. Sarah immediately switched into nursing mode. Despite never working in this hospital before, within twenty minutes of arriving she'd befriended the charge nurse on shift and got her hands on some cloths and basin of cool water. She laid it on the bedside table and gently dabbed the sweat from Steve's face and neck, working deftly around the straps of the mask. Bucky wished he'd thought to ask for this sooner. Some of the tension lines between Steve's brows faded into nothing as the movement and coolness soothed the raging heat of his fever. It was back up to 103.1 and his sats hovered in the high seventies to low eighties.
His eyelids fluttered open when Sarah moved to the other side of his face. He looked at her and blinked once but his expression didn't change. Sarah sighed. "Steve, don't retreat. I know it's hard, but if you let that spark die, you'll be next." Her voice contained a precise combination of warning and gentleness.
"Retreat?" Bucky questioned.
Sarah ran a hand through Steve's hair. "When he was really little, when he got really sick, he'd just…draw back into himself. His personality, that signature Steve Rogers spunk…gone." She redirected her words back to Steve. "That spunk is what's going to get you through this, you hear me? Don't let it go."
He nodded almost imperceptibly and curled his free hand into a fist. Bucky left him in the company of his parents and took a walk, trying to decide how best to tell the rest of their friends. Ultimately, he prioritized his own sanity and got it all out in one message rather than repeating it dozens of times. Messages of concern, questions, and well wishes flooded back at him, but Bucky's head was spinning too quickly to read them. If people wanted to visit, they knew which hospital, and they didn't really need Bucky's approval.
He headed back to Steve's room. Sarah had fallen asleep in her chair, but Joseph sat awake by Steve's side, gently stroking his hand and whispering something, Bucky couldn't make out what. "Hey," Bucky greeted.
"Hi," Joseph replied. "You doing okay?"
"For the circumstances, I guess so." Bucky collapsed in the seat beside Joseph.
"It never gets any easier."
"No, it doesn't."
Not another word was exchanged between them that night.
~0~
Around twelve-thirty in the afternoon, the Rogers went out to grab food for the three of them. Earlier, the nurses had tried to get Steve to eat, but he couldn't do it. He told Bucky everything tasted like mucus and it wasn't worth the effort. His sats clung to just-below-normal during the twenty minutes they had him off BiPAP to try to eat, but they put him back on anyway to make sure they stayed where they needed to be. They took another chest x-ray and listened to his lungs. Bucky didn't understand the technical jargon, but he recognized the grim expressions on their faces.
The lead doctor on Steve's case finished his exam and looked at Bucky before beckoning him into the hallway. Bucky followed and, before the doctor could say a word, told him bluntly, "We have a baby coming in a month." He didn't care if the statement was misleading, that it implied said baby was their child. She may not be Steve or Bucky's flesh and blood, but that didn't diminish the importance of Steve getting to see her. "Tell it to me straight, can he beat this? Can he…will he be able to meet her?"
The doctor took a deep breath, and Bucky knew the next words out of his mouth were not ones he wanted to have to deliver. "I can't give you a yes or no with one hundred percent confidence. I've seen things before that some would call miracles, but there's no way to know. What I can tell you with certainty…is that if he ends up on ventilator, he's not coming off. I'm sorry I can't offer anything more hopeful than that."
Bucky expected to hear something along those lines. He'd seen Steve sick before, but never like this. The rattle in his lungs was audible even without a stethoscope. He nodded solemnly and thanked the doctor before heading outside for some air. Bucky had hated the smell of hospitals ever since he first visited Steve in one, and right now he needed a break. The hospital had a small courtyard with a fountain, some flower bushes, and a few benches. He collapsed onto one and tucked his knees into his chest.
If he ends up on a ventilator, he's not coming off.
Bucky wondered if Steve knew this. If he did, would he refuse that treatment, knowing that while it might save him, he was surrendering all possibly hope of future quality of life? And Bucky was his medical proxy. If it came down to it, would he be able to make that decision? Steve had literally begged Bucky not to let him die until he met Parker's daughter. How could he ever choose anything that didn't fulfill that wish, even if it meant sacrificing everything else? He dug his eyeballs into his kneecaps to stop the visions that arose of Steve suffocating to death while Bucky watched, paralyzed with indecision as the doctors asked him what to do. How could he doom his husband either way? To literally drown in his own mucus, or give up breathing on his own knowing he'd never get it back? Bucky's own breathing started to spiral out of control as the thought set his heart aflutter.
"I can't do this by myself," he thought. His whole life, Bucky had relied on Steve. What would he do when Steve completely relied on him? Or when Steve was gone? Without Steve to complete him, who the hell was Bucky? Alone, he was a mere half a man. He'd rather lose his other arm than his other half. But he didn't have any choice in the matter.
Up until now, he'd refused to entertain the thought of after. He worried about taking care of Steve as he grew sicker, picking up chores around the house that his husband could no longer do, even funeral and burial arrangements, but only up to that point. Bucky didn't dare let his imagination wander to what he would do with his life once this dreadful duty was accomplished. Until today. The only witness to Bucky's complete emotional breakdown was a little bird perched on the edge of the fountain.
~0~
Bucky spent twenty minutes in the bathroom trying to disguise the evidence painted in the tear tracks on his cheeks, and he finished just in time for the Rogers to return with lunch. He only managed a few mouthfuls before his stomach lurched in protest. "We're going to stop by your house to bring you anything you might need here," Joseph explained. "Is there anything you want me to put on the list?"
His brain was way too fuzzy to think about necessities. Bucky ran a hand over his face and tried to think. "Carol's blanket," he stated. It might make Steve more comfortable to have something familiar.
"Okay. If you think of anything else, just text me."
"Okay. I don't think I remembered to lock the door on the way out last night, but if I did, you know where the spare key is."
"Got it. Thanks. We'll be back soon."
"Thank you."
"You're welcome."
Another nurse came in to switch out Steve's IV bags and wake him up to try and eat again. He actually managed a little bit this time around, but started coughing painfully until he brought up a glob of mucus. After that, any appetite he'd managed to conjure evaporated. The nurse hummed thoughtfully and listened to his lungs. "I think I'm going to see if we can get respiratory therapy in here, get some of this junk out."
"Sounds familiar," Steve grumbled. Bucky lit up, because that was humor, and if Steve was making jokes, he hadn't retreated.
"I'm sure it does. You'll be a natural." She patted him affectionately on the shoulder and let him lay back.
"Haven't done CPT in…seven years," he told Bucky.
"I'll bet it's like riding a bike."
"On a super bumpy road."
"Exactly."
An hour later, a knock at the door sounded and RT came in, rousing Steve from the light doze he'd fallen into. Without prompting, Steve reached out to accept the large pillow and nebulizer mask. "You've done this before, huh?" he remarked.
"CF," Steve informed him.
"So I don't need to tell you what to do. That's refreshing. I'm Sean, by the way," he introduced. He grabbed the stethoscope from around his neck and listened thoroughly to Steve's lungs. "We want to start with the worst pockets of infection and work outward from there," he explained. "Your lower lats sound worst off right now, can you turn onto your left side and put your arm over your head?" Steve obeyed, motions slow and stiff. Sean double checked the mask before strapping it around Steve's head, allowing him to directly breathe in the Albuterol to open up his airways. A few deep breaths later, Steve coughed and pulled the mask away to spit. Just that motion clearly tired him out. Bucky moved closer.
Sean adjusted the bed so Steve's head was angled downward and started pounding the little rubber cup against his side. Steve's expression could best be described as fed up. Two more coughing fits struck him before Sean finished that side and helped him to turn over, then repeated the exercise on the other side. Next, he moved Steve onto his stomach, head turned to the side, and worked his back.
"Can you teach me?" Bucky asked. He knew how annoying and even disturbing unfamiliar hands could be, especially when you felt like shit and wanted nothing more than to go home. During treatment, he'd lashed out more times than he liked to admit because he grew too sick and tired of people he barely knew touching him. Though Steve had far more experience with that sort of thing, Bucky didn't think he'd object to his husband attempting to take over at least one duty and turn it into something less clinical. The slight smile that graced his face when Sean said yes proved Bucky's point.
He helped Steve turn over onto his back for the next segment and invited Bucky to stand beside him for a closer look. He listened raptly as he simultaneously explained and demonstrated the technique, and took the cup from him when he offered it. "You can also do it with your bare hands, but often it's more comfortable for both parties to use the cup."
"Definitely," Steve said. Just that single word set him coughing again. Bucky waited for it to cede before starting percussion. Steve spit a glob of thick sputum into the basin clutched in his right hand and croaked, "Go ahead."
Bucky did his best to mirror what the therapist had demonstrated. He offered him little adjustments along the way, and slowly but surely, he got the hang of it. His arm grew tired from the repeated unfamiliar motion, but he ignored it. Steve once told him that his parents did this twice a day—sometimes four when he was sick—for six years, until he switched to the vest. Bucky could handle two thirds of one treatment. Every two minutes, they repositioned Steve to work a different lobe of his lungs.
Sean approved of Bucky's technique. So did Steve, considering the amount of mucus he brought up. That was the whole point of this therapy; the more they could dislodge, the better. Once they got through all the positions, they resettled Steve and switched out the Albuterol nebulizer mask for oxygen. "You're pretty good at that," he remarked, voice hoarse from coughing.
Bucky offered him the straw to a water cup and Steve cautiously sipped at it. "Thanks. It's way harder than it looks."
"I wouldn't know. Never…done it."
"That's enough talking for now," Bucky said. He could see in the furrow of Steve's brow how hopelessly exhausted he was. "Why don't you try and get some more rest?"
"'Kay." He closed his eyes and rolled his head a few times to settle more comfortably into the pillow. Bucky watched the labored rise and fall of his chest gradually slow down as he drifted off to sleep.
