Wednesday 5 October, 2039

Daniel Fleischman, M.D.’s office was as good an example as any of his wife’s impeccable taste. His desk was a deep mahogany with a glass top, and there were two Mondrian reproductions hung one on top of the other between the two tall windows that faced the courtyard garden at the back of the hospital. His degrees and medical certificates were arranged so that, when one sat opposite him in either of the plush, welcoming chairs, they appeared to encircle his head in the style of a stained-glass saint’s halo. The walls were two-and-two, alternated between a smooth beige and a light grass green that served to both complement the furniture and soothe the spirit.

As soon as Daniel showed them into his office—unfamiliar to Kurt, having never before been treated at Mount Sinai—Kurt finally felt himself relax into the firm surety of Blaine’s arm around his waist. He had awoken to a pillow soaked with blood after having had a nosebleed during the night—unsurprising, considering how he had eventually fallen asleep. It had left him feeling dazed, shaken, and panicked—what if he had been sleeping on his back?

Tentatively, exhaustedly, Kurt turned onto his side and folded his arm up beneath his head, the digits of sometime past midnight seared across his darkened vision when he closed his wide-awake eyes. He had been in bed for hours, dozing on and off to begin with but wide awake ever since Blaine had traced fingertips along the sunken line of Kurt’s collarbone and crept from the room. It had been more than an hour and he still hadn’t returned.

Restlessly turning onto his back, Kurt let his hands drift beneath the covers, coming to rest in tandem on his hollow stomach. His fingertips pressed into the bruises that had without explanation blossomed across the skin there, and while he winced at the dull sting, he was nonetheless grateful for it. The discomfort, the insomnia, the constant feeling of being too small for his skin, it all reminded him that he was still alive.

“How’re you feeling, Kurt?” Daniel asked when they were all seated. His hands were loosely clasped together atop the unassuming manila folder on the desk before him, and Kurt couldn’t help the way his attention kept flicking towards it, knowing that it contained his test results, the official diagnosis and his treatment plan.

“Tired, and… Anxious, but mainly tired,” Kurt answered plainly, Blaine’s grip on his hand tightening infinitesimally.

“Have your symptoms worsened at all since you were discharged?”

“I had a nosebleed last night, while I was asleep. The fatigue is worse, but it’s been hard to sleep.”

Daniel nodded, taking his half-moon glasses from the pocket of his white coat and putting them on as he opened the folder. “That’s to be expected,” he said, his tone one of reassurance that everything was as normal as could be. “Kurt, I… I have to tell you that the official diagnosis of your condition is acquired aplastic anemia.”

Waking up in the ambulance wearing an oxygen mask coupled with the expression of soul-wrenching grief on Blaine’s face as it swam into view had been the most terrifying moment of Kurt’s life. Until the young EMT with kind eyes had calmly informed him that he’d lost consciousness, he could hear the heart monitor beeping faster and faster and had been convinced he had followed in his father’s footsteps and had a heart attack, even though the last thing he had been able to remember was a wash of dizziness, and hopping down from his seat at the island to pour himself a glass of water.

In the wake of the consuming fear that he’d had to swallow like a jagged razor blade so as not to worry the twins when they had quietly stepped into his hospital room, gazes downcast and hands wrung, the rest of it was negligible. According to Daniel and his team, his life wasn’t in any immediate danger, and he would know more about the seemingly long road ahead the next morning.

Slumping back into his seat, Kurt looked down at his and Blaine’s joined hands, the skin of his own so much paler than usual. He could feel the skittering pulse at Blaine’s wrist, racing as fast as a wild hare.

“Could—“ Kurt cleared his throat, his voice sounding much weaker than usual. Everything about him was weak lately, and already he couldn’t stand it. “Could you explain to us again just what that is?”

“Aplastic anemia is a rare blood disorder,” Daniel began heavily, clearly struggling to keep his voice steady and retain a note of reassurance. “It occurs when the bone marrow stops producing new hematopoietic stem cells, which eventually results in extremely low levels of red and white blood cells and platelets. The only known cause is autoimmunity, when the white blood cells mistakenly attack the bone marrow, but that’s not the case here. We… We don’t know why it’s happened to you, I’m afraid.”

Squinting over at the alarm clock again, Kurt yawned, slowly slid his legs from beneath the covers and sat up, arms trembling as he braced himself on the edge of the bed. He took three slow, deep breaths before getting to his feet and making his way, step by weary step, from the bedroom. Feeling his way along the wall with heavy fingers, he followed the strip of light shining from the door to Blaine’s studio, left slightly ajar. Upon reaching the door after what felt like minutes, he took a moment to lean his forehead against the cool wood of the frame and wait for the lightheadedness to recede once more to the low-level state of constancy it had occupied for the previous couple of months.

There had been times, in the days since his hospital stay, where Kurt wondered aloud to Blaine what might have happened if he hadn’t been so stubborn and had made an appointment with their usual doctor, or even quietly talked to Daniel on one of the Sunday evenings that he and Julia hosted dinner.

“The outcome would have still been the same, sweetheart,” Blaine had told him. “We might have avoided the fright of our lives, but…”

“I know,” Kurt had managed, chasing warmth as he pressed himself flush against Blaine’s side in their cocoon of blankets. He had apologized, over and over until Blaine had finally silenced him with his lips upon Kurt’s, body slowly moving against him with the arcane knowledge learned over a thousand nights and more until they had spent themselves entirely.

“Is it something I did?” Kurt asked, trying to wrap his mind around the fact that his body was rebelling against him, that he had no control whatsoever over it. It was a hard idea to stomach.

Daniel shook his head, his hand sliding forward across the desk but stopping halfway, as if he were trying to reach out as a friend yet knowing that in his current capacity, he was unable. “No, Kurt. Absolutely not. There can sometimes be certain environmental and/or medical factors at play, but from both your medical notes and what I know of your lifestyle, there’s no reason to think it was something that you’ve done.”

Kurt nodded numbly, turning his head to glance out the window at the courtyard. A scattering of patients shuffled around on the arms of nurses or family members, bundled up in robes and slippers and holding on to IVs. Would he soon be counting himself among them? Would he be shuffling around with the weight of ill health bearing down upon him like his own personal boulder?

Kurt slowly pushed the door open, blinking sluggishly as his eyes adjusted to the brightness that spilled out, and shuffled into the meticulously-kept studio. His chest tightened as he glanced through the glass partition of the sound booth and saw Blaine hunched over an enormous leather-bound book, one hand scrubbing back and forth through his wild curls while he alternated between turning pages and wiping away free-falling tears with the other.

Blaine didn’t seem to notice that Kurt was there until Kurt’s hand was on his wrist, fingers trailing along the sleeve of his striped Henley to curl into the crease of his elbow. He started, a ragged breath tearing at his cluttered throat, and immediately pulled Kurt down to sit across his lap, arms winding around his waist and clinging tightly as he choked out around a sob, “I can’t make any fucking sense out of it, Kurt.”

“So what happens now?” Kurt heard Blaine asking, and came some of the way back to himself. His ‘far away’ episodes were becoming more and more frequent as the blood transfusion he had received wore thin, and after having had so many consecutive, entirely lucid days, it was terrifying. He had thought it was just as a result of the stress of balancing work and family—Kurt had always been in control, yet the loss had been so gradual that he hadn’t even noticed. Unburdening himself to Blaine the previous night had thrown him completely, and he had woken up that morning with his sketchy grasp almost entirely shot. “Where do we go from here?”

“Under normal circumstances, immunosuppressive therapy would be the best course of action, in order to suppress the immune system long enough for it to reset, so to speak. But, as this hasn’t been caused by an autoimmune disorder, I have to recommend a bone marrow transplant,” Daniel said gravely, and Kurt was snapped out of his daze completely, his eyes widening. “There are risks, given your age, but my team believes it’ll be the best possible option for you.”

“Shh, sweetheart. Make sense out of what?”

“This,” Blaine said, gesturing to the book. Kurt turned and flipped the book closed, taking in the deep red cover emblazoned with the title ‘Williams Hematology’. “I’ve been researching online but it just wouldn’t make any sense, so I thought… A book, I could highlight and make notes in the margin. It always helped, back in school, but this… There was a reason I never became a doctor.”

“Baby, why didn’t you just wait until we see Daniel tomorrow?”

Blaine closed his eyes tightly, and when he exhaled his shoulders slumped, tension leaching from them as if they were being wrung of water. “Because—because tomorrow is going to be about treatment plans and going forward and first I needed to understand why this horrible fucking illness chose my husband,” he said, heat flaring behind the flat words. “I have to understand, Kurt, I have to—“

“Could I be the donor? If Kurt and I are the same blood type, I mean?” Blaine asked, and Kurt shook his head. They were not the same blood type, and no matter how many times Kurt told him that, Blaine never remembered.

“Being a match for donating bone marrow isn’t just about having a matching blood type,” Daniel said, hands splayed in front of him. “In fact, some donors and recipients have completely different blood types. It’s also far safer, in terms of the risk of graft-versus-host disease, for the donated cells to come from a blood-related sibling.”

“I don’t have any,” Kurt said.

“In that case, we would look next to a parent or…” Daniel trailed off, pausing momentarily before visibly steeling himself and dragging his gaze to meet Kurt’s. “If necessary, a child.”

“No. Absolutely not,” Kurt said vehemently, shaking his head even though it made his vision swim. “No. My dad is pushing seventy, and the twins… No. I’m not asking them to do that. They’re far too young.”

“Kurt,” Daniel began, his tone both gentle and firm. “The chances of graft-versus-host occurring post-transplant increase significantly when the donor is unrelated to the recipient. I don't want the twins put at risk any more than you do but if there were another option, believe me, we wouldn’t need to be having this conversation.”

Silently, Kurt reached up and placed his hand over Blaine’s mouth, a kiss to his cheek, his temple, into his mussed hair. “You needed to break down, but you didn’t feel like you could do it in front of me or the kids. Am I right?”

His breathing shaky and shallow, Blaine nodded against Kurt’s chest, fingers digging into the flesh of his upper arm so hard that Kurt was sure there would be bruises come morning. “Blaine, come back to bed and let it out where I can hold you.”

“No. No, you don’t need to be dealing with this right now, I’m sorry,” Blaine replied, the words tripping over themselves in his haste to apologize. “I’m sorry, this is about you and what we can do to get you better, not about me having coping issues.”

“Blaine, come back to bed,” Kurt said firmly, taking his hand and weakly dragging him from the room.

“Sweetheart—“

“Blaine, no! I am not putting either of my children through a painful surgery when it’s completely unnecessary. Surely… Surely you can find another match,” Kurt pleaded with Daniel, begging with every last fiber that there was another way. He closed his eyes, and all he could see before him were Audrey and Oliver, needles as long as his forearm being pushed through the malleable barriers of their skin as they lay motionless under the effects of general anesthetic.

“What are the figures?” Blaine asked, turning back to Daniel. “The percentages?”

Daniel sighed, clasping his hands once more and leaning forward on his desk, and Kurt’s eyes slipped closed as he pinched at the bridge of his nose. “For a matched sibling donor, the chances of graft-versus-host occurring are around twenty percent. For a donor from a relative, around forty. For a completely unrelated match, the chance increases to around eighty percent. Everyone should be tested, and as soon as possible.”

Swathed beneath the soft blankets of their bed, Blaine wrapped his fingers around Kurt’s wrist and tangled their legs at the knees, his warm breath ghosting across Kurt’s cheek.

“How can you be so calm?” he asked. “I’ve barely been holding it together these past few days, and you’re so calm.”

Kurt opened his mouth with every intention of stressing the importance of keeping himself collect—he didn’t want to add raised blood pressure to his already weakened state. “I’m not calm, Blaine. I’m fucking terrified,” was what came out instead, and before he knew it, the lump in his throat that had been there since waking up in the ambulance expanded into a gasping sob, and he screwed his eyes shut in an attempt to hold back the tears that stung in their unexpectedness, but it was already too late.

They wept, and in the darkness they held one another until, a long time later, their wrecked bodies finally succumbed to the uneasy tendrils of sleep.

Opening his eyes, Kurt stood and walked over to the window, once more looking out at the patients in the courtyard below. He crossed his arms over his chest as he considered them; their tentative and shaky steps, the hunch of their backs, the sickly pallor of their skin from too great a part of the day spent inside under artificial lighting.

Eighty percent. An eighty percent chance that not only would he be in hospital for any stretch of time, but a long one at that. He abhorred the fact that he was even considering his children for something so dangerous, so invasive, but the more carefully he considered it, the more his knee-jerk reaction appeared to him unwise. There was no way of knowing how long those patients had been in the hospital, how many days, weeks, even months they spent seeing their families for a matter of hours each day. How long it had been since they had last tucked their children into warm and yielding beds before slipping between the sheets of their own and into a waiting partner’s arms?

Blaine’s hand appeared warm at the small of his back, and Kurt sighed heavily. “I don’t want them to have to do this,” he whispered.

“They might not have to,” Blaine answered. “But if there’s even a chance…”

“I know,” Kurt said, and after one last lingering look outside, turned to face Daniel. “Alright. Tell us what we need to do.”