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Tick.
Stuck in the waiting room of yet another doctor's office, Ryuko tapped her foot impatiently, arms crossed over her chest as she slouched in the uncomfortable plastic chair. Every so often her eyes would flit to the ticking clock above the door leading to the back and she'd huff. Fortunately, her watch, a gift from Satsuki, ticked in sync with the office clock. Despite the fact that this had become routine, she didn't think she would ever get used to this.
Tick.
It had been a decade since the death of their mother and things had been going smoothly up until a year ago. Ryuko bit her thumbnail as memories of that fateful day last year crept slowly into her mind like water seeping slowly through a cracked wall. Try as she may to block the thoughts out, they became more forceful until her mind was flooded with memories of the worst day of their lives.
Tick.
A furrowed brow. Ryuko noticed Satsuki's telltale sign that something was wrong almost immediately. "What's up?" she'd asked, noting the way her sister seemed to be attempting to open and close her hand. "Nothing," Satsuki had murmured, hiding her hands under the table and quickly changing the subject. Ryuko had let the topic drop, figuring it was another one of her lover's achy joints from her many years of sword fighting. Little did she know it was the beginning of the end.
Tick.
That had been two years ago. Incidents like that had become more and more common during that first year. White spots appearing on Satsuki's knuckles, making it nearly impossible to bend her fingers. An increasing lack of flexibility. Gastrointestinal issues that made eating a nightmare. At first she'd refused to see a doctor, until Ryuko's urging finally won over.
Tick.
"We're not sure," said the first doctor. "Try seeing this doctor," recommended the second. "I've honestly never seen this in my career," remarked the third. Endless poking with needles, blood tests, CAT scans, endoscopies. Satsuki must have gone through at least 50 tests that first year, restarting the cycle anew with each new doctor. A year after the initial incident, at a fancy hospital in Tokyo, they were finally given a diagnosis.
Tick.
Scleroderma. Ryuko had never heard of this illness before, but she'd chalked that up to her general lack of medical knowledge. This didn't stop her from thinking that it sounded like the kind of bizarre disease that you'd see on TV shows like House, MD. She and Satsuki had hammered the doctor with questions that day. Ryuko could tell Satsuki had seemed to have some idea of what the disease entailed based on the way she’d paled at the diagnosis and by the specificity of her questions. Ryuko remembered only the important words she’d heard from that day.
Tick.
“Connective tissue, such as skin and organs, turning into immovable scar tissue.”
Tick.
“Caused by defective immune system response.”
Tick.
“Incurable but treatable.”
Tick.
“Terminal.”
Tick.
Ryuko remembered how she herself had grown clammy upon hearing those words; the desperate look she’d thrown her sister’s way, despite that fact that Satsuki seemed to be avoiding eye contact; the even more desperate look she’d given the doctor, as if hoping she’d misheard him. Her fist squeezed the arm of the waiting room chair until her knuckles turned white and the plastic began to creak and groan under her grip. She realized that she had bitten her nail down to the skin, drawing blood. Not for the first time and probably not the last, she mused, wiping her thumb on her jeans. It had been a year since the diagnosis and things had not turned around at all for Satsuki. Today’s appointment was meant to gauge her progress.
Tick.
“Ryuko?” The receptionist’s voice broke her concentration and she snapped her gaze upward. “The doctor and your sister are ready for you to come back.” Grunting, Ryuko stood and followed the woman back to a wooden door with the number 3 printed on it. She knocked, then opened the door for Ryuko and closed it once she’d entered the room. Satsuki sat on the exam table, looking forlorn in the cheap paper gown she was wearing. Her sister had lost a lot of weight over the past two years due to her stomach problems, but Ryuko couldn’t push the thought out of her mind that Satsuki looked even smaller and more defeated in the flimsy garb. The doctor sat in a chair across from Satsuki. He had a somber look on his face as he announced, “We have something we need to discuss with you.” Ryuko balked.
Tick.
“It seems that Satsuki’s illness is progressing faster than we anticipated,” he began. “In fact, her case seems to be one of the most aggressive, treatment-resistant cases I’ve seen. Most aggressive in the country, maybe even the continent.” He sighed, crossing his hands in his lap. “We have been treating her as strongly as we possibly could in the past year but it has had little effect on the progression of the disease.”
Tick.
Ryuko didn’t want to believe what she was hearing, but the last two years’ worth of evidence made it nearly impossible for denial to come into play. She’d been watching Satsuki deteriorate for a long time now. The lost weight, the now numerous areas of hardened skin, the joints that barely bent, the increasing incidences of hospitalizations for increasingly severe issues with breathing. Both Satsuki and Ryuko had known subconsciously that it wasn’t going to get better from here.
Tick.
“Satsuki requested that I talk with the two of you about durable power of attorney, or granting you, Ryuko, the power to make the future decisions regarding her health according to her wishes. In this case, she has also looked into making a living will that basically would tell you exactly what her desires are should she become...incapacitated.” He removed his glasses and rubbed at his eyes, then sighed. “Satsuki, I suggest you decide exactly what medical treatment you want, then meet with a lawyer along with your sister to go over the process.”
Tick.
The car ride home was a morbid affair. Satsuki stared out the window of the passenger’s side silently. Ryuko gripped the steering wheel so hard she was fairly certain the imprints of her hands would be embedded in it permanently. When she pulled into the driveway of their home she put the car in park but left it running. Satsuki made to open the door but Ryuko grabbed her arm. “Wait,” she pleaded, finally breaking the silence. They met eyes for the first time since the appointment.
Tick.
“I’m...I don’t want to lose you and, like, this is all happening so fast and now you want me to put your life in my hands and I just, I love you so much!” She’d nearly shouted the last statement as tears had welled up in her eyes. “I’m not ready for all this.” Satsuki had a pained look in her eyes as she responded, “It’s happening regardless, so you’re going to have to prepare yourself.” A moment of silence passed between them before they kissed desperately.
Tick.
A month had passed, and so had the lawyer visit where they’d decided Satsuki’s fate. Ryuko recalled flinching with each box they’d ticked off on the checklist. No CPR. No breathing machines. No medications to increase her blood pressure should it drop dangerously low. No measures that would artificially increase or maintain her life. Everything in Ryuko’s being screamed at her to convince her sister otherwise, but she knew it would be selfish to even try.
Tick.
Another two months had passed. Satsuki’s condition was rapidly deteriorating, much more quickly than anyone had anticipated. Due to the ever increasing hardening of her skin, she now required assistance with all of her daily tasks. The only unaffected joints wer her hips, meaning she had limited mobility, but the debilitation to her fingers and toes meant almost no fine motor skills remained, nor did her balance. Ryuko hated that she secretly liked Satsuki being totally dependent on her, as these were the only memories that would remain in her untimely death, despite the fact that the circumstances around the time spent together were shitty, to say the least.
Tick.
Three months flew by. Satsuki had been hospitalized multiple times in the past 90 days as her disease flared up more and more frequently. She only wanted non-invasive treatments, but often consented to IV medications to ease the pain or attempt to manage her symptoms. Steroids seemed to help a minuscule amount, but only when given consistently. Ryuko managed to talk Satsuki into a PICC line, a long-term solution for administration of medications. Her sister’s skin had long since become too hard to pierce with a needle.
Tick.
One morning as Ryuko brewed a fresh pot of coffee, she noticed Satsuki staring intently at her computer. Watching her absentmindedly for a minute, Ryuko twirled the watch on her wrist around multiple times. Since Satsuki couldn’t type normally, she’d resorted to stiff one-finger typing. “Whatcha lookin’ at?” Ryuko inquired as she poured the coffee into two separate mugs. “Uhh,” Satsuki hesitated, which immediately piqued the shorter sibling’s attention. She plopped down on the couch next to her sister and tried to sneak a peek at the screen. Satsuki clumsily closed the laptop, but Ryuko’s eyes had managed to pick up one word: Switzerland. Putting the implication out of her mind, Ryuko lifted the mug to her lover’s lips, allowing her to sip instead of explain.
Tick.
Never having been one to lie down and take what life was throwing at her, Satsuki had been doing research on humane ways of ending her suffering. She’d briefly considered using the PICC line to inject something herself that would put her down, but there were multiple problems with this method, the first being that she didn’t have anything she could inject that wouldn’t be incredibly painful and the second being that she simply did not have the range of motion to even reach the medical device sutured into her left upper arm. Her elbows had lost their functionality long ago. The black haired girl knew it wouldn’t be long before she was bed bound in a perpetually frozen state as what little good tissue she had left was betrayed by her immune system. Even breathing was becoming more strenuous than she remembered. Just a bit longer.
Tick.
Another month was all it took for the remaining range of motion that Satsuki had to be obliterated. It was fairly obvious to Ryuko that Satsuki was miserable, though she never verbalized it. Confined to a wheelchair, body stuck in a semi-sitting position, she could barely enjoy the comfort of a bed at this time. Therefore she wasn’t surprised when Satsuki instructed her to bring her a folder that was stashed in the very back of the closet. Although she knew the time was rapidly approaching, that didn’t stop her heart rate from increasing at the thought of losing the one closest to her. Placing the folder in front of them on the bed, Ryuko opened it to reveal its contents.
Tick.
Numerous printouts filled the folder, some with maps and addresses, others with the names of facilities whose purposes appeared to be assisted suicide; the two girls’ passports were tucked away inside as well with folded pieces of papers bookmarked inside them. Without prompting, Ryuko pulled out the passports to peek at the papers tucked inside and was somewhat surprised to find plane tickets to Switzerland, scheduled for the next week, along with hotel reservation confirmations and copies of the dying girl’s medical records. The end is near. The thought hit Ryuko like a ton of bricks, knocking the wind out of her. She couldn’t help clutching at her chest in an attempt to steady her breathing, to stay grounded, to stay strong for her. “It’s ok,” came the soft voice of her sister attempting to comfort her. Ryuko looked at her and realized they both had tears in their eyes.
Tick.
They both broke down, Ryuko holding Satsuki as well as one could hold someone who was stiff as a board. They cried for an hour, until the sobs died down, the tears dried up, the noses stopped running. A deep silence fell afterwards as they simply savored each other’s presence, listening to their steady heartbeats that seemed to sync and beat as one. Slumber consumed them, leaving the papers forgotten, strewn across the bed, and delaying the conversation neither of them particularly wanted to have. Both girls were fine with that in this moment.
Tick.
Ryuko woke with a crick in her neck from sleeping sitting up all night, but it was the only way she could hold her partner comfortably. Not that I mind, anyway. Gotta get as much time in with her as I can before she...before she di-- is gone. Ryuko didn’t like to think about any word that implied death, despite the fact that it was rapidly approaching for the other half of her heart.
Tick.
Three days went by. Today was the scheduled goodbye party. It had been Satsuki’s idea to call it that. She’d been chuckling about the name all day despite its morbid connotation. In fact, her mood the past few days had been much improved. It warmed Ryuko’s heart to see her smiling again and hear her laugh. Things almost felt normal, like they’d jumped back three years in time before all this had happened (except for the fact that Satsuki could no longer move, of course). The party went by smoothly mostly due to Satsuki’s cheerful disposition throughout its entirety. All of her friends had shown up looking dismal and teary eyed, but now had tears of laughter streaming down their faces as they reminisced about the years of friendship they’d shared. Ryuko acted as hostess, making sure everyone was adequately fed and hydrated and maybe even inebriated. The night ended with a mix of melancholy and nostalgia as her friends hugged her one last time, sad tears resurfacing once again. The goodbyes stretched on for another hour as nobody was quite ready to accept the untimely death of their friend, leader, comrade. When the house was finally devoid of her found family, Satsuki requested to be wheeled into their bedroom while Ryuko tidied up. Ryuko did as asked before cleaning the dishes and cups and half-eaten food from the living room. When she finished for the night a half hour later and ambled into the bedroom, she found Satsuki crying in the wheelchair beside the bed. The stronger sibling hoisted her debilitated sister out of the chair and into the bed and held her, rocking her tightly. Looking down at her lover’s face, she was only half surprised to see that she was crying with happiness.
Tick.
Ryuko checked her watch for the fiftieth time during the flight. She’d been jiggling her leg impatiently for what seemed like three hours straight. Satsuki had slept through the majority of the twelve hour flight, but Ryuko had too much on her mind to keep her eyes closed. Only one more hour, she thought, dread drowning out the feeling of elation at the thought of finally getting off the god forsaken plane. Too much turbulence for her liking. It was a smoother ride when I flew to fuckin’ space with Senketsu for fuck’s sake.
Tick.
The taxi, as Satsuki had referred to it for the past week, was actually a large limo and Ryuko was surprised that she hadn’t actually expected it. It transported them to the hotel they’d be staying at, a mere half a block away from the facility where Satsuki would be meeting her untimely end. Everything had been set up months in advance, as organized as Satsuki was. The appointment was tomorrow morning at 8:15, a mere eight hours away. The women cuddled on the bed, talking about anything and everything. Many sentences and stories were punctuated by soft “I love you’s” and tender kisses. They finally drifted off around 3:30, five hours before the appointment.
Tick, tick, tick, tick.
Ryuko shot awake, suddenly alert. Something’s wrong! Her mind screamed at her. Scrambling sideways towards the lamp, her gaze flit across the bedside clock, registering 6:19. Fingers fumbled with the lamp in the dark, finally managing to push the button. A hiss escaped her throat as light flooded the room, causing her eyes to water as she squinted. Beside her, she could see that Satsuki was gasping for breath, eyes panicked and abdomen feebly attempting to move air in and out of her lungs. “Fuck!” Ryuko cursed, unsure of what to do. “Do you want me to call emergency services? They can’t do shit though because of the DNR. Tell me what to do!” Think! She’s not breathing right. Help her, duh! Springing forward, she grabbed Satsuki’s chin in one hand, plugged her nose with the other, and began breathing steady breaths into her sister’s mouth. The doctor’s words echoed through her mind: “ Once it hit’s her breathing muscles, she will be dependent on a machine to breathe for her and likely will not ever be able to come off of it.” God, sis, you really have some shitty timing! You couldn’t wait two hours when we were at the death and dying place?! The blueness around Satsuki’s lips was disappearing as she was oxygenated by her sister’s breaths, but both of them knew she wouldn’t be able to keep this up for two more hours. Between breaths, Ryuko asked questions, trying to determine their next move.
“I could call an ambulance, they could come breathe for you until it’s time for the appointment?” A small head shake indicating no. Breath. “I read the paperwork like you asked, do you think you’d be able to swallow the medicine in two minutes in this state?” Another no. Breath. “No emergency services, assisted death place is out of the question too.” A weak nod. Breath. “The only other option is for me to...to stop breathing for you and let you p-pass on your own.” A somber nod. Breath. “Is that what you want? Me to stop and just let you die?” Ryuko was starting to panic. "You want me to do that?” Breath. Nod. Satsuki’s eyes flicked to her bag on the bedside table and back multiple times. “Something’s in the bag?” Ryuko guessed after another breath. “Yes,” Satsuki replied softly with her borrowed breath. Leaning forward, the younger woman grabbed the bag and dug around until she found a white box, about the size of a smartphone box, with the words “In case of Emergency” scrawled on top in Iori’s characteristic handwriting. She tossed the bag aside and gave another breath to Satsuki before yanking the top off. Inside was a handwritten note and a syringe filled with a clear substance. Panicked eyes perused the note as quickly as possible. It was a set of instructions should the worst happen. Yeah, it is fucking happening, and at the worst time ever! She went on to read:
This medication is similar to the medication that would have been ingested at the assisted suicide facility. In case of emergency, where it becomes impossible to make it to the facility in time for the appointment, this medication can be injected into the PICC line in the arm. Simply pull the cap off the end of the syringe, twist it onto the port of the PICC line, and push the medication in over 1 minute. She will quickly fall asleep within five minutes and should not wake up after, though death may take longer to occur. This is normal. Do not worry about consent, she asked me specifically to make this backup plan for her, though I hope she won’t need it.
She gave Satsuki a few simultaneous breaths, as it had taken a bit to read the note. Finally, the implication set in. “You want me to kill you?” Satsuki’s eyes took on a pained look. She desperately wanted to tell her sister so much, that she wanted to spend the rest of their lives together, to make her happy until they grew old and gray. Instead, with the breaths Ryuko supplied, she was able to say, “You’re not killing me…the disease is....you’re saving me from...a painful, scary death...I love you but....I can’t survive anymore…let me die peacefully and pain free…I’m sorry it came to this....but don’t feel guilty....it’d be a greater disservice to prolong this....anymore than you have....I’m ready, Ryuko, I love you.” If she was surprised to feel her sister’s teardrops landing on her face, Satsuki didn’t show it. Instead, she put on a brave face as a means of encouraging Ryuko. The capable sibling sobbed as she twisted the syringe into the port in her sister’s arm. Supplying one last breath, Ryuko began pushing the plunger of the syringe in slowly as instructed. Gathering her wits, she was struck with the sudden thought that the next five minutes was her last chance to say what she needed to say. “Babe, I’m gonna miss you so much and I wish we could have had more time together but I wouldn’t trade the last ten years with you for anything.” She stopped to breathe for both herself and Satsuki before continuing, thumb ever slowly pushing the medication into her sister’s arm. “I really wish that I could find the words to tell you how much I love you and care for you and hic I’m not ready for this but I never really would have been." Another sob broke from her as the plunger stopped moving, indicating the medication was completely administered.
Satsuki looked up at her sister with tears in her own eyes and a look of adoring tenderness adorning her face. Ryuko breathed for Satsuki again before hoisting her upwards into her arms and holding her against her chest. She stroked her hardened cheek and back, peppering her neck and face with sloppy kisses mixed with tears. Satsuki’s eyes were already closing, causing Ryuko’s comforting measures to increase in fervor. She pulled back just in time to notice Satsuki mouth “I love you” one last time before becoming unresponsive. The first look of true peace that Ryuko had observed on her sister’s face in a long time graced her features as her body relaxed as much as her thickened skin would allow it. She knew that the medication coupled with the fact that she was not breathing on her own would hasten the dying process. Not moving from her spot, Ryuko rocked herself and her sister for a long time, even after the pulse in the older sibling’s neck had long since stopped. Silence filled the room, and it took Ryuko a minute to realize that she no longer heard the ticking of the watch given to her by Satsuki all those years ago. Glancing at her watch, she found that the hands had stopped moving, permanently marking the time of Satsuki’s death. Ryuko bawled.
Years later, Ryuko visits the grave of her late lover. The visits never get easier, but Ryuko makes appearances there regularly enough. Squatting in front of the grave, she runs her fingers of the engravings denoting the name she now has trouble speaking without feeling a twinge in her chest. Her sleeve slides down as she lifts her arm to retrace the symbols, revealing the useless watch still adorning her wrist, a constant reminder of the death of her lover and the lingering guilt remaining for her part in the act. Hastily adjusting the sleeve, she covers the watch once more. This is the last time I’ll be visiting you here, sis. I’ll be joining you soon. Filled with peace, Ryuko stands and revels in the light breeze that sends cherry blossom petals cascading down around her. It won’t be long now. As she is walking out of the cemetery, each step is accompanied by a sound from her pocket of a few remaining pills, rattling in a newly nearly-emptied bottle.