The hospital in Queens was a monolith of beige brick and flickering fluorescents, squatting on a corner of Jamaica Avenue like a tired sentinel.
It was late January 2025, a Wednesday night just past 10 p.m., and the emergency room smelled of antiseptic and despair—sharp, sterile, undercut by the faint tang of vomit from a drunk slumped in a plastic chair across the waiting area.
Britney Germanotta stood by the double doors leading to the triage bays, her arms crossed tight over her leather jacket, her boots scuffing the linoleum floor.
Her dark hair hung loose, tangled from the wind outside, and her green eyes were bloodshot, fixed on the doors as if she could will them to open.
She hadn't slept, hadn't eaten since breakfast, and her stomach churned with a nausea she couldn't name—fear, mostly, though she'd never admit it.
Alton Bieber was back there, somewhere beyond those doors, and she didn't know if he was okay.
The thought clawed at her, a jagged thing she couldn't shake. It had started hours ago, back in his Bronx apartment—their sanctuary, their painted haven.
They'd been sprawled on the mattress, her sketching the curve of his guitar propped against the wall, him strumming a new riff, his voice low and playful as he teased her about her crooked lines.
Then he'd coughed—harder than usual, a wet, rattling sound that made her pencil freeze.
He'd waved it off, like always, muttering something about "damn cold," but then he'd doubled over, clutching his chest, and blood had speckled his lips, bright red against his pale skin.
"Alton?" she'd said, her voice sharp, dropping the sketchbook.
He'd tried to stand, to brush it off, but his legs buckled, and he'd hit the floor, gasping, more blood staining his T-shirt.
She'd screamed his name, panic seizing her, and scrambled for her phone, dialing 911 with shaking hands.
The ambulance had come fast—too fast, sirens slicing through the night—and now here she was, waiting, the memory of his shallow breaths looping in her head like a broken record.
The waiting room was a purgatory of noise and stillness—beeping monitors, a nurse calling out names, a TV bolted to the wall droning some late-night infomercial about kitchen knives.
Britney paced, her boots leaving faint smudges on the floor, her mind racing. He'd been coughing for weeks—dry at first, then deeper, a rasp he'd dismissed as "nothing" or "just smoke from the diner."
She'd let it slide, too caught up in their bubble—their songs, their art, their nights tangled under that thin blanket—to push.
Now she cursed herself, her nails digging into her palms. She should've made him see a doctor, should've dragged him here herself.
But Alton was stubborn, and she was scared, and they'd both pretended the cracks weren't there.
The doors swung open, and a nurse in blue scrubs stepped out, clipboard in hand. "Bieber?" she called, her voice clipped, tired.
Britney lunged forward, nearly tripping over her own feet. "That's me—him, I mean. Alton Bieber. Is he okay?"
The nurse glanced at her, assessing—seventeen, wild-eyed, no ring on her finger. "You family?"
"Yes," Britney lied, the word out before she could think. "Girlfriend. Close enough. Please."
The nurse hesitated, then nodded. "He's stable. Doctor's with him now. You can see him soon—just wait here."
She turned back through the doors, leaving Britney with a hollow relief that didn't reach her bones.
Stable. It wasn't enough. She sank into a chair, her knees weak, and pulled her sketchbook from her bag, flipping it open to a blank page.
Her hands shook as she started to draw—Alton's face, his eyes half-closed like when he sang, his lips curved in that crooked grin.
The pencil scratched fast, messy, a lifeline to keep her from falling apart. She didn't notice the tears until they hit the paper, smudging the charcoal into a blur.
An hour later—maybe two, time was a smear—the doors opened again, and a doctor stepped out, a middle-aged man with graying hair and a stethoscope slung around his neck. "Miss…?"
"Germanotta," she said, standing, shoving the sketchbook under her arm. "Britney. How is he?"
"He's awake," the doctor said, his tone measured, too calm. "We've got him on oxygen for now. He had a severe hemoptysis—coughing up blood. We've run some tests—chest X-ray, blood work. Looks like a lung issue, possibly serious. We're waiting on a specialist to confirm."
Her stomach twisted, the words landing like stones. "Serious how?"
The doctor sighed, rubbing his temple. "Could be an infection, could be something chronic—COPD, maybe, or worse. He's young, but he's got signs of damage—scarring, inflammation. Does he smoke? Work around chemicals?"
"No," she said, then faltered. "Not now. His dad smoked—chain-smoked, he said. Around him all the time growing up. Could that…?"
"Secondhand smoke can do a number," the doctor said, nodding. "We'll know more soon. You can see him now—Room 12. Keep it short; he needs rest."
She didn't wait for more, pushing past him through the doors, her boots echoing down the hall.
The triage bays were a maze of curtains and carts, the air thick with beeps and murmurs. Room 12 was near the end, a small space with a bed, a monitor, and Alton—pale, shirtless, an oxygen mask fogging over his mouth.
His eyes flicked to her as she stepped in, and he pulled the mask down, managing a weak grin.
"Hey," he rasped, his voice like gravel. "You look like shit."
She laughed, a broken sound, and dropped into the chair beside him, her bag hitting the floor.
"You're one to talk." She reached for his hand, his fingers cold but steady, and squeezed. "What the fuck, Alton? You scared me."
"Sorry," he said, his grin fading. "Didn't mean to. Just… happened."
"They're saying it's your lungs," she said, her voice trembling. "Tests and shit. You've been coughing forever—why didn't you say something?"
He shrugged, wincing as the movement tugged at the IV in his arm. "Thought it was nothing. Cold, allergies. Didn't wanna worry you."
"Too late," she snapped, but there was no heat in it—just fear, spilling over. She leaned closer, her forehead brushing his shoulder, the hospital gown scratchy against her skin. "You can't do this. You can't just—fall apart on me."
"I'm not," he said, his hand tightening on hers. "I'm fine. They'll fix it—pills or whatever. Don't freak out."
She wanted to believe him, wanted to cling to that stubborn tilt of his chin, but the blood on his shirt—still crumpled on a tray nearby—stared back at her, a red accusation.
She pulled her sketchbook out, flipping to a fresh page, and started drawing him again—here, now, the mask dangling, the tubes snaking from his arm.
Her lines were shaky, urgent, tracing the hollows under his eyes, the way his chest rose too shallow.
"Don't," he said, watching her. "Not like this."
"Shut up," she muttered, her pencil moving faster. "I draw what I see."
He sighed, a faint wheeze in it, and let her work. The monitor beeped steady, a lifeline she clung to, and she finished the sketch—him, fragile but fierce, a fighter even now. She tore it out, folding it into his hand.
"Keep it," she said. "So you remember you're still you."
He looked at it, his throat bobbing, and tucked it under the blanket.
"Thanks," he whispered, then coughed again—lighter this time, but it made her flinch. "Don't tell anyone, okay? Not Tara, not Jamal. I don't want—pity."
She nodded, her jaw tight. "Okay."
They sat there, her hand in his, the hospital humming around them—nurses' footsteps, a cart rattling, a distant sob from another room.
She didn't leave when the nurse came to check his vitals, didn't budge when the doctor returned with more questions.
They kept him overnight, then another, moving him to a room upstairs, a narrow space with a window overlooking the snowy street.
Britney stayed, sleeping in a chair that dug into her back, her sketchbook open on her lap.
She drew the view—snow piling on cars, streetlights cutting through the dark—then him again, over and over, like she could pin him here, keep him whole.
The specialist came on Friday, a wiry woman with sharp eyes and a clipboard thick with notes.
She spoke in clipped terms—idiopathic pulmonary fibrosis, rare, aggressive, scarring from chronic exposure—words that blurred into a roar in Britney's ears.
Alton's face stayed blank, his hand gripping hers under the blanket, but she saw the flicker in his eyes—fear, buried deep.
The doctor said more—biopsy to confirm, treatment options limited, prognosis uncertain—but it boiled down to this: his lungs were failing, had been for years, likely from his father's smoke seeping into his childhood, and there was no cure, only management, only time.
"How long?" Britney asked, her voice a thread, when the doctor paused.
"Hard to say," the woman replied, softer now. "Months, maybe a year. Could be more with luck and care. We'll know after the biopsy."
Alton didn't speak, just stared at the ceiling, his jaw clenched. The doctor left, promising updates, and the room sank into silence, heavy as the snow outside.
Britney turned to him, her eyes burning. "You heard her," she said, fierce. "Months, maybe more. You're not done. We're not done."
He looked at her, his grin faint, forced. "Yeah," he said, but his voice cracked, and she saw the lie.
He was scared—terrified—and so was she, but they didn't say it. They couldn't.
She climbed onto the bed, curling against him despite the nurse's rules, her head on his chest, careful of the tubes.
His heartbeat was steady, a drum she memorized, and he wrapped an arm around her, his fingers tracing her spine like always.
"We'll fight it," she whispered, her voice fierce. "You're not leaving me."
"Not planning to," he murmured, kissing her hair, but the cough came again, a reminder they couldn't paint over.
They stayed like that, tangled in the narrow bed, the hospital a cold cocoon around them.
She drew him sleeping that night, his face slack, the oxygen mask fogging, and slipped the sketch under his pillow—a talisman, a plea.
The shadow had emerged, stark and unyielding, and their sanctuary trembled under its weight.
But they held on, desperate, defiant, love their only weapon against the dark.
And the dark, patient as ever, watched.