“Julian,” he mouthed with a raspy whisper, breaking into a fit of coughing.

 “Try not to talk too much, James. Use your signs.” He let go of Gretchen’s hand to walk to his brother’s bedside. He scooped up James’s clenched fist and patted it. Both the boys had learned sign language when they were young to help James communicate without speaking. It was helpful when the tracheostomy made it that much more difficult for him to speak. “Mom says you’re having trouble breathing. Have you been sneaking pot again?”

 His brother smiled at his joke and shook his head. “Can’t get any. Mean nurses,” he signed. James took a few rattling, wheezing lungfuls of air through the tracheostomy tube in his throat, making Julian more worried the longer he stood there.

 Most people with a tracheostomy could speak by covering the tube with their finger or chin. Because James had such limited control of his hands and arms, that hadn’t been an option for him. Instead, they’d adjusted the valve in his windpipe so he could get just enough air to whisper between breaths. Even then, his speech was limited by muscle control in his throat and face. He tended to sign most of the time to get his point across, but occasionally, he’d speak a few words. It had never taken much for Julian to understand him. They were identical twins; Julian knew his brother inside and out. He just couldn’t help him.

 “James, this is my friend Gretchen. She wanted to meet you.”

 James’s head was almost always cocked unnaturally to the side with a pillow supporting his neck, but his gaze traveled past his brother to Gretchen. His left arm was drawn to his chest, but he waved his fingers at her. “Pretty,” he signed.

 “Yes, she is. She’s very pretty.”

 “I’d hit that,” James whispered with a smile.

 Julian and Gretchen both broke into unexpected laughter. Despite everything, James always had a sense of humor. Whatever trauma that had impacted his ability to control his body had left his cognitive powers intact. He was smart and funny, and it made Julian sad that the world would miss out on what James could’ve done if he’d been born healthy like his brother.

 “Uh, thank you, James,” she said, blushing at his amusing compliment. “How are you feeling?”

 James shrugged. His brother probably didn’t know what it was like to feel good. He had okay days and bad days, but even his best days could be hard on him. Those were the days when he felt well enough to think about how he was trapped in a body that couldn’t do what he wanted it to do.

 A loud, wheezing breath rattled through James’s trach tube, but it was quickly drowned out by a shrill beeping noise that sounded from the machine by James’s bed. Julian looked up, noting that the blood oxygen percentage on the screen was blinking red.

 The nurse came in a second later, checking the screens. “You two will have to leave. We’ve got to get the ventilator hooked up.”

 Two other nurses and a resident came in behind her, and Julian was pushed out into the hallway with Gretchen. As he watched them work on his brother, Julian realized that his fantasies of doing serious films were just that—fantasies. Hard-hitting, low-budget indie films might reap all the awards and get the buzz at Sundance, but they wouldn’t pay these bills. They wouldn’t cover charter flights to Europe for experimental treatments. Giving James the absolute best quality of life was his number one priority. His vanity and his artistic needs would always take second place to that.

 “We’d better go,” Gretchen said, tugging at his arm.

 Reluctantly, he followed her out of the ICU, dreading the news he’d have to share with his mother in the waiting room. The woman hadn’t gotten a stitch of good news in almost thirty years. He hated to pile more on top of it.

 But he knew that with the news would be his promise that he’d take care of it. Just as he always had. And always would.

 * * *

 They stumbled into a Louisville hotel room near the hospital at almost three in the morning. Gretchen was exhausted down to her bones, and yet too much had happened for her to sleep anytime soon. She could tell Julian was feeling the same way after how he’d paced in the hotel lobby while they got a room. Even if they went straight to bed, they’d both likely lie there with their brains spinning.

 Gretchen flipped on the lights of their suite, revealing a tasteful and modern room. It had a separate sitting area from the bedroom, like Julian’s room in Nashville. He carried her bag into the bedroom and laid it out on the bed. They’d left in such a rush, he didn’t have a bag of his own. All he’d had was a small leather travel case he’d taken with him to the wedding chapel with things he might need throughout the day.

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