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"Carl, as your friend, I wanted to avoid some of the formalities of this conversation," the doctor spoke curtly, his normally stoic presentation now marred by visible tension in his shoulders and wrinkles on his brow as each word followed behind the closed exam room door.
The diagnosis hit Carl like a brick, too stunned to really process what he was hearing. He felt as if the news suddenly materialized in his head, his sick, sick head.
"Tim, how?" Carl spoke. "I'm only 47. That's an old man's disease."
"It doesn't have rules. It's most commonly seen in people over 60, but 47 isn't impossible."
"But I'm only 47."
Tim winced, hoping Carl's repetition stemmed from shock rather than the disease manifesting now.
"There's still more tests to run. But everything so far looks like it. The last few tests generally just confirm it, not deny it."
Carl was silent.
"Carl, we can't predict it, but... it tends to be more aggressive when it shows up early like this... I wanted to tell you before Maryanne left. I know you said she was visiting her sister for a bit." Tim paused. "I didn't want you to... be alone with this information."
They sat quietly for several moments. They had known each other since they were kids. Carl had been there for every milestone, and vice versa, but when Tim began his career in medicine he hadn't thought of the weight of treating a loved one with such a horrible disease. It was easy, he thought, to treat a terminal stranger. But suddenly, looking at his friend, he felt like it was his first day in med school again, reading impossible Latin words in heavy, monotonous textbooks.
The two parted as impromptly as the appointment had been scheduled. Carl sat in his car now, staring blankly at the road ahead through the stop and go traffic of road construction. Some time earlier - days? Weeks? - he had scheduled an appointment to discuss his memory and mood, chalking their changes up to stress. His, company, after all, was venturing into bold, new, and increasingly demanding, but lucrative, projects.
"Twenty five years slaving to that business just to end up shitting in a diaper before I'm even fifty," he scoffed.
The car behind Carl honked gently. He hadn't noticed that traffic moved without him, now feeling similarly about his life. The twenty minute ride into the city took over an hour in the present conditions, and an hour was far too long to consider his immediate options. Perhaps he wouldn't tell Maryanne at all. Perhaps he could find a more dignified out before soiled briefs-
"No no," he thought.
Be it denial or resilience, he wasn't sure, but he wasn't willing to let his thoughts wander so darkly. He wouldn't tell Maryanne just yet, he concluded. She would go on her trip and he would have two weeks to determine a solution, or, if he was lucky, wake up from his nightmare. By the end of his commute, he had tricked himself into thinking none of it was real, but the facade didn't last. When he closed his eyes that night, he could only think of how many years he had spent under the guise that tomorrow was always promised. He was angry and confused, and his unrest only increased as he doubted the validity of those emotions... were they simply his diagnosis?
By nature, Carl was a stern man. He wasn't one to show emotions, and an ear to ear grin was considered boisterous by his peers. He was a mechanical, brilliant man of calculated reactions with thinning hair and a nondescript physique. It was typically easy for him to retreat into his fleeting mind, secretly hidden in his despair. And, thankfully, Maryanne was too preoccupied with worry about last minute essentials for her trip. She stressed about logistics and travel in general, and he, no different than normal, opened and closed the doors for her, carried her suitcase to the counter at the airport queue, and kissed her lightly on the cheek goodbye.
Upon returning home, Pixie, Maryanne's half-deaf senior yorkie, trotted eagerly to greet her only to be sorely disappointed upon seeing Carl. Carl had never harmed the dog, but she was simply not fond of him so the two merely coexisted. He frowned, yearning for any degree of comfort, but Pixie huffed in displeasure before returning to her prior activities. For the first time in a long time, Carl openly wept.

That night, Carl's eyes squeezed shut with a grimace. Unrest and exhaustion whirled through his thoughts when he was suddenly annoyed and concerned by a noise unlike one that Pixie could conjure. A whisper? A slither? He was unsure. Was it his pulse rushing behind his swollen eyes? Where even was it coming from? He got up to investigate, his flat feet radiating the cold of the floor through his pale legs as the sound traveled further into the darkness of his home.
He wasn't exactly afraid of what it could be, it just didn't sound like a good thing to hear; thus, he briefly contemplated what he could use as a weapon. Even more briefly, he considered that this possible intruder could be his scapegoat, granting him the escape from the short future he refused to acknowledge. But, searching his expansive house, he could find nothing. And everything was silent once again.
He paused to pour himself a glass of liquor in the darkness of the study. He stared indiscriminately at the bar countertop and examined the flecks in the granite while he sipped the amber fluid. Carl swirled the last of his drink in the ice and contemplated a second glass. He pushed his chair back to stand but stopped to listen when the noise returned. It was raspy breathing now, and it had crept up directly behind him.
"Don't look," the low, gravelly whisper interrupted him as he turned his body.
"What do you want?" Carl questioned factually, abruptly stilling his body movement.
"That depends what you want."
"Quit playing games," Carl commanded, twisting the chair to stand and face the intruder.
"DON'T. LOOK." The whisper turned to a growl and Carl felt a firm grasp on the back of his neck. The digits were cold and leathery and clicked at their joints.
Carl was silent and still, replaying its inhuman pitch in his mind.
"Close your eyes."
He begrudgingly obeyed, and in response the intruder wheezed softly for a moment before sliding something across the counter in front of Carl. Carl could smell its stale breath as it moved near him.
"Look now."
Carl eyed the hand mirror that had been placed before him and quickly held it up to scan behind him.
"There." The voice interjected as the mirror revealed half of Carl's face. The rest of the mirror was filled with darkness.
"Where are you?"
"Look there. Don't you see me?"
Before Carl could answer, he noticed two pinpoints of pale light like distant stars, flickering and waning constantly. They were so faint they'd disappear if you looked right at them. Predatory beacons, staring back at Carl in the reflection.
"What are you?" Carl stammered.
"An option. An answer."
Carl strained his eyes to see the face in the void, but in the shadows of his home, he could only see those cold, faded lights looking back. They blinked at him slowly and indifferently, now slightly brighter, and Carl thought about what it had just told him with such factual indifference.
"An answer?" Carl thought, stiffening his body as he felt the thing move closer to him.
There was silence, but at long last it responded, "yes."
"How?" Carl spoke in half a whisper, knowing that things like this came with a cost and purposely ignoring that his previous question had only been a thought, never an audible statement.
Although he could only see two specks of light, he could feel that it now smiled cruelly at him, a menacing grin full of needle teeth. The eyes stepped back so that they were completely concealed in the darkness. Carl could hear it shift in the shadows, and it whimpered, hissed, and grunted lightly. It was struggling with something out of sight. It sounded as if it were in pain.
Crrrrrack, a wet, hollow sound. "Close your eyes," it commanded again.
Cautiously, he did as he was told and felt his body tense as he listened to a wriggling noise. When Carl opened his eyes he jumped. A chiton appendage twitched in front of him on the counter, sparkling like polished obsidian in its thick coating of translucent mucus. Carl flinched his eyes shut again. Realizing that despite his denial, it was still there writhing and bubbling, he forced his eyes open and found that the spine had melted, leaving only a familiar kitchen knife and a sizzling mess in its place.
"The mirror."
Carl snatched the mirror, stealing a fleeting glimpse of several stilted legs and a multitude of shining eyes.
"Blood," it spoke slowly, once again hidden by the shadows. "Gratitude is paid in blood."

The house practically glowed. Carl had ran through the house turning on as many lights as possible as soon as the conversation with the thing in the void ended and returned to his study. The last several weeks, everything was an ephemeral blur of emotions and doubt, and tonight exemplified such. The bottle of whiskey perched beside him, he had disregarded the effort of a glass, and he carefully examined the kitchen knife while the world spun behind the warmth of intoxication.
Blood... it spoke so cryptically but he was sure what it meant. It had also so graciously assured him that this time it didn't have to be anything grand, that it would accept a small offering. Did it though? Or did that clarification just materialize in his mind? He didn't want to think of that. He shivered as he thought of the implication behind "this time," It would want more, surely.
Disturbed by Carl's antics to illuminate the house, Pixie trembled on her exaggerated arrangement of pillows and blankets in the corner of the study. She never spent much time in here, it was Carl's space, and she was practically glued to Maryanne's hip. Carl set the knife onto the bar counter and peered out the wall of windows beside him. He reminisced about the day he brought Pixie home.
They had always wanted kids. They fell pregnant easily, sure that the conception occurred on their honeymoon 26 years earlier. Seven months into the pregnancy, Maryanne had been struck by a drunk driver and the child was lost... both of them were nearly lost. But a casualty of saving her life left her barren. They quietly grieved the baby for many years, and, when that tragedy found as much peace as it possibly could in their hearts, they grieved the loss of future children too. But it was never mentioned again.
Fourteen years later, Carl had thought that something small and warm would do Maryanne well, and he couldn't have been more correct when he surprised her with a cardboard box with conspicuous holes on the sides. She fell in love with the pup immediately, and Pixie had so much love to reciprocate. It wasn't the awkward steps of a toddler through the house, but the scamper of little paws. It would do.
"She's 14," Carl thought, "and I'm 47. I- I can make it up to Maryanne. I can tell her it was an accident, and I can- I can get her a new puppy. I'm only 47... Pixie- Pixie, I can't leave Maryanne. She's suffered enough. But..." he paused, considering where reality fell only briefly.
He turned to face her and stared silently. The dog quivered and cowed its head.
"I'm sorry," he stated flatly as he plucked the knife from the counter.

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