Valicia Starks leaned over her son, kissed him four times and held his hand to her cheek as he continued clinging to life on Thursday.

Terrell Starks -- whose 24th birthday is Friday -- now sleeps almost all the time. His football-sized heart beats so fast he shakes. His quick breathing is filled with gurgles and squeaks. Sickle cell disease is taking its final toll.

The hospice nurses have increased Terrell's pain medications significantly to keep him as comfortable as possible, yet he still feels pain so severe it makes him wince.

"I never thought it would come to this; I didn't," Valicia said, referring to pain breaking through all attempts to ease it.

Carolyn Cappiello, a nurse with Hosparus, said children and young adults have strong bodies that want to fight, and pain medications often don't work the same way on them that they do on older people. Plus, she said, she could tell Terrell's spirit is fighting as strong as his body.

"He's a very strong young man. He's a tough, tough kid," Cappiello told his parents. "You raised a good boy."

At one point, Terrell's father, Carl, sat down next to his son and stroked his head. Terrell had a rare lucid moment, asking him, in a weak voice, what he ate for breakfast.

When Terrell drifted back to sleep, Valicia confided to Carl: "That's his problem. He's worried about you and me."

Valicia said she doesn't want Terrell to worry; she just wants him to feel less pain. And she wants him to know she will be with him until the end.

As she curled near his pillow, she put her hand on his face and told him: "I'm right here, Rell, OK?"

And as she administered yet another dose of pain medicine, she said she loved him.

Eyes closed, Terrell mustered enough strength to reply:

"I love you, too."

(Photo by Sam Upshaw, Jr.)