Terrell Sparks turned in his bed Friday to look at two pink roses.
"Happy birthday from the hospice team," read the card.
Terrell turned 24 as sickle cell disease continued taking its final toll on his body. Despite high doses of painkillers, he was still suffering. Every once in a while, his body made jerking motions that a Hosparus nurse said might be related to his many medications. Sweat covered his face as his temperature spiked to 101.2 degrees.
"Terrell," his mother Valicia said, leaning close to his ear, "Mama's gonna give you some liquid Tylenol. You've got another fever."
The family's miniature dachshund, Ozzy, cried to get up in bed with Terrell and snuggle with him like they used to. But Valicia and Carl won't let the dog do that anymore. So family friend Donna Morrissette lifted Ozzy up and held him in her lap so he could see his buddy. The dog immediately stopped crying and just watched Terrell protectively.
"Oh my baby..." Valicia murmured.
Later, Carl caressed his son's arm.
"I try to be a pillar of strength for my family, but I only got so much," he said. "For him to still be here, all I see is his determination to live."
Valicia said she knows he doesn't have much time in this world, and she wants him to go in peace.
"If he could leave this world without feeling any pain," she said to the nurse, "that would be beautiful."
(Photo by Sam Upshaw, Jr.)
Laura Ungar has been the Courier-Journal's medical writer since 2004. Major projects have examined Kentucky's poor health, black lung disease, cervical cancer in India and the health insurance crisis among America's middle class. You can follow her series on 
Sam Upshaw, 46, of Louisville, has been a photographer with The Courier-Journal for 22 years. In addition to covering the community on a daily basis, he has visually documented Muhammad Ali, Kentucky's poor health, the University of Louisville's win at the Orange Bowl in Miami and Hurricane Ivan in Florida. Spending time with Terrell, he is inspired by the young man's strength and wisdom, which helps put life's little inconveniences in perspective.
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