Open-heart surgery.
Three daunting words for anyone, much less a seven-year old boy, but they were all Sam Winchester could think about as he lay on the gurney, waiting to be taken into the operating room.
Staring up at the fiberglass tiles and fluorescent bars in the ceiling, Sam tried to be brave; he really did, even while he shook with fear.
"Hey, kid," a soft voice startled the boy and he lifted his head off his flattened hospital pillow, trying to find who had just spoken.
"Over here," the voice spoke again and Sam turned his head to the left to see a girl a few years older than him- about fourteen or fifteen- in the bed next to his.
"Hi," she said with a smile.
Sam tried to return the gesture but he couldn't manage it. He wished his Dad and Dean were here with him but Dr. Thomas had made them stay out. They wouldn't be able to see him until after the operation.
"What's your name?" the girl asked quietly.
"Sam," the boy replied.
The girl reached out one thin hand, "I'm Vivian. But my friends call me Viv."
The seven-year old reached out his hand and placed it into Viv's chilly one. The teen had a pale, narrow face with dark circles beneath chocolate brown eyes. She had no eyebrows and no hair; her bald scalp marked where the surgeon would cut into her skull.
"What are you in here for?" Viv asked, still holding onto Sam's hand tightly, offering him what comfort she could.
"A broken heart," Sam told her.
Viv smiled and squeezed the boy's hand.
"You've got nothing to worry about, Sam," she assured him, "I know it's scary but the doctors know what they're doing."
Sam nodded and put on a brave face. The door to the waiting room opened and Dr. Thomas and his nurses surrounded the boy.
"Ready Sam?" the cardiac surgeon asked, his face obscured by a green mask.
Sam nodded. The nurses began to push the gurney the boy lay on towards the door when the boy lifted his head to peer at the girl waiting her turn for surgery.
"Bye Viv!"
The teen waved back to him as the gurney was pushed through a set of double doors and into the operating room, "Catch you on the flip side!"
SPN
John Winchester felt his gaze being dragged up to the clock hanging on the opposite wall in the waiting room for the nth time since his youngest son had been taken into surgery. He knew Sam was in good hands and that Dr. Thomas knew what he was doing, but the thought of his son undergoing major surgery still terrified him.
The hunter let out a breath and leaned back in the uncomfortable orange plastic chair. They had waited a long time for Sam to be able to get this surgery and John knew that his son's quality of life would improve because of it.
At the tender age of two months old, Sammy had been rushed into the emergency room after displaying some frightening symptoms neither John nor Mary could explain.
For sixty days, the Winchesters had been growing increasingly confused and concerned about their youngest son's frequent fits of prolonged crying, irritability and shortness of breath that followed play or feeding. The infant did not seem to be gaining weight as rapidly as he should have been despite the fact that Mary fed him regularly. Then, the event that had the terrified parents rushing him into the doctor's office occurred one morning in late June.
Mary, home with both her sons, had been preparing breakfast for her eldest while her youngest sat in his highchair, burbling away happily. The mother didn't notice at first when her baby became quiet and with her back to the child, she did not see that anything was wrong. As she was turning to call Dean to the table, plate of pancakes in her hand, Mary's eyes fixed on her infant son slumped over in his highchair, eyes closed, a blue tinge to the skin around his mouth.
Within an hour, the infant had been swept into the waiting arms of nurses at Lawrence General Hospital and underwent at battery of tests to determine the cause for his loss of consciousness and cyanosis.
That very day the Winchesters returned home with the name of the congenital heart defect affecting their infant son.
Tetralogy of Fallot, a combination of four abnormalities of the heart causing a restriction of blood flow to the lungs, deoxygenated and oxygenated blood to combine, and thickening of the right ventricle muscle.
Since Sam was underweight and so young, the cardiologist the Winchesters were referred to, the same Dr. Thomas now performing surgery on the boy, advised the family to wait until the child was older before undergoing the procedure.
Nearly six years had passed since Sam had been diagnosed and was finally able to have the operation to repair the defects to his heart. The intervening years though had not been devoid of medical attention. Luckily, the boy had not experienced a loss of consciousness again but he did become short of breath after exercise or active play, his lips often taking on a purplish or bluish hue as a result. Sam, almost unconsciously squatted when he sat- which forced blood into his lungs and made breathing easier. John tried to ensure Sam saw his cardiologist once a year for his annual checkups, something the boy would need for the rest of his life, waiting patiently for the day he'd be able to have his surgery.
"Dad," Dean's voice drew John away from his thoughts and he peered at his eldest son, "I'm hungry, can we get something to eat?"
The hunter checked the clock on the wall and saw that a half-hour had passed sine he'd last looked at the time.
"Sure, Dean," John commented and stood.
The eleven-year old smiled, "Do you think Sammy will be hungry when he's out of surgery?"
"Probably," the father replied.
"Can we get him a chocolate bar?" Dean asked, "He'd like that."
John smiled, "I do too."
SPN
Consciousness washed over Sam in waves, the tide bringing with it an increasing sense of awareness.
Pain, dull but still very much real, was brought forth on those waves, as well as the sound of a steady beep beep beeping from somewhere close by.
He had no sense of time and so focused on the visceral experiences; the pain, the sounds, and the dryness in his mouth.
Swallowing, the seven-year old felt a ball of nausea form in the pit of his stomach and he groaned. Peeling his eyelids open, bright light spiked into eyes and he quickly closed them again, feeling even sicker to his stomach.
"D'n," he whimpered, seeking the comfort of his big brother.
SPN
"The surgery went very well," Dr. Thomas informed the two elder Winchesters, smiling.
"Can we see Sammy?" Dean asked, a MARS bar sticking out from the back pocket of his jeans.
"He's still recovering from the anesthesia but you'll be able to see him very soon," the cardiac surgeon assured the eleven-year old, "Let's give it half an hour to forty-five minutes, okay?"
Dean nodded and smiled, eager to see his brother.
SPN
Sam blinked and rolled his eyes to try and take in as much of the PACU as he could, realizing he was the only one inside.
Now mostly recovered from the anesthesia, the seven-year old was anxious to see his family.
The pain he had felt earlier was sharper though still not as intense as he had thought it would be. Carefully lifting the collar of his hospital gown, Sam saw white bandages in a line on his abdomen from just below his sternum to just above his navel. Curious, the boy picked at the edge of one of the gauze pieces and tried to pull it up to see the incision.
"Ready to move on?" a female voice asked and Sam looked up to see an older woman in a nurses' uniform.
The boy nodded and the nurse smiled.
"Good," she said, "There are some people outside who are looking forward to seeing you."
Reaching out, the nurse turned off the heart monitor and disconnected the wires from the sticky pads on the boy's chest- there would be another monitor in his room- and gripped the IV stand in one hand she began pushing the hospital bed with the other.
Remembering the girl who had spoken to him before he had gone into surgery, Sam asked the nurse if she had seen her.
"Sorry, Dear," the woman apologized, "I haven't seen her."
The end of the gurney shoved the double doors open and rolled out into the hallway.
"Sammy!" a familiar voice called and the boy struggled to pull himself up onto his elbows, wincing as the movement tugged at the fresh sutures on his chest.
"Dean!"
Suddenly his big brother was walking alongside the gurney, peering down at him. The eleven-year old reached out and gripped the younger boy's hand, careful to avoid touching the IV line.
"You made it! I knew you would," Dean crowed, "How're you feeling?"
"I wanna puke," the boy answered and his brother laughed.
"Wait 'til we get to your room," Dean chuckled.
SPN
John met his sons at the room where Sam would stay until his doctor was satisfied he had recovered enough to go home.
The father smiled as soon as he saw his youngest son awake and chatting with his brother as they entered the room. The nurse set the bed into place, reattached the wires to the stickers on the boy's abdomen and turned the machine on.
"Dr. Thomas will be in shortly," the nurse told them, "If you need anything just press the call button and a nurse will come."
John nodded, "Thanks."
Once the nurse had left, the father turned to his sons, "You did great, son. You weren't even scared."
Sam smiled slightly at his father's praise before he remembered the girl who had been with him before he had gone into surgery.
"I was scared," the seven-year old admitted, eyes cast downward, "But Viv helped me not be."
"Whose Viv?" Dean asked, now sitting on the mattress beside his brother, the better to be closer to his sibling. John took the chair set aside for visitors.
"She was having surgery too," Sam explained, "On her head. She held my hand… told me the doctors knew what to do."
Dean's face softened, "That was really nice of her, Sammy."
The little boy nodded, "I hope she's okay."
"Maybe we can ask," Dean suggested, "Right Dad?"
John nodded, "I don't see any harm in asking."
SPN
Sam was barely listening as Dr. Thomas explained about the painkillers that a nurse was putting into his IV line to help keep him comfortable. He just wanted to know if Viv was all right and if he could see her.
"When can I see Viv?" he interrupted the cardiologist.
Dr. Thomas paused, "Who?"
"Sam, let him finish before you start asking questions," John admonished but the boy ignored his father.
"Viv," Sam continued, "But only her friends call her that. Is she okay? Can I see her?"
"I'm sorry," Dr. Thomas said, "She's not one of my patients but I will ask around okay?"
Sam thought this over for a moment before nodding, "Tell her I want to see her."
The doctor nodded than began speaking with Sam's father.
W
The seven-year old stared down at the tray on his lap and decided he didn't feel very hungry.
His dinner was a round mound of mashed potatoes that looked as though it had been plopped on his plate with an ice cream scoop, a round meat patty of unknown origin, lumpy gravy the colour of diarrhea coating both, mushy peas that looked more like snot, a cup of blue Jell-O and a carton of milk.
"Here Sammy," Dean pulled the MARS bar he'd been carrying around out of his pocket, "Just this once."
Handing the chocolate bar to his younger brother, the eleven-year old took the tray into the bathroom where Sam heard the toilet flush twice before his sibling came back out with a clean tray.
"Don't tell Dad," Dean whispered even though John was on the other side of the hospital in the cafeteria.
Sam shook his head and took a bite of the chocolate bar, relishing the sickly sweetness of it.
W
Dean stopped mid-sentence in the book he was reading to his sibling later that evening when Dr. Thomas stepped into the room.
"Is everything all right?" John, who had been dozing in his chair asked, seeing that the cardiologist was not smiling.
"Is something wrong with Sammy?" Dean asked fearfully.
"No, no, Sam's fine," the doctor assured the family with a wan smile, "But I found out about your friend."
Dr. Thomas was now looking right at his young patient as he spoke. Sam pushed himself up further in bed and frowned at the doctor, "Viv's okay, isn't she?"
"My colleague," Dr. Thomas began, "Dr. Hennessey, was Vivian's surgeon. He told me that Vivian was going into surgery to have a large brain tumor removed."
Sam nodded, recalling the surgeon's marks on the girl's head.
"Sam," Dr. Thomas said, "I'm sorry but Vivian didn't make it."
Disbelief as cold as ice seemed to creep down the boy from his head to his toes and Sam shivered.
"No," he breathed, "No, she said she'd see me again. She said the doctors knew what they were doing. She can't be gone."
"I'm sorry," Dr. Thomas repeated.
"Thank you for letting us know, Doctor," John said and the cardiologist nodded, leaving the room.
Sam shook his head, tears welling up in his eyes. Dean reached out and hugged his sibling carefully.
"It's not fair! It's not fair! She was my friend!" Sam cried, tears running down his face.
Dean said nothing; he just continued to hold his brother as he cried.
John, not wanting to be in the room with his youngest son so upset, left quietly.
SPN
John knew that his son was only seven-year old; he knew that Sam was a rather sensitive boy, but he could not remain in the room without saying something that would end up being hurtful.
Yes, he was sad that a young girl was dead, but that was the way of the world. People lived and people died. Those who didn't deserve death were snuffed out while those who did live long.
Sam was right; it wasn't fair. But he certainly had to get used to it, especially when he started hunting.
Making his way to the cafeteria, John found the coffee machine and poured himself the largest Styrofoam cup of caffeine he could find.
Leaning against the wall beside the machine, John took a sip of his drink and nodded to a man who was making his way towards him.
The man was older than John, with greying blond hair, sad grey eyes and a haggard appearance. The man, who seemed dazed, fumbled with the cups before picking one up and then stumbling over the lever that would open the tap and let the coffee flow into the vessel.
Without a word, John reached out and pressed the lever down with his thumb and the dark liquid flowed freely into the man's cup.
"Thanks," he muttered.
John nodded before releasing the lever and taking a sip of his drink.
"I know how to use these things," the man joked, trying to smile and failing, "It's just… been a long day."
John nodded.
"You got a kid in here?" the man asked.
"Yeah," the hunter replied shortly, not wanting to get into a conversation.
The stranger nodded, "Me too. Been coming here for weeks with my little girl for cancer treatments."
"Hm," John replied not committedly.
"Finally managed to get that damn tumor small enough so the doc could operate," the man continued and John started to wonder if he was talking to himself.
"Dr. Hennessey tried his best," the man kept going, "I know he did but… but… I… I lost my little girl… she died right there on the operating table… never woke up…"
John turned his dark eyes to the man in shock.
"First my wife to a drunk driver," the man turned his grey eyes to John, "Now my little girl to cancer."
The man smiled sadly, "She had a heart of gold, Viv did. Always wanting to take care of others before herself."
John's mouth opened slightly.
"Good luck," the man reached out and put a hand on the hunter's shoulder, "I wish your family all the health and happiness in the world."
Releasing his hold on John's shoulder, the man turned, Styrofoam cup in hand, and melted into the crowd.
The hunter remained where he was, mouth agape, shocked at what he had just witnessed.
W
Both Sam and Dean were asleep by the time John returned to the room. The father crept quietly inside so he wouldn't wake his sons. Stepping up to the bed, he carefully pulled the book from Dean's lax hands and set it on the bedside table. Pulling the thin blue hospital blanket up over both his sons, John leaned down and kissed each boy on the forehead.
"Love you, Dean," he whispered to his eldest.
"Love you, Sam," he whispered to his youngest.
Settling into the chair set aside for visitors, John closed his eyes and fell asleep.
Author's Note:
PACU stands for post-anesthesia care unit (or recovery room).
This idea came to me the other day and I had to write it. I hope you all enjoyed it and hopefully it didn't make you cry- or if it did, not too much.
Tetralogy of Fallot is a heart defect I am familiar with because I was born with it. It is repaired now but I still require yearly check-ups with a cardiologist and may need future surgery.
The names of my two original characters, Vivian and Dr. Thomas are included to honour Vivien Thomas who, with Dr. Alfred Blalock performed the first corrective surgery on infants with Tetralogy of Fallot (or Blue Baby Syndrome) at Johns Hopkins University. Vivien Thomas was the first to create a surgical technique that would repair the defects caused by Tetralogy of Fallot.
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