Title: Shock Advised
Author: Still Waters
Fandom: Supernatural
Disclaimer: Not mine. Just playing, with love and respect to those who brought these characters to life.
Summary: A freak accident at the library sends Sam into cardiac arrest and throws Dean back into an unending nightmare.
It should have been hilarious.
Sam rounded the corner of the library stacks, straight into the path of a massive, airborne missile. The book met his chest with a resounding thump before falling to the old, wooden floor in a muffled finale.
Dean snorted at Sam's 'what the hell?' face. A teenage boy at the far end of the stacks gasped audibly, his previous smirk lost in sudden, shocked embarrassment. "Oh God, I'm so sorry, sir! I thought you were Erik!"
"You usually throw books at Erik?" Sam asked mildly, wincing as he bent to retrieve the book.
"Mike, where the….." Another kid came up behind the book-launcher. He took one look at the scene, his eyes moving smoothly from the fallen book, to Sam and Dean, and back to Mike again with a knowing sigh. "Seriously?" he shook his head disapprovingly. "I still have the bruise from last time."
Dean choked back a laugh. So, this was Erik….and the answer to Sam's question.
"Yeah, well, so do I," Mike countered. "And it still hurts to sit."
With that random bit of over-sharing, Dean turned his attention back to Sam with a nostalgic grin, the two boys in front of them an echo of hundreds of their own childhood….and, well, adulthood…..pranks.
Sam, who was still squatting in front of the book.
"Dude, even for a freakish giant like you, it shouldn't take that long to stand…." The word 'up' died on his lips as Dean saw Sam tip forward, sinking heavily onto his knees. Heart in his throat, Dean threw himself into a mirror position on the decidedly not muddy ground, and met Sam's eyes.
All humor vanished.
His brother's face was distant, the crease between his eyes a near pre-migraine depth, lips a weak grimace, eyes clouded in an impossibly panicked, yet resigned squint; a tapestry of shock, confusion, and searching.
Searching for answers. For Dean.
An expression uniquely Sam.
Sam in distress.
Dean's heart hammered in his chest as he grabbed the sides of Sam's face, forcing his focus. "Sam, what's wrong? What's going on?" he demanded, blinking his eyes rapidly against the sun's assault. It glinted off nearby binding, the reflected maroon a translucent stain haunting the edges of Sam's mouth.
Sun. Not rain. Not blood. Oak floors, but warm.
Until Dean went completely cold at Sam's lost voice; the four year old on the edge of fevered nightmares. "Dean?"
"Yeah, Sammy, right here. Talk to me, what's going on?" Dean dug his thumbs into his brother's cheeks.
"M'chest feels…." Sam frowned once, head tilting slightly to the right, before slumping bonelessly into Dean, head finding his brother's shoulder with an unconscious draw.
Dean froze.
Memories of his own crimson-stained hands, of severed spinal cords, rain-soaked faces, and a single, anguished word pounding through his heart in an unending plea.
No.
And suddenly, Cold Oak was all that existed, the passage of time since that night a fleeting lie, swept away by a flood of unforgiving memory. Everything narrowed to that single syllable, the only sound that came close to containing the devastation of Dean's shattered world. As he cradled Sam's limp head against his neck, he was mildly aware that he should be doing something…..but all he had was muscle memory - the feel of Sam's weight against his chest, the bristle of long hair against Dean's palm as he clutched Sam close, the shuddering absence of warm breath against the pounding in Dean's own neck - and the terror that those tactile memories revived. He thought he heard a distant voice calling for its mother…..but even in his shock, Dean knew it couldn't have been him.
The only one he ever called for was Sam.
Sam, who was being pulled from his grasp.
That got Dean's attention.
With an instinctively feral growl, Dean's eyes snapped into focus…and met a pair of unfamiliar brown eyes in a tight face warring between controlled panic and soft empathy.
"Michael, what happened?" the eyes expanded into a clipped female voice, punctuated by small hands trying to reach for Sam's chest and neck around Dean's desperate grip.
"I thought Erik was coming around the shelves and I threw a book….but it hit that man in the chest. I didn't mean…." Mike's panicked voice replied.
"Damn it, Michael!"
Something in that inflection was so familiar…..
"Sir, please. I need to see Sam….." the woman's voice punctured Dean's fleeting thought, her fingernails scratching Dean's neck as she struggled to reach Sam's buried face.
"I'm sorry, Mom," Mike sniffed.
"Knew it wasn't our mom," Dean thought absently.
"Is he…..?" Erik choked.
"I love you boys, but I swear, of all the idiotic…."
That voice again. What the hell was it with that voice? He didn't even know….
Damn it, boys.
Idjits.
The tone was wrong, but the words, the underlying feeling…and then Dean looked, really focused….and the unfamiliar eyes suddenly cleared into an expression that Dean had seen hundreds of times before under the brim of a worn trucker's hat – panic, understanding, and desperate, knowledgeable resolution.
A silent reach.
Let me help.
The only one Dean trusted to help.
"Bobby?" he croaked.
The woman's eyes widened briefly before desperately latching onto the vocalization, trying to get through. "Let me help Sam. Please. He's not breathing and his heart isn't beating."
Dean frowned, still trying to process the tonal discrepancy, even through the flicker of connection.
And then, those last few words penetrated trauma's cold fog.
He's not breathing.
His heart isn't beating.
Sam.
NO.
Dean gasped as terror funneled into drilled response. "Sam?" his voice trembled as training resurfaced and he began to shift Sam back for an assessment.
"Sir, are you with me?" the woman asked firmly.
Dean swallowed at the familiar words…..and the pressure of the limp form that wasn't with him. "Yeah," he gulped. A pause. "Yeah," he repeated, chest heaving as he strove to steady his breathing, clear his head.
"Good. I need you to lay Sam down," she kept her voice firm, even. Simple commands.
Dean responded immediately, shifting Sam to the middle of the aisle and laying him on his back. He instinctively ducked his head to listen to Sam's chest, only to be interrupted by a pair of scissors being shoved into his hands, with the clear order to cut Sam's shirts off. With proper access to Sam's body, the woman's fingers found his throat, hands tilted his head back, eyes and ears straining in the chill of silence.
"I've got it, Mom," Mike ran up, brandishing a small, plastic case.
"Ambulance is on its way," Erik confirmed, sneakers squeaking jarringly as he skidded breathlessly to Mike's left.
"Good boys," the woman praised as she shifted to Sam's side, having confirmed her earlier assessment. She focused briefly on Dean as her hands sought placement on Sam's sternum. "Sir, do you know CPR?" she asked.
"I do," a voice came from a surrounding crowd Dean still hadn't fully processed.
"Good, you can…." The woman started to reply as she began chest compressions.
"Dean," Dean corrected her earlier 'sir.' "And yeah, I know it." He moved to replace her hands.
She shook her head. "I've got this," she huffed through the count. "Go open Sam's airway and get ready to give him two breaths. Mike, give Dean the mask and bring me the AED." She looked up at the young man who had offered to help. "Do you know how to use this?" she nodded at the plastic case.
"Yes, ma'am."
"Good. Get the pads placed," she said, jerking her chin toward Sam's other side.
Dean waved away the CPR mask, kneeling at Sam's crown and tilting his brother's head back. "Airway's clear," he reported, falling back on the comfort of protocol. "You sure you don't want me to…..?" he nodded towards Sam's chest, watching the woman's flushed face, wincing at the creak of Sam's ribs under focused hands.
"Sam's family, right?" she asked over the robotic voice instructing the young man to attach the pads to Sam's chest.
"M'brother," Dean's voice caught.
She nodded, shaking sweat from her eyes. "Right. I'm not about to make you break your brother's ribs," she said simply.
And that was that.
"Two breaths," she ordered Dean as she counted to thirty.
Sam's chest rose and fell twice as Dean became his lungs, then fell silent as a stranger's hands resumed being his heart.
"Hold compressions," the young man relayed the AED's instructions.
"Everyone back," the woman instructed, holding her hands up to show she was clear.
"Analyzing heart rhythm," the machine droned.
A beat.
"Shock advised."
The woman let out an almost relieved breath as she resumed compressions under the whine of the building charge.
"Shock?" Dean demanded as he took her cue and resumed his place maintaining Sam's airway.
The woman blew at a sweat soaked strand of store-bought red hair as it briefly obscured her vision. "It means that Sam's heart is in a rhythm that the machine can defibrillate," she grunted through continued compressions.
Dean's eyes widened. "That's a defibrillator?" Dean fumbled the word, nodding at the AED. "But, aren't those the things in the hospital with the paddles…." The one he had seen being used on himself as his spirit wandered the hospital in the wake of the car accident. The one used unsuccessfully on Dad. The ones used judiciously in the early morning soap operas he and Sam watched when they hadn't been able to sleep and just needed the comfort of mocking something ridiculous.
"This is one too," the woman said.
"Deliver shock now."
She stopped compressions. "Everybody clear. Dean, let go and move back."
"But…." Dean cringed under the high pitched shriek of the waiting charge.
"Dean, you can't be touching Sam during the shock. He needs this to try and get his heart beating again. Stand back."
She found the right words.
He needs this.
Sam needs this.
Dean moved.
She reached over and pressed the shock button at the wordless plea in the young volunteer's nervous eyes.
"Shock delivered."
TV lied. There was no violently arched back, no immediate gasping breath, no opening eyes – just a mild twitch and a mechanical voice stating, "Start CPR."
Dean returned to Sam's airway, swallowing back nausea. Ever since his electrocution, he had been wary of electricity's backstabbing potential, and he and Sam still hadn't put the tasers back into rotation. Even though Dean understood, loosely, the rationale behind defibrillation, the idea of deliberately, well, electrocuting, his brother just went against every protective instinct in Dean's body.
"Two breaths," a firm voice prompted.
Thirty compressions. Two breaths. Five cycles. Mechanical analysis. Another shock.
The woman was tiring. She searched for breath to request switching off with the young volunteer….
….when Sam's chest moved weakly under her hands, his mouth rounding in a small, silent gasp.
"Sam?" Dean's voice surged with hope. He took Sam's breath, holding it in his own chest, as the woman's hands shifted.
"He has a pulse," she confirmed.
Dean exhaled heavily on the wake of another shallow inhalation from Sam.
Her eyes dipped to her wristwatch, lips silently counting heartbeats before shifting the hand to lay palm down on Sam's chest for another count. "Keep the pads on," she reminded the young man at the AED. On the edge of approaching sirens, she nudged him to Dean's place. "He'll keep Sam's airway open," she assured Dean, gesturing toward the young man. She took Dean's hand, leading him, on heavy knees, to Sam's side, and placed his fingers lightly on Sam's carotid. "Feel that?" she asked.
Dean nodded mutely, eyes blurring.
"Now, it's a little weak and irregular, but that's normal after cardiac arrest. Just keep your fingers there and let me know if anything changes."
Some distant part of Dean's brain realized what she was doing and flooded with a gratitude he couldn't voice. He met her eyes briefly, hoping some of it got through, before shifting his other hand to Sam's chest to monitor his breathing. "What happened?" he finally managed, voice thick with emotion.
"You ever hear the stories about kids at baseball games who get hit in the chest and drop dead?" she asked, eyes and hands skimming Sam's body in silent assessment.
"Yeah," Dean recalled, before suddenly putting the pieces together. "Wait, this is what happens?"
She nodded. "The human heart, for all its amazing resilience, is really a fragile, complex electrical system. Just like a short in your fuse box, if the heart is interrupted, say, by a baseball, or a book, at just the right point in the electrical cycle, it can send the heart into lethal rhythms, called v-tach or v-fib. During those, the bottom chambers of the heart either pump too fast or quiver, which doesn't allow blood to be pumped out to the rest of the body. The AED is an automated external defibrillator – if it reads either of those rhythms, it can deliver a shock to try and break the cycle, to give the heart a chance to resume its normal rhythm." She pushed sweat-darkened hair out of her eyes and took several deep breaths through fatigued muscles and crashing adrenaline.
Sirens crescendoed and silenced.
A stretcher rattled.
Dean was distantly aware of the murmur of conversation as the paramedics arrived, introduced themselves, and began talking to the woman. Occasional snippets of the report penetrated the reassurance of life under his hands – something about the resuscitation only lasting three minutes? – then they were standing up, Sam bundled onto the stretcher, a new host of jumbled sounds as protocols were implemented. He thought he heard one of the paramedics say, "good to see you again, Bobby." The kid helping, maybe? But the heart monitor was beeping, the oxygen hissing, tape tearing to secure IV lines….and Dean was alone in the ER waiting room before he realized he had never even asked the woman's name.
Had never thanked her for saving Sam's life.
And his.
That night, Sam stabilized, opened his eyes long enough to ask for Dean, grasp his hand, and shift from unconsciousness to sleep.
As Dean finally allowed himself to doze, the name of the book that hit Sam flashed through his muddled, fear-filled subconscious.
Dean jerked awake and watched Sam breathe.
It should have been hilarious.
But Sam was on oxygen. IV drips regulated his heart.
In those 2 AM shadows, the thought of laughter, any laughter, seemed almost profane.
The next morning, Chris, the day nurse, brought Dean a sealed envelope along with Sam's morning meds.
Sam blinked sluggishly as Dean tore into the paper. "You're not even here twenty-four hours and you and Chris are already exchanging notes?" he asked, disbelief running strong through a cracked, weary voice.
Dean frowned. "Dude, Chris is a dude," he pointed out, unconcerned with that bit of redundant ineloquence.
Sam grinned widely, eyebrows raised.
Dean shot him a glare. "That is so not cool, man," he warned, shifting back in his chair with a groan.
Sam chuckled softly, splinting his chest with a soft grunt. "So, who's it from?" he asked, eyes drooping.
Dean went silent as he read.
Dear Dean,
I hope this note finds Sam improving and you not beating yourself up…..although I suspect you are, which is why I'm writing to you in the first place. I also suspect you're not a fan of poetry, but tough. Keep reading, because you need to hear it.
"Nurture strength of spirit to shield you in sudden misfortune.
But do not distress yourself with dark imaginings.
Many fears are born of fatigue and loneliness.
Beyond a wholesome discipline,
be gentle with yourself."
We all freak out sometimes, but that doesn't mean we've failed. You're thinking you should have acted sooner, shouldn't have let fear get in the way of training….are wondering what would have happened if that library hadn't had an AED…..well, stop it. Whatever horrific memory shut you down today (and I pray to God you never experience such devastation again) probably felt like it lasted forever. In reality it was only seconds – we got to Sam in time. Could we have started CPR sooner? Sure. But, to tell the truth, those few seconds with you helped me get my own fear under control – I've never done this outside a hospital before. We were both scared, but we persevered. We'll know what to watch in ourselves in the future, but we still succeeded in the present. Remember that you breathed for your brother. You got past the fear of something you didn't know and let a stranger basically electrocute Sam. And you didn't think twice about doing chest compressions on your own flesh and blood, which tells me everything about the kind of man you are and the bond you two have and which makes me even more honored that you allowed me to lead. So, turn away from the dark of 'what if' and look at the light in front of you. The man who rekindled that flame deserves to be gentle with himself.
My son is working through this passage (Max Ehrmann's "Desiderata" by the way – go look it up, I think you'll like it) too. He apologizes profusely for his actions, and he and his friends will certainly never play that idiotic game again. He is studying culinary arts in school right now and would like to cook for you and Sam once your brother's up to it, if you'd like. I'm enclosing our number and address – please don't hesitate to call.
Life threw you a curveball today, but you not only got through it, you kicked its ass. Remember that, because that's what counts.
"With all its sham, drudgery, and broken dreams,
it is still a beautiful world.
Be cheerful.
Strive to be happy."
Today is a good day. Smile. Laugh. Be happy. Even if it's just to spite the darkness.
Wishing you and Sam many more good days. Hope to see you again soon.
All the best,
Bobbie Musangelo, RN
Dean swallowed thickly.
"Good to see you again, Bobby."
Not Bobby.
Bobbie.
The woman in the library with the familiar eyes, comforting inflections, and resolute training.
The one, who, like a sarcastic South Dakota constant, took up that name and joined the Winchesters' greatest fight – to stay together.
Dean and God were generally on rocky ground, but even Dean couldn't deny that there was something beyond coincidence here. That it was a Bobbie who found the right words to get through and refocus Dean on what really mattered. To come up with a plan. To save Sam.
"Dean? What's wrong?" Sam's nervous voice rose over the rapidly beeping monitor protesting the cardiac repercussions of his anxiety and grunted attempt to stand.
Dean looked up at his brother, at the openly concerned face, readable as ever; listened to the familiar voice, to the heart monitor beeping a wordless victory.
Alive.
Bobbie was right – they had kicked that curveball's ass. Time to be happy.
And Dean knew just how.
But, first things first. "Sam, chill out before you set all the alarms off," Dean fussed, moving effortlessly into calming his brother, tucking him in, slowing his breathing.
And, in typical Sam fashion, his brother didn't let go of the blatantly unanswered question, even as he heeded Dean's instructions. "Dean?" he pressed.
"I'm okay, Sam," Dean assured him. "We're good," he watched the monitor settle down.
"Who was the card from?" Sam insisted.
"Why would someone name a girl 'Bobbie'?" Dean countered, eyes focused on the steady hills and valleys of regular sinus rhythm.
Sam blinked, but responded anyway, accustomed to their nonlinear conversation. "It's a nickname for 'Roberta'," he said, brow furrowed minutely in anticipation of Dean's train of thought.
"Huh," Dean mused. "Wait, why do you know that?" he gestured widely with a huff of exasperation.
"Our gym teacher at that school outside Tucson?" Sam prompted.
Dean's face flickered from thought to uncomprehending recollection. "Dude, we were there for what? A week? How do you remember that?"
Sam shrugged, fiddling with the oxygen tubing. "So Bobbie…" he pushed.
"Was the nurse in the library who saved your life," Dean finished quietly.
Sam went silent. "Dean," he finally spoke, "I want to…."
"I know, Sammy, me too. And we will," Dean assured. "Her son wants to share his culinary talents in…." Dean trailed off, choking on the possibilities. Apology? Penance? Either word just brought back the feel of Sam's limp body against his. Dead.
"Dean," Sam said softly. One word, but in it, everything Dean needed.
Alive.
Smile. Laugh. Be happy.
Even if it's just to spite the darkness.
Dean grinned.
Sam immediately looked suspicious. "What?" he asked warily.
Dean's eyes lit up. "You know what book almost took you out?" he bounced mischievously in his seat.
"No…." Sam said slowly. His memories immediately before and after the event were fuzzy to nonexistent.
"'The Complete Kama Sutra.' Thing had pictures and commentary from, like, every sex expert on the planet."
Sam groaned.
"I mean, think about it, Sam – spirits, demons, stuff most people don't even know exists, you kick its ass. But what takes you down? A book on sex," Dean attempted to shake his head disapprovingly through his glee.
"Dude, seriously?" Sam sighed.
"Just saying – I think that's like, an automatic man-card revocation, or something," Dean shrugged. "'Course, you'd need to have had one in the first place…"
"You done?" Sam's long suffering voice slurred slightly under closed eyes and the slowed breathing of imminent sleep.
"No," Dean heaved a put-upon sigh as Sam spoiled his fun.
"Jerk," Sam's lips twitched fondly as he drifted off.
"Go to sleep, Samantha," Dean said, voice soothing under the routine tease. He settled back in the visitor's chair, propping his feet up on the bed, one boot resting lightly against Sam's leg.
The heart monitor beeped steadily. Sam's chest rose and fell regularly.
As long as that continued…..
Dean knew there would be nightmares; knew he'd be wary of libraries and every supernatural brush to Sam's chest for months to come.
But it was 8 AM, the sun was shining, and he had just laughed with his brother.
His brother, who had survived a book of sex to the chest.
It would never be hilarious – nothing that hurt Sam ever could be.
But Sam was alive. No supernaturally orchestrated death, no unnatural deal-with-the-devil resuscitation. Just life, unstained by that all too familiar darkness.
Dean chuckled.
To spite that darkness. He loved pissing things off.
But more because he loved messing with his brother.
Because getting Sam to blush like he just had…..well, it was better than hilarious.
It was awesome.