thank you all once again for the great reviews, i am glad you are all enjoying this. sorry this wasnt up a little sooner, but i got kind of bogged down in all the medical jargon.

hope you all enjoy, as always, let me know what you think. :)

AND OVER AGAIN

Chapter 4

Dean sat on the exam room table, anxious despite himself. He wanted to get this done, he really did. Right? Of course, right. Hell, there was no reason not to get it done. He needed to be able to hunt again, to be able to watch out for Sam like he was supposed to. As he was now, he was a liability, running the risk of putting his brother in more danger, and he just couldn't have that. No, he needed to get this done, his father needed him to get better, Sam wanted him to get better. And that was all there was to it.

But that didn't lessen the fear that was currently building in his chest. He didn't know what there as to be afraid of, he had had surgery before, many times as a matter of fact, it was something he should have been used to at this point. But something was still just a little bit off, his heart rate climbing slowly as he sat in the cold room, waiting for the doctor, his family standing by his side. He should have been excited, should have been happy, not the worried mess he currently was.

Everything was just coming to a head, the true reality of the past year falling down on him with a weight he could never have imagined. Sam's new powers, and his by some weirdo link, were still far from controlled both lashing out at the smallest things, the most innocent of mistakes. And Dean couldn't help but wonder what would happen if they were able to go on larger hunts again. After all, Sam had gone all spoon-bender on him because some flying objects happened to soar in his direction. What would happen if next time, it was something far worse?

The memory of the Traters floated back to him, the images of that cold basement playing before his eyes like a bad movie. He had seen Sam then, seen the emptiness in his eyes, felt the power radiating from him, rolling off of him in visible waves. True, both Sam and John thought he was dead, but that power, that break in his little brother was terrifying. Because, in all honesty, Dean knew what Sam was capable of, knew just how strong he could be.

He had seen it in Montana while his brother was possessed, had seen what the Asura could do with the younger man's powers, and it was something that would stay with the older hunter for the rest of his life. Because, it was then that he realized his little brother was no longer the small child that had run home from school with straight A's, or had asked him so innocently a few short years ago, if he was proud of him for getting into college. No, the Sam he saw in Montana was different, darker and stronger than Dean ever imagined possible. And it scared him.

But, even that didn't explain the trepidation Dean currently felt. It was like standing on the edge of a precipice, every instinct telling him to stay, to stand his ground, but all his heart and soul wanted to do was back away from the danger. And, though Dean would never admit it, to himself or his family, the reason for his fear was staring him in the face. The truth was that there was a very real possibility this wouldn't work, and after that, he would be all out of options.

He couldn't let his family down again, couldn't see the disappointment in his father's eyes if, after spending thousands upon thousands of dollars they didn't have, and calling in every favor they could, this didn't work. The other doctors had been honest with him, his injury so bad that, even with the miracles of modern science, he may be broken beyond repair. And that wasn't something he wanted to hear, ever.

At that moment he still had hope, still held onto the possibility that this could all be fixed, that he could get better. But, having the surgery took away that little bit of hope, forced the situation into clear cut black and white, the gray uncertainty gone in a heart beat. And that was why Dean was afraid.

He was pulled from his silent torment by the creak of the door, his newest doctor appearing before him, his salt and pepper hair combed back neatly, wire framed glasses resting on his nose. Literally, he was everything most people thought doctors should look like, and Dean couldn't help but laugh. It was almost like the guy jumped right out of the pages of a book.

"Dean Miller?"

"Yeah." Dean spoke up, clearing his throat, but it was Sam that stepped in.

"So, Doc, when can we get started?" Sam asked eagerly, and his excitement washed over Dean, lessening the fear and tension that had laid claim to his body.

"I think I'd like to speak with Dean alone." The doctor began smoothly, his voice drowning out what little comfort Dean had found. This definitely didn't sound good.

"No." Dean began, his voice breaking a little. "No, I want them to stay."

"Alright. I'm Dr. Marks, I'm the orthopedic surgeon that will be handling Dean's case." The middle aged man began, extending a hand to each in turn.

Dean knew he was being polite, knew he was trying to calm his patient, but, damn it, he was just making it worse. Dean didn't like waiting, he didn't do waiting, waiting was very, very over-rated. And that's exactly what this man was making him do, wait, and Dean was getting edgier the longer he sat there.

"Now, Dean, you said you fell?"

"Yeah, eight months ago."

"And you had to have your knee partially rebuilt. I see that, along with a fractured knee cap you also tore your ACL and MCL ligaments."

"Yeah, they were replaced with cadaver ligaments." John added, speaking for the first time, his hard eyes on the doctor.

Dean shiver as his father described the surgery, the idea of some dead guy's ligaments holding his knee together was an image he didn't want to have.

"I understand that you have probably been through all this with your other doctors, but I would like a full picture of the condition before we go any further."

"What do you mean, 'any further'? I thought you said I was a candidate." Dean couldn't help the pain in his voice, couldn't help the disappointment that shined through. After all, this had been his only chance, his light at the end of the tunnel, and now it was slipping away.

"Technically, Dean, you are a candidate. But, knee replacement isn't the quick fix everyone thinks it is. And, there is a very really possibility that it isn't right for you."

'I can't walk, how can't it be right for me?"

"The main problem with your injury is your tendons. In your accident you tore your quadriceps and patellar tendons. These tendons, along with your quadriceps muscles allow your leg to straighten. And obviously, that is no longer possible.

"Now, during knee replacement we will remove the damaged cartilage in your knee and replace it with a synthetic material. It should lessen the pain and allow you a greater range of motion, but it will not be the same as it was before the accident. You will have to limit stressful activities, mainly running, and try not to over exert yourself. Also, you will still be unable to straighten your leg completely, and since you are young and very active, you will more than likely have to get the knee replaced again in anywhere from ten to twenty years.

"I know you all came in here looking for a quick fix, and I'm sorry, but I can't give you that. There are risks involved and the knee will not be the same as it was before. With any luck, you should be able to walk without crutches and only a minimal amount of pain.

"Now, there are also complications that I would like to discuss. Along with the regular problems after surgery like blood clots and infections, there are also several complications that go along with a knee replacement. If the new components aren't aligned properly, then your knee will be unstable and you will need another surgery to repair the problem. A problem with the alignment could also cause you knee to dislocate easily.

"What I said before is very important, Dean, so I will say it again. You will not regain the full range of motion you had before the accident. You also won't be able to be as active. You will more than likely be able to walk with little or no pain, but strenuous activity is going to remain off limits. Now, do you have any questions?"

"Even with everything you just said, if I get this replacement, I can still walk, still go up stairs?"

"Yes, you can still walk, though stairs may cause you some pain."

"But, I won't need the crutches anymore."

"Only time will tell. Like I said, the injuries to your knee were very severe. The only thing I can guarantee is help managing the pain and making daily activities a little easier."

Dean looked around the room, his heart sinking when his gaze fell on Sam and John. They had all be waiting for a miracle, waiting for the last eight months of their lives to be erased. But now, as the doctor's words slowly sank in, he realized that nothing would ever be able to accomplish that. He was still injured, and it was something he would have to deal with, just as Sam still had his ever strengthening powers. But, at least this was something, at least he would have tried, and, in the end, that's all Dean could really do.

"How soon can we do it?"

"I want to get more x-rays and run some more tests, but I can have it scheduled for three days from now, if that is alright with you."

"Yeah, Doc, that's great." Dean smiled weakly, the surgeon nodding to each man before leaving the room.

The middle Winchester let out a long, slow breath, his eyes closed, mind trying and failing to shut down. He didn't want to think anymore, didn't want to worry. He just wanted it all to go away, to wake up and find his life back in one piece, back to normal. But, as it turned out, even the miracles of modern science couldn't make that promise.