Urgh. This chapter did NOT want to be written... it fought me every step of the way. I'm still not 100% happy with it. But I figured you'd rather have an update than a Pulitzer-winning piece of literature that never saw the light of day...
Disclaimer: I repeat - not mine. Not mine. Not mine. Okay, enough repeats.
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It had to be one of the most irritating sounds he'd ever heard.
It didn't help that it was repetitive.
It also didn't help that he'd been listening to it non-stop for the last hour.
Dean straightened in his seat, wondering absently why hospital waiting room chairs always appeared to have been designed by someone with severe curvature of the spine, and cast a malevolent glance at the preteen with the Playstation.
Wish I had a rifle with rock salt...
He put a hand to the back of his neck, distractedly massaging the tense muscles.
Why was it taking so long?
He had rushed into Emergency along with the paramedics, desperately hovering over the stretcher bearing his unconscious brother. Sam looked even worse than he had at the motel, his ashen face almost gray, long limp fingers bluing slightly. Dean held the hand that was not attached to an IV line, willing his own warmth to pass to his little brother. Sam was so cold...
He had argued and fought at the swing doors to the Emergency Unit, determined not to be separated from his brother again. It was bad enough that he'd not been allowed to travel with him in the ambulance. But the nurse had flatly refused to allow him in, eventually threatening to call hospital security and have him removed, and Dean had had to give in.
Since then he'd been sitting in the waiting room, staring blindly at the peeling dull green walls and trying to ignore the maddeningly perky "music" of the Playstation.
He stood up explosively, strode to the end of the waiting room and peered hopelessly in the direction of the ER. The boy with the Playstation looked curiously up at him, and he glared back.
Sammy...
He returned and dropped back into his seat, leaning his head against the wall behind him. He closed his eyes and rubbed them with thumb and forefinger. Unbidden, the image of his brother rose to mind as he had seen him upon his return to the motel that evening, the limp huddled figure on the cheap motel carpet. Sam's cell phone had been lying right by his hand. He had tried to call Dean, knowing he needed help, wanting the one person who should have been there, who shouldn't have left in the first place. But he hadn't been able to. His weakened body had betrayed him.
Just like I betrayed him.
Dean leant forward with a stifled groan, dropping his head into his hands.
"Family of Sam Winchester?"
Dr. Elin Landon was on the right side of thirty, dark curls pulled back from a strikingly pretty oval face, blue scrubs unable to conceal what was a decidedly curvaceous figure. In any other situation Dean would have been switching on the charm instantly.
Now all he could think about was the gravity of her expression.
"Dean Winchester. Sam's brother. Is he... how's Sam?"
"If you would just follow me, Mr. Winchester..."
Dean stiffened. That did not sound good. Why wouldn't she –
"No, why can't you speak to me here? What's wrong with Sam?"
"Mr. Winchester-"
"What's wrong with Sam?"
Playstation Boy looked up again, staring avidly. Across the waiting room a porter stiffened and leaned forward. Dr. Landon cleared her throat.
"Mr. Winchester, please calm down. I would rather we spoke with a little more privacy, but if you would prefer to remain here-"
"Just tell me that he's going to be okay."
Dean was unable to keep the quiver from his voice. The blue eyes which had been decidedly frosty softened slightly as they saw the fear in the green pair staring back.
"There is no reason to believe that Sam will not make a full recovery." Her gaze was sincere, and Dean relaxed a little. Her expression remained serious, however.
"Sam is stable and I will take you through to him shortly. I would really rather prefer we spoke somewhere else, though. If you would please come with me we can discuss this in my office."
She turned, obviously unwilling to argue any further, and Dean found himself following her dumbly. Sam was going to be okay. She'd said so herself.
A full recovery.
A full recovery...
He's going to be fine.
His worry diminished sufficiently to allow him to admire Dr. Landon's back view as she preceded him to her office. Pity those scrubs are so baggy... she's got one hot –
"In here, Mr. Winchester."
Dean had never liked visiting other people's offices. There was something about sitting facing someone official across a desk that reminded him of his schooldays, of stern, impatient and hostile principals. Elin Landon was the furthest from a school principal that could be imagined, but the almost forgotten tension rose in him as she leant against her desk.
"What's wrong with Sam?" he said again.
"Sam experienced a severe upper gastrointestinal haemorrhage. As a result he was in shock when he arrived. This is being treated with IV fluid replacement and we will be administering blood transfusions once he has been cross-matched. As I said, he is stabilised now, but we are and will be monitoring him carefully. As soon as adequate blood volume is restored we will be doing an endoscopy to determine the cause and extent of the bleed."
Dean's mouth compressed, one eyebrow lifting slightly.
"But he's okay."
She took a deep breath.
"His condition has stabilised. Many upper GI bleeds resolve spontaneously without too much intervention, but the volume of blood loss in this case is concerning – that he went into shock as a result suggests arterial bleeding. We won't know for certain until we've done the scope. We'll be admitting him at least until that's done so that we can administer the necessary treatment -"
"Necessary treatment?"
"Worst case scenario, surgery. But that is the worst case scenario, and it is most likely that that won't be necessary. As I said, many bleeds resolve spontaneously. We need to monitor his condition, though, for the next twenty-four hours at least."
"Why?"
"I'm sorry?" She looked taken aback.
"Why would he suddenly start throwing up blood?"
Her expression became thoughtful.
"Well, Mr. Winchester, we will hopefully be able to see that from the scope. Meanwhile, you might be able to give us some idea. Has he been complaining of stomach pains at all?"
Dean stared at her, his gaze blurring momentarily.
My stomach hurts, Dean...
Suck it up, Sam...
"Mr. Winchester?"
"Uh... uh, sorry. Yes, he mentioned earlier this evening that his stomach hurt."
"And before that? How long was it hurting?"
Something flickered across Dean's face.
"I... uh... I'm not sure. Not too long... maybe a coupla days?" How long has Sam been feeling sick? What signals did he give off that I didn't notice? I'm sorry, Sammy...
"A couple of days... not before that?"
"Uh... not that I noticed. He didn't complain." Would he? Was I just too blind to see that he was in pain?
"Has he been under particular stress lately?"
"Stress?" Ha. You have no idea, lady...
"Chronic stress can result in stomach ulcers, which are a common cause of upper GI bleeds."
"Oh."
"It's also possible..." she hesitated. "I noticed that Sam has a number of scars -"
Dean's eyes narrowed imperceptibly, but his voice was carefully expressionless when he answered.
"Yes. We're hunters... our work is very physical."
She nodded, although her glance was curious.
"I presume you use painkillers on a fairly regular basis, then."
Dean's mouth quirked.
"Excessive use of non-steroidal anti-inflammatories can increase the risk of GI bleeds. Ibuprofen – Advil, Motrin? Or aspirin?"
Dean straightened.
"Sam had a conc... er... bad headache about a week ago. He took quite a lot of Advil. I was a bit worried so I told him to take aspirin as well – wasn't sure if that much Advil was good for him-" His voice trailed off as he caught sight of her expression.
"He took Advil and aspirin?" She shook her head. "That could very well be the culprit. Mr. Winchester, you should never take those together; they have the same effects and so double the risks. Apart from anything else, aspirin, being an anti-coagulant, would have worsened the bleeding."
Dean was silent.
I told him to take aspirin... It really is my fault. I basically poisoned him and then I ignored him when he tried to tell me something was wrong...
"Mr. Winchester?"
"Huh?" Dean blinked. Dr. Landon was looking at him with more than a little concern in her expression.
"Are you alright, Mr. Winchester? You seem a little... distracted."
"I...no. No, I'm fine." I just almost killed my baby brother. I'm fine. Absolutely peachy.
Her eyes narrowed slightly and Dean could see she didn't believe him, but she let it pass. She straightened.
"I'm sure you'd like to see your brother. I'll take you up to the ICU now."
ICU?! What the hell...
"It's routine in the case of a bad GI bleed," reassured the doctor, although Dean hadn't said anything. "He shouldn't have to stay there too long."
Dean blinked, nodded and followed her without speaking.
************************************************
Sam was too pale.
He hadn't opened his eyes since Dean had arrived. He lay very still, his head turned slightly away with untidy strands of chestnut hair drooping over his face and the pillow. IV lines were taped to both hands.
Dean wasn't sure if he was asleep or just pretending. He was too quiet: Sam asleep was almost more vigorous than Sam awake. But that could be the shock. Sick Sammy was another story altogether.
A story that Dean hated.
He sighed, scrubbing his hand over his forehead and then resting it against his chin.
"Sam..." His voice was low. He wanted Sam to wake up. Oh, how he wanted Sam to wake up! But what would he see when he did? What expression would those green-blue eyes hold? Dean could imagine the accusation, the hurt. You left me, Dean... you didn't listen when I tried to tell you I was sick... And Sam didn't even know the half of it. Dean found himself almost wanting Sam to stay under so that he wouldn't have to face his brother's distress. Then he hated himself even more for wanting that.
Dr. Landon had said that Sam would be fine, that it was just a matter of waiting for his blood volume to stabilise. Then they would do the scope. Dean's face twisted a little. Sam wasn't going to like that – having a camera stuck down his throat. He felt his own gag reflex stir at the thought.
Sam's nearer hand lay limp on the sheet, the fingers curling slightly. Dean wanted to hold it. He would never dream of admitting it, but he appreciated the occasional physical contact they had. He made fun of Sam, called him a girl, when he tried to initiate hugs. Those were sentimental, emotional, for people who lived normal picket fence lives and had normal families. They weren't for Winchesters. Winchesters didn't do chick flick. It was only in situations like this, when one of them was hurting or ill, that he had to acknowledge that he wished they were a little more – normal – that way. How often had he laughed at Sam, seen that rueful smile on his brother's face that was not quite hurt? And turned away wishing he could just have taken the gesture, given in to an embrace.
Showing my brother I love him doesn't make me less of a man.
Now he found he couldn't.
I want to hold his hand because I want comfort. I want reassurance; that he'll be okay, and we'll go back to how we were. That he won't blame me for hurting him, and leaving him.
I don't deserve that reassurance...
There was a faint movement from the bed, and his head jerked up, his eyes flashing to his brother's face. Sam turned his head a little, his eyes scrunching. Then the thick lashes lifted, and his eyes opened.
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I'm so tired.
Head hurts.
Stomach hurts.
Hands – OW! Ah. Hands hurt too. I've felt that before... IV needles?
Am I in hospital?
With what felt like a superhuman effort, Sam opened his eyes.
No motel room had ever been guilty of this spotless whiteness.
What am I doing in hospital?
Why... the ghost? I hit my head.... I think... maybe...
Dean. Where's Dean? Is he okay?
"Dean!" It was a stentorian bellow. At least, that was what he intended. He was vaguely surprised when a weak mumble came out instead.
"Sam? You're awake!"
Sam managed to turn his head in the direction of the voice. Dean was sitting beside him, leaning forward, his eyes wide and worried.
"Dean? What happened? Why 'm I 'n hospital? Are you okay?"
Dean laughed a little, an uncomfortable sound.
"I'm fine. You're the one who was heaving blood all over the floor."
"Wha..." Sam's voice trailed off as the evening's events rushed back. Stomach ache... cold and dark... staggering to the bathroom... vomiting... blood.... trying to get to the phone... so dizzy...
"Sam?" Dean was staring at him. "Are you okay?"
"Did you find me?"
Dean swallowed, an indefinable expression crossing his face.
"Yeah. Yeah, I came back... you were on the floor. Out like a light." I thought you were dead. "You woke up, though – you threw up. Don't you remember?" I thought you were dying...
"N-no." He came back? He left the bar. I ruined his evening.
"Oh. Well, you... you passed out again, so I... I called an ambulance. They brought you here." If I hadn't been so caught up with that STUPID bear I would have listened to you and we would have sorted this out before you lost all that blood and went into shock...
"Oh. Okay." He just wanted a break after that STUPID bear and then I went and fainted like a girl. I messed up his hunt and then messed up his evening.
"It looks like you're going to be fine but they just want to keep an eye on you for a bit longer. And do a coupla tests to see what went wrong." And protect you from your big brother, who's supposed to be the protective one but instead almost killed you.
"Okay. That's good, then." Dean's still mad at me. He's trying to be kind but he's not looking at me... and he hasn't called me Sammy once. I really screwed up this time...
"Yeah. Yeah. So you just lie there and... uh... get better." He does blame me. He's remembered that I left him. He's too polite... and closed off. I really screwed up this time...
Both smiled uneasily. Both leant back, one in his chair and the other against the pillows. Neither said anything more.
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"Well, the scope showed an arterial bleed, which was what we expected. Fortunately it was not as extensive as we'd feared, and we were able to deal with it then and there."
"So no surgery?"
"No surgery." Dr. Andrew Everett, who was on duty in place of Dr. Landon, smiled at the relief in the two faces before him. "We'll be keeping Sam in for another day, just to be one hundred percent certain that everything is okay, but it looks like he'll be walking out of here soon."
He saw the quick glances, as the two young men looked at each other and then hurriedly away. All too seldom was he able to give such whole-heartedly good news; and the reaction was usually more enthusiastic than this. Despite the undeniable relief, both brothers looked uncomfortable. They appeared to be avoiding each other's gaze.
Dr. Everett could see that something was off, but he'd been on duty for thirty-six hours straight and had little energy to play psychologist. He rolled his shoulders and grinned.
"Well, I have to be off now. I have to be in four different places five minutes ago... who'd be a doctor!" Chuckling, he departed.
Sam smiled perfunctorily, appreciating the doctor's humour less for its wit than for what it indicated: that there genuinely was nothing to worry about. Out of the corner of his eye he saw that Dean hadn't responded. His face was sober – almost grim. Sam swallowed, his grin dying.
He's still mad at me.
Dean ran his hand through his hair.
He really is going to be okay. Despite all my efforts to the contrary.
"That's good. That everything's okay, I mean."
"Yeah." Sam's voice was small, and he didn't look at Dean. There was an uncomfortable silence.
Dean broke it by standing up.
"I'm going to get some coffee. You want some?"
"I'm not supposed to drink it right now. Too acidic."
"Oh. Yeah." There I go again – why didn't I know that? "See you just now." He went out, almost hurrying to escape the tension that hung so palpably between them.
Sam sank back against his pillows. To his horror, he felt a suspicious pricking behind his closed eyelids.
I'm sorry, Dean. I really didn't try to screw up... honest. Don't be mad at me...
The room was cold, and he slid down in the bed, pulling the sheets up around him.
Dad was always the one who got angry. Dad would blame me. Dean didn't... wouldn't... I tried for Dad but he didn't understand... Dean didn't really either but he never blamed me. I'm sorry, Dean. I'll double-check next time.
I wish they'd turn up the heating in here.
He turned onto his side.
This blood loss business takes it out of a guy. No pun intended. I'm still so tired... I could sleep for a week....
I feel like I went ten rounds with the ghost of Muhammad Ali.
Oh wait – he's still alive.
The ghost of someone strong, though...
Maybe I cracked a rib vomiting. My chest hurts.
Gonna sleep. Dean's not here – and he doesn't want to talk to me anyway...
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Dean put down the gray-brown sludge that passed for coffee in this hospital and peered cautiously at his brother. Sam was lying curled up on his side, one hand holding the sheets to his chin. His eyes were shut.
Dean's heart wrenched.
He looked so young. So defenceless. More than a little like the toddler of twenty-odd years ago.
That toddler was now a freakishly tall young man who was most definitely not defenceless, but Dean still knew the fierce instinctive protectiveness that had been part of him ever since his tiny baby brother had been put into his arms by their desperate weeping father. Take your brother, Dean!
Look after him... keep him safe...
One hand went to the back of his neck as he took a gulp of the coffee.
The room was quiet, the only sound Sam's breathing as he slept.
Dean frowned, leaning forward a little.
Sam's breathing.
It sounded odd... too fast. Almost strained.
He stood up, leaning over the bed. Sam was pale, a faint sheen of sweat glossing his skin.
"Sam..." In sudden trepidation he put his hand to his brother's forehead.
He had barely time to register the unnatural heat before Sam's eyes opened. He looked at Dean, his expression changing from confusion to discomfort. His hand released the sheets and went to his chest.
"Sam? You okay?"
"Dean..." Sam was scrabbling against the bed, trying to push himself up. Dean quickly put his arm around his brother's shoulders and helped him, feeling with increased alarm the feverish warmth that struck through the hospital gown Sam was wearing.
Sam coughed, long and harsh, and fear thudded through Dean like a physical blow.
This wasn't right. It wasn't supposed to be like this. That doctor had said Sam was fine – that he'd be walking out of there in a day or two.
"Sam? What is it?"
"Dean... don't feel so good... can't..." He coughed again, his chest heaving. Dean could feel the increased effort as air sucked hoarsely in and out.
"Dean... can't breathe..." Sam's hands flailed, as if to catch the oxygen that his struggling lungs was unable to draw in. One found Dean's sleeve and his fingers twisted in the fabric in a desperate grip.
"Sam, calm down, it's okay. Just relax, breathe with me, come on, Sam..." Questing terrified fingers found the call button and Dean pressed it, holding it down.
"Dean... help... me..." Sam's face was darkening, a faint but inexorable blue tint creeping around his mouth and nose. His eyes were glazing but the fear they still held was heartbreaking. Then, abruptly, they rolled back, and Dean felt his brother go limp in his arms.
"No! Sammy!"
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Don't blame me. It was SunnyZim who suggested complications... and who was I to argue?
Hersienings, asseblief! (please review)