Anger's Outcome Ch. 10
Disclaimer: The Winchesters and everything related to them belongs to Kripke and the CW. I am not making a profit from this story.
Author's Note: I have no medical knowledge so please forgive any obvious errors.
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Previously: After quickly assessing the situation, the paramedics placed Dean onto the gurney while John helped his youngest. They got the boys to the waiting ambulance as quickly as possible and loaded them both inside. Turning around to face John, the lead paramedic said, "I'm sorry sir, but there's no room for you. You'll have to meet us at Clark County General Hospital." He then closed the doors before the driver sped off with the flashing lights on and the siren blasting.
John lost sight of the ambulance within minutes as the vehicle roared off towards the hospital. He could only hope that his sons were being well taken care of by the paramedics on board. He knew that things were bad with Dean and prayed that his oldest child had the strength to survive until they got to the hospital. It had scared him earlier when he had seen the blue tinge starting for form around Dean's mouth before the ambulance crew had arrived. It meant that Dean wasn't getting enough oxygen to sustain his body.
"Please hold on Dean, I can't lose you" John murmured as he continued his drive towards the hospital. Tears starting to trail down his cheek as he said "Sammy and I would never survive as a family if you leave us now." John had no doubts that with Dean gone, Sammy would just pick up and leave with the tension that always existed between the two of them. He wished things could be perfect between them like the way it was with Dean, but Sammy just couldn't accept their way of life, was always bucking him on every order and the former Marine just couldn't adjust to that.
Feeling the tears rolling down his face, John raised his arm and swiped them away with his sleeve. "Suck it up Winchester, You know Dean's a fighter and that he'll survive, if not for himself, then for Sammy because he could never leave the kid behind."
Meanwhile in the ambulance
"Step on it Harry, this kid has a possible pneumothorax" Brian shouted to his partner as he applied an oxygen mask over Dean's mouth and nose to help with his oxygen intake. He didn't like the sounds gurgling from the kid's chest and mouth as he vainly tried to pull in life sustaining air into his body. They really needed to remove the air from the kid's chest cavity as quickly as possible so the lung could re-inflate itself before it became a tension pneumothorax which could prove fatal. Brian looked over at the other kid lying on the stretcher. He had huger tears rolling down his face, but he didn't think they were from the pain caused by his broken leg. These boys were brothers and he could relate to what the younger one was feeling since he had an older brother himself.
"Don't worry kid, your brother's fighting with everything he's got" Brian said smiling at Sam. "He won't let you down, that's just how big brother's are"
Sam tried to smile at the comment but it came out as a grimace instead as a sudden pain shot through his broken leg. He attempted to hide the pain that he was going through so that the paramedic would keep his attention focused on Dean and not on him.
"You okay kid?" Brian asked as he watched the pain lines cross Sam's face before he was able to mask them.
"Yeah, I'm good" Sam voiced while unconsciously clenching his fists.
"Yeah, I can see that" Brian smirked as he pulled out a vial of Demerol and a syringe. "Do you know if you are allergic to any pain medications?" he asked before drawing some of the clear liquid from the small bottle.
"No, I'm not allergic to anything but penicillin but I'm good, I don't need anything for pain" Sam said as he looked at the long needle with a leery eye. "I don't need anything for pain."
"Listen uh…what's your name kid?"
""Sam, my name's Sam, that's my brother Dean"
"Listen Sam, I can see that you're in pain. What would your big brother here say if he knew you were hurting right now and was refusing help?" Brian asked hoping that Sam would cave in and accept the injection.
"Dean would call me a jerk, make me take the shot" Sam answered honestly.
"Will you let me help you then?" Brian asked "It's just a shot of Demerol to take the edge off of the pain you're feeling. It won't knock you out or anything and you'll still be able to see your brother here."
"Yeah, okay" Sam agreed as he watched Brian grab an alcohol pad and swab his arm before gently plunging the needle into his arm to deliver the medication. Sam gasped at the feel of the needle entering his skin but began to relax immediately as soon as the medicine started taking effect.
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Five minutes later, the ambulance pulled into the ER bay of Clark County General. Brian opened the back doors just as two orderlies arrived pushing a gurney between them. "The kid is going to need some help getting out, his leg is broken" Brian informed them as his partner met him at the back of the ambulance and helped remove Dean's gurney from the ambulance. Brian and Keith rushed Dean through the open doors and into a treatment room while the orderlies helped Sam.
As the doctor walked in, Brian informed him of Dean's condition. "We've got a victim of a bear attack. He has severe chest trauma with a possible pneumothorax" Brian stated as the doctor walked over and began assessing Dean.
Dr. Nathan Rogers placed his stethoscope to Dean's chest and listened. He could hear the sounds of air escaping and knew immediately that Dean had indeed punctured his lung. "Get this kid down to X-ray now" he ordered as he called them to let them know that he was sending down an emergency patient. Upon conformation of his diagnosis from the x-rays, Dr. Rogers knew that he would have to insert a chest tube to release the pressure so the lung could re-inflate itself. He thoroughly anesthetized the pleura and intercostal muscles to keep the pain at a minimum. Even though his patient was unconscious, he didn't want to cause him any more pain than necessary. He then placed a needle into Dean's chest that was hooked to a small syringe. He knew he had proper placement when no air bubbles rose into the syringe.
Dr. Rogers then did a tube thoracostomy and placed a chest tube into the incision he had made in Dean's chest. After the tube was placed, he hooked it up to a small vacuum like instrument and began to extract the air from Dean's chest cavity. This would allow the lung to re-expand as the air was withdrawn. After completing the procedure, he withdrew the chest tube and sterilized the area and covered it with a bandage. Knowing that the lung needed time to heal, Nathan administered a sedative to keep Dean unconscious and then hooked him up a ventilator which would breathe for Dean until he could do it easily on his own. Finally, he finished up by wrapping Dean's ribs to keep the two broken ribs from shifting and doing more damage. Dean was then taken to a room located in the Intensive Care Unit of the hospital.
While Nathan was taking care of Dean, Sam had been seen by another doctor who had sent him to X-rays and then casted his leg from just below his right knee to the bottom of his foot, leaving only his toes sticking out. Just as Sam was released from medical care and was seated in the waiting room, he saw his dad rush through the entrance.
John was about to go to the nurses desk when he saw Sam sitting on a chair with his right leg stretched out in front of him and a new white cast encompassing most of his leg. Walking quickly over towards Sam, John asked "Where's your brother and have you heard any news yet?"
"No Sir" answered Sam. "I just got finished myself, the doctors haven't told me anything about Dean.
"Well did you even bother to ask?" John questioned and then felt like hitting himself for the sarcastic question when he saw the pained expression on Sam's face. "I'm sorry Sam, I didn't mean that they way it sounded. I'm just worried about Dean."
John and Sam both looked up as a doctor walked out and then questioned the nurse at the desk. When the nurse pointed towards them, John stood up waited for the doctor to approach him.
"Hello Mr?…"
"Connors, John Connors" John said as he reached out to shake the doctor's hand. "This is my son Sam" he said as he pointed to Sammy who was still sitting in the chair.
"Nice to meet you Mr. Connors, Sam. I am Dr. Nathan Rogers and I was working on your other son, Dean correct?" At seeing John's nod, Dr. Rogers went on to say, "When Dean was brought in he was suffering from severe chest trauma and hypoxia from a pneumothorax or a collapsed lung in layman's terms. I had to insert a chest tube and withdraw the air that was in his chest cavity and putting outside pressure on his lungs. We got his lung re-inflated and I placed Dean on a ventilator to breathe for him while his lung heals."
At hearing the word ventilator, Sam's face went deathly pale and he started to hyperventilate. Nathan quickly bent down to where Sam was sitting and pushed his head between his knees. "Take it easy son, slow breaths, in and out, in and out."
When Sam's breathing had returned to normal, Nathan went on to say "I know things seem bad with Dean being on life support, but it will help his lungs to heal faster if they are not stressed from having to do the breathing for him. Dean also had two broken ribs which I have wrapped to keep them from doing any more harm. We have him sedated and resting comfortably in the ICU. If you'll follow me, I'll take you both to see Dean."
John helped Sam to stand and gave him his crutches so that Sam could follow him and the doctor down the hallway. Nathan made sure to take it slow so that Sam wouldn't have to struggle to keep up with them. Upon entering the room, John and Sam saw a pale looking Dean lying on the bed with many different machines attached to his body. He had a pulse oximeter hooked to his finger and electrodes hooked to his chest which showed the regular rhythm of his heartbeat. He also had two IV lines connected to his hand which kept him hydrated and sedated while in the ICU. And of course, there was that awful tube inserted down his throat that was doing the breathing for him. Sam hated the whoosh, click sound of the machine that seemed to cut through his very soul.
John pulled up a chair for Sam to sit in and then another for himself on the other side of Dean. "We're here for you kiddo. You just rest, we'll be here when you wake up."
TBC