Thanks again for all your support. Here is the next chapter, it is devoted to all my readers.
Dean Winchester lent over the side rail of the hospital bed, his fingers gliding through the dark mop that was his brother's hair. His heart ached at the thought of leaving Sammy and only the assurance that Bobby would stay and watch over his baby brother made it possible for him to even think about it.
All his life he had been Sam's protector, the one, who made sure nothing would happen to the kid, but this time he had messed up royally and now he would no longer be able to claim this role. It wasn't that he didn't want to, because his need to be there for the younger man was greater than ever, yet in his selfish need to distance himself from Sam to find closure after their father's death and to deal with the legacy he'd been left with, he had forgotten his most important function. Now his presence was bringing harm and distress to his brother, rather than security and comfort. No, this time he was going to do the right thing and put Sam's need over his own.
His hand slid down the pale cheek, careful not to displace the nasal cannula, which allowed pure oxygen to flow into Sam's respiratory system with every time he took a breath. Dr. Carmichael, the urologist, who performed the surgery on his brother, had just left the room a few minutes ago. He'd explained that they had not been able to repair all the damage to the kidney, as the organ had been more severely injured than they had thought. At this point they could only hope the rest of the damage would heal and the organ start functioning again. There was still a more than fifty percent chance that this wouldn't happen and they would have to remove it. He had also explained that after looking at the scan prior to surgery, he had noticed some changes in the ureter, the tube connecting each kidney to the bladder, on the other side. On exploration he'd found the tube torn and although he fixed it, he had to place a stent to keep it open until it would be completely healed.
Now that the urologist left, Dr. Finch, who until now stood by quietly, started to give her own report.
"We didn't plan on fixing Sam's leg right away, but Dr Zimmer, the orthopedic surgeon on call was in house for another emergency and he offered to take care of it so Sam wouldn't have to go under again. He put rods in both the tibia and fibula, the two bones in the lower leg. This will stabilize and give them a better change to heal. He told me Sam got lucky; the fractures are fairly smooth and closer to the knee, which means they usually will heal faster."
Dean swallowed hard then asked without ever taking his eyes of his brother, "I heard all the stuff the other doc explained and now I listened to what you had to say, but neither of you ever told me, if Sam is going to be alright?"
"You want me to be honest?" The female physician's voice made the older Winchester lift his head for the first time and lock eyes with her. Reading the answer in them, she continued, "I don't know. His leg is going to be fine, his kidney though…I told your uncle earlier your brother can live with only one, but with the severity of the injuries, there is a greater chance for infection and further complications. Yet we couldn't risk taking it, not with the injury to the ureter of the other and the damage it did to that kidney."
"Whoa, whoa, wait a second here!" Dean left his spot by Sam's side and stepped closer to the doctor, "What damage? No one talked about any damage to the other kidney."
Without being intimidated, Dr. Finch continued, "I guess he didn't want to worry you, before we actually knew if there will be a real problem. You see, when the ureter was severed, the urine produced in that kidney leaked into the surrounding tissue, causing swelling and inflammation. We put your brother on some potent antibiotics, but there is still a possibility this could cause an abscess, which could involve the organ itself."
In an attempt to digest the news and come to terms with the gravity of it, Dean turned and walked over to the window, leaving Bobby to ask the question he was afraid to.
"So now what?"
"Now we wait and see if the will antibiotics work and if the other kidney recovers. The only thing I can tell you at the moment is the injured kidney isn't working at all, but the other one is producing a fair amount of urine, which is promising." She answered honestly.
"What if the worst happens?"
"Let's just pray it won't. Dr. Carmichael ordered renal function to be monitored at least twice daily, more often if there is a change to the worse." The physician looked over to her patient, "Let's just take it one day at a time and not make up problems before they happen.
The older hunter moved silently toward the bed and wrapped his hand around the silent young man's. For a moment his eyes rested sadly on Sam, before they moved on to his older brother. His mind reeled over the question why nothing involving the Winchester could ever go the easy way. Didn't those boys have enough to carry? Why did this have to happen? Yet during his time on this earth and especially his time as a hunter, experience taught the salvage yard owner not to ask these kinds of questions, as it had a tendency to bring you more grief.
Pushing it away into the farthest corner of his mind, he said, "Thanks, doc for being so honest. I would appreciate it, if you would continue this way."
Dr. Finch smiled, yet her eyes remained serious, "I will and I'll make a note in Sam's chart that you want to be notified of any test and lab results immediately."
SN SN SN SN SN
It was late evening before Sam fought his way out of the depths of unconsciousness without sliding right back into it. It was also the first time, when he actually became aware of his environment. Feeling the rough hand holding his, made his thoughts instantly move to his brother. Struggling to lift his leaden lids, his mind filled with the accusing mantra, which had followed him down into the abyss before he was able to open his eyes even to a slit. Despondent, he wanted nothing more then to let himself slide back into nothingness, yet was held back by a voice that accepted no defiance.
"It's about time Sam. Open your eyes and let me see you're still in there. You almost gave me a heart attack."
Bobby let out a breath of relief, when Sam's blue-greens finally opened. The last three times he had hoped the young man was going to wake, the kid had slipped away before he had come this far.
Right now the only thing he was worried about was the fact that Dean had left shortly after Dr. Finch had told them about Sam's prognosis. Even though he tried to hold him back by first telling him how much his kid brother would need him now and later by calling him a stubborn idjit, the firstborn Winchester had not been deterred. He continued to insist that after all he had done his present would do more damage then good to his brother.
Drawing in another breath, he continued in a more gently voice, "Good to see you awake, kid, you really gave me quite a scare there."
", …'pened?" Sam mouthed, as his voice was still hoarse from the intubation during the surgery.
The older man reached for the cup of ice water on the night stand and guided the straw between Sam's lips, "Here, take a drink that should help a little."
After taking a few sips, Sam let his eyes roam around the room. It took only a short second before his breathing picked up and the dreaded question came out of his mouth, "Dean, where, where is Dean?"
Not quite ready to fess up the older man's eyes move away from his injured young friend, knowing the boy would be able to read the lie in them, "I sent him to get something to eat."
For the moment Sam seemed satisfied with the answer, yet Bobby could see the confusion written on his face and the wheels in his still foggy brain turning. If there was any doubt left, it was taken from him by the youngest Winchesters next question.
"What happened to me? I don't remember."
"You fell." The older man cleared his voice in an attempt to stall for time, unsure how Sam would react.
"I fell?" Sam's eyes cleared, as they grew larger, reminding the hunter of the little boy he used to be, "Down the stairs again?"
"No, ahem, you remember the sharp decline between my place and town?"
If possible the young man's eyes got even wider, "I fell there? But how…, how did I get there?"
The moment of truth had come and there was no more time for stalling, "You've been sleepwalking…"
The silence that followed would have been complete, if it wasn't for the noises coming from the TV set. The hunter watched the expression on Sam's face but was unable to come to a conclusion of what was going on in his mind. So he was even more surprised, when the younger hunter finally spoke.
"Oh…"
Bobby looked at him in utter bewilderment, "Oh…? I just told you, you've been sleepwalking and all you have to say is 'oh'?"
It seemed like Sam didn't even hear his outburst though, his eyes remained firmly fixed on something that wasn't there and as he continued, it was clear he wasn't talking to anyone else than himself.
"I guess that explains things. It wasn't Dean; it was my own mind accusing me." For a moment his featured smoothed out and complete relief was written on his expressive face. To Bobby's regret it lasted only for an instant, before it was wiped away by deepest despair. "I've been causing him nothing but trouble. I failed him, almost got him killed. Guess dad was right not to trust me."
No, Sammy", the older hunter hurried to say, "You didn't fail him."
Hazel orbs, clouded by tears gazed up at him and this time he failed to avert his eyes in time, "He isn't here, is he?"
"No, but he was here to make sure you were alright and he will be back as soon as he pulls himself together." Bobby tried to assure him.
"It's alright Bobby, you don't have to lie, I understand and he was right to leave." Feeling the need to be alone, he attempted to turn over, the pain the move caused ripping through his back and whole body and taking his breath away.
Scrambling for the call button, Bobby pushed it down as soon as his finger touched the device then his hands went to Sam's shoulders. Gently pressing the young man into the pillow, he soothed, "Breathe through it, Sammy, slowly in and out, just breathe. It's gonna be alright, help is on the way."
He looked up at the nurse, who stuck her head in the door, just to disappear again. Concentrating once again on his friend, he saw that his words didn't make any difference and the kid was continuing the struggle for breath, his lips already showing a bluish tinge.
"Could you hurry up, he's having trouble breathing." Bobby felt panic take over, just when Dr. Finch appeared by his side.
"Change him to a mask, at ten liters and I want some blood gases stat." She ordered then connected a syringe to Sam's IV catheter. She pushed the plunger down slowly, keeping a close eye on her patient while she did. Finally his panting breaths started to settle and his struggling seized at the same time as his eyes fluttered shut. Yet even in sleep the mask of pain and desolation continued to mare the handsome face.
Bobby relaxed slightly, but didn't move his hands away; instead he gently kept rubbing circles on Sam's chest.
"What in the world was this?" He asked at last, his eyes never leaving the younger man.
"Did he move?" The doctor responded to his question with one of her own.
"He tried to turn, but…"
"I was afraid of that." She answered, "See, the surgical wounds would cause some discomfort, but what is really more pain are the injuries to his back muscles and ligaments. I'm gonna write an order for Steroids IV to help with the swelling and inflammation and I'll increase the base and breakthrough rate on his Dilaudid PCA. Hopefully that will be enough for now."
The hunter gave her a puzzled look, "Alright, stop right there. I do understand quite a bit, so I know a PCA is a patient controlled analgesic, but what is that base and breakthrough rate?"
"Sorry," Dr. Finch apologized, "sometimes I forget, please always stop me if I do that. Base rate is the amount of pain medication that flows in per our, in Sam's case it was 0.5mg and I will double that. Breakthrough is the rate he can get with each push of the button, which was 0.25mg every 30 min but I will increase it to every 15 min."
"That doesn't sound like a whole lot. I know the kid has been on much higher doses of morphine in the past."
"That might be, but Dilaudid or hydromorphone generic, is much more potent and I really don't want to overwhelm his system. But I can give an order to increase it, if it's not enough, so they don't have to call me every time." She offered with a smile, seeing the honest concern in the face of her patient's uncle.
She wished more families would be like him, yet it was more common for them to let their loved ones suffer, not because they wanted them to, but out of a false fear they might get addicted to the medication. Most of them wouldn't even listen to her explanations and although she couldn't really blame them, it made it difficult for not just the patient and families, but also for the medical staff involved, who had to stand by without being able to bring relief.
Watching the way Bobby Singer attended to his nephew, she could tell how much the young meant to him. She had observed the same in his brother, which made her wonder, why the other man wasn't here now. There was definitely something going on here, something that seemed to cause a lot of distress. Sighing she left the room, it was not her place to ask unless it caused harm to her patient and at this point she had no reason to suspect it did.
TBC
So, once again, what you do think. I know there wasn't a lot of Dean in there, but I promise there will be more in the next chapter. Hope you still liked it. Please let me know. Hugs, Vonnie