Once again I am humbled by your reviews. They have meant so much to me, and have inspired me to write a better story than I started out with. Thank you.
a/n – If I thought the surgery chapter was hard, this one was agonizing. The previous two chapters ended up being grittier than I had anticipated, and I got to this chapter a little intimidated by the prospect of wrapping up the story along the same lines. When I put myself in Dr. Bates' shoes, I realized he would do whatever it took to save Dean, and that meant leaving my comfort zone and stretching as a writer. Terrifying, but probably good for me. So be warned, if you're a little squeamish, parts of this chapter might make you uncomfortable.
I set out to write the story I wanted to see unfold, the story of the brothers communicating after their father's death, because I didn't have the patience to wait for it to happen on the show. I hope I've accomplished that, and I thank you for indulging me. As it turns out, I ended up taking as long as the show did anyway. :-)
Thanks to Kripke and company for these wonderful three-dimensional characters I've had the pleasure of playing with.
Thanks to GS – because it's all her fault, and to SC in the ER – for the invaluable guidance.
Very long chapter ahead.
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It's a long, long road
From which there is no return
While we're on the way to there
Why not share
And the load
Doesn't weigh me down at all
He ain't heavy, he's my brother
The Hollies
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He Ain't Heavy, He's My Brother
Chapter 10
His body frozen, his brain processing the bare minimum, Sam sat in the same position for nearly half an hour, looking up only when he felt a hand on his shoulder.
"Hey," Ellen was holding an umbrella, trying to shield them both, and failing.
"Is something wrong? Is he okay?"
"He's restless," Ellen said, trying to ignore the red around Sam's eyes.
"Is he awake?" Sam started to get up; he didn't want his brother awake without him in the room.
Ellen put her hand out to stop him, afraid of what would happen if he stood up too quickly. "No, he's still out. It's just a light sleep that's all. He doesn't know you're not there," she added.
Sam nodded. At least he thought he nodded. He was certain his body was frozen solid; he could feel nothing beyond his eyelids blinking against the rain.
"Why don't you come inside?"
"How's his…blood pressure?" Sam's thoughts were muddled, he was so cold. "Did the transfusion work?"
"Seems to be working. Pressure's up." Ellen was tugging on his shoulder. "Come on, Sam, you're beyond soaked."
Sam looked down at himself, as if noticing for the first time that he was wet.
"Let me help you." Ellen fought the urge to kneel and throw her arms around him, to protect him any way she could. His eyes were distant, not fully present, and she wondered if he was in shock.
Sam looked at her, for an instant his eyes betraying his resolve, letting her see the pain and the anguish he couldn't shake. But then it was gone, replaced by the steely gaze of the hunter his father had perfected. The same one his brother tortured him with daily.
The look was eerie, and Ellen wondered if it was a Winchester trademark.
Sam stood, slowly, his brain and his body on different frequencies.
"Sam, you did good in there." Ellen had him by the elbow, afraid to let go of him.
Sam had no response. No movement, no tip of the head, nothing that acknowledged she was even there.
"He can't die." It was a prayer. Directed at no one. Directed at God. At the universe, at the rain and the trees and everything that held life and was close and he could feel. It was a plea. For sanity, for peace, for him, for his brother, for everyone he had ever loved and lost.
They had reached the back door and Sam braced himself for the warmth of the kitchen, the sight of his brother bandaged and unconscious, unable to shelter him from his own pain, his own fears. Sam hated how much he relied on his brother for his survival, how much he needed him, and shoved open the door with his fist, the painful connection clearing his mind.
Dean's motionless body instantly brought back feelings of despair and anguish, of love and hate, of hope and triumph, a sordid mess Sam tried to sort by reaching for his brother, for any part of him that he could connect to.
His brother's hand was warm, and his forehead even warmer, and Sam held his place, letting Dean's fever elevate his own body temperature.
"You all right, Sam?" Dr. Bates was checking Dean's IV line, making sure every drop of versed was used.
"I'm fine," Sam answered, absently watching the water dripping from his clothes. "How is he?"
"Blood pressure's up. Not great but much better. He doesn't need to work as hard."
Sam noticed Dean's breathing was steadier, not as labored. "Does he need more blood?"
"Possibly. But let's wait and see. I don't want to push our luck." Dr. Bates was listening to Dean's stomach with the stethoscope.
"What else is going on?"
"There's some distension in his stomach, which could mean several things," Dr. Bates continued. "An obstruction, intestinal paralysis, an infection. Could just be a result of the surgery and mean nothing."
"How do we know?" Sam shook, his teeth chattering, from the cold, from the information he couldn't process.
"We need an x-ray and a CT scan to be sure, but under the circumstances we wait. See if other symptoms manifest."
Sam opened his mouth to speak but nothing came out, only a short breath that caught between his teeth.
"Sam," Ellen had a hand on his arm. "You have to get out of those clothes."
Sam nodded. "How long…before he…wakes up?" The chattering was incessant.
"We found a little more versed. My guess is 20 – 30 minutes tops."
"I think I'll take…a quick shower…if that's okay." Sam felt battered, bruised, as if he'd been in a scuffle with a wendigo, and hoped a shower would resuscitate him. Revitalize him for what he feared would be agonizing hours ahead.
"Great idea." Ellen was practically pushing him out of the room. "Let me show you where everything is."
Forcing himself to move quickly, Sam didn't bother turning on the cold water as he stood in the shower, the hot water burning his skin for several minutes. He was suffering from a bad case of survivor's guilt, and was grateful for the pain. A punishment of sorts for avoiding the demon's wrath. For surviving the car accident with nothing but a few scratches. For having a healthy appendix.
As soon as he stepped in the kitchen Sam realized Dean was awake. Betty was taking his pulse while Ellen tried to calm him down. Sam didn't skip a beat, and in two long strides was at his brother's side, taking his hand.
"It's about time."
Dean's eyes shot to Sam, the tension in his body releasing immediately.
"How do you feel?" Sam was afraid to ask. Deep, painful lines creased Dean's face, casting dark shadows under his eyes.
"Did you…do it?" It was a low whisper, and Sam had to lean forward to catch the tail end of the question.
"We did. You are now the proud owner of an appendix in a jar. You wanna see it?"
Dean's eyes widened and Sam laughed.
"Ruptured?" So he had been paying attention. It didn't surprise Sam that Dean had gone into the surgery fully aware of everything that was going on. And had probably not let on for his sake.
"About to, but we got it just in time. You're a lucky bastard."
Dean closed his eyes at a sharp intake of breath, letting it out slowly a few seconds later. Sam waited it out, could feel the pain dissipating through his hand.
"You okay?"
"Thirsty."
"Hey, Doc, can he have some water?"
Dr. Bates had been hovering nearby, feeling incredibly helpless. Water. Such a simple request, but laced with so much uncertainty. He had a running list in his head of everything Dean needed that he wasn't getting, and hydration through an IV was near the top. But if Dean did have an intestinal obstruction, or paralysis, anything by mouth could potentially make it worse.
"Doc? Water?" Sam was anxious.
"A couple of sips, Sam. We need to see if he can tolerate it."
Attempting to drink the water was excruciating, and after a few sips Dean gave up, unable to cope with the pain the simple movement caused.
Dean shut his eyes tightly and turned his head away. Away from the concerned stares of strangers, from the pain. From Sam.
"Take it easy, man, it's okay. Just breathe."
Dean tried to listen to Sam, but suddenly felt so nauseous breathing stopped altogether, replaced by the gagging, choking sounds of his body trying to expel what little water he'd just had.
Sam watched in horror as the water trickled out of his brother's mouth. As Dean gagged helplessly, the movement making his body spasm.
"Sam, we have to get him on his side."
"What?"
"If he starts to throw up in earnest he doesn't have the strength to turn on his own. He could aspirate. Inhale his own vomit."
Dean gagged again and Sam felt the sense of urgency drown his fear.
"I'm going to turn you, okay?" Sam didn't wait for a response, for anything that might take the nerve away, and gently, with Ellen's help, rolled Dean onto his left side.
Dean held himself rigid, waiting for the pain to subside. In his stomach, his chest, his head. In his arm with stitches that were barely hours old. And then it happened again. He gagged. Again and again, until he was shaking, in a cold sweat, his insides unable to release anything.
Sam pulled up the one chair in the room and sat directly in front of Dean, bending down to make eye contact as he placed a wet wash cloth on the back of his neck. "Hang on, okay. This will pass."
Dean nodded. Terrified by the look in Sam's eyes. He had never seen that look before. Not in the cabin, when Sam was facing off with the demon, not in the hospital when their father died. Not even in Palo Alto. He had to get himself together. Had to protect Sam. But he couldn't stop gagging. Couldn't stop his insides from burning. Couldn't keep Sam in focus long enough to reassure him of anything.
At the doctor's request Ellen brought out a pillow that Sam gently placed under Dean's head, and Dean found himself once again fighting to keep Sam in focus.
"Hey, Doc, isn't there anything you can give him?"
"Nothing injectable," Bates sighed. "He can't tolerate anything else right now."
Dr. Bates made his way to Dean and put a hand on his shoulder. "Dean," he said. "I'm going to listen to your stomach with the stethoscope, okay. You don't have to move. I can do it while you're on your side."
"Okay." Dean was trying to stay conscious. For Sam.
The doctor listened intently, readjusting his hearing aid several times, until he was satisfied. After a minute he placed his good hand on Dean's stomach and moved it in a circular motion.
"Dean." Dr. Bates was pressing lightly on Dean's stomach. "Besides the burning sensation you can feel throughout your abdomen, especially in the area of the incision, can you tell if there's something else? Something deeper. More like cramping."
"No…I don't know. It just hurts." Dean was cold to the touch, and the words were low and hard to hear.
Sam looked up at the doctor, waiting for an explanation.
"There's no movement, no bowel sounds," Dr. Bates whispered, certain Dean could hear him. Equally certain Sam wouldn't walk away from him to have a private conversation.
"What does that mean?"
Dr. Bates rubbed his chin while he spoke. "The nausea could simply be a result of the anesthetic, but the distended stomach, the lack of any muscular contractions in the abdomen," he paused and shook his head. "My guess is paralytic ileus, but without the proper diagnostic equipment I can't tell for sure."
Sam's eyes widened as he leaned forward.
"It means the intestinal wall has ceased working."
"Why? How?"
"Decreased electrolytes can cause it, peritonitis, but I don't think that's it. There was no rupture or infection when we opened him up. Most likely there was trauma to the nerves supplying the gut wall. It's probably related to the leaky blood vessel."
"Pulse is 85," Betty interrupted. "BP is 85 over 65. Temp is 103.8."
Dean gasped, his hand on his mouth as he convulsed and began to shake. His other hand against his stomach in a vain attempt to control the spasms.
"It's all right, Dean, it's all right. Breathe through it." Dr. Bates put his hand on Dean's neck, rubbing it gently until he calmed down. "Did that feel more like a cramp?"
Dean nodded. "Yeah."
For several minutes there was no activity, no movement, no sound in the kitchen besides the wind and the rain against the windows, besides the low breathless sounds of Dean living through the pain. It was a collective calm of anticipation, of trepidation. Of prayer and hope.
Until Dean broke the silence, his head banging helplessly against the pillow, his hand searching for Sam as he dry heaved into thin air.
Sam put a hand on Dean's shoulder, his other hand against Dean's back as he rubbed mindlessly, feelings of helplessness again threatening to consume him. "Take it easy," he whispered, his eyes searching the doctor for answers.
Dr. Bates was deep in thought, torn by every scenario that came to him. Experience told him there was nothing else he could do. Only his heart was preventing him from giving up.
"Sam, I've got an idea." Bates was hesitant, thinking as he spoke, and Sam didn't miss the uncertainty.
"You don't sound very convinced."
"I'm not," he said honestly. "But we're running out of options." Bates tried to organize his thoughts before saying anything else. "But this might work."
"Might?" Sam was whispering. He had noticed Dean's eyes were closed and he was hoping he was asleep.
"Here's the thing," Bates continued. "The pain from the surgery alone is bad enough, but you throw in the convulsions from the nausea, the associated cramping, the high fever, and it becomes excruciating. Untreated extreme pain will make him highly susceptible to shock. I believe the nausea, and the cramping, is being caused by the paralyzed intestinal wall. If we can regain motility we can alleviate those symptoms."
"And how do we do that?"
"The way to get the wall moving again is to put a tube down his nose and into his stomach and suction."
Sam winced at the thought.
"But we don't have the necessary equipment to do that," Bates added. "My only suggestion…" He hesitated again, uncertainty gripping his every move.
"What is it?" Sam was still rubbing Dean's back, still watching him sleep.
"This is a last resort, because it runs the risk of rupturing the bowel." Dr. Bates ignored Sam's expression and continued. "I suggest we try a low volume, warm enema to stimulate the abdominal wall."
"Fuck no!"
Sam turned to Dean. "I thought you were sleeping?"
"Trying to." Dean winced with the pain speaking caused. "No fucking way, Sam."
"Dean."
"No!" The exertion brought with it more pain, and Dean pushed Sam away as he slammed his fist into the table, head buried into the pillow.
Sam looked at Dr. Bates. "And if we don't do it?"
"I don't know, Sam. Maybe it's not an ileus and the intestine will start working again on its own."
"And if it doesn't?"
"The pain will get worse. And we have nothing to give him. He had an allergic reaction to the Demerol, and everything else we have is in pill form, which he can't tolerate. Paralytic ileus isn't life threatening," he added. "Unless it's left untreated."
"Hey, Dean."
"No." Dean's voice was muffled against the pillow.
"Let's talk about this."
"Nothing to… talk about."
"You're delirious, man. This could help you."
Dean clenched his teeth and forced himself to turn his head. The look in his eyes pure agony as he tried to get across to his brother the sheer terror he was feeling.
Sam reached for his mouth, the urge to throw up catching him off guard. Dean instinctively reached for his brother, forgetting his own pain while he tried to alleviate Sam's.
"Hey," Dean whispered.
"I'm okay," Sam said, feeling foolish. "It's just, I mean…I know you're scared, but this could help."
"It's unnatural, Sam."
"It's medicine."
"We're in a…kitchen." Dean gasped, releasing his hold on Sam's arm.
Sam took Dean's hand, feeling lost, unbalanced, without the connection.
"You let me take out your appendix in this kitchen."
"That was…different."
"How?"
"I was asleep."
If you only knew, Sam thought. "Dean, people get these things every day."
"Not…me," Dean gasped, and squeezed the hell out of Sam's hand.
Dean," Dr. Bates interrupted. "I'm going to feel your stomach, okay. Try to be still for a minute." Bates didn't like the sound of Dean's breathing, or the twitching that came with every move.
Sure enough, Dean's stomach was painfully distended and rigid, and Bates knew something had to be done fairly quickly.
Dr. Bates looked at Sam and shook his head, hoping the lanky kid with nerves of steel had learned to read him in the last few hours.
"Dean," Sam began. "I know this is scary. But you have to trust me." Sam was practically whispering in Dean's ear. This was between him and his brother. "I can barely hold on, man. Watching you suffer like this is killing me. But if something happens to you." Sam stopped. He knew it was a low blow, but he had run out of options. The truth was the only thing left.
"I…can't."
"You don't want to."
"Same thing."
Dean closed his eyes. Against the pain. Against the fear. Against the overwhelming need to protect his brother above all else.
"Dean." Sam couldn't let go, his voice fraught with emotion. "You got me through Jess. Hell, you got me out of the house after mom."
"It was…an order."
Sam couldn't believe what he was about to say. "You've always protected me. How can you stop now? How can you give up?"
"I'm not…giving up." Dean gagged again, and quickly tried to straighten his body when he felt the movement pull on the incision.
"Dean?"
"God, Sam. I'd rather get stabbed by a zombie."
"Is that a yes?"
Dean closed his eyes and tried to take a deep breath, the nod almost imperceptible.
Within a few minutes Dr. Bates was ready, having started the concoction before Dean gave his consent. When he approached the brothers his demeanor was somber.
"All right," he said. "This is what's called an M&M enema."
"You've got to be kidding me."
Sam rubbed his eyes, trying to ignore the irony.
"It was popular in the fifties after surgery. It stands for milk and molasses, blackstrap molasses. Equal parts of each."
"Doc, really." Dean gagged again and Dr. Bates apologized.
"Betty's going to do the procedure while I massage your stomach. The liquid is heated, so you will feel a warm sensation, but not hot. Dean, are you listening, this is very important."
"All ears."
"You will feel some cramping, which is normal, but if at any time you feel full, like you can't take anymore, you have to speak up immediately. You got that?"
"Uh-huh."
Sam noticed Ellen standing a few feet away, helpless and uncomfortable.
"Hey, Ellen, do you mind…"
"God, no," she said, relief written all over her face. "I'm going to see what Ash is up to. Last time I checked he was emailing all the fire stations within a hundred mile radius."
Ellen disappeared and Sam turned to his brother, right away noticing a new sheen of sweat on his face.
"Hey."
"Hmm." Dean was elsewhere, the only way he could cope with what was about to happen.
"Dean." It was Bates again. "I need you to move to the edge of the table. Can you do that or do you need help?"
Dean didn't answer, but began the arduous process of moving on his own.
"Can I help? Sam asked, a hand on his shoulder.
"I…got it."
"Good, Dean, that's good. Right there. Now, this is going to be a little uncomfortable. Sam, I need you to bring his knees up, as close to his chest as he'll let you."
Sam did as he was told, forcing himself to look away from his brother. Stopping only when Dean groaned.
"Okay, Dean, how are you doing?"
"Swell."
Betty positioned herself behind Dean, the card table with a bowl to catch the liquid right beside her. Dr. Bates leaned his round body across the table, his good hand over Dean's legs and on his abdomen.
"Dean," he said. "You have to relax."
"You relax."
Dean was pale, and he was shaking, his nerves getting progressively worse as Dr. Bates began to massage his stomach.
"Dean, honey, if you don't relax this is going to be really painful." Betty was getting resistance with everything she tried.
Sam couldn't face his brother. He got him to agree to this. He had to get him through it. But he was terrified. What if it didn't work? What if it made things worse? What if something ruptured?
"Dean, relax." Dr. Bates was making circular motions on Dean's stomach, looking at Sam, urging him to do something. To help his brother.
Sam shook himself out of his stupor and forced himself to look at Dean. To see beyond the fear that had a grip on both of them.
"Hey, Dean, remember that time we were on a hunt with dad. I must have been eight or nine."
Dean's eyes were wide as he searched for Sam's hand, grabbing it and holding it tightly against his own when he felt Betty begin.
"Dad was really pissed because I had spilled salt all over the back seat."
Dean held his breath against the pressure, his lips pressed together, his eyes shut.
"I must have spilled a five pound bag. I don't even remember how. But dad was yelling up a storm."
Overcome by unrelenting anxiety, Dean took short, quick gasps of air while Sam put his free hand on his head, working his brother's short hair into his fingers against the panic.
"You turned to look at me. You were sitting in the front seat. You were always in the front seat. You rolled your eyes at me. I thought Dad was going to kill me. I think you did too."
Dean tore into Sam's hand, grabbing chunks of his sleeve as he worked his way up Sam's arm. His breathing rough as he fought against the unfamiliar sensation.
"Dad kept saying he was going to miss his chance, and there was nowhere to get salt before daylight."
Dean clawed his way to Sam's shoulder, pulling his brother down with the sheer strength that came from fear and pain bordering on panic.
"I was so scared I started to cry. Quietly, because if Dad knew he'd yell even louder. And you climbed into the back seat."
Dean pushed his fist into Sam's back, practically lifting himself off the table, grunting with the effort it took to stay in control, and Sam pushed him back down, taking his hand and holding it, all the while maintaining gentle pressure on his head.
"And for the next hour you helped me pick up every grain of salt, every last one, until the bag was almost full again. Until Dad stopped yelling."
Dean was spent, trembling, soaked in his own sweat as he reached a point he couldn't bear.
"Stop," he pleaded.
"Do you feel full?" Dr. Bates continued massaging his stomach. Betty stopped and waited for instructions.
"Cramping."
"Can you hold it for a minute?"
Dean didn't answer and Sam thought he had passed out.
"Dean?"
"Do I…have to?"
"Only if you can. You've done great. If you can hold it for a minute that would be better."
Dean let go of Sam's hand, too exhausted to hold on, and braced himself for the seconds to pass.
Sam put an arm around his brother, an attempt to provide warmth, for both of them. And counted the seconds with him.
"All right, Dean, that's it. You can relax."
Dean shuddered involuntarily at the release, against the pressure of the doctor's hand on his abdomen, against the cold sweat he couldn't help. And Sam continued to hold him. Until the shaking stopped. Until his breathing was even.
"How do you feel?" Dr. Bates was pushing his legs down, away from his chest, so he could listen to his stomach.
"Hmm."
Bates didn't expect an answer, just wanted to make sure Dean was still conscious.
He took the stethoscope and listened. The fact that Dean wasn't writhing in agony was a good sign that nothing had ruptured. After a minute he heard it, the low gurgling sounds of the intestinal wall, of the bowel. The procedure had gotten things moving again, and he couldn't help the smile that crossed his face as he looked at Sam.
Sam didn't skip a beat. "Hey, Dean, it worked."
"Whatever." Dean was exhausted from the resistance his nerves had generated, from the fever, from the surgery. And he was pissed as all hell at what they had just done to him.
"Pulse is 79. BP is 85 over 65. Temperature's 103.5."
"Dean, how's the nausea?" Dr. Bates was feeling Dean's stomach, could already see the distention receding.
"Fine…I guess."
"We're going to get you on your back then, okay. It'll alleviate some of the pain on the incision, as well as take the pressure off your arm and those stitches."
Dr. Bates couldn't help worry about the pain, and he marveled at Dean's inner strength. Anyone else would be screaming in agony, or unconscious from the misery. But he knew it was only a matter of time before the pain would overwhelm his senses, weaken his organs beyond repair, and he prayed that help would arrive before then.
He noticed Dean shivering and brought the blanket up to his chest, feeling his forehead with the back of his hand. "Hang in there, okay. I'm sure help will arrive any minute."
Dean brought his eyes up to the doctor and swallowed. "Thirsty," he whispered.
Dr. Bates grimaced at the request. "It's too soon," he said, his hand still on Dean's forehead. "You may not be able to keep it down, and we need your insides to rest a little."
Dean licked his lips in response, his glassy eyes searching the doctor's face for relief.
Dr. Bates moved his hand down to Dean's cheek, holding it in place while he got his bearings. While he got past the crushing feelings of failure. "Let's try some ice chips," he conceded. "See how you do with those."
Dr. Bates went to the refrigerator and Sam took over, taking Dean's hand for the fiftieth time that day.
"Hey."
"What?" Dean was weak, but he managed to pull his hand away.
"Thanks for um, you know."
"For letting some decrepit old woman…stick a tube up my ass?"
Sam laughed and looked around nervously, suddenly grateful that Dean could barely speak above a whisper.
"For letting her save your life," Sam added.
"Not sure it was worth it."
"I owe you."
"Next time there's an…enema up for grabs…it's yours."
"Deal."
"By the way…you were…12."
"What?"
"When you spilled the salt…all over the back seat."
"I was?"
"Yeah, big, chubby kid, blubbering about…salt."
Dean shut his eyes against the pain and turned his head. The conversation more than he could handle. He was so tired of hurting. Of being weak. Of being looked after and tended to.
"How are we doing?" Sam turned to see Ellen, followed by Ash.
"Better," Sam said. "His insides are moving again. Ash, any luck?"
"Not yet," he said. "But I've emailed everyone at the hospital again, every firehouse in the area, every city and county office. I've sent over 50 emails."
"All right, Sam," Dr. Bates said, handing him a small bowl. "Here are some ice chips. It's not much, but let's see if they help."
"Hey, Dean, how about an ice chip?"
Dean turned to face Sam, his movements slow as the pain and the fever continued to wear him down. He was so thirsty. He wanted a bucket of water, not a damn ice chip. But he opened his mouth anyway, grateful for whatever he could get.
The ice felt good on his chapped lips, in his mouth, down his throat, and his body begged for more. He held his mouth open in anticipation, waiting for Sam to give him another one. And again he couldn't get enough, his tongue licking his lips as his body craved hydration.
"Sorry, man, that's it. Hey, Doc, can he have more?"
Dr. Bates placed a hand under the blanket and felt Dean's stomach, happy most of the distension was gone, but not comfortable with giving Dean any more water.
"Sorry, Dean. Let's wait a few minutes and see how your body reacts to what you've had."
The disappointment was jarring, and Dean felt unwelcome tears stinging his eyes. His throat aching for water. His insides on fire.
Dean looked around the room, as far as his eyes would take him, trying to distract himself from the burning sensation across his stomach.
Where the hell did Ellen find that wallpaper with the roosters on it? If I bite my lower lip really hard, will I forget the fire? Didn't think so.
"Dean?"
Not now, Sam, I can't talk right now. Why are you wiping my mouth? I'm so thirsty. Can't you see I'm on fire?
"Hey."
God, Sam, you can be such a girl. Always wanting to talk. Don't you know that sometimes silence is the only way to go? Maybe if I press my fists into the table really hard the pain will go away.
"What's wrong with him?"
Honestly dude, if I could get a word out right now it would be shut the fuck up. Okay, so it's more than one word. Why am I so out of breath? I feel like I just ran a marathon.
"He's going into shock."
Who said that? Oh no, it's Rip Van Winkle. Where the hell did Sam find this guy? You really think that lifting my legs is going to help? A bullet right through my head, that would help. Why are you taking my pillow?
"Dean?"
What are you doing? Oh God, please get your hand off my face. Honestly, Sam, haven't you heard of personal space?
"Pulse is 105 and thready."
Now what?
"Please, Dean, don't do this."
Come on, Sammy, just leave me alone for a while. We can talk later. Right now I just need to put out the fire. Let go of my hand, Sammy. Let me go.
"Pulse is 110."
Hey grandma, can't you see I'm having a conversation with my brother?
"Damn it, Dean, stop."
You are so demanding. I am so cold. How can that be when there's a fire in my belly? Nice trick, Sammy, I can see two of you. I'm just going to close my eyes for a while, okay?
"115."
Jesus lady, can you shut up! Why is everyone talking at once? SHUT UP! GO AWAY!
"He's shutting down."
Why the fuck are you flashing a light in my eyes?
"Come on, Dean, fight this."
Son of a bitch, you did not just slap me.
"Please, Dean. I can't do this alone."
Thank God you're back, Sammy. Please get that quack away from me.
"Dean, don't. Please."
Sammy? What's wrong? Are you okay? Are you hurt? Who did this to you? What did this to you? Does Dad know?
"Sammy?"
"Pulse is 100."
Sam took short, fractured breaths as he stared at his brother, still conscious, still breathing, still with him.
"You okay…Sammy?"
"I'm fine, Dean." Sam knew the drill. Understood Dean's need to make sure he was okay before he would allow a fuss to be made over him.
"How about you? You okay?"
It took Dean a while before he could process the question, closing and opening his eyes several times before he could manage an answer.
"Not so…good," he finally admitted. His face was pale, and Sam knew deep down that he was hanging on by a thread.
Sam turned to Dr. Bates for reassurance.
"It's the pain. It's going to do him in if we can't alleviate some of it."
"And we have nothing we can give him?"
"Nothing that won't make something else worse."
"Ellen, do you have anything in the house?" Sam was grasping at straws, his hand protectively across Dean's chest. His brother's heartbeat the only thing keeping him standing.
"Afraid not." Ellen wanted to take Sam by the hand, to let him know he wasn't alone. But deep down she knew he was. It was how he was raised, how they both were, in thinly controlled chaos that forced them to rely on each other for everything.
"Hey, Doc." Ash broke in. "I've got some marijuana."
"Jesus Christ, Ash!" Dr. Bates was dumbfounded, mouth gaping as he stared at Ash. "You have marijuana?"
"Um," Ash hesitated, unsure if he should fess up or run. "Yeah."
"Why didn't you say something sooner?"
"What?" Now it was Sam's turn to stare.
"Ash, go get it, hurry."
"What? Wait. You're not serious?" Sam couldn't believe what he was hearing.
"Sam, it's a wonderful pain reliever."
"It's illegal for a reason."
"It's illegal because some zealots in the 1930s thought it should be. Before that it was the primary pain reliever in this country until aspirin was invented."
"Ash, go get it."
"No."
"Ash, go get it while Sam and I discuss this."
"There's nothing to discuss."
Ash didn't bother looking at Sam before disappearing.
"Sam, if I told you I had morphine would you think twice about letting Dean have some?"
Sam hesitated, he knew it was a trick question. "No," he finally said.
"And yet, in Dean's condition, morphine would actually work against him. The marijuana will relax him, help with the spasms."
Sam looked at Dean, gaunt, hollow, lips parted as he tried to breathe past the pain that even in sleep wouldn't leave him alone.
"Sam," Dr. Bates sensed his fear, understood he was close to an overload, and treaded carefully. "Marijuana has been used for pain for thousands of years. You've trusted me this far," he added. "This won't hurt him."
Sam sat and buried his head in his hands. He didn't know what he was afraid of, where the hesitation was coming from. He just knew he couldn't think. Couldn't process. Couldn't for the life of him make one more decision.
"Sam." Bates had to get through to him. "Is it a moral question? Would Dean be opposed?"
Sam laughed. "No," he finally said, the question bringing him back. To a place where he could focus. "No, Dean wouldn't be opposed."
Sam stood and faced Dean, a hand on his shoulder when he stirred, when he opened his eyes.
"Hey, you hanging in there?"
"Don't…think…so." The honesty tore at Sam.
"Well try, okay. I promise you it will get better."
Dean answered with his eyes, in a way only Sam could understand. He was trying, and he was doing it for Sam, but even that was becoming hard to do.
Sam turned to Bates. "Okay," he said, his insides churning.
"Good," Bates began, wasting no time. "You have to guide him through it. It's important that he breathe deeply, get as much of it in his lungs as possible. It may cause him to cough at first, which will be painful, but you need to do whatever it takes to get him to continue. Don't let him stop until I tell you."
Ash stepped forward with a joint in hand, lit and ready to go. Sam took it and turned to Dean.
"Hey, Dean, can you hear me?"
"Hmm."
"So, um, we found something that might make you feel better, but you need to smoke it."
Dean opened his eyes, a look of surprise on his face when he saw the joint in Sam's hand.
"You've got to be…kidding me."
Sam couldn't help but smile. "It's medicinal," he said, for an instant wishing he could smoke it instead. "Doc says it's a proven pain reliever."
"Is this what…it took…for Ash to share?"
"Hey, man, I just wish I'd thought of it sooner." And Ash meant every word.
"So what do you say, you wanna try it?"
Dean shut his eyes tightly against a new wave ripping through his insides, and nodded.
Sam waited for it to pass, then brought the joint to Dean's lips.
"Easy, just a little at first, you don't want it to make you cough."
Too late. The first drag burned his throat, and it was impossible for him not to cough.
"Okay, it's okay. Just wait." Sam had a hand on Dean's chest, trying to get him to calm down.
"All right, let's try this one more time." Dean nodded and Sam was once again humbled by the trust his brother had in him.
Dean managed to get through half of the joint before Dr. Bates had him stop, feeling his pulse and looking closely for a sign that it was working. That the drug was giving him a much needed reprieve.
"Well?" Sam couldn't contain himself.
Dean tried to smile, his attempt falling short. "Better," he offered, happy to see the relief on Sam's face.
Sam let out the breath he was holding and handed the joint back to Ash. "Okay," he said. "You tell me when you need more."
Dean's eyes fluttered and then they were closed. And Sam wondered if the marijuana had really lessened the pain, or just relaxed him to the point he didn't notice. Sam didn't really care either way, as long as his brother was comfortable.
Sam looked at Dr. Bates, who was still fussing over Dean, placing the pillow back under his head, feeling his stomach, his forehead, and felt an overwhelming debt of gratitude.
"Sorry about that," Sam offered.
Dr. Bates brushed him away. "Sam," he began, "I can't understand how Dean has managed to carry on a conversation during the last hour. Frankly, I'm not sure how he's managed to survive. And I can't figure out how you're still standing. If I hadn't seen Dean bleed, and hadn't seen your blood in all those syringes, I'd swear you weren't human. You have nothing to apologize for."
"Now I think it's time to triage," Bates continued, looking around the room. "I know you all must be exhausted, and since we have no idea what daylight is going to bring, I suggest those of you that can, get some rest."
Sam started to protest.
"That doesn't include you, Sam. I know better than to get you out of this room."
"I can sleep anywhere, Ellen," Betty said. "A couch with a blanket and a pillow is all I need."
"I've got a spare room," Ellen said, turning to Sam.
"Are you sure you don't want me to stay up with you?" Ellen offered.
"I'm fine. You should get some sleep."
"Your mother would have been so proud of you today," Ellen said, hoping she wasn't overstepping any boundaries. "And of Dean. You two would make any mother proud."
Ellen gave him a hug, an unexpected burst of affection she couldn't resist, and Sam surprised himself when he returned it.
Ash handed Dr. Bates two more marijuana joints. "That's everything I've got," he said before leaving the kitchen.
Betty was checking Dean's vitals one more time before going to bed, a smile on her face when she looked up and met Sam's gaze. "Pulse is 75, BP is 90 over 70," she said. "His temperature is still high, 103.6, but he's doing much better."
And then they were gone, only Dr. Bates remained, checking the IV line, making sure the antibiotic was still pumping into Dean. When he was satisfied, he turned to Sam.
"I'll be back in a few minutes," he said. "I think I've had to go to the bathroom for about five hours."
Sam pulled the blanket up around Dean's chest and watched him sleep. How many times had he done that today?
Today. He turned the word over in his head, marveling at the expanse it covered. He would have sworn under oath that weeks had passed since the old Volkswagon had stalled in the rain, since they had shown up soaking wet, since they had fixed the hole in the roof. The fact that it had been merely hours was hard to fathom. But not as inconceivable as the fact that in between then and now he had taken out his brother's appendix, had gotten an intimate look not only inside Dean's body, but inside his brain as well. And had been terrified by all of it.
Sam pulled the chair close to the table and sat, a hand on Dean's arm as he tried to fight the exhaustion that was forcing his eyes closed. He gave up trying to stay awake and laid his head on the edge of the table, against Dean's shoulder, and slept.
It was a couple of hours before he felt Dean shifting underneath him.
"Hey," Sam said, his voice thick with sleep. "How are you feeling?"
"Hmm."
Sam looked around. Dr. Bates was sitting in a chair a few feet behind him, snoring loudly.
Dean's eyes were still glassy with fever, and Sam automatically placed a hand on his forehead. "You're still really hot," he whispered.
Dean tried to move away from Sam's touch, from the attention. He wanted Sam to stop worrying, but he winced with the effort, having the opposite effect.
"Hey, you okay? You want a couple more hits?" Dean nodded and Sam prayed he was doing the right thing.
Sam lit the joint and helped Dean smoke it, grateful there was no coughing fit. Even half out of his mind with pain and fever Dean's company gave him a semblance of normal, and he was glad the doctor was still sleeping.
After a few minutes Dean pushed Sam away and settled against the pillow, eyes half closed as the drug took effect, as he relaxed. Sam silently thanked the cannabis Gods, and Ash, and decided to worry about dead brain cells later.
Sam found a wet wash cloth and began rubbing Dean's face and neck with it, refusing to stop when Dean tried to bat his hand away.
"Shh," he whispered. "You're really warm."
"Sammy?"
"Yeah?"
"I miss Dad."
"Is that the marijuana speaking or the fact that you almost died 10 times today?" They were the words Sam had wanted to hear, had wanted his brother to say, so they could talk, heal, bond. But after everything they'd been through Sam no longer needed them.
"Prob'ly a little of both."
"I miss him too."
"I know. Everybody knows. You walk around with your gut on your sleeve wherever you go." Dean's eyes were closed, his voice hoarse.
"It's my heart."
"What about your heart?"
"The expression is, he wears his heart on his sleeve."
"I don't do well with hearts."
"So I've noticed."
"You think we'll see him again...someday...when we, you know?"
And Sam's heart broke in a million pieces. "I don't know, man," he said when he could get the words out. Sam looked at his brother, worry clouding his face.
"Did you...is that what you were..." Sam couldn't say it. "Is that where you were going, earlier?"
"He wasn't there," Dean interrupted, forcing his eyes open. "Wasn't calling me. You were."
Sam ignored the pressure in his chest. The suffocating feeling that reminded him how close he'd come to losing his brother. "If you ever pull a stunt like this again, I swear I will kill you myself."
"If I ever get appendicitis again I'll be a freak of nature. But hey, at least then we'll know we're related." Dean tried to laugh, grimacing with the effort.
"Shh," Sam whispered, try and get some sleep." There was no resistance and Dean was out again within minutes.
Sometime around five Dean woke with a start, the pain registering in his eyes immediately. Sam didn't hesitate. Didn't even ask this time, as he lit the second joint and helped his brother smoke it, marveling as Dean relaxed and was asleep within minutes.
By the time daylight filtered through the windows, Sam was so exhausted he didn't hear the commotion in the bar until it had moved into the kitchen. It took him a few minutes to realize what was happening, and when he finally figured out that the two strangers standing with Ellen were paramedics, they had already pushed him out of the way and were working on Dean.
Dr. Bates was talking a mile a minute, giving the paramedics a blow by blow of everything they had done, including everything he was certain Dean needed.
Sam looked at Ellen, too tired to say anything.
"They got Ash's email late last night, but the storm was so bad they didn't get clearance to fly here until this morning.
"They flew here?"
"Helicopter. He'll be at the hospital in no time."
"Sam," Bates said. "He's calling you. You need to calm him down."
The paramedics had wasted no time, and already had two bags hooked up to Dean's IV line. Sam hoped one of them contained a really strong pain killer.
"Hey, Dean, the paramedics are here. They came in a helicopter. You'll be at the hospital in no time, away from all the quacks you've been dealing with. No offense," Sam added, looking at Dr. Bates.
"None taken."
"Helicopter?" Dean's heart skipped a beat.
"Hey, kid, relax. We're going to take good care of you." The older of the two paramedics was feeling Dean's pulse, concerned.
"He's afraid of flying," Sam offered.
The paramedic looked at Dean incredulously. "You let your brother take out your appendix, in a kitchen, in a bar, and you're worried about a helicopter ride?"
Dean shrugged.
The paramedic tried to put an oxygen mask on Dean but he moved away, fighting weakly to keep it off.
"Dean," Sam said. "Relax, man. Let them put you out of your misery."
Dean could barely keep his eyes open, and Sam was sure he was fighting to stay awake just to torture himself.
"You…coming…with me?" And there was the real reason he was still conscious.
Sam looked at the paramedics, not sure what he would do if they said no. Grateful when one of them nodded.
"No problem," Sam said. "You just let them take care of you, okay. Relax, and I promise I will be there when you wake up."
Dean responded by closing his eyes, offering no resistance when the paramedic placed the oxygen mask over his nose and mouth.
Sam turned to Betty and Dr. Bates, at a loss for words.
"I, I don't know what to say," he stammered.
Betty took his hand. "It's been a real honor to work with you, Sam. We'll be at the hospital the minute we can get there. But I want you to know that you and Dean will always be welcome in our home."
Sam thought he might cry, and forced himself to change the subject. "Hey, Doc, whatever happened to the guy with the foot hanging by a tendon. The one you had to operate on during the war? Cooper. Joe Cooper, right?"
"What?" Betty turned to face her husband. "That's the story you told Sam to build his confidence before the surgery?"
Dr. Bates shrugged, a sheepish look on his face Sam didn't recognize.
"What happened to him?"
"He died," Dr. Bates said.
"Oh. No offense, Doc, but Betty's right. As a confidence booster that one sucks."
"It's bittersweet," the doctor replied. "I was so distraught by the whole thing that when I left the army I looked up his family." Dr. Bates turned to Betty and put his arm around her. "Betty was Joe's little sister."
"Still a lousy pre-op story, Henry."
The paramedics were lifting Dean from the table to a stretcher and Sam felt the need to hover, to make sure his brother was okay.
Dean's eyes were opening and closing, but his features were relaxed and Sam could tell he was feeling no pain. For the first time in hours Sam could feel the tension draining.
It took another five minutes to transfer Dean to the helicopter, barely enough time for Sam to thank Ellen and Ash, to gather their things before running out the door.
Just before takeoff Sam leaned forward and took Dean's hand, feeling no awkwardness when the paramedic glanced in his direction. If anything, he felt a sense of pride, of accomplishment. He felt a deep seated awareness of who he was, what he was made of, what his brother meant to him. He finally understood the family curse and its blessing. And the responsibility that came with it.
Sam felt Dean's mild attempt to squeeze his hand, and he squeezed back, for the first time in a lifetime relaxing against his brother's touch.
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So there it is. My heart AND my gut on my sleeve.
I thought of crashing the helicopter, but even I have my limits. :-)
I would love and appreciate your comments.
P.S. I hope the marijuana didn't offend anyone. I live in a state where medicinal marijuana is legal and it's been all over the news lately. When I think of Ash, Dr. BadAss, it's obvious to me that he would have some. And I couldn't ignore it, nor the fact that Sam would have done whatever it took to help Dean feel better. That said, I was happy when Dean said, in Hunted, "One word. Amsterdam. Come on, man, I hear the coffee shops don't even serve coffee." At least I knew for sure Dean wouldn't object.