A/N: This chapter's a little technical. All my knowledge about emergency medicine and procedure I learned from the internet, and Third Watch. I apologize if anything doesn't seem right, and if it doesn't, it might've been on purpose. ;)
It's un-beta-ed, so I apologize for any mistakes.
Jerked awake from a dream in which Sam was choking him with the electrical plug of a table lamp, Dean sits halfway up in bed before the pain becomes unbearable, and he flops back down. His chest is heaving with exertion and adrenaline leftover from the dream, and the pain that accompanies each breath has sharpened in the past day. He feels reflexive tears well up in his eyes, and spill down to his hairline.
There's a sliver of light coming in through the break in the curtains, and he can hear Sam breathing in the next bed, even over the harsh pants of his own breath. Like earlier, he takes hold of the sheets beneath him to ground himself, tries to concentrate on slowing his heart rate and in turn his breathing.
But unlike earlier, control doesn't come.
Each hitched breath brings greater pain, and the pain brings panic. His heart is pounding in his temples, in his chest; he can feel it all the way down to his fingertips. But if anything, it's getting faster, not slower, and with every breath it's getting harder to take another one. There's an invisible weight sitting on his chest, pushing down and compressing his lungs until all that comes out is a pathetic whine and wheeze.
He tries to call out to Sam, because as much as he wouldn't want to admit it, he thinks he's in trouble. But the words aren't coming, like he's forgotten how to form them, or maybe his body just can't spare the energy.
He wants to cry, because being denied breath is the worst thing in the world, but even deeply ensconced in the throes of panic like he is, his father's teaching reaches him. 'Don't let panic rule you. Pay attention to your surroundings, Dean. There's always something you can use.' Wide hazel eyes as big as dinner plates flicker franticly around the room, dismissing everything as useless before landing on the table lamp sitting on the night table in between the two beds, and Dean recognizes it as his salvation. It's getting harder to concentrate, but he knows he has to wake Sam up, and even with diminished capacity he realizes that the lamp might be the only way.
Spots begin to form in his vision, his brain reacting to the lack of oxygen, and he flails out with a weak arm, reaching desperately for the hideous turquoise monstrosity. The room's quiet despite his panting, but there's a roaring in his ears, and as the lamp remains stubbornly out of reach, he can't help but think he's going to die in this smelly hotel room, in these filthy sheets, while his baby brother sleeps peacefully in the next bed.
Sam opens his eyes with a start, not sure what woke him up, but overcome with the feeling of something being wrong nonetheless. He can see daylight through the crack in the curtains, and is mildly surprised to realize he slept that long. He props himself up on his elbows, frowning slightly and wiping the sleep from his eyes.
His brother is still in bed; Sam can see his socked feet sticking out under the end of the covers from the corner of his eye. He rises to his knees, leans over to peer out the window. Through the dirty glass, he can see transport trucks lumbering awkwardly down the highway; the sun is shining, and the sky is clear. For all intents and purposes, it's a beautiful day. But that doesn't explain the feeling of dread he has in the pit of his stomach.
And then he hears it.
It sounds like a whimper, but if Sam thinks about it long enough, he might start to realize it sounded suspiciously like his name. He looks back over to his brother, and through the deceptive darkness, he can barely make out an arm flailing in the space above Dean's head.
"Dean?"
Another whimper, and then Sam suddenly goes cold. He knows why he woke up.
He scrambles out of bed, long legs tangling in the comforter, stealing his balance and sending him crashing to his knees on the thin carpet. His head knocks painfully against the Formica night table. Stars explode behind his eyes, but he ignores them, and hauls himself up to his feet, and Dean's side.
The first thing he notices is the bluish tinge to Dean's lips. His brother's hazel eyes are wider than Sam has ever seen, bloodshot and terrified and begging Sam to help him. His chest is heaving, his back nearly arching off the bed with the effort, but as far as Sam can tell, nothing is coming in or out. Dean reaches for his brother, grabs onto his t-shirt with weak hands.
"Oh, my God."
Sam has no idea what to do, but Dean's hands are pawing bonelessly at his chest, pleading silently with him to do something, anything, to make it stop. Sam has no idea what will accomplish that, he doesn't even fucking know what's wrong, and all that he can think of is the time when he was five and almost drowned in the pond behind their motel in Arkansas before Dean found him.
He presses shaky fingers against Dean's neck, searching for a pulse that might reveal to him what needs to be done, like some kind of messed up Morse code in dots and dashes. But Dean's heart is racing way too fast beneath Sam's fingertips for him to figure anything out.
He lunges for the night table, grabs Dean's cell off the top and flips it open. They've been raised with the training that would enable them to deal with most medical emergencies, but this is too much. This is over Sam's head, and he's not willing to risk his brother's life on the assumption that it will fix itself.
His hands are shaking so badly he misdials twice, and on the third try, Dean's hand comes up and limply slaps the phone out of Sam's grasp.
"Fuck, Dean!"
There isn't enough time for this, for Dean's stupid attempts to save them money, or stop Sam from turning the police onto them. There isn't time when Dean's complexion is getting paler with every passing second, when his hold on Sam's t-shirt is weakening. Sam hates that even when Dean's suffocating right before his eyes, his brother still has enough presence of mind to be a controlling asshole.
He scrambles on the bedspread for the phone, and this time Dean doesn't have the strength to dissuade him. Sam dials the number, and waits with growing dread for someone to pick up.
"Hold on, bro," he says, pressing his hand onto Dean's shoulder. "Try to relax." And even as he's saying it, he's aware of how stupid it sounds. But it doesn't matter, because Dean's in no position to comment, and there's suddenly a voice on the other end of the phone.
"911. What's your emergency?"
"It's my brother. I just woke up and he can't breath. God, his lips are turning blue, please, you have to send someone. I don't know what to do."
His heart is knocking against his ribs so hard he fears it might be difficult for the operator to hear him. Dean's hand slips from Sam's shirt, and falls limply to the bed. His lips are moving, like he's trying to communicate something, but no sounds are coming out.
"Where are you, son?"
"Oh, God, uh, the Motel Six on Route 9. Room number 7. Please hurry, there's no one else…"
"Okay, there's an ambulance on the way. You need to stay on the line, don't hang up."
Sam drops the phone to the bed, and places one hand on either side of Dean's neck. "Listen to me," he says, leaning down until their foreheads touch. He waits a half second for his brother's hazel eyes to focus on him. They're red rimmed, bloodshot, and a little glazed over, but Sam knows he has his attention. "You are going to be fine, you hear me? The ambulance is on the way, you just gotta hang on a little longer." Small droplets of water land on Dean's cheeks, and without thinking Sam thumbs them away. He doesn't realize they're his own tears. "You got that? You are not going to leave me, Dean!"
Dean tries to nod, but his eyes are beginning to fall closed. Sam grabs the front of Dean's t-shirt.
"Dean!" he screams, his voice breaking and frantic. "Don't you fucking do this! God, Dean, please!"
His brother is trembling, his neck chords distended and huge. But as Sam watches him, pleads with him, Dean starts to grow limp, the battle he's fighting with himself is coming to an end.
"Please don't do this." Sam's fingers tighten in the cloth of Dean's shirt. He's crying, not making a sound but great big drops of salt water are spilling down his cheeks. "Please, I need you." His head falls to Dean's chest, which is now frighteningly still. "You can't leave me. You're the only one…I can't do this on my own."
A part of him is waiting for a response, expecting Dean to come back with something sarcastic and snide, and just this side of painful, but nothing comes. His brother remains motionless beneath him.
"God, Dean."
One arm snakes out, wraps around the back of his brother's neck and pulls him close. He begins to cry in earnest now, sobbing with such force he feels an ache in his chest and stomach. This can't be happening. It doesn't make sense. Dean is invincible; the one who comes back from incredible injuries with a witty quip, a nasty scar, and a lesson learned the hard way. He doesn't suffocate to death, while his oblivious younger brother sleeps in the next bed.
A hand touches his shoulder, and Sam flies back, taking Dean with him.
"Did you call the paramedics, buddy?" the closest, and clearly younger of the two men asks. Sam wants to shout, to yell and scream and curse in this stranger's face, because it's so bloody obvious it's too late, that they took too long to get there, and now his brother's dead, and his dad's gone, and he's all alone. He can only nod. His chin bumps against the top of Dean's head.
The other man crosses to the other side of the bed. "Let me see him," he says, reaching out with latex gloved hands. His fingers barely brush Dean's shoulders before Sam erupts.
"Don't you touch him! Don't you fucking touch him! You're too late! God, it's too late! He's gone, he left me, he said he never would, he promised he never would, but he did and now it's just me and I don't know what to do. Oh, Jesus, I'll have to call dad."
He wraps his other arm around Dean's shoulders, and then he's crying again, face pressed into his brother's neck. He feels like he's being hollowed out, every last thing that makes him who he is, is spilling out of him, through his eyes and running down his cheeks. The pain he felt from Jessica's death is a mild annoyance compared to this agony.
"Listen to me, son," one of the paramedics says. He kneels on the bed next to Sam, and carefully lays a hand on his arm. "We have to have a look at him. Sometimes it looks like it's too late, but we can still help. All right? Let us look at him."
It takes a few seconds for the words to sink in, and Sam still doesn't understand completely, but all he hears is that Dean might not be gone. He backs off as though he were burned.
The paramedics set to work, opening their bags and pulling out various instruments. They speak in a medical language that flies over Sam's head, peering into Dean's eyes with a penlight, listening to his chest with a stethoscope. When they cut down the middle of Dean's t-shirt, and tape small circular electrotrodes to either side of his chest, Sam begins to pace. He winces with every shock. He knows he should be thinking about what to do now, how to get in touch with their father, how to deal with the inevitable police, but the only thought in his mind is the memory of a nine-year old Dean, kneeling in front of Sam and tucking a scarf into the collar of his sweater. Sam didn't have an actual winter coat back then, but that didn't stop Dean from trying to keep his brother warm. 'You don't want to catch a cold, Sammy,' he said, pulling an old wool knit hat down over six-year old Sam's ears. 'We're all outta cough syrup.'
Present day Sam presses the heels of his hands against his eyes. This isn't happening. This can't be happening, It's only a nightmare. The worst one he's ever had, and probably ever will, but any minute now, he's going to wake up in bed, sweat pouring down his face, to his brother's predictable concern and inescapable 'you okay?' But even as Sam's thinking it, he knows it can't be true. Not even his sub-conscious is this cruel.
The medics are keeping up a constant chatter between themselves, and Sam doesn't hear any of it, but the words, "I've got a pulse!" manage to pierce through his mental fog. He's at Dean's side in an instant, sitting on the edge of the other bed, close enough to Dean but outside the medic's sphere of work. He reaches out and snags his brother's hand, holding it tightly between his own.
The older paramedic is listening to Dean's chest again. "I've got decreased, very shallow breathing sounds on the right-" he pauses, switches to the other side "-and nothing on the left."
"Check out the bruising." The other man indicates the shotgun-induced markings on Dean's chest. "You thinking what I'm thinking?"
The older of the two turns and captures Sam with a withering stare. "Do you know how these bruises got here?"
"I…" Sam starts to tell the man that he shot his brother in the chest with a shell full of rock salt, but he catches the words before the truth can come out. He doesn't much care about himself at this point, but Dean would be pissed to wake up and learn Sam had been carted off to jail while he was out. And Sam might not be a lawyer yet, but he is pretty sure shooting someone with a shotgun, regardless of what ammo is used or what spirit was influencing him, is generally considered to be attempted murder. "I don't know," he answers finally. "Dean's my brother, but I…uh…I don't know what happened."
The paramedic looks doubtful, but there are more pressing issues with which to concern himself. He turns back to Dean, and resumes work. Sam is quickly forgotten.
He watches with a somewhat obstructed view as they fix a breathing mask over Dean's mouth and nose, and begin pumping air into his lungs by way of a squeeze pump. There's more nearly indecipherable medical jargon, but he catches the word, "breathing valve" and his heart skips a beat in his chest.
The older medic pulls something out of his pack, rips the plastic off it, and Sam doesn't want to watch anymore. His gaze drops instead to Dean's hand. It's pale and cold, still wrapped in Sam's own and disturbingly still. Sam closes his eyes against the sight. In his mind, he sees the same hand, though considerably smaller and less weathered. The hand that even at the age of thirteen, was capable of staking a vampire through the heart, shooting off a .45 with little thought for the recoil, and killing any number of beasties in any number of ways. But it was the same hand that cleaned Sam's scrapes so it didn't even hurt, washed his hair when he was too small to do it himself, and made him peanut butter and jelly sandwiches when their father fell asleep on the couch before dinner.
It is the same hand that squeezes Sam's fingers now.
That squeeze, combined with the shuddered gasp that bursts from Dean's lips, startles Sam so badly he drops his brother's hand and nearly falls off the bed.
"We gotta run," one of the medics says. "You coming with us, son?"
Sam looks up with wide eyes. In the time he spent lost in memories, they had strapped Dean to a bright red backboard and secured him with wide white straps. The older medic is still kneeling next to Dean, squeezing the bright blue pump still held over Dean's face and looking at Sam expectantly. As Sam nods emphatically, the younger medic comes through the open door, pushing a collapsible gurney.
"Then we have to go now. Do you need to grab anything?"
Sam starts to shake his head before remembering he's still in nothing but boxers and a t-shirt with no shoes. He shoves his feet into a pair of boots, grabs his jeans and Dean's leather jacket off the room's chair. He follows closely behind as they wheel his brother out to the waiting ambulance.
A crowd has gathered in the parking lot, attracted by the flashing lights and possibility of death or dismemberment. Sam feels a sharp bite of disdain for the curious eyes grazing over Dean's unconscious body, but he doesn't spare them any more thought.
The paramedics load Dean into the back of the ambulance, then the older one runs around the front to climb into the drivers seat. Sam scrambles into the back, sitting down on a bench across from the other medic, with Dean lying prone between them. The doors are closed, the engine started, and the ambulance starts moving with a lurch.
Sam captures Dean's hand again. His brother's fingers are still cold and unmoving, but this time Sam can feel his pulse working away by pressing two fingers to the inside of Dean's wrist. At this sign of life, he blows out an explosive breath he hadn't realized he'd been holding.
On the other side of the ambulance, the younger paramedic flicks his gaze over to Sam, and smiles tightly. "What's your name, kid?" he says, and Sam almost points out the fact that he can't be much older than this 'kid.'
"Sam. Uh, this is my brother Dean."
The paramedic nods. "I remember. From earlier. My name's Ben, Sam."
Sam nods. He doesn't want to be impolite, one of his personality weaknesses, Dean would say if he were in the position to, but he's really, really not in the mood for small talk. He doesn't care what this man's name is, so long as he fixes Dean and he does it right.
"You can put your pants on, Sam," Ben says, indicating the discarded jeans in Sam's lap. "You brother's pretty out of it; I don't think he'd mind if you let go of his hand long enough to do that."
The words themselves might seem to be teasing, but the tone in which Ben says them is sincere, and kind. Sam glances at him, wondering if Ben is the older, or younger brother in his family. Then he carefully sets Dean's hand down on the gurney beside him, and pulls his jeans on over his boots and boxers.
"He'd kill me if he knew I was doing it," Sam says quietly, picking up Dean's hand once more, and nodding to the meeting of their appendages with his chin. "He hates 'chick flick moments.' He's pretty much got an allergy to anything you would ever find on Oprah or Dr. Phil."
Ben laughs softly, moving his head as though in understanding. "Yeah, it's an older brother thing. I'm the same way myself." He looks up from the portable monitoring machine he hooked Dean up to a few moments ago, and fixes Sam with a serious stare. "But that doesn't mean the feeling itself isn't there."
'And then I carried you out the front door.' Dean's words from the week prior echo through Sam's mind, spoken over the rumble of the nearby Kansas highway. Sam knows his older brother loves him, even if he is a little averse to saying it. He might not speak the actual words, but he says them with his actions. Every time he shoves Sam out of the way of some beastie, or gets after him for not finishing his meal, or bugs him about not getting enough sleep.
"I know," Sam says quietly, sniffing messily and tightening his hold on Dean's hand.
"We're almost there. Not too much longer."
He doesn't look up at Ben's reassuring words. For the first time since climbing into the ambulance, he casts his eyes over Dean's face and really looks. If Sam didn't know better, he might think his brother is merely sleeping. The lines and wrinkles that are present in his face during his waking hours are gone, melted away with his consciousness, and if not for the flecks of blood around his lips, and the oxygen mask over his face, he might even look peaceful. His short, near military cut hair is ruffled from sleep, in a way only Dean can manage, given the length of said hair. The sheet covering him reaches his chin, and for that Sam is grateful. He's not sure he could stand seeing the bruises on Dean's chest in light of all that has happened.
The paramedic up front calls out a warning, then they're jostled slightly as the ambulance pulls into the parking lot.
"Now, those doors are going to open, and people are going to swarm in and take Dean away, all right? But don't worry. This is the best hospital in the country, and they will take good care of him, okay?"
Sam doesn't have time to acknowledge the warning before the doors are opened from the outside. A slew of strange faces reach out, unlock Dean's gurney from its tracks, and carefully lift him to the ground. Ben goes with them, calling out vitals and other things Sam doesn't have a hope in understanding.
Sam tries to follow, his brother's jacket clenched tightly in his hands, but he's stopped by a couple of nurses in bright pink medical scrubs before he can go too far. They flash him sympathetic looks as Dean disappears behind a set of swinging doors, and calmly point out the waiting room, where he can grab a cup of coffee if he feels like it. He doesn't feel like it.
Instead he paces the small, surprisingly empty room, going from the bank of vending machines to the line of uncomfortable plastic chairs on the other side. He's trying really hard not to think about it, to keep his mind from realizing that he nearly lost his brother tonight, and he very well might still lose him.
Sam has led a largely inconsistent life, living out of suitcases and random motels in small towns around the country for the majority of his developing years. The only constants were his father, and his brother. His father's gone; Sam has no guarantee he's still alive, let alone that he'll ever see him again. If he loses Dean too…
The enormity of what happened belatedly hits him like a ton of bricks, and he crashes to his knees under the weight of it all. Dean must've been struggling for breath for minutes, what had to have seemed like hours, while Sam slept peacefully in the other bed. If Sam hadn't woken up when he did, he would've risen eventually to a dead body in the next bed. The whole reason this was happening is because Sam isn't strong enough, because he couldn't hold back a simple spirit.
His hands fall to the floor at his sides, his chin drops to his chest. The guilt and grief rise up simultaneously, wrapping around his chest like a vice and making it nearly impossible to breath. If (no, when) Dean gets out of this, when they're back on the road and putting it in the rear view mirror, Sam won't be weak again. He will not become a liability. He will be a machine. He will be Dean.
Anything else is unacceptable.
