A/N: I promised myself that I'd complete my other story before I posted on this one again, but I'm a filthy, filthy liar, apparently. Oh, well. :)
Dean fumbled with the key to his apartment, trying to balance a stack of library books and his dinner while opening the door. He felt beaten down, as he always did after leaving Sam for the day. He'd used the usual excuse, visiting hours, angry nurses, blah blah blah, the familiar words stale in his mouth. It had taken all of his willpower to keep from screaming when Sam waved goodbye, settling down in his bed and saying "See you tomorrow, Dean." He said it every night, and every time it made Dean's heart clench with grief.
Kicking the door shut behind him, he dropped the stack of medical reference books on the table and kicked off his shoes. He'd rented this shithole of an apartment two weeks after the doctors told him Sam would need to stay in the hospital long-term. It was too expensive to keep paying for hotel rooms, and he needed a home base to work from. Still, he had opted for a month-by-month lease, unwilling to give up the hope that soon this would be fixed and they could move on.
It wasn't that Dean was stupid. He knew it was most likely hopeless, that his brother would live out the rest of his life without forminga single new memory. But the part of him that swore to protect Sam at any cost, the biggest part of him, didn't care about odds or rationality.
He'd read more medical journals and reference books in the last three months than a friggin' med student, searching desperately for a solution. Somehow the more he read on traumatic brain injuries, the more helpless and afraid he felt. He knew that Sam's temporal lobe was damaged on the right side, and that that area of the brain dealt primarily with memory. The blow to his head had caused his temporal lobe to fire wildly, without purpose, and his brain's ability to store new memories had been disrupted.
But the doctors couldn't tell him why this was happening, or what they could do to fix it. They'd fed him line after line about the brain's many delicate mysteries and unknowns, but it all added up to we don't know, and we can't fix it. The longer this went on, Dean knew, the less of a chance Sam had of ever recovering. The hospital staff had already given up. He could see it in their eyes when they looked at him – the pity, the dismissal of his brother as little more than a vegetable.
And John… Dean didn't know what the hell to even think about their Dad. He'd left him message after message –
Dad, it's me, Dean… Sammy's hurt. It, uh, it's bad. Please call me.
Dad, where are you? They say his brain is bleeding, and he's not waking up…
Sam has brain damage, Dad. He… he doesn't remember anything after the accident. He can't form any new memories. I don't know what to do. Please, Dad, call us.
But there was no response, and Dean had begun to believe that their father was dead - until John sent him a set of coordinates last week. There was no accompanying text, but the message was clear. Keep hunting. Dean had smashed the cell phone, his vision literally turning red with rage. Then he'd purposefully, deliberately severed his attachment to his father, cutting him out of his heart.
He couldn't leave Sammy alone and helpless to wake up, every day for the rest of his life, wondering where his big brother was and what was happening to him. That his Dad could even think of asking him to do that… He had no place in their lives now. It was just him and Sam. What was left of Sam, his mind supplied bitterly.
And that was just the thing – there was so much of Sam left. He was normal, except for the amnesia. Dean could almost pretend that it really was just a concussion – that Sam would be walking out of there with him the next morning. When they visited, Sam teased him about his music, brought up childhood jokes and memories, picked up on his moods and emotions with the same uncanny perception he'd always had. Which was what made it so damn hard to keep the truth from him. But the alternative was worse.
Dean grimaced, remembering the week after Sam woke from his coma. Dean had been tired and had slipped up – Sam had been persistent, eventually prying the truth from his big brother. He would never forget the look of terror and grief in Sam's eyes. He'd panicked himself into hyperventilating and the doctor had ordered him sedating, fearing that the stress might exacerbate his injury. Sam had begged as they put him under, pleading for them not to put him to sleep, that he didn't want to forget, he wasn't ready. Dean had felt like they were killing him – the knowledge that his brother would never remember the betrayal, the fear, or anything about the event was not comforting in the least.
Grabbing a plastic fork from the open bag on the kitchen counter he ate straight from the Chinese takeout boxes. As he chewed his way through the Kung Poa chicken he selected a book from the pile and began to read, searching for even the slightest hope that Sam would find a way out of this, that they could have their lives back.
The next morning, Sam took a turn for the worse. They were in the garden, where they ended up every day, sitting on their bench and eating burgers. Dean had been dodging Sam's questions all morning, and lack of sleep and stress were making him irritable. Sam seemed to pick up on that fact that he was walking a thin line because he sighed and changed the subject.
"Hey, they don't have anything good to read around here. Do you think you could pick me up a…" his voice trailed off and he frowned, gesturing vaguely with his hand.
"You know, a.." his mouth opened and closed a few times and he growled in frustration.
"Sam?"
"I can't.. can't think of the word. I know what it is, I know what I wanna ask for, but I- I don't know how to say it. Damn it!" He pounded his leg with his fist.
"What the hell's wrong with me, Dean? I need you to tell me."
"I- I don't know, Sammy. I'm gonna go get a doctor, okay? Hold on."
He'd resisted the urge to run until he got indoors, unwilling to scare Sam, but once he was out of sight he sprinted, and he shouted, until a doctor appeared and followed him back to Sam's side. No more than a minute had passed, but by the time they returned, Sam was listing to the left, is eyes unfocused.
The doctor had called for a gurney and they'd whisked Sam off to do a CT scan. Dean had caught the worried tone to the doctor's voice and had felt his heart sink. He'd spent the last hour vomiting intermittently in the men's room, certain that soon someone would come and tell him his brother was dead.
"Mr. Winchester?" came a hesitant voice from the bathroom door. It was Hannah, who'd been painfully awkward around Dean since he'd called her a gosspy whore.
"Dr. Mitchell is ready to speak with you."
Dean gulped and swiped a hand over his lips before standing unsteadily and stumbling into the hall. Hannah stepped aside, wringing her hands and looking nervous. A tall black man in a white coat stood waiting, Sam's distressingly thick chart in his hands.
"Mr. Winchester? I'm Doctor Mitchell. I need to speak to you about your brother, Sam."
"What's wrong with him? I mean, what else?" Dean rasped, his throat raw.
"Why don't we go to my office, where it's quiet."
"Just tell me," he ground out, dangerously close to punching someone simply to relieve the tension.
"I'm afraid that Sam has developed a condition called hydrocephalus. It's a build up of cerebrospinal fluid on the brain, resulting in increased cranial pressure. It's not uncommon in cases of traumatic brain injury."
"Is that what caused the…" Dean gestured with his hand, ironically uncertain of the proper term.
"The aphasia, yes. Pressure on the brain can sometimes lead to an inability to comprehend or recall language properly."
"Wait," Dean said incredulously. "Are you telling me that not only does my brother have to relive the same day, over and over again, but now he won't understand me? He won't be able to talk?"
"We may be able to reverse this, Mr. Winchester. With your permission, I'd like to put a shunt in your brother's skull to drain the excess fluid and relieve the pressure. If we do it quickly enough we may spare him further brain damage."
A bitter, hysterical laugh barked from Dean's chest and he scrubbed his hands over his face, perilously close to losing it.
"And if you don't? Relive the pressure, I mean. What happens to him?"
"He'll most likely continue to worsen and develop further complications – seizures, worsening aphasia, blindness, eventually a persistent vegetative state, then most likely brain death."
"Oh, god." Dean gasped, sorry he'd asked. "Help him, put in the shunt, just, don't let him go through that, please."
"Okay," Dr. Mitchell said gently, offering him several sheets of paper. "Just sign these consents and we'll get him in to surgery as soon as possible."
Dean scrawled his signature hastily.
"Can I see him? Before you…"
"Of course, but it'll have to be quickly. Nurse Franco, would you please show Mr. Winchester to pre-op room six?"
Hannah nodded somberly, glanced at Dean, and led him further down the hall. Dean trailed numbly after her, his mind overloaded with conflicting doubts and fear.
"Right in there, Mr. Winchester." Hannah said faintly.
Dean took a deep breath and composed himself before stepping into the dimly lit room. Sam lay on his side on a surgical gurney, his right arm extended and restrained, an IV in the crook of his elbow. He was blinking dazedly at the wall as an anesthesiologist adjusted an oxygen pump and a petite blonde nurse shaved the back of his head.
"Sam…" He whispered, and his brother's eyes rolled towards him.
"Dean. Head hurts…" He sounded drugged, too dampened by sedatives to be frightened, and Dean was grateful for that small mercy. He stepped forward and rested his hand on Sam's forearm, brushing it lightly with his thumb.
"Hey, kiddo. I know. They're gonna do an operation, fix that right up for you, okay? And as a bonus, you get an edgy new hairdo from Nurse Heinz, here."
Sam furrowed his brow at Dean, confused.
"It's gonna be okay, Sam." Dean promised, brushing his fingers lightly over his brother's forhead, smoothing the lines.
"Mr. Winchester, we're going to put your brother under now." The anesthesiologist said softly, injecting something into Sam's IV and placing a mask over his face. "I'm sorry, but you need to leave so we can move him into surgery."
"Dean…" Sam exhaled, his free arm fumbling weakly for his brother.
"It's alright," He grabbed Sam's hand and squeezed, letting go reluctantly as they moved the gurney into the hall.
"Don't worry, Sam. I'll be there when you wake up."
I always am…
A/N: More soon, but this time I really DO have to complete BoS before I continue on this story. Thanks to everyone for the prompt and kind reviews, it was inspiration to get this out quicker. :)
