Disclaimer: Refer to chapter one.

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When Angels Cry

By Dawn Nyberg

"Wait, your tired arms must rest, let this moment pass, wait until the morning. Close your eyes and let me see who you used to be left without a warning … if ever was a heart that longed to fly, if ever was a soul that longed to bloom, if ever was an angel, it was you…" Lyric excerpt from singer Janis Ian, song When Angels Cry

"He's in V-Fib," a nurse called out.

"Charge the paddles to 360," Dr. Jaffey ordered. He placed the paddles against Sam's bare chest. "Clear!"

"No change."

"Charge to 450. Clear!"

"We got a rhythm." The anesthesiologist answered before the nurse could respond. Dr. Jaffey allowed himself to exhale a sigh of relief. "Stewart," he spoke to Dr. Kendrick. "You better get out of there soon. If this kid arrests again I don't think we'll get him back." He looked at Sam's heart rate and blood pressure readings shaking his head. "He's literally circling the drain, Stew." Dr. Kendrick gave him a curt nod.

"Almost done, Mark." He spoke to Dr. Jaffey. "Increase his mannitol drip", he ordered the IV tech. He closed the small opening in Sam's skull, and stitched the wound closed with a handful of small sutures, and covered the wound with a small gauze flap. He installed an intracranial monitor, so that the pressure could be monitored. And, if the pressure crisis improved then the monitor could be removed by removing a couple stitches and pulling the thin tube out. "That's it. How's his heart rate and pressure?"

"Well," Dr. Jaffey began. "At least he has a heart rate and pressure. That's something I guess. How long was he down?" he questioned a nurse. She glanced at the clock that they had stopped the moment they got his heart restarted.

"Twelve minutes," she answered. Dr. Jaffey shook his head with concern.

Sam was moved to recovery and was surrounded by machines and monitors. He was so pale and still under all of the equipment that he didn't even appear to be living, but the machines beeping and whooshing around him told a different story, Sam Winchester was alive.

Dean looked up as Dr. Kendrick walked into his room. "I'm Dr. Kendrick, Chief of Neurology. Dr. Masters was called to the ER, so I came to speak to you about your brother."

"How is he?"

"He made it through surgery. We almost lost him," the doctor began. Dean felt his stomach drop. "His heart stopped during the procedure and it took us a few minutes to get him back."

"But, he's okay, right? I mean the pressure in his head. The blood is off his brain." Dean was trying to remain calm. Now, was not the time to lose his cool. He had to maintain for Sammy's sake.

"He's in recovery. I was able to extract the blood and remove the large hematoma. However, the pressure inside his skull is still elevated, but has been reduced. I have him on some IV medications that I hope will control further swelling and help reduce it."

"What happens from here?"

"Once he leaves recovery he will be moved to this unit. And, they are preparing his ICU room right now to accommodate the equipment he'll need. Your brother isn't breathing on his own right now and will be on a ventilator. And, the coma is deep."

"But, when will he wake up?"

"He may not," the doctor answered simply. "But, until he does we won't know the extent of the brain damage he suffered. Until he wakes the level of damage can on be speculated on."

"So, he could be okay then?" Dean was suddenly hopeful.

"I'm sorry; perhaps I should have worded my response differently. I thought Dr. Masters told you about the probable damage."

"Yeah, but he could still wake up, okay?" Dean was in denial.

"If your brother wakes up," he began tentatively. "Even that won't be a quick process. He will have different levels of consciousness as he surfaces from the deeper coma. He may even open his eyes now and again, but he won't be focusing on anything, he won't really be seeing. The coma could last days, weeks, months even, or as I said he may never wake up."

Dean decided he was going to utilize his earlier plan to only listen to what he wants to hear and shut out the rest. "The swelling," he began. "You said you have him on some drugs to help, but if it gets worse that other doctor said you may have to go in again. What happens?"

"I'm hoping I won't have to. I really don't think your brother would survive the surgery. But, if the pressure were to increase to the point brain death is imminent I'll have open a portion of his skull to allow his brain to expand without crushing itself against the inside of his skull. Let's just cross the bridge if we come to it," the doctor suggested.

"Look, I gotta know about it. If Sam needs this…" The doctor held a hand up and Dean closed his mouth.

"If he needs this surgery and it comes to that there will be a tough decision to make."

"What decision? If the surgery will help him you'll do it." It seemed so simple to Dean if something was broken in his brother then by god someone was going to fix it if he couldn't.

"If he needs the surgery I can almost guarantee that he will likely die on the table based on his current status." The doctor saw the stricken look on the older sibling's face. "I know this isn't easy to hear, and I wish I didn't have to say it. I'm a surgeon and I'm supposed to be able to fix your brother, but sometimes the body has just had enough and sometimes the only answer is to do nothing."

"Nothing!" Dean hissed. "You're a damn quack," he huffed. "So, what you're saying is he has the surgery he'll die, but it comes to that I'm supposed to say do nothing if the pressure in his head goes up, and he'll die, too, right? The pressure will go up until his brain dies, and then I have to pull the plug on my little brother because he'll be brain dead. I mean that's what you're saying, right?" Dean's voice was harsh. "You're all fuckin' nuts in this place!"

"Sir, I understand…"

"You don't understand squat."

"It's not an easy decision to make," the doctor was used to family members yelling and making harsh statements. He could sympathize with their dilemma, he was human too after all, and had his own family. But, he wasn't in this young man's shoes and hoped he never would be. "At this point we're in a waiting game to see if his pressure rises. We have an intracranial pressure device monitoring his pressure. We'll keep an eye on it."

"When will you know if the drugs are working?" Dean took a breath and tried to reign in his temper.

"The next 48 hours should show a reduction or increase. By removing the hematoma we did relieve some of the pressure, so that is a good thing. I'm also monitoring his brain activity, as well."

"That other doctor said he had brain activity, so that's good, right?"

"Yes, but I'm sure he explained that your brother's activity is diffused in nature which is indicative of brain damage. Most likely severe to profound."

"Yeah, he said something like that," Dean didn't want to get into all of that again. These stupid bastards couldn't find their asses with both hands, let alone tell him his brother's injury was hopeless. What did they know? They didn't know Sammy and that was for sure. Dean thought to himself.

"Well," the doctor was taking the cue that Dean had heard all he cared to hear for right now. "I will maintain handling your brother's case, so I will give you daily updates either personally or through my intern Dr. Masters whom you've all ready met." Dean nodded.

"When is Sam going to be out of recovery?"

"Most likely another couple hours, and then he'll be a couple rooms past you. Well, I'll leave you now. If you have any questions or concerns I will leave contact numbers with your nurse and either myself or Dr. Masters will be available to answer them for you, okay?"

"Thank you for keeping my brother alive." The doctor smiled and nodded there was something about saying 'you're welcome' that just felt inappropriate in this particular moment.

Two Hours and Forty Minutes Later in ICU

Dean had started to squeeze his hands into fists on his blankets over and over to control his anxiety over not seeing Sam arrive in ICU within the two hours the doctor had predicted. And, then he heard the voices of staff filter into to his room and watched to see if he could catch a glimpse of his brother go by as they took him to his room. First he saw the two nurses guiding two IV poles each all filled with IV bags and tubing. Then he saw Sam, just a brief glance. He saw another nurse walking beside the gurney holding and squeezing a bag attached to a tube he could see was down his brother's throat. He heard the various monitors beeping. And, another couple staff members were pushing Sam. His chest tightened at the brief glance he was given. Sam was white as a sheet, and the dark circles under his eyes had a sickly pale brown hue to them and the contrast of dark against the paleness of his skin couldn't be missed.

He saw just a hint of the bandage covering the other side of his brother's head over his temple area. And, then he was gone again out of sight. Dean wanted so badly to be with him and he internally raged against his broken body that wasn't permitting him to be at his brother's side. That was going to change. He didn't care if he had to tear out his IV's and open sutures crawling to his brother's bedside he would see Sam.

"God, Sammy," Dean choked out loud as the gravity of what he was seeing sunk in and resonated with him. It became too real in that brief moment of his little brother passing by his room. He saw how close his brother is dancing toward the edge. He knew his little brother was too close to the darkness, and he had to be there to keep him from slipping into the shadows. The dark was no place for his brother, not his Sam. Sam was made of light and didn't belong in shadow and dark. Please, God, Dean thought quietly to himself as he closed his eyes trying to center himself. Look, I know I'm not the prayin' type, but Sammy didn't deserve this. Please, God, if you're listening … you don't have to do this for me, but do it for Sam. He's always had enough faith for the both of us. He still believes in the good stuff you know? Make him, okay. Dean felt at a loss, and despite his best efforts he felt hot tears stinging his eyes. I'm so sorry Sammy, I didn't mean a damn word I said to you. Please, be okay. You can't leave me little brother.

"Dean?" Sue's voice from the door startled him out of his private inner monologue. "Sorry, I didn't mean to startle you," she offered with a small smile as she stepped in.

"You didn't. How's Sam?"

"I came in to tell you they have him settled in his room now, and I took him on as my patient, so I can give you updates whenever you need them, okay?"

"Thanks Sue." He paused for a second. "I want to see him."

"Not tonight Dean. You're in no shape to be moved let alone put in a wheel chair."

"Then put my ass on a gurney and roll me in. I'm seeing Sam."

"I'll talk to your doctor and see about tomorrow, but that's the best I can do." Dean nodded tersely, but offered a smile. He knew Sue was just doing her job.

"How is he?"

"Holding his own." She offered. Dean's eyes glinted ever so slighlty.

"That's my boy." He said quietly more for himself, but Sue had heard nonetheless. She smiled.

Sue excused herself after checking Dean's vitals and changing the dressings on his chest. She had given him a mild sedative to help him sleep knowing that he would fight rest with the knowledge that his kid brother was fighting for his life two rooms away. Before Dean succumbed to the pull of sleep his only thoughts were Fight Sammy. Stay out of the dark. I won't let you go. Just fight. And, sleep pulled Dean under and his head lulled to the side, but even in sleep there would be no escape from the worry and the fear of loss for Dean, as his dreams came knocking.

To Be Continued

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