Disclaimer: refer to chapter one
NOTE TO READERS:
FFnet has had some uploading issues, so it has taken longer to post the intended update. I tried around 7 this morning and on and off since when I had time. Now I think it's working.
Thanks for reading and reviewing! I know you had to wait a little bit for this update, sorry! But, with my time constraints I did what I could and did it as fast as possible. It's a long chapter, so that should make you happy. There is a lot going on in this chapter. I hope you like it. I never imagined that chapter 17's cliffhanger would elicit so many reviews. Thank you so much!
Chapter Eighteen
Hanging by a Moment
By Dawn Nyberg
"…Mama, put my guns in the ground. I can't shoot them anymore. That long black cloud is comin' down. I feel like I'm knockin' on heaven's door…" excerpt by Bob Dylan, Knockin' on Heaven's Door
"Is this your son?" Steve asked as he watched John close his eyes and saw the silent tears. "Mr. Winchester?" Steve urged. John opened his eyes to answer him.
Dean sat silently ringing his hands obsessively as his emotions peaked. His mind silently making deals with God that he'd make things right with Sammy. He'd explain he hadn't meant to hurt him. He heard the swinging doors creak and he looked up and saw his father coming down the long hallway. He stood immediately. John met his son's eyes and Dean saw the drying tracks of tears and he felt a violent shudder cascade through his body. "Dad?" His voice caught in his throat. John walked up to Dean and pulled him into a sudden and hard hug.
"It wasn't Sammy," John's voice gruff as he held his child against his chest. Dean squeezed his father tightly.
"It wasn't Sammy," Dean repeated his father's words. John felt his son tremble in his arms and squeezed tighter.
"No," John pulled back new tears filling his eyes.
The Winchester House, 10:00 AM
John and Dean sat silently in the kitchen each with a hot cup of coffee in front of them. The morning's events had drained them dry. The morgue would be an experience they would carry with them the rest of their days. The kitchen phone rang and John leapt up from his seat.
"Hello?"
"Yes. You did! Oh thank God," John let out a calming breath. "Is he okay?" Dean stared at his father hanging on every word. "Thank you," John replied to the caller on the other end and hung up.
"They found Sammy?" Dean's words rushed forward. "He's okay?"
"Sammy's fine. He took shelter at the bus station to wait out the weather," John spoke evenly. "He's okay. They are bringing him home."
"The bus station … on the other side of town!" Dean barked.
"Apparently," John conceded. Neither man had thought Sam would go that far, and they would never underestimate the kid again.
"If he's in one piece I'm going to kill him," Dean hissed. "Damn I think I aged ten years from this little adventure of his."
"Now, Dean," John replied. "I'm upset too, but we gotta tread lightly with your brother. We don't need him running off again."
"Yeah, well … that isn't gonna happen again," Dean asserted. "If we gotta put alarms on the windows or whatever."
"Let's not turn it into a jail Dean. Things are going to work out. He's just having a difficult time. I think we have to put ourselves in his shoes. He knows things are different since his head injury and I think he's realizing that he may never get back everything he lost." Dean nodded.
Twenty Minutes Later
A police officer brought Sam to the front door. "Lose something," he said lightly. "He's not much of a talker." John smiled.
"Sammy? You okay?" he asked his son. Sam simply nodded. John reached out and pulled his youngest child tightly to his chest and held him for a long moment. Dean stood behind his father watching the embrace. He also used the time to look his brother over for any injuries. "Thank you for bringing my son home." John said as he released Sam from his arms.
"No problem," he answered. "I spoke with the bus station clerk and she said he never asked about buses or anything. He just went in to get away from the storm and then the snow drifted and the station sort of had to be dug out."
John extended his hand to the police officer. "Thanks again." He nodded and left.
John closed the door and turned his eyes to Sam. His son stared at the ground and John noted a small shiver work its way through him. He was about to ask Dean to get something warm for Sam, but Dean was too quick for him. "I'm on it," he left the room quickly.
"Here Sammy sit down," he reached out and touched his son and felt the slight chill in the skin of his exposed arms. Sam pulled back slightly retreating from his father's touch. "Sam?" John encouraged. Dean emerged with a sweatshirt for his brother.
"Sammy, put this on over your t-shirt," Dean instructed and Sam complied. Dean felt conflicted and guilty. But, his need to touch Sam won out. He reached down and put a hand on Sam's unruly mop of hair. Sam turned his face up to meet his brother's. "The hell with it," Dean mumbled and bent down pulling his brother into an awkward embrace as he stooped and Sam sat. "Don't do that again kiddo," Dean mumbled into his brother's shoulder before he pulled away from Sam.
"Sam," John began. "You had your brother and I worried sick. We drove around for three hours looking for you and then we had to call the police." Sam sat silent not meeting the eyes of his family. "Sammy do you understand that they took us to the morgue this morning to identify a body they thought could be you?" Sam's head jerked up and he looked at his father.
"Sorry … I didn't mmm…mean to stay gone. I was mmm…mad. I needed to ggg…get some air. But the sss…snow. The mor…gue?"
"Yes Sam the morgue and it's an experience I never want to go through again." John answered as he looked at his watch. "Dean would you go get your brother's medication he hasn't had a pill yet and he's overdue."
"Yeah," Dean jumped up and went down the hall to the bathroom where Sam kept his seizure medication. He came back with a pill and a Dixie cup filled with water. "Here." Sam took it without question or complaint.
"Sam," John asked with intense eyes. "Were there any seizures last night?"
"No," he answered quietly. There was a long moment of silence. "I don't want to be diff…erent," Sam's sad eyes looked from his father to his brother. "People think I'm retarded," his voice shook. "Police talked to me like I'm five. Cus…tomers at the li…library treat me like I'm special and nnn…not in a good way. People treat me like I'm a tard."
"Oh, Sammy … why didn't you say something? You know you can talk to me and Dean about anything." Sam just looked at his family.
"Am I?" His voice broke and silent tears streaked down his cheeks. Dean felt his heart shatter at the sight of his little brother.
"No," John consoled. "Sam you had a horrible head injury and you're healing. You have come so far Sammy. Give yourself time." John soothed.
"But even you and Dean thh…think I'm diff…erent. You won't lll…leave me alone to go on a hhh…hunt. You won't lll…let me hunt."
"Sam," John replied. "Your brother and I are just worried about your seizures and we don't like you to be alone and we can't risk you getting hurt on a hunt."
"Dad's right Sammy. We just worry," Dean replied. "I'm sorry about last night. I didn't mean it the way it sounded. I'm sorry … I was an ass."
Sam nodded at his brother to indicate he accepted the apology. He looked at his brother and father. "I was alone last night … all night. I'm fine. I'm not a kid."
"I know you're not Sammy." John agreed. "It's just you're still healing," he offered. "You can't protect yourself if something were to attack."
"Attack?" Sam looked at his father as if he were nuts. "House surr…surrounded with salt … pro…tection amulets buried outside and hung inside. No…thing will get in."
"Yeah, well, some things don't seem to be phased by certain stuff," Dean chimed in.
"The demon," Sam offered. "He hasn't come. He won't. Please, people need your help. You and Dad go tonight and hhh…help that family… up and back same night."
"Sam," Dean began.
"No, Dean," John interrupted. "Let's try it okay? If Sam thinks he's ready to be left alone for a little bit … let's try it." Sam turned expectant eyes to his brother.
"Dad," Dean's tone was one of confusion and concern.
"Sammy, do you mind if I talk to your brother alone for a minute?" Sam shook his head. "We're just going to the kitchen. We'll be right back, okay?"
"Okay."
Sam sat in his room surfing the net on his laptop waiting for his dad and brother to finish preparations for the hunt. He turned when he heard a knock on his open door. "Mind if I come in?" Dean asked from the door.
"No," Sam answered. "You and dad rrr…ready to go?"
"Almost," Dean was hedging. "Um, Sammy … I wanted to talk to you about…"
"It's okay," Sam replied cutting his brother off.
"No, it's not," Dean's eyes were upset. "What I said in the kitchen last night … I'm so sorry Sammy. I don't want you to think that I think there's something wrong with you. I just worry and …" Dean dropped his eyes from his brother. It was still strange for him to be so emotionally open with his little brother, but things had changed and they called for Dean Winchester to change, as well. "Sammy I couldn't handle it if you got hurt or something happened and I wasn't there for you. That's why I don't like you alone."
"I know," Sam's eyes were sad as he stood from his desk and sat down on his bed. "Dean I don't www…want ttt..to be like this," Sam's eyes filled with unshed tears. "People treat mmm…me diff…erent and I hate it."
"Sam," Dean's voice was hesitant. "Everyday you make some kind of improvement and you're doing your rehab. Maybe some things won't come back 100 percent, but we're not going to ever give up trying to get you there."
"I know you've given up a lot fff…for me …" Dean cut his brother off.
"We're not having that conversation again little brother," Dean replied. "I've told you before that I haven't given up anything. Anything I've done or will do is because you're my brother, okay? And, you'd do it for me," Dean assured. "I just want to make sure we're okay," Dean started. "When you were missing all I could think about was what if something happened to you and it was my fault you left. Nice job with the window by the way," Dean said with a small grin. "But, you try that stunt again … gimp or not I will kick your ass." Sam laughed out loud and was secretly elated that his brother had made the joke because to Sam it meant that Dean was being Dean and in that moment there was no dark shadow of the head injury or its long term repercussions looming over them and his older brother was treating him as an equal with that good natured jab at his physical status.
"Sss…sorry I made you and dad worry. And about the mor…gue…"
"Don't Sammy," Dean replied. "I just want to forget that ever happened, okay? I don't even want to think about it. You're here and safe and that works for me."
"Okay."
"Dean!" John called from the kitchen.
"I better go see what dad wants," Dean suggested. "He's probably just about ready to leave."
"Are you ex…cited?"
"It's just a job Sammy," Dean answered.
"You miss it … don't you?" Dean smiled and decided not to lie to his brother. Sam could read him to well anyway.
"Yeah, sometimes … I guess, but I'm okay with not doing it," he quickly asserted not wanting Sam to get the wrong idea and feel guilty about anything.
"You and dad bbb…be care…ful." Sam replied not addressing the issue any further of his brother returning to the hunt after a year.
"We will."
"Dean!" John called a second time.
"Better go see what the old man wants before he blows a gasket." Sam smiled. The youngest Winchester was happy to see his brother and father bonding again, although he knew that Dean was still apprehensive about their father leaving Sam could see that slowly each day Dean was letting some of his walls down around their father. Sam knew the turning point was when John had been there for Dean in the hospital during his bout with pneumonia. Sam was just happy to see some of that glint back in his brother's eyes and tonight he saw a look of excitement in his brother's face that only a hunt could put there. Sam got up from his bed and headed for the kithchen.
Dean and John prepared to leave for the hunt. John had called Joshua back and had said he and Dean would help the family in Tipton, but they had to finish and be back tonight. They had agreed to allow Sam to stay home alone, but he had to promise to stay inside and they would check in with him. Sam walked his Dad and brother to the door. It was early evening and they planned to be back no later than 9:00. "Remember keep the door locked Sammy, and if you have any trouble…" Dean's voice was anxious. Both Dean and John had their concerns, but they needed to show Sam that they did believe in him, and they also wanted to help a family in obvious need of help.
"I knn…know," Sam rolled his eyes. "I call you and Dad…"
"And, if you don't feel well or you have a seizure or something," Dean countered.
"Call 911, I knn…know Dean. Not stupid."
"I know you're not," Dean replied.
"You sure you're okay with your brother and me leaving Sammy?" John asked.
"I'll be fff…fine dad. Go."
One Week Later
The hunt had gone off without a hitch and both men were reminded of the thrill of the hunt. They had been excited with the adrenalin of the hunt, but eager to return to Sam at home. They had called him frequently eliciting complaints from him, but everything had been fine. John and Dean both contemplated taking occasional jobs that were nearby, but for right now they'd stay close to home, and not make hunting a habit. They both had jobs, rent and bills to pay. And, Sammy still had his rehab.
Christmas was only three weeks away and it would be the first they spent together as a family in years. John had come home from work one afternoon with an artificial tree he purchased at a store across the street from the garage he worked at and his boys had seemed surprised. Dean had actually bought some discount ornaments for it and some tinsel. He even brought back a yellow star that lit up for the top.
"You boys want to grab a bite to eat at the McFulley's Diner?" John called out down the hall. Dean had been home from work about an hour and he knew his boys would be hungry.
"Yeah, sounds good. Give me ten minutes,' Dean called out from his room. John waited in the kitchen. He was tired. It had been a long day at the shop. He rubbed his jaw absently. It ached and had been aching on and off most of the day at work. Probably going to have to see the damn dentist, he complained silently in his head. He was sure he had pulled something in his left arm and shoulder today too … it was tense and ached. He worked it up and down like a bird wing. Getting older sucks, he thought to himself. Dean walked into the kitchen as John finished his shoulder stretch.
"Trying to fly," Dean commented with a smile.
"You're a real comedian, huh?" John replied. "You just wait until you're my age Dean. Things will ache you didn't even know you had."
"You're not ancient dad, geez," Dean countered. "Come on Sammy!"
"Coming!"
"Dean, do we have any antacids around here?"
"Huh?" Dean answered distractedly. "Uh, yeah, the cabinet by the fridge … I think there are some Tums in there. Stomach bothering you?"
"A little," he paused. "I just think I need to eat. I wasn't really in the mood for lunch today."
"Yeah," Dean answered.
The diner wasn't too crowded for 5:00 on a Thursday. The Winchesters talked and Dean and Sam tore into their food. John had poked at his food. "You okay Dad? You haven't touched your food." Dean asked.
"Yeah, I'm good. Upset stomach. A couple of the guys have had the flu and cold's and I think I may have caught a bug. It'll pass."
"Get a doggie bag," Sam commented. "Maybe, you'll want it later," he suggested.
"Yeah, good idea Sammy." John smiled.
Later that Evening
John walked into the kitchen to get a coffee. Dean and Sam were lounged on the couch watching the movie Predator on the Sci-Fi channel. He grabbed a clean mug from the dish drying rack. He was trying to hurry so he could get back to the movie while commercials were playing. He turned to walk to the coffee pot as a sharp pain lanced through his chest. He grunted as he raised his free hand to massage his chest. "Damn," he whispered to himself as he leaned against the counter. The pain was gone as quickly as it had hit. He straightened up and started for the coffee pot again, but this time the pain returned more powerful than the last wave and he staggered. The ceramic coffee mug slipped from his unfeeling fingers and hit the hard kitchen floor shattering. John slowly fell to his knees clutching his chest. Oh God, not like this … not with my boys here, his mind repeated the litany of words over and over.
"Dad?" Dean's voice was casual as he walked toward the kitchen. "You drop something?" Dean walked in and saw his father on his knees. His skin was pale and sweat beaded on his face. "Dad!" He yelled sliding to his knees at his father's side.
"Dean," John forced out through the pain. John pitched forward and Dean caught him easily lowering him to the kitchen floor to lie on his back. "Feels like an elephant is sitting on my chest," John panted as his face twisted in pain.
"Jesus, Dad!" Dean unbuttoned the top of his father's flannel shirt quickly. He could feel his father's skin beneath his touch it was cold and clammy. "Hang on," Dean grabbed the phone dialing 911. "Sammy! Come here!"
"911 what's your emergency?"
"My father," Dean began as he felt the panic rise. Sam had come into the kitchen and immediately went to his father's side. "I think he's having a heart attack."
"Is he breathing? Have you loosened the clothing around his neck?"
"Yes, please, just hurry!"
"EMS is on the way. Your address is showing as 2440 Willow Bend Ave., is this correct?"
"Yes, please hurry." Dean knew there was a firehouse with paramedics nearby and he all ready heard the sirens. I hear them."
"Okay, I'll let you off the line." Sam kept talking to his father as John continued to pant and clutch at his chest.
"It's okay Sammy," John forced out. "Don't you boys worry."
"Dad, just be quiet okay. Sammy go let the paramedics in. I can hear the sirens."
Capitol Region Medical Center's Emergency Room
Dean and Sam sat side by side waiting to hear about their father. The paramedics had moved so quickly starting an IV and hooking their dad up to various portable monitors for transport to the hospital that it had all been a blur. They were instructed to come in their own car because they needed room to work in the ambulance. Dean and Sam had hit traffic and the ambulance had all ready arrived with John ten minutes prior. All Dean knew was that they were told their father was in a trauma room and they would be given news when they had some.
John Winchester was in and out of consciousness and the physical pain was the worst he could recall ever experiencing. "Mr. Winchester? I'm Dr. Jay. I need you to rate your pain from 1 to 10." The doctor had been asking questions and talking to him non stop since they had rolled him into the ER.
John grunted in pain. "10 … Christ it feels like a house fell on my chest." The doctor nodded as he consulted John's EKG.
"Mr. Winchester…"
"Call me John."
"Okay, John," the doctor replied. "You're showing ST elevations with T wave inversions," The doctor continued to say a few more things, but John's attention was waxing and waning.
"English, Doc," John grimaced in pain.
"You're having a heart attack," the doctor answered flatly.
"Really?" John tried for a moment of humor and surprise. "I hadn't figured that out. Look my boys…" A new wave of pain lanced through his chest and he gasped.
"John don't worry about your son's right now. I'm sure they're out in the waiting room. Let's get you stabilized first." John grunted again and clutched at his chest frantically for a brief moment and his head suddenly lulled to the side as his heart monitor wailed. "Sonofabitch," the doctor hissed. "He coded. Start compressions." A nurse started compressions on John while another placed an ambu-bag over his face to begin ventilating him. "Hold compressions," the doctor spoke. He looked at the monitor. "He's asystole. Push a high dose epi. Resume compressions."
"Come on John work with me here," the doctor spoke to his patient. "Hold compressions."
"He's in VF," a nurse called out.
"Okay, gotta shock him," Dr. Jay replied. He grabbed the defibrillator. "Charge to 360." The doctor placed the defib paddles against John's chest. "Clear!" And, the shock was delivered to John's chest and his body arched violently off the gurney.
"Still in VF," a nurse called out again.
"Resume compressions. Give him an amp of Lidocaine." Dr. Jay instructed. "Come on John think about your kids. Fight dammit! Hold compressions."
"Still VF."
"Okay, charge the paddles to 450. Clear!" He delivered a second shock to John's chest.
"No conversion. Still VF."
"All right, get me a cardiac needle and an amp of epi." The doctor took the large needle and drew up the epi. He palpated John's chest near his sternum and drove the needle straight into his heart and injected the epi. He fisted his hand and gave a hard thump on John's chest trying to stimulate his heart. "Resume compressions."
The team struggled to save John's life. "What's his down time?"
"Ten minutes."
"Okay, continue compressions. Get me an ET tube. I need to intubate him, now." Dr. Jay quickly inserted the breathing tube. "Okay hyperventilate him. He's looking a little cyanotic."
The room was working at a fever pitch. Everyone had a duty and they were doing it. "Hold compressions."
"Still VF."
"Charge to 500," he yelled as he placed the paddles against John for a third time and delivered the shock. as John's chest convulsed upward with the electrical current.
"He converted," a nurse yelled out. "We got him back. Pulse thready."
Another nurse came running in with John's blood work results and the doctor looked at them and knew based on what he was all ready seeing with earlier exams and the monitors coupled with John's other symptoms he was in bad shape. John's blood work showed evidence of cardiac enzymes confirming the heart attack on paper and the doctor shook his head. "Allison," Dr. Jay called out. "Look I gotta talk to the family and get permission for a clot buster before he codes again and we don't get him back. Get the med ready. This guy is losing heart muscle as we speak. If we don't hurry there won't be a heart that can be saved." The nurse nodded.
Dr. Jay ran out to the waiting room. "Family for John Winchester?"
"That's our Dad," Dean answered quickly.
"Hi, look I know you have a lot of questions, but I have to be quick. I need you to sign this consent for a clot buster. Your father is having a massive heart attack and I believe that without a clot buster he will die." He looked at both young men and saw the fear. "Your dad will die without the clot buster medication, but there are risks …" he began. "There is risk of stroke, and bleeding into the brain among others. And, right now he is losing heart muscle. And, my goal is to preserve as much as possible."
"You're saying he will die if we don't use this stuff, but, he could still die from the drug?" Dean's voice shook.
"Yes, unfortunately. But, there isn't much option at this point. We will monitor him closely for any adverse effects from the medication," the doctor answered. "Your father's heart has all ready stopped once. If it happens again I don't think we're going to get him back." Dean was at a loss for words. His father's heart had actually stopped beating once. He signed the consent form in a blur and the doctor was gone yelling over his shoulder that when he had news he'd tell them. Dean and Sam sat back down both silent.
Dean and Sam sat side by side waiting and watching the clock. There had been a long stretch of silence between the two brothers. Dean's mind was reeling from the events of tonight. His mind trying to come to grips with the possibility that their father might not survive this attack. Sam had taken to nervous chatter and somewhere in the recesses of Dean's mind he heard his brother's voice. It seemed non-stop as pieces began to sift into Dean's hearing. Sam felt compelled to just keep talking about anything that popped into his head, and he found talking about how he learned to repair a book binding at the library the previous week was something worth conveying in his nervousness.
"And sss…some…times the leather bind…ings are old and want to crr…crack, so you have to bbb…be…" Dean snapped.
"Sammy what in the hell are you talking about? Jesus, our father is having a heart attack. Hell he could be dying right now," Dean hissed. "And you're talking about …what? Book bindings! Damn," he spat. "I can't deal with you right now," he stood up abruptly. "I need a coffee." He stalked away toward the coffee machine across the ER lobby. Sam sat silent and suddenly felt completely alone in a room full of people. He hadn't meant to upset Dean. It was just nerves. Sam looked up and saw some of the people in the waiting room looking at him. He guessed they had heard his brother go off on him, and possibly had heard his meaningless chatter, as well. He stood up glancing at his brother's back across the room getting a coffee. He dropped his head and walked away down a random hall to get some space from his upset brother. He didn't go far and took a seat further down the hallway.
Dean watched as the coffee cup descended and filled his cup. He felt bad that he had snapped at Sam, and he'd fix it later, but right now he was too worried over their dad to think straight. He felt as if one more thing went wrong he'd snap like a twig. His plate was too full, hell it's been too full for longer than he cared to add up, he thought to himself. He pulled the cup from the dispenser and noted it was one of those poker cups that give you a card hand on the side and below the cup is the final card. He glanced at the bottom of his cup and noted with a bemused snort that he had a full house. "Figures," he grumbled to himself… good luck exactly where you don't need it, he thought silently.
Dean glanced back at the seating area and quickly noted that Sam was not where he had left him. "Goddammit!" He hissed. "I don't have time to coddle you Sammy," Dean grumbled. But despite his anger anyone that looked at Dean could see the edge of panic in the young man's eyes as he scanned the room quickly for his errant brother.
"Excuse me," an older woman spoke from her seat in the lobby. Dean looked at her.
"I saw the young man you were with go that way," she pointed down a hallway.
"Thanks," Dean answered with relief. "Thanks a lot."
"You're welcome."
Dean walked urgently down the hall and he didn't have to go too far when he saw Sam sitting in a small bank of chairs with his head down. He also noticed the small tremor shaking his brother's left arm and hand. It was small, but he quickened his pace. Dean's anger from the lobby was forgotten quickly. He sat down next to his brother and put a comforting hand on his shoulder. "It's okay Sammy just take long slow steady breaths, okay? It's not a bad one." Sam lifted his face and looked at his brother and Dean saw the tears streaking down his face. "Hey, hey," Dean said softly. "You're okay. All right? It's not bad. Just stay calm and it'll be okay."
"Sss…sorry I walked away," Sam's voice hitched in his throat.
"No, Sam I'm sorry I snapped. I know you were just worried and it was your nerves talking," Dean assured.
"Still sss…sorry." Dean nodded and put a comforting arm around his brother.
"Well, look at that," Dean replied. "The seizure's over and it wasn't bad at all." Sam nodded. "How long was it happening before I got here Sammy?"
"Couple minutes," Sam responded.
"You see," Dean said with a comforting smile. "It was gone in under six minutes," he replied looking at his watch. "You think you're up for going back to the lobby? I mean, we can see the ER doors from here, but I'd like to be closer." Sam nodded. "Okay, kiddo let's go. Now, I want you to try to relax Sammy. You don't need to have a bigger seizure like the one you had at Ivy Ridge that one time, okay?" Sam nodded.
"Dean…" Sam's voice trailed off and Dean knew what was being left unsaid. He put a comforting hand on the back of his little brother's neck and gave a gentle squeeze.
"He's a Winchester Sammy … Dad's too stubborn to die." Dean said the words trying to console his baby brother, but he was also trying to convince himself too. His mind wouldn't stop running scenarios and he couldn't stop the one thought that kept plaguing him … what if this was the one thing John Winchester wouldn't walk away from alive? Dean and Sam returned to the ER lobby to await word on their father's condition.
Four Hours Later in the Cardiac Intensive Care Unit (CICU)
"Your father is one tough fellow," the doctor commented. "We've managed to stabilize him and the clot buster looks like it worked its magic."
"But, I hear a but coming," Dean replied.
"But… he's in critical condition. We have him stabilized on various IV meds right now, and we've been able to halt the active heart attack. You need to know that he won't be out of the woods for a few days. We are working very hard to keep his cardiac status as stable as possible. He isn't conscious and he's been given a mild sedative to insure he remains in a relaxed state. He's on a ventilator right now and will be until I'm sure he's out of danger.
"What are his chances? I mean, you stopped the heart attack, so …"
"Your father is tough I'll give him that. There aren't many men that could have been resuscitated after the heart attack your father had. But, as I said he is in critical condition and I can't really give you a percentage. He's fighting, so that counts for something. Once he is more stable and out of critical condition I'll be assessing the damage to his heart more thoroughly, but right now we're just trying to keep him stable. He was asking about you both right before he arrested."
"He was?" Dean's eyes softened for a moment.
"Yes, he was very concerned about the two of you.
"Hey Doc," Dean's was hesitant. "My dad's in good shape, but this heart attack…" he paused. "I mean … I've heard stress and stuff can lead to this, and…" The doctor smiled reassuringly as he knew where this was going.
"You didn't do this to your father … neither of you. Yes, stress can be a contributing factor, but it is only one domino in an entire chain of events that led to this. Diet and family history … you name it," he comforted. "There are many factors. Internal and external. This isn't your fault."
"Thanks," Dean wasn't sure he was convinced that the stress of his relationship with his father since he returned hadn't helped to push his dad into the attack. But, the life and diet of a hunter like his dad had become since the fateful night in Lawrence would and probably has taken a toll.
"Now, I can't let you both in at the same time, but you can each visit him for 10 minutes separately." Sam looked at his brother.
"You ggg…go Dean. I ccc…can wait."
"You sure Sammy?"
"Yeah."
"Okay, but sit here in the chairs. I'll be back in ten minutes."
"I'll www…wait hhh…here." Dean smiled and followed the doctor.
"Must be difficult?" The doctor commented idly to Dean as they walked toward John's room.
"What?" Dean asked.
"Your brother," the doctor commented. "Was he born with the speech deficit? I noticed a medical alert bracelet too."
"Huh? No, he was in an accident a year ago. He suffered a bad head injury. The bracelet is for a seizure disorder."
"Oh," the doctor replied. "Is he okay on his own? I mean, can he be unsupervised? This is an intensive care unit for heart patients." Dean stopped and looked at the man.
"Look, I appreciate everything you're doing for our father, but my brother isn't any of your concern. Yes, he's fine to sit and wait. He doesn't need supervised like some kind of puppy. You know he was a Stanford student … he's not stupid, and I expect everyone in this unit to show him the same respect as anyone else. He has some speech issues and some other problems, but they aren't your concern." Dean was enraged, but keeping his voice level and calm. He didn't want to get thrown out of CICU before seeing his dad.
"I didn't mean to offend, but it is my concern in this unit," the doctor added. "Is he emotionally stable enough to handle seeing your father? It could be very upsetting to him if he doesn't understand the magnitude of what's going on … there are machines and IV's it could be upsetting. And, I'm not comfortable with him being unsupervised while he visits your father."
"What are you saying? Look he can handle it, okay? It's not like he's going to start screaming like Rainman or something. My brother isn't mentally challenged and I'll be damned I let him be treated like he is. He is dealing with enough."
"My point exactly."
"You know if you don't want him unsupervised then I'll stay with him while he visits."
"No, there isn't room for two visitors and having more than one inside will impede your father's care and should there be a crisis we need to act quickly. The rules of one visitor at a time are in place for a reason."
"Fine, then he'll visit on his own."
"No, I can't allow it. He'll have to wait until your father's condition is upgraded and moved out of the CICU to the Cardiac Care Unit or what we call CCU."
"So what you're saying is that you're not letting my brother see my father? He could die, right? You aren't keeping my brother away from our dad. You call his neurologist Dr. Rose Myers at Ivy Ridge Rehab Center and she'll tell you he's fine to visit our dad. He's in out-patient rehab now. He can handle this."
"Mr. Winchester," the doctor began. "I understand your distress, but it is for father's own well-being."
"All due respect Doc … that's a load of crap. My dad will want to know where Sam is, and you'll be the one upsetting him if he can't see Sam. Call Dr. Myers. He handled me in the ICU a few weeks ago with pneumonia and it was here in this hospital and no one kept him out."
"I'll speak with his neurologist, but he isn't seeing him tonight. I'll call Ivy Ridge tomorrow to ascertain his mental stability with his brain injury."
"Whatever," Dean was angry, but he wanted to see his father. "Where's my dad?"
"In that room," the doctor pointed. "10 minutes, and should you have any questions about your father, please don't hesitate to ask."
"Yeah," Dean's tone was harsh. The doctor sighed.
"Mr. Winchester," he began. "It isn't anything personal, but I have to think of the big picture and providing the best care for your father."
Dean let out a long put upon sigh, "I heard you all right. I just want to see my dad." And with that Dean walked into his father's room. A nurse was just finishing up with hanging another IV bag, and adjusting what Dean saw was the ventilator settings. She smiled and walked out of the small cubicle. Dean noted that most of the free space was filled with equipment and IV poles. There was a bedside computer console where the nurse did her charting and scanning of drugs before they were administered. Finally, Dean took a breath and stepped toward his father's bed and really looked at him for the first time since stepping inside. Dean's initial reaction was a sharp intake of air. He stared at his father and felt fear. John was unmoving and his chest rose and fell at the will of a machine. Dean scanned the wall of monitors and watched the up and down blue electronic arches on his dad's heart monitor. He listened to the beeping and found some comfort in its constant rhythm. Dean never thought he could feel more fear than he did in this moment. He wasn't prepared to feel at a loss standing at his father's bedside. This feeling he knew well… he was accustomed to it when sitting at Sam's bedside willing him to live. But, he hadn't been prepared mentally to see John Winchester sick and most of all fragile. He studied his father's pale features. He looked almost gray and when Dean reached out and touched his father's arm the skin felt cold to the touch. Dean found himself absently stroking his dad's arm to try and infuse some level of warmth.
He found the intrusive oxygen tube snaking down his father's throat a bit daunting, but he had made it through watching Sammy on life support he would get through this. "Dad," his voice caught and Dean cleared his throat and tried again. "Dad, it's me Dean. Ah, the doc says you're going to be just fine, okay? So, don't getting ideas about bailing on Sammy and me. Got it?" Dean watched his father's still features and it hit him that he and Sam could lose their father. Hot tears welled up in Dean's eyes and he fought against the emotional onslaught rising up in him.
"Listen Dad," Dean's voice had a pleading quality to it, and had John been conscious it would have floored him. "I thought I could stay mad at you the rest of my life, but I can't. Sam was right to remind me about what I wanted back in Chicago when he was in rehab. I wanted the three of us back together again. Dad … we all make mistakes. Look you left Sam and me and maybe I'm still pissed about it, but that doesn't mean I want you to die. We're getting back on track dad," Dean urged.
He held his father's slack hand mindful of the IV tubing jutting from the top of his hand secured on a thin board with medical tape. "Come on Dad … we got Christmas in three weeks," he commented idly. "I mean … you bought a tree and everything. You're going to be okay. You keep fighting dammit. Sam and me are here, okay? And, don't worry about Sammy I'll make sure he takes care of himself and gets his meds. Uh," Dean looked at the clock on the wall and it was almost 10 PM. "Listen dad the doc is only letting me visit once every hour for ten minutes, and my times almost up. Um… he won't let Sammy see you because…" his voice trailed off for a second. "Because he's an idiot, but he's calling Dr. Myers tomorrow so Sammy will be here to see you in the morning."
"Mr. Winchester," a nurse came stood at the opening to John's room. "Your ten minutes are up. I'm sorry."
"All right, but I can come back, right?"
"Yes, you can come back the last ten minutes at the bottom of the hour."
"Okay, I'll see you at 10:50. Uh, if there is any change or anything my brother and I are just around the corner in the CICU waiting area. And, you have my cell number should we be in the cafeteria or something, right?"
"Yes, I have your contact numbers cell and home and I can also have you paged overhead. And, if you need anything or have a concern … I'm your father's night nurse, and my name's Connie."
"Thanks Connie."
Dean walked into the small waiting area in CICU. The room was just outside the automatic doors that led into the unit. There were only five chairs in there, and right now its sole occupant was his rather distressed looking younger brother. Sam stood when Dean walked in. "Hey Sammy, you doin' okay?"
"I'm fine. How's Ddd…dad? Ccc…can I ggg…go in now?"
"Listen Sammy sit down I gotta talk to you." Sam's eyes were alarmed as he sat instantly.
"No, no Sammy," Dean was quick to allay his fears. "Dad's holding his own right now, but here's the thing," he trailed off. There was no easy way to broach the subject, so he just had to jump in. "Dad's doc is worried about you getting upset, and he doesn't think you can be in there right now." Dean saw the hurt cross his brother's eyes. "Sammy he's going to call Dr. Myers tomorrow and talk to her and you know she'll say you can handle seeing dad. The doc is an idiot."
"I ttt…told you people ttt…think I'm a tard. I'm nnn…not. I want ttt…to see dad."
"Sammy I know you do kiddo, but it's not happening tonight."
"No!" he snapped back.
"Sam keep quiet," Dean warned. "They hear you yelling they'll never let you see dad while he's in there no mater what Dr. Myers says."
"I not sss…stupid. I just www…want ttt…to sss…see ddd…dad." Dean turned to Sam detecting his brother was getting too upset as his speech began spiraling out of control.
"Sammy you gotta calm down, okay? You all ready had a small seizure earlier. Please, I now you're upset. I am too. But, tomorrow the doc will clear you."
"Ddd…dad could die," Sam blurted. He stood up and paced the small confines of the room and flailed his arms up and down in irritation.
"Sam sit down," Dean got up trying to urge his brother back to a seat. "Relax, okay?"
"No! I'm nnn…not dam…aged. I want to sss…see…" his voice fell off quickly and Dean's eyes darted to Sam's face. Sam was grabbing his head, and suddenly Dean recognized what was happening … it was a vision, but this time something else was different. He watched in horror as Sam's eyes rolled back into his head and he collapsed against Dean. "Oh shit," he hissed as he realized with sudden clarity that a seizure and a vision had just clashed. It was the perfect storm. The seizure coupled with the synaptic explosion of the vision caused the minor seizure to crescendo into a full blown violent episode Dean had never witnessed before. He did the only thing he could, "Help! Somebody help me!" He tried to keep Sam from hurting himself as the seizure grew worse. As he stared at Sam's face he felt a cold pit of terror replace where his stomach used to be as his heart hammered in his chest.
He heard running feet coming down the hallway and all he could do was try to protect his brother's violently bucking head from hitting the floor. "Help! In here!"
Dean kept panicked eyes on his little brother's face as he heard footfalls fast approaching. Sam's lips were beginning to turn blue and frothy foam began to slide out the corner of his mouth. "Sammy!" Dean screamed. "Please! He's turning blue." Two nurses and a doctor burst into the small waiting room. The seizure wasn't stopping and Dean suddenly felt himself pushed back as the doctor moved into his previous spot.
"Christ," the young doctor hissed. "Get a damn crash cart. This kid isn't breathing. Dammit get me some Phenobarb, now! He needs to be bagged!" The doctor saw the med-alert bracelet, and roughly flipped it and glanced at Dean. "He has a seizure disorder?"
"Yeah, but never like this," Dean's eyes were horrified. "He has Jacksonian seizures … never this."
"Is he on medication?"
"Yes, Dilantin 100 mg."
The staff poured into the room and began administering injections of drugs and it all seemed a blur to Dean. They fought against Sam's convulsions to attach a heart monitor and pulse ox. He watched the doctor push the Phenobarb into his brother and waited for the seizure to stop … it always stopped, but this time not fast enough. "Dammit, that's it," the doctor barked. "I gotta paralyze him now! Before we lose his pulse. We'll just administer the paralytic reversal drug in the ER."
Dean watched the doctor prepare a vial and draw the drug up into a needle and inject it into his brother's IV line they had managed to start while someone had held his arm down. Within forty seconds the seizure began to slow and within a minute and a half Sam was completely still. "Hyperventilate him," the doctor instructed. "He's cyanotic." The nurse increased her bagging rate with the ambu-bag. "Hold off a second," the doctor said after he was certain Sam's oxygen SAT's had come up to an acceptable level. Dean watched the doctor listen to Sam's chest and the doctor frowned. "He's not having spontaneous respirations. I gotta tube him." Dean felt sick as he watched his brother intubated. He hated this and he had never wanted to see it again. Memories of Sam's coma accosted his mind. Dean blamed the vision for this extreme seizure, as another part of him wondered what the vision had been about. Sam was loaded on a gurney that would take him to an elevator leading to a trauma room in the ER.
"I want his neurologist called. I have her pager number," Dean snapped out of his stunned stupor at the events he'd just witnessed. Dean gave the information and rattled the number off by heart. The doctor attending Sam wrote the information down. "I mean it," Dean asserted. "I want her called. She is his doctor."
"We'll have her called right away. But we need to provide him with some immediate emergency care to stabilize him." Dean nodded out of reflex more than coherent thought.
He was torn between his father and his brother. His father was clinging to life and his little brother wasn't conscious or currently breathing on his own. He had reached his last straw and stood stock still, absolutely frozen in the hallway as he looked at the doors to CICU and turned and watched the gurney with his brother begin to wheel away. He couldn't do this alone, and felt so overwhelmed that he knew his grip was starting to slip. He pulled out his cell phone and filed through the programmed numbers and pressed send. He knew it was late. But, something in him was desperate to hear one voice he hadn't heard in a while, but knew could help him not lose it completely. He needed help. His world was falling a part. His entire family's lives seemed to be precariously balanced at the edge of a large precipice. He felt torn, desperate and at a loss to be of any help for his dad or his little brother. His life was unraveling at an alarming rate, and he felt the pull of dark thoughts and unbearable loss. He needed a life preserver now. The other end of the connection rang three times before a sleep inflected voice answered, "Hello?"
"Missouri?" Dean's voice shook and cracked in desperation.
To Be Continued
Well, let me know what you think. A lot of stuff happened in this chapter, I know. I hadn't planned on combining two of the events, but it sort of worked out that way and I went with it. I appreciate your reviews and comments! They are excellent motivators for more chapters.
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