A/N: So continues my "short" sequel to the story I wrote about Dean having food poisoning. This is dedicated to all you fantastic reviewers out there who urged for continuance of limp Sam and seem to gain enjoyment, pleasure, glee…from seeing Sam in pain. Shame on you all.
Disclaimer: I don't own Supernatural or the characters …
Chapter 6
"Sammy!…" Dean's yell reverberated around the shabby motel room.
Quickly kneeling by Sam's side, he placed a gentle hand on his unconscious brother's chest. A wave of relief washed over him as he felt the familiar thud of Sam's heart pumping blood throughout his body. Immediately Dean checked Sam's breathing, noting with terror that his brother was only taking small shallow breaths even though he was obviously out cold. A small vivid red bump was visible on Sam's pale forehead, evidence of his encounter with the table.
"Sammy" Dean repeated, desperation showing in his voice. "Sammy, wake up … open your eyes."
Sam could hear his brother's pleading voice rousing him from his weightless state. He fought the anxious call, reluctant to return to the world of pain.
Dean ran his hands over Sam's body, lightly shaking his shoulder, eager for a response.
"Come on Sammy …that's it …just open your eyes." Dean pleaded, impatient for some sign of reaction from Sam.
Sam's eyes slowly fluttered open as he fully returned to consciousness, the pain once again assaulting his weary body. Gasping in pain, he moaned, desperate for some relief from the ache in his chest and the hammering in his head. Breathing had suddenly become more difficult, and his current prone position was exasperating the heavy weight that seemed to have settled on his chest.
"Dean" he beseeched, the single word trembling from his lips, imploring in that single word for his brother to help him, but unable to muster the strength to say any more.
"Hang on Sammy, I'm calling for an ambulance." Dean reassured his trembling brother.
He grabbed his phone from his pocket, thankful for the strong reception.
Dean's fingers fumbled in his first attempt to dial 9-1-1. In frustration, he had to start again, cursing himself for wasting precious time.
Quickly and concisely he relayed the necessarily details to the 9-1-1 operator as she asked the questions, relieved when he was told that an ambulance was being dispatched and should arrive in only a few minutes.
He didn't bother staying on the line.
Dean didn't let go of his brother's hand until he heard the ambulance sirens directly outside, followed immediately by knocking on the door. For once, he gave a small prayer of thanks that they were in a motel in a town with medical services, and not in the middle of nowhere, which was all too often the case.
Reluctantly, he left his brother's side for just long enough to gain admittance to the paramedics, before following them back to his brother, kneeling down to run his hand over Sam's fevered brow. He answered their sharp questions concisely, without thought, providing them with essential information about Sam.
Dean was deaf to the words that passed between the paramedics as they continued to assess Sam's condition, so focused was he on just looking at Sam, reassuring himself that Sam was still alive. Everything had gone down hill so fast, and he'd shamefully done nothing to hinder that fall. He knew he should have gotten Sam to medical help sooner.
He knew that if Sam didn't get better, he'd have no one to blame but himself.
He'd failed to watch out for Sam. His brother. The only family he had left.
Dean didn't stir from his self induced trip of blame until his arm was forcefully shaken by one of the paramedics. Rapidly snapping out of his tunnel-vision induced haze, he blinked, focusing again on the events before him.
The paramedics already had Sam positioned and strapped onto a gurney, obviously ready to transport him. An oxygen mask was secured over his face, and thankfully Dean could see the condensation in the mask from his brother's breaths.
"Sir, we're going to take your …" the paramedic stated.
"Brother. Sam, he's my little brother." Dean interrupted.
"We're taking Sam to the hospital now. It's just a few blocks away. You can follow us in your car," the paramedic stated, inviting no argument.
Dean grabbed his car keys off the dresser, following his brother's journey out the door towards the waiting ambulance. Unwilling to be parted from Sam, Dean headed for the Impala as soon as the ambulance doors closed, determined to follow directly behind the ambulance, being there for Sam as soon as he arrived at the hospital.
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The trip to the hospital was rough for Sam, each bump and movement jerking pain throughout his body. In despair, he closed his eyes, breathing shallowly through the oxygen mask. He didn't want to go to the hospital like this, drawing unnecessary attention to himself. He had just wanted to slip in, get a check-up, and the necessary medication needed to make him well. He didn't want to arrive with sirens blazing and people staring. Wearily, in a pain induced haze, he hoped that Dean would be there when he got to the hospital, and that …well…and that he'd just be there.
Sam again lightly slipped into unconsciousness.
The hospital was a hive of activity, and Dean struggled to stay by Sam's side throughout the preliminary examination, answering as many of the doctor's questions as he could. He stood by silently as Sam's shirt was cut from his body, reaching across without thought to take the discarded item of clothing. He stood by silently as hands traveled along his brother's body, touching and assessing. Sam slowly woke through the examinations, struggling to gain focus on his surroundings, struggling to breathe, struggling to answer the doctor's questions. Closing his eyes, Sam shut out his surrounding, instead chosing to focus on breathing, focus on managing the pain.
Dean stood by silently, unable to do anything to help his brother this time.
He was powerless.
He twisted and clutched Sam's shredded shirt in his fists, before tossing the offensive garment in the closest trash bin. He didn't need the reminder.
It was with a sense of relief when the gurney Sam was on finally came to a stop in a small room, and he was transferred to the waiting bed.
Privacy, of a sort, at last.
The doctor continued to examine his brother whilst nurses bustled around. Needles were inserted, blood drawn and an IV hooked up. Sam's eyes remained closed throughout most of the action, and Dean was concerned. He still hadn't been told what was wrong with Sam. No one had addressed him throughout this procedure, apart from asking questions about Sam's medical history, and his patience was wearing thin. It was only the fact that he didn't want to hinder the help that they were offering Sam that enabled him to keep quiet and just observe.
Enough was enough though, Dean thought, as his brother was stabilized and the frantic activity lessened. He needed information. He needed reassurance.
"Doctor?" he questioned; keen to remind the professional of his presence.
"Sorry Sir" the doctor replied absently, his attention still focused on Sam.
"Sir" a nurse interrupted awkwardly, "You need to fill out these forms" she said, thrusting a sheaf of hospital admission forms at Dean. "If you could wait out in the hallway for a moment, we just need to get your brother into a gown."
Resignedly, Dean took the offered pen and forms, and reluctantly moved out to the hallway, standing just outside the door. He didn't want to go any further. He needed to be near Sam …just in case …just in case Sam needed him. He proceeded to complete the required information, being as detailed as he could without drawing attention to unnecessary past injuries. He passed them back to the nurse a few minutes later when he was permitted back into the room. Sam was now clothed in a thin drab hospital gown, accentuating his pallor. His eyes remained closed as he rested in a propped position against the pillows on the raised hospital bed.
He had to wait patiently for a few more moments before the doctor finally moved from Sam's side to speak with him.
"Sir…" the Doctor spoke quietly to Dean.
"It's Dean."
"Dean. We've stabilized your brother for the moment. Sam was in a pretty bad way when he was brought in. He's very dehydrated, so we have him hooked up to an IV which should quickly give his body the necessary fluids. However, I am concerned about his other symptoms." Dean listened to the doctor acutely as he moved to his brother's side, taking a hold of his hand, offering reassurance of his presence. Offering Sam comfort.
The doctor continued once he was sure he had Dean's full attention. "Your brother has been experiencing chest pain and shortness of breath and, to be frank, I'm concerned about his heart."
The doctor's words invoked an unsurpassed feeling of panic in Dean. This was his brother. His baby brother. The brother he swore to protect. It took Dean a moment to get his panicked feelings under control and again focus his full attention on the doctor. He knew he needed to listen.
As the doctor continued, Dean idly stroked Sam's hair, listening intently.
"I understand that Sam has had a bout of Salmonella, …that is, food poisoning recently." The doctor stated, waiting for confirmation.
"Yeah, he's had it this last week, but he was getting over it …until this." Dean replied, moving his hand restlessly over Sam.
"It looks like Sam may have developed complications from the food poisoning" the doctor continued. "Complications occur when the Salmonella bacteria make their way into the bloodstream. Once in the blood stream, the bacteria can enter any organ system throughout the body; in your brother's case, the heart. A chest x-ray will give us more information, and now that he's stable, Sam will be taken down to x-ray shortly."
"But you can treat it right …Sam will get better?" Dean strived to keep the shake out of his voice, desperate to hear confirmation from the doctor.
"We should wait and see what the x-ray's show us. If your brother does have pericarditis …sorry, that's what we call the condition; then it means that fluid has collected in the pericardial sac, putting pressure on his heart. From my initial examination and from the description of his symptoms, I believe this is what has happened in your brother's case. The most common symptom of pericarditis is chest pain, which Sam has. The pain is predominantly felt below the breastbone and, or, below the ribs on the left side of the chest and, occasionally, in the upper back or neck. Breathing causes the lungs and heart to move in the chest and rub against the irritated pericardium, worsening the pain. As in Sam's case, pain often worsens when the patient lies down and may improve when they sit up and lean forward. Changes in position can increase or decrease pressure on and irritation of the inflamed pericardium," the doctor paused, giving Dean a moment to take in all the information.
"I don't, however, want to rule out any other causes of the chest pains, which is why I'm sending him down for an x-ray" continued the doctor.
"Yeah, okay" answered Dean. "But if he has it, you can treat it right?" Dean failed to keep the slight shake from his voice. He looked to the doctor, desperate to hear words of affirmation.
TBC
A/N. Next and probably final chapter should be posted tomorrow. Please review. Thanks.