Disclaimer: refer to chapter one

NOTE TO READERS: Thanks for the review! I have made an effort to reply to everyone that takes the time to review. I do appreciate it. Again, I'm surprised how many readers are enjoying my characterization of Ellen and Jo in this story. Thank you for your comments and observations.

Chapter Four

The Dark Backward

By Dawn Nyberg

Jo appeared in the doorway suddenly. Ellen and Dean both looked at her and saw the distress in her eyes. And, the flurry of activity running by Dean's room window set both Ellen and Dean's heart's racing. And, Jo's fearful words shattered the tenuous moment, "Something's wrong with Sam."

Ellen stood abruptly her hand immediately going to Dean's chest as she anticipated him try to lurch up into a sitting position. Dean felt like a pinned butterfly, but relented in part to her gentle force and his pain. "What happened?" Ellen barked. "Jo?" Her daughter shifted panicked eyes from her mother to Dean and settled on her mom again.

"Dammit," Dean growled. "What is it?"

"I don't know," Jo blurted. "Machines started making noises and then they shoved me out." Dean turned agonized eyes to Ellen. She nodded knowing silently what Dean was asking.

"I'll go find out. You stay put," she ordered lightly. Dean gave her a clipped nod. "Joanna Beth sit your backside down and make sure he doesn't try anything stupid." Ellen left quickly.

10 Minutes Later

"What's taking so damn long?" Dean hissed. "Can you see your mom out there?" Dean asked as he watched Jo leaning back in her chair trying to see out the window to Sam's room.

"I just see people coming and going. I saw some machines, maybe an ultrasound thingy. I don't see my mom."

"Go find her. I gotta know what's happening with Sam."

"Dean," Jo started. "You know she'll come back as soon as she's asked the doctors everything under the sun."

"It's just…" his voice trailed off as he stared at a small fray in his cover and started playing with it out of nerves. He felt like he had to occupy his mind with something because thinking about Sammy felt like all of his oxygen was being squeezed out of him.

"I know you're worried," Jo offered. She didn't feel equipped for this situation. She didn't have the words. "Hey," she said absently. "I see her … she's coming this way with Dr. Rosen."

"What else do you see? What's your mom look like?" Jo turned her eyes toward Dean for a second.

"What? What is it?" Dean felt his heart miss a beat in his chest.

"She looks stressed," Jo offered bluntly. "They stopped," Jo continued her running commentary from her window vantage point.

"What are they doing?"

"Talking … wait I see people in surgical scrubs … they're taking Sam away on a gurney."

"What? Where? I want to know what the hell is happening," Dean yelled.

Ellen and Dr. Rosen heard Dean's shout from his room, and quickly hurried inside his room. "Dean," Ellen spoke first.

"Jo said she saw them taking Sam away … where? You can't cut him open again," Dean declared. Now Dr. Rosen spoke.

"Dean there's been a complication."

"No shit," Dean hissed.

"Dean," Ellen replied casting a stern look at Dean. "Watch your tongue."

"It's okay," The doctor tried to assure Ellen. He had heard much more colorful language from other family members over the years. He understood it was fear talking.

"Screw my language. He's my brother! I want to know what the hell is happening. Why are you taking him back to surgery?

"Based on some exams and stat blood tests we had to send him back in," the doctor began. "After a surgery and especially with a patient that has experienced bleeding and clotting problems…" he was cut off.

"I thought Sam's blood was clotting better. He's bleeding again?"

"No," Dr. Rosen replied. "His liver as you know sustained trauma and a portion of it was removed. Sam's surgeon Dr. Paquet believes Sam has thrown a massive clot inside his liver and has subsequently blocked his hepatic artery. If the artery isn't unblocked Sam will be die within the hour, most likely a lot less than that I'm afraid."

"He believes he has a blood clot," Dean accused.

"Dean, please just listen to the doctor," Ellen urged.

"Dean there are a number of tests that we can run and Dr. Paquet and myself both agree that Sam's liver functions are compromised to the point of imminent failure. He was already starting to show signs of severe jaundice, a yellowing appearance to his skin. I assure you that Sam would not be going back into surgery if it wasn't a matter of life and death." The doctor looked at Dean and decided to be blunt. "If the liver stops functioning completely and we believe Sam is dangerously close to that outcome due to the suspected clot … if the liver stops functioning death can and often does occur within thirty minutes." Dean's eyes widened.

"But," Dean couldn't speak anymore as his mind was too overwhelmed with everything he'd just been told. A paralyzing fear gripped him. Ellen saw the desperation. She placed a tentative hand on his shoulder as she stood next to him.

"Dr. Rosen," she spoke. "How long until we hear something?"

"It's a delicate procedure. Dr. Paquet will have to dissect the artery to evacuate the clot and possibly repair the artery if damage occurred due to the clot. He will have to verify that the liver is profusing and when there is a blot clot present one must be very careful in extraction to prevent any of it breaking off and entering Sam's blood stream."

"Why?" Dean asked as he found his voice and strength under Ellen's strong grip on his shoulder.

"A loose clot in Sam's system could go to any number of places, his lungs, his heart causing a heart attack or even the brain causing a stroke. So, Dr. Paquet must be careful. The bit of luck Sam has had is the fact the clot is believed to be so large it was actually caught in the artery and didn't enter his system. Also, the fact he didn't develop another clot elsewhere that could have killed him within seconds."

"So, you're saying we could be in for another long wait?" Ellen questioned.

"Yes, afraid so, but when I get updates of any kind I'll personally notify you all, okay?" Ellen nodded. Jo sat along the wall and looked shell shocked. Dean simply stared at his folded hands no longer knowing what to do with the emotions battling inside his body. Dr. Rosen looked at his patient. "Dean," he spoke with a well practiced comforting voice. "I know this is a lot to deal with all at once, and that things just keep stacking up. Dr. Paquet will do everything he can to bring Sam through this. He's a good man and your brother's in the best hands he can be right now." Dean met eyes with the doctor, but said nothing. "Now," the doctor started again. "I'm going to have Cathy your nurse take your pressure again, okay. And, I know this is asking a lot, but I want you to try and rest and let your body heal."

One Hour Later

Jo was curled in a corner on a sleeping chair under a blanket. Ellen sat by Dean and simply tried to offer comfort and support by just being in close proximity. She wished he would sleep, but he only dozed in short naps. "Dean, Hun, please try to sleep. Your blood pressure is still too low, and you need to rest," she paused. "Just like Dr. Rosen said earlier, you need to let your body heal." Dean looked at her with haunted eyes.

"Let my body heal," his tone devoid of emotion. "Sammy's body is a wreck. He… he could be …" his voice hitched despite his effort to keep control. "He could be dying right now. It's my fault. We shouldn't have done that damn hunt. He's dying because of me." He lost the battle with his stoic nature and his face crumbled. He turned away from Ellen, so that she would see his tears. She reached over and took his hand in hers. She felt him tense, but he didn't pull away.

"You listen here," her voice was strong and emphatic. "Sam isn't going to die … you have to believe that. And, this hunt, it wasn't your fault." Dean turned his face and looked at her. She saw new tears brimming in his eyes and a level of anguish in his face that took her breath away.

"You don't know," he choked out. "You weren't there. It's my fault."

"Okay," she conceded. "Then tell me what happened," she urged. She knew Dean needed to talk whether he knew he realized it. She had to let him say his peace and then shoot as many holes in his reasoning as possible and then make him believe that Sam's injuries weren't his fault. "I'm waiting," she encouraged.

"Sammy said we needed to know more, but I was sure I knew how to handle it," Dean forced out of his tight throat. "We figured it was a wendigo that had been attacking the hikers and campers, but I under estimated it. I shouldn't have," Dean hissed. "We've hunted wendigo's before."

"What happened?"

"I made us follow a hiking path that had a recent attack. Of course the park service had up signs telling everyone there had been recent animal attacks. No big deal," Dean continued on as if on auto-pilot. "Sammy said the hunting patterns were off with this one that it seemed to hunt whenever it wanted because some people were attacked during the day and not at night like usual. I called him a geek and said he thinks too much," Dean's voice caught in his throat.

"He was right Ellen we shouldn't have gone into the woods like we did. That thing was hunting us the moment we entered the woods. I thought he was being dramatic about the day time attacks. I just didn't think it was important … you know flukes. The other attacks … all of them, but three were at night … I should have listened to him, but I…"

"Dean you can't blame yourself." Ellen suddenly felt at a loss. Dean glared at her.

"Yes, I can," Dean replied hotly. "Come on, Ellen who are we kidding here? It was an obvious change in pattern and I blew it off and Sammy paid for my fucking mistake."

"Dean, hunts can go bad so quickly even with the most prepared ones. It happened and now we deal with the fallout."

"We?" Dean hissed. "We don't have to deal with anything. Sammy's my family, my blood. Jesus, Ellen if he …" he took a shaking breath. "If he dies, I killed him. I killed my little brother." Ellen stood up abruptly and reached out taking Dean's chin roughly in her hand.

"Look at me boy," she demanded. "You haven't killed Sam. You saved him with the flare gun." Her voice and eyes softened. "Your brother is fighting Dean and you can't give up on him." Dean's jaw was tight and Ellen could see his muscles twitching. He met her eyes.

"I can't lose him," his admission was quiet and heart wrenching to Ellen's ears. "He's all I got." Dean's bottom lip quivered ever so slightly. Ellen wanted to say with absolute certainty that he wouldn't lose his only brother, his only family, but she couldn't.

"Dean, hun," she replied tentatively. "Sam survived the attack because of you; otherwise you would have both died. You gave him a chance. You have to tell yourself that. Fine, maybe the attack could have been prevented, maybe not." Ellen spoke with an assured tone. "But it happened and now we go from there, together, okay? You're not alone, you never will be," her voice steadfast. "You hearin' me boy?" Dean's nod was almost unperceivable, but Ellen had seen it.

"I can still hear him screaming," his voice sounded more like a small child than the young man in front of her eyes.

"Oh, hun," Ellen had no words now. And, before she could think about it or reconsider her decision to move forward she leaned down and wrapped her arms around Dean and hugged him to herself. Dean tensed and she held steady. Ellen felt Dean give into the physical touch and suddenly his emotions were given release and he cried in her shoulder and she held him. She held Dean tightly and she knew deep down that his tears were for Sammy, yes, but they were also for so much more and she held him as his crying hitched in his chest and sobbed. Dean Winchester was crying for his brother, his father, his mother, and a life held to the fire since he was four years old. "Shh," Ellen whispered as she stroked Dean's back with one hand while she held him tightly.

Three Hours Later, the OR Hallway

Dr. Rosen walked into the OR portion of the surgical unit intent on getting news about Sam when he learned the nearly four hour surgery had finally ended. He walked into the hallway that lie between the OR and the recovery room in time to see Dr. Paquet rip off his surgical mask balling it in his fist and throwing it into a biohazard bin as he muttered "Sonofabitch," under his breath not knowing that Dr. Rosen was behind him. The doctor knew the news wasn't good. He cleared his voice to get Dr. Paquet's attention. The doctor turned and met eyes with his colleague.

"Ron, how long have you been there?" Dr. Paquet regarded his friend.

"Long enough Mike," he replied. "Did you lose him on the table?" Dr. Paquet dropped his eyes and let out a sigh that seemed a combination of defeat and frustration.

"No, but almost," Dr. Paquet answered. "The kid's heart stopped again, it took a while to get him back. I came damn close to calling it, but then the last Epi finally kicked in and we were able to defib him back into a rhythm."

"But his liver," Dr. Rosen knew there was more. He knew his friend too well.

"I was able to remove the clot. We were right about it occluding the hepatic artery. It had caused a complete blockage. His liver is profusing fine now and the jaundice began abating as soon as the clot was removed."

"Come on Mike I know you to well … what is it?"

"He's weak Ron. The kid has been through too much. His vital signs aren't getting stronger…" Dr. Rosen interrupted his friend.

"He's not going to make it is he?"

"I think it'll take a miracle for him to survive until the sun comes up. Do you want me to talk to the family?"

"No," Dr. Rosen replied. "Dammit," he hissed. "I know you did everything Mike. The kid's just been through too much."

"Frankly, I'm surprised we even got a pulse back Ron. The kid is fighting so damn hard, but he's getting tired and …"

"He's starting to let go," he finished his friend's observation. Dr. Paquet nodded.

"Look if anything comes up … I'm on duty all night just page me," Dr. Paquet replied.

"Do you want me to page you when…" Dr. Rosen began and stopped.

"Yeah, I'd appreciate it. I don't know what it is about this kid, but I feel completely invested. I want to see it through."

"I know how you feel. But, the kid's older brother is going to take it hard. I talked to his aunt and apparently the boys lost their Dad a few months ago, and the mother has been dead since the youngest was a baby. There's no way his brother will just let him go quietly. He'll want us to do a full code on his brother when he arrests."

"Yeah," Dr. Paquet answered with a tired sigh. "Do what you have to … maybe it'll give his big brother some closure if he knows everything was done. Damn shame, really." Dr. Rosen nodded at his friend. "He'll be moved back to ICU in a few minutes. I'd keep him in recovery longer, but…"

"I know … let the family have time with him."

"He shouldn't die with strangers around him."

Ten Minutes Later, the ICU, Dean's Room

Dean was numb after Dr. Rosen had broken the news about his brother. Ellen was stoic and Jo sat unmoving staring at the floor. There weren't words. "He's not dying," Dean said suddenly. "I won't lose Sammy."

"Dean," Ellen wanted to tell him to hold on to that hope, but the doctor had been clear there was no hope. That Sam would likely die before the sun rose on a new day. "I know you want to believe …" Dean cut her off.

"Don't," he barked. "Not after all that damn pep talk you gave me about Sammy making it. You can't tell me he's gonna die … you don't get to say those words to me … not you!" Ellen dropped her eyes suddenly feeling like a hypocrite and that she had let Dean down in some way.

"They should be in here shortly to take you over to his room once he's settled," she replied deciding not to address Dean's previous comments to her.

"I want to see him alone," Dean spoke firmly. "The doc already said I could stay as long as I wanted."

"Jo and I will wait for you here," Ellen offered. She wanted to see Sam to visit with him too before … but she knew it wasn't her place and she'd not force herself into this. Sam was Dean's only family, his little brother and it was his sole right to be with him when he was released from this world and she wouldn't intrude. She felt a tremor work through her and she privately thought to herself, I'll say goodbye to him before they take him away … after he's gone and Dean's back in his room … damn she hated this. Things hadn't seemed this wrong or upside down since William, her husband had died years ago. Too soon. Too much life left to live. It was simply wrong.

One Hour Later, Sam's ICU Room

The blinds on Sam's window opening up into the unit had been drawn and his door closed slightly allowing Dean privacy with his sibling. He stared at his brother's pale face as he had for the past hour and watched the mechanical rise and fall of is chest. Dean held Sam's hand between both of his own. He stared at the heart monitor and watched as Sam's heart struggled to beat. He knew a heart rate barely maintaining 50 was bad, and Sam's blood pressure was barely readable he had been told earlier.

"Sammy," Dean began after long moments of just watching his little brother. "I thought we had a deal," he began bluntly. "You know the Winchester brothers against the world." His chin trembled as he fought to say what he needed to while he held his fear, and ultimately his grief at bay. "It can't end like this Sammy. This isn't how it's supposed to be. It ain't right," he choked. "This shouldn't be happening to you." Dean lifted Sam's hand up and pressed it against his face. Sam's cool hand sent a shiver through Dean when it touched his warm cheek. Tears ran unchecked down Dean's face.

"Please," his voice was desperate. "You can't let go Sammy. I'm not letting you go," he asserted. "I can't do this without you. I don't want to." Dean gazed at his brother with agonized eyes. "Come on Sammy open your eyes prove them wrong. You're too stubborn to die." Dean cast a look at the heart monitor and saw Sam's heart rate had dropped even lower as it hovered between 46 and 48. Sam was slipping and Dean felt it. "No, Sammy," Dean's voice assertive. "Please," he begged again. The numbers dropped once more to 44 and Dean's resolve crumbled. Death was coming and he couldn't kill it, he couldn't fight it … Sammy was letting go and Dean felt so incredibly empty. Dean did the only thing he could he leaned forward forgetting his own physical pain and dropped his head onto his brother's shoulder. He held Sam's hand within his own. "Please, Sammy, don't do this," he pleaded. "I'm not gonna say its okay, I won't. It's not okay for you to let go. Please," his voice broke and a sob escaped. "Please …. stay," he choked out. "For me Sammy, stay for me."

Long minutes past and Dean stayed where he was … his head on Sam's shoulder holding his hand. "Please stay," had become a soft mantra. Dean's head jerked up suddenly when he felt the slightest pressure in his hand. He cast eyes to his brother, but Sam's face was the same, lax almost peaceful in its pale repose. He thought he'd imagined it. "Sammy?" And then he watched as fingers weakly twitched in his hand and curled ever so slightly around Dean's own.

Dean felt a mixture of panic and happiness. Was Sam saying goodbye or was this the miracle he had been praying for silently? He looked up at the heart monitor and smiled when he saw 61. "Sammy, I'm here," Dean practically cooed. He stroked his brother's bangs gently and rhythmically.

Sam heard his brother's voice distant at first and then closer. Come on back Sammy. Fight. Keep fighting. I'm here. Sammy, don't leave me and he struggled against the darkness holding him and then he heard the words clearly through the dark and they showed him the way home, they showed him the way back to Dean, Stay Sammy… stay for me.

Dean watched as Sam's eyes fluttered. "That's it Sammy, open your eyes. I'm here," Dean encouraged. And, although the room was dim bathed only in the pale light creeping in through the blinds and slightly ajar door … Dean would have sworn he was standing in the rays of the strong afternoon sun as … Sam's eyes opened.

Dean smiled so wide his mouth hurt. He quieted Sam as he feebly resisted the ventilator. He was too weak to really even contest its intrusion in his throat. "Shh… it's okay. Hey, little brother, I'm here," he whispered softly as he stroked Sam's bangs. Sam's tired dark eyes focused on Dean and his big brother's comforting words. Dean didn't care that he felt tears slipping down his cheeks once again as he smiled softly at his brother. "Thanks for staying," he whispered quietly as he leaned in a kissed his little brother's forehead.

To Be Continued

Well, I hope you liked that chapter and no cliffhanger. I have one chapter left and this story will be complete. Thanks for reading and I look forward to reading your reviews and thoughts.

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