'Cliffhanger'

Chapter 7

Notes: Sorry this chapter took a bit longer than usual, but wouldn't you just know it … a bunch of 'slow dancing' aliens abducted me … (grabs nose in desperation as it starts to grow from blatant fib) – okay, okay, I give … no excuse, other than that it was friggin' complicated to write like a Doctor, I don't know how 'House' manages ROFL ;)

Thanks as always to my amazingly-talented-fountains-of-information-beta's PADavis (who has been taking some awesome photo's for me from her trip to OBX, to show me all the places that Sam and Dean visit in her story titled, wait for it …. 'OBX' - a new project in store for this story, more news soon) and my grounding force Amarintha, both of whom send me virtual hugs of encouragement, virtually every day … cause I'm so needy ;)

Also virtual chocolates, to virtually everyone for the amazing reviews, fav's and alerts … hope you're still reading and haven't died of boredom yet (if not, this may just be the chapter that does you in) rushes off to practice first aid on gerbil, now where did I leave that epipen? ;)

Warning: Language

Doctor Peter Webber's POV

I watch through the large glass window while Dean is being prepped, standing alongside Tony as we scrub up.

"You're tellin' me they're brothers?"

"Yeah, it's not looking good either, they were stuck on the mountain overnight cause of that storm … he arrived here about forty minutes ago."

I nod my head in Dean's direction.

"Both boys fell off a cliff, the dad says it was a hiking accident."

Tony glances at me, eyes wide, knowing as well as me just how serious these injuries are.

"I've got the scans ready for you to look at. He's suffered blunt thoracic trauma, splenic vascular blush on abdominal CT, probably a sign of pseudoaneurysms of splenic arteries."

"Holy shit … that bad?"

I nod my head again.

"Yeah, we nearly lost him twice already … the dad's in a state. The younger brother's already in OR."

We move over, a nurse helping us put our surgical gowns and masks over our scrubs, and we push through the doors to the surgery. We stand by the x-rays and scans, viewing them up on the light-board, as we work out our game plan.

I point to the areas highlighted on the CT scan.

"We'll need to manage the blunt chest trauma first, which is going to be tricky seeing as he's still in hypovolemic shock. We also have unilateral absence of breath sounds, deviation of trachea, and a decompression of the chest cavity. We've already started an auto-transfusion."

He nods in agreement of my initial assessment.

"Okay, we should do a splenorrhaphy … try for splenic preservation if we can … drain the blood with a wide-bore tube, basal drain and re-expand his lung."

We move over to the surgical table, discussing the steps we need to take, while Tony checks the instruments and read-outs and I adjust the overhead lamp, letting it illuminate the kids' severely bruised torso. Tony is reading Dean's chart.

"From the looks of things we'll also need to do an emergency thoractomy for the massive haemothorax. The kids lost more than 200ml of blood over the last hour."

I watch as the members of our team carefully lift Dean's pelvis slightly and tilt it to the right, mindful of the wires and tubes.

"Is the airway maintained?"

The anesthesiologist nods, "Yes doctor, we're ready."

Tony and I glance at each other briefly again before we begin, knowing this young man's life is in our hands now.

We've both agreed on the laparotomy technique to operate on the spleen and the internal organs. The kid had lost too much blood already. Tony makes a small incision in the upper abdomen. I lift the peritoneum layer with forceps, as Tony makes a small opening with the surgical knife along the midline. Blood spurts out across the table, but I control the bleed temporarily by compressing the splenic pedicle. The anesthesiologist confirms that our patient is in a satisfactory condition to proceed.

We both carefully examine the abdominal organs for further signs of injury or other abnormalities, spending the next hour talking through each step, working methodically, until Tony finally manages to begin sutures on the spleen.

I call for suction.

"He's hemorrhaging rapidly, people … let's keep running those multiple IV lines and fluids …"

A nurse leans over to insert another chest drain, the suction noise competing with the methodical beeping of the heart monitor.

"Clamp."

I keep a wary eye on the ECG.

"How's he doing?"

"Pulse and blood pressure are still weak, Doctor, but he's stable."

Shit, this kid is hanging on by a tooth and a nail.

Just keep fighting, Dean.

For the next two hours, Tony continues with the splenorrhaphy, while I start surgery on the fracture of the tibial plateau of Dean's knee. There's a small break, and luckily the bone hasn't separated. Just need to re-align the leg and drain the fluids building up around his knee.

My concentration is so intense that I'm surprised to find that another hour has flown by as we continue with our efforts to save this boy's life. I've moved on to the surgery on Dean's collar bone, Tony's voice startling me.

"We have lower rib fractures …"

There's nothing much we can do about that, but I know my colleague is just listing the injuries for record purposes. I'm stabilizing the fractured bone when I see it. Ah crap.

"… we also have a first rib fracture."

Tony looks up at me in disbelief.

"Shit."

Our eyes meet for a second, both knowing that a fracture of the first rib is serious chest injury. The chance of a full recovery from that is no more than thirty percent not to mention that the kid will probably have significant nerve damage if he survives. I look down at Dean's pale face worriedly, watching as air is mechanically forced into his lungs. God, his chances of survival have just nose-dived.

With that thought, there is a sudden loud beeping of alarms, and my eyes fly to the panels, looking at the readouts.

'Doctor, he's in cardiogenic shock, myocardial infarction …"

"Come on, kid, don't quit on us now."

I quickly order an injection of an intropic agent to enhance his heart's pumping capabilities, but we also need to minimize heart muscle damage. I frown, still watching, waiting … and then finally, he stabilizes again. I find myself sighing. Shit, kid, just hang in there … just hang in there.

"Let's maintain those fluid replacements."

Half an hour later, Tony's tired voice interrupts the tense silence.

"Okay, looks good on my side … let's sew him up and get him to recovery."

After a careful double check for bleeding, he closes the abdominal incision, before he applies a gauze dressing over the stitches.

Six hours and ten minutes after starting the operation, we're scrubbing up again, as they wheel Dean through to recovery. We'll have him in intensive care until he starts showing signs of improvement.

I sigh wearily. God, I just hope it was enough.

"So, I'll see you at racquetball on Saturday?"

I blink tiredly, watching the soapy water swirl down the drain as I scrub my hands.

"Yeah, yeah … but you better bring your game, buddy-boy … I'm not losing again."

Tony chuckles as we say our goodbyes. He's the best thoracic surgeon I know, and I'm grateful he was able to help me on this case. I feel better knowing that John's son was in his capable hands.

I walk through to ICU, wondering at the strange concern I suddenly seem to have gained for this family. I see hundreds of patients, but I always try to maintain some sort of clinical distance from them, it's just easier that way. But somehow this family has managed to break that rule, in just the few short hours that I've known them. Maybe it's the thought of a father losing both children at once.

I'm still contemplating these strange events as I walk into Dean's room. I check the monitors and read outs again, check his pulse and blood pressure. I'm putting off something I'm going to hate doing … I need to go out there now, and speak to John. He's son is so critical, and suddenly I don't want to be the one to give him the news.

I make my way down the passageways, looking in at the waiting area, but he's not there. I find him sitting next to the youngest Davis boy … I look at the chart hanging by the door, hooking it down before reading it … 'Sam Davis'. John is holding the boys hand in his own, gently rubbing circles on the inside pad of his thumb.

He turns as I enter the room, his eyes swollen and red. But it's the sudden look of relief as he sees me that nearly breaks my heart.

"My son?"

I move forward, pushing him back down gently as he attempts to stand. I bend to kneel beside him instead.

"John … he's in recovery, he survived the surgery."

A deep sigh escapes his lips as he rubs a shaky hand over his tired face. The multitude of lines already mapping his features seem deeper.

"How bad is it?"

"He's doing as well as can be expected. He's a fighter."

I look over at the young boy lying in the bed next to us, hooked up to the machinery that's keeping him alive.

"Both your boys are."

He gives me a tentative smile, his lips trembling.

"We'll have Dean on constant monitoring, keep an eye open for reactions to medications, pneumonia, infection … but all that matters right now is that he's stable."

I don't have the heart to tell him the true extent of his son's injuries. He looks exhausted, but there is still hope in those eyes, and I don't want to take that away from him.

"Can I see him?"

"Yeah, come with me."

He follows me back to Dean's room, which is only a few doors away from Sam's, and I stop him just before he enters.

"You know what to expect, right?"

He nods, a silent strength radiating from him as he walks past me and into the room.

I watch silently by the door as he moves next to Dean's bed. He doesn't say anything, just leans forward and tenderly brushes his hand across Dean's brow. He settles into the chair next to his son, and suddenly I feel like an intruder. I leave him alone then, as I make my way to the busy nurses' station.

Half an hour later I've done my rounds and I've managed to speak to Doctor DeMarco about Sam's case.

He needs to run more tests, but there was extensive swelling on the boy's spinal column. He's not too sure of the true extent of the damage, and worried that Sam may be paralyzed. John has already been told, and I'm surprised the man is still managing to function at any level after the devastating events of the last day or so. Before I realize it, I'm standing by Dean's door again. John's soft voice is echoing in the silent room.

"… keep fighting, kiddo, please, please … just keep fighting …"

I clear my throat, and he turns quickly to look at me.

"Sam? Is everything alright with Sam?"

God, I should have realized.

"Yes, sorry … yes John, he's still fine, no change."

His hand moves to his chest as he swallows hard.

Shit, I'm an idiot. I move further into the room, checking Dean's vitals again, satisfied that he's still holding his own, I return my attention to John's pale and drawn features.

"When last did you eat something?"

The look of confusion only confirms my suspicions.

"Come with me."

He looks back at his son, uncertain.

"He'll be fine, I promise, they'll call us if there's any change to either of the boys. Come on, John, it's on me."

He reluctantly follows me to the dining room. I watch as he fills his plate with a cheese and ham sandwich. I add a chocolate dessert, muffin, and a strong cup of coffee to his tray before paying, and moving to the nearest table. It's late, but the canteen stays open all hours.

I watch him intently, his focus on the plate in front of him, I can see he's not in the mood to chat, he just keeps pushing the food around aimlessly. I keep my voice steady, trying to calm his fears.

"John … I know you're worried, but we really are doing everything in our power to save your boys."

He looks up then, he's eyes staring right into my soul.

"I know … I do … and I can't thank you enough."

"That's not what I meant … what I'm trying to say is that you need to keep your strength up. Your boys are going to need you more than ever, you need to healthy for them. We can't have all three Davis' admitted, now can we?"

He looks at me nervously, before shaking his head.

"No, I guess not, you're right."

He takes a big bite of his sandwich, he's probably hungrier than he even knows, and I suddenly feel a lot better. We manage to have a decent conversation, revolving mostly around small talk. He doesn't divulge any information that he's not willing to give, even though I try to fish it out of him. The man's a complete mystery, and I find myself more intrigued by this mysterious family then before.

"So, do you have a prognosis on my boy's conditions?"

I knew this was coming, still doesn't make it any easier.

"Yeah."

He raises his eyebrow impatiently.

"Well?"

I grin at his no-nonsense attitude, before plucking up the courage to go through the catalogue of injuries that Dean has sustained.

"… previously we would have just done an immediate laparotomy to remove the entire spleen …"

He listens to me with keen interest, and I'm surprised to realize that he actually understands most of the medical terms I'm using. I can only imagine how he's feeling right now, but oddly enough, he still seems completely in control of his emotions.

"… Sam's condition is still pretty unstable. We won't know the full extent of his head injury until he regains consciousness."

And here it comes, the thing I didn't want to say.

"But you need to understand, John … that may never happen."

He looks at me with complete confidence reflecting in his eyes.

"He'll be okay, both of them will. I have to believe that. I have no choice."

I watch him in amazement again, finishing the rest of our meal in companionable silence.

I walk him back to Sam's room, his voice stopping me just before I turn to leave.

"Doc, I'd appreciate it if you would keep in touch with me tomorrow, I have a few errands to run, I need to fetch our equipment and the car … but I'll have my phone … if anything happens, anything … please call me."

"Yes of course."

"And also, I've phoned a few of my friends, Bobby Singer might phone for an update, and Pastor Jim Murphy is on his way. If I'm not back before he arrives …"

He's putting his trust in me, and I get the feeling that's a hard thing for him to do.

"I understand John, I'll let him see the boys."

"… thanks …"

I smile, watching as he moves back to his vigil next to his son.

The rest of the evening is thankfully quiet and I manage to catch a few hours sleep in the Doctors lounge. When I eventually wake up and look at my watch, I'm surprised to find that it's already 8am.

The nurse on duty gives me the message that John has left already, leaving me his telephone number. I do my rounds, starting with Sam, chatting to his physician to get an update, before moving through to Dean's room.

He's condition hasn't changed, except that he now has a low grade fever, which I was expecting. He's off the ventilator though, breathing on his own with slight difficulty, a nose cannula providing him with much needed oxygen. I order a new round of broad spectrum antibiotics.

I'm taking a reading of his pulse, when his eyes suddenly fly open, staring blankly at the ceiling. I look at him in shocked surprise. There's no way he should be awake this soon. I check his chart again, seeing what medication and dosages he's on.

My penlight shines in his eyes as I check for and see the response of his pupils to the light. Holy shit. He's awake and in pain.

I hit the call button and order a stronger dose of sedatives and pain killers stat, my attention returning worriedly to my patient. How the hell is this possible?

"Dean, can you hear me? … do you know where you are?"

His eyes are watering, trying to focus on my face … and they're filled with … fear?

"Smy?"

TBC

Next chapter from Dean's POV