As promised...another chapter. Hope everyone had a great Thanksgiving!
Sam wakes up in the ER. There is a flurry of activity all around him, doctors and nurses shouting orders and statistics across the room to each other, machines beeping, instruments flying. His body is a mass of pains, old mixed with new; sharp, dull, throbbing, constant. His last memory is of the rope around his throat, constricting, cutting off his airway, crushing his windpipe. That makes him realize, now, that there's a different pressure on his throat, almost numb, but he can tell there's a tube crammed down there. Panic sets in. Alarms start blaring.
"He's awake. He's fighting the breathing tube," someone calls out unnecessarily.
Suddenly there's a face looming over his own, mere inches from his nose. The woman doctor, her skin a creamy milk chocolate, smiles kindly, yet sternly. Her wiry salt and pepper hair is pulled back into a tight bun and she wears minimal makeup, only a soft pink lipstick shows up. "Sam, I'm Doctor Webster. You're in the ER right now. Can you understand me? Squeeze my hand if you understand."
Sam feels her gloved hand slide into his loose grip and he squeezes weakly, just enough to tell her he hears her, as he continues to thrash against the restraining hands of the nurses and orderlies.
Doctor Webster offers a curt nod and orders, "Sam, you have to calm down. I'll tell you what's going on, but first you have to be still. Otherwise I will be forced to sedate you. Do you understand?"
Wild eyes finally tame as the impact of her words set in. Sam goes limp, compliant, and waits expectantly to hear what she has to say.
"Sam, you have a tube down your throat. It's there to help you breathe. Right now you are breathing on your own, but your throat was starting to swell shut and we had to put the tube in before you suffocated. It has to stay there until the swelling goes down. Alright?"
Sam nods once, his wide eyed expression following the lady doctor's every movement, pleading, hoping for more. He doesn't care about himself right now; his own condition isn't even registering as important. He wants to know about Dean. Needs to know if his stupid brother sacrificed himself to save him, because how the hell else can he be lying here – alive - in the ER unless Dean's somewhere fighting for his mobility. Damn stubborn bastard.
"It also looks like you have several recently treated injuries in addition to some new ones. Have you already been here recently? Do you have a chart?"
Sam nods again and tries to speak. Dean. I want to know about Dean!
"You won't be able to talk with that tube in," Dr. Webster announces, a hint of apology in her voice. "Can you write it down for me? If I give you something to write with can you tell me your last name?"
He reaches his hand out, ready to accept the pen. A wipe off board marker is placed in his weak fingers, with the board held about arm level. In childish chicken scratch Sam scribbles out Keyser and then Dean???
"Who is Dean, Sam? Is he someone we can call for you?"
Sam shakes his head and shakily writes Brother. Hurt 2.
"He's the young man who was found with you? Dean is your brother?"
Damn it, yes lady. I just spelled it out for you. Tell me how he is! Sam's eyes scream what his mouth can't and by some miracle the doctor gets it. She looks around the room, finds an eager young intern hovering by Sam's feet, and points a finger.
"Garner, his brother is over in ER 3. Run and get me a status on him. Quickly."
Alternating between relief and consternation, Sam allows himself to relax a bit. The doctor takes this as her cue that he's ready and able to answer more questions and she leans over him anxiously.
"I need to know if you have any allergies? Are you allergic to any medications, Sam?"
Geez, what's with the need to repeat every question twice? Sam thinks as he shakes his head. No allergies.
"Good, that's good. How does your head feel, Sam? Do you feel any dizziness? Nausea? Numbness or tingling in your extremities?"
One question at a time, doc. I can't talk, remember? He reaches for the wipe off board they've provided him and writes Some dizzy.
Dr. Webster chews her lip nervously and examines Sam's chart before leaning over to a nurse and whispering something Sam doesn't hear into her ear. The nurse nods, disappears from sight, and Dr. Webster once again leans over Sam as she shines her pen light into Sam's eyes.
"I'm worried about your head, Sam. I want to run some blood tests and take you up for an MRI. Do you know what that is?"
Sam nods. Of course he knows what an MRI is. He's had so many MRI's in his life he's practically magnetic himself. He'll go - what does he have to lose - but first he needs to know about Dean. With a fisted hand he wipes the ink off the board, giving himself a semi-clean surface to write on, and scribbles - Want 2 C Dean 1st. Then MRI.
The air in the ER room gets heavier suddenly as Dr. Webster scans the area, her eyes settling longest on the door as though she's looking for someone. The intern. But she doesn't get the answer she seeks, and instead she blanks her face and shakes her head. "I'm sorry, Sam. I don't think that's a good idea."
It's too late. Sam has already seen the trepidation on her face, knows there's something she's not telling him, something dire about his brother. He wants to know. Tell Me! He writes, screwing his face up in his most determined face - I mean business.
Sam see's the young intern return to the ER, eyes cast downward, only willing to seek out the doctor. Dr. Webster crosses the room, clearly relieved to escape her demanding patient, stalling the inevitable. Sam watches the two lost in a quiet huddle as the doctor's hand oscillates between her mouth, her chest, her belly, cycling over and over again. It's bad. He knows it's bad.
When she returns to his side the doctor is all business, speaking rapidly to her crew, spouting orders and demands as though Sam isn't there at all. She won't meet his stare, tries not to see the wipe off board that he's stubbornly still marking on - drawing line after line underneath his demand to enhance it's urgency. Someone finally removes the board from his reach, takes the marker from his grasp, and Sam is left with only one way to communicate. Force.
His hand shoots out, grabs the doctor's wrist in a vice grip, and pulls her to him. Instinctively, she jerks back, eyes growing wide. But Sam's hold is strong, as is his gaze, and it only takes a minute for Dr. Webster to realize he means business. He wants to know about his brother, and he wants to know now.
"Alright, Sam, I'll tell you. But you're not going to like it."
He glares at the doctor, grip unrelenting despite her agreement to talk, not willing to let go until he's heard what he wants to know.
Dr. Webster sighs. She studies her patient for a little bit longer, as though she's trying to decide if maybe she can sneak a sedative into his IV before he can stop her, and decides to do as Sam asks.
"They're taking him up to surgery right now to try and stabilize his spinal cord. He's not feeling any sensations at all, but I understand some of that has to do with the neuroblockers in his system. They can't know the full extent of the damage until the drugs have been flushed from his system. Right now, it's just a game of wait and see."
The words tumble from the doctor's mouth in a cacophony of jumbled sounds and phrases. Sam really only hears a few select words because his mind has effectively shut the rest out as he internally berates Dean for being so stupid and stubborn and self-sacrificing. He ended his life - life as he knew it - for Sam. Now it's wait and see...wait and see if he will ever walk again. Wait and see if he will ever hold a gun again. Wait and see if he will ever breathe again. Stupid. Stubborn. Ass.
Sam's eyes water, but he doesn't try to wipe them dry. They don't water for him, they water for Dean. Sam deserves to feel embarrassed at his un-manliness. He deserves to feel the chest clenching, gut wrenching pain and suffering, knowing that Dean sacrificed himself so that Sam can live. He deserves whatever comes his way now. It's his guilt to shoulder.
"Are you ready to go now?"
Feeling the gentle hand on his shoulder, Sam blinks and sees the compassionate face of his doctor hovering over him once more. The wrinkles in her eyes and the purse of her lips declare the fact that she's sorry for having been the one to give him the bad news, wishes it could have been better. But he doesn't need her pity, her sympathy. She should scorn him, recoil from him. This is his fault.
He doesn't bother to try again to ask about seeing Dean, already knowing what the answer will be. So instead he shrugs non-committal and feels the gurney start to move forward, out the door. There's only one thing Sam knows for certain right now, and that's the need for him to live. He doesn't deserve it, but Dean doesn't deserve to be left alone now either. Not after what he's sacrificed to save Sam.
The MRI department is backed up five patients long, and the nurse doing Sam's bloodwork is new, so it takes over three hours before he's finally finished with all the testing and is admitted to a room. They've got an immobilizer on his knee, a new brace on his wrist, some fresh tape wrapping his injured ribs, and seven new stitches hidden beneath the stark white bandage on his head. That's not to mention the soft collar they have around his neck and the vent tube that is still shoved down his throat, although he's breathing on his own. It won't come out until the swelling goes down, and the swelling could take several days to recede. That's the worst case scenario.
Best case scenario, which Sam is determined to accomplish, is that the swelling recede enough by the evening that he can have the tube removed so he can talk to Dean.
They won't tell him how his brother is; only that he's now out of surgery and they have him stabilized. Dr. Walters assures him that Dean's doctor will be in shortly to speak with him, but that was over an hour ago now, and Sam's patience is wearing thin. He has to see Dean, has to see for himself that he made it through surgery. Dean needs him.
He sits in relative silence for another four hours, his forced meditation interrupted only by the nurses who flit into and out of his room checking vitals, and administering fluids and medications. One arrives around dinner time with some thick brown liquid type thing that she pours out of a can into an elevated bag that's attached to a tube in his nose. Until now, Sam had thought that was some sort of additional oxygen tube. Now, as the stuff flows down to his stomach, he knows it's a feeding tube and he's never been more disgusted in his life. But he sits there, lets his stomach get filled up on the Ensure, and wonders when Dean's doctor is going to grace him with his presence.
The man waits until close to nine that night before he shows up, breezing into Sam's room with a cocky arrogance that immediately has the young Winchester on edge. He'd gotten his wish just a few minutes earlier, that the tube be removed from his throat, and while his neck is still swollen and sore, and he can barely get in a decent breath let alone speak, Sam still demands news on Dean before the man has a chance to say a word.
The doctor sighs, rolls his eyes without even trying to hide it, and crosses his arms against his chest, leaning over Sam in a domineering fashion. He's the best in his field - that's what Dr. Watson had told Sam earlier - and the man clearly knows it. The only reason Sam doesn't jump up and throttle him right then and there is because Dean needs the best.
"Sam, I'm Dr. Prentiss. I treated Dean when he was brought in this afternoon," the man says flatly, as though he's telling Sam the details of his boring day. I went to the grocery store, then stopped and filled the car with gas...
"How is he?" Sam demands, voice raspy and barely there. He lets his eyes do the real talking.
"He's as good as can be expected under the circumstances. I have stabilized his spine with a steel rod, and removed the string your, um ... captor ... had threaded in there. There is some swelling around his spinal cord, and the string in there has caused a minor infection. Right now he is unable to breathe on his own and there is no sensation or movement from the top of his shoulders down."
"Is it permanent?" Sam interrupts, unwilling to listen to the neurologist drone on about his brother being powerless, stuck in a bed.
Dr. Prentiss glares at Sam, clearly getting the point across that he doesn't appreciate being interrupted, but continues. "I don't anticipate the condition to be permanent, no. But we really can't know for certain until the swelling recedes, and for that to happen we need the infection to go away. With luck, your brother should be experiencing sensations within the next three to five days."
"So he's going to be okay?" Sam demands.
"I believe so, with time, yes," Prentiss agrees, and Sam knows this isn't standard doctor procedure. Doctors give odds and possibilities, but in the end they give you the worst case scenario and work their way up from there. He wants to believe this man more than he's ever wanted anything in the world, but he knows better than to put all stock into the statement. The man is a pompous jerk, and pompous jerks are incapable of admitting their failures. He can only hope the man lives up to his reputation, not his appearance.
"Does he know all this? Is my brother awake?"
Prentiss nods again, crossing his arms against his chest. "He has come in and out of consciousness since he was brought in. He was mildly sedated during surgery, but he came out of it relatively quickly. We spoke after that."
Immediately terror clenches at Sam and he finds himself scrambling to get up out of bed. The thought of Dean being alone, scared, helpless, as Prentiss told him his fate with that cold, uncaring tone has Sam's blood boiling. He has to get to Dean; has to make sure he's okay.
The doctor's mouth falls into something akin to incredulity as he sees what his words have provoked in the young patient before him. It takes him a moment to find his voice. "Young man, what on earth do you think you're doing?" he finally demands, rushing for the call button to attain some assistance; a nurse, orderly, another doctor.
"I need to see my brother," Sam rasps, wincing at the feel of the thousand knives stabbing into his throat. "He's got to be going crazy right now."
It only takes a few minutes for Sam to convince the staff to let him see Dean, certain it's his threat to sign himself out AMA that finally does the trick, and now he's being wheeled brusquely down the hallway by a muscular orderly who has clearly been on duty for a few too many hours. The man isn't exactly rude, but he's not entirely fun and giggles either. They traverse the hospital to the Neurology unit in silence, and the guy only speaks enough to inform the nurses caring for Dean that he's dropping 'the brother' off before depositing Sam at the nurses station to let them finish the work.
The woman who takes over is in her late fifties, thin, with dyed red hair and a meticulous makeup job. She crouches in front of Sam, settling her manicured hand on his good knee and making eye contact as she introduces herself. "Sam, I'm Holly, Dean's primary nurse for this shift. Have they told you what to expect?"
Sam shakes his head nervously, meeting her gaze and allowing himself to feel safe in her capable hands. "Dr. Prentiss barely told me enough to know he's alive and awake," he spits out, unable to keep the annoyance at the doctor from his tone.
Holly offers a knowing smile and pats him on the knee. "Prentiss is the best there is, but he's got the bedside manner of a grizzly bear. Let's go over here and talk for a minute before I take you in to see your brother." She doesn't wait long enough for him to give a response, just pushes back to her feet and steers Sam's wheelchair to an empty corner. Sitting in a chair across from him as she gives him the twenty on his brother's condition.
Her description is both more comforting and more disturbing than Dr. Prentiss' and when she finishes Sam isn't sure if he feels better or not. Holly starts off by assuring Sam that Dean's diagnosis is promising; there's no indication that the damage to his spinal cord is anything more than some severe swelling and that he's expected to make a full recovery sooner rather than later. But that's the end of the comfort factor.
She tells Sam that Dean is currently on a ventilator - they're using the tracheostomy site that was already there, and it's clear that she's more than a little confused as to why it was there in the first place. Sam doesn't feel like explaining. He's still not even sure that he knows all the details.
She tells Sam that Dean isn't able to move or feel anything from his shoulders down, and that they have his head immobilized to limit the movement in his neck, which basically means his brother is reduced to his lips and his eyes - definitely not something Dean is likely to be happy with.
She tells Sam that Dean is hooked up to multiple tubes and wires to monitor his vitals and feed him and give him fluids. And that they have him in some sort of moveable frame that Sam doesn't bother to remember the name of, so that they can spin it and rotate Dean's position periodically so he doesn't get bed sores. And Sam doesn't ask what bed sores are when she glosses over their definition, deciding that he doesn't want to know because it's not important. What is important is that Dean is going to get better and all this medical mumbo jumbo that they're spewing at him right now will soon be obsolete. What's important is that Adam and Lori Ann didn't get what they were trying to get, and that they are now in jail for what they've done. Sam hasn't yet talked to anyone to know they somehow managed to escape.
When Holly feels confident that Sam has as much knowledge as he needs to see his brother she offers to take him into the room. Sam nervously considers his answer. Her description is both more comforting and more disturbing than Dr. Prentiss' and by the time she has finished Sam is no longer sure if he feels better or not.
Finally Sam nods, eager, yet hesitant, and she takes control of the wheelchair and guides it down the hall to the curtained off partition that hides Dean. She pauses before drawing back the curtain, giving Sam one more chance to prepare himself.
The big reveal elicits a gasp from Sam that he's unable to hold in. There is barely any part of his brother's body unencumbered by some type of medical equipment. A neck brace, similar to the one from their captivity, keeps Dean's neck stable as the blue tubing of the ventilator snakes away from his throat at the tracheostomy site. A blood pressure cuff encircles his left bicep, continuously filling and emptying as it takes a constant readout of his pressure. Electrodes decorate his torso, monitoring his heart rate. IV's run from ports in the back of one hand and the crook of the other elbow. Another tube is running into his nose, providing sustenance, and yet another is a catheter, peeking out from the sheet draped over Dean's waist.
The frame scares Sam the most, its mediaeval appearance seeming more torturous than helpful. He can only assume there's more to it than meets the eye. The part Dean is lying on is like any normal bed, rectangular, twin size. But built up from that are foam walls, one on either side of his chest and running down past the outer edge of his legs, a triangular piece that braces him on the inside of his legs, and one wall on either side of his outer arms. Two square metal braces are locked down on top of each leg, padded side down, to keep his legs in place. Another two foam covered metal ovals rest on either side of Dean's head, near his cheeks, keeping it steady. Fabric seat belt-looking straps are secured across his torso, shoulders, and head to keep the rest of him in place. The bed rotates on a central bar, capable of laying horizontal or of rotating up to ninety degrees in either direction. Currently they have the bed on a constant, slow rotation to evenly distribute the pressure.
The sound of the ventilator whooshing and the heart monitor beeping fills the silence of the room, plotting out a steady rhythm for Dean's life. Sam stares, mesmerized, at the monitors above Dean's head, almost too afraid to rest his gaze too long on his broken brother. He knows it's not permanent, forces himself to remember that over and over again because the alternative is too horrible to think about. A millimeter more, a second later, and Dean would be dealing with this for life. They have no clue just how lucky they are.
At first glance Dean looks like he's sleeping and Sam takes control of his own wheelchair, approaching quietly so as not to disturb his resting brother. He's torn between wanting to talk and not knowing what to say, but finally just fills his silence with his brother's name.
"Dean..."
At the same time, the nurse steps forward to stop the movement of the bed, halting it so that it's at a forty-five degree angle facing the curtain partition and Sam.
His brother's eyes open immediately, making it obvious that he wasn't asleep after all, but the pain and desperation that shines through has Sam wishing he had been.
'Sammy,' Dean mouths silently, unable to speak without the valve their captors had provided him with. Apparently, the hospital staff doesn't feel it necessary to offer the same amenities Adam had. 'You're okay.' The older man's relief is palpable in the tense air, but it vies for attention with Dean's fear and his frustration.
"Shhh," Sam leans over Dean and puts a finger gently on his lips. It's the only visible spot Sam can see that is equipment and bandage free and he knows Dean will be able to feel his hand there. The rest he's not so sure. "Don't try to talk. Just rest. I'm here and I'm not going anywhere."
Dean closes his eyes against the tears that threaten to invade his body, biting down on his lower lip but turning his face toward Sam's hand. Right now that little bit of touch is the only thing he has, and he doesn't want to lose it.
"You're going to get better," Sam reassures, widening his hand to give Dean more surface area of touch. "Dr. Prentiss did tell you that, didn't he?"
If you can call his announcement of 'congratulations, I'm a genius,' a revelation of my healing, then yeah, he told me. Opening his eyes again, Dean nods, the bracing on his head making the movement almost imperceptible.
"Just a couple of days and you'll be as good as new," Sam continues. Dean knows his brother is moving into rambling mode. He always rambles when he gets nervous, and Sam is clearly nervous.
But right now it's a minor comfort in his utterly screwed up world. Sam is here with him; they're both safe. A little worse for wear, but definitely safe. Hospitals are safe. Adam and Lori Ann are...shit! They're still out there!
His eyes slam back open, round saucers latching onto Sam as his heart monitor starts to go berserk. He has to warn his brother. They're still out there. They could still come after them. Adam didn't exactly get what he had wanted, and Dean has no doubt the man will keep coming until he has won. Or is Dead.
At the sound of Dean's monitors shrieking, Sam immediately jumps to his feet and starts scrambling around the room in a panicky uproar. Not exactly the reaction Dean is hoping for. He needs Sam to look at him, needs him to focus on his lips and understand what he has to tell him.
Instead, Sam runs for the nurses station and grabs the first person he sees. It's Holly, who was already on her way in at the sound of the shrill alarms. "Dean, you need to calm down," Holly insists, placing her two soft hands on the sides of Dean's face, pulling him into her touch.
'Danger,' Dean mouths, trying to convey his urgency through his eyes. He swallows against the tube in his throat, can feel the piping going down, and wishes like hell it wasn't there right now. 'Danger. Sam.'
Holly doesn't seem to notice him trying to speak, never really looks down to see his lips moving before she's pulling out a syringe seemingly from thin air and feeding it into the port at the back of his hand. "This will help," she assures him as she gently massages his shoulder and his neck, trying to ease the tension within both.
Then Sam is back, swaying unsteadily on a protesting leg that never should have borne so much frantic weight in the first place, and he sets his enormous hand on Dean's forehead. Sammy's own forehead is wrinkled in confusion, unsure what it is that has gotten his brother so worked up in the first place.
'Sammy,' Dean mouths desperately, his eyes darting frantically back and forth as he works to get his brother to look at him. To look at his mouth.
The medicine in his IV is fast acting and he can already feel his brain going foggy. He has to tell Sam. NOW. He can't go to sleep without warning his baby brother. They're in danger. Sam is in danger.
Dean blinks, trying to bring Sam's face back into focus as his vision starts to blur. He can see the concern in the tilt of his brother's head, but there's no sign that Sam is looking at his mouth - at least not one he can make out as the big picture fades in and out. It's now or never. He just has to hope Sam is watching.
'They got away, Sammy.'
"Wa? Eean, wa ow ooo sssaaayee?" Dean hears echoing back at him. He knows it's Sam's voice, but he doesn't know what it's saying. Has no clue whether it means 'I'll keep us safe,' or 'I don't understand.' All he knows is his time is up.
One more semblance of 'Danger,' passes over Dean's silent lips as his eyes finally shut closed for good, the drugs taking their final effects on his overtaxed body, forcing to make him lose his fight for consciousness. Leaving himself and Sam vulnerable.