Chapter 5.
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Sam was not doing any better when he woke up again sometime midday and he definitely wasn't in any shape to do anything else than stay horizontal all day. That was why it hurt Dean deeply inside to be forced to help Sam into his shoes and a jacket before helping his brother to the car so that they could drive to Sioux Falls General.
"Dean, stop hovering." Sam sighed when Dean reached over and buckled Sam in before wrapping a blanket around the younger man.
"Stop complaining." Dean retorted while tugging the blanket closely in.
Dean then stepped back, closed the passenger door and turned to his surrogate father who had been watching the brothers with a soft expression on his face. Dean lifted an eyebrow and Bobby cleared his throat while getting rid of the softness at the same time.
"You let me know what the doctor says, Dean." Bobby ordered and Dean nodded while quickly glancing at Sam's pale face through the glass of the side door window. "Sam will be alright."
"Yeah." Dean said without much conviction.
"You can't give up on him. Sam is a strong kid." Bobby said.
"Oh, I'm not giving up on him." Dean said. "I just don't believe in a miraculous recovery because, let's face it, luck never came with being a Winchester. But if the doctors can't help him, I'll find a way to fix him."
"What's that supposed to mean?" Bobby wanted to know.
Dean just shrugged his shoulders and started walking around the car to the driver side.
"Dean?" Bobby asked but the younger hunter didn't answer the question. "Just.. don't do anything stupid now, okay?"
"Bye, Bobby." Dean said before he got inside the car, turned the key in the ignition and left the salvage yard behind with his sick brother by his side.
Halfway to the hospital, Sam's nausea got the better of him but Dean had luckily been prepared. As soon as Sam showed the first signs of being about to throw up, Dean had quickly pulled the car over, had reached for the bucket he'd brought from Bobby's and had placed it in Sam's lap just in time for the younger brother to start vomiting. As Dean soothingly rubbed Sam's back, he wondered with worry how Sam could continue to throw up when he was barely able to eat anything at all.
"I'm sorry." Sam apologized when he was done heaving.
"Don't apologize, Sam, it's not your fault." Dean reminded his younger brother as he placed a hand on Sam's forehead and used it to guide his brother's head back against the seat.
Sam was panting hard – his breathing ragged and a bit wheezing which Dean so not liked the sound of. Sam should never have been off the extra oxygen and Dean once again felt guilty about taking Sam out of the hospital in the first place. He then noticed that Sam had some saliva on his chin so he found a napkin and held it out in front of Sam.
"You've got something on your chin." Dean said and awkwardly waved the napkin in the air. "You good or do you want me to.."
"I'm good." Sam said, cutting Dean off, and even though the younger brother could barely grab the napkin with his shaky hand, Dean still let him. If he couldn't make Sam's illness go away, he could at least let his little brother keep a little bit of his dignity.
Sam slowly removed the saliva from his chin with the napkin but when he looked down on it, he suddenly stopped dead in his tracks.
"Dean." He said and the oldest Winchester brother immediately jerked his head towards Sam by the tone of Sam's voice.
"What?" Dean asked.
Sam held up the napkin and Dean's heart dropped when he spotted the red stains on it. Blood. He looked from the napkin to the bucket in Sam's lap and noticed the red-colored spatters on the sides of it. Dean's heart pounded wildly inside his chest and he gaped stupidly for a few moments.
"Dean." Sam then said with panic evident in his voice which was what made Dean snap out of it.
"It's alright, Sammy. Nothing to worry about." Dean said and took the bucket away from Sam before steering the Impala back on the road.
The two of them remained silent for a few miles until Sam finally broke the silence.
"It's bad, isn't it?" Sam asked.
"It's just a little blood." Dean said between gritted teeth. "You've had worse."
"Throwing up blood is never a good sign. Besides, it's not just that – it's this whole mess." Sam said. "I'm not stupid Dean, I know there was a reason you hit that doctor. What did he tell you?"
"Sam." Dean sighed exasperated.
"What did he tell you?" Sam repeated and studied his brother's face. "Did he tell you I was gonna die or something?"
"Sammy, please." Dean begged.
"That's it, isn't it? He told you I'm going to die." Sam concluded and felt nausea well up again – this time from the realization that he probably wasn't going to make it through this one.
"You're not going to die!" Dean assured but Sam wasn't very convinced.
"You don't know that, Dean." Sam said.
"Dammit Sam!" Dean shouted and punched the steering wheel which made the younger brother jump a little. "I'm telling you you're gonna be fine! I promise, okay? Do I ever break any promises?"
Sam didn't answer. He just looked out of the window with a clenched jaw.
"Come on, Sammy." Dean said and Sam sighed.
"Yes, you've broken a lot of promises." Sam finally answered and Dean glared.
"Fine, let me rephrase it then; do I ever break any promises I make you?" Dean asked.
"No." Sam said without any hesitation. "But Dean, you have to accept the fact that I'm seriously ill and that this probably won't end well."
"Says who? The doctor?" Dean asked. "Sam, the doctors don't know half of the stuff we do. Somehow or another, I will find a way to fix you."
"But not on the expense of you." Sam said.
Dean didn't say anything and Sam was too tired to argue any further so the brothers stayed quiet the rest of the way to the hospital.
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The hospital staff at Sioux Falls General was quite efficient. Dean had barely gotten Sam inside the hospital before the younger brother was admitted and put back on oxygen. Sam's new doctor – a sympathetic elderly man with crescent-shaped glasses and grey hair - had examined the youngest Winchester brother as soon as they got there, and he'd assured the brothers that there was no need to panic about the bloody vomit. Apparently it came along with the kidney failure and Dean didn't know whether to be relieved or not about that conclusion. Sam had also been complaining a little about chest pains that occurred every time he took a breath and only got worse when he was lying on down flat, so Sam's bed had been elevated a bit to relieve the pain.
Dean had just been getting himself a cup of coffee when he returned to the room to find the doctor hovering over his brother – his little brother who by the way looked even worse now.
"What's going on?" Dean wanted to know and closed the gap between the door and the hospital bed.
"Sam is running a little fever." The doctor explained and shot the younger brother a mild smile.
Sam tried to return the smile but it came out as more of a grimace than anything else.
"Is that normal?" Dean asked and put the cup of coffee on a table next to the bed.
"It's nothing we can't handle." The doctor said. "Now, I suggest we let Sam try to get some rest. Can I have a word with you Mr. Singer?"
"Sure." Dean said before turning his attention towards Sam. "I'm just gonna talk to the doctor and then I'll be right back."
"'Kay De." Sam said and then coughed a little.
Dean's brow furrowed a bit but he chose to not comment on it and instead gave Sam's shoulder a mild squeeze. He then followed the doctor out of the room and closed the door behind him before following the man a little further away from Sam's room.
"I still can't believe you're Bobby Singer's nephews. Bobby is an old friend of mine." The doctor said before his expression turned serious. "I'll cut to the chase, Mr. Singer. Sam has developed acute pericarditis which is an inflammation of the pericardium – the fibrous sac that surrounds the heart. Before you ask, then yes; it is serious but not with the right treatment. I've already started Sam on Naproxen and he should be alright."
"Okay." Dean said while trying to process the new information and trying to control his rapidly-beating heart.
"I'm more worried about his kidneys." The doctor continued. "I'm going to start him on dialysis as soon as possible. Since Sam's stage of kidney failure is pretty advanced and he needs to be on dialysis at least three times a week, what I need to discuss with you is how you will like the treatment to happen. There are several options."
"Like what?" Dean asked.
"Well for instance, we can treat your brother at the hospital or we can have him on home-dialysis instead which some people prefer to spare the journey back and forth the hospital all the time." The doctor said. "If you choose the latter, we have some special equipment you can take home with you."
"So you're saying that I can take care of Sam without having to stay at the hospital?" Dean asked and when the doctor nodded, the older Winchester brother smiled wryly. "I guess we have a deal then, doctor."
"Home-dialysis it is then." The doctor smiled and shook Dean's hand. "I'm going to give him the first round of dialysis here at the hospital and make sure the pericarditis is treated before I'll release your brother, but afterwards you're free to leave. You of course still have to check in every now and then so we can keep an eye on Sam's health – especially since a kidney transplantation might be necessary at some point – but for now, this is how we're gonna do this."
Dean returned to Sam's hospital room in a lighter mood than he'd had when they'd first got there and he pulled a chair over to the side of Sam's bed before grabbing his cup of coffee. Sam was asleep and the younger man's pale face looked peaceful for now. Dean adjusted his little brother's covers and leaned back with the coffee to watch over Sam – like he'd always done – while thinking about how their lives were going to change for a while. As long as Sam was this sick they wouldn't be able to go on any hunts, but right now Dean couldn't care less about it. Yes, he did care about the lives of the innocent people out there in the world but Sam's well-being came first. Always had, always would. Dean picked up his cell phone and dialed a number before putting the phone to his ear and waited for the person on the other end of the line to pick up.
"Hi Bobby." Dean said in a hushed voice when the older hunter picked up. "Listen, you might wanna keep that mattress in your living room a little longer. Sam and I are gonna hold up for a while."
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TBC..
Thanks for your patience – it's been some stressful days lately.
Please review, lovelies!
-Elisa.