A/N: Thank-you so much to all my readers out there. I honestly was so ecstatic with the response to the story and the great reviews I got. I only hope it lives up to the anticipation and expectation everyone has. I want to thank everyone again for the kind reviews and also for the follows and favorites. A special thank you to the four guests I could not respond to personally. Thank you for reading and reviewing.
"Sir are you injured anywhere?" A voice asked him. It was another paramedic, a female.
"My leg," Dean managed to get out. He also made a waving motion to his bruised ribs. Her partner brought over a stretcher and they helped Dean to sit on the edge of it.
"What happened?" She asked.
"I don't know," Dean answered truthfully, because he really didn't know what was going on. He was the one with injured leg so why was Sam now at death's door?
She cut some of his pant leg and examined his ankle.
"It's pretty swollen and your ribs look bruised too. We better take you in for some x rays."
Dean waved the paramedics away as they tried to get him to settle on the stretcher. He wanted to walk. Maybe walking would help him figure it out, understand how Sam went from walking, talking, living, breathing to possibly dead in such a short span of time.
He limped over to the waiting ambulance, no longer even registering the pain. He felt numb to it all. He managed to climb up with some help from the other paramedic and sit down on the stretcher.
The ride to the hospital was a short one so he knew at least Sam was receiving medical help quickly. Since the paramedics had listened to his lungs in the ambulance, treated him for some minor smoke inhalation, and decided he wasn't on the verge of death, he was placed in a small curtained off cubicle in the ER to wait his turn to be seen by a doctor. He sat on the gurney hoping someone would come in soon to collect his information so he could ask about Sam. Luckily he didn't have to wait long.
"Can I ask for information on a patient?" Dean immediately asked the woman. He didn't even allow her to introduce herself.
"I think I need to get your information first," she said, smiling politely.
"I want to know if my brother was brought here. We were involved in that fire at the college campus."
She looked at him confusedly and seemed quite flustered as if she has never encountered such a situation before. Finally she left him telling him she'd be back.
However, Dean was tired of waiting. He figured if this was an emergency room, Sam would have to be in this area. He carefully got off of the stretcher and gingerly placed his feet on the ground. His ankle ached again and pounded along with his ribs. However, he inched his way down the corridor, past other curtained off areas. The receptionist area was practically abandoned at this time of night so no one attempted to ask where he was going and even if they did, he was going anyway.
He wasn't sure how he got there but he found himself in front of a room with frantic activity happening around someone who was on the gurney in the center of the room. There were impossible amounts of blood everywhere and Dean found himself transfixed, rooted to the spot. He couldn't tell, didn't dare to believe, who the person was but he was in bad shape. There was a heart monitor keening in the background as doctors rushed around back and forth. Then abruptly one of them moved and Dean saw and he knew.
He couldn't quite get over the shock of seeing his brother sprawled on the bed like that, face ashen, hair spread around his face like some kind of halo, or the macabre sight of his chest gaping open wide while a doctor leaned over massaging his still heart, another standing by with metal paddles in his hand.
"Clear!"
He practically jumped out of his skin as the metal paddles shocked Sam's heart. It was too late though, the image forever burned into his retinas. Then he started to retch. He fell down on the floor practically in a crawling position, dry heaving.
"What is he doing here?" He heard someone ask. Then he was being helped up off the floor and guided back to his cubicle. He barely remembered much of what happened next as he figured they drugged him. He welcomed the darkness however, hoping what he saw was only his worst nightmare.
ooooo
He woke up slowly, feeling slightly numb. For a second he forgot where he was but then it all came rushing back in an instant. He was propped up on some pillows, a slight ache settled in his ribs. His ankle was encased in a removable boot and an IV drip was suspended over his head. He was going to push the call button when a doctor came walking in.
"Good to see you awake. I'm Dr. Welsh and you are?" She asked, pleasantly.
"Dean," he answered. He was distracted still trying to forget the horrors he had witnessed before, too afraid to even ask the question because he inevitably knew what the answer would be. Sam was dead. There was no way anyone could survive after going through something like that.
"Are you in any pain?" She asked him, sensing his discomfort.
He shook his head but didn't meet her eyes.
"I heard about what happened to your brother."
Dean instantly looked down at the pillows. He didn't want to know.
"I'm sorry you had to see that," she continued. "However, it was necessary to save your brother's life."
Wait a minute. Save his life? Was Sam alive? Dean thought.
"My brother? Is he…" Dean asked, dropping off, afraid to complete the question.
"Yes he is still alive."
Dean couldn't believe it. He still didn't even know what had happened to Sam and what they were even doing to him.
"Our staff has been very curious about our two John Does. You both had us on our toes last night. What exactly happened to you two?"
"We were checking out that frat house, just to see what all the hype was about. Then we saw smoke so we went in to see if there was anything we could do. I tripped and hurt my ankle and ribs and then my brother, Sam, just collapsed," he said. Even he didn't believe the story but it was all he could muster.
She eyed him carefully.
"I would have thought you'd been in some kind of scuffle to be honest with the bruising on your ribs and fracture to your ankle. Luckily the fracture is minor and so was the injury to your ribs. You should be back on your feet soon."
"What happened to Sam?" Dean asked, ignoring the doctor.
"Sam suffered a blunt force chest trauma which led to an aortic rupture."
"What? How?" Dean asked, not fully comprehending the extent of Sam's injuries.
"Based on the bruising, it's consistent with him hitting his chest against something with a high velocity of speed. It's not common and usually the result of a freak accident. Usually we see this with car accident victims. Luckily we had a cardiologist on call, who had an inclination that Sam was bleeding inside his chest cavity."
"You mean when he hit himself against that fireplace, it caused that much damage?" Dean asked, without thinking.
"Fireplace?"
"Sam tripped too," Dean said stupidly, feeling like an idiot. "When we were trying to escape from the fire."
Dr. Welsh paused again, skepticism written all over her face.
"Why did Sam look like that?" Dean asked, changing the subject.
"Unfortunately due to the severity of Sam's injury, we needed to perform an emergency thoracotomy or in layman's terms, crack his chest, not to sound crude. It's not pretty and we only do it as a last resort. We were trying to control the bleeding around Sam's heart until we could get Sam to surgery. The paramedics were able to restart Sam's heart en route to the hospital. However, he flatlined again when we were examining him. Sam required cardiac massage and internal defibrillation to get his heart started again. Then he was taken to surgery to repair the rupture in his aorta."
"What's the prognosis?" Dean asked, tentatively.
"I'm afraid his prognosis isn't good."
"Wait a minute," Dean began. "So you are telling me you went through all these great lengths to save Sam and that he survived the surgery. Now you're telling me he's not going to make it?"
"Dean, I'm sorry if I gave you false hope. However, these types of injuries are almost always fatal. Most people die before they ever even get to the hospital. Also, the fact that we had to crack Sam's chest puts him at a high risk of mortality."
"I want to see him," Dean said, not meeting her eyes.
She didn't answer him right away as if she was weighing if it was a good idea or not.
"Dean, last time you saw your brother, it didn't go over so well."
"I don't care. Take me to him."
ooooo
Thirty minutes later, Dean had signed his release forms and agreed to be brought into Sam's room in a wheelchair. The doctor didn't think Dean was in any condition to be using crutches yet with his bruised ribs. Dean suspected she was afraid he'd pass out again.
Dean peered down the hallways and at the various signs as the orderly wheeled him down the hall. He saw a sign that said CCU: Cardiac Care Unit and he knew they were in the right place.
Dean allowed the orderly to wheel him in beside Sam's bed and he took in his brother's appearance. He was hooked up to a ventilator and a tube was also inserted down his nose. There were chest tubes snaking under the blankets. Sam's doctor told him he should expect this, that they had to make sure Sam's incision was draining properly. The doctor also said Sam was heavily sedated because of the amount of pain associated with the procedure of open heart surgery. They didn't want to risk any further damage to Sam if somehow he managed to pull through.
Overall, Dean could sense the doctor's pessimism and that he doubted Sam would make it. Apparently they "were doing all they can" and "now it was up to Sam." Before Dean would have argued, said for sure that Sam would fight to his dying breath, that he would not give up. However, now even he had to admit he had his doubts. He just wasn't sure what Sam wanted anymore. Did he want to fight alongside him? Or did he wish to be somewhere, anywhere, else?
He stood up slowly, once the orderly was gone and placed his hand on top of Sam's. He didn't know what else to do, what encouraging words he could speak. He just wanted Sam to know he was there, to feel his connection.
Do we even have a connection anymore? The thoughts intruded even as he tried to think positive for Sam and he desperately tried to push them aside but found that he couldn't stop them, couldn't rid himself of the deep down resentment he still felt. He felt repulsed by his own mindset, letting these thoughts overpower him when he looked at the shape Sam was in but he couldn't help it.
ooooo
Two days later, Dean got the surprise of his life when Sam opened his eyes. The doctors had said they were guarded in believing Sam could pull through given he was still alive 48 hours post surgery. However, Dean never expected his brother to wake up this soon and definitely not in such a violent way.
He instantly began gagging on the ventilator, thrashing his limbs. The heart monitor responded in kind with a frantic beeping. Dean panicked because he knew any unnecessary strain on Sam's heart could cause dire consequences. He also knew jostling any of the tubes in Sam's chest could be fatal too.
A medical team rushed into the room before Dean could even consider what he should do and hustled him out the door. He had been wheeled over to the waiting area when his phone alerted him he had a new message. He expected it to be from Garth or about another hunt but this was different. It was another e-mail from a college Sam applied to, asking him to please resend his essay because it was the last thing he needed before they could decide if they would accept him or not. He nearly laughed at the irony of it all.
"Dean, Dean?"
He was interrupted by Sam's doctor calling out to him.
"How is he?" Dean asked.
"Well he's not out of the woods yet," the doctor began.
Dean sighed heavily in response.
"He woke up which is a good thing," the doctor continued, sensing Dean's impatience. "However, his body still has a lot of healing to do. We don't want him getting too stressed, given his fragile condition. We were able to remove the ventilator but we've given him some more pain medication and a sedative, hoping he'll continue to rest. We are going to send him off for some tests soon and we'll know more then."
Dean wasn't exactly satisfied with the doctor's answers, or lack thereof, as he entered Sam's room. Sam was propped up slightly in the bed this time. The ventilator and nasal tube were indeed gone, replaced by an oxygen cannula under Sam's nose. His head was facing the wall so Dean figured the sedatives must have kicked in and Sam was asleep. However, Sam turned to face him as he approached the bed.
"Stupid," Sam said simply and forlornly.
"What?" Dean asked. He had no idea what Sam meant.
"So stupid of me to believe I could ever get out," Sam said through gritted teeth. "Brick couldn't get out and neither could Hans."
Dean watched as his brother's eyebrows knitted together in pain and a thin sheen of sweat formed on his forehead. Then Sam began adjusting himself in the bed, trying to find a comfortable position.
"I'm sorry, Dean," he said. Then he let out a loud yelp in pain, taking in ragged breaths.
"Sammy?" Dean said, alarmed. "You need to calm down. You hurt your heart and you can't let yourself get this upset," Dean continued, hoping to calm Sam down. He had a feeling that he was apologizing for more than just their current predicament and it was causing him emotional, as well, as physical pain.
However, it was too late. Sam dissolved into sobs unable to even form coherent words.
"Dean, it hurts," he managed to gasp out, biting into his lip so hard it drew blood. He gripped Dean's arm so tight that his fingers left gouge marks in his arm.
Dean could tell that Sam was in an unimaginable amount of pain and he couldn't understand why the sedatives and medicine were not helping him.
Dean limped out into the hall, calling for help.
Once again, Sam's room was crowded with medical personnel and he was thrown out. However, this time when the doors to Sam's room opened, Dean knew the news was not good. They were wheeling Sam out of the room and away from him.
"We have to make sure he's not having another bleed," a nurse told him quickly before dashing off.
Dean just stood there staring down the empty hallway, contemplating how much the odds were now stacked against his brother, wondering how he could be so stupid. He knew Sam was more than just in physical pain. He was enduring his own mental anguish. However, he had ignored Sam's pain and focused on his own. He only hoped he would have a second chance, that the doctors could repair Sam so he could repair his relationship with his brother.
TBC