Disclaimer: refer to chapter one
NOTE TO READERS: Okay, I wanted to get this chapter out since my schedule will start getting even busier than usual. Plus, I'm getting over walking pneumonia, and then as an added bonus I came down with an acute sinus infection topped off with an ear infection this week, too. Fun times, not. This chapter is around 8 pages long and I tried to give you all a little break from a cliffhanger, so I hope this chapter satisfies and doesn't disappoint. Happy Reading, I hope!
So Long, Good-bye
Chapter Nine: Stop All the Clocks
By Dawn Nyberg
"…The stars are not wanted now: put out every one; pack up the moon and dismantle the sun; pour away the ocean and sweep up the wood. For nothing now can ever come to any good …" Poem excerpt by W.H. Auden, Stop All the Clocks
Four Days Later, ICU
Dean and his father sat in the ICU waiting room while Sam was examined. They had urged Bobby to go back to the salvage yard to take care of his auto salvage business. The older hunter had assured he'd return later. "Dad, I'm telling you I saw the 'Assist' light on Sammy's vent come on a few times and go back out over the last day and half. I'm not imagining it."
"Let's just wait until Dr. Finley finishes with Sam's exam, okay?"
"Why can't you believe that Sam's gonna pull through this?" Dean's eyes were tired and angry. "His fever is way down and …"
"Dean, son, I agree his fever is down and maybe you did see the 'assist' light come on. It's just I think they'd had said something about it if it had, I mean that machine keeps records, right? Look, I want Sammy leaving this hospital as much as you Dean, but…"
"But nothing Dad, he's gonna pull through this, I know it."
"Dr. Finley's been in there with him over an hour now Dean, it might not be the news you're wanting," John couldn't allow himself to hope too much, he wanted to but after the scare a couple days ago when Sam's heart had gone into an arrhythmia that required emergency treatment, it had scared him and he thought he'd lost his son in that moment but he'd been pulled back from the edge and responded to the drugs he was administered. His heart started beating regularly again and the alarms had quieted, but John's fears still screamed and seemed to block his hope.
"Men?" Dr. Finley's voice stopped Dean from responding to his father.
"How's Sam?" Dean stood quickly and strode toward the doctor. John followed with expectant eyes.
"Here," the physician motioned to the bank of chairs; the waiting room was currently empty. "Have a seat."
"Doctor, how is my son?" John asked standing his ground.
"I guess we're standing then," he offered with a soft smile. "Okay, I'm going to say one thing is certain, Sam is one hell of a fighter." Dean broke into a huge smile and glanced at his father.
"What are you saying?" John pushed. "He's going to pull through this?"
"I had to examine him thoroughly, but I can confirm that he is in fact triggering the vent and now quite frequently. We're going to try and start weaning him slowly over today and if there are no setbacks he'll be taken off the vent completely tomorrow at some point…" John put a hand up and interrupted the doctor.
"But, just a couple days ago his heart went into some kind of arrhythmia and you were saying…"
"I know but he's rallied and the arrhythmia was brought on by his low blood pressure and a sudden decline."
"What about my son's pressure? He hasn't been able to sustain his pressure and…"
"John, over the last couple days the dosage of his IV meds hasn't needed adjusting for his blood pressure and that was a good sign but I just wanted to hold off saying anything because, well, frankly, the kid surprised me and I didn't want to give false hope. But, I've withheld the IV meds for the last hour and he has maintained his pressure. In fact, his BP is pretty good considering where we were a few days ago."
"Sammy's gonna make it out of here isn't he?" Dean rushed his words; his face alight with hope and John reached over and clasped his shoulder, no longer able to deny the possibility that his son would survive this latest setback.
"Well, all signs are pointing toward that and with his pressure maintaining and with more stable vitals, he should be regaining consciousness soon. It might be another day or two but I think Sam fought his way past this bought of aspiration pneumonia."
"I want to see Sam," Dean stepped toward the door and John followed.
"Of course, I'll check back later. I've left word with his day nurse to page me if there are any changes, okay?" Both men nodded.
Two Weeks Later, Bobby's House
"The physical therapy is very good for him," Valerie encouraged as she talked to Dean and John while the visiting therapist worked with Sam in his room. "It's good for him to get his muscles worked since he is mostly bedridden unless he's in a wheelchair." Sam had started getting physical therapy visits, although he wasn't able to stand on his own the therapist was still able to stretch Sam out and work his muscles from the bed.
"The pain medication is helping," Dean said as he glanced down the hallway.
"Yes, I think Dr. Finley finally found the right combination for Sam. Margaret tells me he is resting well for the most part at night." Margaret was Sam's evening caregiver who nightly writes up care notes for Valerie to read when she arrives in the morning. Margaret stays with Sam from early evening and through the night, so that everyone in the house can get some sleep. She leaves at 5 AM and Valerie comes at 8 AM to 5 PM but some days she stays later if Sam is having a bad day with allowing his family to care for some things like his evening bath, but sometimes he allows his brother to do it, but Sam can be stubborn. She liked the family and despite the professionalism that is required for her job, she's human, too. She cared for Sam and staying a little later never bothered her. She was a sucker for those soulful eyes of Sam's.
Later that Day
"Hiya Sammy," Dean came into the room with a smile on his face.
"Hi," the voice was slurred but it was Sam's and that was a gift to Dean.
"So, I was thinking I'd get you in your chair and take you out on the porch for some fresh air, how's that sound?"
"Ddd…Dad?"
"He's in town kiddo," Dean figured on another meeting for a potential cure but he had stopped telling him. Dean figured it was to prevent him from being let down yet again when nothing panned out. "He'll be back later. Val's on the phone and taking a break. You're stuck with me."
"Not … stuck," Sam forced out and smiled at his brother.
"Well? What about that trip outside, hmm?" Sam nodded and offered his brother a lopsided grin. Dean felt so lucky to have his brother alive and back home. It had come so close the last time, but he pushed those thoughts away and decided to cherish this moment.
Twenty Minutes Later
"Nnn…nice," Sam slurred. Dean looked over at his brother and wrapped his arm around his little brother's shoulders and smiled warmly.
"Yeah, it is," he replied trying to swallow the lump in his throat. "You warm enough?" he questioned.
"Sss…Seventy degrees," Sam struggled but got the words out. "I'm okay," he focused and got the words out.
"Yeah, but …" Dean started. Sam shook his head and smiled, so Dean let it go. Sam let a small cough pass his lips and Dean's eyes darted toward him. "Sammy?"
"Jjj…just a cough," he puckered his lips in frustration. He had so much to say and wished he could get it all out but he knew that wasn't going to happen … if he could just write it down, but that wasn't an option either. He reached out a hand and patted his big brother's knee assuring him he was okay. Sam reached up and scratched at his right cheek and plucked at the edges of the tape holding his feeding tube.
"You need me to get Valerie to get you some fresh tape?"
"Later," Sam forced out.
"I know even the cotton tape bothers you when it's been on for a while. I could get her to take it off for a while or …"
"Ddd…Dean stop," Sam smiled. "I'm okay," he garbled out but Dean understood.
"Okay, but I'll get her to change it when we're back inside okay?" Sam nodded. "It's about time for you to eat kiddo. Umm, you know the doc wanted us to think about …"
"Not yyy…yet," Sam struggled. He had been stalling giving an answer to Dr. Finley's suggestion before he'd been discharged from the hospital about keeping his PICC line and starting TPN nutrition, but Sam wanted to keep with the feeding tube for a bit longer, so they had adjusted the rate at which they pushed the liquid nutrition and so far there had been no more vomiting episodes, but they all knew it was going to be sooner rather than later for the TPN IV nutrition and to have another PICC line placed since Sam had had his removed when he was discharged from the hospital. "Ddd…Dean?"
"Yeah, kiddo?" Dean was so happy to be having the short little conversation with his brother today it was more often than not that he was silent a lot, so today was a gift. He almost wished his father were here to have a chance to talk with Sam, too, but he was in town and Dean hoped he'd return with a lead that could help Sam.
"Www…want to sss…stand," Sam's voice sounded so innocent and hopeful even through the slurs.
"Sammy, you haven't walked in a while or stood for that matter, but…" he knew Sam wanted to try and it trying wouldn't hurt him physically because Dean wasn't about to let anything happen to him. He'd hold him completely up if that's what it took for his brother to stand on his own two legs, but it was the potential failure he worried would be just one more hit to Sam. "But, if you want to try I'm willing to help," he smiled and Sam returned the smile. He watched his little brother struggle to look at his big brother and for a brief couple of moments their eyes met and Dean felt his throat spasm in emotion. He swallowed hard, "you ready?" He stood up and locked Sam's wheelchair. Sam nodded.
It was a struggle but Sam stood and Dean held one of his brother's arms across his shoulder and the other around his waist firmly holding him against his side and hip. They leaned on the porch railing. Sam stood on his own legs with a lot of help from his brother but he was up and Dean couldn't get over the sheer look of happiness that was clearly in his brother's face. "Thhhh….thanks," Sam's voice was quiet.
"You're doin' it kiddo," Dean said with excitement for his brother. "I'm just the prop post Sammy, you're standing on your own legs little brother," he smiled at Sam. He felt Sam begin to tremble from the effort. "Maybe it's time to …"
"Minute more," Sam garbled out but Dean understood. He couldn't deny his sibling this simple request.
"Sure thing Sammy, sure thing," he squeezed his brother and held him tight as they both looked out over Bobby's front yard and into the salvage yard from the porch.
Later that Afternoon
Dean sat in the kitchen eating a small bowl of chili while Sam slept and Valerie sat with Sam and read a book to herself. John walked into the kitchen through the back door. "Hey," Dean called casually. "You've been gone a while … anything good happening in town?" John sat down and looked at his son with an unreadable expression.
"Maybe," he hedged.
"What!" Dean's voice was quiet but insistent. "There's a lead … you found a way to …"
"Easy, Dean," John put a hand up. "I said 'maybe' and that's a long ways from saying this is fixed. Look until I can find out more I don't want to get our hopes up, okay?" That deflated Dean instantly, if it was a real potential fix his father would be more eager, probably already packing to go get more information, but John wasn't packing.
"What is it?" John shook his head.
"Not important. I'll look into it and if it's real and can save Sammy then come hell or high water I will find this lead," John looked at his first born with determined eyes. "But, for now I called in a couple favors with a friend who is going to look into it for me and let me know what they find out, so I can stay here for a while longer with both of you boys." John would leave if the lead panned out but not until he absolutely had to because he was partially scared he'd lose his baby boy sooner than any help could come and it terrified him to think he'd be away if he could be here as long as possible. Dean nodded.
"We went outside today on the porch and sat for a while," Dean smiled warmly at the memory. "Sammy liked it and he stood a little bit, too."
"Stood?" John looked at his son. "How much were you holding him up?"
"Doesn't matter Dad, he stood on his own two legs support or not," Dean answered easily.
"Yeah, you're right," John conceded. "How was it?"
"It made him happy," Dean answered quietly afraid to say more as he felt his emotions welling once again. John reached over sensing his child's inner battle.
"I'm glad you were able to give Sammy that," he squeezed Dean's right forearm. "I wish I had got to see it."
"Yeah," Dean smiled at his father.
"Is Valerie with him now?"
"Yeah, he's sleeping but he'll be up in a little while for his bath."
Sam had awakened a little while later and Valerie had John and Dean help Sam into the bathroom where she was going to bathe him. The bathroom had been made accessible for Sam and there was a bath hoist installed now that helped Valerie get him into and out of the tub now. They had installed a hand held spray nozzle with scald control on it to prevent any accidental water scalding. Valerie would be leaving in a little over an hour and always liked to see Sam through his early evening bath time after he'd been given his last tube feeding for the night. She would brush his teeth in the morning and at night for him since he could spit the toothpaste out and she would swab his mouth afterward and throughout the day with medicated swabs. She had shown the family how to swab his mouth for him if he wasn't able and his hand control was getting worse, so his personal care was almost completely handled by herself or Sam's family.
Dean, John and Bobby sat in the living room and watched TV waiting for Valerie to finish with Sam, now that they had the bath hoist she could get him out of his chair and into and out of the tub and back in his chair without calling them in to help.
"There you go Sam," Valerie smiled as she dried Sam off with a fresh, fluffy towel. She grabbed a pull-up adult diaper and then put Sam in fresh sleeping clothes. His favorite was a pair of pale dove grey sweats and an old hand-me-down black t-shirt that said Led Zeppelin 1971 World Tour … it had been Sam's big brother's she knew because she had asked Sam and he had smiled and said it was Dean's. Sam whimpered and Valerie looked at him quickly.
"Sam what is it?" her voice soft but determined. "Are you having pain?" He looked at her and she saw him wince slightly. "Sweetie what is it? Am I hurting you?" He shook his head and reddened in embarrassment. She understood, "No worries sweetie you know that … I've got an extra pull-up here and can get you all cleaned up in no time at all," but her mind remembered the wince. She looked at her patient for a moment. "Sam?" His roaming eyes looked at her for a brief moment before they went back to flitting around the bathroom. "Did it hurt when you wet your pull-up?" He nodded.
"Was it pain or a burning, honey?"
"Bbb…burn," Sam slurred out.
"Okay, we'll get that taken care and have Dr. Finley see you tomorrow, okay?" He nodded. "It looks like you might have a urinary track infection Sam but remember we discussed that this could happen, remember?" He nodded. She smiled and proceeded to take the sweats off of Sam and remove the pull-up adult diaper and put a fresh one on Sam and redress him.
Valerie took Sam into his room and pulled a bed hoist over to help get Sam back into his bed. Sam had been frustrated and embarrassed being lifted by his Dad or brother, so Valerie had ordered the hoist for the bed since the bathroom one worked so well for her young patient. "Sam, I'll be back in a minute, okay?"
"K," he answered trying to meet her eyes.
"Sammy good?" Dean stood up as Valerie walked into the living room. "All clean and in his bed. I'd like to call Dr. Finley and have him come out tomorrow and have a look at Sam."
"What is it? What's wrong?" Dean asked quickly his eyes full of concern as he cast a glance toward the hallway and the library where his brother was. John and Bobby both stood at Dean's side.
"Nothing serious," she assured. "I think he may have developed a urinary tract infection or UTI for short. It's burning when he urinates, so I'd like to get that addressed. I'll call Dr. Finley's service before I leave for the night and have them give him the message. This isn't uncommon with PSP patients," she assured. Dean nodded and knew she was right and had read about frequent UTI episodes. "I'm sure he'll prescribe an antibiotic and it should clear it up in a few days."
Later that night Dean sat with Sam and looked at the clock and knew that Margaret, Sam's night care giver would be here in another couple hours to start her shift with his brother. Sam was awake but was having a quiet night and had his head turned toward the window and was watching the sun drop lower behind the tree line as evening approached. Dean studied his little brother and wanted so desperately to know what was going on in his brother's head. There was a hint of sadness in those dark, soulful eyes and it made Dean ache to fix the hurt and take away whatever was bothering his brother. Dean didn't know what he was doing until he was doing it. He lowered a bed rail and slid in next to his brother. He sat higher and put an arm under Sam's neck. He pulled his brother close and looked out the window with Sam.
"Penny for your thoughts little brother," Dean said gently and Sam simply pushed himself closer to his brother and Dean dropped his chin and rested it on his brother's soft chestnut hair … Sam had just spoken volumes to his big brother without a single word. Dean just pulled him closer. "I got ya Sammy, I got ya," and they watched the sunset together.
To Be Continued