Chapter 8
Before the blazing warehouse was even out of the Impala's mirrors, Dean had pulled out his phone and called Dr. Brad Sinclair - attending physician at the University Hospital ER in Columbia, Missouri, and the doctor Sam and Dean had saved from a vengeful spirit. He answered on the sixth ring.
"This is Dr. Sinclair." The voice on the other end of the phone sounded tired, like Dean had woken him up. Being that it was after midnight, Dean figured he probably had.
"Brad, this is Dean Winchester. You remember me and my brother Sam?" Dean replied, trying to keep his voice composed.
"I remember. What do you need?" the doctor replied immediately - being haunted wasn't something he'd soon forget. He heard the stress in Dean's voice and figured this wasn't a social call, so he didn't waste time with small talk.
"Sam's hurt, and he needs more help than I can give him. You know we avoid hospitals when we can, but we're only about 50 miles away from you - can you help us?" Dean asked, bluntly. He hadn't intended to be so forthright, and a short silence on the doctor's end made him wonder for a second if he'd screwed this up.
"Of course I'll help. What happened to Sam?" Dr. Sinclair replied, and Dean let out a sigh of relief. Thank God.
"Look, it's a long story, but Sam was kidnapped yesterday and I only just got him back. The guys that took him... well, they tortured him," he told Brad slowly, looking in the rearview mirror at his little brother lying motionless in the back seat and still hardly breathing. Dean took a deep breath before he went on.
"He's got broken ribs, knife wounds, burns, and some broken fingers and toes. They also tore his back up with a whip, and he's probably got internal injuries I can't see. He's not breathing well, either - really shallow and irregular." Dean felt tears stinging the back of his eyes as he listed Sam's injuries. Somehow, saying it out loud made it real.
"Okay - Dean, are you sure you don't want to take Sam to a hospital?" Dr. Sinclair sounded more serious now - that list of injuries was longer than he'd been expecting, and it was obvious he thought Sam should be hospitalised.
"I can't risk that, doc. There are too many things looking for the two of us right now and we need to stay off the radar if we can." Dean sighed, steering the car with his knees while he rubbed his eyes. He understood that the doctor only wanted what was best for Sam, but Brad didn't understand that the Winchester boys were in the middle of a war. They couldn't afford to put themselves out in the open and risk the other side tracking them down.
The doctor paused for a second before he answered. "Well, if you can't go to the hospital, there's a clinic nearby that's closed at night. I volunteer there, and it should have all the equipment I need to look after Sam - it's on Anthony Street, near the Boone Hospital Centre. I'll meet you there."
Dean immediately committed the address to memory. "Thanks. We'll be there in less than half an hour." He hung up and shoved his phone back into his pocket, then took another look at Sam in the rearview mirror. "Don't worry, Sammy, we're going to get you some help." he said, and anxiously chewed on his bottom lip as he pealed out onto the interstate. Inside the car, it was silent for once - Dean had turned the radio off so he could listen to Sam's breathing. Or, more accurately, so he'd know if it stopped.
Almost within sight of the clinic in Columbia, just as Dean was starting to relax, he heard Sam's breathing starting to get more strained. It wasn't just shallow and irregular now - it sounded like Sam was having trouble getting enough air into his lungs. "Hang on, Sammy, we're almost there!" Dean could hear Sam stirring in the back seat as he struggled to inhale - he was conscious enough to know he couldn't breathe properly, and he was obviously scared. He was paler than he had been, with flushed red spots high on his cheeks, and covered in a thin film of sweat.
Sam had to work incredibly hard for every breath, using all the accessory muscles in his abdomen, chest and back to expand his chest as far as was physically possible. He was ignoring the pain from his broken ribs, the need for oxygen overriding the desire to not disturb the fractures, and the sight of him sent Dean's heart rate through the roof.
This isn't good, Dean. Hurry the hell up. He gunned the engine, breaking the speed limit all the way down Anthony Street.
As the Impala screeched to a stop outside the clinic, Brad opened the front door and came outside with a wheelchair. Dean leapt out of the car and pulled the back door open, and was leaning in to get Sam just as Brad reached them.
"How's he looking?" the doctor asked, as Dean started to bring Sam out of the back seat as quickly and gently as he could.
"His breathing's worse now," he answered, groaning as he strained to lift his 6"4' little brother - he was still 220lb of dead weight and that was hard work, even as fit as Dean was.
With some help from the doctor, Dean managed to get the blanket-wrapped Sam into the wheelchair, up a concrete ramp and into the clinic. Brad led him briskly through the eggshell-blue waiting area and past the consulting rooms, into a small, sterile-white room designated 'Acute Care' by black lettering applied to the frosted glass panel in the door. They laid Sam out on a gurney, and Dr. Sinclair immediately put an oxygen mask over his face and turned the gas on. That helped a little: he had to make less of an effort to breathe, but still couldn't seem to get enough air. Dean stood back a little, one hand on his hip as he ran the other through his hair, watching anxiously as the doctor started listening to Sam's chest, paying particular attention to the left side.
With Sam now in the capable hands of Dr. Sinclair, Dean could finally take a minute to contemplate their situation. On the drive to Columbia, when he hadn't been looking at the road or at Sam, he'd been checking the rearview mirror for anyone following them. He hadn't seen any tails, and he was almost certain there was no-one tracking them - there's probably no-one left, he'd reasoned - but Dean knew he couldn't take any chances. If someone (or something) did turn up to try and finish the job Owen, Ray and Kate had started, he sure as hell wanted to have something more substantial than his Colt and a magazine-and-a-half of regular lead ammunition.
"I have to get a few things from the trunk, doc. I'll be right back." As much as he hated to leave Sam, Dean knew he was in good hands. The doctor nodded wordlessly as he took Sam's blood pressure, and Dean took one last look at his baby brother before he ran back down the carpeted hallway and out to the Impala. He ransacked the trunk, grabbing an assortment of weapons: knives, guns, ammunition (conventional lead rounds and salt shells) and even some holy water, and tossing it all into an olive drab duffel bag.
"Come after us now - I dare you." Dean muttered to no-one in particular, as his eyes quickly scanned the deserted street. Satisfied no-one was lurking in the shadows watching him, he slammed the trunk, slung the duffel over his shoulder and jogged back up to the clinic. He was feeling a little better now he was properly armed.
When Dean got back into the acute care room, things had changed dramatically. He skidded to a stop just inside the door, eyes wide as he took in the scene. He barely noticed as the duffel fell from his hand and landed hard on his foot, all his concentration focused on his little brother lying motionless on the gurney. Dean gasped as he realised why Sam was so eerily still.
Oh God - he isn't breathing.
Time slowed down for Dean then, and the only sound he could hear was his own heart pounding in his ears. The doctor had a scalpel in his hand, and was preparing to cut into Sam's chest. He was talking to Dean, his mouth moving in slow motion as he bathed the left side of Sam's ribcage with rust-coloured iodine, but Dean didn't hear a word of it. He stood frozen for what seemed like an eternity, one thought - one prayer - repeating over and over in his head: Please don't take him away from me. Please don't take my little brother.
As he stood shell-shocked in the doorway, Dean heard a faint voice through the drumming in his ears. It was Dr. Sinclair, yelling at him. He blinked a couple of times, and the doctor shouted at him again: "Dean! Come over here - I need you to hold Sam's arm!" He waved Dean over to the side of the bed, and placed the dazed Winchester's hand on his brother's forearm.
"Sam has a haemopneumothorax. His left lung collapsed and I have to get the blood and air out of his chest - I need you to hold his arm out of my way." Brad told him, under control and professional again. He didn't put too fine a point on it, but Dean understood what the doctor meant: if I don't reinflate his lung, your brother's going to die. You need to get a grip and help me.
Dean took a deep breath and gingerly bent Sam's arm up over his head, holding it down to the mattress. "Sam, don't you dare die on me!" Dean told his brother, quietly but intensely. Hs heart was racing as he held back Sam's arm, a slight fever making his skin hot to the touch.
He watched the doctor count down the ribs on Sam's left side, then make an incision into the fifth intercostal space as Dean prayed silently to God, or whoever was in charge of life and death these days, not to take him. His eyes went back to Sam's face and filled with tears as he watched his baby brother's lips turning blue.
As Dr. Sinclair used a surgical clamp to swiftly dissect the layers of intercostal muscles underneath the incision, Dean winced. "Don't worry, Sam can't feel any of this - I anaesthetised the area just after you left. I saw this coming as soon as I listened to his lungs, and I was prepping for the chest tube when he went into respiratory arrest." Brad answered the question before Dean could ask it. Dean nodded, and drew a shaky breath as a frothy trickle of bloody fluid ran out of the incision, down the side of Sam's chest and soaked into the bedlinen beneath him.
"You're gonna be okay, Sammy. We're gonna save you." Dean assured Sam, his voice barely above a whisper as he watched the doctor introduce the chest tube - it looked impossibly huge to Dean, like a length of clear garden hose with an array of small holes at one end and a surgical clamp closing off the other. As Brad slid the perforated end deep into the pleural space inside Sam's chest, the tube immediately filled with the same bloody fluid that had escaped from the initial incision.
"It's gonna be all right, Sammy." Dean patted his brother's arm, saying the words mostly for his own benefit. Sam was out cold, and he couldn't hear anything Dean was saying.
Dean wasn't quite prepared for what happened next. Dr. Sinclair set the end of the tube into a plastic bowl and removed the clamp, and there was an audible whooshing sound as air that had been collecting in Sam's chest bubbled out, followed by a stream of purplish-red fluid full of half-clotted blood. Suddenly, Sam took a deep, gasping breath and started breathing on his own again - he remained unconscious, but the colour slowly returned to his face as Dean watched, and he heaved a sigh of relief as he put Sam's arm back down by his side. It was only when he reached for a towel to wipe the film of sweat from his little brother's face that he realised his hands were shaking.
"How long did these guys have Sam?" Brad asked, attaching the end of the tube to a collection container before he began suturing the perforated end to Sam's chest.
"About 24 hours, but I don't know how long they actually spent..." Dean trailed off, and Brad looked up to see his bloodshot eyes fixed on the purplish-red puddle collecting in the bottom of the canister. Each breath he took forced more air and fluid out of Sam's chest, and it was collecting rapidly in the plastic container.
"Is that normal? All that bleeding?" Dean asked, his gaze moving up to the doctor. He was controlling it well, looking relatively composed as he wiped the sweat from his brother's forehead, but Brad could see that Dean was still terrified Sam might die.
The doctor sighed as he considered his answer. "The men that took your brother used him as a punching bag, Dean. He's got broken ribs, and that often comes with damaged blood vessels inside the chest and sometimes a punctured lung as well. I'd say Sam has been slowly bleeding into his chest for hours now, and he likely has a small tear in his left lung. Blood and air have been accumulating in his chest to the point that his lung collapsed, but the tube I just put in will keep draining it until his lung heals and the bleeding stops." Dr. Sinclair was treating Dean like next-of-kin now, explaining and reassuring. He could see the eldest Winchester was exhausted, and needed someone else to drive the bus for a while.
"So that's not gonna happen again?" Dean asked, sinking into a nearby chair and rubbing his hands over his face.
"It shouldn't, no." Dr. Sinclair sounded confident, and that made Dean feel slightly better.
"Okay, so what now?" He watched as Brad took Sam's blood pressure again and listened to his heart and lungs through his stethoscope.
"I'm going to do exactly what I'd do if you brought Sam into the ER." he replied, replacing the stethoscope around his neck. "I'm going to set up an IV, take some x-rays, then start patching him up." he went on, and Dean nodded. Now that he'd got Sam this far, into the care of an actual, licensed doctor, he could start to relax. Dr. Sinclair was very good at his job, Dean knew, and he felt comfortable leaving his brother's life in this man's hands. At least, as comfortable as a Winchester could be when he wasn't in control.
"Can you patch him up?" Dean asked somewhat apprehensively, his voice low. He watched with tired eyes as Brad slid a cannula into a vein on the back of Sam's right hand, well-practiced and efficient. Dean was worn out, his nerves were shot, and his body craved sleep; but there was no way he could even consider getting any rest until he knew Sam was out of the woods. He got up and busied himself setting down lines of salt at the door and windows, trying to keep the drowsiness at bay.
As Dean laid down his salt, Brad took stock of the assortment of lacerations, wounds, burns and bruises that covered Sam's body. "I can't work miracles, Dean. Your brother's going to have some pretty significant scars, but there's only so much I can do without access to an OR and a plastic surgeon," he began, connecting the clear plastic IV tubing as he spoke.
"If I saw Sam in the University Hospital ER, I'd send him to the burn centre, get a consultation from plastics, and have him in surgery before dawn. I'm guessing we can't actually do any of that, though." Brad looked over at Dean as he opened the IV line and let the saline flow. He could see Dean was conflicted.
As he stood at the window, staring at his pale, unconscious little brother, every instinct screamed at Dean to avoid the hospital. There would be forms and questions and records... they couldn't justify that unless it was life or death, and it wasn't. Not anymore, anyway. On the other hand, the big brother in him wanted to erase all traces of this ordeal; Dean wanted so badly to tell Brad to patch Sam up, take him over to University Hospital and do everything he could to minimise the scars that would remind Sam every day what Owen and Ray had done to him.
Brad saw this internal struggle play out on Dean's face, and offered up a solution so simple Dean couldn't believe he hadn't thought of it. "Look, you don't have to decide now. Let me stabilise Sam and get him stitched up, and maybe then he can answer the question for you. If he wants me to, I'll refer him to a plastic surgeon I know that owes me a favour," Dr. Sinclair said, as he picked up a hypodermic needle. "Does Sam have any allergies?" he asked, and Dean shook his head. He finished his last salt line as the doctor injected two substances into Sam's IV - a strong, broad-spectrum antibiotic and some morphine.
"You're planning on x-raying Sam's ribs, right?" Dean asked suddenly, as something occurred to him.
"I am." Brad replied slowly, looking up from the IV. Dean smiled a little as he put the salt container back in his duffel, then realised Brad was looking at him like he was crazy. He couldn't understand what Dean found amusing about a chest-ful of broken ribs.
"Sam and I both have a heap of angelic graffiti carved into our ribs. You're gonna be hard-pressed to see anything through that." Dean explained, and the doctor raised his eyebrows.
"Angels." He thought that over for a second, but apparently angels aren't such a big leap after being haunted by a vengeful spirit, because he didn't freak out. "Um, okay - well, I guess I'll just have to check what I can see. Give me a hand, will you?" Brad kicked the brakes off the gurney's wheels, and he and Dean wheeled the unconscious Sam into the x-ray room. The doctor proceeded to x-ray every bone in Sam's body, while Dean paced restlessly back and forth behind the lead shield.
Back in the acute care room, while Dr. Sinclair studied the digital x-ray images, Dean sat quietly next to his semi-conscious little brother until a small gasp from the doctor drew him over to the screen. He looked over Brad's left shoulder at the x-ray of Sam's chest - just as he'd predicted, Cas' angelic chicken-scratch obscured all but the worst damage to Sam's ribs.
"Told you." He smiled grimly as Brad zoomed in and traced a sigil on Sam's sternum with his finger.
"That's amazing." he breathed - he'd never seen anything remotely like this, and he took a minute to study it silently. He wasn't used to analysing a chest x-ray filled with Enochian sigils, but he was coping pretty well with the whole angels-are-real thing and Dean was actually kind of impressed.
The x-rays of the rest of Sam's body were much more revealing, and any levity in the room disappeared when Brad started counting broken bones - he actually had to make a list. As he scribbled each fracture down on a piece of paper, he read it out for Dean.
"Sam has six broken ribs; fractures to his left cheekbone and eye socket; a broken nose; a fractured left wrist; fractured metacarpals in both hands and fractured, dislocated fingers on his left; a small hairline fracture to the right iliac crest of his pelvis; and his right foot is a mess of broken metatarsals and four toes that have basically been shattered." Brad didn't even try to sugarcoat it. There was just no way of making that list sound anything less than horrific.
Brad switched the screen off as soon as he was finished assessing the images, and Dean went wordlessly back to his seat beside Sam. His eyes were shining with tears as he looked again at the bloody, swollen reality of the injuries that looked so clean on the x-rays.
"He's not in any pain, Dean, and all these injuries will heal. He'll be okay." Dr. Sinclair told him, and Dean smiled bitterly.
"He was in pain, though. For hours - I found him hanging by his wrists from the ceiling, and when I cut him down I heard the broken bones grating." He wiped his eyes with his sleeve. "How is he ever going to be okay after that?" Dean asked softly, looking down at Sam's bruised and swollen face. Brad could see that Dean was blaming himself for his little brother's condition, but he didn't have any idea why and Dean obviously didn't want to talk about it.
So, instead of pushing the brooding Dean to talk, Dr. Sinclair set about patching Sam up. There were so many injuries to deal with that he initially wasn't sure where to start, but after cutting the remains of Sam's clothes off him it became obvious that the first thing he should do was get this kid clean. Sam was covered in blood, sweat, dirt, and worse, and that was likely what had caused the infection responsible for his fever.
The doctor filled a big plastic bowl with warm water and a little disinfectant soap, then used a towel to start wiping Sam down from head to toe. He was surprised when Dean wordlessly picked up a second towel and began to help, tentatively at first, but with more confidence as he saw the dirt and blood coming away from his little brother's skin.
Brad and Dean couldn't help irritating some of Sam's numerous wounds, and occasionally he would try and pull away or moan softly, scrunching up his face and furrowing his brow. Dean stopped and looked up at Dr. Sinclair, who smiled reassuringly. "He's not in any pain, Dean, don't worry. He can feel us touching the wounds, but it's not hurting him," the doctor said, and kept washing. Dean didn't, though - he continued studying Sam's face, crumpled up like he was still in pain.
"Why not give him some more morphine?" Dean asked, and Brad took a breath before he answered.
"Morphine can depress respiration in large doses, and although he's breathing fine at the moment, I want to give Sam as little as I can. And he might need more when I start setting bones and cleaning his wounds, so I want to minimise how much he has now." Again, he didn't beat around the bush. Dean looked away from Sam's face and concentrated on rinsing and wringing his towel - he hated the idea that Sam might have to endure any more torture tonight.
"Don't worry, Dean. I should be able to patch him up without causing him any further pain." Brad assured him - he didn't want to hurt Sam any more either; the poor kid had definitely had enough of that for one day. The limp, pale form in front of him now was worlds away from the energetic, personable young man he'd met a year ago, and Brad couldn't believe someone could do such awful things to such a nice guy.
When they were done washing, Brad and Dean had turned three bowls of water a murky red-brown, and the angry scarlet wounds and purple bruises now stood out starkly against Sam's clean, pale skin. While he was wiping dirt and blood and sweat off his little brother, Dean had had a chance to get a good, close-up look at Owen and Ray's handiwork: beyond the numerous lacerations and burns and bruises, Dean saw the fingernails torn out at the roots; the fingers that had been viciously dislocated, one by one; the deep cuts that had been packed with salt...
Dean knew all too well the kinds of things those animals had done to his little brother, and he found himself wishing he'd made them suffer more before he'd ended them. There was a part of him - a bigger part than he'd like to admit - that would have taken pleasure in doing to them what they'd done to Sam. That, and worse; Dean had skills Owen and Ray couldn't have dreamed of, and he would have done things to them they'd never imagined in their darkest nightmares. They didn't think so at the time, but Owen and Ray - and even Kate - had gotten off lightly.
Dean quickly put those thoughts firmly out of his mind, and watched Dr. Sinclair examining Sam's right foot with newly-gloved hands. "A couple of these toes have compound fractures. I'd kill for an OR right now," he muttered under his breath, and Dean frowned.
"Compound fractures are bad, right?" he asked, and Brad nodded.
"The broken ends of the bone have been exposed to the outside environment through open wounds. I need to clean those wounds and close them so the bone doesn't get infected." He went over to a supply cupboard and started picking out various boxes and packages.
"I'd really prefer to do this is an OR under a general anaesthetic, but I can give Sam a nerve block and do it here without causing him any pain," he added, and Dean watched silently as the doctor finished collecting his equipment. Brad quickly set up a sterile field, saturating Sam's entire foot with iodine and draping everything below mid-shin with sterile cloths. When he was satisfied the area was as aseptic as he could make it, the doctor put several injections of local anaesthetic into Sam's ankle, targeting the nerves supplying his foot and flooding them with lidocaine. While that was taking effect, he went over to the sink to thoroughly scrub his hands and forearms.
Dean pulled the plastic chair right up to Sam's bedside and sat down, looking on as Dr. Sinclair set out a small collection of surgical instruments, syringes, gauze and sutures, then pulled on a fresh set of latex gloves and started working on Sam's right foot. Owen had hit the four smaller toes with a hammer, striking each toe progressively harder, and when he worked his way down to the fourth and fifth toes they had split open like overcooked sausages. Brad could see fragments of white bone in the bottom of the wounds, but apart from clotted blood and a few specks of dirt, they actually looked fairly clean.
Dean was now standing up and watching from a few feet away - when Brad had started poking around in the open wounds, he found he couldn't sit still. So, he got up out of his uncomfortable plastic chair and started pacing instead. "There's not a lot of contamination in here. I've seen compound fractures full of everything from dirt to broken glass, and this is pretty clean." Dr. Sinclair was pleased to be able to give Dean some good news for once, but it didn't improve his mood much. He continued pacing silently beside the gurney.
The doctor could see there was nothing he could say that was going to make Dean feel any better about this situation, so he got on with closing the wounds. It didn't take long to thoroughly wash the torn flesh and neaten up the edges, but he just didn't have the instruments he needed to repair the multiple fractures. So Dr. Sinclair aligned the bones as best he could and closed the wounds, one layer at a time. Dean watched on, still pacing like a caged animal.
It was only when Brad was finished suturing that Dean finally understood why he had numbed Sam's whole foot and not just the toes he'd operated on - he started manipulating the other broken digits with his gloved fingers, trying to re-align the fragments of bone. Dean winced when he heard the ragged ends grating on each other as Dr. Sinclair reduced the fractures as much as he could.
"It's quite possible Sam won't have much movement in these toes when they heal, but I'm going to make the bones as straight as I can," he told Dean, unfocused eyes looking off into the distance as he manoeuvred the broken bones by feel.
"We're lucky this is all they did to him, doc," Dean replied, matter-of-factly, and Brad looked at him in surprise. The eldest Winchester was now standing stock-still, arms crossed over his chest, watching every move the doctor made with dark eyes.
"Dean, what the hell happened to make those guys do this to Sam?" Dr. Sinclair had been dying to know ever since Dean had called him earlier that night, completely out of the blue.
"You don't wanna know." Dean scowled, and Brad frowned.
"Don't you think I deserve to know why I'm here patching up these injuries in the middle of the night?" he asked, simply, and Dean's eyes narrowed a little as he thought that over. Deep down, he knew the doctor was right.
The guy is going out on a helluva limb to help Sam - you owe him an explanation.
After a few seconds' pause, Dean took a deep breath and started to give him one. "The guys that took Sam... they thought he'd done something really bad. Evil, actually. As far as they were concerned, he was a creature worth hunting - he wasn't really human, in their eyes. They could have done worse." He spoke slowly, neglecting to mention what Sam had actually done, and also that it was exactly what the hunters had suspected. "They were about to kill Sam when I got there, and when I went in to rescue him they tried to kill me," Dean continued, watching Brad start working on the last of Sam's broken toes.
"I just wish I'd gotten there earlier." He sighed, and while the doctor splinted Sam's right foot and took another x-ray, Dean told him the whole story. How he'd driven into Blue Springs to find Sam missing to turning up at the warehouse and hearing Sam's screams, and even burning the hunters' bodies before he left Odessa; although he left out the parts about Lucifer, the looming Apocalypse and Sam's demon blood addiction.
Those weren't things Dean even wanted think about, and he sure as hell didn't feel like explaining it all to Dr. Sinclair - even if he was saving Sam's life. He felt kind of bad about not giving the doctor the whole story, but Dean told himself it was for the best.
No reason to scare the crap out of this guy by telling him the Apocalypse is starting. If Michael and Lucifer do go head to head and demolish the planet, then at least he'll be able to enjoy what time he has left.
Brad listened silently to the whole saga as he worked, and when he was finished telling his abridged version of the story Dean half-expected him to pick up the phone and call the cops. Instead, he looked up from the x-ray on the screen in front of him and said something Dean never expected to hear come out of a doctor's mouth.
"You did the right thing." Brad told him, firmly. Dean stared back at him for a second, not quite able to believe what he was hearing.
"So you're not going to turn me in to the cops for committing a triple murder...?" he asked, eyebrows raised, and the doctor gave him a tired smile.
"You saved Sam's life, Dean. Your little brother was kidnapped by people that were going to kill him - that almost did kill him - and you got him back. You did what you had to do." Brad looked back down at the computer screen, and Dean could see he genuinely believed that. He wasn't about to spoil the moment by admitting he was going to shoot the hunters dead anyway, whether they tried to hurt him or not.
It was after two o'clock in the morning when Brad finished with Sam's foot and moved on to the wounds that covered the rest of his body. He started with the deepest lacerations and burns - the ones Owen and Ray had inflicted late that night, when they were finished trying to get information out of Sam and just wanted to hurt him. He gave Sam as much morphine as he dared, but when he started to cut the dead, charred flesh from the deep wound in his thigh the youngest Winchester groaned and stirred, trying to pull away.
Dean jumped out of his chair and was immediately at his brother's side as Dr. Sinclair drew the forceps and scalpel back, frowning. "I thought he couldn't feel anything?" Dean looked at Brad, confusion clouding his face.
"There are some really serious wounds here, Dean, and I can't give Sam enough morphine to kill all the pain. I've given him as much as I can and I hoped it would be enough, but debriding these burns is obviously breaking through." He scrubbed a hand over his face, considering his other options.
"Can't you use some more local on the deep wounds?" Dean asked what he figured was an obvious question, and Brad pursed his lips as he thought.
"You can overdose on lidocaine, too, Dean," he sighed, but picked up the syringe anyway. "What I'd give to have an anaesthetist." he muttered under his breath, injecting the muscle around the wound with as little lidocaine as possible. Dean hovered over him now, watching every move.
"Sit down, will you? Sam will need you to be 100% when you guys leave here, so for the love of God, get some rest." Brad stood up and actually pushed Dean back onto a second gurney sitting against the far wall. Dean looked mildly shocked at first, but the irritation was quickly overshadowed by the realisation that he was going to have to look after Sam when the doctor was done saving his life.
Looking after one another after an injury wasn't uncommon for Sam and Dean - bruised ribs, the odd dislocated shoulder or sometimes a concussion. Usually it only meant one brother making all the food and coffee runs, carrying all the bags, stuff like that - but neither of them had every been this badly hurt and not been in hospital, so this was uncharted territory.
I've never even had to keep a house plant alive before, Dean thought to himself, as the gravity of the situation dawned on him. How the hell am I going to look after Sam?
"What am I going to do with him when you're finished stitching him up?" Dean asked, and the doctor looked up from Sam's leg.
"Well, I've been thinking about that. There's a motel on Waugh Street that I pass by on the way to and from work: I want to set Sam up there with an IV and everything you'll need to look after him, and I'd come by every day to check on him and change dressings and things like that." he replied, and Dean raised his eyebrows.
"You'd do that for us?" he asked, the surprise showing in his voice, and Brad smiled.
"You two helped me once, and I'm just returning the favour. I can't leave Sam like this." The doctor genuinely liked the Winchester boys, and he couldn't abandon them in their hour of need. His conscience wouldn't let him. Dean couldn't help but smile a little as he sat on the gurney - this was the second person that had gone above and beyond for them today, and it was nice not to have to muddle through by himself for once.
"Thanks for doing this, doc. You could've hung up on me when I called out of the blue and woke you up in the middle of the night, but you didn't. I just want you to know how grateful I am - Sam is all I have, and I don't know what I'd do without him." Dean told the doctor, somewhat awkwardly. Usually he would rather walk over hot coals than share his feelings like that, but he wanted Brad to know how much this meant to him, so he sucked it up and got the words out as smoothly as he could.
"You did the hard part, Dean - you rescued him. I'm honestly just glad I can help you guys this time." The doctor smiled.
"How long do you think it'll take him to get up and around?" Dean asked, changing the subject as he leaned back against the wall. Brad thought about that for a minute as he continued debriding burnt flesh. Dean tried to ignore the crunching sound of the metal instruments on the crisp, black edges of the wound.
"That depends on Sam. If he doesn't develop a serious infection, it's just a matter of healing time. He should be feeling better in a couple of days, but beyond that... I can't say for sure." Dr. Sinclair flushed the wound in Sam's thigh with saline as he spoke. A stream of bloody liquid carried with it chunks of clotted blood and scraps of charred skin and muscle as it ran down his thigh, leaving a pink stain on the linen, its edges ringed with charcoal. The doctor then began to close the layers of tissue as Dean watched with tired eyes, fighting his body's demands for sleep.
By the time Dr. Sinclair was finished debriding, cleaning, suturing, and also setting Sam's broken wrist, sunlight was starting to seep in through the blinds. Dean had finally lost the battle and fallen asleep just after three a.m., curled up on the gurney by the wall.
Brad roused him gently, and it took Dean a few seconds to remember where he was. "Is Sam okay?" he asked sleepily, looking up at Brad's tired features. The doctor looked exhausted.
"He's fine, but I've done as much as I can for him. I cleaned his lacerations, debrided the burns, put in probably a few hundred sutures and dressed all the wounds that really needed it. I also cleaned his back as best I could, but there's not much else I can do for damage like that." Brad told Dean, who took it all in silently as he looked over at Sam resting peacefully across the room.
His breathing was slow and even and his colour was good - if there weren't huge dark circles under his eyes and the left side of his face wasn't bruised and swollen, you might not even have been able to tell the kid had just been through hell.
Dean got up off the gurney and groaned as his stiff limbs protested the sudden movement. As he stretched, his eyes fell on a cardboard box by the door that was filled to the brim with dressings, painkillers, antibiotics, syringes and all sorts of other medical paraphernalia.
"Is that all for Sam?" he asked, and the doctor nodded.
"I'll bring some fresh IV bags with me when I visit, but there's a week's worth of dressings and things in there. When we get Sam settled in the motel, I'll go through it all with you." He scrubbed a hand over his face and stifled a yawn.
"Guess it's time to go, then." Dean pulled his car keys out of his pocket, and Dr. Sinclair went to get the wheelchair.
Thanks so much for all the lovely reviews for Chapter 7! *hugs and apple pie all round!*
Dean shooting out Ray's kneecap was by far the most popular event, followed closely by him killing Owen, Ray and Kate... Who knew you were such a bloodthirsty lot? ;)
This might sound a little crazy, but this chapter was kinda fun to write. During all those human pathology and anatomy lectures (and cadaver dissections) at uni, I never expected to use the knowledge for fanfiction...! I didn't even know I remembered most of this stuff, and it was a pleasant surprise when it started appearing on the page in front of me :) Just like riding a bike, I guess!
It felt like a bit like my Grey's Anatomy textbook at times, but hopefully I softened the technical detail enough. I'm sure you'll all let me know, because you're all going to review, aren't you...? ;)