Ok, this absolutely had to be written. I watched the episode last night and this morning had to write the tag. It came out in about five hours, so it's not the greatest. It refused to slow down for me to write better. Not Beta'd so all mistakes are mine.
Disclaimer: I don't own the boys, I'm only playing with them (and slightly torturing them).
Jerking awake Sam panted heavily, gasping for breath. Beside him he could hear Dean doing the same thing, both brothers in shock over what had just happened. As his shock passed though Sam became aware that his side was screaming in pain. He couldn't breathe properly, pain shooting across his chest at each inhale. At first he wasn't sure why, then he remembered that the kid had been beating him with a baseball bat in the dream world.
Gritting his teeth, he tried to control his breathing. "You ok?" he asked Dean, cursing when his voice came out a little gravelly and cracked at the end.
Considering himself, Dean nodded through the fuzzy haze of sleep that was clouding his mind. A few bruises from the fight with himself but he'd live. "You?" he threw back at his brother, glancing over. He didn't need Sam's reply. The minute he saw his brother he knew Sam wasn't ok, and his sleepiness vanished.
"Me not so much." Sam gasped back. Each breath he took was harder than the one before, pain screaming through his chest and stomach. A particularly sharp bolt had him bending forward. "Shit," he gasped. "Something is wrong."
"Sammy!" Cursing, Dean turned the car on and threw it in gear, aiming for the nearest hospital, one arm grasping his brother's shoulder to both hold Sam into the seat and to reassure himself. He was pretty sure he'd seen a sign a while back for one. Sure enough the blue sign, white 'H' shining in his headlights, appeared. "Hang on Sammy, we're almost to the hospital."
Sam wanted to say no, to just take him to the hotel, but this wasn't something Dean or even Bobby could deal with. They'd been hurt enough over the years to know their own bodies and when something couldn't be taken care of at the motel, and he could feel that something was definitely wrong this time. By the time Dean pulled up at the hospital, had the car door open and was kneeling beside him Sam could barely breathe. Every gasp was an agonized struggle, and black dots were dancing on the edges of his vision.
"Hang on Sammy, it's ok." Dean soothed, holding his brother up when Sam threatened to topple out of the car and trying to control his fear. Sam looked terrible; he was showing the effects of two days without sleep, since he had refused to sleep if Dean couldn't, and he was clutching his left side while he gasped for breath. Already his lips were turning blue from oxygen deprivation, his skin was pale and he was covered in sweat. He was going into shock. As he watched Sam coughed weakly and blood appeared on his lips.
"SOMEONE HELP! WE NEED HELP!" He hollered again, glancing around angrily. Where the hell was everyone? When nobody immediately arrived he swore and reached for Sam. They couldn't sit there and wait for someone to notice them. Sam's knees buckled the minute he was upright and he moaned in pain so Dean swept him up into his arms, cradling him against his chest. It was an awkward position and he staggered a few feet before he caught his balance but he wasn't throwing his brother over his shoulders.
"Dean" Sam gasped when he was swung up into the older Winchester's arms, the sound barely a pained breath. "Hurts." He could barely think, barely breathe, and he admitted he was scared. He could feel that something was bad. Every time he moved or took a breath he could feel bones grinding together and the weak coughs he managed came with the coppery taste of blood.
"HELP! MY BROTHER NEEDS HELP!" he yelled again, staggering through the door. Thankfully someone noticed and a nurse came hurrying over with a gurney, looking alarmed.
"What happened?" The nurse asked, taking in Dean's face, which was starting to bruise, and the already forming bruises on Sam's.
"I don't know. One minute we were walking home, and the next we were being beat up. They got my brother with a baseball bat," Dean lied, lying Sam down on the gurney as gently as he could and holding onto his brother's hand as Sam was rushed towards a set of swinging doors into the emergency room. A weak cough drew his attention back to Sam and he gripped his brother's hand tighter. "Easy Sammy, it's ok. Take it easy."
Dean was stopped by another nurse at the set of doors. "I'm sorry, you have to wait here," she said. Dean wanted to argue but a clipboard was thrust at him and he was led over to some chairs. "You'll need to fill those forms out." Giving him a compassionate smile, she patted his shoulder and her voice softened from the clipped tone it had been. "Someone will be out soon to tell you about your brother. He'll be fine, don't worry. We're not a big hospital but Dr. Andrews is on duty tonight, and he's one of the best."
"Yeah, ok. I need to call our uncle." Dean replied. Standing back up he hurried outside and flipped his phone open, his fingers immediately tapping out Bobby's number.
"Dean, what's going on? Did you get the guy? Are you and Sam ok?" Bobby's worried voice answered.
"We got him Bobby, but Sam's hurt." Dean replied, his voice trembling slightly. "We're at the hospital, I think the kid beat him up. He can't breathe and he's coughing blood." He clenched the phone tightly. "I thought this couldn't happen, that what happened in the dream world didn't hurt you unless you die?"
"Well we must have been wrong." Bobby replied, sounding surprised and angry at the same time. "I'm on my way, I'll be there in half an hour. Use my insurance since they already think you're my nephews."
The line went dead with Bobby's last words. Glancing down at the clipboard he was still holding Dean flipped his phone shut and walked back inside. He sat down on one of the hard plastic chairs and, with a glance to the doors separating him from Sam, began to scribble in the insurance details for Sam Singer.
Sam felt the loss when Dean was stopped at a set of swinging doors. He reached back, trying to keep in contact with Dean, but the nurse gently pushed his hand back onto the gurney. "It's ok, your brother is right outside and we're going to take good care of you. You'll be back with him in no time, ok?"
Sam tried to answer but all that came out was a cough that stole what little breath he had.
Frowning with worry the nurse eased an oxygen mask over Sam's face. "Just try to breathe easy. She said.
Gasping through the cough, Sam tried to breathe deeply from the oxygen but couldn't. "Hurts. Can't breathe."
At that moment a doctor appeared, pushing through the curtain and moving immediately to Sam. "I'm Dr. Andrews. The nurse tells me you're having trouble breathing?" he said to Sam, beginning to look him over. The nurse came in again too, taking a pair of scissors and making quick work of Sam's shirt and pants.
Sam couldn't even manage a nod. It took all he had just to breathe in shallow gasps and even that was getting harder than he could manage. Each breath was more painful and desperate than the one before. Another hacking cough sent the worst bolt of pain so far stabbing through his chest and suddenly he couldn't breathe at all.
The nurse, who had been holding him up slightly to ease the strain on his chest, noticed. "He's going into respiratory arrest!" she exclaimed.
Activity immediately exploded out around Sam. As he watched, his eyes frantically darting around the room, more staff hurried into the cubicle, swarming around his bed. The doctor's face appeared over him, a blurry flesh-coloured blob to his oxygen deprived brain. "Sam, we're going to have to insert a breathing tube so you can breathe. You've got several broken ribs and one has punctured your lung, causing it to collapse. Just relax, we're going to sedate you for it."
Without waiting for an answer the doctor motioned to a nurse standing beside him and Sam felt a prick in his arm. Already someone was tipping his head back in preparation for inserting the tube. Then everything faded out into blackness.
Dean sat in the waiting room, glancing up every time he heard a door open in the hopes it was Sam's doctor come to tell him what was going on. His heart leaped into his throat each time with the fear that he would be told Sam hadn't made it. Sam had looked so bad, pale and sweaty and coughing blood. He was so engrossed in the doors they wouldn't let him through that he didn't hear Bobby approaching until the older man's hand fell onto his shoulder.
"Any news on Sam?" Bobby asked, ignoring the way Dean jumped half a foot off the chair in surprise.
"No, nothing," Dean replied with a shake of his head. "It's been almost an hour though, someone has to know something."
Bobby sat down next to Dean and gave his shoulder a supportive squeeze. He could sense the younger man's anxiety a mile away. "Sam's strong, Dean. He's a Winchester, he'll be fine."
Dean sighed and nodded, letting his head fall into his hands. "Yeah," he muttered, hoping to God it was true. He hated waiting rooms; no matter how many times he sat in one, waiting to hear if Sam was going to live or die, he never got used to it. Thankfully it had only happened a few times for Sam, though. Normally it was their dad he was waiting to hear about, but even that was the same. The fake looks he swore they taught at nursing school, jumping at every noise in the hope it heralded news; it was all too much.
By the third hour Dean was ready to climb the walls. He'd already been to the nurse's desk twice to ask about Sam and been told there wasn't any news. He was just contemplating barging through the doors and demanding someone tell him what was going on when the door swung open and a doctor strode through. "Dean Singer?" he called questioningly.
Leaping to his feet Dean strode over. "I'm Dean, how's my brother?"
"Dean, I'm Dr. Andrews, I treated your brother." The man introduced himself. "Why don't we talk in my office?"
"Just tell me how he is, please," Dean almost begged. He didn't want to be taken to a doctor's office, he just wanted to know how Sam was.
Sighing in resignation, the doctor nodded. Clearly the young man in front of him, and the older gentleman he remembered had been a patient recently, wouldn't rest until they had news. "Let's at least talk over here where we're out of the way." He said, leading them over. Once they were all seated in the hard plastic chairs he cleared his throat. "As you know Sam was having significant trouble breathing when he was brought in. He went into respiratory arrest in the exam room, and we were forced to intubate before we rushed him into surgery."
Dean's face paled at the doctor's words. Sam had stopped breathing. His brother had been hurt so badly he'd stopped breathing. Suddenly he became aware that someone was still talking, and looked up into Bobby's worried face.
"...ok Dean. Just breathe, it's ok."
Oh, breathing. That might be good. Taking a deep breath Dean nodded. "Sorry, I'm ok." Bobby was still looking at him, so he waved a hand. "Really, I'm ok."
"I'm sorry Dean, I shouldn't have started with all the bad news. I thought starting from the beginning would be the easiest." Dr. Andrews apologized gently, appearing and handing him a cup of water. "Sam is going to be fine, I promise. A lot of rest and he'll be good as new in a few weeks." He stood up. "Why don't we talk while we walk up to Sam's room? Then I can finish filling you in and prepare you for what you'll see."
Dean almost leapt to his feet, but stopped. "What do you mean, prepare us?"
"Like I said, Sam went into respiratory arrest while in the exam room." Dr. Andrews explained. "He suffered three broken ribs, one of which punctured his lung, causing it to collapse. We have him on a ventilator to relieve the strain on his lung. We'll wean him off of it in twenty-four to forty-eight hours if he shows improvement."
Dean didn't reply so the doctor led the way to Sam's room. Stopping outside the door he continued, "Sam's spleen was also ruptured and he has considerable bruising to his kidney and liver. He's got a chest tube in place and he's very bruised. He's also sedated to keep him from pulling out the ventilator."
"But he'll be ok?" Dean asked, needing the reassurance that Sam would be fine.
"Yes, he'll be fine. You got him here in time and he's a very strong young man. It will take a few weeks but eventually he is going to be just fine. It all sounds much worse than it is." Holding out his hand, which Bobby took and shook, Dr. Andrews motioned to the door. "You can stay as long as you want. If you have any more questions the nurse can page me, and I'll be around in the morning to check on Sam."
"Thanks Doc." Dean replied. When the doctor walked away he took a deep breath and stepped into the room, with Bobby behind him.
Sam lay on the bed looking much smaller and younger than usual. He was as pale as the pillow under his head with dark circles under his eyes and dark bruising on his cheek and jaw. The ventilator clicked and hissed with each rise and fall of Sam's chest, IV's snaked out of both his hands, a heart monitor beeped steadily and a catheter tube and chest tube snaked out from under the standard blue hospital blanket covering him.
"Aw, Sammy," Dean sighed, suddenly feeling guilt fighting inside him for dominance over the worry and fear. "I'm sorry, this is my fault. I shouldn't have let you come with me to stop that kid." Going to the bed he took Sam's hand in his, careful of the wires and tubes and IVs everywhere and brushed his brother's bangs back from his face. After a minute he hooked the chair with is foot, pulling it over to sit down.
Bobby moved in, pulling a chair over to sit on the other side of the bed. "Don't blame yourself Dean, you ain't at fault for this. You didn't take a bat to Sam." He said without preamble, giving Dean a calculating look.
"I let him go in with me. I could have stopped him and I didn't, and he's the one hurt. It should have been me, not him." Dean stared at his brother's face, pale and calm in his medicated sleep. "It was my dream."
Bobby just shook his head in resignation. "You Winchesters, you're all about blame aren't you? You gotta feel guilty for whatever happens; you can't just blame the bad guy, who I should add is really at fault here."
Dean just shrugged and continued to stare at Sam, his thumb brushing gently over his brother's knuckles. A while later Bobby stood up. "I'm gonna go get some coffee, you want some?"
Surprisingly Dean didn't. "No, I think I've had enough caffeine for now," he replied with a faint grin.
"Suit yourself," Bobby said with a shrug. Giving Dean a long look he seemed to change his mind. "On second thought, why don't you go back to the hotel and get a few hours' sleep, you look like you could use it."
"Yeah, right," Dean snorted, then sighed. "You go, you've been awake as long as we have." He looked at Bobby, making it clear to the older man that he wasn't going anywhere. "I'll grab a couple hours of sleep here, I'm good."
"Make sure you do sleep then, Sam don't need to wake up to find you passed out from exhaustion."
"Yes dad," Dean purposely made his voice snotty, earning an exasperated look from Bobby before the older man strode from the room. Chuckling to himself he scooted his chair closer to Sam's bed and rested his head on the mattress. He was exhausted and he hadn't lied when he'd said he would get a few hours sleep. "Night Sammy," he muttered before surrendering to sleep.
"Can't you do it while he's asleep?"
"No, Dean, we need him awake and aware when the tube comes out. If he's unconscious his body might not register the breathing tube has been removed and he may not start breathing on his own. And we need to wean him off of it. We'll wake him up and put it on assisted mode for a few hours and when I'm sure his damaged lung can handle it we'll pull the tube." Dr. Andrews spoke patiently, though his voice held a tint of exasperation with his patient's brother. He'd never had a relative so curious and protective before.
"What about the restraints? Are they really necessary?" Dean glanced back at Sam, frowning. The younger Winchester was going to panic when he woke up tied to the bed and Dean knew it. He was a hunter, and being tied up never went over well, especially not with Sam.
"It's hospital policy, Dean. I've already explained that." Dr. Andrews' voice had gone from exasperated to irritated. "Once he wakes up we need to make sure he's aware and able to breathe, and during that time it's necessary to restrain him so he doesn't pull at the tube."
"It's ok, we understand. Dean, go sit down, you ain't helping by badgering the doctor." Bobby stepped in, pointing to the chair Dean had vacated a few minutes before.
Opening his mouth to protest Dean snapped it shut again at Bobby's look. He knew not to argue when the old hunter gave him that particular look. Instead he huffed in annoyance and flopped down in the chair, reaching out to take Sam's hand and looking like a chastised child. A few minutes later he jerked, leaping to his feet, when Sam's hand tightened briefly on his. "He's waking up!" he called to Bobby and the doctor who were still over by the door talking.
Both men hurried over. "Sam, can you hear me? You need to open your eyes," the doctor called, tapping the side of Sam's cheek and giving his shoulder a bit of a shake.
Sam gave a pitiful moan around the breathing tube and his eyes slowly opened, blinking rapidly and then squinting against the bright overhead lights. Suddenly he gagged, his hand jerking against the restraints they had him in.
The unfamiliar voice demanding he wake up was bad enough, but when Sam opened his eyes he found he couldn't breathe. Something was down his throat, blocking air and refusing to let him take a breath. He tried to reach a hand up to pull away the offending object but found his hands were held down. He was restrained, tied to the bed. That only upped his fear and he jerked harder, gagging as he tried to take in a breath, his lungs screaming for air.
"Sammy, hey, relax it's ok. Just relax, you're on a ventilator. Take it easy, ok? Relax and let it do the breathing for you." Dean soothed, leaning over Sam when his brother started to panic, one hand gripping Sam's hand tightly while the other reached up to brush through his hair. "Slow, even breaths, thats it. In...out...in...out. I know you like the Smurfs, but dude you don't need to be one."
Sam's frantic search of the room finally ended when his eyes fell on Dean. He concentrated on his older brother's voice and forced himself to relax and stop fighting the ventilator. Gradually the weight started to lift from his chest and the desperate need for air disappeared. But he was still restrained, and he wanted the tube out, and his right side, from his shoulder to hip, was a ball of agony. He locked eyes with Dean, trying to communicate his need to his brother, blinking back the tears that were pooling in his eyes and feeling one slip out anyway.
Dean saw the tear, and the fear in Sam's eyes. "Hey, hey, it's ok. I promise. They'll take the tube out soon." He brushed Sam's bangs back and smiled when his brother tightly squeezed his hand, some of the fear leaving his face.
"Sam, I'm Dr. Andrews. I have a few questions, and I want you to answer me yes or no. Blink once for no, twice for yes, ok?" The doctor appeared beside Dean as he spoke.
Sam gave two blinks, but didn't take his eyes off Dean. He couldn't; Dean was the only one keeping him grounded at the moment.
"Good. The ventilator is on assisted mode, meaning it is helping you breathe rather than breathing for you. Are you having any difficulty?"
"That's good. Do you feel any dizziness or nausea?" Dr. Andrews made notes on Sam's chart while he spoke.
"Excellent. Now one more. On a scale of one to ten, where one is very good and ten is very bad, how is your pain level? Is it below a seven?"
Sam considered himself for a minute and took into account the warning look Dean was giving him. Dean needn't have worried; the pain was bad enough he wasn't going to gloss it over. He blinked once.
"Is it a seven?"
"Is it eight to ten?"
Scribbling one last note on the chart Dr. Andrews set it down and motioned to the nurse who had been standing off to the side. "Ok, we're going to give you something for the pain, and then in a few hours we'll see about taking the tube out, ok?"
Sam jerked. They weren't going to take it out yet? Shaking his head, he squeezed Dean's hand. They had to take it out, he couldn't lay there for hours with it in.
"Try to relax Sam," Dr. Andrews calmed. "We need to make sure you can breathe sufficiently on your own first. It'll only be a few hours, and later this evening I'll be back to take it out, ok?"
Sam just stared at Dean, his fear evident in his eyes. He hated hospitals and he hated ventilators more, Dean knew that. Surely Dean would make them take it out?
"Can you take it out any earlier?" Dean questioned, reading Sam's fear. "You can't leave him like this for over ten hours, he's terrified."
"I'll come back this afternoon then, and see how it's going. I want to wait at least six hours to be safe." Dr. Andrews finally said, his exasperation clear. "But that's the best I can do, I'm sorry."
With a nod to everyone the doctor left, the nurse following a few minutes later after checking the IVs and ventilator and injecting morphine into the IV on Sam's left hand. "Try to relax, the day will go by faster than you know, and soon you'll be able to talk to your brother." She said kindly, pausing to pat Sam on the shoulder before she left.
Through the whole thing Sam didn't take his eyes off Dean and kept a tight grip on Dean's hand, using his brother to keep his panic at bay. The tube in his throat kept threatening to strangle him and he had a desperate urge to swallow. Another tear slid down his cheek that Dean reached up and gently wiped away.
"Hey, it's ok, a few hours and they'll have that tube out." Dean soothed in a gentle voice. "I'll be right here the whole time, and Bobby is here too." Nodding over to Bobby and not surprised when Sam didn't break eye contact to look, Dean smiled. "You gave us a scare there, little brother. If you want to see how long you can hold your breath you should really warn us first."
Sam tried to laugh but choked on the ventilator instead. Dean immediately leaned over him, squeezing his hand and urging him to relax. His eyes were watering, not with tears he swore, by the time he was able to breathe again.
Dean again reached up and wiped his face before sitting down in the chair. Sam sensed Bobby sitting on the other side and managed to look his way, receiving a smile from the older hunter. "Hey there Sam. Good to see awake."
Turning his head back Sam stared at the ceiling as silence filled the room. Every few minutes Dean would squeeze his hand, and he kept looking over at his brother, receiving an encouraging smile. Eventually his eyes started to droop as exhaustion crept up on him.
"Go to sleep Sammy, we'll be here when you wake up."
Since he couldn't sigh or smile or make any acknowledgement Sam squeezed Dean's hand again and let his eyes close, but sleep wouldn't come. Every time he started to drift off the uncomfortable tube would make him jerk and start choking again, pulling weakly at the restraints until Dean's voice penetrated his brain and helped him calm down. Eventually he gave up trying to sleep and concentrated instead on the conversation Dean and Bobby had. Dean seemed to understand and included him in it, directing comments at him that Sam answered with a squeeze of his brother's hand.
In that way they got through the six hours relatively well, and Sam had calmed considerably by the time Dr. Andrews and a nurse entered the room. "How are you doing, Sam?" the doctor enquired, moving over to look at his chart and study the readings on the ventilator. With a smile he turned to the three men, all of whom were staring at him expectantly. Sam's anxiety had leapt with the appearance of the doctor, and he couldn't help grip Dean's hand tighter and tighter. "Everything looks good. I'd prefer to wait a few more hours, but given Sam's anxiety level I think it would be best to take the tube out now."
Nodding to the nurse, he glanced at Dean and Bobby. "I'll have to ask you two gentlemen to step outside, please."
Sam stiffened up, his already tight grip becoming impossibly tighter on Dean's hand. In response Dean shook his head and squeezed back. "I'm not leaving."
"I'll wait outside. Never did like seein' this part," Bobby commented, adjusting his hat on his head. "I'll bring back some coffee for ya Dean."
Dr. Andrews watched Dean for a minute before seeming to resign himself to having the older Winchester there. "Fine, but please don't get in the way."
"I won't," Dean replied. Undoing the restraint on Sam's right hand he gripped it tightly.
"Ok, Sam, take a deep breath and cough for me." Dr. Andrews reached for the tube coming out of Sam's mouth, undoing the tape holding it in place. When Sam coughed he pulled gently and the tube slid out.
Sam's purposeful cough turned into a jagged coughing fit as his lungs adjusted and took in a breath of fresh air. Dean eased him forward, rubbing his back and muttering soothingly to him. When he was able to take a few shallow breaths with the help of the oxygen cannula the nurse had settled under his nose Dean helped him lay back then tipped a cup of water to his lips while Dr. Andrews and the nurse moved around, removing one of the IVs and looking him over.
Taking a few small sips of the water Sam eventually leaned back and gave Dean a weak smile. "Thanks," he rasped, reaching up to rub his throat with his free hand. He jerked at the other and raised an eyebrow.
Dean grinned and reached over to untie his other hand, pulling both restraints off and handing them to the nurse, who took them with a smile before leaving the room.
"So, how do you feel, Sam?" Dr. Andrews asked once he was finished, laying the chart back on the end of Sam's bed.
"Ok, what happened?" Cringing when his throat protested talking he rubbed it again.
"You have a few broken ribs, one of which punctured a lung. We've had you on a ventilator for two days to take the stress off the damaged lung." Smiling, Dr. Andrews patted his leg. "Get some rest, I'll be back in the morning to check on you again."
Sam nodded. When the doctor was gone he turned to Dean. "Two days? What happened?"
Holding the water out for Sam to drink from, Dean waited until Sam was settled before he spoke. "That kid gave you a beating with a baseball bat in the dream world, remember? You woke up in the car and couldn't breathe. You scared the crap outta me Sammy."
"Sorry," Sam rasped, swallowing in the hopes it would help his throat. He hated ventilators, they always left him feeling like he'd swallowed crushed glass.
"No, I'm sorry Sam. I shouldn't have let you come with me." Dean looked down at his lap when he spoke. He felt terrible that Sam had gotten hurt because of him. He never should have drank that beer, it had been stupid and because of his stupidity the kid had almost killed his brother.
"Dean no, it wasn't your fault." Sam replied. Squeezing Dean's hand, that was still in his, he waited until Dean was looking at him. "You tried to stop me and I wouldn't let you. It was my choice to take the dream root. It isn't your fault I got hurt, it was that kid. If you want to blame someone blame him."
Dean snorted a laugh. Trust Sam to repeat what Bobby had said. "Yeah, ok Sam." Sam yawned then and he smiled, pulling up the blanket and patting his brother's chest. "Go to sleep, I'll be here when you wake up."
"Still not your fault, jerk." Sam replied sleepily, giving Dean a tired smile.
"Go to sleep Bitch."
With another grin Sam let his eyes close, feeling Dean settle into the chair beside his bed, his brother's hand still in his, and drifted off into the oblivion of sleep.