Author: Tari_roo

Rating: PG13/R (Gen)

Summary: Prompt fic for hoodie_time Dean-focused_hurt/comfort meme. Noose happy ghost equals crushed larynx. Crushed larynx = panicked Dean. Panicked Dean means Difficult Patient with a capital D. Sum = Poor Sam.

Disclaimer: I own nothing, I profit from nothing. I have a thing for Dean as a cowboy – I make no apologies

Spoilers: Season 4 or 5, non specific for those season, but mentions of Hell.


I'll keep asking until I get it! Dean ends up trached and on a ventilator in the hospital (crushed larynx, intubated too long, Spinal Cord Injury - I'm not picky). If Dean thought waking up intubated was scary just wait till the damn thing's stuck through a hole in his throat! Cue Sam trying to calm him down and attempting/failing at reading Dean's lips as Dean tries desperately to communicate without a voice.

Trust Dean to regain consciousness in the 5 point 2 minutes it took Sam to give in his screaming bladder and leave the room. 5 minutes tops that Sam is out of sight, out of the way, nowhere close to handle the situation and wham! Dean wakes up. His brother has perfect timing.

Sam leant forward over the wash basin in the tiny bathroom designed by paperpushers to ensure maximum space for minimum cost. The mirror was cool against his forehead, water dripping from his hairline and face down the smooth surface, pooling at the base. The soft hum of the hospital was muted in the small room but that only made it easier for the litany of sounds Sam was desperately trying not to think about to ring louder and louder in memory.

The frantic drum of Dean's heels on the ground as he tried to force air through and into his desperate lungs. His agonised wheezing as his throat got tighter and tighter and less and less air was inhaled. The ghost used to hang people for a living. It tried to hang Dean. Damn well nearly succeeded before Sam got the bones lit.

At first Dean was calm enough to let Sam work, assess the damage but it was damn near impossible to stay calm when your brother had to keep giving you mouth to mouth. Sam wiped his mouth absently, still tasting the blood. Dean's blood.

The sound though that ran around his head with a giant whistle, screaming look at me, look at me, was the sound of cartilage popping as he cut into Dean's trachea. A soft, wet pop.

It was probably a combination of blood loss, lack of oxygen and stress that primed Dean to lose it. The trigger though was a blade so close to his face that he could see his reflexion and that blade being pressed to his throat. Natural instincts or hell-born nightmares, it made no difference as Dean fought and bucked to get Sam away, all the while going blue and wheezing, gasping the whole damn time.

Sam dropped to his haunches in the cool whiteness of the bathroom, forcing his hands to stop shaking. There had been no time, no time to be gentle and reassuring. Dean was suffocating. Dying.


Weakened but frantic, Dean didn't make it easy to straddle him, press knees into elbows and just force him to stay still long enough. Eyes rolling back in his head, hands clawing into the ground in desperation, knees hammering at Sam's back, Dean fought and fought, until Sam had to hold his head back, hand over chin and just cut. Quick. Efficient.

Soft. Wet. Pop.

The only tube Sam had was an old bic pen, broken in half. As he wrestled his brother into submission, and waited for the opening he needed, all he could think was, 'Its filthy. He's going to get an infection. Its freaking filthy!'

Sam stood, rubbing his hands over his jeans, wiping away the blood that was long gone. The glimpse of his reflection in the mirror wasn't pretty, not at all. Just like the tracheotomy hadn't been pretty. But shit it worked.

Even as Sam fumbled for his cell, belatedly dialling 911, Dean relaxed, blessed oxygen sucked into through an old yellow bic. Snapping directions was easy in comparison to the soft wet pop, and as Sam checked Dean's vitals it was also a relief to see he'd passed out. The trip in the ambulance was cautious, the paramedics relaying details on his 'you should have waited for us' emergency procedure. Sam spent the whole ride watching the tube, the old one and then the new one inserted in the ER.

And for the past hour, maybe two, he'd been watching the tube covered in plastic and his brother's chest, waiting for Dean to wake up. Straightening, Sam pulled what he could of himself together, and headed for the door, but the litany of drumbeats, wheezes and pops disappeared at the scream of alarms and monitors going off.

Dean's room was close, but too far away and as Sam skidded into the room, Dean was fighting two nurses, trying to pull out the tracheotomy. "Dean, Dean, Dean. Hey!" Dean's frantic gaze found him, and his struggles increased. "Stop, Dean. Stop!"

There was no stopping, not just yet and Sam squeezed in next to the nurses, leaning over Dean, trying to reach him. "Dean. It's ok. You're ok. You're in a hospital. Hospital."

The nurses were nodding in concert and Dean was staring at Sam like he was heaven and hell all rolled into one. "I swear, Dean, you are in a hospital. Ok? Hospital!"

Sam tried to will as such belief and nonverbal reassurance as he good, not wanting to verbalise the 'not there, not in hell, not there' litany he so wanted to. The easing off was minute, the backing off tiny, but Dean didn't fight as much. He was mouthing something, over and over again but hell if Sam could figure it out. So, he went with, "Crushed larynx. I had to do the trachea. Hospital, with hot nurses. I swear."

Please believe me.

Dean didn't stop trying to talk, but his struggles did, and his heart rate slowly dropped to more normal levels. Sam and the nurses waited, waited for it to be a false positive, but Dean was relaxing, still trying to talk, but relaxing.

"That's it Mr Ford, just relax. Breath naturally, I know it's strange."

Getting rid of the nurses was tricky, they wanted to stick around and make notes and do tests but Sam was persuasive, insistent and looming. Dean was still twitching, reflexively reaching for the tube even as he caught himself. He hadn't given up on trying to get Sam to understand though.

"Slower. Try it slower. Like I'm five."

You are five, was clear as a bell, accompanied by the eyeroll and smirk. Sam replied, "And you're a two year old."

The list of possible urgent things Dean had to say was long. And Sam hoped he'd be able to cover all the bases. Not Hell. How Long. Job Done. He was ok. He was prepped and ready for the questions. Instead Dean slowly, deliberately mouthed, Take it out.

"Dean, you need it, for now. Your larynx is still too damaged..."

Take it out.

Firm. Unbending. Stubborn.

"Dean. Just be patient."

Take it out, now!

Sam sat down on the edge of the bed, bumping his brother's legs, covering his hand with his own. Not too sure how Dean would respond, Sam said quietly, "It's got to stay, for now. Why can't... does it remind... is it Hell?"

Hell with a capital H. The Winchesters had two hells, lower and upper case. Both hellish. Dean's eyes narrowed, furious and he mouthed loud enough to be shouting, Take the damn thing out!

The knee jerk reaction to reach for the tube Sam caught in time, and Dean snarled, a strangled sound. He was pissed, mouthing off a stream of silent, incomprehensible curses and Sam just nodded along with them.



Dean slammed his head back into the pillow and the monitors blipped. Sam leant forward, pressing against Dean's legs, his hands pinned by hands capable of so much damage. Soft, intense, Sam hissed, "Maybe it's Hell and maybe you're just being pigheaded, but we will sit and wait it out, ok. Nice and calm."

It was reluctant agreement, grudgingly given, but Sam was determined and Dean eventually nodded, short, sharp, angry. Sam let go, slowly, his brother's hands warm beneath his. And Dean stared at him, furious but he didn't try and pull the tube out. Sam sat a while on the bed, but Dean was done trying to communicate and eventually Sam sank back into the chair with a sigh.

The hiss and whir of machines was the only sound in the room and Sam focused on those, ignoring the returning memories of 'soft wet pop'. Looking up at Dean, silhouetted against the brighter light of the window, painted in greys and shadows, Sam figured the hiss of a vent was better than the sound of Dean's throat being severed.

Dean was glaring at the blinds, gaze long and deep, far far away. "Dean?"

A stiff middle finger was his only reply and Sam couldn't help the smile. "Yeah, whatever man."