Summary: A few miserable weeks might be only the beginning.
Disclaimer: Not mine, but man, that would be nice.
Feedback: Always welcome
Notes: Written for the Summer of Sam Love 2011. The recipient was faye_dartmouth and her prompts included: Sam and pneumonia. Enough said. And Sam and a hotel room surgery. It's been a busy few months! I always tell myself that things will slow down in the summer, but they never do. I decided to commit to the challenge so I would HAVE to write something and now I'm hoping to get back to the joy of my hobby. Enjoy!
It started with a tiny tickle.
Just a little flutter in his chest, that would make him feel like coughing; make him want to clear his throat.
At first his brother would shoot him questioning glances, but Sam just ignored Dean…he was fine, no need to worry.
Besides, people were in danger, people were dying and the beginnings of a cold wasn't gonna sideline him.
At least that's what he kept telling himself that first week and even into the second.
But then the little flutter in his chest turned pulsing…hacking…purging and the throat clearing now produced putrid, greenish, gooey phlegm.
Three weeks into whatever this was and Sam sounded like a steam whistle when he tried to breathe.
And breathing…breathing had become more of a job then just an involuntary, natural, body function
He was so congested that Dean went from subtle glances to hard staring, from quiet questioning to firm demands to see a doctor.
The hunt was long over; they had killed the 'swamp' monster that had been snatching folks from their beds in Honey Island, Louisiana and just like they had always done, they packed up and moved on.
On to the next thing that put innocents in danger, on to the next monster that was killing those who didn't know what was out there in the dark.
And Sam, Sam was still sick.
Earlier he had convinced himself that it was just a summer cold, maybe a sinus infection, or even the flu.
But now, sitting in an ER waiting room of some tiny town, having succumbed to his big brother's badgering, hardly able to take in a deep breath, Sam had to admit, he might be in trouble.
Three weeks earlier.
"I've never seen anything like that thing before." Dean slid into the booth across from Sam. It was early evening and the bar crowd was still kinda sparse, but Dean just wanted to celebrate a little before they hit the road for the next town, the next fugly creature.
He pushed a bottle of beer over the worn wooden surface of the booth and even though Sam took the bottle in hand, his brother didn't look too interested in actually drinking it. "I mean it was all long arms and hutched back, and the stench… Good thing you found some lure or we would be…"
"You think we can get outta here?" Sam said, finally taking a swig from his bottle, but when he put it down on the table he pushed it to the center, an offering for Dean if he wanted it. Sam wasn't one for drinking, but he also wasn't one for wasting money either.
Outta here could mean the bar or the town, but Dean suspected the latter, since the job was done and Sam was still itching to find their father, so he sighed, then nodded and said, "sure…you got an idea of which way to head?"
Sam clutched his satchel, standing, then shook his head but offered, "let's go up north…see what we can find. I read an obit about a preacher in Baltimore, might be our kinda gig."
Sometimes Sam was so transparent, Dean could shine a light right through him.
When their dad had sent the coordinances for Honey Island, Sam had used a little of his giant brain and a lot of his hacking skills to figure out which cell towers their dad had been near when he placed the text.
Dean had found the information on the laptop the other night and for a guy with such a big brain, you would think Sam would know how to erase his browsing history.
Or maybe because he was so smart and sometimes a little sneaky bastard, Sam had left it there on purpose for Dean to find. Which would mean that Sam knew that Dean checked the browsing history and that way, Dean could decide to follow the lead to find their dad and if he didn't suggest it, Sam could claim the obit was the reason for the choice of location…or maybe it was Sam's way of making Dean think it was his own idea for heading up the coast, or maybe…ah, whatever, now he was giving himself a headache.
The point was, his brother needed to be actively looking for their dad, because their dad was on the trail of the thing that killed their mother, the thing that killed Jessica.
Sam needed that hope.
So he tossed a few dollars on the table next to his empty beer bottle and grabbed up Sam's unfinished drink as he slid from the booth.
Sam rubbed his nose, trying to stifle a cough and Dean promptly put Sam's full beer back on the table.
His brother had been sniffling and coughing since they had rolled into town. Dean was hoping that his cold would be over in a day or two, but Sam never did anything by halves.
Better not chance it.
It was bad enough when one of them was sick, he couldn't chance them both being down for the count.
"So," he said, waiting for his brother to make the first move.
Sam took the hint and walked through the thickening crowd and into the early evening, not bothering to see if Dean was following, because where else would Dean be.
When Sam got to the car, he tossed his junk in the back seat, slid in and waited for Dean to get behind the wheel.
With the windows down, they peeled out of the lot and Sam said, "Let's just grab our junk and hit the road. It's too damn hot here."
Since it was getting dark, he thought they might just get some sleep, check out in the morning, but it seemed Sam was itching to go.
"Ah, come on Sammy, you're not gonna melt or anything, I think it's nice out tonight."
He waited for his brother to say something, but all he got was a roll of Sam's eyes and a sigh before Sam shifted down on his seat.
It had been hot during the days, and the old air conditioner unit at the motel was spotty at best, spitting out cool air for the most part, but if Sam really was in that big of a hurry, he guessed he could oblige.
Baltimore was a bust, on both fronts.
Now Sam sat slumped on his side of the car seat, head cradled in his arm, arm pressed against the cool window.
He didn't know if he was pissed because his dad wasn't anywhere to be found or if he was just in a foul mood because his nose wouldn't stop dripping…probably a little of both.
"We could stop and get you some…"
"No, I'm fine." Dean might have believed him if he hadn't sneezed six times in a row right after declaring he was good to go.
After spending nearly a week in Maryland, coming up with nothing, Dean got another text.
And maybe that was the real reason Sam was pissed, or moody if you believed Dean.
He felt so useless sometimes and he just wanted to talk to his dad. He wanted to know why his dad was on the run and why he wouldn't let his sons in on what he had found out.
He and Dean had talked about it and they both knew the reason for their dad's absence, even if they hadn't said it out loud.
Their dad was onto something big and damnit, Sam wanted to know what; he needed to know if the thing that killed his mom…if his dad had a lead on what killed Jess…
"How about a potty break?" Dean said, probably sensing that Sam was headed for an ugly place in his brain. "I could stand to stretch my legs."
He picked his head up off his arm and looked at his brother, ignoring the smirk that sprouted on Dean's face, probably because his hair was sticking up or something equally stupid, like saying potty break, but then it didn't take much to amuse his brother. "Stop if you need too…I'm fine."
"Sure you are, Francis."
Dean found a pull off for a gas station and Sam just realized they were on a turn pike. "Where are we?" he asked, feeling a slight tightness in his chest, trying to keep the cough in.
He didn't want a repeat of the last stop.
When they had breaked for lunch, Sam got a whiff of whatever was frying at the diner and for whatever reason the smell had hit him funny. He felt suddenly sick but when he opened his mouth to tell his brother he was going to the john, an eruption of hacking exploded from him and he had to double over to just catch his breath.
"In Ohio…" Dean slammed the car door, heading for the bathroom on the side of the building and Sam did a double take of the stick figure on the men's room door.
It had its legs crossed, fingerless hands reaching down to cover its junkless shape. If he had been feeling better he may have laughed, but laughing might set off another session of Sam trying to expel his lungs through his throat.
While Dean dilly dallied in the facilities, Sam went into the station and picked up a Snapple peach tea for himself and a bottle of Mountain Dew for Dean.
He wasn't hungry, even though it was well passed dinner, but he did grab a cellophane wrapped deli sandwich and a bag of chips for his brother.
That way they could stay on the road and maybe reach their destination by morning.
He waited briefly in line, the cashier smiled and he supposed she was pretty, but while she accepted the couple of crumpled bills from his pocket, he started to cough again and she snatched her hand away.
He tried to say he was sorry, but for a second, nothing was coming out, not even his inhalation, which just made him choke some more. Finally the air was moving in and out of his lungs again and he felt a bit nauseous when a thick wad a gunk slid back down his throat.
"Here," she said and along with his seventy-two cents change she handed him a few individually wrapped cough drops.
"Thanks," he managed, feeling more slime shift down his throat.
He wished he could have spit it out.
Better out than in, his dad used to say, which just made him think of his father and get mad all over again.
Dean was leaning against the driver's side when he got back outside.
He handed him the bag and twisted off the cap of his tea, draining most of it before he even slid into the passenger seat.
It would be his turn to drive again soon.
That was if Dean decided to give him a turn and in truth, he hoped his big brother would play the stubborn card and refuse to be relieved of the driving duties. Not that that would be fair to Dean, who had been behind the wheel for most of the last eleven hours.
Anyway, it looked like he might be spared for the time being as Dean got behind the wheel, started up the engine and pulled out into the heavy traffic.
Dean opened his sandwich one handed, "thanks." He said and finished one-half of it in two big bites. Bracing the bottle between his knees, Dean shifted the other half of ham and cheese to the hand holding the wheel and twisted off the cap to his drink, downing most of it in a few swallows.
Looked like they were both thirsty and Sam hoped he hadn't shared his bug with his brother.
The rest of the sandwich went the way of the first half and soon Dean had managed to open his chips, munching awhile before glancing Sam's way.
Feeling uncomfortable with the scrutiny, Sam asked "Where are we?" again, because even though he remembered asking, he couldn't remember the answer.
Before he had run off for his chance at a normal life, Sam had seen some of the states, some more than once, but in truth, their dad tried to stay put when he could, leaving them with Pastor Jim, Bobby or Caleb. Sometimes they would be in a town for over a year and while their dad got real work, hunting on the side and only going within a few states distance, they would stay with a sitter and when they got older, by themselves at a motel or rented house.
But in the last year or so, since he had been back with his brother, they must have criss-crossed the country at least four times.
Seen just about some part of every state and sometimes Sam thought this would be it for him.
All there would ever be to his life.
"Sammy?" Dean looked worried when Sam finally turned toward him. "You okay, you spaced out there for a minute."
"Yeah, Dean." Sam rested his head back against the glass, but it didn't seem as cool this time. "I'm fine."
They road in silence for a bit and from time to time his brother would glance his way, either to gauge how tired Sam was or to see if he had gotten sicker.
It wasn't like Dean would take, 'I'm fine', for an answer anyway.
When Sam shifted, trying to get comfortable, he spotted a bottle of Nyquil on the seat between them. How or when Dean had acquired the cold medicine, Sam didn't know.
But what he did know was that that bottle held a promise of sorts from Dean.
They were going to stop for the night and Sam was going to take his medicine like a good little boy and get some rest.
And the thing about Dean, when he made a promise, he kept it.
"Okay, I've had enough…it's time to see a doctor."
Sam didn't want to admit it, but that might just be the case.
He had just spent the last half an hour hugging the porcelain throne and the snot in his nose still ran down his throat to gag him.
They were somewhere in Missouri, cooped up in a dingy, yellowing, motel room.
Their father had been absent from the last place he had been and for the last couple of days, under the guise of doing research, they had been holed up in this depressing room.
Dean told him they needed to wait until Dad sent them someplace new and in the meantime, there was something here, dragging people off into the night, never to be seen again.
But Sam knew it was more about keeping him put then figuring out whatever was snatching folks. He had overheard a call to Jim about sending someone else to check out what was taking the towns people.
And at this point, Sam had found it a little hard to care.
For the last four days his congestion had gotten so bad he could hardly breathe, he hacked up whatever came loose in his chest and spit it out when he could, but worse yet he knew he was running a low grade fever and that meant he had an infection somewhere.
Dean seemed a little shocked when Sam agreed, but shut down the computer, stowed there stuff and walked silently behind Sam to the car.
The hospital was small and the ER was mostly empty, which was a good thing, because now Sam felt sweaty and sore and he just wanted someone to make it stop.
An older woman came to the waiting room, calling for a Daniel Jenkins.
Dean had to elbow him before he remembered that he was suppose to be Daniel Jenkins, because that's what the insurance card said.
"Here, he's here." Dean finally said when all Sam could manage was to look around the room bleary eyed and wonder where he was again.
"This way," she told them and it was a good thing Dean took over. Somehow while he was waiting, Sam had forgotten how to walk, or…something. He felt like he was a newborn colt or maybe a little drunk, but in a daze explained the sensation a little better.
He stumbled along the corridor, Dean's hand firmly under his elbow, until he reached a little curtained off room.
The nurse eyed him patiently as Dean helped him slide up and onto the exam table.
She stuck a thermometer in his mouth, telling him to hold it as she took his blood pressure. When both machines beeped, she unwrapped his arm and clicked the sheave of the thermometer into the trash.
"The doctor will be with you in a moment," she told them. "You can wait with him if you like."
For some reason Sam thought that her last statement was a little funny and even laughed out loud when he felt Dean's hand on his forehead.
"What's so funny," his brother wanted to know, but when he opened his mouth to explain, he started to cough, just little ones at first. Dean handed him a tissue from the nearby counter, because more often then not, sneezes would follow, but this time the cough got worse.
Hacking barks echoed through the little curtained off room and when he finally managed to bring something up, shaking and sweating with the effort, someone shoved a little collection cup under his chin and told him to spit.
He dropped the tissue away from his lips and spit the yellowish phlegm into the cup. When his eyes stopped watering, he could see a man dressed in scrubs cap the cup and hand it to the nurse he had seen earlier.
"I'm Doctor Abrams, Mr. Jenkins. Sounds like you're pretty congested; can you unbutton your shirt for me?"
Sam needed help with a few, but he managed to get his over shirt unbuttoned and then felt his undershirt being pushed up and something cool press into his chest. "Can you breathe in and hold it?" He did. "Okay, breathe out…good."
The stethoscope moved around his chest and then over his back as he breathed. He tried not to cough, allowing only a few aborted huffs to escape.
The doctor listened for awhile, moving the scope back to the center of his chest and then slung the scope around his neck, he pulled Sam's sleeve off his right arm, wrapping the blood pressure cuff around his bicep. After getting a reading, the doctor repeated the process with the left arm and Sam found himself shirtless.
"Just breathe as normal as you can."
Sam watched the man watching him breathe, but before he could become self conscious about sitting half naked on a table, being watched by a stranger, with his brother across the room, the doctor handed him back his shirt.
"I'd like to get a chest x-ray. Could be just bronchitis, but the x-ray will tell us more."
The doctor took some time to write some notes into what Sam thought must be his chart.
He felt, well he felt weird…not sick, really, although sometimes his stomach would roil and he was afraid he might just be sick after all, but mostly he felt strange.
That was the only way he could explain it.
"Your friend said you've been sick going on a few weeks." Sam didn't remember his brother talking to the doctor. "I'm gonna get some blood and send your sputum sample to the lab. It'll take a couple of days to get your results, but in the mean time, I'm gonna start you on these." He tore off a sheet of paper from his prescription pad and handed it to Sam. "You can fill it on your way out. Someone will come get you when imaging is ready for you and then you are free to go."
After some more notes were written, the doctor seemed to turn his attention to Dean. He had a hard time paying attention, but it seemed like the doc was telling his brother he needed to take it easy, use Tylenol for his fever and to take the meds he prescribed.
When they were alone again, Dean moved closer and sat in the chair along the counter. "Doc Abrams will look at your x-ray before you leave and will call us with the results of your lab tests. Either way he said the antibiotics should clear you right up."
Sam nodded, shifting down to wait for his turn in x-ray. Dean pulled a sheet up and over his shoulder. "Why don't you close you're eyes for a bit, Sam."
So he did, because even though he couldn't even remember if he said one word to the doctor, he knew his brother had his back.
"You're looking a little pale."
Sam still lay under the sheet, but now his gurney was in the hallway outside of x-ray. A car accident took priority over his brother, but it was a good sign that some orderlies came and collected him.
"I'm just tired…and cold." And to prove his point, Sam started to shiver under his covers.
"I know, but you're up next and then we'll get you settled back at the motel and you can sleep."
"What?" Dean moved closer to Sam. "Are you going to be sick?"
His brother shook his head, face becoming paler if that was possible and he still shivered under his covers. Whatever bug that had been dogging Sam over the last couple of weeks had finally caught up with him.
"No," Sam's teeth chattered. "Just…I'm, it's nothing…I'm okay."
Clearly Dean didn't believe his little brother, but the door to x-ray finally opened and a dude wearing pink scrubs came out and asked Sam his name. It was a miracle that Sam remembered his cover.
He was wheeled into the dark room and asked to sit up on the gurney. Sam had to take his shirt off again, shivering in a room that even Dean thought was cold. A heavy drape was laid over his lap and a collar of sorts was secured around his neck with Velcro.
"Lead shields," the tech explained to Dean. "Please step behind the divided wall with me."
Dean headed over to the other side of the room, where a large window showed what was happening on Sam's side. He could see the tech roll a machine closer to Sam and stop right in front of him. The tech used a switch to move the machine up until the top edge was level with Sam's chin and then the man pressed his hand into his brother's back, pushing him flush against the machine.
He said something to Sam and then got behind the wall with Dean. He used the controls on this side to work the machine, asking Sam to lift his right arm over his head and then his left. He went back in and reversed the machine so that it was now facing Sam's back and repeated the process.
When that was done, he pulled a large metal tray from the machine and told Sam he could get dressed.
They went out the door on the other side from where they had entered and were told to wait in a room off the hallway. A few other people were there as well, but after giving each a quick once over, Dean's attention went to Sam.
His brother sat slumped in the chair, chin nearly resting on his chest and even though he wasn't sleeping, his eyes were closed.
Within a few minutes he would be asleep, but before he could drop off, Dr. Abrams found them. "The x-rays show some abnormal densities in both lungs. I'd say you have the beginnings of Pneumonia, probably secondary to bronchitis. Take the full course of antibiotics, Tylenol for fever and aches and see your primary in a week or two for follow up. You need to rest as much as possible, but since it seems we caught it pretty early, you should make a full recovery. Do either of you have any questions?"
Dean looked to Sam, who just looked…well lost. When his eyes met the doc's again, the man said. "Pneumonia can cause extreme exhaustion and the low grade fever also can take a toll and because of that, sometimes the patient seems to be in a fugue state. He just needs plenty of rest and to take his meds and he'll be fine."
"Thanks Doc." Dean shook the doctor's hand and then attempted to get Sam on his feet.
Once they got back to the motel, Dean would ply his brother with the pills and plenty of water, and make sure he stayed in bed and rests.
Hopefully in a few days Sam will be feeling better and in a few weeks he would be back to normal. "You ready to go, Sammy?"
Sam nodded, but made no attempt to stand. Dean had to get him under the arm and pull upward. Once they were up and moving, they made it out the door and to the car with little problem.
Back at the motel, Dean helped Sam undress, not liking the hotness of his brother's skin. He got Sam settled under the covers, his pills down, a bottle of water in him next and then the lights dimmed.
Sam was out before Dean returned from his shower, so he got under his own covers, took out his phone and dialed his dad's number. He waited for the message to play, telling other's to call his son Dean if they needed help and once the recorded message ended, Dean started to talk. "Dad, it's me. I just…I just wanted you to know that Sammy is sick…he's…he's gonna be okay, but don't send us anything right now…I'm gonna hole up with Sam until he's better. Call me if you ca…" The phone beeped before he could finish, but Dean didn't care.
Either is dad would get the message or he wouldn't.
Almost a week later and Sam still wasn't feeling any better. His breathing seemed to get worse and even though he wasn't coughing as much, it seemed he would bring more phlegm up then before and now it was sorta greenish brown…but maybe that was a good thing.
He was hot, but the meds would bring his fever down soon. Dean had just plied him with his latest dose.
He really needed the bathroom, but Dean was in there doing god knows what. His brother probably thought Sam would be asleep by now, since that was all he had been doing lately, but for whatever reason, he felt restless, achy and his back was hurting him.
He'd only been out of bed to use the john and to take quick sink baths because he still felt so weak and all his joints felt stiff from lack of use. His head pounded too, in tune with his heartbeat, which seemed a little fast, but it was hard to judge.
Finally the shower came on, so maybe Dean was wrapping things up in there.
He decided to try to sit up some more, because it suddenly seemed harder to breathe. The more vertical he got, the dizzier he got, but he managed to push up against the headboard and rest against the pillows pilled behind him.
He expected to be breathing better, but a peculiar flush of sweat overcame him. His heart beat harder and his chest felt tight, like someone was squeezing his ribs on the right side.
Beads of sweat peppered his hairline and upper lip as he tried to breathe in.
He shifted, trying to keep the panic at bay.
The shower turned off in the bathroom.
He turned toward the door separating the two rooms, expecting it to open.
Seconds ticked by.
Nobody was coming to help him.
He felt like he was drowning.
Black dots danced across his vision.
Someone slapped him hard across the face and a tiny bit of oxygen leaked from his lungs.
He was able to pull in a shuddering gasp.
Even though darkness crept on the outer edge of his sight, he could make out Dean above him, leaning over him, speaking frantically into his cell phone.
He was being pulled from the bed.
Laid down on the hard floor.
Dean kneeled by him, pressing his ear to Sam's chest, then shaking his head to whatever was being told him from the over end of the phone line, and then he was up and running to the door.
Dean was leaving him.
Sam was dying.
He closed his eyes to wait.
Hands slap at his face again and this time when he opened them, sound came rushing back.
"Sammy!" his brother screamed. "Don't you do this…don't you dare. I'm trying."
And Sam realized that last part was meant for the person on the phone line.
"God damnit…please hurry….yes, yes…I understand." Dean had a bottle of water. He twisted off the cap and upended the bottle, spilling out some of the liquid. Sam could feel the wetness seep into his thigh and then he saw a long tube that Dean was shoving in the water left in the bottle. "I'm sorry, Sammy…I'm sorry."
And then Sam understood.
He knew what his brother was about to do.
He tried to move, to roll away, but Dean held him tight, sitting on his pelvis, tangling their legs, pleading for him to, "hold still, please Sammy, hold still."
He had heard his father tell the story just as much as Dean had and he knew what was coming next.
He couldn't breathe, but still he tried to squirm out of his brother's grip.
Dean pulled at Sam's night shirt, ripping it at the collar and down the front, tossing the pieces aside.
"Yes, I have too" Dean said, tossing the phone.
Sam rolled his head from side to side since he couldn't move his body.
"It's okay, Sammy…look at me…You're gonna be okay."
Something cold and wet ran along the side of his rib cage as he met his brother's eyes.
"You have to trust me here, Sammy."
He nodded or at least he thought he did and then all he felt was burning hot pain lance across and through his chest.
His skin was being cut.
One of Dean's knives was carving a hole through the muscle between two of his ribs.
His eyes slammed shut.
His body flushed hot and then cold.
His fingers dug into the short fibers of the carpet.
Hot, sticky blood oozed from the wound.
Tears ran freely down his face.
His mouth opened and he gasped.
He could breathe!
"I'm so sorry, Sammy…please, it's okay…they'll be here soon." Dean's voice was horse and Sam realized he most have been saying those words over and over again.
His brother slid off of him.
When Sam dared to open his eyes again, Dean turned away, wiping his hands on a dirty tee shirt then using his stained fingers to wipe at his eyes.
He pulled some tape from their first aid box and secured the tube to Sam's chest.
He wanted to ask were the tube came from, but then Dean told him.
"Only one ambulance and they had a call for a heart attack across town, but the operated said they are on their way…ten minutes out. So hang in there, Sammy. You're gonna be fine now."
He nodded, because his throat was on fire and Sam didn't think he could speak right now anyway.
"They told me to listen to your chest. They said you might have a collapsed lung and I thought…well you know the story dad used to tell about his buddy. How he learned about negative pressure just a few days before he needed to use it to save the guys life.
I told them I could do it…I don't think she knew what to say about it, but I had to do something…I cleaned you up as best as I could and the wiper fluid line too…I flushed it out with alcohol and got a water bottle since I didn't have a canteen handy." Dean tried to smile a little.
In the distance they could both hear the sirens.
Sam's eyes rolled up and he passed out before the cavalry could get there.
Dean paced outside the ER in the small waiting room.
Dr. Abrams had been out once to say that they were trying to stabilize his brother and that he had probably saved Sam's life with his quick thinking.
The paramedics didn't know what to make of the wiper fluid tube inserted into their patient's lung, or the bottle of water that the other end of the tube was immersed in, but they left it in place and when Sam reached the ER the tube was replaced with a real chest tube.
Sam's right lung had collapsed and the new x-rays showed his pneumonia was getting worse.
The doctors told Dean they were running more test, to look at Sam's kidney and liver function and that a rush had been put on the results for Sam's blood work and sputum.
But Dean didn't know what all that meant.
He just wanted to know what was wrong with his brother.
The doctor motioned for him to follow, so Dean slipped through the Personnel Only door and followed the doc down the hallway.
"We've moved your friend to the ICU."
Dean stopped in his tracks and when Dr. Abrams notice he came back down the hall a few steps. "He's stable. You did a good job of reinflating his lung and we cleaned the wound. Hopefully the antibiotics will stave off any additional infection."
Dean started walking again. When they reached the elevator, Dr. Abrams pressed the button for the second floor. "I wanted to warn you that we put Mr. Jenkins on a respirator as a precaution. We needed to establish as airway and in this way we can give his lungs a break while we wait for the test results."
When they disembarked on the second floor, the doctor turned right and Dean followed along the hallway and too a locked door. The doctor used his ID to open the door and once they passed the nurses station, they came to a large window overlooking a patient's room.
Sam laid on the bed, pale as death, a ridged tube protruding from his throat, his chest rising and falling in an artificial rhythm.
Dean needed to look away. And he wanted to know, "but it is pneumonia, right? I mean, why did you order the tests on his liver and kidney if it's his lungs?"
"He definitely has pneumonia, but sometimes that is a result of an underlining condition. His blood results showed a modest increase in his white blood cells, a mild abnormality in his liver function, and a slight decrease in his kidney function. We're monitoring his output so we can keep an eye on his kidneys. His urinalysis showed identifiable proteins of Legionella antigens."
Lega whata? That word sounded familiar. "What is Legion…"
"It's a bacterium. Most people call it Legionnaires."
Dean knew that word and if he remembered correctly, it was very deadly. "But…"
"It's too soon to know for sure. For now, he's holding his own. Even if it is confirmed, he's young, and was in good health. We've been treating him with broad spectrum antibiotics, but since he most likely has this bacterium, I'm starting him on Cipro."
Dean was going to be sick…or maybe pass out. How in the hell could Sammy have gotten Legionnaires Disease?
"You can sit with him…is there any family…"
"No…I'm all he has. Doc you said most likely, does that mean he might not have it?" Dean looked back beyond the glass and into the room at his brother. "What if it's something different?"
"There is no definitive test that will give us an immediate answer. When the culture is ready, we'll know more, but even if it's some other bacterium, this treatment plan is the best course of action." The doctor looked in on Sam now too. "The nurses will be monitoring him remotely and well be by to check in on him every twenty minutes or so. Since you are his only family, you can stay for fifteen minutes every hour and you will need to wear gloves, mask and a gown."
"I understand…thank you for helping my, for helping Daniel."
The doctor shook his hand and then went back down the hallway the way he came. Once Dean was alone the nurse from the station approached him with a yellow gown like the ones he'd seen TV doctors wear.
She was young, but not too young, reddish brown hair pulled into a ponytail and a splash of freckles across her nose and cheeks.
"I'm Corina and I'll be taking care of your friend for the rest of the night. Would you like to sit with him now?"
Dean nodded, only half listening to her prattle on about picking up a gown at the nurses station before each visit and were to dispose of it once he was done. She showed him an alcove that had boxes of rubber gloves and face masks and they washed their hands before she helped him tie the gown. She snapped on her gloves first and then tied the mask over her nose and mouth.
Dean did the same.
"I'm just gonna look him over and then you can sit and talk with him." Dean followed her through the sliding glass door. "He's been given a sedative to help him rest and stay calm, but he may be able to hear us and it helps to have someone familiar near."
He watched as she looked at all the machines his brother was hooked up too, appreciative when she spoke to Sam before touching him, telling him what she was doing.
She checked the new tube that was sticking from Sam's right side and the IV line that attached to both arms. "I know this seems scary, but all this," she said, nodded toward the machinery. "All this is here to help him. This one," she pointed to the largest machine to the left of Sam's bed, "monitors his heart rate, blood pressure, oxygen levels and these leads." She showed Dean the leads on Sam's chest and a thingy on one of his fingers, the cuff around his left arm that was inflating even as they spoke. "They connect to the machine that sends all the information it collects to the nurse's station, so we are in constant contact with his vitals. And this one is helping him breathe."
Dean could have figured that one out on his own.
She moved to the bottom of the bed and checked a bag hanging from the rail. "I guess Dr. Abrams told you we are monitoring his urine output, so he has a catheter for now. It'll come out when he's a little more lucid. We don't want to cause a secondary infection, so once he's off sedation he can use the bed pan."
"Right," Dean said, because number one, he got it and B, he just wanted her to leave already. "Um…thank you, thanks for taking good care of him."
She smiled sweetly, but Dean dismissed her by sinking into the chair to Sam's left. When he heard the door sliding shut, he reached forward and touched Sam's arm while calling his name. "Sammy? I'm here, man. You heard the lady, you're gonna be fine, so just rest. I'm gonna stay with you, okay. You don't need to worry, just concentrate on getting better, ya hear Sammy…get better."
Sam heard people talking, sometime around him, sometimes to him.
He knew when a nurse was in the room and he knew when it was his brother calling his name and holding his hand.
Right now, he was feeling good.
Floating on a cloud.
Wrapped in soft cotton and down.
Dean had his hand, was using his fingers to rub soothing circles into the skin around his knuckles and wrist.
A small cough escaped and he remembered his pneumonia, remembered the feeling of not being able to breathe.
A tickle at his throat made him cough again and now he could hear voices, people in the room with his brother.
Dean was saying, "it's okay…it's helping you breathe…don't fight it."
And then his eyes popped open.
"There he is," a new but somewhat familiar voice said and Sam moved his eyes to the left. Dean was standing over him, smiling down at him, looking relieved.
"His been tripping the monitor all morning, I think we can take it out." When he rolled his eyes to the right he saw the doctor from the ER and a nurse he didn't know. "Go ahead and disconnect it…Dan? Can you hear me? Squeeze my hand if you can hear me." The doctor picked up his right hand and he squeezed it as best he could. "That's good. You've been sick, but you're gonna be fine. A machine has been helping you breathe, do you understand?" He squeezed the doctor's hand again, feeling a little strength coming back to his fingers. "You don't need it, so we are going to take the tube out of you throat. Squeeze my hand if you understand."
Sam did, shooting a worried look the other way towards his brother, getting a squeeze to his left hand. "It's fine…don't worry."
"You're gonna feel some pressure. Take a deep breath and then blow it out. You ready?"
He managed a little nod, taking in a lungful of air, relieved when he was able, but hacking as soon as the tube cleared the back of his throat. The nurse mopped up the drool that came out with the tube and then pressed a straw to his parched lips. "Take little sips."
The water was the best thing he had ever tasted.
"Thank you," he rasped, coughing a little more, but quickly got that under control. She put a pronged tube under his nose and in his nostrils, making breathing a little easier. He expected it to hurt more to take in a full breath, but mostly his side was sore and his joints ached.
"You're in the ICU, but you've been improving over the last week."
He shot Dean another questioning look and his brother patted his shoulder.
"We're gonna keep you here another day or so and then ship you over to the ward and a more private room."
When the doctor said private, Sam scanned the room he was in, noting the glass walls and doors. "I…"
"Save your voice…you're throats gonna be sore for a couple of days because of the vent. Corina is going to check you vitals and see what we can disconnect you from. I'll be back to see you in a bit."
Sam nodded, eyes drooping, but opening again when he felt Dean squeeze his hand. His brother leaned over the bed, putting his mouth close to Sam's ear. "Listen Sammy, I'm gonna go down to the cafeteria for a few, let the nurse get done what she needs to and be back soon. You gonna be ok for a few minutes?"
He wanted Dean to stay, but understood that whatever she might be disconnecting him from might be embarrassing now that he was fully awake and appreciated the fact that Dean was willing to spare him that.
It didn't take too long for her to move the respirator out to the hall, unclip the thing from his finger and check some sutures he had on his right side. She unhooked the collection bag from the bottom of the bed and told him she was going to remove the catheter.
He nodded, opting not to watch as she rearranged his sheets and untapped a tube from his leg. He expected it to hurt more when she pulled the tube from his body, but did get a little panicked when she sat a hand held urinal on the tray table in front of him.
"I know you don't like the idea, but you're still pretty weak and you will need to stay in bed for a few more days. I can put it under the sheet and you can leave it where you need it if you want."
He thought about it for a second or two and then nodded. What he didn't want or need was Dean's help when he did need to use it.
"Depending on how you're feeling, the doctor might start you on solids in the morning. We need to get your digestive system moving."
Dean knocked on the glass door before entering. "All done, Corina?"
"Just about," she moved to a closet along the far wall and a pulled out some contraption with a tube and three chambers, each one holding golf sized, pink balls. After unwrapping it she explained its function and how Sam needed to use it at least ten times a day. He had to put the tube in his mouth and breathe in, trying to keep all three balls above a top line on the cylinder. She made him give it a try and he could barely get them above the lowest. "It'll take some time to get your lung capacity back, but just keep working on it."
After she was gone, Dean sunk into the chair by his bed. He looked tired, but the worry lines around his eyes weren't as bad.
That must mean that Sam really was going to be okay.
Dean looked at him for a good three minutes before he shifted forward in his seat. He started to tell Sam what had happened since Dean had to carve up his side and Sam almost couldn't believe it.
"Legionnaires? They're sure?"
Dean nodded, "took awhile, but your culture came back positive."
"But how…I mean when would I have been exposed and why didn't you get sick too?"
"I told Dr. Abrams you started going down hill once we hit Honey Island. He did a little digging and found they had a mini outbreak. It seems the motel and the shared diner we were staying at had some stagnant water in their air conditioning unit. One known way the bacteria spreads is by inhaling the mist that the units shoot out.
Could be an infected person stayed at some point, or ate at the diner and caused the contamination, but no one really knows. Plus your bed was closer to the unit and I spent less time in the room and remember, you went to the diner because the internet signal was stronger."
Sam nodded, listening, but having a hard time keeping his eyes open.
"Go to sleep, Sammy. The doc says you'll probably need to sleep a lot for a little while."
Before Dean finished his sentence, Sam was out.
On his forth day out of the ICU and into a regular room, the doctor brought some good news. "I think we can spring you a little later today."
Sam was still sore, still achy, still very tired, but he was getting better, he was feeling a little more like himself.
He could inhale, using the tester and keep all the balls afloat near the required line for a few seconds.
He was eating, well picking mostly, but his bowels were back online.
He got out of his bed a few times a day to walk the corridors and even though he needed a nap when he got back, he was starting to feel stronger.
"We need to get a blood gas and maybe run a few more tests, but your latest sputum culture came back clear."
Dean came in just as Dr. Abrams was finishing up Sam's last exam. He smiled when Sam delivered the news, but the smile didn't reach his brother's eyes.
They watched a movie for awhile, Dean had found a Mummy marathon and they caught the end of the original one and Sam managed to stay awake through the first little bit of the second.
At lunch, someone brought a tray and sat it on Sam's rolling table.
"Sammy, grubs here." Dean called, but Sam didn't even twitch.
His breathing was steady and even, but Dean could still hear some congestion in Sam's lungs, or maybe he just thought he did.
He'd come so close to losing him, to damn close.
Dean reached forward and put his palm on Sam's forehead, feeling the cool skin and reassured himself that Sam was fine, the fever was gone and they had dodged another bullet.
Earlier in the hall, when Dean excused himself to give Sam some privacy, Doc Abrams had told him it could be upwards of six months before Sam was feeling as good as before this all happened.
Six months…well, they could use a break.
Dean's phone chirped and he opened the text.
From his dad…a set of coordinance.
"That dad?" Sam asked, shifting over to his side and wiping at his eyes.
"No," Dean lied. "Just some girl I met awhile back….go back to sleep, Sammy."
"I'm not tired," Sam tried out a lie of his own, but looked away when Dean clearly was not buying it. "Okay, I'm tired of being tired."
"I know, man…but it'll get better."
A knock on the door signaled the end of the girly show of feelings and a nurse Dean hadn't seen before came in rolling a cart. She looked at her papers, then up at Sam. "Mr. Jenkins, I'm here to get some blood and do a blood gas."
Out of everything that had been done to him over the last few weeks, that procedure was the thing that Sam dreaded most.
Hell, if that was the worse of it, then Sam came out of this better than he would have. He was still having nightmares of cutting Sam open so his brother could breathe.
Sam watched as the tech laid out numerous tubes, lining them up neatly on the bed along his side. She opened some gauze and pulled off a few strips of tape, sticking the tips on her cart. "Okay, just a standard draw and then we'll get the blood gas."
Sam held out his arm for her, turning his head to look at the TV.
She tightened a rubber tourniquet around Sam's bicep, signaling the coming needle. "Make a fist." And Sam did, making a face when he felt the needle prick and pierce his skin and then the pressure around his upper arm released. "Relax your hand."
Dean watched as she moved around, pulling one tube away to be replaced with another, watched as Sam darted a quick look toward his arm, and the dark red slowly filling the tube.
It was strange, because Sam could take the sight of blood, even his own. It was just something about needles and little tubes that wierded his brother out.
When the last tube was filled, she pulled the needle from Sam's inner elbow, pressing gauze against the tiny puncture to stanch the blood welling up there.
Once the tiny round bandage was placed, she asked Sam to put the head of the bed up. Dean jumped up to help, knowing that this was really the part Sam didn't want to have anything to do with.
Once he was more upright she pulled out a sheet of paper and set a form in front of him on the tray table, handing him a pen to sign his consent.
He read over the paper, possibly a stall tactic, before signing on the signature line.
The tech took his arm in her hand, rubbing her gloved fingers down to his wrist and back to his elbow. "It might be a little bit uncomfortable. We need an arterial sample to check how your body is oxygenating."
Sam nodded again, already knowing the why.
She held a slightly bigger needle, the sight of it making Dean a little queasy. He had missed the last few tests like this because he was usually out of the ICU when they did any procedures on his brother.
The tech tapped her fingertips around Sam's lower arm again, just above his wrist.
"Just relax, it's going to sting." She pushed the needle in, slightly to the right, bending Sam's hand back to expose the arterial vein; the bright red blood slowly filled the vacuum tube. Another one took its place and then she quickly pulled the needle from Sam's wrist, catching the flow of blood that dribbled down his palm and between his fingers.
The tubes were placed in a cooling box with one hand, while the other continued to press the puncture site.
Sam looked a little green, but seemed relieved that this part was over and it was one more step toward freedom.
The tech stayed another few minutes, keeping a firm hand over Sam's puncture, and then wrapping his whole wrist tightly in a blue pressure bandage. She instructed him to leave it in place until the next morning.
When they were alone again, Sam tried to brooch the subject of the text, but Dean shut him down.
"I don't want you to worry about it, okay. We're taking some time off. If Dad finds a hunt, he can pass it along to someone else…you need you're rest, to get back you're strength and those things out there, Sam. They'll always be around…"
Dean couldn't decipher the look on Sam's face, but it didn't matter. As far as he was concerned the subject was closed. If they hadn't been following one of Dad's leads, Sam would have never gotten sick. If Dean had been sleeping closer to the air conditioning unit, this would have never happened.
"You know," Sam said. "This isn't dad's fault and it isn't yours either. It was just a fluke, it could have happened to anyone."
He knew Sam was right, but that didn't change a thing. Fluke or not, it was and always will be Dean's job to protect his little brother…whether said brother liked it or not.
"So," he changed the subject, because even though Dean knew there was no way to protect Sam from every freak or fluke out there, he sure as hell was gonna try.