WARNING: Although I'm not a medical professional and I do not have paraplegia (nor am I a guy), this story is, I hope, a realistic portrayal of what it's like to be a male with an SCI (spinal cord injury), and nothing is sugarcoated. There are detailed, sometimes crude, descriptions and references to bodily functions in this fic. I debated on whether I should give this an M rating, but after skimming over other stories with that rating, this one seemed tame by comparison. However, depending on feedback I get (if any), I will change the rating if a lot of you think I should. The "F" word and other bad language is also in this fic.
Author's note: This is set sometime in Season 2. It is pretty much AU. John was killed when the Impala was hit by the semi. There was no deal with the demon to save Dean's life. He just healed through modern medicine and is fine.
A/N 2: As I said, I'm not a medical professional, so I apologize for any inaccuracies. Please know, also, that I read a lot of personal accounts of men with SCI, and a lot of what Sam experiences is based on those accounts. I have nothing but the utmost respect for these awesome guys, and no offense was intended in the writing of this story.
A/N 3: Last but not least, this is not my first fan fic, and I don't have a beta. Please forgive any proofing mistakes or typos. Also, if you end up liking this story, I now have a sequel posted called "Rocket Science."
Sam was lying almost flat on his back, plastic oxygen cannula in his nose, and he was hooked up to IVs and wires that lead to various bags of fluid and monitors. He felt groggy and sluggish. He had been told they would have to work on inclining his bed a few degrees at intervals because sitting him up too quickly would cause him to pass out. He'd been in and out of consciousness for a couple of days following his surgery, but today he'd been more aware of his surroundings—too aware. He wanted to fall back into oblivion and never come back. He knew what was coming, and he didn't want to face it.
It was supposed to have been a relatively simple job, a haunting, an easy salt-and-burn. What they hadn't counted on was the poltergeist—the poltergeist that thought it was fun to throw professional-grade kitchen knives at them. Sam and Dean had been running to get out of the house, but before Sam could make it to the door, he felt the sharp, white-hot pain of a knife penetrating his back, a direct hit to his spine. He felt his ability to feel and move the lower half of his body drain from him, as if draining away through the hole the knife had created in his back, replaced by a terrible cold, and then nothing. The next thing he'd remembered was waking up in recovery from surgery and feeling the strange, terrifying sensation that half his body was missing.
Dean was standing next to Sam's bed now, his hand on Sam's shoulder. It was meant to be a comforting gesture, a show of support.
Dr. Longwell, Sam's neurosurgeon, stood on the other side of the bed opposite Dean so Sam could see him. The stocky, fortyish man in hospital-green scrubs and a white coat cleared his throat, his grave demeanor clearly giving off the vibe that he'd rather be anywhere than where he was standing at that moment. "You seem more cognizant today, Sam. Do you feel like talking about the results of your surgery?"
Sam felt Dean squeeze his shoulder, and Sam blinked slowly and nodded, although he didn't really want to hear.
"We stopped the bleeding, and everything looks good on that score. There were no broken vertebrae, so there was no need for any orthopedic intervention, such as rods or screws, which should make your time in this hospital and hopefully rehab much less. There should also be less pain." He paused and sighed deeply before continuing. "I'm sorry, Sam, but the spinal cord itself was completely severed."
Sam had known it was coming, but it didn't keep his heart from plummeting to his stomach. Tears burned his eyes, and he fought them by staring at the ceiling, unable to look at Dean or the surgeon.
Dean was silent too, but his grip on Sam's shoulder had tightened to where it was almost painful.
"Contrary to what most people believe, a truly severed spinal cord is very rare. Usually, the only things that can penetrate the tough dura protecting the spinal cord are bullets or a knife. The knife that penetrated your back cut your spinal cord so perfectly it was almost surgical in nature. I've never seen anything like it." He paused, and his manner was grim. "I'm sorry, Sam, but there's not much hope I can offer. Based on the degree of movement and sensation you've exhibited thus far, it looks like you have complete paraplegia at the T10 level.
Even though Sam had expected it, it still felt like the doctor had to be talking to someone else. This couldn't be happening. It hadn't been him in that house getting stabbed in the back by a fucking ghost. It was some bad movie he'd been watching or some horrible nightmare, or maybe the painkillers were causing him to hallucinate. That fucking surgeon hadn't just told him there was no hope, hadn't just told him his spine had been cut, hadn't just implied that he would never walk again.
It couldn't be real. He was only twenty-three years old, and his life was over.
Dean's voice was heavy and gruff when he said, "That level—" He faltered and cleared his throat. "What does 'T10' mean?"
It means I can't feel or move a fucking thing from the waist down, Sam thought angrily, still staring at the ceiling. He felt his throat thicken and a rush of warmth suffuse his body—at least the part he could feel—and he clenched his fists so his hands wouldn't shake. He could hear the heart-rate monitor beep faster as his pulse began to hammer.
Dean seemed to realize he had a death grip on Sam's shoulder, and he loosened it and began to rub gently in reaction to the rapid beeping of the monitor. "Easy, Sammy. It's gonna be okay."
Sam fought back another rush of tears.
"T10 is at the level of the umbilicus or navel," explained Dr. Longwell, looking even more uncomfortable than he had in the beginning. "It means that below that level of the thoracic spine, there is no, uh, sensation or function. I'm sorry, but it means that in addition to complete paralysis of the legs, there will most likely be no control over the bladder or bowel, and," he cleared his throat nervously, "sexual function to any degree is also highly unlikely but not completely impossible. However," he quickly added, "the injury is low enough that Sam will have most of the function of his abdominal muscles, which will aid tremendously in trunk control and balance. He will most likely be able to sit up without aid."
Dean was silent.
Wow, I'll never have sex again, but I'll be able to fucking sit up! Sam might have laughed at the incongruity of the words if they hadn't been so utterly devastating. Instead, he wanted to die. Half of him was already dead, was just dead weight anchoring him to earth. He was half a man.
"Some patients with that level of injury are able to stand and walk with the aid of leg braces and a walker or crutches. It probably wouldn't be the preferred method for getting around in day-to-day activities, but it would be a good way to exercise and stretch out your muscles and skeleton, if you are able."
A long, uneasy quiet settled over the room until Dr. Longwell finally cleared his throat again and said, "Well, if there are no more questions for now, I will let you two, uh, have some time to, uh, maybe discuss this." He gave Sam's forearm an apologetic squeeze and left Sam's line of sight, his footsteps receding quickly out the door of Sam's ICU room.
Dean sank down into the faux leather chair next to Sam's bed that had been Dean's home for the last three and a half days.
Sam couldn't look at him, didn't want to see the pity and sorrow that he knew was on his brother's face, so he continued to stare at the ceiling. The patterns on the acoustic tiles were becoming etched in his mind, and he willed himself to stay in control, to take it like a man.
Then he remembered he wasn't a man anymore, was only half a human, and he was overcome with humiliation and grief. He closed his eyes, refusing yet again to cry. It was all he had left, all he could control, and he'd be damned if he'd let a single fucking tear fall, despite the huge mountain of a lump that threatened to close off his throat from air.
He heard Dean say, "It'll be okay, Sammy. We'll figure this out." There was a hesitation, and then he said, "I'm gonna call Bobby."
Sam forced himself to look at Dean, willing his voice to push through his narrowed throat. "No. I don't want you to call Bobby."
"Sam, he would want to help. He—"
"I said no. I don't want him here."
Dean was silent for a moment, and then he sighed and squeezed Sam's forearm. "They don't know what we know. It's gonna be okay."
Sam slowly closed his eyes and turned his head away. Fuck off, Dean. Nothing would ever be okay again.
Six weeks later, Philips Rehabilitaiton Center, Des Moines, Iowa
Sam was sitting in his new titanium wheelchair, one custom made for his height and needs. He'd had it for a week, and it was now the most important thing in his life. It was his means to do just about everything from now on, and he should be grateful to have it, should force himself to get used to it, but he couldn't. He hated it, despised it, and when he was in it, he felt claustrophobic. It didn't give him a sense of independence or freedom. It made him a prisoner. Of course, he hadn't told anyone how he felt. He never told anyone anything. He talked enough to get him through the day and no more.
His psychiatrist, Dr. Logan, had voiced her fears that he was severely depressed and threatened to put him on an antidepressant. He already took pain meds for the phantom burning sensation he sometimes felt in his legs and medication to prevent his legs from spasming, so what was one more drug? Maybe it would make him feel nothing. At least that would be better than this black hole of anger and despair that he just kept spiraling down into.
So far, though, Dr. Logan hadn't acted on her threat. She just kept trying to get him to share, to talk to other patients at the center who knew what he was going through.
As far as Sam was concerned, though, there was nothing anyone could say that would make his current situation any better, and he didn't want to hear it. He wanted to finish the rest of his rehab and get the hell out. He still had six more weeks to go, and the thought just sent him further into depression.
Jake, his occupational therapist, was sitting at the little table in Sam's room at the rehab center across from Sam, and Dean was in between them, sitting in the extra chair. They had been discussing some of the bathroom modifications Sam would need, and Jake was providing them with a packet on how and where to make the adjustments. "You will need a shower chair," Jake was saying, "and the type will depend ultimately on where you end up living and the type of tub or shower it has."
"We're going to live at our friend Bobby's in South Dakota," Dean informed him.
Sam looked at Dean in surprise, which quickly morphed into anger.
"Don't look at me like that, Sammy. Bobby offered, and it's the best solution for right now. He's gonna make some modifications to his house so it will be easier for you to move around."
"Sam, let's just wait until Jake is finished, and then we can talk about it."
"I said no. I'm not going to live there."
Dean drew his brows into a vee. "All right. You got a better suggestion?"
"Good accessibility and good weather. Easier for me to get around and regulate my body temperature."
"Yeah. It's also in California, one of the most expensive places to live in the U.S."
Sam shrugged. "It's where I'm going to live, Dean. If you don't like it, don't go."
Dean looked hurt for a split second before he could hide it, and in the days before his injury, Sam might have felt guilty for what he'd just said. But, now, he just didn't care. His compassion had been numbed along with the lower half of his body. The only thing he could feel was rage and resentment—resentment for anyone with two working legs, and that included his brother.
Dean stared at Sam, so many things he wanted to say written on his face.
But Sam knew he wouldn't say them. Dean handled him with kid gloves, now. The Dean that used to never pass up an opportunity to joke around with Sam and tease him was gone. There was nothing to laugh about anymore, nothing funny about your little brother being a paraplegic for life, and Sam took advantage of it. Dean would go to San Diego without another word. It's what poor, crippled Sam wanted. And if, by some remote chance Sam was wrong, it didn't matter. He would go to San Diego with or without Dean.
Jake cleared his throat, clearly uneasy at the tension between the two brothers. "Maybe we should cover the rest of this another time."
"It's fine," said Sam in a flat, detached tone. "Go ahead."
Jake looked even more uncomfortable. "It's just that, um, we need to talk about your bladder and bowel management programs now that you're out of the spinal shock phase. As you know, for your bladder program right now you have an indwelling catheter and leg bag, but your doctor, your physical therapist, and I think you're ready to choose a better solution."
Sam suddenly felt sick to his stomach. Anything to do with his catheter had been taken care of by nurses until now, and Sam had stared at the ceiling, a common habit of his these days, whenever they had dealt with it. He had always pretended that he was somewhere else, that what they were doing was being done to someone else, but Jake's words were a hard slap in the face. Sam closed his eyes and swallowed hard, forcing bile back down his throat. Taking a deep breath and clenching his jaw, he said, "I don't want to discuss this in front of Dean."
Dean slumped a bit, that same look of sorrow crossing his face that Sam hated.
Fuck off, Dean. I don't want your pity.
Dean rose from his chair and squeezed Sam's shoulder.
"I'm gonna go get some coffee. I'll be back in a little while.
Once Dean was gone, Jake cleared his throat. "Okay, Sam. With your type of bladder dysfunction, there are three types of bladder management methods—indwelling cath with leg bag, which is, as I said, what you currently have; external or condom catheter, which also includes using a leg bag; and CISC, or clean intermittent self-catheterization, which involves emptying your bladder with a temporary catheter every four to six hours, depending on your bladder capacity and fluid intake. The consensus is that CISC would be the best choice for you, as it is for most paraplegics, and we think you should see how that works for you before trying the condom cath. We don't recommend sticking with the indwelling cath, since urinary tract infections are more common with that method."
This isn't real. I can't be having this conversation. When am I going to wake up from this nightmare?
"With CISC," Jake went on, "there is less chance of contracting a urinary tract infection, and it prevents the bladder from becoming overfilled and losing its muscle tone. It allows the bladder to be fully emptied, preventing the problem of residual urine backed up in the bladder, which could cause a bladder infection. Most importantly, it is the method that is most like normal voiding, and you don't have to deal with collection bags. You can just empty directly into a toilet."
Jake continued to explain, showing Sam a diagram of how to do the procedure, but Sam could barely hear him. There was a sort of buzzing sound in his ears, and he felt as if the blood was draining from his head. He had ignored it before, had let nurses take care of everything, had been in denial; but the stark, humiliating reality that he was incontinent, that he couldn't even piss or take a crap anymore without "managing it," had just suddenly made itself known with a vengeance.
He couldn't live like this. The nightmare was getting worse with each passing day. It was even harder knowing there was no hope. Other patients at the rehab center, even those diagnosed with complete injuries, still had hope that maybe their doctors were wrong or maybe there would be a miracle cure. None of them had completely severed spinal cords except Sam. Dr. Longwell had told Sam later on that he hadn't even been able to see one of the ends of Sam's spinal cord. There was no one-in-a-billion chance that it could ever be sewn back together or that some breakthrough in research might help him. He had nothing to reach for, to dream about. He would be like this forever, no matter what, unless he could find something supernatural to cure him.
He knew that Dean and Bobby had been looking for some supernatural solution for the past six weeks, and they had found nothing, except, of course, making a deal with a demon or selling his soul. At first, even Sam hadn't considered those options, but, lately, especially after sessions like this one with Jake, Sam had begun to reconsider. He was already living in hell here on Earth. Why not sell his soul for at least a few years of being whole before he was eternally damned?
He would give it a little more time. Maybe Dean and Bobby or Sam himself would be able to find a better choice. But if they didn't, he was going to do something to get himself out of this fucking wheelchair, no matter what it took.
Six and a half months later, San Diego, California
"Sam?" said Dean with a scowl as he walked out of the kitchen of their apartment in San Diego, holding a pair of Sam's boxers and oversized jeans in his hand that Sam had worn yesterday. Dean had been in the utility nook off the kitchen doing his and Sam's laundry.
Sam was sitting in the living room on the black-vinyl sofa they'd bought at the local Salvation Army, staring at some idiotic reality show on TV that he wasn't really interested in, but he had nothing better to do. He was, of course, capable of helping Dean with the laundry, but Dean never asked for his help, and Sam wasn't going to offer. Dean felt sorry for him, and Sam hated him for it, and he got a perverse pleasure out of taking advantage of Dean's pity. Dean waited on Sam hand and foot, and Sam let him.
"There's a stain on these," said Dean, holding up the offending articles of clothing. "A lot of it. You been checking your skin like you're supposed to?"
"Yeah," Sam lied, and looked back to the TV, feeling a sinking feeling in the pit of his stomach.
Sam had to wear his pants loose, usually a size larger than what he actually needed, in order to avoid rubbing his skin and causing a breakdown. Because he was in one position sitting in his wheelchair most of the time—or always sitting somewhere—he was supposed to be vigilant about looking at his skin on the lower half of his body for pressure ulcers, but he hadn't done it in a while. He hated looking at his already-shrinking buttocks and legs, hated taking a mirror and forcing himself to look at the parts of his body that he couldn't move or feel.
"You sure you been checking?"
Sam's jaw tightened. "Yes."
Dean came over to the sofa and sat down next to Sam, laying the boxers and jeans on the coffee table. Leaning forward and resting his elbows on his knees, he said in a quiet voice, "Let me see."
"Fuck you," said Sam without ever looking away from the TV.
Dean exhaled a deep breath. "You can cooperate with me, Sam, and this can be done quickly, or we can do it the hard way, and I can kick your ass first. Either way, I'm gonna take a look."
"Go ahead and kick my ass, Dean. I won't feel it."
There was a beat of silence, and then Dean said, "Dammit, Sam! This could be serious. If you've got a pressure sore, it needs to be taken care of as soon as possible. You know that. They drilled that into both our heads at rehab."
Sam didn't answer. Truth be told, the thought that he might have a pressure sore scared the shit out of him, but he wasn't going to let Dean look him over like he was some helpless invalid. The thought of Dean seeing the dead half of his body was mortifying.
Dean reached over and put a hand on Sam's forehead.
Sam leaned out of his reach, batting his hand away. "Don't touch me."
"You've got a fever. I can feel it. If you won't let me check it out, Sam, then go look for yourself. You can't ignore this."
Sam would never admit it, but he knew Dean was right. He gave an annoyed sigh and slammed the remote down between him and Dean on the sofa. With little effort, he pulled his butt forward on the sofa, fisted a hand on the sofa and grabbed the frame of his wheelchair with the other, and transferred himself to the seat of it. He then lifted his legs one at a time and positioned his feet on the footplate. The maneuver was second nature to him now, and that thought made him even angrier. He didn't want to adjust to this life, didn't want to accept it.
Without another word, he wheeled himself to his specially modified bathroom, which he also hated the sight of because it looked like some bathroom from a nursing home, and grabbed a hand mirror. He then wheeled himself to his adjoining bedroom, transferred himself to his unmade bed, lay down, and shimmied off his jeans and boxers. With the hand mirror, he reluctantly looked at his buttocks, and was horrified by what he saw. There was a hideous, oozing sore about two inches in diameter on his right butt cheek, and the sight of it almost made him gag. For once, he was almost glad he couldn't feel it, because if he could, he knew it would be extremely painful. Of course, if he could feel things down there, he would never have gotten the fucking sore in the first place.
Feeling more debased and horrified than he ever had in his life, he painstakingly began to get his boxers and jeans back on, having to roll himself to one side and then the other until he finally had them pulled up to his waist, which was how he had to get his pants on these days. He lay there for a moment, feeling a little short of breath, trying to summon the nerve to tell Dean he needed to go to the hospital.
He had been taught in rehab the importance of keeping an eye out for pressure ulcers. He was supposed to check his body for them every day. It should be second nature, like brushing his teeth or combing his hair, but because he'd been in denial and blown it off, he was probably looking at some serious hospital time.
He was overwhelmed by the enormous unfairness of it all, and he clenched his teeth and tightened his fists, could feel himself tremble with futile rage. But he didn't shed a fucking tear. Instead, he sank just a little deeper into the black abyss of misery that was now his pathetic life.
A few hours later, Sam was lying on his side in a hospital bed pretending to be asleep. They had lightly sedated him in order to insert a PICC line into his arm to administer antibiotics to him long term. His doctor, Dr. Salazar, had estimated that Sam would be in the hospital around a month. Sam had been exposed to a bacterial infection as a result of the open wound of the pressure sore, and it was causing him to run a low-grade fever. That, and the fact that pressure ulcers were notoriously slow-healing, ensured a long hospital stay and probably several weeks or months of bed rest once he got home. It was going to suck.
He could hear Dean and Dr. Salazar talking quietly near the door to his room. Obviously, they thought he was asleep. It was a semi-private room, and he had the bed nearest the door. He didn't have a roommate, as of yet.
"It's a Stage III ischial tuberosity ulcer on the right side," explained Dr. Salazar, "which basically means it's on his right butt cheek. I'm classifying it as Stage III because it has just hit the deeper skin tissue and because of the infection, but some might call it a bad Stage II. Sam's lucky. He won't need surgery."
Oh, yeah. I'm the luckiest guy in the world, thought Sam sarcastically.
"Dean, this should have been easy for Sam to detect and nip in the bud if he'd been diligent in watching for it. I see that he's a little over six months out from his injury. How do you think he has been adjusting up to this point?"
Dean snorted. "He hasn't. I mean, he goes through the motions, does the things he has to do—or I thought he was, anyway—but he's really angry and depressed. I wouldn't say that he's adjusting, not by a long shot."
"His records say he's not on an antidepressant; is that correct?"
"Yes. They threatened to put him on one in rehab, but they never followed through."
"I think it's time we put him on one. It might help him to adjust better. Sam's failure to look over his skin as he was taught in rehab isn't laziness, just so you know. It's a form of denial."
"Yes. When Sam has to scrutinize the immobile part of his body to look for skin breakdown, it forces him to see how his life has changed in a very brutal, intimate way. There is no escaping what has happened to him. We can hardly blame him for not wanting to face that."
Dean was silent.
"Go easy on him, Dean. I know you were upset with him when you brought him here earlier, but just put yourself in his place. It's going to take him a while to accept what has happened to him, but hopefully the antidepressant will offer him some relief from some of the destructive feelings he's having, and he'll come around. Since he's going to be hospitalized for several weeks, we can monitor him closely to see how he does on the new medication and how it interacts with his painkiller and the antispasticity med. I'm also going to have him taking some protein supplements. His blood work showed some nutritional deficiencies that we need to address, especially since he's got this pressure ulcer. Proper nutrition is vital to facilitate healing."
"He basically eats a diet of Lucky Charms at home."
The doctor cleared his throat. "I don't think I need to tell you that's not going to do him much good."
"You're preaching to the choir, Doc. I've tried to get him to eat better, but he basically does the opposite of whatever I tell him. He can be pretty stubborn, and everything I do or say seems to piss him off." Dean sounded angry.
"That's normal, too, Dean. Sometimes the people that love them the most are the ones that bear the brunt of their angst. It'll pass. As I said, just give him time."
Again, Dean was silent.
"I'll instruct the nurse on duty to start him on Endep as long as Sam's on board with it. We'll see how he does on it."
When the doctor left, Sam could hear Dean settle himself into the chair that was sitting by the window. It was evening, now, and Sam wondered if Dean would stay the night as he had the many nights Sam had been in the hospital and even a few nights when Sam had been in rehab. There was a difference this time, though. Normally, Dean would have pulled the chair close to Sam's bed. He would have rubbed Sam's shoulder to comfort him, to let Sam know that he was near and that Sam was safe.
This time, however, Dean kept his distance. His big brother was still watching over him, but Sam knew that it was only out of duty. It was only because it had been engrained in Dean by their dad to watch out for Sam at all costs. Sam had always known this, but he had never felt like a burden before. The rift between them was palpable, now, and Sam knew that he was just another job for Dean, Dean's third shift in addition to his job as a mechanic during the day and his job as a bartender in the evening. Sam knew he was a drain on his brother, and it was just one more thing to fuel his despair.
Each day, he hated himself and what he'd become more and more, but he couldn't find a way out. Part of him wanted the gruff love and comfort that Dean had always readily given, but part of him was enraged that he needed it. His anger was the only thing he had left that made him feel like a man, and the thought of letting go of it and crying like a baby in his brother's arms was unthinkable. So, instead, he pushed Dean away, and like some dumb animal that didn't know any better, Dean just kept coming back—but only out of obligation.
Sam's self-respect wasn't the only thing he'd lost that night he'd been stabbed in the back. He'd lost his brother, too.
Five months later
Sam felt someone shake his shoulder, but he fought to keep his hold on sleep. He couldn't remember what he'd been dreaming, but he didn't want to let it go. Plus, he felt the familiar cotton mouth and head full of cobwebs that signaled yet another hangover.
"Wake up, Sam. Get your lazy ass up." Dean was standing next to Sam's bed wearing his Firestone uniform, obviously ready for work.
Sam was lying on his stomach, and he buried his head under his pillow.
"I'm serious, Sam. You need to stay on your schedule."
"Fuck off, Dean," said Sam, not bothering to take the pillow off his head.
Dean sighed. "You got drunk again last night."
Sam felt instant anger at Dean's righteous attitude, and the residual effects of sleep began to wear off. The reality of his situation, that he couldn't just jump out of bed and go for a run, that he couldn't feel or move his legs, hit him like a ton of bricks, just like it had every morning for the eleven and a half months since his injury. He took the pillow off his head, pulled the sheet and coverlet off of him, and pushed himself onto his back so he could see Dean better, glad that he was wearing sweat pants so Dean wouldn't see his worthless, atrophied legs. "So what if I had a few beers. It's none of your fucking business."
Dean rubbed his mouth with his fingers, an unconscious gesture of distress that he'd always had. He looked as if he was trying to be patient and said calmly, "It's my business if you put yourself in danger. It wasn't just a few beers. You were wasted to the point that you could fall during a transfer. You've been drinking way more than you ever did before your injury, and you know alcohol can enhance the sedative effect of your antidepressant; plus, it keeps it from working."
News flash. It never has really worked, although it does make me feel like a zombie from time to time. Sam gave an ironic snort. "You sound like you've got a stick up your ass, Dean. If I want a beer, I'm gonna have a beer."
"Look, I know you're going through a tough time right now, but—"
"You don't have a clue what I'm going through!" Sam felt a cold rage grow from his chest and slowly spread through his body. "Do you have to dig the crap out of your own ass every other day, Dean? Do you have to stick a catheter up your penis—your penis that you can't feel—every five hours to make yourself pee? Do you look at a hot, beautiful girl and realize you'll never have an orgasm again?"
Dean stood there, frozen.
"No. I didn't think so," said Sam with sarcastic venom. "I've been a good boy, Dean, since I finally got rid of that fucking pressure sore on my ass. I make sure I eat enough food and the right foods and get enough fluids so that my bowel and bladder programs don't get screwed up. I check every inch of the flaccid, useless, numb lower half of my body every day now so I won't have to spend another five months waiting for a damn pressure sore to heal again. I do my passive range of motion exercises on my legs every day so I don't get joint contractures. I deal with the phantom, excruciating, burning pain in them that the painkiller doesn't even take the edge off of sometimes, and I deal with the spasms that sometimes make it seem like my legs are possessed by a demon, even though I take medicine for that, too. Should I go on?"
Dean didn't answer.
He gave Dean a challenging, hard stare. "Should I really have to justify it if I want to get rip-roaring drunk every now and then or every goddamn night, if I feel like it?"
Dean looked toward the window and swallowed, and when he spoke, his voice sounded thick. "I'm sorry. It should have been me. If I could switch places with you, I would."
Sam scoffed. "Thanks. That makes me feel so much better, but I don't need a fucking martyr."
Dean looked at him, raw emotion on his features. "I don't know what to say to you anymore, Sam."
"Then don't say anything." Sam sat himself up, pulled himself to the edge of the bed, and in one swift motion transferred himself to his wheelchair, which was always sitting next to the bed. As he placed his bare, unfeeling feet on the footplate, he said, "Go to work. You're gonna be late." He then wheeled himself past Dean and made his way into his geriatric-style bathroom and slammed the door behind him.
He sensed, even though he couldn't hear him, that Dean was still standing by the bed. Just fuck off, Dean.
He took out a clean catheter from under the sink and went through the procedure to empty his bladder, cleaning the cath once he was finished. After he put it back in its place under the sink, he grabbed his not-so-secret stash of Jack Daniel's whiskey, which he also kept under the sink, and took several sips, savoring the burn as it slid down his throat. He needed a little hair of the dog to take the edge off his hangover. His friend Jack had become a permanent part of his morning routine.
Once he started to feel a buzz, he put the fifth back under the sink, brushed his teeth, took his meds, and then started running the water for his shower. Halle-fucking-lujah, he thought darkly. At least he didn't have to go butt spelunking this morning.
He took an extra-long shower, using all the hot water. Once he was done, he dried himself off with a towel that he always left folded on the side of the tub. Then he slid his wet, numb butt along the surface of the shower chair to the edge of the tub, put his towel in the seat of his wheelchair to keep the cushion dry, and started to transfer himself to his chair. He was feeling pretty good. The cocktail of meds mixing with the whiskey made him feel relaxed and the closest he ever got to happy these days.
And then he fell.
He had grabbed the titanium frame of his chair as he always did, but his still-damp hand slipped, and that was all it took. His shoulder and head hit the hard tile of the floor with a heavy thud, and sharp, nauseating pain shot through him. He tried to summon the strength to yell for Dean, but in his heart he already knew his brother would be gone, and he couldn't take a deep enough breath to yell. His last thought before losing consciousness was that he hoped Dean would decide to come home for lunch, because eight hours would be a long time to be stuck there naked on the cold floor.