Disclaimer: The characters of "Supernatural" were created by Eric Kripke and are owned by the CW Network. No profit is being made.
Note to Readers: Well, this is the last chapter of the story and I hope it's enjoyable. It could have been longer but I really wanted to have it concluded before the October 3 premiere of season 8. So, for better or worse this is it.
I have some more fic ideas brewing, but for my next story I plan to have at least 3 or 4 chapters done before I start posting, so I can stay ahead in case my schedule gets packed. Many thanks for the reviews and PM's. Also, thank you to all the readers that leave review's as a 'guest' and don't sign in. I'm not able to thank you by PM, but I'd like to thank you for reading and reviewing, it's appreciated!
Happy Reading, I hope!
When All Other Lights Go Out
Chapter 7: Still Waters
By Dawn Nyberg
"Wait, your tired arms must rest let this moment pass, wait until the morning …" lyric excerpt ~ Janis Ian, When Angels Cry
It felt like some sort of distant nightmare to Dean when he thought about his time in Purgatory. He was down there for months and had left Sam alone. He watched Sam's chest rise and fall artificially with the will of the ventilator and his eyes filled as he thought how his little brother risked so much to get to him, to save him.
He sat vigil at his brother's bedside where he had since he'd pulled up to the nearest ER from the old frontier cemetery they had emerged from a week ago. He idly read the hospital mission statement that hung on the wall near the opening to Sam's ICU cubicle, "We provide hope through advanced care for our patients and families." Dean's eyes went back to his little brother and leaned forward taking his hand and holding. He squeezed and silently thought he needed that mission statement to be true because Sam was hanging on by a thread and he needed some hope … they both did.
One Week Earlier
Dean sat in a treatment room where they had insisted on treating his clawed arm while Sam was treated in an advanced treatment room for critical care. He had convinced them that they had been camping up by the old cemetery and playing amateur ghost hunters and they had been attacked by an animal in the dark outside in the surrounding woods. The doctors had looked at Sam's scratch injuries and had told Dean they were pretty sure it was a Black Bear that had attacked them. Dean had only said it happened so fast and there was a growl and no real warning. So, now he sat in a treatment room and looked at his bandaged arm that had needed cleaning and had showed signs of infection starting, but they had given him some IV antibiotics as he waited in the treatment room. One doctor had come in and asked about the stitch job on his brother and he'd simply said they were really far put and he needed to do something.
Now, suddenly he and his brother were mini-celebrities in this small hospital that survived a few days in the wilderness after being attacked by a bear. Dean didn't care about any of it, he just wanted his brother to be okay, but he so clearly wasn't.
They had taken Sam off to the advanced trauma room and he'd only been given brief updates as they had fought to save Sam. They had wanted to admit Dean but he'd refused because that meant being separated from where Sam was and he refused to leave the ER.
When the update had finally arrived that Dean was waiting for from one of the doctor's treating his sibling he almost wish he hadn't. Sam was on his way to surgery to fix some of the deep tissue injury and fix some vessel damage. His blood loss was critical and the bite wound to his neck, although the doctor had said the bear must have only got a small portion of its fangs into Sam before Dean was able to get it off his brother there was some deep penetrating damage that needed fixed by a vascular surgeon they were having brought in by helicopter from a larger hospital seventy miles away. Sam was in hypovolemic shock and they were aggressively treating him with blood and fluid replacement. Sam's respirations were poor on arrival which Dean knew when he had raced the Impala through back roads with Sam after he'd taken the cure. Sam's breathing was so shallow that Dean had placed his fingers near Sam's mouth and nose to feel the shallow exhale. There had been a bit of blue tinge at the corners of Sam's mouth when they pulled up to the ER entrance.
Sam had stopped breathing in the ER, so he was now intubated and Dean's mind reeled at the list of issues: respiratory arrest, extremely low blood pressure, low body temp they were trying to get up, his kidney function was decreased, his cardiac output was low and they were aggressively treating him.
Dean's mind came back to the present and he looked at Sam who hadn't stirred in a week. "Sammy," Dean's voice was hushed, it was late in the ICU and Sam's room was only one of four cubicles in the small hospital. "You can't save me and check out that's not how this works, okay?" Dean ached watching the ventilator breathe for his little brother and he hated that red light that glowed brightly that said 'Mandatory' because he knew his little brother wasn't taking any breaths on his own. Every day he hoped to see a flicker of 'Assist' light up meaning Sam was trying to take breaths on his own. There were still multiple IV bags hanging around his brother, filled with medications to help his brother's blood pressure and cardiac output. Sam was slipping away and Dean could feel it.
"Mr. Smith," the voice was one Dean knew pretty well by now, it was Sam's physician, Dr. Highting and Dean turned his head toward the man at entrance to Sam's cubicle.
"Call me Dean doc," he replied. The older doctor smiled.
"Sorry, I keep doing that don't I?" Dean offered a small smile that didn't reach his eyes.
"It's okay, how's my brother doing?"
"His blood counts are rising but we are still dealing with the problems that the extreme hypovolemic shock has created. He isn't rebounding as quickly as I would like."
"What's that mean?"
"As I've mentioned in earlier conversations this week, Sam's heart is still having trouble with output and requires IV medications to help it pump more effectively. His blood pressure remains an issue and he is unable to maintain it on his own without drug support. His kidney function isn't where I'd like it." The doctor paused a moment, "Dean," his voice softened.
"Don't," Dean's voice suddenly strong. "I'm not pulling the plug on my little brother, he can beat this."
"Dean," the doctor pulled up a rolling stool that was along the wall and sat down in front of Dean. "We're doing everything we can, however, there comes a time when hard decisions may have to be made." Dean turned his eyes toward his brother.
"He wouldn't give up on me, I'm not giving up on him," Dean's voice was definitive and told the doctor to tread lightly. Their conversation was interrupted by the wail of a monitor and it seemed Sam was once again trying to help his brother out by making a decision his big brother couldn't and Sam's heart stopped.
Dean was pushed from the room as staff descended on Sam. He stood stock still outside and watched his brother rolled to his side as a board was put under him, his ET tube disconnected from the vent and an ambu bag attached as the gave his brother's breaths as rescue efforts continued.
"We got nothin'," a young resident said as he looked to Dr. Highting for guidance. The staff moved in sync each person doing what they had to in order to try and get Sam's heart beating again.
"Let's get some epi on board," Dr. Hightings commanded. "Continue compressions."
The efforts seemed to go on forever to Dean as he stood outside watching. They had tried to get him to step outside the unit but he wasn't leaving his brother. "What's his down time," Dr. Hightings asked.
A nurse looked at the running resuscitation clock, "seven minutes." The doctor shook his head and went back to work.
"Dr. HIghting's," the resident asked as he continued compressing Sam's chest.
"Stop compressions let's see what we have," the doctor instructed. The young resident stopped compressing but left his hands in place.
"Okay, we've got a V-fib, let's shock him," everyone stepped back. "Clear!" Dean watched the paddles applied to his brother's chest and saw Sam's chest arch slightly from the defibrillation. The doctor looked at the monitor and shook his head, "okay, let's go again, charge to 275, clear!"
Long minutes later, Dean seemed to only just that moment notice that Dr. Highting's was standing in front of him looking grim and he was talking. "What?" Dean asked, suddenly all his attention on the doctor obstructing his view into his brother's cubicle.
"I said, we got his heart beating again, but…" the doctor began. Dean checked out for a moment at that statement and then brought his attention back to the physician.
"But, what," Dean asked.
"He was down almost ten minutes," the doctor began again. "His heart arrested despite the medications we're using Dean."
"What are you saying?" Dean's eyes were scared.
"I think you might want to consider comfort care at this point for your brother. We are doing everything we can, but his condition isn't stabilizing. He has been critical since he arrived and we have only been just staying ahead of the curve with him, but I think with this latest episode we are losing ground quicker than we're gaining."
"Then try harder," Dean barked. "Sammy's fighting as hard as he can, so you do your job and help him fight. He can beat this … I'm not losing my brother."
Several hours later Dean sat next to his brother. Sam was pale, his skin almost porcelain-like. Dean tried not to think back to that time in Cold Oak, his brother's skin looked the same way, but this time was different, Sam was alive, the monitors said so, his heart was still beating. "Sammy, listen to me, okay," Dean began his voice low, just for his little brother's ears. "Look I know you're tired Sammy, I do. But, you can't check out on me not like this. I need you to fight, I need you to do it now," Dean commanded softly in his brother's ear. "They think I should let you go, but that ain't happening … you hear me. You can't quit." His voice choked, "please," his big brother bravado slipped away suddenly as he looked at his little brother, and knew he was slipping away. "Please, Sammy, don't leave me, I need you kiddo. I need my pain in the ass little brother, okay?" he waited and couldn't stop a hand from reaching up and pushing back his brother's long hair gently and then allowed his hand to rest gently on the side of his brother's head.
Dean fell asleep in small snatches of time too afraid Sam would slip away, but he still clung to life and Dean had no intention of letting him go anywhere. Dean stretched in his sleep chair and sat up. He got up and sat in the chair next to Sam's bed, "I know it's late Sammy," Dean started and glanced at the clock, "it's 3 in the morn' but I had somethin' to say and I don't think I said it before. Now, don't read into this," his voice was low. "I still think you were a blue ribbon dumbass for doing what you did to get me out but thanks little brother, I'm damn proud. So, please don't let this beat you or it'll be my fault," Dean offered. "So, stay, okay?" Dean rested a hand on his brother's forehead, "so, I'm going to back to sleep but I'm right here," he assured and went back to his sleeping chair.
Shortly, before dawn there was an odd random beep or two from Sam's vent that had Dean awake and sitting up, as if on auto-pilot. He stared hard at the vent settings and one thing was different and suddenly he felt excitement and anxiety when he noticed that the 'Assist' light was glowing. "Sammy?" Dean was on his feet instantly. He turned and went to the opening of his brother's cubicle. "Kara," Dean kept his voice low in lieu of the time. Kara was Sam's night nurse. She brought her head up from a chart.
"Yes," she asked standing. "Do you need something, Dean?"
"Sam's triggering the vent, I think," Dean's voice expectant. Kara looked surprised as did some of the other nurses at the station.
"Let me take a look," she offered lightly. When she walked in she expected to see no changes but it was reading 'assist' and that couldn't be denied. She did a couple more tests and then turned to Dean. "I'll have Dr. Highting paged, he wanted contacted day or night if there was any changes in Sam's status."
"So, this is good, right?" Dean moved from one foot to other. "He's taking breath's on his own, right?"
"It appears he is Dean and a couple of my tests were positive, so I'm going to page the doctor," Kara replied with practiced ease. She didn't want to give false hope but she didn't want to kill his hope either.
"But, this is a good sign, isn't it?"
"It's a good step," she answered. She could give him that much at least but Dr. Highting would be the final say on Sam's status.
It was three days later, and Dean hadn't felt this light in almost a week and half. Sam was still in the ICU and unconscious but he was off the vent and was turning a corner. The doctor and the staff were a little in awe and honestly a bit stupefied that Sam was fighting back. He had begun to really rally a day and half ago. His cardiac output was improving and his blood pressure was holding as they reduced his support medications. He had a nasal cannula but it beat to hell that damn vent, so Dean was thrilled.
On the evening of the fourth day, Dean had fallen asleep leaned back in the chair next to his brother's bed with his hand on Sam's forearm. When he felt a gentle pressure on his arm, he figured it was a nurse encouraging him to lie down on the sleeping chair, but when he opened his eyes he saw his brother's hand and looked up and met eyes with his little brother. "Sammy?" his voice excited and low as he stood up. Sam looked at his brother. He could see the heavy stubble which indicated days of no shaving and the dark smudges under his eyes that spoke of many a restless night filled with worry. He blinked slow as his mind tried to play catch-up and try to remember his last memory. "Sammy, you know where you are? You're okay, man … I'm here," Dean's words rushed in his excitement.
Sam looked around the room and back at his brother. He saw the bandaged arm on his big brother, "y'all right?" his voice a quiet whisper but it was the best sound to Dean's ears. He huffed a laugh at the question. Leave Sam to worry about a friggin' bandage on his arm while he's hooked up to monitors and tubes in an ICU.
"I'm good Sammy, it's you I've been worried about."
"Hospital?" Sam asked as he looked around.
"Yeah, you're going to be okay. It was touch and go for a while but I told them you'd make it." Sam tried to follow his brother's words but he was so tired and his eyes kept dipping closed. He felt his brother touch the top of his head and when he tried to open his eyes again Dean just slid his hand down resting it over Sam's eyes. "Sleep Sammy, I'll be here. We'll talk later. Rest," it was a quiet command full of safety and love and Sam for once followed his big brother's command without a question and went back to sleep.
Sam was discharged after another week and half in the hospital and now Dean just wanted to get his brother somewhere safe and quiet to finish getting his strength back. He was still weak and didn't have a lot of stamina just yet, but Dr. Highting had assured them both that he'd be back to 100 percent in another month or two. Sam had bounced back from the edge and the doctor had said that Sam had renewed his belief that maybe medical outcomes weren't always cut and dry.
"Where we headed?" Sam asked casually as he sat next to his brother in the Impala as they got on the highway. Dean had kept Sam in town after being discharged for a final follow-up and to have his stitches removed by Dr. Highting before leaving town and now they were finally leaving. Dean looked at his brother and smiled.
"I was thinking Sheriff Mill's for a while. I called her when you were in the hospital and she wanted to come out, but I told her 'no' but she wanted called with updates …" Sam interrupted Dean.
"She was there for me after you were gone, she's a good person Dean."
"Did you call her Sheriff Mills?" Sam gave him a knowing smile and Dean laughed.
"Yeah, and she chewed my ass a new one, told, me to call her Jodie or she was going to kick my ass."
Sam smiled and laughed and it was music to Dean's ears, "and she could so kick your ass Dean," Sam confirmed.
"You too, princess," he answered playfully. Sam smiled. Dean looked at him for a moment. "Why don't you grab a nap Sammy, we'll stop for some food in a little bit I'll wake you up."
"I'm good Dean," Sam assured.
"Okay," Dean was hesitant "but if you feel tired don't fight it, okay?"
"Yeah, yeah," Sam humored him.
"I told Jodie we'd be there in a couple days." Sam just nodded and looked out the window at the scenery. Dean looked at him. "You feelin' okay?"
"Yeah, I'm good." Dean returned his eyes to the road ahead and after a few minutes of comfortable silence with only the radio playing he decided he needed to say something.
"Yeah?" Sam looked at his big brother
"We haven't talked about that purgatory vamp stunt you pulled you know?"
"I'd do it again," Sam's voice was quiet but he looked at Dean his gaze not wavering and Dean saw his brother for the man he'd grown up to be and he felt pride swell.
"Yeah, well, you pull that crap again like that and I'm gonna kick that Sequoia tree ass of yours into next year, deal?" Sam chuckled.
"Deal," Sam replied with a dimpled smile. He knew there'd be more talk about what happened and probably about Benny but he'd wait until Dean brought it up.
Dean looked at his brother, "okay, deal," Dean agreed easily. "Why don't you pick a channel for us to listen to," Dean offered and Sam looked surprised. After all, the rule he'd grown up with seldom changed: Driver picks the music and shotgun shuts his cakehole.
"You sure," Sam asked.
"Yeah," Dean answered and looked back out at the road and when the channel stopped on a song Dean just looked at his brother, "Sam," the tone warning and Sam just laughed as Chicago's "You're the Inspiration" played loudly on the Impala's radio.