A/N: Holy crap guys! Y'all are amazing! I'm honestly shocked at the number of follows and reviews and they just keep climbing! Thank you so much :D
Thank you to the awesome Chronic Potterphile in agreeing to beta this story! She is a doll, extremely talented and just amazing so check out her stories. Thanks for enduring my endless rants and complaints and being so very supportive. She is the only reason that the medical jargon in this chapter with make sense to any medical fans/junkies out there ;)
Sorry for the late update. This is a very hard fic to write, but I'm doing my best for you all :)
Leukemia. Blood Cancer.
These words reverberated around the room as the occupants tried to process what the doctor had just said. Dean and Bobby were sitting on either side of Sam's bed while John stood at the foot of it.
Dean felt his heart flutter as the words reached his ears. He ran a slightly trembling hand through his hair. He couldn't believe what he was hearing. Sam already had one type of cancer, didn't he? Was it possible to have two cancers at once? No. The doctor was wrong, Sam couldn't have cancer.
Bobby couldn't believe it either. He took off his cap as he stared in shock at the doctor. Sam was just starting to smile again, beginning to accept the fact that he was going to be okay, and now this bomb had dropped. How would the kid take it now?
John almost lost his footing as he stumbled backward. He clutched at the bedrail for support. Why? Why was his family on the verge of tearing apart? Wasn't losing Mary bad enough? And now he would lose Sam too?
Rachael could read each and every emotion in all three of their eyes and she felt her composure waver. She hated giving bad news to families, and they were always families she cared about. As much as she tried, she couldn't help but get attached to the children she treated. She was just like that. Her gaze wandered over to Sam who had a blank look on his face. It terrified her that she couldn't even read him, because if there was one other thing she was good at, it was reading people's emotions — faces. She had a good sense of observation.
"Are you sure?" Bobby asked, finally breaking the unnatural silence upon the room.
"Almost. Since Sam's blood reports are not normal, I'll need to do a bone marrow biopsy," Rachael said, trying to keep her voice from shaking.
"What's that?" Sam finally asked. True. He had been shocked when he heard it, almost sliding off the bed towards Dean, but he knew that he'd have to accept it. He'd seen the look of fear, of pain and suffering on Dean's face out of the corner of his eye when Rachael had announced the results and her diagnosis. He needed to stay strong. He needed to fight this…for Dean, for his family, for himself. It was scary, yes. It even hurt sometimes, and made him feel weak. But he wasn't just going to give up.
Rachael smiled, seeing the determination in Sam's eyes. She could tell he wanted to fight this. It made her feel proud. She decided that she was going to do all in her power to help the boy.
"A bone marrow biopsy is a test which will let me look at the cells inside your bone marrow," she said, frowning for a second, trying to figure out how to explain it.
"In Leukemia, the cancer attacks your white blood cells or WBCs which form in your bone marrow. Their number is in a specific range and when the cell count goes above or below that, it's a problem. It means that the bone marrow has been attacked, and is producing an excessive number of white cells, which are all abnormal, immature, and not even fit to participate in immunity. They just damage and weaken the body further. So I'll have to confirm the presence of these immature cells, also called blasts. Normally, there's a fixed limit of these in the bone marrow but if the upper limit is exceeded, it points towards leukaemia.
"That's how with the biopsy, I could pin point directly whether or not you have leukemia. If you do, it'll let me find out what type of leukemia it is so that I can then start your course of treatment," Rachael finished.
Sam nodded as he tried to take it all in. He understood very well. He felt like he needed to know what was going on inside him, so he could come to terms with it. Just then, another thought came to him, "Okay. And what about the osteosarcoma? You said you'll be able to remove the tumour with surgery, but the parts of cancer in my brain are still there, right? How will you get rid of those?"
Rachael was impressed that the kid actually remembered the name of the cancer and everything else she'd said to them. It genuinely warmed her that Sam trusted her with his life, and was asking questions, taking initiative in his own treatment.
"Yes," she said," I'll be able to remove the tumour in your leg. Since it's a part of the bone, they'll be removing the infected part along with some neighbouring empty tissue, and replacing it with a bone graft or a special metal rod.
"Now this graft or rod will lengthen as you grow, but once you're an adult, you'll have to have another surgery to get it replaced with a better, stronger one. And since it's a bone surgery, an orthopaedic surgeon will be operating on you. You then will need to have chemotherapy to eliminate any other cancer cells in your body. As for the mets in your brain, you will need radiation to eliminate them," Rachael answered.
Sam nodded all through the explanation. Something was still eating at him though. "The seizure? If I have parts of the cancer in my brain and a seizure brought me here, why am I not getting any more?" he asked. Knowing that he'd had a seizure had frightened him enough, but it didn't sit right with him that he hadn't had even one since he'd got here.
Rachael sighed. This kid was smart. " We've been giving you anticonvulsants through your IV so that the seizures don't occur. It's safer," she said.
Bobby's attention perked up more as he heard the mention of anticonvulsants. He now understood the signs that Sam had been showing, though hardly noticable to a person who didn't know the Winchesters. One of his hunter friends had gotten pretty banged up once and had started seizing. During his treatment the hunter had received anti-convulsants so Bobby knew most of what could happen. Though Sam may not have paid much attention to it yet, Bobby could tell that Sam was slightly drowsy and light headed and by the look of Dean's face, Bobby knew that Dean was aware of it too.
Sam listened attentively to Rachael. The part about the bone graft scared him, but he knew that if he wanted to beat this, he needed to accept the changes. And the chemotherapy and radiation didn't sound so bad. "Okay," he managed. "Will it hurt?" he asked again in a small voice. He felt ashamed to be asking such a thing considering the lives they led. But this wasn't an injury from a hunt. This was cancer.
Rachael felt her heart break. Sam didn't deserve any of this crap. She ran a light hand through her hair as she answered, "I'm not going to lie. The treatment for cancer is aggressive. As effective as the drugs are, being cytotoxic , it kind of acts like a poison at the same time. You'll feel a few side effects to the drugs. The most common is nausea and vomiting. You'll be given anti-emetics for those to curb the nausea but it's normal to vomit and feel worse the first couple of days. You'll get used to the anti-emetics and soon, the vomiting should stop. You'll still be taking them though to stop it from coming back during the course of your treatment.
"There is also the hair loss. The chemotherapy drugs and radiation usually make the hair fall out. It's not permanent though. Once you start to recover and lay off the chemo drugs, then your hair starts growing back. Apart from that you'll feel tired and drowsy because of the continuous administration of medication. Some days you may not feel hungry, some days you'll feel feverish as your immune system will be weakened."
Seeing Sam's face fall and pale at the revelation, Rachael couldn't take it. She moved closer to Sam's bed and looked him in the eye and smiled. "Look, honey, I know you're scared and it's totally okay to be afraid. But trust me when I say, everyone here is going to be by your side every step of the way, including me."
"She's right, Sammy. All of us are going to be here for you, so you have nothing to be afraid about," Dean added, smiling at his baby brother. "Plus, you don't have to worry about your hair. You'll look awesome bald and you can even wear a cap like Bobby if you want to," Dean added as an afterthought, trying to cheer his brother up. He'd seen Sam's broken expression as Rachael had gone through the adverse effects and knew that losing his hair would hit his baby brother hard. Sam chuckled at Dean's attempt to cheer him up and smiled. Dean grinned back and inwardly took a deep breath. After all that Rachael had said, the way she treated Sam and talked to him, Dean finally felt…hopeful. He somehow knew that this doctor would do anything and everything to help Sam battle this.
Rachael smiled as she got up. "Okay, so I'll let you know when your surgery is finalized. In the meantime, I'd like to discuss your treatment plans with your father and uncle, okay, sweetie?"
Sam nodded, tears in his eyes. Everyone was there for him. He wasn't alone in this, like he'd felt before. "Thank you," he whispered, earning a warm smile and nod from Rachael before the left the room.
John slumped down onto one of the chairs outside Sam's room as Dr. Myers walked away after discussing Sam's treatment schedule. He felt exhausted. Rubbing a hand over his face, he sighed. It was ironic how his family was the one that always suffered, whether it was a supernatural case, or an illness that threatened to kill his son each minute.
"Jesus, Bobby," John muttered as he jumped violently as Bobby laid a hand on his shoulder.
"Sorry," Bobby muttered. He couldn't see his family in pain like this. Yes, family. The Winchesters had made a place in his heart that no one else had. "It'll be fine John. You'll see. Sam's a helluva fighter. He's got the stamina, the power, the heart to beat this. You know he does," Bobby comforted as he sat next to John.
John nodded. It made him feel safe to have Bobby on his side, especially for a situation like this. "Thanks," he muttered, not used to the emotional talks. Bobby shrugged.
"I'm going to get a coffee, you want anything?" John asked as he got up. Bobby denied and watched the other man walk away toward the main reception area where the coffee machines stood. Hospital coffee never tasted good, but people rarely drank it for its taste. People drank it as a distraction, as an attempt to stay alert and watch over their families, their loved ones who were ill or on their death bed.
"Don't you dare tear this family apart anymore," Bobby whispered in a combination of prayer and threat. The Winchesters had been through enough. They didn't need more pain on their hearts.
After finishing her rounds at the hospital, Rachael welcomed her break time. Sure, sometimes even break time was abandoned when her patients were on the edge of life and death, but for once, everything was going smooth. She hastily retreated to her office and deposited all the case files she'd been carrying around.
Out of all the cases, the one that worried her most was Sam's situation. Teenagers getting cancer was rare, but two types of them? An extremely rare situation. Then there was the fact that his past history had nothing to indicate the cause for the cancer. But then again, more than half the cases were like that. Cancer was like that. An unpredictable, painful, life altering, family breaking illness that was plaguing the world like a swarm of locusts.
She rubbed a tired hand over her face as she sat down on her desk chair. She remembered her sister's journey through the cancer battle all too well.
Nineteen-year-old Rachael sighed as she sat next to her sister's bed. Sixteen-year-old April hadn't woken up for quite a while now. Ever since she and her mother had found out that April was suffering from Leukemia, things had gone out of control. Their father, well…'father' didn't seem like a deserving title in Rachael's eyes. He drank all day and yelled at and abused them by night. He was now on the run from the police after being a prime suspect in the murder of some bartender. Rachael was more than glad to see her father disappear.
Even though she hated it, her dad was the one source of income they had. Sure, he was a drunk and he didn't care about his family but on the rare days that he decided to drink a little less and go to work, he'd earn enough to keep them going a while. And her mother, she did all she could to make ends meet. Being a waitress and singer in a small bar didn't get you much, but it's all she could do to keep her broken family stable.
Rachael had argued with her mother countless of times about quitting her education and helping out with the household chores, and maybe finding a small job to lift the burden off her mother, but her mother wouldn't hear of it.
The elder sister sighed as silent tears streamed down her cheeks. It had been two years since her sister had gotten cancer. Some days were good, some were downright horrible. And more than two times now, Rachael had seen her little sister almost die. She was barely keeping it togetherbut she knew she had to. Her little sister needed her. April was all she had apart from their loving mother.
"I promise you'll fight this April. You have to fight this. I can't lose you," Rachael whispered as she held onto her sister's hand.
"I won't lose you."
Bobby paced worriedly outside Sam's room. Dean had drifted off to sleep by his brother's bed. Sam had soon been lulled into dreamland as well when the nurse came in to give him his meds. It had been thirty minutes since John had gone to get coffee. He should have been back by now. Bobby had even gone and checked the coffee machine area but didn't spot John anywhere.
"Something wrong, Bobby?" Dean asked, walking out of the room after checking to see that Sam was peacefully under. Bobby jumped at the unexpected voice behind him and calmed himself down seeing Dean. Already jumpy and on edge from John's disappearance, he cursed under his breath.
"Nothing, just looking for your dad," Bobby replied offhandedly, not wanting to worry the boy. He knew that Dean had made peace with his father just recently, and he didn't want to spoil that. John's heart was in a good place. He cared for his boys, but sometimes, he could get really one-track minded and screw up everything.
Dean frowned. "Did he say if he was going somewhere?"
Bobby shook his head in denial. Just then, a nurse walked over and handed over a piece of paper to Dean. "A John Winchester told me to give this to you," she said. After handing over the note, she walked away to resume her duties.
Dean's face turned from a look of confusion to a look of rage and pain. "HE PROMISED! HE FRIGGIN' PROMISED!" Dean yelled before storming off towards the exit.
Bobby stared in shock after the older Winchester and picked up the piece of paper that Dean had balled up and thrown to the ground. It read –
I'm sorry, Dean, but something has come up.
Bobby, I know you'll hate me for this, but if I don't go I'll lose everything. You have to trust me on this.
I know this is a bad time, but I can't ignore this.
"Damn it, John," Bobby cursed. He couldn't pin-point it, but he felt like something wasn't right here. He ignored it because the way he saw it, John had chosen work over family...again.
Dean ran towards the exit, needing air. I'm sorry, Dean, but something has come up...I know this is a bad time, but I can't ignore this. The words in the note kept floating around in his mind. How could his father do that? How could he run off when he promised he'd be there for him and Sam? Why would he do that?
Dean exited the hospital and took a deep breath, scanning the parking lot as he did so. Just as he expected, his father's jeep was gone. His Dad had let him down again. The man Dean looked up to had broken his trust.
"Why, Dad? Why?" Dean whispered as silent tears streamed down his face.
*hands over box of tissues*
I made myself sad by the end. Sorry. I'll try and update soon :)