Heroes-Revisited

By Ridley C. James, July 2006 re-edited in 2007

Beta & contributor: Tidia

Disclaimer: Nothing Supernatural belongs to me.

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Chapter 10/13

”Heroism feels and never reasons, and therefore is always right.”

Mac hit the call button beside Dean's bed as he simultaneously placed his hand against the young man's carotid artery. The boy's pulse rate was too slow. Damn. He should have expected the worst with the Winchesters.

"Yes?" A woman's voice came across the intercom.

"Page Doctor White and your top neurology consult to Dean Winchester's room STAT, and I need a BP reading in here, immediately."

"Yes, sir."

“Dad?” Caleb’s voice was laced with fear. “He’s in trouble.”

Mackland gently nudged past his son, breaking Caleb’s connection with Dean. He forced the younger psychic back a few feet. “I know, Son.” Mac also knew he was to blame for allowing this to happen. But Caleb wouldn’t see it that way.

"Mac?" John made his way to Dean’s bed, hovering on the other side as the physician raised each of Dean's eyelids, and flashed his penlight in one, then the other.

Sam tried to follow his father. Caleb caught his arm and held him on the bed. “No, Runt.”

The teen had just made a miraculous recovery, but was still attached to several monitors, including an I.V. "Dean?" the teen whispered.

Reaves wrapped a restraining arm around Sam's shoulders when the kid tried once again to climb off the mattress. "Let him work, Sammy."

"Pupil response is abnormal," Mackland mumbled more to himself than the concerned men around him. He gently slapped Dean's cheek. "Dean? Can you hear me, son? Dean!"

There was no response and Ames placed his cheek closer to Dean's face, detecting the distinct patterned breathing. "Damn it," he swore softly. "Abnormal respiratory functioning."

Mac placed his hands on Dean's face, turning the teen's head gently to peer in his nose then in each ear. "Sinus cavities have been breached." He looked up and met John's terrified gaze just as a nurse rushed in followed by Dr. Ryan White.

"What's going on?" White looked confused, first staring at Sam, unconscious the last time he saw him to his own patient who had been totally coherent, but was now the one in distress.

"Get a BP on him," Mackland instructed the RN. He turned to White. "I think we're looking at Cushing's Triad."

"Fuck!" White shoved John out of the way, going through the same diagnostics. "How the hell did I miss this? He was fine a few hours ago."

Ames knew there was no time for explanations. "We need a new CAT scan-could be looking at a hematoma. Where's your neuro-specialist?"

White ran a hand through his blond hair. "This is a two horse town, Dr. Ames. The closest we've got to the kind of specialist you're referring to is the surgeon who was in charge of the younger brother's case."

Mac sighed. "Page him down to Radiology. I want these tests done quickly. We can't afford to lose any time."

"BP is 160 over 62." The nurse glanced to both men as she pulled the cuff off Dean.

"Get some orderlies in here." Mackland motioned to the door. "Contact radiology."

"Systolic is climbing while diastolic is dropping," White knuckled his eyes. "Shit, I should have watched closer."

"Will one of you please tell me what the hell is going on?" John demanded, tired of being kept in the dark, shoved to the wayside.

Mac met his gaze. "Dean is displaying all the signs of Cushing's Triad. It's a way to check for increase in intracranial pressure."

"Yeah, Sam's doctor explained all that when he was afraid that Sam had suffered a traumatic brain injury. But none of it applied to Sammy's case."

Mackland didn't have to say it. It was written on his face. Dean wasn't going to be so lucky. "This is different, John."

There would be no psychic cures for whatever Dean was going through. "He'll be okay, right?"

Before Ames could answer orderlies pushed in with a gurney. Caleb hopped up onto Sam's bed to avoid being run over. The two techs helped White and Mac transfer Dean to the other bed. White grabbed the I.V., running alongside the gurney as they rushed out of the room.

"Dean?" Sam seemed to snap out of whatever shock he was in, realizing his brother was being taken away. "No! Wait."

"Sam." Reaves tightened his hold. “Take it easy.” It was hypocritical considering Caleb had the same irrational desire to chase the gurney too.

"No, let me go." The teen struggled out of Caleb's grasp, finding the I.V. and pulling it from his arm before Reaves could stop him. Blood splattered on the sheet and Caleb hissed.

"Damn it, Sam!" The boy continued to fight him, pulling electrodes from beneath his hospital gown, tugging his finger from the lighted clip.

"Samuel! Stop it!"

It was not the words, but his father's strong grip that quashed his attempt to follow his brother. "Dad, let me go," the teen pleaded.

"Look at me." John turned his son around, giving him a slight shake. "You can't go with your brother. They're taking him down for tests."

"But it's my fault," Sam whispered softly. "I did this."

"No, you didn't." John squeezed the boy's shoulders; the blame lay squarely on his head. "Your brother wouldn't want you saying stuff like that."

"He'd be pissed, Sammy," Caleb interrupted. The thirteen-year-old looked up at him and watched as the older hunter gently placed a wad of tissues against his bleeding hand. "The raw head caused all of this. And we killed that evil son of a bitch, so as soon as Deuce wakes up we can all have a good laugh about this little game of musical comas you two have going on."

Mackland rushed by the room, and John called out. "Mac?"

"I need to consult with Gentry, John. I'll send another physician in to check on Samuel."

"I'm coming with." John shoved Sam towards Caleb, making sure the younger hunter had a hold of the boy before releasing his grasp. "Watch him!"

Caleb rolled his eyes. "Sure leave me with the easy job."

John rushed out of the room and Caleb sensed more than felt Sam's intentions. "I'm so not in the mood to chase you down, kiddo; but you can bet your ass I will."

Sam glared up at him. "He's my brother."

"Yeah, the shared mile-wide stubborn streak is a dead giveaway, but he's in the best possible hands right now, Sammy," Caleb replied. He was trying to convince himself as much as the younger boy. "Or did you finish med school while I wasn't looking?"

The teen bit his lip to keep from crying when he realized he wouldn't be following his brother anytime soon. He took a hitching breath and glanced down at the green gown he was wearing, and then gazed at the numerous machines around him. He glanced at Caleb with confusion. "What's going on, Caleb? What the hell happened?"

"What do you remember?" Caleb sighed and took a seat on the bed, lifting the make-shift bandage to see if Sam's hand was still bleeding.

"Going to camp." Sam winced. He remembered the fight he had with Dean. Then things were foggy and filled with nightmarish scenes he couldn't quite decipher.

The small puncture wound had stopped bleeding so Caleb tossed the tissues in the trash and finally met Sam's gaze. It was going to be a long story. "Well, you know what an ass your brother can be…"

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John paced in the Radiology waiting room, forcing a few of the other visitors to flee because of his display of barely-restrained volatile emotions. When Mac finally did enter the room Winchester nearly pounced on him. "How is he?"

"Believe it or not, he's been in and out of consciousness."

"Thank God." John ran a hand down his beard. "Can I see him?"

"We need to discuss his treatment first."

"What treatment? He's awake, that's good right?"

Mac motioned to some chairs and tried to tell himself this was like any one of the other thousand plus consults he'd done in the past. The clenching in his chest mocked him for even trying that spineless tactic. "Dean has a subdural hematoma, John."

"A blood clot?" Winchester frowned. “Sam’s doctor used that word.”

Mac nodded. "A subdural hematoma is the rupture of the bridging veins that run between the surface of the brain and the skull, causing a collection of blood on the brain. Acute subdural hematomas are often fatal, and at the least require surgery to remove them." Mac paused to see how John was processing the information. He continued on with his explanation. "What I believe we're seeing with Dean is a subacute subdural, or perhaps even a chronic type, both of which often times can correct themselves. The bleeding stops on its own, and that's what we're hoping for. After seeing the CAT scans that's what I believe will happen."

"Why do I feel a big but coming on here?"

Mac sighed. "But any intracranial hemorrhaging, no matter how slight, can trigger an increase in intracranial pressure."

"Like swelling of the brain?"

"Sort of. More like extreme pressure on the brain. Worse case scenario, the brain is deprived of oxygen, and we see ischemia."

"That doesn't sound good, Mac."

It wasn’t good. But Ames chose to focus on the solutions not the worst case scenarios. "There are several things we can try with Dean before we even start looking at surgical intervention."

"What?"

"Before I left the field I was doing some pretty intense research with a couple of colleagues at Duke and Stanford. We were working on treating TBI's, traumatic brain injuries, with hypothermia."

"Hypothermia?"

"Doctors have used it in pre-ops for years to reduce bleeding. It lowers a person's metabolic rate better than any drug. For every ten Celsius drop in temperature a person's metabolic rate falls by fifty percent."

"And how does this help?"

Mackland sympathized with his old friend. "It's complicated. We want to slow the body's processes, especially the brain. Lowering the metabolic rate not only slows blood flow, but also inhibits the release of neurotransmitters such as dopamine."

"The same neurotransmitters that were stimulated when we did that psychic shit?" John asked, anger and guilt lacing through his voice.

Mackland was victim to the same self-recriminations. "Yes."

"And if it doesn't work?"

"We can induce a barbiturate coma, which I'd rather not do considering the brain contusions from Dean's primary injury. Then there is surgery-a burr hole or craniotomy."

John paled. "You mean trepanning?"

"Come now, Jonathan. You make it sound like we're still in the medieval times."

"I'm sorry, Mackland, but you're talking about drilling a fucking hole in my kid's head. They'll never be enough advances in your precious neurology to convince me that's a good idea."

"I'm not suggesting surgery. I'm suggesting we use hypothermia, and even though I don't have access to a cold suit, we can do it the old fashioned way."

John sighed. "Which is?"

"We use cold blankets, ice packs, and a cold saline."

"Shit." John rubbed at his eyes.

"It sounds worse than it is. We only take the body down to 32 degrees Celsius. Any lower than that would be counterproductive."

"And even at 32 degrees there are serious risks." Ryan White joined them. The young doctor seemed to have aged a few years in the past hour. He looked from John to Mac. "No offense, Dr. Ames but Dean is my patient. I should have been in on this consultation."

"No offense taken." Mackland cleared his throat, reminding himself he no longer ate hot-shot interns for breakfast. "Because of my past history with Mr. Winchester, I thought I should talk with him first."

"What risks, Mac?" John ignored White.

"Myocardial infarction for one," the young doctor interjected once more.

Mackland glared at the other physician. "Perhaps if Dean were my age that would be true."

"A heart attack?" John shook his head. "What the fuck, Mac?"

"Heart attacks are rare, usually only occurring in the elderly due to the increased demand for oxygen. Dean is seventeen and athletic. The side-effects of a surgical decompression or a drug-induced pentobarbital coma are far more reaching than what I'm suggesting."

"Did you tell him about the ventilator?"

John looked from the young doctor to his friend. Mac sighed. "We'll intubate him, and put him on a ventilator as patient shivering increases oxygen use on an average of 200 percent. With Dean's broken ribs, we can't take the chance of a lung collapsing."

John laughed, but no signs of humor emerged. "This just keeps getting better."

"Whatever it is you decide, John, we need to work fast. I'm not risking further swelling or a mid-line shift. If those things happen the chance for recovery is slim." Mackland refused to accept he would be the cause of losing someone as special as Dean.

John held his friend's gaze. "I trust you."

Ames nodded, and then looked up at White. "Let's keep this simple, shall we? I want an isolated room we can cool, and warm when we need to. We'll need cold blankets-I'm assuming you do have those?"

"We're not that rural, Doctor."

"Good. I'll also want icepacks and an ample supply of cold saline."

"We could use isotonic saline; take care of the blood pressure, too." White offered.

Mac looked impressed. "That's a good idea." The older physician decided to reciprocate. "Have a crash cart standing by, just in case."

"I want to see Dean." John licked his lips, pushing himself to a standing position. "Sammy too."

Mackland saw the fear in the other man's eyes, a rare emotion he hadn't witnessed very often in his friend. "Sam should see his brother. Caleb, too." He didn’t want to acknowledge it, but things could go very wrong and the boys deserved a chance to say what needed to be said. Ames suddenly looked up at the young doctor. "That is if it's okay with Dean's physician?"

White raised a brow when John looked at him for confirmation. "Dr. Gentry gave your other son a clean bill of health." He looked at Mac. "It would seem Dr. Ames’s reputation is not unfounded. So I don't have a problem with it. I'll send a nurse for you as soon as we get Dean settled into a room."

"Thank you." John met Mac's gaze for only a moment before walking away without another word.

Ames watched him go and felt White's gaze upon him. He turned to the younger man reading the question in his inquisitive eyes. It didn’t take Caleb’s ability to know what the kid was thinking. "No, it's not easy when you're dealing with family.”

“You’re close to Dean?”

Mackland nodded. "Yes, and it is a hundred times harder than you can imagine. I am breeching every medical text protocol, seeing as how I have no business dealing in a situation where my impartiality could be called to the table."

“But you’re still going to do it.”

Mac offered him a sad knowing smile. "Yes. Because books, no matter how well written, or who they are written about, can never prepare you for real life and all of its chaos. In real life a man as close to me as a brother is on the verge of losing his son-a boy I have watched grow into a young man. A boy whom I love very much. How could I not be involved when I have the means to help?"

"Real life is a bitch," White said with a slight nod.

Mac smiled reminding him that he missed having young, naïve interns to enlighten and mold. "You bet it is, son. You bet it is."

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John had never felt quite as tired as he did exiting the elevator leading to the pediatrics ward of the hospital. He'd nearly panicked when he'd gone to Dean's old room and found it eerily empty and void of life. A kind nurse had quickly explained Sam's doctor had moved him to the children's ward as it was protocol for anyone under the age of fourteen. Gentry apparently wanted him held a few more days for observation. John wagered it was more of 'keeping their ass out of the proverbial sling,' especially in light of what was happening with Dean.

That was fine with John, because he really didn't feel like fighting with Sam about leaving anytime soon. The nurse also told him with a dreamy look in her eyes his brother had completed the additional insurance forms.

He opened the door to Sam's room and took in the sight. Sam was asleep, looking far too young, small and fragile in the bed surrounded by Mickey Mouse wallpaper and a Donald Duck lamp on the bedside table. Caleb slumbered in the chair next to the bed. An open book was spread across his chest, and his hand was suspiciously close to actually covering Sam's.

John only made it a couple of steps into the room before the younger hunter was sitting up, dropping the book, and taking a protective stance. "Easy, tiger." John sighed, holding his hands out in front of him until Caleb found his bearings.

"Damn, Johnny, give a guy a heart attack why don't you?"

"You shouldn't be sleeping on watch," John said gruffly, but his lip twitched revealing just a hint of dimple.

Caleb motioned towards Sam. "Yeah, well, you deal with the boy wonder hyped up on too many Mountain Dews and M&M's, not to mention being scared out of his mind about Dean, and see what happens. It's a fucking miracle he went to sleep. He asked a record number of questions in an hour."

"Who the hell bought Mountain Dew and M&M's?"

The younger man ducked his head. "I did." He snorted. "But that'll be the last damn time."

Caleb was indulgent to Sam on a good day. In fact, John was pretty sure the kid would probably have sneaked Sam a six pack if his son had asked, considering he was certain Caleb felt guilty. "How's he doing, besides the fact you OD'd him on junk food?"

Caleb yawned and rubbed his eyes. "Gentry said he'd be tired for a while, maybe grumpier than usual, but besides that he's a perfect specimen of a thirteen-year-old."

“Finally, some good news.”

"But Sammy was pretty pissed about being moved into the kiddie ward, and let me tell you, I had to threaten bodily harm to get him to agree to that new hospital garb." The younger hunter motioned to the boy who was covered with a blanket. "But the big question is, how's Deuce?"

"Your old man wants to put him in the deep freeze to keep his brain from blowing a gasket."

"Say again?" Caleb fully sat up.

John waved a hand in the air and lowered his voice when Sam shifted in his sleep. "Some damn technique involving hypothermia Mac researched a while back."

Caleb frowned. "And here I thought he might want to drill a hole in the kid's head or something."

John took a seat on the corner of Sam's bed. He settled his hand gently in his son’s mass of long brown hair. "Yeah, well, that could be a possibility, too."

"Damn," Caleb swore, leaning forward. "Is this from the projecting?"

John didn't have to be a brilliant doctor to understand what Caleb was asking. "No." He shook his head. "This was from the blows to the head Dean took from that raw. Acceleration-Deceleration trauma, Mac called it." John shrugged, letting his fingers slide through Sam’s too-long locks, calming his own nerves. "Some kind of latent hematoma formed. Happens in a lot in car wreck victims-the walking/talking wounded. Apparently, it can also occur by having your head slammed into things like the ground. All in all, it can cause some nasty things to happen."

"But the psychic traveling couldn't have been good for it?"

"No." John let his hand still, coming to rest along Sammy's forehead. "We probably didn't do the smartest thing for Dean."

Caleb nodded. "But we got Sammy back. Dean would have done it even if he knew what was going to happen."

John met the younger man’s gaze unsure if Caleb was trying to let him off the hook or ease his own misplaced guilt. "True."

"You made sure of that when you trained him to be such a good guard dog.”

John rolled his eyes. So much for letting him off the hook. "Dean's not some Pit Bull, Caleb."

"Jim's been telling you that for years, man. I didn’t think you would ever understand."

"Don't."

"Whatever." Caleb stood and stretched. "I seriously need some air."

"Sammy and I are going up to see Dean. You’re going too. Then I have some errands for you to run."

Caleb’s brow furrowed. “What kind of errands? I don’t want to go far.”

"For one- I want some damn decent coffee, not this hospital sludge."

"Anything else?" Caleb sighed dramatically.

"Yeah. I want you to swing by the apartment and pick up some clothes and stuff for me and the kid. Bring Sammy's books too. Anything to keep him occupied." And out of my hair. "This hypothermia thing is suppose to last a couple of days."

"Shit." Caleb ran a hand over his mouth, a little more color seeped from his face.

"Yeah." John rubbed at his aching neck. It was going to be a hard couple of days for everyone. "You could call the boys' school. The number's on the 'fridge. Give them the same story we fed the doctors."

"Damn, Winchester, what do you think I am?"

John smirked. "Apparently you're my brother, or did you forget?" He shook his head slightly. "Being in this family doesn't come without a whole hell of a lot of shitty stuff, Reaves. You should know that by now."

Caleb held his hand out expectantly to the other man. "Then I'll be needing the keys to the black beauty, bro."

John growled, but fished the Impala's keys out of his pocket. "I take a pound of flesh for every scratch, and you don't want to know what happens for dings or dents."

"I'll take care of it like my own Jeep."

"That's what I'm afraid of." He couldn’t help assuage the young hunter's guilt. He'd have to leave that to Mac or even better, Dean. “Why don’t you go on up, see if Ace is in a room yet? Your Dad says he’s awake.”

John watched some of the shadows fade from Caleb’s gold eyes. “Why the hell didn’t you tell me that to begin with?”

John watched him go and then looked at Sam. He reached out to rub at what appeared to be a smear of chocolate on his face.

"Dad?" Sam's eyes fluttered as John wiped off the rest of the M & M remnants with his thumb.

"Yeah, kiddo."

The teen quickly struggled to sit up, knuckling the sleep from his eyes. He glanced to the chair Caleb had vacated and then back to his father. "Where's Dean? Is he okay?"

"He's hanging in there, Sammy."

"Can I see him?"

"As soon as he's in a room you and I are going to visit with him for a bit."

"So…he's going to be okay?" Sam swallowed hard as he watched his father hesitate. "Dad?" Sam's brown eyes were wide. There was more than a hint of fear and dread.

"I'm not going to lie to you, Sammy. Your brother is pretty sick."

Tears brimmed in the teen's eyes, but John could tell that Sam was struggling to maintain a brave front. He hadn't actually seen his son cry in years. John wasn't sure what that said about his parenting skills.

"It's all my fault."

"No, Sam." John reached out and squeezed his son's shoulder. "None of this is your fault."

"Caleb told me what happened. How I got locked in my own stupid head and Dean came to get me." The boy actually remembered bits and pieces of it like the fuzzy leftovers of a bad dream, but mostly he recalled feeling lost and scared. Then safe when Dean had found him.

John sighed. "You were trying to save Dean when this happened to you, Sam. You put yourself in danger to help your brother. That's what we do."

"But Dean's tough. He'll get better. Right?"

"Right." John nodded confidently. "He's a Winchester. No little headache is going to take him down."

Sam's mouth twitched, a hint of dimple showing. "You always said Dean's head was like reinforced steel."

John grinned, reached out and ruffled Sam's hair affectionately. "Winchester secret weapon."

"You really believe he'll be okay?"

The older hunter wanted to believe it. Couldn't imagine it any other way. He could not lose his children. "I know it, Sammy." He forced another grin. "I don't think your brother trusts me to raise you by myself."

Sam didn't get a chance to reply because the door to his room suddenly opened again and a young nurse stepped inside. "Mr. Winchester, Dr. White wanted me to inform you that your son is now in ICU, room A-10."

"Thank you." John looked back to Sam once the nurse had gone. "You ready?"

Sam pulled back the covers and started off the bed, but stopped suddenly. "Uh…Dad?"

John looked up. "Yeah, son?"

"Can I have my own clothes?" Sam motioned to the gown he was wearing, which John now saw was a pale blue color with tiny images of Goofy and Pluto playing baseball. "Dean will never let me live this down." It was bad enough that Caleb had seen it.

At the worried, slightly mortified look on the teen's face, John laughed the first real laugh he'd had in days. He felt some of his exhaustion fade at the normalcy of the situation. "I think that's a good idea. Heaven forbid we give your brother any more ammunition to use against you."

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Caleb heard Dean before he saw his room. The teen’s voice was raised in frustration or fear, maybe a mixture of both and it was cause for the hunter to quicken his pace.

“What’s going on?” Reaves asked, barging into the room heedless of what might be going on inside. “Deuce?”

“Caleb.”

Despite the weak and pain-roughened inflection, the immense relief was audible and Caleb sought out the threat as he quickly stepped to Dean’s bedside. He found only Dr. White and two harried nurses. “What’s wrong?”

“They won’t let me see Sammy.”

“I was explaining to Dean about the hypothermic and sedation process. We need to get started soon,” White explained.

Reaves frowned at the physician and turned to Dean. He placed a hand on the teen’s shoulder. “Sammy’s awake, Deuce. He’s just downstairs. He and your dad will be up in a minute.”

“Mac told me he was okay.” Dean licked his lips, his voice lowering. “But I was afraid I wouldn’t get to see him in case…”

Caleb sat on the bed with a firm shake of his head. “Cut it out with the ‘just in case,’ dude. Everything’s going to be okay.” Reaves glanced up at White. “Give us a minute, Doc.” He watched the physician move away, taking the nurses with him before focusing on Dean again.

“They’re going to knock me out, pump me full of ice water and let some machine take over my breathing.” Dean sought out his best friend with imploring green eyes. “You can’t tell me that’s okay, Damien.”

Caleb forced a smile. It was so far out of the realm of okay. “Are you kidding? Han Solo survived the carbonization chamber with no problem. You so can do this.”

He didn’t get the grin he was expecting. Instead Dean’s cool fingers latched around his. “Just get me out of here. I’ll be okay.”

“Dean.” Reaves was shaken by the request. “Did Mac tell you what’s going on in that freaky head of yours?”

Dean closed his eyes for a moment and sighed. “His groupie intern explained it all.” The seventeen-year-old forced his lids open again. “I’ve hit my head worse before and it could get better on its own.”

Caleb shook his head. “Or you could end up with all the charm and charisma of one of Pastor Jim’s prized zucchinis.”

“Please.” Dean tried. “I don’t want to do this.”

Caleb felt the crushing weight of the pleading tone and the cutting edge of Dean’s fearful gaze. It was obvious the kid was scared and Caleb could completely empathize. He was freaking terrified himself. “I can’t risk your life, Dean.” Caleb had made enough mistakes by acting out of fear lately and look where it had gotten them. Where it had landed Dean. “Life would be extremely boring having my smart-mouthed, pain in the ass sidekick replaced by Veggie Boy.”

It took a moment, but finally Dean’s mouth twitched and his painful grip on Caleb’s hand loosened. “I’m nobody’s sidekick.”

Caleb continued on. “Although a cumquat probably pays more attention to orders than you do. Maybe some ears of corn would be just the thing I need.”

“That’s bad.” Dean laughed, but then winced as his head was jarred. He closed his eyes and clenched his jaw against the pain.

“Hey.” Caleb rested a gentle hand on his hair. “Just breathe, Deuce. It’ll get better.”

Dean swallowed thickly and took a few short breaths. When he looked at Caleb again some of the panicked glaze had abated. “Sorry I freaked out on you.”

“You don’t have anything to be sorry for, kid.” Caleb was the one who should have been begging for forgiveness. If anything happened to Dean…

“I know it’s Mac and he’s the best but…”

“It’s still scary as hell.” Caleb raised a brow. “Dude, I’m the one who gets the willies just seeing one of those big blue ‘H’ signs on the interstate. I get it.”

“So, you don’t think I’m being a girl?”

Caleb squeezed his hand. “Well, I know it's that time of the month, Deana, I’m just trying to make you feel better in case you croak or something.” Reaves grinned. “Is it working?”

Dean snorted. “Like magic.”

A nurse stepped over and touched Caleb’s shoulder. “We need to start the cold saline drip on your brother now.”

Reaves glanced up at the woman, but didn’t correct her. He removed his touch from Dean with a sense of dread and the teen gave him a look somewhere between resignation and forgiveness.

“Now that the freezing process is about to begin, you sure you’re not going to do the whole Princess Leia confession thing, Damien?”

Caleb appreciated the humor, despite the knife of guilt it thrust in his gut. “Me? The L-word? Come now, Deuce. There’s about as much of a chance of me kissing a Wookie.”

Dean smirked. “Right.”

Caleb stood and started to move out of the nurse’s way, but then hesitated. His eyes met Dean’s again. “But just because I don’t say it, doesn’t mean it’s not true.” Maybe the silence made it more so.

The teen nodded, seeming to understand. After all, they both studied at John Winchester’s ‘when in doubt- repress’ school of hard knocks. “I know.”

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After Sam’s quick change into a pair of borrowed scrubs, John led his son to Dean’s room where they met up with Mackland coming off the elevator.

"Any change?" John asked, still holding out hope his son would miraculously pull out of this in typical Dean fashion.

"No.” Ames glanced up from the chart he’d been reading. “His BP is still erratic and respiratory functions haven't returned to normal. I've ordered the cold isotonic drip, and I want to start the respiratory push soon."

John nodded grimly. "Just let me talk to him first."

"Of course." Mackland opened the door leading to Dean.

John felt Sam hesitate as a flurry of activity greeted them.

Mac placed his hand on the teen's shoulder. "It's not as bad as it looks, Sam. All this equipment is going to help us monitor Dean's condition during the hypothermic process.

"Hypothermic?" Sam glanced up at the doctor.

"I haven't really explained everything," John said with a shrug.

Ames favored him with an exasperated look. "How about we explain it to Dean, so I only have to do it once."

John and Sam made their way through the nurses and found Dr. White by Dean's bedside. Caleb was in the corner of the room and he nodded to the teen when their eyes met.

White gave Sam a quick smile. "Seems your big brother couldn't stand for you to get all the attention."

"He's…always hogging the limelight, Doc." Dean's voice was weak and laced with pain, but to Sam it sounded beautiful.

"Dean?" Sam leaned against the bed. "You're awake!"

"Hard…to sleep with all these women putting their hands all over me. And then there was all of Caleb’s blubbering."

One of the nurses currently placing an icepack on Dean's chest winked at Sam. "I bet he thinks he's really smooth with the ladies, doesn't he?"

Sam nodded. "But, he doesn't even have a girlfriend."

“And there aren’t very many prospects either,” Caleb added.

"Shut up," Dean growled, and Sam felt as if his face might break with his large smile. It was so good to have some sort of normalcy amidst the strange chaos surrounding them. Dean returned the grin with a decent imitation of his usual shit-eating version. "At least I've…actually kissed a girl."

Sam ignored the dig. "Are you okay?"

"I'm good, Sammy." The older teen licked his dry lips. "How…'bout you?"

"I'm okay," Sam said softly, biting his lower lip as he stared at his brother. "Thanks to you."

When Dean didn't reply Mac spoke up. "Dean, I want to explain what's going to happen as we try to contain the problem you're having with the intracranial pressure."

Dean lifted his hand slightly off the bed. "No need, Mac." Dean took a quick shallow breath. "You're putting me on ice, until my brain shrinks. Dr. Bedside Manner told me"

White shrugged when the other physician looked at him. "I simply explained the procedure in lay terms."

Mackland rolled his eyes. "Do you understand about the ventilator?"

Sam's eyes went wide at the term and then sought out the machine now being set up next to his brother's bed. A wave of terror washed over him. He recognized it from countless TV medical dramas. "Why does he need that?" the teen asked harshly. He sent a challenging glare to Mac. "He's breathing on his own."

"In a hypothermic state, Sam, Dean's body is going to need more oxygen," Ames began in his most pragmatic, lecturer's voice.

His patient cut him off with a rolling of his eyes. "Sammy, take it easy. It's…just Mac being Mac. Mister Cautious."

"I don't like it," Sam replied, sounding much younger than his thirteen years.

Dean forced a grin. "Me neither, little brother."

"You going to be okay with all this, Ace?" John asked.

"It'll be fine, Dad." Dean looked up at his father. "Besides, I can take a little frostbite if it gets rid of this headache." He shot Caleb a look out of the corner of his eye. “Piece of cake.”

Sam again looked at Mac. "Hypothermia is dangerous." Hunting was an outdoor career most of the time, forcing those who participated in it to be well-versed in survival skills. Sam knew how to counter the cold killer since he was seven or eight, but he never once ever heard of it being helpful. "It can kill you." He added, accusingly, his glare shifting between the physicians and his father.

When Mac didn't answer right away, Dr. White took it upon himself. "Only if it's not controlled, Sam. Lots of things are dangerous in the medical world. Take radiation for instance. Definitely not something you want to be willfully exposed to, because it will bring about a slow and torturous death, but it can cure cancer and save a life if it's used in the right way."

"Do you mind not traumatizing…my little brother any further?" Dean shook his head slightly. He looked at Sam, who'd turned green. His breath was shaky and it was difficult to say long sentences. "Look, Sammy, it's not like I'm out lost in the woods, okay. I won't get that cold."

Sam frowned, moving closer to the bed. "Will it hurt?" he whispered, his eyes leaving Dean's and traveling to Mac's.

"No," Dean answered, quickly. "I'll be asleep, right, Mac?"

Mac nodded. "Of course."

"I still don't want you to do it." Sam reached through the bars of the hospital bed and grasped his brother's hand, not caring who was standing by or worrying about how Dean might tease him about it later.

That old familiar fear was back, the thirteen-year-old felt six again. He needed nothing more than his brother to tell him it was all going to be alright. If the panic got much worse, Sam was sure he would crawl right up in the bed with Dean and refuse to let go. "Something might go wrong."

"Son." John laid his hand on Sam's shoulder. "We don't have a choice here."

Sam again looked at Mac. "Can't you do something? You helped me."

Mackland sighed. "Samuel, this is all that I can do."

"It'll be okay, Sammy."

Sam felt the first tear slide down his cheek. He hated the way it made Dean physically flinch, causing him even more pain, but he couldn't help it. This was his fault, and no matter what the doctors, Caleb, his father or even Dean said, Sam was terrified this would be the last time he'd talk to his brother.

He still hadn't apologized for all the things he'd said before his trip, nor had he told Dean what a great big brother he was. "Don't let go. Okay?" He choked, holding his brother's gaze, praying he'd get another opportunity. "Just don't let go."

Dean tightened his grip on his brother's hand again. "I won't, little brother. I promise."

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