The Telltale Heart Monitor
The Telltale Heart Monitor
Asylum tag. Dean suffers complications from the shotgun blast to the chest. Sam breaks the “no chick flick moments” rule every which way he can. Dean uses every trick he can think of to fend him off. He is not helped in his efforts by a heart monitor.
Dean has to struggle through several hazy shades of grey before black finally becomes white.
“Hey,” Sam says softly right beside him. Turning his head is too much effort, so Dean lets his eyes slide to the right, registering the hospital room as they go. When he can work up the focus on Sam’s face, he sees his brother give him full-on puppy dog eyes and the gooey, tender smile that has always been achingly reminiscent of their mother. That’s when he realizes a ginormous hand is resting gently on his forehead.
“’Ryou pettin’ me?” Dean slurs.
“Nope,” Sam replies, his smile quirking a little.
“’Kay then.” His eyelids droop and he reopens them with an effort.
“You can go back to sleep, Dean,” Sam says in the warm, soothing voice he uses on frightened civvies. But he also throws in his best rendition of the reassuring, confident tone his big brother has always used on him. “I’m right here, and everything’s okay. I’m taking care of everything, don’t worry.”
Dean feels the soothing, rhythmic motion on his forehead again, and he would’ve called Sam on it if it hadn’t lulled him right back into welcome oblivion.
The next time Dean wakes up, his muddled senses register nothing but Sam massaging his hand. He gently kneads it between his big paws, then digs his thumb into the muscle between the bones, and finally rubs and tugs each of his fingers in turn before starting the process all over again. Dean watches in fascination until Sam speaks up.
“Look who’s awake. How are you feeling?”
“Fine,” Dean lies automatically, his attention still riveted to his hand. It occurs to him a few moments later he doesn’t know what he’s lying to cover up. “How badsit?” he asks lazily.
“You’re going to be all right,” Sam says in his warm, soothing voice. “Your left lung was punctured by a broken rib, and it collapsed. They operated on you to repair the damage and everything went fine. Now comes the hard part.” His hands still for a moment until Dean looks up at him before he continues: “Getting you to lie still long enough to heal.”
He smiles fondly down at his big brother, who blinks for a few moments until the words and the teasing humour behind them sink in, then gives him a small smile in return.
“How’s the pain? Do you need more morphine?” Sam asks as he works on the muscle at the base of his thumb.
Dean thinks about this for a while, and eventually concludes if he’s having a hard time processing the question and coming up with the right response, then the answer’s probably no. He watches Sam gently mobilize his hand.
“Well?” Sam asks.
“Hmmm?”
“Do you need more morphine?”
“Oh. No, don’t think so.”
“Good.” Sam starts on his index again. “When the nurse comes back, I’ll ask her to connect the heart monitor to this finger so I can massage the other hand as well.”
“’Kay,” Dean mumbles, marveling at how good it feels to have the tension worked out of his fingers. Something eventually occurs to him. “’Sno pain in my hands,” he points out to Sam.
“I know,” Sam replies easily as he works. “That’s the whole point.”
Dean wants to say “Either my morphine dose is too high or you’re batshit crazy” but it’s too much effort to string that many words together so he just raises his eyebrows. Sam gets the message, though.
“It’s sophrology. I’m flooding your brain with non-painful sensory stimulation to occupy the receptors and block the pain messages.”
Dean’s eyebrows drop back down into a puzzled frown and Sam rephrases his explanation in terms that will more easily penetrate his morphine-fogged mind.
“It’s a diversionary tactic. I’m keeping your attention focused on your hand so you forget about the pain in your chest.”
“Oh.” Dean watches his hand for a few moments and decides it’s working, so he gives it a happy, dopey smile and drifts back into sleep.
When Dean wakes up the third time, there’s no one stroking his forehead or hand, and the heart monitor suddenly starts to beep urgently in response to his moment of panic. Sam hastily puts down the cup of coffee he’d grabbed from the machine in the hallway and rushes to Dean’s side.
“It’s okay, I’m right here,” he says as he grasps Dean’s arm. He watches bewildered hazel eyes look around frantically as he tries to get his bearings, then settle down once they’ve focused on Sam. The beeping immediately slows.
“You’re in the hospital, remember? A broken rib, a collapsed lung, but you’re going to be okay.”
Dean works his dry, pasty mouth with a grimace and Sam quickly pours him a glass of water. He slides a hand behind Dean’s head and gently lifts him enough so he can drink from the straw, then lays him back down on the pillow.
“So how long do they want to keep me stuck here?” Dean asks, looking around grumpily, already irritated at being confined to bed.
“A couple more days.”
“I don’t want to stay that long.”
Sam’s back straightens and his jaw juts out and his eyes turn steely.
“Too bad. You had emergency surgery just this morning. You almost died and you scared the shit out of me. Look, I get you didn’t want me taking care of you, I’m the one who blasted you in the chest. But for two days, you lied to me. You kept telling me you were fine, you were just coming down with a cold. But dude, you were far from fine. What started out as a broken rib escalated into severe tension pneumothorax. So much air leaked into your chest cavity it not only collapsed your lung, it was compressing the blood vessels that feed your heart. When I woke up this morning, you couldn’t breathe and your face was blue and you barely had a pulse. Why would you rather end up on death’s doorstep than tell me you were hurt? Did you think I wouldn’t care? Dean, you were dying right there in my arms, and the paramedics weren’t getting there fast enough, and there was nothing I could-” Sam breaks off his tirade when he chokes up, but when he speaks again it’s with vehemence. “You’re staying if I have to tie you to the bed.”
Dean’s eyes widen for a second, then he relaxes.
“Didn’t peg you for the bondage type, Sammy,” Dean smirks, and Sam softens.
“So. If you’re making sick jokes, I take it you’re feeling better?”
“Yeah, I’m okay.”
“How much pain are you in?”
Dean looks down at his chest.
“Broken ribs are always a bitch, but I’ll live,” he says.
“Okay. They just decreased your morphine dose a bit. Do you want me to ask them to up it again?”
“Nah, this is fine. Pain’s bearable. I’m hazy as it is, I’d rather not be totally out of it.”
“So you’re good then.”
Dean gives him a puzzled frown.
“Yeah, I’m good.”
“Good,” Sam says, nodding with a gleam in his eye.
Dean’s frown turns from puzzled to suspicious.
“What?”
“I’m about to take advantage of the fact you can’t slug me or stomp away,” Sam says with a smile.
“Dude, if you try to hug me, I’ll-”
“Relax,” Sam cuts in forcefully. “Although, you know, it’s not such a bad idea. If you’d just let me show you how I feel about you once in a while, maybe you wouldn’t have all these doubts.”
As they stare hard at each other, Sam suddenly realizes the heart monitor is beeping at a quick, staccato pace. Dean keeps his game face on, pretending he can’t hear it and hoping Sam won’t notice it. But as soon as Sam’s gaze cuts towards the machine, Sam sees him wince out of the corner of his eye.
“Huh,” Sam says pensively. “All this time, I thought your aversion to anything even remotely touchy-feely was because it was an affront to your macho exterior.” He looks back at his brother, his eyes probing. “But it goes a lot deeper than that, doesn’t it?”
“Sam,” Dean draws out in a warning tone, turning his face towards the far wall and pulling his arm out of Sam’s grasp.
“So what is it then?” He cocks his head as he considers his brother. “Is it because you feel you don’t deserve it?” he asks, and when the monitor speeds up even more, he knows he’s on the right track. Dean glares murderously at the traitorous machine, but it blithely continues to telegraph his emotions for everyone to hear. “That’s it, isn’t it. All those years you took care of me, there was no one taking care of you, and it made you feel like you weren’t worth it.”
“Sam! Cut the…Dr. Phil…crap!” Dean pants angrily, his breath hitching. He clutches his chest as he tries to roll away from Sam, off the far side of the bed. The monitor goes crazy.
“Whoa! Take it easy,” Sam says as he grabs Dean by the shoulders and gently presses him back down to the mattress. “It’s okay, just relax. Just breathe for me, okay? Slowly. Easy.”
Dean stops fighting and closes his eyes while he focuses on getting his breathing under control. He lays perfectly still until the pain subsides in his rib cage and his healing lung is no longer screaming in protest. Sam starts massaging his hand again, but Dean yanks it away, so Sam just waits patiently until his heart rate has slowed back to normal.
He looks at the machine and wonders if he could get a hold of one. When making his way through his brother’s emotional minefield, a metal detector would sure come in handy.
He turns his gaze back to Dean, who is keeping his eyes closed as his only means of escaping his brother. Sam questions his plan to settle the events at the asylum while Dean is physically impaired. But he knows that once Dean is out of bed and off the morphine, he’ll have no hope in hell of ever having this conversation. And he is now even more certain than ever that if he doesn’t, he would be leaving a gaping wound to fester on what is already a badly injured self-esteem.
In this case, he’s sure his father’s ruthless triage of physical over psychological wounds is not the right way to go, and since he’s in charge right now, he’s going to do what he thinks is right. He may cause Dean a little discomfort in the short term, but it will save him a lot of emotional pain in the long term. He’ll just have to proceed carefully, and keep a close eye on his metal detector.
A young blonde nurse bustles in and goes straight to the heart monitor. She’s so pretty she can even work the painfully loud pink scrubs.
“Everything okay in here?” she asks. “Your heart rate peaked into the tachycardia range for a moment there.”
“That’s cuz I was dreamin’ of you,” Dean says with a smile that crinkles his eyes but doesn’t quite reach them.
The nurse blushes a little and Sam rolls his eyes out of habit more than anything else. He waits patiently through the flirting/vital-sign checking, glad for the intermission. When she finally leaves with a promise to return later, Dean enjoys the view as she walks out the door then glances back at Sam still smiling before his eyes slide away uncomfortably and the smile dies.
Sam thinks carefully before he speaks again.
“Hey, you know what the nurses’ scrubs remind me of?” he asks lightly.
“You mean the fugly pink?” Dean responds, all for the change of subject.
“Yeah. It reminds me of Banana Jones.”
“What?”
“Remember that time, I think I was about ten, I made you promise to bring me to the amusement park?”
Dean’s frown clears as he makes the connection. “Oh yeah! That carny kept trying to con me into losing more money at the shooting range.”
“Right, but actually, you were hustling him. And in the end you won forty bucks off him and that big-ass stuffed gorilla you gave me. Remember it was wearing a fedora, so you called it Banana Jones.”
“And after we went on that ride that looped us upside down, you upchucked all over it, and you’d eaten all that cotton candy so it was bright pink. Dude, you even puke like a girl.”
“Yeah, that’s what you said at the time. And every single time you’ve told the story since.”
“Good times,” Dean smiles in fond remembrance. “Well, maybe not for Banana Jones. We never could get that fugly pink out of his fedora.”
“And do you remember your foot was broken that day?” Sam asks in the same casual tone, but he’s looking intently at his brother.
Dean’s smile vanishes when he realizes he’s been ambushed.
“In fact,” Sam continues, “your foot had been broken for three days by then. And yet, you never told Dad, and you never let on to me either. You walked all over an amusement park and got tossed around on the roughest rides and I never even saw you limp or wince or groan once. If Dad hadn’t gotten up in the middle of the night and caught you icing your foot down, I wonder how long you’d’ve gone on masking like that.”
“I may not be able to clock you one now, but I’ve got a good memory,” Dean says ominously.
But Sam isn’t deterred.
“Why do you do that, Dean? Do you think everyone else’s needs come first even when you’re badly injured? Do you think no one will care that you’re hurt?”
The beeping rises to a frantic crescendo.
“Fucking hell,” Dean spits.
His arm suddenly snakes out and grabs the machine and yanks it closer, looking for a way to shut it up. Sam leaps up to tug it away from him and push it back out of his reach. Morphine has dulled Dean’s wits but he nonetheless immediately comes up with an alternate plan-he just fails to see the fatal flaw in this plan. He tugs the clamp off his finger. He twirls it by the cord triumphantly when the telltale heart rate is instantly silenced, but a few seconds later a nerve-wrenching alarm sounds when the monitor flatlines. Sam whirls around in a panic that turns into exasperation when he sees what Dean has done. He snatches the clamp mid-twirl, and grabbing Dean’s hand quickly fits it back over his index finger. Blips immediately reappear on the monitor’s line, and the alarm mercifully turns off.
There’s a commotion in the hallway so Sam sticks his head out the door and calls: “False alarm!” Once the nurses are reassured the crash cart isn’t needed, Sam looks back at his brother, who smiles and gives a little shrug with the shoulder on his uninjured side, both sheepish and unrepentant. He turns his attention back to his hand and waggles the clamped finger. Sam shakes his head-he just can’t stay mad when his bad-ass big brother somehow manages to look all of five years old.
Just as Sam starts back towards the bed, Dean comes up with another plan. He grabs the call switch and with his thumb poised just above the red button he intones in a mock threatening voice: “Don’t take another step.”
Sam huffs a laugh and spreads his arms wide. “What good is that going to do you?”
“I can call the nurse and tell her you’re bugging the shit out of me and ask her to throw you out on your pansy ass.”
Sam looks at his brother appraisingly.
“You don’t really want me to go,” Sam says.
“Don’t I?” Dean demands, wiggling his thumb a mere millimeter from the button.
“Okay. I’m leaving,” Sam intones, turning around and heading towards the door, listening carefully to the monitor.
Dean’s heart rate actually skips a beat and then scrambles to find its rhythm again. Sam smiles knowingly and turns back to his brother.
“You can’t bluff right now, Dean. You’ve got a tell,” he says, sitting back down by the bed. “Like I said, you don’t really want me to go.”
“I want you to shut up! I’m not in a caring and sharing kinda mood!”
“That’s the problem, Dean! You’re never in a caring and sharing kinda mood. That’s why I’m doing this now when I’ve got a captive audience, ’cause there are a couple things I really need to say. I can’t-” Sam’s voice breaks unexpectedly. He takes a deep breath, and tries again in a quieter tone. “I shot you, and you almost died, and I can’t-Look, I just really need to say this. And I think you really need to hear it. After that, I’ll shut up, I swear. In fact, you can pick every topic of conversation until you leave the hospital. Okay?”
Dean’s face has softened, and he casts Sam a look that’s both shy and concerned. “A week,” he says.
“What?”
“I get to pick what we talk about for a week. And where we eat. And what we watch.” He gestures enthusiastically with his clamped finger when he thinks of one more. “And all the music too.”
“You already pick all the music!” Sam exclaims in exasperation.
“That’s your fault for having such crappy taste! No way am I letting you play Death Cab for Cutie in my car! That shit’s so fucking whiny and maudlin I don’t know whether to stick a fork in my ear or my neck!”
“Hey! It’s poetic and melodic and-” When Sam sees the satisfied smirk on Dean’s face, he huffs and rolls his eyes. “No. Nice try, but I’m not falling for that. We can talk about Death Cab for Cutie all you want during the week you get to pick everything. But first you’re going to listen to what I have to say, right? I mean, really listen.”
“I’m all ears,” Dean smirks, crossing his arms and adopting an attentive look that is totally lacking in sincerity.
But Sam isn’t deterred.
“Dean, you almost died right under my nose because you hid from me how badly injured you were. I need to know you won’t do that again. I want you to care about yourself as much as you care about me. But if you won’t do it for yourself, then do it for me. What do you think it would’ve done to me if you’d died? As if losing you wouldn’t be bad enough, I’d have to live with the knowledge you died because I shot you and because I failed to see you needed help.”
“Sam, it’s not your-”
“Don’t! We’re both adults now. I’m just as responsible for you as you are for me, all right? And I need you to promise me you will never hide an injury from me again.”
Dean squirms uncomfortably for a few moments. “Okay,” he says on an exhalation of breath.
“You promise?”
“Yeah.”
Sam frowns when he notices Dean’s breathing is fast and shallow. His features look pinched and he has an arm curled protectively across his chest.
“How are you feeling?”
“Fine.”
Sam raises his eyebrows and gives Dean a look that says remember that promise you made just a few seconds ago?
“Okay! I’m in pain!”
Sam checks his watch. “The morphine is wearing off. The nurse will be in with your next dose in fifteen minutes. Can you wait till then?”
“Yeah.” Dean closes his eyes and concentrates on controlling his breathing.
Sam thinks about trying the sophrology trick again, but he’s pretty sure Dean would swat him away. He opts for giving his brother some space and goes to look out the window. He keeps glancing back over his shoulder at Dean though, and it pains him to see both his brother’s hands fisted into the blanket. Five minutes later he grabs the switch and calls the nurse.
“I told you I could wait,” Dean grits out through his teeth.
“I know. I couldn’t.”
The pretty blonde nurse breezes in a minute later, bearing a smile and a syringe.
“I bet I know what you want,” she says playfully.
Sam knows Dean really is in pain when he doesn’t use the opening to flirt back.
“If that’s morphine you’ve got there, then you guessed right,” Sam says.
“Don’t worry, this’ll kick in quickly,” she says to Dean as she inserts the needle in his IV tube. “Do you feel up to eating yet?”
“Maybe later,” Dean grumbles.
“Supper’s in an hour. I’ll have a tray sent in just in case you’re hungry then.”
“Thanks,” Dean says, and the nurse leaves with a quick smile.
Sam lets Dean rest for a while longer. It’s obvious when the morphine starts taking effect, as his whole body seems to melt and relax. Then Dean tries to lever himself up and Sam rushes to the bed to coax him back down.
“Where do you think you’re going?”
“Water,” he says, looking at the glass out of arm’s reach on the table.
“Just ask,” Sam says, grabbing the water and then cupping a hand behind Dean’s head.
“Dude, I’m not an invalid!” he gripes, trying to pull himself up and hold the glass himself.
“Yes, you are. Just for a couple of days.” Sam helps him drink then watches him for a bit. Once he’s sure Dean is doing okay, he decides to plough on. He might as well hit his brother with this while he’s flying high on the best painkillers in town.
“Hey Dean,” Sam begins softly and feels Dean brace himself. “You know, being born the youngest of the Winchester men puts me in a tough position.”
Dean relaxes visibly. While he struggles like a demon in holy water whenever his emotional welfare is the topic of discussion, he’s always willing to look out for his little brother’s. It’s what Sam is counting on, a Trojan horse to sneak in the real issue he wants to address.
“I’m always at the bottom of the chain of command, without a hope in hell of ever being promoted.”
Dean considers this carefully, looking at Sam out of the corner of his eye, and nods his understanding, like he’s just been given a crucial clue to a mystery.
“As soon as I was old enough to want to take charge of my own life, it became unbearable. And I think you and Dad got all the military genes-I’m just not a natural-born soldier. Taking orders without question is just contrary to who I am. It really chafes, and because I’m at the bottom of the totem pole, there was nothing I could do but get out from under it.”
“Okay, I get it,” Dean says quietly, his eyes dropping to the generic white hospital blanket.
“Do you? Do you understand that’s why I left? It’s because I had to lead my own life, and not because-” Sam cuts himself off when the beeping sends up a warning.
Okay, big-ass mine buried right under the surface. Tread carefully.
He takes a deep breath, and says very softly: “I was young, and I rebelled, and I didn’t mean to hurt you, and I’m sorry.”
“It’s okay,” Dean says, picking at the blanket.
“I learned something today though,” Sam continues. “In the past, whenever one of us ended up in the hospital, either you or Dad took care of everything. Today, I had to do it all myself. Figure out cover stories, identities, insurance. Explain a weird shotgun wound to the police, authorize your surgery. I worried myself sick because your welfare was in my hands and I was so scared of screwing up, so scared I’d make the wrong decision and you would pay for it. I learned being the one in charge isn’t all that fun either. So I saw things from your end, and I want you to know I really do appreciate how much you’ve always looked out for me.”
Dean starts to shrug and freezes suddenly with a grimace when the movement shoots pain through his torso.
“Don’t mention it,” he says.
“You know, you’re far from pathetic, Dean. You’re the best big brother anyone could ever ask for. But you’re not just a big brother. You don’t exist just to take care of me, and of other people. I know that’s what it must feel like, because that burden was dropped on your shoulders when you were only four and you can barely even remember it ever being any other way. But you deserve to be taken care of too. So I want you to let me take care of you, sometimes.”
Dean casts his gaze towards Sam but can’t look him in the face. “So, you done with the Dr. Phil moment now?”
Sam smiles and shakes his head.
“I’m getting there. I’m trying to explain what happened back at the asylum.”
“Sam, just let it go,” Dean sighs and shifts uncomfortably.
“Sorry, I can’t. I really need to make sure you understand something. Yeah, I do have an issue with taking orders and being bossed around. But the hatred, that did not come from me, that was all Ellicott. Yeah, there are times when you piss me off, and there are even more times when you annoy the crap outta me, but never ever for even a second have I ever hated you.”
Dean nods slightly, still staring at the blanket, and Sam wonders if he should dare spell it out with the L-word.
Better not, the heart monitor might explode.
“On the contrary,” he says earnestly instead, imbuing the words with as much meaning as he can, and squeezing his brother’s hand for emphasis.
Dean shoots him a shy glance, and opens his mouth to say something, before closing it again. After a moment, he mutters softly: “Bitch.”
“Jerk,” Sam shoots back with a smile.
For a while, there’s a comfortable silence marked only by slow, rhythmic beeping. Sam smiles at the sound of it, knowing he made the right choice in lancing Dean’s emotional wounds.
Then he grabs the remote and pointedly hands it over to Dean, who happily flips through the channels until he picks a movie. They simultaneously exchange a glance and a smile, before settling back to watch The Shining.
“Just to clarify the terms of our deal,” Sam says. “I may have to put up with your bad taste in movies, but I don’t have to put up with your bad movie impressions.”
Dean just grins, his eyes gleaming with anticipation, and Sam knows he’s in for all of his brother’s favourite Jack Nicholson lines.