FIC - "Vent" (Gen) - Part 1/2
Title Vent
Author earzwideopen
Rating R
Word Count 6666 (not creepy at all)
Pairing/Genre Gen, very light hinty peripheral Dean/Doctor!OFC (gahh forgive me, it just happened)
Spoilers: nd of Season 3, I guess (It's technically set in Season 4, but there are no spoilers for S4 events or characters.)
Warnings Language, heavy angst that occasionally hints at suicidal ideation, graphic description of scars, scary hospital situation, mentions of Hell/post-Hell stuff
Genre H/c
Summary Dean ruptures his spleen on a hunt and needs to have it removed. Without his spleen to keep his immunity intact, Dean's health takes a dive after the surgery, and his spirits follow suit. Sam, frustrated at Dean's self-destructive attitude, tries his best to hang on to his brother. Hurt!Spleenless!Sick!Depressed!Dean, Caring!Frustrated!Sam.
Notes I'M SILLY AND ORIGINALLY LABELED THIS AS OMC INSTEAD OF OFC. I'M POSTING THIS IS TWO PARTS DUE TO LENGTH but it's meant to be read as a one-shot. It gets pretty angsty, but I couldn't keep myself from writing a hopeful ending! (Also, bear with me if you're not an OC fan. I figured that if there was gonna be a doctor involved, she might as well have more a purpose than just doctoring. But really, it's The Dean Show through and through). ;)
Written fo maypoles' hoodie_time ishlist! Hope it's everything you wanted!!
Archived:on AO3
LiveJournal Read Part One after the cut!
Additional Parts on LJ Part 2/2
Dean knows instantly where he is and what he's on when he wakes up, mostly because it was a light sleep to begin with. He's in a hospital bed with the top half tilted up so he's not totally horizontal, pillows at his back and beeping in his ears...
And he's on the Good Drugs.
The Good Drugs, they make voices sound like tiny tinkling bells on the horizon of your hearing; they sweep a paintbrush of pastels across your field of vision and infuse light with a rosy glow; they make whatever pain they can't completely get rid of seem hinted-at, like the pain's part of you but only vaguely, only by proxy. Just a little twinge, the ghost of pain, a spectral projection of whatever your nerves tried to scream at you. As a rule, hospitals never took chances with pain unless they suspected you were faking... What was that mental disorder again where people faked sick all the time, Munchie syndrome? No, that wasn't right...
Ah, whatever.
All Dean knows is that these meds are giving him the warm and fuzzies, which is a-ok. He also knows that he woke up in a state of delaudid-induced enlightenment: there's a slice of time he can't account for between staggering into the waiting room with his left side on fire and now. Doctors're talking about it, apparently. The little jingly voices of the labcoated shapes floating around are vaguely amusing, like robots in science fiction movies who take everything way too seriously. Dean, knowing the doctors'll bug the crap out of him if they figure out he's awake - How bad is your pain? Do you have any allergies? Does it hurt when I do this? What about this? - opts to keep his eyes closed and just listen...
And all of a sudden someone's yanking open his left eyelid and shining a flashlight at him, and he's as lucid as a dunk tank victim.
"Sonofabitch! Woahwoahwoah, watch it, lady!" he blurts out, tongue thick and sticky from the meds, and the doctor examining him jumps back a step. The monitor beeps speed up. Dean thinks If I have a damn heart attack it'll be their damn fault. Dammit.
"Mr. Plant," says the doctor, a youngish willowy brunette woman in narrow glasses that seem more like a fashion choice than a necessity. She's attractive enough that Dean thinks he might be a good patient for once - or at least a tolerable one. She's the only one in the room now besides him. "Glad to see you're awake," she says. "Your timing is impeccable; I just walked in."
Dean has a fleeting panicky senior moment and forgets that hospitals equal aliases ('Plant' who?). But the moment passes and he nods.
"Doctor Jenn Kelsch," she says, offering her left hand because her right one's holding a clipboard, and instinctively Dean notices it lacks a wedding ring. He takes it in his own hand, the one with the little finger-puppet heart monitor, not the one with the catheter sticking out of the back of it. He tries to fight off the aches and wooziness and seem off-the-cuff, badass. Hospitals really aren't Dean's style - the quicker he can communicate that he's rearing and ready to leave, the better.
Doctor Jenn Kelsch breaks the handshake and continues, thumbing through some charts with doctorly aplomb, "So, looks like you came in with a knock on your head, pretty nasty bruising to your left side. And abdominal pain, which is always a good reason to come in... Can't believe the triage nurses left you sitting in the waiting room for so long; you must have a high pain tolerance..."
"You could say that," Dean grumbles. His mouth tastes chalky and his head is humming. His stomach does hurt, now that she mentions it - an ominous burning swimming under the meds like Jaws under the surface of the open sea. He wants to ask where his brother is, but the doc said "You came in," not "Your brother brought you in," and he's too hazy from the drugs to try and contemplate the how of having gotten to the hospital, or whether Sam even should be there at all. Last thing he remembers is that poltergeist throwing a refrigerator at him. Of all the nutty ways for a job to go south.
He knows he shouldn't be freaked about Sam. There've been plenty of E.R.-necessary situations where it's been best for them to split up - whether it's because of the case, the police, whatever. Still... Dean can't ignore the nagging feeling that Sam should be sitting in the bedside chair this time, especially this time, even if he has a good reason to stay away...
More page-thumbing and pen tapping from the doctor. "You said earlier your pain was an eight..." (I said eight? I never say eight... Shit this can't be good...) "Looks like they already got you started on some fluids and meds, so I bet you're feeling a little better right now... Temp was a hundred point six before the Tylenol... Hmm - BP's looking a bit low for my taste." Doc Jenn Kelsch is wearing her best 'doctor frown' now, a guarantee something's up. Sure enough, the next thing she says sounds spring-loaded, tense and focused, which is far from the most reassuring tone an ER doctor's voice can take:
"Mind if I take a look at your belly, try and see what we're dealing with?"
Dean casts his eyes sideways. "Not like I'm goin' anywhere," he says. He doesn't wanna admit he kinda likes this chick, in a you're-nosy-and-invading-my-personal-space-but-I-guess-it's-okay sort of way. He's always had a thing for hot women in scrubs.
Jenn Kelsch's olive skinned hand pulls the covers down and his gown up. For a short moment he prays Dean Junior won't embarrass him; he's had stronger reactions to less hot women while on more drugs. "Let me know if anything hurts," Jenn Kelsch says. She huff huffs some warm air onto her stethoscope like she's fogging up a window and presses it gently to his gut, here, there, there, back there again. Dean watches her face. Her brow furrows deeper under her glasses. She's not doing a bang-up job of hiding her apprehension.
"I'm just gonna feel around a bit, now..." she murmurs, her hands replacing the stethoscope. Dean can tell she's in deep concentration; this isn't a routine check-up, it's a determination of just how fucked things are. "Again, tell me if it hurts."
Dean's surprised to find that her hands aren't cold and dry like most doctors'; they're a little on the warm side, and soft, and about as gentle as someone probing your stomach could be. She starts out low, near his hips, and moves up toward his ribs. Her prodding isn't exactly pleasant - everything in the area feels sore and tender. Dean is pretty sure the ribs are just bruised, although he has to admit it that the pain isn't like most bruising he's ever had... It's a little deeper, somehow. More urgent, even with the meds.
"Well, your abdomen's definitely distended..." Jenn Kelsch muses as she works. Dean knows the term - abdominal distention - enough to know that it usually means nothing good. Now that she's pointed it out, he does feel a little odd... bloated or something. Yuck. He focuses on breathing and tries not to think about it.
"You say besides your ribs, your abdomen hurts in general," she says as she works.
"'Bout right," Dean says shortly. "Kinda just... everywhere."
"So nothing in one particular spot...?"
"Like I just sssssAAAAHHHH dammitdammitdammit," he hisses, because she's pressing on the upper left part of his abdomen and it's excruciating. A manic spasm of pain hurtles all the way up through his shoulder - his shoulder, for Chrissake. Son of a bitch, she's not even touching his ribs...
He sees through the pained tears in his squeezed-up eyes that Jenn Kelsch is nodding; like all doctors, she doesn't seem surprised at his reaction. She says, like a friggin' mind reader, "Did you feel pain all the way up to your shoulder just then?"
Dean can't bring himself to form intelligible words. He nods and lets something between a grunt and a groan burst out of his lips.
E.R. Doctor Jenn Kelsch, M.D. is now wearing her best 'just-as-I-suspected' face. For a split second there's something else in her eyes - pity, or some other non-doctorly emotion, like she's actually feeling his pain. Maybe it's just the meds. Whatever it is, though, the extra emotion's gone pretty quickly and Jenn Kelsch is all business, striding over to the curtain and leaning her shoulders out into the ward.
"Hey Christy," she says, and there's definitely a nervous clip to her words now, "let's get somebody from imaging down here for a CT. Room 22-C."
STAT, Dean adds to himself with a nervous grin.
"Somebody from imaging" shows up in nothing flat; it's making Dean even more nervous that he's in the ER and not having to wait forever to get tests done. Jenn Kelsch is briefing the "somebody," talking a mile a minute. "Trauma to the upper left quad with severe localized pain and rebound tenderness, diffuse abdominal pain, referred pain in his shoulder. BP's one ten over seventy two and not getting any higher."
"So basically?" radiologist dude asks, but judging by his tone Dean's sure the guy knows the answer already.
"You're gonna wanna check for blush and splenic laceration."
"Woah, woah, woah, woah, woah," Dean says, making a T as best as can with his wired-up hands and his drugged-up brain. "Time out, Kerry Weaver. I'm not gonna give you the go ahead to microwave my insides until I know everything you know. What the hell's wrong with me - in English, not freakin' Grey's Anatomy Pig Latin."
Jenn Kelsch wears her best doctor's "I-save-people's-lives-and-this-is-how-they-thank-me" face. She wraps her arms around the clipboard and rocks back on her heels. "Dean," she says, "you seem tough, so I may as well give it to you straight. Odds are, you have a ruptured spleen and it's bleeding out into your abdomen." She says 'ruptured spleen' like anyone else would say 'hangnail.'
Dean's eyes pop so hard he's afaid they might eject themselves from his face.
"Don't sugar-coat it," he chokes. He knows what internal hemorrhaging means. Every hunter knows what internal hemorrhaging means - surgery, exploratory at the least. Sometimes a major open surgery, big old incision, blood transfusion, the whole nine yards. He hears the monitor beeps speed up and thinks where is Sammy ah god where the hell is Sammy, and then a violent rip of pain from his ribs to his navel blurs his vision. He slams his head back against the pillow and curses through his teeth.
He thinks he hears a voice saying take it easy, take it easy, and suddenly a morphine torrent whirls into his head and reels it like a top.
He's half-conscious from the meds by the time he's lying belly-up in the CT scanner. The diagnostics room is dark and gray-blue. The little red light on the scanner prompts him to hold his breath while the machine clangs over his stomach. With the meds detaching him from it all, he sees his situation clearer, like he's looking down on himself. Now the idea of blood filling his abdomen isn't as disgusting as it is fascinating, almost amusing... Sammy would probably bitch him out for thinking about it that way, though... Good ol' Sammy... He pictures his brother's face hovering over him - Sam's fists are reaching down and clenching around Dean's shouders on the gurney. Little tears sparkle in Sam's eyes.
Dean, you're an idiot, Sam says like he's Jack talking to Rose in the goddamn Titanic, you're so stupid. Can't you see you're dying?
Can't you see...
As he's being wheeled back from diagnostics, Dean starts to feel dizziness and chills that can't be explained by a morphine high. He's curious about why his vision is so damn blurry. He hears doctors shouting things about "BP dropping" and wonders if gas prices are finally getting lower...
He's in the O.R. counting down from a hundred before the CT scans even develop.
When Dean is halfway between sleep and waking, he sees white light and hears muffled voices, like he's lying on a cloud and wearing earmuffs.
...They let him sit in the waiting room bleeding internally for how long?
This place was really... freakin' white. Sam sounded... Sam sounded really pissed... Who was bleeding internally, now...?
Mr. Plant, your brother would have needed the same surgery regardless of how long he waited. He's resting now; the procedure went as smoothly as it possibly could have gone. The blood transfusion is for what he lost-
What he lost while you guys were screwing around not diagnosing him? ...No, no I'm sorry. Thank you for everything you've done. I just...
For what it's worth, your brother put on a very brave face until the last few minutes. Most of the time, people in the hospital exaggerate; it's rare for them to do the opposite.
I just find it hard to believe that you base your priorities on who's acting the sickest.
You have to understand, sir... What Dean was going through... I have never watched anyone shove down the pain of a ruptured spleen that convincingly. The organ was a mess when we took it out, one of the worst I've ever seen.
Well... I hope your learned your lesson...
Yes...
he...
vaccines...
Dean falls asleep again.
"You're gonna have to break all the mirrors in motel bathrooms from now on, Sam," Dean croaks.
He's out of the recovery room and back in his usual bed. Has been for a couple days. There are oxygen tubes jutting up his nostrils. A bore needle feeds fluids into his neck; they ran out of veins after his blood transfusions. He pushes it out of his mind. He feels listless and parched and sore.
"Why's that?" asks Sam. "Don't you think you've had enough bad luck for one lifetime?" Sam's long legs sprawl out from the bedside chair. He's resting his chin in his palm. He looks haggard and pale.
"I'm not gonna be able to look at it," says Dean, "the damn..." He can't even say it. What is he, four?
"Hey, enough with the drama. You haven't even seen the scar yet; how do you know it's that bad?"
"You heard the doctors, Sammy," Dean says miserably. "They frickin' gutted me like a fish from breastbone to belly button."
"So you wouldn't rather have that than a slow death by internal bleeding?"
"Believe you me, it wasn't gonna be slow," Dean snaps. He clenches his jaw. He feels hollow, and not just because he's down an organ. The world looks like a white sock that got stained because it went in the wash with the darks. The only thing with any color is a little plastic vase full of flowers on his bedside table that Sam insists he didn't buy. Dean doesn't wonder who did - they're not cheering him up, anyway.
"At least you get to go home today," Sam says in an asinine attempt at hopefulness. Dean can tell that he's holding something back, wonders how long it'll take to draw it out of him.
"Yeah, I'm gonna love nursing my Frankenstein gut wound on Bobby's couch with a decades-old heating pad and doctor's orders not to drink booze."
Sam's eyes flash. "You're not helping yourself by thinking like that."
"Man, I don't know what to think," Dean growls, the strain of talking sending a fire through his stitched-up diaphragm. "'Case you haven't noticed, Sam, I don't have a goddamn spleen anymore. That's not exactly like losing a baby tooth." He grimaces.
"I just mean," Sam replies, trying not to let his fists clench, "that stress hormones can make your pain worse."
"Well I don't give a crap about pain. I'm pissed. Pain doesn't change that."
Sam's face flushes with anger. "You know what, Dean? You should care about pain, because the doctors said you nearly killed yourself ignoring how miserable you felt."
"I was hopped up on freaking morphine, Sam. I could barely think, let alone judge whether I was bleeding out. Where were you, anyway?"
"I was out saving some kids, Dean! I thought you'd be mature enough to demand faster care from an Emergency Room staff! If it were me, you would have carried me past the waiting room and into the OR yourself."
"Well it wasn't you, was it? It was my problem."
Sam jumped to his feet. "I can't believe how selfish you sound right now! Don't you think I care whether you live or die? I'm your god damn brother, Dean! I'm so sick of you not giving a shit what happens to you. Whether or not you're healthy doesn't just affect you!"
"So I guess you don't care about those stress hormones anymore," groans Dean, sweating through new waves of pain, digging for a way to end the conversation.
"No..." says Sam. He's shaking his head. There are tears on his face. "No no, no you are not gonna turn this around on me, not when I was so scared I was gonna lose you..."
And now Dean's eyes are watering too. This is just terrific...
And then (Dean hears Fight Club in the background: "And just then, in our most perfect moment together...") Doctor Jenn Kelsch does the doctorly "knock-on-the-door-but-enter-the-room-regardless-of-whether-anyone-said-'come-in.'"
When she takes a good look at Dean, her face is weirdly guilty. Maybe she had a thing for him after all. Maybe she still does. Her eyes are a little hard to read behind the glasses, though.
"How's your pain?" she asks tiredly.
Dean gives her a nice long stare, thinking How do you think my pain is you crazy heartless gentle brutal sexy sexy woman.
"I'll order you one last dose of morphine for the road," Jenn Kelsch says. She doesn't appear to have heard his inner monolgue, which is really a shame. "You know, you can go home as soon as this bag of saline is done. Recovery's mainly going to involve doing as many 'healthy things' as possible. You're gonna need rest and as many fluids as you can get your hands on. I'm prescribing you pain meds and antibiotics to ward off infection.
"Remember, earlier we went over ways to take better care of yourself without your spleen, which normally would help you fight infections. You're going to be more susceptible to the flu, pneumonia, staph, foodborne illness... I made a list of recommended vaccinations and a number you can call to set up the appointments for them. Call us or a doctor's office right away if you start to feel sick. That means sore throat, runny nose, bad indigestion, anything. Just..." she pauses, looking up from her clipboard to meet Dean's eyes. "Dean, I've seen your type come through here before. Promise me you're not going to rush back into things. Take some time to get better, alright?"
Dean really hates Jenn Kelsch - E.R. Doctor Jenn Kelsch, M.D. - with no wedding ring and bouncy brown hair and cute glasses and warm soft hands. He really hates it when the people he wants to listen to give him advice he doesn't wanna take.
Still, somehow he hears himself grunt, "Alright." And that's that.
As she's turning to go, Jenn Kelsch stops.
"You're really lucky to have your brother, Dean," she says. "Not every patient I admit has someone who's willing to stick up for them the way Sam stuck up for you in the recovery room."
Dean barely knows what she means by that, but he can imagine Sam making a stink about how the doctors didn't act fast enough with the whole "busted spleen" situation - and when he thinks about it that way, he feels a little better already.
Jenn Kelsch keeps looking at him for just a second too long. Dean puts two and two together and says:
"Thanks for the, uh... for the flowers."
After his IV gets taken out and all the release papers are signed, Sammy helps Dean get his clothes on, making sure to be careful of for scar and the IV bruises. He pulls socks onto his big brother's feet and ties up his black bootlaces. Dean grumbles a little about Sam being his handmaiden, but never pushes his brother away. He also never looks down at his abdomen.
Dean drifts off just before he feels Sam lift him out of the Impala to carry him into Bobby's.