Archive of Our Own

Chapter Text

The drive to the hospital was something Dean would never remember clearly afterward. It survived only as scattered fragments, disconnected moments that refused to fit together no matter how hard he later tried to piece them into a complete memory. Most of the journey disappeared beneath a haze of fever, pain, and exhaustion, leaving behind only brief flashes of awareness before everything faded away again.

He remembered being held tightly against someone in the back seat.

He never actually saw who it was.

He simply knew there were strong arms wrapped around him, keeping him upright every time the car turned or hit a bump. Through the roaring in his ears he could hear the same quiet voice repeating itself over and over, calm despite the fear hidden beneath it.

"You're okay, Deanie."

"We're almost there."

"Stay with me."

"You're gonna be okay."

Dean wanted to answer. He wanted to nod, to tell whoever was holding him that he was trying, that he wasn't giving up, but every attempt seemed to stop somewhere between his brain and the rest of his body. His eyelids weighed too much to lift, his tongue felt impossibly heavy, and even breathing seemed to require more effort than he could spare. He drifted in and out of awareness instead, catching only pieces of the frantic conversation happening around him before darkness swallowed everything again.

At one point another voice broke through the fog.

Soft.

Shaky.

"I'm sorry."

Dean recognized it.

Garrett.

Even in his confused state he frowned slightly. Why was Garrett apologizing? None of this was his fault. Dean wanted to tell him that, wanted to squeeze his hand or say something reassuring, but before he could force his eyes open the warmth surrounding him blurred together once more, and sleep or something much deeper than sleep pulled him back under.

The next time awareness returned, it did so violently.

A deep, crushing pain exploded through the center of his chest, so sudden and unfamiliar that for one confused instant it overwhelmed even the pain in his back. The sensation came again, hard enough that it seemed to shake his entire body. Somewhere nearby voices overlapped one another, though none of the words made immediate sense.

"Dean."

"Can you hear me?"

"Stay with us."

He tried.

He really did.

His eyelids fluttered weakly, opening only a fraction before immediately falling shut again. The bright lights above him burned against his fevered eyes, leaving everything washed out and blurry. He couldn't focus on any faces. They were only indistinct shapes moving around him while hands worked quickly somewhere beyond his fading awareness.

The voices continued.

"Blood pressure's dropping."

"We need an ICU bed."

"Call the intensivist."

"Get another line in."

Someone else answered immediately.

"I've already called."

The words drifted farther away with each passing second. Dean wasn't sure whether he was falling asleep or simply slipping beyond the point where he could keep listening. The sounds around him became muffled once again, blending into a distant hum as exhaustion reclaimed him.

The last thing he remembered before consciousness disappeared completely was hearing someone say they had a spot waiting in the ICU.

Then once again there was nothing.

***

The aftermath of what Dean had dismissed as a "little UTI" was something none of them would ever forget.

The boy had ignored his bladder for so long that the infection had traveled to his kidneys, hence his back pain, and from there, bacteria had entered his bloodstream, and what had started as an untreated urinary tract infection had become sepsis. The ICU doctor later explained to the boys that Dean had arrived critically ill and dangerously close to progressing into septic shock. 

Looking back, the fever that refused to come down, the repeated vomiting, the dizziness, the confusion, and the increasing exhaustion had all been warning signs that his body was struggling to keep up with the overwhelming infection.

Those first thirty-six hours had been the worst. More than once the ICU team had gathered outside his room to discuss whether they needed to place him on a ventilator. Dean had panicked the first time the possibility was explained to him, terrified at the thought of being intubated, and because he was still breathing on his own and maintaining enough oxygen, the doctors agreed to give the antibiotics a chance to work while watching him minute by minute.

Every few hours they evaluated his breathing, his blood pressure, his mental status, and whether his body was beginning to respond. The treatment was aggressive from the moment he arrived: three different intravenous antibiotics, liters of IV fluids, medications to support his blood pressure as it repeatedly drifted lower than the team liked, frequent blood work, continuous cardiac monitoring, and nurses who rarely left his bedside for more than a few minutes at a time.

Dean remembered almost none of those first days. Later, Garrett realized that the first three days Dean spent in the ICU simply didn't exist in his memory. They were nothing more than disconnected flashes, a nurse adjusting his oxygen tubing, someone asking him his name, the sting of another IV, a blurry glimpse of Logan asleep in the chair beside the bed, Coach Jensen standing quietly near the doorway with his arms folded, Garrett holding his hand while thinking Dean was too out of it to notice. Most of the time Dean drifted in and out of consciousness, waking only long enough to answer a question or take a few sips of water before the fever and overwhelming exhaustion pulled him under again.

It wasn't until the fifth day that the doctors finally allowed themselves a little optimism. The antibiotics had begun controlling the infection, his blood cultures were improving, his temperature stopped climbing into dangerous territory quite so often, and, most importantly, his blood pressure started holding on its own for longer periods. When they heard one of the doctors quietly say, "I think he's finally turning the corner," it felt like the first full breath any of them had taken in days.

Now, on the eighth day in the ICU, the atmosphere inside Dean's room was almost unrecognizable compared to that terrifying first night. He was propped up against several pillows with a blanket over his lap, an IV still running antibiotics into one arm while a heart monitor continued its steady rhythm beside him. His cheeks had finally lost the angry crimson color of the fever, though he was nowhere near getting out of the hospital which Dean hadn’t been happy to hear. 

The infection was finally responding, yes. His blood pressure had stabilized. His fever curve looked significantly better than it had during those first terrifying days, and the cultures showed that the antibiotics were doing what they were supposed to do. All of that was good news.

But sepsis had taken a toll on his body, and right now the biggest concern was his kidneys.

They had been hit from several directions at once. The original infection had already spread upward from his bladder and involved his kidneys before bacteria reached his bloodstream, and then the prolonged period of low blood pressure during the worst of the sepsis had reduced the blood flow they desperately needed. His creatinine had climbed considerably from the level it had been when he first arrived, his urine output had dropped, and even though the numbers were no longer worsening quite as rapidly, they weren't improving the way the ICU team wanted either.

One of the nephrologists had described it that morning as Dean's kidneys being "stunned."

Not one had particularly liked that description. 

Dean had been far less accepting of the fluid restriction than he had been of almost anything else the ICU team had asked of him. Learning that he was now limited to roughly a liter of total fluid over twenty-four hours had therefore gone over terribly, especially when he discovered that the restriction did not simply mean he could drink that much water whenever he wanted. 

Everything containing fluid had to be counted toward the daily total, including what he drank with meals, anything he swallowed with his medications, ice chips, and certain parts of his medical treatment, which meant the nurses were constantly keeping track of exactly how much he had already received and how much remained available for the rest of the day. 

The restriction became particularly frustrating at night and first thing in the morning, when Dean would wake after several hours of sleeping with his mouth open feeling unbearably dry and immediately wanting water. He was allowed small amounts, and the nurses were hardly trying to leave him miserable, but they had to space those amounts throughout the day so he wouldn't consume most of his allowance before lunchtime and then have almost nothing left when he became thirsty later. They offered ice chips occasionally and helped keep his mouth moist, but Dean remained deeply unimpressed by every substitute because none of it felt the same as being allowed to pick up a bottle of cold water and drink until he was satisfied. 

But, the fact Dean was complaining was a relief to everyone. 

Only a few days earlier, he had been so sick that he barely noticed what was happening around him, drifting through examinations and procedures without enough energy to object to much of anything. So complaining was good, really good, even if Garrett occasionally had to remind himself of that when Dean started his fifth argument of the morning about why three additional sips of water couldn't possibly destroy his kidneys.

“Morning, guys.”

Dr. Bennett, Dean's nephrologist, walked into the room pushing a portable ultrasound cart ahead of him, maneuvering the bulky machine through the doorway while Garrett followed closely behind with two coffees balanced in one hand. Coach Jensen came in after him, automatically stepping aside to let the doctor position the machine before quietly closing the door behind them.

Dean, Logan, and Tucker all looked up at almost exactly the same time.

The three of them had been crowded around Tucker's phone for the last fifteen minutes watching highlights from a hockey game they had missed while Dean was sick. Tucker had claimed he was simply catching Dean up on what had happened around the league during the previous week, although the amount of arguing coming from Dean's bed suggested that very little actual catching up was taking place.

Tucker was sitting in the chair pulled close to the mattress with his phone held horizontally between them, Logan had claimed the edge of the bed near Dean's feet, and Dean was propped against several pillows in the middle, wrapped in a hospital blanket while criticizing practically every defensive decision appearing on the tiny screen.

It was one of the most normal scenes anyone had witnessed in that room since Dean had been admitted.

Technically, the ICU did have rules about how many visitors were supposed to be in a patient's room at one time, and during those first critical days the staff had enforced them more carefully because there had constantly been physicians, nurses, respiratory therapists, technicians, and equipment moving in and out around Dean. As Dean stabilized, however, those boundaries had become somewhat more flexible during the daytime, particularly because the staff had quickly discovered that the Briar hockey team was unusually difficult not to like.

The boys were loud when they were together, certainly, and the nurses had needed to remind them more than once that an ICU was not a locker room, but they were also unfailingly polite to everyone taking care of Dean. They moved immediately whenever somebody needed access to the bed, learned which chair had to remain clear for the nurses, stopped talking whenever a doctor was explaining something important, and somehow seemed to know exactly when Dean needed distraction and when he needed the room to become quiet so he could sleep. 

Coach Jensen had also become an equally familiar presence, although he was considerably quieter about it. He spent hours sitting in the corner answering emails or working from his laptop while Dean slept, occasionally disappearing to handle something with the team before inevitably returning. 

More importantly, Dean was noticeably better when they were there.

He talked more. He ate more when someone was sitting beside him stealing pieces of toast from his tray. He stayed awake longer when Tucker had something ridiculous to show him. He was more willing to sit upright when Logan was beside him talking about hockey, and Garrett had developed an almost irritating ability to tell when Dean was pretending he wasn't exhausted and needed everyone to leave him alone for twenty minutes.

That morning was a perfect example.

Dean had been awake for almost an hour, which was impressive by his current standards, and the hockey highlights had kept him interested enough that he hadn't immediately fallen back asleep after breakfast.

He still looked sick, though. 

The swelling had become considerably more obvious over the previous two days, especially in his face. There were faint creases along one cheek from the pillow because he'd spent most of the night sleeping on that side, and the swelling made those marks linger considerably longer than they normally would have. By now, several hours after waking, it had gone down slightly as gravity redistributed some of the retained fluid, but it was still immediately noticeable to anyone who knew him.

His ankles weren't much better.

The hospital socks he'd been given left shallow impressions around them, and the usually obvious contours of the bones along either side had nearly disappeared beneath the swelling.

“You walking around, buddy?” Dr. Bennett asked as he stepped closer to the head of the bed, using the pads of two fingers to press delicately beneath one of Dean's eyes before moving across the bridge of his nose and checking the puffiness beneath the other. He was careful not to press hard against the already sensitive skin, but even the gentle examination made Dean squint and instinctively pull his face back a fraction.

“Yeah.” Dean paused for a moment, distracted when Dr. Bennett gently lifted one swollen eyelid to get a better look before releasing it. He blinked several times afterward and rubbed his lips together, clearly trying to remember what he'd been about to say. “The catheter sucks, though.”

He gestured vaguely toward the side of the bed where the urinary catheter tubing disappeared beneath his blanket before emerging again and running down toward the collection bag secured below mattress level. There wasn't much urine sitting in it despite the fact that the bag had been emptied earlier that morning, something Dean had become increasingly aware of now that he was alert enough to pay attention to everything attached to him.

Dr. Bennett's gaze followed the gesture automatically.

The bag was one of the first things he checked every time he entered the room now.

Dean had hated the catheter almost from the moment he'd become awake enough to understand what it was. During the worst of the sepsis, he had barely registered its presence because he'd been far too sick and exhausted to care, but once his mental status improved, the irritation had become impossible for him to ignore. He disliked the constant sensation of the tubing, hated having the collection bag hanging beside the bed where everybody could see it, and found walking with it particularly awkward because someone had to make sure the bag came with him and remained below the level of his bladder.

“We walked yesterday,” Logan explained from the foot of the bed when Dean seemed more interested in glaring at the catheter bag than finishing his answer. “Around the hallway for about twenty minutes. We were supposed to do it again this morning, but he was tired.” 

Dr. Bennett glanced from Logan to Dean and then toward the collection of people surrounding the bed, amusement slowly appearing across his face as though the explanation had confirmed something he'd already suspected.

“These boys are too easy on you, Dean,” he said with a chuckle.

“Hey, we are not,” Garrett immediately defended them from beside the bed, sounding genuinely offended by the accusation. He gestured toward Dean as if the patient himself were evidence in Garrett's favor. “Do you know how much he complains when we make him do anything?”

“Sure,” Dr. Bennett replied, in the unmistakable tone of someone who believed absolutely none of it.

Coach Jensen laughed quietly behind his coffee while Tucker shook his head, and even Dean managed a tired smile from where he was slumped against the pillows. 

The truth was probably somewhere in between. The boys pushed Dean when they knew he was capable of doing something, particularly when it came to eating, sitting upright, walking, and participating in the increasingly annoying breathing exercises respiratory therapy kept leaving him with, but they had also spent eight days watching him become frighteningly sick. There were moments when every single one of them still reacted to every wince or exhausted expression as though Dean might suddenly deteriorate again. 

“Now, about our plans for the day. We're doing an ultrasound of your kidneys now, and then we're going to collect some labs, okay?”

Dean's eyes moved briefly toward the machine and then back to Dr. Bennett. Of everything he'd been subjected to during the admission, an ultrasound and another blood draw hardly ranked among the worst, so there wasn't much resistance left in him for either.

“Okay,” he agreed.

Dr. Bennett lowered the side rail and began arranging the ultrasound supplies within reach before looking back at Dean.

“Now roll onto your side for us so I can get a good look at those kidneys.”

Dean nodded and pushed the blanket away from his upper body. Logan reacted almost immediately, rising from the edge of the bed and reaching toward him out of habit, but before his hands could make contact, Dr. Bennett lifted one hand.

“Wait.”

Logan stopped.

“Let him try first.”

Dean gave Logan a vaguely triumphant look, as though he'd just won an argument neither of them had actually been having.

Then he attempted to turn over.

The movement was much harder than he'd expected.

Before the hospitalization, rolling onto his side would have been so automatic that he wouldn't have thought about it. Now every movement seemed to require planning. Dean planted one hand against the mattress and bent his knee slightly, trying to use the leverage to shift his weight toward the opposite side while being mindful of the IV tubing connected to his arm and the catheter tubing disappearing beneath the blanket.

He managed to lift himself slightly.

Then stopped.

The muscles in his abdomen and thighs immediately protested, weakened after more than a week spent mostly in bed, and his arm began trembling from the effort of supporting even part of his body weight. Dean clenched his jaw and tried again, stubbornly refusing to look toward Logan now that Dr. Bennett had specifically said he should attempt it himself.

He got a little farther the second time.

Not far enough.

His breathing had already become noticeably heavier from an activity that should have required virtually no effort, and the realization seemed to irritate him more than anything else. Dean paused with one hand gripping the sheet, gathering enough energy to make another attempt.

Coach Jensen was the one who finally stepped forward.

Unlike Logan, he didn't immediately take over. He simply moved close enough to the bed to place one hand behind Dean's shoulder and the other lightly at his hip, giving him just enough support to help complete the movement Dean had already started.

“There you go,” Coach Jensen murmured.

With the extra leverage, Dean finally managed to roll fully onto his side.

He breathed out heavily once he was settled, his head sinking into the pillow as though he'd just accomplished something considerably more strenuous than changing positions in bed. Coach Jensen kept one hand against his shoulder for another few seconds until he was certain Dean wasn't going to roll backward, then started to pull away.

Dr. Bennett was watching with an amused expression.

“You're special, Dean. I don't do this for every patient,” he joked as he adjusted Dean's gown upward enough to expose the area along his back and flank that he needed for the ultrasound.

“Lucky me,” Dean breathed out.

“Is he breathing okay?” Coach Jensen interrupted, looking at Dean then at the monitor.

Dean was breathing comfortably enough while lying quietly, but conversation exposed the difference. Whenever he tried to say more than a short sentence, he seemed to run out of breath before reaching the end of it, forcing him to pause for a second or two and take another breath before continuing. His respiratory rate was a little faster than it had been previously as well, and although there was no dramatic pulling between his ribs or obvious distress, his breathing had become more deliberate.

“He's oxygenating okay,” Dr. Bennett said, keeping his voice calm as he watched Dean's chest rise and fall. “His saturation is good, but saturation only tells us part of the story. He does look more winded than I'd expect just from turning onto his side.”

Dean opened his eyes again.

“I'm... fine.”

The statement would have been considerably more convincing if he hadn't needed to stop between the two words to take a breath.

Dr. Bennett gave him a pointed look.

Dean frowned.

“I am. Just...” He paused again, inhaling slowly before continuing. “Tired.”

“He wasn't like that yesterday,” Tucker added.

That got Dr. Bennett's attention immediately.

Tucker had been sitting quietly until then, but now he leaned forward with his forearms against his knees, watching Dean with considerably more concern than he'd shown a minute earlier.

“Yesterday when we walked, he got tired, but he wasn't doing that when he talked.”

Logan nodded. “He was winded after the hallway, but once he sat down it went away.”

Dr. Bennett set the ultrasound probe down temporarily.

That information mattered more than any of them probably realized because it suggested this wasn't simply Dean's baseline weakness after eight days in the ICU. Something had changed, even if the change was relatively subtle.

Dr. Bennett reached for his stethoscope.

“Dean, stay on your side for me.”

Dean didn't argue.

The nephrologist placed the stethoscope against his back and listened carefully, moving from one area to another while asking Dean to take slow breaths through his mouth. The first few were easy enough. By the fourth, Dean's breathing had become deeper and he needed a brief pause before taking another.

Dr. Bennett spent considerably longer listening near the bases of his lungs.

“What are you hearing?” Garrett eventually asked.

“His lungs aren't terrible,” Dr. Bennett reassured them, although he continued listening for another few seconds before removing the stethoscope. “But his air movement at the bases isn't quite as crisp as I'd like.”

Dean shifted his head against the pillow, “What does that mean?”

Dr. Bennett helped him settle more comfortably before answering.

“There are a few things that could be contributing. You've spent most of the last week in bed, so you're deconditioned. Your muscles are weaker, including the muscles you use for breathing, and you've probably been taking shallower breaths because you're exhausted. That alone can make talking and activity feel harder than they normally would.”

Dean listened quietly.

“But,” Dr. Bennett continued, “we also know you're retaining fluid because your kidneys aren't clearing water and sodium efficiently right now. We're seeing that fluid in your face and your legs. If your overall fluid balance keeps becoming more positive, some of that fluid can begin affecting your lungs too. It doesn't necessarily make your oxygen saturation drop immediately, especially early on, but it can make breathing feel heavier and make you run out of breath when you're talking or moving.”

Coach Jensen remained focused on the doctor. “And if it is fluid?”

“Then we have to reconsider how we're managing him.”

“A diuretic?” Logan asked.

“Potentially. Something like furosemide may help him produce more urine if his kidneys are able to respond to it. But I don't want to give medication just to make the number in the catheter bag look better. We need to know what we're treating and whether he'll actually benefit.”

Dr. Bennett allowed the explanation to settle before returning his attention to the ultrasound. He picked up the probe again, added another generous amount of gel, and rested it against Dean's exposed flank while adjusting the depth and gain on the machine with his free hand.

Dean immediately tensed.

The kidney infection had improved considerably since admission, but the area was still sensitive, particularly along his lower back and beneath his ribs where the worst of the pain had originally been. 

“Still tender?”

“A little.”

Dr. Bennett lightened the pressure temporarily before changing the angle of the probe. The screen filled with different shades of gray as he swept through the kidney from one direction and then another, freezing images periodically and using the machine's measurement function to place small markers across the organ.

Tucker leaned forward from his chair.

“What are we looking at?”

Dr. Bennett glanced toward him and then back at the screen. “That's his left kidney.”

Tucker stared.

“That?”

“Yes.”

“It looks like absolutely nothing.”

He froze another image and pointed toward the monitor with one finger, taking advantage of the moment to explain what he was evaluating rather than leaving the boys staring anxiously at shapes they couldn't interpret.

“The darker area around the outside is the renal tissue, and this brighter central portion is the renal sinus. What I'm looking for here is the overall size and appearance of the kidney, whether there's any obvious obstruction to urine draining, whether the collecting system is dilated, and whether there's anything else structurally that could explain why his kidney function isn't recovering the way we'd like.”

Garrett moved closer enough to see the monitor.

“So you're looking for a blockage?”

“Among other things. With acute kidney injury, especially when urine output is low, one of the things we always want to exclude is an obstructive component. If urine couldn't drain properly from one or both kidneys, that would change what we need to do.”

He moved the probe again.

Dean sucked in a breath.

Dr. Bennett stopped immediately.

“That one hurt?”

Dean nodded against the pillow.

“Sorry.”

“Don't apologize. Tell me when something hurts.”

Dean's eyes closed again as Dr. Bennett repositioned the probe rather than pressing directly over the most sensitive area. Even with the gentler approach, Dean occasionally flinched whenever the probe passed across the sorest part of his flank. It wasn't remotely comparable to the severe pain he'd experienced before antibiotics, but his kidneys and surrounding tissues had been through a significant inflammatory process, and eight days hadn't erased that completely.

Dr. Bennett took several more images before switching on color Doppler briefly, flashes of color appearing across the otherwise gray picture.

“What does that do?” Logan asked.

“Lets me assess blood flow. And there is blood flow.”

Dean gave him an unimpressed look.

Dr. Bennett saved another image before finally wiping some of the gel from Dean's left side.

“So far, I'm not seeing a big obstructive process on this side,” he explained. “That's good. The kidney still looks somewhat affected by everything it's been through, which isn't surprising given the pyelonephritis and the acute kidney injury, but I'm not seeing a dramatically dilated collecting system that would make me think urine is simply trapped behind a major obstruction.”

“So that's good?” Garrett asked.

“It's good in the sense that I don't see something here that needs to be urgently drained or mechanically corrected. It doesn't mean the kidney is functioning normally.”

That distinction quieted them.

Dr. Bennett had Dean shift slightly so he could examine the other kidney, and once again the movement proved more difficult than it should have. Coach Jensen steadied Dean's shoulder while Dr. Bennett repositioned the probe, and Dean lay quietly through the second half of the examination, becoming progressively less interested in what appeared on the screen as fatigue caught up with him.

The right side was somewhat less tender, although he still winced when Dr. Bennett pressed deeply beneath the lower ribs.

Dr. Bennett repeated the same series of views, measuring the kidney, examining the collecting system, checking around it for obvious abnormalities, and briefly assessing blood flow before eventually appearing satisfied with what he'd obtained.

“Right side looks similar in the important ways,” he explained. “I'm not seeing significant hydronephrosis or an obvious obstructing lesion. Structurally, there's nothing here that gives me an easy explanation we can simply fix and suddenly have his creatinine return to normal.”

Dr. Bennett took several more images of Dean's right kidney, changing the angle of the probe and making a few final measurements before apparently deciding he had seen everything he needed from that side.

“Alright, kidneys are done,” he announced as he placed the probe down long enough to wipe the remaining gel from Dean's flank. “Now I want to take a look at your bladder.”

Dean opened his eyes again.

He had become increasingly quiet during the last few minutes of the examination, partly because lying on his side wasn't particularly comfortable and partly because even the relatively minor effort of repositioning himself had left him tired. His breathing had settled again while he'd remained still, although Dr. Bennett had continued glancing toward the monitor every so often.

“For that I need you on your back again.”

Dean gave a small nod and started moving before anyone could help him.

This time Dr. Bennett didn't stop him.

Dean planted one hand against the mattress and slowly pushed his shoulder backward, trying to roll himself from his side onto his back. He managed most of the movement independently, although it was awkward with the IV tubing running from one arm and the urinary catheter tubing disappearing beneath the blanket. Coach Jensen quietly caught his shoulder during the final part of the turn and helped guide him down rather than allowing him to drop heavily against the mattress.

“There you go,” Dr. Bennett said.

Dean exhaled and settled flat against the bed.

“Much easier going that direction.”

“Progress,” Garrett offered.

Dean closed his eyes. “Shut up.”

Dr. Bennett smiled and pulled the blanket down just enough to expose Dean's lower abdomen while keeping him covered everywhere else. Because the catheter was continuously draining his bladder, he wasn't expecting it to be particularly full, but the scan would allow him to check its appearance, look for obvious retained urine or debris, and make sure there wasn't anything in the lower urinary tract contributing to the overall picture.

He added fresh gel to the probe and placed it just above Dean's pubic bone.

Dean immediately tensed.

“Cold.”

Tucker snorted from the chair.

Dr. Bennett angled the probe downward toward Dean's pelvis, and the ultrasound image changed completely. Instead of the kidney they'd been staring at before, a darker structure appeared on the screen.

“That's your bladder,” Dr. Bennett explained, making several small adjustments to the probe. “It's mostly decompressed, which is what I'd expect with the catheter draining continuously.”

Dean craned his neck as though he might somehow understand the image better from several feet away.

“Meaning?”

“Meaning there isn't a huge amount of urine sitting in your bladder while nothing comes out into the bag. That's useful because it tells me the low output we're seeing is much more likely to be coming from the kidneys not producing enough urine rather than your bladder being full because the catheter isn't draining.”

Garrett looked toward the collection bag.

“So the catheter isn't blocked?”

“It doesn't look like it from this.”

Dr. Bennett shifted the probe slightly and followed the catheter balloon within the bladder, confirming its position before taking another image.

“And there's the balloon from the Foley. That's sitting where it should be.”

Dean looked distinctly unimpressed by the knowledge that everyone in the room had apparently just been shown the inside of his bladder.

The bladder itself was relatively collapsed around the catheter, and there wasn't a large residual volume hiding there that could explain why the collection bag remained so disappointingly empty. From a diagnostic standpoint, that was useful information. From Dean's standpoint, however, it meant the problem remained exactly where everyone had feared it was: his kidneys simply weren't producing enough urine yet.

Dr. Bennett froze another image and measured the small amount of fluid visible.

“Not much in there,” he explained. “Which fits with what we're seeing in the bag. So between the kidney views and this, I'm not seeing evidence that you're sitting on a major obstruction that we can simply relieve and fix the whole problem.”

Dean stared at the ceiling.

“So we're back to my kidneys being lazy.”

“We're back to your kidneys recovering from a significant injury.”

“Lazy sounded better.”

Dr. Bennett was about to answer when his eyes moved toward the bedside monitor.

Dean's oxygen saturation had been sitting around ninety-five percent throughout most of the ultrasound.

Now it read ninety-three.

Dr. Bennett paused.

He didn't say anything immediately.

The pulse-ox waveform remained clean, and Dean's heart rate hadn't changed dramatically, so he continued watching rather than assuming the number was artifact.

Ninety-two.

Dean hadn't noticed.

He was still lying completely flat because that position gave Dr. Bennett the best access to his lower abdomen, his head resting against the thin hospital pillow while he watched the ceiling with a tired expression.

Ninety-one.

Dr. Bennett's attention left the ultrasound screen completely.

Coach Jensen noticed the change in his expression.

“What?”

Dr. Bennett looked at Dean first.

His breathing wasn't dramatically distressed, but it was faster than it had been when he'd been sitting upright earlier, and there was slightly more movement through his upper chest with each breath. Dean himself hadn't complained about it, perhaps because the change had happened gradually or because he was simply too tired to recognize it.

“Dean, breathing okay?”

Dean glanced toward him.

“Yeah.”

The answer came quietly.

Dr. Bennett watched him for another second.

“You don't feel short of breath lying like this?”

Dean considered the question rather than answering automatically.

“A little heavier, maybe.”

That was enough.

“Tucker, raise his bed for me.”

Tucker immediately reached for the control.

“How high?”

“Start around forty-five degrees.”

While Tucker finished raising the head of the bed, Dr. Bennett kept one eye on the monitor and watched Dean's oxygen saturation respond to the change in position. The improvement wasn't instantaneous, but it was steady enough to be reassuring. Ninety-one became ninety-two, then ninety-three, and after another minute with Dean comfortably propped at roughly forty-five degrees, the number returned to ninety-four and finally settled around ninety-five percent.

Dean looked more comfortable too.

He hadn't been dramatically struggling while flat, which was partly why he hadn't said anything, but once he was upright again there was a subtle easing to his breathing.

“I'm going to steal another couple of pictures while I've got this here.”

Dean looked suspiciously at the probe.

“I thought you were done.”

“With your kidneys and bladder.”

“That sounded like done.”

“Unfortunately, you've become interesting.”

“Lucky me.”

Dr. Bennett smiled and moved the probe higher.

“This part shouldn't hurt.”

He added another small amount of gel before placing the probe against Dean's chest, first near the lower edge of his rib cage and then angling it upward beneath the sternum. Dean looked down curiously as the ultrasound screen changed once again, the relatively still images of his kidneys and bladder replaced by something that moved rapidly with every heartbeat.

“That's his heart?”

“That's his heart.”

Dr. Bennett adjusted the probe and concentrated on the screen. This wasn't a formal echocardiogram, and he explained as much when Garrett asked what exactly he was checking. He was doing a quick bedside assessment to give himself more information about Dean's overall volume status and to make sure there wasn't an immediately obvious cardiac reason for the change in his breathing.

“With all the fluid he's retaining, I want to get a rough idea of what his heart is doing with it,” Dr. Bennett explained. “I'm looking at how it's squeezing, whether there's any obvious fluid around the heart, and a few other clues that can help us understand his circulation. This doesn't replace a formal echo if we decide he needs one.”

Dean remained unusually interested for several seconds, watching his own heart contract on the screen.

“Is it squeezing?”

“It is.”

“Good to know.”

Dr. Bennett moved through a few different views, occasionally asking Dean to breathe normally or hold his breath for only a second while he adjusted the probe. He didn't spend long on any single image, but his expression remained focused as he looked at the chambers, the general movement of the heart, and the surrounding space.

“I don't see a large pericardial effusion,” he eventually said, mostly for the benefit of the increasingly concerned audience surrounding the bed. “And from this limited look, the heart is contracting reasonably well. Again, this isn't a complete cardiac study, but I'm not seeing something obvious here that suddenly explains everything.”

Coach Jensen nodded toward Dean's swollen ankles.

“So we're still thinking the kidneys?”

“The kidneys and his overall fluid balance remain very high on the list.”

Dr. Bennett then shifted the probe away from Dean's heart and toward the side of his chest.

Dean flinched slightly when the probe pressed between his ribs, although this time it seemed to be more from surprise than pain.

“What now?”

“Your lungs.”

Dean frowned.

“You can ultrasound lungs?”

“We can look for certain things around them, yes.”

That brought Tucker closer again.

Dr. Bennett placed the probe along Dean's lateral chest and began working systematically between the ribs, comparing several areas on each side. Rather than looking through the air-filled lung itself, he explained that he was interested in the pattern created where the lung met the chest wall and in whether there were ultrasound signs suggesting increased fluid within the lung tissue or fluid collecting around the outside of the lungs.

“Normally, lungs contain a lot of air, and ultrasound doesn't travel through air particularly well,” he explained while moving to another space between Dean's ribs. “But fluid changes the pattern we see. There are artifacts called B-lines that can become more numerous when there's increased fluid in the lung tissue. We can also look down at the bases for pleural effusions, which would be fluid sitting around the lungs.”

Garrett watched Dr. Bennett's face instead of the screen.

“And?”

“Give me a minute.”

That immediately silenced everyone.

Dean remained propped against the raised bed, his saturation holding at ninety-five percent now, while Dr. Bennett examined several areas along his right chest before crossing to the left. Occasionally he asked Dean to take a deeper breath, and those breaths still seemed to require more effort than they had the previous day, particularly after several in succession.

Dr. Bennett paused longer near one of the lower lung fields.

“You're seeing something.”

Dr. Bennett didn't answer until he'd checked the opposite side for comparison.

“I'm seeing more B-lines at the bases than I'd expect,” he eventually said. “And there may be a small amount of pleural fluid down here as well.”

Dean's eyes shifted toward him.

“So there is fluid?”

“There are signs suggesting you've started accumulating some fluid in and around the lungs, yes. It doesn't look massive on this quick scan, and you're certainly not drowning in fluid, so nobody needs to panic over that wording.”

Tucker visibly relaxed by approximately half an inch.

Dr. Bennett continued.

“But it fits with everything else we're seeing. Your ankles are more swollen. Your face is more swollen. Your urine output is still low. You're more breathless with talking today, and when we laid you completely flat your saturation dropped. Put all of that together with what I'm seeing here and I'm more suspicious that the fluid retention is beginning to affect your lungs.”

Dean stared down toward his swollen ankles, “Is that bad?”

“It means we need to do something about it rather than simply watching the swelling.”

Dr. Bennett paused after saying it, giving Dean a few seconds to absorb the information before continuing. He had spent enough time with Dean over the previous week to recognize when the younger man was becoming overwhelmed, and the sudden quietness coming from the bed was a much clearer indication of that than anything Dean could have said.

There was another issue they needed to discuss, however, and Dr. Bennett would rather bring it up while Dean was stable, awake, and able to participate than wait until circumstances forced everyone into making a rushed decision.

“There is one other thing I want us to start thinking about,” he said carefully. “Not because I'm saying we're doing it today, but because I don't like being surprised in the ICU. If your urine output keeps falling, the fluid continues accumulating, or your labs give us another indication that your kidneys need support, I would like to have a dialysis catheter placed ahead of time so we have reliable access if we need it.”

Dean's head snapped up.

“No. Absolutely not.”

The answer came so quickly that he ran himself out of breath halfway through it. He stopped, inhaled through his nose, and swallowed before continuing, irritation mixing rapidly with genuine fear.

“We're not...” Another breath. “We're not doing that.”

He pushed himself straighter against the elevated mattress as he spoke, apparently wanting to sit completely upright despite already being propped at nearly forty-five degrees. The movement pulled at the monitor leads across his chest and made the catheter tubing shift beneath the blanket, but Dean barely seemed to notice.

“You said that wasn't necessary.”

“And it still isn't necessarily,” Dr. Bennett replied immediately. “I'm not changing what I told you before.”

“Then why put one in?”

“Because things can change quickly, and I would rather be one step ahead than one step behind if they do.”

Dean shook his head, “Think about other ways, then,” he muttered.

“There are other things we're considering. We're getting the labs. We're getting the chest X-ray. We're going to review everything you're receiving through the IV, and depending on what your blood pressure and labs look like, we can try a diuretic and see whether your kidneys respond. I'm not skipping any of those steps.”

“Then do those.”

“We will.”

“Good.”

“But I still want us to discuss access.”

Garrett had been quiet throughout the exchange, watching the fear gradually replace the irritation on Dean's face. He finally stepped closer to the bed.

“D, he's not saying you're definitely going on—”

“No, Garrett!”

The sudden volume startled everyone.

Dean had practically yelled it, or at least attempted to, but his lungs wouldn't let him sustain the force behind the words. The shout ended abruptly and Dean stopped, breathing harder as he tried to recover from it. His saturation flickered down a point before returning, and Dr. Bennett instinctively lifted one hand as though to remind him not to exhaust himself.

Dean ignored him.

“I don't want to be stuck at a machine.”

His voice cracked slightly at the end.

Garrett stopped moving.

Dean dragged in another breath, his chest rising more noticeably now, and when he continued there was considerably less anger in his voice.

“I want to go home.”

Dean looked down at the blanket gathered across his lap and swallowed.

“I've been here eight days. I want this stuff out.” He gestured toward the IV, then toward the catheter bag. “I want to sleep in my own bed. I want to shower without somebody standing outside the bathroom. I want to go back to practice. I want to...” He had to stop again, catching his breath before finishing much more quietly, “I just want to go home, and putting another catheter in me isn't helping that.”

Dr. Bennett pulled the stool closer and sat down, “Dean, look at me.”

Dean didn't at first.

His fingers remained tangled in the blanket.

“Buddy.”

Eventually Dean looked up.

“I hear you,” Dr. Bennett said. “And I understand why you're hearing dialysis and thinking it means we're moving farther away from getting you home. But I need you to understand something important. If your kidneys need temporary support, refusing that support doesn't get you home faster. It does the opposite.”

Dean looked away again.

Dr. Bennett continued calmly.

“The quickest route out of this ICU is getting your body stable enough that it can manage without us. Right now your kidneys aren't doing their full job. For several days we could afford to give them time because the rest of your body was tolerating that. Today I'm seeing signs that the margin may be getting smaller. You're retaining more fluid, you're producing less urine than I want, you're more breathless, and you don't tolerate lying flat as well as you did yesterday.”

“But I'm still breathing.”

“You are, and you're doing it reasonably well sitting upright. That's exactly why we're having this conversation calmly now rather than during an emergency.”

Dean remained unconvinced.

Dr. Bennett leaned forward slightly.

“If I thought you needed dialysis right this second, I would tell you that directly. I don't think that right now.”

That finally made Dean look back at him.

“What I'm saying is that I can see a situation where we try the diuretic and your kidneys respond beautifully, you start producing more urine, some of this swelling comes off, your breathing improves, and this entire conversation becomes unnecessary.” 

Dr. Bennett gestured toward Dean's neck and upper chest.

“A temporary dialysis catheter is not the same thing as committing you to permanent dialysis. It's access. Nothing more by itself. Having one does not mean we have to use it, and using it wouldn't mean your kidneys are never going to recover.”

“How temporary?”

“If you needed dialysis because of this acute kidney injury, our goal would be to support you only as long as your kidneys required it. That could mean a short period while they recover. We would reassess you continuously. Acute dialysis after severe sepsis is very different from telling someone with irreversible kidney failure that they're going to need long-term dialysis.”

Dean was listening now, although he still looked miserable.

“So I'd have another thing in my neck.”

“Most likely we'd use a large temporary central catheter in an appropriate vein, yes.”

Dean's expression immediately soured again, “That sounds horrible.”

“I'm not going to lie and tell you it's fun.”

Dr. Bennett gave him a moment before continuing, watching the way Dean's fingers had tightened around the blanket again.

“Do you want to think about it?”

Dean shook his head almost immediately, “No.”

It wasn't angry this time. If anything, the answer came out tired, as though Dean had simply reached the limit of how much information he wanted to process that morning.

Dr. Bennett released a quiet sigh.

“Alright. I'm going to let you think about it for a few minutes anyway.”

Dean opened his mouth, probably intending to argue that thinking about it wasn't going to change his answer, but Dr. Bennett had already turned toward the ultrasound machine. He wiped down the probe, discarded the remaining supplies, and started gathering everything he'd brought into the room while the nurse made a note of the orders he'd requested.

“We'll get your blood drawn shortly, and radiology should be up for the chest X-ray. Until then, stay propped up and take it easy. I'll come back after I have your labs and X-ray.”

Dean nodded without looking up.

Dr. Bennett pushed the machine toward the doorway, and the nurse followed him out a moment later. The door had barely closed before Coach Jensen looked around the crowded room.

“Guys, give me a few minutes alone with Dean.”

Garrett's attention immediately moved toward his friend.

Dean didn't react.

For a moment Garrett looked as though he might object, particularly after the way Dean had reacted during the discussion about dialysis, but Coach Jensen gave him a small nod that made it clear he wasn't asking because something was wrong. He simply wanted a chance to speak with Dean without four other people listening.

Logan stood first, “Come on.”

Tucker slipped his phone into his pocket and followed him toward the door, although not before looking back at Dean.

Garrett was the last to move.

He squeezed Dean's forearm gently.

“We're right outside.”

Dean gave him a tired nod.

“I know.”

Once the three boys had disappeared into the hallway and the door clicked shut behind them, the room suddenly felt enormous.

And for the first time that morning, it was quiet.

Coach Jensen pulled the chair Tucker had been using closer to Dean's bed and sat down, resting his forearms loosely against his thighs. Dean remained propped against the elevated mattress exactly as Dr. Bennett had left him, his hospital gown slightly rumpled around his shoulders and the blanket pulled across his swollen legs.

The anger from several minutes earlier had disappeared.

Now he just looked exhausted.

His eyes were still noticeably puffy, and the emotional conversation had left them slightly red around the edges. Dean rubbed at them again with the heels of his hands, pressing carefully around the swollen skin before dragging his fingers down his face.

Coach Jensen watched him for another few seconds, “Wanna talk about what's on your mind?”

Dean shook his head without lowering his hands, “No.”

Coach Jensen nodded, “Okay.”

Dean slowly dropped his hands into his lap.

He'd clearly expected more resistance than that.

Coach Jensen leaned back in the chair.

They sat quietly.

Thirty seconds passed.

Then nearly a minute.

Dean glanced toward him,“You're just gonna sit there?”

“Yep.”

Dean looked away again, his attention settling somewhere around the blanket gathered over his lap. His fingers worried absently at one of the folds for several seconds before his shoulders dropped with a tired exhale.

“It was supposed to be just a UTI,” he mumbled.

Coach Jensen nodded slowly, “Yeah, kid. But it hasn't been just a UTI for more than a week.”

Dean didn't answer.

Coach Jensen let that sit for a moment before continuing, keeping his voice calm rather than trying to soften what had happened into something it wasn't.

“UTIs get treated at home with antibiotics. Maybe you feel lousy for a couple days, you drink plenty of water, take your medication, and complain about it until you're better. They don't usually put you in a hospital bed for eight days. They don't put you in an ICU room with monitors and wires everywhere, a catheter measuring every drop of urine you make, three IV antibiotics running, doctors checking your blood pressure every five minutes, and everyone arguing over whether you might need help breathing.”

Dean's eyes dropped toward the monitor leads disappearing beneath his gown.

“You didn't have a little UTI by the time you got here,” Coach Jensen continued. “You had a kidney infection that got into your bloodstream and made you critically ill. Your body took one hell of a hit from it, and now you're dealing with what that hit did to your kidneys. I know that isn't what you thought was going to happen when this started, but pretending you're still dealing with the same thing you had at the beginning isn't going to make any of this easier.”

For a few seconds Coach Jensen thought he might argue.

Instead, Dean lifted one hand and rubbed roughly beneath his eye, “I don't want dialysis.”

The admission was barely above a whisper.

His hand remained against his face, wiping impatiently at the stubborn tears gathering despite every effort he was making not to let them fall. The swelling around his eyes made them look even redder, and Dean seemed almost angry at himself for crying, repeatedly brushing the moisture away as quickly as it appeared.

Coach Jensen's expression softened.

“I know, kid.”

“I really don't.”

“I know.”

Dean sniffed and wiped at his face again.

“I don't want that catheter in my neck. I don't want another machine. I don't want them taking more blood every five seconds and measuring everything and telling me how much I can drink.” His voice started gaining speed until his breathing couldn't keep up with it, forcing him to stop and draw a deeper breath. “I don't want any of this.”

Coach Jensen leaned forward.

“Slow down.”

Dean shook his head.

“I want to go back to practice.”

“I know you do.”

“I should be at practice.”

The tears came more easily now, although Dean continued wiping them away almost angrily.

“The guys are practicing without me. We're playing without me. I haven't skated in—” He stopped, apparently realizing he wasn't even entirely certain how many days had passed. “I don't know. Forever. And I'm sitting here getting tired from rolling over.”

“Dean.”

“I walked for twenty minutes yesterday and then slept for like two hours.”

“Dean.”

“And now Bennett's talking about dialysis, and if I do that, then I'm gonna be stuck here even longer, and then I'm gonna lose more conditioning, and when am I supposed to—”

“Dean.”

Coach Jensen's voice remained quiet, but there was enough authority behind it that Dean finally stopped.

He was breathing too quickly now.

Not dangerously so, but enough that his already limited reserve was making the conversation harder than it needed to be. Coach Jensen reached over and placed a steady hand around Dean's forearm.

“Don't try to solve the entire rest of your season from an ICU bed.”

Dean looked at him miserably.

“I'm serious. You're sitting here trying to jump from what Bennett said this morning all the way to whether you're going to be able to play hockey again, and there are about fifty steps between those two things.”

“But—”

“No. Listen to me for a second.”

Dean fell quiet.

Coach Jensen waited until his breathing had slowed somewhat before continuing.

“You want to go back to practice. Good. I'm glad you do, because eight days ago you barely had enough energy to open your eyes when somebody said your name. Wanting to get back on the ice sounds pretty damn good to me compared with that.”

Dean wiped beneath his eye.

“But practice is not your job today.”

“It should be.”

“No, it shouldn't.”

Coach Jensen's answer was immediate.

“The team has practice covered. Garrett has it covered. Logan has it covered. Tucker has it covered. I have it covered. There is absolutely nothing happening at that rink that requires you to drag yourself out of an ICU bed to fix it.”

Dean stared at him.

“Nobody is sitting around thinking you should be there. Nobody is pissed at you. Nobody thinks you're letting the team down. Half those guys would probably come sit in this room themselves if the nurses let them.”

“And the rink isn't going anywhere.”

Dean swallowed.

“You don't know when I'll be able to go back.”

“No, I don't. But neither do you, and that's my point. Bennett hasn't told you you're never playing again. He hasn't even told you that you definitely need dialysis. Right now he has told you that your kidneys are taking longer to recover than everyone hoped and that he wants to be prepared if they need temporary help.”

Dean's gaze dropped.

“Still sounds bad.”

“It is serious. I'm not going to insult you by pretending it isn't.”

Dean blinked hard.

“But serious doesn't mean permanent.”

That got his attention.

Coach Jensen continued more gently.

“You were septic, Dean. Really septic. There were people standing outside this room discussing whether they were going to have to put a breathing tube down your throat because they weren't sure your body could keep doing this on its own.”

Dean was listening quietly now.

“And eight days later you're sitting here arguing with a nephrologist, watching hockey with Tucker, walking around the hallway, complaining about your water allowance, and telling me you want to get back to practice.”

Coach Jensen gave him a small smile.

“That's not nothing.”

Dean's lower lip trembled again.

He immediately pressed it between his teeth.

“Feels like nothing.”

“Well, for me, it's pretty impressive,” Coach Jensen said.

Dean gave him a doubtful look, but Coach Jensen didn't elaborate immediately. He leaned back in the chair instead, folding his arms loosely across his chest while studying Dean for several seconds.

“So,” he said eventually, raising one eyebrow, “you don't want to try the possible dialysis and consequently not give your kidneys the support and time they might need to recover, or do you want to get it over with if Bennett decides you actually need it?”

Dean stared at him.

“That is a very unfair way of asking that question.”

“Probably.”

“You're supposed to be making me feel better.”

“I am making you feel better. I'm just not going to tell you what you want to hear while I do it.”

Dean frowned and rubbed carefully beneath one swollen eye again.

Coach Jensen continued before Dean could retreat entirely into himself. “You keep talking about dialysis like Bennett wants to do it to you, when what he's actually talking about is doing it for your kidneys if they can't keep up right now. Those are two very different things.”

“I know what dialysis does.”

“I know you do.”

“Then you know why I don't want it.”

“Of course I do. Nobody would want it.”

Dean looked down toward his lap.

Coach Jensen leaned forward again, resting his forearms against his thighs. “But wanting to avoid something unpleasant and refusing something your body might actually need are also two different things, kid. If Bennett comes back and tells us your labs look okay, the fluid isn't as bad as he thinks, and he wants to try medication first, fantastic. You won't hear a single complaint from me.”

“Or me.”

“I'll believe that when I see it.”

Dean gave him a tired glare.

“But if he comes back and says your kidneys need temporary support, then what exactly are you accomplishing by refusing?”

“Not getting a giant catheter in my neck.”

“For a little while.”

Dean's expression soured.

“And not being hooked up to a machine.”

“For a few hours at a time, if that's what they decide you need.”

“Still sounds terrible.”

“It probably won't be the highlight of your week.”

Dean let out a quiet, humorless laugh.

“You've already done the terrifying part, Dean. You got through the infection getting into your blood. You got through your pressure dropping. You got through three days you barely remember. If your kidneys now need somebody to take some of the workload off them while they recover from all of that, I don't want you deciding that's somehow worse than letting them struggle because you're scared of the machine.” 

“I hate this.”

“I know.”

“I really fucking hate this.”

“You're allowed.”

Dean rubbed at his cheek.

“I just thought I'd be better by now.”

Coach Jensen nodded. “I know you did.”

“I thought once the antibiotics worked, that was it.”

“So did we.”

Dean looked back at him, apparently surprised by the admission.

Coach Jensen shrugged slightly. “You think I expected to learn this much about kidney function this week?”

A tiny smile tugged at Dean's mouth.

“I figured they'd treat the infection, you'd complain dramatically for a few days, and then I'd spend the next month fighting with you because you wanted to play before you were cleared.”

Coach Jensen watched him for a moment before continuing. “And that's what I mean when I tell you I'm impressed. You're sitting here thinking you're doing nothing because you can't practice. I'm looking at a kid who was barely conscious a few days ago and who walked around the ICU yesterday.”

“For twenty minutes.”

“Twenty more minutes than you managed four days ago.”

Dean opened his mouth.

Coach Jensen held up a finger.

“Nope. You're not arguing your way out of that one.”

Dean rolled his eyes.

“Recovery doesn't only count when you're back on skates. Yesterday, walking counted. Today, maybe staying upright and getting some of that fluid off counts. Tomorrow, maybe it's something else.”

“If I did it,” Dean finally said, speaking slowly, “and my kidneys got better, they'd stop?”

“That's what Bennett was telling you.”

“And take the catheter out?”

“When they didn't need it anymore.”

Dean chewed his lower lip.

“And I could still go home.”

Coach Jensen's expression softened.

“Kid, if dialysis became necessary, the whole point would be helping you get well enough to go home.”

Dean blinked hard.

Coach Jensen leaned forward again.

“Stop thinking of every new treatment as another chain tying you to this bed. Sometimes treatment is what gets you out of it.”

Dean remained quiet for several seconds, his gaze drifting from Coach Jensen toward the nearly empty catheter bag and then back again. He still looked deeply unhappy about the entire situation, and there was nothing remotely enthusiastic about the way he finally released a long breath and nodded.

“Okay.”

Coach Jensen raised his eyebrows slightly.

“Okay?”

“Okay,” Dean repeated, more firmly this time. “I'll do it.”

A smile slowly spread across Coach Jensen's face, although he was careful not to make too much of the decision when Dean still looked as though he might change his mind if anyone celebrated too loudly.

“I'm letting them put this giant, horrible catheter in my neck,” Dean said, giving Coach Jensen a small, resigned smile. “Happy?”

Coach Jensen laughed as he stood from the chair.

“Good call, kid.”

He stepped toward the bed and squeezed the back of Dean's neck affectionately, careful around the hospital gown and monitor wires, before running his hand through Dean's already disheveled hair and deliberately ruffling it even worse.

Dean immediately ducked away.

“Coach.”

“What?”

“My hair already looks like shit.”

“Least of your problems.”

***

Coach Jensen had been right.

His hair was not a problem at all.

Three hours later, Dean had considerably bigger things to complain about.

The chest X-ray had been done first, followed almost immediately by another round of blood work that had required more tubes than Dean thought any reasonable person should be expected to surrender at one time. Then, last but very much not least, Dr. Bennett's plan to stay one step ahead had become a reality.

Dean now had a brand-new temporary dialysis catheter sitting in his right internal jugular vein.

He had agreed to it.

That didn't mean he had enjoyed a single second of it.

The procedure had gone smoothly from a medical standpoint, which everyone kept assuring him was the important part. Ultrasound guidance had been used, local anesthetic had numbed the insertion site, the catheter had been placed without complication, and the dressing over the right side of his neck was clean and dry.

From Dean's standpoint, however, the experience had been awful.

He had hated having to lie positioned for the procedure when breathing already felt easier upright. He had hated the sterile drape around his face, hated the pressure and pulling sensations despite the local anesthetic, hated knowing exactly what was being placed into his neck, and particularly hated the uncomfortable tugging sensation every time someone manipulated the catheter after it was inserted. By the time everything had been secured and the bed was raised again, the fear he'd spent the morning trying to control had turned into pure irritability.

Then the local anesthetic had started wearing off.

That had made his mood considerably worse.

The right side of his neck was sore now, not sharply painful unless he moved the wrong way, but persistently aching around the insertion site. Turning his head pulled unpleasantly against the dressing and reminded him immediately that something large and unfamiliar was sitting there, so he'd gradually stopped moving his neck much at all. His right shoulder had become stiff because he was unconsciously holding himself strangely to protect the area, and every time someone asked how it felt, Dean's answer had become progressively less polite.

Garrett had eventually decided everyone needed to stop asking him questions.

That had been nearly forty minutes ago.

Now Dean was curled against Garrett on the hospital bed, finally asleep.

The bed remained elevated because Dr. Bennett didn't want him lying completely flat after the earlier drop in his oxygen saturation, so Garrett had arranged himself awkwardly against the pillows and side of the mattress while Dean rested against him. The blond's head was tucked carefully against Garrett's chest with his face turned toward the left, keeping pressure away from the new catheter on the right side of his neck. One of Garrett's arms was wrapped around his shoulders while the other rested across Dean's upper arm.

It had taken forever to get him comfortable.

Dean had initially insisted that he didn't need to sleep at all, despite barely keeping his eyes open. Then he'd complained that every position pulled on his neck. His back hurt. His ankles felt tight from the swelling. The catheter in his bladder was irritating him. His mouth was dry. 

Eventually Garrett had stopped trying to reason with him, climbed carefully onto the bed beside him, and told Dean to find whatever position didn't hurt.

Dean had done exactly that.

Within ten minutes he had been asleep.

Coach Jensen had already gone home after making Garrett promise to call if anything changed, and Logan had disappeared downstairs to collect coffees and something for Tucker to eat. That left only Garrett, Dean, and Tucker in the room, with Tucker stretched out on the small couch scrolling silently through his phone while Garrett remained almost completely motionless because he was terrified that moving would wake Dean.

The room had been peaceful for approximately fifteen minutes when the door opened.

Jane stepped inside.

She had been Dean's primary day nurse for most of his ICU stay, which meant she had seen almost every version of him by now, the confused, feverish Dean who couldn't stay awake long enough to answer her questions, the miserable Dean vomiting into a basin, the irritable Dean demanding water, and now the swollen, exhausted Dean who had spent half the afternoon complaining about the catheter in his neck.

Garrett looked at her immediately.

Then he looked at the supplies in her hands.

His arm instinctively tightened around Dean.

“You're not gonna wake him, are you?”

Jane stopped.

Tucker looked up from his phone.

Garrett's expression was almost pleading now, “He literally just fell asleep.”

Jane's eyes moved toward Dean.

Dean hadn't reacted to her entrance at all. He remained deeply asleep against Garrett, his left hand curled loosely into the front of Garrett's shirt and his breathing slow and regular. The swelling around his eyes was still obvious even while they were closed, and the new dressing on the right side of his neck stood out starkly against his skin.

Jane looked almost apologetic.

“I'm going to need some blood.”

Garrett's expression fell immediately.

From the couch, Tucker looked over the top of his phone.

“Good luck.”

Garrett shot him an irritated look.

Tucker shrugged. “What? You saw him after the last blood draw.”

They all had.

Dean had been cooperative, but only technically. By that point he had already endured the chest X-ray, multiple examinations, the discussion about dialysis, and the anticipation of having the new catheter inserted, so when somebody had appeared with yet another collection of blood tubes, his patience had been practically nonexistent. He'd held out his arm with the expression of someone personally betrayed by modern medicine and then complained through almost the entire process.

Jane shook her head.

“It's from the access, so hopefully he won't feel much of anything.”

Garrett looked toward the new catheter, “From that?”

“From the dialysis catheter. Dr. Bennett wants another set of labs, and since we've already got central access, there's no reason for me to stick him again just to collect them.”

That softened Garrett's objection somewhat.

He released a long sigh and looked down at Dean, who remained completely oblivious to the conversation happening over his head.

“Fine. But if you wake him, you're getting him back to sleep.”

Jane smiled, “Deal.”

She collected what she needed before approaching the bed, moving more quietly now. The first thing she noticed was Dean's position. He had fallen asleep wherever comfort had finally found him, which meant his body was curled toward Garrett while his head remained turned awkwardly away from the new right-sided catheter. It kept pressure off the insertion site, but it also left his neck slightly twisted and his right shoulder held higher than the left.

Jane frowned, “He's going to wake up with his neck killing him if he stays like that.”

“It already hurts.”

“Exactly.”

Garrett immediately became wary when she reached toward Dean.

“Careful.”

“I know.”

Jane slipped one hand behind Dean's upper shoulder and the other beneath the pillow rather than grabbing his head or neck directly. Garrett loosened his hold enough to give her room while still keeping Dean supported against his chest.

“Just let him come back a little.”

Garrett shifted carefully.

Between them, they managed to straighten Dean's upper body by only a few centimeters, taking some of the rotation out of his neck without rolling him onto the catheter side. Jane then adjusted the pillow beneath his head, tucking it closer behind his left cheek and shoulder so his neck remained supported rather than hanging at an angle.

Dean stirred.

Everyone stopped.

His eyebrows drew together, and his fingers tightened in Garrett's shirt. A small sound escaped him as he shifted his face against Garrett's chest.

Garrett immediately rested his palm against Dean's back.

“Shh. You're okay.”

Dean never opened his eyes.

Garrett rubbed slowly between his shoulder blades until the tension disappeared again, and within seconds Dean's grip loosened.

Jane waited a little longer before moving.

“Better,” she whispered.

Garrett inspected Dean's position as though he were personally responsible for approving it.

“Yeah.”

“Now I need access to the line.”

That was going to be slightly more difficult.

The catheter exited from the right side of Dean's neck and was secured beneath a large transparent sterile dressing, with the external lumens lying against his upper chest. Jane didn't need to disturb the insertion site itself, but she did need enough room to reach the appropriate lumen without pulling on it.

She performed hand hygiene, put on gloves, and carefully moved the collar of Dean's gown away from the catheter while Garrett kept him steady.

Dean slept through it.

Jane inspected the dressing first. There was still a small amount of dried blood beneath it from the insertion, but nothing appeared to be actively bleeding, and the dressing remained firmly sealed around the catheter.

Then she carefully picked up the external lumen she intended to use.

Garrett watched every movement.

“He won't feel you doing that?”

“He might notice some handling around the area if I pull on it, which I'm not going to do. But the blood is coming directly from the line. There's no needle going into him again.”

“Best thing that catheter has done so far,” Tucker murmured.

Garrett actually nodded.

“For once, I agree with you.”

Jane cleaned the access point thoroughly and allowed it to dry, keeping the catheter stabilized so none of her movements transferred to the sore insertion site in Dean's neck. Once everything was ready, she connected the syringe.

Garrett watched with fascinated discomfort as dark blood began filling it.

Dean didn't move.

Not even slightly.

“That is so weird,” Tucker whispered.

Jane glanced at him, “What's weird?”

“He's asleep and you're stealing his blood.”

“I'm not stealing it.”

“Feels like stealing.”

“Would you prefer I wake him up and ask permission every time the ICU needs labs?”

Tucker considered that, “No. Continue stealing.”

Garrett suppressed a laugh because Dean's head was resting against his chest.

Jane first withdrew the small amount required according to the unit's protocol before attaching the collection system for the actual specimens. One tube began filling, then another, the blood flowing easily through the catheter without requiring Dean to be moved or disturbed.

Jane finished the final tube and disconnected the collection device before carefully handling the catheter according to protocol, making sure everything was properly secured again. Throughout the entire process she kept one hand stabilizing the external portion so there was never any unnecessary tugging at Dean's neck.

When she was finished, she arranged the lumens neatly against Dean's upper chest and made certain they weren't caught beneath his gown or positioned somewhere Dean might accidentally pull on them when he woke.

“All done,” Jane said, taking a step back and glancing once again toward Dean’s neck.

The new position was considerably better. His head remained turned slightly toward Garrett, keeping him off the sore right side, but his neck was no longer sharply rotated. His shoulders were more even, and the catheter tubing had enough slack that nothing pulled against the dressing.

“Try to keep him roughly like that,” she said quietly. “He doesn't have to stay perfectly still, but with how sore he already is, we don't need him sleeping with his neck twisted for two hours.”

Garrett nodded, “I've got him.”

Jane smiled, “I know you do.”

She finished gathering the last of the supplies from the bedside table, placing the labeled blood tubes together before looking from Garrett to Tucker. Both of them looked considerably better than Dean did, but that wasn't exactly a difficult standard to meet. Garrett had dark circles beneath his eyes that had become progressively more obvious with every day Dean spent in the ICU, while Tucker had been covering a yawn every few minutes since she'd walked into the room.

“You boys should probably take a nap too,” Jane suggested. “He most likely isn't waking up anytime soon.”

Garrett looked down at Dean.

Considering how deeply asleep he was, Jane was probably right. Dean hadn't even woken while she'd repositioned him and drawn several tubes of blood from the new catheter, and now that nobody was touching him anymore, he'd gone completely limp against Garrett. His left hand remained loosely gathered in his shirt, but there was no tension behind the grip anymore, and his breathing had settled into the slow, even rhythm that Garrett had learned meant Dean was properly asleep rather than merely dozing.

Tucker and Garrett looked at each other.

There was a silent moment of consideration.

Then Tucker shrugged.

“Sounds good.”

Garrett nodded too.

“Yeah.”

Jane shook her head with an affectionate smile before crossing toward the wall controls. She dimmed the lights gradually rather than switching them off completely, leaving only the softer illumination around the doorway and enough light from the monitors for staff to move safely through the room. 

The effect was immediate. After an entire morning and afternoon filled with examinations, procedures, conversations, machines, blood draws, and people constantly entering and leaving, the room finally began to feel quiet.

Even the ICU beyond the door seemed unusually subdued.

Jane lowered the blinds over the interior window slightly as well, reducing some of the bright hallway light without completely obstructing the staff's view into the room. She checked Dean's monitor one more time before leaving him alone. His oxygen saturation remained around ninety-five percent with the head of the bed elevated, his heart rate had settled into the seventies while he slept, and his blood pressure remained stable.

Once she had left and quietly pulled the door almost closed behind her, Tucker stood from the couch and stretched, his back cracking loudly enough that Garrett winced.

“Jesus, Tuck.”

“What?”

“You're gonna wake him.”

Tucker looked toward the bed.

Dean hadn't moved.

“I think a bomb could go off right now and he wouldn't wake up.”

“Don't test the theory.”

“I wasn't planning to.”

Tucker pulled the extra blanket that had been folded over the back of the couch free and rearranged one of the pillows. Unlike Garrett, who was effectively trapped beneath Dean, Tucker had the luxury of stretching out properly.

He kicked off his shoes and lay down.

“This couch is terrible.”

Garrett looked over.

“You have an entire couch.”

“You have a mattress.”

“I have Dean crushing half my body.”

As if responding to his name, Dean shifted closer.

Garrett immediately looked down at him.

Dean's head moved slightly against his chest before settling again, his body instinctively curling more securely into Garrett's side. His knee was bent beneath the blanket, one arm tucked between them, while Garrett's arm remained wrapped around his shoulders.

Tucker watched.

“Yeah. You look miserable.”

“Fuck off.”

Tucker grinned and pulled the blanket over himself.

Garrett tried to make himself more comfortable without disturbing Dean. It wasn't easy. He was half sitting rather than properly lying down because the head of Dean's bed needed to remain elevated, and his left hip was already beginning to protest the position he'd been holding for nearly an hour.

Still, he wasn't moving Dean.

Not after how long it had taken to settle him.

He carefully shifted one pillow behind his own head, then pulled the blanket higher over Dean. The swelling around Dean's ankles was still visible beneath the hospital socks, and Garrett made sure nothing was pressing tightly against them before letting his hand return to Dean's back.

A minute later Tucker spoke again without opening his eyes.

“G?”

“What?”

“You think they're gonna use it?”

Garrett knew immediately what he meant.

His gaze dropped toward the dressing on Dean's neck.

“I don't know.”

Tucker was quiet.

“Bennett wouldn't have put it in if he wasn't worried.”

“I know.”

Neither of them said anything for several seconds.

The catheter looked strangely prominent now that the room was dim, the transparent dressing catching the faint glow from the monitor. Dean had been so frightened of it only a few hours earlier. Now he was sleeping with it as though it had always been there.

Garrett's hand moved slowly along Dean's back.

“At least it's already in if they need it.”

“Yeah.”

Another silence.

“And maybe they won't.”

Garrett nodded even though Tucker's eyes were closed.

“Maybe they won't.”

That was enough for now.

There was no point lying awake predicting what Dr. Bennett might say when the rest of the labs came back. They had spent eight days doing exactly that—waiting for the next blood pressure, the next temperature, the next culture result, the next creatinine level, the next doctor to walk through the door with another update.

For the next hour, none of those things were theirs to control.

Garrett let his head settle against the pillow.

His eyes closed.

Then opened again when the monitor beeped once.

He looked immediately.

Ninety-five percent.

Nothing had changed.

From the couch came Tucker's sleepy voice, “Go to sleep.”

“You first.”

Garrett rolled his eyes and closed them again.

This time he kept them closed.

Within several minutes Tucker's breathing had deepened from the couch, and not long afterward Garrett's hand stopped moving over Dean's back as sleep finally caught up with him too.

***