Tired and Hungry and Totally Useless
Title: Tired and Hungry and Totally Useless
Summary: I was asked to write a story about Sam with Lyme disease. This happened. Probably the most research I've ever done for a fic.
Warnings/Spoilers: I don't think any. I guess spoilers for like, the first ten minutes of the pilot.
Author's Note: To my Physician's Desk Reference, shangrilada
Dean’s phone rings in the middle of the night.
It’s not that outrageous, actually, because it’s only one am in California, and because Sam’s nineteen, and Dean remembers enough about being nineteen to know that one am isn’t very late even if it is four in the damn morning in Pennsylvania.
“Hey, bro!” Sam’s drunk, Dean can tell instantly by the exuberance in his voice. Sam’s quiet, pensive, brilliant, not exuberant, except for sometimes at four in the damn morning.
“Sam. What? You better be dying.”
“Nooooo.”
“Jesus, where are you, a frat party?”
“Douche.” Sam’s smirking audibly. How can a smirk be so audible over the phone? Sam. “It’s spring break.”
“Yeah?” Dean’s ears perk up slightly, despite the hour. “Girls going wild?”
“Girls going on Habitats For Humanity trips,” Sam amends. “It’s not like the movies, Dean.”
Dean glares at the mouthpiece, because seriously, why would you burst that bubble, Sam?
“Campus is pretty empty,” he says. “Boring boring. What are you doing?”
“Hunting a vengeful spirit outside Pittsburgh. Killed some kids in a public park. Dad’s working on something down South.”
Sam whistles long and low. “You’ll get it, Dean. Hey.” He pauses, like he’s considering something. “You want a hand?”
“What?”
“I could come out of retirement.” Sam’s crowing just a little, like the first time he shot a beer can off a fencepost, like the first time he shot a salt round through a spirit that was descending on their father. “I could be back in action.”
Dean laughs. “You’re drunk.”
“So?” Sam says. “We’d have fun, right? I’m on break. I could fly out there, fight some shit, hey, maybe this could be a thing. We could do this every year.”
“Sammy, I thought you didn’t want to hunt anymore.”
“Well, not full time,” Sam says, exasperated, like this is something that should be obvious. “I don’t want to live with Dad anymore, but that doesn’t mean I don’t want to see him.”
There’s a stunned sort of awkward silence. They don’t talk about Dad. Sam and Dad haven’t seen each other in months, and Dad hasn’t mentioned his name since he’s been gone, and fuck, maybe Sam never will see them. Dean knows the same thought is occurring to Sam. Shit.
“Yeah, Sammy,” he says, swallowing the lump in his throat. “Come out. I’d love to see you.”
The truth is, he really fucking would.
***
Dean hasn’t seen Sam since early August, since he boarded that bus in Omaha that took him away into the sunset (goddamn it, why do you have to think of things in these picturesque, romantic terms? He went to school) so meeting the plane from Palo Alto is literally one of the best things that’s ever happened to him.
Sam walks off the jetway looking tan and taller than Dean remembered and healthy and happy and thriving, and it’s not even possible to pretend to himself that Stanford wasn’t the right choice. Sam has never filled himself like this, has never reached out and touched every corner of the potential he has, and Dean is momentarily stunned with pride in the fact that Sam knew how to become this man and fucking went and did it in the face of Dad’s disapproval and with no help to speak of from Dean.
He grabs Sam in a hug and lingers for a second because Sam is here and remembers what it felt like to scoop this boy up in his arms and spin him around and around and listen to him shriek with joy.
Sam says, "Tell me about this spirit," and Dean does, but he's not listening to himself talk, he's taking in Sam and he's so fucking proud of this kid, this young man his brother is becoming.
But also, godfuckshit don't leave again, Sammy.
He has to go. Dean gets it. It's changed his entire life, he's not this sad, pale, scared little kid anymore, he's...
Is he even Dean's anymore?
Then Sam does this thing. And it's such a little thing. He angles his body sideways and into the crook of Dean's shoulder and bends his neck so his cheek is against the side of Dean's head, and this is so familiar. This is so Sam. And suddenly it's like he never left.
Dean feels a smile steal across his face. "Sammy."
***
Dean doesn’t tell Dad about that week in Pennsylvania, mostly because he doesn’t want to say I told you so. He doesn’t want to shove it in his Dad’s face that college has clearly been great for Sam, that he’s happy, that he’s bursting with news and talking more than he has in his entire life about things that make no sense to Dean, hierarchies of needs and standard deviations and noun declensions (he’s always spoken Latin, Stanford, you’re not special) and the off-sides rule, which apparently cost his intramural soccer team a critical game. He sounds normal. He sounds so goddamn free.
But - and this is the thing, this is the real I told you so - Sam can still hunt. His instincts are as sharp as ever, and he can still make that trick shot of his where he spins and drops to one knee and plugs the spirit with a direct hit. He keeps up with Dean in the woods and at the bar (little Sammy pounds beers like a pro now, it’s mind-bending) and Dean can’t find it in him to say “Sam came to see me and he didn’t come to you and you were wrong, he was fine, he is fine, he’s better than ever and he was right to go.”
He especially doesn’t say anything when summer rolls around and school lets out and Sam very conspicuously doesn’t come home. He knows what Dad said, they all know what Dad said, but Dad says a lot of things when he’s pissed off and there’s been this air of “well but not really” about him as the semester’s drawn to an end. On some level, Dean knows, Dad was waiting for Sam to come home.
He should have known Sam was too proud.
But not seeing the kid is a disappointment Dean doesn’t know how to handle, so what the fuck, he decides, he shouldn’t have to.
“There’s a hunt in Nevada,” He says one morning over a grab-and-go breakfast of bananas and cereal.
“Mmmph.” Dad chews and swallows. “We’re in the middle of a hunt, Dean. This is going to take at least another week.”
“But you can do it without me,” Dean says. “It’s just a matter of figuring out which grave to salt and burn, and you don’t need me for that. Let me go handle this other thing.”
“What is it?
“Not sure,” Dean fibs easily. “Strange deaths. Bodies with shrunken organs.” God, he’s disturbingly good at making this stuff up. “They autopsied a woman whose kidneys were the size of kidney beans. I read about it online.”
Dad frowns. “What could do that?”
“No idea. Sounds worth checking out, though.”
“Where’d you say this was?”
“Nevada.”
A knowing look crosses John’s face, and for a moment Dean thinks he’s found out. “You just going out there for strippers, boy?”
Christ. It’s not like he wants Dad to catch on to what he’s doing, but how fucked up is it that he assumes strippers before Sammy? “It can be both, right?” Dean says with a smile he knows is charming.
Dad sighs. “Get gone. No more than two weeks, you hear?”
An hour later, Dean’s on a bus to Palo Alto.
***
He calls Sam from Salt Lake City and leaves a message.
He tries again in Reno. Kid’s not picking up his phone.
The bus pulls into the turnaround of the Stanford Student Center at five am and leaves Dean standing there with his duffel bag and absolutely no idea where his brother lives. The woman at the information desk says she’s not allowed to give out student addresses, but she does call Sam, and apparently this time he picks up his phone, because he hears her explaining that there’s a visitor here.
“Dean,” Dean mouths silently.
“Sean,” She relays to Sam. Dean rolls his eyes.
She hangs up the phone. “He’s coming.”
Dean reads a bulletin board about alcohol safety (“always have a sober buddy,” the Stanford Cardinal advises) while he waits, and about fifteen minutes later he’s engulfed from behind by giant arms and he’s surrounded by the smell of Sam and the sound of Sam’s voice in his ears, and it’s not until he shoves Sam off him and turns around to hug him properly that he realizes something’s wrong.
***
Sam leads the way back to his apartment, but it’s slow going because he’s walking sort of gingerly, like there are rocks in his shoes and it’s hurting him. Dean’s filled with an urge he hasn’t felt in years, to pick Sam up and carry him for a while.
The apartment is a mess, which is weird because Sam’s usually so neat. There are dirty dishes in the sink and the bed is unmade. School books are strewn everywhere, uncapped highlighters drying out on top of them.
“Sam, jesus, what…”
He’s skinny. Sam has always been slim, but he hasn’t been skinny since he was fourteen years old and started acquiring muscle mass like a damn magnet. Now he’s pale and strung out, collar bones prominent under his t-shirt, which hangs on him loosely even though Dean knows that shirt and knows how it’s supposed to fit Sammy and it’s supposed to cling, okay, it’s not supposed to look like an empty sack.
“I didn’t know you were coming!” Sam hugs him again, properly. “Why didn’t you call?”
“I did call, Sammy, you…jesus, are you on something”
“What are you talking about?”
“You must have lost thirty pounds since March.”
“Oh.” Sam shuffles guiltily. “I don’t know, I haven’t…I guess I haven’t been eating a ton.”
Dean tugs open the refrigerator. Sure enough, it’s all but empty. “Do you need money or something?”
“No, I have a job.”
“You do? Doing what?”
“I work the circulation desk at the library.”
Of course he does. “Are you overdoing it? You really don’t look good.”
“I’m fine. Hey,” Sam hugs him again. “I can’t believe you’re here. This is so great.”
“Yeah, can I crash on your couch for a few hours?” Dean asks, because he’s been on a bus for a day and a half and it’s five in the morning and there’s no pretending he’s not exhausted.
Dean falls asleep to the sound of Sam getting his shifts covered for the next two weeks.
Five hours later, he wakes up and Sam is still sleeping.
***
Dean cleans the apartment while he waits for Sam to wake up. He caps the highlighters and gathers them in a paper cup on Sam’s desk. He bookmarks the textbooks with scraps of paper and stacks them up. He picks up clothes off the floor and puts them in the hamper and hopes he’s guessing right that these are dirties. Sam’s still asleep, so he walks down to the convenience store and buys frozen dinners and soup and vegetables and soda and water and chips and stocks Sam’s fridge.
There’s a Ninja Warrior marathon on TV, so he mutes it and watches and tries to decide which of the physical challenges he’d be able to handle. The strength ones would be no problem, but he has a feeling he’d struggle with the balance ones. At 4 pm, the network switches to some remodeling show, and Dean turns it off.
Sam’s still not awake.
***
He finally emerges at about seven o’clock, looking like the very act of sleeping has exhausted him, and there’s this brief moment when he looks at Dean likewhat are you doing here? that spooks the hell out of Dean.
“You’re…you came?” Sam says uncertainly.
Dean chuckles a little, even though this is starting to feel less and less funny. “You picked me up at the student center, remember, Sammy?”
“I…what?”
“Early this morning. I guess you weren’t quite awake yet, huh?”
“Oh.” Sam looks confused and upset, and no, Sam, god.
“What’s going on with you?” Dean asks quietly. “Something’s wrong, Sammy, don’t tell me there isn’t.”
“I don’t know.” Sam’s face is resigned, he’s not pretending he's fine anymore.Good boy. "I haven't been feeling great."
“Yeah? What symptoms?”
“I’m tired. Like, all the time tired.”
“Right now?”
“Tired."
“Are you sleeping at night?”
“I’m sleeping always. And then, I get these headaches, and they make me want to sleep more.”
“Bad ones?”
“Killer.”
“Lost your appetite, too, I guess,” he indicates Sam’s eroded body.
“No, it…it’s not like that. I’m so hungry.” There’s a desperation in Sam’s face as he says this, a genuine need.
Dean swallows and tries to talk around the lump in his throat. “Eat something.”
“I try,” Sam says quietly.
“Well, I got you all kinds of rare delicacies from the 7-11. We’ll try tonight.”
“Okay,” Sam swallows hard and doesn’t really look like anything’s okay at all.
***
Dean wants to heat up a couple of Banquet dinners, but Sam’s eyeing them mistrustfully, so he settles for a can of Campbell’s Chicken and Stars. He heats it up on the stove, and when he comes back into the living room with the bowl balanced on a tray, Sam’s asleep on the couch.
He’s been awake for maybe twenty minutes.
Don’t even try telling Dean something’s not wrong here.
He sets the soup on the floor and gets his arms under Sam and lifts him, raising him into a sitting position, and he’s struck again by how light Sam is. Maybe this exhaustion is due to undernourishment. Sammy definitely needs to eat.
“Ready for soup?” He asks as Sam blinks awake a little.
“Hmm?”
“Chicken and stars.”
“Oh.” Sam nods. “That sounds okay.” Like it’s the first time he’s hearing of it, like they didn’t agree ten minutes ago that chicken and stars would be okay, what the fuck is wrong, Sam?
Dean sets the tray on Sam’s lap and Sam just kind of sits there staring at it.
“Eat, Sammy.”
“What?”
“Jesus, you’re falling asleep in your soup.” He is. He’s drooping like a tree over a blessed well.
“Sorry,” Sam says quietly. “So tired. Maybe a few more hours.”
“After your soup, Sam, okay? You can sleep all you want, I promise.”
“Okay.”
Sam takes bites of soup robotically, slowly, and Dean watches and wonders if this is what the last few weeks have been like. Sam sleeping all the time, barely eating, exhausted and headachey, and something is up with his memory, he’s clearly sick and confused and scared and why the fuck didn’t he call somebody?
Why didn’t he call me?
Midway through the bowl of soup, Sam’s eyelids begin to grow heavy and the spoon stops traveling from the bowl to his mouth. A moment later Sam’s head drops onto Dean’s shoulder.
“Sam.”
“Hmmm?”
“Keep eating, buddy. Not naptime yet.”
“Hurts.”
Dean’s heart twists. “What hurts, Sammy?”
“Hand.”
Dean takes Sam’s hand in his own, and oh, shit, it’s swollen like the surgical gloves Dean used to inflate for Sam at the pediatrician’s office, the joints painful and inflamed. “Sammy, what happened? Did you…” fuck, he has no idea what to ask. He has no idea what to think. Sammy’s sick, Sammy’s sick.
“It hurts,” Sam says softly. “Always. When I move too much. Do too much. So tired, Dean,” and then he’s crying quietly into Dean’s shoulder. “Something’s wrong, something’s wrong.”
Dean shoves down his panic, that is not helpful, and rubs Sam’s back gently. “Your hand hurts when you use it too much?”
“Everything,” Sam sobs. “My knees. If I walk. Elbows. Everywhere. Hurts so much. So fucking tired.”
“Can you…can you eat just a little more for me?”
Sam shakes his head, pressing into Dean’s shoulder like he’s burrowing.
“Come on, Sammy.” Dean wraps an arm around him and lets Sam rest against his shoulder while he brings a spoonful of soup to his brother’s lips. “Just a bit more.”
Sam swallows the soup, and six more bites, before he slips into sleep against Dean.
“Oh, kid,” Dean whispers, easing his brother down on the couch. He covers Sam with a blanket and packs his hand in ice to try and reduce the swelling, and then he notices it’s Sam’s other hand too, what the fuck, so he packs that one.
And then, on a hunch, he finds Sam’s thermometer in the medicine cabinet and slips it under his sleeping brother’s tongue, and Sam’s running a fever of a hundred and one.
Dean gets online and finds the nearest walk-in clinic.
***
The nurse takes about a quart of blood from Sam and leaves him shivering on the examination table. She offers him a blanket, but he shakes his head, which doesn’t stop Dean from wrapping the kid up in his hunting jacket after she leaves. “Hey. You okay?”
Sam nods a little - brave kid - and leans forward into Dean’s shoulder, his breathing shallow. “Tired.”
“Yeah, I bet, you’ve got no blood left in you.” Dean climbs onto the table behind Sam and pulls him down so Sam’s head is resting in his lap. “Take a nap if you want, it’s fine.”
It’s telling that Sam doesn’t resist, just nods and lets his eyes slip closed and shivers through the thick lining of Dean’s jacket. “Don’t worry,” Dean says quietly. “Don’t be scared. Gonna get you all fixed up.” Sam moves a little, but he might just be stirring in his sleep.
Dean might just be talking to himself.
How is it possible that Sam has deteriorated this much since March?
The doctor comes in and apparently gets it, because he doesn’t wake Sam. He talks to Dean about the tests they’re going to run and says they probably won’t know anything for a few weeks, and Sam should just rest up and try to eat.
“He’s been getting bad stomachaches,” Dean says. “He doesn’t want to eat because it hurts.”
The doctor nods. “It’s probably unrelated. My feeling is, this is mono. He probably lost his appetite for a while and now he’s having trouble getting back into a normal eating routine. That’s why you’re seeing stomachaches. Keep him on light foods - broth, yogurt, crackers - until he feels ready to try something with a little more sustenance.”
“Okay.”
“Meanwhile, he can have some amoxicillin to keep the fever down and ease some of the pain.” The doctor scribbles on a prescription pad and rips off the paper. “This is for a course of antibiotics. Might just clear the whole thing up.”
Dean pockets the paper.
“Let me know if anything further comes up,” the doctor says. “The phone number’s on the script.”
***
The next week and a half are a parade of negative diagnoses. Sam doesn’t have mono. He doesn’t have lupus. He doesn’t have cancer (thank fuck, but also, enough of what he doesn’t have, tell us what he does have). He doesn’t have any strain of flu the doctors can identify.
More tests, they say. They’ll order more tests. But they sound perplexed, almost indulgent - Sure, we’ll order more tests, butwe don’t know. What is there even left to test for? Dean’s starting to feel desperate. Sam’s mostly too tired to feel desperate, but some nights he’s up with that awful, twisting stomachache that makes him screw up his face, that makes Dean pound at the edges of his sanity because now Sam won’t eat tomorrow, and on nights like that he looks up at Dean hopelessly like he’s giving the fuck up.
“I’m not going to let you quit,” Dean grumbles into his ear.
And then one morning the phone rings.
*Dad*
Shit.
Dean answers warily. “Yeah.”
“You about bagged that monster yet, kid?” Dad’s gruff voice comes over the line. “Need you back here.”
And just, fuck. Because no, Dean has not bagged the monster, the monster is still eating Sam alive, Dean hasn’t solved this one yet, Dean hasn’t come close.
“I need more time,” he hedges.
“Dean…” There’s a note of warning in Dad’s voice.
Sam blinks awake. “Is that Dad?”
Dean nods. Sam rolls away and pulls the blankets over his head.Fuck.
The thing is, Dean’s never learned to defy his father.
But the thing is, Sammy.
But the thing is (and this is the real thing), nothing Dean’s doing here is making Sam any better.
So when Dad says “time to call it a day and get back to work,” Dean swallows his anger and his fear and the piece of his heart (all of his heart) that belongs to the sick kid lying in the bed and says “Yes, sir.”
***
-how you feeling kid
-okay
-you lying to me?
-a little. Don’t worry.
-any more from dr?
-I don’t have shingles.
-text if you hear anything.
-kay
-not hepatitis
-good I guess?
-at least it would be something
-eating?
-yeah
-you lying to me?
-a little
-eat, sammy.
-hurts though
-fuck, kid, i know
-sam?
-sam, text me.
-dude, you getting this?
-sam?
-sorry, was asleep
-for twenty-seven hours?
-I guess. Everything ok?
-didn’t hear from you. Got nervous.
-shit did I say I was going to text you?
-no…
-losing track of shit…fuck I hate this.
-you’re not on webmd are you
-no
-you lying to me?
-sam, get off webmd
-sammy?
you don’t think it could be syphilis do you?
-wtf?
-not syphilis
-duh. You have to have sex to get that.
-I hate you
-hate you too, sammy.
***
“Who do you keep texting?” Dad asks.
“Um, Carly.” It’s the first name that pops into Dean’s head.
“Who’s Carly?”
A fair question. “Girl I met. Uh. In Nevada.”
Dad shoots him a look. “Did you leave that hunt unfinished because you were screwing around, Dean?”
I left it unfinished because you dragged me back. “No, sir.”
Dad’s quiet for a minute. “You’ve been texting her for a few weeks now. This getting serious?”
“Maybe.” Dean’s not going to elaborate on his fictional fucking girlfriend.
Dad looks like he’s expecting more, but he lets it drop. “Okay. Well, pack up. There’s some unnatural stuff happening in Ohio I want to check out.”
***
-dean?
-yeah, buddy?
-you awake?
-sure. You okay?
-fever
-shit. How high?
-103
-god, sammy
-so tired of this
-i know. Fuck.
-i just want to get better
-taking your meds?
-they took me off them
-WTF?
-wasn’t working
-sam you’re sick go back to the doctor first thing am.
-okay
pneumonia. checking into er. might not have service for awhile.
-sam?
-SAMMY?
***
A few days go by.
They’re probably the worst of Dean’s life.
When he can, he gets online and looks up Palo Alto area hospitals and writes the phone numbers on his hand, and tries to get away from Dad to call and ask if Sam Winchester is a patient there, if he’s doing any better, if he’s scared, if he’s fuckingalive, but they all say the same thing - they can’t release patient information. “He’s mybrother, Dean growls into the phone, again and again, but that doesn’t seem to hold water.
“He’d have been admitted three days ago with pneumonia,” Dean desperately tries to sway the Stanford Hospital nurse receptionist. “Samuel Winchester. W-I-N-C-“
Dad walks in.
Dean freezes for a moment.
Fuck it.
“-H-E-S-T-E-R,” he spells, making eye contact with his father, daring him to say something. “Age 20. Tall, skinny, sleeps all the time.”
Dad’s eyebrows meet in a wordless question and Dean does not have time.
The nurse pauses. “Hang on.”
Hold music takes over, and Dean speaks before his father can. “Sam’s been sick. I didn’t go to Nevada. I was with him. We don’t know what’s wrong, but he’s in the hospital with a side of pneumonia and I guess they’re running more tests and I need to know he’s okay. I’m sorry, he’s my brother, he’s my little brother and he’s mine and Ihave to know.”
Dad stares at him for a minute and then crosses the room in two steps and wraps Dean up in a hug. “Why didn’t you tell me?” He whispers. “You should have told me. He’s mine too, Dean, he’s my baby. God, shit, is he okay?”
“I don’t know,” Dean’s voice breaks. “He’s so sick, Dad, he’s not eating and he sleeps all the time and he’s lost so much weight and he’s hurting, he’s scared, he doesn’t know what’s wrong with him, I don’t know what’s wrong with him, I don’t…”
“Dean?” The voice on the other end of the line sounds small and scared and tearful. “Is that you?”
“Sammy. Sammy.” Dean breathes and squeezes the fuck out of his dad’s arm. “What’s going on?”
And then Sam’s crying, and through his tears Dean makes out, “it’s Lyme disease. I have Lyme disease” and Dean’s brain is spinning because what is that, how bad is it, Sam Sam Sam.
“Can you come?” Sam says between sobs.
“Yeah, Sam. Yeah. I’m on my way.”
***
Dad guides Dean into a seat and holds his shoulders because Dean’s shaking too hard to stand. “What? What did he say?”
“Lyme disease. I have to go, Dad, I have to go.”
Dad swallows and nods. “Go.”
***
Dean opens nine or ten websites about Lyme disease before he boards the bus and uses the time to read. The first thing he learns is that it’s caused by ticks, primarily in northeastern states.
States like Pennsylvania.
So essentially, Sam is sick because he came to see Dean for spring break, and there’s nothing even remotely okay about that. He feels sick to his stomach.
Probably not as sick as Sam. Shit.
It’s a bacterial infection that spreads throughout the body and affects other things as it takes hold, which explains Sam’s exhaustion, headaches, memory loss, maybe even the pneumonia.
What’s scaring Dean, though, is that too many of Sam’s symptoms seem to fall in the column labeled “late disseminated Lyme disease” - the sleeping, the memory problems, the chronic pain. The column that also talks about cognitive damage and psychiatric symptoms.
No.
His phone buzzes in his pocket. *Sam*
-my hearts going so fast
-take deep breaths
-i am oh god
-get your doctor sam
-sam?
-SAM!
He looks back down at the website and sees heart palpitations, right there on the same line with hearing and vision loss, and he doesn’t know what a palpitation is, really, but something’s wrong with his baby brother’s heart and no no no fuck why won’t this bus go any faster, why is he so far away, he needs to be beside Sam and feel that he’s safe.
Sam doesn’t text again.
But they would call. The hospital. He must be Sam’s in-case-of-emergency contact, who else is Sam going to put down? They would call him if something happened. They would tell him. He would know.
He repeats this to himself until it’s a mantra. They would tell me. I would know.
Sammy’s okay.
***
It’s three in the morning when the bus pulls up to the student center.
Dean gets instructions to the hospital at the information desk and sprints the entire fifteen blocks.
Sam.
***
He’s lost weight since Dean was here, which just doesn’t seem possible and makes Dean want to crawl right up onto the bed beside him. A couple of tubes dangle, tentacle-like, from his upper left arm, like they’re built in, like they’re fucking part of him. ‘Dean’ is written in permanent marker on his left hand, like a reminder. His breathing is heavy and congested, and when Dean touches his forehead, he’s blazing.
Dean pulls the bench under the window over to the bed and shoves his duffel bag up against the arm, because he’s tired, because he couldn’t sleep until he saw his brother, and he’s all set to let the rise and fall of Sammy’s chest sing him to sleep when a nurse walks in.
She smiles when she sees him. “You must be Dean.”
“I, uh,” Dean articulates.
“He’s been asking for you.” She nods toward Sam’s hand. “When he found out you were coming, he wrote it down so he wouldn’t forget, and now every time he sees his hand he says, ‘when’s Dean coming?’” She chuckles like that’s not the saddest thing in the entire world.
“Lyme disease?” Dean means to keep his voice neutral, but it cracks.
Her face goes soft. “Oh honey. It’s treatable. He’s going to be just fine.” She messes with the tentacle tubes a bit. “Actually, now that you’re here they might decide to let him go. He’ll be more comfortable at home.”
“But…is that…”
“He needs to take his antibiotics,” She says. “I’ll show you how to use the PICC, and then you can do it at home.”
Dean swallows and looks at his brother, weak and tired and laid out in this sterile antiseptic bed, and god fuck what if I screw it up?
“Hey, Sam,” the nurse says softly, leaning over Sam, gripping his shoulder, his neck. “Guess who’s here!”
Sam’s eyes blink open. Dean leans close. “Hey, Sammy.”
“Dean,” Sam whispers, and fits his hand into Dean’s, and the nurse smiles and retreats and they hang on to each other.
***
They let Sam go in the morning.
He’s still running a fever of a hundred and four, but apparently no one but Dean is particularly concerned about that. An orderly helps Dean load boxes of antibiotic bags and syringes into the passenger seat of the taxi, and Dean buys a fleece blanket from the hospital gift shop and wraps Sam up in it and carries him out to the car because fuck wheelchairs, because Sam is so light.
Dad calls while they’re in the cab and Dean tells him they’re leaving the hospital and going back to Sam’s place. “Let me speak to him,” Dad says, and Dean holds the phone against Sam’s ear so he won’t have to free his arms from the blanket.
He listens to the low vibrations of his father’s voice, though he can’t tell what’s being said, and Sam is quiet and breathes slowly and heavily and at some point Dad says something that makes him close his eyes and start crying softly, which just about breaks Dean’s heart.
After awhile Sam looks up at Dean and nods, and Dean takes the phone back. “Dad?”
“He heard me?” Dad’s voice is ragged.
“Yeah.”
“How is he?”
“High fever. They gave us some antibiotics, but he’s still fighting off pneumonia.”
“How can they send him home?” Dad sounds angry, and Dean feels like crying because he’s just got no anger left. He’s been angry and worried for too long. Now he’s just sad.
“They put a tube in him,” he says, swallowing, trying not to let his father hear how close to tears he is, shit. “They put a tube in his arm - in his heart - “
“Dean.”
“I’m sorry, I’m sorry.”
“Dean, god, don’t be sorry. I know.”
Dean breathes and breathes and wants his father.
“Should I…” he hesitates. “Should I come out there?”
It’s as if Dad is reading his mind. “I…I don’t know.”
“I don’t want to overwhelm him,” Dad says. “He’s going to be okay?”
“Yeah. Yeah.”
“Take care of him.”
Like Dean could do anything else. “Yes, sir.”
Sam rolls over and buries his face in Dean’s stomach.
***
It takes Dean three trips to carry Sam and all his new medical supplies into the apartment, and by the third trip Sam’s already asleep. Dean takes this as a good thing, because that fever’s not going anywhere on its own. He sets up the IV pole and prepares Sam’s antibiotics.
Sam wakes up with a cry when Dean shoots the saline wash into his PICC tube. “Too cold -“
“You’re sick, Sammy,” Dean whispers. “It’s okay.”
“No, it’s cold, it’s cold, I don’t like it.” He scrubs at his arm, at his chest, with his opposite hand. “Stop.”
“Shhh.” Dean hangs the antibiotic bag on the IV pole and attaches it to his brother. “Good medicine, Sammy, you’re going to feel so much better, I promise. Go back to sleep.”
He does, with a quiet whimper that tugs the breath from Dean’s lungs (he’s sosick) and Dean sits beside him, tired but alert, one hand twisted gently into his brother’s hair, the other cupping the PICC tube so he can feel the cold rush of antibiotics across his palm as they drip towards Sammy’s heart.
***
Sam doesn’t feel better.
He doesn’t feel better when he spikes a fever of 105.6 and can’t fall asleep, despite his exhaustion. He sits up in Dean’s arms and lets Dean flush his PICC.
“It’s in all my veins,” he says, shuddery. “Like spiders.”
“I know.” Dean threads his fingers in Sam’s.
“Is Dad hunting alone?”
“Yeah.”
“He’ll g-get hurt…”
“Shhh, no, Sam.”
“You g-gotta help him…Dean…”
He’s a hot mess in Dean’s arms, and Dean could swear he’s about to break into a sweat but he doesn’t, it keeps climbing, agonizing inch by inch, until he’s a shade under 106 and clinging to Dean with tears in his eyes, whispering “whywhywhy?”
Dean pushes the hair out of his eyes. “Why what?”
“Why’s it always worse?”
“Come on, Sam.”
He draws a bath and helps Sam into it, and Sam cries when the water touches his skin because it’s cooler than room temperature because Dean just has to. He wraps the arm with the PICC in a towel and holds it in his lap like it’s his baby while he rubs a washcloth over Sam’s back. He rubs his thumb over the skin of Sam’s arm just above the sutures, where he can still feel the slight bulge of the tube protruding, and whispers “get better. Get better.”
“I want to.”
“I know, baby.”
***
Dean’s finishing up Sam’s antibiotics that night, throwing away the used syringes and bags and stuff, and Sam says, “D-dean…” in this panicked voice like a dart.
Dean turns around and oh shit god fuck Sam is bleeding, he’s fuckingleaking like a punctured balloon, thick beads of dark red sliding from the PICC down his arm and into his hand. “Sam, holy shit, Sam.”
Sam is shaking with fever, breathing so goddamn hard, staring at his wide open vein, baffled.
“What did I do,” Dean gasps to himself, hands all over the leaking PICC, trying to find the problem, and oh god, here, he unscrewed the wrong goddamn piece and threw it in the trash and now Sammy’s bleeding all over everything, motherfucker.
Hang on, Sam. There’s no time to hold him, tell him it’s going to be fine, no time to apologize for opening his veins and leaving him hung out to dry. Dean paws through the trash can like a stray dog until he comes up with the missing piece of the PICC. He wastes a saline syringe flushing it - but he can get another one of those, dammit - and screws it back on, and now there’s time, crisis over, but he’s still heaving with panic and self loathing, he still just bled the fuck out of his sick little brother.
“Okay,” Sam says. “Okay.”
Dean gets a towel and wets it and wipes away the blood and just holds that poor fucking arm, that poor fucking boy.
Sam falls asleep mumbling “okay okay okay.”
Dean feels the moment his fever breaks.
***
Gradually, things are better.
Sam eats ravenously, pizza and burgers and scrambled eggs and the stupid salads from the Greek restaurant he likes. He laughs while he eats, and afterward he looks full and satisfied, content. He begins to fill out again, to look healthy. Color returns to his face, and Dean feels the strength come back into his hug.
They stay up until two in the morning one night, watching reruns of sitcoms that were terrible the first time. Sam talks about the history of television and the place of entertainment in society and what shows like these say about their contemporaries. Dean listens to him talk, doesn’t focus on the words, just enjoys the sound of Sam’s bright and earnest voice.
Dad calls. Sam cradles the phone against his ear and nods along quietly, and says “I love you too.” Dean pretends he isn’t hanging on every word.
There’s a morning Sam wakes up feeling great and wants to go for a jog, and they get half a mile down the beach before his knees swell up. He limps home groaning and sweating, with a smile on his face and his arm across Dean’s shoulders for support.
“It’s better,” he says.
***
“I have to go.”
“I know.”
Sam’s sitting on the edge of his bed, watching forlornly as Dean packs his things. “I’ll come back,” Dean says. “Dad will understand.”
“Because I’m sick?”
“Sam, no. Come on.”
Sam nods. “I know. Sorry.” He’s feeling sorry for himself just a little.
Dean crosses to him and grips his shoulder. “It isn’t going to be like this. Sam…you scared the hell out of me this time. I thought…I’m not going to let you disappear just because you’re going to school.”
Sam leans forward and lets his hair fall into his eyes. God, sometimes it’s like he never stopped being seven years old. Little brother.
He gets the IV pole set up and reaches for Sam’s arm to do the saline wash. Sam watches, vaguely amused. “I can do that, you know.”
Yeah, Dean knows, but he’s not going to be able to drive away from this kid without the muscle memory of having done it. He needs to feelSam’s taken care of in his bones.
“Call me,” he says. “If…anything.”
“Yeah.”
Sam walks him to the student center to catch the bus and waits with him. The girl working the desk glances up at them several times.
Well, mostly at Sam.
Dean’s about to tell her off for looking at his goddamn sick kid when he notices Sam’s looking back at her.
A minute later, Sam shifts in his seat, bringing the ace bandage covering his PICC into view.
Dean chuckles to himself. Fucking pimp, Sammy.
***
A month later, he’ll be on the phone with Sam and Sam will tell him he’s lying on the bed with the phone between the mattress and his ear because everything fucking hurts and he can’t move.
Six months later, he’ll be on the phone with Sam and Sam will tell him he hasn’t slept in three days and he can’t remember where he put his calculus textbook and he’ll sound nearly hysterical and Dean will say “Sam, Sam, shh, Sam,” until he’s hoarse and they’re both tearful.
But today Dean boards a bus and watches out the window as Sam approaches the information desk and says something to the girl on duty, and she tucks a lock of hair behind her ear and smiles.
Summary: I was asked to write a story about Sam with Lyme disease. This happened. Probably the most research I've ever done for a fic.
Warnings/Spoilers: I don't think any. I guess spoilers for like, the first ten minutes of the pilot.
Author's Note: To my Physician's Desk Reference, shangrilada
Dean’s phone rings in the middle of the night.
It’s not that outrageous, actually, because it’s only one am in California, and because Sam’s nineteen, and Dean remembers enough about being nineteen to know that one am isn’t very late even if it is four in the damn morning in Pennsylvania.
“Hey, bro!” Sam’s drunk, Dean can tell instantly by the exuberance in his voice. Sam’s quiet, pensive, brilliant, not exuberant, except for sometimes at four in the damn morning.
“Sam. What? You better be dying.”
“Nooooo.”
“Jesus, where are you, a frat party?”
“Douche.” Sam’s smirking audibly. How can a smirk be so audible over the phone? Sam. “It’s spring break.”
“Yeah?” Dean’s ears perk up slightly, despite the hour. “Girls going wild?”
“Girls going on Habitats For Humanity trips,” Sam amends. “It’s not like the movies, Dean.”
Dean glares at the mouthpiece, because seriously, why would you burst that bubble, Sam?
“Campus is pretty empty,” he says. “Boring boring. What are you doing?”
“Hunting a vengeful spirit outside Pittsburgh. Killed some kids in a public park. Dad’s working on something down South.”
Sam whistles long and low. “You’ll get it, Dean. Hey.” He pauses, like he’s considering something. “You want a hand?”
“What?”
“I could come out of retirement.” Sam’s crowing just a little, like the first time he shot a beer can off a fencepost, like the first time he shot a salt round through a spirit that was descending on their father. “I could be back in action.”
Dean laughs. “You’re drunk.”
“So?” Sam says. “We’d have fun, right? I’m on break. I could fly out there, fight some shit, hey, maybe this could be a thing. We could do this every year.”
“Sammy, I thought you didn’t want to hunt anymore.”
“Well, not full time,” Sam says, exasperated, like this is something that should be obvious. “I don’t want to live with Dad anymore, but that doesn’t mean I don’t want to see him.”
There’s a stunned sort of awkward silence. They don’t talk about Dad. Sam and Dad haven’t seen each other in months, and Dad hasn’t mentioned his name since he’s been gone, and fuck, maybe Sam never will see them. Dean knows the same thought is occurring to Sam. Shit.
“Yeah, Sammy,” he says, swallowing the lump in his throat. “Come out. I’d love to see you.”
The truth is, he really fucking would.
***
Dean hasn’t seen Sam since early August, since he boarded that bus in Omaha that took him away into the sunset (goddamn it, why do you have to think of things in these picturesque, romantic terms? He went to school) so meeting the plane from Palo Alto is literally one of the best things that’s ever happened to him.
Sam walks off the jetway looking tan and taller than Dean remembered and healthy and happy and thriving, and it’s not even possible to pretend to himself that Stanford wasn’t the right choice. Sam has never filled himself like this, has never reached out and touched every corner of the potential he has, and Dean is momentarily stunned with pride in the fact that Sam knew how to become this man and fucking went and did it in the face of Dad’s disapproval and with no help to speak of from Dean.
He grabs Sam in a hug and lingers for a second because Sam is here and remembers what it felt like to scoop this boy up in his arms and spin him around and around and listen to him shriek with joy.
Sam says, "Tell me about this spirit," and Dean does, but he's not listening to himself talk, he's taking in Sam and he's so fucking proud of this kid, this young man his brother is becoming.
But also, godfuckshit don't leave again, Sammy.
He has to go. Dean gets it. It's changed his entire life, he's not this sad, pale, scared little kid anymore, he's...
Is he even Dean's anymore?
Then Sam does this thing. And it's such a little thing. He angles his body sideways and into the crook of Dean's shoulder and bends his neck so his cheek is against the side of Dean's head, and this is so familiar. This is so Sam. And suddenly it's like he never left.
Dean feels a smile steal across his face. "Sammy."
***
Dean doesn’t tell Dad about that week in Pennsylvania, mostly because he doesn’t want to say I told you so. He doesn’t want to shove it in his Dad’s face that college has clearly been great for Sam, that he’s happy, that he’s bursting with news and talking more than he has in his entire life about things that make no sense to Dean, hierarchies of needs and standard deviations and noun declensions (he’s always spoken Latin, Stanford, you’re not special) and the off-sides rule, which apparently cost his intramural soccer team a critical game. He sounds normal. He sounds so goddamn free.
But - and this is the thing, this is the real I told you so - Sam can still hunt. His instincts are as sharp as ever, and he can still make that trick shot of his where he spins and drops to one knee and plugs the spirit with a direct hit. He keeps up with Dean in the woods and at the bar (little Sammy pounds beers like a pro now, it’s mind-bending) and Dean can’t find it in him to say “Sam came to see me and he didn’t come to you and you were wrong, he was fine, he is fine, he’s better than ever and he was right to go.”
He especially doesn’t say anything when summer rolls around and school lets out and Sam very conspicuously doesn’t come home. He knows what Dad said, they all know what Dad said, but Dad says a lot of things when he’s pissed off and there’s been this air of “well but not really” about him as the semester’s drawn to an end. On some level, Dean knows, Dad was waiting for Sam to come home.
He should have known Sam was too proud.
But not seeing the kid is a disappointment Dean doesn’t know how to handle, so what the fuck, he decides, he shouldn’t have to.
“There’s a hunt in Nevada,” He says one morning over a grab-and-go breakfast of bananas and cereal.
“Mmmph.” Dad chews and swallows. “We’re in the middle of a hunt, Dean. This is going to take at least another week.”
“But you can do it without me,” Dean says. “It’s just a matter of figuring out which grave to salt and burn, and you don’t need me for that. Let me go handle this other thing.”
“What is it?
“Not sure,” Dean fibs easily. “Strange deaths. Bodies with shrunken organs.” God, he’s disturbingly good at making this stuff up. “They autopsied a woman whose kidneys were the size of kidney beans. I read about it online.”
Dad frowns. “What could do that?”
“No idea. Sounds worth checking out, though.”
“Where’d you say this was?”
“Nevada.”
A knowing look crosses John’s face, and for a moment Dean thinks he’s found out. “You just going out there for strippers, boy?”
Christ. It’s not like he wants Dad to catch on to what he’s doing, but how fucked up is it that he assumes strippers before Sammy? “It can be both, right?” Dean says with a smile he knows is charming.
Dad sighs. “Get gone. No more than two weeks, you hear?”
An hour later, Dean’s on a bus to Palo Alto.
***
He calls Sam from Salt Lake City and leaves a message.
He tries again in Reno. Kid’s not picking up his phone.
The bus pulls into the turnaround of the Stanford Student Center at five am and leaves Dean standing there with his duffel bag and absolutely no idea where his brother lives. The woman at the information desk says she’s not allowed to give out student addresses, but she does call Sam, and apparently this time he picks up his phone, because he hears her explaining that there’s a visitor here.
“Dean,” Dean mouths silently.
“Sean,” She relays to Sam. Dean rolls his eyes.
She hangs up the phone. “He’s coming.”
Dean reads a bulletin board about alcohol safety (“always have a sober buddy,” the Stanford Cardinal advises) while he waits, and about fifteen minutes later he’s engulfed from behind by giant arms and he’s surrounded by the smell of Sam and the sound of Sam’s voice in his ears, and it’s not until he shoves Sam off him and turns around to hug him properly that he realizes something’s wrong.
***
Sam leads the way back to his apartment, but it’s slow going because he’s walking sort of gingerly, like there are rocks in his shoes and it’s hurting him. Dean’s filled with an urge he hasn’t felt in years, to pick Sam up and carry him for a while.
The apartment is a mess, which is weird because Sam’s usually so neat. There are dirty dishes in the sink and the bed is unmade. School books are strewn everywhere, uncapped highlighters drying out on top of them.
“Sam, jesus, what…”
He’s skinny. Sam has always been slim, but he hasn’t been skinny since he was fourteen years old and started acquiring muscle mass like a damn magnet. Now he’s pale and strung out, collar bones prominent under his t-shirt, which hangs on him loosely even though Dean knows that shirt and knows how it’s supposed to fit Sammy and it’s supposed to cling, okay, it’s not supposed to look like an empty sack.
“I didn’t know you were coming!” Sam hugs him again, properly. “Why didn’t you call?”
“I did call, Sammy, you…jesus, are you on something”
“What are you talking about?”
“You must have lost thirty pounds since March.”
“Oh.” Sam shuffles guiltily. “I don’t know, I haven’t…I guess I haven’t been eating a ton.”
Dean tugs open the refrigerator. Sure enough, it’s all but empty. “Do you need money or something?”
“No, I have a job.”
“You do? Doing what?”
“I work the circulation desk at the library.”
Of course he does. “Are you overdoing it? You really don’t look good.”
“I’m fine. Hey,” Sam hugs him again. “I can’t believe you’re here. This is so great.”
“Yeah, can I crash on your couch for a few hours?” Dean asks, because he’s been on a bus for a day and a half and it’s five in the morning and there’s no pretending he’s not exhausted.
Dean falls asleep to the sound of Sam getting his shifts covered for the next two weeks.
Five hours later, he wakes up and Sam is still sleeping.
***
Dean cleans the apartment while he waits for Sam to wake up. He caps the highlighters and gathers them in a paper cup on Sam’s desk. He bookmarks the textbooks with scraps of paper and stacks them up. He picks up clothes off the floor and puts them in the hamper and hopes he’s guessing right that these are dirties. Sam’s still asleep, so he walks down to the convenience store and buys frozen dinners and soup and vegetables and soda and water and chips and stocks Sam’s fridge.
There’s a Ninja Warrior marathon on TV, so he mutes it and watches and tries to decide which of the physical challenges he’d be able to handle. The strength ones would be no problem, but he has a feeling he’d struggle with the balance ones. At 4 pm, the network switches to some remodeling show, and Dean turns it off.
Sam’s still not awake.
***
He finally emerges at about seven o’clock, looking like the very act of sleeping has exhausted him, and there’s this brief moment when he looks at Dean likewhat are you doing here? that spooks the hell out of Dean.
“You’re…you came?” Sam says uncertainly.
Dean chuckles a little, even though this is starting to feel less and less funny. “You picked me up at the student center, remember, Sammy?”
“I…what?”
“Early this morning. I guess you weren’t quite awake yet, huh?”
“Oh.” Sam looks confused and upset, and no, Sam, god.
“What’s going on with you?” Dean asks quietly. “Something’s wrong, Sammy, don’t tell me there isn’t.”
“I don’t know.” Sam’s face is resigned, he’s not pretending he's fine anymore.Good boy. "I haven't been feeling great."
“Yeah? What symptoms?”
“I’m tired. Like, all the time tired.”
“Right now?”
“Tired."
“Are you sleeping at night?”
“I’m sleeping always. And then, I get these headaches, and they make me want to sleep more.”
“Bad ones?”
“Killer.”
“Lost your appetite, too, I guess,” he indicates Sam’s eroded body.
“No, it…it’s not like that. I’m so hungry.” There’s a desperation in Sam’s face as he says this, a genuine need.
Dean swallows and tries to talk around the lump in his throat. “Eat something.”
“I try,” Sam says quietly.
“Well, I got you all kinds of rare delicacies from the 7-11. We’ll try tonight.”
“Okay,” Sam swallows hard and doesn’t really look like anything’s okay at all.
***
Dean wants to heat up a couple of Banquet dinners, but Sam’s eyeing them mistrustfully, so he settles for a can of Campbell’s Chicken and Stars. He heats it up on the stove, and when he comes back into the living room with the bowl balanced on a tray, Sam’s asleep on the couch.
He’s been awake for maybe twenty minutes.
Don’t even try telling Dean something’s not wrong here.
He sets the soup on the floor and gets his arms under Sam and lifts him, raising him into a sitting position, and he’s struck again by how light Sam is. Maybe this exhaustion is due to undernourishment. Sammy definitely needs to eat.
“Ready for soup?” He asks as Sam blinks awake a little.
“Hmm?”
“Chicken and stars.”
“Oh.” Sam nods. “That sounds okay.” Like it’s the first time he’s hearing of it, like they didn’t agree ten minutes ago that chicken and stars would be okay, what the fuck is wrong, Sam?
Dean sets the tray on Sam’s lap and Sam just kind of sits there staring at it.
“Eat, Sammy.”
“What?”
“Jesus, you’re falling asleep in your soup.” He is. He’s drooping like a tree over a blessed well.
“Sorry,” Sam says quietly. “So tired. Maybe a few more hours.”
“After your soup, Sam, okay? You can sleep all you want, I promise.”
“Okay.”
Sam takes bites of soup robotically, slowly, and Dean watches and wonders if this is what the last few weeks have been like. Sam sleeping all the time, barely eating, exhausted and headachey, and something is up with his memory, he’s clearly sick and confused and scared and why the fuck didn’t he call somebody?
Why didn’t he call me?
Midway through the bowl of soup, Sam’s eyelids begin to grow heavy and the spoon stops traveling from the bowl to his mouth. A moment later Sam’s head drops onto Dean’s shoulder.
“Sam.”
“Hmmm?”
“Keep eating, buddy. Not naptime yet.”
“Hurts.”
Dean’s heart twists. “What hurts, Sammy?”
“Hand.”
Dean takes Sam’s hand in his own, and oh, shit, it’s swollen like the surgical gloves Dean used to inflate for Sam at the pediatrician’s office, the joints painful and inflamed. “Sammy, what happened? Did you…” fuck, he has no idea what to ask. He has no idea what to think. Sammy’s sick, Sammy’s sick.
“It hurts,” Sam says softly. “Always. When I move too much. Do too much. So tired, Dean,” and then he’s crying quietly into Dean’s shoulder. “Something’s wrong, something’s wrong.”
Dean shoves down his panic, that is not helpful, and rubs Sam’s back gently. “Your hand hurts when you use it too much?”
“Everything,” Sam sobs. “My knees. If I walk. Elbows. Everywhere. Hurts so much. So fucking tired.”
“Can you…can you eat just a little more for me?”
Sam shakes his head, pressing into Dean’s shoulder like he’s burrowing.
“Come on, Sammy.” Dean wraps an arm around him and lets Sam rest against his shoulder while he brings a spoonful of soup to his brother’s lips. “Just a bit more.”
Sam swallows the soup, and six more bites, before he slips into sleep against Dean.
“Oh, kid,” Dean whispers, easing his brother down on the couch. He covers Sam with a blanket and packs his hand in ice to try and reduce the swelling, and then he notices it’s Sam’s other hand too, what the fuck, so he packs that one.
And then, on a hunch, he finds Sam’s thermometer in the medicine cabinet and slips it under his sleeping brother’s tongue, and Sam’s running a fever of a hundred and one.
Dean gets online and finds the nearest walk-in clinic.
***
The nurse takes about a quart of blood from Sam and leaves him shivering on the examination table. She offers him a blanket, but he shakes his head, which doesn’t stop Dean from wrapping the kid up in his hunting jacket after she leaves. “Hey. You okay?”
Sam nods a little - brave kid - and leans forward into Dean’s shoulder, his breathing shallow. “Tired.”
“Yeah, I bet, you’ve got no blood left in you.” Dean climbs onto the table behind Sam and pulls him down so Sam’s head is resting in his lap. “Take a nap if you want, it’s fine.”
It’s telling that Sam doesn’t resist, just nods and lets his eyes slip closed and shivers through the thick lining of Dean’s jacket. “Don’t worry,” Dean says quietly. “Don’t be scared. Gonna get you all fixed up.” Sam moves a little, but he might just be stirring in his sleep.
Dean might just be talking to himself.
How is it possible that Sam has deteriorated this much since March?
The doctor comes in and apparently gets it, because he doesn’t wake Sam. He talks to Dean about the tests they’re going to run and says they probably won’t know anything for a few weeks, and Sam should just rest up and try to eat.
“He’s been getting bad stomachaches,” Dean says. “He doesn’t want to eat because it hurts.”
The doctor nods. “It’s probably unrelated. My feeling is, this is mono. He probably lost his appetite for a while and now he’s having trouble getting back into a normal eating routine. That’s why you’re seeing stomachaches. Keep him on light foods - broth, yogurt, crackers - until he feels ready to try something with a little more sustenance.”
“Okay.”
“Meanwhile, he can have some amoxicillin to keep the fever down and ease some of the pain.” The doctor scribbles on a prescription pad and rips off the paper. “This is for a course of antibiotics. Might just clear the whole thing up.”
Dean pockets the paper.
“Let me know if anything further comes up,” the doctor says. “The phone number’s on the script.”
***
The next week and a half are a parade of negative diagnoses. Sam doesn’t have mono. He doesn’t have lupus. He doesn’t have cancer (thank fuck, but also, enough of what he doesn’t have, tell us what he does have). He doesn’t have any strain of flu the doctors can identify.
More tests, they say. They’ll order more tests. But they sound perplexed, almost indulgent - Sure, we’ll order more tests, butwe don’t know. What is there even left to test for? Dean’s starting to feel desperate. Sam’s mostly too tired to feel desperate, but some nights he’s up with that awful, twisting stomachache that makes him screw up his face, that makes Dean pound at the edges of his sanity because now Sam won’t eat tomorrow, and on nights like that he looks up at Dean hopelessly like he’s giving the fuck up.
“I’m not going to let you quit,” Dean grumbles into his ear.
And then one morning the phone rings.
*Dad*
Shit.
Dean answers warily. “Yeah.”
“You about bagged that monster yet, kid?” Dad’s gruff voice comes over the line. “Need you back here.”
And just, fuck. Because no, Dean has not bagged the monster, the monster is still eating Sam alive, Dean hasn’t solved this one yet, Dean hasn’t come close.
“I need more time,” he hedges.
“Dean…” There’s a note of warning in Dad’s voice.
Sam blinks awake. “Is that Dad?”
Dean nods. Sam rolls away and pulls the blankets over his head.Fuck.
The thing is, Dean’s never learned to defy his father.
But the thing is, Sammy.
But the thing is (and this is the real thing), nothing Dean’s doing here is making Sam any better.
So when Dad says “time to call it a day and get back to work,” Dean swallows his anger and his fear and the piece of his heart (all of his heart) that belongs to the sick kid lying in the bed and says “Yes, sir.”
***
-how you feeling kid
-okay
-you lying to me?
-a little. Don’t worry.
-any more from dr?
-I don’t have shingles.
-text if you hear anything.
-kay
-not hepatitis
-good I guess?
-at least it would be something
-eating?
-yeah
-you lying to me?
-a little
-eat, sammy.
-hurts though
-fuck, kid, i know
-sam?
-sam, text me.
-dude, you getting this?
-sam?
-sorry, was asleep
-for twenty-seven hours?
-I guess. Everything ok?
-didn’t hear from you. Got nervous.
-shit did I say I was going to text you?
-no…
-losing track of shit…fuck I hate this.
-you’re not on webmd are you
-no
-you lying to me?
-sam, get off webmd
-sammy?
you don’t think it could be syphilis do you?
-wtf?
-not syphilis
-duh. You have to have sex to get that.
-I hate you
-hate you too, sammy.
***
“Who do you keep texting?” Dad asks.
“Um, Carly.” It’s the first name that pops into Dean’s head.
“Who’s Carly?”
A fair question. “Girl I met. Uh. In Nevada.”
Dad shoots him a look. “Did you leave that hunt unfinished because you were screwing around, Dean?”
I left it unfinished because you dragged me back. “No, sir.”
Dad’s quiet for a minute. “You’ve been texting her for a few weeks now. This getting serious?”
“Maybe.” Dean’s not going to elaborate on his fictional fucking girlfriend.
Dad looks like he’s expecting more, but he lets it drop. “Okay. Well, pack up. There’s some unnatural stuff happening in Ohio I want to check out.”
***
-dean?
-yeah, buddy?
-you awake?
-sure. You okay?
-fever
-shit. How high?
-103
-god, sammy
-so tired of this
-i know. Fuck.
-i just want to get better
-taking your meds?
-they took me off them
-WTF?
-wasn’t working
-sam you’re sick go back to the doctor first thing am.
-okay
pneumonia. checking into er. might not have service for awhile.
-sam?
-SAMMY?
***
A few days go by.
They’re probably the worst of Dean’s life.
When he can, he gets online and looks up Palo Alto area hospitals and writes the phone numbers on his hand, and tries to get away from Dad to call and ask if Sam Winchester is a patient there, if he’s doing any better, if he’s scared, if he’s fuckingalive, but they all say the same thing - they can’t release patient information. “He’s mybrother, Dean growls into the phone, again and again, but that doesn’t seem to hold water.
“He’d have been admitted three days ago with pneumonia,” Dean desperately tries to sway the Stanford Hospital nurse receptionist. “Samuel Winchester. W-I-N-C-“
Dad walks in.
Dean freezes for a moment.
Fuck it.
“-H-E-S-T-E-R,” he spells, making eye contact with his father, daring him to say something. “Age 20. Tall, skinny, sleeps all the time.”
Dad’s eyebrows meet in a wordless question and Dean does not have time.
The nurse pauses. “Hang on.”
Hold music takes over, and Dean speaks before his father can. “Sam’s been sick. I didn’t go to Nevada. I was with him. We don’t know what’s wrong, but he’s in the hospital with a side of pneumonia and I guess they’re running more tests and I need to know he’s okay. I’m sorry, he’s my brother, he’s my little brother and he’s mine and Ihave to know.”
Dad stares at him for a minute and then crosses the room in two steps and wraps Dean up in a hug. “Why didn’t you tell me?” He whispers. “You should have told me. He’s mine too, Dean, he’s my baby. God, shit, is he okay?”
“I don’t know,” Dean’s voice breaks. “He’s so sick, Dad, he’s not eating and he sleeps all the time and he’s lost so much weight and he’s hurting, he’s scared, he doesn’t know what’s wrong with him, I don’t know what’s wrong with him, I don’t…”
“Dean?” The voice on the other end of the line sounds small and scared and tearful. “Is that you?”
“Sammy. Sammy.” Dean breathes and squeezes the fuck out of his dad’s arm. “What’s going on?”
And then Sam’s crying, and through his tears Dean makes out, “it’s Lyme disease. I have Lyme disease” and Dean’s brain is spinning because what is that, how bad is it, Sam Sam Sam.
“Can you come?” Sam says between sobs.
“Yeah, Sam. Yeah. I’m on my way.”
***
Dad guides Dean into a seat and holds his shoulders because Dean’s shaking too hard to stand. “What? What did he say?”
“Lyme disease. I have to go, Dad, I have to go.”
Dad swallows and nods. “Go.”
***
Dean opens nine or ten websites about Lyme disease before he boards the bus and uses the time to read. The first thing he learns is that it’s caused by ticks, primarily in northeastern states.
States like Pennsylvania.
So essentially, Sam is sick because he came to see Dean for spring break, and there’s nothing even remotely okay about that. He feels sick to his stomach.
Probably not as sick as Sam. Shit.
It’s a bacterial infection that spreads throughout the body and affects other things as it takes hold, which explains Sam’s exhaustion, headaches, memory loss, maybe even the pneumonia.
What’s scaring Dean, though, is that too many of Sam’s symptoms seem to fall in the column labeled “late disseminated Lyme disease” - the sleeping, the memory problems, the chronic pain. The column that also talks about cognitive damage and psychiatric symptoms.
No.
His phone buzzes in his pocket. *Sam*
-my hearts going so fast
-take deep breaths
-i am oh god
-get your doctor sam
-sam?
-SAM!
He looks back down at the website and sees heart palpitations, right there on the same line with hearing and vision loss, and he doesn’t know what a palpitation is, really, but something’s wrong with his baby brother’s heart and no no no fuck why won’t this bus go any faster, why is he so far away, he needs to be beside Sam and feel that he’s safe.
Sam doesn’t text again.
But they would call. The hospital. He must be Sam’s in-case-of-emergency contact, who else is Sam going to put down? They would call him if something happened. They would tell him. He would know.
He repeats this to himself until it’s a mantra. They would tell me. I would know.
Sammy’s okay.
***
It’s three in the morning when the bus pulls up to the student center.
Dean gets instructions to the hospital at the information desk and sprints the entire fifteen blocks.
Sam.
***
He’s lost weight since Dean was here, which just doesn’t seem possible and makes Dean want to crawl right up onto the bed beside him. A couple of tubes dangle, tentacle-like, from his upper left arm, like they’re built in, like they’re fucking part of him. ‘Dean’ is written in permanent marker on his left hand, like a reminder. His breathing is heavy and congested, and when Dean touches his forehead, he’s blazing.
Dean pulls the bench under the window over to the bed and shoves his duffel bag up against the arm, because he’s tired, because he couldn’t sleep until he saw his brother, and he’s all set to let the rise and fall of Sammy’s chest sing him to sleep when a nurse walks in.
She smiles when she sees him. “You must be Dean.”
“I, uh,” Dean articulates.
“He’s been asking for you.” She nods toward Sam’s hand. “When he found out you were coming, he wrote it down so he wouldn’t forget, and now every time he sees his hand he says, ‘when’s Dean coming?’” She chuckles like that’s not the saddest thing in the entire world.
“Lyme disease?” Dean means to keep his voice neutral, but it cracks.
Her face goes soft. “Oh honey. It’s treatable. He’s going to be just fine.” She messes with the tentacle tubes a bit. “Actually, now that you’re here they might decide to let him go. He’ll be more comfortable at home.”
“But…is that…”
“He needs to take his antibiotics,” She says. “I’ll show you how to use the PICC, and then you can do it at home.”
Dean swallows and looks at his brother, weak and tired and laid out in this sterile antiseptic bed, and god fuck what if I screw it up?
“Hey, Sam,” the nurse says softly, leaning over Sam, gripping his shoulder, his neck. “Guess who’s here!”
Sam’s eyes blink open. Dean leans close. “Hey, Sammy.”
“Dean,” Sam whispers, and fits his hand into Dean’s, and the nurse smiles and retreats and they hang on to each other.
***
They let Sam go in the morning.
He’s still running a fever of a hundred and four, but apparently no one but Dean is particularly concerned about that. An orderly helps Dean load boxes of antibiotic bags and syringes into the passenger seat of the taxi, and Dean buys a fleece blanket from the hospital gift shop and wraps Sam up in it and carries him out to the car because fuck wheelchairs, because Sam is so light.
Dad calls while they’re in the cab and Dean tells him they’re leaving the hospital and going back to Sam’s place. “Let me speak to him,” Dad says, and Dean holds the phone against Sam’s ear so he won’t have to free his arms from the blanket.
He listens to the low vibrations of his father’s voice, though he can’t tell what’s being said, and Sam is quiet and breathes slowly and heavily and at some point Dad says something that makes him close his eyes and start crying softly, which just about breaks Dean’s heart.
After awhile Sam looks up at Dean and nods, and Dean takes the phone back. “Dad?”
“He heard me?” Dad’s voice is ragged.
“Yeah.”
“How is he?”
“High fever. They gave us some antibiotics, but he’s still fighting off pneumonia.”
“How can they send him home?” Dad sounds angry, and Dean feels like crying because he’s just got no anger left. He’s been angry and worried for too long. Now he’s just sad.
“They put a tube in him,” he says, swallowing, trying not to let his father hear how close to tears he is, shit. “They put a tube in his arm - in his heart - “
“Dean.”
“I’m sorry, I’m sorry.”
“Dean, god, don’t be sorry. I know.”
Dean breathes and breathes and wants his father.
“Should I…” he hesitates. “Should I come out there?”
It’s as if Dad is reading his mind. “I…I don’t know.”
“I don’t want to overwhelm him,” Dad says. “He’s going to be okay?”
“Yeah. Yeah.”
“Take care of him.”
Like Dean could do anything else. “Yes, sir.”
Sam rolls over and buries his face in Dean’s stomach.
***
It takes Dean three trips to carry Sam and all his new medical supplies into the apartment, and by the third trip Sam’s already asleep. Dean takes this as a good thing, because that fever’s not going anywhere on its own. He sets up the IV pole and prepares Sam’s antibiotics.
Sam wakes up with a cry when Dean shoots the saline wash into his PICC tube. “Too cold -“
“You’re sick, Sammy,” Dean whispers. “It’s okay.”
“No, it’s cold, it’s cold, I don’t like it.” He scrubs at his arm, at his chest, with his opposite hand. “Stop.”
“Shhh.” Dean hangs the antibiotic bag on the IV pole and attaches it to his brother. “Good medicine, Sammy, you’re going to feel so much better, I promise. Go back to sleep.”
He does, with a quiet whimper that tugs the breath from Dean’s lungs (he’s sosick) and Dean sits beside him, tired but alert, one hand twisted gently into his brother’s hair, the other cupping the PICC tube so he can feel the cold rush of antibiotics across his palm as they drip towards Sammy’s heart.
***
Sam doesn’t feel better.
He doesn’t feel better when he spikes a fever of 105.6 and can’t fall asleep, despite his exhaustion. He sits up in Dean’s arms and lets Dean flush his PICC.
“It’s in all my veins,” he says, shuddery. “Like spiders.”
“I know.” Dean threads his fingers in Sam’s.
“Is Dad hunting alone?”
“Yeah.”
“He’ll g-get hurt…”
“Shhh, no, Sam.”
“You g-gotta help him…Dean…”
He’s a hot mess in Dean’s arms, and Dean could swear he’s about to break into a sweat but he doesn’t, it keeps climbing, agonizing inch by inch, until he’s a shade under 106 and clinging to Dean with tears in his eyes, whispering “whywhywhy?”
Dean pushes the hair out of his eyes. “Why what?”
“Why’s it always worse?”
“Come on, Sam.”
He draws a bath and helps Sam into it, and Sam cries when the water touches his skin because it’s cooler than room temperature because Dean just has to. He wraps the arm with the PICC in a towel and holds it in his lap like it’s his baby while he rubs a washcloth over Sam’s back. He rubs his thumb over the skin of Sam’s arm just above the sutures, where he can still feel the slight bulge of the tube protruding, and whispers “get better. Get better.”
“I want to.”
“I know, baby.”
***
Dean’s finishing up Sam’s antibiotics that night, throwing away the used syringes and bags and stuff, and Sam says, “D-dean…” in this panicked voice like a dart.
Dean turns around and oh shit god fuck Sam is bleeding, he’s fuckingleaking like a punctured balloon, thick beads of dark red sliding from the PICC down his arm and into his hand. “Sam, holy shit, Sam.”
Sam is shaking with fever, breathing so goddamn hard, staring at his wide open vein, baffled.
“What did I do,” Dean gasps to himself, hands all over the leaking PICC, trying to find the problem, and oh god, here, he unscrewed the wrong goddamn piece and threw it in the trash and now Sammy’s bleeding all over everything, motherfucker.
Hang on, Sam. There’s no time to hold him, tell him it’s going to be fine, no time to apologize for opening his veins and leaving him hung out to dry. Dean paws through the trash can like a stray dog until he comes up with the missing piece of the PICC. He wastes a saline syringe flushing it - but he can get another one of those, dammit - and screws it back on, and now there’s time, crisis over, but he’s still heaving with panic and self loathing, he still just bled the fuck out of his sick little brother.
“Okay,” Sam says. “Okay.”
Dean gets a towel and wets it and wipes away the blood and just holds that poor fucking arm, that poor fucking boy.
Sam falls asleep mumbling “okay okay okay.”
Dean feels the moment his fever breaks.
***
Gradually, things are better.
Sam eats ravenously, pizza and burgers and scrambled eggs and the stupid salads from the Greek restaurant he likes. He laughs while he eats, and afterward he looks full and satisfied, content. He begins to fill out again, to look healthy. Color returns to his face, and Dean feels the strength come back into his hug.
They stay up until two in the morning one night, watching reruns of sitcoms that were terrible the first time. Sam talks about the history of television and the place of entertainment in society and what shows like these say about their contemporaries. Dean listens to him talk, doesn’t focus on the words, just enjoys the sound of Sam’s bright and earnest voice.
Dad calls. Sam cradles the phone against his ear and nods along quietly, and says “I love you too.” Dean pretends he isn’t hanging on every word.
There’s a morning Sam wakes up feeling great and wants to go for a jog, and they get half a mile down the beach before his knees swell up. He limps home groaning and sweating, with a smile on his face and his arm across Dean’s shoulders for support.
“It’s better,” he says.
***
“I have to go.”
“I know.”
Sam’s sitting on the edge of his bed, watching forlornly as Dean packs his things. “I’ll come back,” Dean says. “Dad will understand.”
“Because I’m sick?”
“Sam, no. Come on.”
Sam nods. “I know. Sorry.” He’s feeling sorry for himself just a little.
Dean crosses to him and grips his shoulder. “It isn’t going to be like this. Sam…you scared the hell out of me this time. I thought…I’m not going to let you disappear just because you’re going to school.”
Sam leans forward and lets his hair fall into his eyes. God, sometimes it’s like he never stopped being seven years old. Little brother.
He gets the IV pole set up and reaches for Sam’s arm to do the saline wash. Sam watches, vaguely amused. “I can do that, you know.”
Yeah, Dean knows, but he’s not going to be able to drive away from this kid without the muscle memory of having done it. He needs to feelSam’s taken care of in his bones.
“Call me,” he says. “If…anything.”
“Yeah.”
Sam walks him to the student center to catch the bus and waits with him. The girl working the desk glances up at them several times.
Well, mostly at Sam.
Dean’s about to tell her off for looking at his goddamn sick kid when he notices Sam’s looking back at her.
A minute later, Sam shifts in his seat, bringing the ace bandage covering his PICC into view.
Dean chuckles to himself. Fucking pimp, Sammy.
***
A month later, he’ll be on the phone with Sam and Sam will tell him he’s lying on the bed with the phone between the mattress and his ear because everything fucking hurts and he can’t move.
Six months later, he’ll be on the phone with Sam and Sam will tell him he hasn’t slept in three days and he can’t remember where he put his calculus textbook and he’ll sound nearly hysterical and Dean will say “Sam, Sam, shh, Sam,” until he’s hoarse and they’re both tearful.
But today Dean boards a bus and watches out the window as Sam approaches the information desk and says something to the girl on duty, and she tucks a lock of hair behind her ear and smiles.