Summary: Dean has carried around the effects of rheumatic fever since he was young. Things begin to catch up with him right after he and Sam reunite after the Stanford era. This takes place in S1 before "Faith." A look at how much Dean has sacrificed – past and present – while hunting with a chronic and sometimes life-threatening condition. AU, flashbacks to wee!Chesters and teen!Chesters, but story is mainly about Sam and Dean in S1. Not quite sure where this will lead except the episode “Faith” is on my mind. Some things I think I’ll try and tie into it.

Genre: h/c, no Wincest

A/N: Get this. My computer crapped out on me and had to go away for awhile – it'll be three weeks come Tuesday. . .a major hard drive failure for no apparent reason. . .kind of like how a car will go on you is how it's been explained to me. It's getting fixed but I am so, so sad. . .most of my writing is safe but I am going to be behind on NaNo and I lost all my pics of Johnny and J2 and hot Paul Gross. . .well, you know how it is when your computer fucks you over.

Nonetheless, I offer you this new Sam and Dean fic! Yes. Because writing it made me feel better. I needed to have the boys make me feel better, and this is what did it. That, and a bit of some Italian wine. And a cuddle from my seven year-old. So, I hope others enjoy, but I really wrote it for myself, hoping it would make me feel better.

And it did.

There will be typos. Because this computer is Lucifer himself.

******************

“So, hey,” Sam asks Dean one night, when they’re sitting in the motel room, enjoying a beer or three, Dean’s eyes on the tv and Sam’s glued to his computer screen. They’re in some Illinois motel, on their way to St. Louis to check out some kind of shapeshifter thing. “You need to stop in somewhere and get a shot of something?”

Dean frowns, freezes and then flushes, all in the space of thirty seconds. He knows exactly what Sam is referring to, and he even knows why Sam is bringing it up – Dean struggling to breathe when he’s lying down the past couple of nights – but what Dean doesn’t know – never knows – is whether or not it’s a good time to deal with this – crap – yet again, not when there’s a shapeshifter in St. Louis that they’re supposed to be taking care of in the next few days.

“I’m okay,” Dean answers, taking another swallow of beer – probably something he shouldn’t be drinking right now, not when his body is turning against him yet again. “I might be getting a cold from that – lake thing.” He’s referring to being short of breath, knows that’s what Sam wants him to address.

“Dean, that was – awhile ago.”

“So, what? I can’t be getting a cold now? That water was freezing and I was in it forever. Not to mention I swallowed a shitload of it.”

“Of course you can be getting a cold,” Sam says, but now he’s looking at Dean, not at his computer. “But just don’t be blaming the – dunk in the lake two weeks ago for it.”

Dean rolls his eyes. “This just might be the most fucked up conversation we’ve ever had,” he says. “What’s the difference if I caught a cold from swimming in a freezing lake or touching some doorknob in a dirty john somewhere?”

But Sam won’t budge, won’t take his gaze down from Dean’s face. He knows what Dean’s trying to do, trying to change the subject and be slick about it at the same time. “Is that what this is?” he asks again. “A cold? Or do we need to go in somewhere and get it looked at?”

And just like that, there they are, back to the good old days, hearkening back to a time and place that Dean has tried to trick himself into believing he left behind when Sam went to Stanford.

***************

Of course, it’s not a cold – or, maybe it is, Dean does feel like he may be coming down with some kind of – respiratory thing, the scratchy feeling in his throat and the stuffy feeling in his nose, but all of that is secondary to what’s really going on with him, and Dean knows it and, more importantly, Sam knows it as well.

Thing is, Dean’s been through this before, more times than he cares to remember, and so has Sam, so it’s not as if Sam is messed up or doesn’t know what he’s talking about. Dean probably should get his ass into the hospital and have everything checked, let them take a listen to make sure nothing out of the usual is going on, have them give him a shot of prednisone, a dose of antibiotics so he doesn’t end up with the – whatever it’s called, the heart infection bullshit – again.

Of course, it’s the same old, same old, no insurance other than the fake shit, no real way to pay for anything, and Dean’s well aware of the hassle of everything.

As is Sam.

Of course, if Dean doesn’t go in, and it’s more complicated than a cold and he doesn’t get it taken care of, he’s going to end up in the hospital anyway, probably for a few days and probably for a few thousand dollars. Per day.

And not just that, but the hunt in St. Louis will be in jeopardy, and right now, Dean isn’t sure he can carry that particular weight, putting something like that off, people dying because he’s got his own issues that he doesn’t always know how to take care of in the most proper or timely fashion.

If Sam wasn’t here, Dean knows what he’s do. It wouldn’t even be a question.

He’d ignore all the symptoms and make his way to St. Louis.

But he’s not alone, Sam’s with him, and when Sam’s around, what they do and how they do it doesn’t really go according to how Dean thinks it should go.

At least, not all the time.

***************
When he was twelve.

That’s when Dean remembers having the strep throat, the thing that supposedly started this whole mess, at least according to the doctors.

He remembers it because it was an unusual thing for him, to get a sore throat – to get sick with anything, for that matter. Sam was the one who got different bugs -- messy, drippy head colds and stomach viruses and low-grade sore throats so that he’d have to stay home for a couple of days sipping ginger ale and chicken and stars soup while schlepping out on the couch watching bad daytime television.

Dean? Not so much.

Not ever, really.

If he did come down with something, it was almost always in the form of a cold. He rarely puked, and he wasn’t one to run fevers like Sam, but he did tend to get heavy colds, colds that would last a couple of weeks if he was lucky and sometimes more than a month if they were really bad. No matter how minor it might seem at first, if it started out as just a few sniffles, it never just ended there – like it would with Sam – but settle down into his chest, sometimes turning into bronchitis or some other kind of annoying respiratory infection, but even if it didn’t, he was guaranteed at least a couple weeks of dealing with a deep, hacking cough that messed with his sleep and put his father on edge (“Jesus Christ, Dean, aren’t you rid of that thing yet? You sound like you’re dying of lung cancer.”). But John knew this is how it went with Dean, the pattern his colds followed, so rarely was there a doctor’s visit, not unless Dean was running a fever or showing signs that he was really sick.

Which was what happened this time. Why go to a doctor for a sore throat, a sore throat Dean never complained about?

Yet it was a sort throat that would turn into something that would change his life.

Change all their lives, really.

It started off as any sore throat would start – or so Dean imagined, seeing as he’d never had a sore throat before and had nothing to compare it to – and he thought he was coming down with one of his usual, patented colds.

Except the sore throat he had was nothing like the usual scratchy feeling he was used to when he was getting a cold. This sore throat was painful from the get go, wasn’t relieved by drinking something or sucking on cough drops or even using those numbing throat sprays. Dean tried all those things, and if anything, it made the pain worse. And then he’d spiked a fever, and eventually, his throat had swollen enough so he couldn’t eat, could barely force any fluids down, until he’d ended up staying home from school.

Dean doesn’t quite remember the exact order of events after that, other than he started puking his guts out at some point, every twenty minutes like clockwork – or, at least that’s what Sam had told him, and while the kid had only been eight, he remembered everything, still does even to this day.

After the puking and the lying on the bathroom floor curled around the toilet for hours came the debate about whether or not this warranted a visit to a doctor, but in the end what had actually come of it was John bringing Dean some kind of medicine – a bottle of thick pink goo that was supposed to taste like bubblegum but in reality tasted more like crap. “A teaspoon twice a day,” John had told him grimly. “ ‘Til it’s gone.”

Neither Dean nor Sam knew where John had gotten the medicine and they didn’t ask.

The first dose Dean took came back up ten minutes later.

John had measured out another teaspoon and, sick as he was, Dean had been able to see the grimness in his face soften into concern, like this was the first time John understood just how sick Dean was, how serious the situation might be. He’d carried Dean back into the bedroom, set him on the bed, covered him up and sat down on the mattress next to him, his hand alternately brushing Dean’s hair off his forehead or resting on Dean’s hip. “Twenty minutes,” John had said, after Dean had swallowed his second dose of the pink glop in fifteen minutes. Dean had been fairly sure he’d never heard his father’s voice sound so – soft – before, at least not with him. “I need you to keep that down for twenty minutes. After that, you can puke all you want but you need to wait twenty minutes.

And Dean had laid there trying with everything he had not to throw up again, Sam anxiously hovering in the background, John waiting it out next to him. At one point his father’s hand on his forehead was too much, too stifling, made Dean feel even more nauseous for some reason, and Dean had been too weak to push it away, could only manage to croak, “Dad,” and move his head aside, but it was enough, John had somehow understood what Dean was getting at and had stopped stroking Dean’s head, had instead gently rested it against Dean’s lower back, and that had been okay, the steady pressure just enough to relax him so that Dean could breathe through the urge to puke until he knew he couldn’t take it anymore, and he’d weakly asked, “Has it been twenty minutes yet?” and John had checked his watch and said, “Twenty-two,” and Dean had somehow flung the covers back and gotten out of bed and made it into the bathroom to stick his head back over the toilet just as another round of yellowish-green bile and pink goopy medicine rushed out of him.

But he’d made it past the twenty minute mark and after that, Dean had collapsed back into bed, out for the night until John woke him to swallow another teaspoonful, and they repeated the whole process of inching toward the twenty minute mark, and that time Dean had kept it down almost forty five minutes before waking back up to puke, and the next time after that, later in the day, everything stayed down, and a couple days after that, Dean had been better.

Or so they’d thought.

The pink medicine was gone in five days, even with Dean scraping it from the sides of the bottle and eking out every little drop of the stuff that he could. His sore throat (“strep” John had mentioned) was not as bad but it had still been there. Dean had been back on his feet, the fever still present at times but nothing terribly high. It wasn’t as if he couldn’t push through it, the fact that he wasn’t completely better – and hell, what did Dean know about strep throat or whatever the fuck it was anyway, other than it hurt like a bitch and the pink goop had made it feel better.

Not great, but better.

Which sometimes was the best they could hope for in the Winchester household, given what their lives entailed.

So Dean had kept quiet, said nothing about how he still had a sore throat and slight fever and no one was any wiser for it. Sometimes it felt a bit better, sometimes he felt like he could hardly drag himself around, but about two or three weeks after he’d drank the last of the wretched pink stuff the fever had been gone three days and the sore throat had finally disappeared as well, leaving Dean tired and relieved and more than unsure of what he’d had and completely sure that he never wanted to experience that kind of crap again, that he’d take one of his fucking colds with all the coughing and wheezing – take it for six weeks, morning, noon and night if need be – rather than go through that again.

But as it would turn out, Dean wasn’t going to get his wish on that.

Not even close.

*******************

That very night, the night that they’re chilling in the room and drinking beer, ostensibly trying to research the next hunt but really attempting to be comfortable with each other again, after the hunts they’ve just come off of, close a little of the gap they’ve spent apart – Dean can’t sleep. It’s not just the shortness of breath plaguing him when he lies down – though there’s that – but now his lungs are both tight and – spongy, which is the only word Dean can think of – and he coughs so he can breathe, leans forward from his sitting up position against the headboard, pillow stuffed up against his face so he doesn’t wake Sam.

But, of course, Sam hears him right away, most likely never really falls asleep, and is on Dean the minute he starts coughing into the pillow. “You need to go in,” he says. His voice isn’t unkind, but it is firm, like he’s not going to put up with any of Dean’s shit. “You’re a heartbeat away from congestive heart failure. Literally.”

“Sam. . .” It’s all Dean can think to say but he knows it’s fruitless to try and talk Sam in or out of anything right now, especially about this.

But, Jesus fuck, when Sam lays it out like that – congestive fucking heart failure – it makes everything seem like it’s on such a fucking downer.

“It could just be a cold,” Dean croaks out, when he has a free moment between coughing and gasping. Not that a cold would be much of a bargain, not if it’s some kind of shitty chest thing that’s going to shove all his other problems into the limelight, edge him into the hospital anyway.

It’s happened before.

“Don’t care,” Sam says. He’s out of bed, and even though the room is bathed in darkness, Dean can sense him making his way to where their bags are, beginning to rummage around looking for something. “What meds do you have with you?”

“What – the fuck – meds are you talking about?” Not that Dean shouldn’t have some meds with him – hell, he should probably have a whole slew of them with him, and not just for show but to actually have them to take so he wouldn’t be in this position even as it plays out, Dean’s goddamn heart trying to give out on him one more time, all because of some childhood infection that was never taken care of properly, a fucking sickness that’s virtually unheard of anymore in developed countries, something that no one ever has to worry about getting in this day and age because of the development of the miraculous antibiotic, but yet here Dean is, struggling with goddamn rheumatic fever and its after effects, some fifteen years later all because he once had a case of strep – something everyone in the damn Western world had at one point or another, and managed to recover from just fine – that hadn’t been treated right and his damn body had crapped out on him, had been too weak or fucked up or whatever to withstand the havoc the bacteria had wreaked on his system and now he’s forced to contend with heart infections and congestive heart failure and prophylactic antibiotic therapy and diuretics for when his fucked up body becomes edematic, swelling up like some kind of human sausage, and cortisone shots for the inflamed wrists and knees and just a whole bunch of bullshit that should never have happened.

“No meds?” Sam says now, incredulous. “Nothing? Not even for back up?”

“I – haven’t needed – ‘em,” Dean says, and this is the truth, this is how it works, he’ll be sick for awhile – sometimes really sick – and then – nothing. No infections, no lungs filling with fluid because his ineffectual heart can’t keep everything moving correctly, no excruciatingly painful wrists that scream with pain at the merest touch or knees so sore he can’t even pull himself out of bed – none of that shit. Up until now, Dean’s been free of all of it for over a year, well before he dragged Sam out of California. It’s been so long and he’s felt so relatively healthy that he’s almost lulled himself into believing his body has somehow magically cured itself.

Except, obviously it hasn’t.

“What about leftover stuff from – before?” Sam is asking. Not that Sam would know when that was – sometime while he was studying Latin and political science and whatever other crap pre-law students study – and Dean was back with John trying to hunt and –

Not miss Sam so much –

“It’s been awhile Sam,” Dean answers. “So, no, I don’t have anything. He tosses the pillow aside and leans wearily against the headboard, closes his eyes, manages to bring his arm up and give one last hacking, wheezing cough, a last attempt to get his fucked up heart and strained lungs a chance to work right, or at least enough so he can get enough air to be able to sleep. “It’s been over a year and a half since I’ve had to deal with this.”

Sam gives up looking in the dark through their bags, comes over and sits on the side of Dean’s bed. “Really? You’ve gone that long without any problems? But aren’t you supposed to be on the antibiotics even if you’re doing well?”

“You know that’s not always an option.”

“It’s not an option not to take them,” Sam says. “Wasn’t that supposed to be Dad’s job, making sure he got those for you?”

“For Christ’s sake, Sam, I’m how old? What do you think, Dad should be taking care of me when I’m fifty, treating me like some kind of little kid?”

“I think he should’ve taken care of you right from the start and this never would’ve happened.”

“Goddamnit, Sam, how many fucking times do we have to have this conversation? Everytime I get sick? Because it’s really starting to get old and I don’t really want to listen to it again – it doesn’t change anything – so maybe I’ll need to go on to St. Louis without you if you can’t just – leave it alone.”

He’s pissed, but mostly at the fact that he can’t breathe well at the moment which, deep down, tells him he’s got some shit going on with his heart and it’s more than just a damn cold, no matter how he tries to spin it. He’s not really that peeved so much at Sam’s words or what he thinks. Dean’s used to it – how Sam feels about the whole – situation, has known Sam’s stance forever. There’s probably a grain of truth to what he believes – that John fucked up, should’ve made sure Dean was taken care of properly when he was first sick – so Dean allows him to feel the way he does, just as Sam allows him to think that there wasn’t any malice in John’s actions, that had John known what the outcome would be, he would’ve never gone the way he’d gone, would’ve had Dean inside an emergency room within an hour.

“Should we go in now?” Sam asks quietly, once Dean is done coughing, trying to get a decent breath. “Because if you can’t breathe we need to go now.”

“I’ll be all right if I stay sitting,” Dean murmurs. “For all I know it’s just a cold anyway. You know how – sucky – my colds are.”

“Yeah,” Sam says. “But even if it is just a cold you still need to make sure it’s not something you need the antibiotics for.” Dean’s eyes are closed again, and he suddenly feels the mattress shift beneath him as Sam leans forward, lay his hand against Dean’s chest.

Dean doesn’t move, doesn’t even flinch – having Sam cup his palm against his chest like this, splay his fingers across his heart is something he’s gotten used to Sam doing, since this all happened when Sam was just eight. It’s as natural to Dean as breathing, having Sam feeling the beat of his heart, listening with his fingers to see where Dean’s at, and while he can’t stand having Sam or anyone touching his forehead or his neck – touching him anywhere for any reason, really – he never tells Sam not to lay his hand on his chest, never acts irritated or tries to pull away.

He knows Sam needs to do it.

And, yeah, Sam knows what he’s doing, knows what he should and shouldn’t be feeling when he has Dean’s heartbeat beneath his fingers, has actually saved Dean’s life at least once by his vigilance, so – no bullshit – Dean needs him to do it as well.

He sits now, unmoving, waiting as Sam holds his hand steady, his eyes closed as he concentrates, keeps some kind of count. He pulls his hand down after a minute. “Not too bad,” he says, in answer to Dean’s unspoken question. “It’s missing, though. And the murmur is definitely there.”

“That’s always there,” Dean says, but his voice is going away, he’s getting sleepier and his breathing feels slightly easier. “You should’ve been a doctor, Sammy.” Sam reaches over for the pillow Dean flung aside earlier, slides it behind Dean’s back, pulls the blankets up a little higher.

“Tomorrow, Dean,” Sam says, just before Dean dozes off. “No matter what, you’re getting checked tomorrow.”

“We’ll see,” Dean whispers. “How I feel in the morning.” But he knows he’s just posturing, that they’ll be stopping by some kind of clinic or ER tomorrow. “But I’m not staying in the hospital. They can give me the meds or whatever and then we’re going to St. Louis.”

“We’ll cross that bridge when we get to it,” Sam answers smoothly. “St. Louis will be there next week if we have to wait.”

And Dean is too tired to answer, to tell Sam that waiting is what will get more people killed, but there’s no point in saying this to Sam anyway, all he’ll do is give some smart ass answer about how Dean won’t be much good to anyone if he’s dead or some such shit like that, and the thing is, it’s true but Dean doesn’t like to admit when Sam is right.

*****************

“Come here, son.”

They were in the hospital, a few weeks after the strep throat business. Dean and Sam were up in the pediatric ward, John off somewhere, calling someone about something. Sam wasn’t really supposed to be there, at least not as much as he was, but the nurses adored him, thought he was just the cutest thing, and once they knew Dean wasn’t contagious, were willing to let Sam stay much longer than they normally allowed young siblings to stay unattended.

The strep throat had eventually gone away, but not really. A few weeks after the sore throat ands the fever were gone, Dean's wrists were fucked up.

His wrists. His damn wrists.

He'd woken up in the middle of the night and they were shrieking with a burning pain, even felt hot to the touch.

Dean would've been scared if he hadn't been so -- pissed. Pissed that they hurt so damn much, but also pissed that he'd just gotten over some sore throat and now there was this.

He'd crept out of bed, mindful of Sam, gone into the bathroom and tried running cold water over them. It maybe eased the burning sensation a little, but the pressure of the water made it worse and he quickly abandoned the idea. It had been like they were broken or something but of course they wren't, and whatever was wrong with them had affected not one but both, which made it all the more strange.

He took some aspirin but it didn't do a thing, didn't touch the pain and he spent most of the night trying to lie still so as not to put any pressure on his wrists.

He'd finally fallen asleep near dawn, but when he woke up a couple of hours later, his knees were hurting as well, enough so he didn't think he could walk on them, at least not without drawing a lot of attention to himself. John had been away, but was due back within a day or two, so Dean had stayed home from school, kept Sam with him only because the walk was long and he didn't want Sam making it alone. Dean had never gotten out of bed and Sam had spent the day bringing him juice and toast and generally being kind of a pain, but by the end of the day Dean had been spiking another fever, and by the time John had arrived the next day, he'd found Dean having a hard time catching his breath, complaining of a pain in his chest and Sam nearly frantic.

There'd been no dicking around at that moment, no trying to find some half-filled bottle of medicine from God knew where -- John had loaded everyone into the car and driven them to the nearest ER.

They’d stuck Dean in the hospital the minute they realized his sore wrists and his sore knees and his fever and his difficulty breathing had started after having strep throat. They ruled out pneumonia and bronchitis right away, just to be sure and then laid it on them without further ado: some weird thing called rheumatic fever, not technically a fever but more of a disease.

“So, fix it,” John had growled, before they’d even admitted Dean, before they had even gone over just how serious this really was. In John Winchester’s world, things were fixed one way or another, regardless.

“Mr. Cassidy,” the doctor had said, using the name on the fake insurance card they were going by. “This isn’t something that can just be fixed. It can be managed, but not fixed."

After that, Dean can't quite remember every little detail, only that he was admitted to the hospital and the doctor who dealt with him was named Berger -- which Sam got an enormous kick out of because it reminded him of a hamburger -- and given a whole bunch of tests and then a whole bunch of medicines for a bunch of different things. Something they gave him made the pain in his wrists and his knees disappear soon after they got there, and something else they gave him have to piss all the time but also put his breathing back to normal. By the third day he and John were ready for him to get out of there, and Dean couldn't understand why he still had to be in a hospital when he felt perfectly fine.

Right before Dean was discharged, Dr. Berger stopped in when Dean was sitting around playing video games and Sammy was sitting on his bed, watching him.

He came to listen to Dean's heart -- which was something they did constantly -- and when he saw Sam, it was like a light bulb went off in the old guy's head.

“Go ahead, listen,” Dr. Berger had said, putting the stethoscope in Sam's ears. “That’s your brother’s heart. I’m going to show you that it doesn’t sound like – your’s does.” He let Sam listen for awhile and then he took the stethoscope and put it against Sam’s chest. “This is your heart. Your’s is a little faster because you’re younger but it’s beating differently in other ways. Can you hear it? The difference?”

And, for the love of God, Sam had sat there a good ten minutes, letting the doctor move the stethoscope back and forth between Dean’s heart and Sam’s, and Sam – only eight but already smarter than a lot of eight year-olds and definitely more wise in the ways of the world – had sat and listened, a look of intense concentration on his face.

And then he had Dean do the same thing, but for the life of him, he hadn’t really heard the difference between his heart and Sam’s, other than the fastness thing. “Dean’s makes more noise,” Sam said. “It ticks more. But sometimes it doesn’t. Sometimes it skips.”

“You’re exactly right,” Dr. Berger had said, smiling. Dean had been floored because – really, what eight year-old would know that? Dean himself certainly hadn’t picked up on it, the skipping and noises and whatever else Sam had heard. “The noise is a murmur and the weird skips and extra beats aren’t supposed to be there. But we’ll give Dean some medicine for that and he’ll be fine.”

“What about the murmur thing?” Dean had asked.

“That’s yours for life,” Dr. Berger had said. “But it shouldn’t be a problem. It’s the skipping and extra stuff that has to be taken care of.” Then he’d turned to Sam, very serious. “I wanted you and Dean – and your dad when he gets back here – to know what Dean’s heart sounds like when it’s – not feeling well, and what it should sound like – like yours – when it’s feeling good. Do you know why that it is, boys?”

Sam shook his head solemnly. Dean hadn’t said anything at all, hadn’t been able to really, his head still spinning at the mini-anatomy lesson his baby brother had apparently kicked his ass in. “Because sometimes,” the doctor said softly. “When something is wrong with a person’s heart, you can hear it – even feel it – with your hand – before the person knows how sick he is. Do you understand?”

Again, same thing, Sam had nodded in serious agreement and Dean had sat there mute, unable to really pull his shit together, still stuck on the fact that there was something wrong with his heart. “That’ll be your job, Sam,” Dr. Berger went on, standing up. “Keeping a listen to your brother’s heart when it seems like he might need it. So, if he’s starting to get sick again, he can get to the doctor right away.”

“Don’t I need one of – these?” Sam had asked, fingering the stethoscope he was still messing with. God, the kid couldn’t even say the name of the instrument, was hilariously amused by the doctor's name reminding him of a hamburger -- how could he be expected to figure out what he should be listening for?

“Nope,” Dr. Berger said. “Just your ears. And maybe your hands. All you need to do is listen for the way everything is skipping or sounding – funny. And Dean will be able to tell you. When your Dad gets here, I’ll have him take a listen as well.”

“I like hearts,” Sam had said, and put his hand over his own chest for a minute before laying it against Dean’s. “You’re right. It does feel different.” And he smiled a little. “Really different.”

Dean hadn’t really given much thought to it then, other than John never did get his lesson in with Dr. Berger, what with having to play the usual games with staying ahead of the false insurance they were using and trying to get ready for whatever the next hunt would be once he got Dean out of the hospital.

They ended up giving Dean a bunch of things, something to regulate his heart, steroids for the inflammation in his joints and lining of his heart and lungs, antibiotics for – everything. To try and prevent anymore infections that could start all this up again. Or something. Dean didn’t catch at all, and he was pretty sure John had only been half-listening to the instructions about drug refills and further testing and other necessary treatments, especially since Dean seemed fine when they finally let him go, seemed just like he always had before, everything back to normal. No pains, fever, messed up heartbeats, crazy breathing. Just Dean, like always, so it was no wonder that John didn’t feel the need to give Dean’s heart a listen or make sure the prescriptions were refilled or he took him in for further testing to see just where things really were at?

Why would he – when Dean looked and seemed fine and there were far more important things to take care of, like find the next demon to chase or next clue to follow in the quest to find out who killed Mary or just try and stay one step ahead of the law and whoever else might be after them while they did all this.

But Sam never wavered, even after Dean had long forgotten the whole “listen to Dean’s heartbeat” lesson in his hospital room, never forgot his job.

Which was to make sure Dean’s heart was sounding the way it was supposed to.

It was okay when Sam was eight. Just a little kid. With no mom and an absent father. And now a big brother with some kind of – weird disease that could cause a lot of headaches. So, yeah, when Sam was eight and even nine, Dean could let him climb up on him and lay his ear against his chest and not get mad about it. Sam was still kind of a baby – he needed to do it, for whatever reasons. Feel important. Reassure himself that Dean was okay. Whatever. If putting his head against Dean’s chest for a minute every now and then and listening to his heartbeat made Sam feel better about – things – than Dean could give that to him, especially when Sam would announce after that everything sounded like it was supposed to.

But when Sam got older, began inching toward his teen years – Dean already entrenched there – he seemed to understand that Dean wasn’t going to put up with his kid brother just laying his head against his chest listening to the way his heart was sounding. So Sam switched tactics, began laying his hand on Dean’s heart while Dean was asleep, taking stock of how Dean sounded when he was only half-awake at best.

The first time Sam pulled this, when he was about eleven – Dean couldn’t believe it, couldn’t believe Sam would have the nerve to do it while he was trying to sleep. “That’s a good way to get your hand broken,” Dean had mumbled, barely cracking his eyes open. “What the hell are you –”

“Just making sure,” Sam said, his hand still over Dean’s heart, not even fazed by the broken hand threat. “You seem tired.”

“No shit,” Dean had answered. But just as Sam still kept his hand on his chest, Dean made no move to push it away. “Did you see me sleeping by any chance?”

“I mean, tired all day,” Sam answered. “Now shut up so I can listen.”

And the crazy part was – Dean had actually shut his mouth and Sam had actually been able to feel Dean’s heart with just his hands, could tell if it was beating like it was supposed to be beating or not. “It sounds okay,” Sam had said. “It sounds like it’s supposed to.”

“Sammy, stop freaking out for no reason.”

“I’m not. I’m supposed to do this, remember? Make sure we hear things if they’re going bad before – you get really sick again.”

“I don’t think the guy meant for you to do it the rest of your life.”

“Why not? That’s how long he said you’re going to have this, right?”

And Dean had been unable to answer, to speak at all right away, the enormity of the truth of it all – that his heart was going to be fucked up the rest of his life – hitting him like a ton of bricks for one thing, but the idea that Sam had understood this and was already – dealing with it, already there – was even more mind boggling to Dean.

It’d been like Sam was saying they were going to be like this forever, sticking around and doing the hunting thing together.

And Sam was going to make sure nothing happened to Dean's heart.

Of course, things hadn’t gone that way, but at the time, it had been one more thing to give Dean that – security – that idea that Sam would always be around.

*************

Dean manages to fall asleep at some point but he feels like crap when he wakes, still propped against the headboard. His t-shirt is drenched in sweat, and this is the third night that this has happened, the night fever and sweats that only happen when his heart is going haywire on him, becoming overtaxed for whatever fucking reason.

Still. He slides into the shower before Sam wakes up, goes as quietly as he can and tries to make himself appear presentable and reasonably healthy in the face of Sam’s impending inquisition.

Dean really doesn’t want the hospital. For a whole host of reasons, some fairly obvious and some he’s not able to articulate at the moment. The hunt they’re supposed to be on. The search for John and the idea that Dean wants to be strong and – ready – when they find him. Just the whole shitty nature of hospitals in general. The fact that they don’t have any money or insurance or the means to cover their tracks for a very long period of time. Putting Sam through all this shit again – some of the very crap Dean knows he was trying to get away from when he left for Stanford. Dean has a million and one reasons for not wanting to land back in the hospital again, all of them valid.

But the main thing is the freedom he’s tasted in the past eighteen months or so, the longest period he’s gone in his adult life without having to worry about pills and how his heart is acting and not being able to breathe in the middle of the night and waking up with his joints so sore he can’t move – can’t hold a gun, can’t run so therefore, can’t hunt. For the past year and a half Dean has had a taste of what life was like before all this rheumatic fever bullshit hit him, and he’s reluctant to give it back.

Sam is still asleep as Dean quietly shrugs into his jacket, sits on his bed and gets ready to pull his boots on.

His plan is to get out of there and get breakfast, show Sam that he’s all right, that the night before was nothing more than a bad night – which has happened countless times before – and that they should get their asses to St. Louis.

The only flaw in Dean’s plan is that he can’t get his damn boots on.

His fucking ankles are swollen – hugely so – and he can’t get them into his boots.

Either one.

Goddamnit to fucking hell.

He knows it’s futile yet he keeps trying to stuff his goddamn swollen feet into his boots, even goes so far as to take the laces out. Once they’re out he gets the boots on but it doesn’t matter, it looks exactly like what it is, and he knows Sam is never going to let it slide by, when his fucking ankles start getting this swollen it means his damn heart isn’t pumping right and he’s going to have to get to a doctor unless he wants to end up in heart failure.

With a “fuck,” Dean takes one of his boots and pitches it as hard as he can across the room. It flies into a lamp and both crash to the floor, waking Sam right up.

He jumps up, awake but unsure of what’s happening. “What’s going on?”

“Nothing,” Dean says, but then he coughs, the same hacking, wheezing crap that always happens when his heart is behaving like a bitch and his lungs can’t work right and there’s fluid building up in them, just like the fucking fluid swelling up his ankles.

And then Sam knows, it’s not all that hard to figure out and he comes over to Dean who’s still coughing and gasping but somehow manages to get to his feet. “Can’t get your shoes on?” Sam gently asks.

Dean nods, but can’t really look at him. “Fuck,” he says again.

Sam reaches over, pulls Dean’s jacket aside, cups his hand over Dean’s heart. Like he’s done hundreds of times before.

They both wait.

When Sam is done listening, he takes his hand away, gives Dean a small, sad smile but doesn’t say anything.

He doesn’t need to.

Dean knows he’s going back to the hospital.

To be continued. . .I think