A/N: The inspiration for this piece kind of struck me out of nowhere. I've always had a fascination with the soulless Sam character, but I've never been able to think of a good story idea for him until now. So I hope you enjoy this one. It is set between Clap Your Hands if You Believe, and Caged Heat, which is very close to the end of Sam's soulless period.

Disclaimer: Shocking though this may be to all of you, I do not own Supernatural or its characters

Disclaimer #2: I am not a doctor, nor am I involved in the medical profession in any way. While I tried to be as accurate as possible, all medical information in this story comes from google and the recesses of my mind.


Chapter 1

Sam Winchester watched his brother stagger into their motel room, exhaustion written on every line of his face. The older man looked like crap, with yellowed skin and sunken cheeks. It had taken him five minutes to walk from the impala's parking space, a distance that Sam had covered in seconds.

"Something's wrong with you," Sam stated.

Dean looked up from the duffel bag in which he had been rummaging, expression tense.

"Oh?" he snapped. "I didn't realize I was under inspection."

"That's not what I meant," Sam said calmly. "You're sick. I noticed it a week ago, but you're getting worse. You should go to a doctor."

"What?" Dean asked incredulously. "Sam, I'm fine. I don't need some quack telling me that I need to take it easy and lay off the hard stuff."

"You've been moving slower, your skin is getting yellower, I've seen you getting up in the middle of the night to puke. It took your nose two hours to stop bleeding after that vamp caught you in the face two days ago, and your nose wasn't even broken. I can tell you've been feeling like crap. I was going to ignore it, but you're getting worse, and you need to get treated."

"Maybe the reason I feel like crap is because we've been running ourselves into the ground as Crowley's errand boys. You may not need rest, but I do, and I haven't been getting much of it lately."

"Dean," said Sam, exasperated, "I wouldn't have mentioned it if it wasn't important. You almost crashed the car today because you can't stay focused. Just go to the doctor."

Dean ignored him, grabbing some clothes from his duffel bag and stalking into the bathroom. The sound of the shower running did not quite cover the retching noises as Dean vomited again.

Sam rolled his eyes, exasperated. Dean had been getting more and more irritable lately, undoubtedly getting fed up with dealing with his soulless brother, not to mention working for Crowley, which went against just about every principle he had. But that did not mean that he should just ignore reason. At this rate, he was going to get himself killed before he could die of whatever had turned him into Typhoid Mary.

Oh well. If Dean continued to get worse, Sam would just take him to the hospital himself.

Sam needed to get out for a bit. He scribbled a note to his brother, then shrugged on his jacket and strode out the door to spend a few hours at the bar down the block. He considered picking up a woman to have some fun with, but the options at this particular bar were pretty slim, and he did not feel like putting in the effort. Besides, Dean might need him.

Sam sighed, fingering his third glass of whiskey thoughtfully. Dean thought that his brother didn't care about him, and perhaps he was right, but Sam still felt…something. Perhaps it was the memory of the love that the old Sam had for Dean, or the knowledge that Dean's help was his best chance of getting his soul back. But whatever the reason, Sam wanted Dean to be all right, and felt the need to go check on his brother.

He set a few bills on the table, then walked back to the motel. He frowned, noticing that the impala was missing from where Dean had parked it earlier. The older hunter must have gone out, though an inspection of the room revealed that he had not bothered to leave a note.

Sam sighed. Soulless or not, he still knew how to read his brother. He could tell that Dean was close to giving up on him. He was not sure what to do about it though. Even when he had been trying so hard to fake his old emotions, Dean had known that something was off. And after all the things that Sam had said and done, there was no point in going back to pretending. He just hoped that Crowley gave his soul back before Dean finally decided he'd had enough.

Then Sam heard the familiar rumble of the impala's engine, and Dean walked in a few moments later. Sam gave him a smile, hoping that it could be some kind of peace offering, a sign that he was still trying.

"What?" asked Dean, staring at him.

Apparently not.

Sam let his face relax as Dean went to grab a beer from the fridge. Except he did not grab a beer, he grabbed a bottle of water. Sam glanced at the clock. It was eight thirty; usually Dean would have been on his third drink by now.

"Where were you?" Sam asked.

"Out," Dean replied shortly.

Sam grimaced. If Dean did not want to talk to him, fine. He turned back to his computer, which he had been using to look for cases, especially those of the monstrous variety. His brother ignored him for the rest of the evening, seeming unusually distracted.

Hours later, when Dean had fallen asleep, Sam began to get restless. He hated being cooped up in motel rooms for long periods of time, and not being able to sleep through the boredom made it that much harder.

He stood, beginning to pace back and forth. He picked up Dean's dirty clothes, putting them in the laundry bag. Even without a soul, Sam still had a desire for neatness and order. He continued to tidy the motel room, eventually clearing out a container of takeout leftovers from the fridge that had gone bad. He went to drop the old food into the trashcan, but paused when he saw a flash of color in the bin. He frowned, reaching down to extract what turned out to be a pamphlet.

Sam read through the leaflet, eyes widening when he realized what it was. He glanced over at Dean, whose face was pinched and grim even in sleep.

How to deal with your diagnosis of acute liver failure.

Sam had known that Dean was sick, but he'd had no idea it was something that serious. Why hadn't he said anything when he got back from the hospital? And why had he thrown the pamphlet detailing his illness and the measures required to treat it into the trash?

Surely…no. Dean could not be stupid enough to let this go untreated. Maybe he was just going to call Cas down to heal him. But there had been complete radio silence from the angel for weeks now, despite the prayers that both Winchesters had been sending. There was no guarantee of help from Cas.

So why wouldn't Dean…? Sam felt a strange pressure in the pit of his stomach. The pamphlet had made it clear that Dean would need a liver transplant, and soon. The Winchesters' aliases were not strong enough to stand up to the scrutiny required to be placed on the transplant list, which meant that it was not an option for Dean. The only other alternative was a partial transplant from a relative. Dean only had one real relative left, and apparently no reason to think that he could expect his brother to fork over half of his liver.

Sam ran a hand through his hair. Was Dean right? Sam knew the risks involved in donating an organ, even part of one. He could get an infection or blood clots, not to mention the fact that he would be down an entire lobe of his liver. There were also the weeks of recovery that they would both need, weeks when he would not be able to defend himself. It would be stupid to take that kind of risk.

But…it was Dean. Some part of Sam knew that there would be no point in getting his soul back if he let Dean die before then. And even soulless, Sam was better with Dean; he knew that.

So against his better judgment, Sam grabbed the keys to the impala from the nightstand and left the motel room. He made the fairly quick drive to the hospital listed on Dean's pamphlet and found the appropriate help desk.

"I need you to test me as a potential liver donor for my brother," he barked at the nurse behind the desk. She stared up at him, flustered.

"What?" she asked. Sam held back an impatient growl. Why did everyone have to be so slow?

"My brother, Dean Page, came in here and got diagnosed with acute liver failure. He needs a liver transplant as soon as possible. I would like to give him part of mine, but in order for that to happen, I need to get tested to confirm that I'm a match for him. Do you think you could make that happen for me?"

The woman bristled at the scorn in his voice, but she began tapping at her computer.

"Dean Page?" she confirmed. Sam nodded. "Right. We've got his information on file. It says he left AMA. Dr. Ryan wanted to admit him."

"I can get him back here," Sam promised.

"Okay. Well, I can make an appointment for you to get your physical exam and your blood drawn sometime this week. We have spots open on-"

"You'd better have a spot open now," Sam interrupted coldly. "Because that's the only time soon enough for me. Did you miss the 'acute' part of my brother's diagnosis? His clock is ticking."

"Sir, I understand that, but it's the middle of the night, you can't just-"

Sam shoved his FBI badge under her nose.

"This is a hospital. I know that there are still doctors and nurses here. I don't care if it's inconvenient, I care about getting it done."

The nurse went cross-eyed staring at his badge. They both knew that FBI status did not give Sam the right to completely ignore hospital protocol, especially when it was not related to a case, but Sam had been intimidating enough that the nurse did not protest further. She just cleared her throat and pushed a button on her phone.

"Judy, I'm sending a man back to you, by the name of Samuel Page. He needs a rush job on a donor match."

"What?" asked an incredulous voice over the speaker.

"Just do it," the other nurse snapped, pushing the button again to end the call. She looked up at Sam with a pained smile. "Go right on back," she said, her voice strained. "Down the hall, fourth door on the left."

Sam strode past her without another word or glance. He heard her muttering about him as he passed, but he could not have cared less. He found the door that she had indicated, pushing it open and entering the small and empty examination room.

A minute later, another nurse entered, presumably Judy. She gave Sam a flustered smile, which he did not return.

"Uh, hi. I'm Judy," she told him. "You must be Samuel Page."

"Sam."

"Right. Well I'll be doing your bloodwork and preliminary physical exam today…er, tonight."

She giggled nervously, and Sam raised an eyebrow. Did she expect him to apologize for the inconvenience? She would be waiting for a very long time, if that were the case.

"Um, so I'll need to take your family history first," she went on when it became clear that Sam would not respond. "Has there been any cancer in your family?"

"You do realize that I'm here for my brother, right?" Sam asked, as if her were talking to a five year old. "We have the same family history, and I assume his was taken when he came in today for a diagnosis."

Judy got even more flustered then, and Sam got the feeling that the old him would have felt sorry for her. All he cared about though was getting this done with maximum efficiency.

"I'll save you some time," he said. "My family history is already on file. As far as I know, there've been no serious illnesses that would have genetic implications. The people in my family don't really live long enough to die of natural causes. As for my personal history; I'm perfectly healthy. I've never had any heart or liver problems, or any issues with blood clotting. I haven't taken any drugs, prescription or otherwise, within the past year, except for reasonable amounts of painkillers. I don't smoke, and I'm not an alcoholic. I did have a few drinks today though, so those'll show up on my screening. I don't have diabetes or any other preexisting conditions or STDs. Does that about cover it?"

Judy just nodded mutely, setting down the clipboard of papers that she had been holding. She directed Sam to the scale in the corner, where she measured his height and weight, then took his blood pressure before tying a tourniquet around his bicep, making his veins stand out prominently. She inserted a needle into Sam's arm, and the hunter watched his scarlet blood flow into the collection tubes. Once Judy had collected four vials of blood, she withdrew the needle carefully and taped a piece of gauze over the spot.

"Right," she said, trying valiantly to cling to her chipper attitude. "That's everything for now. I'll send these to the lab, and they'll call you when-"

"I'll wait," Sam interrupted.

"Excuse me?"

"I'll wait here in the hospital for the results."

"Mr. Page, it usually takes days to process-"

"It's Agent Page. And I don't care how long it usually takes. I'm telling you that it's not going to take that long this time. I'll see you in a few hours."

He walked out of the door, leaving the stunned nurse in his wake.

ooooooooooooo

Sam smiled to himself when he saw Judy hurrying towards him less than three hours later. He did not know why Dean disapproved of his methods so much; they were undeniably effective. He stood to meet Judy.

"Good news, Agent Page," she said, waving the stack of papers clutched in her hand. "You're an excellent match for your brother, and you appear to be in great health."

"When can we come in for the surgery?" Sam asked, mildly surprised by the feeling of relief that seeped through him at the nurse's words. He had not realized that he had been worried.

"Don't you want to discuss this with Dean first?" Judy asked.

"No."

"Okay. Well, um," Judy fumbled with the pages in her hands before extracting two packets of paper, which she gave to Sam. "Here is some more information about the donating process, as well as pre-op instructions for you and your brother, assuming that everything is cleared. Dean's doctor will want to look both of you over before the surgery so that he can make sure that you're both suitable candidates for it."

"Fine. We'll be here tomorrow."

The nurse looked like she was about to protest, then she just sighed.

"Eleven o'clock?" she asked.

"Ten."

Judy just nodded in defeat and Sam walked away. He drove back to the motel, unsurprised to find Dean awake and waiting for him.

"Where were you?" the older hunter asked, annoyed and exhausted. Sam knew it was a sign of how bad his brother was feeling that Dean did not stand up to confront him. Sam had taken the impala without asking, which was a punching offense under other circumstances.

"Same place you were earlier today," he said coolly. Dean blanched.

"You went to the hospital? How did you even know I was there?"

Sam snorted.

"Throwing away your treatment pamphlet in the trashcan of the room that we share wasn't exactly the most effective way of getting rid of the evidence," he said scornfully. Dean glowered at him.

"Well excuse me for not thinking straight when I'd just had a death sentence placed on my head!" he snapped. Sam rolled his eyes.

"Oh, don't be so dramatic. It's not a death sentence."

"Liver failure, Sam!" Dean was shouting now. "Acute liver failure. I've got days, a week or two if I'm lucky!"

"Unless you get a transplant," said Sam calmly.

"You and I both know there's no chance of me getting on the transplant list." The fight left Dean as suddenly as it came, and the man slumped back in his chair, defeated.

"Yeah. If only you had a brother who had a perfectly healthy liver that he could share with you."

Dean's head snapped up, his gaze locking on Sam.

"You would do that?" he asked, and his disbelief bothered Sam for some reason.

"I already got tested," Sam told him. "We're a good match. We have an appointment with your doctor at ten tomorrow."

"Are you serious?"

"Yeah. Here, the nurse gave me instructions for you. Depending on what the doc says, we can probably get the surgery sometime this week."

Dean stared down at the papers that Sam handed to him.

"I…I don't know what to say, Sam," he said, his voice rough.

Sam sighed. He had been hoping to avoid an emotional exchange, but apparently dying had made Dean sappy.

"You don't have to say anything," he told Dean. "This is the decision that makes the most sense."

And it was, mostly, though logic was not really Sam's only motivator. But he did not want Dean to expect further affection from him.

"Yeah, well, thanks," said Dean. Sam nodded.

"You should go back to sleep," he told his brother. "I don't think tomorrow's going to be fun."

ooooooooooooo

Sam turned out to be exactly right. Not only did Dean feel exponentially worse in the morning, but he and Sam both needed to undergo numerous tests, confirming that they were a good enough match that Dean's body would not reject Sam's liver, and that they were both suitable candidates for the procedures that they needed. After being poked with a ludicrous amount of needles, sent through a CT machine, and sacrificing far too many bodily fluids, both brothers were admitted to the hospital, and Dean started on a medication to help with the effects of his illness. The boys were given a double room, where they would stay until their surgeries, which were scheduled for the next day. This was faster than usual, but Dean's steadily worsening condition had forced his doctor's hands.

The brothers waited together, mostly in silence, occasionally interrupted by doctors or nurses checking on their conditions and explaining their situations and treatment options with more detail. Dean passed the time by watching the horrendous hospital drama that he was not-so-secretly obsessed with. Sam did not understand his brother's fascination with the show. Aside from the ridiculous name (Dr. Sexy MD, really?), Sam would have thought that the whole thing would be ruined for Dean after he got shot on Gabriel's twisted version of the show. But nope. Dean's passion still burned strong.

Sam settled for trying to tune out the noise as he worked on his laptop. They would both have to stay in the hospital for a while after their surgeries, but Sam wanted to have a case to work once they had recovered. He had found a few possible options by nightfall, which was when Dean suggested that they call Bobby.

"Why?" Sam asked. "What good will that do?"

Dean sighed, and Sam could tell that he was grumpy, probably from hunger. Neither of them was allowed to eat before their operation.

"Because he's like our father, Sam, and he cares about what happens to us. He'll want to know about something this major. Besides, we're going to be out of commission for a while. We can stay at his place while we recover."

He had a point, so Sam waited as Dean dialed Bobby's number, putting the old hunter on speaker.

"Yeah?" Bobby said by way of greeting.

"Hey Bobby, it's Dean. Sam's here and you're on speaker."

"What's wrong?" Bobby asked immediately.

"Why does something have to be wrong?" said Dean defensively.

"So nothing's wrong?" Bobby's tone was skeptical.

"Well, I didn't say that."

Bobby sighed, and Sam could practically see him rolling his eyes.

"So what is it?"

"We're in the hospital."

Dean held the phone further away from him as Bobby's voice increased significantly in volume.

"Both of you? What damn fool mess did you idjits get yourselves into this time?"

"Turns out that mainlining alcohol and painkillers hasn't been so great for Dean's liver," Sam cut in, leaning towards his brother's bed and the outstretched phone. "He's in liver failure."

Dean gave his brother a look as Bobby cursed over the phone.

"Do you need a donor? How long will it take to find one for you?" the older man asked, concerned.

"Why does no one think of me?" asked Sam, mildly indignant. "I'm his donor, Bobby. The surgery is tomorrow morning. We're only calling you because Dean thought you'd want to know about it."

"You're damn right I want to know about it. Where are you? I'll drive out to meet you."

Dean gave Bobby the address, which was only a few hours away from Sioux Falls, then hung up after goodbyes were exchanged.

"It'll be good to have him around," said Dean, setting his phone on his bedside table.

"Yeah." Sam's tone was less enthusiastic. He knew that Bobby was uneasy around him, perhaps with good reason. But they would need his help.

Silence stretched between the brothers, until Dean let out a bitter chuckle.

"What?" Sam asked. Dean shook his head.

"Nothing. It's just…our luck, man. I mean, I'm in a hospital because my liver crapped out on me, next to my little brother who lost his soul in the freakin apocalypse. Just, what the hell, you know?"

Sam merely shrugged.

"Life's a bitch," he said simply, choosing to ignore the jab at his soullessness.

"Ain't that the truth," Dean agreed.

After another moment of silence, Sam asked the question that had been plaguing him all day.

"Hey Dean?"

"Yeah?"

"Why didn't you ask me?"

"Ask you what?"

"For my liver? The doctor had to have told you that any siblings were your best shot. Why weren't you even going to give me the chance? Did you think I would say no, or did you not want me to take the risk?"

Dean sighed.

"I don't know, Sam. Maybe a little bit of both."

Dean sounded so exhausted that Sam decided to leave it at that. The two of them lapsed back into silence, staying that way until Dean fell asleep. Sam simply watched the shadows on the wall move as cars passed by on the street below.

He wondered again what he was doing there. Surely he was not about to risk his life out of familial loyalty? He would not have done this for Samuel Campbell, had the old man been the one to get sick. Of course, neither he nor Dean had considered their grandfather as a potential donor because they both knew that he was even more unlikely than Sam to put himself on the line like that, especially for a man who was essentially a stranger to him, so perhaps it was not the same situation. It also was not the same as when Sam risked his life on hunts. That was a simple cost-benefit analysis. The more threats he neutralized, the more lives he saved. Besides, he enjoyed the work, the hunting.

But with Dean, there was only one life on the line. Either Sam risked his life and health to give his brother a shot at recovery, and Dean got better, or he didn't, and Dean died. There would be no other fallout, not really. So why wasn't the second option an option at all?

Sam thought back to his time with a soul, an activity that he rarely took part in. At every stage of his life, Dean had been there, supporting him, caring for him. Dean had given everything for Sam, time and again, and he never asked for anything in return. Sam would always owe him; there was no getting around that, no paying him back. But he could try. He could give Dean his liver, and when they were both recovered, he would work even harder at giving him his little brother back.

Thoughts of family and old loyalties and days gone by chased themselves around Sam's head as the sun came up, bringing with it the day of the brothers' surgeries.


A/N: Thanks for reading! I know that even with all the bullying he did, Sam would probably not be able to make things happen as fast as he did, but I was using my artistic license and I invite you all to suspend your disbelief right along with me. This story is going to have at least one or two more chapters, which I will try my best to get posted shortly. Reviews are always greatly appreciated. Thanks!