Title: Sacrifices

Author: BlackWingedbird

Beta: Amy

Standard Dis

Warnings: Hookman and Home spoilers

Author's Notes: This idea came to me this afternoon and would not leave until I wrote it in a fic. I hope this gets you thinking! Thanks to Amy for the name.

'Hope is necessary in every condition. The miseries of poverty, sickness and captivity would, without this comfort, be insupportable.'
-William Samuel Johnson

He should have known Sammy was sick.

The whole Haley Joel-thing- that was just the tip of the iceberg. A decoy, if you will. The phenomenon of the visions had eclipsed the importance of what was really happening to Sam, and it was a mistake Dean would hate himself for the rest of his life.

The visions had been hitting Sam almost regularly by the time they stopped at a small diner in southern Georgia. There was little warning- just the really fast onset of an intense headache, followed closely by even more crippling pain, and then Sam would just sorta… zone out. Completely unresponsive, focused on a scene that was playing for his eyes only. Dean was helpless to do anything but keep Sam upright and shield him from prying eyes.

Then, just as quickly, the pain and visions would dissipate, releasing their hold and lifting into the sky like harmless smoke. Sam would blink and come-to, and Dean would be there to offer comfort and support. Sam was instantly and completely normal again- never groggy or confused- and he'd push himself to his feet, brush himself off, and explain the newest situation.

Almost like it'd never happened.

Dean had gotten used to the cycle of things. It was never easy to watch his little brother suffer through that kind of pain, but Dean knew the signs, knew the patterns, knew what to expect and what Sam needed when Sam himself didn't know. He let Sam drive less and less, afraid that a vision would hit while they were traveling at 80 miles an hour down a major interstate. Tylenol was always on hand, along with a spare bottle of water. They'd learned to cope with the visions, integrating them into part of their not-so-normal everyday lives.

But right now, as Dean sat alone in the stark hallway of a bustling hospital, he was afraid. This time, the visions had hit while the brothers were seated across from each other in a moderately busy Denny's. One minute Dean had been stealing sausage links from Sam's plate and the next- Sam was grasping his head, pinching his forehead in between his eyebrows. By the time Dean had made it around the table, Sam had slid to the floor, eyes screwed shut and gasping for breath.

Dean waved off the concerned waitress and Sam stilled, the vision finally encompassing him. Dean searched the vacant eyes for the moment Sam would return, his hand firmly grasping Sam's shoulder.

Just as Sam started blinking to awareness, a middle-aged man in dress pants and an ironed shirt kneeled down on the floor next to Dean. "It's okay," the man said. "I've already called the ambulance. I'm a doctor."

Dean's attention was on Sam as he shook his head. "He doesn't need an ambulance, he's fine. This happens all the time."

"Is he on medication?"

Dean smiled as Sammy took in his surroundings. "For what?"

"His seizures."

And that is how Dean wound up alone and ignored in the middle of a southern Georgia hospital. Ever since the word 'seizure', Dean's lungs had been starving for oxygen. His world had totally been turned upside down, and he'd landed hard on his ass.

He hated landing on his ass.

Seizures. That word struck more fear into his heart than 'deava' or 'Shtriga'. 'Seizure' conjured up images of violent convulsions and bit tongues and flailing arms and bloody, foamy drool and pissing your pants… and brain damage.

But Sam didn't do any of that. Sam got headaches, Sam fell to his knees, Sam spaced out. The vision itself was almost… calm. There was no way Sam was having seizures. It just wasn't possible.

Couldn't be possible.

"Mr. Young?"

A woman with a white lab coat and long, wavy brunette hair approached, her eyebrows furrowed as her heels clicked across the tile floor. A chart was tucked under her arm and Dean looked at it warily.

"You're waiting on your brother, Sam, correct?" she asked when he hadn't spoken.

"How is he?" Dean asked as she stopped next to him. "Can I see him? Is he okay?"

She sighed and pulled out the chair from beside him so that it was facing him before taking a seat. "Let me introduce myself. I'm Dr. Stevens and I'm in charge of your brother's care while he's here. I've already talked with him but I'd like to fill you in on his condition before I let you see him."

Dean shook her hand quickly and reflexively. "What condition? He can go home now, right? He's okay?" They couldn't afford to have a team of medical professionals tell them what they already knew.

She glanced at the folder in her lap. "Mr. Young, does your family have a history of epilepsy?"

Dean blinked. "No. I don't think so. I don't know." They'd never talked about it- but then again, they never talked about their relatives at all, at least on such a personal level.

"How long have these… 'black-outs' been occurring?"

Dean thought back to Sam's first vision- more of a nightmare, really- about their old house in Lawrence and the evil spirit that still dwelled there. "Since the fall of last year," he replied numbly. Had they really gotten so much worse that quickly?

"And how often do they occur?"

Dean shrugged, the information failing to come to him when he needed it. "Maybe… once a month?"

Dr. Stevens clicked the end of a ball point pen and made a note in the cart. "How long does the average 'black-out' occur?"

Again, Dean shrugged. "I don't know… it depends. 15, 30 seconds maybe."

More notes. "And Sam is immediately responsive after the attack?"

"Yeah," Dean nodded. "Pretty much." He looked at her, waiting for her to stop writing. "He's not having seizures. They're just some type of… spell, right? Nothing to worry about?"

Of course there was something to worry about. Sam was involved.

"I'm afraid Sam is experiencing what's known as 'absence seizures'," she replied, clicking the pen and setting it down. "Otherwise known as a petit mal."

Dean gulped, forcing the glob of glue down the back of his throat. "How…" his voice gave out, and he tried again. His fingers were numb. "What causes them?"

"During normal waking and sleeping, your brain cells produce various electrical discharge patterns," she explained patiently. "If the electrical discharges by your brain cells become abnormally synchronized, a convulsion or seizure occurs. The abnormal firing of your brain cells can remain localized to a small area or can spread rapidly to involve your entire brain. In Sam's case, only a small portion of his brain is affected- thus the mild seizures. He's very lucky- most people with these types of seizures get them multiple times per day."

Dean shuddered- he couldn't imagine what kind of hell that would be.

"Without knowing your family's history, I can't know for sure what's causing them. His metabolic rate is normal. Has your brother ever experienced any brain trauma?"

Dean blinked, then sucked air into his burning lungs. "Brain trauma?" A wave of guilt swept over him. The Hookman had shaken Sam up pretty hard just a week before his first prophetic nightmare. "I don't- I mean…" How was he supposed to explain? What could he say that wouldn't invite a police investigation? "He's had his share of knocks to the head- we both have. Football and all."

Dr. Steven's nodded and wrote in the file again. "Does he continue to play?"

He picked at a loose thread on the arm of the chair. "No- we haven't for a while." Does a lie within a lie make it a truth?

"Good. I wouldn't suggest it."

"What…" Dean pulled out the thread and flicked it to the floor before starting on the next one. "What do we do? How do I take care of him?"

She smiled gently. "I'd like to put him on a prescription to see if it reduces the frequency of the seizures," she said, already writing a script that they couldn't afford. "Other than that- there's not much you can do. As long as Sam's attacks are short and he recovers quickly, he should still be able to enjoy life. I'd like to limit any high endurance activities, such as swimming or skiing. Make sure he gets a full night's rest- exhaustion can trigger an episode. Also, you may want to invest in a medical bracelet, in case you're ever not there when he goes into one."

Dean shook his head- there would never be a time when he wasn't there for Sammy. "Okay."

"I know it's a lot to take in," she said sympathetically. "The onset of these seizures so late in his life is rare, but very manageable. I'll have some written information for you when he checks out."

Dean perked up. "When can we leave?"

"Because the physical symptoms are so mild and the frequency so low, there's no reason for us to keep him here," she replied. "He may check out any time."

"Can I see him now?"

"Of course."

She rose and pushed her chair back against the wall before leading Dean down the hallway. As they walked his mind raced, struggling to gain perspective. Knowing now that Sam's paranormal visions had a very real basis in the medical world, Dean doubted he'd be able to think of them in the same way again. The news changed nothing and everything at the same time. Never again would Dean be able to sit with Sam through a vision without his mind screaming to get help.

The ante had been upped- the price for saving other people's lives just got a whole lot higher.

And Dean wasn't sure how high his little brother could go.