WARNING: This piece contains self harm, oh yeah, and spoilers for the season 2 premiere.

Hey there,

Still working hard on Energies and Ice Cream for all of you who have been keeping tabs on its progress. Sorry, but the season 2 open momentarily derailed me into writing this short piece.

I really needed to get it out of my head. After Dean almost flat lined, the glazed, dazed look in Sam's eyes just left me needing more, so here's my more…

PS - for all of you who don't have the episode memorized, Dean's opening lines are directly from the episode.

Decisions in Blood

Sam backed out of the hospital room and stood numbly in the hallway. His head contained too much: to much pain, too much possibility, and now he was certain he had just heard his brother's voice.

"Don't worry Sammy. I'm not goin' anywhere." Dean stood in front of his brother, talking as if he were still flesh and bones. "I'm getting that thing before it gets me. It's some kind of spirit, but I can grab it, and if I can grab it, I can kill it."

The glazed look in Sam's eyes remained as his lower lip began to tremble. He took an unstable step backwards.

"Sam?" Dean looked at his brother and really saw him. Dean had just been talking, talking about what he'd found out, passing the information to Sam as if they were on any other hunt. But Sam wasn't listening. Sam wasn't hearing. Sam was only thinking. Dean only disconnected himself from what he was saying when he registered his younger brother's unstable form. "Sammy?"

Sam shook his head, turned, and took off down the hallway. "Sam!" Dean ran after him through the corridors, watching his brother stumble clumsily until he finally slammed himself into one of the side doors. Sam fumbled with the knob, pushed the door open, and closed himself inside. Dean reached the door only steps after him, glanced at the men's symbol posted on the outside, then grabbed for the knob. As his hand went through it, Dean cursed. He backed away, took two deep breaths, then…

Dean stepped through the door.

He came out on the other side into a small one person bathroom. Toilet and sink to his right, towel dispenser and in-wall trash can to his left.

"Shit, that was way too easy," Dean said patting his chest down and glancing at his body to make sure everything was still there. Then he saw Sam.

Sam stood in the corner facing the wall, leaning into it, right arm held high in front of him, palm pushed flat against the tiles. He slowly scrubbed his other hand down his face, then let his head drop and hang as he gasped heavily trying to catch his breath. Dean just stared at him, pissed at himself for not noticing sooner how all this was tearing his kid brother apart. He took a step to Sam's side and bent down slightly, trying to get a look at his brother's face.

"Sammy? Aw Sam don't. Don't. Come on man, pull yourself together. It'll be okay… it will."

Sam turned away from him, rolling himself against the wall until his back was pressed full into the corner of the room. He braced himself up with shaking legs as he stared out at nothing, his breath increasingly unsteady, his eyes caught deep in suffering.

Dean turned away unable to stand the look on Sam's face. He knew how much pain Sam carried, but seeing it was different.

"No… no…" Dean heard his brother whimper. He turned back to find tears sliding down Sam's cheeks and onto his lips, salt burning into the still open cuts on his recently wounded face. "I can't anymore… I can't… I can't…," Sam blurted shaking his head at the world.

"Sam, don't talk like that! Be strong. Be strong for me," Dean stated firmly.

Sam puffed out small breaths and brought a hand over his eyes. He pulled it down with the tears and covered his mouth trying to keep in the sounds that so needed to escape him. Slowly his strength subsided, and he slid down the wall, his bottom hitting the cold tile floor with a bump. He brushed the tears off his face hiccupping and whimpering, then pulled his knees to his chest, and let his head fall forward onto them, burying himself in anguish. Dean knelt next to him.

"Sam…" he began, then stopped. There was nothing to say. Even if he were actually there, able to be heard, he wouldn't have know what to say to his brother to make it all go away. Dean's eyes deepened, and slowly came to resemble his brother's. He reached a hand forward, held it just above Sam's head, then dropped it down into his hair, literally into it… through it.

Sam's head jolted up with a harsh shiver. He pulled his arms around himself and looked out into the empty room before him, hesitated, then spoke on pure belief.

"Dean?" he questioned trying to steady his breath. Dean already had his arm back at his own side as he stared at his brother, startled, unsure how to answer him, unsure how to let him know he was really there.

"Dean? Are you…" Sam stumbled with his thoughts and words, "are you… here?"

"Yeah… yeah man, I'm here… don't give up on me," Dean whispered as his thoughts pulled in on him. Suddenly Sam was standing and stumbling to the sink. Dean gazed at his brother, unsteadied by the look in the kid's eyes. "Sam?" Dean slowly got up and walked over to him.

Sam stood with his hands braced on either side of the porcelain basin, staring directly into the mirror, eyes growing bloodshot with reckoning.

"Sammy… what the hell's going though that head of yours?" Dean asked, knowing from experience trouble was brewing.

Sam's eyes dropped shut, and his breath finally calmed as he seemed to come to some sort of resolve. He opened his eyes again and stared out blankly.

"I'm coming Dean…" Sam said in an deep exhale, "I'm coming…"

"What'd you mean by that?" Dean asked uneasily.

Sam let go of the sink and reached into his pants pocket. He pulled out his keys, and unlatched something from the ring. Sam held a small pocket knife in his hand. He stared at it for a moment, then snapped open the blade.

Dean's eyes flared as he started to piece together Sam's reasoning.

"Sam… Sam what do you think you're doing with that?"

Sam turned his left arm over, exposing its tender underside, and cut the blade across his wrist.

"Sam no!" Dean grabbed at his brother, but his hands simply pushed through him. Sam winced and tightened his lips as he sliced again, just as deep, and slightly higher up on his arm. "No Sam, stop! Stop it!" Dean yelled. How could he be this close, directly in front of him, yet completely helpless to stop his brother's actions?

Sam wavered slightly as he watched the dark blood stream from his arm. He grabbed hold of the sink and steadied himself.

"Sam put the damn knife down and go get help!"

Sam sliced two more times quickly, one above the next, moving up his arm. "Sammy!" Dean shouted, then slowly pushed his hands through his hair as both his eyes and tone softened. "Aw Christ," he whispered, "Christ."

Sam dropped the knife into the sink. It hit with a clink and slid through the blood and dripping water down to settle by the drain. Sam looked at himself in the mirror one last time, then grabbed his bleeding arm and staggered backwards. He dropped to his knees continuing to hold his bloody gateway to his older brother out in front of him, as all Dean could do was watch.

"Sammy… Sammy please…" Dean begged. Sam let his eyes shut with hope as he dropped back and landed with a hard crack to the tiles.

"NO!" Dean screamed. Sam settled to the floor unconscious, his color draining, his slashed arm out at his side, lying in a rapidly widening pool of blood.

Dean stood above his brother. He wanted so much to touch him, to reach down, lift him up, and carry him to safety, to somebody, anybody who would fix him. He couldn't. He couldn't touch him; he couldn't lift him; he couldn't save him, not in the manner which he had come to take for granted. Dean moved to the door. The lock, he worried. Dean focused his energy and hit at it. It took a couple of tries but eventually the knob turned and the lock popped open from its center. Satisfied that someone could at least get to his brother, Dean pushed back through the door and began screaming at everyone he saw. "Somebody help! Help me!" As no one responded, Dean remembered he was speaking with breath he no longer possessed. Dad, he though with hope. Dean ran through the halls to his father's room only to find it empty. "No… no… DAD!" He yelled rushing back into the hallway and down to his own room.

John stood in front of Dean's bed staring at his oldest son. Dean pushed in front of him.

"Dad! It's Sammy, I need you to come with me, I need you to come now!" Dean begged. John just stood looking through his son, at his son. "Dad please, you've gotta hear me. Sam's dying!" Dean slowly backed down. He had hoped that like Sam, his father would be able to sense he was there, but John clearly felt nothing.

Dean stepped behind his father trying to think of what to do. He had to get him to Sam fast, the blood was pouring out of him; his brother couldn't have much time. "Dad!" He yelled again, and as John remained unmoved, Dean suddenly realized he had been focusing his efforts, when what he needed to be focusing was his energy.

Dean pulled on all of his frustration and all of his fear, then channeled it into the sole purpose of saving his brother. He tightened his fists, clinched his jaw, and let out a guttural yawp as he pushed himself into his father.

John felt a shiver run though him and suddenly his thoughts shifted from one son to the other.

"Sammy," John said under his breath. He turned from Dean's bed and headed out of the room and back down the hallway. John picked up his pace, although he wasn't sure why. He moved quickly until he came to the closed door of a men's room a couple of corridors away. As John reached the door, Dean fell backwards out of his father's body. Exhausted, Dean collapsed to sit on the floor just behind his dad. John stared calmly at the door unsure of what he was doing here.

"Open it, damn it!" Dean yelled at his father's hesitation.

John pushed opened the door to find his youngest son lying in a thick pool of his own blood.

"Sammy?" He questioned, still not comprehending what he was looking at, then it clicked. "Help! I need help in here!" John shouted. Dean sighed, overwhelmed with the relief of hearing the words screamed by someone who could actually be heard. John pushed the door into the room, kicked the doorstop to the floor, and rushed to his son. Dean watched his father hesitate before touching Sam, much as he had done himself several minutes earlier, then listened in shock and horror as he took in his father's words.

"No…" John whispered, "not both of them… not both of them." John pulled his hurt arm from its sling and lifted Sam into his arms. He turned Sam's lifeless face into his chest and as the reality of the situation set in, John cried out harshly, pleading to save what he believed he had lost years ago. "Somebody help my son!"

Dean backed himself away as a doctor quickly moved into the room. He glanced blankly at the floor, then turned and looked behind him as two more people rushed past. As he began to shift his focus back into the room, he noticed someone standing behind him. Dean scanned his eyes from floor to face, then pushed himself up unsteadily, unable to remove his focus from the tall and stoic form of his brother.

Sam stood next to him staring blankly into the room, hurt and confusion in his expression as he watched his father cradle his limp, bloody, body. He never even noticed Dean was in front of him.

"Sammy?" Dean spoke to him lightly. Sam's lip trembled as he continued to take in the scene before him. Dean took a breath, then reached out and actually touched his brother. "Shit," he gasped unhappy with the contact, knowing full well what it meant. He pushed his brother away from the room and attempted to bring the kid's focus onto him. "Sam," he tried again. Sam finally shifted his vision and made eye contact with his brother.

"Dean?" he asked shakily. "I…"

"Sam what are you doin'? You're not suppose to be here."

"Look at him, Dean," Sam said gazing past his brother to his father. "He's actually scared of losing me. I… I can't believe it."

"What! Yeah he's scared! I'm scared! You're not suppose to be here, Sam!" Dean grabbed his brother firmly and shook him. "Sam, what the hell were you thinking?"

"I … I came to help you," Sam explained, toughening up. "I…"

"No Sam, not like this," Dean stated firmly.

"Then how? How Dean? Tell me how to help you. I need to help you!"

"I don't know Sam, I just know not like this!"

"Well I'm not leaving until we figure it out, Dean."

"Yes you are. Go back in your body, Sam!"

"No!" Sam pushed away from him. "I have to help you, I did this to help you!"

"Well it's not helping, it's only putting you in the same situation! Go back! We'll find another way."

"What other way, Dean? Tell me, 'cause I'd love to hear how you're gonna fix this!"

"I don't…"

"You don't know, do you? Do you! And that's why I'm not leaving, Dean! I'm not! I'm…" Sam dropped his words and broke down, "I… I can't leave you Dean… don't… don't leave me Dean," he whimpered. "Please don't leave me. Please." Sam dropped his head into his hands, crying.

"Sammy…" Dean began softly, overwhelmed by his brother's current frailty. Sam lifted his head back up and brushing the tears from his face, looked into his brother's eyes.

"I'm scared, Dean… I… what if… what…" Dean stared at him. He wanted them to be together, he wanted Sam to stay, but he knew things couldn't be fixed like this.

"I'll wake up Sam," Dean stated with false confidence. "We'll figure it out, but you have to trust me and go back to your body. Now."

Sam could feel it pulling to him. He grabbed his brother by the arms and tried to hang on. "Dean please," he begged. "You have to… I can't…"

"You can… and you will," Dean stated calmly. "Go Sammy, I'll be right behind you. As soon as I figure out how."

Sam stared blankly at a lose for words, slowly coming to believe his brother was right. After a moment he drifted. He swayed away from Dean, then fell forward onto him.

"Sammy?" He panicked. Sam looked up at Dean, then suddenly pulled through him. Dean grabbed himself and coiled forward, as he felt his brother's emotions shoot painfully through his chest. He had never felt so much emotional suffering, never. Dean steadied himself as he heard the sounds from the room behind him; he turned when he heard his name.

"Dean… Dean…" Sam moaned from his wounded position on the bathroom floor.

"It's okay Sammy…" John comforted, "Dean will be okay. I promise, he'll be okay. Just stay with me son. Stay with me."

"Dean… Dean…" Sam continued to moan breathily, his head tossing as he slowly began to come to. Dean stepped away from the door as the doctor and a couple of nurses prepared to move Sam onto a gurney. Once Sam had been moved, they rolled him from the room and headed down the hall. As the room cleared, John hung back.

John silently glanced the room, then stepped out into the hall trying to recollect exactly what it was that had brought him here.

"Forget me dad," Dean said, recognizing the reason behind his father reluctance to leave. "Go be with Sammy. He needs you." John looked towards Dean, but not at him. "Go," Dean repeated, sacrificing his own need for his father, in return for the knowledge that his brother would be safely watched over by somebody who could physically protect him. John scrubbed a hand down his face, and walked away.

Dean stepped back into the bathroom, stared at the blood on the floor, then at the knife in the sink. He could still feel his brother's pain inside the room, inside himself. For the first time Dean realized he needed to get back into his body not only for himself, but for his brother. "Shit Sammy," he gasped under his breath as he fell into the corner of the room and dropped slowly to the floor. "How the hell am I gonna get back to you? I just wanna get back." Dean's fear crept up on him. He pulled his knees to his chest, and clung to the echoing feeling of his brother's pain. It was all he had.

Two corridors away John Winchester followed the moving gurney. He had made his decision, only now did he see how it would save both his sons.

Thanks for reading. Please let me know your thoughts with a review if you have the time. And if you like, help me gauge my angst: on an angst-o-meter of 1 to 10 - ten being mucho angst - rate this piece!

I secretly just wanted to say - angst-o-meter : )