The First Cut is The Deepest
Summary: Something unexpected happens to Sam after a hunt that solidifies the bond between the brothers. Set during S1 shortly after the pilot.
Part 2 of 2.
Sam was having a hard time making sense of what had happened. He knew his focus was off but for some reason that didn't bother him. A part of him, the still rational part, realized this ran counter to his usual control freak personality and it should have worried him. But for the moment he was content to relax and catch his breath.
Peace was his for the taking if only he could figure out why his tailbone throbbed so much. It was an incessant ache that made his whole body tense up. He was so intent on figuring out the source of his pain that he didn't register his brother leaning over and testing his forehead for fever until he was already withdrawing his hand and frowning at him.
Dean had an array of expressions that may not be apparent to a stranger but Sam could still read him. Right now his forehead was creased while a foot impatiently tapped on the linoleum; concern was dueling with frustration. He saw Dean snatch up the first aid kit and move his way. Florence Nightingale meets Nurse Ratched.
His thoughts zoomed away to One Flew Over the Cuckoo's Nest and before he knew it Dean was cautioning him that the peroxide was going to sting. A fresh wave of sweat broke out across his forehead as his brother diligently cleansed the wound on his palm. He kept his head firmly turned away from the action. His own blood had never bothered him before but he didn't want to chance it. Not while he was feeling so out of it.
He wriggled a little, trying but unable to find a comfortable position. The elevated legs were putting too much pressure on his tender tailbone. "Do you think I can have the pillows under my head instead of my legs? I feel kind of silly."
Dean quickly moved to comply. "Silly, huh. Not nearly as silly as you looked when you were doing the fish on the floor earlier. Flopping here and there. That was a sight."
A half smile flashed on Dean's face as he arranged the pillows against the headboard and helped Sam lean back against them. The pressure on his coccyx was still there but had improved marginally.
His brother's words about flopping like a fish finally sunk in. "Is that why you thought I was having a seizure?"
Dean adjusted a pillow one more time before stepping back and staring Sam in the face. "You haven't grown any scales so yeah, the flopping definitely played into my thoughts on the subject."
Dean's face tensed in anxiety as he talked about Sam's jitter-bugging on the floor. He'd known something had alarmed Dean but it was just now making sense; he'd caused his brother's calm to falter. Or at least his little fit had.
Dean was assembling the thread and needle when a loud knock sounded on the door. "Oh for God's sake, now what?!"
His brother swept the stitching material into the kit and stowed it under the bed before stalking over to the door. The muscles in Dean's back bunched as he answered the knock. He heard Dean speaking in a low, subdued voice and then he was turning to face his brother. "Sam, Officer Jones wants to talk to you for a moment. I'll be right outside."
Before he could register Dean's words, a tall brunette moved into the room and closed the door firmly. As the figure moved closer, Sam realized he was looking at a woman. "So, Sam, your friend says you cut your hand and passed out. How are you feeling?"
The words were delivered in a casual drawl but her pretty blue eyes searched his face with intensity. "To be honest, I'm feeling kind of stupid. I've never done anything like that before."
Her face relaxed minutely. "So, can you tell me exactly what happened here?"
A slight smile lit her face as she looked Sam up and down. He shivered a little, feeling as though he were on display and not liking the feeling.
Sam cleared his voice. He didn't have a cover story but he certainly couldn't explain that he'd cut his hand on a sword while slaying a Harpy. He'd be thrown into a straightjacket in a New York minute. He remembered cutting his hand a long time ago, when he was seven or eight. He'd have to use that as his cover. "I pushed a can down in the trash and caught it on a can. Stupid, I know. But it really bled for a while."
Officer Jones smiled widely so that it reached her eyes and a dimple twitched. "So you don't like the sight of your own blood?"
Sam didn't know if she was slurring his masculinity but he didn't feel up to defending it. His back and head were throbbing more than his wounded hand and he really wanted a pain reliever and some sleep. He reached up and rubbed his eye with his uninjured hand in a bid to keep himself awake.
The officer's attention shifted from mild flirtation to concern. "Hey, you don't look very good. Are you sure you don't want me to have an ambulance dispatched for you?"
Officer Jones was actually very attractive and her concern warmed him. But the last thing he wanted was to be checked out by paramedics or taken to the hospital. He was pretty sure he just needed some rest. And something for the pain. "I'm just sore and tired. But I'll be fine."
She pulled out her notebook and morphed back into her capacity as cop. "Could I please have your name? I need it for our records."
Sam dutifully told her his real name. He had nothing to hide. Except his embarrassment.
She tucked the notebook away and looked him in the eye, all sincerity. "I have to ask this question so please don't feel uncomfortable. Do you ever feel unsafe or threatened by your…"
Her words trailed off as she tried to find the right word. Sam sensed her discomfort and supplied the word for her. "Brother. And no, I don't feel threatened by him. All in all he's a pretty great brother. And he always puts my safety first."
And he realized he meant it. He'd missed Dean while he was at Stanford. A lot.
She broke from her official role and leaned over to squeeze Sam's left shoulder gently. "I'm sorry, but I had to ask. When someone hangs up on 911 we need to make sure that the person who called isn't a victim of violence."
Sam tried to shift to a more comfortable position and had to work to prevent a groan from escaping. "I appreciate you checking on me. And I'm sorry we wasted your time."
She shrugged off his apology. "It was a pleasure meeting you, Sam."
Officer Jones moved toward the door but paused before opening it, turning to face him. "You know, you should get one of those can openers from Pampered Chef. They don't leave any sharp edges. In fact I've got a spare one at home. Maybe I could drop it off tomorrow sometime."
It had been so long since someone had hit on him that Sam was flummoxed. "I, ah, thanks. You're too kind."
He could feel his face heating up. Officer Jones was a fine looking woman but he wasn't in the market. Well, technically maybe he could have been but he wasn't much of a one night stand kind of guy and he missed Jess too fiercely to start another relationship.
The back of his head was now throbbing as much as his tailbone. He closed his eyes and willed the pain away. It wasn't listening.
He heard the door open and close and then Dean was locking them in. "Hey, that hot babe was right. You don't look so good."
Sam cracked his eyes open and found himself begging for something to dull the pain. "Could I please have something now?"
His own voice sounded weak and had a catch to it. Breathy and needy. But he didn't care. He just wanted something to make the pain go away.
Dean reached down and gently massaged the same shoulder Officer Jones had rubbed. "I'm sorry, Sammy. You might have a concussion so I think we need to wait a while. Maybe you can have something before we turn in for the night."
Sam knew his brother was right. His mind was still fuzzy but he knew the protocol for possible concussions; check every hour for PEARL – pupils equal and reactive to light.
Slumping back, Sam eased himself down until he was more horizontal. He was completely at the mercy of his brother right now, unable to do anything for himself except lounge on the bed. It would normally have bugged him, being beholden to someone else for taking care of him, but in this instance he felt only gratitude that is was Dean. He trusted his brother. But he felt a twinge of guilt for causing him brother more work.
Maybe he could fall asleep and then he wouldn't have to hide his misery from Dean.
His brother was trying to be a stoic in true Winchester fashion but pain was etched deeply in the grooves on either side of Sam's mouth. More pain than a gash in the hand could account for.
Dean decided it was way past time he checked for broken bones. The visit from Officer Friendly had distracted him from both dealing with Sam's hand and conducting a thorough assessment of his brother's body. After all, Sam had dropped like a sack of potatoes onto the hard floor. First his ass had collided with the unforgiving linoleum followed closely by the back of his head.
Sam's eyes were tightly closed shut. Dean would start there by checking his pupils. He rustled in his bag for a moment before pulling out a mini-maglite. The room was just darkening as dusk settled in for the evening so the contrast between the shade of the room and the maglight were the perfect conditions to evaluate for a concussion.
He reached out and cupped his hand gently over Sam's closed eyes. His brother jumped lightly, and he could feel the flutter of long lashes against his palm. "Just relax for a moment. I'm going to check your eyes."
He gently thumbed up Sam's right eyelid and shone the maglite directly in his face. His brother squirmed and gasped but didn't fight Dean's hold. The pupil contracted just a tad. If he didn't know any better, he'd think his brother was flying high, doped up already.
Before he gave into the concern that was setting up residence in the back of his head, he thumbed back Sam's other eyelid. Same reaction.
And then he remembered, his brother had taken migraine medication earlier in the day so maybe it was that and not a concussion that was causing some of his brother's symptoms.
He'd been so distracted when his brother blacked out right in front of him that he'd neglected to look at the big picture. All's he could see was Sam's pale features, his limbs jerking on the worn tile. Dean had just found his brother, he wasn't about to lose him. And he'd let the panic of that thought cloud his judgment.
Dean turned off the maglite and watched some of the discomfort ease from his brother's face. Harsh lights were a bitch when it came to head injuries. He eased himself down on the edge of the bed so as not to jostle his brother.
Supporting Sam's neck with his left hand, Dean lifted it so he could sweep his right hand through the back of his brother's hair, searching for an injury. There, on the occipital bone, he found a smallish knot that had Sam pulling away and hissing in distress. He pulled his hand out and noted the absence of blood. Still supporting his brother's neck in his hand he tried to sooth his brother. "Almost there. I just want to check your back. I'm going to sit you up for a moment."
Sam's eyes slitted open as he acknowledged his brother's words. "What do you need me to do?"
The voice was soft with the edge of exhaustion. He hated the pain he caused with the poking and prodding but it was necessary if he was going to keep Sam healthy. "Not a thing. I've got it covered."
Dean lifted Sam up further off the mattress with his left hand before his right hand snaked around to support his upper back. It was difficult to maneuver his brother into position without causing him further stress but Dean stiffened his back and countered Sam's weight to lever him up. He tried to distract his brother with a running commentary, "I'm going to pull you up…that's it…let me check your spine…does it hurt anywhere else?"
He was sitting on the edge of the bed, facing his brother, with Sam pulled forward to rest lightly against his chest. His hands competently roamed his brother's back in search of injury. He couldn't feel anything out of place until his right hand brushed across the lower back area. His brother tensed and pushed into Dean's shoulder, burrowing forward in an attempt to evade the pressure of the hand.
It would have been an awkward moment, Sam practically draped across his shoulder with Dean cradling the back of his head with one hand and hugging him with the other to keep him from falling over, save for his brother's condition. His suffering was palpable but Dean couldn't stop yet; he needed to look at the area before he decided whether they could treat it with ice or if Sam was in need of medical assistance.
Dean took a moment to catch his breath and let Sam do the same. He'd comforted a Baby Sam a million times, just like this, while lightly rocking and crooning to him. This time he would forego the rocking and crooning but he didn't quickly shift away from his ailing sibling. Sam needed him and was counting on him.
He waited a moment, until his back protested and his arms began to fatigue, before moving. It was time to view the damage "I'm going to lay you back down. Easy. There."
Dean slowly lowered Sam back onto the pillows. Cognizant of the lump on Sam's head he smoothed the hair gently back before slapping Sam's thigh with a manly punch. "One more thing to do and then I'll take care of your hand."
He smoothly slid the pillows out from behind Sam's head, his brother wincing at the movement. He knew his brother had a high tolerance for pain so there was no question he'd really done a number on his body when he'd hit the floor with his considerable weight. "I'm going to help turn you over so I can see your…backside and then I think I can give you a mild pain killer."
Dean had hesitated over saying "butt." He wasn't sure if that was owing to his brother's modesty or his own sensibilities. He didn't want to see that part of his brother's anatomy but out in the field there were a lot of things you did because you had to in order to survive. And Winchesters were very much into survival.
Sam tried to relax but everything hurt. The light in his eyes had triggered a drum solo in his temples that wrapped around and pulsed at the back of his head. It was bad enough when Dean's hand had found the bump on his head but when he'd put pressure on his low back he'd wanted to pass out. Again.
Now Dean was intent on flipping him over to get better access to the area. Sam had been able to work open the fly of his jeans but he was unable to pull them off by himself one handed while lying flat. Without having to ask, Dean had silently pulled them off before sliding a navy pair of sweat pants up his legs and snugging them up.
By this time Sam was too sore and tired to be embarrassed. He was sure Dean was embarrassed enough for the two of them though so he did his best to follow his brother's instructions to make it up to him. The instructions were so simple even he could follow them in his addled state – don't move a muscle and let Dean do all of the work. It wasn't fair to his brother. He must really be out of shape if one little knock to his body left him so traumatized. Maybe Dean had been right; Sam had grown soft while at Stanford.
The room rocked as Sam was tilted onto his side and then turned on to his stomach. He couldn't hold back the brief gasp as his shifting legs caused pain to shoot into his posterior. Once he was in a prone position the pain faded to a tolerable level. He felt a rush of cool air as his shirt and t-shirt were hiked up followed by the sweat pants being tugged down. He shivered, not sure if the exposure or mild temperature had caused it.
Turning his head to the left, Sam pulled his left fist up to curl against his cheek. He allowed sleep to pull him in and comfort him before Dean had finished his ministrations.
Dean didn't have to undress Sam very far to see the large, red mark smudged across the indent below his spine. His brother was going to have one helluva a bruise in another day.
Straightening his brother's clothing, Dean then moved for the first aid kit. He'd assured himself that nothing was broken and although he'd monitor for a concussion he didn't think it was a serious one. He had no idea why Sam had fainted and that bothered him. Badly. But for now he'd settle for sewing up the open wound on his brother's palm.
Sam seemed more relaxed on his stomach, muscles lax, eyes hidden by lowered lids. His breathing was deep and even and Dean was pretty sure he'd fallen asleep. With his weight off his tailbone, the pain had finally eased up.
He took in the curve of his brother's pale cheek, fist resting against it just like when Sam was a baby. Apparently that was one habit Sam hadn't shed when he'd gone off to college.
Dean pulled the towel from his brother's injured hand gently so as not to rouse him. The wound actually looked pretty good with some mild oozing. If it had been on a different part of the body he might have left it alone to heal. But Sam would be constantly using his right hand so he opted to apply a few stitches to hold it together. Gathering his supplies up yet another time he was relieved when the phone didn't ring and there was no knock on the door. It was just himself and his sleeping brother.
Sam was still sore but he felt better than he'd expected. It had been a week since they killed the Harpy. Or perhaps he should say since he'd tumbled onto the floor in front of Dean and done the fish.
The stitches in his hand pulled but he knew that was a sign of healing. He still couldn't move with complete ease; pushing off of surfaces to stand was still the most painful. But while Sam had slept that first night, his brother had applied ice to his bruise. He'd never even twitched but the ice had worked wonders on his abused buttocks.
But Dean watched him with blatant suspicion. He hovered and lingered and was generally driving Sam crazy. But he conceded that had it been Dean who had passed out and flopped in front of him, he would have been out of his mind with worry, too.
Sam had a hunch his migraine medication had something to do with his one way ticket to the floor. He knew it lowered blood pressure and that along with the resultant drop in pressure due to his cut probably pushed him to the limit. But it was just a hunch and his brother was worrying at the situation with fervor. Nothing Sam said or did seemed to allay Dean's fears.
Sam had finally convinced Dean they could leave the area and his brother had agreed, albeit reluctantly. He'd made Sam sit on the bed while he loaded up the Impala which hadn't set well with him at all. But he tried to hold his tongue. He appreciated Dean's concern and didn't want to belittle it.
They'd been on the road for about four hours when Sam's tailbone began to lightly throb. He'd been expecting it and knew he just needed to pop a couple of Aleve. But Dean was hyperaware of every little shift or twitch he made and it was wearing on him. He tried to be discrete, casually reaching into his bag and withdrawing the bottle while grabbing his water. Before he could swallow the pills, Dean was exiting the interstate and looking for a place to stop. "Why didn't you say something? I knew it was too soon for you to travel."
Sam shot his brother the evil eye and grounded out a response. "You're joking. I just needed some pain reliever and it was way past time to move on and you know it."
He hadn't meant to snap but he was sick of being coddled. Loving concern was one thing but this was more like harassment.
Dean looked every bit as disgruntled as Sam felt; his face was pale with bright pink spots riding his cheeks and his lips were pulled back into a straight line. Sam was certain the brothers were going to have a showdown but Dean pulled in front of a diner and put the Impala in park before closing his eyes and visibly calming himself. "Fine. Let's take a break and get something to eat."
Sam accepted the peace offering silently by nodding his head. He didn't want to say something that would rile his brother back up. He exited the passenger seat as smoothly as possible, stretching to his full height. A reflection off a moving car hit Sam squarely in the face and he turned his head away while stepping to the side. His foot brushed the cement parking block and he stumbled a step before righting himself.
He turned back to find an angry Dean advancing on him. He took him none too gently by the upper arm and dragged him back to the car. "I knew there was something wrong. I'm taking you to the doctor. Get in. Now."
Sam knew why he had tripped but he could read the concern in Dean's face. Since nothing would deter his brother he finally caved in. "If the doctor determines I'm okay will you let it go?"
Dean's head swiveled back at him in disbelief. "You mean you'll see one?"
Sam sighed. "If that's what it takes, then fine, let's go."
Dean seemed confused at his acquiescence but quickly stuffed Sam in the passenger seat. "I'm going to ask about a clinic. Stay put."
Moving with a single-minded purpose, Dean entered the restaurant. Sam crossed his arms over his chest and reminded himself to be patient. He didn't need a doctor but they couldn't go on this way.
Sam had maintained he was fine for so long that Dean didn't know what to make of his sudden agreement to see a doctor. Maybe he wasn't feeling so great after all.
Although he had to admit that his brother was moving more freely these days. It was the seizure thing that had been weighing on his mind. He just couldn't let it go. What if there was a problem and he ignored it and Sam got sick or worse?
In their line of business they were always fighting through injuries, large and small, but nothing had ever shaken him to the core as when Sam had collapsed with some sort of convulsions before him. He felt justified in making Sam see a doctor.
They'd had to wait most of the afternoon for an opening but as the clock neared 4:30 the nurse called Sam's name to see a Dr. Yaeger. Both brothers were cranky with hunger but Sam had agreed to see someone and Dean had held him to that promise.
Dean jiggled his foot with nervous energy. He was the only person in the waiting room and he was tired of waiting. He stood up and paced around. The two women manning the front desk watched him with interest but he couldn't even work up the energy to flirt with them. Not while all of his energy was focused on his brother's health.
He'd seen a couple of nurses bustling in and out with a cart and other equipment but he tried to dissuade himself from thinking that it was for Sam. But he had to concede that all of the other patients had already left.
Dean was starting to think of possible scenarios – Sam had epilepsy, or a severe concussion that Dean had missed, or a terminal illness. He could feel his muscles twitching with anxiety. Sam had tried to tease him out of his mood but he wouldn't allow it. He had to know why Sam had collapsed; Sam was his baby brother, placed in his care from an early age, and he took that responsibility seriously.
Someone opened the door and Dean was disappointed when it wasn't the object of his thoughts. "Dean, could you please come back? The doctor would like to see you."
Dean could feel the blood draining from his face. It had to be something serious. He followed the nurse through the maze of rooms, his thoughts a blur.
He was ushered in to an exam room where he found Sam, fully dressed, sitting on the exam table while a short, blond woman talked to him. The woman rose to her feet and firmly shook Dean's hand. "I'm Dr. Yaeger. Please have a seat."
She waited while Dean sat in the chair next to the exam table. His jaws ached from clenching them. He was all nerves.
Dr. Yaeger sat back down and crossed her legs before picking up a chart. "Let me start by saying your brother is extremely healthy. He said you've really been concerned so he wanted you to hear my findings directly from me."
Dean let out the breath he hadn't even been aware he was holding. Sam shot him a look but it was one of sympathy instead of condescension. It hadn't even occurred to him that Sam might lie about what the doctor told him but it did ease his mind immeasurably. Doctors weren't perfect but with the equipment at their disposal they did get some things right.
The doctor smiled gently at him. "I did an EKG and his heart is fine. He passed the neurologic exam with flying colors. We drew some blood to test Sam's sodium level and blood counts and I'll have those results tomorrow. I don't anticipate any problems but of course I'll follow up with you about any irregularities we might find."
Dean still didn't understand and he wanted answers. "But why did he pass out?"
She nodded her head. "That's an excellent question and I can't tell you with complete certainty what happened to your brother but I do have an idea. Sam said he's been under a good deal of stress lately and that coupled with the effects of the migraine medication and the cut on his hand were enough to trigger what we call a vasovagal response."
Dean thought vasovagal response was a fancy term for fainting but he wanted to hear more. "Could you please explain that for me?"
Dr. Yaeger didn't seem in the least bit perturbed by his request and launched into a detailed explanation. "When a certain stressor – fear, pain, pressure, dehydration, etc. – occurs, it can trigger a syncopal response. Prior to losing consciousness, a person frequently experiences a prodrome of symptoms such as nausea, sweating, ringing in the ears, and visual disturbances which last for a few seconds and typically occurs when the person is sitting up or standing. When they pass out, they fall down and effective blood flow to the brain is immediately restored, allowing the person to wake up."
She explained that if the person moved too quickly upon waking it could trigger another response. He didn't know what Sam had experienced right before he passed out but he could testify to the wooziness that had assailed his brother when he sat him up. It totally explained why he'd been so passive and zoned out.
When no more questions were forthcoming, the doctor gave Sam her card and asked him to call her if he had a recurrence of the symptoms. If that happened she needed to know because it would be time for a CAT scan. Sam was told to call the clinic the next day for the results of his lab test and then the brothers were shown the way out.
So Sam, who had tolerated painful injuries in the past with nary a peep, had succumbed to stress. The stress of losing his girlfriend, of leaving school, searching for their missing dad, hunting again, hell, even being on the road with Dean. Yeah, he had to admit that Sam's life had been stressful of late.
His feelings of protectiveness had just been validated; Sam needed him and he wasn't going to let his guard down. Even if that meant occasionally going up against his own brother.
The brothers had returned to the diner for a well deserved meal after an afternoon of waiting for the doctor and then found a room in town at Dean's insistence. The night had passed without incident and Sam had just called the doctor's office and received the all clear. His blood tests had all come back within normal range.
Despite the good news, Dean still found himself searching out his brother for twinges of discomfort or impending black outs. But he'd agreed if the doctor said he was okay, that he'd let it go.
So he resigned himself to letting it go while they prepared to hit the road again. Sam was anxious to find their dad and Dean was just itching to be on the move.
Surveying the bags for loading he realized just how much he was ready to head out. But not before he ribbed his brother about his faint. "So, I have to ask you, Sam. How does it feel to faint like a girl?"
He didn't mention how much his brother had scared the crap out of him, probably trimming off one of his nine lives. Or how relieved he was to know Sam was healthy.
A slow smile spread across Sam's face. "It really hurt. So I have to ask you, if you were standing so close why didn't you catch me?"
Dean felt his face flame in embarrassment. He'd wondered that himself. He was supposed to have cat like reflexes and he had watched, dazed, as Sam had swooned right in front of him.
In his defense he'd never expected it. Brothers weren't supposed to fold up like lawn chairs for no reason.
Unable to form a suitable, biting response, he settled for slugging Sam in the arm. Very hard.
Sam, unfazed, slugged him back.
His brother wasn't sick. They were a team again. Life was good.
A/N: Thanks again to my beta and friend, Faye Dartmouth. You're the best.
Thank you for reading this story. My next story, Every Breath You Take, is a collaboration with Gidgetgal9 and we're going to post it under her account. Perhaps you'll check it out when it's finished!