Summary: It was just routine surgery. But this was Sam. Nothing was routine. Sick!Hurt!Hospitalized!Sam, Worried!Awesome!BigBrother!Dean - John, Bobby, and Pastor Jim also included

Disclaimer: Not mine.

Warnings: Just the usual heads-up for language

Author's Note: Dedicated to KKBELVIS for several reasons, but the three most important: 1) for being so freakin' awesome; 2) for listening to me ramble on and on and ON about this story; and 3) for inspiring it with this line from her "A Spot To Remember" story: "And what about the tiny white spots decorating the back of Sam's throat, that time the kid got tonsillitis and had to have them removed." In my review of that oneshot, I asked her to write a story to further elaborate on that part, but she threw the ball back in my court...and here we are.

Before we get started: This takes place April 1997; Dean's 18, Sam's 13-going-on-14. I realize that cell phones weren't as advanced or as prevalent then as they are today. But the clamshell/flip model that we're so familiar with was available in '97, so I included it because much like my generation, this story would find it hard to exist without a cell phone. Also, while the medical portions have been researched, I'm not a doctor, and this is still fiction, right? Right! So, enough setup. On with the story...

Nothing is as simple as we hope it will be. ~ Jim Horning

One Thing Leads To Another

Dr. Can't-Pronounce-Your-Name sat on a wheeled stool, as he propped a clipboard in the crook of his elbow. "Let me get this straight..." he began, staring over the top of his glasses at his young patient. "You've been diagnosed with strep throat four times over the past year, and this is the first time anyone's mentioned a tonsillectomy?"

The paper sheet that covered the cold metal of the exam table crinkled as Sam shifted, his feet swinging nervously. "Um..."

Dean stepped closer to his little brother, his hand settling on Sam's back – calm down – as he bristled at the tone, irritated by this doctor's sarcastic doubt and all the other doctors' implied incompetence. "They usually just give him antibiotics."

"Well, he needs surgery."

Dean wasn't surprised – he thought the same thing this morning when he shined his flashlight into Sam's mouth, hence this visit – but he felt Sam flinch at the words.

Dean gently squeezed the nape of his little brother's neck. "When?"

"As soon as possible. Any more edema in his throat, and we'll be discussing a breathing tube instead of surgery."

Sam turned wide, horrified eyes to Dean, and Dean felt like punching a doctor.

Dr. Can't-Pronounce-Your-Name just became Dr. Dickhead.

Dean narrowed his eyes. "Don't you need to run tests to confirm it's strep before you go cutting into people?"

"No," Dr. Dickhead replied abruptly. "Swollen lymph nodes in the neck, inflamed tonsils with the characteristic white patches, fever, difficulty swallowing…" He trailed off and shrugged. "It's definitely strep throat, and he definitely needs surgery."

"How about today?" Dean asked, wondering if Sam's eyes could possibly get any wider.

Dr. Dickhead made a dismissive sound. "Not likely. The patient must be off ibuprofen at least three days before surgery, plus refrain from eating or drinking after midnight the day of the procedure as well as – "

"Sam hasn't eaten anything since yesterday's lunch," Dean paused and looked meaningfully at Sam – yeah, I noticed – "and we ran out of ibuprofen four days ago..." – which I'm still pissed about, but I guess it's working to our advantage now – "So, he's good to go. Let's do this."

Sam's breath hitched. "Dean..."

Dean responded by lightly patting Sam's back. It's okay.

Dr. Dickhead looked skeptical. "Are you serious?"

"Hell yeah. Seize the day, right Sammy?"

Sam said nothing at Dean's nudge, as the doctor's gaze flickered between the brothers.

"I'd have to check with United Hospital over in Blue Earth, see if there's anything available this afternoon."

"Blue Earth," Sam echoed, his voice a whisper as he glanced at Dean.

"Yes, since Wells Clinic is part of the United Hospital District, we usually send our referrals over there."

Dean nodded. "Sounds good."

"I should warn you that they don't like their patients to travel out of reach of their facility for at least 14 days after surgery, in case of complications. You'll want to keep that in mind when arranging where you'll stay after Sam's released, since you said earlier that you were just passing through Wells."

Dean nodded again, making a mental note to call Pastor Jim and to research "tonsillectomy complications," just as Sam leaned into him, the kid's body a rod of rigidity and yet his legs were still swinging.

Dean smiled softly and reacted to his little brother's tension by rubbing his thumb at the base of Sam's skull. Seriously. Relax. It's okay.

"How soon will you know if they can fit Sam in?"

"Let's see..." Dr. Dickhead sighed and checked his watch. "It's almost lunchtime, which means it'll be hard to get in touch with anyone for at least an hour, then figure in time for calls and pages to be returned…" He shrugged. "I'd say we'll know something by 3:00 this afternoon, which should be plenty of time since the actual surgery doesn't usually take more than 30 minutes."

Dean felt Sam marginally relax as he looked up, hopeful yet skeptical, his voice quiet. "That's all?"

"That's all," Dr. Dickhead confirmed, and the way he almost smiled at Sam made Dean think that he might have to change this man's name again to something a little less harsh. "But you'll still have to go through recovery, and then you'll be moved to a short-stay post-op room just to make sure everything's okay. If no problems present, then you'll be allowed to leave, but it will take at least a week or two, if not three, for you to be completely recovered and back on your feet to resume normal activities."

Dean snorted as Sam sighed, his thoughts mirroring his brother's: Dad's gonna love that.

"But we're running ahead of ourselves." The doctor stood. "Let's concentrate on getting the surgery scheduled, and in the meantime, you two can wait out in the lobby. If you need to leave, make sure you give your number to the nurse so we can contact you." He glanced at Sam on his way out. "And sorry to say it, but no lunch for you or anything to drink until we know what the afternoon holds."

Sam nodded that he understood and waited for the door to click shut before sliding off the table and looking up at Dean. "I have a bad feeling about this."

Dean rolled his eyes. "Dramatic much?"

Sam's expression immediately darkened.

"Hey. Don't bitchface me."

"'Bitchface' isn't a verb."

"It is with you," Dean snapped and turned toward the door. "Stop being such a girl and move your ass. We've got calls of our own to make."

Sam didn't budge, his scowl melting into his other not-so-secret weapon, as his large eyes welled with tears and blinked under the fringe of his bangs.

"Dude," Dean said, his tone both irritated and gentle. "What's with you?"

Sam shook his head and looked away, embarrassed. Dean was right; he was a girl.


Sam shook his head harder, closing his eyes to stop the tears but feeling them slip from the corners instead. Traitorous bastards.

Dean stared at his brother, taking in Sam's flushed face and slumped posture and slowly nodded, realizing the problem and feeling like an ass for not recognizing it sooner.

Sam had felt like crap for at least a week; he had been the source of an argument with their dad in a motel parking lot just a few hours ago; and now they were talking about surgery. Dean knew from 13 years of experience that his little brother was crying from being sick and exhausted and worried and scared and too damned overwhelmed to take anymore.

Dean gently grasped Sam's shoulders, pulling the younger boy toward him. Sam didn't resist, his head pressed to the center of his big brother's chest, his cheek beside the amulet that hung from Dean's neck. Dean's right hand rested on the back of Sam's head as his left hand splayed between his shoulders, rubbing back and forth.

"You know it's going to be okay, right? We'll take care of this, go to Pastor Jim's for a few days. Everything's gonna be fine."

Sam's only response was a strangled sob as his arms circled Dean's waist.

Dean instinctively tightened his grip. "Hey. Relax, kiddo. I'm here, and you know I'm not gonna let anything bad happen to you."

Sam nodded against Dean's chest, silent tears streaking his cheeks as he leaned into the solid presence of his brother, comforted by the fact that although he may endure teasing later, Dean would stand there as long it took for him to pull himself together.

A knock on the door startled both brothers before one of the nurses entered. "We're going to need this room."

Sam sniffled and turned his head sideways to look at her, still resting against Dean. The fact that he hadn't immediately separated from his brother upon a stranger's arrival was testament to just how crappy he felt, and Dean felt his protective streak flare.

Dean gave her a cursory glance before turning back to Sam. "Give us a minute."

"We have other patients and – "

Dean glared over his shoulder, effectively repeating himself and shutting her up.

The nurse nodded, backing into the hall and closing the door.

"What's with all the staff around here? All bitches and dickheads, I swear..." Dean groused, encouraged when he felt Sam take a shuddering breath and huff a shaky laugh. He carded his fingers through the hair at the base of Sam's skull. "You good?"

Sam pushed back, his face flushed from fever, fatigue, and tears. "Yeah," he responded, emotion making his voice hoarser than it was before, sounding like he had gargled rocks. He smiled shyly, wiping his eyes with the back of his hand. "Thanks."

Dean returned the smile, holding his brother's gaze – anytime, Sammy – before breaking into his best announcer's voice. "And the Academy Award for Best Dramatic Performance goes to..."

Sam answered his brother with one finger even as he grinned, dimples and all.

Dean laughed, looping an arm around Sam's neck. "C'mon, Sammy," he said, steering his little brother toward the door. "Everything's gonna be fine."

"Dad, it's us," Dean said, squinting in the early afternoon sun as he stood outside United Hospital, holding out his cell phone between himself and Sam. "They say it's strep throat again, and Sam's tonsils need to come out. In fact, we're in Blue Earth right now, about to head into the hospital. Sam's scheduled for surgery in a few hours."

Sam wrinkled his nose and shifted from where he stood facing his brother. The more he heard that idea, the less he liked it.

There was silence, and Dean checked to make sure the speaker function was turned on.


"Yeah," John replied.

Dean exchanged glances with Sam. They knew that tone.


"Well," John echoed, sounding annoyed and then dismissive. "Handle it, Dean. It's just routine surgery."

Sam gulped, his eyes wide as he stared at Dean. As predicted, this news did not put John in his happy place.

Dean shook his head slightly and was surprised by the irritation that flared at his father's flippant tone. This was Sam. Nothing was routine. "I know, but don't you think you should still – "

"Dean, I don't have time for this," John interrupted.

"But Dad – "

"Take me off speaker."

There was a moment's hesitation, but Dean did as he was told – as John knew he would – and Sam watched as his older brother's jaw tightened and twitched from restrained frustration and anger over the orders he was receiving. Even the customary "yes sirs" that punctuated any conversation Dean had with John were absent, and Sam didn't even know the phone call was over until he realized his brother was just standing there, staring at the phone.

Sam's gaze flickered to the sidewalk, uncomfortable with the awkward silence, especially since he knew what it meant. Sam knew from personal experience that no returned parting words – no "bye, Dad...see you to you soon" – meant John hadn't offered any, either; he had just given orders, expected them to be followed without question, and hung up.

Dean slowly pocketed his phone before rearranging his expression. "Well," he said, forcing a smile. "Looks like it's just me and you, kiddo."

Always is, Sam thought as he nodded in response, and although he'd never admit it to Dean, he preferred it that way.

Sam loved his dad, but he hadn't liked him in years. Dean was the only constant in his life, the only person he loved unconditionally and trusted without question. As long as he had his brother, the rest of the world could kiss Sam's ass...including John Winchester.

"It's okay," Sam rasped, glancing up through his bangs, trying to soothe Dean more than himself.

Dean's gaze drifted to the traffic in the street beyond, his jaw still bunched and tight with suppressed emotion.

He was frustrated.

He was pissed.

And if he was honest with himself, he was disappointed.

Even though experience had taught him otherwise, Dean always thought that this time would be different; this time their dad would come through; this time their dad would put them ahead of a hunt. Only every "this time" turned out like last time...and Dean was sick of it. Sam deserved better.

"You deserve better, too."

Dean smirked, looking back at his little brother, equally touched and amused – but not surprised – that Sam knew him so well as to know what he was thinking.

Sam smiled shyly and then shivered as a brisk wind swept through the covered breezeway of the hospital. It was April, and the sun was shining, but it was still cold in Minnesota.

"Come on," Dean said, draping his arm over Sam's slender shoulders and steering him toward the double automatic doors. "Sick people should be inside."

"Not according to Dad."

"Well, Dad's an ass," Dean stated bluntly, remembering all too well the confrontation earlier that morning in the motel parking lot about how fresh air and exertion were good for the body, how it was all about "mind over matter," how Sam should push through.

Normally, Dean might have been inclined to agree – he had hunted with a sore throat many times – but one look in Sam's mouth had changed his mind.

White splotches, almost like a film, coated the back of Sam's throat, and if his tonsils swelled any more, they probably would obstruct the kid's breathing. Not to mention the fever and general listlessness.

In typical Winchester fashion, Sam had said nothing about being sick, but Dean could write a book on the stages of sick Sammy, and he knew the signs: less talking, more sleeping, and no eating meant a sick little brother.

Dean had stood his ground, adamant that Sam needed a doctor, as John had stood in stony silence and Sam had stared at the pavement. Dean didn't know how much time had passed before John had opened the door of his truck and climbed in.

"Call me later," he had said before driving away.

Dean snorted. A lot of good that did.

"Do you think Pastor Jim got our message?"

Dean glanced over at Sam as they entered the hospital lobby. "I'm sure he did."

"What if he didn't? He didn't call back."

"I didn't ask him to."

"But what if he doesn't know we're coming and we just show up?"

Dean shrugged, effectively ending the topic. It wouldn't be the first time the Winchesters showed up on Jim Murphy's doorstep unannounced.

"So..." Sam sighed and then coughed when the rush of air irritated his throat. "What now?"

"First of all, you stop talking. You sound like shit."

Sam glared, the expression dulled by the fevered weakness in his eyes.

"And second of all," Dean continued as they approached the nurses' desk, "we get this show on the road."

"Hi. May I help you?"

Dean smiled at the woman behind the desk – "Helen," according to her nametag – and wondered idly if her head hurt from the tightness with which her graying hair was pulled back in that bun.

"My brother's scheduled for surgery."

"Let's see..." Helen said, adjusting her glasses as she grabbed a clipboard and looked at Sam. "What's your name, sweetie?"

"Sam." He cleared his throat and then winced. "Sam Cooper."

Helen frowned at the sound of his voice. "Goodness. Guess you're my tonsillectomy patient, huh?" She smiled as Sam nodded. "Well, this will be no sweat; you'll be in, out, and home before you know it." She looked at Dean, pushing another clipboard into his hands from across the counter. "The clinic sent over the paperwork you completed earlier, so we have Sam's medical history and most of all the other information we need, but there's a couple of sections we need to go over." She flipped to page three and pointed. " forgot to fill out the insurance portion, and we're definitely going to need that."

"Sure," Dean replied casually even as his stomach dropped.

While the clinic had overlooked the omission, he should have known that wouldn't be the case at the hospital – especially when they were here for surgery – which sucked because the information was omitted for a reason.

Insurance for them was a complete sham, but at least they usually had a card to make it look official until it was too late or they were too far gone for it to matter. But their latest insurance cards had met untimely deaths in last month's laundry – thank you, hot blonde chick in the Laundromat for proving that temptation does lead to distraction – and although John had been pissed, replacing them hadn't been at the top of his list.

Dean noticed Sam's worried gaze and shrugged slightly. He was good at making up shit. He'd think of something.

"Also," Helen continued, flipping to page six, "since your brother's a minor, we need the signature of a parent or legal guardian giving consent for the surgery...but you signed."

Dean cut his eyes at the nurse, fighting to keep annoyance out of his voice. ""

"Well, unless you're primarily responsible for Sam's care, your signature is not going to be sufficient."

Dean's eyes narrowed, his voice unnervingly calm. "Sam is my responsibility."

"Well, I'm sure he is when your parents aren't around, but where's your mother?"

"Dead," Dean spat, hearing Sam's quick intake of air and thinking he would be completely justified in slapping this woman.

"Oh." Helen blanched. "I'm...I'm sorry. Your father?"

"Not here."

"Is he alive?" Helen asked tentatively.

"Last time I checked," Dean responded, amused when the nurse's expression indicated that she thought he was being a smartass. If only she knew their line of work.

"Then we'll call him."

"He's out of town and unavailable."

Helen paused, sizing him up. "Do you have any other relatives?"

Dean sighed loudly. "No."

"Then who's responsible for your brother?"

"I. Am."

"Well, yes of course, but – "

"Listen, lady – I'm 18 and an adult, and in the absence of a parent, an adult sibling can give consent for medical care of a minor."

Translation: Fuck off, bitch.

Sam shifted nervously in the silence that followed, hoping the nurse was smart enough to let it drop. Few things pissed Dean off any faster than having his care of Sam called into question. Sam knew that among all the words his older brother would use to describe him, "mine" would be at the top of Dean's list. Sometimes that possessive, overprotective nature annoyed Sam. But other times...most of the made Sam feel safe and loved – and watching others squirm when faced with Dean's wrath was pretty cool, too.

"Point taken," Helen said finally, withdrawing her hand from the clipboard Dean still grasped. "I apologize."

Dean nodded tightly, his jaw clenched in an effort to rein in his words and his temper. He glanced at Sam and softened when he saw how exhausted his brother looked.

"You okay?" he asked quietly.

Sam nodded, but Dean noticed that his little brother's bangs were sticking to his forehead now, and he swallowed with more effort than before

"Look," Dean said, turning back to the nurse. "It's kinda been a long day, and I'm kinda tired of seeing my brother in pain, so if you're done playing 20 questions..."

Dean trailed off, his focus going to Sam.

"Yes, absolutely," Helen responded, tracking Dean's gaze and understanding the message. She rounded the desk and stood beside Sam, eager to make amends. "Ready, sweetie?"

Sam looked alarmed and stepped closer to Dean, bony shoulder brushing muscular arm.

Dean smiled affectionately, lightly patting Sam's back and hoping his little brother would always seek him as a sanctuary. "We're ready." He nodded at Helen. "Lead the way."

TBC ~ will hopefully post on Mondays, Wednesdays, and Fridays