Summary: Pre-Series – Asthmatic Sam, Big Brother Dean – It started like it always did, with the startling realization that he couldn't breathe.

Disclaimer: Not mine.

Warnings: Just the usual language.


re·spire (r-spr) v. – 1. To breathe in and out; inhale and exhale. 2. To breathe easily again, as after a period of exertion or trouble.


It started like it always did, with the startling realization that he couldn't breathe.

He couldn't breathe.

Sam's eyes snapped open, blinking rapidly as he acclimated to his surroundings.

Dark room.

Uncomfortable mattress.

Brown, leak-splotchy ceiling.

The hum of the air conditioning unit.

The hiss of the traffic as it passed by on the rain-slick street outside.

Bluish glow from the muted television left on.

Dean's rhythmic breathing in the neighboring bed.

Sam blinked again, his panic instantly escalating as he realized this was not a dream; it was real.

He couldn't breathe.

One would think after seven years of dealing with the condition – with always having to check the box beside "asthma" on medical forms and then list his medications – he would respond better; that a 14-year old could handle this; could calmly sit up, get his inhaler, take a hit, and go back to sleep.

But it had been awhile – a few months, at least – since Sam had woken up like this; in the middle of the night with crushing pressure in his chest; struggling for a shallow breath while hoping the next would be deeper; feeling claustrophobic in his own body as he slowly, quietly suffocated.

And if he could breathe and think rationally, he would probably be embarrassed by how panicked he felt.

But he was not embarrassed.

He was freaked.

Because he couldn't breathe.

He couldn't breathe.

Instinctively, Sam turned toward his brother.

"D..." he began but was abruptly interrupted by harsh coughing that choked him and further stole his breath.

Fueled more by anxiety than strength, Sam rolled onto his side; feet tangling in the comforter, hands bunching the sheet as he realized he was wheezing; could hear it, could feel it.

Sam closed his eyes and swallowed, then coughed again.

He couldn't breathe.

"De...an."

The whispered name came out in two syllables on a strangled breath and was barely audible.

But it was all it took.

Dean was instantly awake; eyes focused on Sam the moment they opened; only needing one look at his brother's face to know what was wrong.

Sam couldn't breathe.

He couldn't breathe.

"Ah, shit," Dean sighed, throwing back the diamond-patterned comforter and sitting up as he swung his legs over the side of the bed; shivering at the sudden chill of the room on his arms and feeling the orange shag carpet nestling between the toes of his bare feet.

Dean scrunched his face – he hated that feeling – and stood, crossing to Sam's bed in two steps as his hand reached toward the nightstand, reaching for something not there.

Dean frowned when his fingers glided over the smooth surface – no white plastic inhaler to grasp – and felt his heart beat faster as he heard Sam's wheezing abruptly change into a distressed whistling; could hear his brother's legs rustle the sheets as Sam moved restlessly, desperate for breath.

Because he couldn't breathe.

He couldn't breathe.

"Where's your inhaler, Sam?"

Wordlessly, Sam stared up at him; mouth open as though he were silently screaming; eyes narrowed in pain; neck muscles tight; his body contorted in an awkward position as he tried to compensate, tried to find a position that would allow more oxygen to flow into his starved lungs.

But it wasn't working.

Because he couldn't breathe.

He couldn't breathe.

"Sam!" Dean called, feeling his own anxiety rise as he squatted beside the bed; knowing the bluish tint to Sam's lips wasn't just from the television's glow. "Your inhaler's not here," – which would explain why Sam hadn't already taken care of this himself – "So, where is it?" he demanded.

Because sometimes it was in his toiletry kit; sometimes it was in his duffle; sometimes it was in the Impala's glove compartment; and sometimes it was just plain missing.

Dean felt his heart stutter at that last thought.

Please don't let it be missing.

The doctors had always said it was a good idea to have several inhalers and keep them in various places in case of an emergency. But that was easier said than done when your family engaged in health insurance fraud and credit card scams. Usually they could only afford one. And after tonight, Dean was going to tie it around his brother's neck.

"Sam!" Dean yelled. "Where is it?"

Sam inhaled – and fuck, Dean hated that whistling sound – and darted his gaze toward the bathroom.

Kit.

Dean nodded. "Got it." He stood, squeezing Sam's arm as he did. "Just hang on, man."

Sam closed his eyes against the sudden brightness of the bathroom light, feeling dizzy and detached, unsure of how much longer he would be able to do that, to hang on. Blood roared in his ears as the sweaty heat of panic was replaced by a cold, tingling numbness that swept over him, and he knew from experience that they literally had seconds before he would be beyond the help of an inhaler.

Because he couldn't breathe.

He couldn't breathe.

"Almost got it," Dean's voice called, an echo-like quality caused by the tile in the bathroom. "Just hang on. I'm coming, Sammy. I'm coming," he promised, inexplicably reminded of how he used to say the same thing when preparing baby Sammy's bottle or retrieving toddler Sammy's favorite toy.

Some things never changed.

Not really.

What Sam needed, Dean would provide.

And right now, Sam needed...

"Yahtzee," Dean declared, snatching the inhaler from underneath a tube of toothpaste, not even bothering to switch off the bathroom light as he crossed back to Sam, noting his brother's lack of movement. "Sam?"

Sam's eyes opened, weak and unfocused as a whistling inhalation turned into a hacking, chest-vibrating cough and then was followed by an expression of renewed pain and panic.

Because he couldn't breathe.

He couldn't breathe.

"It's okay," Dean soothed, even as he was internally panicking himself. "You're okay," he assured, years of experience allowing him to maneuver his brother to a sitting position with one hand – and then settling on the bed behind him, one leg on either side of Sam, his little brother's back against his chest – while shaking the inhaler with the other.

In a sudden burst of energetic coherence, Sam clumsily reached for the inhaler as Dean brought it to his mouth.

"Stop," Dean softly admonished – knowing they were well beyond Sam doing this himself – and swept away his brother's hand, noticing the blue-tinged nail beds, before placing his own palm on either side of Sam's chest and then pressing it against his brother's sternum; feeling the intercostal and sternal retractions coincide with Sam's wheezing and whistling as he felt his own jaw clench.

Stupid fucking asthma.

Too bad Dean couldn't kick its ass, couldn't destroy it much like he would like to destroy the shtriga that had caused it all those years ago.

Sam had been a perfectly healthy seven-year old until that night; then one week later, he had suffered his first asthma attack; had scared the shit out of Dean and had even caused their hospital-phobic father to haul ass to the emergency room.

Several hours later they had received the diagnosis – severe persistent asthma – and the doctors had been baffled as to how the condition had developed and had become so severe so quickly.

But Dean had known.

And John had known, too.

Even now, seven years later, if their father were around when Sam was suffering an attack, John would look at his oldest with an expression that Dean always interpreted with two words.

Your fault.

And whether his father meant it or not, was aware of communicating a nonverbal accusation or not, Dean saw it and believed it because it was nothing he hadn't already told himself.

Sam's condition was his fault. If he had not left his little brother alone that night; if he had followed his father's orders, the shtriga would not have had the opportunity to feed off Sam. And if the shtriga had not fed off Sam, then Sam would not have asthma; would not spend every day of his life – and most nights – struggling for a deep breath.

Dean sighed and shook his head. Enough of that. What was done was done, and while he could not change what had happened, he could make it better; had learned everything there was to know about asthma; had always been Sam's own personal first-responder during an asthmatic emergency.

"Okay, Sammy..." Dean gently placed the white plastic mouthpiece between Sam's parted, blue-hued lips. "Let's do this, huh?" he asked conversationally, pausing long enough to get the rhythm of Sam's breathing; to allow his brother to exhale; and then pressing down on the canister, hearing the hiss of the mist as it entered Sam's mouth and hopefully, his lungs. "You know the drill, Sam," Dean continued to coach, his hand rubbing soothing circles on his brother's chest, willing the medicine to work. "Hold it as long as you can, kiddo."

Sam gave an uncoordinated nod and did as he was told, always uncharacteristically obedient during an attack. A few seconds passed before he exhaled forcefully and then coughed, sucking in a ragged breath.

A whistling ragged breath.

Not that Dean was surprised; he was planning on giving Sam two hits, at least. But his brother seemed increasingly distressed, weakly pushing against Dean's chest as he arched his back in an attempt to breathe.

But he couldn't.

He couldn't breathe.

Sam made a sound – half gasp, half strangled moan – and hyperextended his neck, pressing hard into Dean's shoulder as his hands bunched the fabric of Dean's sweatpants; desperate for strength, for help, for breath.

"Hey," Dean called, once again shaking the inhaler as he continued to rub Sam's chest – back and forth, back and forth. "Relax, huh?" Back and forth, back and forth. "Sammy." Back and forth. "You know it usually takes more than one hit."

And Sam did. He knew that.

But holy shit.

He couldn't breathe.

He couldn't breathe.

"Alright, dude. Here we go. One more time..." Dean placed the inhaler's mouthpiece between Sam's lips again; waited for his brother to exhale; then pressed the canister, idly wondering what it felt like when the mist entered Sam's lungs. "Hold it, Sammy," he reminded as he set the inhaler on the nightstand and then glanced down at his brother.

Sam's eyes were squeezed shut; tears of panic and pain and frustration slipping beneath his lashes as his white-knuckled hands continued to grip Dean's legs.

Dean sighed – he fucking hated this – and thumbed the moisture from his brother's cheeks before lightly resting his chin on Sam's head. "I know, Sammy," he soothed, gently patting his brother's chest. "Almost over, kiddo."

And it was.

But fuck.

How many times did they have to go through this? Would Sam ever experience a day when he just breathed like everyone else? When he didn't have to worry about the next breath being shallower than the first?

Dean sighed again, hearing Sam slowly exhale with a soft cough and then inhale more easily, still wheezing a little but no whistling and – Dean's hand moved to either side of his brother's chest and then back to his sternum – no retractions.

Things were definitely looking up.

As if to prove it, Dean started softly humming the opening chords of "Smoke On the Water". While some measured time with a clock or a watch, Dean measured it with songs. And he knew from experience that after he got through the entire intro – all 51 seconds of it – Sam would finally feel the full effects of the inhaled medication; would finally take a deep breath; would finally be able to relax.

So, he hummed.

At 1:56 on a Saturday morning, sitting in a gaudy motel room, bathed in the garish mixture of light from the bathroom and the television, Dean hummed. While holding his little brother and prying Sam's hand off his left leg and lifting it to press against the kid's own chest, he hummed. Covering Sam's hand with his own, purposefully measuring his own breaths in an effort to get his brother to match his inhalations, Dean hummed.

And 51 seconds later, it was over.

Sam inhaled – deeply and quietly – and then sighed, tension melting from his body as the grip his other hand still had on Dean's right leg loosened.

And although Dean knew, he still had to ask. "Better?"

Sam's fingers twitched beneath his brother's hand. Better.

Silence settled between them; the sweet, taken-for-granted silence of easy breathing.

And Dean savored it, was immensely thankful for it.

Sam inhaled again – barely making a sound – before swallowing nosily and turning further into Dean, his damp bangs and sweaty forehead smearing slick moisture across his brother's neck.

"Dude. Gross," Dean grumbled even as he lifted the hem of his own shirt and wiped it across his brother's face, feeling cold perspiration soak into the fabric. "The things I do for you, huh?" Dean continued to gripe but smiled affectionately as he resituated his shirt and then gently shrugged his shoulder, feeling Sam's head lift with the motion. "Hey. You good?"

If Dean hadn't felt Sam's hair wisp against his neck, he wouldn't have known his brother nodded.

"You sure?"

Sam nodded again.

"You goin' back to sleep now?"

Sam nodded once more, his eyes still closed; his bony shoulder digging into Dean's ribs as he turned over and situated himself; snuggling into his big brother's side as his cheek rested on Dean's chest, his arm draped across Dean's waist, and he sighed; quiet and content, safe and breathing.

Simultaneously amused and touched by Sam's actions, Dean shook his head – because only Sam could make him feel this way, this loved, this needed – and pulled the sheet and comforter higher, covering Sam's shoulders as he smiled softly, affectionately carding his fingers through the kid's hair.

Dean knew his little brother could be clingy after an asthma attack – especially a bad one like this – and while Sam was just dozing right now, he would be deeply asleep in a matter of seconds, always exhausted in the aftermath. But any sleep Dean got the rest of the night would be gotten in snatches while sitting up against the headboard.

And that was fine with Dean.

Although he would never admit it aloud, Sam's attacks always left him feeling a little shaky and clingy, too; wanting to be close to his brother in case of another flare-up; needing to feel Sam's steady heartbeat and rhythmic breathing to assure himself that the worst was over, that the kid could breathe.

Finally.

He could breathe.

"Hey." Dean nudged his brother's shoulder. "You still good?" he asked, realizing he was straddling the line between "concerned big brother" and "irritating mother hen".

Sam shifted and nodded.

But for some reason, that still wasn't good enough for Dean. He needed to hear his brother's voice. "Sam, I need you to say something."

There was a pause.

"Something," came the hoarse whisper.

Dean snorted and then chuckled. "Smartass."

Sam smiled drowsily, knowing what Dean wanted to hear, what his big brother needed to hear in order to breathe easier himself. "M'okay, Dean."

"You sure?"

"Mm-hmm," Sam sighed, rubbing his cheek against the fabric of Dean's shirt as he nestled impossibly closer into his brother's side before his breaths evened out in sleep.

Dean glanced down – wondering how it was possible to love one scrawny, floppy-haired kid so much – and brushed Sam's bangs away from his eyes; feeling drier, cooler skin; seeing a more peaceful expression; and knowing Sam would sleep through breakfast, would be lucky to be awake by lunch.

Dean sighed, his arms loosely wrapped around his brother as he shifted under Sam's weight and stared at the muted infomercial about some kind of electric trolling motor for boats, the Jarvis Marine Watersnake.

Marine.

Ah, yes.

John.

Dean sighed again.

He would have to call John later that morning. Their dad would not be happy about the delay in them joining him in the next state over for a hunt, but that was tough shit. The day after a severe asthma attack was usually a rough one, and Sam needed to rest. And while John would be pissed – would make his displeasure known – he wouldn't push the issue, having learned several years ago not to fuck with Dean about Sam.

But this latest confrontation with his father was still hours away and not even worth a second thought.

The only thing that mattered – that ever mattered – was that Sam was with him, safe and healthy and breathing.

As long as Dean had that, he could handle anything else.

FIN