Author's Note: Written for the 2011 Summer_Sam_Love Exchange. Recipient: Verucasalt123. Huge thanks to Sendintheklowns for the title, the speedy beta and for all the support you've given me.
"You mind your brother, Sam."
"Yes sir." Like Sam needed reminding, his dad only told him every time he left on a job.
"Dean, I should only be gone about a week. I'll call if it looks like it'll be longer."
Again, the same speech John Winchester always delivered, and Sam knew their dad wouldn't be back in a week, and he wouldn't call. He'd just show up again whenever he damn-well pleased.
His brother practically snapped to attention when he acknowledged their father. Father. More like a freakin' drill sergeant, Sam thought.
At 16 years old, Sam Winchester no longer felt like blindly following orders like his older brother Dean did. He wanted to know what was going on and why, and his constant questioning led to many an argument with his father. He watched, almost glad Dad was leaving again, as John climbed into his truck and drove off. At least with only him and Dean, life was a lot more peaceful.
Sam had Dean to thank that they were left behind this time. Ever since Sam had turned sixteen, John had wanted to take them both on hunts more often, even if that meant pulling Sam out of school. But it was Finals week, and Sam had pleaded with Dean to get him to convince their father that Finals were just as important as hunting. Dean had negotiated a deal with their dad, let Sam finish out the school year hunting only on weekends, and Sam would pull his weight over the summer. It wasn't a deal Sam was terribly happy about, but it solved his immediate problem.
"Come on, Sam. If you're ready in five minutes I'll drop you off at school." Dean called, breaking Sam from his musings.
Sam hurried inside the run-down house that was their current home and grabbed his backpack before heading back outside to the waiting Impala.
As Sam climbed out of the black classic when it pulled up outside the school his brother yanked him back.
"I need you to start dinner tonight. I gotta work late."
Dean had a job at the local hardware store, and tonight was their late closing night.
"Can't. I got study group after school. I won't be home until seven or eight."
"Okay," Dean smiled, wondering if there was a hot girl in Sam's study group that had his brother's attention or whether his geek-brained bro really was that much into studying. "Pizza it is. I'll pick it up after work. Just make sure you're home by eight."
Sam rolled his eyes and with one last heave pulled himself loose from his brother's grasp and out the door. He didn't even look back as he slammed the door and took off towards the main school building.
"Hey! Watch out for my Baby!" Dean yelled, but Sam was already out of earshot.
Sam wasn't the most popular kid in school. They'd been in this town for a month and Sam had wasted no time in being noticed by the bullies who resented that Sam was smart and consistently got better grades than they did, that he was also good at sports and that, since his last growth spurt, he now stood at almost six feet tall. He was as tall as his brother, which irked Dean no end because Sam clearly still had a lot of growing to do. Being tall and skinny, and smart, made Sam stand out like a sore thumb. Which was something he hated above all else.
Study Halls and lunch periods were often spent alone, reading a book or doing some extra study in the library. Even the study group Sam was assigned to didn't pay him any attention outside of their allotted study times. At most of the schools he'd been to Sam had usually managed to find at least one kindred spirit, but not at this school.
Every day he felt nauseous and had no appetite. His brother and father had noticed how thin he'd become but largely wrote it off to his sudden growth spurt – nearly six inches in the last six months. And hadn't that been fun with leg cramps, stomach cramps, and the embarrassment of not having a single pair of jeans that fit anymore. Dean had shared his jeans with Sam until John had decided it was finally safe enough to buy Sam some "new" ones of his own. New being relative, new to him but from the goodwill store. As a consequence, they fit him in length but were way too big in the waist. The material bunched up under the tightly drawn belt that he was forced to wear.
On this particular day Sam sat in the library after school waiting for the rest of the study group to arrive. He'd just about completed all the work when the first of them arrived.
"Winchester!" Tom Layton called out to him as he rounded the shelves and found Sam in his usual hiding spot. "Hey, you find all the references we need for tonight?"
Sam sighed. "Yeah." He indicated the pile of books on the table beside him. "They're all marked."
"Great, should mean we can get out of here pretty early."
'We' was another relative term that Sam had gotten used to. It meant the other three members of the group. Sam's willingness at the beginning of the project to help the others out had quickly morphed into Sam doing the lion's share of the work and the others expecting him to do it for them. And since the grading of the whole group was going to be averaged, Sam couldn't afford to just let the others coast along. They may not care about getting anything more than a passing grade, but Sam did. Education was his ticket out the hunting life, and he intended to keep his grades high enough that he could go to any college of his choosing, and hopefully qualify for a scholarship since he knew his father would never agree to pay for it.
The remaining two group members arrived nearly a half hour after the group start time was scheduled. Rosemary and Tina were both on the cheerleading squad and had obviously been to practice since they were still in uniform.
"What you got for us, Sam?" Tina asked, wiggling her pink lacquered fingernails at him.
Sam passed out the notes he'd made, and the books he'd marked. The only thing he couldn't do for the rest of the group was actually write their papers. Their English teacher would see through that in a second. But his notes were comprehensive enough that the others could spend little time expanding on the notes, and since it was necessary that they knew the actual location and passages in the books that were referenced, they would have to do a little reading. It all worked out to be minimum effort for each of them, and with Sam carefully checking their work before it was handed in each week it meant they were currently looking at least an A minus for their overall grade. Sam wasn't particularly happy about that but there wasn't much more he could do about it.
Long after the rest of the group had left, Sam continued to work. Assignment and homework finished he used the rest of the time to read through some of the Latin books the library had. For a small town school library they had quite a good collection and Sam made good use of it. Not that Latin was something he loved, but if he could show his father that he was making good use of his education to learn more dead languages it might get him off his back a little.
His aching stomach finally made Sam decide it was time to quit. The burning pain that had become a constant companion for the last month or so was flaring up again, and with it the nausea that often followed. Today had been a particularly bad day. Sam hadn't been able to face eating anything at lunch time drinking only a carton of milk. That had eased it for a while, but now the pain was back with a vengeance. He hadn't said anything to Dean about it, it wasn't really that bad most of the time and Sam had put it down to more growing pains and maybe a little stress.
Checking his watch Sam saw that it was nearly 7:30. He had enough time to get home and make it look like he'd already eaten dinner. He couldn't face the thought of pizza and he didn't want Dean to give him the third degree again about not eating.
Nearly a week went by and John was due home. Dean got a call from Uncle Bobby saying that he was with their dad and another job had come up that shouldn't take too long so maybe they'd be there in another four or five days, a week tops. But likely to be out of phone range until then.
Dean relayed the news to Sam.
"Big deal," he muttered as he poked the spoon around in his cereal listlessly. Sam's stomach was really bothering him this morning.
"Aw come on, Sammy. It's not like we aren't used to this." Dean reasoned.
Sam dropped his spoon and stood. "You're right, Dean. This is just like usual. Typical Dad. I'm going to school."
Dean sighed. Even when their dad wasn't there he and Sam were butting heads. "Hey, you want me to drop you?"
"No, Dean!" Sam yelled. "I'm not five, I can get myself to school."
Sam literally threw his still-full breakfast bowl into the kitchen sink and stormed off to the bedroom the brothers shared, emerging a moment later with his backpack. Before he made it out the door, Dean rounded on him.
"What the hell crawled up your butt?"
"Nothing! I'm just sick of being treated like a baby. I don't need you taking me to school."
Dean threw his hands up in a conciliatory gesture. "No sweat, man. I was going that way anyway, just thought you might like a ride. But hey, don't let me hold you back. You wanna walk, then walk." Dean grabbed his keys and walked out the door.
Sam stared after him. "Shit!" he exclaimed.
He was about to run after his brother and apologize when pain ripped through his abdomen.
"Guh!" Sam doubled up, hanging on to the back of the kitchen chair for support.
Oh, this was not good. Taking deep breaths just like his dad had taught him Sam rode out the pain. Slowly it eased, and after about five minutes it was bearable enough that he could stand up straight again. When he felt like he could move without falling over Sam picked up his bag and slowly made his way to school.
That night, when he refused dinner, Dean blew his top.
"What is with you, Sam? I've about had it with this not eating crap. You've hardly touched your food for the last week."
Sam almost giggled with relief. Dean had only noticed the last week?
"Is this to do with Dad being gone again?"
"No," Sam replied. When had it ever been about Dad being gone? "No. I'm just not hungry."
"Somethin' bothering you at school?"
"No. Not more than usual."
"Well, what? Is it somethin' I've done to upset you?" Dean demanded.
"No, Dean, it's not you. You're the best. It's… it's nothing."
"Not eating isn't nothing, Sam." Dean ran his hand over his mouth, thinking desperately. A horrible thought came to him. "You're not, like, anorexic or nothin', are ya?"
"What! No!" Sam exclaimed. At least he didn't think he was. Although strictly speaking he might have been. Except that his not eating had a very definite physical reason. And maybe he should come clean about that. He was about to answer when the phone rang.
"Hold that thought," Dean held up a finger then crossed the kitchen to pick up the phone. "Oh hey, Janet." "No, I was gonna call you, honest. I just got some stuff goin' on with my little brother, ya know."
Sam rolled his eyes at Dean, got up and went into the living room. Dean watched him as he flopped on the sofa and turned on the TV, turning it up loud enough to drown out Dean's conversation with his girl of the week.
By the time Dean had been able to finish the conversation with Janet Sam had fallen asleep on the sofa. The kid looked so worn out that Dean didn't have the heart to wake him and continue their discussion. Instead he shook Sam awake enough to walk him to bed. But he was by no means going to let the matter rest. There was something going on with Sam, his 'Sammy-radar' was pinging like crazy and Dean was determined to find out what.
The next morning was chaotic. Dean got a call from work to come in earlier than usual so they could get a big rush order out by nine. He shook Sam awake, telling him he was leaving and Sam would have to get himself to school.
His younger brother waved him off, sleepily hauling himself up in the bed with a mumbled " 'm up."
Sam had never felt so tired in all his life. He hadn't slept well, the pain in his stomach keeping him awake half the night. Now he felt so nauseous that he just knew it was only a matter of time before…
Sam ran to the bathroom, falling before the old stained toilet just in time to puke. His eyes were screwed shut with the force of it and for a moment he didn't think he was going to stop until he'd thrown up his toenails. Finally it stopped and Sam blindly reached for a washcloth on the sink beside him. He opened his eyes and what he saw almost made him faint. The water in the toilet bowl was bright red and when Sam wiped his mouth there was more blood on his lips.
This definitely was not good.
As he stood up a wave of dizziness assaulted him. Sam only made it half way to the phone before he passed out, sprawling untidily onto the living room floor.
"Winchester!" Dean's boss called across the store to where he was stacking paint cans. "Telephone!"
Dean wondered who could possibly be calling him at work at 9:45am. His first thought was that it was his dad or Bobby and something was wrong. He took a deep breath before picking up the phone handset from the counter where it had been left.
"Good morning, am I speaking to Dean Winchester?"
"Uh, yeah, this is Dean." Not his dad, then. But someone official sounding. Dean's blood ran cold.
"This is Mrs. Stryker from the Center Valley High School office. I'm calling because we have this number on file and can't reach anyone on the primary number. You are Sam Winchester's brother?"
"Yeah, that's right." Sammy? What was wrong with Sam? He was really worried now.
"Sam hasn't come to school today. Our policy is to call if we haven't been notified of absence by 9:30. Is he unwell?"
Sam wasn't at school? What the hell? Sam never ditched school unless he was made to.
"Uh, he was fine this morning. Lemme find out what's going on."
Dean hurriedly hung up and called the house. There was no answer. Dean swore. If this was Sam goofing off he was going to kick his ass.
"Hey, Joe? I need an hour, okay?"
"What for?" his boss demanded.
"I gotta go check on my kid brother. Something's wrong."
"Yeah, whatever," Joe answered. Dean was a hard worker, so he was prepared to be lenient this one time.
Dean gunned the Impala, tearing through the streets as fast as he dared without getting pulled over. Something in his gut told him to hurry. He was out of the car and at the front door to the house almost before the Impala had come to a full stop. The door was unlocked, just as he'd left it this morning.
"Sammy!" he yelled as he burst into the living room. He almost tripped over his brother's prone form. "Oh God, Sam!"
Dean dropped down beside the still figure. He checked for a pulse in Sam's neck. It was there, but weak and thready. His younger brother's breathing was shallow and his skin cold and clammy. Shock, Dean's brain supplied. What the hell had happened?
"Sam? Sammy!" Dean tried to rouse his brother but he got no response.
He ran to the bedroom to grab a blanket to cover his brother. On the way back he noticed the bloody washcloth lying on the bathroom floor. He stopped to pick it up and noticed more blood in the toilet. He ran back to Sam and quickly checked him over for wounds. He found none and frowned. He turned Sam over so he was lying on his side in the recovery position and covered him with the blanket. He checked Sam's eyes. They were dull and showed no sign of consciousness. Then he noticed the small amount of dried blood on the corner of Sam's mouth.
Dean bolted into the kitchen, snatched up the phone and dialed 911 with shaking fingers.
"911, what is the nature of your emergency?"
"Yeah, my brother. He, uh, he's passed out on the floor. I need an ambulance."
"Yes sir. Can you give me your address?"
"Uh, um, yeah. It's 11247 Oak, near Banks. Please, tell them to hurry."
"Thank you sir," The calm voice on the other end of the phone seemed in no hurry at all. "I'll need some more information to relay to the paramedics. How old is your brother?"
"Sixteen. Sam's sixteen." Dean had the phone cord stretch all the way out as he once again knelt beside his brother, needing to be in contact with him.
"Okay. Is he conscious?"
"No. I don't know how long he's been layin' here. He was fine when I left for work." Dean was close to panic.
The calm voice hastened to reassure him, "You're doing fine, sir…"
"Dean, my name is Dean."
"You're doing fine, Dean. EMT's should be with you in about four minutes. So, no sign of a fall? Could he have taken something?"
"No, at least, I don't think so. It looks like he's puked up some blood."
Oh God, could Sam have taken something? No. No, Sam wasn't the type. But something had been going on lately. Dammit, he just didn't know.
Dean could hear the siren approaching now.
"I can hear them, they're nearly here."
"I'll stay on the line with you until they get there, Dean. Just hang in there. When they arrive, they're going to want you to go check to see if there's anything that Sam could have taken. Check the bathroom, his bedroom. Anywhere you can think to look. It's important, Dean."
"Yeah, yeah, okay."
"Okay, they've just relayed that they are about to pull up outside. Can you see them?"
"Good. I'm going to go now, Dean. All the best."
"Thanks, uh, thank you."
There was a knock on the door. Dean rushed to let the paramedics in, standing aside to make room for the gurney and equipment they carried. He stood there, feeling helpless, watching as they two EMT's got to work assessing his brother, putting an oxygen mask on Sam's pale face. One of them looked up at him.
"Okay, Dean. I'm Vince, this is Chad. We're gonna try and figure out what's going on here. Did Marcy mention we need you to look for anything Sam might have taken?"
Again Dean nodded. "Is he gonna be okay?" he asked.
"We don't know yet. We need to figure out what's wrong with him. You said he'd vomited?" At Dean's nod Vince continued. "I need you to show me."
Vince got up and followed Dean into the bathroom while Chad continued to work on Sam, taking vitals, relaying information to the hospital. After a quick look at the emesis in the toilet, Vince glanced briefly around the bathroom.
"Alright. I need you to check everywhere you can think of to look, okay?"
Another dumb nod from Dean, whose voice seemed to have fled. He was seriously freaked. He glanced back at the living room where Sam was still unresponsive.
"Dean, you said he was fine when you left. What time was that?"
"Uh, a little after seven. I had to go to work early."
"Okay, how did he seem then?"
"I'm not sure. He wasn't really awake, ya know? I shoulda stayed until he was up. Maybe I'd 'a noticed something."
Sam was still in his night clothes, he must've passed out not long after Dean had left. Now he felt guilty.
"Don't beat yourself up, Dean. Might not have been anything you could do."
"I coulda been here."
Vince gripped him on the shoulder. "Don't think about that now. I need you to look."
"Okay. What am I looking for?"
"Anything – pills, containers that might have held pills, anything that looks like it doesn't normally belong."
"You think Sam overdosed?" Dean was horrified. If that was what had happened and he'd missed it…
"No, Dean. I don't think anything. We just need to be thorough so we can give the Docs all the information. If he has taken something it's helpful to know what. It'll save time ruling stuff out and get him treatment more quickly. I gotta go back and help Chad. You gonna be okay?"
"Yeah," Dean replied. Now he had a job to do.
Dean searched the bathroom thoroughly, although there wasn't much to go through. Next he virtually trashed Sam's OCD-neat side of the bedroom, pulling stuff out of drawers, turning the mattress over. He found nothing. He checked Sam's backpack, the duffle in the wardrobe, every inch of the room – just like his dad had shown him one time they were looking for hex bags. Dean was including them in his list of things to look for, too, although he didn't tell Vince that. He wasn't ruling out that this could've been caused by something supernatural, even if he couldn't think of a reason why it could be.
He found nothing, and as he ran back into the living room Vince and Chad were loading Sam onto the gurney and strapping him down for transport.
"Okay," Chad said, "We're ready to roll. Are you able to follow?"
Dean had hoped to ride along and it must have shown in his face.
"If ya want, you can ride up front with me," Vince offered.
"Thanks." Dean wasn't sure he was capable of driving right then.
The ride to the hospital was a blur to Dean. Arriving in the ER was an even bigger blur. Information was rattled off by Chad to the doctor waiting for them; numbers, stats, terms Dean couldn't begin to understand.
Dean stood to the side of the trauma room feeling lost and out of place. Vince gave him an encouraging smile and a pat on the arm as he and Chad left. Next thing Dean knew a nurse was trying to hustle him out of the room to fill in paperwork.
"No, no. I need to stay with my brother," he argued.
"He's in good hands, honey. We just need a few details filled out. By the time you're done the doctor might be able to tell you something but we need to give them room to work."
She was gentle yet firm and Dean found himself having no choice but to follow her out of the room.
Once he'd filled in the forms, using the information his dad had said was safe to use in his usual 'before I hit the road' lecture, Dean had nothing to do but sit and wait for news. It was almost an hour later that the doctor came out to see him. Dean was on his feet the instant he saw the scrub-clad man come through the door. The doctor spotted him and waited for Dean to make his way over to him.
"Dean. Mr. Winchester's my dad."
The doctor smiled. "Dean. Is your father here by any chance?"
"No. He's outta town on business. Anything you gotta say about Sam you can tell me. How is he?"
The doctor frowned, but covered it quickly. Not quickly enough that Dean didn't catch it.
"What?" Dean demanded. "Is Sam alright?"
"Sam is very sick." He led Dean back through the doors into the treatment area, heading back towards the trauma room and Sam. "We've run some preliminary tests and blood work. You'll be relieved to know this isn't drug related. We're pretty sure Sam is bleeding into his stomach, most likely from a perforated duodenal ulcer."
They were inside the room where Sam was laying now, hooked up to all kinds of monitors and tubes, clear fluids running into one IV and blood running into another, with an oxygen mask on his face. He was so pale and looked so sick. A nurse was hovering over him, monitoring everything carefully.
"An… But Sam's only sixteen! How could he have an ulcer?"
"It's rare in teenagers but it can happen," the doctor answered. Dr. Collins, his name tag read. "Has Sam been taking a lot of aspirin or anti-inflammatory medication lately?"
"No." Dean thought hard. Sure they trained a lot and that combined with hunting led to injuries, muscle strains and what not, but he was pretty sure Sam hadn't… wait.
"He did take something to ease the muscle spasms he was getting when he hit his growth spurt."
"Do you remember what it was?"
"Uh, yeah. Napro-something. The doc didn't say anything about it causing an ulcer, though."
"Naproxen Sodium? Did he take it for long?"
Dean shrugged. Sounded right. "Nah. Sammy hates taking anything. Said it didn't really help so he only took it a coupla weeks."
"That probably wouldn't cause an ulcer then. No heavy aspirin use?"
Dean shook his head.
"Has Sam had any other gastric episodes in the last few months or so? Like food poisoning?"
Dean snorted. With the dives they ate in? When didn't they get the odd dose of food poisoning? And Sam always was a picky eater so when there was no other choice than a greasy spoon joint, it often wound up with Sam feeling sick afterwards.
"Maybe. Coupla times. Why? You think that mighta caused it?"
"It's the most likely cause. Bacteria can stay in the stomach and weaken the lining which eventually causes an ulcer. If Sam has had more than one bout of food poisoning in the last six months that could have caused some damage."
Okay, that was it. Only the best, healthiest food for Sam from now on. Dean was going to see to that.
"Right now, we need to get Sam up to surgery."
"What?" Dean felt dizzy for a second. Surgery?
"Yes. We need to do an endoscopic examination – put a camera down into his stomach to confirm the diagnosis and see how bad the ulcer is. If it's bleeding still, we'll need to go in and repair it."
"Go in? How?"
The doctor was hesitant to give Dean the full details because he was so young himself, but without a parent around Dean was responsible for any decision making and Dr. Collins needed his consent.
"We'll try laparoscopic first – insertion of a tube into the abdomen. We may need to remove the part of the duodenum that's damaged, but hopefully we will just be able to enlarge the opening into the duodenum and small intestine, enabling contents to pass more freely from the stomach. A strong course of antibiotics will help to kill the bacteria in his system and he should be fine."
"But you don't know that?"
"Any surgery is risky. Sam has already lost a lot of blood. He may not have really noticed much, but this thing has probably been bleeding for maybe weeks. Had you noticed whether he'd been listless, tired, maybe cranky lately? Not eating? Losing weight?"
Dean chuffed a laugh. "Doc, he's sixteen! Isn't all that normal for a sixteen year old? Sam's been doing a lot of growing the last six months. Shot up at least six inches. It's kinda hard to tell if he's been losing weight when it's all gone into growing, ya know?"
Dean knew that didn't excuse him not realizing that his brother was sick. But Sam… he must have known something was wrong. Why hadn't he said anything? Dean was standing by the exam table now, holding Sam's hand, rubbing some warmth back into the cold fingers.
"Has he woken up yet?"
"No," the doctor answered, "and that has me a little worried. We're transfusing him now, trying to get him a little more stable before taking upstairs to the OR. If you'll excuse me, I have another patient to see. Jackie over there will be taking good care of your brother. She'll let me know the minute he's ready to go into surgery. If you have any questions ask her, she probably knows more than the doctors anyway." Dr Collins gave the nurse a wink as he left.
"Why don't you take a seat, honey," Jackie offered, pushing a stool in Dean's direction. "Talk to him, see if you can get him to wake up."
"Thanks." Dean sat. He kept massaging Sam's hand. "Hey, Sammy, come on dude it's time you woke up and told me what's going on with you, man."
Dean talked softly to his brother, cajoling, teasing, even insulting him in the hope he'd wake up and bitch back, while Jackie continued to watch all the monitors with an eagle eye.
One of the monitors started beeping, an urgent sound that had Jackie hastening to silence it. She checked and adjusted the IV, then checked the monitor again. Dean didn't like the look on her face. Something wasn't right. Jackie pushed past him to the phone on the wall. She paged Doctor Collins to come to the trauma room, stat.
Less than a minute later the doctor arrived and Dean looked on fearfully.
"What you got, Jackie?"
"BP's dropping rapidly. Eighty over sixty."
The alarm started up again.
"Dammit." Collins exclaimed, rushing over and putting his stethoscope in his ears with one swift motion. He listened to Sam's heart, checked the readings for himself and then started issuing orders. "Open that IV up wide, then give me 2 milligrams Epinephrine."
Jackie busied herself following orders. Another doctor and two nurses ran into the room. One nurse silenced the alarm again, the other helping Jackie and following the order being barked out. It was all too much and too fast for Dean to follow, and he found himself being pushed into the background.
"Marc, get on the horn and let the OR know we're coming up now, ready or not. We just have to hope he'll hang on until we get that bleed under control."
Within seconds Dean found himself alone in the room bewildered and scared. Sam had been whisked away, and he hadn't even had a chance to say… No, Dean didn't need to say goodbye. Sam was going to be fine. He was!
Jackie came back a few minutes later to find him still standing there. She put a sympathetic arm around Dean.
"He's in the best hands, sweetie. Doctor Collins is one of the best internists in the state. Is there someone I can call for you? To come and sit with you while you wait?"
"No, uh, thanks. I'll do it. " Dean cleared his throat, "Can I use your phone? I think I should call our dad."
Dean had drunk three cups of coffee and had run out of paper cups to shred. Sam had been in surgery for nearly two hours. He wondered how much longer it would take, and whether the length of time it was taking was a good or a bad sign.
He'd tried calling their dad, but not unexpectedly he only got voicemail. He left a message, just saying that Sam was sick and they'd had to go to the hospital but not too many details, because he honestly didn't know what to say. He'd just said that they should get back here as soon as they could, but that he had everything under control. He wondered if his dad would be able to hear the lie in his voice. Dean didn't think that things could get any more out of control. But then he swept that thought aside. No use tempting fate.
He'd also called Pastor Jim, their emergency contact when Dad was out of reach. Their hunting friend had offered to come and be with Dean but Dean had declined, said that he was okay and that he'd call if he changed his mind or things got worse. He'd also called the store and told them he wouldn't be in the rest of the day, although he figured Joe had probably worked that out by now. His boss had been kind and told him to take as much time as he needed.
The doors to the surgical suite whooshed open and Dean looked up out of habit. There were still two other groups of people sitting in the waiting room with him so odds were this wasn't Sam's doctor, just like the last three times the doors had opened, except this time it was Dr. Collins.
Dean was on his feet instantly. He held his breath as the doctor approached, searching for any clues in the other man's expression. Dean crazily thought that he'd hate to play poker against this man.
Dean's heart skipped several beats.
"He's going to be okay."
Dean's heart thudded back into action loud enough to be heard down the block, he was sure. He let out the breath he'd been holding and gasped in another, his knees suddenly going weak. He sat, almost falling, back down into the chair he'd been camping in.
"Thank God!" he exclaimed. "W-what… how… I mean…"
Dr. Collins smiled warmly and sat, pulling Dean back into the chair beside him. "It's okay. I know you're a little overwhelmed. Sam's not completely out of the woods yet, he's very weak. We had to give him three more units of blood during surgery. The bleeding was pretty extensive, but we've managed to cauterize the ulcer and open up the passageway from the stomach and duodenum into the intestine. It should prevent this from occurring again. We've also started him on a course of strong antibiotics to combat the bacteria. It's up to him now, but I think he should make a full recovery."
Dean scrubbed a hand down his face, the utter relief shining in his expressive eyes.
"Thank you. Thank you, so much. God, if anything had happened to Sam… I don't know what I'd do."
"I can see you two are close." The doctor stood. "He's in recovery. He woke up briefly, coming out of the anesthetic, so it looks like the lack of consciousness earlier was attributable to the blood loss. He's nicely topped up now, but we'll monitor him for a day or two to see if he needs another transfusion.
"All going well he should be taken to a room in about a half hour." He eyed the used coffee cups and shredded remains on the end table. "If you want my advice, and so I don't end up with another patient from your family, I'd recommend you head down to the cafeteria. It's mystery meat day so avoid that but they make a mean turkey and Swiss on rye."
"Thanks, but I'm not…." The rumble Dean's stomach suddenly made put the lie to what he was about to say. "Okay, maybe now I know Sammy will be okay I guess I am a little hungry."
Dr. Collins clapped Dean on the shoulder. "That's the spirit. Half an hour, then you can walk up with them when they take him to his room."
Dean checked his watch for maybe the hundredth time. It was a little past four in the afternoon and apart from several sleepy blinks about a half hour ago, Sam hadn't yet woken up. The cute nurse who was looking after Sam had told Dean not to be concerned, that Sam was doing well, and that it was perfectly normal for him to be sleeping it off.
Sam still looked terribly pale to Dean's trained eye, but Dean guessed that it would take a few days to get Sam back on his feet. He took in the monitors that Sam was still hooked up to that constantly recorded his heart rate, blood pressure and God only knew what else. Then there was the IV feeding into the vein in Sam's left arm. It was piggy-backed with the antibiotics that the doctor had told Dean about earlier. But it was the other two tubes that Dean knew Sam would bitch about – the feeding tube up his nose and the catheter that was... He smiled to himself. Garbage in, garbage out. Too bad, Sammy, you let yourself get this way so you're gonna have to put up with a little discomfort.
Movement under the sheets drew Dean's attention back to the here and now. Sam was starting to make his waking up noises, little snuffles and grunts that preceded the opening of those big puppy eyes. Right now his brother looked six, not sixteen. He grabbed Sam's hand and rubbed soothing circles on it.
"Hey. You awake?"
Dean watched long lashes flutter as Sam blinked awake slowly.
"You with me here, Sammy?" Dean chuckled.
Sam blinked, eyes unfocussed. "D'n?"
"Yeah, Sam. How you feelin'?"
Sam fumbled the hand Dean wasn't holding towards his stomach.
"Lemme fix that for ya."
Dean pressed the button on the pump that sent a small dose of morphine into Sam's system. The frown lines on his brother's forehead smoothed out as Sam made a sound that sounded suspiciously like a purr.
"Good stuff, huh Sam? That'll get ya flyin' nice and high. You just enjoy it while it lasts. We got some talkin' to do as soon as you're sober."
It felt like something had died in his mouth and its dry remains had sucked all the moisture from his tongue. His throat was irritated and there was a muted promise of pain in his belly. Far off sounds became clearer as he rose towards consciousness, closer were the soft whirr-click sounds of a machine functioning and the most comforting sound of all, the familiar breathing pattern of his big brother in sleep mode.
A slight groan escaped before his brain could head it off. Sticky, sleep encrusted eyes struggled open and his brain started to play catch-up.
The room was dimly lit but as he looked around he could make out the form of his brother slumped uncomfortably in a chair, head dropped back and slight snores issuing from his half-open mouth. Pre-dawn light filtered around the edges of the drawn blind. Through the small glass pane in the door he could see the lights on out in the corridor were on, the daily hustle of hospital life awakening going on.
Sam looked for but couldn't see anything to drink. He was so thirsty but he didn't want to disturb Dean. He should have known better, should have known his protector's Sammy-sense would kick in as it always did. Dean was awake and hovering over him in the time it took to blink.
"Hey little brother, welcome back to the land of the living. How you feelin'?"
Sam's mouth worked for a second before he could whisper out one word, his tongue sticking to the roof of his mouth. "Thirsty."
"I'll bet. Hang on, okay? I'll go get you some ice chips."
Dean had been shown where the small ice machine was located in the kitchenette near the nurses' station so that he could get some as soon as Sam was awake. He was back in record time and raised the bed up a little.
Sam opened his mouth to accept the offered spoon. The small amount of heavenly ice quickly melted in Sam's mouth. Birdlike he opened his mouth for more.
"Slow down there, slugger," Dean quietly admonished, "You're only allowed a coupla mouthfuls."
The glorious frozen chips provided some small relief but Sam still had a raging thirst. "C'mon Dean, I'm dying of thirst here. Get me some water. Please."
"Quit that," Dean scolded, steeling himself against the patented Sam puppy-eyes. "That's all I'm allowed to give you until they come check you out this morning. You won't die of thirst, you've got that -" Dean indicated the IV "- and that." He pointed out the bag of what looked like baby formula running through a pump, the tube snaking down and across the pillow.
Sam raised a shaking hand to his face, fingers encountering both the nasal oxygen canula and the tube that was taped to his cheek and disappeared up one nostril.
"Ewww, gross," he huffed dropping his hand back down.
He was feeling tired again already but he needed to do something before he went back to sleep. Sam grabbed the bars of the bedrails and tried to pull himself up, only to drop back immediately as the action pulled on tender abdominal muscles.
"What the frak do you think you're trying to do?" Dean asked incredulously.
"Help me up, man. I need to go to the bathroom."
Dean chuckled softly. "No."
"What? Dean, come on, man. Help me!"
"Nope," Dean replied, a little smugness accompanying his sly grin as he sat back and folded his arms.
A look akin to panic was forming on Sam's face.
"I am not using one of those bottle things."
"That's okay, you don't need to." Dean saw no reason not to have a little fun at his brother's expense.
"Oh, you're just being cruel, dude. You want me to wet the bed? God, Dean!"
"That's not gonna happen either, kiddo."
Sam frowned then a look of pure horror formed as realization dawned. He lifted the covers and peered down the bed.
"My humiliation is complete," he moaned.
"Yeah well I consider it just punishment." Dean's voice hardened.
"What do you mean?" Sam asked hesitantly.
"Sam…" Dean stood, scrubbed his hand over his mouth and paced up and down a few steps, his mood suddenly darkening. "Do you have any idea what you've just been through? What I've been through the last 24 hours?"
Sam could see Dean was angry now, and he felt tears start to well in his eyes. He hated it when Dean was angry at him. No scratch that - this wasn't anger, it was disappointment. And that was so much worse.
Truthfully, Sam hadn't really given much thought as to why he was in the hospital, hooked up to more hardware than a space shuttle. Sure he remembered the pain and throwing up blood, but the rest was a blank. He'd figured something had happened, maybe a bad dose of gastric flu?
"I…", he started.
But there was no stopping Dean when he was on a tear. "No? Well let me tell you, Sam. You almost freakin' died, man."
Sam stared, shocked into silence.
"Yeah," his brother continued. "You had a bleeding ulcer in your friggin' stomach, Sam! You nearly bled out. They had to give you four transfusions. They had to freakin' operate on you, Sam!"
Dean was almost shouting now and Sam shrank down in the bed.
"I… I didn't know," Sam answered softly.
Dean exploded. "How could you not know, Sam? Huh? Jeez, the doc said you had to have been experiencing symptoms for friggin' months for it to be that bad."
Dean's own feelings of culpability would be only fueled his anger. Sam knew Dean would be as angry at himself as he was at Sam. More so, probably.
Sam's mind worked overtime to analyze what Dean had just said. Symptoms? Yeah he'd had an upset stomach but that was the crappy food they ate and stress, right?
"I hadn't really noticed?" It wasn't really a question, and it seemed like a pathetic excuse. "I just thought it was, you know, stress or somethin'. Or more growing pains, I dunno."
Of course Dean would pick up on only one word. Dean sighed, concern creasing his brow.
"Stress? What kind of stress, Sam? Why didn't you tell me you weren't feelin' good?"
Sam shrugged. "Didn't want to worry you. I could handle it."
A mirthless laugh chuffed out of his older brother. "Bang up job you wound up doin' 'handling it'." He turned to stare at the closed window blinds. Getting himself back under control, Sam knew.
"I'm sorry, Dean. I didn't realize things had gotten so bad. Honest." Sam dropped his gaze to where his fingers were nervously twining the sheet into knots.
Dean turned back around and Sam hazarded a glance at him from under his too-long messy bangs. He saw Dean physically deflate as he sat back down again and leaned forward onto the bed and gently pulled the sheet from where it was strangling Sam's fingers.
"It's okay, kiddo." Dean said softly, reaching up and cupping the back of Sam's neck in his hand. A gesture that was all comfort and understanding and forgiveness in one touch. "How 'bout you tell me what's goin' on? Let big brother help you out a little, huh?"
Sam's eyes stung and he fought back the tears that filled his eyes to overflowing. Two fat drops trickled down his cheeks when he blinked. He didn't know where to begin. Each little issue on its own seemed frivolous, petty.
"I dunno, it's just…" Sam sighed, hiccupped a breath in, "lotsa little things, really."
"Dad?" Dean asked gently.
Sam shrugged. "Sometimes. I just wanna go to school. I don't want to hunt all the time."
"Yeah, but it's what we do, Sam. You know that."
"I just wish we didn't, then we wouldn't move around so much. It's hard fitting in at new schools all the time, you know that."
Sam saw Dean nod in agreement. But Sam had always found it harder than his big brother to fit in.
"This one harder than most?" Dean asked.
"It's almost the end of the school year, and everyone already has their friends. No one wants a Goodwill loser hanging around. Not unless he's useful for something."
"Sam, you are not a…" Dean couldn't even say it. "Don't even think like that. You are better than all of them put together. Smarter too."
Sam smiled as another tear escaped. He hurried to brush it away. He knew his brother was trying to help in his own way, but he just never seemed to understand why Sam couldn't fit in like he always had.
"So, anyone find you 'useful'?" Dean asked, a sly glimmer in his eye, teasing Sam slightly.
Sam snorted. "Oh yeah." And he went on to confess to Dean how he'd been doing nearly all the work for the study group for the last few weeks.
"Well that stops now," Dean growled.
"No, Dean, please!" Sam begged. "You don't understand. I need that grade. If the teacher finds out and the others have to do over we'll all get marked as a fail. Trust me. Please!"
Thankfully his big brother seemed to give in and agreed not to make any waves, but Sam knew his brother wouldn't let it rest at that and he was fearful of the consequences.
"Hey, don't worry about it," Dean ruffled Sam's hair affectionately. "You just get some rest, huh? So you can get better and we can blow this popsicle stand."
"I'm good, Dean." But Sam's huge yawn betrayed the lie, "we can go whenever you're ready."
Sam blinked sleepily, expecting Dean to tell him to haul ass and get ready to go. He drifted off to sleep mumbling that he'd be good to go in a minute.
Dean watched his baby brother fall asleep in between one sentence and the next. It was so typically a Sammy thing to do; he'd be full of energy and talking nonstop one minute and out like a light the next. He felt like a bit of a heel letting Sam believe that stress had contributed to his ulcer but it had been worth it to get his little bro to open up like he had. Sam used to tell him everything, but lately things had been a bit strained all around as Sam had grown into a fully fledged teenager and the 'rock, hard place' relationship between Sam and their father had festered to the point where they seemed to argue every time they spoke to each other. That had flowed over somewhat into Sam and Dean's relationship as Sam had tried shutting himself off from all things hunting related even as their father tried to get him more involved.
Dean knew he couldn't fix things between Dad and Sam, but he could do something about those dirt bags that were using Sam at school.
As Sam slept Dean headed out of the hospital and to the school. He left a note for Sam saying he'd be back soon.
He left the impromptu meeting with Sam's year advisor with a grin on his face. He was still an awesome big brother.
The teacher had been horrified to hear what Dean told her Sam had said, but had also confessed she'd had a sneaking suspicion that something was going on. It was completely out of character for those particular students, Sam excluded, to turn in the standard of work they'd been submitting on this assignment. She said she'd hoped it was just Sam's good influence on them but should have maybe paid closer attention. The end result was that, even with the project unfinished, Sam would get an A Plus with extra credit and the other three would be failed. As she bade Dean farewell she also asked him to give Sam her best wishes for a speedy recovery and not to worry about rushing back until he was a hundred percent fit.
Dean stopped in at the house on the way back to the hospital to clean up and pack some essentials for Sam. As Dean stood under the steaming hot spray in the shower he resolved to pay better attention to his brother. They'd been lucky this time, there wasn't going to be a 'next time'.
From now on, when it came to Sam, Dean was going to do what he'd always done in the past - trust his gut feeling.