Author's Note: Someday I will stop being mean and making the characters I love sick, hurt, miserable, etc. But don't worry. That day is not today.
They've been in the car for 17 hours. Lancaster, PA to Minneapolis, MN, or thereabouts. Sounds like an angry spirit, a simple salt and burn. But the thing is moving fast, and they've gotta be faster.
Dean drives all day, stopping only when the gas tank is on E. Normally, Sam doesn't mind long car rides. Practically grew up on them. But lately he's got restless leg syndrome or some shit, and he just wants to stretch his legs. "Are we almost there?" he asks, then winces when he realizes how bad that sounded.
Dean shoots a corner-eyed glance in his direction. "What are you, five years old?"
Sam ignores the question and tries to stretch, wishing he would have stopped growing about a foot ago.
It turns out to be one of the fastest and easiest hunts they've had in a while. The only snag they hit is when Sam pisses the spirit off and gets tossed against a tree right before the bitch goes up in flames.
"You okay?" Dean asks, wiping his hands on his jeans as he walks over.
Nothing feels broken. Sam grunts and accepts Dean's outstretched hand to help him up. "That was fast."
"We're just getting too good at this, Sammy."
The next morning, Sam winces when he gets out of bed. His back feels bruised and there's pain in his right calf.
"You limping?" Dean asks as Sam makes his way to the bathroom.
"That tree," Sam says vaguely, waving it off. No big deal.
Dean's got a newspaper spread out in front of him. "Looks like there might be something near Madison, Wisconsin. A bunch of people gone missing."
Sam limps the rest of the way to the bathroom. More time in the car. Another hunt for him to get tossed around in. Yippee.
Two days later, they're near Madison, but this case is not nearly as straightforward as the last one. Sam's back is 100% better, but his calf is still bugging the hell out of him.
"What's wrong with your leg?" Dean asks when he catches Sam massaging below his knee for the thousandth time.
"Pulled a muscle," Sam says.
Dean smirks. "Oh, Princess, you want me to rub it for you?"
Sam smacks Dean upside the back of his head and doesn't even feel bad about it.
Two more days and Sam's not sure this is a pulled muscle anymore. It's getting worse, not better, even though they're doing more research and grasping at straws than actual hunting. Sam likes to think he has a pretty high tolerance for pain, but whenever they have to walk a long ways or stand for a while, his calf friggin aches. His foot and ankle are kind of swollen, too.
"Dean," he starts at one point when he thinks he ought to say something about it.
Dean looks up from the book he's reading. "Yeah?"
But then Sam predicts Dean's reaction to a pulled muscle, up to and including calling Sam a "pansy-ass bitch" and telling him to suck it up. He changes his mind. "You, uh, find anything yet?"
Dean turns back to his book and Sam turns back to the computer and rubs his leg.
Three days later, they're heading to interview the family of the latest victim. Sam's sitting on the edge of the motel mattress, but either his right shoe shrunk or his foot is a lot more swollen than it was before. Sam stares down at his socked foot.
"What's the hold up, Sam?" Dean asks, duffle bag slung over his shoulder, keys in hand.
"I can't get my shoe on."
There's a pause. "Seriously, Sam? I'm pretty sure I taught you that when you were still in diapers."
"My foot is too swollen," he says in lieu of a witty comeback.
"Shit." Dean drops the duffle bag and the keys. He crouches in front of Sam and gently tugs off the sock that's way too tight. "Did you twist it when you got tossed against that tree?"
"Don't think so."
Careful but sure fingers feel along the bones that are hiding beneath the swelling. Turn his ankle from left to right. "That hurt?"
"No." It feels a little tight because of all the extra fluid, but it doesn't hurt. That is, not until Dean flexes his foot up towards his shin and pain explodes all the way up to his calf. "Fuck," he hisses.
"That?" Dean asks, and Sam wants to punch him when he flexes the foot again, just to be sure.
"My calf," Sam groans, clutching at the muscle there.
Dean frowns and narrows his eyebrows. He forces the pant leg of Sam's jeans up to his knee, runs his hands over shin and calf. Then he pushes up the other pant leg as well.
"If you're trying to feel me up or something…" Sam starts, but doesn't get very far before dean interrupts.
"Your whole damn leg is swollen."
Sam looks down and compares leg to leg. Huh. Shit. It is.
"You get bit anywhere?" Dean asks, checking the right leg again.
"Don't think so."
"I don't see anything. Nothing seems broken." Dean stands and walks over to the duffel bag. Riffles around until he finds a bottle of Ibuprofen. Shakes three out of the bottle and hands them to Sam. "Can you walk?"
Hurts like a bitch, but yeah. He can walk. "Yeah."
Dean hefts the duffle bag back up. "Come on. We'll hit the ice machine on the way out. You can ice it in the car."
Sam dry-swallows the pills and limps out of the motel room with one bare foot, extra boot and sock in his hands.
They're going to need a fucking big bag of ice.
The next day, Sam's boot is on only because he took the lace out completely, and even then it's still on the uncomfortable side of tight. The pain is worse, but he doesn't tell Dean because it's just a pulled muscle. Just a pulled muscle that's practically bringing him to tears with every slow, limping step.
They're stopped for lunch when Dean says, "Scale of one to ten?"
Sam sighs over his bowl of soup. "Eight."
Dean's hazel eyes look concerned when he hears the number usually reserved for bullet wounds and open fractures. "Maybe we should get it checked out."
A few hours later, Sam is sitting on a hospital bed in the ER, wondering why they made him change into a gown when he's just got a pulled muscle. Dean is sitting in the chair next to the bed, holding Sam's clothes and boots – one with a lace, one without.
"Don't dick around, okay? Tell him how bad it is. Get them to give you the good drugs for whatever it is."
Sam nods and looks up as a doctor walks in.
Sure, why not? "Yes, sir."
The doctor is graying and balding, but has a kind smile when he shakes Sam's hand. "I'm Dr. Roberts." He turns to Dean.
"Dean Rodriguez. His brother," Dean says.
"What seems to be the problem today, Mr. Rodriguez?"
Sam shows the doctor his swollen leg. Explains the pain. Answers the obligatory questions.
"This hurt?" the doctor asks before flexing Sam's foot like Dean did before, like he already knows it's going to hurt.
"Yes," Sam hisses, bunching the bed sheet in his fists.
"Easy," Dean says, patting Sam's arm. "Relax."
Sam tries, but fuck, that hurt.
"Sorry," the doctor says. "Have you experienced any shortness of breath? Coughing? Chest pain?"
Even though Sam says no, the doctor spends way too long listening to Sam breathe for someone who came in with a leg injury.
"What do you think, doc? Gonna get some x-rays?" Dean asks as the doctor puts his stethoscope back around his neck.
"Possibly." He jots something down on a clipboard. "First I'm going to send you for an ultrasound."
"Hey, isn't that what pregnant chicks have?" Dean asks.
The doctor smiles. "That's one of the uses, yes. But this will be an ultrasound that shows the veins in Sam's leg. Make sure there are no circulatory problems. I'll put the order in now. Transport should be here to take you to radiology soon."
Sam nods. "Thank you." Once the doctor is gone, Sam flops his head back against the bed and turns to Dean. "Before you get any bright ideas, you are not coming with me."
"Wrong. I'm totally coming with you. I want to see if the baby's going to be a boy or a girl."
"What? Is the baby kicking? Did your water break?" He's so amused by himself that there's actually a twinkle in his eye.
"Fucker," Sam says. But he smiles just a little.
"Shouldn't talk like that, Sammy. The baby might be able to hear."
Before Dean can fire off any more pregnancy jabs, someone from transport arrives. "Ready to go for your ultrasound, Mr. Rodriguez?"
Dean stands and sets Sam's clothes down. "You bet we are."
The radiology technician squirts warm gel onto Sam's leg, up near his groin.
"See, Sammy?" Dean asks. "Told you they're looking for a baby."
The technician laughs. "Sure," she says. "Just hold still, okay, Sam? This shouldn't take too long."
She presses the wand to Sam's leg, and a mess of black and white lines and shapes appear on the screen. She inches the wand down Sam's leg, stopping every few seconds to press buttons on the machine or squeeze Sam's leg in different places.
A lot of weird noises come from the machine's speakers, and Sam doesn't know whether to be impressed or grossed out that he can see and hear what's going on in his body.
"Are you sure there's not a baby in there?" Dean asks, squinting at the screen.
"Yes, Dean," Sam deadpans. "There's a baby in my thigh. That's why my leg has been swollen."
Dean flips Sam off, but the technician just laughs again. "I know it doesn't look like much, but once you understand what you're looking at, it can tell you a lot."
"If you say so," Dean says, shaking his head.
The technician continues working, moving the wand down to the side of Sam's thigh, almost to his knee. She squirts more gel on his leg and flips to the back of his knee, down his calf. Every time she presses down now, Sam winces.
"I'm sorry. Does that hurt?"
"It's okay," Sam says even though it's not.
"Almost done. How long has your leg been swollen?" she asks.
"About a week."
"Have you had any shortness of breath?"
"Why do people keep asking him that?" Dean snaps. "It's his leg that's the problem, not his lungs."
"Dean," Sam admonishes. "No. I haven't had any shortness of breath."
"Good," the technician says. But when she smiles at him this time, he swears he sees sympathy on her face. What the hell is wrong with him? She turns off the machine. "I'll show this to the radiologist. Transport will be here soon to take you back to the ER, and Dr. Roberts should be back with you shortly."
"What is it? What did you see?" Dean asks.
"I'm just the technician. Dr. Roberts will be able to tell you soon." The way she says it indicates that she definitely saw something wrong.
"Fuck," Dean mutters once she's gone, rubbing a hand over his face.
Sam would have preferred a pregnancy joke.
"Well, Mr. Rodriguez, I'm afraid I don't have the best news," Dr. Roberts says.
"Okay," Sam says. He sees Dean tense in the chair next to his bed.
"You have an occlusive deep vein thrombosis in the right popliteal vein."
"English, please," Dean all but growls.
"A blood clot, which is also called thrombus, is completely blocking the deep vein behind your knee and into your calf. It's a fairly significant clot."
"But…that's not serious, right?" Even though he asked the question, Sam's not really sure he wants to hear the answer.
"As long as the clot stays in the leg, it's not significantly dangerous. However, if any part of the clot breaks off and travels to the lungs, heart, or brain, that could be a problem."
"Shit," Dean breathes.
And Sam nods, because yeah, dying could be a problem.
"You can give him a medication for that, right? Take care of the clot? Get rid of the pain? Send him home?" Dean asks.
The doctor gives a sympathetic smile. "Unfortunately, it's not that simple, Mr. Rodriguez."
And Sam should have known it wasn't a pulled muscle, because for the Winchesters or the Rodriguezes or whoever the hell they are, it's never that simple.