A/N: This is set sometime season seven after Bobby dies, for some reason season seven Sam and I have got along very well, where Dean has been nearly silent. I have been accused of taking research to far before, and here we are again, the Winchesters suffering along with me. I have nothing but respect for the medical profession, but the events here are as they happened, the names are changed of course.
It was supposed to be a simple salt and burn. That was the plan, I thought it would help. Dean has been on edge since Bobby's death and Lucifer has been oh so much more vocal lately, so we decided that it was time for something simple. One of those cases that gives you the satisfactory ending without a lot of the torture that can go along with something that's more involved. That was the plan at least. Something simple, but really, I should have known—lately nothing has been simple, not even a salt and burn.
That's not quite true. The salt and burn was simple. It was what came after that went horribly wrong. I think it was a push—to see how far Dean was willing to go, or how much I could take, or how much Dean could take. I know he is skating on ice every bit as thin as mine, and he has his own demons and me to deal with. Sometimes my Soulless Self points this out right before sleep—just before I close my eyes, he says "tonight's the night he ends you." This little episode I think was a test before a full-on run at us. I'm not sure, but with the way things played out…
Even now I am not sure exactly what happened. Dean has been silent on the subject, which I suspect means he did something a little extreme to save me. He's been doing that since I was a child and as I have gotten older and realized what he has done for me, it has created a mixture of fury and gratitude that I suspect no one else could quite understand. Well, unless they lived the life we've lived.
It started right after the job was done, we were heading out of town and I noticed a twinge in my chest. I got thrown around towards the end of the job and I suspected a pulled muscle. Lucifer wasn't helpful. He was singing "Heart and Soul" and have I mentioned how much I hate his singing? I leaned back in the seat, this car—I think Dean said it was a Falcon—just didn't have the leg room of the Impala. I must have started rubbing my chest because Dean started glancing my way and with each glance the frown deepened just a little bit.
"He really hopes you are going to die, you know, free him of the burden he's been carrying since he was four," Lucifer said in a break between verses. My Soulless Self agreed with him. I think I hate him more than Lucifer, since he is actually part of me. Lucifer is who he is, a pain in the ass, slowly driving me insane, but not part of me. That Soulless Self is part of me, and it holds memories that, when I look, are in some ways worse than Hell, because I was there, I committed those crimes, not some demonic energy. Me.
"Sammy? Hey," Dean says, his hand on my arm.
I blink and look around, we're in a small town, the streetlights all red. "What?"
"Are you okay?"
"Yeah," I answer immediately and see my brother's eyes fall on the hand I have been rubbing against the pain in my chest. "My chest hurts," I say, giving in.
"Hurts how, Sam? Muscle or something else?" Dean is frowning, he knows about the pain a destroyed heart creates.
"I thought it was a muscle…" I break off wondering still, is it a muscle or something else?
"Sam?" There is an edge to his voice, it's there a lot lately. It's because he knows what I fight every day, who is here with me. "Answer me." Dean looks to—in his eyes—an empty back seat and adds, "And no help from you!"
"Touchy," Lucifer says.
"Don't know, Dean." And in the next moment it feels like something reaches into my chest and tries to rip my heart out.
"Right," I hear him say from a long way away. His hand is on my arm as he drives, that physical anchor that is often there these days. It was there most of our lives, it was only when it was gone I realized how often it had been there. Dean always was the physical one, I talk, he nudges, punches, leans—makes contact. Now I need that contact to keep me in this world. Without it, I would spin away and the others would take me away.
"What's going on?" a crisply professional voice asks from beside me.
"Chest pain," Dean answers for me. "It started several hours ago, but it got a lot worse about fifteen minutes ago."
"Dean?" I wheeze out, and there he is, that hand on mine.
"He brought you here to put you down like the pathetic animal you are," Lucifer says, my Soulless Self agrees, and I flinch when the needle slides in for the IV line.
"What is your pain on a scale of one to ten?" the voice asks.
"Nine," I answer. Dean squeezes my hand and lets me know the answer is okay.
"Yes." I try opening my eyes, only to be met with the glare of fluorescents, I let them slide close again.
"I'll see about that, you just wait here." Someone pats my leg—the gesture too familiar and I flinch.
"It's okay, Sammy, I'm right here," Dean says.
"Me too," Lucifer adds and starts singing again. It sounds like the greatest hits of Rogers and Hart today.
My chest is starting to burn, and with the pain comes the return of Hell, it always seems to happen. When the pain slips out of control, all my control slips and the me that is held together by a scar in my hand, the strength of will and my brother, is all gone and I am back in the cage, burning, having my flesh flayed from me, tortured for eternity.
"Hey," Dean says, taking my hand in both of his. "You're in a hospital, they have a heart monitor on you, can you hear the beep, Sammy?" I nod, I can hear the comforting regular beeping behind me. That is a sound wholly of the earth. There is nothing like that in the Hell I knew. "Focus on that," he urges. "I'm right here."
The pain is increasing. I don't even know what it is. As far as I know my heart is healthy, Dean is the only one that has ever had issues with his heart. In the background of the misery, I can hear my brother answering questions, they sound like the same ones again. It's amazing how many times you have to answer the same questions at an ER, it's like they are triple checking you to catch you up on something. I remember once, long ago, when Dean had been gravely injured and dad took him into an ER, the fourth person to ask the same questions had very nearly gone out the window. Dad and I were both under a little stress. The memory makes me smile.
Suddenly I taste the weird musky flavor of a flush in the IV port. Lucifer laughs and my Soulless Self says it's time to die. I struggle a little, but Dean's hand on my head calms me. "It's just morphine and an anti-nausea, I checked, Sammy."
"That's what he'll say when he puts you down too, that's what they always say," Lucifer is kind enough to point out.
The morphine hits almost immediately, the pain dropping a little in my chest. I manage to open one eye and look up at Dean. His face is white, his lips tight with worry. He's watching the curtain that leads out to the main part of the ER like a hawk, his eyes tracking someone's movements.
"It's okay, Sammy, I just don't like the look of that nurse."
"Why?" Now that the meds are pushing some of the agony away, I am a little more focused, able to ignore Lucifer a little better and able to hear what Dean is saying.
"I don't know, she is just setting off warning lights."
When my chest gives another twist, I gasp, Dean tightens the grip on my hand and a doctor comes in, staring at the monitors. "We're not sure what's going on," he says to Dean, not to me.
"You are invisible, you are invisible," Lucifer taunts me. It was oddly one of my greatest fears when I was first back, something even my Soulless Self recognized, that fear that no one would listen, no one was there to hear me. Even he missed Dean now and then, not that he—we—would ever admit it then.
"What do you think it is?" I ask.
"His heart seems okay, the blood works looks okay, but there is something going on," the doctor continues speaking to Dean. "How is his pain?"
"You like how they completely ignore you? You know why? They know you are craaazzyyyy." Lucifer is in a helpful mood, apparently.
"Ask him," Dean growls, his voice low and dangerous. "Sam? Has is gotten better?"
"A little, not much. Maybe an eight?"
"Okay." The doctor looks over me at Dean. "We'll make him a little more comfortable, then we need to get him up to a room."
"He's being admitted?"
"Yes, they want to run some tests in the morning, so we need to keep an eye on him tonight."
The doctor leaves, Lucifer moves to lean at the end of the bed and I ignore him, turning to my brother instead. "I don't want to be here, Dean."
"I am not leaving," Dean says firmly. He'd made the promise years ago, and he stuck to it, no matter what hospital staff said. I know once a doctor called security to have him removed from my room and, long story short, Dean had ended up staying. Winchesters, we make dumb promises sometimes, but we stick to them.
"Thanks," I manage to say before my chest seizes up again and I am pretty sure I cry out. Dean's hand on mine is tight enough to hurt, his other is on my head.
"He thinks it's Hell coming back, you know," Lucifer says, perching on the bed. "He thinks this time he is going to have to lock you away."
"Hurts," I say to Dean.
"I know, Sam, I wish I knew why." Something is bothering him, and unlike the ever-so-helpful Lucifer, it's not that Dean is worrying I've finally gone off the rails. There is something going on that he doesn't like. Human or supernatural, I can't tell, but he is on high alert, which should freak me out, but I find comforting.
An orderly appears and unlocks the bed and we are on the move. I wonder exactly when in all of this I ended up in a hospital gown, but I have one on now. It must have happened in that moment between the first terrible pain and the IV getting started. I don't remember much from those moments. Funny, I can remember Hell, but not the last hour or two. The room they push me into is a single, the orderly pulls the curtain partially closed so I can't see into the hall and Dean drags the heavy chair over to the bed so he is right there beside me.
"I need to take his vitals," a voice says, it sounds a lot like the voice from the ER.
"Be my guest," Dean snaps. "You have his whole right side."
"Sir, you need to leave."
"Let me think about that for a minute," Dean says. I open my eyes and watch him. He smiles. "No. Not leaving."
"No," Dean says firmly. If she knew him better, she would be running. That voice doesn't appear unless my brother is deadly serious about something. There are very few things in this world that make that voice come out of him, unluckily for the nurse I am one of them.
I feel the blood pressure cuff inflate on my arm and she puts the little thing on my finger that does whatever it does. I know they always stick it on there. The cuff over-inflates as always and hurts. Dean told me once that it was a way they tested your pain response, and you know? I believed that for years. She hmphs and leaves, returning a moment later with syringes. There is another flush, then the relief of morphine—no something a little stronger—it hits harder and I feel oddly removed from myself. The anti-nausea meds burn up my arm, and she is gone.
"Don't worry, I am sure they have you on a schedule, make sure you are comfortable before they kill you," Lucifer says, stretching out on the windowsill. I really want to tell him to get lost, but I am pretty sure I don't want to acknowledge him in this state.
"I'm right here," Dean says when she is gone. I look over, he is a little hazy and there is something behind him. I blink and it's gone, whatever it was. Hell beast, hallucination, I'm not sure at this point. All I really know is the throbbing point of pain in my chest and his hand on mine, keeping me grounded. "Sleep if you can, they have you pretty pumped full."
I nod and between one breath and the next I'm asleep.
Burning pain wakes me, well that and my brother's angry voice. "You blew the vein, that's what's wrong," he is saying, his voice harsh with worry and that undercurrent of barely maintained violence that is often there these days. I hear something pop and a gentle warmth covers the burning pain in my arm. "It's okay, Sammy, they're going to get another line started."
"What happened?" I open my eyes, it's the deep dark of night, the hospital is quiet, and Dean is still beside me.
"The stupid bitch blew the vein when she started the flush. I saw her do it. If I didn't know better, I'd say it was on purpose. How are you feeling?"
"That's what we were going to take care of," he says, looking up. "Here comes someone."
The someone turns out to be a man from IV therapy who efficiently starts a line in my hand but tells us to make sure we tell everyone that it needs to be treated tenderly. Dean nods his head, and the man leaves. As soon as he gone, the nurse comes in.
"He said to take it easy on that one," I say to the nurse.
"I know what I'm doing." And I guess she does, she blows the vein with perfect precision, causing my hand to convulse in agony.
"Stop!" Dean is up, leaning across the bed.
"It's the anti-nausea meds, they are hard on the veins," she says, shaking her head and walking away.
"She did it on purpose," I say.
"Yes," Dean growls. "I'll be right back."
"Finally, we're alone," Lucifer says.
It's hard to ignore him in that room, all by myself. A loud noise in the hall makes me jump—someone dropped something, but it's enough to start a little tendril of panic creeping through my brain. In Hell, the worst things happened after the quiet. They would leave me alone for a day, a week, a month—however time was counted there—and then the payback would come in increased torture, terror, never-ending pain. I am shaking now, I can actually hear the bed rattling. Lucifer is happily singing again and I am about to bolt when I hear the comforting tones of Dean very quietly explaining to someone they better start a decent IV line, and it had better be done right this time, period. That quiet calm voice—I think he might have learned it from me, I remember he called it the "scary Sammy calm" which always precedes the storm. Just hearing it, having it to focus on, takes some of the tremor away.
"So, how about the greatest hits of who we killed when we were having fun?" Lucifer asks. My Soulless Self chuckles and a large man appears in the chair by the bed. He has eyes the color of Dean's. I remember him. He was in a little town, full of demons, I'm not even sure he was a demon or just collateral damage, that part of me doesn't care. It should, you should, the whisper of the me who was in Hell says. Being three people in one some days is exhausting. Add Lucifer on top and I really am not sure why Dean still bothers.
"That's why you are alone," Lucifer says helpfully. "He's left you here to them."
THAT terrifies me. I start to struggle up. A hand stops me, solid flesh replaces the visions, and Dean is there, taking my hand in his. "I'm here, Sammy, don't worry. They are going to be in to take care of you."
I nod and close my eyes, never letting go of my anchor. Sleep claims me at some point, because I open my eyes to movement. "Dean?"
"They are taking you for a test, Sam, I can't be there, but I will be right here, waiting, promise." He gives my hand a final squeeze and I am pushed down a hallway and into a room with a large machine and a bright light. I hear a soft laugh that sounds familiar and I taste the flush of the saline, then something else, I can't move, but that's all. No sleep, nothing, I am aware as the doctor forces my mouth open and starts feeding a tube in. It hurts. I can even hear myself protesting the pain, a grunting scream, like it's all my body can muster in the situation. It's ignored and they continue. The pain gets worse.
Lucifer thinks it's the best entertainment he's had in a long time.
I finally black out on the way back to the room, when I wake up, Dean's hand is in mine again, and my throat hurts. "Sammy, hey," he says as I open my eyes.
"What, yeah, you're awake."
"No, during, awake."
I see the realization dawn on his face—horror followed by anger. "I will be right back." He leaves, his back stiff with anger.
"Back again," the nurse says, smiling at me. She flushes the line in my arm and it starts to burn, I protest and she leans close. "One sound out of you and I will take all the medicine away. Be a big boy and take your medicine." With that she pushes in pain meds and the burning anti-nausea meds so hard that, for the third time, a vein is blown.
I don't say anything, I just wait for Dean, ignoring the voices that are all around me. I try not to talk to them, but some I know I do. Not Lucifer, but some of the others that are there. I know dad is there briefly, I talk to him and he smiles at me sadly, that love I have lost over the years of anger plain in his face. There are others too, some from my Soulless Self's time on earth. More than anything I don't want to probe there too much. I think returning to Hell would be better. At least that was Hell, and in a way Hell was a cleansing. I paid for my sins, and I might be crazy, I might see Lucifer and hear him sing operettas, but that time was of my choosing and I did it to save my brother—and the world. My Soulless Self is a whole other ball of wax, and one I am not sure I will ever be able to face.
"Sammy!" A hand on my shoulders is holding me down.
"They're going to take you away…" Lucifer chirps.
"Sam!" The slap is gentle, but hard enough to ground me again.
"My arm," I say.
Dean looks down and I see it—that violence that's been held in check has just found an outlet. "Two more minutes, Sammy, you count them off, okay? Like we used to." He presses the hand with the scar and walks away.
I start counting. Lucifer is dancing at the end of the bed, trying to get my attention, and the room is slowly filling up with those phantoms again. I close my eyes. Lucifer laughs, but I keep counting. It's actually at one hundred thirty-six that Dean reappears.
"I took care of it, Sammy, how's the pain?"
Weird that he asks, it feels better, more like the pulled muscle I thought it was and less like the agony from earlier. "Better," I answer. "What did you do?"
"Took care of it, for now at least. We're getting out of here," he says. With an expert's ability, he slides the IV out of my arm and presses a gauze to it and tapes it down.
"Trust me, Sammy."
"Yeah, he's taking you to the crazy ward," Lucifer says.
"Then let's go before they find them."
I don't even ask who the "them" are. Dean is ready to move. He hands me my clothes and helps me dress, then eases me onto my feet, steadying me as I fight through the drugs. Dean keeps a hand on my elbow as he moves to the door, looking out and making sure the way is clear, we walk past the nurses' station. Out of the corner of my eye I see blood coming out from under a closet marked storage. I look at it, then move on as Dean half carries me out of the hospital. We are out and he is dropping me gently into the car before there is even an alarm in the hospital, we are out of the parking lot and on the road before anyone can follow.
"I grabbed pain meds—everything we might need, Sam," Dean says, keeping his hands on the wheel as he speeds down the road.
"To put you out of your misery," Lucifer says, hitting me on the head.
Maybe, I will actually acknowledge that one, not to Lucifer, but to myself. If it ever gets too bad, if it ever goes too far, maybe that is something I will ask. He promised me once, that was a long time ago, but I won't ask now. I can see his fragile control slipping every day, if I fall to Lucifer and my other selves, what will be left of my brother? I am getting tired, I admit it. Almost too tired, and I think everything out there knows that, knows Dean is getting tired too, and one day it will be too much. This last adventure felt like a test of some kind, to see how far I could be pushed, how far Dean could be pushed.
"Dean?" I ask.
"Was she… the nurse…?"
Lucifer is winding up to start into "The Desert Song", my Soulless Self points out for the thousandth time it has to be real because I don't know all the music to that play, and my poor From Hell Self, just wants to crawl away.
"Demon, And the doctor who did the test. Don't worry about them, Sam, they are gone."
I will worry about the man in the seat beside me. I reach out and his hand closes over mine in an affirmation of life, of the earth and safety, however fleeting it is before the nightmares begin again—for both of us.
A/N II: It occurs to me that it was a year ago I wrapped Multum in Parvo, and it was actually something related to my GP and esophageal spasm that put me into the hospital and led to that story. So, in answer to the unanswered questions, yes, this too was an episode with my esophagus, leading to a worsening of symptom. I am telling you this to spread the word about Gastroparesis and esophageal spasm. We need awareness before we can even start looking for a cure!