Although they had been back on the road together for over a year after Dean showed up at Stanford, Sam found that he still had some patterns to relearn. It was easy enough to fall back into "make sure there is caffeine available as soon as Dean wakes up" routine because the signs were impossible to miss and the consequences were dire. Other patterns were reinforced simply because Dean wouldn't let them die – primarily "driver picks the music, shotgun shuts his cakehole".
But there were other situations that didn't present themselves often, and the signs were more subtle. These were the traps that Sam stepped into unprepared.
It started sometime after they were in Philadelphia with Jo, but Sam didn't see it. At first Sam chalked it up to Dean being broody about Ellen giving him shit. It may have kicked into higher gear after Baltimore, but Dean seemed to have more on his mind than usual and he had been awfully stingy with his chatter since Dad died. Sam was dealing with his own grief, not to mention the distraction of a broken arm, and though he had a growing sense of uneasiness, Sam couldn't determine exactly what it was he felt was wrong.
It was somewhere on the way down south that Sam finally pinpointed what was bothering him – Dean was very quiet.
This wasn't "I'm ignoring you" or "I'm going to shut you out" kind of quiet. Both of those usually involved very loud music and equally loud singing. Dean's method of shutting Sam out was aggressive over-talking which ended up resolving itself into white noise. When they pulled over to get something to eat or find a place to crash for the night, Dean kept up an almost constant commentary about the food and the locals. It was like living with a live-action version of MST3000.
No, this quiet was not directed at Sam; it was internal. This was a "something's not right but I'm not going to admit it, instead I'm going to focus all of my energy on making it go away" sort of quiet. Sam's heart lurched in his chest when he finally started to put the signs together.
Dean was sick.
If asked, Sam wouldn't have been able to explain why he had such a visceral reaction when he finally connected the dots between Dean's silence and his illness. There was just something about Dean being so muted and internal that messed with Sam's head. But being able to verbalize his response wouldn't have made Sam's anxiety any less.
Sam could've kicked himself for missing the signs. If he had caught the connection between the decrease in Dean's chatter and increase in body temperature earlier, he felt like he might've been able to step in, maybe do some preventative doctoring. But he was out of practice after having been away for so long, and it wasn't like he'd had many opportunities in the past to take care of Dean either. When they were younger, he was always the one who caught whatever bug was going around, and Dean was the one who took care of him.
Once he figured out what was going on, Sam had to determine the best hand to play. Should he wait on Dean and let his brother continue to tough it out? Should he insist they pull over so Dean could get some sleep after taking large amounts of Tylenol that exceeded the recommended dose? The tricky part was that other than his unnerving silence, Dean wasn't displaying any outward symptoms of an illness – no coughing, no visible pain. Sam wasn't even sure what was wrong, just that something was.
Sam's opening gambit was suggesting that they stop a little bit earlier for the night. Although their chosen driving direction was "south", so far they had no established hunt, no particular monster that they had to prevent from killing innocent people right now. Sam was counting on the fact that Dean had no counter argument. It was a somewhat disturbing that Dean didn't put up even a little bit of a fuss.
Sam had to wait on his next move was to see what Dean did once they were settled in the motel. Sam was pretty sure he set some kind of land-speed record for moving their gear from the car to the room. Dean seemed to pick up on the fact that Sam was determined to take care of unloading and just let him do it; but, that was something Dean would've done on a good day, so that didn't worry Sam.
What was worrying, was that without a given direction, Dean appeared lost. Outside of his comfort zone in the driver's seat, Dean was directionless and had stopped all forward motion. As Sam moved around him, Dean stood in the middle of the room, his gaze wandering aimlessly. In the weak afternoon light filtering through the curtains, Dean looked exhausted.
Time for Sam's next move. He tried to keep his tone casual when he asked, "You want to grab something to eat?"
The mention of food always got a reaction from Dean. This time was no different, but his response came slower than usual, like it cost him something. "Nah. Not really hungry."
Dean's voice was much raspier than usual – so there was the culprit, a sore throat, undoubtedly accompanied by a fever. Sam could tell that Dean really didn't want to admit he had no appetite, but once he did it seemed to break the spell on his motionless state and he shuffled forward slowly to the closest bed.
Dean dropped heavily onto the bed; butt on the bed, and boots on the floor. He rested his forearms on his legs and allowed his head to fall forward. Sam waited anxiously, watching for Dean's next tell and hoping that now that this was all starting to come back to him that he wouldn't miss any more signs. Sam knew that if he just stood there watching and waiting Dean would get aggravated so he busied himself organizing the stuff. Unfortunately that didn't keep him occupied for long.
Sam was very unsure of what to do, and Dean didn't look like he was going to take any action at all other then falling over onto the bed. Sam had never been in the position to doctor Dean when Dad wasn't there to give him orders. That realization hit Sam like a fist to his gut and rocked him off of his heels - it was yet another "first" without Dad. Unable to control his emotional reaction to really being in charge Sam rapidly retreated into the bathroom to pull himself together.
In one swift move Sam darted into the tiny bathroom and pulled the door shut behind him. He leaned against it heavily and tried to control his racing heart and ragged breathing. Sam pushed the heels of his hands hard into his eye sockets because, dammit, he wasn't crying.
Dammit! Leave it to Dean to be in a feverish semi-coma but still know when Sam was freaking out.
"Be right out." Sam did a fair job of making his response sound normal.
Sam pushed away from the door and stumbled to the sink. With shaking hands he splashed water onto his face. He looked in the mirror and was surprised at just how stressed out he looked. Sam placed his hands on either side of the sink, leaned in and squinted at his reflection, and then he stood up and straightened his shoulders. It was time to step up; Dad was gone, and Dean needed someone to take care of him. Sam had to be the man for the job.
When Sam exited the bathroom, Dean was still seated slouched over his legs, but he looked up blearily to peer at Sam. "You okay?"
Sam had to laugh, Dean was the one who couldn't stand up straight, but he was still making sure Sam was okay. But more important than that, Dean was talking.
"I'm good." Sam plopped himself in a seated position next to Dean and leaned so they were shoulder to shoulder. Though he turned his face toward Dean, he didn't make eye contact when he said, "You're the one who's not so good."
Sam could feel Dean tense beside him, like he was gearing up for a fight, so Sam just forged ahead. "It's a good thing we're already settled for the night and have no particular place to go."
Dean didn't exactly agree, at least not with words, but the tension ran out of his shoulders and Sam counted that as a win. Sam jutted his chin toward the floor and asked teasingly. "You gonna take off your boots or do I have to do it? I'd rather not get that close to your feet."
"Fuck you, Princess," Dean replied with a spark of fire in his raspy voice. "I can take off my own damn boots." Then he gave Sam a shove for good measure.
Sam stood up and walked over to the med kit; it was the first thing he brought in from the car. Now that Dean had sort of acknowledged that he was sick, Sam didn't hide the fact that he was gathering medical supplies. Dean did that thing where he rubbed his hand down his face and then got to work on the laces of his boots. Dean was moving slowly, but he was steady enough for Sam to feel comfortable running out to vending for drinks and ice.
By the time Sam returned, Dean had changed into a t-shirt and sweatpants. Sam didn't miss the hoodie Dean had also dug out of his duffel and tossed within easy reach. There was a little bit of a fuss with Dean complaining about the number of pills Sam insisted that he take and the size of the water bottle Sam presented to him, but in the end he took them both before he crawled into bed, exhausted.
Sam pulled out his laptop and tried to pretend he wasn't listening to Dean breathe over the sound of the baseball game on the television. Sam was nearly as restless as Dean was; neither one of them able to relax. Sam's web surfing was aimless and Dean kept moving, trying to find a comfortable spot in the lumpy bed. Sam's thoughts turned to John and he tried to recall any tricks for dealing with a sick Dean.
Then it came to Sam in a rush. What he had to do had nothing to do with Dean being sick, and everything to do with being in charge. He cursed himself for an idiot as he launched himself out of the chair and toward their supplies. His rapid motion got Dean's attention so Dean picked up his head and tracked him across the room. In a few efficient moves, Sam had salted the door and windows. He was in the middle of carving a protection sigil above the door when he heard Dean sigh heavily.
Sam turned back toward the beds. Dean was on his back sprawled under the sheet with his blanket tossed away. His face was fever flushed, but his features were finally relaxed.
Sam nodded to himself. He got off to a rocky start with this whole caretaker thing, but now he was feeling solid. For his whole life he had Dad and Dean taking care of him; then he had plenty of time to learn how to take care of himself when he was off at Stanford. Now, Sam just needed to learn how to take care of Dean and make some new patterns for them to fall back on.
With a new purpose, Sam resettled at his laptop and started researching homeopathic remedies for strep throat. He wondered if it would be worth the entertainment value if he tried to give Dean tea instead of coffee in the morning. He laughed at himself and decided they'd play that by ear.