A/N: Thank you all for reading and reviewing. It's good to be back sharing with you. As I carefully pick out these titles I wonder if I should translate them—or let you go hunting Sam Winchester style. I have a deep respect for the medical profession, I have close friends who are nurses and my specialists and doctors are amazing. I have had wonderful experiences in Emergency Rooms. However, they are not all perfect, and sadly—as they used to say on Dragnet—the story you are reading is true the names have been changed to protect the… well you'll see.

A Posse Ad Esse

Ut Dictum

The waiting room was overly warm. Sam could feel sweat trickling down the back of his neck, he was trying hard not to squirm, but the sensation was almost impossible to ignore. Dean was sitting quietly beside him, the blood pressure cuff they'd used when they first arrived in his hands. Every time his brother swallowed, Sam was aware of the little tensing of muscles, indicating his brother was in a lot of pain.

"How long?" Dean asked.

"An hour and a half," Sam growled. "I'll be right back." He got up and paced over to the reception desk. "Hi, I was wondering how long it was going to be?"

"Who are you?"

"I'm with Dean Iommi. We've been here three hours. His doctor said he called ahead and said you would know what was going on?" Sam kept his voice light. Starting a fight right now probably wouldn't help Dean.

"Oh, yes, I see," the woman said, looking down at some papers. "We'll get to him as soon as we can."

"He can't swallow."

"We will get to him as soon as we can."

"The guy with the flu was taken back twenty minutes ago!" Sam huffed. He shook his head. Killing the reception staff wouldn't help Dean.

"Well?" Dean looked up at him as he stalked back.

"They will get to you as soon as they can."

"Killing them won't help, you know," Dean said, grinning. "You know the drill. They don't believe me, they don't understand how if it hurts as bad as I say it does if I can say it calmly."

"Remember that bitch in California that said you should only be capable of screaming if you hurt that bad?" Sam asked, sitting down again.


"You screamed."

"I did, scared the hell out of them." Dean leaned against him. "It's the same, every time in every city. Much easier to get help when the blood is gushing."


"It's okay."

"Dean…" Sam took a deep breath. His brother was right. They had sat in many emergency rooms while doctors told them there was nothing wrong, it was all in Dean's head and other equally degrading things. It was one of the reasons it was getting harder and harder to get Dean to go in at all and why the fact he came willingly this time was making Sam panic. It had to be beyond bad for Dean to walk into the place—especially after the last time when both nurse and doctor had told Dean it was all in his head and he was just exhibiting drug seeking behavior.

"Dean? Dean Iommi?" a man in scrubs called.

Dean stood and Sam followed. They were led to a small room, and Dean sat in the only chair. The man—his ID said his name was Pat—took Dean's blood pressure, pulse and temperature again, then started poking at his face.

"Any pain here? Or here?"

"No, I can't swallow."

"Nausea? Vomiting?"

"Yes, I have gastroparesis."

"Ah. Chills? Coughing?"

"Wait a minute," Sam said as what was going on dawned on him. "Are you triaging him for the flu?"

"Yes?" Pat said.

"He can't swallow. His doctor called ahead. He is supposed to be scheduled for a barium swallow, they told us to come here immediately because he couldn't swallow his own saliva."

"Oh, huh. Well, go out to the waiting room and I will see what's going on."

"Sammy." Dean put a hand on Sam's arm. "Don't." He stood and walked back into the waiting room and sat back down in the chair he'd just vacated.

Sam started pacing. He was beginning to get anxious on top of the panic and it was going to explode in something bad if he couldn't rein it in. He started counting his steps, concentrating on the steps, the color of the tiles, how many tiles for each stride, how many strides across the room. It would only work so long, so he hoped they would get it figured out quickly. Every time he looked at Dean he felt that flutter of panic. His brother was getting worse, not better. The tight lines around his mouth meant the pain was starting to creep up the scale beyond where Dean could ignore it.

"Dean?" a woman in purple scrubs called from the door.

"Here," Dean said, standing and walking towards her.

"You need a pass from security," she said to Sam, pointing at a window where a guard sat watching TV. "Room fifteen, Joe."

"Right," he said, bored, and handed Sam a bright orange sticker that had Dean's name on it and "Room 15".

"Thanks." Sam peeled the back off the sticker and stuck it on his shirt as he trailed behind Dean and the nurse. As they walked in the back, he noticed most of the rooms were empty.

"Take off everything above the waist and put this on, it ties in back."

"It's not my first hospital gown," Dean growled. He handed Sam his shirt, then leaned back on the bed as the nurse asked him questions and took his vitals again. "I can't swallow. Dr. Brian Gleason said he was calling to arrange…"

"Yes, I see that. We are doing our best, the radiologist went home half an hour ago."

"We were here three hours ago. He called before that," Sam said, trying to control the rage that was starting to boil along his spine.

"Yes." The nurse gave them a smile and walked out, closing the curtain behind her.

"What the hell?" Sam looked out into the main area of the ER, the nurse was talking to a small dark-haired woman in a white coat.

"It's the same thing as usual."

"I am getting tired of the same thing as usual, Dean." Sam leaned against the bed so he could be in contact with his brother.

"I know, Sammy." He sighed, shifting in the bed.

"I'm Dr. Walters," the dark-haired woman said, coming into the cubicle. "What's going on tonight?"

Sam took a breath in and let it out slowly. "My brother can't swallow, his doctor phoned and arranged a barium swallow and told us to come to the ER," he looked at the clock on the wall, "four hours ago."

"Our radiologist has gone home," she said.

"We heard," Sam growled, Dean patted his hand.

"What is it like when you try to swallow?" she asked, glaring at Sam, then turning her attention to Dean.

"Really thick peanut butter and it feels like it gets stuck half way down. I have esophageal spasm and…"

"Okay, we will get an IV going and see what we can do." She walked out before they could say anything.

"This one is fast becoming a special experience," Dean said, smirking at Sam.

"It is." Sam stepped aside as a nurse came in and started an IV, hung a bag of liquid on the hook over the bed and left. "They are talkative too."

"Can you lift the bed? It's easier to swallow."

The nurse was back with a handful of syringes. She smiled and twisted one on the port on the IV. Sam stopped her. "What is it?"

"Just a flush, then something to help… Dean… with his swallowing." She glanced at Dean's wrist band to confirm his name.

"I hate the way the damn flush tastes," Dean grumbled when she left. "I wonder what they gave me, I don't feel any different."

"Maybe it takes time?"

"Yeah, IV meds always take time."

Sam started pacing again. This was beginning to feel like the debacle several months before that resulted in a formal grievance filed against the hospital where Dean was treated. The fact that so many people were willing to just dismiss his brother's pain as nothing… "Hey, no one asked about your pain."


"They didn't do that one to ten thingie."

"They didn't." Dean frowned. "That's a first."

"Hi! I'm Terry." A man in scrubs came in with a cup in his hand. "The doctor wanted to see if the drugs worked."

Dean gave Sam a funny look, but took a sip from the straw in the cup. He pulled away, looking green. "Can we try just ice water? I am not sure apple juice is a good idea right now."

"Oh sure, be right back." And he was, with another cup and straw. He held it while Dean took a sip. Sam watched his brother's muscles tense with the first swallow. Dean took a second sip—and started coughing, water running out of his mouth.

"Don't think the meds worked," Sam snapped, as Dean leaned back in the bed, white as the sheets. "No one's asked about his pain either."

"What?" Terry asked, looking surprised.

"No one has asked if he's in pain, or done anything about the nausea."

"Are you in pain?"

"Yep, about a nine."


"I have GP and just drank apple juice. Yes, I am nauseated."

"Okay, I'll see about that. Here." He handed Dean one of the bright blue vomit bags and disappeared.

"What do you think they gave you?" Sam asked. "They seem to think you should be better."

"I think they gave me jack because I am obviously nuts."

"But the doctor told us to come."

"I know. You know. They suck."

"Hey." Terry stepped back into the room. "I have some morphine and Zofran."

"Phenergan works better," Dean said, sighing as the morphine hit his system.

"We have to give the Zofran first."

"Because it is more expensive and not as caustic."

"Uh, yeah," Terry said, looking a little confused.

"We've been through this before." Sam was watching the other man.


Dean was watching Sam pace. It seemed to be the only thing keeping his brother in check. The doctor had shown up twice in the last two hours to tell them she was working on getting them the scheduled barium swallow the next day. Sam growled a little louder every time she came back. Terry checked on Dean regularly, even though he was not the nurse assigned to his case. It was getting harder and harder to concentrate, though, because even with the morphine and anti-nausea drugs in his system, he still couldn't swallow and the slowly tightening muscles felt like being choked to death.

Unfortunately, that brought back a memory of almost being choked to death. That anxiety combined with the spasm that was already wrapping an iron band around his chest kicked off the worst spasm to date. He was pretty sure it was going to kill him this time. They finally hooked him up to some oxygen, but it was way past his ability to keep it under control. Usually a little morphine, some deep breathing, Phenergan and he could leave in one piece. This time it was completely beyond his control and he could feel tears trickling, unbidden, over his cheeks. Dean tried to stop them because he knew it freaked Sam out, but he couldn't this time. Sam glanced over at him, stopped, squinched and walked out of the room. Dean could hear his voice and a moment later Terry was back with Sam and a syringe. Dean heard "more morphine and Ativan" and then the weird pressure at the base of his skull that he always got with morphine.

It knocked it all back enough for him to take a breath. He closed his eyes and let the drugs work and started to get things under control.

"What?" Sam's voice had the low dangerous pitch that kicked off the alarms in Dean's head. He opened his eyes, his brother and the doctor were standing just outside the curtain.


"Oh no, oh hell no," Sam growled. "I want him transferred right now."


"Transferred now."

"Mr. Iommi…"

"Did you or did you not give my brother a shot of sugar?"


"Sammy?" Dean called, the tone in Sam's voice was scaring him. When his brother stepped into the room he was even more worried.

"We're getting you transferred to the hospital in the next town, Dean."


"Yes, we are, doctor. We are transferring him, you are calling ahead and arranging it and I will be calling his doctor and making sure they know why we are there and who they need to talk to about what's been going on."


"A fucking placebo, Dean. They gave you a fucking placebo. We waited until the radiologist was gone—even though they were expecting you and then they gave you a placebo because this woman thought you were faking. We are going."

"Sir, I…"

"I want his chart too."

"You can have it during normal business hours."

"No, I saw the supervisor out there, I want it right now. The whole damn thing photocopied. In my hands and in my sight. I don't want anything going missing."


"I already called Brian's service and left a message." Sam loomed over the doctor.

"Here's the chart," Terry handed Sam a sheaf of papers.

"I won't authorize a transfer by ambulance," the doctor said.

"That's fine," Sam said, his voice so completely calm Dean was surprised that the order to evacuate hadn't been given. Hurricane Sammy was about to blow. "I'll transfer him." He handed Dean his shirt. "And we'll be talking again soon too, I think, doctor."


"Can you make it for about fifteen minutes, Dean? Terry told me how to get to the hospital the fastest way."

"Is that why he just gave me the morphine and Ativan?"


"Okay." Dean let his brother help him off the bed and they headed towards the doors.

The doctor was walking towards them. "Just don't," Sam said, opening the door. He smiled sweetly at the girl at reception. "Can I get the number for feedback? I want to make a comment about our awesome care."

"Sure, here it is."

"Thanks." Sam tucked the card in his pocket.

"Brian told us to come."

"The order was here."

"They ignored it," Dean said.

"They did worse than that Dean. I'll tell you when we get you comfortable." He helped Dean out to the car and carefully closed the door.

"Okay." Dean closed his eyes and focused on not panicking as he tried to swallow through the pain and the terrifying band around his throat. "Not far, right?"

"Nope, just hang on."

"I'll do my best." Dean felt a tear trickle over his cheek.

To Be Continued.