Author: hansons-angel
Genre: Gen
Rating: PG-13 for language
Word Count: approx. 56,900
Spoilers/Warnings: General spoilers for any episode in seasons 1-5. I don't believe in warnings for every little thing, but as for the big triggers - this story does NOT have those. However. It does have a character death, so if that's upsetting for you to read, please don't read it.
Summary: This isn't a story about the Apocalypse. It's not even really a story about demon hunting and the supernatural, though all these things are featured. It's an AU story about the deep bond that brothers have, and the lengths they'll go to for each other, beginning when Sam and Dean Winchester are children, and Sam needs a kidney transplant. It's not about one brother over the other, but the idea that, without one brother there isn't the other. It's an exploration of sacrifice and unconditional love, the study of what family can mean - what it should mean. It's about love and despair, fear and grief, heroism and ultimately - hope.
A/N: Wrote this for LJ's Big Bang in 2010. I no longer have an account over there, and I am not really writing a lot of SPN fic anymore, but I did want to archive this story somewhere, along with my 21 Jump Street story, "The Mission Field." These are the two stories I've written that I'm most fond of, and after some thought, I decided I wanted to put them in a place from where they could always be retrieved. If you do wade through this, remember it is definitely AU, and I wrote the majority of it before the end of S5, some of it before I knew there was going to be a sixth season, so it was definitely Kripke'd. Also, keep in mind I try to be accurate with medical details but I probably have a few slip-ups in this - apologies to anyone who knows more than I do about kidney disease.
/
Sam Winchester's entire life has pretty much been about revelations.
Revelations about who he is.
Who he isn't.
His strengths. His weaknesses.
His wants and desires.
Those things he doesn't want any part of.
The fact that he sometimes has no choice in the matter.
And sometimes, the knowledge he has all the choice in the world.
And choice can be as completely meaningless as fate.
There are revelations that creep in unaware, so stealthy that he isn't even sure that they're there until time passes and he thinks back on them and comes to understand that certain things were revealed to him and he just didn't know it.
And then there are revelations that up and smack him in the face from the moment they're present, revelations that are hard and gritty and breath-taking and unimaginable and impossible to linger on, they are that important and forceful, and even more impossible to deny.
There are revelations about what he can do.
What he can't do.
What he's meant to do.
But the biggest revelation Sam Winchester ever receives has nothing to do with who he is, or consequences of choices made or what he can or can't become - though the revelations he has about all those things are very important, no question about it.
The biggest revelation Sam Winchester is blessed with has to do with things being given and things being taken away, how things that are seemingly right are not meant to be, and how things that should be so wrong end up being the best gifts that can ever be given.
/
When Sam Winchester is five - and, ironically this is one of Sam's first "real" memories, sitting in a doctor's office with his older brother, Dean off to one side and his father, John on the other, some imposing figure seated behind a big brown desk in front of all of them, delivering the bad news while Sam plays with a toy truck, running it around the big, brown desk and then over Dean's arm, until Dean bats it away and hisses, "Stop it, Sammy," - they find out he has some kind of kidney thing, something called polycystic kidney disease. PKD for short, as Sam comes to understand, as he gets older and the disease becomes more entrenched. He's always had weird - things - throughout his life, fevers that come and go, soar high and then disappear, in a nearly predictable pattern of every six to eight weeks. The fevers gradually become less frequent as he grows a little older but he has other things, pain in his back and sides that appears and disappears, pain that Sam can't even walk through some days, that John chalks up to "the flu." Whenever these "episodes" happen, John ends up carrying Sam to the couch and setting him up in front of the tv while he and Dean bring him glasses of ginger ale and bowls of chicken noodle soup until the pains pass, or at least lessens enough so he can get around again.
He's small for his age, delicate almost, something that his father attributes to Sam "not eating enough," but it's often hard for Sam to eat, either because he's not all that hungry or he's downright nauseous, and if John was paying closer attention to things, he might figure out a pattern to all of it, how the fever precedes the lack of appetite which either coincides or comes right on the heels of the debilitating pains in his side and back. But John doesn't pay terribly close attention, not when whatever ails Sam seems mild enough despite the frequency of it, and he's got other things on his mind, the obsession with tracking down whatever it was that killed Sam and Dean's mom - Mary - always at the forefront.
Because he's around more, it falls on Dean to pay more attention and Dean does pay attention, somehow understands that, young as he is, something is not right with Sam, that he's getting "sick" way more than he should, even if it doesn't appear serious. Dean would know; he hardly ever gets sick himself despite the fact that he's in school all day long and has plenty of opportunity. On the days when Sam is hurting or feverish or just plain feels like crap, Dean will bring him whatever he needs without complaint, without saying much of anything, really, but it isn't until later, when Sam is quite a bit older that he understands Dean's grim-faced actions were borne out of equal parts worry and suspicion and annoyance. Worry that something was really wrong with Sam - which there was - suspicion that they weren't doing enough to find out what was really going on - which they weren't - and annoyance at their father for not taking everything as seriously as he should.
Which is true.
It's Dean who finds him unconscious in the bathroom when he comes home from school one fall afternoon - Sam remembers little of it, other than he was five, home from kindergarten and John had just run out to pick Dean up from school. His back had been hurting enough that John was considering driving him to the nearest ER after he picked up Dean; he'd practically crawled into the bathroom after John left, tears of pain running down his cheeks. He doesn't remember anything after that until he'd woken up in the PICU of the local hospital, attached to a ventilator. According to Dean and John, he'd passed out trying to go to the bathroom, and Dean had found him unconscious on the floor, the toilet filled with fluid the color of Coke. They'd been unable to rouse Sam and had frantically raced him to the hospital where things had slid even further downhill from there, the medical people determining that Sam was a very sick little boy, his kidneys and liver were failing and then his heart started to go as well and that's when he'd been put on the ventilator.
No one knows what's happening at first but eventually the tests come back and they find out Sam is sick. Deathly sick, and has been since he was born, some kind of congenital kidney disease which has systematically destroyed his right kidney, covered it with enough cysts to effectively shut it down and partially knocked out the left one as well, all of it happening unbeknownst to any of them.
They find out it's pretty much incurable.
They find out that, despite the fact that they get Sam's remaining kidney working again, and his heart and liver right itself, he'll most likely need a kidney transplant at some point down the road.
They discover that their lives - already unconventional and unfortunate and just downright fucked up at times, what with the loss of their mother and the lack of money and the long absences of John - are about to become even more haphazard and difficult in ways they'd never imagined possible.
There are very few revelations as important to Sam Winchester than the one he has handed to him in 1991, when they're in Broken Bow, Nebraska.
He's eight, and Dean is twelve and it's Christmas.
John is gone.
John, once again, has lied.
But Dean is there, and Dean doesn't lie.
Sam is nobody's fool, even at eight.
Lying is a big deal to Sam by then, being told the truth about his health something he relies on his father and brother to do, especially with how much time he has to spend in hospitals and doctors' offices, and what could likely go wrong with him if he does or doesn't do certain things. He's always assumed both John and Dean have told him the truth about everything - and not just with the whole sickness thing - but with everything.
Turns out, that isn't the case.
He's suspected for awhile that John's doing questionable things, things involving secrecy that could even get him - them - into trouble. He's known for awhile that Dean sleeps with a gun underneath his pillow, and then, to put the icing on the fucking proverbial cake, in a pique of frustration with every damn thing, Sam picks up John's journal and reads it cover to cover in a mad rush while Dean's out Christmas Eve day.
And has his eight year-old mind blown to bits.
His Christmas present for John - the amulet - the amulet that Uncle Bobby told him was "special," the amulet that Sam planned on giving to his father because it is so special - suddenly becomes his present to Dean because it becomes clear to Sam that Dean is more worthy to receive the gift than John, after Dean tries to not only give Sam a Christmas but tells Sam the truth about what their father does when he's "away," understands that it's more important for Sam to know what's going on - painful as it might be - than to be kept in the dark - about anything.
Dean has always understood that.
So they "celebrate" Christmas and Dean gives Sam a gift more precious than anything material could ever be - the truth - and Sam gives him something special - or, at least as special as he can give - to Dean in return: the amulet meant for John. Of course, it isn't "just an amulet," and it's true significance won't become clear to them until almost two decades later, but from the moment Dean places it around his neck he makes it clear that he regards it as something eternally special to him, something he proves over and over by never taking it off unless he has to.
Christmas Day night, when they're lying side by side in the motel bed, no word from the still absent John, Sam feels himself becoming drowsy - but something is nagging at him, something he knows he'll need cleared up before he can fall asleep. "Dean."
And Dean is as sleepy as he is. "Hmm?" It sounds as if he's barely listening.
"What about me?"
"What about you?"
"Will I be all right?"
"Sam, I told you already. Dad's good at what he does. He's not going to let anything happen to us."
"No," Sam says. "I don't mean about that. I mean - about what's wrong with me. The kidney disease. Am I going to be okay?"
It's a question that's always in the back of his mind. Because even though Sam is eight, he knows that he isn't "just sick," every now and again, that having to go to the hospital every few months and take pills all the time and feeling crappy out of the blue for seemingly no reason goes beyond what "being sick" means for most people, and while he's never really come out and asked his father what's up with all of it, he suddenly thinks maybe his father wouldn't give him the full story anyway, not if he's already kept things from Sam, has left it up to Dean to be the one to fill Sam in on things.
"What kind of question is that?" Dean grumbles. "Aren't you okay right now?"
"Yeah," Sam agrees. "But I'm not always okay. You know that. And I've heard Dad and some of the doctors say stuff about - me." He's only eight, and can't always get what he's referring to into the words he wants to say.
But Sam does know about being very sick, being close to - death.
"About how I could die."
Dean rolls sleepily toward him, one arm nestling underneath Sam's back and lazing across his shoulder. "You're not going to die. Not while I'm around," he whispers. "As long as I'm here, nothing's going to happen to you."
"Are you sure?"
"Promise," Dean says, for the second time in as many days and gently ruffles Sam's hair through his fingers, just for a second. "It's what I'm here for. To take care of my pain-in-the-ass baby brother. Everything will be fine, Sammy. But right now you need to go to sleep."
And Sam does, rather easily if he remembers correctly, and he doesn't doubt again, not about Dean being there to protect him, to be there for him - not just through the hunting stuff, the supernatural secrets that he's just been let in on - rather hastily and rather brutally - but everything - everything and anything - important in Sam's life.
Dean will never hold back from him.
Dean will always be right there for him. No matter what.
Sam is only eight but he's still aware that this is a revelation, a truth that lulls him to sleep that night and one he carries with him everywhere he goes starting from the moment he wakes up the next morning. Of course, as Sam's life goes on, he doesn't always give this thought.
But he knows it's always there.
/
Sam is eleven, in the fifth grade, when his one working kidney craps out on him.
They don't know it at first, just think he's having one of his times where his lone kidney isn't working as well as it should. This has happened before - more times than Sam cares to remember - where his kidney stops working the way it should and he ends up sick and in the hospital until they can get it functioning right again.
This time is no different. He comes home from school one day tired and weak and throws up his dinner, something he's done in the past when things are off, and John - for once around and on the ball - brings him to the doctor the next day, and they're in Texas at the time, near Dallas so the doctor who sees Sam doesn't fuck around, sends Sam onto Baylor once he finds out Sam's situation, sees what's happening. It doesn't take long for the people there to figure out just how serious everything is.
Sam's other kidney has shut down and he needs a kidney transplant.
John and Dean learn very quickly that it's not going to be as easy it sounds.
It's not as if every hospital is stocked up on kidneys, just waiting to be transplanted into those who need a new one. There needs to be a kidney with a close match, which isn't that easy. They test John immediately, but despite the optimism of the staff, that the best match for a donor is usually a close relative like a parent, there's something weird and abnormal with John's blood, something that Sam's blood doesn't have or some weird shit - it's something rare but whatever it is, Sam's body won't tolerate John's kidney inside him and they're back to square one, Sam needing a kidney and nowhere to find one. There's a data base, a waiting list and Sam is put on it, but for whatever reason, a close match - even a reasonably good one - eludes them for the next couple of years.
"What about me?" Dean asks, when they find out that John can't be the donor. "Maybe I'm a good match."
"You're not old enough," John says right away, and the nurse, or social worker or whoever it is helping them out, immediately agrees and tries to push the conversation elsewhere. But Dean's having none of it. "How old do I have to be?" he presses.
"Dean." This from John, harsh and clipped in its finality. Shut-up. Don't ask questions about things you know nothing about.
The woman - and Sam doesn't think she's a nurse, but some other official type person - hesitates but then answers Dean's question. "Eighteen. But hopefully there'll be a donor for Sam long before then."
"Can I at least find out if I'm a match?"
"We don't involve minors in any way with the donation procedure," this woman says firmly, leaving no room for any further argument. "But if Sam still needs a kidney at the time you turn eighteen, we'll be happy to test you and see if you're a match. But as I said, I think we'll find a donor for Sam before then."
It's easy to see that this woman is very good at her job - saying all the right things, dangling all the correct assurances in front of them. Even Sam can see that.
It's too bad she's completely wrong, and there is no kidney donor for him in the foreseeable future, and it becomes almost three years of pure hell for him, possibly the worst period of Sam's life.
/
The next step is dialysis, something that's fucked up and invasive and nothing that Sam is really ready for, regardless of the preparation he's given. As much preparation as an eleven year-old can be given.
It's also something that he needs to survive.
John explains to the medical people how his "work," takes him all over the country, how he can't really stick around in any one place to make sure Sam gets his dialysis treatment three times a week. The staff is just as aggressive with him in return, wondering what sort of job he has that makes him travel all over the place yet doesn't give him health insurance and everything has to be paid for with Medicaid and other government subsidies. Of course, John can't tell them his "work" involves hunting and killing things in the supernatural world, and the doctors are just as adamant that Sam needs this treatment, that it's going to not only involve long hours hooked up to some kind of dialysis machine but medications and diet requirements and follow-up visits with a nurse, if not a "patient care team," at least every couple of weeks.
In other words, it's serious business and the medical people are a little put out and not a little concerned that John doesn't seem to grasp the gravity of the situation, that Sam has no kidneys left, that the dialysis is all that is standing between him and death for right now.
Dean, of course, gets it right away.
He tries to drop hints to John, get him to see reason on the subject even though he and Sam both know that, while he gets it, he isn't going to give up hunting, is not going to rest until he finds out what happened to Mary. He might change the approach, take things in a different direction but he won't stop completely, not for either Dean or Sam.
He never says this out loud, but they both know this is his stance.
And perhaps the staff picks up on this as well, and rather than risk him taking flight with both boys before they have a chance to get things under control, they switch tactics and cautiously bring out some other options for him, something to do with doing all the dialysis treatments at home instead of bringing Sam in three times a week for them. It would involve putting some kind of catheter in Sam's stomach, John - and Dean, eventually - learning how to inject some kind of solution into this catheter and then exchanging it for another and having it run through some kind of machine - or some such shit - but the upshot is Sam could have all this done at home and they wouldn't have to be tied to any one place, necessarily.
The medical people don't really come out and say this in so many words, but that's the implication.
So John goes for it.
And by default, Dean goes for it as well.
But it's pretty much Sam and Dean that end up learning how to do everything they need to do to keep Sam's blood free of toxins, first Dean and then Sam as he gets older and becomes used to it. It's not a super hard procedure, doing the dialysis at home, and most of it takes place when Sam's asleep. There's just steps that they have to make sure they follow so that there's no infection, no fuck-ups so that Sam gets sick.
Dean's fine with doing all of it. None of it bothers him in the least.
John's a different story.
Oh, he can do everything, he's not an idiot so he knows what the steps are as far as pouring what solution into the catheter, how to clean everything, how to do - whatever.
But after the initial hoopla surrounding everything, the two weeks of training to learn how to do all of it, the endless visits with the nurse who comes in, the constant phone calls back and forth between everyone, John basically bugs out on the whole dialysis thing and by default, puts Dean in charge of everything.
Because Dean will do it.
Dean will never not do something for Sam, especially something this important, and John knows it.
Though luckily, Dean doesn't mind. Or, at least he doesn't seem to, doesn't ever show signs of resentment that he basically has to quit the hunting - something he'd started really getting into right before Sam's remaining kidney shut down - and be tied to the house every day to help Sam with all the dialysis crap. If he's pissed that he's the one who has to make the calls to the doctor's offices or the hospitals or where the fuck ever or see that Sam keeps his follow up appointment or just even have to mess around with the fucking catheter and solution and machine every damn night, he never lets on, never even seems annoyed or pissed. He does what needs to be done and on top of that, tries to make it as easy as possible for Sam, which Sam himself can't think on too much because he knows it's not right for Dean to have to do all this but then to do it and put Sam ahead of himself without a second glance back is -
Well, too much. Just too fucking much sometimes is all.
Sam has no problems being all kinds of pissed. Sometimes pissed with his situation, sometimes pissed with Dean for different reasons, some valid and some just petty, but mostly with his father, reasons that gnaw at Sam night and day and having to do with how his father doesn't seem to give a fuck about either Sam or Dean - not really and not in the long run. Because Dean is who he is and doesn't seem bothered by anything, Sam eventually is able to push his own resentment aside, slowly but surely accept what his brother does for him as the gift that it is. But he never completely lets go of his anger toward John and it remains something that lingers within him for a very, very long time.