Disclaimer: Supernatural and its characters are the property of Eric Kripke. Sadly, I do not own any of these guys.

"If the situation had been reversed – if I'd been the one dying – you'd've done the same for me."

"No, Dean. I wouldn't have."

For a moment after Sam spoke, neither Winchester was sure of what to do next. The words of their exchange hung heavy between them, especially those last three. Sam stared hard at his older brother, his eyes glinting coldly in a way that dared Dean to get angry, lash out at him, something to try and prove Sam wrong. Dean just stood there for a few seconds, blinking in stunned silence at what his little brother – the one he'd risked life and limb for time and time again – had just told him. Sam would rather have let Dean die than work to bring him back.

"I'm gonna head to bed," Sam said quietly, jaw locked firmly in place and not a hint of remorse in those defiant green eyes. Dean watched him go, still too dumbfounded to offer any kind of retort. When Sam's footsteps finally faded out of earshot, he sank down into one of the chairs at the table, his eyes drifting blankly over the label on the whiskey bottle while he poured himself another glass. Of all the things Sam had ever said to him in the last three decades, that one probably hurt the worst.

Was it true? Was he really the selfish one? He'd never thought about it before, not really. From the moment their mother had burned on the ceiling all those years ago, Dean's only real mission in life had been "protecting Sammy." It wasn't something he put in terms of right and wrong; it was just instinctual, something as second-nature to him as eating or field-stripping a gun. Hell, Sam was practically Dean's son, for all the time he had spent raising the kid compared to John. To let Sam die went against every single thing he'd ever learned, and everything he thought was right. It was simply not possible for him to do so. He'd tried four years ago, at Sam's request, and the effort of living without his little brother, of not going after him when he knew he could, had very nearly destroyed him.

Sam knew that, and yet here he was, essentially telling Dean that he'd rather be dead than have let his older brother save him. If that wasn't a slap in the face, Dean didn't know what was. He'd never had kids before, other than the year he spent with Ben, but hearing that from Sam's mouth… Even at his lowest, Dean had never wished for death. It was so permanent, so lonely, and so painful for the ones left behind. He could only imagine that this was what a parent would feel if their son had said there was nothing to gain from being alive.

Did Sam really think so little of him? Think that after all they'd been through together, as brothers and not just fellow hunters, Dean had just kept him around because he didn't want to be alone? If that's all Sam thought he was worth, Dean had seriously failed him, because he was so much more than that. He was Dean's purpose, the very last thing keeping the shattered, beaten-down hunter tied to the world of sanity when every other friend but Castiel they'd ever had was either dead or forever out of reach.

Anger boiled in his veins as he gulped down a second glass of whiskey, and he clenched his fists on the table so hard it made the muscles in his arms begin to ache. Well, if that was how Sam viewed it, like some poor victim forced to live in a cruel world where his brother kept him alive to suffer just for company's sake…

Maybe John had been right all along.

Maybe Sam should've just stayed gone. Obviously he was so terribly miserable having to stay around his selfish older brother. Would he have been happier if Dean hadn't sold his soul for him at Cold Oak – hadn't endured forty years in the Pit just so Sam's life wouldn't be cut tragically short at only twenty-three years old? Was that the reason Sam hadn't looked for his brother while he was stuck in Purgatory? He was happier without Dean around to tie him down? Tears began to pool in the older Winchester's eyes, and he didn't bother wiping them away; not like anyone was going to come in and see him cry.

As he stood up and made his way to his bedroom, he could feel his heart racing, pounding painfully as the full implications of what Sam had said slammed into him. Maybe that was it. Maybe Dean was the only one who enjoyed having his brother around, and Sam was still here just because he had nowhere else to go. Maybe Dean really was the selfish one, too wrapped up in his personal quest to keep Sam alive and put him back together to notice that his brother… hated him? Hated him, that must be it. And apparently enough to say he'd let Dean die if their roles had been reversed.

"Oh, God, what do I do?" Dean whispered, hearing the hitch in his breath moments before he felt the hot burn of salty tears streaking down his face and onto his pillow. "Am I really that much of a monster? Is that the kind of person I've become now?" That thought was absolutely terrifying, and he had to swallow hard against a sudden feeling of nausea. He felt like there wasn't enough air in the room; guilt was always very efficient at making him feel like his ribcage was wrapped in an iron belt.

He sat there for another ten minutes, trying to get control of himself and let his body catch up to his mind. The tears gradually slowed and finally stopped, the nausea dropping to a more manageable level when his breathing ceased its stuttering and evened out. His chest still hurt, probably from the effort of forcing himself to suppress so many sobs, but aside from that he was fairly relaxed.

Or at least, he was relaxed for a minute or two. For some reason, the feeling of having an iron band around his ribs hadn't lessened; in fact, it had gotten worse. Come to think of it, his entire upper body was sore, and hurting more by the minute. He grunted when his neck and jaw muscles throbbed particularly painfully, cursing that rogue Pishtaco for making his life so freaking difficult. He hadn't felt completely right since he'd eaten that drugged pudding, and having to fight something with all the strength and speed of the average vampire certainly hadn't helped.

He stood up from the bed, prepared to go grab some Tylenol and let whatever muscle he'd pulled heal on its own, when all the strength in his legs suddenly drained away, sending him to the floor on his knees as the pain suddenly ratcheted up a notch, shooting across his chest and down both arms. Dean's eyes widened, his breath quickening as he realized what was happening to him. As he dragged himself toward the bedroom door, feebly calling out his brother's name between pain-filled gasps, he prayed that Sam had just been blowing smoke earlier about being willing to let him die.

If not, he was completely screwed.

Sam had regretted what he'd said the minute it had come out of his mouth. The look on Dean's face – the raw, unconcealed hurt replacing his brother's usually confident mask – was almost enough to send him into frantic apologies right then and there. But he couldn't. He had a point to make, and he had meant what he said about being ready to die.

He'd also meant what he'd said about letting Dean die if their roles were reversed, but he had a feeling his brother had completely misinterpreted his words. It wasn't that he didn't love Dean. He did – probably, no, definitely more than he had ever loved John as a father figure. But Dean and Sam were really not all that much alike. Sam was alright with being alone, and living life only for himself and the few others he chose to associate with.

Dean was the exact opposite. He put others' wellbeing, especially his family's, above his own at all times. He was happy when they were happy, and when he was with them. Sam understood that, and he understood that Dean needed him, as the last member of his family, around to ever have a chance at happiness again. That was fine. He didn't always like it, but he understood. He also knew that because he was so different from his older brother, he'd never be able to reciprocate the sacrifices Dean had made for him. Maybe it was because he was sometimes a little too uncaring, coldhearted, or even just inherently selfish. But whatever he might be, Dean seemed to know, to understand, and to care about Sam regardless.

What Dean apparently didn't understand was what Sam had meant by what he'd said earlier. What he intended to say was, "If you died, you'd get to see everyone you've lost and mourned. You'd get to be happy again. And because of that, it wouldn't be right to keep you here, in this screwed-up world, with only me for company." Of course, in the heat of the moment he hadn't been able to sound nearly that eloquent, so what Dean had most likely interpreted was "You're not worth enough to me to save if I have to make a sacrifice to do it."

A fresh wave of guilt assaulted him when he came to this realization, and it took only a few minutes to gather his courage enough to get up and start making his way to Dean's room. He hated these overly-emotional conversations, especially when they were supposed to be on "strictly business" terms at the moment, but this was simply too large a misunderstanding to let go. Pride be damned if it meant healing some of the immeasurable damage he'd probably just done to his brother's trust in him.

He had made it halfway up the hall when he got the sense that something was off. He couldn't rationalize it – nothing was out of place, there weren't any strange shapes in the shadows, and everything was as quiet as it should have been at night. But still, something spurred him on into a jog, taking him to Dean's closed doorway before he even knew why. When he reached it, he thought he heard Dean close to the door on the inside, muttering something in an uncharacteristically weak voice. That sent off alarm bells in his head immediately; was he drunk, or was it something else?

"Dean?" he called, rapping the door three times with his knuckles and hoping his brother was just suffering the effects of a little too much booze. "You alright?"

A moment of silence, and then:

"S-Sammy… Help… Need help… Please, Sammy…"

That was all the motivation Sam needed. He opened the door as quickly as he could, glad all of the doors in the bunker opened outward when he saw how close to the door his older brother was sitting. It took less than a second to realize that Dean looked absolutely terrible. His face was pale and clammy, making his stubble appear darker than ever, and deep gray circles stood out prominently under his wide eyes. He was bent double over his knees, one hand pressed against his sternum and the other keeping him from falling face-first into the carpet.

"What's wrong, Dean? Are you hurt?" He knelt down beside his brother, checking him for fever despite the pallor of his skin.

"My chest…" Dean said breathily. He groaned and swallowed hard, staring blearily at Sam and clutching his shirt in his fist as he futilely tried to ease some of the agony behind his breastbone. "I think I need a hospital, Sam. This feels like a… a heart attack…"

"You sure?" Sam asked, praying this was some kind of sick joke. He knew his brother wasn't one for these kinds of pranks, but the timing of this seemed almost too perfect to be real. Honestly, what were the odds that his brother's healthy heart would start acting up right after Sam – hopefully metaphorically – had done his best to break it?

Dean nodded, continuing to pant when Sam slid a hand flat beneath his to feel the rapid heartbeat hammering in his chest. "Had two in… my life, remember? Both of 'em felt… a lot like this…" He whimpered softly, then, clutching at Sam's jacket when the larger man moved to stand up. "Sam, what're you – don't l-leave me here!" he gasped out, his voice shaking terribly.

"I'll be right back, Dean. I promise," Sam said, feeling his own voice threaten to crack at the raw fear in Dean's words; he really did think Sam was going to leave him for dead. "Just wait here." He didn't give his brother time to retort, instead rushing out of the room and running down the hall, snatching a bottle of aspirin from the bathroom and his phone from the bedside table. He had already dialed 911 by the time he got back to Dean's room, and he popped open the bottle of aspirin and shook two out into his hand while he waited for them to answer.

"Here, chew these up," he said, pressing the pills against Dean's lips and making sure he did so as the dispatcher finally picked up. "Yes, I think my brother might be having a heart attack," he said in a voice that was surprisingly steady, all things considered. "Thirty-five. I just found him here, so I don't – hold on. How long has your chest been hurting, Dean?"

"Maybe… fifteen, twenty minutes?" Dean answered, trying to stand and grunting in pain when it just made his chest throb again.

"Hey, stay still!" Sam hissed, pulling Dean over to lean heavily against him before turning his attention back to the woman on the phone. "About twenty minutes. Trouble breathing?" That question was apparently meant for Dean again, and the older Winchester nodded, still panting harshly as he tried not to vocalize his pain and fear. "A little bit. Yeah, I just gave him two aspirin. No, I'll drive him there. It'll take them too long to find us," he answered when the dispatcher offered to send an ambulance. "Okay. Okay, thanks."

"What'd… they say?" Dean asked, hoping that talking would distract him just a little from how scared he was right now. Freaking out with an already elevated heart rate was probably not good.

"The docs in the ER'll be waiting when we get there," Sam said, for once cursing the fact that the bunker was a place that had to be kept secret. He'd feel much better if the paramedics could take over, since they were better equipped for this kind of thing. "Come on. No time to waste." He bent down and picked up Dean's full weight, carrying him bridal-style. What really frightened him was that Dean let him; he didn't even try to protest as Sam hauled him out to the garage, seated him in the Impala, and tore off down the street as fast as he could without killing them both.

He kept up a steady stream of pointless babble the entire way, strings of "You'll be okay," and "Hang in there," and "Just a few more minutes," in an attempt to keep Dean's attention on him and keep himself from thinking too hard about how exhausted and quiet his brother had become. "Almost there, Dean. Almost there," he said when the older hunter listed to the side and leaned against Sam's shoulder. "Everything's gonna be fine."

He'd never wanted to be more right about anything in his life.

It was a couple of hours before Sam was allowed to see his brother again. As soon as they'd stepped into the ER, the nurses had taken Dean away in a wheelchair, saying something about EKGs and "possible myocardial infarction" and lots of other medical terms that Sam wished he didn't know the meaning of. After the first twenty minutes of filling out paperwork, he did something he hadn't done in a very long time – he prayed. He prayed to Castiel for an hour and a half, begging their friend to tear himself away from whatever angelic business he might be attending to and take care of Dean. He prayed for his brother to be alright, and that the last thing Dean would ever hear from him wouldn't be "I would let you die."

"Oh, God, please don't let that be the last thing I ever say to him…"

Finally, when he was sure he couldn't stand the waiting any longer and still be sane, a nurse came out to find him – he'd been so terrified he hadn't even been able to think of an alias for Dean this time. He was up and halfway down the hall almost before she'd finished saying Winchester, and when he finally reached Dean's room he very nearly dropped to his knees in exhausted relief.

Dean was sitting up in bed, dressed in standard-issue scrubs loose enough to let a multitude of electrodes and monitors trail out underneath it to their machines. A doctor stood nearby and adjusted a few bags of intravenous fluids that hung beside the bed, dosing him with medications Sam couldn't even read the names of at this distance, and an oxygen cannula was situated under his nose. But overall, he looked worlds better than he had when they'd come in. He even offered a tired smile when he saw Sam, and damn if that didn't make the younger Winchester feel like the world's biggest asshole.

"Heya, Sammy," he said softly, his voice a little raspy but a lot steadier than it had been. "You got here just in time. The doc's about to tell me what all they found out, and I figured they'd better tell you instead, since you're the geek of the two of us."

"Sure. Okay."

"Alright, Mr. Winchester," the doctor said, adjusting his glasses as he flipped through Dean's chart. "The good news is, this wasn't a heart attack. What you experienced tonight is called Prinzmetal's variant angina, or a coronary arterial spasm. Basically, the walls of the coronary artery contract repeatedly, temporarily cutting off blood flow to the heart. It can feel very much like a heart attack, and left untreated it can sometimes lead to cardiac arrest, but it's usually not caused by a blockage or blood clot."

"So what causes it, then?" Dean asked, and Sam found himself preparing to memorize whatever the doctor said.

"Coronary arterial spasm has several causes, but some of the most common would be smoking, drugs, excessive use of stimulants, extreme stress, and alcoholism. It's also more common at night or in the early hours of the morning, and usually in people under the average age for heart disease. The good news is, it's easily managed and usually temporary, so if you take care of yourself you shouldn't have to worry too much."

Sam tuned out whatever the doctor said next. He had ceased hearing any of it after "stimulants and extreme stress." Stimulants... Come to think of it, he had been the one to give Dean that super-caffeinated energy drink when he'd been drugged, trying to bring him out of it. And then Dean had been drinking later, right about the time… Oh, hell. Right about the time Sam had essentially told him he wasn't worth saving. "This is all my fault. Oh God. Oh God."

"Sammy. Hey, Sam. Sam!"

"Huh?" he said with a startle, not even realizing Dean had been talking to him. Apparently he'd been spaced out long enough for the doctor to leave, too, because they were suddenly alone in the room. He just hoped the doctor and Dean hadn't seen the way tears were beginning to pool in his eyes.

"Jeez, what's the matter? The doc just said I was fine, remember? What are you brooding about now?"

Dean wasn't expecting six-and-a-half feet of bawling Sasquatch to come over and grab him like a giant teddy bear, but that's exactly what happened. He sat still for a moment, dumbfounded, as Sam leaned over the bed and held him almost tight enough to rip the electrodes from his chest, sobbing and hiccuping hysterically as he muttered something that was total gibberish to Dean's ears. It didn't really matter what the reason was, though. A crying Sammy was always something Dean needed to deal with, whether he was three or thirty.

"Hey, hey," he said softly, reciprocating the hug and not caring that this was without a doubt the chick-flickiest moment he'd had in a long time. "What's wrong? I'm gonna be fine, Sam. Give it a few weeks and I'll be back to burgers and pie like nothing ever happened, okay?"

"…my fault…"

"Huh?"

"I said it's my fault," Sam said, staring up at Dean with a terribly guilty look on his face. Thinking he was going to lose his brother for real had temporarily stripped away all pretense of being a tough, heartless hunter. Everything they'd been through today had made him as scared and vulnerable now as he had been when he was five.

"What are you – how in the hell would any of this be your fault, Sam?"

"Remember what the doctor just said – stimulants, stress, and alcohol? After you got drugged, I gave you that ginseng energy drink, and the caffeine probably caused some interaction with whatever the drug was since I didn't know what they'd given you at the time."

"Told ya, Sammy. All that health food crap is bad for you," Dean said with a chuckle, but Sam only glared at him.

"That isn't funny! Who knows what kind of drugs they gave you! And then you were drinking a bunch of whiskey when I said…" He couldn't finish the sentence, but he knew by the look on Dean's face that he understood anyway. "I'm so sorry, Dean. What I said, I… I didn't mean it the way you probably heard it."

Dean tensed, gazing away from Sam for a moment with a look of deep hurt in his gaze, and sighed. "So what did you mean, then? Because telling me you wouldn't have bothered to save me if I was dying after the Trials sounded pretty damn clear to me." He hadn't wanted to discuss this, but if Sam was this broken up about it, obviously they wouldn't be able to brush this one under the rug.

"No! That's not it!" he said vehemently, standing up and pacing around the room anxiously. "I just… How do I put this? You're not like me, Dean. I don't mean that in a bad way," he added when Dean quirked an eyebrow in apparent offense. "I can survive fine without having people to lean on, or to protect. I might like it better when I have friends, but I can make it fine without. You, though, you can't. That's why, if the situation was reversed, I'd've let you go. You'd have gone on to Heaven, man, and everyone you ever knew would be waiting for you. Why in the hell wouldn't I let you have that over staying in this unfair, demented world with just your screwed up little brother for company?"

Dean's face was totally serious when he answered that question. "Because my screwed up little brother's the whole reason I started hunting, Sam, and this 'unfair, demented world' is where he is. Wherever my family is, that's where I wanna be. End of story."

Sam stared at him, completely at a loss for words. How had Dean, even on some really good pain medicine, somehow managed to take everything Sam was worrying about and wave it away like he was a little kid again?

"So, are we good now? You gonna drop this whole 'don't sacrifice yourself for me because I'm not worth it and I shouldn't be alive' crap? 'Cause personally, I think I suck pretty bad at not acting like your brother, and I'd appreciate it if you'd just cut the tough guy act and save me the embarrassment."

Sam smiled, his first genuine smile in a long time, and nodded. "Yeah. I can do that."

"Good. Now go to sleep. We both know you only get this emotional when you're too tired. It's been that way since you were born."

"Fine," Sam said, stretching out in the chair with a yawn when he realized it was three in the morning. "But only if you get some sleep too."

Dean yawned too, and turned his back to Sam so he could bury his face in the cool side of the pillow. "Deal."

In spite of all that had transpired over the last few days, the two of them slept peacefully for the rest of the night, neither having nightmares for the first time in a long time. And from his perch outside the hospital room window, Castiel smiled warmly at the sight. Tomorrow, he would heal Dean completely and make sure nothing like this ever happened again. But for now, he was just happy to see that Sam had finally figured out how much he needed his brother. That familial love, more than anything else, had always been what set humans apart from the angels. And he was sure that someday soon it would help the Winchesters save their world yet again.

A/N: Okay, so the inspiration for this story was a little weird. Lately I've been getting really tired of the way Sam's been treating Dean in Season 9, acting like family is worthless and their relationship is "just business" now. And after the things he said at the end of episode 9x13, well, something has to give.

My family's always had this policy of making sure we say "I love you" before we hang up the phone or leave the house. The reason being that life is unpredictable, and you never really know if that might be the last thing you ever say to someone. So I thought, "What if Sam thinks that terrible line was the last thing he'd ever get to say to Dean?" Would he be such a tough guy then? I really doubt it. And thus, this fic was born!