A/N: Warnings for language, discussion of blood donation/transfusions, and hospital stays. No real plot, just some random scenes of h/c. I'm not a medical professional, but I try to do my research. Fun fact: the bit about the shrimping boat in Delacroix Louisiana is cannon. The title is from a Castiel quote in 7x21.
Dean had his first blood transfusion two weeks after his tenth birthday. Sammy was with Pastor Jim for the weekend while Dean went on his third real hunt with his dad. It was supposed to be just a simple salt'n'burn, but Mrs. McDoffin had other ideas. Dean manned the shotgun while John dug out the grave. Dean was a good shot, and fast, especially for his age, but Mrs. McDoffin was faster.
That wasn't the first time Dean had been thrown by a spirit. It was the first time he'd seen his own bones.
John hadn't known how bad it was, only that Dean was whimpering and that Mrs. McDoffin was screaming bloody murder. So he did what any good hunter would do and ganked the monster before it could hurt anyone else. By the time he'd crawled out of the grave and made his way over to Dean, the kid was in shock.
One unit of blood, two nights in the hospital, three different casts, and four weeks later, Dean was as good as new.
John didn't ask where the blood had come from, not any more than he wondered where the plaster for the casts came from. He only knew that his son had needed it, and had received it.
"Nurse, can I have a word?" Sam called down the hall. She wore bright pink scrubs covered with some sort of yellow cartoon character. It clashed horribly with her orange-dyed hair.
"Sure thing," she replied with an overly-cheery smile. "How can I help?"
"My brother," Sam snuck a brief glance towards Dean. He'd seen plenty of ghosts with far better color. They'd been hunting vamps, and Dean had been taken prisoner. They'd been using him as an open bar for two days before Sam could find their lair and stage a rescue. He'd not really been consious since Sam carried him to the Impala. He hadn't really even been conscious then.
"How's Dean doing?" the nurse briskly flipped through the summary clipboard. Sam noticed disinterestedly that her nametag was covered with enough overly-happy stickers to almost obscure the 'Suzie' emblazoned on it.
"Not well. He needs another blood transfusion, at least three units. Why haven't you started that?" He tried to stay professional, but internally he was furious. Dean wasn't actively dying, but that could so easily change. Blood transfusions weren't hard and they didn't take all that long to set up. Why wait when the fix was so easy?
"We've got him on saline right now to increase his volume," Suzie said placatingly. "He should be fine in a few…"
"Saline won't do jack for his oxygen levels," Sam interrupted. "He's struggling to breathe already because of those busted ribs and all those bandages around his neck. He needs blood, not fancy-ass water!"
The nurse's face fell. "I know," she said softly, her exuberant manner vanishing. "You're completely right. Dr. Fulsom ordered three more units as soon as your brother came in, but…"
"So where are they?" Sam snapped.
"We don't have enough of his blood type. In fact, we don't have any blood available for non-critical situations. Your brother has a rare…"
"Rare blood type, I know. O-negative. But isn't that the most common type used in hospitals anyway?"
"Yes and no. It's used almost exclusively on the ambulance and in the emergency room. We use O-neg when there isn't time for typing. But your brother is an inpatient, which means that there isn't such a rush."
"You've had plenty of time to find some. Where is it?"
Suzie pulled back, putting the clipboard between herself and Sam defensively. His looming height and angry tone had clearly scared her. Sam consciously calmed himself down. He couldn't help Dean if he was thrown out of the hospital.
"Sorry," he tried and failed to smile apologetically. "Just… he's all I have. And…" He snuck another glance at Dean. The heart monitor was still beeping way too fast and the respiratory stats were all wrong. After so much time spent in hospital rooms, he would know.
"Usually this wouldn't be a problem," Suzie set down the clipboard. "But there haven't been enough blood donors lately, and because it's summer we're seeing a lot more accidents that need transfusions. We have so much demand, and so little supply. I'm sorry about your brother, and we'll do what we can, but… unless something changes, other people need that blood more. I hope you can understand."
Sam closed his eyes and counted heartbeats until he didn't feel like killing everything. He hated everything about this shitty situation, from the fact that he had botched this hunt so badly that Dean needed a blood transfusion to begin with to the idea that other people apparently deserved it more. As if Dean sacrificing himself over and over and over again for Sam didn't qualify him as the most deserving. As if saving the entire goddamn planet over and over again didn't make him the most deserving. As if Dean deserved to be laying on that hospital bed, paler than the bandages around his throat and wrists, struggling to breathe because his ribs were busted and his blood volume was too low and they couldn't even give him morphine to help with the pain because that would make it even harder to breathe.
"Get out," Sam gritted out before turning away. If Suzie couldn't help, she was pointless.
Sam had his first blood transfusion five days after he finished sixth grade. They'd thought they were hunting a Black Dog, but it had turned out to be a Wendigo. They discovered this when it darted out of the darkness just long enough to gut Sam. John went after it, while Dean tried vainly to stem the endless flow of blood escaping his brother.
That wasn't the first time Dean had his brother's blood all over his hands. It was the first time he'd seen Sammy's intestines.
John hadn't known how bad it was, only that Sam whimpered when he fell to his knees, and that Dean was screaming bloody murder when he caught his brother on the way down. So he did what any good hunter would do and ganked the monster before it could hurt anyone else. By the time he'd watched the thing smolder into embers and had hiked back to the campsite, both of his kids were in varying levels of shock.
Seven units of blood, eight days in the hospital, nine different doctors, and ten weeks of physical therapy later, Sam was good as new.
John didn't ask where the blood had come from, not any more than he wondered where the thread for all the many stitches came from. He only knew that his son had needed it, and had received it.
Dean was going to rip their freakin' lungs out. All of 'em. Slowly, so that they would know that he meant it when he said that if they didn't hurry up and fix Sammy, he was going to be upset.
Crap like this was why Dean usually just patched up Sam himself. He could practically apply for an M.D. at this point, he was so good at it. He could stitch up lacerations and reset bones and relocate joints and dress burns with the best of them. Besides, long practice meant that Sam trusted him enough that he oftentimes would just pass out or fall asleep in the middle, and that made everything that much easier.
Of course, there were some things Dean just couldn't do. Like neurosurgery.
They weren't operating on Sam's brain, thank Chuck and all the demi-gods Dean hadn't ganked yet. But ghouls seemed to have a thing for slicing his brother's arms into ribbons, and they seemed to have a particular fetish for slicing right through all of the nerves in the general area in the process.
Dean would never forgive himself if his nerdy brother lost the ability to use his freakishly large hands to type random geeky shit into his precious computer. So he'd wrapped Sam's spurting arms in towels and tourniquets and had sped away from that damn crypt where those manky ghouls had kept him for too damn long as fast as the car would go to the nearest hospital.
The staff took one look at his arms, drew the obvious (incorrect) conclusions, and then promptly became morons.
Sam could barely stand from the blood loss, but they wanted to talk to him about his feelings and choices and emotional coping strategies. And when Sam finally just passed out entirely, they moved on to questioning Dean. He'd put up with it, barely, because eventually they were going to let Sammy out of surgery and Dean was definitely going to be there when they did.
Of course, Sam hardly looked better for all the hours of work they'd supposedly put into him when they finally rolled him into the recovery ward. He was paler than the overbleached and over-thin sheets they'd half-heartedly tucked around him, plus they'd cuffed to the bed. Cuffed! After a lifetime of waking up in pain and tied to various things because of various monsters and after several lifetimes trapped in a Cage and in agony… no. Dean wasn't even going to think about what would have gone through Sam's mind if he'd woken up in pain, in a strange place, disoriented from drugs, alone, and immobile. Nope, nada, no.
Instead, Dean was going to focus on picking the lock on the cuffs and think about how he was going to rip their freakin' lungs out for even considering doing such a thing to his baby brother.
"Dnnn," Sam groaned. Dean reached for his hand, thought better of it, and grasped the back of his brother's neck comfortingly instead.
"Right here, man. Open up, lemme see those emo eyes."
Sam compiled, and Dean couldn't help but smile softly. "How're you feeling, tough guy?"
"Like crap," Sam's blink lasted a tick too long. "How's my…"
"Don't try and move your hands," Dean cut in. "The doc says they'll be fine as long as you don't push things. We'll get Cas to give you a touch-up next time we see him though, just to be on the safe side."
"...Kay," Sam grunted. Dean put a straw against his lips, and Sam managed a few sips of lukewarm water. It helped his voice, but not his color.
"How much blood they give me?"
"Dunno," Dean started looking for Sam's summary chart. "But it's gotta be at least several gallons worth, to fill up all those hollow Sasquatch legs."
Sam laughed weakly.
Dean was definitely going to rip their freakin' lungs out.
"Whaddaya mean, you aren't going to give him any more? You barely gave him enough to keep him from going into shock again. The kid's basically a ghost! You can't possibly think that…"
"Mr. Wilson, I think you need to calm down."
"I'll calm down once you people get your heads out of your asses and actually treat my brother! Do you have any idea how much blood he's lost? If he wasn't the size of a house he'd be dead already!"
"We realize that your brother came in in critical condition but we assure you that he is on the road to full recovery…"
"No thanks to you crackpots!"
"But we're running a little short on blood right now. It's needed for more critical cases and…"
"Critical cases like what, exactly?" Dean growled. The last brave nurse fled, leaving him alone with the one doctor stupid enough to still be standing there not helping Sammy.
"Your brother's blood has some… unique markers. It makes it very difficult to type correctly."
"How hard can it be? There's only like six types, right? O, A, B, plus and minus for each. Not exactly rocket science, folks."
"Yes, but those are only the most basic. There are literally hundreds of other more minor markers. The more we match, the more likely a successful transfusion."
Dean crossed his arms and tapped his boot. The doc had about thirty more seconds before he was going to get an involuntary amature lobectomy via his blabbing mouth.
"Simply put: there aren't enough blood donors," the man spent ten of his remaining seconds meticulously cleaning his glasses on his white lab coat, "And too many patients."
"Who," Dean spat, returning to the most important point of this conversation. "Who could possibly be more critical than my brother right now?"
"A leukemia patient a few floors up. She's six and halfway through chemotherapy," the man shot back, finally losing his patience.
Dean felt himself deflate instantly. The doc noticed it too, and pressed his advantage.
"You want to tell her single mother that her daughter might die because some suicidal idiot 'needed' that blood? Because I certainly am not. Now sit down and shut up, Mr. Wilson, or I shall have you removed from my ward."
Dean walked slowly to his brother's bedside. Sam's eyes were shadowed with dark circles that were indistinguishable from bruises.
"It's alright," he murmured weakly. "I'll be fine."
"You could be a lot better," Dean grumbled, crossing his arms.
"She needs it more," Sam leaned back tiredly. "I've lived through worse."
"That's no reason to…"
"Limited resources, Dean," his brother interrupted him. "The hospital's doin' the best they can."
"Bullshit," Dean growled. "A coupla pints and you could walk outta here tonight. As-is, your anemic ass isn't going to be hunt-worthy for another month at least."
Sam didn't have anything to say to that, because he was right and they both knew it. Sure, his blood volume would bounce back in a couple of hours, but it would be weeks before his blood cells matured enough to effectively transport oxygen. Until then, he would be weak, short of breath, intermittently dizzy, and prone to infections. Any one of those complications could be deadly during a hunt. That wasn't a risk Dean was willing to take.
Castiel had his first blood transfusion several million years after his creation. He'd been blasted by a sigil from Van Nuys California to Delacroix Louisiana. Onto a shrimping boat, of all things. Luckily he'd not landed in the water. He couldn't drown… theoretically. But it certainly would have complicated things.
That wasn't the first time Castiel had been banished. It was the first time he'd triggered a sigil carved into his vessel's chest.
Cas hadn't known how bad it was at first, only that he whimpered from the unaccustomed pain when he first regained consciousness, and that Jimmy Novak wouldn't stop screaming bloody murder in his head. Or their head, or whatever. Cas just knew that he had to get to the Winchesters as fast as humanly possible, humanly being the operative word because he was far too weak to fly. Castiel wasn't a hunter, and it wasn't possible to kill Lucifer, but it just might be possible to stop his fallen brother from hurting anyone else. By the time Bobby's money came through and he escaped the hospital and ridden a bus (what an odd experience) back to the Winchesters, he was having trouble breathing (even though angels didn't need to breathe) and they were moments away from a painful death courtesy of Pestilence. Cas shouldn't have been shocked at the amount of trouble they'd managed to find in such a short time, but he was.
He never told the Winchesters about the disorienting day he spent in the Delacroix hospital. Or the two units of blood they gave him to counteract what he had lost through his self-inflicted wounds. Or the three doctors that told him that angels must be watching out for him, never understanding the profound irony of their words. Being mostly human was painful in more ways than the physical, and if the world wasn't ending, Castiel wasn't sure if he could have coped. Luckily God remade him better than new after he died a few days later, so he didn't have to find out.
Castiel didn't ask where the blood had come from, not any more than he wondered where his nurse had gone to college. He already knew that the first unit came from a high school student named Susana from Terrytown, Louisiana. The second unit came from a retired Vietnam veteran named Simon from Shell Beach. His primary nurse, Bethany, had gone to school in Texas. Castiel wasn't much of an angel anymore, but he could tell that much. He wasn't sure why they had donated their very lifeblood for a stranger, but he was grateful and honored to have received it.
"You can't," Sam sighed behind him. Dean practically had a heart attack: little brother was frickin' Batman when he felt like sneaking around silently.
"Whadda ya mean, I can't?" he asked, nursing the knee he'd slammed against the table in his haste to get to his feet to face the threat of an unlawfully quiet sasquatch.
"I mean, you can't." Sam's face was a study in apologetic expression. "Neither of us can."
"Why, exactly?" Dean raised his eyebrow. "Neither of us have mad cow disease, or take recreational drugs, or have sex for money or with other men. Unless you've got something you want to tell me, Sammy?"
"It's not that," he sat down across the table. "First of all, we do plenty of involuntary donating anyway. It's not healthy for us to lose even more blood on a regular basis."
"We've got Cas to give us a top-off if we need it," Dean countered.
"Yes, and that's part of the problem. We've been mixed up with so many supernatural and magical crap over the years… who knows what our blood would do to some unsuspecting civvie."
"You're saying you could give some poor bastard the hankering for demon blood by proxy? Or I could pass on some residual Cain-crazy?"
"Yes, no, I don't know, that's the point!" Sam stuttered. "We don't know. And I don't want to risk it. Nevermind what could happen to us if some monster got ahold of that much of our blood."
"What do you mean?" Dean furrowed his brow.
"Do you have any idea what kind of spells can be worked with that much blood? Nasty stuff, Dean. Like 'enslave us to their every whim for the rest of eternity' or 'keep them in constant agony for the rest of their lives' kind of nasty."
He swallowed hard. He'd not thought about it that way, but his nerd brother was completely correct. And they'd made far too many enemies for one of them not to try it, given the opportunity.
"Well this sucks," Dean closed the Red Cross website on his laptop with as much force as he could without damaging the mouse.
"What brought this on, anyway?" Sam folded his hands and leaned forward in his usual 'talk to me' pose.
Dean rolled his eyes, not exactly looking for a chick-flick moment. "Just… after your last trip to the hospital… You needed blood, and there wasn't enough. Or a few months ago, when I needed some extra and there wasn't enough either. And right now, some kid with cancer and a shot immune system might not have enough of their type to keep them healthy. Or someone's brother was just in a car wreck and they don't have enough in the ambulance to keep him from going into shock. Or someone's mom is having surgery and…" he shook his head and clenched his jaw. Sam's 'understanding' eyes were in full force now, Dean could feel them without even looking up to check. "I just wanted to do something, that's all."
"We do a lot already," Sam pointed out. Dean nodded in acquiescence. They did to a whole freakin' lot. But that didn't mean he didn't feel bad about not helping people. Especially when they owed the blood bank so much already. "But let me do some research… I'm sure there's another way."
The next morning, Sam shoved a cup of coffee in his hands and practically tossed him into the car.
"Where're we goin' Sammy?" Dean tried to blink his tired eyes open as Sam jammed the key into the ignition. He'd actually slept well, but mornings were really not his thing.
"Blood drive two hours away. They need volunteers."
"Thought you said we couldn't, cuz magic blood and stuff," Dean took another swallow of coffee and willed the caffeine to start working.
"I said we couldn't donate. But we can do crowd control and pass out flyers and carry stuff. They need help, and we can help. It was either this or donate money, but since all of our money isn't exactly kosher I figured this was a better idea."
Dean turned to look at his brother properly for the first time that morning. It wasn't the worst plan Sam had ever had, not by far. It wasn't exactly Dean's first choice for how to spend a day off, but hey, it was better than watching reruns and listening to Sam bitch about his eating habits.
"Besides, there hasn't been a hunt for days, and I checked and there aren't any cases today either. We might as well. Get out of the Bunker for some fresh air, and all that."
"Good plan," Dean grunted before settling down in the passenger seat. "Be good to my Baby and wake me when we get there."
Five hours and forty-two units of blood after they had arrived, the Impala pulled out of the parking lot.
It had felt good to just chat with the other volunteers as they set up tables and moved around equipment. They reminded him that there were wholesome things out there that were worth fighting for, not just evil things that needed fighting against. Besides, stacking boxes and flirting with nurses certainly beat getting thrown into walls by ghosts and trying and failing to avoid getting eaten by monsters. Sam had finally found a use for his emo hair and puppy-dog eyes, charming dozens of college students off the streets and into the donation center. He seemed lighter and more relaxed than he had in a long time. It warmed Dean's heart to see. They'd have to do this again sometime.
"You know, we might have saved more people today than we did all last month?" Sam spoke up.
"Huh?" Dean pulled his eyes away from watching the sun sink into the road ahead.
"Each unit of blood can save up to three people. So we potentially saved over a hundred and twenty lives today. We certainly saved several dozen."
"Awesome," Dean smiled.
A/N: Blood donation is a cause that I feel very passionate about. It's very simple and easy to do, and it quite literally saves lives. I realize that many people can't donate for various health reasons, and many struggle with it because of needle phobias and the like. But if you can donate, please do so, and do so often. Most people only donate once in their life, and that is not enough. The need is constant.
Check out the Red Cross's website (just google 'red cross blood drive near me') or research your local blood bank. It takes five minutes to set up an appointment, and no more than an hour or so to donate. All things considered, that's a pretty low price to become someone's literal lifesaving hero. If you're still nervous about it, PM me: I've donated over a gallon over the years and would love to talk with you about my experiences.
The SPN family is amazing in so many ways, not the least because of their passionate activism. If even one person is compelled to donate blood because of this story, I will be ecstatic, because that one donation has the potential to save three lives. THREE. Sam, Dean, and Cas aren't real (more's the pity) but three lives are still three valuable lives, three people with passions and families and the potential to save the world.
Thanks :)