Beep...beep...beep...beep...beep...
Dean watches his brother from the doorway of the secluded hospital room where Sam is just a vegetable on a shiny hospital bed, and Dean pretend he's just asleep. His chest raises and lowers as he breathes, but he doesn't really look alive. Dean is reminded of the day he had to lay his dead brother on the old, stained bed at Bobby's place. Standing in the doorway, there was nothing to do but stare, vision blurred by the stinging tears gathering in his dead eyes, and think about all that could be but never would; the complete 180 his life just took. He couldn't do it. He just couldn't do it.
Dean sees his brother with the tubes wrapped around his ears and in his nose, keeping him breathing. Alive. He sees Sam in that hospital bed, his face smooth and flawless, his hair kept and neat against the pillow, but he doesn't really see his brother. Dean is reminded of Sam being possessed by Lucifer. His face was the same, but it wasn't really. His eyes were dark and filled to the brim with fury, his smirk was evil and cringe-worthy. Dean hated every inch of Sam's body like he never though he could. He wasn't the snot-nosed kid Dean had practically raised, he was Satan. But that didn't mean he was going to leave him to die. He couldn't do it. He just couldn't do it.
Dean thinks of what his life will be from here. Sam-less. No little brother to look after, like he's always done. His life is Sam. He sometimes feels like he'd turn into some sort of soulless creature without Sam to keep him on the right track. Dean is reminded of his year without Sam after he jumped in the pit, in which he spent with Lisa. He remembers the nightmares, the paranoia, never, never, feeling quite like himself. He tried, for Sam, to not turning into the hunter he knew he would if he had no reason not to. He tried, for Sam, to live the apple-pie life and be the common suburban man. But never, in that year, did he feel like he did with Sam around. Did he even feel like Dean. He couldn't do it. He just couldn't do it.
Dean thinks about what the doctors had told him. There's little-to-no chance that Sam would wake up. There's nothing left to try. There's nothing left for Dean to try either, even knowing what he knows. He's looked for some sort of miracle healer, called every hunter he knew to look too, but nothing came up. With every second, the little spark Dean had in his soul was getting dimmer. Dean is reminded of when Sam was going through his mental break-down and dying. Dean could barely hold himself together to look for a way to help Sam. He felt dark and empty inside. Everything he had told him that it was useless. That there was no way to get Sammy through it this time. He was dead. But there wasn't a chance Dean was letting Sam go again; he was through losing Sam. Losing Sam was losing his life and happiness and love. He couldn't do it. He just couldn't do it.
Dean knows that it's all up to him—whether Sam continues living, if you could call this state living, or pulling the plug and having absolutely nothing left of his brother except a cold corpse. The decision seems simple; he needs to keep his brother with him. Alive. That's really the only option. But is it really an option at all? Dean is reminded of when he was in a coma all those years ago. He was a ghost, and he refused to let go. To die. Sam doesn't have that option; he's going to keep living if Dean let's him... but only half-alive. He'll be a spirit. He'll never be at rest. He'll be stuck in this world for as long as Dean keeps him here, and he'll have no one... just himself, isolated in his own cold universe, begging Dean to let him go in a voice so quiet not even the angels can hear him. Sam deserves peace... but Dean wants his brother breathing... He can't do it. He just can't do it!
Beep...beep...beep...beeeeeeeeeeeeeeeeeeeeeeeeeee eeeep!