Sam wakes up to the blare of the alarm, feeling like there's something he ought to remember, but he can't quite put his finger on it.
He stumbles into the bathroom, pisses for what feels like twenty minutes, brushes his teeth, tries to get the mossy feeling off the back of his tongue. He'd be lying if he said he wasn't a little hungover.
Dean is coming awake when Sam gets back out into the room, blinking his eyes open slowly, trying to get his bearings before he risks any movement.
"Morning," Sam says. "Doctor's appointment in an hour and a half."
Dean runs a hand over his face, doesn't answer, just gets himself up on his elbows and pulls his body into an almost-sitting position against the headboard of the bed. He gropes for the Vicodin on the night table next to him, swallows a few with a swig of the lukewarm water sitting next to them.
"How you feelin'?" Sam asks, even though he knows, he knows he's just gonna get a glare for his troubles, because it's clear that Dean really isn't feeling too hot. But he has to ask. It's like some sort of bizarre obsessive-compulsive thing. How are you? Are you okay? Leg buggin' you? Hip hurt? How you doin'?
"Fine," Dean says, and Sam wonders if he asked less if maybe Dean would give him a straight answer now and again. Probably not.
"You feel up to going out for breakfast, or you want me to bring something back?"
"Can you give me a minute here?" Dean demands. "I'm barely even awake yet."
"Right," Sam says, backing off, though goddammit he's sick of being yelled at.
Dean pushes himself up a little more with a slow exhale of breath, reaches for his cigarettes, frowns at the two left in the pack.
Sam pulls a t-shirt out of his duffle and gives it an exploratory sniff before exchanging it for the one he's got on. He wiggles out of his pajamas and into his jeans as quickly as he can, because Christ, it's cold, hopping up and down on one leg and then the other, bouncing on the balls of his feet to keep warm. He's zipping his fly when he catches Dean watching, a strange expression on his face.
He almost says, What?, almost makes some stupid joke, but Dean looks away quickly, pulls in a breath of smoke and ashes into his empty water glass, and Sam realizes that the look he saw was envy. Envy for how easily Sam does something that takes Dean twenty minutes, these days. Sam swallows, leans down slowly to put on his boots, hopes to god that the doctors can do something, because fuck.
"Guess if I'm gonna get poked 'n prodded, I should probably take a shower, huh?" Dean says, taking a last drag of his cigarette and sliding his legs out from under the blankets. "It's been a while."
"I doubt they care, dude," Sam says, because this place doesn't have handicapped facilities and the shower is in an old tub, slippery, nothing to hold onto.
"Matter of pride," Dean says, breathes deep and gets himself up onto his crutches, starts moving towards the bathroom. "Why don't you get us something to eat," he says over his shoulder. "And buy me a couple packs of cigarettes."
Sam hesitates, doesn't want to tell Dean that no way is he leaving while Dean's alone in the shower, because even he knows he'll sound like an overprotective psycho, but seriously, what if he slipped and fell and busted his head open and died while Sam was ordering French freakin' toast?
"I want an omelet with some kind of dead animal," Dean says. "And cheese."
Well, okay. There's a start. Dean hasn't specifically shown an interest in food for a while.
"Toast?"
"Sure."
"Coffee?"
"You're kidding, right?"
"Right." Sam tugs on a hoodie and a jacket, pulls a hat down over his head and brushes the bangs out of his eyes. Stalls for time. "Uh, so I'll have my cellphone on."
"Great." Dean arches an eyebrow.
"I shouldn't be more than half an hour."
"I'll be sure to finish jerking off by then."
"Please, dude, imagery," Sam says, screws up his nose, puts a hand on the doorknob. "Uh." Be careful. "The shower can get kind of hot. You should watch out."
"Sam," Dean says, in his I-know-exactly-what-you're-thinking voice. "God's honest truth? You want some imagery? I'm probably just gonna soap up a towel and give myself a sponge bath. I saw that fuckin' tub, and, yeah, there's no way."
"Oh," Sam says, can't help his face from relaxing a little. "Okay."
"Not really," Dean says, and Sam doesn't get it until he's halfway out to the Impala.
He grimaces at the cold leather of the seat that knifes through his jeans, grimaces again at the overflowing ashtray that makes the whole place smell like a dying tobacco factory. This is the smell of his life – stale cigarettes, car exhaust, and underneath it all, blood. Smoke. And – sniff – is that maple syrup? Huh. Guess there have been kind of a lot of pancakes in this car.
He wrinkles his nose at the ashtray, decides fuck it, no way is he gonna be a part of Dean's bad habit anymore. He'll just pretend he forgot when he shows up empty handed.
His cell rings as he pulls out of the parking lot, and he flips it.
"Dude," Dean says on the other end. "Don't forget my cigarettes. Two packs."
And Sam wonders for a brief, terrified second, if maybe his brother really can read his mind, cause, damn, busted.
He waits on a stool at the diner's counter, and it's an old-fashioned place, so he can see their breakfast being made, watches the cook crack a bunch of eggs into a bowl for Dean's omelet.
"Can you put extra cheese on that?" Sam calls. "Extra meat? Some vegetables? Like, tomato, something good for you?"
"Sure thing, honey," the cook says, and hmm, a little disturbing, cause the cook is six-foot five of beer belly and three-day stubble.
Sam stops at the gas station on the way back, buys one pack of cigarettes and, fuck it, a pack of top-strength nicorette, cause life might suck but he'd like to try to be optimistic about something.
Dean's dressed when he gets back, cleaning the guns, which is just a tad passive-aggressive, since Sam did it yesterday, but he doesn't comment.
"Food," Sam says, drops the styrofoam container in front of Dean, but his brother ignores it, scans Sam's hands.
"Cigarettes?"
"First you have to eat."
"You forgot. Oh my god, you—"
"I did not forget, so cool it. If I have to bribe you like a five year-old, I'm gonna bribe you like a five year-old. Remember when you'd let me shoot the gun if I finished all my vegetables? It's like that."
Dean grumbles disbelievingly, but it works – he eats most of his omelet and half the toast, takes a couple bites of Sam's pancakes, even, before Sam relents and gives him his cigarettes, and the nicorette.
"The hell is this, dude?" Dean asks, then reads the label, rolls his eyes.
"You need to cut back," Sam says, like a broken record, but dammit, he means it.
Dean looks at him for a long moment, fingers tightening around the pack of cigarettes, but, to Sam's amazement, he slowly puts it down and starts tearing open the gum.
"Seriously?" Sam says, jaw dropping.
Dean shrugs, looks a little surprised at himself. "Don't start waggin' your tail yet, sparky. Just wanna see what this is like." He pops a piece into his mouth. "Ugh. Ass, that's what."
"Can't be worse than a cigarette."
"Cigarettes taste like heaven," Dean says. "Now, please don't talk about them when I'm trying not to smoke."
"Hang on," Sam says, reading the pamphlet that came with the gum. "There are instructions. You have to chew it till you feel the tingle, then put it in your cheek or something till the tingle fades. Then repeat. Otherwise you're gonna get too much nicotine at once and you'll get sick."
Dean bugs his eyes out dramatically. "It's gum. You're givin' me instructions on how to chew gum?" But Sam can see that he follows the directions, tonguing the gum behind his teeth, making a face.
To his credit, he makes it through almost an hour, pops another couple pieces of gum halfway through even though the instructions – and Sam – warn him against it, lasts until they get into the car to go to the doctor, and Dean sees the full ashtray.
"Okay," Dean says, spits the wad of gum onto the pavement with a wet smack. "Done quitting."
"Did it work at all?" Sam asks.
"Yeah," Dean allows. "Maybe a little."
Sam can't help the triumphant way he puts the Impala into gear.
But Dean is nervous on the twenty-minute drive to the hospital, jumpy, undoes the good of the gum and smokes three cigarettes in a row, lighting one off the other without pausing for air.
As they pull into a handicapped parking space, Dean turns to Sam, and his face is a little pale, almost green. "I feel kind of nauseous," he says. "I think I overdosed on nicotine."
"Told you not to eat that second piece of gum. Then you went and smoked all those cigarettes."
"Christ," Dean says. "Maybe we shouldn't do this. I mean, not right now. Not if I'm gonna puke all over everyone."
"Get the fuck out of the car," Sam says wearily, unbuckling his seatbelt.
Dean gets himself out after one failed attempt, looks towards the looming brick building and puffs out a jittery breath, follows Sam slowly up the ramp and into the waiting room of the doctor they've been referred to.
Sam glances around at the other people slumped in the sickly-green faux-leather chairs; the miserable-looking goth teenager with his arm wrapped in a black sling and his mother patting his mohawk distractedly, the old woman with the walker in the parrot-patterned mumu, the middle-aged guy hanging onto a pair of crutches much like Dean's.
The secretary behind the desk is friendly but impersonal, shoots them a brief smile out from under over-plucked black eyebrows.
"Uh, Steve Howe," Dean says, and feels a flash of nausea that has nothing to do with his excessive nicotine consumption. He never thought he'd use that name again. His dad may be a jackass, but at least he set him up with some legitimate insurance. Dean still doesn't know where the money for surgery came from, but it hasn't bounced and it hasn't run out and for that, Dean will be eternally grateful.
"Why don't you have a seat and fill this out," the woman says, starts to hand him a clipboard but changes direction in mid-air, gives it to Sam instead. "Bring it right back up here when you're done. Can I see your insurance card?"
Dean gets through the logistics while Sam takes a seat with the clipboard, starts examining it until Dean comes over and eases himself into the chair next to him.
"Hey," Dean says, "that's mine."
Sam hands it over with a frown, peers over Dean's shoulder as he starts filling it out.
"You're gonna be honest on that thing, right?" Sam asks as Dean hesitates over the first question in the section titled PAIN: Describe the pain on a scale of 1 to 10, with 1 being no pain and 10 being the worst pain you can imagine.
"You're gonna get the fuck out of my hair and let me fill this out in peace, right?"
"Yeah," Sam says, flops back in his chair. "Sorry." He watches out of the corner of his eye, though, as Dean pencils a circle around the 7, then erases it and circles the 8 with a dark line, lightly sketches circles around the 7 and 9.
Sam stretches out next to his brother, crosses his hands in his lap, feels like a giant in these little waiting chairs. He pretends to scan a magazine, but keeps his eyes on the papers in his brother's hands, because dammit, Dean doesn't tell him anything, so if he's gotta be stealthy about it, he's gotta be stealthy about it. Rate your difficulty in performing the following activities on a scale of 1 to 10, with 1 being easiest and 10 being impossible. 8 for getting up from a chair. 8 for getting out of the car. 7/8 for putting on pants. 8 for tying his shoes. 6 for going to the bathroom. Sam looks away.
"Lemme know when you're done and I'll bring it up to the desk," he says.
Dean grunts, but after a moment hands Sam the clipboard facedown. His name is called not five minutes after Sam turns it in to the indifferent secretary.
A nurse pushes open the double doors that lead to the examination rooms, checks a list, calls, "Steve? Steve Howe?"
"That's me," Dean says, and pushes himself to his feet, Sam behind him. "Dude," Dean says, give him a pained look. "You can't come in with me."
"Oh," Sam says. "Oh, right. I'll just. I'll just be out here, then."
"And I'll be in there," Dean says, swallows, and Sam can see a glint of fear in his brother's green eyes – maybe not fear, but apprehension, the desire to bolt, that trapped wild animal look that Dean gets sometimes.
"G'luck," Sam says, and Dean nods, turns, heads up to the compact, curly-headed nurse, who greets him with a warm smile and a flickering once-over.
Sam watches as he disappears through the doors, then cracks his knuckles, looks around for a magazine or something to do, but the only magazines are things like "Good Parenting" and "The Financial Times," which doesn't interest Sam too much.
He takes out his notebook, meaning to look at some Latin he's been trying to memorize, but he ends up sketching instead, that tree, same one from yesterday, same one from his dream, same one from –
And suddenly he remembers where he's seen it, and something clicks into place, something cold and frightening and the hackles raise on the back of his neck and he feels like the air has gone still, feels it so strongly that he glances around and cannot believe that the other people don't feel it also.
He stands, hesitates, palms his cellphone just in case Dean comes out for some reason and can't find him, then bolts to the car. He cracks open the trunk and begins pawing through his duffle, till finally he finds what he's looking for: a faded photograph of his family, pre-fire, in front of their old house, in Lawrence, Kansas. Behind them is a tree. The same tree he's been drawing for two days. The same tree waving in the back of his dream, behind the screaming woman, who is pounding her fists from inside a house, from inside the house he lived in for six months of his life and knows only from this one photograph.
He rocks back on his heels, stunned by the discovery, knowing full well what it means but not wanting to admit it to himself. But he has to. It's clear that they need to get to Lawrence.
He knows it's crazy, but he's ignored his dreams before, and look what happened. Whoever's living in their old house, they're in danger, and he knows it, and it might be tied up with the fucking demon that killed their mother, and Jess, and Sam'll be damned if he lets this one go.
But, fuck, he's the one who was pressing for a break over breakfast, and God, there's no way Dean can hunt in this condition. Just no way. He doesn't know what the doctor's going to say, but he's pretty sure it's not going to be "Go forth and do battle with the evil of the world."
He moves slowly back into the doctor's office, still clutching his sketch and the photograph, and sinks into a waiting room chair, willing Dean to hurry up and come the fuck out because they've got shit to discuss. Places to go. Work. Work to do.
Dean's fucking right. Evil doesn't take breaks. And neither can they.
***
Dean is sitting on the table in the doctor's office in his boxers and a paper robe, feeling like he might pass out. Any second now, here it comes – but he doesn't, stays conscious. He's waiting for the doctor, after the nurse practitioner – Wendy – has taken his blood pressure and checked his ears and, embarrassingly, helped him up onto the examination table, cranked the back so he could sit up without pain, found a cushion for his knee.
The door swings open, finally, just when he thinks he can't take the suspense anymore, and the doctor comes in, tall and stern-looking, mid-forties, graying hair pulled back in a tight bun.
"Steve," she says. "Hi. I'm Dr. O."
"Hey," Dean says, feels awkward as she comes forward to shake his hand. He smoothes his paper gown self-consciously.
"So," she says, glances at the clipboard in her hand. "Looks like you've been having some trouble with this hip, huh? More than usual, that is."
"Right," Dean says.
"I've been looking over your records, checking out some old x-rays," Dr. O continues, raises an eyebrow. "Ain't too pretty."
Dean sniffs a laugh. "No, it ain't," he agrees.
"Says here they've got you on a pretty steady diet of Vicodin ES, but judging by these questionnaires you've filled out, it doesn't look as if it's doing much good."
Dean shrugs, glances towards the door.
"Your brother tells me you've been knocked around a little, recently, and that he thinks it might have exacerbated your condition."
"Yeah."
"Okay," Dr. O says, places the clipboard on the table. "I'm just going to do a brief physical examination, and then we'll take some x-rays, have you do some exercises for us, how's that sound?"
"All right," Dean says, can't help but tense up as she comes towards him and reaches towards his head.
"Ease down," she says with another raised eyebrow. "Little on edge?"
"I don't like doctors," Dean blurts. "No offense."
"None taken," Doctor O says, cranking down the table so he can lie comfortably. "How's that? You all right?"
"I'm good," Dean says, balls up his fists.
"Okay," she says, "I'm just gonna pull this back and have a look at your hip, that all right?"
"Do your thing, doc."
She folds his robe over, tugs the hem of his boxers down a little. "What time of day is the pain the worst?" she asks, skims a palm over his hipbone.
"Uh, right when I wake up, I guess," Dean says. "And before I go to sleep."
"Does it keep you up at night?"
"Yeah."
"Is the pain worse when you move?"
"Yeah."
"Do you find that it's difficult to rise from a seated position?"
"Fuck, yeah. Sorry."
She nods, prods his hip gently with two fingers, and he lets out an involuntary gasp.
"That hurt?" she asks.
"Yeah."
"Okay. I'm going to have you roll over onto your side, can you do that for me?"
Dean grunts his way over on his good left side, puts a palm to the table for balance.
"Is that position painful?" Dr. O asks.
"I'm fine," Dean says. "Just, uh, how long do you need me to stay like this?"
"Not long," Dr. O says, presses down on the point of his hip.
"Christ," Dean spits, his eyes flying shut.
"Painful?"
"Uh, yeah."
She moves her hand down to his thigh, says "Does it hurt if I do this?", and Dean can't help but think of Claire, blurts a laugh even as he hisses in pain.
"What was that noise?" the doctor asks, smiles a little. "Are you ticklish?"
"No! No, I was just remembering something."
"I don't think I want to know," Dr. O says wryly, and Dean laughs again, until Dr. O performs the same motion against his thigh.
"Yes, yes it hurts," Dean says, grits his teeth. "I don't know if I can hold this position much longer."
"All right," Dr. O says, puts a hand under his shoulderblade to help him ease onto his back. "How's your knee been holding up?" she asks. "Saw those x-rays."
Knee? His hip's been screaming for attention for so long, he's almost forgotten about his fucking knee, but hey now, there it is again, joining the chorus. "Hurts, but not as bad."
"Scale of one to ten?"
" 'Bout a seven. Fuck. Eight, when you do that."
"About how often do you find yourself taking your pain medication?"
"Every few hours, or so, I guess. Every five hours?"
Dr. O looks at him skeptically.
"Every three hours?" he tries. "It really depends."
She nods. "And does it help?"
"Yeah. Don't really know what I'd do without it. It's great."
"But not great enough to control the pain."
He shrugs as best he can while lying flat on his back, shakes his head.
"Okay," Dr. O says, cranks his table back up. "I'm going to leave you here to get dressed, and then we'll go down to the testing rooms. I'll send Wendy in to get you."
"Okay," Dean says. "Hey, you know about how long this is gonna take?"
She purses her lips. "Shouldn't take more than an hour. Can you get off that table all right?"
"Yeah," he says. "Thanks."
She nods, slips out the door.
Dean gets himself down off the table, sinks into the chair that the Doctor just vacated, gets his cellphone out from his jacket pocket.
B 1 hr or so. Go feed yr tapewrm or sumthn.
He grimaces his way into his jeans, rests for a moment before starting on his shoes. He should probably invest in something easier to put on than freakin' biker boots, but he's not really a loafers kinda guy.
His phone buzzes and he flips it open.
Okay, call me when you're out. I think I'm just going to go to the café down the street. Everything all right in there?
Sammy, always with the perfect punctuation, even in freakin' text messages. He texts back Peachy, pockets his phone.
He catches a sharp whiff of medicine all of a sudden, feels his stomach seize up. Please, he prays, to anyone, to no one, please, just no surgery, no surgery, that's all I ask. No more fuckin' surgery.
Jesus, he needs a cigarette bad, wonders if Dr. O would consider letting him step outside before the tests start.
Suddenly he remembers something, dips his hand in his back pocket and feels his fingers clamp down on the pack of nicorette Sam bought him.
He pops a piece into his mouth just as Wendy comes back in, all smiles.
"Looks like we're going to the x-ray room!" she says, comes forward as he struggles to get up.
"I'm good," he says, gets himself to his feet, chomps down hard on the gum, wills nicotine into his bloodstream, comeonecomeonecomeon… He feels a tingle on his tongue and tucks the gum away by his back teeth. Okay. Really not gonna make up for the fact that he can't smoke a cigarette in this fucking office.
The tests and x-rays are pretty standard, and pretty fucking painful, and he remembers them from the hospital, suppresses the little shiver of panic that runs through him every time he thinks too hard about what they mean. What it means that he can't do most of the exercises they want him to do.
Finally, he's back in the doctor's office, perched awkwardly on the edge of the chair, watching as Dr. O opens a folder on her lap, licks a thumb and pages through the sheets of paper she's got there.
"All right, Steve," she says, slow and smooth, and Dean feels his heart clench in his chest. "It looks like certain parts of your leg are healing relatively well, given the givens. The fractured tibia has mended seamlessly, and your ankle retains almost full range of motion."
Dean nods, drums his fingers on his good knee. He knows all this. Just get to the bad part, lady.
"Your hip and knee, as I'm sure you are aware, have not fared nearly as well. It is likely that you will never regain full mobility in either joint, and painkillers will probably always be a necessity."
"Yeah," Dean says, "I know," digs out the pack of nicorette and slivers through the foil with his thumbnail, tries to keep cool.
"Right," she says. "We'll discuss your pain management options in a moment. But first," and she pulls out an x-ray, scoots her chair closer to show it to him, "we'll deal with the problem at hand. You, my friend, have a pretty severe case of Trochanteric Bursitis."
"In english, please?" Dean demands, knows he's not being too polite, but his heartrate has already spiked and he can practically feel the operating table beneath him.
"The bursa is a fluid-filled sac located here," she says, runs a finger over the x-ray. "Its job is to provide a barrier between your tendon and your bone, and when it becomes inflamed, it can be extraordinarily painful. And, given your pre-existing condition, for you it's no doubt excruciating."
"Okay," Dean says, drags a thumb across his mouth, chews ferociously on the gum.
"Generally speaking, bursitis can be treated with a regimen of anti-inflammatories and some ice. In your case, though –"
Jesus, here it comes. Dean takes a deep breath.
"—in your case, I'm also going to prescribe a week of bed rest."
Dean lets his breath out in a whoosh. "Bed rest?"
"For at least five days. You can get up to go to the bathroom, that sort of thing, but basically you ought to stay as still as possible. And continuous icing, alternated with heat packs."
Dean breaks into a smile, can't help himself. Bed rest, fuck, that sucks, but compared to what he thought he was gonna hear, it's like a miracle.
"Okay," he says, knows he looks like an idiot, grinning his head off. "And after five days of lying around and taking aspirin, it'll just going away?"
"It should," Dr. O nods, smiling like she can't help herself, though she clearly has no idea what she's smiling about. "Sometimes a cortisol shot is necessary, though it's a simple outpatient procedure. You'll need a check-up in a couple weeks to determine whether or not we'll take that step."
"All right," Dean says. "Awesome."
Dr. O nods. "Now let's discuss long-term options."
Dean feels his grin fade. "Long-term."
"Yes. You suffered a two-compound fracture of the hip socket, and usually when that happens, there is still some part of the joint that is attached to the pelvis, which is what the surgeon uses to begin rebuilding. However, in your case, the pelvis itself was pretty wrecked, and that connection didn't exist, so your surgeon had to reconstruct it from the bone fragments floating around in there."
"Right," Dean says, and just like that, his heart's banging against his chest again.
"It's a hard surgery at the best of times, and your damage was pretty extensive. So what's happened is the bone and cartilage didn't heal as smoothly as one may have hoped… it's quite literally much rougher than a normal hip joint, which creates sort of a grinding effect that wears down the bone and cartilage."
Dean winces.
"So what we need to be worried about is the slow deterioration of your hip joint, due to the inconsistencies in bone that I've mentioned. We're looking at a pretty serious risk for post-traumatic arthritis, somewhere along the line."
"And…"
"And, at some point, you're probably going to need a total hip replacement."
Dean blanches, leans back in his chair. "At some point."
"Yes. I'm merely warning you what's to come. You're still quite young, and active, and therefore I would not recommend that you get a THR at the moment. But in ten or fifteen years, maybe sooner, depending on how well you take care of yourself, I can almost promise you that it will be a necessity."
"Oh," Dean says, relaxes. That's forever away. He probably won't even live that long. "Well. Thanks for warning me."
"As for pain management," Dr. O continues, starts scribbling on a pad, "it's clear from the surveys you've filled out that Vicodin ES is not as effective it ought to be, Bursitis notwithstanding. So I'm going to change your prescription to Vicodin HP, which has a higher concentration of hydrocodene per millogram. Why don't you try that out for a while and see if you notice any improvement." She rips the piece of paper off and hands it to him.
"Thanks," Dean says.
"I'm also going to give you a prescription for Actiq, which will control what we call break-through pain – the pain that 'breaks through' the cover of your normal medication. Pain that may come with movement, or what is often referred to as end-of-dose failure; that is, the pain you feel when a dose of Vicodin is wearing off and you have yet to take another one. Actiq provides more immediate relief – kin to liquid morphine. It comes in the form of a lozenge on a stick, like a lollipop, that you can swab around your mouth in instances of break through pain. There will be instructions in the box."
"All right," Dean says, takes the second piece of paper she offers him. "That sounds great." Morphine. Morphine works.
"It is a highly abused drug, and you need to be very careful with it, all right? Also, brush your teeth often, because they contain sugar."
"Got it."
"And you won't need a prescription for this, but you need to pick up some ibuprofin and take it for the week of bed rest. As well as ice-packs and heat packs, which you should use on a regular, alternated basis."
"All right."
"Do you live with your brother Ryan?"
Dean's startled, by the question as well as by the pansy-ass name Sam made up. "Uh, yeah."
"Do you think he can take off work to stay with your for five days, or would you like a list of in-home caregivers?"
"Ryan can stay," Dean says, horrified. "I don't need a caregiver."
"All right," Dr. O says, corner of her mouth quirking up for a moment before she settles into a more serious expression. "We just have a few more things to discuss."
"All right," Dean says slowly, not liking her tone.
"I spoke to Ryan on the phone for a while, yesterday. He seemed worried, tells me you haven't had much of an appetite, lately."
"Guess not."
"Why is that?"
Dean shrugs uncomfortably. "I don't know. Nothing tastes good. Eating just… makes me feel tired, I guess."
She nods a little. "How are your sleeping patterns?"
"Uh. Fine?"
"No trouble sleeping?"
"Maybe a little. Kind of hard to fall asleep, sometimes. Wake up early. I don't know."
"He says you seem as if you're uninterested in things that used to give you pleasure. Like food, for example."
"Why the hell did you talk to my brother about this?" Dean asks, suddenly annoyed, defensive, though he's not sure why.
She looks at him for a moment, then says, clicking her pen and beginning to write, "Steve, I'm going to put you on a mild-antidepressant. I think it will help with your recovery process."
"Hey," Dean says, "No, I'm fine. I really don't need anything like that. Can doctors even prescribe that stuff?"
She glances up at him. "I was a psychiatrist for years before I went back to school to study orthopedic medicine. And yes, doctors can prescribe this stuff." She hands over the prescription and he takes it automatically, puts it in his wallet with the others. He's not gonna fill it. He doesn't need that shit. He's fine.
"Steve," she says gently, watching his face. "How old are you, twenty-five?"
"Twenty-six."
"You're very young, and very active. This type of injury can be quite difficult for anyone at first, not just physically, but mentally. Perhaps even more difficult mentally. It's extraordinarily common for people in the early stages of a life-changing disability to have feelings of depression. But these feelings have a physiological effect, as well, can worsen your physical symptoms, which in turn will make you feel even worse. It's a vicious cycle. So you don't have to fill that prescription, but I highly recommend it."
"Okay," Dean says dismissively.
"If you do fill it, it may take some time for you to feel the effects. Up to a month, in some cases. And it's important that you monitor yourself, see how you're feeling. It may be that we need to adjust the medication, in which case you can get a referral to a psychiatrist."
Dean checks his watch, nods to the wall. "Okay."
"All right," she says, leaning back. "Wendy will come in to give you the instructions for your bed rest and pamphlets for the Actiq. Feel free to call if you have any questions, now or in the next couple of days, or if the pain gets worse or doesn't go away. You should plan on scheduling a follow-up in a couple weeks."
"Okay," Dean says. "Thanks very much."
"Take it easy," she says, fixes him with a stern glare. "You're young, but you're not invincible."
"No shit," he says, and she snorts a little.
"Good luck," and she closes the door behind her.
Dean barely has time to pull out his cell to text Sam when Wendy comes back in, smiling brightly.
"Let's talk about this bed rest stuff, huh?"
To be continued…