A/N: So we all know it's Sam's appendix now, and he's in surgery, but there's still a few chapters left, and I have an active imagine when it comes to h/c fics. You can blame my beta. She brings out that side of me in ways that are inexplicable. Anyway, again, thanks to all the readers and reviewers--this process doesn't really exist without you, so I don't know how to show my gratitude except to POST. Also again, credit to my beta, who is away skiing for a long weekend, but I still post in honor of her (after all, she's the one who squee-d so hard when I mentioned the idea of an appy fic that I HAD to write it for her...we have lovingly referred to this fic as our happy appy piece..). Oh, and Nerissa, e-mail address never come through on this site! You can find my e-mail address on my profile page, though. I would still love to talk to you about teaching!

Chapter Six: Lapse

It would have been easy to move, to shift in his seat, restore the sensation in his legs, but he couldn't bring himself to do it. Part of him liked the numbness, craved the emptiness, and prayed that it would overtake all of him.

The nurse had been hesitant, but let him fill out the medical history form and accepted the fake insurance cards he handed her.

He had nearly lost it filling out the forms, trying to figure out how many of the hospitalizations Dean should admit to for his younger brother.

Instead he told the nurse that this was all he could remember, and turned the form in with half-truths and omissions.

He tried to call his father and was almost relieved when he just got voicemail. This wasn't a message he knew how to leave, so he didn't.

An hour passed. Then two. He couldn't stop himself from thinking about Sam laid out on an operating table, cut open, anesthetized. He could almost visual the doctors in their gowns and masks, exchanging equipment, peering at his brother's insides.

His stomach turned and the image fled. How did we end up here?

He was beginning to wonder if Sam would ever be out of surgery when someone finally came up to him.

Dean didn't really like doctors. Rather, it wasn't so much that he disliked doctors, but he disliked everything associated with doctors. Doctors represented his loss of control, a problem he couldn't fix, a threat greater than he wanted to ever face.

This doctor was older than Dean would have liked--he always felt that surgeons should never look over 50 because then he worried about the steadiness of their hands. But this one, who introduced himself as Dr. Hepker, had a benign face and a detached simplicity Dean appreciated.

"Sam definitely had a ruptured appendix. We removed what was left of the appendix and suctioned out as much of the infected matter as we could," he explained, sure to make continual eye contact with Dean. "The surgery was without complication, although we are very concerned about Sam's condition. Have you been able to contact your father yet?"

Dean shook his head. "He's on a business trip."

"You need to call him, son." The doctor spoke with subdued urgency.

"I did," Dean lied. "He's coming home as soon as he can."

Dr. Hepker looked skeptical of the young man in front of him. "Sam is very sick."

Dean was grasping at straws, desperate for some reassurance from the doctor. "But I thought people had this kind of thing all the time. I thought they were no big deal, easy recovery. Get it out, you're done, no problem."

"It usually is, if caught in time. The initial symptoms can be easily confused with the stomach flu among a host of other ailments. I mean, the nausea, vomiting, slight fever--if I were to list all the possible diseases those were symptoms of, we'd be here all afternoon. Usually the pain intensifies in the lower right side."

Dean remembered that, and wished Sammy had pointed that detail out. If he had just been more specific, then maybe…

"It gets quite painful-building until finally the appendix bursts. Though this initially relieves the pain, it's very dangerous. At that point, infected pus is let out into the abdominal cavity. It's only a matter of time before a dangerous infection of the abdomen--peritonitis--sets in."

Dean stared at a speck on the floor. Sam had admitted to pain and Dean hadn't even acknowledged it. Suck it up, Sammy. No matter what Sam may have said, Dean should have seen the truth, not tried to guilt him into submission.

The doctor took a deep breath. "I'm afraid that's what has happened to Sam. Unfortunately, Sam went quite some time without treatment. The pain probably returned as his abdomen was attacked by the infection. Given what you've told us of his illness and the severity of his fever, we think the infection is quite advanced."

And then he had let it linger on, fester. He had gone out partying while his brother was getting sicker--dying.

Dean suddenly felt weak, his knees buckling. He felt himself be snatched upright, then maneuvered to a chair. The room was spinning, the monochromatic hospital walls blurring.

"Easy now, son," the doctor was saying. "Deep breaths."

Someone shoved his head between his knees and he remembered to breathe. Within a few more moments, he was sitting up, sprawled against the chair, panting.

"You feeling better now?"

Dean kept breathing and let his silence stand.

"We've already got him a full spread of antibiotics. We're monitoring him very closely, so at the first sign of any additional complications, we'll be able to act immediately."

"What kind of complications?"

Dr. Hepker looked hesitant. "His fever is still dangerously high. And if the infection doesn't improve there's a high risk of septic shock, which could then lead to organ failure."

Dean felt bewildered, too shocked to speak.

He must have looked it to. The doctor patted him gently on the shoulder. "We're taking care of him, son," he said. "You need to call your father again. Get him here. Then a nurse can show you to Sam's room."

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Dean finally left a message on his father's voicemail, and let the nurse show him to Sam's room. She's left him with a soft smile and vague reassurances. Inside the room, Dean's heart quickened in his chest. As much as he wanted to see his brother alive, he did not want to face the guilt of seeing him in a hospital bed. Again.

Sam looked thinner than usual, the days of not eating catching up with him. His face was pasty, accented by the limp strands of hair that strayed across his forehead.

Dean inched forward soundlessly, not wanting to wake his brother.

His efforts at stealth were thwarted. Sam turned his head, looking tiredly up at his brother.

Sam smiled weakly. "Hey." His voice was quiet, rough.

Dean cocked his head with a coy grin. "Hey back. How you feeling?"

"…told you I had a stomachache," Sam replied, letting his eyes drift close for a long moment.

The words weren't malicious, but struck painfully at Dean. "Yeah, guess you did."

"…s'okay," Sam said, glancing back at him. "..never listened to me before…why start now?"

Sam wasn't trying to mean. Dean recognized his joking as a Winchester self-defense mechanism. Never let them see you hurting.

Aw, hell, Sammy. "First time for everything."

Dean avoided all the things that he wanted to say, that he needed to say. "Look, Dad should be here soon, so just rest easy."

Sam laughed breathlessly. "He's going to flip out about this," Sam said closing his eyes again. He approximated his father's voice: "How can I trust you to watch my back when you can't even figure out how to protect yourself? No son of mine would let an appendix keep him down."

"Come on, Sammy," Dean said. "This isn't your fault."

Sam opened his eyes, wanting to believe his brother. For as much as he trusted Dean, he knew that his brother never understood the lack of faith his father placed in him. There was no way Dean could because for Dean, that faith was given without question, without reserve. "Yeah."

"Seriously, Sammy. How are you going to keep your appendix from rupturing?"

"He'd find a way," Sam quipped.

"Don't worry about Dad," Dean assured him. "This burden doesn't fall on you. It's me he's going to chew out."

"You? What for?"

"For not catching this sooner."

"And what medical degree do you have?"

"I never should have left you home alone that night, Sammy."

"What are you going to do, Dean? Watch me every second of every day? You can't do that, it's not realistic." Sam seemed winded. "Besides, I'm not a baby. You're going to have to see that someday."

"Yeah. Whatever." Dean could not bring his voice above a whisper. He shifted the conversation away from himself and back on Sam. "You need to get some rest now. Surgery is nothing to scoff at there, little brother."

Sam nodded with a ghost of a smile on his face. "I'm not feeling much…must still be the anesthesia."

"Probably," Dean agreed. "Get back to sleep while it's still working."

The suggestion was all Sam needed, and he let his eyes close again. "You sticking around?"

"Course I am, Sammy," Dean said flippantly. "There are some hot nurses. Saw this redhead down the hall--Catherine--I'm hoping she checks on you, so I've got to stay."

Dean's elaborate story was lost on Sam, who had surrendered back into the folds of unconsciousness.

Without Sam to put a front for, Dean felt himself collapse. His shoulders fell and he let his head rest in his hand. To see Sam fall victim to something so…natural. It unsettled him. He could fight a ghost, he could exorcise a demon. But he felt helpless as he watched Sam suffer from an ailment he couldn't combat.

Sam slept long, though he fluttered lightly below awareness on and off, leaving Dean perpetually perched on the edge of his seat, awaiting a change in Sam's condition. Nurses came and went (including the perky Catherine) and Dr. Hepker kept offering the same clichés, prompting Dean each time to get his father here.

That insistence made Dean nervous. Parents were never so big a deal unless they suspected additional forms had to be signed and important decisions needed to be made. He didn't know what he'd do if Sam took a turn for the worse.

The fever made Sam restless. His kid brother shifted weakly under the blankets, small whimpers escaping from his mouth occasionally. Dean hated to watch it, but couldn't bring himself to look away. He had seen Sam through a variety of childhood illnesses but the sight of Sam in a restless sleep never got easier. Sam looked younger in the hospital bed, with his bangs swept aside, exposing his forehead. Dean resisted the urge to straighten his hair. Sam never let it lay like that--not anymore. In fact, Sam held out on getting a haircut as long as possible, and it seemed to Dean like his kid brother was trying to hide behind his hair, obscure himself so he wouldn't have to face the world.

Dean hated this. He had more experience with it than he wanted to admit. But it had always been because of evil before. It had always been on the hunt, something paranormal they couldn't control. This was an appendix.

The tactics that kept them safe in the hunting world, were the same tactics that alienated them from society, that cut them off from everything around them. They were the same tactics that made them vulnerable to the daily burdens.

They spoke to each other without words. They existed in a vacuum. They believed that all the good things they had to say were understood and all the problems would never be real if they didn't give them words to make them tangible.

It was about trust. They trusted each other to watch their backs, to know their hidden feelings, to never breach the wall of denial they built around themselves. They were supposed to know when things were wrong and they were supposed to know when it was wrong enough to deal with.

Dean had trusted Sam to let him know it was serious. Sam had trusted Dean to figure it out. And in the lapse between these two trusts, everything had fallen apart. Life had wormed its was between them and played their strengths against them, leaving them all shell-shocked in the aftermath.