Dean clipped his shoulder on the door and flipped the lights on. The room bleached out under the fluorescents. Dean slipped and hit something, the world tilting then righting itself and Dean ignored the sharp sting in his hip as he rushed to Sam's bed, his heart beating out of his chest, blood rushing in his ears. He reached Sam and landed heavy hands onto the unmoving, blanket-covered mound that was his brother.

"Sam! Sam!" Dean shouted. Sam didn't wake but his face was in a rictus of pain. Dean ripped the blankets off. There was no blood, no apparent injury. He remained prone, curled into a ball, face pale and sweaty, messy hair still damp, and gasping silent screams.

Dean braced Sam with one hand on his waist, the other on his shoulder. His sharp eyes scanned Sam again, trying to figure out what was wrong. At a loss, he went back to Sam's strained face. "Sam! Sam!" Dean called. "What hurts!? Where's it hurt, Sammy, c'mon!" Dean yelled futilely. Sam's eyelids fluttered and he inhaled deeply before letting out a piercing scream, shattering Dean's eardrums. The cords and tendons in Sam's neck stressed as he contorted in bed, his back lifting off the mattress. He stopped screaming and slammed back down to the mattress, panting.

"Fuck," Dean whispered, shaken. What next? Pea soup?

Dean grabbed the kid's coiling body and put him onto his back. With firm hands on Sam's bony hips, Dean dragged him down towards the center of the bed to give himself more room to work. Sam's damp tangled hair tracked along the pillow, splaying out against the pale blue sheets. Sam gasped, his eyes opening wide, so dilated Dean could barely see his brother's hazel coloring.

"Sam! Sammy c'mon look at me, damn it!"

Sam writhed and spasmed, still caught and essentially immobilized by whatever horror show was playing behind his eyes. He kept up the cries and choked screams, breaking every few seconds to gather more breath before starting up again.

"Sam!" Dean yelled directly into his brother's face. Sam only flinched and shook more. Tears broke and streamed down his face. Sam gasped another breath and the next scream tore through Dean's heart when he heard his own name barely enunciated in a desperate, hopeless bid for help.

"Sam! Sam, I'm right here! I'm right here!"

Sam coughed and gurgled on a choked sob.

"Fuck Sam, c'mon!" Dean bellowed, nearly in tears himself now. He pulled Sam's feet and arms out, laying him out so he could examine him more closely. Sam continued to tremble, panicked eyes glued to the ceiling but he didn't react. Dean trailed pressure along Sam's shoulders, chest, stomach, hips and legs all the while watching for any classic pain responses. Nothing but goose bumps along bare skin and sharp spasms and trembles that shook his little brother's frame. Sam had no reaction to anything. Dean finished his exam with Sam's ankles and feet. There was no way he could have anything broken or dislocated.

Head injury? Dean chided himself for not checking that first but how the hell would Sam have gotten a head injury? None of this made sense though so Dean just leaned forward and placed gentle pressure around the kid's head. He watched Sam's already terrified expression for any flinch or indication of physical pain and got nothing. He moved on to his brother's forehead, temples, cheekbones, jaw...

In hindsight Dean couldn't believe he'd missed it for so long. In his defense, his hands were practically numb with panic and he was running on the expectation that he'd trigger pain to find a specific injury in Sam. He wasn't even thinking about what he found next. Dean placed his palm against Sam's neck and slid down to his collarbone. It took him a second to register ice cold, clammy skin.

"Holy shit," Dean murmured heavily, "Sam, you're freezing cold."

Dean leaned back for a second, dread spreading through him as he assessed the kid for hypothermia, a condition that hadn't occurred to him because it was absurd. The bunker was normally in the low seventies fahrenheit and Dean had raised it even higher before getting the kid out of the bathroom earlier.

Beads of sweat rolled down Sam's face and straining neck, mingling with tears and spit as Sam continued to holler himself hoarse. His pale, papery skin was a whole new level of white and stood out starkly against his dark hair. Dean couldn't stop his own tears when he realized Sam was repeating garbled 'D' sounds in between anguished wails.

Sam continued to scream out frantically, his garbled words and moans nearly indecipherable but still with that cursed 'D' sound intact, haunting Dean. Dean refused to acknowledge that sound, knowing he'd be incapable of handling the situation if he thought too much about his brother's blind, panicked begs. Sam was undergoing torture of some kind, Dean was sure of that. To be so destroyed that Sam would openly call out for him, desperate... No. No, Dean couldn't think about it.

Whatever was happening it was plainly obvious that it was removed from reality. It was something separate, something psychological. Dean didn't know if he felt better or worse about that.

Dean bit his lip, stared at Sam and weighed priorities. Whatever the cause of Sam's unresponsiveness and hypothermia, it was going to have to take a back seat. He had to just treat the symptoms and get Sam's temperature up.

Dean hated himself for leaving Sam in tears alone on the bed crying for him but he couldn't waste time. As he left Sam's room to scour the bunker for supplies, an appalling revelation hit him that probably should've hit him sooner. With all of Sam's symptoms supernatural in nature, no hospital would be able to help. With Castiel unavailable right now, Dean was all alone to keep his brother alive.

...

Sam only registered light flashing into his retinas and staying there, a signal that Lucifer had begun the next scenario. Trapped, he waited in despair, using his lungs and breath and vocal chords.

Sam heard his brother, a faint call in from beyond and all around the frosty misted eternity. He shouted back, suspecting it was false but willing to enjoy the ghost of his brother's voice. Sam's wheeze sounded out briefly before getting swallowed up by the vast, clouded monochrome nothingness, everything falling back into cloudy muffled silence.

...

Dean tore through the hallway and into his room to grab the thermometer on the nightstand along with all the blankets and covers he could hold. Nearly tripping over the edges dragging along the floor, he rushed back to Sam, dropped his cargo at the foot of the bed and climbed in to kneel over his brother. Dean's heart constricted when he thought he could see Sam's lips turning blue, a macabre match with his bed sheet.

"Fuck," Dean whispered, voice breaking. He braced Sam from jolting around so he could press an ear over Sam's heart: the beat was too fast, as expected, but more importantly and actionable, Sam's t-shirt was soaked through with sweat.

A scream burst from Sam suddenly, scaring Dean backwards before he scrambled back.

"Damn it, Sam, shut up and hold still," Dean begged, moving to take Sam's wet t-shirt off. He threw the t-shirt aside and turned back to focus on the crushing sounds and expressions of Sam's terror, panic-filled face. Helpless rage boiled up in him and he had to look away. There was nothing to punch or stab or shoot and he couldn't shout or shake Sam out of this. He blanked the situation out and took a deep breath to temper himself.

Slightly rebalanced, Dean left his shivering, oblivious brother to grab the blankets he'd dropped at the foot of the bed. One after the other he spread them over Sam. Before the last blanket settled, Dean climbed in and tunneled under. Sam had turned on his side at some point, having done his best to curl into a ball despite his body stiffening from the cold. "Sam! Sammy!" Dean rasped, gingerly sliding up against Sam's bare, chilled spine. Dean grimaced as he pressed a warm palm against Sam's freezing cold ribcage. Sam shuddered under the touch.

"Dean, help. Help me please..." Sam whispered, tears streaming, his grated voice having shifted to raw sorrow. The words were articulated and quieter than any he'd said yet but they damned Dean. Grief-stricken and despairing appeals like that, Dean knew Sam didn't think they'd be heard; didn't think Dean would actually help him.

Dean cautiously rolled Sam onto his back as he lifted himself to hover over him. Their foreheads nearly touched as Dean tried to get through to his traumatized brother again. "Sammy! Sam snap out of this! You're hallucinating!" Dean demanded. He leaned on his elbows and cradled Sam's head in his hands under the covers. Sam choked on tears, squeezed his eyes tight, and actually shook his head like he'd heard Dean, like Dean's voice was finally cutting through whatever veil of unreality was keeping his brother trapped.

Sam's hypothermia was well on its way to reaching extremes but the elation of seeing his brother responding to him was too strong to ignore. Dean needed to take a baseline temperature and come in closer for skin-to-skin contact but he was so close.

"It's not real! Sam! I'm right here! Right here! You're safe!" Dean cried, repeatedly brushing Sam's hair back. He shoved his arms up under Sam's shoulders and wrapped him in closer. Sam's face screwed up into disbelieving grief, shaking his head as if refusing to give in. "C'mon, Sam, c'mon back to me now, Sammy!" Dean whispered, a tear of his own slipping. Nothing more happened. "Damn it," Dean sniffed and swallowed his emotions as he let go of his brother so he could rearrange their positions.

Dean briefly recalled the memory of him and Sam attending courses in emergency medical care their father would schedule for them throughout their teens. They'd acquired the practical, if unofficial, training equivalent to that of a paramedic. Perhaps even better, having been educated on recommended procedures for a wide range of disaster survival scenarios, many of them assuming a lack of resources and supplies. Sam and Dean held these courses and workshops in high regard. They always received full marks. But they couldn't ignore the more awkward life-saving techniques like CPR and using skin-to-skin contact to warm someone up in the event of limited supplies. They had jokingly promised each other they were cool with letting the other die in the event.

Dean huffed at the memory as he used his arms and legs to line his brother up against him. "Holy shi-" Dean gasped, starting to shiver now as his bare skin pressed flush against Sam's frigid flesh. "Oh my god, Sammy," Dean breathed, upset, and tried to adjust. He funneled the instinctive reaction to pull away from the cold dermis into gripping Sam tighter against him, warming him up. He tangled their legs together and willed his warmth into his icy brother.

...

Dean's voice echoed through to Sam again and again. Grief swept him out from under, robbing him of screams and leaving him shattered with heaving sobs and cries. He wanted Dean so badly it was a separate ache all its own.

This wretched eternity had never allowed Sam to forget his brother's voice, pulling it out into the atmosphere at the worst moments of torture to crush desperate tears out of his eyes, breaking him every time.

The idea that Dean could be near lent itself to a hope that he could save him in this deep, locked corner of hell. That hope had always destroyed whatever vestiges of strength Sam still had, reducing him to a terrified beggar reaching out to the hallucination of his big brother for salvation. He'd scream for Dean for all he was worth and the Morning Star would cackle with glee as he cut into Sam deeper until there was nothing left of him.

And then it'd start again.

...

Dean would never have imagined that he'd prefer to hear Sam crying over anything else but the way Sam screamed… It was horrifying. He'd never heard Sam like this. Like it was beyond torture. All while he was freezing cold...

That's when it dawned upon Dean. The memory of Lucifer's words in Detroit cut through him like lightning, neurons firing as the connection made itself known.

Sorry if it's a bit chilly. Most people think I burn hot. It's actually quite the opposite.

Sam's hypothermia might have triggered his memories of the cage. He could be in some kind of a flashback nightmare, the sleep keeping him trapped and at the flashback's mercy to flesh itself out in hideous detail.

"Sam! Sammy you're here with me in the bunker, bud, c'mon!"

Sam cried out in fright and started bucking against the heat and pressure against him. "Sam! No, it's okay!" Dean shouted but Sam resisted. Dean had no choice but to snake his arms around Sam's chilled body in a firm embrace. He leaned his head against Sam's as they rode it out.

"Shh calm down, calm down, Sammy, I've got you, I've got you," Dean whispered, his words rising and falling at every frantic jerk and jolt Sam made to get away. "Come on, relax, Sammy. Easy, Easy, Sam, c'mon, it's just me," Dean continued.

Sam eventually settled with a hopeless, miserable sob. "Good job, Sam, good, you're okay," Dean murmured as Sam dissolved into soft, quiet cries.

Dean felt around to get his little brother's heart under his palm. It was too fast but Sam was still with him, still fighting. Now that he was quiet, Dean hoped he'd be able to hear him better. He kept Sam clutched tightly in his arms as he spoke as calmly as possible.

"Okay, okay, Sammy listen to me. You're not in the cage. You're not with Lucifer. You're never going back. I've got you," Dean started rocking them slowly. "I've got you, Sam - there's nothing to be afraid of. Nothing can hurt you. I promise, Sam. C'mon, Sammy, c'mon, come back to me." He kept talking, praying that he'd get through soon.

...

Sam could barely sense anything in the cage, his spirit shattered, mind in pieces. At his most rudimentary core he just wished for Dean's voice in the mists to continue. It was his only comfort in this level of hell, hardly audible.

Slowly, sluggishly, the cold began to recede. He had felt the ghost of a full press of something soft but solid against his back earlier and it seemed to be coming back again. He considered whether it was Lucifer but it wasn't hurting him. There was no pain, no prior injury of a split spine torturing him as it just remained there against him, doing nothing but existing. Sam couldn't sense warmth exactly but something was improving in him. Something was different about this presence around him.

Sam's despair dulled, allowing a few scarce sparks of hope to light up as he realized he couldn't sense Lucifer anymore. The Morning Star's sheet of ice that'd wrapped itself around him had lifted and he felt his own intact limbs twitch and spasm.

Sam squirmed, moving around as much as possible, still listening to the wisps of Dean's voice. They were real words in strings, sometimes full sentences all encouraging, reassuring, promising him his big brother was right there with him somehow.

Sam felt the first sharp shock of warmth up his back and immediately wriggled towards it. Dean's voice broke through again, his tone urgent and excited and praising as if he was reacting to what Sam had just done. He narrowly felt gentle warm pressures moving around and against his chest.

Sam didn't know what was going on but with another whimpered prayer for strength, he tried to do it again.

...

Sam gave a sudden shudder. He gasped a cry and, still shaking in Dean's arms, managed to move around under his brother's hold, nudging against Dean's back.

"Yes! Sam, good, good, c'mon, c'mere, I'm right here, Sammy, I've got you," Dean called, thrilled to feel his brother moving around. Sam's eyes were closed, his expression still full of pain and fear but the kid had started trying, had finally picked up on Dean's presence well enough to move towards him and his warmth.

"C'mon Sammy, you've got this, c'mon, c'mon," Dean pushed and pressed against his brother with his arms, trying to trigger more awareness that he was there. With another short, sharp cry of effort, Sam's arms shot out to grab onto Dean's, his fingers like icicles wrapping around and clutching his wrists.

"Yeah Sammy! Sam! Good job, good boy," Dean said, accidentally regressing his praise but at this point who cared? "Do it again, Sammy, c'mon, wake up, wake up for me, I'm right here," Dean pushed, tears of desperation and relief rolling down his face as he whispered into his little brother's tangled hair.

Sam was devastated but Dean could tell he was fighting to surface, to get back to him. Crying out, shaking and terrified, he still molded himself against Dean, slowly melted under Dean's weight and warmth. Dean held his little brother tight, rocking them, whispering to him he was in his arms and safe.

...

His brother's hushed, gravelly voice kept whispering into his ear, the sound getting louder and clearer. Sam gasped wetly and swallowed. Still trembling, he was growing disoriented. Trying so damn hard to figure out what was going on, he writhed and wriggled into the warmth he now felt in fleeting streaks and pressures all over his body.

"Wake up, Sammy. I'm right here. I've got you," Sam felt his body hugged, warmth and comfort seeping into him just as his brother's words resumed, "You're safe. I'm right here holding you. Right here. You gotta come back to me, Sam. You gotta hold on… You gotta hold on for me, Sammy..."

Full reality slammed back into Sam.

Writer's Note: Thank you so much for reading! Please comment/review if you can spare the time! Love, Alex