CHAPTER TWO:

THE EFFECT

Sam was in Hell.

Certainly, he realized, the real place is much worse, though he couldn't deny his current existence felt akin to the same amount of torture.

As soon as the radiation treatments began, it wasn't long afterwards when the first round of side effects hit Sam like a line-drive plowing into an unsuspecting baseball fan. The doctor said the aftereffect differs with each patient – some may not experience any reactions, whereas others are more acute. Sam dealt with the worst of nausea and vomiting, almost as bad as a pregnant mom with Hyperemesis Gravidarum. The first bout of vomiting hit in the middle of the night after the first treatment and hadn't – it seemed – stopped.

Interspersed with blinding headaches, constant fatigue, and hypersensitivity to touch, Sam became so, so sick. Dean read up on all the expectant and un-expectant side effects, trying to be prepared for whatever may come their way. He scrambled trying to find towels, wipes, anything to clean up when uncontrolled projectile vomiting or diarrhea occurred. Poor Sam apologized to him every second of the day, sweating, weak on his bed, clearly embarrassed. Dean tried to assure him, but it was like speaking with an abused puppy.

Towards the end of the first week, Sam found himself pacing in his bedroom. His nerves were on fire, everything in his body aching. His insides squirmed as if a hot poker stirred inside, the muscles in his back taut like they were electrified, and the soles of his feet twitched with unrelenting spasms. The pain kept him awake. The pacing hadn't helped to relieve it either. Tears sprung to his lids as he worked hard to stop his shaking hands.

Finally, he decided to wake Dean up, hoping his big brother had a solution. Quietly, he knocked on the door. There was no answer so he stepped in, ambling toward a snoring Dean. Hands trembling, he tapped him on the shoulder. "Dean, wake up."

It took a few more prods, but Dean soon stirred from his deep sleep. "Whatsit Sammy?" he slurred.

"Um…um…" Sam couldn't find the words. He hugged his body tighter trying to stifle the shakes.

"Sam?" Dean sat up.

He couldn't take it anymore and a torrent of tears flowed down his cheeks. "I'm in a lot of pain and I don't know what to do."

His big brother was on his feet in seconds, guiding him down on his bedspread. He turned on the bedside lamp and knelt down beside him. "Where does it hurt?"

Sam wiped away his tears, steadying his breath. "All…all over…just everywhere…"

"Okay, just try to relax all right? You're very tense and I don't think that's helping," Dean encouraged. "Wait here, I'll get a heating pad and will call your doctor."

"He's not available right now. He's probably asleep."

"Then I'll wake his ass up. I nicked his cell phone number from the receptionist's desk…you know, extra insurance," he smiled.

A minute later, he came back in with the heating pad, instructed him to lie down on his side while he turned it on and placed it over his back. Sam obliged, somewhat relieved he wasn't going to endure this misery alone. Small twinges of pain undulated up his spine and neck, working its way to the back of his head.

Dean entered the kitchen and made a call to his doctor. After an awkward exchange of 'how did you get this number' and a subtle threat, the doctor gave Dean what he needed. He returned to his bedroom with a container of liquid Codeine.

"The doc said it was okay to give you this," he poured some in a small cup and gave it to Sam who slurped it down without hesitating. "That should take the edge off whatever's going on."

"Thanks Dean," Sam said through gritted teeth, still tense and unable to rest. "What else did he say?"

"Only that this wasn't a side effect of the radiation treatment and may be that the brain tissue around the tumor is inflamed and pressing on your nerves."

"Great…" Sam shuddered. "This sucks."

"I know Sammy. Just hang in there." Dean assured. "You can stay in here tonight. I don't want you to move…at least not until the Codeine kicks in."

"Okay." Sam was appreciative of the offer. His brother then sat beside him on the bed, his back to the headboard, and he relayed some of his most embarrassing stories during his school years. It helped to pass the time for the Codeine to do its job in suppressing the small spasms and fire burning through his body. Dean did this for an hour until Sam finally relaxed and fell asleep.

"Goodnight Sammy." Dean rustled some of his hair accidentally taking a clump out. He looked at the wad of hair in his hand and frowned despondently.

The Monday on Week Three had arrived and Dean knew Sam was dreading the next radiation appointment. His body, they learned, became highly sensitive to the treatment; itchy, sore, and slightly dehydrated due to the vomiting. The anti-nausea pills he was prescribed had little effect as they consistently made their way back up. Dean resorted to mashing them in his Pedialyte, desperate for the kid to stomach something. He had lost nearly twenty pounds in the last two and a half weeks. Due to the constant vomiting or dry-heaving, Sam could barely eat or drink which stressed Dean's worried nerves.

John had told him not to worry about how they were going to find the money. Money had always been tight in their family. However, now, it had been stretched very thin due to the office fees, the visits, and medications Sam needed. John was out every night, his boys knew, working on various hustles to acquire some extra cash. It was not ideal, or even a moral, sense of an income, but it helped. For once, Sam didn't argue. He was too tired.

One morning, Sam ran out of bed into the bathroom, tossing whatever contents – very little – into the porcelain throne. Dean called his name, asking if he was all right. Face flushed, spittle spilling over his lips, he crawled over and whipped the door shut. He laid down on the cool tile, pulled the towel off the rack, and used it as a pillow. His lids were so heavy, all he wanted to do was sleep. The regular wave of nausea ebbed and flowed, like the ocean waves under a full moon, billowing in his throat. He crawled back over and laid his head down on the toilet seat, mewling, in wait for the never-ending torture to resume its course.

Dean came to the door and knocked. "Sam? You okay?"

"I'm…fine," Sam's voice croaked from behind the door. "Leave me alone."

"Okay dude," his brother sighed. "Let me know if you need anything." Dean then entered Sam's room and noticed the vomit stain on the sheets and blanket was tinged in pink liquid – most likely from the sores in his mouth. Shaking his head, he collected the sheets and took them to the sink to soak. Laundry day was once per week at a local laundry mat. They were already scrounging for change these days, so the old fashioned way was in order.

Dean had hung the freshly washed sheets on the back of the kitchen chair when John entered through the front door. "How is he?" he asked, pulling out a wad of cash and placing it in the envelope under the urn in the fireplace.

"Still tossing his cookies all over the bathroom."

"Has he been able to eat or drink anything?"

"Not much. I gave him a Pediasure earlier hoping that will stay…but from the sound in there, I don't think it is. He hasn't been able to keep much down."

"We need to keep an eye on that Dean. We can't let him get dehydrated."

"Yes sir. How's our bank doing?"

John gave a short nod, taking a seat at the kitchen table. "It's fine," he said, though Dean could tell he omitted some part of the truth. "We'll be fine."

Dean shrugged, taking a seat opposite of his father. "We can always rob a bank. We've got the tools and contacts. That'll take care of everything."

His father gave him a sour look. "Sure, and then we'll be on the run with your brother in his condition. Great plan…"

"Sorry sir," Dean replied sheepishly. "I really hate saying this…but we can try selling the Impala."

"You love that car!"

"I know…but this is important. We've got the truck to get around. She's in good condition. She'll get us a good price. That'll help for a while." The lines in his face creased, his eyes bristled with tears; the thought of giving up his beloved hot rod felt like taking a Samurai sword to the heart. "She's just a car."

"No, Dean!" Sam cried from behind. He leaned shakily against the fridge, breathing hard. "You're not selling her, not for me!"

"Sam, that money can help us."

"Dean, that car's the only consistent home I've ever known. I don't want to lose her." He made a small 'urp' and then ran back for the bathroom, the sound of retching filling the hallway.

"It doesn't sound good in there," John said.

"Yeah…he just needs to get through it," Dean responded quietly, on the verge of exhaustion. He stared pensively at the wall. "There may be another way in solving this thing."

"Solving what? The money?"

"No, for Sam. I've been thinking about it…and I think maybe we can find an alternative source for getting rid of this tumor."

"What are you talking about?"

"Dad, we know things," Dean asserted. "Things most people don't know about, things that'll work better than any of these doctors…like some hoodoo priest or healing spell or something."

John leaned forward, staring at his son darkly. "Dean, listen to me," he said authoritatively. "That is not an option. I've already looked into it and there is nothing that can help Sam, apart from making a deal with a devil. If you try anything like that, I'll break your legs."

"Why not? Why not find some supernatural smuck and use some form of leverage?"

"I said no. That's a dark hole son, and you won't find your way out of it," his gaze softened as he said, "Just trust me on this. There was a guy I knew that did something like that…"

"Dad, I know –"

"Don't interrupt me," he growled to which Dean instantly fell silent. "There are deals you can make with witches, demons, and many other sorts. The most popular one is the Crossroads Deal. It's a deal where you sell your soul as payment in exchange for whatever you want. They come to collect that payment after a length of time."

He continued, "I worked with a man named Barry Whitmore. He was a hunter, knew him through Bobby. He told us what he had done while we were on the hunt for a nest of vamps. He sold his soul to gain information for a thing he was hunting for years. He ended up killing it years later. However, the payment came due on that hunt. We found him in his cabin…torn to pieces. So I'm going to say it again…you will not make any deal with anything. It never ends well no matter how desperate you are. Do I make myself clear?"

Disappointed, Dean muttered, "Yes sir."

A week later, Dean found Sam at the bathroom sink next to a set of clippers. His soft, brunette hair was much thinner than he recalled before, some parts completely missing from the back of his head, aside from the biopsy patch and stitches. Sam stood staring at his reflection, upset, a clump of his hair held tight his fist.

"Sammy, you okay?" He knew it was a stupid question given how the kid was rigid.

"No," Sam whispered, sniffling. He grabbed another clump of his hair and it fell out easily, the strands falling through his fingers. "It won't stop coming out. I knew this would happen eventually, but I was hoping it wouldn't. I got the clippers…but…this is so weird man. I need to do it…I'm just…I don't know what I'm waiting for."

Usually Dean would give him a sarcastic quip about 'how it needed a trim anyway' or 'it'll help with the shedding problem', but decided against it. Instead, an idea came to him. He picked up the clippers, turned it on, and mowed a strip off the middle of his head. The act made him look like Larry from the Three Stooges. Sam's jaw dropped and he stared in awe.

"Welp, I guess I can't stop there!" Dean said sarcastically, then continued to shave off the rest of his short golden hair, until there was nothing left but a buzz cut. After the work was done, Dean shrugged rubbing the fine hairs left on his scalp. "It's not half bad."

The impromptu hair cut sent Sam into a fit of laughter. "I can't believe you did that!"

"What do you think? Do I look cool like Brad Pitt in Fight Club?"

"More like Sigourney Weaver in Alien 3."

Dean made a funny look and then flashed his devil-may-care smile. "I'll take that as a compliment. Ripley's a total badass."

The exchange gave Sam the confidence he needed. He grabbed the clippers from Dean's hand, took a deep breath, and trimmed off a section from the side of his head. Nodding in affirmation that this was the right choice, he ran through another section. After three shaves, his arms tired and Dean offered to shave off the rest. Once the job was done, the brothers rubbed their heads, observing their new looks.

"We look like Jar-heads."

"Yeah… smooth, cool bastards, that's what," Dean agreed. He opened his palm where Sam gave him a high-five.

"Yeah, we look cool," Sam said, somewhat relieved.

Dean tried to make the drive as pain-free as possible. Every bump in the road, every jostle, every turn, Sam emitted small gasps of pain, cringing at every motion. "Sorry dude," he said. "We're almost there."

They were on their way to the local walk-in clinic, much to Sam's chagrin. Dean was sure he had tired of the medical visits, the daily meal of drugs, and the incessant protests his ailing body made. With the persistent vomiting, Sam had become severely dehydrated. No matter how much Dean tried, the kid couldn't keep down any food or water. The feeling of vertigo, the clammy hands, and rapid breathing forced Dean to half carry his brother to the car. They needed some help.

Exhausted, with a cramping stomach, Sam stumbled into the clinic alongside his brother. Some of the waiting patrons stared. Dean surmised his brother's pale face, red-rimmed eyes, and really skinny build caught their attention. He curled an arm around Sam's shoulders, hoping to shield him from the penetrating looks.

They approached the counter and met a young, Hispanic woman with beautiful curls. "Uh…hi, we need some help."

The woman gazed at them, concerned. Dean continued, "My brother is not feeling well and I think he may be dehydrated. Just looking to pump him full of the good stuff."

At that moment, Sam teetered, his knees buckling under. "Oh!" Dean caught him in time before he fell to the floor and hoisted him up. "I gotcha buddy."

"Honey," the receptionist began, "in his condition, I think he needs to go to the hospital. We can call and have an ambulance pick him up."

"No, please don't." Dean pleaded. "Miss, I know this looks bad, but honestly, he just needs some fluids and he'll perk back up. We can't really afford to go to a hospital. Can we just get him some fluids? That's all."

"I…"

"Please, I'm begging you."

"It's okay Sonja," a pretty, blonde nurse in blue scrubs came out and approached the counter. "I'll take a quick look at him. Have Steve cover my next patient. I'll call General if we need to."

"Sure, Sarah," Sonja shrugged, typing in some information. "Follow her to the back and we'll take care of paperwork on the way out."

"You got it, thanks!"

The nurse, Sarah, invited them back to a room. Dean filled her in on Sam's case as he helped his brother climb onto the examination table. She understood and left to retrieve the equipment. Soon Sam was hooked up to an I.V. and asleep in a fetal position on the table. Dean found a blanket from under the counter and draped it over him. Sarah checked his other vitals, reading the results from the file copy Dean gave to her, making notes in it based on the day.

"He can stay in here until the bag is gone. We're slow today, so it should be fine," she told him.

"Thank you. It's been really hard for him to keep anything down. I may have to do this at home."

"Do you know how?"

"No. I've been reading up on this as much as I can, but I can't make heads or tails on a lot of things."

"So far, you're doing fine," she said sweetly. "Right now, it looks like he's getting much needed rest. We have a few minutes and so if you want, I can help you learn how to attach an I.V."

"Really?"

"Technically speaking, I shouldn't. I can get into a lot of trouble, but…I'll make an exception today if you keep the secret between us."

"Yeah, definitely. You steer the ship and tell me how to sail."

She left to gather the needed equipment for the lesson. Dean became antsy, almost excited, when she returned. He listened intently on exactly what each piece was, its purpose, and how to insert the needle into a person's vein. He wanted to try it on himself, only Sarah then offered for him to test it on her.

"Uh…I don't think that's a good idea."

"You need to learn how to do this properly. I don't recommend doing it on yourself for the first time. Here," she extended out her arm, "give it a go."

Screaming with nerves, Dean followed the directive and practiced attaching the I.V. on the nurse following her instructions. She allowed him to practice three times on both arms and on her hand. He felt more confident now in learning this new skillset. She brought him a small box of Saline solution bags and tubing in case he will need it at home.

"Thank you Sarah. I really appreciate this, more than you really know."

She nodded with a small smile. "You're welcome. Here," she handed him a small encyclopedia. "This is mine. It got me through school in more ways than one. While he's asleep, get yourself familiar with some of the signs and how to take care of them. Let me know if you have any questions about anything."

"Awesome!" Dean replied, excited. Any knowledge in how to help his little brother he would take without hesitation.

"Come get me when the bag finishes and I'll help you carry him to the car."

"You got it."

He took another look at his sleeping sibling and adjusted the blue beanie on his head. The MRI scan Dr. Singh needed was done two days ago, so the test results should be coming in any day now. Those results would tell them if the tumor grew or shrunk, if the treatment is working, and/or what Sam's chances are. Butterflies fluttered around in his stomach, his gut singing. He hated that feeling. Any time his gut sang, trouble was just around the corner.

Needing the distraction, he opened the book and began to read.

His book bag lay packed; his homework done, stacked neatly in his notebook. Sam checked it off the mental checklist he performed each day before school. He was looking forward to going back today. Though the effects of the radiation had depleted most of his energy, he felt a little better today, well enough to leave the house, well enough to try and have some semblance of his former life. He needed a distraction before his next radiation appointment later that day, and the impending results from his last test. The results were expected to come in the mail. His stomach completed a somersault every time the mail truck stopped by. With half the tasks of his list crossed off, he headed into the kitchen to complete the rest.

Teeth brushed…check.

Extra underwear, in case he had an accident at school…check.

Medication…he swallowed the pills under the Thursday container…check.

Books to return to the library…he shoved them into his backpack…check.

Breakfast…he went to the cupboard and pulled out his usual Apple Cinnamon Cheerios and set up a bowl. His stomach seemed settled enough to try it.

He had opened the milk when his right hand suddenly twitched, growing numb. Next, several spasms worked their way up both his arms, the milk carton falling onto and splashing the kitchen table. Alarmed, he gripped the edge of the table, short of breath, his arms shaking like they were made of Jello. In less than fifteen seconds, he lost all control of his body and he fell to the ground, twitching and jerking. His body became rigid, his back arching, his breathing noisy and difficult. He couldn't scream, all sense of responsiveness gone. Terrified, confused, he fell into the beast-like clutches of this disease, unable to escape.

At the sound of a loud thud, Dean was on his feet in his bedroom. "Sam?"

John also heard the noise and came out into the hallway. "Dean, what was that?"

Strange grunts and scraping chairs propelled both father and son towards the kitchen. Dean leapt into gear upon seeing Sam, on the floor, in a convulsive fit. He was at his brother's side, gently touching his side. "Sammy!"

"Dean, he's seizing!" John called from behind.

"I know!" Dean yelled. "Dad, quick, give me a towel, pillow, something!"

John ran into the bathroom and brought out a towel off the rack. Dean instantly placed it under Sam's bucking head. "Dad, move the table and the chairs, so he'll stop hitting them. We have to let it pass."

His father did as he was asked – which was a first for Dean – and pushed back the kitchen table and chairs. Sam jerked and twisted, his whole body shaking, his eyes rolling upwards. Dean stayed by, careful not to touch him, eyeing his watch every few seconds. If the seizure had gone on for longer than two minutes, they needed to call the emergency number.

John stood paralyzed, unable to move, watching in horror. "What do we do?"

"Nothing yet!" Dean answered, still watching the time.

One minute later, the spasms ceased and Sam stilled, his body lax. Dean immediately checked for his breathing. When he learned there was no present sign of danger, he worked in rolling Sam over in the recovery position. Dean lain down next to Sam and listened intently to his breathing, barely moving an inch for another two minutes.

John was amazed at how calm his son was, focused, relentless, how he trained him for the hunt. But to see it in action with caring for something he had never expected to experience, he was beyond glad he had his eldest.

When Dean felt they were in the clear, he rolled Sam back over and into his lap. He patted his cheek, attempting to elicit a response, but was unsuccessful. Sam fell into an exhaustive and deep sleep. Dean looked to his father and said firmly, "He'll be fine in a few minutes. He's just exhausted."

"It's getting worse."

"He'll be fine," Dean pressed. "Help me move him. Let's get him to the couch and let him sleep. I'll call the school. He can't go into today."

Nodding in agreement, John assisted his son in carrying the youngest to the couch. Dean placed a blanket over Sam and took a seat on the recliner, his face falling into his hands. He worked hard to suppress the tears that threatened to spill over his cheeks. All he needed was a moment of solitude.

"I'll…um…I'll go get the mail. His results should have come in by now. Maybe we'll have some good news for a change?" John murmured, exiting out the door. It was apparent this latest episode was overwhelming for their father. He hadn't yet seen the worst when it came to the effect this disease had on his son. This was probably a reality check he hadn't vied for. Perhaps the fresh air should help calm his anxiety?

John slowly trudged through the door a few minutes later reading a letter. He had with him a grave, despairing look. Dean stood up immediately in dread understanding what it was. It was Sam's latest test results, the test that revealed if the treatment was working.

"What does it say?" Dean asked shakily.

His father closed his eyes in anguish and sat down on the coffee table. "It's not working. The tumor has grown and now is pressing on his brain stem. There's no chance of operation. They anticipate with how fast this thing is growing, he…uh…"

"What? He what, Dad!"

The once resolute and strong-willed man, who has faced countless terrors of the night and come out unscathed on many bloody encounters, now was timid, nearly speechless. Then said frightfully, "Two months, maybe less…they think he only has several weeks left to live."

"Oh my god…" Dean exclaimed and then collapsed.