Thank you again for all the wonderful reviews. You have made this so much fun!

a/n – I hope you enjoy what's to come. I promise Dean will feel better…eventually…in someone else's story…just kidding. 

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He Ain't Heavy, He's My Brother

Chapter Six

Ellen stood still as she watched the brothers, not sure what to do, how to help. Automatically, she reached for Sam as he reached for Dean, and waited. For the shaking to stop. For the vibrations in the room to cease. For both brothers to get what they needed from each other in order to breathe again.

After an eternity Sam straightened his back against her touch and she could see him fighting for calm, struggling for a force he could pass on to his besieged brother. But there was no imminent relief for Dean, and therefore there was none for Sam.

Inundated with fear, Sam felt his resolve weaken, and he pleaded silently for his brother to pass out, to give up whatever misplaced idea he had of heroism and bravery, and succumb to a blackness that could protect him.

But as luck would have it, the protection didn't come in the form of oblivion, and Sam was left to provide it, as best he could, through his own pain and anguish. Finding his voice was the first step, but when he tried it he choked on his own breath, stopping briefly before trying again.

"Dean." It was weak, and he knew it had to be stronger if he was going to get through to his brother, through the suffering.

"Dean." Better. Stronger. "I'm right here." It would have to do. It was all he had.

Dean was still sucking in air, in gasps and spurts, his body frantically searching for a position that offered no resistance. But in spite of his weakened state, the grip on Sam's hand was a constant.

Sam put his free hand on Dean's chest, over his heart, willing it to slow down, to quell the rapid rate that was fueling Dean's panic. His panic.

"Shh," he whispered. "Slow down. That's it, easy." The self consciousness Sam had felt earlier was gone, replaced by an unrelenting desire to take care of his brother. To be there, physically, emotionally, any way he could, to prove to his brother that he wasn't alone.

Miraculously, Dean responded to his brother's touch, to the sound of his voice, and his breathing eased, his panting slowed.

Sam could see Dean was putting great effort into listening, could feel it in the hand Dean gripped like a vice. Could see it in his gaze as he made eye contact, tearing him apart with a look that spoke volumes, and yet betrayed nothing.

He wanted to tell Dean to stop trying to protect him. To release whatever he could of the pain and the fury, because he could handle it. But he realized it was Dean who couldn't handle it. The deep seeded sense of responsibility towards his younger brother would never allow it. Could never let it happen without causing him more pain, more misery. So Sam stopped trying instead, choosing to focus on the moment, on the immediacy of the situation, and prayed that it would be enough to ease some of his brother's struggle.

Long minutes passed before Dean was completely still, his breath steady, his heart strong but even. Sam kept his hand on his chest and watched as his brother turned to face him, the strain of the movement causing him to wince.

"Don't," Sam offered. "Lie still."

"Tired," Dean replied. "Of…lying…still."

"You wanna dance?"

"Not my…type."

Dean shivered and Ellen took that as her cue to take his temperature.

"What…are you…doing?"

"Just taking your temperature."

"In…my ear?"

"You're a better patient when you're asleep, Dean Winchester." The thermometer beeped and Ellen looked at it, offering both boys a smile. "104."

"You're so…easy to please." Dean was licking his lips, and Sam noticed for the first time they were dry and chapped.

"Hey, are you thirsty? You want some water?"

"Hmm." Dean nodded, finding it difficult to say anything else.

"Be right back," Ellen said, heading to the kitchen.

"Sam?"

"Right here."

"Where are…my clothes?"

"Now you notice. We took them off. Ellen wanted to look for an injury, before we knew what was wrong, and we needed to bring your fever down." Sam searched his brother's face to see if he was following the conversation, subconsciously readjusting the covers so they reached his waist.

"Ellen," Dean said with great effort. "Likely…story."

"Yeah, that's right," Sam mused, for an instant getting a glimpse of his brother, the wise cracking ladies' man he missed terribly. "'Cause nothing turns women on more than men in pain."

"Could…happen."

Dean was making a superhuman effort to stay in the room, to add levity where there was none, but it was taking its toll.

"Sam." It was breathless, his allotment for the time being depleted.

"Right here, Dean."

Dean bit back a stabbing pain and fought to stay in control. He really didn't have anything to say to Sam, or to anyone for that matter. Why couldn't he just pass out? He closed his eyes, willing himself to lose consciousness, to find a black pit that held no pain.

Sam watched his brother's face flush in agony, watched as he steeled himself against an imaginary wall. He watched as Dean arched his head back, a gasp on his parted lips just before he released Sam's hand, his body finally succumbing to blessed unconsciousness.

"Thank God." Ellen was standing right behind Sam, startling him. "I thought he would never pass out."

"Me too." Sam looked at his watch. "How long has Ash been gone?"

"A little over an hour."

"That's it?"

"Sam, you know, Ash might come back empty handed."

"Ellen, not now."

"We just need a plan B."

Sam couldn't think of plan B, he wasn't even sure that plan A was viable, and he didn't need Ellen to remind him.

They were at the mercy of her hospitality, and she had been more than accommodating, but Sam couldn't deal with someone else's doubts right now. It was hard enough controlling his own fears.

A month ago he thought he was losing his brother, and ended up losing his father instead. But as hard as that was, he was certain, without question, he could not survive without his brother. There would be no point.

Sam leaned forward and put his head in his hands, unable to say anything to Ellen that would come across remotely coherent. He felt her hand on his shoulder, but didn't budge, didn't look up to meet her gaze.

"Your father would be so proud of you," she said. "Of both of you."

Sam registered the comment, tucked it away for later, and closed his eyes. He was so tired. So scared. Maybe if sleep claimed him too he could wake up when it was all over. Or better yet, he would wake up to find out it was all a dream, a nightmare. Sam almost laughed at the thought. It was becoming increasingly difficult for him to decipher his nightmares, to differentiate between the ones he had when he was sleeping and the ones he lived through while awake.

In spite of himself, and because his body gave him no choice, he let himself relax until he nodded off.

Minutes later he was awake, ushered back into reality by the hushed tones of Ellen soothing a shivering Dean. His brother had a wet towel draped across his chest, and Ellen was stroking his hair, whispering God knows what to him. Whatever it was, it wasn't working, and Dean, while unconscious, was becoming more anxious with every passing minute.

"What's wrong?" Sam was rubbing sleep out of his eyes, and looked at his watch. He had slept for over an hour.

"Fever's back up to 104.5."

Sam was in motion instantly, reaching for his brother's hand, taking over for Ellen as he stroked Dean's hair.

"Hey, Dean, it's me. It's Sam," he whispered. "It's okay. Go back to sleep."

Dean was visibly calmer within seconds, and Ellen shook her head. She had tried everything to relax him, and Sam did it instantly. She was certain Sam could have said anything to him and it wouldn't have mattered. It was the voice, the rhythm of his brother's voice that settled Dean, that offered him any peace.

Ellen heard footsteps and turned to see Ash, soaking wet from head to toe, leaving puddles of water wherever he went. He was followed by the very elderly Dr. Bates, and his equally elderly wife, Betty.

Sam looked up just in time to see Dr. Bates enter the room. Had he not been so worried, had the events of the entire day not been so surreal, he might have laughed. Instead, he realized rather quickly that his brother's life most likely depended on the ancient creature before him.

The good doctor was barely five feet tall, but Sam guessed that in his hey day he might have topped five six, so bad was the osteoporosis curving his spine. He walked with a cane that was held in place by a red ribbon tied into a bow, and his fingers jutted out in different directions, most likely the victims of arthritis. He was impossibly round, without being huge, and wore gray polyester pants that were held up with suspenders.

Despite the fact that his body shouted hundred year-old man, Dr. Bates sported a full head of silver hair, long and shaggy in every direction, including down his forehead and over his coke bottle glasses. Sam liked him instantly.

"Dr. Bates, Betty, thank you for coming." Ellen was leading the doctor into the room, towards Dean. "This is Sam, and this," she said, pointing to her bed, "is Dean – I trust Ash filled you in?"

"Good to see you, Ellen," he said, turning to face Sam, his right hand extended.

"Henry Bates," he said, his handshake surprisingly firm. "You must be the brother. It's a pleasure to meet you." His voice was deep, deeper than Sam would have expected from someone so old, and Sam liked the presence it carried. It was reassuring if nothing else.

"Likewise," Sam said, his own voice a mild combination of awe and fear.

"This is my wife Betty," Dr. Bates said, pointing with his right hand, his good hand, at his wife.

Betty was a miniature version of her husband, except that her silver hair was tied into a bun, her thick glasses covered half her face, and she was wearing lipstick. Like her husband, she sported what appeared to be a million wrinkles, but, unlike her husband, she moved with agility and grace.

Betty extended her hand to Sam, not to offer a handshake, but rather a gentle squeeze that offered support. Her tiny hand easily disappeared in Sam's, but the gesture was grand and Sam felt himself choking back his emotions when it occurred to him that maybe help had arrived. That in spite of the fact that she and her husband were a far cry from the cavalry, perhaps they had something they could offer his beleaguered brother.

Dr. Bates suddenly held up his left hand and the cane came with it, missing Sam's head by mere inches. Betty was at his side instantly, untying the red ribbon and releasing the cane from her husband's awkward grip.

While flexing his distorted fingers, the doctor turned to Sam and began asking him questions.

"Tell me about your brother," he said. "First, why is his arm bandaged?"

Sam was grateful the doctor was wasting no time. Grateful there was no need for small talk.

"He cut himself earlier today. Ellen took care of it."

"Stitches?"

"Five."

"What are his symptoms?"

"He's in a lot of pain," Sam offered, reliving the last few hours as best he could. "It's pretty constant now, but every once in a while he gets a really sharp jolt. When he does it tears him apart, his breathing becomes erratic, he curls onto his side, protecting himself."

"And what came before the pain?"

"I'm not exactly sure, because he hid it, but a headache, I know, that he's had for a few days."

"Dizziness, nausea," Ellen added. "And he said he threw up this morning, after breakfast."

"Which he barely touched," Sam offered.

"How long has he been unconscious?"

"About an hour and a half."

"But he's restless," Ellen volunteered. "Not so out that he isn't uncomfortable."

"And before that?"

"He's been in and out for the last three hours. But he's getting worse."

"How so?"

"The lucid moments are fewer and further apart. He's…he's been hallucinating." Sam stopped. He didn't want to share this information with a room full of people. The fever had allowed him to see into Dean's soul, and what was there had left him raw, his emotions about his father, his brother, his family, a tangible mess he couldn't expose right now. For his sake. For Dean's sake.

"Hallucinating?" But the doctor was curious.

"Fever dreams, mostly," Ellen ventured. And Sam glanced at her, his gratitude in the exhale.

"I take it the wet towel is for the fever?"

Ellen nodded. "It's been as high as 104.7, came down to 104 and was 104.5 a few minutes ago."

Dr. Bates turned to Sam again. "I'm going to need to examine him."

Sam realized the doctor was asking for his permission. The responsibility weighed heavily, and Sam blinked at the sheer force of it. All he could do was nod, afraid that anything that came out of his mouth would be laced with emotions he couldn't handle.

Sam looked at his brother and said a silent prayer. He prayed for an end to the suffering, to the torture on his brother's body, his psyche. He prayed for a life that offered a modicum of peace. For both of them.

"Ash, did you bring in my bag?"

"It's right here." Ash held out the doctor's black bag, and Sam swore it came straight out of a movie set from the forties.

"I'm going to change and check my email," Ash said. "See if anyone from the hospital has checked in." Ash handed Betty the bag and left the room.

Betty positioned herself on the bed across from her husband, on the other side of Dean, and opened the bag, pulling out a stethoscope first, and then something else Sam couldn't make out.

Dr. Bates sat on the chair Sam had been using and began the examination by placing a hand on Dean's forehead.

"Very hot, very hot," he said to no one in particular. He moved his hands down Dean's face and onto his neck, feeling around for swollen lymph nodes, a pulse.

"Good pulse, good sign," he said, again to no one in particular. Betty handed him a small pen light and he looked in Dean's eyes, moving the light from one end of each eye to the other, tracking the pupils as he went. Satisfied, he turned to Betty and nodded.

Betty took out a blood pressure cuff and wrapped it around Dean's arm, while her husband listened to his chest with the stethoscope. Dean's breathing increased with all the attention, and the doctor placed the palm of his hand on his forehead to steady him, to soothe him. When he was satisfied, when Dean was visibly calmer, Dr. Bates looked to his wife.

"90 over 50," she offered.

"Is that good, bad?" Sam couldn't keep from asking.

"It's low," the doctor answered. "But to be expected. His chest is clear, which is a good sign. No infection in there right now that could easily lead to pneumonia later."

Pneumonia? Where did that come from? Sam wasn't sure he wanted to stay in the room, and yet nothing could drag him away.

The doctor handed the stethoscope back to his wife and leaned forward, his head turned to the side, his right ear centimeters from Dean's stomach.

Was he listening to his appendix? Could he hear blood vessels bursting as the infection spread? Sam shook his head to clear the thought, and realized he was holding his breath.

The doctor leaned back and pressed a hand on Dean's left side, and then his right, and Sam looked away, anticipating the inevitable groan from his brother.

Sure enough, right on cue, Dean gasped, his eyes fluttering open for an instant when Dr. Bates pressed on his right side. Sam held his breath again, releasing it only when he was confident Dean was still out. He didn't know how much more of his brother's suffering he could take.

"Classic, rigid abdomen," Bates said, looking in Ellen's direction. "I believe you made the right diagnosis, Ellen. This boy's appendix has to come out. And judging from the pain you've described, and the fever, chances are it's already ruptured. This is one very sick young man."

Sam blinked several times before he could speak. It was information he already had, but up until that point it had been speculation, now it was real.

"You can help him, right?" Sam was working hard to keep the panic out of his voice.

"Sam." The doctor looked at him, his eyes huge and wide, distorted by the thick glasses he wore.

"That's why you're here, right? That's why you came? So you could help him?" Sam gave up trying to hide the panic. It was oozing out of every pore.

"I haven't performed a surgery in over 30 years."

"But you have, right? Did you go to the clinic, did you find what you needed for the surgery?"

"We did." Ash had just returned and was facing Dr. Bates, eyebrows raised. He spoke to Sam, but looked at the doctor. "Dr. Bates took everything he needed to perform a surgery."

"Ash, did you get any response to the emails?" Ellen interrupted.

Ash shook his head. "Nothing."

Sam was still staring at the doctor. "So what's the problem? What's happened in the last 15 minutes to make you change your mind?" Sam was on the edge, unable to see gray, only the black and white reality of his brother's predicament.

Dr. Bates hesitated before continuing. "His condition is so much worse than I anticipated."

The reasoning made no sense to Sam, and he tried hard to keep his temper in check.

"Wouldn't that make you want to operate even more? My brother is going to die if we don't do something now. You said it yourself, he's very sick."

Sam reached for the dresser, something solid he could lean into besides relying on his legs to keep him standing. He was sure the room was spinning, could see the light playing tricks on him, dancing in circles out of the corners of his eyes.

"That's it," Dr. Bates admitted. "A straight appendectomy I can do, well not me exactly, but I figured I could guide one of you to do it. But this, this is more intricate. If indeed the appendix has ruptured, and there's every indication that it has, there could be complications, we could lose him during the surgery."

"We're going to lose him if we don't do something." It was Ellen this time, and Sam was so grateful he could have kissed her.

"You don't understand." Dr. Bates was scratching his head, trying to be as gentle as possible as he laid out the facts. "To begin with, the supplies at the clinic were limited, and in this environment, even a quick appendectomy, one with no complications, is risky. If anything goes wrong, if we have to keep him open longer than we expect, the chance of further infection is great. He may need a transfusion, or a…"

"Do…it." The demand, loud and clear, was lost on no one, and every person in the room turned to face Dean.

"Hey," Sam was instantly at his side, wondering how much of the conversation his brother had heard. "You hanging in there?"

"Not…really." The words were hard fought and painful, and a new sheen of sweat was already forming on Dean's face, highlighting the deathly pallor of his skin.

Sam bit his lip and forced himself to focus.

"Dr. Bates is here," he said, glancing at the doctor with a determination that was hard to miss. "He's going to take out your appendix."

"Bates? Like…Psycho…Bates?

"Yes, just like him," Sam replied, marveling at his brother's ability to crack a joke no matter the situation.

"No…shower then...oka…" The words were interrupted by a sharp pain that sent Dean curling on his side again, his knees pulled up tightly to his chest, his breath shallow, as he frantically sought a position he could tolerate.

"SAM! S…A…M!" It was a command. An order. Dean was close to his breaking point.

"I'm here Dean, I'm right here."

"If you can't…make it…go away…you have to…kill me."

The words came in short gasps, and took forever, and when Dean was finished, Sam had reached his own threshold. His own limit of how much he could take.

"You have to help," Sam begged the doctor, unbidden tears staining his face, his voice cracking with emotion. He had held himself in check for so long, but he could no longer look at his brother without despair. Without the uneasy feeling in the pit of his stomach that told him he was about to lose control.

Betty put a hand on the doctor's arm and Sam could have sworn she squeezed it. The doctor faced his wife, and then Sam, before speaking.

"There are so many risks."

But Sam didn't want to hear it.

"I know that," he interrupted, barely able to keep the sobs from his voice. "But it's our only choice."

"Can you do it?" Dr. Bates asked. "Can you cut into your brother, and take out his appendix? Can you do it if I tell you what to do?"

Sam looked at Dean, who looked right back at him with a glassy unfocused expression that nearly betrayed his resolve.

"Do…it…Sammy."

It had come down to this. The moment Sam had been praying for suddenly became the moment he'd been dreading. But when he looked at the doctor, when he replied, nothing betrayed his own response. Not his heart, threatening to burst through his chest, not even the voice in his head screaming at him to run.

"I can do it," Sam said.

Dr. Bates paused for a long time before responding. "Very well," he finally said. "But you should know there are no guarantees."

Sam nodded and placed a hand on Dean's shoulder. But as hard as he tried, he couldn't look his brother in the eye.

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Well, what do you think? Please let me know…very insecure writer here…would love to hear all comments – even the yelling for torturing Dean so much! 