Thanks to all my reviewers.
Thanks to my beta for this chapter, K. Hanna Korossy.
Sorry for the wait everyone, and I'm sorry I only had time to send this to one beta before I posted it. I'll make sure you get the next one, Wolfschild.
Enjoy chapter 4. Happy Thanksgiving.
Chapter 4: Diagnosis
Sam sat on the hospital bed, fully dressed save for his shoes; he'd taken them off for the neurological tests and hadn't bothered to put them back on. He was slouched forward a little, staring at the wall. His brother was sitting next to him, close enough that they were almost shoulder-to-shoulder, leaving the chair by the bed unoccupied. Sam pretended he didn't notice, but he genuinely appreciated the gesture.
He'd started to feel better during the car ride to the hospital. Things were brighter, clearer, his mind sharper. He could pinpoint the exact moment his sensitivity had returned; they were just turning into the parking lot and Sam had looked over at Dean and felt—not just sensed but actually felt—how tense he was. His empathy, he figured, was the best way to gauge his sanity.
The doctor had left them alone about twenty minutes before, while the toxin screen was being processed. Sam had noticed some suspicious glances directed at his brother before the doctor had left. He'd thought about asking Dean about it, but he hadn't been able to find his voice. In fact, since the doctor had left neither Dean nor Sam had said a word. It was getting to both of them. Sam wondered who'd crack first.
"Feeling any better, yet?" Dean asked weakly. He didn't do well with awkward silences.
"I don't know. Are we in a hospital?" Sam replied hesitantly. Dean's eyes went wide with fear. Sam smirked back. "'Cause if we're not, I'm still hallucinating."
The shock bled off Dean's face, replaced by equal parts relief, annoyance, and humor. He punched Sam in the ribs with appreciable force.
"Ow!" Sam yelped. "What was that for?"
"That shit is not funny," Dean protested through an unwilling grin.
"I know." Sam put his hands up. "Sorry."
Dean looked at his brother with just a hint of gratitude. "It's all right. I'm glad you're feeling better."
"Yeah, I'd better enjoy it while it lasts, I guess," Sam said carefully.
Dean shot him a concerned look. "Sammy, this might not be the thing everybody else has got. It could just be something weird going on with your visions."
"Then why did I see an address that didn't exist?" Sam challenged.
At Sam's suggestion, Dean had checked whether there was a house on Melnore Street with the number Sam had seen before considering whether to call it in to the police. There had been no such address, as Sam had feared. The "vision" had been a part of his psychotic break.
"I don't know. But it doesn't mean you're…" Dean trailed off.
"What, Dean?" Sam stopped for a few seconds, momentarily struggling with his composure. "Going crazy?"
Dean clenched his jaw and hung his head, looking as lost as Sam felt.
Sam felt shitty. He shouldn't have been that blunt. But he needed Dean to face the reality of this, not least because he was having trouble facing it himself. Sam was hiding from it, trying not to feel it, but this hurt in a way he couldn't have expected. In a way that struck at the very core of his self-confidence.
Dean was strong. Despite being smaller than Sam, there was never a question that Dean was the better fighter. He had incredible instincts and lightning reflexes. He was bold and decisive, a natural leader. Sam was no slouch, and he was by no means indecisive or slow, but Dean was better; maybe even better than their father had been.
But Sam was smart. He was logical, rational, and empathetic. He read people, he solved puzzles, followed the clues and figured things out. Dean had a greater practical knowledge, but lately that lead had started to narrow. Dean wasn't stupid, or bad at any of these things, but Sam was naturally better, and that was what he brought to their partnership. That was the thing he contributed.
This disease was taking that away.
If Sam couldn't trust his mind, then he wasn't useful. All he could do now was drag Dean down.
A part of him, the part of him that was a little brother, the part of him that competed with Dean and struggled to live up to him, resisted that assessment. He looked at the man next to him, catching Dean's jade green eyes, and found what he was looking for: the quiet strength he so envied and admired. Sam had tried to develop strength like that. He'd worked at it for years. He'd confused it with things like passion, discipline, and confidence, but it was none of those things, and so every time he'd thought to measure himself against Dean in that dimension he'd failed. But it always spurred him to work harder, to better himself.
It was trite, almost embarrassingly so, but it all came down to this: Dean wouldn't give up if their places were reversed.
So Sam would take whatever medication the doctor prescribed and that would give him enough useful time to help his brother get to the bottom of this. Then he'd be okay, just like Dean had said, and things would go back to normal. No problem.
Dr. Matthews returned, and his sober eyes told Dean everything he needed to know.
"The tox screen was clean. There are no traces of drugs or alcohol in your system. It's my conclusion that your symptoms were caused by a schizo-affective psychotic disorder. It is most probably the same disorder that's been spreading throughout the town for the last few months."
There it was, like a judge bringing his gavel down. Finality. Dean saw his brother duck his head. He put a gentle hand on Sam's back.
"There is no cure, but there is treatment. I'm prescribing high dose antipsychotic medications. This should slow the progress of the disease, and reduce the frequency of psychotic episodes. At least initially, most patients also notice that what episodes do occur are less complex and convincing while on the medication."
"Initially?" Sam ventured, glassy-eyed and somber-voiced. Dean was almost glad to see that this was hitting him so hard. As long as Sam could still feel, Dean knew he'd be okay.
"Yes, well, so far we haven't been able to stop the progress of the disease. Eventually you will need stronger medication. And at some point, treatment will simply cease to work."
"What happens then? When the meds stop working?"
Dr. Matthews took a moment, perhaps figuring out how to put it delicately. "The final stage of the disease is a permanent confusional state. You'll lose connection to reality and never regain it."
Sam looked like he might throw up.
"We'll stop it before it gets that far," Dean whispered, just loud enough for Sam to hear. Dr. Matthews regarded them curiously. Sam looked up at the psychiatrist.
"Thank you, Doctor," he said.
"I'll make sure you get the meds before you leave." The psychiatrist paused and turned to Dean. "And, Jack, if I could have a moment to speak with you in the hall?"
Dean looked to Sam, and Sam nodded his assent.
"Look, Jack," Dr. Matthews began the moment they were out of sight of Sam. He was furious. As well he should be. "I'm not fond of getting played for a fool. Who the hell are you, really?"
"My name is Dr. Jack Danislaw, and I'm with the CDC. Sam is my assistant. I haven't lied to you," Dean said with as much authority as he could muster.
"Bullshit," Matthews replied. "That kid is maybe old enough to have graduated from college; he sure as hell isn't old enough to be working in any significant field capacity for the CDC."
Dean didn't have an answer for that one.
"You've got about ten seconds to explain yourself before I call the police," Matthews warned.
"Fine!" Dean snapped. "He's my brother."
"Your brother?" Matthews was incredulous. "You have different last names. And he doesn't look anything like you. You need to stop lying NOW."
"I'm not lying," Dean said defeatedly. "My name is Dean Winchester. I'm not a doctor. I'm not with the CDC. Sam is my little brother."
Matthews went from livid to apoplectic.
"What?" he demanded in a harsh whisper. There was a long lull in which Dean tried to figure out something he could say or do to convince this guy not to turn them in. Eventually Matthews composed himself. "What are you doing here, and why did you want those files?"
"We're trying to figure this out. Just like you are," Dean answered. "Only we have a less…conventional approach."
"What the hell does that mean?"
All Dean had at this point was the truth, as unsettling as that was. "Do you believe in the paranormal?"
Matthews visibly balked. "Are you serious?" the doctor replied.
Dean nodded his head slowly. "Sam and I hunt things people might call supernatural," Dean said, as earnestly as he was able. He wasn't reaching the guy at all. This was going to end with prison time.
"There is no such thing as the supernatural. Nothing happens contrary to nature."
"Only contrary to our understanding of it," Sam finished.
Dean turned and saw his brother standing at the door to the examination room. He had apparently been listening to the conversation. Good boy.
"Mr. Winchester," Matthews started, not a little flustered by the rejoinder.
"Look, you can't explain what's happening to me, or to everybody else. You can't explain why sometimes we're okay and sometimes we're not. You can't explain how the disease is being contracted. You can't even find a decent pattern," Sam argued, not letting Matthews construct a defense. Dean couldn't help but be impressed with when and how his brother could find strength. "So here's the question: why reject a potential avenue of investigation? Why not let us try to figure this out? If we can't do it, or you figure it out before us, you can still have us arrested then."
Matthews looked shocked and unsettled, but he wasn't going anywhere. "How do I know you won't skip town?" he asked cautiously.
Dean put out a hand. I've got this one. "Because Sam is my brother," Dean looked at Sam meaningfully, because he wasn't used to saying this in front of him. "He's my responsibility. We know some of your patients left before the quarantine, and we know they haven't gotten any better. We think whatever is doing this is here, in this town. So the only chance my bother's got to live the rest of his life without medication is for us to stay here and stop whatever's causing this."
Matthews sighed exasperatedly. Dean could see the doubts they'd planted. He could see how much the doctor needed this mystery to be solved. The man was desperate, and that was the only reason they even had a shot.
"I'm an idiot for doing this," Matthews started, almost to himself. "Fine. Cast your tea-leaves or whatever it is you do. But Sam—you take those drugs I gave you. Even if this disease isn't a normal one, the treatments do help. And if things get worse, come back here and I'll get you something stronger."
"Thank you, sir," Sam said sincerely. He turned to reenter his room, and Dean moved to follow. Matthews stopped him.
"I still need to talk to you," Matthews whispered to Dean, loudly enough for Sam to hear, but not enough for him to understand. Sam's eyes went to his brother.
Dean cocked his head. "Okay," he said. "Give us a minute, Sammy?"
"Look, if you want to yell at me some more, I get it—"
"That's not what this is about," Matthews said uncomfortably. "As difficult as this is, I'm still your brother's doctor. I need to make you understand what he's going to need from you."
That got Dean's attention. "Okay," he said tentatively.
"Things are going to get worse. There may come a time when Sam will need round-the-clock institutional care…"
"No. Absolutely not."
"Mr. Winchester, I don't think you understand…"
"No," Dean said, his voice betraying no doubt or hedging. "No, you don't understand. I've taken care of him since I was four years old. And maybe I don't know a lot about schizophrenia…but Sam trusts me. He knows me,"
That was the moment Dean started to feel it again, and he quavered a little.
"He's scared. Terrified. And there is nothing you could possibly say that would convince me to leave him with strangers," Dean blinked against the unwelcome warmth in his eyes. He breathed in deeply, composing himself. "So just tell me what he needs."
Matthews watched him sympathetically. "Okay," the doctor sighed. "You're going to need to watch him, pretty much all the time. There will be times when he simply cannot control himself; you are going to need to be there when that happens."
Dean swallowed the lump in his throat and nodded. Matthews continued.
"Most schizophrenics who have to take antipsychotic medications at dosages as high as I prescribed for Sam do not like to do so. We've come pretty far in the last ten years, but these drugs are still extremely powerful and have significant side effects. What I'm saying is, you need to be the one in charge of the drugs, and you need to make damn sure that he's taking them."
Matthews paused. Dean looked up at him coolly. "Is that all?"
"Your brother is going to hallucinate again," the doctor said. "And he's going to have paranoid delusions. As I'm sure you've noticed, it's extremely disturbing to see someone you know and love act so irrationally. But he needs you to confront him. Sometimes you'll be able to convince him that what he's seeing isn't real, or what he's thinking isn't true. Sometimes you won't be. But it's extremely important that you try."
Dean couldn't deny how much that first break had rattled him, and while he now believed he was more prepared for the next one, he certainly wasn't looking forward to it. Dr. Matthews seemed to notice his disquiet, and his tone softened.
"It's possible, though unlikely, that he'll become violent. It's much more likely that he'll harm himself; for some reason this particular psychotic disorder causes suicide with a much greater frequency than normal schizophrenia."
Dean didn't even want to think about that. "Sam wouldn't—" he gulped. "Sam's strong. He wouldn't do that."
"Yes, he would," Matthews replied firmly. "A bad enough psychotic break and anybody would."
"I'll watch him," Dean said absently. At this point the conversation was almost tangential, given the thoughts running through his head. "He's not going to like it."
"For his sake you can't let that stop you."
It was late at night, but his church was filled. If anything, there were more this evening than there had been in the morning. Of course, that was to be expected; he had promised to heal a man afflicted with the spreading madness.
He was not nervous, and he did not lack conviction. These people would see a man healed, and that would solidify their faith, their subservience, to him.
His patient sat in a wheelchair next to his pulpit, so far gone that he no longer spoke aloud, and only moved in fits and starts. He was young, perhaps in his late twenties, and in good health and shape. He was the perfect symbol of the indiscriminate nature of this disease, which was why he had been chosen.
The pastor spoke not a word; he had said everything he needed to already. He raised his hands to the sky and his body shook with power. His head jerked upward and from his mouth issued the alien words of the world beyond. He was taken, as if by a spasm, and his hand jolted to the forehead of the stricken man.
From around him came whirlwinds of black smoke, up from the ground and in through the cracked windows around the church. They came up around the preacher, shifting and moving organically like a swarm of locusts. They traced the length of his outstretched arm and followed it to the younger man, pouring in through his eyes and mouth until they had wholly disappeared into his body.
The young man's eyes snapped wide open, shining midnight black.
Then they cleared, and he rose from the chair, and with the young man's smile came a joyous clamor like none the pastor had ever heard.
He had them all, heart and soul.