Prompt from Shennanigans:
I have a prompt if you want it. Sam, any age, has gastritis and a slow intestinal bleed. This is discovered through his behavior due to anemia (weak, hazy, forgetful, drunk-like, tingly appendages, take your pick). Dean is an awesome, caring big bro, who might give Sam a hard time at first, but softens when he realizes their lifestyle is to blame.
This is set early season 8, between Southern Comfort and A little slice of Kevin, when the boys are trying to get back into the swing of things but their relationship is strained.
The coffee cups in his hands were hot, burning his palms, and he hurried from the Impala over to their motel room with a greasy paper bag tucked under his arm. Dean managed to skip past a car just in time and stopped outside of their door, he banged his elbow against it.
"Sam!" he called, "Open up! I don't have any free hands."
There was no answer and Dean was forced to place the cups down on the ground before his fingers were seared off. He shook his hands out a little, hoping they might cool down and he dipped into his pocket for the room key, unlocking the door he kicked it open.
"Sam, damn it, what the hell are you doing?" he demanded as he retrieved the coffee cups from the pavement. Dean stepped into the room, surprised to find Sam was still in bed where he'd left him. Dean scowled and set breakfast down on the nearest table.
That morning, Dean had shaken Sam awake before heading out, and Sam had promised he'd be up by the time he got back. Dean pushed the door closed as loud as he could. Sam jerked under the bedsheets at the slam and blinked blearily over his shoulder at Dean.
"You forget something?" he asked. Dean snorted because it didn't even sound like Sam was joking.
"I've been gone for like half an hour, Sam," Dean growled, "And you were supposed to be ready to hit the road by now."
Sam frowned and rubbed his eyes, he nearly gasped when he glimpsed at his watch.
"What's wrong with you?" Dean grumbled, "Did suburban life turn you into a slob?"
Sam dropped his head and swung his legs over the side of the bed. "I'm just tired," he said quietly and disappeared into the bathroom, scrubbing a hand over his face. Dean dropped into one of the seats at the table when he heard the shower running.
He grumbled to himself as he sipped his coffee. Purgatory had made him sharper, he was constantly ready to get out there and work a case. Maybe Purgatory hadn't had mortuaries to investigate or weeping widows to question but it had had a crap load of monsters to kill. And wasn't killing a crap load of monsters what Dean was best at?
And then there was Sam. Sam, who hadn't even bothered to look for Dean, who had hit a dog with Dean's car, who had kept it and moved into a suburb with the damn vet. Wasn't running away what Sam did best?
Dean grit his teeth. Sam took longer than usual in shower which only ground his teeth harder. By the time he came out of the bathroom in a puff of steam, not looking much better than when he went in.
"You look like shit," Dean remarked, tapping his foot impatiently.
"Thanks," Sam mumbled, not looking in the mood for talking much. Tough. He went about pulling on some clothes, moving like his joints ached. Dean frowned.
"You okay?" he asked, it was hard to keep the worry from his voice.
"I'm fine," Sam sighed, even facing away from Dean it was obvious he was rolling his eyes, "Just tired."
Dean raised his hands. "Sorry," he drawled, "Next time I won't ask."
Sam didn't answer, just took his sweet time buttoning up his shirt. Dean stood up, grabbing his bag. "I'll wait in the car," he said, still eyeing Sam, "Unless you need a hand tying your shoes?"
"Screw you, Dean," Sam huffed, still not turning around. Dean scoffed and headed out the door.
He had the music turned up, tapping his fingers to the beat on the steering wheel, when Sam dropped into the passenger seat with a tired sigh. Dean didn't bother saying anything, just started his baby up and turned onto the road. He finally glanced over to Sam about half an hour in, Sam was leaning against the window, looking half-way between awake and asleep.
"What's up with you?" Dean had to ask. Sam jerked a little, blinking at Dean.
"Huh?"
Dean sighed. "You're looking like the walking dead," he told him, "Seriously, you sick or something?"
Sam shuffled around in his seat a little until he was upright. "Dunno," he said around a yawn, "Maybe I'm coming down with something."
Dean felt himself relax a little. It was just a cold. He cleared his throat. "Well, don't go breathing near me," he said, "We can't have both of us being useless."
Sam paled a little, Dean realised, which must have been some kind of feat since he was already looking white. Dean should have noticed that. Maybe he shouldn't have been so harsh on Sam.
Maybe Sam shouldn't have abandoned him for some girl.
He focused on the road, trying hard not to watch Sam out of the corner of his eye.
"I just don't understand," Mrs Alan managed to stutter out before she burst into another fit of tears, "H-he always c-came back f-for dinner..."
The brothers had been interviewing the victim's wife for almost half an hour, mostly because Mrs Alan was slowing the process with her tears. Dean glanced quickly to his side where Sam was sitting. His brother was normally the one to jump in at this point to offer the widow/widower a shoulder to cry on, but Sam had been strangely quiet.
Looking at him now, Dean noticed that Sam's colour wasn't looking much better than before, in fact, the kid had a sheen of sweat on his pale brow. Dean cleared his throat which got Sam's attention, he lifted his head as if it were heavy on his shoulders and blinked a little at Mrs Alan.
"Are you okay, detective?" she asked from behind her tissue, her brow was drawn together in concern.
"I, uh," Sam shook his head a little and cleared his throat, "I'm fine, thank you."
She gave him a water smile and dabbed at her eyes a little. "If you're sure," she said, "But maybe you could come back another time."
"Yeah," Sam nodded, looking awfully grateful, "Thank you."
He was already getting slowly to his feet and Dean didn't have much choice but to follow. He quickly shook Mrs Alan's hand when Sam just walked right past her. She watched them go from the doorway, but grabbed Dean's arm before he could catch up to Sam.
"Try to get your partner checked out?" she suggested, "My husband, God rest his soul, was a doctor, as you know. I know a little about medicine but I do know that he doesn't look well at all."
Dean gave her a small smile and gently removed himself from her grip. "Don't worry, ma'am. I'll keep an eye on him."
She let out a breath, either from relief or maybe she was just that tired out from crying, and she waved to them before heading back inside.
Dean dropped behind the wheel, Sam was already in the passenger seat with his head dipped back and his eyes closed.
"Shame she doesn't know that our ghost targets unfaithful men," Dean remarked, then looked at Sam again, who had barely moved. He leaned over and shook him a little, Sam jerked.
"What is it?" Sam asked, sounding half-asleep. Dean frowned.
"You are sick," he realised, "Maybe I should take you to the clinic."
"No," Sam was quick to protest, "We've got a job."
Dean frowned, unsure. Finally, he relented. "Okay," he said, "We'll head back to the motel to do a little research. But, Sam?"
"Mm-hm?"
"If I hear you so much as cough then I'm dumping you at the nearest clinic."
Sam sighed. "Fine," he agreed and rested his head against the passenger window.
As soon as they were back in the motel room, Sam had slumped down onto the end of the bed, then he'd laid down just for a second and now he was completely out. Dean took a seat in the kitchenette and looked through some old records and files to find anyone who might fit the profile of their mystery ghost, but Dean was finding it hard to concentrate. He kept glancing over to Sam now and then. He couldn't deny that he was actually getting a little worried.
He got to his feet and went over to where Sam was asleep, legs still hanging over the edge of the bed, and gave him a few nudges.
"Sam," he called, still prodding his shoulder.
Sam blinked awake and looked up at him. "Huh?" he mumbled, "Did I fall asleep?"
"Yeah. But I thought maybe we should reconsider that visit to the clinic."
Sam shook his head and pushed himself into sitting position. Dean took note of the way Sam had to make an effort to stay up straight.
"Did you find anything?" Sam quickly changed the subject. He scrubbed a hand tiredly over his eyes.
"Not yet," Dean said. He hadn't taken his hand away from Sam's shoulder, half-worried that Sam might topple over if he did.
"I can take a look," Sam offered, pushing to his feet. Miraculously, he stayed there. "Maybe I should go to the local library. Look through their archives."
"Sam," Dean growled, that got his brother's attention, "I'm serious. I think you're sick."
Sam rolled his eyes, but in his current condition it just looked like he was trying to force them to stay open. "I'm fine. I'll be fine."
Dean eyed him critically. "Okay. We'll go to the library."
Without another word he grabbed the car keys from the table and headed for the door. Sam followed him out to the car and settled himself in his usual stop as Dean started up the engine. Even over the loud rumble Dean could hear Sam's heavy breaths.
"Sammy, you sound like crap," he remarked.
"I'm fine."
Dean was getting sick of hearing it. Sam was clearly not fine. He was white and tired-looking, even now Dean noticed that Sam looked a little skinnier than usual. Come to think of it, Sam hadn't had much appetite recently, less than usual. He made a sudden decision, quickly swerving left instead of right, causing another car to honk angrily at him.
"Dean!" Sam gasped.
"We're going to the clinic," Dean told him, "And don't tell me you're fine because it's pretty obvious that you're not."
"Fine," Sam finally said after a moment of quiet. He was hunched forward a little, arm wrapped around his middle.
"What's wrong?" Dean asked, a little worried, "You in pain?"
Sam managed a nod. "My stomach."
"How long?"
Silence.
"Sam, how long?"
"A while."
"Damn it!"
Dean felt like a grade A dick for brushing Sam off. He could see a sign telling him that the clinic was near and his fingers relaxed around the wheel a little. He came to a stop at a traffic light and looked over to Sam.
"You doing okay?" he asked. Sam was still white but now his face was creased with pain and he was shaking.
"Sam?" Dean tried again.
Sam looked over to him. "I don't – "
Blood spattered across the front window. Sam's mouth was covered in it. His torso was soaked in it. His body heaved again and more blood came pouring from Sam's mouth and onto the dash.
"Holy shit!" Dean was already pressing on the gas, hurtling down the road despite the red lights. He swerved past other cars on the road, took no notice of the angry beeps from other drivers. He kept one hand tight on the wheel and the other was spread gently over Sam's back.
"Sammy, you're gonna be fine," he promised, "We're almost there, you hear me?"
Sam answered him by choking up another mouthful of blood.
Dean didn't bother finding a parking space. He came to a screeching halt right in front of the clinic's entrance. He leapt out of the car, completely forgetting about the keys, and rounded to the passenger side. He yanked the door open.
"Can you walk?" he was already trying to pull Sam to his feet.
Sam couldn't speak around the blood. There were tears in his eyes as he clutched onto Dean's jacket. Dean didn't wait, he hauled Sam up, only for Sam to drop heavily to his knees on the concrete, pulling Dean down with him. He carefully leaned Sam against the car and pressed his old blue bandana to his lips.
"I'll be back," he promised, "I have to get someone."
He dashed into the clinic, the smell of sanitiser barely covered up the smell of sickness. But with a quick look around, Dean saw that these people weren't sick. Not like Sam. It was filled with crying babies and burley men nursing boken arms and elderly people sitting in wheelchairs.
He almost collided with the main desk and the receptionist gave him a disapproving look. She slid a sheet of paper and a pen over to him.
"Fill it out then take a seat," She recited.
"No," Dean snapped, "My brother's outside choking on his own blood. Do something!"
She gaped up at him.
"Now!" he shouted. She flinched and jerked out of her seat, running off to a separate room, shrieking something about getting a doctor. Dean didn't bother waiting for her, he was already running out to the car where Sam was still propped up.
The good news was that he wasn't coughing up blood anymore. The bad news was that he wasn't conscious.
"Sam!" Dean cried, skidding to his knees. He shook Sam, thankful when Sam opened his eyes, half-lidded. There was a sluggish trickle of blood coming from the corner of his mouth and Dean quickly shifted Sam onto his side, breathing out in relief when Sam coughed out his mouthful of blood.
"I'm sorry, Sammy. I should have thought. They're coming. Help's coming."
A doctor turned up soon after. She checked Sam over, placed a blanket over him and hooked him up to a bag of blood which they hung from the car door. She called an ambulance to take them to the nearest hospital, the clinic didn't have what Sam needed, and she waited with them until the ambulance arrived.
Dean wished more than ever that Cas were still with them.
Dean wasn't sure if Sam was quite with him as he hurried alongside the gurney, pushing through double doors, down a long hospital corridor, but he talked to him anyway. Promised him he'd be fine. Promised he wouldn't leave him.
He couldn't be sure of the first promise. The second was a lie. A moment later he was told he couldn't go any further before he was pointed towards a grey plastic chair. He dropped down into it and tapped his foot. He did it for forty-one minutes before a doctor approached him.
He was in the doctor's face before she'd made it halfway across the room.
"Is he okay?" he demanded.
"Let's take a seat, shall we?" she suggested, already walking past him. Dean had no choice but to join her.
"I'm going to get straight to it," she began, "Sam has gastritis. Gastritis is an inflammation of the stomach lining, a condition that has a range of causes and is usually treatable. Now, the defensive barrier between Sam's stomach wall and stomach acid has been damaged and the stomach wall has been eroding away."
Dean blew out a breath. "And that's why he was coughing up blood?"
"Gastritis can go unnoticed for a long time. The internal bleeding was caused by a stomach ulcer which perforated. The ulcer formed because the condition has gone unnoticed for so long. The internal bleeding had caused anaemia, no doubt you've noticed fatigue or breathlessness in your brother?"
Dean nodded. "What happens now?"
"We're making sure he's stable right now. We're giving him blood transfusions and oxygen. We'd like to take him to surgery to remove the damaged tissue."
Dean sighed shakily. "Do whatever you've gotta do, Doc."
"You can see him before we take him to the OR, if you like. He's very tired but he should be lucid."
He followed her out of the waiting room. "What caused this?" he asked.
"Like I said, there are a range of causes," she said, "Common causes are severe stress or trauma, or excessive drinking or drug use. Do you think either of these could relate to your brother's situation?"
That was an understatement. Stress or trauma? How about a dead girlfriend, a dead dad, a brother in Hell, a knife through your spine, kick-starting the apocalypse, the cage? And excessive drinking or drug use? Did chugging down demon blood count as drug use?
Dean settled for saying, "Sam's been through a lot."
The doctor nodded, but she didn't seem completely satisfied. "We can continue this when we talk about post-surgery treatment."
They were in a long room lined with beds, some were empty and some were blocked off by a closed curtain. She took him to one near the end and told him someone would be by soon to take Sam to the OR. Dean waited for her to leave before pulling back the curtain.
Sam was too big in the hospital bed, his feet just about stayed on the end, and he was half-propped up with a basin on his lap which already had a spattering of blood in it. He looked over to Dean lazily and lifted a finger as a tired wave.
Dean took a seat at his bedside, feeling thankful that someone had cleaned most of the blood from Sam's mouth and replaced his drenched clothes with a clean hospital gown.
"You look like crap," Dean commented. Despite the transfusion Sam still looked too pale and his eyes looked purple and bruised.
"Feel like it," he managed to whisper. He seemed completely heavy in the bed, like he couldn't have even shifted his legs which were hidden beneath a tangle of blankets.
"I hear…" Sam went on, his voice was raw, "that I'm going to be cut open."
"Yeah," Dean confirmed. He dropped his head and sighed. "I'm so sorry, Sam. I've been… a dick."
Sam managed to huff a small laugh, but his brow creased painfully. "You're not wrong."
Dean rolled his eyes. "Anyway, what I'm saying is… I haven't been fair on you and maybe it's time to give you a break. I know I hold grudges but I can't do that with you. You've paid for your mistakes, a thousand times over."
"And now I'm paying again," Sam added, "Probably shouldn't have downed all that demon blood, huh?"
Dean's eyebrows shot up. Sam was making a joke about that? Sam avoided any mention of Ruby and the blood like the plague. Sam must have noticed Dean's surprise.
"I'm a little stoned right now," he explained. Dean smiled.
"I think you're going to be stoned for a while longer," he said, "Enjoy yourself."
"Oh, believe me, I'm having a blast," Sam remarked sarcastically, as best as his raw, slurring voice allowed. Sam was beginning to close his eyes when a couple of orderlies and a nurse arrived, unhooking his bed from the wall.
"I'll see you when you wake up," Dean promised, following along as they made it to the corridor. He stopped outside the elevator as Sam was wheeled inside.
"Yeah," Sam waved with his finger again, he leaned heavily into his pillow and Dean watched him take a deep breath.
"Bitch," Dean called as the doors began to close. There was the ghost of a smile on Sam's lips as he mouthed back jerk.
Once the doors were closed and Sam was out of sight, Dean immediately felt like he was missing a limb. He still felt sick to his stomach from everything he'd seen that day. He swore he would never see Sam hack up his own blood again.
Wow… it's been a long time.
First of all: No more prompts please. I will finish the ones I already have but I won't take on any new ones. I'm busy with the Sam I Am sequel right now (I'm already behind my schedule oops)
Secondly, thank you so much for being patient. I really appreciate it. Thank you so much for your reviews and prompts, it means a lot to see people take an interest in my writing. Until next time…