When Dean wakes up, it is three o'clock in the morning and his back is killing him, but that's not what woke him up. Sam is groaning in pain. Dean calls for a nurse who comes rushing to his brothers' side. She checks his vitals, stating that everything is fine. Sam opens his eyes then, and Dean is by his side in seconds.
"Dean? Wh-" His voice cracks. The nurse helps him up and gives him a small glass of water. Sam downs it like a man stranded in the desert and asks for another. He downs that one as well before he can speak again.
"Where am I?" He looks disoriented.
"You're in Sioux Falls County Hospital." Dean's voice is soft and comforting.
"What happened?" Sam looks honestly confused.
"You, uh. What do you remember?"
"Uh, ditching the second half of school? Ruby invited me to hang out at her place, so I went. We were sitting there talking and then everything goes fuzzy." Sam looks around confused.
"If I'm in the hospital where is everyone?"
Dean laughs, "It's three a.m. you dork. I stayed the night." Sam looks guilty.
"Why didn't you just go home? Sleep in a bed like a normal person."
The nurse leaves the two brothers alone, "and leave you here alone? No way in hell."
There's a bit of silence before Dean has to ask, "Sammy. Did you try to kill yourself?"
He looks appalled. "What?!"
"You overdosed Sam. That's why you're here. You know what that means?" At Sam's blank stare, Dean yells without raising his voice. "It means either you tried to overdose, or someone tried to Date Rape you." Dean stares at Sam gaping like a fish.
"I would never try to kill myself, Dean. NEVER. How could you even think that?"
"I don't know what to think Sam. You've been pushing us away. Every time I try to talk to you, you freak out and either shut down or blow up." Dean hangs his head in shame.
"Dean, I would never leave you guys willingly." Sam lies back down and glares at the ceiling.
"I figured you guys were mad at me for getting Jess killed."
"Whoa, whoa-What?" Dean whips around and glares at Sam.
Sam jerks back and flounders for an answer.
"How could you ever think you got Jess killed?" Sam goes to answer but Dean just cuts him off, "You had nothing to do with Jess' death, Sam. You didn't kill her; you couldn't have stopped it if you wanted to."
"If I could hav-"
"No, Sam. If you went to her, you'd be dead too. What good would that do?!" Sam sighs, Dean can see the tears welling up in his little brother's eyes.
"Sam, I know you miss her-we all do- but Jess dying is not your fault." He sits beside his little brother and pulls him close. Sam breaks at the contact, letting loose the tears he'd been holding back since Jess' funeral.
"You don't get it Dean!" He sobs.
"I do, Sammy, I do. Believe me." Dean thinks of his parents and how much it hurts to not see them every day. He thinks of how much it had hurt to not see Cas every day.
"No, Dean. You don't. I wanted to end it with Jess!"
Dean freezes for a minute. "Like…"
"I wanted to break up with her, Dean. When she walked away at the park I wished there was an easy way to break up with her! Then-"
"That does not mean you killed her Sam. That was a horrible accident." Dean pulls his brother closer.
"But-"
"Is Dad's death my fault?"
"Of course not Dean!"
"Then Jess' isn't yours." But Dean knows how this works. There's always going to be a small part of Sam that blames himself for Jess' death
"Dean. I- I should probably talk to that therapist, huh?"
"Probably." Dean lets go of Sam and tucks him in-with complaint from the sasquatch-before heading back to his spot on the floor.
They both fall asleep with Dean humming Hey Jude.