Apologies for the delay in getting this chapter out to you. I have been slogging away on Going It Alone and its sequel and I neglected this. I will have more time to dedicate to Cross That Bridge now, so the next chapter shouldn't take so long to get out to you.

CoM x

Chapter Four

Dean sat back on the chair in the back room at the clinic and looked around. It was small, with a counter loaded with a coffee machine and a few dozen magazines and bunch of mugs. The walls were painted a clinical white and there were posters listing breeds of dog and other animals. He felt distinctly uncomfortable alone in here with Amelia. Sam had excused himself and left them to talk in peace. Dean guessed he didn't want to hear what Amelia had to say; he already knew it all for himself.

"So," Dean said slowly. "You're a vet?"

Amelia nodded. "For a few years now. But I'm thinking you didn't come here to talk about my choice of career. You want to talk about Sam."

Dean raked a hand over his face. "He thinks you can make me understand what he can't."

"You know the medical facts, I assume."

"Sammy has cancer, some kind of brain tumor." He paused. "And he says he's dying."

She looked at him sympathetically. "And you want me to tell you he's lying maybe or that he's overstating it."

"Can you blame me?"

"No, but I can't tell you what you want to hear. I wish I could, you don't know how much I wish that, but it would be a lie. Sam is very ill. I wasn't overreacting when I saw him. I honestly thought he'd been dead these last few months. Seeing him, especially seeing him as he is, still doing well, is a heck of a shock."

Dean huffed a laugh. "Doing well? Did you get a good look at him? He's a wreck."

Something dark crossed Amelia's face, some knowledge Dean wasn't privy to. It annoyed him. He was done with secrets. If there was something to know, he should be in the loop. Sam was his brother after all.

"He's doing better than he should be," Amelia said softly. "He looks better now than he did last time I saw him. I think it's you."

"What's me?"

"You've given him something to fight for."

"Not enough," Dean said bitterly. "He's not fighting now."

Amelia crossed her arms over her chest. "You don't understand. If the doctors were right, Sam should be in the active stages of dying right now, but he's not. He's up and around and living. Don't you see what an achievement that is on its own?"

One part of her tirade stuck in Dean's head—if the doctors were right. Did that mean there was a chance they weren't? Could this all be some kind of mistake? Could Sam be all right after all? The possibility filled Dean and lifted him from his despair for a moment.

"You saying there's a chance they're wrong, the doctors?"

Amelia sighed and looked at him with a little too much understanding in her gaze. "No, Dean. I may not be a human doctor, but I know what I'm talking about. I saw the scans."

Dean rubbed a hand over his eyes. "Do you realize how messed up this sounds. It's Sam; he shouldn't be dealing with this. I don't know how much he told you, but believe me, he's paid his dues to the world. He shouldn't have to go through this."

"I know everything and nothing about Sam at the same time. I know the exact color of his blood, but I don't know what he did for a living before he got sick. I know the various ways of telling he's in pain, but I don't know where he grew up. I think I know more about you than I do him. He spoke about you a lot."

Dean felt like a jerk for every scathing thought he'd had towards his brother since he came back from Purgatory. He had believed Sam hadn't looked for him because he had been happy with his woman, when in truth he'd been leaning on this woman to survive as he battled cancer. He knew intellectually that it wasn't his fault, Sam had lied to him, but he felt like he should have known from the start. What kind of brother was he that didn't realize his brother was sick?

"Sam said he fought," he said thoughtfully.

"He did fight, harder than I thought anyone capable of. He hit it with everything he had and then some, but it beat him down."

"There has to be more they can do. You said you thought he was dead before, but he's doing well, so maybe there's a chance…"

She smiled sadly. "I wish there was. Sam could maybe eke out a little more time if he had more treatment, but it would only be time, and it would hurt him to do it. He suffered so much before. I can understand him wanting to live free more than live long."

Dean sighed and rubbed at his eyes. "I still can't believe this is happening."

Amelia opened her mouth to answer, but the door creaked open and Sam poked his head in. "I, uh, need the car keys."

Dean looked up and saw the deep frown lines on Sam's brow. "You okay, man?"

Sam nodded slowly. "Yeah, fine, just need to get to my meds."

Amelia rose to her feet and crossed the room. She placed a hand on Sam's cheek and he leaned into the touch. "How bad is it?" Amelia asked in a whisper.

Sam squeezed his eyes shut. "Seven, maybe an eight." He swayed on his feet and Dean lurched towards him. Gripping Sam's arm, he led him to a chair and eased him into it as Sam's knees buckled.

"Do you know where his meds are?" Amelia asked.

Dean nodded. "I think they're in his duffel back at the motel." He cursed himself for not bringing them out with them. Why hadn't he thought?

Sam moaned and shook his head. "Glove compartment. Spares."

Dean pulled the keys out of his pocket and jogged out to the car. He found the yellow bottle of pills and ran back into the clinic. He was gone maybe a minute at the most, but something had happened in the time he'd been gone. Amelia was kneeling in front of Sam and he had his head buried against her neck. He was drawing deep breaths and his hands were shaking.

"Sammy?"

"M'fine," Sam said in a hoarse voice. "Just need the pills."

Dean handed them to Amelia and she shook a pill out into her palm. Sam fought to get himself upright again and he dry swallowed the pill with a grimace. His eyes were red looking and wet.

Amelia ran a hand through his hair gently and asked in a soft voice, "Do you need anything else?"

Sam closed his eyes and took a deep breath. "Just give me a—" Whatever he was asking for they didn't know, as at that moment, he pitched forward onto Amelia. Dean lurched forward and supported his shoulders and Amelia struggled out from under him.

Dean pushed Sam back in the chair and cupped his head in his hands. For a moment, he had a very real fear that Sam was dead, but then reason caught up with him as he saw Sam's chest rising and falling.

"Help me get him down," Amelia said. "He'll be more comfortable."

With difficulty, Dean and Amelia eased Sam down to the floor. Amelia knelt and pulled Sam's head into her lap. She ran a hand over his cheeks tenderly.

"What happened?" Dean asked.

"His body couldn't take anymore," she said. "The pain was too much for him, so it shut down. It's a defense mechanism."

Dean pulled his phone out of his pocket and was about to dial for an ambulance when Amelia spoke up. "What are you doing?"

"What do you think I'm doing? I'm calling an ambulance. My brother just took a nosedive at my feet. He needs a doctor."

Amelia shook her head. "This isn't the first time this has happened, Dean. He'll be awake soon and he won't want the fuss."

"Tough shit," Dean snapped. "He needs a doctor."

Amelia sighed and turned her attention back to Sam whose was lying pale and still on the floor. "Do what you feel you need to, but be prepared for him to be pissed."

Dean huffed a laugh. "Sam's spent half his life being pissed at me. This will be nothing new."

Dean followed the ambulance in the Impala as it raced towards the hospital. Amelia rode in the ambulance with Sam. Despite her assertions that he would come around in his own time, it was obvious that she was worried too as Sam had remained unconscious through the ambulance's arrival at the clinic and his being loaded onto a stretcher.

For his part, Dean was terrified. Sam had called it a process, and Amelia had been shocked that he was doing as well as he had been. Was this the first step in Sam's downward spiral? How fast would it happen? Would he even wake up this time?

He had a hundred questions and no one to answer them. No one yet, anyway. As soon as he got hold of Sam's doctor, he was going to get some answers.

He had to park the car in the lot, so he was it was a little after Sam's arrival that he walked through the doors of the ER. Amelia was standing just inside the entrance, waiting for him.

"How is he?" Dean asked immediately.

She took his hand and led him to a corner. Dean immediately sensed bad news was coming, and his heart contracted painfully in his chest. "He's okay, right?"

"They've taken him down for a scan. He's still not conscious."

"You said he'd wake up!" Dean said angrily. "You didn't want me to call the ambulance."

Amelia looked down at the floor. "I was wrong."

Dean turned away from her and gritted his teeth in anger. For all her talk about how well she knew Sam, she was useless. If it had been down to her, Sam would have been left on that floor until he woke up, which he still hadn't done.

"I'm sorry, Dean," she said.

Dean rounded on her. "I thought you knew what you were talking about!"

"I do. This isn't the first time it's happened, and Sam has always come out of it on his own before."

Dean checked his watch. "Well, it's been thirty minutes now, and he's still not out of it. They're scanning him now for what exactly?"

"There were signs of increased ICP—intracranial pressure—and they need to see what's causing it. It could just be the tumor, as it grows, but they can't be sure without a scan."

Dean grimaced. "I read up on this. It could be a bleed or something, too, right?"

"That's a possibility," she admitted.

Dean cursed and scrubbed a hand over his face. Bleeds were bad, Sam could end up paralyzed or worse. Even now, he could be slipping away without even his brother with him. It was so messed up. He needed to see Sam.

"Come, sit down," Amelia said gently. "There won't be news for a while yet."

As the anger bled from Dean, so did the adrenaline, and he was suddenly exhausted. He allowed Amelia to lead him to a chair and he sank down onto it with his head in his hands.

He stayed like that, bowed over and attempting to ignore Amelia's nervous chatter, for a long time. Eventually, a distraction came in the form of a middle-aged man wearing pale green scrubs. He came over to the corner where they were sitting and greeted Amelia effusively.

"Doctor Jacobsen, this is Dean, Sam's brother," Amelia said.

The doctor held out a hand to Dean. "It's a pleasure to meet you, Dean."

Dean shook his hand and finally asked one of the questions burning in him. "How's Sam?"

The doctor smiled. "He's not happy at the moment, but medically, he's doing well."

"He's awake?" Amelia asked.

"He came around in the MRI. As you can imagine, he's most unhappy to be back here." He looked around the waiting room. "I can take you to see him now, if you like. He's on the ward."

Dean was torn. He wanted to see Sam again, to make sure he was really okay, but at the same time, he needed to talk to the doctor. "Can we talk a little first?" Dean asked. "I've got a hundred questions."

The doctor frowned. "I can only answer so much. I am bound by doctor-patient confidentiality."

"But he's my brother."

"That is true, but as my patient, Sam has the right to privacy. I can't tell you anything without his say so."

That didn't worry Dean. Sam would give the doctor to go ahead to talk to him. "Let's get that from him then," he said.

The doctor led him and Amelia through a set of double doors and into a long hall with door leading off it. As they passed nurses and orderlies in the hall, they all smiled at and greeted Amelia as if they were old friends. Dean guessed they probably were. If Sam had been in hospital for a while and Amelia had been taking care of him, she would have had plenty of time to make friends with the nurses. That should have been him. He should have been the one taking care of Sam. It was through no fault of his own, he had been trapped in Purgatory at the time, but he felt guilty nonetheless.

The doctor knocked on a door and then eased it open. Dean wasn't sure what to expect when he saw his brother. Would he look as bad as he did at the clinic? Would he still be in pain? What he definitely didn't expect to see was Sam sitting on the edge of the bed tugging at his IV. Beside him was the clear plastic tubing of a nasal cannula. It looked to Dean like Sam was working towards getting out of the door when they arrived.

"Sam," Doctor Jacobsen said patiently. "I know I told you I wanted you to rest. Attempted break-outs don't count as resting."

Sam shook his head. "And I know I told you I wasn't staying, so I guess we're both disappointed." He looked past the doctor and saw Dean and Amelia. "Who called the ambulance?"

Dean expected Amelia to rat him out, she seemed to like to keep Sam sweet, but she merely glared at him. "You needed to be brought in, Sam. You were out for over thirty minutes, and you look like hell."

Sam shrugged and looked to the doctor. "So, what's the damage?"

The doctor gave Sam an appraising look. "I'll tell you if you lie down again and leave your IV alone. That's quality painkiller you are rejecting."

Sam sighed and sat back on the bed with his legs stretched out in front of him and his ankles crossed. "Can't deny that. You guys definitely have the good stuff."

The doctor sat down on a chair and clasped his hands on his knees. He looked from Dean to Sam. "Are you sure you want to discuss this now?"

If Sam asked him to leave, Dean thought he would slug him, brain tumor be damned. He was finally within reach of getting some answers and he wasn't going to leave now. Not for anything.

"Nah," Sam said easily. "This is my brother. If you don't tell him everything now, he'll beat it out of me later." His lips tugged into a smile again and Dean wondered what exactly it was in that IV that had Sam so relaxed after a medical incident like the one he'd just gone through. Neither Amelia or the doctor seemed bothered by it, which meant they were used to dealing with a stoned Sam, or maybe this was the face Sam presented to them all the time—the happy-go-lucky guy he had been what felt like a lifetime ago when Dean had collected him from Stanford.

"Okay," Doctor Jacobsen said. "The news isn't good, I'm afraid. The tumor is growing and this is putting increased pressure on your brain."

Sam nodded thoughtfully. "Nothing unexpected though?"

The doctor frowned. "No, that's not unexpected, and from your outward presentation, I would say you are doing very well, however…"

And it had been sounding so good, Dean thought. Why did there have to be a however?

"However?" Amelia prompted and Dean's attention snapped back to the doctor.

"However, while we had you under the MRI I ran a few other checks."

"Kidneys?" Sam said cryptically.

The doctor nodded. "Yes, kidneys." He leaned forward in his seat. "Sam, how long have you been exhibiting symptoms of kidney failure?"

Sam looked down at his hands clasped in his lap and his face said it all. It was his 'busted' face. The last time Dean had seen it had been when Sam's had admitted to seeing Lucifer again. It was the face he had when he was trying to hide something big but he'd been caught out.

"Answer the man," Dean said harshly. He didn't mean to take his temper out on his brother, but he had to blame someone other than himself.

"A week or so," Sam said quietly and then looked the doctor in the eye. "Is it secondaries?"

"Secondaries?" Dean asked though Amelia seemed to have understood. She was watching Sam carefully.

The doctor nodded. "There is a new growth on your right kidney. This wouldn't be such a problem if your left was fully functioning, but it seems to be working at a fifty-percent capability."

"You telling me he has more cancer!" Dean said hoarsely.

"It's okay, Dean," Sam said. "This is what's to be expected. It's how it happens."

Dean shook his head. He had come here hoping to hear that Sam and Amelia were overstating it, but he was hearing that not only did Sam really have cancer, but he had more than they knew, and parts of him were failing. He didn't think he could take much more. He rubbed at his eyes. "Okay, so what do we do about this new kidney thing?"

"There are options," Doctor Jacobsen said. "Chemotherapy is one, but you should know any treatment now will not be curative. It will merely give Sam more time."

Dean clapped his hands together. "Right. Let's get to work on that then. The more time the better."

"No, Dean," Sam said firmly. "No more treatment. We've got other things to be doing."

"You think I care about that… stuff?" Dean said pointedly. "This is about getting you well, Sam."

"You're not listening. They can't get me well. They can just give me more time."

Dean crossed his arms over his chest. "Time sounds good to me."

Sam drew a deep, steady breath and looked at the doctor. "Would you guys mind giving me a minute with my brother?"

"Of course not," the doctor said, getting to his feet. "I will be back into see you later. Do me a favor until then, leave your IV alone and stay in bed. The nurses will be on my ass otherwise."

Sam huffed a laugh. "I make no promises."

Doctor Jacobsen patted his shoulder and made for the door. Amelia stared searchingly at Sam for a moment but when he nodded, she followed.

When the door clicked closed behind them, Dean sat down in the chair the doctor had vacated and looked at Sam expectantly.

"I am not having more treatment," Sam said doggedly. Dean opened his mouth to speak but Sam held up a hand to silence him. "I'm not having anything else done until we find Kevin and get the tablet back."

"How can you say that when you know what you're risking?" Dean asked. "Sam, you could die before we even find Kevin, let alone close the gates. I have a feeling it's going to be more than a case of finding the right key and giving it a twirl. If you want to be alive for that, you need the treatment."

Sam shook his head. "Let's face facts, Dean. I'm not going to be here to close the gates. What's happening now, my kidneys, that's the first step in my body giving up. I don't have long, and I want what time I have to be used for something other than sitting around in a hospital bed. You weren't here before; you didn't see what the radiation did to me. I was sick all the time and so tired all I wanted to do was sleep. That was just radiation. Chemotherapy will be even worse. I'm not putting myself through that for the sake of a couple of extra weeks when those weeks will be spent lying useless in bed. I'm not so bad right now. The pain is manageable, and I can get around still. You need me on my feet not lying in a bed."

"I need you alive," Dean said through gritted teeth.

Sam shook his head. "No, you want me alive. I'm sorry this has happened so fast for you. You've not had the time to prepare, but I have. I know what's coming for me."

"Stop with that already!" Dean said angrily. "I've had it with this whole 'strength in the face of death' thing. It's crap. You know how I know that? Because it was crap when I was doing it before my deal came due. Remember how pissed you were at me then? 'Cause I do."

"That was different," Sam said. "You were facing Hell then." He shrugged. "Unless I did something awful in the last couple years, I'm good for Heaven. That's not frightening. Dean, that's amazing."

Dean stared into his eyes and knew there was no moving his brother from this. Sam was determined to find Kevin, and nothing he could say or do was going to change that…. Unless. An idea occurred to him. If anything would work, this would.

"Okay," he said. "Say I agree. I help you bust out and we go find Kevin and get the tablet back. Will you have the treatment when we've found him?"

Sam nodded. "Sure. I'm not suicidal, you know. I just want it to count for something. If we find Kevin and get the tablet back, I'll let the doctor use me as a lab rat all he likes."

Dean got to his feet. "Awesome. I need coffee, how about you?"

Sam smiled. "Coffee would be good. I guess I've got to let this IV run its course, and then I'll be good to get out of here."

Dean walked out of the room and along the hall. He saw Amelia and the doctor talking in a corner and he guessed they were talking about Sam, but he didn't join them to listen. He had something more important to do. He walked into the bathroom, where he could be assured of privacy, and dialed. He got voicemail, which he had expected, but that didn't bother him. He figured someone as OCD as Kevin had to be checking his messages.

An automated voice told him to leave a message and he took a deep breath. "Listen up, Kevin. I know you're pissed at me because of the whole almost killing your mother thing, but you're going to have to suck it up and listen to me. Sam's sick, he's more than sick, he's dying, and he refuses to get help until we find you. So, here's the thing. You're going to call me and tell me where you are as soon as you get this message. If you don't, and my brother dies, I will dedicate the rest of my life to hunting you down. I don't care how many AP classes you took. If I lose my brother because of you, I will find you and make sure you pay for it."