Sam had hoped that the pain and weakness would be gone when he woke again, but it was not to be. His eyes burned as he squeezed them shut, his focus turned within, taking a mental inventory of his body, of what still hurt and realizing he felt worse than before.

Sam blinked drowsily and slowly sat up, his stomach, chest, and left shoulder screaming as pain sliced through them. Taking shallow breaths, he sat on the edge of the bed as he did earlier that morning, staring at the floor and waiting for the pain to subside.

It didn't.

The sun had moved to the opposite side of the room, and Sam knew that it must be late afternoon by now. Maybe 4:00...probably closer to 5:00. He listened intently but heard no sounds of movement in the house. Did that mean Jim was still at the church and he was alone?

Dean wouldn't like that, Sam thought as he carefully stood up, shutting his eyes once again as a wave of dizziness swept over him. After several minutes, he cautiously opened them and moved toward the closet door, peering into the mirror.

Pulling up his hoodie, Sam was alarmed to see even more dark blue bruises on his torso, especially on the upper left side of his chest. He looked closer and was relieved to find no such marks on his face or neck, but his relief was short-lived as he noticed that he was still extremely pale. Even his lips had lost their color, and he had dark smudges under his eyes.

I look like shit, Sam thought.

And he knew Dean wouldn't like that, either.

Sighing, Sam lowered his hoodie, wondering where he was going to find the energy to make it downstairs – and how he was going to placate Jim once the Pastor saw him.

Moving abnormally slow, Sam shuffled out the door and down the hall, bracing against the wall, his forearm gliding along the slightly wrinkled wallpaper until he reached the stairs, sighing again at the enormity of the task ahead of him.

Taking one step at a time and resting for considerable periods in between – because he knew he wouldn't survive another fall right now – Sam made his way down the stairs. Each step was a victory over the unrelenting torture of breathing and moving. A constant suffocating pressure in his chest kept him from taking anything but shallow breaths, and even those cost him agonizing pain and an immense amount of energy to accomplish. It took him a long time to inhale and even longer to exhale, as if he was pushing against a vacuum. His heart slammed painfully in his chest, and the slicing sensation beneath his ribs was almost more than he could bear.

As he reached the last step, Sam stopped, his original goal of the sofa completely abandoned as he saw the phone on the end table. He stared at it, his frantic mind seizing on one thought: call Dean.

Sam swallowed, momentarily choked by his panting breaths, his knuckles turning white as he gripped the banister trying to regain his balance. He squeezed his eyes shut against the lancing pain in his stomach and chest, trying to gulp air, his breath catching in his sore throat.

He was exhausted and wondered how much longer he would be able to remain upright, wondered if he would even be able to make it to the phone, to dial the number, to say the words when Dean answered.

Through his hazy thoughts, Sam heard a car door slam and then heard footfalls mounting the porch steps and approaching the door. For a split second, he wondered if it was something evil coming to claim him...but at this point, it didn't matter. He stood frozen in place, his body refusing to move, refusing to be pushed anymore.

"Hey, Sam," Jim greeted as he opened the door and entered the house. "Sorry I'm late, but I stayed longer than I expected at the church and then I stopped by the store to see if I could find something you might want to eat since you skipped breakfast and really need to take those pills." He crossed to the kitchen to deposit the grocery bags he carried. "Are you feeling any better?"

Sam remained silent, allowing Jim's voice to wash over him like warm water, soothing his fear, easing his anxiety. He wasn't alone. Jim was here. Jim could call Dean. Dean would know what to do.

Sam opened his mouth to speak, but nothing came out. His silence must have caused the Pastor to worry, because Jim appeared a few seconds later, standing in the doorway of the kitchen.

"Sam?"

Sam breathed has deeply as he was able. "Pastor Jim, I..."

His voice trailed off, words swept away in a jumble of incomprehensible thoughts as an opaque curtain descended before Sam's eyes, blurring his vision. He felt his grip loosening on the banister as dizziness hit him with a staggering force, and he swayed.

"Sam?" Jim quickly moved toward Sam and grasped his shoulders. "What's wrong?"

An expression of panic, of frightened, helpless confusion crossed Sam's face before his knees buckled.

"Sam!" Jim yelled, catching the kid as he collapsed.

Sam's head limply flung back as it rested in the crook of Jim's arm, the muscles of his neck stretching, his mouth parting slightly as his jaw slackened in unconsciousness.

For a stunned moment, Jim held Sam closely, bearing the weight of the youngest Winchester, before lowering him to the floor. Sam was astonishingly still, his pale complexion a sharp contrast to the dark wooden floor beneath him.

"Sam!" Jim called, placing his hand on Sam's forehead, feeling clammy skin and damp bangs.

The Pastor trailed his fingers along the smooth contours of Sam's jaw and firmly pressed them against his neck, feeling a fast pulse galloping under his fingertips. Soft gasps escaped from the kid's pale lips as Jim reached for his phone because he wasn't taking any chances. Not with Sam.

"9-1-1. What's your emergency?"

Jim stood at the bottom of the stairs, his hands laced tightly together as he forced himself to remain in place and out of the way as the EMTs assessed Sam.

"Sir?"

Jim's attention flickered to the EMT standing before him.

"My name is Steve, and I need to ask you a few questions."

Jim nodded.

"What's his name?"

"Sam."

"Has he been ill recently?"

Jim nodded again. "Yes. He had his tonsils out about four days ago."

"Any medications?"

"Just antibiotics and painkillers."

"Any bleeding or high fever?"

"He felt warm this morning."

"Any breathing problems or signs of dehydration?"

"Not that I've noticed."

"Does he have any other medical conditions?" Steve continued.

"He gets migraines sometimes."

"Any medications for that?"

Jim shrugged. "Just over-the-counter stuff."

Steve nodded. "Any allergies?"

Jim paused, trying to remember any mention of such in all the years that he had known the Winchesters. "Not that I know of."

Steve nodded again as one of his colleagues interrupted.

"Temperature 103.3...heart rate 185 BPM...BP 80/50...O2 sat rate of 88%."

"Jesus," Steve quietly swore, turning away from Jim. "Okay, let's get an oxygen mask in place and then I want the EKG in here."

There was a scurry of activity as Steve leaned over Sam, cutting through his hoodie and exposing his chest. Jim gasped, closing his eyes briefly to block out the image.

Dark bruises covered Sam's chest and abdomen, marring the pale flesh in unsightly shades of blue. The ends leached to a soft gray, webbed with tiny red vessels that stretched outward. As his hoodie was completely removed, more bruises could be seen, covering his forearms and left shoulder.

"What the hell?" Steve whispered, once again loosing his grip on professional conduct. He exchanged glances with his fellow EMTs before directing his attention to Jim. "Has he been in an accident?"

Jim shook his head, too shocked to speak.

"A fight?"

"No. Nothing," Jim choked out. "He's been fine until this morning."

"Has he – "

There was movement on the floor, and all eyes turned toward it.

Sam stirred restlessly as he slowly opened his eyes. He didn't recognize any of the faces hovering over him and shivered as he became aware of the cool air on his bare skin. Although he was disoriented and confused, his mind seized on one word, on one name, on one person: Dean.

Sam didn't realize that he had actually spoken the name until he felt a familiar hand tenderly stroke his hair and then rest on his head.

"Dean..." he repeated.

Jim knelt beside Sam as the EMTs continued their assessment. "No, Sam. It's me."

Sam tried to focus on the face above him. "Pastor Jim?" He swallowed thickly. "Where's Dean?"

"Sam," Steve interrupted and waited for his patient to make eye contact. "My name is Steve, and I'm here to help you. Right now my buddies are going to hook up an EKG, so you're going to feel them pressing sticky pads to your chest. I need you to be a good boy and stay still, okay?"

"'Kay."

Jim smiled tenderly. Any other time and under any other circumstances, Sam would have bristled at being talked to as though he were a child, even though at 13-years old, he wasn't far removed from that description.

Steve nodded to his colleagues before directing another question to Sam. "Can you tell me how many fingers I'm holding up?"

Sam closed his eyes.

Steve looked at Jim and then back at his patient. "Sam? C'mon, kiddo, talk to me."

Sam sighed. Kiddo.

The word seemed to soothe him but then suddenly his agitation increased.

Dean.

Where was he? He was always there when Sam needed him. Where was he now? He needed to see him. He needed him here.

For the first time since he regained consciousness, Sam tried to push himself up on his elbows.

Steve shook his head frantically. "No, Sam." He looked to Jim, his eyes questioning. Was he missing something? "You need to be still for us, remember? Be still, Sam."

"Where's Dean?" Sam rasped, his eyes searching beyond those around him.

"Shhh," Jim soothed. "It's okay, Sam. He'll be here later, okay?"

Sam stared up at the Pastor, his eyes filled with confused tears. "Later?"

Jim nodded. "Later. I promise."

"Who's Dean?"

"His brother," Jim said as he traded glances with Steve. "He's...out of town."

"Oh," Steve said simply. "Any other siblings?"

"No."

"His dad?"

"Also out of town."

"And his mom?"

Jim sighed, wondering why any of this mattered right now. "Deceased."

"Oh," Steve repeated, noticing his fellow EMTs starting over again with the set up of the EKG. "Sam, I didn't mean to upset you, but you need to be still while these guys hook up the EKG, okay? And I need you to answer my questions."

"Try."

Steve nodded and smiled. "Trying is good." He held up his finger. "Let's try this again: How many fingers am I holding up?"

"One."

"Good. Now, I want you to follow my finger with your eyes only. Don't move your head. Okay, good. Are you in any pain?"

Sam nodded weakly.

"Where?"

"Every...where."

Steve nodded. "Can you describe it for me? Is it burning, throbbing, aching, sharp, dull...what?"

Sam took so long to respond that Steve thought he had lost consciousness again. He rubbed his knuckles along his patient's sternum.

"Sam?" Steve prompted.

Sam hissed from the pain and violently flinched. "Please..."

"Stop," Jim ordered, glaring at the EMT as his hand protectively hovered over Sam's small chest.

Steve paused. "I'm sorry, Sam. I just need you to answer my questions. What kind of pain?"

"Don't know," Sam whispered. "Sharp...burning. Just h-hurts."

"On a scale of one to ten, with ten being the most pain, how much pain are you in?"

Sam swallowed, remembering Dean asking him the same question a few days ago.

"Where's Dean?" he asked, his voice hinting at tears.

Steve sighed and looked at Jim. "Was he this confused and disoriented before he collapsed?"

Jim frowned, surprised by his annoyance at the question. "He's not confused or disoriented. He just wants his brother." And if Steve knew Sam, he'd know they couldn't ask for a better sign of coherency. Jim swept Sam's bangs from his forehead. "Sam? One to ten, buddy."

"Ten."

Steve nodded, not surprised. His hands moved to palpate Sam's ribs and abdomen, pushing his fingers deeply into the bruised flesh, eliciting a moan from his patient.

"Enlarged spleen, some abdominal rigidity, possible hemorrhage..." Steve commented to himself. "Sam, can you tell me how you got all these bruises?"

Sam's breathing became ragged.

"Sam?" Steve persisted.

Sam's gaze shifted to Jim, tears filling his eyes.

Jim's heart stuttered. "What, Sam?"

"I'm sorry," Sam whispered, tears silently slipping down his cheeks.

An overwhelming sense of dread spread through Jim as he gently rubbed his thumb over Sam's forehead. "It's okay," he automatically soothed. "Just tell us..."

"Fell."

"You fell?" Steve clarified.

Sam nodded weakly.

"Fell?" Jim repeated, shaking his head slightly. Maybe Sam was confused and disoriented. "No, Sam. You didn't fall, buddy."

Steve didn't seem to agree, immediately launching a new set of questions. "When? When did you fall, Sam?"

"Last n-night."

Steve nodded. "Where? What happened?"

"Tripped...on the stairs." Sam looked back at Jim. "I'm sorry."

Jim felt his heart drop as the pieces of this particular puzzle slid into place, beginning with him finding Sam sprawled on the mattress last night, borderline unresponsive as he had finished putting the kid to bed.

Steve opened his mouth to ask another question when one of the other EMTs called his attention to the EKG printout.

Jim carded his fingers through Sam's hair, trying to soothe his young charge, while his own heart slammed in his chest. The EMTs' hushed tones and grim expressions made his own breathing become shallow.

"Call ahead and tell them," Steve said as he turned back to Jim. "There's abnormal electrical activity in Sam's heart. It's beating entirely too fast and irregular, and since cardiac arrhythmias can lead to cardiac arrest, we're taking him to United."

"Of course," Jim responded, noticing that Sam had once again lost consciousness. He sighed and reluctantly moved back so that the EMTs could load Sam onto the stretcher.

"Oh...and his father and brother?" Steve asked, rising from the floor and looking directly at Jim.

Jim swallowed, fear clenching his gut as his eyes darted from Sam to Steve. "Yes?"

"I'd get them here."

TBC

Off to the hospital...which makes me happy 'cause Sam's never been in the hospital on the show. Dean's been three times; John's been; Bobby's been; even Cas has been. But Sam? Nope. Just there to visit or keep bedside vigil, which is so not fair. Just sayin'.