Chapter Eight

Dean had protested when Sam had pointed the car at the nearest clinic, but eventually it was the expression on his baby brother's face that shut him up. Well, almost.

"I'm fine, Sam," he insisted. "There's nothing wrong, really. It's probably just lack of sex."

"You turned grey, Dean," Sam told him, as they waited for the return of the doctor, "Your face turned grey, you grabbed your chest, and you fainted."

"I did not faint!" Dean complained. "I just had a, you know, a very manly dizzy spell. On account of having just been jumped by a pack of assholes." He subsided under a full frontal Bitchface #9™ (I Know What I'm Doing, Jerk), and wiggled on the uncomfortable narrow clinical bed – if it was necessary for a stake-out on a job, he could lie absolutely motionless and silent for hours, but when confined to a cubicle for medical assessment to be poked and prodded by a number of medical staff, Dean's patience didn't so much evaporate as spontaneously detonate. "I hate these stupid gowns," he complained. "Nobody can look hot in these gowns. Even the Living Sex God can barely look hot in them."

"Well, right now, you are not the Living Sex God, so it doesn't matter," snapped Sam. "This is not some injury you can tough out, Dean – if something is systemically wrong, you can't just ignore it and soldier on."

Dean subsided, with a mutinous mutter about inadequately hot nurses, but let the matter drop – ever since the episode with the rawhead that had damaged his heart, Sam was going to react badly to anything that made him think that Dean was suffering from any sort of cardiac problem.

Eventually, just as Dean has started whining for a bacon cheeseburger to tide him over until he could get to another bacon cheeseburger, a tired but smiling middle-aged face appeared around the thin curtain. "Dean Young? I'm Frank Dennison, one of the cardiac consultants here, for my sins."

"Great," humphed Dean, "And I hope you're here to tell Florence Nightmare that I'm not having a heart attack."

"Oh, you're definitely not having a heart attack," the older man chuckled as he sat down. "Well, not yet."

"Not yet?" Sam yelped. "What do you mean, not yet?"

The doctor looked down at his folder, which was stuffed with a collection of pieces of paper, then back at Dean. "I get the feeling you're a man who doesn't have any time for fancy talk and big words that nobody can understand," he began, "And I prefer to be straight with patients, in order to make sure they grasp the situation. You didn't have a heart attack – what you suffered was an angina attack."

"What the hell's that?" Dean demanded. "It sounds like I was hit by an Italian car."

"It's when the muscle of the heart doesn't get enough oxygenated blood, due to constriction of the cardiac arteries," Sam filled in. "It's like a heart attack that's not serious enough to be an actual heart attack."

"Couldn't have put it plainer myself," the doctor noted. "In fact, I may steal that in future. Classic example – asymptomatic until it's brought on by unaccustomed strenuous physical effort, which would be the fight you were involved in this evening."

"Unaccustomed?..." Dean's indignation subsided under a warning scowl from Sam. "They started it," he muttered, glaring at his brother like a sibling who's angry at being snitched on. "We won."

"Good for you." The doctor paused. "The thing is, you might not have had a heart attack, but you are currently headed for one." He shuffled through the folder, then looked Dean in the eye. "What happened to you was a warning. Mr Young – Dean – given your current physical state, and your current dietary habits, and your current alcohol intake, I can confidently diagnose you as a man eating and drinking yourself into an early grave."

"I've been telling him that for years," Sam stated, trying but not completely succeeding in keeping all traces of smugness out of his voice.

"Well, he's not going to listen to anything his little brother tells him," the older man laughed. "I sure as hell rarely do." His face became serious. "But I hope you'll listen to him on this, and maybe to the old fart in the white coat. I see this a lot. In fact, I've lived it myself." He smiled ruefully. "You don't think anything of it when you're in your teens, your twenties – you play sport at school, or after work, if only socially, but regularly, and you drink on the weekends with your friends, and you're too busy living life to worry much about your health, and it doesn't make any difference anyway, because it seems to absorb whatever you throw at it and carry on. Sound familiar?"

"Definitely," Sam stated firmly, before Dean could say anything to break their cover.

But then, along comes that bitch called Real Life."

"Real Life?" echoed Dean, not liking the sound of the capital letters that were clearly there.

"Uh-huh," nodded the doctor, "Time passes, and you get older. Life changes: you get a job, that job changes, and you get other responsibilities, maybe even a family. You're not so active, but you don't want to give up beer and pizza nights with the guys. Sound familiar?"

"Well, yeah," Dean agreed, "Nobody wants to give up beer and pizza."

"Of course. And while this is happening, your own body is sabotaging you as it ages: and if you keep on behaving the way you did in your twenties, it all starts to catch up with you. In all sorts of ways." The doctor thumbed through some paper. "It happens slowly, gradually, so you don't really notice it, until one day, wallop."

"Wallop?" repeated Dean.

"Yup," the doctor nodded. "Dean, I'm sorry to say, you are a classic case of what's happening to half the men of America: you are overweight, and underactive, you have high triglycerides – blood fat – high blood pressure, and high blood sugar, and I would bet my house that if we did a fasting glucose test, you're pre-diabetic. And that's before we begin to talk about the markers for liver disease."

Dean looked appalled. "Diabetic? As in, your body not processing sugar properly?"

"That's the bunny," the doctor nodded. "Not quite, but you're getting there. I could sit here and tell you horror stories about the consequences of improperly managed diabetes, which affects every system of the human body for the worse, but let's just summarise by saying that it's a complicated disease that will reduce the length and quality of your life."

Dean's face looked almost as horrified as Sam's.

"Fortunately, there is a remedy for this," the doctor smiled, "And I can tell you from personal experience, it works. It will improve your cardiac function, lower your weight, make your blood pressure drop, fix the problems with your blood work, even your liver will get with the program – in the end, you will probably end up not having to be on any medication at all."

"Well, thank fuck for that," spluttered Dean, "So, write me a prescription so I can get the hell out of here."

That made Dr Dennison laugh aloud. "I wish I could," he chuckled, "I wish there was a pill I could prescribe to fix this – it would make my job easier, and my patients a lot happier, and more compliant. Hell, I wish I could invent the pill. Or at least have shares in the company that does. No, Dean, I'm afraid that what we're talking about here are some long-term lifestyle changes."

"Lifestyle changes?" Dean blinked with incomprehension.

"Your diet, bro," Sam's face wasn't smiling, but Dean could hear his brother's voice practically smirking. "It means, switching from your usual daily intake of cowpig sandwiches, pie and alcohol, to a more nutritionally sound diet. And maybe some exercise," he couldn't help adding.

"Huh?" Dean stared at the doctor in disbelief. "But... that's going to be really difficult, doc – we travel a lot for work, always stayin' in a different place, we eat out a lot..."

The doctor leaned in and gave Dean a level stare. "Dean, I am about to say something that you are really not going to like," he stated. "It is possible. I know that, because your brother is clearly managing it. Quite well. In fact, if I didn't know different, I would never have picked the two of you as full blood siblings."

"What? Him?" Dean let out a scornful snort. "But he's not normal, you should see some of the stuff he eats, doc, it's green, and not even cooked, and sometimes there's damned lentils, for fuck's sake! What he eats isn't food for people – he eats what my food eats!"

"Don't forget the exercise, bro," Sam's face gave up, and let the grin happen. "The ol' cardio workout, you can't beat it."

"I get plenty of cardio workout!" Dean protested. "Believe me, makin' a lady's toes curl three times a night is not for the unfit..."

"Well, I've given you my medical opinion," the doctor, a veteran of dealing with patients receiving the unwelcome news that they were going to have to take responsibility for their own health, cut in smoothly. "I'll give you a referral to a clinical dietician, and I suggest you consult an exercise physiologist, or the like. When I found myself in your position, I got a lot of benefit from some work with a personal trainer who specialised in helping people get their health turned around. To start with, I suggest observing the little brother in the wild. Eat what he eats, do what he does."

"There aint nothin' normal about goin' for a run if there's nothin' chasing you," Dean griped sullenly.

"You don't have to run," the doctor consoled him. "Take your dog for a walk – I can see the hair on your jacket, there. It'll be good for both of you, and I'll bet the dog would enjoy it."

"He would," Sam enthused, "He loves to go for walks! You can't say the w-word out loud in front of him, he gets so excited."

"I'll give you something for the angina pain, in case it happen again," the doctor went on, "But essentially, your brother has nailed it. It's up to you to fix this for yourself, Dean. Move around more, lay off the booze, and eat less crap."

"Yeah, well, it's the only thing he's nailed for too long," Dean mumbled for Sam's ears only "And it's affecting his brain."

The doctor scribbled out a prescription, and handed Dean some paperwork. "There are a lot of useful resources online these days," he told them, "Buck up, Dean – this can be fixed."

"But what about pizza?" Dean almost wailed. "What about beer? What about pie?"

"Oh, nobody's suggesting you give up everything fun entirely," the doctor reassured him, "Life's too short for that! You just have to moderate it. Now me, depending on when I work, I usually have what I like to call Fuck It Friday – by the end of the week, neither my wife nor I can be bothered cooking dinner, so we go out or have take out. And for that one meal a week, we go nuts!"

"One meal a week?" Dean sounded like a horrified parrot.

"Oh, yeah," Doctor Dennison smiled widely, "Once a week, it's deep fried, saturated and refined, washed down with a six pack between us! So, good luck," he shook their hands in farewell, "I'm counting on you to help your big brother form some new habits here, Sam, these long term changes can be challenging."

"I'm on it, doc," Sam said seriously, with a resolute expression – Dean half expected him to salute. "Count on me."

"Good man. Good luck, Dean. You'll be amazed at how much better you'll feel." With those encouraging words, the cardiologist took his leave.

"So, happy now?" Dean griped on the way back to the car. "I'm not havin' a heart attack. I told you I wasn't havin' a heart attack!"

"Yeah, okay," Sam conceded, sliding into shotgun, "You're not having a heart attack."

"Okay then." Dean eased the Impala out of the parking lot, "So, we'll just get these pills, then something to eat, I'm frigging starving, all that lying around when I should've been eating... aha!" Spotting a drive-through, he smiled widely. "Okay, so, I vote for a cheeseburger, we'll see if they do low-fat, high-fibre and dolphin-friendly yoghurt for you..."

"Dean!" Sam snapped in horror, "Didn't you hear a word that doctor said?"

"Sure I did," Dean rolled his eyes, "He went on and on about it enough. 'Fuck It Friday'? Seriously? Just makes me even more glad I never went to college."

"He was serious, Dean," Sam went on, "Your lifestyle habits are damaging your health! You had an angina attack, for fuck's sake!"

"No I didn't," Dean protested, "This body did. This body aint my body."

"But for now, you're in it," Sam countered, "And Mr Average American there is a pre-diabetic cirrhotic heart attack waiting to happen! What happens if you push it over the edge while you're still inhabiting it?"

"I won't, Sam," Dean wheedled, "We'll figure out what's going on, and we'll fix this, well before anything happens to..." he broke off and inhaled sharply.

"What is it?" demanded Sam.

"Nothin', Francis," Dean grinned infuriatingly as he rubbed at his chest, "Probably just an aftershock. I'm probably just faint from lack of cheeseburger."

"Dean." Sam turned to him with a Bitchface™ that was a combination of #7™ (You Can Be Impossibly Unreasonable Dean, You Know That?), #8™ (You Are Now Officially Talking Complete Shit, Dean) and #9™ (I Know What I'm Doing, Jerk). "This is not a joke. This could kill you. Or disable you. This is not something to be messed with. We will fix whatever happened to you, but we don't know how long it will take. And that body has to stay alive until then."

The pleading note in Sam's voice broke through Dean's bravado. "Yeah, yeah," he sighed, "I guess I don't want to die in this body if I can't even leave a good-looking corpse. Fuck." He passed the drive-through. "But I am hungry."

"You are allowed to eat," Sam reassured him, "It's not about starving yourself, it's just about, you know, moderation."

"Fine," Dean gave in, "Find us somewhere to eat. But I warn you, Samantha, you try to make me eat lentils, I will punch you. With extreme moderation of moderation."

Poor Dean, assailed by Real Life. Alistair had nothing on the horrors that Real Life can throw at a person. Send reviews for Beau-Ponty to eat, because Reviews Are The Fuck It Friday In The Sensible Dietary Intake Of Life!