Sam groaned into his palms and rubbed his eyelids with the heels of his hands, his shoulders hunched as he cradled his head in his hands.

"Cas, I don't know where you've been the past few months, and I don't even really care. I'm sure you have your reasons for not answering me, but I think you need to know... when I say Dean's hurt, I don't mean something superficial that he'll recover from in a few months. I- I think he's dying." Sam's voice had started to crack and he knew if he'd had any tears left, they'd be streaking down his hot face. He focused on the slow, irregular beeping sound that signaled his brother's weak heartbeats and willed his voice to obey him. "I don't know if you can hear me, or even care, but if there's any part of you that's still listening," Sam took a deep, ragged breath. "We could really use you here, man." Sitting back in the uncomfortable pastel-colored chair, Sam pulled his hands from his face and was surprised to find them wet from his salty tears. He wiped them on his jeans and winced as he took in the feeble form under the thin, hospital blankets. He reached for his brother's hand, careful not to disrupt the mass of wires and tubes attempting to keep Dean alive. His brother's hand was cold and clammy, Sam swore it grew lighter everyday, and the veins of his hand grew more and more pronounced through his ashen skin.

It wasn't the first time he's prayed to Cas, he felt like he never really stopped. It's been almost two months since Dean had crashed the Impala into a guard rail on highway nine. He'd been drinking alone in the car, Sam had never seen him drive drunk before, when Dean failed to slow down enough to take a tight corner. The wreck hadn't been all that serious, he hadn't been going more than forty, but the metal rod that was bent from a past accident found its way through Deans window and into his torso, puncturing a lung. Sam couldn't stop picturing all the blood he'd found on the road when he'd showed up to tow the car whenever he heard the faint clicking and air flow of the machine working to push oxygen into Dean's ragged chest. Dean would probably be furious about the state of his baby (but not nearly as furious as Sam would be about the drinking), if he ever opened his eyes. The various doctors and nurses had explained to Sam again and again about how they thought it better to keep him sedated so he wouldn't wake and fight the intubation tube blocking his airway. As much as Sam wanted to see his brother conscious, especially if he didn't pull through, how could he argue?

"Sam." The gravelly voice made him jump. His head shot up to take in the trench-coated figure now positioned at the end of the bed. Sam felt his jaw drop open, appalled that their angel had shown his face at last. "What's happened?"

"Cas." Sam's voice came out little more than a whisper. "I didn't think you'd come."

Castiel's gaze left Sam's face to take in the rest of the room. His face hardened when his eyes fell on the crumpled form, almost completely still on the hospital bed. Cas' eyes narrowed into slits as they traced the thin limbs, pale face, and sunken skin that could barely be recognized as Dean Winchester. "Why didn't you call me sooner, Sam?" His voice was a low monotone, but Sam could sense the blame that his words implied.

Sam felt his eyes widen and the anger boil up in his chest. "Cas, I haven't stopped praying to you since it happened-"

"What exactly did happen, Sam?" Cas interrupted.

"Dean crashed the Impala, a pole pierced his chest," Sam spat out, not willing to forgive him yet.

Cas approached the side of the bed opposite Sam, examining Dean closer. "He punctured a lung, didn't he?" He glanced up at Sam to take in his nod.

"Amongst other things. Excuse me for saying this, but where the hell have you been, Cas?"

"I'm not sure I understand what you mean?"

Sam was sure his impatience was becoming clear all over his face. "I've been trying to get you to get your feathery ass down here for months, Cas. Months." Sam sighed to calm himself, "Dean's done nothing but get worse and he hasn't been conscious since they brought him in."

Cas' face looked pensive. His voice echoed Sam's, "Months." Castiel was silent for a few moments, his eyes staring out the window. "Sam, I think it's safe to assume my thoughts and perceptions have been tampered with. I only recall being absent from your presence for a few days." Cas pulled his eyes away from the angry clouds littering the sky, they returned to rest on Dean's crumpled body. "My powers may have been affected, but I'll do what I can to heal Dean." He took a few measured steps until Dean's forehead was within arm's length. When Cas' fingers pressed onto Dean's temple, Sam saw Cas' eyes widen ever-so-slightly, taking in the unsettling coolness of Dean's skin.

Upon contact, Dean's eyes popped open, revealing the long-hidden green irises Sam had hoped he's get to see again. A choking sound began emanating from Dean's chest, his eyes darted from Sam and then to Cas' face, full of questions and panic, his hands rising to clamp around his throat, his cough now becoming louder and more alarming.

"Dean, it's fine, they intubated you, I'll get the nurse," he tried to calm him. Sam had backed towards the door and now he wrenched it open, searching for the nearest person in scrubs. He spotted a woman at the nurses' station. "Help! My brother needs help!" The woman's head jerked up at the volume of Sam's shouts and she quickly jogged over and into Dean's room.

"He must be fighting intubation," she stated matter-of-factly as she lowered the section of bed supporting Dean's head. Her quick hands got a hold of the contraption hooked around Dean's ears,and she steadily and slowly removed the tubing, trying to spare Dean as much pain and discomfort as possible. As soon as the machinery cleared his airway, Dean wiped his watering eyes and tried to speak. This just started him coughing again and the nurse scolded him for his effort. "You should try and stay quiet, your throat's gonna be pretty raw for awhile. I'll go get you some water and let your doctor know what's going on." Sam took in the subtle emotions playing across her face: confusion, disbelief.

As soon as she was out of sight and ear shot, Dean tried again, "What the hell is going on?!" he asked, his voice sounding like he'd gargled with a handful of gravel. He cleared his throat and tried to swallow as he waited for someone to answer him.