Thank you so much Jenjoremy for working your beta magic in this for me, and thank you Gredelina1 for helping me with pre-reading.

Thank you all for reading and reviewing. Your response to this story has made me so happy.

Chapter Six

The next morning found Dean with Doctor Maddox in the family room. The air was filled with expectant silence as Dean tried to find the words to explain what had been happening to Sam before the accident. He couldn't say too much for fear of them thinking they were both crazy. Alfie said she needed to know though, and Dean could see the truth in the advice, so he took a deep breath and said, "Before he ended up here, before the wreck, Sam was having troubles."

"What sort of troubles?"

"He'd been through something pretty rough, and it was still affecting him." He shook his head. He needed to be clearer. "Sam was hurt by some people, really hurt, and he couldn't deal with it. It wasn't his fault. He wasn't weak or anything. He was just overwhelmed by it."

"What form did this 'overwhelm' take for Sam personally?" she asked.

"He was seeing and hearing things."

"Hallucinations?"

Dean nodded. "Pretty much. It was the memories of what had happened to him breaking through. But it was his sleep thing that was the worst. It got really bad and lasted days."

"Do you mean he was having trouble sleeping?"

Dean huffed out a breath. "Yeah. Trouble. Before the accident, Sam hadn't slept for days. Three days. He just couldn't switch off."

She looked startled. "Sam didn't sleep for three days?"

Dean nodded. "At least."

"Do you know how unusual that is? Our bodies need sleep for all kinds of things, not just energy. Our minds process memories while we sleep. We grow muscle, and tissues repair; it heals us. Prolonged sleeplessness has serious consequences."

"Tell me about it," Dean said bitterly.

"I mean more than the accident. Sam would have become very ill if his insomnia had become much more prolonged."

"But he's sleeping now," Dean said. "So that's okay, right? You said he slept through the night, and his liver is healing."

Her hands were on her lap, and her fingers drummed together. "Yes," she said carefully. "He is healing, and he slept past the point that the sedatives would have been out of his system, so we can assume that part is over. To be sure, I would like to see him sleep without any assistance at all. That's something we can monitor here. Hmm… These hallucinations though, were they brought on by the insomnia or were they really the cause?"

She didn't seem to be speaking to Dean, but he answered anyway. "They started before the sleep thing. He said the person he was seeing was stopping him sleeping."

"This Bobby he mentioned?"

"No. Bobby was family. Seeing him is new. I don't know why he's seeing him now. That's what worries me more. Bobby is dead. Sam knew that, but when he got upset, he didn't seem to know."

"And he said Bobby needed help," she said thoughtfully. "Yes. I remember. That is a concern." She laid her hands flat on her knees. "Okay. Here is where I think we should start. We will monitor Sam's sleep pattern carefully, and if it looks like it is becoming a problem again, we will treat it. Secondly, I will arrange a psych consult for him."

"Sam's not crazy," Dean said, the words bitten off.

"I didn't say he is, but you can't deny he needs help if he's hallucinating. I am a neurologist; I understand how brains work, but I don't know enough about how minds work. I would have explained the hallucination of Bobby as post-waking confusion, but if the problem presented in some form before he was in the accident, it makes it doubtful."

"That's what Alfie said."

She smiled. "Alfred is a very good doctor and a talented neurosurgeon. He knows what he's talking about. He can help you, but Sam needs more help than you, I, or Alfred can give him for this problem. I will confirm this with the psychiatrist of course, but I think it's better that we not correct him if he mentions Bobby again. We don't want him to become upset. I don't want to need to keep sedating him."

Dean nodded. "I can do that; I won't correct him."

"Good. When he is awake I am going to run some checks, and I am also going to arrange for Sam to have an EEG to check if there is an underlying seizure condition or if it was circumstantial. I will also get him an MRI scan so we can get a clear picture of his brain."

"You're checking for brain damage, aren't you?" Dean asked quietly.

"Yes, I am," she said. "These tests might be able to reassure us that one problem is taken care of, and if it doesn't, we will be able to make a plan for Sam to move ahead. The more informed we are, the better we can treat him." Seeing Dean wasn't reassured, she went on. "Celebrate the victories, Dean. Sam is awake now. That is better news than you have had for days now."

Dean nodded. "Thanks, Doc. We both appreciate what you're doing for him."

"You're welcome."

They both looked up as there was a knock on the door and Jean peeked in. "I'm sorry to interrupt you, but Sam is awake and he's asking for you, Dean."

"How's he doing?" Dean asked, getting quickly to his feet and following her along the hall.

"He seems okay. He isn't saying much, but he's calm."

They came to a stop outside Sam's room and Dean tore open and put on a gown. Jean tied it for him and said that she would be close if they needed her.

Dean eased open the door and went in. Sam was sitting up higher in the bed than he had been before, and he was staring out of the window.

"Hey, Sammy," he said.

Sam turned to him and frowned. "Why are you wearing that?"

Surprised by the lack of pleasure or relief at his arrival, Dean plucked at the front of the gown he wore over his clothes. "I have to wear it so I can be in here with you," he said. "They need to keep the room as clean of germs as possible."

"It looks weird."

"It does," Dean agreed. "Maybe we won't have to wear them, soon. You're already doing much better."

"Good. I don't like them."

Dean frowned. Sam didn't sound like himself. He wondered if he was still angry about Dean holding him down the night before. Sam could hold a grudge, but he must be able to understand it had been necessary.

He pulled up a chair beside the bed and said, "You okay, Sammy?"

Sam shrugged. "I don't like it here. When can we go home?"

Dean didn't know if he mean home to the Impala, a motel or to Bobby's. There was no way of knowing how confused he was yet. He didn't want to bring up Bobby or memories of why the Impala was on lockdown, so he hedged and said, "Soon."

"I want to go home."

"We will just as soon as you're ready. You had a really bad accident. You've been sleeping for days. Though, you obviously needed it."

"Why did I need it?"

Starting to worry, Dean said, "What do you remember last, Sam?"

"Bobby," he said promptly. "He was talking to me." He narrowed his eyes at Dean. "You held me down."

"I'm sorry," Dean said. "But you were going to really hurt yourself. What do you remember before that though? Do you remember being in the car? You called me after the accident. Remember that?"

"No," Sam said neutrally. "I just remember Bobby. I want to see him. Where is he?"

What the doctor had said about not correcting him still at the forefront of his mind, Dean said, "He's not here right now."

"Where did he go?"

"He's on a case."

"Can we call him?" Sam asked.

"Not yet. We don't want to get in the way. He'll call us when he can."

"But I want to talk to him," Sam said.

It finally clicked for Dean what Sam reminded him of. It was Ben when he was pissed and petulant at some enforced rule that he didn't think was fair. It was Sam at around the same age when John said they had to move on before he'd finished the year at school; when he was told it was time for weapons drill instead of homework. Sam was talking like a child.

Confused and worried, Dean said, "You need anything, Sam? You thirsty maybe?"

"No. The lady before gave me some water. She said I can maybe eat when the doctor has been. When's the doctor coming?"

"Soon, I think. She's setting up some tests for you."

"I don't want to take a test. I'm tired."

"It's not that kind of test. It's a scan and something else. They want to know how your body is doing after the accident. She's probably going to ask you some questions, too, so you need to remember you're Sam Smith right now and I'm Dean Smith."

"Why can't I be Sam Winchester?"

"Because Smith is the name Frank set us up with. They can't know who we really are."

"I can lie. But will we be able to go after?"

He wasn't petulant now. He sounded scared and needing reassurance. That worried Dean even more.

"As soon as they say it's okay, we'll go," Dean said. "We have a friend that's going to help us."

"Bobby?" he asked hopefully.

"No. He's a new friend called Alfie. He's been really good to us."

"Okay," he said, sounding uncertain. "When will the doctor be here?"

Dean glanced at the window and saw her outside, tying on a gown. "I think she's coming now. Remember, you're Sam Smith."

"I know, Dean." He was back to annoyed now.

The door opened and Doctor Maddox came in. "Hello, Sam," she said. "My name is Doctor Maddox, and I have been taking care of you since you were admitted. I met you last night. Do you remember?"

Sam cast Dean a worried look as he shook his head. Dean tried to smile reassuringly.

"That's okay," she said. "You have been very unwell, and it's normal to forget things that happened when you've just woken up. Now, I am going to ask you some questions, and I need you to try to answer them for me. Don't worry if you don't have the answers though. You might be a little confused still."

"When can I have something to eat?" Sam asked.

She pulled up a chair on the opposite side to the bed to Dean and lifted her clipboard. "As soon as I've done this test," she said, no sign of concern in her for Sam's unrelated question. She was either a good actress or she was really not worried. Maybe this was what Dean should have expected from Sam. Alfie said he would be confused. The hallucinations might not be related to waking up, but this change could be.

"What do you want to know?" Sam asked.

"Can you tell me your full name?"

"Sam Smith." His expression morphed into distaste as he said his new alias. Dean didn't understand why it seemed to be a problem since they'd spent half their lives giving false names to people. They were more often using a rock alias than they were the name Winchester.

"When is your birthday, Sam?" she asked.

"May second."

"And where do you live?"

"In the Impala," he said promptly. "Dean calls her Baby. I don't call her anything."

Doctor Maddox cast Dean a quick look and he nodded. It might not be the address he'd given on Sam's intake forms, but it was the truth. The Impala was their home.

She made a note on her form and asked, "Do you know where you are now?"

"In a hospital. I don't know what one."

"That's okay. No one has probably told you yet. It's the Providence Milwaukie Hospital. Do you know why you're here?"

"Dean said there was an accident. I don't remember."

"What do you remember?"

"I was very tired and then Bobby was here. Is he coming back soon?" he asked hopefully.

Up until then, Dean had been feeling better. Sam had been answering the questions and not mentioning Bobby. He'd let himself fall into a false sense of security.

"I'm sure he will come when he can," she said. "I would like to ask you some more questions now. Can you tell me the date?"

Sam started to answer, but then his gaze became distant and he fell silent. He stared vaguely at the wall.

"Sammy?" Dean said, rising to his feet.

Doctor Maddox held up a hand to him and she took Sam's hands and squeezed them. "Sam, can you hear me?" she asked. "Can you squeeze my hands?"

Sam didn't respond, and Dean's worry grew as she took a penlight from her pocket and swiped it across Sam's vision.

"What's going on?" he asked.

"I'm not certain," she said. "Have you seen episodes like this before?"

"Yes, when Sam was seeing stuff he would vague out like this. We could usually call him back though. What is it?"

"It could be a hallucination manifesting again, or it could be a kind of seizure. It looks like it could be what we call an absence seizure, but his history makes me uncertain. We will wait for this to end, and then I will see if we can bump his EEG up the list. I would like a definitive answer sooner rather than later."

"And if it is a seizure?" Dean asked. "What do we do? Will we have to start medicating him?"

"Yes. I know medication seems frightening, but if Sam is epileptic, it will improve his control and therefore his life. It's the best thing we can do for him, Dean."

Dean nodded. It worried him though. Sam wouldn't want to be medicated. And if this change in him, the confusion, stuck around, it would be even harder to get him to take the medication. He always kicked up a stink about taking meds when he needed them for something like pain. If he didn't understand what was happening to him, if he couldn't, it would be even more complicated.

He sat back down and waited for Sam to come back to them, every second feeling like an eternity. It was worse than when he was unconscious, because they knew then that was because he was sedated. This was all on Sam, and he worried Sam wouldn't be able to pull out of it again. He also wondered what Sam was seeing, if it was another hallucination. Was Lucifer with him again?

When Sam eventually pulled out of it, after a longer wait that Dean had ever seen before, he seemed dazed.

"Welcome back, Sammy," he said. "You okay?"

"What happened?" Sam asked.

"We're not sure," Dean admitted. "What happened for you? Do you remember?"

"I don't know. I saw something."

Dean grimaced. He would have preferred an actual absence, even thought it meant medication for Sam, as he wanted Sam to be seeing Lucifer again even less.

"What did you see, Sam?" Doctor Maddox asked.

Sam turned his face away. "I don't want to talk about it."

Dean was sure it was Lucifer then. He cursed quietly and Sam shot him a wary look. Dean quickly smiled reassuringly, though Sam seemed to take no comfort from it.

"I want to sleep now," Sam said.

"Don't you want something to eat?" Dean asked hopefully. He didn't want Sam sleeping yet.

Sam shook his head. "I want to sleep."

"That's probably better," the doctor said. "We're going to run an MRI soon, Sam, and you can sleep then maybe—it can be a little loud—but we're also doing something called an EEG and you will need to be awake for that. You have a rest now and I'll try to arrange the MRI first so you can sleep longer, and then you'll be ready for the EEG."

"I don't want an MRI," Sam said with a frown. "I just want to sleep."

"You need it, Sam," Dean said. "We need to make sure you're okay. You've been really banged up."

Sam looked imploringly at the doctor. "Can Dean come with me?"

"I'm afraid not, but he will be here when you get back, won't you, Dean?"

"I promise," Dean said.

Sam looked unsettled still, but he nodded and made himself more comfortable against the pillows. He must have been very tired, as he quickly fell asleep and didn't wake when Doctor Maddox told Dean she was going to make arrangements and left.

Dean stayed seated at Sam's side, watching him sleep and wondering what was going on in his head and what it meant for him now. Was it possible Sam was going to be like this forever?

Was he really damaged after all?

Dean was in the family room, waiting for Sam to get back. They'd taken him well over an hour ago, and Dean was impatient. He just wanted to talk to him already, reassure him, make sure he knew Dean was there for him. Sam needed that as much as Dean did in his new, more vulnerable state.

The door opened and Dean heard a keening cry from outside as Alfie hurried in.

He leapt to his feet. "What's going on? What's happened?"

Alfie took a moment to unbutton his jacket and set down his Tupperware boxes before answering, and when he did he avoided Dean's eye. "The young man in room five passed away. His parents have just been told." He shook his head. "Terrible thing."

Dean's heart sank. The cry seemed to be tearing through his heart still. Someone out there, just a closed door away, was living a nightmare. He felt sick.

"How's Sam?" Alfie asked.

"Better than that poor kid," Dean said. "What happened to him?"

Alfie sighed. "He was in a car accident, too. Broke his spine. He developed aspiration pneumonia and his body couldn't fight it. He was only twenty-four, and he leaves a fiancé behind. Terrible."

Dean sat down again and raked a hand over his face. That kid was younger than Sam and his life had been snuffed out. Dean thought his situation was a nightmare, but they were lucky compared to that poor family. He felt guilty for feeling like they'd been dealt the worst blow when really they hadn't. Sam was awake and healing, whatever else was happening; he was at least alive.

"So, how is Sam?" Alfie asked.

"He's having some tests. He slept through the night, and I told Doctor Maddox about the hallucinations and sleep thing this morning. She's going to get him a psych consult."

"How do you feel about that?"

"Honestly, I was kinda freaked about the whole idea at first—Sam isn't crazy—but now I'm thinking some sort of crazy might be the best diagnosis; I mean compared to some sort of brain damage. When he was… attacked, he was a wreck. Someone helped him, but it was all kinda undone. I was so mad about that, I forgot that the fact he was back at all was a miracle. I could have really lost him."

"You could have," Alfie agreed. "I know it doesn't feel it, but Sam was lucky."

There was a time that Dean would have protested that vehemently as Sam had only bad luck, but he saw the truth that his certainty was wrong now.

"Yeah."

"What are they testing now?" Alfie asked.

"They're giving him an EEG and MRI. He had a vacant moment today. The doc doesn't know if it's a kind of seizure or hallucinations again. He said he saw something after, but I don't know how these seizure things work. He could have been seeing the person that hurt him again."

Alfie nodded thoughtfully. "It could well be a seizure. We don't know enough about them to be sure. The EEG should give us an answer though. And the MRI will help."

"That's checking for brain damage," Dean stated.

"Yes. I know that is frightening, but the better we understand Sam's condition, the better we can help him. How does he seem to you now?"

"Different. He was talking strangely this morning. Not slurred or anything; it was more like he wasn't all the way there. He sounded very young again. I practically raised Sam, and I remember what he was like, and that was how he sounded this morning."

Alfie steepled his fingers under his chin. "I see."

"What? What are you thinking, Alfie?" he asked. "Do you know what's wrong with him?"

"I don't know anything. I would need to see the MRIs and speak to Sam myself, hear how he sounds, before I even started to advise. I think it's better you wait until Katherine can give you some more information. I have been retired ten years and knowledge and technology has vastly improved in that time. She's the very best person to advise you."

"You think there's brain damage, don't you?" Dean said quietly.

"I don't know, Dean. I can only make guesses, and they are not helpful in this situation. I can give you some general advice though, if you'll allow me."

Dean nodded. "Sure."

"Remember Sam is alive. If there is damage, if he needs a little extra help for a while, you will not be alone. Elsie and I will be with you every step of the way as long as we're needed." He gestured to the door. "It could be so much worse."

It could be worse, Dean knew, and he was massively relieved that Sam was alive and had gotten off comparatively lucky physically, but he was worried about his brother's condition still. Sam was going to struggle if there was damage. He had always been so virile and his mind was incredible. How was he going to handle this if he was changed because of the accident?

"Have something to eat," Alfie said, handing him a box. "There's some sandwiches in there made with Elsie's very own homemade bread. It's better than anything you can find in any fancy bakery."

Dean took it and forced a smile. "Thanks, Alfie. And thank Elsie for me, too."

"You can do that yourself," he said. "I have a feeling you're going to be meeting her soon."

"I am?"

"Yes. I could be very much mistaken, but I don't think Sam will be here much longer, and then you'll be coming home with me." He clapped his hands together. "Elsie can't wait. She's filling the cupboards for you both, getting all the fixings in for pies."

"Pie?"

"Yes. She said you seem like a pie kind of man." He winked and then gestured to the box in Dean's hands. "Eat up."

Curious of how someone could seem like a 'pie man' without even meeting them, Dean took a bite of the sandwich and chewed thoughtfully. Was there more to Alfie than he knew? He'd have said he was an angel before he actually met one, but he knew from experience that angels were dicks. There was definitely something about him though. Maybe he was a human approximation of what angels were supposed to be.

So… A couple signs of Sam's future in this and the last chapter. What do you think of the direction it's going in?

Until next time…

Clowns or Midgets xxx