Thank you so much Jenjoremy for beta'ing this for me. You're an absolute star. Thank you Gredelina1 for all your help.

You guys are awesome! With the last update I reached 100 reviews! I have never reached this milestone so early in a story before. You really are the best. Thank you so much for reading and reviewing. It means the world to me. As a thank you I am posting an extra chapter this week.

Chapter Seven

Sam had eaten half of the sandwich on his plate and drank the juice, but his fresh fruit plate went untouched and he was now picking the bread apart and making a small pile of it. He seemed lethargic and not entirely engaged with what Dean was saying as he asked him about how the tests had gone.

Eventually, Dean gave up on his questions and said, "You should eat some more, Sam. You haven't had much."

Sam looked down at his plate and shook his head. "I'm full."

Dean guessed a week without solid food was going to make him struggle to eat more for a while. It was strange though that Sam hadn't even tasted the fruit because he usually went for the healthy choices first.

Alfie walked past the window and waved a hand at them, lifting a paper cup of coffee to show why he couldn't come in yet. Dean nodded in acknowledgment while Sam frowned at him.

"Who's that man?" he asked.

"That's Alfie. He's the one I told you about. He's been helping me a lot while you've been here. He's a doctor but he's retired now."

"Is he good?"

That question from Sam would usually mean was he competent and could they rely on him, could they trust him even. It felt more like a question of Alfie's morality now though.

"Yes, he's very good," Dean said. "He has helped me understand what's been happening. He's been great. He's going to help us both when you get out of here. We're going to go stay with him."

"Why?"

"Because you're going to be recovering a while. We'll need somewhere decent to stay. A home." He hesitated after, realizing that this could trigger questions about Bobby and the home they'd had with him sometimes. It did, though not in the way Dean expected.

"When's Bobby coming back?" he asked.

"Not for a while," Dean said evasively.

"Why not?"

"He's on a case."

Sam frowned. "Are we on a case?"

For the first time, Dean considered the fact that they'd abandoned the hunt they'd been on when Sam had the accident. He hadn't even arranged for Garth or one of the others to take over. He should have set them up with the information for that real estate agent. Someone should have been looking into it. He couldn't take it up again, not with Sam the way he was, but he should contact Annie and see if she had someone to spare to check it out.

"Right now, our case is you," he said. "We're getting you back on your feet before we tackle anything else."

"I'm okay. We don't need to wait for anything."

Dean shook his head. "We need to wait for me, too. I'm not back on my feet either."

"Oh. Okay. We can wait," Sam said obligingly.

"Thanks, Sam," Dean said, grateful that he was letting it go so easily.

Sam pushed away his tray and wiped his hands on the sheet. "Dean," he said slowly, his eyes fixed on the tray in front of him.

"Yeah, Sammy?"

He looked up at him, a hopeful look in his eyes. "Is Jess coming soon?"

Dean felt the breath rush out of him in a whoosh.

Sam rarely spoke about Jessica at all. When that dick Osiris had mentioned her, when Dean had been on trial, he had seen the pain on Sam's face. Dean never brought her up to save Sam from the reminders that still hurt him all these years later. Now he wasn't just mentioning her, he was asking for her. What the hell could Dean say? This wasn't just a subject wrought with danger for Sam; it was yet another sign of something really being wrong with him. He could understand the confusion of Bobby—maybe—as Bobby's death was recent and Sam had apparently seen him recently, but this made no sense unless he had seen her, too.

"When did you see Jess last, Sam?" he asked.

Sam considered. "I'm not sure. I miss her."

Dean's eyes stung. He knew what the doctor had said about not correcting Sam, but this was different. It was Jessica. He hedged. "I'm not sure, Sam."

Sam's lips downturned. "She'll come though?"

Dean was saved from answering by a knock on the door and Doctor Maddox coming in with Alfie behind her. "Sam, I have arranged someone to speak to you now," she said. "His name is Doctor Platt. He's going to ask you some questions while I have a talk with Dean."

"I don't want more questions," Sam said. "I want Jess."

She glanced quickly at Dean and he shook his head slightly, unnoticed by Sam who was glaring at her.

"It won't take long," she said. "And then we'll be able to do some things to help you. We're going to move you to a room on a different ward where Dean can stay with you longer. He won't need the gown either."

"I don't like them," Sam said.

"Then you'll be much happier soon. You talk to Doctor Platt and we will arrange your room change."

"And Dean can stay?"

"Not right now, but when you've changed rooms, yes."

"Why not now?"

"Because Dean needs to eat something," she said, cleverly tapping into Sam's caretaking side. "And I need to talk to him about some stuff. Give us maybe an hour and you'll be together again."

Sam looked suspiciously at Dean. "You'll come back?"

"I promise."

"Bobby said he'd be back, too, but I haven't seen him," Sam said.

"I'm not Bobby," Dean said. "I always come back. You know that."

Sam nodded. "Don't be long."

"I'll be back as soon as I can." He stood and patted Sam's arm.

He felt Sam's eyes on him as he left. He walked from the room and stopped outside the door where a man that looked only a few years older than Dean stood. "Doctor Platt?" he asked.

"Yes." He held out a hand and Dean shook it. "You must be Dean. It's nice to meet you. I won't keep you from your brother any longer than is necessary."

"Thanks," Dean said, dropping his voice so that Sam couldn't overhear. "Look, there's something you should know about before you speak to him. Sam's asking for Jess, his girlfriend."

"Is that a problem?"

"Yeah. Jess died years ago, but Sam doesn't seem to know that right now. I don't want him remembering and getting upset, especially if I'm not with him, so don't ask about her, okay?"

He nodded. "Absolutely. I will try to steer clear of the topic. This is more of an assessment session anyway. It's my job to gain an understanding of Sam's mental state before a plan of action can be created between us all."

"This isn't just about getting him medication?" Dean asked. "You're going to 'treat' him, too."

"Giving medication alone would be negligent, he said. "We need to take a holistic approach to Sam's care. Doctor Maddox and her colleagues are taking care of Sam's body. I will help to take care of his mind."

Dean frowned. "This all sounds like a lot."

"It is," he agreed. "But so is what's been happening to Sam. Between us all, we're going to get to the bottom of it and help him."

"Okay," Dean said. "Go easy on him, though. He's not as strong as he looks."

"I will be very careful," he said. He smiled and slipped into the room and Dean heard him say, "Hello, Sam. I'm Doctor Platt, and I am here so we can talk about some things…"

"Would you like to come to my office, Dean?" Doctor Maddox asked.

"Sure," Dean said. "Can Alfie come, too?"

"Absolutely. Whatever you need."

They fell into step beside her along the hall and through a door with smaller rooms labeled with names instead of just room numbers. She opened the door to one and gestured them inside.

The room was painted a generic beige but it was light and airy. The window had a blind that had been rolled up to let the sunlight flood in. The desk was lightwood and neatly ordered. The chair behind it was padded cream leather, and the ones in front were cushioned tan fabric. There was watercolor art on the wall, and a couch with throw pillows on it and a blanket. It seemed a comfortable and welcoming space where the receival of bad news was unlikely. Having spent his life looking past appearances for the truth, Dean was at once on his guard.

"Have a seat wherever you wish," Doctor Maddox said.

Dean took one in front of the desk and waited for Alfie and the doctor to sit too.

"It's very different in here," Alfie said, then explained for Dean's benefit, "This used to be my office."

"Yes, I remember some very dark wood furniture and a chesterfield couch," Doctor Maddox said. "Very formal."

"Ah, but I am a product of my time, Katherine," Alfie said. "That was how we decorated in my day."

"And this is how we decorate now," Doctor Maddox said with a smile.

"It's great," Dean cut in. "Can we get to Sam now? I don't want to leave him longer than I have to."

"Of course," she said, becoming serious. She lifted a file from the desk and flipped it open. "We have two things to discuss. Sam's EEG and his MRI. I will start with the EEG." She pulled out a folded strip of paper and laid it on the desk.

Dean leaned forward to look at it. It was covered in dancing lines that rose and dipped in seemingly random places There was an area that had been highlighted in yellow, and he examined it carefully. It looked more confused than the other areas; the peaks were higher and closer together. He knew it wasn't good news, and he didn't want to hear it explained. He just wanted to go back to Sam and talk about nothing important and pretend this was all some nightmare he was going to wake up from.

Doctor Maddox pointed at the highlighted section with a pen. "This part here is the important part. During the light stimulation phase of the test, Sam had a seizure."

Dean pulled back in his chair, distancing himself from the words. He did not want to hear this.

"It's not uncommon for an epileptic to be trigged by the light. You may have heard of the problem strobe lights present to them, too. That's very close to what Sam was exposed to this morning."

"So he is epileptic," Dean said. "It's for sure now?"

"Yes," she said soberly. "I know this is not the news you were hoping for, but it's probably not as bad as you're thinking either. Epilepsy doesn't mean Sam can't live the fullest life he's capable of. We will start him on a medication called Lamotrigine. It's an anticonvulsant that should help us…"

Her words became white noise. He was trying to take in what he'd heard. He'd known it was a possibility, but hearing it was harder than he could imagine. This was something Sam was going to have to live with. He could live with it, he was strong, but it was going to limit him. How was he going to hunt with this risk? How was he going to handle the news even? Sam was so independent.

"You said capable of," Alfie pointed out, and Dean's attention snapped back to the room.

"What does that mean?" he asked suspiciously.

Doctor Maddox sighed. "I know you have discussed the possibility of brain damage with Doctor Bennett, and you and I have spoken about it, too." She stood and lifted a large brown envelope from the desk. She walked to the lightboard on the wall beside the couch and tacked two dark transparent sheets in place as she flipped on the light behind it.

Dean turned his face away. He did not want to see what she was evidently going to show him. He wanted out of this. He didn't want to hear her speak more or make him look at those scans. He just wanted to be with Sam again, on the road, hunting. He wanted his brother to be able to do that again. He wanted to tell Sam about this nightmare he'd had and Sam could laugh at the idea he, Sam, could ever be brain damaged.

"Dean," she said softly.

Dean shook his head.

Alfie stood and walked to the board to examine the scans. He leaned close and then turned to Dean. "Come and see."

"I don't want to," he said. He knew from Alfie's serious tone and the doctor's somber expression that it wasn't going to be good news.

"I know you don't, but you need to," Alfie said gently. "Come and see, then we can explain what you need to know for Sam."

It was the word need that did it. Sam needed him to know this so he could help. He stood slowly and walked to the board. He forced his eyes to look at it. He could see nothing wrong. There were none of the dark areas that he'd seen on Doctor Sexy when someone had a tumor or needed half their brain cutting out. It looked normal to him.

"What am I looking at then?" he asked belligerently.

"This is the scan from this morning," Doctor Maddox said. "This here is the area that's important."

Dean followed the line of her finger to the edge of the scan. It looked fine to him. They were making him scared for nothing, he was sure. "What's so important?" he asked.

"This area here is lighter," she said. "That shows the contusions on Sam's brain. When he was in the accident–"

She cut off as Dean raised a hand. "You tell me, Alfie."

"Katherine is better able to tell you," Alfie said. "She is his doctor, Dean. I am just…"

"A friend," Dean said. "You're my friend, and you're a doctor, too. If I have to hear this, I want it to come from you. You can see what she's talking about, right?"

"Yes, I can see." He glanced at Doctor Maddox and she nodded to him. He lifted a mottled finger and pointed at the same spot Doctor Maddox had been indicating. "This is where the damage is. It's called a contusion, but that basically means it's a bruise. As I told you before, Sam's head was thrown around in the accident and his brain couldn't keep up. It hit against the sides of his skull. That was what hurt it. It's called a Traumatic Brain Injury. Now, this area is where the bleed was localized." He pointed at a different, darker spot that Dean hadn't seen. "This is where the brain was placed under additional pressure. It has essentially killed tissue."

"Sam has brain damage," Dean stated.

"Yes," Alfie said, his face drawn and sad.

Dean swayed, and he was vaguely aware of someone leading him back to a chair. He fell into it and covered his face with shaking hands. His eyes burned and when he blinked, wetness streaked down his cheek. The first tear seemed to open a floodgate. As fast as he wiped them away more flowed. He gave up trying and hugged his arms around himself instead, rocking back and forth as he sobbed silently.

He couldn't take it in. Sam had brain damage. He wasn't going to be the same anymore. His brilliant, intelligent and often pissy brother was changed. How was he going to handle this? Did he even know what had happened to him? Was he aware that he was different now? He was always so damn independent, but what would life offer him now?

He didn't know how long he spent lost in his thoughts, crying, but the tears slowly tapered away, and he wiped over his face one last time as he straightened up. "Okay," he said in a dead voice. "What does this mean for Sam?"

"We're not sure," Doctor Maddox said, taking her seat behind the desk again. "I didn't know Sam before the accident, so I can't judge how he is different now. Tell me what you have seen."

"It's like talking to a child. The way he speaks and the things he says are all changed. He's not the same. I don't…" He raked a hand over his face. "Dammit, I don't know. He's different. That's all I know."

"It's possible that damage such as Sam sustained would cause symptoms that present as mental regression, but they often mean that language skills and temperament are changed rather than his capabilities. This is going to be a case of waiting and seeing, Dean. As he recovers from his other injuries, his cognitive state will be revealed more. You will know better than anyone what the damage has done to Sam, so you will need to guide the rest of us."

"He was so clever," Dean said quietly. "He went to college to be a lawyer."

"He is still clever," Alfie said. "Brain injury such as Sam's doesn't lessen his intelligence. It just makes it harder for him to access and show it."

Dean nodded as if that was better, but he thought in truth it made it worse. Sam knew his mind still, and thoughts, but he couldn't wrangle them.

"Is that why he's asking for Jess and Bobby? Is he seeing Bobby because of the damage?"

"I think it's possible that his injury has dislodged his sense of time," she said. "It's not amnesia exactly. It's his becoming displaced in his memories. I am still unsure of why he saw Bobby though. Perhaps Doctor Platt has some insight. We will ask him when he's finished with Sam."

Dean drew a breath through his nose and nodded. "What do I do now? What happens next?"

"It's going to be a learning curve for a while," she said. "At the moment we know little about Sam's physical capabilities. We haven't been able to run a full assessment as he was upset when he woke. We know he can talk and feed himself and he can recall names."

"That was in doubt?" Dean breathed.

"To be perfectly frank, everything is in doubt until Sam shows us otherwise. We will remove the ICP catheter tonight so he can begin to move around. There may be some weakness from his period of inactivity and there may be some from the injury. We will assess it as he is able to test himself more physically and we have more time with him awake."

"How can I help him?" Dean asked. "How do I…" The question he wanted to ask was how did he make this right for Sam? How could he fix it? There was no way though. Sam was hurt and Castiel was gone.

"The most important thing you can do for Sam is remember that he is still Sam," Doctor Maddox said. "With the changes you have noted already, it might be tempting to treat him as a child, to 'take care' of him and protect him, treating him differently to how you would had he broken a bone. He isn't broken, and he isn't a child. To treat him as one would be damaging. He is who he always was but it's like he's seeing through a fogged window. The world isn't very clear to him right now. Sam needs to feel as normal as possible."

"I can do that," Dean said. "What else?"

"Be patient. There may be days on which he'll need extra help to do simple things—that may be all days—but give him time to do things at his own speed. It might take him longer to articulate a thought or need, but don't speak for him if you can help it. Don't try to spare him jobs that you can do yourself faster to ease the weight on him. Let him do as much as he can. If there are dishes to be done, for instance, let Sam help if he's physically able. The worst thing he can do it sit idle while everything is done for him. He needs to have as much involvement in real life as he can." She looked Dean in the eye. "One of the most important things you can do is take care of yourself. This is going to be difficult for you. Even if there is no more damage than has already presented itself, Sam will need to be monitored. The seizures, depending on the control we can gain over them, will need to be managed as they come. We will educate you on how to deal with them for when they do come. You're going to be exhausted if you don't take care, Dean. Alfie says you're going to stay with him, yes?"

"Yeah."

"Then let him help as much as he can. Your instinct might be to take care of Sam by yourself, to not put upon other people more than you have to, but that will wear you out fast, and ultimately you and Sam will both suffer for it. Sam will see what it's doing to you. Do you think that will upset him?"

"Definitely," Dean said.

"Then ease that weight on you both by caring for yourself as much as you do Sam. It's going to be emotionally tough as well as physically, so take breaks frequently. Even if you only go to the store, give yourself space when you need it. Reach for help when you need it." She smiled at Alfie. "With Alfred, you'll have the best doctor I have ever worked with and one of the kindest men I know helping you. Take advantage of it."

Alfie cleared his throat. "Use us, Dean. Elsie and I are going to be right there with you, so tell us what you need when you need it."

"I will," Dean said, though he wasn't sure he would be able to. He and Sam were a unit. Even taking help from Bobby had sometimes felt wrong.

"Sam will be monitored for a few more days before we can think of him being discharged," she said. "The timing depends on any physical restrictions he has. I would use that time to explore as many of the changes you can. Learn as much as you can to be better equipped to help him when he leaves. We will run more tests, but you can gauge him much better than us by comparing him from before to now."

Dean braced himself as he asked the question that he was scared to have answered. "Can he get better? Is there a way he can heal from this?"

She set looked serious as she said, "Brain cells are unusual as, unlike most cells in the body, they don't regenerate. The damaged and dead tissue will not heal, but that said, the brain is incredible. It won't heal, but it can forge new nerve pathways and use undamaged parts of the brain that it didn't access before. There is no way of knowing what faculties Sam will regain, but there is a good chance it would be some."

"He could get better?" Dean asked. When she didn't answer, he looked at Alfie. "He could be really him again, right? How he was before, I mean."

"There is no way to be sure, Dean," Alfie said. "The brain is incredible, but there is no way of knowing how Sam's brain will react. I think it's better to expect less and be pleased with more than it is to be disappointed."

"It will take time," Doctor Maddox said. "We used to believe there was a two-year window in which recovery could happen, but that's been disproved now. As long as Sam lives, he could regain skills."

"Years?" Dean breathed. "It could take years."

He couldn't wrap his mind around it. It could even take all that time and nothing would change. Sam could remain this confused for the rest of his life. And would it end there? They had a heaven together. Sure, Sam's part was a stream of some of Dean's crappiest hits, but it was together. If they made it there, was Sam going to be healed or was this it for him now?

"Yes, years," Alfie said gently. "This is going to be a long, hard road. You can help though. Concentrate on making this as easy for Sam and yourself as you can, hope for the best but don't expect too much. That way anything else that comes is a blessing."

Doctor Maddox nodded. "Keeping him active is a good step for that. Don't let Sam just languish and dwell on what's happened. Stimulate him. Make his brain work."

"Is there anything else I need to know?" Dean asked. "I want to be ready when the shrink is finished with him."

"There are things to discuss, but we can come to them later. You should take some time to process what we have said. When Sam is finished with Doctor Platt, we'll move him to a different ward, so it might be better if you're ready when he's being moved to help him settle in."

Dean stood and shook her proffered hand. "Thanks, Doc."

"I'm sorry I couldn't give you the news you were hoping for," she said.

"It could have been worse," Dean said, glancing at Alfie who nodded his agreement. "He's alive at least."

And that was what he had to cling to. Sam was damaged and changed, and he might never be the same again, but he was alive.

That didn't stop the tears from falling as he walked back to Sam's room though.

So… We know the real subject of the story now. I have never written Sam like this before, and it's been a challenge. I hope I'll be able to do it justice.

Until next time…

Clowns or Midgets xxx