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The Pleural Cavities

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The Pleural Cavities




One of the paramedics digs Dean’s phone out of his pocket. “Do you want me to call someone for you, Mr Burton?” she asks.

Everything’s spinning. Dean closes his eyes. Fuck. Obviously Sam has to know or he’ll flip the entire state upside down looking for him. And hell, going through this shit alone isn’t exactly appealing. But maybe pretending he’s living someone else’s life—Dean Burton’s life—might be a nice reprieve from his own monumentally fucked up one.

His head spins at the mere thought of nodding, but Dean does it anyways. Manages to mumble his brother’s name loud enough for her to hear it through the oxygen mask over his face. 




He’s out for the rest of the ride. Wakes up again with a bright light shining down on him that might as well be a pair of trash pickers jabbed directly into his eye sockets. He tries to twist away from it, but strangers are holding him down with hands in unsettling latex gloves, telling him not to move.

“It’s alright, Dean,” someone says, voice deep and sure like his father’s. “You’re safe now. We’ll take good care of you.” The words sound like they’re from an alternate universe and cast some kind of spell on him, easing the tension enough to let them get back to work.

When they poke an IV into his hand, things get fuzzy and warm for a while and he doesn’t care so much about how swollen his arm looks or the way his bones feel like they’re moving around inside him every time he breathes. They poke at his stomach, check his eyeballs, and ask him to wiggle his toes, and no machines go crazy and no one says anything about surgery so he figures he’s gonna live.

Everyone except the deep-voiced guy disappears. He rolls a big machine over, and tells Dean they need x-rays of his chest and arm. And then suddenly Dean’s lying all alone in this big room with a bunch of hospital equipment, in too much pain to move. And for the first time in a long time, he doesn’t feel like he’s dangerous. He feels vulnerable and small. Sure, it sucks. But it’s also a serious fucking relief. 




A sharp pain radiating through his ribs wakes him when he hadn’t even realized he was sleeping, and Sam is just there, as if he always was. 

The lights are mercifully dim, but his head throbs again as he takes a shot at lifting his head.

“Take it easy. Easy,” Sam urges, a hand on Dean’s hospital gown-cloaked shoulder. “Just relax okay?”

“Sam. Jesus—”

“Dean…” Sam’s voice cracks like it does when he needs something desperately, and his eyes wander up and down the bed, his head shaking in disbelief. “Who did this to you?” 

Dean tries to assess what ‘this’ actually entails. Finds his arm in a cast from shoulder to thumb, suspended in a swing. His ribs clattering together like a drawer full of rusty kitchen knives every time he takes a breath.  

“Doesn’ matter,” he mumbles.

Sam squints at him. “Like hell it doesn’t matter. Have you seen yourself? They broke your arm and seven ribs. They gave you a serious concussion. And they aren’t going to just… just get away with it.”

But Sam doesn’t get it. Dean already made that decision.

“I let ‘em,” Dean tells his brother.

“What’d you mean, you let ‘em?”

“Didn’t wanna kill ‘em,” he says, trying oh-so slowly to sit up. “Was tryin’… ugh… was—“ It doesn’t go so well.

“Woah, relax. Jesus, Dean. You mean you didn’t defend yourself?”

Sam looks so goddamn confused. Where the hell has he been these past few months? Dean swallows back his frustrations—with his useless body and his oblivious brother—and stares blankly at the swollen fingers peeking out of the end of his cast. 

“Didn’t wanna… flip the switch.”

Sam ponders that turn of phrase for few seconds, and then his eyes finally widen in horror. “God. That… that sucks, man.”

Dean doesn’t know what to say—no fucking kidding?—so when his nurse comes in, all business, he’s kind of relieved.  

Her name is Shelly and she’s got this plastic gizmo with her that looks like it belongs in a meth lab—some kind of beaker with little valves and bobbles—calls it an incentive spirometer and tells him he’s supposed to breath into it or something. Which would be easy enough if his chest hadn’t recently been turned into a Chop-o-matic.

He flinches when she angles his bed up, but it’s nice to not be staring at the ceiling anymore. She takes a seat across from Sam and says, “I know it hurts to breath right now,” false eyelashes batting away under her 80’s perm. “But it’s important you try to take deep breaths as much as you can, darlin’. So let’s just give it whirl, hmm?”

You give go-karting a whirl. You give line dancing a whirl.  When Dean tries to take as deep a breath as possible with his lips around a little plastic nozzle, everything except Dean starts whirling. 

It isn’t just the pain, although that’s excruciating, it’s also the feeling of his broken ribs moving around inside of him, the ends rubbing together like brittle wet twigs, which feels—

So. Incredibly. Wrong.

Tears well up in his eyes and he tries to muffle the whimpering noise coming from the back of his throat with little success. 

Sam takes his good hand and squeezes. He looks at Dean with his big worried eyes, and then at the nurse. “Should he be doing this?” he asks, like Dean’s a lame horse trying to race at Flushing Meadows.

He’s not that far off. 

“S’okay, Sam,” Dean gasps rather unconvincingly.

Shelly, for her part, at least looks sympathetic. “It’s plain awful, I know. But it’s real important. The number one complication from injuries like this is pneumonia. And something like that can get serious darn quickly.”

Sam nods, but his frown doesn’t budge. Nether does his grip on Dean’s hand.

Shelly holds the whirly-gig back up to his lips. “Ready to go again?”

Dean nods. 

He hates this. It’s just… breathing. He shouldn’t even have to think about. He shouldn’t even notice. But now, that thing that’s always come so naturally, that’s so crucial to his survival, suddenly hurts so bad he can’t see straight. Oh, and if he want to keep it from getting worse, he has to make it hurt even more? It’s enough to drive a person insane.

“You’re doin’ fine, sweetheart,” Shelly says, rubbing his knee through the fuzzy yellow blanket over his legs, “just four more times, okay?” which is cold comfort coming from someone with a perfectly intact skeletal system.




If Sam’s right hand was busy holding Dean’s, he must have been texting Cas with his left, because as soon as Nurse Shelly leaves, the familiar sound of giant invisible feathers fills the room.

Of course. One simple touch and—presto!—Dean can be strong and well again, and this whole nightmare can be over with.

And he can get back to that other nightmare. 





They really don’t get it. Not that Dean is surprised—it’s not like he enjoys being in the hospital anymore than they enjoy seeing him here. But the alternative—

“Are you saying this because you’re concussed?” Cas asks, his concern evident from the quickly diminishing space between his eyebrows.

Meanwhile, Sam just seems annoyed. He’s started pacing. “Dude. Stop dicking around and let him heal you.”

“Not dicking. Don’t waste your mojo, dude.”

Cas lowers himself into the chair next to Dean’s bed, shakes his head. “Dean. I would never think of healing you as a waste of anything,” he says, so earnest that it hurts Dean’s heart.

“I woulda killed them,” he whispers, on the verge of breaking down. Using every damn scrap of strength he’s got trying not to cry. “I can’t… all those men I killed back in Pontiac. I thought I wasn’t in control. But it was my fault. I let the mark take over.”

Sam’s movements slow and he grabs the bar across the foot of the bed like he needs it to stay vertical. “No. You didn’t know,” he says quietly, trying to meet Dean’s eyes, while Dean tries to avoid his.

Cas is leaning towards him, squinting at him too. And Dean wonders what they expects to find when they looks at him like that. Aren’t all his imperfections big enough to see from miles away? 

“You have a right to defend yourself,” Cas says.

“It’s better like this. If I’m not strong enough… I can’t hurt anyone.”

“Dean. You’ve already shown you can control it. You can do this,” Sam says.

“And next time? What if… what if I can’t? Then it’s my fault if people…  if I…” He can’t bring himself to say anything else. He’s made his case pretty damn clear.

“Dean….” Cas’ hand touches his shoulder, thin blue cotton the only barrier between their skin. Dean stares at it like a blasphemy.

“Don’t touch me.”

“You’re in pain.”

“Please, Cas. Don’t.” 




He must have hurt Cas’s feelings or something because he disappears after that, and it’s just him and Sam again. And Shelly. And the whirly-gig of pain.

“Stupid name,” Dean rasps after the third torture session. He feels like someone just threw a bowling ball at his chest.

“What is?” Sam asks, flicking aimlessly through tv stations.

“Incentive… spirometer? Excruciating pain… is shitty… incentive.”

“Next time I’ll give you a cookie,” Sam says, patting his lap.

“Sub the cookie for a shot of morphine and it sounds perfect.”

Sam lowers the remote and turns to Dean, and just like that, everything’s serious again. “Dean…. you know, you don’t have to—“ 

“Don’t, Sam. This is the way it’s gotta be.”

 But this time, Sam’s quick to surrender. “It’s your choice, man,” he says, hands in the air.

Dean thanks him, even though he has a nagging suspicion that the only reason Sam’s forcing himself to go along with this is to prove a point about what happened with Gadreel. Bodily autonomy or what have you. Which is fine by Dean.

“You’re not welcome,” Sam says. “This fucking sucks, man.”

“Yeah. Tell me about it.”




Things go south the next day. When Dean wakes up there’s a big oxygen mask over his face again. He feels hot and cold all at once, and it hurts more to breath than it did before. Sam’s sitting real close to him, pressing something soft and cool up against his forehead, and the deep-voiced doctor is back, standing at the foot of his bed, scribbling on a clipboard. 

Everyone else seems to already know what’s going on. Like Dean slept through the first act or something.

“I think he’s waking up,” Sam says.

“What…“ he croaks, kind of horrified at how weak he sounds. It better be enough to prompt someone to tell him what the hell is going on.

That someone is Nurse Shelly, who’s busy adjusting the pillows supporting either side of his ribcage. “Hush now. You had a little setback, sweetheart. There was fluid building up in your lungs and making it hard for you to breathe, so we had to put tubes in your chest to help drain all that junk out. You need to try not to move too much okay?”

Tubes in his chest? Christ. 




“Dean... You don’t have to put yourself through this,” Sam says once the others have left them alone. “Please… ”

“I can’t—” Dean says, but his barely audible protests can’t compete with Sam’s desperate, yet well enunciated ranting.

“No, listen,” Sam continues, still plying Dean’s fevered forehead with a cold compress. Like it’s the only thing keeping him alive. “I fucked up, okay? I mean, after Metatron? I shouldn’t have let you think this was all up to you, that you should be expected to control the mark all by yourself. Because I don’t. And you’re allowed to protect yourself, even if you think you might loose control.  Because that’s not on you. That’s on the mark, and it’s on any asshole who tries to hurt you, got it?”

Dean wants so badly to buy what Sam’s selling. But he keeps seeing flashes of the carnage in Pontiac. Even if it’s not completely under his control, isn’t it still his responsibility? 

“But what if I… what if—“

“You do the best you can, Dean. And if saving your own life means the mark takes over, then let it.”

Does Sam even realize what that implies? He doesn’t deserve to live any more than someone else who’s made bad decisions.  Or at least… he shouldn’t be the one deciding something like that. It’s too much.

“…can’t do that...” he rasps, surprised that Sam can even hear him.

“Then… then we keep you safe until we figure out how to get rid of the thing. No hunting. No solo bar nights. And I’ll stay with you. Or Cas will. And if anyone tries to hurt you, we’ll take care of ‘em.”

Under different circumstances, what Sam’s proposing would sound intolerable. But the way he feels right now? It’s a lot like how he felt when Metatron stabbed him in the chest. Only over and over again, every time he takes a breath. It puts the meaning of the word intolerable into pretty clear perspective.

 “Sam… everything’s so messed up…” he says, because as far as options go, these suck big time.

“I know, man. But we’ll get through this. Please. Just let Cas heal you.”

Not that long ago, air used to enter his lungs without him even noticing. It’s hard to imagine. 

“Please, Dean. Let us take care of you.”


Dean’s not sure if it means he’s incredibly weak, or incredibly strong. All he knows is that he’s so damn tired. And Sam… Sam is his brother. And he trusts him. 

He whispers, “Yeah… okay,” and Sam nearly collapses in relief.

“Oh, thank god. You’re gonna be okay,” he says, already fumbling with his phone to call Cas. “Just hang in there, bro.” 




Cas only heals his lungs at first, so they don’t raise any red flags. The chest tubes, oxygen, and extra IV get the boot, and soon thereafter Dean signs himself out AMA. Nurse Shelly hovers disapprovingly as Sam and Cas help him into a wheelchair, and she holds back her rage as they barely feign interest in her directions on how to care for their patient. Dean feels a little guilty, and takes her hand as Sam pushes him down the hall. 

“Thanks, Shelly.”

“If I see you back here, I will not hesitate to kick their butts to kingdom come.”

“I’ll be okay. Swear.”

“Well someone’s lookin’ out for you. I’ll give you that much. Though it’s clearly not these nimrods.”

Affronted, Cas raises a finger in the air and starts to open his mouth to speak. He’s about to set the record straight.

“Well,” Sam says quickly, “we should get going!”

It hurts when Dean laughs, but it’s worth it. 

As soon as they hit pavement, Cas touches his forehead again, and Dean feels a soft wave rock through his body, folding his bones back together as if they were something fluid. 

Taking a deep breath almost seems clichéd, but Dean does it anyways. Feels the cold prairie air fill his restored lungs, feels his chest expand willingly. It’s glorious.

“If only Shelly knew,” Cas says, staring wistfully back at the red brick hospital’s entrance.

At least Dean’s free from one prison.




When they get home, Sam helps him cut the cast off his arm. And some stupid part of Dean indulges the faintest possibility that somehow, the mark will have magically disappeared. 

It’s completely nonsensical. That’s all faith is to him anymore, really.  But maybe that’s okay. Because it’s not about faith anymore, it’s about watching Sam cut open the plaster around his arm with a blade sharp enough to slice it like butter—and never flinching. Not once.