Sam whimpered as they pulled up in front of the clinic. Dean took a deep breath. Sam was not having a great day. Dean reflected that none of his days were great – but this wasn’t good even going by where Sam was now.
He got Sam out of the car and into the waiting room. There weren’t many other people in the room thankfully, so he sat Sam down and quickly checked in with the desk. He must have mumbled though.
“Sam... Wochester?” called the office admin.
Dean stood up without bothering to correct her. “C’mon Sam,” he said. “It’s our turn.” Sam, who was staring intently at an empty corner of the room continued to mutter to himself in Enochian. “Sammy,” said Dean trying to keep his tone even. Sam gave a small flinch, but Dean saw his hands tighten on Winnie Bear and felt like crap for scaring him.
Neither of them had gotten much sleep last night. Sam had had several violent nightmares, and had been desperately afraid, hallucinating, and unwilling to try to sleep in between. Dean had only gotten a few hours of sleep and none of those hours had been in a row. They were both exhausted.
Sam finally stood up, hunching his shoulders against anticipated pain. The scars on his back were tight, Dean knew, but it was hard to get an accurate assessment of pain from Sam. As they made their way out of the waiting area, Sam’s muttering grew louder. A woman looked up from where she was reading to her toddler and scowled. Dean bit back the urge to tell her off, reminding himself that Sam didn’t notice or care about other people’s reactions, but yelling at the woman, and her yelling back would upset him for sure.
In the exam room, Sam continued to run his fingers over Winnie Bear. Dean learned back in the chair and closed his eyes. He had not been this tired in a long time. He drifted a little to the sound of Sam’s muttering.
He woke as the door opened softly. Same stopped muttering and whimpered. The doctor was not at all what Dean had been expecting. She was very pretty, and she was stylish, with her hair styled and a skirt that looked straight out of magazine. “Okay – Sam and Dean Wochester, hi there,” she said, looking up from the chart in her hand as she came in. Her eyes widened at the sight of them.
“Wochester – Winchester! I thought Bobby said you two would be by!”
Sam whimpered again and looked down at his lap low enough to hide behind his bangs. The Enochian muttering got a little louder.
Dean frowned, “What does it matter what our name is?”
The Doctor smiled, “Let’s be very frank, shall we? I want to help you. I don’t care if your name is Lee, or Smith or Kazowski. But for me to be able to help, I’ll need you to be honest. If even half of the stories about you two boys is true, then it’s no wonder you’re here. That’s why Bobby sent you to me. My Willy was a hunter – and I’ve patched up enough of them to understand that all the wounds aren’t on the outside. And even among hunters, the Winchesters are legends.”
Dean wasn’t sure what to say to that. “Doc, we’ve been flying under the radar so long that we don’t know how else to be. I don’t think we’re on the FBI’s most wanted list anymore, but only because they think we’re dead. The only people patching us up usually are each other.”
“That sounds very stressful,” the doctor said, sounding genuinely sympathetic. Dean looked away from her to check on Sam. Sam had stopped muttering and was staring at the doctor like he’d just noticed her.
“Lorna?” he said. Dean was surprised – he and Bobby had both told Sam about what was going down today, but it was always hard to tell what Sam understood, and with such an awful night sleep Dean hadn’t expected much.
“That’s right, Dr. Miller is awfully formal.”
“Stressful,” he said.
“Dean was telling me. I’m sorry things have been so hard.”
“No – GE – me.”
“No get you? What’s going to get you?”
Sam made a sound rather like an elephant. “Not stressful me. Stressful Dean.” Each word seemed painfully full of emphasis. He pointed at the doctor and then at his brother, obviously indicating that Dr. Lorna should examine Dean.
Dean frowned. “Oh no Sammy. Don’t you turn this around on me. We’re here to help you.”
Dr. Lorna cut in. “I made time for you both. No need to pick and choose.”
“Doc, no offense, but we really couldn’t afford...”
“Dean, this is on the house. All hunters are. I have a pretty good living here. This is my community service. I’m going to help with whatever I can, for both of you.”
Dean sighed again and rubbed his hand over his face. “All right, all right. But Sam first.”
“Deal,” said the doctor, sticking out her hand. Dean shook but couldn’t help feeling like he’d made another deal with a demon.
With things decided, Dr. Lorna got to work. Sam, having made his point, had gone back to staring at things Dean couldn’t see and muttering. “So let’s start with the basics. What brings you in?”
Dean opened his mouth. Shut it. Opened it again. “How far back do you want me to go?”
“Let’s go back pretty far but stick to medically relevant.”
“He was always a pretty healthy kid. Smart too – went to Stanford,” he added with that touch of pride he always had. “He got back into hunting after his girlfriend died. Umm, it’s been a rough few years – he’s definitely had a few concussion, and he broke his wrist once. Then we stopped the apocalypse. Well, Sam did. Sam. Sam was possessed by Lucifer and jumped into his cage in Hell with Lucifer in tow. We don’t know how long he was there – time moves faster in hell. I managed to pull him out a few months ago. He was all bloodied, couldn’t speak English, was terrified of everything. Has a hard time figuring out what’s real and what’s not.” Dean swallowed, glad that he had manage to spit that all out without breaking down.
Dr. Lorna stared for a second. She thought she’d been prepared when Bobby had called – she’s heard rumours about the Winchesters before – but the actual, real apocalypse seemed a bit more than anyone could expect. “Dean, that’s an awful lot to be dealing with.”
Dean snorted. “Yeah. You sure you still want into this?”
“Oh I’m all in. When you say he jumped in the cage…”
“I mean he was locked in with the devil for longer than any of us can imagine, in a place where he couldn’t die and his torturers had nothing else to ever do.”
Sam whimpered again, and then flinched, and began to cry. “BabalonSam, BabalonSam,” he sobbed. Dean grabbed his hands as Sam tried to scratch at his wrists. Sam tried to pull away.
“Sammy, Sammy, hey, hey, hey. Eyes on me, eyes on me. It’s not real. We got you out. We got you out.”
Sam managed to make eye contact and saw Dean. It was so hard to trust what he saw.
“Sam,” said the doctor, “tell me five things you can see.”
Dean squeezed Sam’s hands in encouragement and Sam licked his lips. He’d forgotten what he was supposed to do. He looked away from Dean frantically, because if he didn’t answer he’d be punished, if he gave the wrong answer he’d be punished.
“Sam,” said Dr. Lorna, getting his attention again. She’d noticed his breathing speeding up. “5 things you can see. Any 5 things, no wrong answers.”
Sam nodded. “Dean,” he said, and Dean’s eye lit up. Sam looked around, concentrating. “Chair, book.”
Dr. Lorna nodded. “2 more,” she encouraged.
“Otoscope, sphygmomanometer,” Sam finished. He was holding Winnie Bear in a death grip, but Dean could tell he was back in the room with them.
“Doc, that was amazing.”
Dr. Lorna gave a little laugh. “It’s actually a really well-known technique for panic attacks. I’ve got a handout here somewhere about it.” She pulled a pen from her coat.
“Okay, Dean, Sam, how have things been since Sam got back?”
Dean looked at Sam before beginning. “Umm, seizures? He has a hard time talking sometimes, especially in English. When we got him back, his back was all tore up. We patched it up the best we could.”
Dean paused to take a breath while Dr. Lorna made notes. Sam seemed to have checked out of the conversation again, but Dean appreciated that Dr. Lorna’s questions were always addressed to them both.
“He has a hard time staying with me,” Dean said softly, “He gets trapped in the memories, and I have to let him know he’s not there. Eating is hard – he doesn’t have a lot of things he can tolerate.”
“Food is trick,” added Sam. “Before food.”
Dr. Lorna finished her notes and looked up. “Okay boys, let’s do a basic physical on both of you.”
Dean stood up. Sam nodded but didn’t move. Dr. Lorna started with Dean, weighing and measuring both men. She took Dean’s blood pressure, and both of them talked Sam through having his done. She looked in their eyes, ears, and throats. Then she looked at Sam.
“Can we have a look at your back?” Sam whimpered, clutching Winnie Bear.
“C’mon Sammy, I know you don’t like it, but she might be able to help. Shirt off dude.”
Sam didn’t answer, but didn’t protest either, as Dean prompted him to lift his arms.
Dr. Lorna prided herself on her professionalism but could not help but gasp when she looked at Sam’s back. The damage went down through the muscle in places, and the scars were thick and ropy. Some of them had obviously been stitched together by someone without medical training. Lorna assumed that was Dean. Some of the scars still didn’t looked completely healed.
“How long has he been back?” she asked Dean.
“’Bout 6 months? The angels tried to help, but the... damage was done with an archangel’s grace, so all we could do was stitch him up. They’ve taken a long time to heal, and I have no idea if they are still hurting him, or if they even CAN heal.”
Dr. Lorna nodded, trying to get her feelings under control. “Well, you’ve done a great job keeping them clean. And that’s the hardest part with an ongoing wound.”
Dean helped Sam back into his clothes and Dr. Lorna tried to assemble all the information into some kind of feasible plan.
“Okay, let’s start with Dean. Your blood pressure is high. Not terribly high, but high enough that I’d like to do something about it.”
Dean looked shocked. “We’re here to get help for Sammy – I’m fine.”
“Dean, you told me that you are Sam’s main caregiver?” Dean nodded. “So what happens to Sam when you have a heart attack? Or have other debilitating symptoms? Vision trouble, circulation issues... Sam needs you to be in tip top condition.”
“That is a dirty move,” said Dean, scowling.
Dr. Lorna smiled. “Maybe it is. But here is your prescription- You need to eat better. Less meat, less salt, more vegetables and fruit. Come back in a month and get it checked again. If I don’t see improvement, then we’ll add a medication.”
Dean took the handout she offered and stuck it in his back pocket. Lorna counted it a win.
“Okay, on to Sam. I need more information about the seizures. How often do they happen?”
“It’s not always the same. He’ll go weeks without one, and then he’ll have several in few days. Sometimes he’ll have one if he has a bad flashback. Sometimes it seems like it’s out of no where.”
She nodded. “How long do they last?”
“Never more than 5 minutes.”
“Good. Does he experience any other types of seizure activity?”
Dean looked at her blankly.
“Absence seizures, where he loses a little time?”
“I...we...we wouldn’t be able to tell. He’s ‘absent’ an awful lot.”
Dr. Lorna nodded thoughtfully. “Okay, leave it with me. It might be dissociation, but I don’t know enough about it to say for now. In the meantime, I’m going to prescribe something to hopefully help prevent seizures. I’m also going to prescribe a daily medication for anxiety as well as a rescue medication. I’m assuming you’ve been using something like Xanax?”
Dean blushed a bit, knowing how most doctors felt about hunters less than legal medications. “Yeah, just when it’s really bad. I know they’re addictive.”
Dr. Lorna nodded. “It’s good to be aware. Hopefully the daily med will decrease the number of bad flashbacks he experiences. You can also use the rescue med to help the seizures – they’ll dissolve in his mouth, so there’s no risk of choking. I’m also going to give you a few handouts on dealing with panic attacks.”
Dean nodded. “That’d be great doc.”
“The scars on his back. The best two things you can do are using some Vitamin C oil – I think I have a sample to give you before you leave – and to do some physical therapy stretches. I’ll grab a handout on that too – you’ll be able to do that with him, and it’ll probably be good for you too.”
Dean stared at her, lost again.
“Gentle exercise Dean. How long has it been since you stopped hunting?”
Dean shrugged. “A little over a year?”
“And I can assume that you haven’t replaced ‘running for your life’ with any other kind of fitness?”
He shook his head.
“So, you can help Sam stretch his back to get as much relief as we can provide and get you up and moving too.”
Dean scowled but didn’t disagree.
Dr. Lorna left the room to grab a few things and Dean looked over at Sam. He wasn’t talking to himself anymore, but his eyes weren’t tracking either.
“You there Sam?” he said softly. He got a string of Enochian in response.
Dr. Lorna opened the door quietly as Dean moved closer to Sam. “Hey Sammy,” he said as he moved his chair next to Sam’s chair. “You got Winnie Bear?” With their chairs side by side, he gently pressed his right thigh along side Sam’s left thigh, hoping to provide some grounding.
Looking at the door, he saw Dr. Lorna watching them closely, but when she saw Dean look at her, she gestured for him to continue what he was doing. Dean reached out carefully, well within Sam’s sight line, and began to rub his arm very gently. Sam said something in Enochian, and whimpered, but didn’t pull away. After another few breaths, Dean brought up his other arm to rub Sam’s back, but this was when the shit hit the fan. Sam jumped up roaring in Enochian, “GE!!!!” and then collapsed onto his rear end, quickly wedging himself between the exam table and the wall.
“Dammit Sam,” Dean said, getting down onto the floor in front of his brother.
Sam curled himself up as small as he could. It was cold – so cold. He shivered, and bit down another whimper. Lucifer was giving him a break – letting him hide. He would enjoy it while he could because he always had to pay for it later. When he heard the Devil start calling his name, he couldn’t help but let out a sob. The walls of his hiding place began to crush him, and he realized it had been a trick – a trap. Lucifer loved to trap him in return for having re-trapped him in the Cage.
“Sam, Sam, Sam,” said Lucifer. “What shall we do today? I’m in a … crushing mood today.” He smiled viciously.
Dean knelt in front of Sam, watching his eyes dart around the room, wide and unseeing. When Sam started to cry, he felt his heart break. Dr. Lorna still hadn’t moved from the door, and Dean wasn’t really thinking about her anymore. He carefully picked up Winnie Bear from the floor and placed him under Sam’s left hand – his right was still clenched in a tight fist. “Hey Sam, no big deal, we’re just here in the doctor’s office. You got a little spooked but that’s okay. We can just take it slow.” He kept talking as Sam’s hand began to familiar pattern of rolling and petting the soft fur of the stuffed animal.
Sam was sobbing quietly - always quietly or Lucifer would cut his vocal cords again – as he was gradually crushed by two giant blocks of ice. He shivered and bit back a scream. That was when he noticed a tiny bit of warmth under his left hand. It seared his hand at first, and he braced himself to have his environment shift from freezing to burning. It wouldn’t be the first time. Looking at his hand though he saw something he didn’t recognize. It was… soft. He began to touch the softness gently and heard a sigh. That was when he realized that Dean was next to him.
Both Dean and Dr. Lorna saw when Sam cam back. His eyes refocused as he stared at his brother. “Dean?” he asked, reaching out his right hand to touch Dean’s face.
“Yeah Sammy. It’s me.”
Dr. Lorna sat down on her stool and made some notes in her file. When she looked up, she saw that Sam was looking at her. “Hi Sam,” she said, smiling.
“Doctor?” he asked hoarsely.
“That’s right, and who’s this?”
Sam held up Winnie Bear. “Winnie Bear, helps,” he said.
Dr. Lorna kept writing. “How does he help?”
“Winnie Bear, soft. Before, nothing soft. Winnie Bear is After.” Dean could hear the capital letters Sam placed on Before and After.
“That’s great, I’m glad to see you using whatever helps.”
Dean shrugged awkwardly. “A kid gave it to him when we were in a diner. When … well, when Sam was having a hard time.”
Sam nodded. “Annabelle,” he said. “Kiss.” Dean huffed a laugh.
“Yeah you lady killer, she kissed you.”
“Kid not lady Dean.”
“Whatever Sam.” But Dean was grinning now, so Sam felt like everything was back on an even keel.
Dr. Lorna laughed too. “That sounds like a heck of a story,”
Sam’s eye line drifted again, but he didn’t show any sign of distress, so Dr. Lorna continued. “All right, I have some prescriptions for you, and a few different pamphlets. I also wanted to discuss this one with you Dean.”
Dean looked at the tri folded paper on top. It was titled Caring for a Family Member.
“It’s a course,” Dr. Lorna started, when she realized that Dean was already shaking his head. “It’s an online course.” Dean raised an eyebrow which she took as her cue to keep going. “Caring for someone is hard – not just emotionally but also physically. And Sam is not a small guy. You need to know the best ways to help Sam without hurting your back or fucking up your knees.”
A hand grabbed the pamphlet and Dr. Lorna was amused to see that it wasn’t Dean. “Yes Dean. Dean…. School.”
Dr. Lorna laughed gently. “Good job Sam. You hold him accountable, okay?”
Dean rolled his eyes, but he smiled too.
“And just for my records, was that a flashback Sam?” The mood in the room shifted instantly. Sam, who had been laser focused on the pamphlet a second ago let it drop to the ground and his eyes lost their focus again. “Sam?” she repeated gently.
“He won’t answer those kinds of questions,” Dean said very quietly. “He’s afraid he’ll tell us what he sees.”
“What he sees?”
Dean’s eyes got very dark, and he muttered, “Hell.”
Dr. Lorna got very still. If she was being honest with herself, despite what she knew about the supernatural world, she had still been shocked by the very little that Bobby had told her over the phone. Adding what Dean had said, and what she’d observed from Sam, she was basically boxing up her feelings so that she could freak out privately when she got home.
Up until the Winchester boys had arrived, she hadn’t known that Hell was a real place that you could go. Never mind coming back from it. With all that Trauma.
She shook it off – Hell or no Hell, she needed to care for her patients. “Basically, I’m just trying to figure out where we are. I’m going to have to consult with a colleague to see about dissociation episodes vs. seizures as I don’t think Sam would let us do much in the way of testing. And if we can’t do testing then I’m going to have to ask questions. I know that it’s hurtful and I’m sorry.”
Dean wiped his hand down his face, looking utterly exhausted. “Flashback, I’m pretty sure. He’ll try to speak Enochian after a seizure, but he doesn’t yell it at random.”
She wrote that in her notes, which gave both her and Dean a few seconds to compose themselves.
She checked her notes again, taking a deep breath. “So, we have the beginning of a treatment plan. Dean, I’m not going to lie to you – this isn’t going to be easy. For either of you. Bobby said that you were thinking about settling down somewhere on your own?”
Dean scratched the back of his neck awkwardly as Sam watched them intently. “Well, it’s an idea. We’re staying with Bobby right now, which isn’t ideal for a lot of reasons. We’ve started talking about maybe renting a house somewhere and me looking for work, but it’s all up in the air, especially with Sam.”
Lorna nodded again, writing a few quick notes. “I don’t see any reason why that wouldn’t work long term. We just need to make sure that you are prepared and have everything you need. So, let’s try what I’ve given you for a month, then you can come back and we’ll either tweak things to make them better, or I can give you a file with some background information to take with you to a GP somewhere else.”
Lorna smiled, “Well, I have a contact who is able to add a few Hunters who’ve had to retire to the VA rolls. Gets you some insurance.”
Sam whined and shrank back, which surprised Lorna. “What’s wrong Sam?”
“No lies. No lies. He won’t lie, no lies,”
“Well Sam, this isn’t really a lie. You were injured in a war; it just isn’t one the US government has been paying attention to. This isn’t your fault.”
Sam looked at her suspiciously, but his attention wandered again.
“Sorry Doc, he didn’t sleep much last night. Neither did I for that matter.”
She waved it off. “It’s better to see what you are really dealing with, you know?”
Dean nodded. Dr. Lorna stood up and Dean shook her hand before helping Sam to his feet. She reflected that Sam was probably not able to pull himself back to Earth for the moment.
“Thanks Doc,” Dean said, “see you soon. I guess.”
Dr. Lorna waved as they walked out, wondering if she’d actually ever see them again.