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at least that's what they tell me

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Sam Winchester is three years old and he knows exactly one word. It's "Dean," and he doesn't even say it right, because he can't quite make the 'n' connect in time. He understands people just fine, as well as any three-year-old can, but he communicates in looks and gestures and his brother's name. Dean is seven, and he doesn't think there's anything wrong with that. John is thirty-two, and he's pretty sure there is something wrong with that, but he doesn't have the time or the money to figure out what it is.

In Urbana, Illinois, John manages to get Sam into a government daycare while Dean is in school. They do a routine evaluation, and a very professional woman calls him and requests he come in for a meeting.

They say he's very bright, but behind developmentally. The social worker says maybe autism. The speech therapist says maybe apraxia. They strongly recommend further testing.

"There's no reason he can't catch up with his peers and go on to lead a perfectly normal life," says the man wearing a polo and a reassuring smile. "It will just take some time, and some patience."

John nods seriously. He takes the folder they offer. He says he'll look into it. He thanks them for their time.

Two days later, they're speeding across the state line, the packet of information and advice in the dumpster behind the Oasis Motel.

"We understand him, and he understands us," says John, eyes on the road, more to himself than to the seven-year-old in the back seat. "That's what matters."

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Sam is six years old and he can talk, more or less. He can make himself understood, anyway, eventually, even to strangers.

Dean helps. With, "Hey Sammy, betcha can't do this," and a tongue stretching up to his nose. With, "C'mon, sing along," and a frightful rendition of Bon Jovi. With, "Learned a new word today," and a mispronunciation he knows his smarty-pants little brother won't be able to resist correcting.

It's fine.

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Sam Winchester is twelve years old and he spends every other day in a darkened motel room with his head clutched in his hands, occasionally vomiting into the trashcan. The school is starting to ask questions, and John leaves for a hunt with gruff instructions to deal with it before he gets back.

In Fort Wayne, Michigan, Dean drags Sam to the free clinic down the street.

Migraines, they say. Chronic. Issues with tension or blood pressure or hormones. They might go away on their own, they say, but in the meantime, make an appointment and we'll get you on some medicine.

They don't have insurance, or time. Sam makes a distraction and Dean swipes some painkillers. Three days later John is back, nodding in approval as Sam runs lap after lap around the motel. His head pounds in time with his feet against the pavement. The world is too bright and too loud and too hot. He grits his teeth. He keeps going.

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Sam is thirteen years old and he can make it to school, most days. The painkillers take the edge off, and the sunglasses keep the light at bay, and the nausea is easy enough to avoid if he skips breakfast, maybe lunch too.

Dean helps. With, "Ugh, sunlight," and blinds pulled shut. With, "You know they say loud stuff will have your ears ringing when you're fifty," and the radio turned down. With, "It's fucking hot in here, huh?" and a towel soaked in cold water.

It's fine.

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Sam Winchester is sixteen years old and he winces with every step. John frowns suspiciously and tells him he's not getting out of training. Dean rolls his eyes and says he probably picked up some weird flu. And the pain shoots through his fingers and his ankles and his wrists and his feet, and it doesn't stop and it doesn't stop and it doesn't stop.

In Helena, Montana, there's another free clinic, another well-meaning doctor. Well, she says, there's no swelling, but we should run some tests to check for inflammation and ANA. Could be arthritis, could be undifferentiated connective tissue disease, could be psychosomatic. Have you been under a lot of stress lately?

They still don't have insurance, or time. He lifts the meds himself this time; anti-inflammatories.

He cleans the guns with aching fingers and bites his lip until it bleeds.

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Sam is seventeen years old and he's doing better, kind of. The flares come and go, but he's learning to ride them out. After all, it doesn't matter what he does, it hurts the same. Might as well get on with things.

Dean helps. With, "Headed my way, Princess?" and a ride home from school. With, "Give it a rest," and a pen pulled from shaking hands. With, "Dad, check it out," and a timely diversion.

It's fine.

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Sam Winchester is twenty years old and sometimes he wants to die. Sometimes it's because he feels bad and sometimes it's because he feels good and sometimes it's because he doesn't feel anything at all, and sometimes he doesn't even know why. His thoughts skitter and ooze through his brain, time skips and jumps, words shiver and change. He's ruled out hauntings and possession and everything else he can think of, besides the obvious.

In Palo Alto, California, there is a conveniently located counseling center right on campus. A middle-aged woman with kind eyes listens patiently, and nods, and asks questions, and writes things down.

Okay, she says, carefully. From what you're describing it could be several things. Some of those symptoms would be classified as psychotic, but don't let that scare you. It can come along with more severe episodes of a lot of mood or personality disorders. I'm going to set you up an appointment for next week, and give you a referral for a psychiatrist, if that's alright with you.

He has insurance, and time. Warily, he accepts.

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Sam is twenty-one years old and he doesn't want to die, usually. The meds don't do much, but routine keeps him steady and classes keep him focused and counseling keeps him talking.

Dean . . . isn't there.

Jess helps.

It's fine.

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Sam Winchester is twenty-two years old and he is heaving up bile and smoke and he is thinking it's my fault, it's my fault, it's my fault.

Sam Winchester is twenty-two years old and he hears himself say "We've got work to do" as if it's someone else, someone stronger, someone well.

Sam Winchester is twenty-two years old and he can talk and stand and walk and live but it hurts, it hurts, it hurts.

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Sam is twenty-three years old, and sometimes – often – he closes his eyes and puts a finger on his pulse and sits very very still. His heartbeat always feels just a bit too fast. He thinks maybe he was made wrong. He thinks maybe he was never meant to be human. He thinks maybe if he could just replace his blood with someone else's, someone better, he could be alright.

Sometimes, Dean asks him what's wrong.

Nothing, he replies.

It's fine, it's fine, it's fine.