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It’s just skin, at first. The skin the Hellhounds ripped from Dean’s body when they tried to drag him down. Sam stitched him up the best he could, but there were still bits and pieces missing, and now he’s out on the street at midnight, telling himself it’s just skin, it’s just skin, it’s just skin. It’ll grow back, he tells himself. At least it will for someone who’s still regularly alive.
The old doctor made the risks more than clear to him. As long as Dean’s body is intact, he’ll never die, but immortality is, as the old man said, high maintenance. Lose too many pieces, and Dean’s body will start to fall apart, crumble to dust, send his soul to Hell. For now, it’s just some skin, but Sam isn’t taking any chances.
One swift blow to the back of the head, and his first victim is on the ground. Sam kneels down behind him and rolls up one leg of his jeans. He smells blood as he drags the tip of his knife in a straight, smooth line down the back of the man’s calf, and he bites the inside of his cheek until he tastes blood, too. The man’s out cold and doesn’t make a sound, but Sam still imagines him screaming. Three times in all, he does it. He doesn’t take more than an inch or two from anyone, and he bandages them up when he’s through. It makes him sick, but he does it. He has to. He’s seen his brother die too many times already, and after that, after what he saw tonight… Compared to that, this is nothing. It flashes through his head that they might never break the deal, that this could go on forever, that someday he could be out here looking to replace Dean’s hands or his eyes or his heart, but he puts it out of his head. It’ll never go that far, he tells himself. He’s just buying them time, that’s all. Just buying time.
When he gets back, Dean’s sprawled out on a hotel bed, asleep or passed out from fear and pain and exhaustion. It’s been one hell of a day, after all. But when Sam sits down on the bed next to him, he hears Dean struggling up into consciousness. “It’s okay,” he says. “It’s me.”
Dean looks up at him, dazed. Sam doesn’t know if he’s still seeing things, or if he’s just having a hard time believing this is real. “Where you been?” he asks.
“I got something for you,” Sam says, bracing himself for Dean’s reaction. He doesn’t want any of this. Sam had to beg and plead and threaten to go to Hell for him to even get Dean to accept the formula, and that was thinking they’d find a way around the deal a long time before they’d have to start replacing body parts. No way this can go over well. He pulls the plastic bag containing the skin out of his coat pocket, and he waits for Dean to scream, or hit him, or be sick.
He does go pretty green at the sight of the skin, fresh and bloody through the clear plastic. “Oh, Sam, you didn’t…”
“I had to,” Sam says, “You heard what he said, Dean, you could still die if you don’t take care of yourself.” Sam sees the look on his face, the maybe I should just die, then look, and after all he’s been through, he can’t stand it. He grabs Dean by the shoulders, shaking him, and he whispers, “I am not letting you go to Hell.”
Dean looks away from him. “I can’t, Sammy,” he says. “I… I can’t.” He pushes the bag away. “Just… get rid of it.”
“No,” Sam says. “I already took it.” He lowers his voice. “Those people are going to suffer now no matter what. And if you just throw this away, it’ll be for nothing.” And when that isn’t enough, “What would you do if it was me, Dean? If I was dying?”
It’s a low blow, and Dean’s face closes off. “You know,” he says.
“I do,” Sam says, and it’s awful, he knows it, but he pushes harder. “And you won’t let me do the same for you, so at least let me do this. I want to save you.” His voice breaks. “I have to.”
Dean hangs his head and stares through the floor like he’s wishing for Hell to swallow him up, but then he looks at Sam, and he sighs. “Okay,” he says, “but only because you already…” He can’t say it. “Never again, Sam,” he says as he strips off his shirt to reveal the raw, red wound in his chest. “Promise me you won’t-”
“I won’t.” He won’t say ‘I promise.’ He’ll do whatever it takes to keep Dean alive. “Hold still.”
Dean leans back against the headboard, his fists clenching, moaning a little as Sam pulls a needle though his battered flesh. When it’s done, he looks down at his new patchwork skin with disgust so clear on his face that it makes Sam heartsick. “We can’t keep doing this, Sammy,” he says. “You know that.”
“Yeah,” Sam says. “I know.”
But one month later, he’s out on the street again, thinking it’s just bone, it’s just bone, it’s just bone.