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In the grand scheme of things, it shouldn’t matter how the kid died. The boys have a kidnapped reaper on their hands, plus Tessa showing up and trying to stick her hands into the whole mess.
But the moment he hears it was asthma, Dean is fighting the flashbacks, trying to focus on the case. On anything, besides the memories.
Five-year-old Sam fighting for breath out of nowhere; Dean screaming for John. Holding Sam’s hand, both of them clutching each other for dear life. Thanking a god he didn’t believe in even at nine, because he didn’t want to think about what would’ve happened if John had been on a hunt.
Eight-year-old Sam looking at Dean with panic written all over his face, because there’s suddenly no air to breathe. Dean grabbing the inhaler, which John had made Dean’s responsibility as soon as they got back from the hospital three years prior. Trying to take care of his brother even though he’s just a kid himself; trying to reassure Sam it will be okay even when he’s not sure it will.
Nine-year-old Sam, the year John insisted on a hunt in the desert even though the dust wreaked havoc on Sam’s lungs.
Ten-year-old Sam, eleven-year-old Sam, twelve-year-old Sam. Always that same look of panic, that look that screamed help me.
Eighteen-year-old Sam, the night he left for Stanford. Dean telling him, even through the blinding hurt and anger, to bring his inhaler. Sam, insisting that he hadn’t had an asthma attack for years and didn’t need it anymore. Dean, slipping it into his backpack when Sam turned away.
Twenty-two-year-old Sam, the night his life fell apart and he watched the woman he loved burn. The night he reunited with his brother for good, come what may. Dean, checking Sam’s bag to make sure he has the inhaler; double-checking the one he keeps in his own bag just in case. Sitting down at the table across from Sam’s bed, watching as his brother sleeps fitfully. Ready to wake him when the nightmares inevitably intrude.
Dean tries not to think about the many times Sam could’ve ended up like Cole. The many times Dean was the only one there to prevent this from being Sam’s fate. And his heart aches for this kid and his mom.
They get the job done, because they always do.
But for days that bleed into weeks, Dean can’t stop thinking about it. Especially when they get word of a quick case to wrap up. In the desert.
It goes against Dean’s gut, but it’s a break from reality and it’s sorely needed. Sam convinces him it’ll be fine, and Dean decides the odds are in their favor for once. It’s an angry spirit, the easiest of easy cases. Two nights, max. One, if they get lucky.
They’re eating dinner and researching the case when Sam starts to clear his throat. Once, twice, three times. Dean immediately locks eyes with him, but Sam tries to brush him off.
“Sam?” Dean asks anyways.
“I’m fine,” Sam tries to assure him. “It’s just a little dusty.”
“It’s….the dust,” his nine-year-old brother wheezes, clutching at his throat, gasping for breaths that won’t come.
“We should get out of here.” Shaking off the memory, Dean is already standing. He shoves the rest of his cheeseburger in his mouth and closes Sam’s laptop, ignoring his brother’s protests.
Sam glares at him, but the ends of his mouth are quirking up fondly. “I’ll make it through a quick salt and burn, Dean. Let me just go take a shower and that should help.”
“You better not lock that door,” Dean threatens as Sam walks off. Sam chuckles and flips Dean off over his shoulder, but there’s no click of the lock. The shower turns on, and Dean forces himself to take a breath. Sam has made it years without an issue, he should be fine. He’s almost convinced himself of that when he hears the first cough. Then the second.
“Sammy?” Dean calls, already moving to the bathroom door.
“I’m fine, Dean,” Sam calls back, but there’s a strain to his voice that wasn’t there before. Another cough, then silence for a few seconds. But then the coughing comes back, and Sam is taking more and more time to recover between fits.
Dean races across the room to his bag and rips the inhaler out. He can hear the water turn off, and Sam’s stumbling footsteps in the bathroom as he pulls on clothes. “Dean-“ his name is barely out of Sam’s mouth before Dean is pulling the door open. Sam practically collapses into Dean’s arms, and Dean has to brace himself to keep them both upright.
“Shit. I’ve got you, Sammy, it’s gonna be okay,” Dean murmurs, lowering Sam to the ground. “Cas? A little help here?” He calls into the ether. Nothing.
Sam’s still coughing, and he’s not getting a break in between anymore. His breathing is ragged, wheezing, and Dean can tell he’s hardly getting any air. He tries to say Dean’s name, but Dean shushes him as he pulls out the inhaler.
“Cas, now would be a really great time for some help!” Dean yells, trying to keep the panic out of his tone. He pushes Sam gently upright, trying to help him get as full a breath as possible. Sam leans his head back against the wall and drapes his arm over his eyes, fighting off a wave of dizziness.
“Here, Sam,” Dean says, placing the end of the inhaler in Sam’s mouth. Sam reaches up to do it himself, but his hands are shaking violently. Dean pushes them away as gently as he can and asks if he’s ready. At Sam’s nod, he dispenses the medication and prompts Sam to inhale. He starts counting down from ten, but Sam only makes it a few seconds before breaking into another coughing fit.
“Okay, you’re okay,” Dean murmurs. Sam looks up at him, his gaze all wild panic. His skin is growing pale and he’s grabbing at his chest, mouthing, can’t breathe. Heart sinking, Dean realizes the kid is starting to get shocky already. “Come on, one more hit.” He repeats the process, hoping Sam will get more medicine into his lungs this time. He does, by a slim margin, but it doesn’t seem to help much. Dean can see Sam’s eyes starting to glaze over, and he knows he’s losing him. This time, when Sam reaches up to grab at his chest, his nails are turning blue. Dean’s blood turns to ice.
New plan: get Sam to a hospital, fast. “We’re five minutes from the ER, Sam. You can do this.” Dean launches himself to his feet and tries to help Sam up. The kid is basically dead weight, but Dean drags him to the Impala anyways. Sam’s legs keep giving out on him, every few steps, making the walk feel torturously long. Dean tries not to focus on the rasping, desperate breaths right next to his ear, tries not to think about how he’ll remember that sound for the rest of his life. But they make it, and then Dean is flying down the road trying to make a five-minute drive in two.
“You’re okay, kiddo.” He’s not, but Dean has to say something, has to keep talking to dull the sound of Sam’s breathing getting quieter. Dean keeps stealing glances over at his brother, wondering if he’s imagining his skin getting paler every time he looks. Sam is in and out of consciousness now, head hanging limply.
“Cas!” Dean screams one more time, voice breaking when Sam doesn’t stir at the sound. He reaches out for Sam’s neck, feeling his skyrocketing pulse under cold, clammy skin.
“Yes, Dean?”
The sound of Cas’ voice from the backseat almost makes Dean swerve and crash the car. Instead, he slams on the brakes and pulls them haphazardly to the side of the road. He could kill or kiss this angel right about now. Maybe both.
“Help him. Save him,” Dean chokes out. “Please.”
“I can’t fully heal him. He will still be weak,” Cas cautions, glancing worriedly at Sam.
“He’s going to be dead if you don’t help him, Cas!” Dean can barely hear Sam breathing anymore. He knows they have minutes, maybe.
Without another word, Cas touches his fingers to Sam’s forehead. Sam startles into consciousness with a gasp, and starts coughing again. Dean’s heart nearly stops, but Sam is able to clear his throat and get the coughing under control this time. The kid still looks like shit, but Dean will take it.
“Dean?” Sam asks, voice raspy.
“We’re getting out of here.” Dean starts to shift the car into gear, but Cas stops him.
“I recommend we lay Sam down in the backseat. It will be easier for him to catch his breath and get some rest.”
Dean leaves the car in park and helps Cas do just that, laying Sam gently down in the back. Dean bunches up his flannel as a makeshift pillow and scans his brother’s face. Sam still looks out of it, eyes closed and breathing deeply. Without thinking, Dean takes Sam’s hand and glances at his fingernails. Pink. Thank god. Or his angel.
Sam’s eyes flutter open, confused. “What about our stuff?”
“I’ll come back later, or Cas will. For now, we’re getting you out of here.”
Dean makes sure Sam is settled before climbing back behind the wheel. He tries to ignore Cas watching him as he takes a deep, shaky breath and places the heels of his hands to his eyes. He allows himself only the briefest moment to compose himself, then they’re taking off to get Sam somewhere safe. “You keep an eye on him, you hear me?” He instructs Cas, who shifts his position to better watch Sam.
They drive for four hours straight, in silence. As much as music would help Dean’s nerves, he can’t risk not hearing something happen with Sam’s breathing. They stop for gas in a small town in the middle of nowhere, and Cas finally convinces Dean to stop and let them all get some rest. Since they’re safely out of the desert, Dean agrees. He books a motel room and he and Cas help get Sam up the stairs and settled into bed. Sam falls asleep almost immediately, still exhausted from the ordeal.
Dean takes his pulse once more before leaving his brother’s side. Then he takes a seat on the bed opposite Sam, watching the rise and fall of his chest. He double and triple checks the inhaler that’s in his pocket, ready at a moment’s notice. He’s maybe five feet away, still small enough of a gap that he could close it in an instant. But after the events of the last few hours, it feels like lightyears.
“You should get some rest, Dean,” Cas prompts.
Dean doesn’t bother to turn and face him, doesn’t move a muscle.
“If you’re just going to watch Sam breathe all night, I can do that for you. I don’t sleep, if you recall.”
Dean clenches his jaw, swallowing hard. “He’s my responsibility.”
Seeing the look of devastation on Dean’s face and sensing his barely-constrained emotion, Cas, for once, shuts up. He takes a seat on the bed next to Dean, and the pair settle in for a long night of watching Sam.