Submerged

She hates this time of year, Sara decides as she makes her way across the parking lot. The cold just won't go away, returning with a vengeance every time she thinks the worst part's over. And there's the way night shifts mess with her sense of time, too; after all this time, it still takes effort to successfully ignore that disturbing feeling of wait, what? she gets whenever she makes the mistake of glancing at a clock. Emerging from the antiseptic cocoon of low-buzzing neon that is the ER to get a cup of coffee and some fresh air feels like stumbling into a parallel universe.

She welcomes the feeling tonight more than usual. It's been slow, a trickle of the usual broken legs and chest pains and high fevers, and nothing else. It's not that she has high hopes for medical drama – it takes about one day in rotation to beat that particular misconception right out of you – but somehow she found herself sharing tonight's shift with Tim. It's just too much to deal with when there are no distractions.

So, coffee, again. From the machine by the drugstore across the street, again; because that means having to walk that distance and dealing with questions like why is it so damn cold, still, or is it really wise to keep drinking coffee that pretty much tastes like rust, instead of thinking about inexplicably imploding relationships. Yup, sounds like a solid deal.

She shivers as she makes her way to the machine, stopping a few steps behind some guy who is getting what has to be a desperately needed cup of steaming, dark liquid; he is wearing just jeans and a T-shirt, both faded and threadbare. He can't possibly be able to keep warm in those, but it's really none of her business. She waits.

And waits.

And waits.

The man standing in front of the machine shows no interest in moving, and she bristles in annoyance as she notes that he is holding the cup of coffee up to his lips, having apparently decided to drink it on the spot rather than take it and walk away like a decent human being might do when someone is waiting in line behind them.

People, she thinks, and clears her throat loudly. I am really not up for this tonight.

No response. Either the guy doesn't care, or he hasn't recognized the sound she made as the universal sign for let's move this along, shall we?

She sighs.

"Excuse me?"

Still nothing.

"Excuse me? Are you done with that? I'd kind of like to get a cup, too."

He's not moving, nor is he turning around at the sound of her voice. Maybe he can't hear me, she thinks suddenly, feeling stupid for not having considered the possibility sooner. She takes a couple of steps to enter his field of vision before she tries again.

"Um, sir, are you done with - - "

This time she doesn't finish the sentence, because she can see his face.

The man – mid to late twenties, sandy, short hair, dark circles under his eyes – is clearly unaware of her presence. And he is not drinking his coffee, as she originally assumed; the cup is hovering near his mouth, so close that the steam has to bother him, but he is holding it still without taking another sip or bringing it down, his fingers too white around the rim. Nothing happens as he stands there with the cup in his hand like he's forgotten how to move, mouth slightly open, eyes unfocused and staring at nothing.

Sara feels the beginning of a knot forming in her stomach.

"Hey, are you - can you hear me?"

It strikes her again how underdressed he is for this weather; his exposed arms (no scars, no track marks, the diagnostician in her notes) are covered in goosebumps, and his fingernails are practically purple, but he doesn't seem to actually feel the cold. In fact, she realizes with alarm, he's not even shivering. His breathing is slow and even, his face expressionless; if his body is in distress, he doesn't seem to know it.

She carefully – carefully – reaches out and places a hand on the man's bare forearm to try and get his attention. The skin is colder than she expected.

"Hey. Hey."

That doesn't seem to register, either; he is still staring into the middle distance vacantly, jaw slack, long eyelashes damp by now from the steam rising from the cup he is still holding in a hand that seems frozen solid.

What do I do now? Sara feels for the cell phone in her pocket, thinks of who is likely to pick up back in the ER, decides to try again.

"Can you look at me? Sir? Can you try to tell me what's wrong? It's okay, I'm a doctor." She feels like a moron saying that, for some reason, but sometimes it puts people at ease.

The man blinks slowly, more reflex than a reaction; his gaze doesn't focus. The dark circles under his eyes seem almost blue in this light. Insomnia and pain have more than one way of bruising you after a while, she remembers that all too well; kind of wishes she didn't. She wonders if lost sleep has anything to do with whatever is going on here.

It suddenly occurs to her that, cold as he might be, the guy is probably burning his hand holding the cup of steaming hot coffee like that, without even a cardboard sleeve. Great.

"I'm going to take that coffee from you, okay? Just for a moment."

There is no resistance as she gently extricates the cup from his grip, then brings his hand down to his side. He is eerily pliant, and she'd like to think he's being cooperative, that this is a good sign, but she can tell it's not; it feels like everything about this man is working on autopilot, vital systems performing but no one at the helms. If she steered him into the middle of the highway he would probably follow. And then stand there until he got hit by oncoming traffic.

She suppresses a shudder and tries one more time to rouse the man, pressing a careful hand to his cold cheek, asking for his name and telling him hers. It doesn't work, of course it doesn't. And now he is swaying a little, not in any intentional way – again, she'd consider that progress - but as if whatever internal mechanism was helping him keep his balance is failing. The faraway stare only seems to grow more vacant, and she gets the uneasy feeling that this has something to do with her touch, like any attempt to break into his bubble only makes him shut down further. What could have made him disconnect like that?

This is not something that can be resolved in the middle of the street, she thinks with a sigh, and this time she reaches for her cell and dials.
Less than five minutes later, Tim is shining a penlight into the man's eyes and snapping his fingers next to his ear. He brought Sara's overcoat with him, which she has to begrudgingly admit was a nice gesture; she wraps it around the unresponsive man's shoulders instead. Whether he is feeling the cold or not, the guy is going to catch pneumonia standing out here in that ridiculous T-shirt.

Tim seems to share the sentiment.

"We need to move. Get him inside, sort this out."

She nods, waits for Tim to angle the checkout wheelchair and gently presses down on the tall man's shoulders. This time she encounters some difficulty, but she suspects it's only because by now he's been standing motionless so long that his leg muscles are rigid, offering their own resistance. Tim finally manages to get behind him long enough to awkwardly bend his knees and bring him down to a sitting position. The fixed stare doesn't move an inch.

"Man, he's really out, isn't he?" Tim isn't necessarily a prime candidate for Empathetic Resident of the Year Award, but he frowns as he looks down at the motionless man, genuinely concerned. Maybe because the guy isn't really a patient, not yet anyway. "Here we go. We're just going to take a little trip, okay?"

The man's head lolls to the side as they wheel him into the ER, empty green eyes – Sara sees their color now that there's decent lighting – staring past rows of plastic chairs and tired, angry, worried faces. If he's taking any of it in, he isn't showing it, and Sara suddenly wishes she had something else to do when two of the orderlies make their way over to move him to a waiting bed. She is used to patients coming in crying, terrified, enraged, in pain; human misery, at least the physical kind, is a frequency she can tolerate (if not tune out) better now than she did when she first started working here. But this is different; vulnerability looks wrong on this man, like he has a distaste for it and might find it humiliating. As he is lowered onto the mattress, head rolling limply on Jake's arm, open eyes unseeing, she wonders if some part of him is awake for all of this; if maybe he's been in there the whole time, trying to claw his way back to the surface, trapped but present.

She doesn't think so.

"Watch it, will you?" Tim snaps as the back of the man's head bumps painfully against the rail. Sara can't help but hiss in his stead.

Jake raises his hand. "Sorry, doc. He got away from me, sorry." He looks down at the patient's face. "Don't think he minds, though," he says, squinting at the man's empty eyes. "What's up with this guy?"

"He's catatonic. At least I think he is. Pupils are reactive to light, he's breathing fine, heartbeat's good. It's clearly taking too long to be an absence seizure." Tim sighs. "It's really too soon to tell, but as far as intuition goes, I'd put my money on something… well, emotional."

Jake seems mildly interested. "Like what?"

Tim rubs his forehead grimly. "Just venturing a guess here, but I've seen post-traumatic patients do this when I did my psych rotation. Some of them just… switch off, out of the blue. Not that common, but it does happen. With enough severe stress, sometimes all it takes is one powerful trigger to make the mind shut down without warning, for a while at least. Then they come back at their own pace."

Sara raises an eyebrow.

"You mean he saw something out by that drugstore that made him… slip under like that? He was just getting coffee, Tim, there wasn't even anyone else there. I can't imagine - - "

Tim shakes his head. "Could be anything, Sara. That's my point. It doesn't take actually seeing something disturbing. Virtually anything can be a trigger; it can be a sound, a smell. I remember one patient who reacted a little like this to a song she remembered playing on the radio before her car accident. Some army vets can't stand the smell of anything burning, you can imagine why. Who knows what this guy's story is, or what his triggers are."

Jake shrugs as he pushes the wheelchair out of the room. "The mind can pull some seriously weird shit sometimes. Let me know what happens."

As he leaves, they both turn to look at the man lying motionlessly on the bed, his vacant eyes now staring up at the ceiling.

Sara tries to sound anything but frustrated, fails miserably.

"What exactly do we do with him?"

Tim massages the back of his neck in a way that reads I'd seriously rather be doing anything other than this. She knows that has more to do with her presence than with their patient, and finds that she is too tired to take offense. "I'm going to call psych and get someone down here. You know what, actually, I'll just go up there, it might help speed things up. They're swamped tonight. Will you check his vitals, maybe see if he has any ID on him?"

It's actually a relief. "Yeah. Sure."

He doesn't look at her, leafing instead through the empty pages of John Doe's chart.

"Okay then." There's an awkward silence. "I'll see you later."

Nothing about catching a ride with her when their shift is over, like he usually does. Her gratefulness makes her feel hollow.

"Okay."

Tim is out of the room for a good two-three minutes before Sara turns her attention back to the catatonic man, mentally kicking herself. He is draped over the thin hospital mattress the way the orderlies left him, one arm folded against the sheet and the other at his side; the palm of his open hand catches her eye. Four small, red crescents tell her more than enough about stress; his hands weren't balled into fists when she saw him by the coffee machine, but they must have been earlier. They were recently clenched hard enough for those short, square fingernails to break the skin.

She takes his hand in hers, uncurls the strong fingers that stay slack in her grip. The wounds aren't serious, they can deal with them later. The pulse of the artery flutters under her thumb, a solitary sign of life in a body seemingly abandoned by its owner, and she suddenly feels a lump in her throat. Ridiculous, she thinks, you are being ridiculous. You don't even know this man. You are most definitely not crying over a patient in the ER like it's your first week.

She puts the lax hand down, pulls a stool up to the bed. "Hey," she says, lowering the rail, "I don't know if you can hear me, but I need to check you over, just to make sure you're not injured. I'll try to be quick. Okay?"

No response.

Sara leans down, gently turns the man's face towards the light, thumbs each green eye open wider to check his pupil reaction again. Normal, as is his breathing – in fact, it's a little sluggish, like his pulse. She thinks about deep sea divers slowing down their own metabolism, preserving oxygen as they go under, and wonders about the extent of darkness and solitude this man is floating in.

There are no scars on him, no sign of previous injury or a head wound that might account for his current condition, and no fever. Not that she was expecting an easy answer. Something tells her that Tim's hunch was accurate; that whatever chased this man so far into himself that he can't – or won't – come back out has nothing to do with his physical health.

She studies her patient's pale face more closely. He is young, yes, but there is a kind of old pain ghosting over his features in a way that even his disturbing blankness can't erase completely. It's always been an unwelcome gift, noticing too much. She is alarmingly accurate at recognizing a life that's been shattered and glued together unskillfully too many times. It's more like a heightened sense of smell than a spiritual thing - pain just itches, it buzzes, tripping all her wires like a nail glowing in a fuzzy X-ray. And this guy – if she can sense so much turmoil when he's out, it might explain why he can't stand being fully aware all the time.

But that kind of thinking is not going to get her anywhere.

Sara doesn't bother with announcing her actions before she leans back down to check the back pockets of the unresponsive man's jeans and – thankfully – retrieves a cell phone. By now it's obviously pointless. Doesn't make her feel any less shitty about it, she notes bitterly as she starts scrolling for contacts.

It must be a new cell, because all she finds are two names. The list of outgoing calls reads: Sammy Sammy Sammy Sammy Bobby Sammy Sammy. Okay then, Sammy it is. There are a few increasingly angry text messages from the guy as well, which is how she learns her patient's name.

She dials, speaks to a frantic-sounding young man who sounds like he's been expecting something far worse than what she has to tell him. He fills in the blanks while (if the background noises are any indication) dressing and stumbling out the door: Dean is his big brother, yes, he has recently returned from a war zone, Sam doesn't know all the details but it was very very bad; he thinks his brother might be suffering from PTSD, but he has never agreed to be properly checked out so no diagnosis. Could she stay by Dean's side until he gets there? Could she maybe try not to move him or touch him too much though, because he might not know - -

Sam's voice is cut off so suddenly that, for a few seconds, Sara thinks the connection was lost, but then he talks again, and she realizes he choked on the words.

"He might be feeling some of what's going on around him, okay? And he might think he's still – it could make it worse for him. Not that I don't appreciate - -"

Sara interrupts him."Has he had other episodes like this one before? Do you know?"

Sam sighs. "It gets bad, he can get confused about where he is or who - - well, it gets bad. But I've never seen him disconnect completely like you say he did. I'm just glad he's alive, honestly. He hasn't been answering his phone since last night." There's a pause like he needs a second to collect himself.

"I'm on my way, okay? Please keep an eye on him, he's - - he's all I – will you watch him in case he comes to before I get there?"

Sara closes her eyes. "Yes. Of course."

It's a promise she can't make, not in an ER or any other part of a working city hospital, but there is no point in having the guy crash his car on the way over because he's too frantic to watch the road.

"He won't be alone. When you get here, just tell the guy at the front desk that Sara called about your brother. He'll let you through."

She hangs up and sits back down by the bed. Squeezes a limp hand, lets go when she remembers the wounds. "Hey, Dean? Your brother is coming. I spoke to Sam just now. He was so glad to hear you're safe, and he's on his way over. How about that?"

The slow rise and fall of Dean's chest doesn't change; he continues to stare at the ceiling, gaze as blank as ever.

"You're safe," Sara repeats, thinking about what Sam (Sammy?) said. War zone. Well, that'll do it. "You are in a hospital, Dean, in the U.S., and you're safe. I promise you no one is going to get you in here. Can you try to come back? I'm sure Sam will be relieved when he gets here and sees that you're doing better. Come on, Dean."

Nothing. Just a glassy-eyed stare that goes right through her. It's like she's talking to an empty bed. No one is there to hear her, she can tell; she hopes for Sam's sake that he has some serious influence over his brother, because whatever panic room in his mind Dean has barricaded himself in, it doesn't look like he's coming out.

There is no sign of Tim, or anyone from psych, while she waits; when Jake sticks his head in to check how things are going, she finds herself hoping that he won't ask. He doesn't. She wonders if there is anyone in the ER who isn't caught up on her and Tim's little drama, and decides that she doesn't want to know.

Sam turns out to be one particularly large, worried little brother when he bursts through the ER doors only twenty-five minutes later. He looks like he ran a good portion of the way, sweaty and flushed despite the cold, broad chest heaving under a plaid shirt as worn as his brother's T. He brought what looks like Dean's jacket with him, and is clutching it nervously in a way that makes Sara suspect he hasn't put it down much in the last 24 hours.

She leads him to the bed in the corner and hangs back, watching silently as he approaches his brother, eyes widening as he studies Dean's unchanging face.

"Hey," Sam says softly. His hand hovers above Dean's for a few seconds before he pulls it away. "Dean, I'm here. Can you hear me? Come on, man. I know you're in there. "

When there's no response, he seems to fold into himself. For one horrifying, illogical moment Sara thinks he is about to succumb to the same thing that put his brother in that bed, that she is about to have two broken, unresponsive men on her hands tonight. But he only takes a deep, steadying breath - of course he does, he did just run who knows how many blocks. Calm down, she thinks, and go talk to him before he gets too overwhelmed to help.

She makes her way to them quietly, watches Sam as he shakes his head, eyes closed.

"You okay? We can step outside if you need a minute."

He forces a pale version of what must have been a lovely smile once.

"I'm fine, thank you. I'd rather stay with my brother."

She nods.

"How long has he been… having trouble? Like this?"

Sam rubs his palms together like he's cold. "Since he got back. A while. I don't even know what will set him off sometimes. He's not big on sudden noises, but usually he'll just be jumpy when that happens."

His eyes avoid hers. "I know anything that has to do with blood is a problem. It never used to be, before. But he - - he underwent some - - there was torture. Where he was."

The look on his face is so pained it's hard to look at. Sorrow closes itself around Sara's heart like a fist.

"Anyway, that's where we are. We pretty much stopped everything we were doing before, and we're trying to get him more stable, I guess. Not really succeeding, so far."

She opens her mouth to say something comforting and utterly useless, then closes it because she thinks about Dean freezing with a cup of coffee at his lips, unable to lower it. Cheap coffee, with that lingering metallic aftertaste.

Anything that has to do with blood is a problem.

She suddenly feels nauseous.

The room is quiet for a while after that; she doesn't think Sam notices, or cares, when she slips out. He is too busy talking, telling Dean that it's okay, he's okay, to please, please come back. He doesn't tell him where he is like Sara did, or that he's in a safe place. Perhaps he doesn't think he'll believe him. That's the only reason she can conceive of.

Sara spends the next hour or so dealing with everything else the night shift has to offer, happy to do anything that involves patients who actually know she's there. Broken legs and chest pains and high fevers are fine by her, and she almost manages to forget the two men at the far end of the ER after a while. Almost.

Sam is sitting by Dean's bed when she comes to check on him, bent in what has to be a painful angle on chair that's too small for his height. His head is resting on Dean's chest, messy brown hair hiding half his face, but she can tell he's nodding off, probably out of sheer exhaustion.

Dean, however, is awake. Or at least getting there. The blank expression that made his face so hard to look at is gone, replaced by what seems like distant confusion.

"S'mmy," he says, hoarse as if he's been crying for a long time, or screaming. He coughs. "Sam."

Sam's head snaps up. "Dean? Dean, hey, hey. Talk to me. You okay?"

Dean nods, barely; he looks like someone trying to shake off the aftereffects of anesthesia.

"What - - - what - -"

"You kind of went away for a while. I don't know exactly what happened, but they found you in the street and brought you here. You're okay now, you're good. Take it easy."

Dean shakes his head, blinks furiously like he's trying to see through a fog. "I don't, I was, I - - I went out, and then there was this - - there was - - "

His eyes grow dull, gaze trailing upward again. Sam grabs his chin, voice low and authoritative as he speaks. He's done this before.
"Dean, stay with me."

Sara watches, fascinated, as his body language changes, and wonders who it is he is channeling.

"Hey. Hey! Look at me. Dean, eyes on me. Dean!"

With great effort, Dean tears his gaze away from the ceiling and turns it to his brother.

"Huh?"

Sam squeezes his shoulder. "I need you to focus. Can you do that or me?"

"Y- - yeah. Uh." Dean looks down and appears dismayed.

"S'mmy, ma boots," he slurs. "They took - -"

"I got your boots right here, you jerk. You nearly gave me a heart attack, but I'm glad to see you haven't lost track of what really matters."

There is no heat behind the words; Sam's hand remains on Dean's shoulder, his eyes focused on his brother's face. There's a hint of a smile tugging at the corner of his lips.

"Man, you are loopy when you get like this. Wish I had my phone with me, I'd have some great video to show you tomorrow, when you deny this ever happened."

"Mmmm - hmmm," says Dean helpfully, ignoring the cell phone sticking prominently out of his brother's shirt pocket.

Sam streches, groans. "Fucking hospital chairs. I should make you switch places with me for once. See how you like it. Wouldn't mind an hour or two on a nice, soft bed."

Dean shrugs.

Sam's face loses all traces of humor as he looks down the hall, just missing Sara. "They'll be bringing in someone from psych to talk to you, probably. Because of how you were when you - - when you got here."

Dean's face hardens. He looks around him, surveying the room.

Sam hesitates before he continues.

"You - - you wanna wait? Maybe talk to the guy? See what they—"

Dean cuts him off. "We need to go." He seems wide awake now, eyes sharp, fine lines that were softened earlier by lack of awareness deepening. He looks like a different man, Sara thinks. There is no relief in seeing him alert.

Sam doesn't argue, just takes the jacket he brought with him off the chair and hands it to his brother. Sara sighs, hating what she knows has to come next. She has to walk over, demand that they stay, explain to Dean that this will only happen again, that there is no use - -

There's a sound like something feathered is moving behind her, and she turns around, sick with sudden fear.

When asked about it later, Sara tells the chief resident that she never saw John Doe leave. She sees no point in telling the truth. And she has no idea, just as she didn't at the time, why it never occurred to her to try and stop the three men on their way out. Why all she did was watch them through the window as they walked away, impossibly long shadows stretching behind two of them on the pavement in the early morning light.

She never gets coffee from the machine by the drugstore after that, although she can't remember why.