A/N: I will apologize for yet another incredibly long delay in posting a fresh chapter. Let's just say that I was seriously afraid that this chapter just didn't want to be...and couldn't be...written. I have struggled and struggled to put down something that I could be proud of and that reflected the quality of my 'pre-hiatus' work. I'm actually not certain that I've even come close and I'm still a bit ashamed/embarrassed/upset to be posting a chapter that I'm not really happy with. Unfortunately, I've worked and worked and re-worked this chapter in a hundred different directions and, well, this was the best mutt in the pound. Hoping I'll be able to get my mojo back in subsequent chapters.

In this chapter, I also make a reference to a US TV show called 'American Pickers'. For those not familiar, it's basically about two guys who travel the country scavenging through old barns, junkyards, flea markets or any other spot that looks interesting for rare toys, signs, vehicles, or other items forgotten by history. During their search, the viewer is treated to all sorts of trivia about the various items. After haggling over the price, they take their finds, get them restored and then offer them for sale at much higher prices than they paid for them.

From the previous chapter:

The room fell silent as each person absorbed the information that they had been provided and considered just how heavily the deck was stacked against Sam. Just one wrong turn of the cards and Sam's life could end or, at the very least, be changed forever. This is one time, Cameron thought, that a little favor from Lady Luck and a lot of prayer could come in handy.

"...Don't know what you got till it's gone
Don't know what it is I did so wrong
Now I know what I got
It's just this song
And it ain't easy to get back
Takes so long..."

- excerpt "Don't Know What You Got (Till It's Gone), Cinderella

Atrox

Chapter 20: Don't Know What You Got (Till It's Gone)

"Ok, gang," Dr. Jessup crowed to gain his 'staff's' attention. "We're doin' pretty good at gettin' IV fluids into him now. We're gonna do another liter of the chilled fluid as quickly as it'll run in. After that one, we'll slow the rate to roughly a half-liter every hour for an additional liter and then we'll back it off to aim somewhere around a quarter-liter an hour."

Normally, Jessup would be ordering everything in "cc's per hour". But, without an IV pump to control it or proper IV tubing with a drip chamber where Jessup could count drops the old-fashioned way, he had to work in larger units and eyeball flow rates by how quickly their one-liter bag was emptying. It was somewhat crude but, so far, had proven to be effective.

Still, getting those fluids into Sam, and doing it correctly, was something that was so crucial that he thought an additional review with everyone was a good idea. "We allneed to be keepin' a good eye on this IV. Runnin' too slow is just as bad as runnin' too fast. We can't afford to be lettin' it clot off. But, if we let those fluids infuse too fast, we could overwhelm his circulatory system. So, if you even think somethin's wrong, say somethin'. Also, this jugular access is just too dangerous to leave any longer than absolutely necessary so, as soon as he's hydrated well enough that I can get a good line in an arm or leg vein, this access is comin' out. Until that time," he added more gravely, "there is to be someone stationed here at Sam's head at all times. No exceptions. We can rotate out every hour so we stay alert. Debra? Do you think you can coordinate that for me?"

"I'll do my best, Gene."

"I'm certain you will," the elderly physician assured. "I'm suspendin' the chilled saline down the NG now that we've got the line. We're bumpin' his sodium levels up with the IV but too much stomach lavage and we could start strippin' him of other electrolytes he just can't spare. For now, the NG stays in, though. God forbid somethin' happens to this line, that NG may be the only way we have to get chilled fluids into him and control his temp."

"Speakin' of his temp...Cam, I want you to be my 'temp man'," Jessup commanded. "I want you to keep a steady stream of damp sheets goin' and every half-hour I want an updated temp. While the jugular line is in place, I want as few things as possible goin' on that might set him off, so we're gonna switch from rectal temps to axillary….uh, under the arm….temps instead. We'll just have to add a degree to whatever your thermometer says to get an accurate reading."

"You can count on me," Cameron assured the medic.

Jessup stood up from the seat at Sam's head and noted that Dean quickly slipped into it like someone playing musical chairs when the music suddenly stops. He was pleased with how seriously his commandment that someone be at Sam's head was being taken. Then again, with Dean, he really wasn't surprised by that.

"It's been awhile since I checked that wound. Don't want somethin' gettin' outta hand because we're not payin' attention, so I'm gonna take another look at it," Jessup stated. "And I'd really like Bobby's help with the herbs he's been using."

"You got it, Doc."

"And I need you to keep a steady supply of that saline comin'," Jessup asserted as he peered over at Dennis. "Chilled, until I say otherwise."

"I've got two liters chilling in the 'frig now," Dennis informed his long-time friend. "Before I brought your coffee up, I pulled another two liters off the burner to cool before going into the 'frig and I can boil up another two liters now. But that'll only take about fifteen or twenty minutes...tops. What do you want me to do then?"

"We can't let this bag run dry so, by then, I'll need you to bring some of the chilled solution up with you and help me add it to this bag. After that, you can step into one of the rotations."

"One last thing," Jessup continued as Dennis started heading for the door. "Until that jugular line is gone, there will be no fewer than two attendants in this room. If Sam starts comin' around and gets combative, one person isn't gonna be able to deal with him and safeguard that line. Everybody got it?"

Everyone nodded their understanding and Jessup nodded in return. He was pleased with how his "troops" were whipping into shape. "Good. Let's get started."

Debra took a quick look at her wristwatch and noted the time. "Dean, I'll relieve you in an hour. Dennis can relieve me. By that time, Bobby should be free and can take over from Dennis and then Doc. When someone's not 'on duty' they can either assist Doc Jessup with whatever he needs, give Cam a hand with the damp sheeting or catch a quick nap to 'recharge their batteries'."

Jessup shook his head approvingly. He was really impressed with Debra. She had started out meek, hesitant and fearful but somewhere along the way the crucible of their situation had forged a confident woman with a 'damn the torpedoes, full steam ahead' attitude. By the time this is all over, Jessup mused silently, I'm gonna have one helluva good charge nurse on my hands.

ooo000ooo

Bobby and Dr. Jessup were huddled over the wound that still marred the landscape of Sam's right palm and forearm. This was only the second time that the medical practitioner had seen the wound; an utter devastation of the soft tissues that left him in awe of the powerfully destructive effects of rattlesnake venom.

Jessup sat back and looked at the pale, young man that lay before him. Dean was still stationed at Sam's head and Cam had quickly learned how to work around the physician and Bobby as he skillfully tucked the damp sheet over the boy's body without disturbing the pair's ministrations. Jessup took a deep breath and blew it out.

God must think yer someone special, kid, 'cause He's had his angels workin' overtime for you, Jessup thought.

"Everything ok, Doc," Bobby questioned, his eyes flashing over their patient's motionless form before landing on the boy's older brother. He was really starting to wonder exactly which Winchester boy took the prize for looking the most wan and sickly.

Jessup took another deep, cleansing breath and rolled his head a few times before flexing his shoulders forward and back. "Just needed a little stretch, is all." He tilted his head side to side a few more times for good measure and returned to his exploration of the wound. "And you say you used cayenne as an anesthetic?"

"Didn't have much choice," Bobby explained. "He wasn't much for goin' back to any hospitals after what he went through with that surgeon."

"I don't doubt it," Jessup commiserated as he probed lightly around one of the thick retention sutures. The country doctor had removed a few at each end when he had checked it the first time, but several of the stark criss-crosses still spanned the wound. Normally, the skin edges of sutured wounds touched and allowed the efficient growth of healthy, new cells to quickly heal the wound closed. But, in Sam's case, the destruction of the tissues had left little to work with and a yawning chasm still remained between the wound edges despite it having been sutured as snugly as anyone dared. Jessup had to admit to himself that for all that Sam's surgical specialist had lacked in tact and personality...and apparently common human decency, from what Bobby had told him...his work proved him to be a first-rate surgeon. "These heavy sutures have been in place for quite some time already and it's a bit redder around 'em than I'd like," Jessup stated as he pushed his Q-tip around the bases of a few of them again. "But I'm not findin' any pus or seein' any sloughing of the tissues. So without any real evidence of an out-of-control infection, I think it's just too risky to pull anymore right now. Removin' the support of the sutures would add more stress...more pull...on the little bit'a healin' he's done and that could end in the whole darn thing bustin' wide open again. We're just gonna have to keep watchin' this thing like a hawk to make sure we stay ahead of anythin' that starts brewin'."

He pointed a knobby finger at a small canning jar that contained a cloudy, yellowish liquid. Usually, the glass jars, cut with fancy diamond shapes that almost made it appear quilted, were filled with various flavors of Dennis' homemade fruit preserves. This one was filled approximately half full with apple cider vinegar and pulverized mustard seeds. "Lemme have a bit more of that, will ya?"

Bobby handed over the jar with the odorous concoction in it to the physician who, then, cradled it in one hand while dipping a clean cotton swab in the liquid with the other. "Guess it was a good thing Sam was passed out at the time," Jessup asserted as he gently applied the solution to the wound with the Q-tip. " 'Cause I can imagine cayenne on a raw wound, 'specially one as big as this, probably ain't all that pleasant."

"He wasn't out," Bobby corrected. "Or, at least he wasn't until the burnin' from all that cayenne sent him there."

The platinum-haired physician shook his head in wonderment. "Your nephew's one tough kid, Bobby. But, I probably don't have to tell you that, do I?"

Now it was Bobby's turn to stop cleansing the wound and sit back. He looked with tenderness at Sam and at Dean. They both had been through so much… and not just with the snakebite and all that had gone on since. Their whole lives had been rough; losing their mother at such young ages, then watching a loving, affectionate father succumb to an all-consuming obsession that turned him into a cold, unfeeling soldier on a relentless quest. With no say of their own, their father's crusade eventually drew the boys into the lonely and often physically and emotionally painful life of the hunter. The physical injuries were bad enough, and there certainly was enough of them, but, as far as Bobby was concerned, it was the emotional wounds that had produced the ugliest scars on the young pair…and they were the hardest for Bobby to witness.

Bobby broke away from his thoughts and shot the physician a weak, almost embarrassed, smile as though he thought the medic might be able to tell his thoughts had become as sappy as a schoolgirl's. He turned back to his ministrations of Sam's injured arm and busied himself with inspecting it closely. "They're both tougher 'n you know."

Jessup stopped what he was doing and looked at the grizzled junk man. It was as obvious as the nose on his face that Bobby had a deep affection and a protective streak a mile wide...five miles wide...for both boys. Even though he'd spoken just a few words, Jessup could sense Bobby's sentimentality and, thinking it was an emotion the rough-around-the-edges man probably didn't deal with very often, he let him off the hook by changing the subject.

"How was it you came to know 'bout the cayenne? As a numbin' agent, I mean."

"Huntin' accident in Louisiana," Bobby confessed. He knew it was the God's honest truth and, boy, wasn't that something a hunter rarely ever dealt in, but he knew he was safe in saying it because those outside the supernatural community would assume he meant that they had been hunting wild game. "Back in the middle of nowhere; didn't have nothin' else, so we made do with what we had. Speakin' of which, what's up with this vinegar and mustard stuff?"

"Ancient Chinese secret," the centenarian quipped. Jessup knew that Bobby was old enough to recall the old commercial where the Asian laundromat owners claimed an 'ancient Chinese secret' made their clothes so white when, in reality, they were using the modern laundry powder that the commercial was advertising. Bobby chuckled lightly at the long-forgotten joke before Jessup added, "Nah...not really. My Gran'ma used to use that a lot; long before antibiotics came along. Always seemed to work real good and I couldn't argue with success, so I incorporated it in my practice years ago. Real cheap, too. Lots cheaper than some of these new-fangled medicines. Folks 'round here don't have a lot of money, 'specially on the reservations, so they appreciate when I can keep costs down. And, you know, I just read a study a couple'a months ago that oroved Gran'ma was right - that combination's a mighty fine antibacterial."

"There. I think that's good," Jessup asserted, sitting back from the wound once more. "Let's get that herbal mix'a yours on there, get it covered with some clean towels and secure 'em in place as best we can with some tape."

ooo000ooo

Cameron Gilchrist III sat hunched at Sam's beside, staring at his hands while he absently picked at a rough edge that had formed on his left thumbnail. "What's it like?"

Dean had long ago finished his one-hour stint as jugular IV bodyguard, as had Debra and Dennis, too. With each changing of the guard, Dean had been encouraged to take a break and grab some shut-eye but he'd stubbornly refused; parking himself, instead, at Sam's other side and assisting Gilchrist with the damp sheets they were still applying to the boy's overheated body. "What's what like," Dean questioned as he reached up, smoothed a wrinkled area of the sheet and checked to make certain the fan was aimed correctly to increase the evaporative cooling effect of the soggy material.

Cameron looked up from his fidgeting and Dean saw a real sadness in the kid's eyes. It lent a strange vulnerability to the square jaw and rugged good looks of the man that Dean hadn't seen in him before. In that instant, the athletic adult had been transformed into a wounded child.

"What's it like…..having a brother?…..O-one that loves you, I mean." Cameron looked quickly away; immediately embarrassed that he'd gone all sappy about his family once again. Sitting there in the heavy silence of the room, the mechanical regularity of his sheet and temp routine adding a layer of monotony and watching the unending and, for Cameron, unfathomable devotion of Sam's brother, it got him thinking of his wretched relationship with his own brothers.

"It's…it's," Dean struggled to find the words. He stopped fussing with the damp sheet and peered at his baby brother's pale face. Emotions flooded over him but he didn't know how to put them into words. Feelings? Geez, dude, I could really use your help right now. Thisis more your territory than mine. You're the one that's comfortable with this emo crap….the one that can go all dewy-eyed sensitive one minute and demon-slaying badass the next. You're the one always harping on me to talk with you, to tell you how I'm feeling. But talking...that just isn't my way. I mean, how do I describe something like that? How do I describe what it's like having you for a little bro when I've spent my whole life trying to push down my emotions and avoid vulnerability? How do I explain something so strong and so personal, something that feels as natural and automatic as taking my next breath, something that is so utterly visceral that you know your universe would crumble without it?

Just the thought of it, of not having Sam, sent a shiver through Dean. He grasped Sam's flaccid left hand in his and gave it a slight squeeze as much to assure himself that Sam was still there as the other way around. He closed his eyes for a moment, savoring the contact, and when he looked back up he found Cameron peering at him intently, obviously still waiting for an answer to his question, so Dean looked him in the eye and answered the only way he knew how. "It's…..everything."

Cam nodded lightly and attempted a wan smile before dropping his head and, once again, digging at one thumbnail with the other. Somehow, he'd known that would be Dean's answer and it made his family situation - a checked-out mother, a father obsessed with his business and brothers who pretty much didn't want a thing to do with him – all the more painful.

"Look," Dean started when he saw the absolutely crushed look Gilchrist had unsuccessfully tried to hide. "Even me and Sammy….it's not all rainbows and unicorns and off into the sunset like the Western heroes, dude. We fight. God, do we fight."

Dean's mind tripped back through their fight just outside of Burkittville, Indiana. Sam had angrily climbed from the car and Dean had just as angrily sped away in the Impala. Before it was all said and done, Dean had nearly met his end at the hands of what he had aptly called "one fugly scarecrow" and his little brother had his first encounter with the evil that was Meg Masters.

Then, of course, there was Roosevelt Asylum. True, it had taken the 'help' of the spirit of a doctor who was as psychotic as the patients he allegedly 'treated' but they'd had a whopper of an ugly heart-to-heart there.

And after John died, it seemed that all the boys could do was argue. Didn't seem to matter what it was about, they'd argue. But the way in which each of them worked their way through the loss of their father...or didn't...was definitely high on the list of incendiary topics.

The most incendiary conversations, though, had been about the deal that Dean had made with that crossroads demon to save Sammy's life. It was a deal that had doomed his own in the process and had sparked more than its fair share of fiery arguments. But the arguments hadn't just been confined to being between he and Sam. Bobby had given him a pretty damn fine chewing out, too, when he'd realized the deal that Dean had made.

The granddaddy of them all, though? Well, hands down, that still had to be the night Sam took off for Stanford. It had started off as a fight between Sam and John. Dean had tried so hard to stay neutral, play the referee, and defuse the situation but, eventually, the crescendoing tempers, mixed with healthy servings of Sam's need for normalcy, John's controlling ego and Dean's abject terror at the prospect of losing Sam, dragged Dean in until he found himself hurling words and accusations at his baby brother that he would spend the next four years wishing he could take back.

"Sammy and I….we didn't talk...". Dean closed his eyes at the painful memory as if doing so would erase it. "We didn't talk for four years."

When he opened his eyes, Cameron had abandoned picking at his thumb and was looking at him, his eyes searching Dean's face for any hint of untruthfulness. "Really?"

There was still a deep soulfulness in the boy's eyes and, in that moment, it struck Dean how much his expression reminded him of Sam. The familiar expression caught him off guard and before he knew what he was doing, words started tumbling out of his mouth.

"Not proud of it, but, yeah." Dean stared off into space, the images of that awful night as vivid today as they were the night it all happened. He broke from his thoughts with a small shake of his head. "Hand me that next sheet, will ya," Dean asked as he pointed at the large stock pot that contained the alternate sheet and cold water from the nearby tub. Cameron turned, pulled the soaking sheet from the cool liquid, wrung it, waiting until the water stopped dripping, and then handed it to Dean in exchange for the warm one the older Winchester had already removed. He turned back to the pot and dunked the warm sheet before turning back to assist Dean in applying the cold one.

"See," Dean started again while arranging his side of the damp sheet. "Sam and my Dad..….Well, let's just say they were a lot alike. Neither one of 'em could see it. Or, maybe they just didn't want to admit it...I dunno. All I know is, once they started goin' at it, neither of 'em would give an inch. Sam….he was hell bent on going to college…...becoming a lawyer." Dean smiled at the thought of Sam dressed in an expensive suit and tie, hair carefully cut and coiffed into a professional look, and seated in a huge leather chair behind an equally enormous desk. "Would'a made a great one, too. Anyway, Dad….well, he had other ideas. He wasn't gonna be satisfied until Sammy followed him….us...into the family business."

Dean tugged the damp sheet a little higher on Sam's chest and then reached up to brush a small hank of Sam's hair away from where it had fallen close to the boy's eye. He chuckled derisively. "To this day, I still don't know when he applied, but the night Sam announced to Dad that he'd gotten a full ride to Stanford and nothing was gonna stop him from going…...They went at it like terriers...tearing into each other about anything...wouldn't let go. I tried getting them to see each other's side but neither of 'em was having it." Dean pulled at the damp sheet again, pain etched on his face. "God, I'd never seen them fight like that…..not like that. I didn't know what to do….everything was falling apart. I begged Sam to reconsider...to….. Begged Dad to relent….."

Dean laid his hand over Sam's left forearm, his thumb stroking back and forth to calm himself much like a child thumbing a security blanket. "You know, I've played that night over in my head a million times…..looking for what I could have said, what I could have done different. They were asking me to choose between them! What was I supposed to do? How could I choose between my brother and my Dad?"

Dean looked up at Cam, his face etched with pain. "And then….."

Dean stopped short and looked away. Bobby snaked a hand out from where he sat at Sam's head and placed it on Dean's shoulder with a supportive squeeze for good measure. He knew the story well and he knew how the whole blessed thing had torn the kid completely apart...how it still did. "The boys' Daddy….he, uh,….he gave Sam an ultimatum...told him if he walked out the door, he was never comin' back," Bobby explained quietly, his hand still on Dean's shoulder.

"Sam left," Cameron surmised quietly.

Bobby gave a confirmatory nod. "In his mind, Dean had betrayed him by tryin' to stay neutral..."

"...and Dean felt betrayed that Sam could throw him away like that," Cameron finished for Bobby, knowing all too well what it was like feeling that you had no value to your family. It had certainly left a huge hole in his own life; one big enough that he wasn't sure he'd ever find a way to fill it in. "But, you guys are close again. You had to find your way back somehow….you know, found a way to forgive."

"I won't say it doesn't still sting sometimes," Dean stated with a shrug, "but he's my brother and I know I can't make it without him." Dean looked away, feeling suddenly very uncomfortable revealing his emotions.

"You said Sam would have made a good lawyer. He didn't finish?"

"It's been kinda tough for Sam the past couple'a years," Bobby explained. "Lost his girlfriend in an apartment fire. He couldn't save her and he's dealt with a lot of guilt over that. Then their Daddy dyin' after a car accident…..It wasn't Sam's fault, but he was drivin' and, well…...".

Bobby caught the way Dean closed his eyes and dropped his head at the mention of John's death and knew Sam wasn't the only Winchester dealing with guilt. No matter how hard he tried to convince Dean otherwise, the boy still felt responsible for the deal that resulted in John's death and the mysterious loss of the Colt.

Gilchrist nodded understandingly. "And joining Dean in the family business provided a bit of comfort in an otherwise overturned world," the athletic blonde guessed.

Dean started turning the damp sheet down, neatly folding it into sections so that it would fit into the kettle of cold water. Seeing this, Cameron turned and, once again, removed the alternate sheet from its cooling bath, making certain to ring just enough water from it that it no longer dripped. Once the exchange of sheets was made and Cam deposited the warm one in the kettle to cool, he turned back to help Dean to finish unfurling the cold sheet. He tucked the cold, wet sheet as close to Sam's skin as possible, careful not to disturb the makeshift dressing on Sam's right arm, and then sat back.

"Don't take this the wrong way, Dean, but you guys don't strike me as the 'bed and breakfast in the middle of nowhere' type," Gilchrist admitted. "What kind of business would bring you to someplace like Crowheart?"

At the exact moment that Dean answered "pest control", Bobby answered "historic firearms". They must really be exhausted, Dean thought, for them not to have their story straight. He shot Bobby a slightly disconcerted look and then quickly started covering. "Well, our main business, is pest control. You know, really tough infestations. Roaches, bees…," demons, he thought. "But the traveling gives us a chance to look in out-of-the-way places for historic weapons, too."

"So you guys are like the firearms version of 'American Pickers'? Cool. So, I guess the town's alleged connection with Colt is what drew you here?"

A stirring from the bed grabbed Dean's attention before he could answer. Dean's eyes widened as he watched his baby brother's body stiffen. "Doc?" Dean called out as the stiffening quickly morphed into a light jittering.

Bobby sat forward, his eyes scanning the form in front of him. Cam and Dean had just recently switched sheets; this one as cold as they could possibly get from the tap. "Is...is Sam shivering?" Bobby questioned to no one in particular. "Or is this...another….?"

As if in answer to Bobby's question, Sam's body exploded in a frenzy of knotted muscle and wildly jerking limbs. Harsh grunts poured from Sam's throat as the forceful spasms grew in intensity.

"Doc!" Dean screamed. "Doc! Get in here!"

Satisfied that everything was under control at the moment and that his team was capably handling their respective jobs, Dr. Jessup had disappeared through the adjoining bathroom nearly forty minutes ago to what had previously been Dean's room. He had tried to get the older Winchester boy to bed down for a bit, but not being successful in that, he had taken the chance to grab some shut-eye of his own. That is, until now.

Jessup barreled through the adjoining bathroom into Sam's room, his clothing slightly rumpled and his normally sculpted silver locks standing up crazily to one side. Before he even got close to the bed, he could see that Sam was, once again, seizing violently and that it was taking everything Cameron, Bobby and Dean had to try to keep the boy as close to being on his left side as the seizure would allow.

"His arm!" Bobby hollered out. "Get his arm!"

The violent paroxysms had almost instantaneously turned the sheet that had been lying over Sam from a smooth and carefully placed cocoon into a furiously rumpled mass that had quickly entangled itself around everything in its path, including the boy's right arm. It had taken just two of the violent spasms to completely tear the makeshift dressing away and with each merciless convulsion the tightening grip of the damp fabric caused it to grind and sheer at the wound, pulling at the inflamed skin and sutures and threatening to tear the wound wide open.

"Bobby! The IV line!" Cameron screamed out as he tried in vain to hold Sam's right arm still enough to allow Dean to loosen the vise-like grip the sheet was placing on that injured arm. "The sheet is getting tangled in the line!"

Sam's body continued to buck and strain with unrelenting force as Jessup arrived at Sam's head. Immediately, he and Bobby went to work hurriedly trying to free the crazy tangle of fabric that tugged perilously at the IV line. If they couldn't work the line free before much more tension was brought against it, the IV would almost assuredly be ripped from its insertion point. Whether that resulted in a broken IV cath, a tear in the jugular or an additional air embolus was of little matter. Either way, if this IV was compromised, especially so violently, it would ultimately result in only one thing - a certain death sentence for Sam.

Jessup held the line at a point several inches from where it entered Sam's neck and tried to draw some slack. Bobby's fingers clawed at the fabric knotted around it as he prayed that the spasms would soon stop. Several times he'd had the tangle loosened but powerful muscle contractions jerked the sheet before the scrap metal man could release it and he found himself doomed to begin his attempts anew when the noose tightened around the IV tubing once again.

The junkman fumbled and blindly tore at the cloth. His hand flashed to his hip and then back again to his fabric foe. There might have been a time when he would have felt bad for sticking his knife through the inn's expensive sheets and rending a huge gash in them, but this wasn't it. "Got it!"

Jessup knew before Bobby had even said it that he'd finally been successful in releasing the tubing from its bonds because the pull against the line disappeared suddenly. He'd taken a huge chance wielding a knife around an unpredictably seizing man but, in this case, Jessup wasn't gonna argue. The IV line was safe and, at this point, that was what mattered most.

There was another twenty seconds of powerful convulsions before they finally began to soften and slow. Jessup's immediate attention went directly to the jugular line. True, it seemed that all had turned out well in their fight to preserve it but he wasn't ready to simply take it at face value. Next up would be figuring out where this second seizure came from.

"Ok, gang. Looks like he's done," Jessup intoned. "Let's try rollin' 'im onto his back."

Jessup's trained eyes and fingers flashed over the jugular insertion site. The catheter was still securely taped in place, there was no bleeding, leaking or swelling and the tubing, although battered by the violence of the seizure and the boa constrictor-like grip of the knotted sheet, had survived with just a few kinks that were easily worked out of the flexible plastic.

Without saying a word, Jessup turned from the jugular line, had his stethoscope into his ears and the bell resting against Sam's chest. In the quiet anticipation of the room, Jessup could hear a noticeably fainter whirring in Sam's heart than he'd noted before. Was this the cause of the seizure? Was he hearing less whirring because another air bubble had broken away and become a dangerous embolus? They'd taken what precautions they could. Sam had been maintained on his side as protocol dictates right up until the seizure. Maybe he was hearing less air because some had already been reabsorbed into Sam's system.

Possibly, there was another cause for the seizure. Jessup pulled the stethoscope from his ears and looped it around his neck in one smooth motion. He laid the palm of his hand against Sam's face then quickly moved it to his forehead and then his chest.

"Temp," he said dryly. "What was his last temp?"

"One-oh-four-point-three," Cameron stated. Knowing that it was important, the blonde quickly added, "….with the one degree added."

The physician's hand settled on Sam's forehead again. "Check it again" he stated urgently.

The fifteen seconds that it took for the digital thermometer to chime that its work was complete seemed interminably long. Cameron could hardly believe his eyes when he retrieved the instrument and peered down at it. "One-oh-SEVEN-point-one?"

"Dammit! I was afraid of this," Jessup confessed, not even caring if that fever was with the added degree or without it. At this level, knowing an exact number wasn't paramount; getting it down quickly was.

"I don't understand," Cameron cried. "We were doing the sheets….and...and...taking his temp under his arm every fifteen minutes just like you said! His temp was one-oh-four-point-three just ten minutes before the seizure! We were watching him! We were! What did we do wrong?!"

Jessup brought his weathered hands up and pumped them in front of himself in a 'calm down' gesture. "It's ok, Cam. You and Dean didn't do anything wrong. In fact, you did everything right. He seized because his temp spiked so much in such a short time…..it took a bit of time buildin' up, but I'd be willin' to bet the farm that it spiked because we dialed back on the chilled IV solution."

"Well, then, let's dial it back up," Bobby asserted, figuring it was the most logical answer to their current problem.

"I wish it were that easy, Bobby. But we can't."

"Why not?" Dean questioned with a hint of anger once again leeching back into his tone. He was trying to maintain his cool, but when it came to his little brother 'no' was not an option he was willing to accept. "If he needs cold fluids, we'll give him cold fluids...and plenty of 'em."

"Look, I'm not sayin' we're not gonna give him cold fluids. He's got cold fluids runnin' now," Jessup stated flatly. Why did he always feel like he was on the defensive when it came to Dean? "What I'm sayin' is that the cold IV fluids did the trick when we were able to run them in wide open, as fast as they could go. But we can't do that now. We keep runnin' fluids in as fast as they'll go and we'll push 'im into circulatory overload. That happens, there's only one place for excess fluid to go – to his lungs. We keep pumpin' fluids like that and I'll guarantee you he'll drown on dry land."

Jessup paused for effect. His ice-blue eyes stared hard at Dean to drive home the point that he was one-hundred percent certain that opening the IV wide again was the absolute wrong thing to do. Dean's gaze almost imperceptibly softened and that's when Jessup spoke again.

"We go back to doin' chilled saline down the NG on a limited basis. As I said before, we can't afford to strip him of other electrolytes he doesn't have to spare by goin' overboard. We go conservative. We get even one degree down and we back off."

Dean scrubbed a quivering hand across his mouth and then reluctantly shook his head in agreement. They'd butted heads more than not but there was a good chance that Sammy wouldn't be here with them now if it hadn't been for what Jessup had already done for him.

Jessup drew in a deep breath and blew it out in relief. One more battle won, but he knew there would be plenty more to come. He pulled his stethoscope from behind his neck as he turned back to his patient.

As his eyes scanned the nasogastric tube for the first time since the convulsion, Jessup realized that there was no longer any tape across the bridge of Sam's nose, as there had been. They'd left the tube in place, securely fastened in the proper position with a wind of tape around the tube, each end extending up the nasal bridge and another longer, fatter strip applied cross-wise over top for added security. Now, though, that same tape lay near the lower edge of Sam's sternum.

It was always protocol to recheck the position of an NG tube before instilling fluids down it, but he was damned sure gonna check after seeing that. "Hand me that turkey baster, will ya, Cam?"

Jessup attached the air filled baster to the end of the tube and positioned the bell of his stethoscope in the squishy area just below Sam's breastbone. Then the elderly medic mashed as hard as he could on the baster bulb and heard…..nothing. This was not good. This was so not good.

They hadn't had any tincture of benzoin to add a little extra stickiness to the tape so he hoped that the seizure had simply caused the tape to pull loose and slip down the tube. In his heart, he knew it was wishful thinking and that there would be no such luck. It looked as though the tube had become partially dislodged in the frenzy of the seizure and they'd have to reposition it before they could use it. So much for being able to spend some time basking in the glory of a battle won.

"Tube's gotten pulled. We've got to get it repositioned before we can safely use it or we risk dumpin' fluids right into Sam's lungs. Trouble is, we can't sit 'im up or flex his head forward like last time in case we are dealin' with a travellin' embolus so this isn't gonna be so easy this time."

Remembering the way that Sam had fought as though he was fighting for his very life, Bobby huffed out a sardonic laugh. "I don't remember it bein' all that easy last time, Doc."

"S'pose not," Jessup agreed. "Ev'rybody ready?"

Three heads nodded in unison and Dr. Jessup gently grasped the tube between his right thumb and index at a position a few inches from the tip of Sam's nose. He slowly advanced the tubing into Sam's nose, noting with a slightly ambivalent sense of relief that he didn't see any sign that Sam was likely to object to, or was even aware of, their ministrations. On one hand, the fact that Sam was oblivious was helpful. They could get the tube repositioned and back in service without any further chance of Sam inadvertently pulling out his jugular IV while struggling and generally making matters worse. On the other hand, the fact that Sam had not regained consciousness but one time since Dean had first found him cocooned under a tangle of blankets, burning with fever, and had now seized twice certainly seemed to lend itself to the prospect that they could be facing a rather gloomy prognosis.

Dr. Jessup slowly began advancing the winemaker's tubing that they had turned into a makeshift NG tube. All seemed to be sailing smoothly for the first few small advances but then Jessup felt the tube meet some boggy-feeling resistance. The aged medic was familiar with this sensation and knew that the tip of the tubing was at the back of Sam's nose and he'd have to carefully negotiate the tubing around the nearly ninety degree bend that would send it into his esophagus and, eventually, into the stomach.

Jessup pushed lightly on the tubing, hoping that the gentle pressure would flex the plastic around the anatomical curve and send it easily into the esophagus. The resistance persisted and he fought the temptation to simply push harder. Instead, he backed the tubing out slightly and then made another approach.

Again, he felt an unrelenting resistance so he paused. He raised his hand slightly and once again applied some gentle pressure to the tubing. The change in angle often worked but, this time, it still didn't enable the tube to advance around the curve.

"There a problem, Doc?" Cam was on the edge of his seat. Sam had not reacted well the first time they placed this tube and there was no telling if, or when, the kid might take exception this time, as well. He just wanted to get the damned thing down and secured in place before that happened.

"There's a sharp bend in the anatomy at this point," Jessup explained. "You gotta be careful not to apply too much pressure here anyway for fear'a perforating the fragile tissues linin' the area but a real NG has a distinct advantage over our version. The end of a real NG is rounded and polished smooth. Tends to make the U-turn pretty slick. Ours has a straight-cut end. It's gonna scrape and drag on the tissues a lot more so I've got to go as easy as I can."

Jessup slightly raised the hand holding the tubing once more and slowly began to rotate the tube between his thumb and index finger. "Gonna try an old-timer's trick. Slowly spinning the tube while applying a bit'a pressure can sometimes catch just the right angle to get past.…..There! Slick as a cat's whisker!"

Jessup quickly advanced the tubing but soon realized that something didn't feel right. He stopped his forward motion. He hoped he was wrong but experience told him he'd be chalking up this attempt as 'unsuccesful'.

"Hold the tubing for me, will ya, Dean?" Jessup indicated that Dean should grip the tubing in the same manner and at the same spot that Jessup was. "Don't let the tubing pull out….but don't push it in, either."

Jessup relinquished the tube to the elder Winchester sibling. Using the gentle pressure of one hand, the silver-haired physician opened Sam's mouth.

"What in tarnation?" Bobby's eyes were wide as a wadded up tangle of winemaker's tubing suddenly jutted from Sam's mouth like some plastic alien.

"This can happen if the patient isn't followin' your commands to swallow," Jessup reassured. "Real common with unconscious patients like Sam that can't follow commands."

The physician slowly and carefully started reeling the plastic tubing back out through Sam's nose, watching to assure no knots formed in the process. Jessup stopped pulling back when he saw the tip of the tubing pointing downward just at the back of Sam's throat. "Just means we pull back and try again."

This time, as Jessup attempted to advance the tube, a round of strangled gasps and harsh coughing ensued. Realizing the tube was headed into Sam's lung, the physician pulled back until the boy took a large, unencumbered breath and the coughing quieted.

Once again, Jessup slowly advanced the tubing. Within seconds Sam was coughing harshly and Jessup pulled back immediately. He had been afraid that getting this tube placed again was going to be difficult and it appeared his fears had not been unfounded. It especially concerned him that with just two misdirected attempts a light wheeze had already developed.

Jessup took a steadying breath and slowly began advancing the tubing. A short prayer for success had just crossed the medic's lips when Sam erupted in raspy coughs that turned his face a deep red. Jessup retreated as quickly as possible and waited several cycles of inspiration and expiration before deciding that he needed to slow down; take a more measured and methodical approach.

He paused, gripping the tubing and watching for the young man to swallow naturally. As dry as Sam was, waiting to advance the tube until Sam swallowed on his own was going to be time-consuming but it might be their best chance at getting the nasogastric tube back in.

Jessup's fingers threaded the tube forward as Sam swallowed. As he waited for the next swallow, his eyes scanned his patient for any signs of problems and was encouraged when he didn't find any. It seemed to take forever before Sam swallowed again but Jessup was ready. Once again, his arthritic fingers somehow nimbly threaded the tubing quickly forward.

This time, Sam's body reacted with a vigor that none of them had expected. He coughed violently; deep, grating coughs that racked his entire frame. When he attempted to draw air back in, it was accompanied by a squealing, high-pitched wheeze that sent shivers down Dean's spine for as much as it reminded him of the sound Sam had made as his throat swelled shut back in that ER in California.

Jessup pulled the tubing back as quickly as he could but Sam's body shuddered violently as another round of rough coughing and tortured gasps struck. Jessup was sure that he had pulled the tubing back far enough to be well clear of Sam's lungs but the light wheezing had now morphed into a sustained and disconcertingly coarse wheeze. They had to be careful. From what Dean had told him of Sam's recent hospital stay, it wouldn't take much to send this kid into respiratory distress...an event they had little to no hope of reversing.

Jessup bowed his head in frustration. This kid didn't have much of a chance as it was and, if he wasn't careful, he could end up blowing what little chance he had. He threw his head back, sighed, closed his eyes and prayed for divine wisdom in what he was about to do next.

Jessup blew out a breath of resolve and without saying a word, pulled the makeshift NG completely out. It was one thing to lose a patient in the course of care; it was another to kill them attempting to give that care. He was killing this kid trying to get this NG down. It had been seventy-some years ago that he'd taken the Hippocratic oath to 'first, do no harm'. He'd taken it seriously then and he took it seriously now. He was doing harm and he couldn't do it any longer.

Jessup rose from his spot next to Sam and headed for the bedroom door. He gave the doorknob an angry twist and yanked the heavy door open. God as my witness, Jessup thought, I can't do this anymore.

A/N: Ok, so I was almost ashamed to use a Cinderella song as a chapter title because, much like REO Speedwagon, I'm pretty sure Dean wouldn't approve. I'm all but certain that he would say about the 1980's glam metal band, Cinderella, what he said about REO Speedwagon's Kevin Cronin all the way back in Season 2's, 'Simon Said' - "he sings it from the hair". Anyway, I decided to put Dean's opinion aside since the song title does speak to both Dean's feelings when Sam ditched he and John for Stanford and, also, to Cam's sense of loss that he doesn't have a loving relationship with his own brothers.