A/N: A friend and I were talking about 11x02 and while it was a great episode, we felt it was missing something. I think we both felt so badly for Sam, how he was all alone, left to fend for himself, and so this story was born. She gave me a prompt to expand it further and I wrote this as a birthday gift for her. The title comes from the poem Lady Lazarus by Sylvia Plath.

A/N 2: This story is deeply personal on some level even though it's about Sam. I must give a trigger warning that this story discusses self harm and suicide ideation. I understand if you have to stop reading due to that. However, even though these are dark subjects, I want to deliver a message of hope. I suffer from mental illness, as does my friend, so I hope she feels that I do the subject proper justice. I also want to thank her because even though this story is for her, writing this was cathartic for me as well. This story is written in a different style, namely the present tense, so it's not what I usually do. However, I felt that this story necessitates that so we can be in the moment with the character.

A/N 3: I just want to give a shout out to Jared Padalecki as well, for portraying the character of Sam Winchester and bringing his battles to life. I also commend him as a person for openly discussing his own personal struggles. He's recently launched a fourth Always Keep Fighting campaign and I suggest you check it out. I own three shirts already and I wear them all the time for strength. My heart goes out to anyone reading this right now struggling with a mental illness or with a loved one who struggles. Thank you for reading and always keep fighting.

Lazarus

Dying

Is an art, like everything else.

I do it exceptionally well.

I do it so it feels like hell.

I do it so it feels real.

I guess you could say I've a call.

It's easy enough to do it in a cell.

It's easy enough to do it and stay put.

It's the theatrical

Comeback in broad day

To the same place, the same face, the same brute—Sylvia Plath "Lady Lazarus"

Sam Winchester looks into the mirror, and watches the black veins creep and crawl up his neck, serpentine in nature. He's infected. Again. But yet, he's always been infected, always will be. It's not new, but he hates it anyway.

He just got off the phone with his brother, and he feels an ache within because it was as if he was in reach at that moment but now he's miles away, both literally and figuratively.

"I mean, it sounds like something out of the exorcist," he tells him as Dean explains what is going on, even managing a small chuckle when his brother cracks a joke. He really hopes that it is enough to fool Dean, yet at the same time he wishes Dean would hear right through the flimsy façade and come to his rescue because right now his head is pounding and his body aches everywhere.

But no he doesn't really want that. He won't put Dean in danger. He is going to do what he set out to do, save everyone. He remembers as he hangs up the phone, feeling the disconnect between them once again, and it isn't just the fact that the call is over. It's that divide that is still present between him and his brother, the one he just can't seem to bridge no matter what he does.

I burn bridges, not build them. I am the accelerant that is just an ember away from starting an inferno, he realizes then.

He looks over at George's body on the floor, his discarded pudding cup beside him. He hopes it was some small comfort to him, but he doubts it. He watched him die, chained up while he writhed in agony, while his hope died along with him. He can't help the guilt he feels because he told him that he would save him and he didn't.

"Liar! You and me, we're dead!" George shouted at him, not long before he died. He'd also suggested he put a bullet in his head.

How many times have I heard that? He wonders.

Too many, he thinks.

Lucifer had suggested it many times to him. Suzie had as well. He can't forget how going into her house where she lived as a recluse, but still a safe recluse, had changed everything. She'd killed herself and he still can't get her eyes out of his head.

You're the reckless one. You'll do anything to keep clinging to that doomed brother of yours. How many more will die, Sammy? You know it. You have to be stopped. And the only one who can stop you is you! Do it, Sammy!

He recalls her words, the cold hard glare of her eyes, as she looked over at the gun. She had been right. He knows this inherently. More people are dead because of him. Even Dean thought maybe he should die to keep the world safe, maybe he had done more harm than good. Maybe they all have a point.

How many times have I actually considered that?

He has to admit that sometimes he does think of that, thinks of how much better the world would be without him. When Dean suggested he needed to die to put a stop to all the evil he caused, he didn't hesitate. He wasn't trying to manipulate Dean when he reminded Dean that they were still good, because he needed Dean to see that he was still good. If Dean had decided right there that everything would be better without him, he'd have died on the spot. He'd been relieved when Dean chose not to kill him, because it meant most importantly that he still had faith in himself, and maybe even a small amount left over for his little brother. But right now? Is he still good? He isn't so sure anymore.

He knows George was right. He is a liar and he didn't save him. Maybe he is just being selfish and stubborn by keeping himself alive and thinking he'll come up with a cure. As he makes his way to his feet on wobbly legs, it doesn't get much better. That's when he encounters Billie, the reaper. She's less than pleased with him and can sense that he is dying.

"So the next time you or your brother bite it, well, you're not going to Heaven . . . Or Hell. One of us - and, Lord, I hope it's me - we're gonna make a mistake and toss you out into the Empty. And nothing comes back from that. I know you're dying. I can feel it. You're unclean in the biblical sense. So I'll be seeing you again, Sam . . . Seeing you real soon," she says, making her way down the hallway.

Sam shudders both from her words and from the chills that wrack his body. It isn't so much the fact that she thinks he is dying. No, he's made peace with that. It's the idea that she says she'll toss Dean into the empty and that is the last thing he deserves. As she says, he is the unclean one, not Dean. He's been tainted since he was fed demon blood and nothing can wash that away. He isn't pure and it is that fact that sometimes makes it hard for him to reconcile the worth of his life. He's done horrible things and somehow he presses on, but he can't forgive himself for the one thing he has no control over.

As he continues down the hallway, meandering in a circle, not really sure where he is going, he sees the word "Chapel" and walks inside. He supposes it is that tiny flicker within him that propels him forward, that maybe they can be saved, maybe he can be saved.

"So . . . I know it's been a long time," he begins. He realizes then that it has been awhile since he really sat down and talked to God.

"But . . . Dean and I, we've - we've been through a lot of bad. But this is different. This is my fault, and I don't know how to fix it. And if I have to die, I've made my peace with that, but . . . Please. Dean deserves better. Dean deserves a life," he continues, feeling tears threaten. He needs God to know that Dean should be spared. His little brother's very existence is Dean's burden and he doesn't deserve all the consequences that come with it. Even before he took on the mark, he has been marked with the curse of his little brother. Dean is the casualty of the ongoing war between good and evil within him and it isn't his battle to fight.

"There are people out there, good people, who are going to suffer because of me, and I am not asking you to clean up my mess. Hell, I don't even know if you're out there, but . . . If you are . . . And if you can hear me, I, um . . . We need your help, God. We need to know there's hope. We need a sign," he finishes.

Somehow he hopes that maybe God does see beyond his taint, sees him as one of the good guys. He waits in silence for several moments as if the sign will be instantaneous. Suddenly he hears a noise behind him and his hackles go up.

He jumps to his feet, looking around. He hears it again. He approaches the pew and sees someone hiding just underneath.

"Who's there?" Sam says, gruffly.

She whimpers but won't answer.

"Come out!" Sam commands.

"You going to use that taser thing on me too?" She asks fearfully.

"No, I don't have it," Sam admits.

Finally Sam sees a head pop out from under the pew and he can see it is a girl, dark wavy hair, most likely in her 20's, the black veins standing out on her neck.

She stands up finally, and Sam can see a hospital bracelet on her wrist.

"What are you doing here?" Sam asks.

"I was at the hospital when…you know…everything happened."

"What's your name?" Sam asks her.

"Elena," she replies, softly. "What's yours?"

"S..Sam," he stutters, as he feels an overwhelming spike of pain in his head as horrifying images dance across his vision. It's him, being tortured.

Is it the cage?

No it's not really a memory that he truly recalls. He doesn't understand it. Is this the sign?

"Are you okay?" He hears a voice, echoing around him and someone shaking his shoulder. "Sam?"

He realizes it is Elena and that he's now on the floor.

"What happened?" Sam asks.

"I don't know. One minute you were telling me your name and then you fell down screaming. I think you passed out. Maybe it's the infection?" She suggests.

"I don't know," Sam admits, because he doesn't know really what that was. He only knows he feels worse, as his head pounds incessantly like a train charging down the tracks right through his skull.

He sits up and leans against the pew as Elena does the same. He notices immediately the marks on her arm.

"Did someone hurt you? What happened?"

"I happened," she says simply, shrugging her shoulders nonchalantly.

Those words sound all too familiar to him. Hadn't he said the same thing when Charlie died?

I happened.

He thinks this phrase is an accurate interpretation for everything that's ever gone wrong.

Realization dawns on Sam then as he looks at her arms, and he nods feeling the pain migrate down his neck.

"Yeah, I get it. You think I'm nuts," she says, pushing a strand of hair over her ear.

"No, I don't," Sam says softly. "We all have our demons." He understands this completely because he has the ones he meets every day, but also the ones who live in his head and he knows the ones you can't see are worse. Maybe he hasn't taken a razor to his arm but he's certainly been self destructive, hurt himself intentionally, in other ways. His demon blood addiction perhaps? Sure he wanted to save people but deep down he knew he was slowly killing himself. Then again what did it matter? He was tainted no matter what.

"Well mine suck," she says ruefully. "I never feel like I'm good enough, and I guess I feel I deserve to be punished, so then this happens," she says, holding up her arm.

Sam can see old scars there, and some fresh ones slightly scabbed over. An awkward silence passes between them.

"Sorry," she says sheepishly. "Didn't mean to treat you like my therapist."

"It's okay," Sam says. He realizes more than ever that they aren't that different. Many times he felt he deserved to be punished too for not being good enough, but unfortunately it has been those he cares about that are the victims instead.

"You feeling alright?"

"Not really," Sam says, truthfully. "I think I'm getting worse. When did you get infected?"

"This morning. One of them spit on my arm. That will teach me to mark myself up, huh? I don't think they got to everyone in the psyche ward right away because we're sort of locked in. I came to the hospital because I thought I'd be safe. Oh the irony," she says, rolling her eyes.

"Safe from yourself?" Sam asks.

She nods, glumly.

"It's not exactly a happy place, but it's safe. Well it was, anyway. You a patient?"

Sam shakes his head no, which makes the pain in his head that much worse.

"Didn't think so. I heard the TV and saw you outside with that homemade taser. You Macgyver or something?"

"No," Sam says, with a small smile.

"I kind of followed you in here," she admits. "I heard you talking to God. Sorry to be nosy but who is Dean?"

"My brother."

"Sounds like you care about him a lot. Wish I had someone praying for me like that."

"I was here before with him. Do you have family in the area?"

"Next town over, if you want to call my parents that. They aren't too happy with the damaged goods they wound up with. They gave me a ride here. It was the least they could do," she says, sarcastically.

"I'm sorry," Sam says, sympathetically. He knows what it is like to feel unwanted, especially lately. He isn't even sure Dean wants him around anymore, even if he did decide to let him live.

"Where's your brother?"

"I told him to leave."

"Did you get in a fight or something?"

"No, I wanted him to be safe."

"But what about you?"

"I can handle it," Sam says, defiantly, even though he knows that isn't true.

"I know how that is with the one sided relationship. It's like my parents. I'd do anything for them, to make them happy but they don't care. I hide my feelings to protect them. They should be protecting me."

"No, it's not like that," Sam says, not sure where she is getting that idea. "Dean is a great brother," Sam says sincerely. No matter what, he'll always believe that. He's the reason why there is a rift between them, not Dean.

"If that's your story," she says, sardonically. "Anyway, unlike you, I can't handle it," she says, dejectedly. "You know today is my birthday?"

"Happy birthday," Sam says, sincerely, even though he knows it's not a happy occasion for her.

"Nothing happy about it," she says, confirming his suspicions. "My parents forgot about it completely and I didn't even get my one wish."

"I'm sorry. What did you wish for?"

"To not be here to see it in the first place," She says, matter of fact. "Sometimes you just have to know when to cut your losses and be done with it."

"But you're here," Sam says, not understanding where this pep talk is coming from since he can't find it within himself to believe the same. "You came here for a reason. You must want a chance. You could have just given up."

"It was a stupid move," she says, a hint of anger in her voice, turning her head away. "Doesn't matter now. We're all dead."

Her words echo George's and he feels guilty all over again.

"You believe in all this?" She asks, gesturing to their surroundings.

"You mean God?"

She nods.

"Yeah, I do," Sam says, realizing he needed the reminder himself.

"I'm not sure if I do. I mean, I've prayed for help and never got it. Do you think you got your sign? I heard you asking for one."

"I'm not sure," he says, not entirely convinced that the vision or whatever it was is actually a sign.

"Figures," she says. "Might as well just put ourselves out of our collective misery."

"Stop," Sam objects. "I'm going to figure this out."

"I told myself that a time or two as well," Elena says. "But have you seen yourself lately? You were strong with that guy but now you don't look so hot. You're sweating and I can feel the heat from the fever from over here."

He knows she's right. He feels awful, almost as bad as when he was going through the trials. However, he gets up dizzily, swaying on his feet.

Elena looks up at him, nervously.

He begins to pace, thinking. Was the vision a sign? He was being tortured or punished. Maybe for being unclean?

You're unclean in the biblical sense.

Billie's words echo in his ears, and he's running while he hears Elena behind him. He starts researching on the computer, about purification.

"What are you doing?" Elena asks, anxiously, following him from room to room.

He ignores her when he's found his answer and then he's off and running to get the Holy oil and some gauze.

Elena blindly follows him, but stops short when she sees him with the gauze ablaze as he holds it up to his neck.

"Don't do this," she pleads, standing in the doorway, looking frightened. Her words mix with his own internal monologue telling him to stop as well. However, he listens to the voice that says he can do it, and holds it up to the bulging black veins on his neck. He feels the sting of the flame but also something within, something happening.

He stumbles backward, realizing it worked. He still doesn't feel well, in fact he feels faint, but when he looks in the mirror, the veins are gone. He sees just his wan reflection staring back at him.

"How did…you did it," Elena says, incredulously running into the room.

"Come on. We have work to do," Sam says, a new determination ignited in him by the holy fire.

"Sam, I…now that you aren't infected," she stutters. "We aren't the same anymore and…" her voice drops off.

Sam understands her. She's afraid that maybe she'll turn, maybe she'll attack him.

"No, we are still the same. I believe in you," Sam says, truthfully.

Then they are off, as Sam creates a clever scheme to lure all the other infected people into a ring of holy fire. He instructs Elena to get in as well, as she looks unsure. He gives her a reassuring nod and she steps in as he lights the match.

He watches the flames dance higher as the woozy feeling he has been fighting takes over. The flames blur his vision as he suddenly sees two rings of fire, even though he's pretty sure he made one. He feels himself losing his footing as he falls to the ground slowly, to his knees. A hand reaches out of the ring and grabs his.

"You saved us. Thank you."

"It's the last thing he hears before he collapses completely, the pain in his head nearly blinding now. His eyes are half lidded, his cheek pressed into the cold ground, and he thinks he can faintly hear Elena calling out to him but it's all muffled. He's not sure what's wrong but he's happy he could at least save the people, even if he couldn't save himself.

oooo

When Dean Winchester arrives at the hospital, he's aggravated. He's been calling Sam's phone repeatedly but hasn't gotten an answer. He knows he's worried too, but Sam said everything was okay and he was inclined to believe him.

He walks in and he smells a hint of smoke in the air. He follows the smell until he sees a sign that says "Chapel" and makes his way there. Somehow he knows Sam will be there.

When he walks in, he sees a group of people gathered, some embracing each other. They are looking down at someone on the floor and instantly Dean's heartrate quickens as he sees it's Sam. There is a girl hovering over him as he draws his gun.

"Get away from him!" He yells. He's not sure what is going on and if these people have killed his brother. However, they react in fear as some scatter. However the girl doesn't move from Sam's side.

"Sam, wake up," she says, tearfully. She has a cold rag in her hand and she's wiping his face.

"I said, move!" Dean warns her again. He takes a closer look and sees that none of these people appear to be infected. There are no black veins to be seen and she appears to only have concern for Sam. However, he's not taking chances.

She finally acknowledges him.

"Who are you?" She asks.

"His brother. What did you do to him?"

"You're Dean?" She asks. "I didn't do anything. He saved us and then he just collapsed."

Dean double checks again that there are no black veins in sight. She knows his name so clearly she's talked to Sam before. He puts his gun away and then he bends down next to her to get a look at Sam.

"Sammy," he says, tapping his brother's face. He realizes it's warm and he can see the bruises on Sam's face from where he punched him in the cantina. There looks like there could be some fresh bruises as well as if someone else hit him.

"Sammy?" He says again, this time giving his brother a shake. He's getting worried over his brother's lack of response and he still doesn't know what is going on.

"De-," Sam mumbles incoherently, but doesn't open his eyes. He's slightly relieved, but not really. Sam still isn't lucid.

"What happened?" Dean asks Elena.

"I told you. I don't know. Maybe if you'd been here, you would," she says, somewhat angrily.

Dean isn't sure where the hostility is coming from but he ignores her.

"Let me help," a man says, stepping forward. "I'm a physician's assistant here at the hospital."

Dean looks at him and sees he looks young, even younger than Sam but there aren't too many options at the moment.

"We should get him to one of the exam rooms," he says. "I can see what supplies we have."

Dean isn't sure what else to do but he complies. Next thing he knows someone has rustled up a gurney and he carefully lifts Sam on to it. Someone offers to help, but he ignores him because this is his job. However, everyone seems eager to help Sam.

They wheel Sam down the hall and Peter, the physician's assistant is joined by a nurse, as they get Sam into the exam room. Elena tags along casting concerned looks at Sam the entire time, while Dean looks on in confusion. Both Peter and the nurse manage to get an IV started on Sam because they both think he is dehydrated due to his fever. They also give him some medication to bring down his temperature. When they check it, it's 101. Peter also thinks Sam might have a slight concussion, but assures Dean his pupils are equal and reactive to light. The nurse listens to Sam's lungs and she tells Dean they sound slightly congested, but his breathing isn't labored.

Peter and the nurse exit the room for a short time to see if any of the other cured people require medical treatment and also to see if they can find the doctor.

Dean and Elena sit in awkward silence, until she walks over and takes Sam's hand. She looks teary eyed again.

"I don't know what's wrong with him," she says. "None of the others seemed to be sick after they were cured."

"But Sam wasn't infected."

"Yes he was," she says, raising an eyebrow.

Dean feels as if the floor has dropped out from underneath him.

"We were all infected but then Sam figured it out," she continues. "He took some fire and held it up to his neck, probably the scariest thing I've ever seen someone do. I actually thought he'd lost it to be honest, but it worked."

Dean sits there, shocked into silence. Suddenly he completely understands her anger at him. How could he miss this?

"When was he infected?" He asks, scared to know the answer.

"Last night," she says, confirming his fears.

Sam was infected when he talked to him on the phone, yet he didn't even detect it in his voice. He was so distracted that he didn't know.

I should have known.

He chastises himself because he knows this is his fault.

Did I even ask Sam if he was okay after the car was taken over by the darkness?

He realizes he didn't. He never checked to see if Sam had been injured. After all, he had been removed from the car and protected but Sam wasn't.

"I thought you knew. He said he asked you to leave, to keep you safe. He prayed for you," she says, quietly, as if she's not sure she should tell Dean.

Dean hears the words as a cruel taunt even though she doesn't mean them that way.

"Look, I'm sorry," she says. "I just know what it's like to be alone, wishing someone was there to comfort you. I shouldn't have lashed out at you. You're here now."

He realizes she was deflecting earlier but he knows she is right. He should have been there.

"Your brother is a really great guy," she continues. "He understands people and cares about them in a way I've never seen before. He made me feel like...like I matter," she finishes, giving Sam's hand a squeeze.

Dean responds with a weak smile.

He wants to tell her how right she is, how Sam seems to be able to look into the human soul and truly see what is reflected there, how everyone matters to Sam.

Saving people means all the people.

His little brother's words come back to haunt him and he wonders if Sam feels like he includes himself in that group. The idea that he doesn't and sees his life as having less value than anyone else's, is a real possibility and he knows he hasn't helped matters.

"I'll wait outside," she says, going out into the hallway.

Dean walks over to his brother's side and sees how gaunt he looks. The bruises on his face are darker than before, bright purple, a sharp contrast to his pale skin.

"Sammy, I heard about what you did," Dean says, proudly. "You should see the fan club outside, waiting to see if you're okay. You're a hero."

Sam sighs then and he waits on baited breath. He's rewarded when Sam begins to stir. He looks up at him, with bleary, fever inflected eyes.

"Dean?" Sam says. He tries to get up but Dean pushes him back down.

"What happened?" Sam asks, confusedly.

"I heard you saved everyone and then you faceplanted. You remember?"

"Yeah I do."

"How are you feeling?"

"Not too good to be honest. My head hurts and I feel like I have the flu."

"Might have been nice to know you were sick," Dean says, gently. He doesn't want Sam to think he's angry with him because he's not, at least not anymore. He realizes that he was before, how he was harboring resentment, but that's over.

"I'm sorry," Sam says, tiredly.

"It's okay," Dean reassures him. "Remember saving everyone means you have to look after yourself too. I'm sorry I wasn't here, Dean says, realizing it's enough for now, a start. There's a lot more to be said, but for now Sam needs to rest. He places a comforting hand on Sam's forehead and he closes his eyes, looking more at peace than he has in awhile.

He sees Elena peering in the window, a small smile on her face and he smiles back at her, this time the smile reaching his eyes.

ooooo

Peter returns about an hour later with the nurse. Sam's temperature has come down since the IV and fever meds. He's awake again and he's much more alert. They are unable to find a doctor but they believe he has some kind of virus. Dean says they'll get Sam checked out at a hospital that's more operational just to be sure it's not anything else. Sam gets to his feet on his own and he has to admit he feels better.

"Thank you," he says to Peter and the nurse.

"No, thank you," they tell him, happily and he feels a tiny bit of self worth return to him. The people in the hallway who smile at him as he walks through the door, as if they are glad he's okay, help a bit too.

Elena is in the hallway and Dean steps aside.

"Happy birthday again," he tells her.

"Thanks and I just want to thank you again for everything."

"You need a ride?"

"No, one of the women here, Denise, is going to take me home to my parents. We have a lot of talking to do. I shouldn't have jumped to conclusions about you and your brother before but I figure if you did have something to work out and you managed to, that maybe I can work things out too."

"That's great," Sam says, sincerely.

She suddenly grabs him into a hug and Sam hugs her back.

"Bye Sam," she says, turning away.

"Hey, Elena," Sam says and she stops and turns around.

"Remember when you asked if I got that sign?"

She nods.

"I think I did. Always keep fighting okay?"

"I'll try," she says, smiling.

Sam turns back to Dean and sees he is smiling too.

"Ready to go little brother?" He asks.

Sam nods, happily, relieved to see his brother isn't angry with him, that he still wants him around, that he's calling him "little brother." If Dean still believes in him, he'll keep fighting too.

The End