This is an episode tag for S12, E11 "Regarding Dean." When I watched Sam in this episode, I knew I had to write a tag for it. My thanks to Fanpire 101 for beta-reading. I own none of this, save any leftover typos.

Note: I am not a doctor. However, I think I'm taking better care of Sam than the original writers did.

Cross-posted at Archive of Our Own.

An hour after parting ways with Rowena, Dean still marveled at the familiar feeling of Baby's wheel in his hands. Miles of beautiful scenery whizzed by, accompanied by good tunes - Hey, I can remember lyrics again! - and the rush of fresh air from the open windows. After being cooped up in a motel, recalling next to nothing from minute to minute, it was sweet relief to reconnect with his memories, with his life. Most of it, anyway. Dean tried not to dwell too much on his time spent in Hell, his brother's months of soullessness, Purgatory...

Dean cleared his throat. No time like the present, right?

"So, Sam." He turned toward his brother with a too-bright grin. "It's good to be back, huh? No more writing notes for me."

Sam didn't reply. His brother's left hand scrubbed at his right ear, his face contorted in an odd mixture of curiosity and distress. Dean glanced at the road, and then back at Sam. The younger man now had his left hand covering his left ear. The wrinkles on Sam's forehead seemed to be multiplying.

"Hey," Dean tapped him on the knee, his smile fading as Sam jumped. "What'cha doin'?"

Sam shook his head as if to clear it. "Nothing, I was just thinking." He worried his bottom lip between his teeth.

"Oh, yeah? What about?"

No answer.

"Sam!" Dean poked him again, eliciting another flinch, this one accompanied by a glare. "What's wrong?"

Sam huffed and rolled his eyes. "Dean. If you want to have an actual conversation, turn down the damn music."

The older Winchester narrowed his gaze but did as Sam requested. "What's the matter, Princess? You got a headache?"

"No, it's just too loud." Sam winced as he rubbed beneath his right ear again, a frown firmly in place. He rolled up the passenger side window with his left hand and wrapped both arms around his stomach.

"You cold or something?" Dean snaked a hand across and felt his brother's forehead before Sam could bat his hand away. No fever. The older hunter frowned. Whatever's going on, his reflexes are shot.

Dean blew out a breath. Damn it. He had no desire to relive his bout of witch-induced amnesia, but if something was wrong with Sammy, Dean had to fix it. And if Sam wouldn't tell him, he was going to have to figure out the problem himself. He couldn't help what he didn't know. Dean pulled off the highway at the next exit and drove straight toward the nearest diner.

Sam turned wide eyes on him. "Why're we stopping now? It's not even noon."

Dean shrugged. "I'm hungry." And when we're out of the car, I'm gonna check you over.

Sam gave an exasperated sigh, accompanied by bitch-face number 15: Dude, you're always hungry.

Dean parked in front of Flapjacks-R-Us and hopped out of the Impala, making a mental note to oil the driver's side door. Sam followed more slowly, Dean noted, but he didn't expect to see his brother nearly nosedive into the cement. He flew around the car and supported Sam's right side. Sam pulled away and clutched the passenger door with his left arm, swallowing hard. After a minute, he blew out a breath, nodded, and stood to his full height.

"You okay?" It wasn't really a question. Dean knew Sam wasn't okay. Now, he just needed to get his brother comfortable enough to open up and tell him what was wrong. Hopefully, feeding him would help.

Sam turned away. "Yeah. Late night catching up with me, I guess."

Dean stuck to Sam's side like a stubborn label on a beer bottle as they walked toward the front of the diner. The little joint was surprisingly crowded given the time of day. He grinned and let out a low whistle as they walked in. "Full house equals good eats," he crowed, pointing to the sign for an All-You-Can-Eat flapjack special.

"Awesome," Sam responded, his voice tight.

Sheila, an older woman with a wig full of platinum blond curls, smacked her gum as she led them to a long counter in the center of the restaurant. "We don't have no more tables," she explained. "Hope you boys don't mind sittin' with the cook."

Dean grinned at her as he sat to the left of Sam. He didn't miss the wince his brother gave when Sheila smacked her gum in his ear. "Nah, this is great, huh, Sammy?"

Sam looked up, pain in his eyes, and didn't even bother faking a smile at the waitress. "It's great," he parroted, in that same little pinched voice that said just the opposite.

Dean, of course, ordered the special. Sam, as usual, had questions about the menu. Dean ignored him - Who cares which items are gluten-free or whether there's a lower cholesterol egg substitute? - until he noticed their waitress spitting out her gum in the trash and realized that Sam had asked her to repeat herself more than once.

Dean frowned. Sam had his head cocked to one side, the same way he often looked when they were interviewing witnesses. It was his careful listening face, the one he made when he was paying very close attention to what someone was saying. Why is he on guard here?

The older man glanced around the diner, spotting nothing out of the ordinary. Clanking dishes, the sizzle of the griddle, laughter from a table of truckers, a crying baby in her mother's arms, a gleefully shrieking toddler running past where they were seated. Nothing to see here. Just another average morning in middle America.

"I wish that damn kid would shut up," Sam mumbled after the waitress left. He took a sip of his tea and rubbed the side of his head.

Dean rolled his eyes and gulped his coffee. "Somebody got up on the wrong side of the bed this morning." He raised his eyebrows and smiled at his brother.

"Dean." Sam stared at him. "There's nothing funny about this! We didn't get any sleep at all last night! Remember? Taking down that pack of witches? Finding the Black Grimoire? Rowena casting a spell to get your memory back?"

Dean set aside his coffee and leaned into his brother, hissing, "Why don't you say that a little louder, Sammy? I don't think the truckers in the back heard you." He gave a smile and a nod to the young mother, who now stared at them with wide eyes as she reached for her screeching toddler.

Sam flushed pink. "Shit, damn it, I didn't mean-" The mother abruptly scooped the child up with her free hand and clutched both baby and toddler tight as she rushed away from their table.

Dean chuckled, forking another wad of pancake into his mouth, syrup dripping down his fingers. He shook his head and sipped his coffee. "Man, you're on a roll today." Dean licked the errant glob of syrup from his hand.

"Shut up, Dean. And chew with your mouth closed."

"Bitch." He said it softly, so as not to further upset the young mother.

There was no response.

Dean frowned when Sam didn't reply with his usual "jerk." He turned to study his brother surreptitiously. Greasy hair, bags beneath his eyes. Worrying about me was hard on him. Dean felt a pang of guilt for upsetting his brother, but set it aside to continue his assessment. Faded jacket, worn boots. Boy needs some new huntin' gear. It was only when he looked closely that he noticed a spatter of blood on his brother's red and black checkered shirt. Where in the hell did that come from?

As if in answer to his unspoken question, his brother's left hand snaked up again, pushing aside his long hair to rub beneath his left ear. Dean's breath hitched. Although Sam's hand was clean, the beds of his fingernails were caked in dried blood. Dean swallowed hard when he caught sight of traces of blackish-red in the shell of Sam's ear, blood that his brother had clearly tried - and failed - to clean up. No wonder Sam had been begging to stay another night at the motel - he had wanted to shower away the evidence. It was Dean who had insisted, despite their all-night witch hunt, that they put some miles between the Winchesters and Eureka Springs before bedding down for the night.

Dean felt his heart pound. What happened last night? He turned away from his little brother and flagged down their waitress."Check, please."

"Dude!" Sam turned toward him in surprise when he caught sight of Dean standing up and throwing down bills. "I'm still eating."

Dean swallowed hard. "We're leaving." He walked toward the door, so anxious and angry that he nearly felt faint. The kid is bleeding from his ears and he didn't tell me? What the fuck? He paused briefly at the door to ask a waitress for directions and then went to pace around the Impala.

Sam finally made his way out a few minutes later. He looked unsteady on his feet, and Dean cursed himself for not realizing there was a problem sooner.

"Get in," he barked at Sam, intentionally raising his voice.

His brother glared at him as he sat down. "What the hell, Dean? You don't need to yell at me."

Dean floored the Impala, taking a right turn with such gusto that the car's left tires briefly lost contact with the ground. "Apparently, I do." He drove like a madman through the little town, tires squealing in protest as he rounded each corner.

"What's that supposed to mean?" Sam finally replied, crinkling his wide forehead.

Dean slammed a hand on the dashboard. "I don't know, Sam! You tell me." He threw the Impala into park.

Sam peered out the windshield. "A hospital? Why are we here? You got wind of a case or something?"

The other hunter stalked toward the emergency entrance without answering, leaving Sam scrambling to follow him.

"Dean, what're you doing?" Sam tugged at his brother's sleeve as Dean passed through the sliding glass doors, but the older man ignored him and charged ahead to the desk.

He gave the receptionist a tight smile. "Hi. My name's Dean Wesson. My brother Sam here is bleeding from his ears and he's got some hearing loss."

The receptionist turned to Sam, who gaped at her and Dean like a beached fish. Dean crossed his arms and raised his eyebrows. Sam dropped his eyes and chewed his lower lip.

"He's unsteady on his feet and loud sounds hurt his ears," Dean continued when Sam didn't add anything. "No fever."

The woman came around the desk. "Okay, honey," she said, extending a hand to Sam as if he was about to pass out. "My name's Jackie. Let's take you back to triage. Now, how did this happen?"

Dean sidled up to Sam's other side, not willing to miss any part of this story. He twined an arm around his brother and gave Sam a smug smile. His brother blanched and frowned at him before turning back to the receptionist, who apparently doubled as a triage nurse.

"I...um...I was exposed to some loud music at a party last night."

"That must have been some party," Jackie clucked. She set him down in a chair and checked his right ear with the otoscope. Sam hissed in pain. When she moved on his left ear, she added, "Do you remember exactly when it happened?"

"At a friend's house." As Dean and Jackie gave him competing quizzical looks, Sam revised his answer. "Oh, you asked when, not where." His cheeks reddened at the error and he looked away from them both, fixing his eyes on the far wall. "There was a band playing for a few of us. The guy mixing the sound turned up the treble really high. I was right by the speaker so it was kind of deafening. I..." he glanced at Dean before continuing. "I...uh...I passed out for a few minutes from the pain."

Dean closed his eyes briefly and shook his head. Ah, Sammy. Why in the hell didn't you say anything?

"Are you hurt anywhere else?"

As Sam bit his lip, Dean forced himself not to stare at his brother. "I...um...I got into a fight earlier with one of the guys. He threw me into a wall and I hit my right arm. I...uh...I dislocated my shoulder a few years back and had surgery on that elbow. There's a couple of pins in there." He took a deep breath. "I don't think it's broken again, but it hurts."

Dean ground his teeth. Damn it, Sammy. You never told me you had surgery either. He shook his head. Freakin' witches.

The nurse clucked unhappily as she examined his arm, eliciting a wince. "Must have been a lot of liquor at this party." Before Dean could interrupt to defend his brother, Jackie added, "If I didn't know better, hon, I'd think you were in an explosion. Your injuries are consistent with impact from a blast." Dean noticed that she was taking care to speak more slowly and clearly to Sam now that she understood the full extent of the damage. It upset him at the same time that he felt grateful to her. "On a scale of 1 to 10, how's your pain level now?"

Sam cast a worried look at Dean. "Uh," he said, clearly uncomfortable at admitting this in front of his big brother. That meant it had to be more than a five.

Dean tried to school his features into something less menacing. No sense in yelling at him now. He nodded at Sam, relieved when his kid brother dropped some tension with a returning nod and a resigned sigh.

"About a six," Sam mumbled, staring at his hands.

"Are you dizzy or nauseous?"

"I'm sorry, am I what?" Sam looked up and squinted at her, cocking his head to the side, the same way he had at the waitress earlier that morning. Dean's stomach dropped. Sam's fingers cupped his left ear protectively. "I'm having some ringing in my ears," he admitted.

She repeated the question, making sure Sam's eyes were on her.

"A little," he replied. "Especially when I change positions from sitting to standing."

Damn Winchester luck. Dean sighed and rubbed the bridge of his nose. Why can't we ever catch a break?

"All right, hon," Jackie said. "Good thing we're not too busy this morning. Let's get you into a bed." She led Sam back to a tiny curtained cubicle with one guest chair and handed him a gown. Puppy dog eyes met his, and Dean helped Sam out of his shirts and into the gown. Once Sam was dressed to the nurse's satisfaction, she made sure that he was safely seated on the rolling bed. Jackie locked the wheels and adjusted the height to a more comfortable position. "The doctor will be in to see you shortly."