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Dr. Dean Winchester has been at the hospital for almost twenty-four hours.
He's sitting at the circulation desk eating from a bag of potato chips, wondering why he volunteered for the night shift when a nurse hands him a tablet. "Patient. Bed six." She walks away.
Dean groans. He continues to eat while he studies the chart.
Castiel Novak. Male. 38 years old. Fever of 105. High blood pressure. Low pulse ox. Complaints of fatigue, fever, nausea, persistent and productive cough. Brought in because of hallucinations brought on by the high fever.
And then, below all of that, in bold letters: Patient has a fear of hospitals. That would explain the high blood pressure and why this patient didn't see a doctor sooner.
Dean throws away his empty bag of chips and walks to bed six. In it sits a man who he assumes would be handsome if not for the sickly pallor. The tousled black hair and blue eyes are what really gets him. "Mr. Novak?" Dean asks.
Dean notes the man's tight grip on his blanket. He clears his throat. "Yes."
"I'm Dr. Winchester." Mr. Novak nods. His anxiety is so obvious that it probably didn't even need to be written in the chart. Because of this, Dean adds, "But you can call me Dean, if that makes you more comfortable."
"Call me Castiel, then." He smiles but in an uncomfortable way.
Dean smiles back. "So, Castiel, do you mind telling me what brought you in here today?"
Castiel's eyes dart across the room. "Um... I, uh..."
So Dean takes the initiative. "You've had a fever." Cas looks back at him and nods slowly. "High enough to cause hallucinations?" Cas nods. "Could you please elaborate on that for me?"
"My brothers knew I was sick. I've been sick for a week, almost two. They came to visit me and, um, well I don't know. I just woke up in the car on the way to the hospital."
Rather than asking more questions since that seems to be making Cas uncomfortable, Dean offers the information that require confirmation rather than answers. "So you've been having symptoms of a cold, correct? Fever, headache, coughing, some nausea, lack of appetite?" Castiel nods again. "Now the coughing – is that dry or wet?"
"Wet." Dean notices his fists tightening around the blankets again; it seems to happen each time he answers a question.
"Have you been coughing up mucus?" Castiel winces almost imperceptibly. "Sorry. Gross question." Dean smiles briefly, hopefully encouragingly.
"Yes, I have."
Dean sets the chart down. "Okay. I'll start my physical examination now." This time, Cas' whole body tenses. Dean recalls his sensitivity training in med school and the seminar they had a couple months back. "All I need to do is listen to your heart and lungs and look in your ears, nose, and throat." Telling a nervous patient what you're about to do before you do it is usually helpful. Making conversation is said to help as well so that's exactly what Dean does.
"So the brothers you mentioned, are they here?" He walks alongside the bed to the wall, picking up the otoscope.
"I sent them down to the gift shop or cafeteria or something. Gabriel was trying to make me feel better by joking about hot nurses, and Balthazar was just hovering."
"I'm just gonna look in your ear real quick." Dean puts the tip of the otoscope in Castiel's ear. "Balthazar. That's a strange name." No redness or other sign of infection. "Can you turn so I can look in the other ear?"
Cas turns his head to the side. "Our parents had a thing for angel names."
"Hmm," Dean says. He throws away the tip of the otoscope and tests the light on the end against his hand. "Let me just look in your throat and then I'll listen to your heart and lungs, okay?"
"Okay."
"Open your mouth and say 'ah.'" Cas does. Dean looks for a few seconds and then leans back. "Your throat is pretty red. Have you been coughing a lot?"
"Yeah."
"Alright." Dean puts back the otoscope and takes the stethoscope from around his neck. "Quick listen and then I'm done." Dean puts the earpieces in and then rests the tip over Cas' chest where his heart is. It's beating hard and fast, but it sounds fine. It concerns Dean that Cas is still this nervous after being here so long. He almost considers calling psych to see if anyone can help but figures it's best to broach the subject later. Dean moves to Cas' lungs. He listens for a few seconds. They sound bad, crackling in many places probably from fluid in the air sacks of his lungs. He figures it could be this bad for one of two reasons. One: it's just pneumonia and it sounds like this because he's waited so long to come in. Two: it's something worse. Dean would rather it be the former. "Take a deep breath for me," he instructs. When Cas breaths out, he can hear shaking accompanying the crackling. So, still really nervous.
Dean takes off his stethoscope and straightens up. He's about to start speaking when a voice behind him says, "Cas, how are you feeling?" Dean turns to see two men, presumably Castiel's brothers, approaching.
"Not much better since I saw you half an hour ago." Dean almost laughs at that.
The taller of the two brothers reaches out. Dean shakes his hand. "I'm Balthazar and this is Gabriel. We're Cas' brothers."
"Nice to meet you," Dean says. "I'm Dr. Winchester. As I was just about to tell Cas, I think he has pneumonia." Again, Cas' hands tighten around the blanket, this time pulling at it too. He turns to look at Cas. "I'd like to get x-rays of your lungs to see exactly what's going on and then we'll go from there." He's almost certain Cas will need to stay for at least a few days, but he doesn't want to scare him any more than he already is.
Cas looks up at Balthazar, with almost pleading eyes. "Is that really necessary?" Balthazar asks for him.
"I'm afraid so. I'd rather see what's going on inside before I decide on a course of treatment." To Cas, he says, "Don't worry. X-rays don't hurt or anything. All you have to do is stand and hold your breath for a few seconds. Okay?"
Cas nods reluctantly. "Yeah."
"I'll put the order in and someone will be up soon." Looking down and seeing Cas' knuckles almost white around the sheet, he amends, "You know what, no one else is here right now and my shift is almost over anyway. I'll just take you up there myself."
He sees some of the tension leave Cas' body then. "Thank you."
"Sure thing. I'll be back in a little while."
As he walks away, Dean hears, "I think he likes you, Cassie."
"Shut up."
Dean smiles.
• • •
On the way up to radiology with Dean pushing Cas in a wheelchair as per hospital policy, Dean asks, "So what do you do for a living?"
"I'm an interpreter for deaf people. I work from home. It's usually like a hearing person calls a deaf person and the deaf person sees me on the screen signing what the hearing person is saying."
"That's cool. My brother's fiancée is deaf. I'm trying to learn but it's not as easy for me as it was for him. He picked it up in, like, a month."
"I could help you some," Castiel says.
"That would be great actually."
They turn down a hall and reach the door to radiology. Dean puts the brakes on the wheelchair on. "Wait here for a sec. I'm gonna talk to the radiologist real quick."
Dean goes in the room where Charlie sits at a computer. "Hey, Charlie," he says.
"Hey, Winchester. What brings you up here?"
In a low tone of voice, he says, "I've got this patient with bad anxiety. I thought it'd make him more comfortable if I came up with him."
"That's sweet of you." Charlie smirks.
"Shut up. I need x-rays to confirm pneumonia."
"Sure thing. Bring him on in."
Dean goes out in the hallway to get Cas. "We're ready," Dean says. He wheels Cas into the radiology room where Charlie is already standing by the x-ray machine. She smiles warmly at Cas. "I'll be just in the other room behind the glass while Charlie sets you up," he says. He locks the brakes.
"Alright, come over here," Charlie says.
In the other room, Dean watches as Charlie takes him to the machine on the wall. She guides him forward, telling him to press his chest against it. "So just take a deep breath when I tell you to and hold it until I tell you to breathe out. Okay?" Cas nods. "I'll be right back," she says.
She sits in the chair next to Dean. "He's sweet," she comments. "I bet he's great, you know, when he's not in the hospital." She clicks on the screen a couple times.
"Yeah, I'm working on that. Trying to make him more comfortable so he can get better faster."
"I'm getting strong gay vibes," she says nonchalantly. She presses on the intercom button, ignoring Dean's deep blush. "Take a deep breath," she says. "Hold." She clicks a few times. "Okay, done. You can sit down. Dean'll get you in a minute."
Dean points at the scans. "Pneumonia."
"Yeah. Bad, too." She sucks in a breath through her teeth. "That's gotta be, what, at least a week in the hospital."
"At least."
"He's not gonna like that."
"No, he's not." Dean straightens up. "Well, I'll see you later. Thanks."
"Sure thing. See you later."
Dean goes back in the other room and gets Cas' wheelchair. "So?" he asks.
Dean considers telling him he wants to wait to talk to both him and his brothers but figures that would only freak him out more. "You do have pneumonia." He hears Cas take a shaky breath. "I'd like to wait until we get back to the ER with your brothers before discussing your treatment plan."
"Okay," Cas says nervously.
Dean wracks his brain for something to say, to help Cas take his mind off all this. "So my brother's fiancée, Eileen, they've known each other for about a year. It's funny, actually. After they talked, and Sam realized she's deaf, he went to sign 'thank you' but accidentally signed 'fuck you.'" Dean laughs.
"What did she do?"
"Well she's really sweet so she just showed him how to sign it right. She didn't tell him until later what he did. He was so embarrassed."
"When are they getting married?"
"Three months from now She wants to go to Ireland where her family lives which sucks for me because I had planes." He shudders.
"Really?"
"Oh, yeah. They scare the holy hell out of me. I've only been on one three times."
"Ireland is a long ways away, even on a plane."
"Thanks for the reminder."
"Sorry."
"I was joking, Cas," Dean reassures him.
"Oh."
"How did you get into sign language?"
"A guy in my freshman class of high school was deaf. No one really talked to him or anything so I made an effort."
"That's sweet."
"Yeah, well. We ended up dating later." Dean's heart jumps; so he is gay. "Thankfully the horrendous breakup didn't destroy my love of sign language otherwise I wouldn't have the job I do."
"That is a good thing. The best thing I ever got from a boyfriend was a Led Zeppelin tape. I still have it too."
"That's not so bad."
"Can't make a career out of a music tape, but at least the breakup didn't destroy my love of Led Zeppelin." Cas laughs quietly.
They enter the doors of the ER and Dean takes them to the bed where Cas' brothers remain.
"Hey, man," Gabriel says.
Dean pulls the wheelchair to the side of the bed and Cas gets into the bed, under the covers.
Right to the point, Dean says, "So Castiel does have pneumonia."
Gabriel starts to say something, Dean guesses it's along the lines of "I told you so" based on his expression, but Balthazar tells him to shut up.
"Based on the severity of your symptoms, you'll need to stay here for a few days." By that, he means a week, but he doesn't really want to say that. Doctors do that all the time, understate the realities of the patient's situation to keep them from getting scared or something.
Cas' hands pull at the blanket. "But–"
"Cas, let the man finish," Balthazar says gently.
"Normally, with someone your age, I'd just send you home on oral medication, but since you waited so long, that wouldn't really be safe." Cas starts to protest again but Dean keeps going. "You passed out, you were hallucinating. You should see the amount of fluid in your lungs. Low pulse ox, high fever. None of that makes a good combination." Sincerely, he says, "I'm sorry, but you need to be admitted." Cas takes as deep a breath as he can, trying to calm down. "I'll do what I can. I'll get you the nice nurses, make sure they know about you. I volunteered for the night shift so I'll be here the rest of the time you're staying." Dean puts on a smile. "You'll be fine, okay?" Cas nods. Dean lowers his hand, lets his fingers skim Cas'. "I'll start the paperwork to get you admitted. I'll be back later."
• • •
That night, after Castiel Novak is successfully admitted and asleep in his hospital bed, Dean leaves to go to an on-call room. He's dead on his feet from working who-knows-how-many hours this week and there's no way he's driving home now when there are perfectly good (decent) beds right here in the hospital. He flops face-down on the bed and falls asleep almost as soon as his head hits the pillow.
Only a few hours later, he's awakened by the obnoxious beeping of his pager. Despite being in an on-call room, he isn't actually on-call, so who the fuck is paging him?
He picks up the pager, squinting at it. It's the room number for Castiel Novak. Shit. Dean quickly gathers his things and rushes out of the room, down the hall. He enters the room to see Castiel hunched over a basin and coughing into it. A nurse is standing there, rubbing his back. "The doctor's here now, sweetie," she says comfortingly.
Dean walks over. "You can go now," he says to the nurse. "I got him." She leaves.
"Hey, Cas," he says quietly. Castiel just continues coughing, almost gagging. Dean sits on the bed next to him. "It's okay. You're gonna be okay." Dean puts a hand on Cas' back and rubs in soothing circles. "Just ride it out." Cas coughs for another minute. Dean continues rubbing his back until he's stopped.
Cas inhales once shakily and then leans back into the bed. Dean takes the basin from him, looking at the tissues lining the bottom and, thankfully, seeing no blood.
"Let me take a quick listen," Dean says. He takes his stethoscope from around his neck and puts the earpieces in. Castiel nods, closing his eyes; Dean notes the tears that leak out as he does so. Dean rests the diaphragm over Cas' heart. It's pounding worse than before from the strain the coughing put on him. Dean moves to the lungs. They don't sound better but he doesn't hear anything that would indicate anything worse than pneumonia. "Can you please sit up for me?" Dean asks. Cas does. Dean puts his hand on Cas' shoulder, keeping him steady and hopefully providing some comfort. After that, he tells Cas to lay back down. "How do you feel?"
"Like crap." Castiel wipes his cheeks, smearing away the tears.
Dean smiles. "For real, though."
"I feel the same as before."
"That's to be expected," Dean says. "You've only been here a few hours. The fluids may have brought your fever down but the antibiotics take a little time to work." Cas closes his eyes. He looks more exhausted than Dean feels. "I'll leave you to sleep and be back in a few hours to check on you."
He starts to stand but Cas reaches out. He misses Dean wrist and ends up grabbing Dean's fingers in his weak grip. "Can you please stay?" His blue eyes are pleading as he asks. "I don't want to be alone."
Dean hesitates, his heart breaking just a little for his patient. "Of course," he says. "Of course." Dean pulls out a recliner from the corner and sits on it.
Cas falls asleep minutes later and Dean follows suit.
• • •
Dean's woken up sometime later by a person shaking his shoulder. He runs a hand down he face before looking up to see a nurse. Quietly, she says, "I was just coming in to check Mr. Novak's vitals."
"Oh, that's okay. I'll do it since I'm here."
"Alright," she says, and then leaves.
Dean stands. He stretches, cracks his neck and his back. On-call beds may not be the best but they definitely beat the recliners in patient rooms.
Dean reaches out and gently touches Cas' shoulder.
Cas opens his eyes slowly but then they widen when he remembers where he is. Dean squeezes his shoulder lightly. Cas' eyes dart to him and them he seems to relax, if only minutely.
"Hey, Cas. It's okay. You're okay."
"Yeah," Cas responds quietly. Then he asks, "Did you sleep here all night?"
"Yeah."
"I'm sorry. I shouldn't have asked you to do that."
"No, no. It's okay. You were..." he trails off.
"Scared," Cas finishes for him. Dean provides no comment.
"So, uh, I'm gonna check your vitals, if that's okay?"
"Sure."
Dean goes to the cart the nurse left and rolls it closer to the bed.
He gets out the thermometer and puts it under Cas' tongue. Then, he takes out the blood pressure cuff. Cas' eyes widen almost, almost, imperceptibly. "Try to relax," Dean instructs. "Lay back, close your eyes. Focus on your breathing and think about being someplace else." Castiel settles into the bed and shuts his eyes. Dean wraps it around Cas' arm. He puts on the stethoscope and puts the diaphragm of it under the cuff. He starts inflating it. When it's fully inflated, Dean glances up from the numbers very briefly to look at Cas' face. His eyes are squeezed shut. Dean then looks back at the numbers before uninflating it and taking the cuff and then his stethoscope off.
"A lot better than last night," Dean says. He puts that back and then grabs the chart, recording the numbers. The thermometer then beeps and Dean takes it out. "That's a little better too." Dean throws away the disposable sleeve from the outside of the thermometer and puts it back. "Neither are where I'd like them to be, but it's still improvement."
Dean then checks some other things like his heart and lungs, the IV bags, and his pulse ox.
When he's done, Dean's stomach growls, loudly, and he's reminded that all he had for lunch yesterday was a sandwich and all he had for dinner was a bag of chips.
Castiel smiles very slightly. "You should go, if you need to eat," he says.
Dean exhales a laugh. "Yeah, I think I will. I'll be back real soon," he says.
When he exits the room, he runs right in to Dr. Harper. "Winchester. What are you still doing here?"
"Uh –"
"Look, you know the new policy. I happen to know you've reached the max amount of work hours for this week. Go home. Shower. Eat something. Whatever, just get out of here."
"I –"
"Do you want me to get sued? Because that's what HR keeps telling me every time a doctor goes even one hour over."
"But I've got this patient –"
"We've all got patients, Winchester," he says harshly. "Someone'll look after yours. You've got two days off. Use them wisely." Dean glances behind him at Cas who looks worried. "Out. Now," Dr. Harper insists.
Dean leaves.
• • •
Hours later, after Dean has brushed his teeth, showered, eaten, and fallen asleep, his phone rings. He squints at the caller ID before answering. "Dr. Cooper?" he asks groggily.
"Hey, sorry. I tried your pager but you didn't respond so I figured I'd call."
"What is it?"
"Your patient, Castiel Novak, his blood pressure went through the roof. I think he had a panic attack. He won't let anyone touch him. I called psych but he wouldn't talk to her. He kept asking for you."
"Tell Cas I'm on my way." Screw Dr. Harper, he thinks.
• • •
Dr. Harper happens to be the first person he sees as soon as he steps off the elevator. "Winchester, I told you to go home." His voice is a mixture of frustration and annoyance.
"Sir, with all due respect, I have a patient with acute anxiety who was having a panic attack while I was at home and I seem to be the only person here who can remotely calm him down. On top of that, he has lungs riddled with pneumonia. Panic attacks will only make things worse, you know that." Dr. Harper glares. "Just consider me a friend or family member for the next two days. I don't even have my scrubs or lab coat with me." He's met with silence. "I won't be his doctor; I'll let the nurses and whoever has his case now work on him. Let me stay with him. Please?"
Dr. Harper looks at the ceiling and shakes his head. "Fine. Go."
"Thank you so much, sir." Dean rushes off.
• • •
By the end of the two weeks, Cas is almost completely better. He's ready to go home. Couple days bedrest and he should be fine to work.
And that's what Dean tells him. What comes as a surprise is the look of disappointment on Cas' face when he gives him what should be good news. His anxiety has gotten a whole lot better since he first got there. Of course, it was rough for awhile. Really rough, actually, but as he started getting healthier, his anxiety started going down. Dean had spent every waking hour with him for fourteen days. He learned his triggers, what to do to help him prevent an anxiety attack, and what to do when they happened. So Cas' look of sadness prompted him to ask, "What's wrong?"
"Well, I'm happy to get out of the hospital, of course. I feel a lot better and it's not like I like the needles and all the vitals checks. I just... I really like you." Cas faces away from Dean, blushing. "I'll miss you."
Dean touches Cas' hand lightly, drawing his attention back to him. "Hey, did you think our relationship would stop here? I don't think I could do that. I like you too."
"Oh," Cas says. He looks shocked.
"What? Did you think I didn't?"
"No. I don't know..."
"I made a reservation for two at Fratellis for next weekend." Dean smiles.
Cas blushes again. "That sounds nice." He smiles back.
"Right, so, you go home, rest up for a bit. I'll pick you up at six."
Cas smiles widely. "I can't wait."
"Me neither."