Twist and Shout

Chapter 11

"We should go...that's what...I said..." his speech was slightly slurred, and Dean reached for the call button.

He waited outside while Doctor Ether, or so Tessa called him, administered the tests, Tessa with him. Dr. Ether left first, his coat flapping around him. He didn't stop to tell Dean anything, but Tessa came out after a moment, her face worried.
"What's the matter with him?" Dean asked, and Tessa put her hands in the pocket of her long heather grey sweater.
"He's...we don't really know," was all she could say. "I'm sorry Dean, I can't really explain right now, I have rounds." She trotted off down the hall, and Dean was left alone.
When he peeked into Cas' door, he was staring out the window again and Dean slipped backwards, following where Dr. Ether had gone. When he was nowhere to be found on the floor he went down to the first floor. He needed food, he realized suddenly. He never remembered to eat these days. Cas teased he would get as thin as he did, though Dean never found those jokes especially funny.
Dean spotted the man sitting at one of the many cafeteria tables; he was poking at some kind of pasta, but mostly drinking calculated sips of steaming coffee. He was a drawn-looking man, with heavy bags under his eyes and thin, precise, hands. Though Dean had only seen him from the back before, he knew he was the person he needed to talk to.
He didn't waste any time after that, navigating the crowded room as best he could until he was finally peering down at the doctor from the chair opposite him. The doctor nibbled on his issued breadstick, but didn't bother to look up at Dean. From this proximity, Dean saw that beside the plate was a kind of file, the manila folder folded and the neat white stacks of paper sitting on top, attached to the inner cover.
He flipped the page over and then motioned with his free hand at the empty chair.
"Don't hover. Sit."
The sound of the furniture scraping away at the tile floor was drowned out by the drone of occupants; nurses, patients, but mostly the displaced friends and family of said patients - and of course, the doctor in front of him.
Dean glanced at his coat and saw the printed nametag clipped right above the pocket of his white doctor's coat. Dr. Ether. He was right.
"I have some questions for you." Dean began, glancing up from the words to the man's sharp face. His bone structure was alarming, and his black hair made his white skin even whiter. Dean wondered how he wasn't confused for a mortician, not a man who saved lives.
"What makes you think I will answer them?" the man drawled, and then he stopped flipping through the papers and looked squarely into Dean's face. "Though, I admit, it's charming how forward you are."
"You are Cas' doctor, and I have some questions about it."
Dr. Ether's face dimmed considerably as he tilted his head in recognition of the name.
"Ah, so you're Dean."
Dean leaned forward in the chair, his hands folded in front of him.
"So what if I am?"
Dr. Ether, surprisingly enough, cracked a smile.
"My patient's brother warned me you might be making an appearance at some point." He gave Dean a once over and smirked. "He also mentioned you might be concerned."
"Oh, I'm a little beyond concerned," Dean growled, clenching his fists. Dr. Ether took another small, calculated, bite of his breadstick and pasta and patted his mouth gently with the paper napkin from the dispenser beside him.
"You've earned my attention, so ask."
Dean watched Dr. Ether take a drink of water from a glass on the tray in front of him and felt his mouth become drier than before.
"Why isn't he getting better? I see people in there constantly, but he hasn't changed in a week."
Dr. Ether took a breath and looked blankly at his beige pasta and the formica table top, as if he didn't know where exactly to start. Dean could already feel a lump forming in his throat that was becoming impossible to swallow down.
"Do you have any knowledge of what your immune system does?" the older man started, smoothing over the edge of one of his fingernails.
"It protects you - from infection."
Dr. Ether smiled grimly and met Dean's panicked eyes.
"Precisely. It protects the body from infection."
He took another sip of his water and wiped the condensation on his trousers.
"Castiel Novak has no immune system," he said calmly. Dean's eyebrows lowered almost automatically.
"What do you mean he has no immune system?"
Desmond Ether looked at the ceiling, closed his eyes and then tapped a point on the papers in the manila folder. Dean realized with horror that the papers were Cas', that the numbers and figures, the notes written in the spidery scrawl and the red underlines. They were all his.
"His T-cell count is practically non-existent." Dr. Ether shook his head side to side, his expression perplexed. "Truly, we've never seen anything like it - his body is beyond compromised. Boys have been coming in with it over the past month, and nearly all of them are like you. Mid-thirties, homosexual." He tapped his finger again. "My colleagues and I are very disturbed by it, and the numbers keep growing. They've had to call the contagious disease center. We've had an agent looking at Mr. Novak's case for almost his entire stay. He's just one in a string of strange occurrences we've had."
Dean tried to understand exactly what he was being told. He knew Cas had pneumonia, and from what he had gleaned, it was a rare form. But that should have been treatable. Cas was young, he had always been healthy.
"So what are you going to do?" Dean blurted, watching the doctor push his pasta around with no intention of eating it anymore. His fork paused, prongs spearing a piece of vegetable, and he almost seemed to look shocked at Dean's question.
"Do?" he responded quietly, squinting at Dean. "What am I to do?"
"To help him!" Dean said fiercely, sitting forward. "To help him beat this!"
Dr. Ether's eyes narrowed further, this time in pity.
"I apologize for not making myself clear - there is nothing to be done. I thought that would be obvious when I told you that there is nothing protecting Castiel Novak from anything that would ever chance to waltz into his body. These boys are dying. I can't doctor them. I am merely shuttling them along to the inevitable."
The words seemed garbled and foreign to Dean, like he was hearing them - and he knew they were words, but he couldn't quite make out what they meant.
"...w-what do you mean...," he tried, shaking his head. "...There has to be something - you're a doctor," He added desperately, his anger mounting. "Don't fucking tell me you can't do anything, that's bullshit!" He slammed his fist on the table, rattling the cutlery and the napkin holder. Water sloshed unevenly from the glass and fell into the tray. Dr. Ether said nothing for a long while as the stares of other people gradually busied themselves elsewhere.
"I cannot give him a new immune system," Dr. Ether said quietly,."I cannot even help him grow a new one." The doctor took a moment, perhaps to internalize. "There is nothing I can do for him. We have tried to manage his symptoms, but at this point it doesn't matter. Do you comprehend that?"
"Please," Dean whispered. "Please, if it's about money, if it's about anything."
Dean stopped as a hand touched his own. He hadn't realized he was moving it forward and reached out. Now he was grasping hopelessly at the man's sleeve. He felt like he was already slipping to his knees to beg.
"Son," Dr. Ether's face was grave. "You have to understand that he is being eaten alive from the inside out. I couldn't buy him an hour if I wanted to, even if money were no object."
"So you're just going to let him rot?" Dean cried. "You're fucking just going to let him sit in there, and waste away?!"
The doctor felt Dean's hand dig into his forearm. He winced.
"We are doing everything we can to make his transition comfortable."
Dean looked away, at the busy cafeteria line. His grip loosened and he pulled his hands back to fall listlessly into his lap. His brain felt too soft in his skull.
"Transition," he whispered, his voice snagging. All those times Tessa came to check on him, she was just helping him...to die? Numb him up so it didn't hurt so badly - because they were gonna lose him.
We're gonna lose him.
It was like a nightmare. The bad dreams he would have overseas. He would just have to wake up, and it would all be over. Everything. He'd wake up and he'd be in bed in the apartment, and Cas would be right next to him, one leg over, one leg under. He'd kiss him and then go back to sleep, the only thing to show for this trauma a light sweat and a shake of his head to clear it.
"We're down to days, at this point. Respiratory and cardiac arrest are sudden. His heart could stop anytime."
Dean tried to swallow, but the lump wouldn't go down.
"If we are dealing strictly in terms of the pneumonia, the lack of oxygen has put his heart into an unreasonable gear. It's doing twice the work with half the results. It's going to fail him. That is, if the fluid doesn't drown him."
There was a beat of silence before the doctor continued, his voice slow and thick, like molasses trickling through Dean's ears.
"Before then we may lose everything. His body is turning off as we speak - kidneys; liver; bowels. It's all shutting down."
Dean kept looking away, so that the doctor wouldn't see him as he bit the inside of his cheek so hard he feared he might tear through it.
"The only thing I can give him is you."
Dean snapped his head back to the Dr. He was looking out the windows over Dean's shoulder, his hands folded over one another. He nodded to himself.
"It was so hopeless," he murmured, "but when you came we saw small improvements. Minor things. Superficial things, but still, any positive results we welcomed. I've been a doctor a long time, Dean, so I don't know why I keep being surprised by what love does to people."
Dean flushed.
"I don't know what you're-" he began harshly, but the doctor's pitying smile found him again.
"There is no reason to lie," his voice was low, "It makes no difference to me. In fact, I'm glad. Dying people need a reason to wake up in the morning, or else they wouldn't."
Dean's heart was beating so fast in his chest. He felt dizzy, strange. Like he wasn't really in his body, but floating right above it, watching as all the horrible things kept getting said.
"So you'll let me stay with him?"
Dr. Ether sighed.
"If I could prescribe such a thing, I would, and if anyone has a problem with it they can see me. You...partners...or what not, you're crucial to the investigation. You can give us details about what Cas did before, what his habits were. Anything to give us some kind of foothold."
Dean looked away again.
"But, if you stay, you'll need to know what you're going to face."
Dean nodded blankly.
"We have planned for the worst, Dean. He will lose his vision. His speech. All of it. What you've seen is the just the tip of the iceberg. His brain is just like any other organ and it is just as vulnerable to whatever's swimming around in him. Even if he is conscious at the end, communication will be difficult. It will frighten him; his disease causes anxieties because of the impaired breathing."
Dean shut his eyes and then opened them, tiredly. He didn't have the energy to feel anything. He wanted to get back to the room.
"So his memory?"
"You've seen for yourself."
He wanted to go look at Cas, because he was alive, and he needed to look at him.

He didn't know if Cas knew or not.
"Just tell me what to do," he breathed, "and I'll do it."
Dr. Ether took a deep breath himself and let it out slowly.
"Talk to Tessa. She'll tell you everything. I'm afraid I need to go work."
Just like that, the conversation ended and Dr. Ether closed the cover on the file and slipped it under his arm. There was no goodbye, no real exchange. Dean knew it was because it would be redundant. There was nothing else to be said.
Dr. Ether got up and left, and Dean kept watching the line of people. After a few minutes he stood shakily and went and bought an orange and carried it back to Cas' room. He stalled in the door when he got there, watching Tessa fuss with the IV drip; Cas opened his eyes and smiled at him under his oxygen mask.
"You were gone a while," Tessa said with a smile, having returned, voicing what Cas' face could only show. She was looking up from her work, studying Dean. Dean shrugged weakly and went to the chair at the bedside. Cas felt for his hand automatically and stroked his fingers, eyeing the orange. He didn't want to watch her put more morphine in the bag.
"You want some?" Dean asked and Cas grinned. Dean licked his lips and saw to peeling it, pulling his knife from his pocket to get it started. Cas watched his hands the whole time, still smiling.
"Is orange your favorite, Cas?" Tessa asked and Dean had to crack a little at that. He heard the rustle of Cas shaking his head on the pillow.
"Blueberries," Dean answered. "He eats them by the gallon." Ate them, his mind corrected. His finger almost slipped while he was putting the knife away.
"They...aren't....in season," Cas said slowly, pulling his mask aside before he couldn't keep his hand up any longer. He smiled sheepishly and Tessa patted his shoulder, laughing.
"Well, maybe I can round some up for you."
Dean didn't respond, just continued peeling the orange, tossing the peels on the bedside table. He heard the door click shut as Tessa left and found his hand wasn't moving anymore.
"...Shh." He heard Cas say and it sounded like it was across the room. "Dean..."
"I'm sorry," Dean sobbed. "I'm sorry, shit - I didn't want to do this."
He pulled the orange apart, sectioning it, but he couldn't see what he was doing.
"Shit."
"Dean."
"I'm sorry."
He stared at the orange, and there was juice all over his hand. He laughed, pathetically, and threw it with the peels, wiping his palms on his jeans, and while he was doing that his body bent forward over his knees; he just couldn't hold himself up anymore.
"I ruined it, sorry!" he sobbed into against his sticky fingers. They smelled sweet.
"It's ok," Cas said quietly. "Don't...worry about it."
"Don't tell me not to worry about it!" Dean cried. "I just - I'm really sad, ok? I'm really...I'm really sad."
"Dean?"
Dean sniffed and raised his head, hiccupping slightly.
"I...I want to tell you," Cas said, his words slow and thought out. "I want to tell you...why I wanted you to...come...and see me."
Cas held his eyes and placed both of his hands over Dean's.
"You...have to stop," he continued, voice low and gravely and faint, "...you have to stop...blaming yourself."
"We've already talked about this, Cas," he muttered.
"Well...listen."
He looked up at Dean from his pillows, his sweater all bunched around his neck, his shirt wrinkled. His face was yellowish in the light from his bedside lamp and Dean knew what he was trying to say.
"You...you...gotta promise," Cas hushed, "...look at me..."
Dean, whose eyes had wandered, returned his gaze.
"...Don't hide anymore. Don't run anymore...I want you to be happy...I want you...I want you to be happy without me."
Dean tried. He really did.
"Don't ask me that," he whimpered. "Don't ask me to do that."
"Dean," Cas said, sternly, forcing him to keep looking into his eyes. "...Dean, I'm dying...and...I..." he shook his head on the pillow, eyes closing, but he didn't cry. It was as if he refused to. "...I don't want to. I don't...but you...you aren't dying...you aren't...you aren't dead...so stop acting like you are."
"How am I supposed to be happy without you?" Dean rasped. "How do I do that? You're everything. You've always been everything."
"You...have to try," Cas replied. "You...have to...or none of...this...will be worth it."
"I'm not worth it - none of it was worth it," Dean interrupted. "Look what it did to you? Look where it got us?"
"Don't - ever!" Cas said fiercely, stunning Dean. His eyes were clear and furious, as coherent as they'd been in days. "Don't everapologize for...us."
He had to pause to catch his breath again, and his eyes softened.
"Don't...don't apologize for...who we were."
Dean shook his head and Cas brought his hand to his face.
"You made me...so happy Dean," he breathed. "We did our best...we gave it...our best try...and it was...really beautiful."
Dean nodded, not completely convinced, but he understood what Cas was saying. He just wished someone would explain it to his heart.