Dr. Novak bustled through the hospital entrance shortly after eight thirty in the morning, duffel coat hanging carelessly off his arm and staff keycard clamped in his mouth as he made a valiant effort to juggle keys, paperwork, his briefcase and an almost-overflowing cup of coffee whilst frantically negotiating his way through the busy corridors.
Someday, he thought, he would correct his lack of organisation and punctuality; but today was not that day. Especially when there was a staff meeting scheduled thirty minutes before he usually arrived in. A staff meeting which he was already late for.
He raced up three flights of stairs, almost losing the coffee once or twice, before arriving at the door to the staff lounge and not-so-skilfully swapping the keycard in his mouth for a folder of patient files. He swiped the door open and let himself in, relieved to see the meeting hadn't started yet; and everyone else was still milling around, looking as tired as he felt. He made his way through the crowd of grumbling staff to his locker, depositing his coat and keys before taking a seat with his coffee and sorting through his notes.
It wasn't long before the room was hushed by the appearance of the hospital's Director of Clinical Care and consultant anaesthetist, Dr. Henricksen, followed by a middle aged man Castiel didn't recognise.
Dr. Henricksen slowly stepped into the centre of the room, pausing as the staff formed a circle around him. Castiel stood up and joined the circle, curious as to the reason he missed a good half hours sleep this morning.
"I'd like to thank everyone for making it in early this morning" he began, "although some of you look like you're here only in body and not mind." A short, customary hum of laughter rippled through the group before returning to silence.
"The reason I requested a staff meeting was to introduce the changes in the Department of Surgery, effective as of today. As you know, I held interviews last week to select a new Chief of Surgery after the retirement of Dr. Devereaux, and over the weekend the new positions have been confirmed. I'm pleased to announce Dr. Uriel Vorster as your new acting Chief of Surgery."
The group applauded as Uriel stepped forward and clapped a heavy hand on Dr. Henricksen's shoulder, grinning widely around him. Castiel sighed inwardly and he lazily brought his hands together a few times, only just refraining from rolling his eyes.
He had studied medicine at Kings University Belmore alongside Uriel Vorster, and discovered his characteristic arrogance hadn't ceased any when they both ended up working at the Royal Celeste Hospital a decade later; Uriel as a maxillofacial surgeon and himself as an accident and emergency consultant. Out of all the hospitals in Ireland, it was his luck to be working alongside one of his more obnoxious classmates.
Uriel took his place back in the crowd as the applause ended, and Dr. Henricksen continued.
"In Dr. Vorster's place on the surgical team, I'm also pleased to tell you we have employed a new member of staff – Dr. Dean Winchester, a general surgeon from the nearby Grace City Hospital."
The man Castiel had seen earlier stepped forward to shake hands with Dr. Henricksen, surveying the group with what Castiel guessed was his most charming smoulder. Ruby and Meg, the staff nurse and radiologist, giggled from somewhere behind him and he sighed. A couple of weeks of the nurses acting like nine year olds was definitely on the cards.
Dr. Henricksen let go of Dean's hand, momentarily checking his watch. "The shift swaps over in ten minutes, which is sufficient time for everyone to adjust to the new team. Thank you all again for coming in early, and my best wishes to Doctors Vorster and Winchester in their new positions."
As soon as he left, Dean Winchester was predictably surrounded by almost every woman on the hospital staff. Castiel returned to his seat on one of the sofas and emptied the rest of his coffee.
"Not even two minutes in and he's already encircled." Came a voice from above him before Castiel was nearly bounced off the sofa from the force of another body being thrown ungracefully onto it. He was very glad he finished his coffee when he did as a smiling Garth turned to face him.
"I wish nurses dug microbiologists as much as they did surgeons." He said wistfully.
Castiel harrumphed beside him, not taking his eyes off the page he was reading. Well, attempting to read. He wasn't actually taking in a single word.
"Aren't you going to say hello?" Garth enquired, tilting the pages Castiel was holding to read them himself. He was too eager for such an early hour and just looking at him made Castiel feel tired.
"It's too early to be talking to anyone, even you." He yawned, whisking the pages out of Garth's hand and bouncing them off his head before stuffing them in his briefcase.
"I need at least one more coffee before any form of social interaction can happen, and no amount of caffeine would make me want to pick through that hoard of rabid women for a handshake."
Garth laughed as Castiel got up and made himself a cappuccino, with two extra shots for good measure. He wasn't a morning person at all.
He sipped his coffee as he leant against the counter and surveyed the new surgeon. He seemed to be the same age as Castiel – mid thirties he guessed, and everything about him screamed 'ladies' man'; from his styled hair to designer shirt and expensive shoes.
He was currently answering questions from his admirers, eyes bright as he told them some story that caused them to burst into a chorus of over-zealous laughter.
Ten minutes and two coffees later, people started to drift out to get ready for their shifts. Castiel, feeling slightly more energised than when he arrived, clipped on his nametag and shoved everything in his locker. Grabbing his stethoscope, he looped it round his neck and headed out the door, catching a glimpse of Garth giving the new doctor a high five as they made to leave.
He was sure he'd hear everything there was to know about the man from the nurse's station on his lunch break.
The rest of his morning went fairly quickly. He was assigned to cubicles when he reached the A&E department on the first floor and was busy from the get-go.
After a fair bit of suturing, wrapping various sprains, sending a few suspected fractures up to Meg in Radiology and helping the team deal with a three car RTC involving some tricky intubations, he was on to his last patient before his break.
He was finishing up, rechecking with the abdominal ultrasound whilst reassuring the patient that his pain was caused by kidney stones which would pass naturally. Going over the aorta however, he was stopped as he recognised a familiar swelling.
Unfortunately for the man, further investigation proved he had a small abdominal aortic aneurysm, a turn of bad luck unrelated to his complaint of kidney stones. He explained as gently as he could to the patient what he had found, and left him to absorb the news as he rang for a surgical consult.
Minutes later, Dr Winchester appeared, offering a hand to Castiel.
"Dr Winchester." He beamed. "What can I do for you?"
"Dr Novak" Castiel offered back, giving a quick handshake before ushering him away from the cubicle.
"Triple A" Castiel said softly, opening the patient notes and handing them to the other man. "His only other condition is kidney stones. We've found it in the early stages though and it would be in his best interests for you to book him in for surgery as soon as possible"
Dr. Winchester flipped a few pages, and leaned back to peer at the patient before snapping the file shut.
"No way."
Castiel blinked. "Excuse me?"
"Dude, he's sixty years old. Risk from surgery is greater than risk of rupture. There's no point. It's not safe."
"The aneurysm is relatively small, and at his age that puts the risks at an equal level. It would make sense to operate now instead of waiting until it grows larger - by which time he'll be older and the risk from the surgery will be disproportionate."
The other doctor was already shaking his head before Castiel had finished speaking, and he had to make an effort to keep the frustration out of his voice in the last few words.
Holding the file out to Castiel, Dr. Winchester turned as if getting ready to move on. Castiel ignored it. He sighed, facing him again.
"Look, Dr. Novak. If we don't operate, he'll definitely live for another ten or fifteen years before it causes him any trouble. If we operate at his age, he could die on the table."
"And you're happy condemning a man to aortic dissection at the age of seventy?"
"Rather that, than killing him right now, which is a clear possibility."
"That's completely foolish" Castiel huffed. "If we take a small risk we could grant him his full life."
"Well that's not a risk I'm willing to take. End of discussion"
"Dr. Winchester…" Castiel started, but the patient file was thrust into his hands.
"Call me Dean" the doctor said. "You have a nice day now." He winked before walking purposefully away from the ward and out of sight down a corridor.
Castiel clenched and unclenched his fists, attempting to dissipate his annoyance at this cocky, confident and close minded moron.
He'd only just met him, and did not like this Dean already.