Castiel once read, in his recreational perusal of studies otherwise unrelated to his work, that a twenty six minute nap improved performance by 34% and alertness by 54%. Since then, he's had a timer ready to go on his phone for long shifts at hospitals: he's been pulling long hours whenever possible since he was an intern, and is used to curling up in a bunk in the on-call room and snatching that minimal amount of rest in several quick cat naps during times of 24-hour call, or his 16-hour double shifts.

Since marrying and moving into a home with Dean, he's been less inclined to spend all of his time at the hospital, but with the impending paternity leave once their children are born, Dean encouraged him to accrue as many hours in the hospital as he needs to, to have enough vacation to take for the children.

He has a few weeks left.

Or so he thought.

He's so used to sleeping through people shuffling in and out of the room, only coming around when his name rings out over the intercom, that Hannah's voice doesn't rouse him right away. He's snatching her hand off of his shoulder defensively before he really recognizes that he's been asleep, blinking up owlishly at her alarmed face, trying to orient himself.

"What is it?"

"Can I have my hand back?" Hannah is trying for patient and reasonable, which irritates Castiel for the most part because he didn't realize he's still gripping her wrist to keep her hand away from him.

"Yes." Cas moves as soon as he drops her hand, sliding to a seated position because it's awkward being under her scrutiny when he's sprawled in bed. Raking his hand through his hair, Cas grabs his phone, stabbing it to stop the countdown with just under five minutes left. He repeats himself, more alert now as his brain kicks into gear. "What is it?" It could be an accident, a medical emergency. His patients are all stable and were resting when he finished his rounds checking on them, but anything can happen at a hospital.

"Your Omega mate is. . ." Dean. Cas is on his feet and shoving his phone into his pocket and grabbing his coat before she finishes. ". . . being seen in the emergency room." That gives him direction, and Hannah has to trot to keep up as he strides out of the room and down the hall, forgoing the slow elevators to take the stairs two at a time. "There's an older gentleman with him who indicated that he became very disoriented, and then vomited, and he insisted on bringing him here for medical attention. The ER nurse has noted swelling in his hands and elevated blood pressure. . ."

Of course Dean has elevated blood pressure. He's been working too hard, trying to head a civil rights campaign and waiting for a Supreme Court ruling while denying he needs help doing it all. He's trying to shoulder all of the stress and worry for an entire gender designation.

Cas should have been there. There's no sense in accruing time to spend with their children if he neglects his husband in the pregnancy to do it. At least Bobby was with him this evening. The adoptive patriarch of their family has his hat folded in his hand, standing outside of the emergency room waiting for Cas, and he gives him a terse nod when he arrives.

Bobby lost his wife in childbirth. He'll never have children of his own, and the Winchester boys helped fill the gap she left in Bobby's life. Castiel knows that Bobby championed for Cas, while Dean was still hesitant about their relationship, and he's come to appreciate the nuanced relationship Bobby has with them all, and is slowly becoming another of the irascible mechanic's adopted charges.

So when Bobby grabs his sleeve to stop him, Cas stops against every instinct to get to Dean.

"He's alert, and even if it turns out he's physically fine he ain't in a good place. The stubborn idjit's been beating himself up since I showed up, like if anything happens to him or the twins you're gonna blame him for it. Don't you feed into that. I'll call Sam, you just worry about Dean for now."

It's sound advice, gives Castiel a good view of Dean's current mental state, and he would have thoughtlessly forgotten to bring Dean's brother into things in his urgency to help his husband. Nodding his understanding and thanks, Cas claps Bobby on the shoulder in passing as he picks up the pace again. "Thank you."

"Thank me by making sure he's taken care of. I'll be in the waiting room, you damn well better let me know what's happening." Bobby calls at his back before making his way toward the seats, pacing and pulling his phone out to bring the younger Winchester up to speed.

Dean's staring up at the ceiling when Cas rounds the corner and into the room, catching a glimpse of him through the gap left open in geometrically patterned curtains separating beds in the room. Hannah is still flanking him, brought up short when Cas stops in the doorway, eyes narrowing as he takes Dean in unseen. "Please see about readying a room in LDRP. Let Dr. Gaines know Dean is being admitted, and that we may need him prepped for an emergency C-Section. I need to know who's in NICU tonight. If you could let Lenore know to call in another physician to cover the rest of my shift . . ."

Hannah, for all that Dean instinctively dislikes her, is efficient at her job. She nods her understanding and disappears, leaving Cas to take a breath, trying to quell the panic and fear before he gets near Dean—they don't need to be feeding each other's anxieties, he needs to be collected. He underestimates how well they recognize each other's presence, though.

"You just gonna stare at me all night, Cas?" Dean sounds short-of-breath, tired, and doesn't tear his eyes away from the ceiling. With a grimace, Cas nods sheepishly to Tessa as she sweeps the curtain back to take him in standing there staring in at Dean.

"Tessa."

He picks his feet up again, still clinically observing Dean as he lays stretched out on the cheap bleached sheet of the wheeled hospital bed. He's more flushed than usual, ruddier in the cheeks, his slender fingers stiff and swollen as Hannah had indicated. Sweat has darkened his hair like it does after hard labor, hot days or good sex. Dean's beautiful, even now, but Cas knows him well enough as his husband and doctor to know these aren't good signs. The words are a tradition, a routine, and he offers them as he pulls up the stool next to his mate and takes Dean's opposite hand, mindful of the oxygen meter and blood pressure cuff. "Hello, Dean."

"Hey, Cas." Dean gestures with their joined hands at Tessa, turning his head towards her. "Go ahead and tell him all that crap you just told me."

"Potential preeclampsia?" Castiel's a trained physician, and more than that he's a worried expectant father who compulsively read every pregnancy text he could get his hands on. He doesn't need Tessa's diagnosis.

"He's showing enough symptoms that it's the likely verdict, yes, though we don't know until the delivery is over and the symptoms go away." Tessa agrees softly. Cas has always appreciated her gentle but honest demeanor in the emergency room, encouraging others to keep a level head even in the face of death. He reminds himself that this is nowhere near as dire a situation as he's seen her in, and if it were she would tell it to him straight. "It's his first pregnancy, twins, and he's at 33 weeks, so he fits the mold too. His blood pressure's still elevated, dizziness, headaches, and the swelling isn't going down. . ."

Cas nods, and it's apparent that's a dismissal because Tessa pauses, looking between the two of them. "I brought in the ultrasound and fetal heart monitor if you want to take over. I'll go draw up the admittance forms. . ." She's being kind, letting Cas assure both of them that the twins are okay and giving them something to focus on, and he appreciates it. With another silent nod, Cas answers her and waits until she leaves them, ducking down to rest his chin on Dean's shoulder and waiting for acknowledgement.

"What's today?" Dean asks at length, finally turning his head to take in Cas nearly nose-to-nose with him.

"November fourteenth." He's filled it out on half a hundred forms since he started his shift early this morning, the answer comes easily. Leaning forward he grazes his lips over Dean's forehead, trying to exude calm and composure and support and love, and probably just coming across as clingy and nervous. "As good a day as any."

Dean snorts, closing his eyes. "Bullshit. I think any day about a month and a half from now'd be better."

"Multiple pregnancies rarely ever go full term, Dean, outside of a rigidly controlled environment." Outside of a crèche or a farm, keeping their pregnant 'breeders' drugged and monitored and forced to term, no matter how unhealthy it is for the Omega, and some of the lower end farms with multiples whenever possible just to maximize profit. The idea's sickening, not a thought Castiel wants to entertain when chances are they'll be parents in a few short hours at most. "We're just a few weeks ahead of average for twins in a natural pregnancy."

A few very important weeks, granted, but an Omega is not just a human incubator as those places maintain, and Castiel won't play dice with Dean's health. He has faith—this will work out. Cas steals a kiss that Dean is at best a passive participant in for once, laying their linked hands over his stomach. "How long's it been since you felt them move?"

"I dunno." They aren't moving and kicking as much these days: even at this stage they're in cramped quarters, and of course now Dean's feeling like he should have been timing between movements. Dean's fear, pain and misery are acid, eating at them both. If he weren't certain it'd just make Dean feel worse, he'd call him out for doing this to himself emotionally. He's always too quick to see every setback as a sign of personal failure.

Cas kisses him again, chaste, comforting, and quick, and then pushes himself to his feet, dragging the curtain tightly closed around them and hooking over equipment with his foot, reassuring himself with the familiarity of medical routine. Tessa's already gotten Dean into a medical gown instead of his shirt, but they'll be moving into a room soon anyway, and Castiel wants Dean ready and comfortable. "Let's get your pants off."

"Buy me dinner first." Dean grumbles, and Castiel flashes him an encouraging smile, recognizing it as Dean working on sounding more like himself despite the pain he's in and the fear. He accepts the dirty look that wins him easily, as he slides his hands under the edge of the medical gown, fingertips playing along the edges of the waistband tucked beneath Dean's belly, a teasing intimacy.

"I bought you dinner last night. And pie. Now, pants." Rolling his eyes, Dean braces his feet against the table and lifts his hips slightly with a grunt of effort and discomfort, and Castiel tugs his husband's sweatpants and boxers off with practiced ease, fussily folding them and putting them aside atop the oversized hoodie Dean wore in, before drawing the blanket up over his bare legs and lap protectively. Dean snorts in bitter amusement as he lays his head back against the pillow again and closes his eyes, like that much exhausted him. Cas doesn't like his blood pressure or pulse rate, but he's trying not to give that away and Dean is desperately trying not to show the strain.

"They're going to get an eyeful pretty soon anyway, Cas."

"It's surgery, so not necessarily, and not everyone." Cas counters, flipping on the monitors and easing the medical gown up, exposing Dean's stomach between the blanket and gown. It's not terribly professional of him to bend and lay his cheek against Dean's skin, pressing a kiss over the rise of him where his skin is stretched thin over their growing children, but he's here as a husband and father, not a doctor. Not entirely, at least. Dean's hand clumsily lays over his hair, and he knows that it's helping, however little, to be this close.

They need each other—Dean's stopped resisting the truth of that, and Cas never doubted it.

Pulling away reluctantly, Cas gets to work, talking as he warms up the ultrasound gel and uncoils the fetal heart monitor. "The doctor is going to come in and discuss anesthesia with us. They're going to opt to put you under because of your blood pressure and to ensure this takes care of what's happening to you." He doesn't want any surprises for Dean, not now. "I have Hannah getting a room ready for us, they'll do everything in it, and it will be where you recover as well, so I'll be there the entire time. . ."

The rapid whump-whump-whump of two infant heartbeats fill the air around them like a helicopter in flight when Cas carefully places the transducers and bands them into place. Moments later the grainy grey image of their son sucking his fist is on the ultrasound, and Dean seems to melt into the table once Cas moves to the other side and finds their daughter, who squirms trying to get away from the pressure of the monitor within her confined space. Dean's abrupt relaxation proves the source and presence of a terror in it's suddenly absence, despite the fact that Tessa would have already listened for herself and assured him they were fine. It's one thing to be told that they're safe, and another to know.

"Okay, so they're gonna knock me out, I'm gonna wake up, you're gonna be there, and we're gonna be parents." Dean's laying this all out to prove he was listening, taking command of himself again because he's uncomfortable being weakened in public and he needs the semblance of control it gives him to make this his own decision. His words are breathy, chest constricted, and Castiel hides his frown at that. "You better use the names we agreed on."

"Of course. Muriel and Shamsiel, correct? Continue my family tradition?" Castiel dodges the swat at him easily, putting away the equipment and leaning down to kiss Dean softly again. "Or was it Ambriel and Qaphsiel?"

"How the hell'd you find an angelic name worse than yours for if a substitute teacher's ever gonna read it?" Dean tugs at his arm, and Cas glances at the curtains around them before deciding to go with it, knowing what Dean's asking for. Lowering the rail on one side, he carefully moves the leads for Dean's sensors, and climbs precariously into the bed with him, curled against his side, a hand splayed over his stomach.

"You wound me. I was a priest. There is no limit to my useless esoteric knowledge." He's careful in slipping his other arm beneath the thin pillow under Dean's head, tucking himself in closer, fingers tracing the curve of his neck to the rise of his shoulder, stopped by the edge of the gown. "You'll be okay."

"Yeah." Dean agrees, eyes closed, trying to pattern his breathing off of Cas's as he's had to for panic attacks before. They're terrible experiences for him, but for now Cas is glad he's had them, teaching him how to center himself. "How 'bout you?"

Cas ignores the sweat to tuck his face against Dean's hair, and eventually shrugs uselessly. He promised Dean honesty. "I'm terrified." No, that gave the wrong impression, he can tell. "I still have no idea how to deal with children, Dean."

Dean snorts quietly with a slight toss of his head. "Look at our dads, Cas. Figure it this way. Only way to go is up."

From an obsessed, neglectful and verbally abusive father who drank himself into an early grave rather than deal with his guilt, or a rampant egotist with a god complex who thought of children as a status symbols, ignoring the basic human rights of the Omegas he used to get them.

Dean has him there.

He stays tucked around Dean quietly, trying to keep relaxed enough to help despite the twanging nervousness and fear for Dean and their children. He leaves the heart monitors on but turned low, a steady white noise for them offering perpetual reassurance as Cas watches Dean's own heart and blood pressure reading over his mate's head until the curtains draw back and Hannah blinks down at him in confusion and surprise. "How are you both fitting there?"

"'S nothing. You should see what we can do in the back seat of a car."

"Dean. . ." Someday Castiel is going to be able to deal with Dean making a teasing reference to sex outside of the bedroom without turning scarlet. Today is apparently not that day, despite the fact that there's no clearer evidence of their very active sex life than Dean's pregnant belly under his hand.

Hannah is similarly flustered by it, blinking as Castiel carefully eases back out of the bed, finding himself trapped by Dean who deliberately lays a kiss on him one last time before letting him up. Whoever attributes territoriality to Alphas alone has never met Dean Winchester. It may be mildly embarrassing to be caught in the middle of that for no discernable reason that Cas can tell, but it's Dean. Castiel's hard pressed to think of anything he wouldn't do for Dean on a good day, let alone with him in the emergency room about to have their children.

"It's time?" Hannah nods, Cas can hear Dr. Gaines beyond the curtain in the room coming towards them, and Tessa's soft voice as she fills Gaines in completely. Cas sweeps Dean's sweat-matted hair back off of his forehead and presses a kiss to his furrowed brow. "I'm going to speak to my colleague. I won't be far."

Hannah lingers inside the curtain once Cas is away, and she waits until Dean's eyes are on her, bloodshot but curious as to what she could want to say to him enough to not want Cas around. "You don't have to be wary around me, Dean. Dr. Winchester expressed his 'priorities' to me very clearly a few months ago."

"Yeah, how'd that go?" Dean's voice is a croak right now, thick, pained now that he doesn't have to hold it together much longer for Cas. . . as Cas holds it together for him.

"Awkwardly, but he got the point across." Hannah admits, flashing a faint smile. "You're lucky. He's a good man."

Dean can't argue that one. "I know."

Cas sweeps in again a moment later dispelling the strange moment for him. Having a room full of people tutting and fussing over him is difficult, and he still hates emergency rooms. By the time the drugs take hold he's just ready to be unconscious, aware until he's under of Cas's hands holding his.

xXx

You don't really know how many abdominal muscles you use for something as simple as coughing until you've been gutted like a fish and stitched back together. A simple attempt to cough and clear his dry throat in that hazy stage between unconscious and awake ends up with Dean aware of the fact that if he weren't coming down off some really good drugs and still hooked up to an IV giving him more, he probably would have regretted that a lot more. As it is, he opens his eyes to Cas leaning over him, a hand behind his head to support him, holding an ice cube to his lips in a dim room where he's tucked under a mound of blankets.

"This'll help. Welcome back."

The disoriented feeling lasts only a few moments, and he hastily swallows down the ice cube, grabbing for Cas's arm braced on the bed beside him. "The twins. . ."

"Are fine." Cas promises, cupping Dean's face in his palm, thumb running along the cheekbone. "They're in the Neonatal ICU, but they're fine. I'll help you see them in a minute, I just. . ."

Dean's lips are cold from the ice, but Cas surrenders into the kiss even knowing that it's a distraction as Dean tries to kick the blankets off of him, only to find himself strung up with damn sensors and IVs and a frikkin' cath.

It's a good thing looks can't kill.

"I need to see them."

"How do you feel?" Cas looks him over, searching his face, registering the glare aimed at him. "I'm going to take that as 'better.'"

"I want to see our children."

"And I said I'd get you there." Castiel mutters, meticulously tucking him back in. "I didn't say you were going to make a daring escape on your own to do it. I didn't want you to wake up alone, Dean, and they needed to do some basic tests on the twins and set up their care. I was getting in the way." Satisfied that Dean's safe, Cas pushes back up to his feet. "Now, it's easier for me to steal a patient if you cooperate with me a little, Dean."

They're not working against each other: Dean should have known better. They're co-conspirators, and have been since the day they met. Dean nods, making himself slump back into place on the bed, and he's rewarded for it with another swift kiss before Cas makes them mobile, wheeling the bed out of the wide doors of the recovery room and navigating them adeptly.

The NICU is, to Castiel, the only frightening place in the entire hospital. Every patient is so fragile, tiny little creatures in their plastic-sided homes, and he's useless here—too big, too inexperienced, and every incubator he sees makes him flinch and think of the crèche. The crèche was always full—here, there are so few infants, but they belong to someone. There are colorful blankets, toys tucked safely away in the corner of their incubators, something more than a sterile incubation crib carefully labeled designation, purchase number, and surname. The memories are distant, hazy things, but he spent the first six years of his life in the crèche, the triplets left there to age in a place meant mostly for newborns, the abandoned toys of a rich man.

He waited until Dean was awake, because he won't disregard his husband like his 'job' is done now that they've had children, but he understands needing to be here. Needing to see. Needing to make sure their children know they're wanted.

The NICU nurse shoots him a knowing look that Castiel shrugs in the face of as he wheels Dean in, but she carefully clears space for them in one of the private rooms off of the main room, usually kept for infants born with suppressed or nonexistent immune systems, who need to be kept apart. He fits Dean's bed against the wall and plugs it back in again, as Dean looks out of the windows into the main nursery worrying his lower lip unconsciously.

"Let's get your gown off." Dean swings an incredulous stare toward Cas that he misses entirely because he's busy tugging his own shirt off.

"Dude. Not in the mood. Pretty sure we're never having sex again, actually. Ever. You owe me a blowjob or twelve though once we're home . . ."

"Yes, well, we can negotiate that when we're not in a nursery surrounded by infants." Castiel deadpans quietly in response, then realizes when Dean rushed him out that he missed a step in his explanation. "It's called kangaroo care, Dean. It's beneficial for preterm infants, improves bonding, stabilizes body temperature more smoothly than an incubator, reduces of risk of nosocomial infection, and has been proven to result in an average earlier discharge despite prematurity. . ." Dean is giving him that look again, the one that says he's talking but not really explaining himself, and Cas palms the back of his neck sheepishly as he tosses his shirt aside and pulls a reclining chair over near Dean's bed, grabbing himself a blanket. ". . . I may have pushed an argument in favor of a practice not as widely used in the US, and not at all in South Dakota, but it lets us hold the twins for as long as we want every day, while they're in the NICU."

Castiel carefully researched the health benefits of snuggling, and successfully argued it with his bosses. He stood in front of his employers and used the words 'kangaroo care' like he was talking about a serious medical practice instead of something that sounds like it should be in a PBS kids program. Dean married a genius. A dork, but a genius.

To think, Dean used to pretend not to want that kind of nearness. Cas changed that. Kids are sure to screw his public 'no chick flicks' edict to hell too. He's spent months talking to his own stomach whenever Cas wasn't around, assigning emotions to a kick or a roll or a flutter of movement. He's unreasonably anxious to "meet" them finally.

When the nurse carefully rolls in two incubators, Cas's hand on his shoulder is all that keeps Dean from trying to sit up and reach for them, and he can feel the tension in Cas too as the nurse carefully lifts up the first hood. "Don't be afraid if you hear an alarm go off, it's fairly routine and we'll come in to check on you all. You should speak to them quietly, or sing. Right now they need a bit more time before their sucking reflex means they can bottle feed, so don't worry... They're getting nourishment from the tubes. All you need to do right now is be here for them..."

Cas is nodding, listening intently, but both of them are fixed on her hands as she carefully lifts up Mary Winchester from her cradle. "Mommy first...?"

Castiel swears he can hear Dean's teeth grind at being casually misgendered in that sweet, patient voice, just because of his designation and because he just had two kids. He's either too tired or too eager to hold their children to argue this time, though, as he did every time they went shopping for nursery supplies, taking aback shopkeepers across the city.

The moment passes swiftly, and Castiel stares transfixed as Dean carefully situates Mary on his chest as Cas instructs him to, where she can hear his heartbeat and share his heat, her tiny fists curled against him. Stroking a fingertip down her back, Dean's voice is thick when he finds it. "Hey, baby girl."

"Can he hold both of them for now?" Dean needs this more than he does, no matter how much Cas desperately wants the chance to hold them. He feels faintly guilty that he saw the twins first, before the tubes and sensors and cuffs overwhelmed them, no matter how brief it was and how little contact he had before they were cloistered away.

"Just shut up and sit down where I can reach you both, Cas. We can swap in just a bit." That's probably the sweetest voice Dean has ever used to command him in, pitched soft and gentle for the infant who seems dwarfed by the hand spanning her back.

Like his sister, Jimmy is a tiny thing, barely any weight at all when he's carefully laid out along Cas's skin, and Castiel pulls the blanket over them immediately, afraid of their body heat leaching away in the hospital room. Dean's hand finds Jimmy immediately, and Cas knows Dean is watching them settle in. He tries not to let himself hear how Dean swallows back tears, resting his hand over Dean's on their son, and Dean nods finally, at something unspoken. They're going to be okay.

"We're getting rid of all the pink and blue stuff as soon as we can talk Bobby into swinging by the house for us." Dean's whispering, and he touches a finger to the powder blue cap on Jimmy's head, tipping his chin down to nuzzle into the pink one that's folded over to fit on Mary, both too small for the standard hospital issued coverings.

Cas doesn't argue. He wouldn't anyway, even if he could find his voice. They're a family. He has a family. He questioned the Winchester family tradition of naming their children after lost loved ones, but Jimmy's heart is thrumming against his, tiny and trusting and perfect, and he wouldn't change any of it.

"She said we should talk to them, or sing..." Dean muses and Cas nods in answer, too dumbstruck by this to really be of much use in the matter. Dean laughs at Cas's expression, startling Mary, and he hushes her quietly.

It's instinct, it feels right to Dean when the first soft lyrics spill out as he reclaims another memory, taking away the bitter sting it's held for years.

"Hey Jude, don't make it bad... Take a sad song and make it better." Castiel looks up from their son to watch as a smile teases at the corners of Dean's mouth; for this moment he is content. "Remember to let him into your heart, then you can start to make it better."