Chapter 2
This.
This was the worst part.
Dean took a deep breath. His hands shook, and an uncomfortable heat spread towards his stomach making him feel sick.
Dean had always wanted to be a doctor, not because it was the family business from who knew how long ago, but because he really thought he could help people. Because he'd thought he'd be good at it. And he was. Third in his class, top pick for practically any hospital or clinic he wanted. And he loved it.
But... but this. This. This was the part he couldn't stand. Because it meant he'd failed. Of course he'd lost patients before. Ones that he'd known were probably a lost cause, but Mr. Balford – Tom – he'd had a chance. What had Dean done wrong? The surgery had gone so well.
But there was nothing for it. Dean tried again to force calm upon his body, and succeeded marginally. At least hopefully his voice wouldn't shake. He exited the stairwell and walked determinedly towards the waiting room where the nurse said they'd be.
"Mrs. Balford?" he asked of the only three occupants of the room. Wife and two kids, a son and a daughter, both around twenty.
Mrs. Balford stood from where she had been chatting idly with her son. She smiled at him and nodded. "Where's the doctor?" she asked.
Dean was young. He got that a lot. "I'm the doctor," he clarified.
"Oh, I'm sorry." And she did look sorry. Terribly sorry. She blushed, and started, "I didn't-"
Dean didn't let her finish. If he didn't get it out soon, he thought he might explode. "I operated on your husband."
She smiled again kindheartedly and put a hand on her chest. "How is he?"
For a moment, Dean didn't think he'd be able to do it. How much easier would it be if he just ran away now and ordered some nurse to do it. To tell them that their husband and father was dead. Dead because Dean had failed. They didn't look worried or stressed. They'd been fully expecting him to come away from his heart attack, maybe not unscathed, but alive. They'd expected the surgery to be successful. They'd expected him to be okay.
Dean's heart speed up again. How fitting would it be for him to have a heart attack of his own right here. Maybe it would fix everything, and could bring Tom Balford back. A life for a life.
"He didn't survive." It felt awful on his tongue. Heartless and cruel.
Mrs. Balford stood still for a moment, her kids sat behind her, smiles frozen on their now deadened faces. After a second of trying to process the news, she forced her jaw to work. "What?" she breathed, almost inaudible. Probably all she was capable of at the moment.
Dean almost couldn't do it again. His heart felt fit to burst, so he fell back onto what he knew. "We were able to restore blood flow to the heart with the operation... but he developed a lethal arrhythmia and we couldn't resuscitate him."
Mrs. Balford blinked, took a breath as if it were the first she'd taken in hours, and she raised her hand from her bosom to either reach out for help or point at him accusingly, Dean wasn't sure, but she laid it back down and said, "Wait. I'm sorry, I don't understand. A what?"
He saw tears forming, and felt his own face flood with heat. "I'm sorry."
"But, but... um. Excuse me. I'm sorry." It sounded like bargaining. But at least she was getting it.
The Balford's daughter's manicured fingernails dug into her cheek just below the line of her mouth. "What did you say?" asked the girl. "What?" her voice rose hysterically.
Dean's mouth opened, but he suddenly couldn't speak. The panic had won, and now he was failing even at this.
Mrs. Balford's son stood and hugged his mother, and Mrs. Balford reached behind her and put a hand on her daughter's head. "Oh my God!" the girl sobbed into her mother's side.
Dean couldn't stay any longer. He left the family to deal and all-but ran out the door.
O0o0o0o0o0o0o0o0o
Castiel followed as Dean Winchester slammed his hands onto the stairway door. He sprinted up three flights before he finally stopped and sat heavily on a step. The tears he had been holding back for so long burst forth, now that he was alone there was no reason to keep them hidden. Castiel could hear Dean's thoughts, desperate and broken as he cried.
On the table, on my table. I'm sorry.
I'm sorry.
His head hung forward, one hand clutched at his hair in grief, and his breath hitched with sobs.
I'm sorry. What happened?
What happened?
A graft occlusion? What?
Castiel stepped forward and knelt in front of Dean. He could hear Dean's heart pounding in his chest. Could feel Dean's soul aching with misery. It rolled off him in waves, and Castiel couldn't help but feel as if the man were calling out for help.
Dean raised his head, gasping for air, red eyes looking straight ahead, and, Castiel knew, not at him.
It was textbook. It was textbook, his mind wailed.
Castiel waved a hand in front of Dean's face, but still he did not see.
He collapsed back into tears, his face scrunching up and he grasped roughly at his hair again, causing it to stick up unnaturally.
I'm so sorry, he thought as he continued to weep for his patient. The room got so big. I was so small. How did I get so small?
I should've gone back on. I should have massaged longer. I should have gone back on.
Dean's hands fell to his lap, and Castiel covered them with his own, trying to offer some comfort. Anything he could give to this man to stop his soul aching and cure his sense of helplessness would be worth it. How could it be right for a man with such a big heart to suffer such.
Dean moved his hands back up to his face. I should have massaged longer. I lost it.
I lost it.
His hands fell back onto his lap, and Dean continued to stare ahead. Castiel thought, just for a second, that maybe Dean's eyes had focused in on his, and he smiled. But then Dean blinked, spilling the last stubborn tears from his eyes. Castiel watched them fall, the small smile on his face fading.
This human. Dean Winchester. He'd looked right at Castiel in the Operating Room. Why could he not see him now?
How was it even possible? In Castiel's entire existence, he had only ever allowed himself to be seen by those living souls just brushing the veil. Those who needed someone to guide them to the other side. So why had Dean seen him then? Did he need help? Was he in such despair that his life was on the line? Castiel hoped not. He prayed it were not true. He knew that the world was in his Father's hands, Dean Winchester included, and Castiel would never have thought to go against His will, but...
But Dean had seen him. He needed something from Castiel.
Feeling suddenly as if he were intruding, looking in on something private, something not meant for him, Castiel left.
As always, he had faith that he would be lead in the right direction.
o0o
Castiel came into step alongside with Balthazar as they perused a small convenience store in the lower-class part of the city. The store held only a few occupants, and they went about their business quietly. Two were regulars, they came in all the time and knew the cashier by name. In fact, one was good friends with him, and had just shared a beer with him three nights ago. He waved merrily at the cashier as he passed, but focused on his shopping. He would have a quick chat with him when he went to check out. The last two occupants were complete strangers, to the cashier, to the regulars, and even to each other. The first was just stopping in for a bite to eat before heading out to Reno, and the other had other things occupying his mind.
As they walked along, Castiel turned to his companion, and asked, "Have you ever been seen, Balthazar?"
"You're looking at me," he answered coyly.
Castiel shook his head, and clarified. "No, not by me. And not by the dying or the delerious." Balthazar studied some bottles of soda on a shelf. "Have you ever been seen... like you were a man?"
Balthazar looked up, contemplatively. "In a diner once, a blind woman turned to me all of a sudden, and asked me to pass her the mustard."
"But she was blind."
He pointed at him, "But she knew I was there.″"
Balthazar was not being very helpful, but Castiel continued anyway. "That doctor... in the operating room... he looked right at me."
Balthazar cocked an eyebrow at him. "He didn't see you, Castiel. He can't see you." His head tilted to one side, curiosity evident on his features. "No one can see you unless you want them to."
"And if I want him to?"
Now he looked amused. Yet, Castiel detected a hint of something deeper. "Why would you want him to?" Balthazar asked.
"To help him," Castiel answered honestly.
"Open it!" the voice of the preoccupied young man cut through their conversation, and they turned to view the new turn of events. "Open it now!"
The young man, Joshua he was named, took a gun from the pocket of his hoodie and swung it around at the other patrons. "Everybody down! Do it! Do it!" he shouted amidst the yells of surprise and horror. He pointed the gun back at the cashier, Eric, who flinched violently, hands working shakily at the register.
The friend of the cashier, Tori, lay face-down on the floor. Shit, Eric! Just give him the money.
The man going off to gamble thought, irrationally, Did I leave the lights on? I left the lights on (it was his first robbery, after all) .
The sole female customer kept her eyes down, hands on top of her head. It was not her first time in this situation. All she could think was, I should have gone to Ralph's.
The two angels walked calmly, invisible to the humans, toward their charges.
"Do it!" Joshua shouted, waving the gun about wildly.
"Relax," said Eric the cashier. "I'm doing it, okay?" In his head, he thought, I never saw the Grand Canyon. I'll never see my grandkids again.
Balthazar placed his hands onto Joshua's shoulders. What am I doing, Castiel heard him think. Joshua gave a quick shake of his head. Just be cool. Be cool.
Castiel lad his hands on Eric, pushing calm though the palms of his hands that the man could not feel. Not physically anyway. "Be cool, man," Eric said with as much bravado as he could muster. "Be cool." He finished putting the money from his register into a paper bag. Joshua, the robber, snatched the money and fled the store. "Holy shit," said Eric.
Balthazar looked at Castiel, a mournful look on his face, and said, "They don't need to see us."
o0o0o0o0o0o0o0o0o
Dean stood in his OR the next morning, stomach rolling. He could barely even find it in him to breathe properly.
He stared hard at the table in the half-light given off from the prep room window. But it wasn't an empty bed he was seeing. He replayed the operation over and over again in his mind, running different options and different routes, meticulously searching his head for the bad decision he'd made that had gotten Mr. Balford killed. What could he have done differently, how could things have gone so that Mr. Balford would be with his family right now.
He should have kept pumping. Maybe if he'd kept going and gotten Mr. Balford back on bypass, he'd have been able to find the problem and fix it.
Dean sucked in a breath, the chilly air of the OR slicing through his lungs.
Why was this affecting him so badly? He'd lost people before...Was it because Mr. Balford had insisted on meeting him beforehand? Did he do it to get Dean emotionally invested. Or was it just to see the face of the man he was putting his faith in?
Rule number one of being a doctor: you can't save everyone, my friend. Some of his more sardonic professors at med school even went so far as to say that each and every single one of them would eventually get a patient killed. And he was right. Dean's first year as an intern, and he gave too low of a dose of antibiotics to an elderly patient, and the sickness took hold. No matter what he'd done after that, nothing could have been done to bring her back. If it weren't for Sam, he would have quit right then and there.
You can't save everyone. Yeah, sometimes people just die. Good people, who have things to live for, families to take are of. Dean could still see the looks of utter despair on the faces of Mr. Balford's family. They probably blamed him. Hell, he'd blame him.
And his operation today... If Dean fucked up the last operation, what was to say that he wouldn't screw the pooch on this one too? He was nothing more than a monkey with a knife, and eight years worth of knowledge of what not to do. What the hell did that even mean? Nobody was perfect, and with the way his hands were shaking right now, who knew what he might nick accidentally. Who knew which step he might forget to do.
Dean felt a trickle of cold sweat bead and drip down the back of his neck into his collar. His scalpels and his clamps and all his tools were just instruments of torture. He was no better than an infernal demon torturing souls damned to Hell. All the blood... he surely knew his way around a knife. It was almost second nature to him, the feel of skin coming open under the blade. Just the right amount of pressure, not too much, but you couldn't be too afraid to do it, or it wouldn't work. And that first spurt of plasma, dribbling down the skin, that meant you were doing a good job. He took pride in that small modicum of his work. The rib spreader was particularly effective as well, when you wanted shit out of the way.
He didn't even flinch when Ash came in and flipped a switch and the light right above him blared to life, Dean's eyes still full of red . "You're early," Ash said conversationally.
Not having gotten an answer, Ash went about moseying around, collecting his equipment.
Oh, god , Dean thought. The equipment Dean would be using today. The blood... the skin...
Dean, suddenly unable to breathe at all, sprinted from the room. He burst into the nearest men's restroom, and barely made it into a stall before he was emptying the meager contents of his stomach into the bowl.
When he came out, still sweaty, but feeling marginally better, Dean was surprised to see his staff filing past, pushing equipment away from the OR.
"Doctor," Ash said.
Benny smiled kindly, almost pitifully at him before averting his eyes.
Highly confused, Dean spotted Jo in the prep room across the hall. She looked up as he saw her through the glass door. Dean made his way over to her. "What's going on?"
She looked concerned, but didn't say anything. "Dr. Braeden was looking for you. Dean," she jerked her head to the next room where Lisa was standing looking over a patient in surgery. She wasn't operating, but she held a mask over her face. She looked up though, as if sensing Dean's gaze. She nodded, and made her way out to him.
She was hardly out the door before Dean was asking, "What's going on? I have a mitral valve to do." He saw Jo toddle off out of the corner of his eye.
"They canceled it," she said.
"Who canceled it?"
"Sheffield."
Dean knew he couldn't argue with the boss. But he was by no means satisfied. "Why are you telling me?"
"He was busy," she said placatingly.
"He was chickenshit," Dean replied. Sheffield sent Lisa because he knew Dean would probably take it better from a friend.
Lisa's eyes softened. "Dean, you're sick."
Dean felt his eyebrows knit together. "I'm not sick!"
Lisa huffed, and looked around. There were more than a few people milling about, so she put a hand to Dean's chest and pushed him into an empty room. "I'm not sick," he said quietly, trying to remain calm, though anger pulsated with every heartbeat.
"You're sick. You can't operate. They've rescheduled it for Monday. It was just an elective valve, no big deal," she said.
Dean clenched his jaw. "It's unprofessional, and," a group of nurses walked past, so he lowered his voice to a whisper, "and it embarrasses me in front of my staff." He stepped away, going to the operating table and leaning on his hands. Now everybody thought he was a murderer.
As if reading his mind, Lisa said, "I saw the chart on Balford."
"What?"
She sighed, "I'm on the committee. It's on review."
Dean gulped. Of course it was.
"It wasn't your fault," Lisa intoned, coming around the bed to face him from the other side.
Panic attack this morning aside, Dean wasn't an idiot. He knew he did everything he could have done. But it didn't make the present situation any better. "I know," he said defiantly.
"Then what's the problem?"
Early mid-life existential crisis? Dean thought helplessly. "I don't know," he whispered, emotion slurring his speech. He clenched a fist into the sheets. Lisa reached over from the other side of the table and covered his hand with hers.
"Dean, you put up a terrific fight."
He put on a smile, "Yeah. We fight for people's lives, right?"
"Uh huh."
"Do you ever wonder who it is we're fighting with?"
Lisa's eyes narrowed in confusion, only for a second, but Dean knew he'd said too much.
He pulled his hand away and ran it down his face. "So," he supplied helpfully so that she wouldn't have to, "I'm crazy and chemically imbalanced."
"You're tired," she said compassionately. "You have moments." She waited a beat before asking softly, "Why didn't you call me?"
He smirked, but it was a wasted effort. "Because I never sleep when you stay over."
She raised an eyebrow, knowingly. "You never sleep whether I stay over or not."
Dean didn't respond. They both knew she was right.
"You're good," she said. "You know it. Come back Monday and get back on the horse."
As pep talks went, it left a lot to be desired, but Dean knew her heart was behind it. She was like him, terrible at saying shit out loud. She was better at showing her feelings through actions. But he took it for what it was worth. She cared.
The door opened, and a nurse Dean recognized but didn't know popped her head in. "Doctor," she said to Lisa, who nodded.
The nurse left, and Lisa looked up at him. She reached up and kissed him on the cheek, a careful caress. "I'll see you."
o0o0o0o0o0o0o0o0o
Castiel stood off to the side of the operating room, watching Dean watch Lisa leave the room. Dean stayed for another moment, but, with nothing else keeping him there, eventually he left.
Castiel wished he could show himself, if only to offer comfort to the man he knew was in pain. But he was not his charge, and nothing he could say would do anything other than confuse him further.
And he had someone. Someone who could help him in a better way than Castiel ever could.
So, he winged away from the hospital, and away from Dean Winchester.
o0o