I
The sense of detached recognition upon returning anywhere after time away is a difficult one to shake, even if the time away has only been a week. Dean stood at the refrigerator in the break room in gentle bemusement as he attempted to draw the atmosphere of the surgery center back into him, become reacquainted with the cadences and ebbs and flows of time as it swirled around surgery schedules and coffee breaks and the inconstant pauses between cases.
"Hey, stranger," he heard someone say, and he snapped back to the present and grinned as Jo playfully shoved him to the side so she could open the refrigerator to deposit her lunch. "I was worried you weren't coming back."
"I almost didn't," Dean replied, only half-joking. He hadn't realized that it was possible to miss driving aimlessly for days on end. Even now, something tugged at him to just turn around and leave, looking back only to admire the cloud of dust he left behind. He shook his head to clear it of the ridiculous notion. Romanticizing the life he'd worked so hard to cast off was the worst possible way to remember it. "What's on the schedule for today?"
"Guess." Jo said with a wry twist to her mouth, pulling a folded schedule from her front pocket and thrusting it at Dean. "I'm really, really glad you're back, because if I ever have to scrub for that man again I'm going to stab him in the eye. Preferably with something blunt, so that I really have to dig around with it to do some damage."
Dean stared blankly. "Did he spit on you or something? I thought he was…you know…getting better with the whole 'being a douche' thing."
"Oh, he's a perfect gentleman with you," Jo said, lowering her voice. "All I heard last Monday was 'Dean does it this way' or 'try Dean's way' or 'you should have Dean show you how he manages his ties.' I swear he'll be announcing his engagement to you any day now."
"Shut up." Dean looked down to scan the schedule. The only thing scheduled for his room was an arteriovenous fistula repair, which was scheduled to fill all the hours between the room opening and lunch. He winced.
"I mean it," Jo pressed. "He clearly has a thing for you, and, well…I mean it'd work out, wouldn't it? He's gay, and you're gay, and –"
"I'm going to stop you right there," Dean said, feigning deep interest in the schedule so he wouldn't have to look up. "One, I'm not gay. Just…not straight. And I'd appreciate it if you didn't shout it to the sky in the middle of the goddamn lounge."
"Dean, everyone already knows," Jo began in a whisper, but Dean held his hand up.
"Everyone thinks they know, and there's a big difference between everyone thinking they know and everyone actually knowing. And that big difference includes me being able to sleep at night." Jo looked like she was about to say something, so Dean barreled on before she could. "Two: just because we're – we're – let's call it 'preferentially compatible' – doesn't mean we're the least bit interested in each other. May as well assume that you've got eyes for Kevin because he's a dude."
Jo reddened visibly at this, and Dean decided not to wonder if he'd accidentally uncovered something. "Three –"
His third reason for Jo to well and truly avoid ever bringing the subject up again was interrupted, because at that exact instant, Dr. Novak stepped into the lounge and Dean instantly felt his mouth go dry.
He had, of course, seen Dr. Novak in street clothes at the picnic nearly a month ago; the jeans and black button-up shirt had certainly done him justice in a casual sort of way. Dr. Novak was clearly dressed to receive patients – likely the lack of scheduled surgeries in the afternoon slots meant he would be holding clinic hours during that time – and the deep chocolate of his suit only emphasized the clean lines of its cut across the surgeon's shoulders and the contrast between it and the pale blue of his dress shirt. The blue of his shirt and the darker blue of his tie did impossible things to the surgeon's eyes, which were some new and fascinating definition of blue that put Dean at a sudden horrifying loss for words. He was acutely aware of his tattered hoodie and threadbare black jeans, as well as the fact that he didn't think he'd done anything with his hair other than rake a sleepy hand through it before he'd gotten out of the car.
"Morning." Dr. Novak grinned, then offered the coffee cup he held to Dean, who took it automatically before blinking hard to dispel the idiotic expression he was sure he was wearing. "Long case today. I'm going to need you on your toes."
He was already backing out of the lounge, so Dean could possibly have completely imagined the wink just before Dr. Novak disappeared around the corner, if it hadn't been for Jo pointedly clearing her throat.
"You were saying?" she asked, voice smug.
"Shut up," Dean said, absently bringing the coffee to his lips.
II
"Dean Winchester, friendly neighborhood surg tech," Dean said cheerfully. "I have all the instrumentation for this case, and the graft for the possible shunt is in the room if we need it. There's quarter percent Marcaine with epinephrine on the field as well as heparinized saline and plain saline for irrigation. Counts have been established. Bobby?"
Bobby recited his portion of the time-out, Dean tuning it out as largely redundant. Necessary, but redundant.
"Cas Novak, surgeon" Dr. Novak said, but something in his voice caught at Dean's attention and he peered closely at the surgeon. "We'll be correcting a previous arteriovenous fistula, possibly with a shunt, on his left arm. This should be routine and I don't expect any unusual blood loss. He'll go home today. Any other concerns?"
Dean was fairly certain he wasn't imagining it: even considering the early hour of a Monday morning, there was definitely something subdued about Dr. Novak, somehow drained of the cheer with which he'd brought Dean the coffee. He handed over the local anesthetic with a questioning expression, but Dr. Novak did not look up as he took the syringe.
The minutes flowed slowly by, the silence broken only by Dr. Novak's murmured requests for ties, hemostats, or scissors. Once, Dean was able to catch the surgeon's eye. He cocked his head in a wordless query, but the surgeon responded with a minute negative shake and let his eyes fall back to what he was doing.
"Sinski," he said at one point, holding out his hand.
Dean's brain screeched to a halt as he stared dumbly at his tray. "I don't have any Sinskis in this set," he said slowly. "I can get one, but –"
"Right there." A note of impatience colored Dr. Novak's tone, which was at least marginally better than the dead, flat timbre it had been glazed with all morning.
Dean looked at what the surgeon was pointing at and had to stifle a laugh. "Ah. That's, uh, actually a Satinsky. Sinski's an ophthalmic hook."
"Whatever." Dr. Novak waggled his fingers. "Give me what I need, not what I ask for."
"Really?" Dean asked, pitching his voice to be very carefully teasing. "I don't think you're allowed to use that phrase unironically."
Dr. Novak looked up again, and this time he did not hide the haunted shadow behind his eyes very well at all. Dean swallowed and wordlessly placed the vascular clamp into the surgeon's hand.
Dean didn't try to make any more jokes; the atmosphere in the room pressed against Dean's skin with almost tangible tension. Three hours later, skin adhesive still drying on the closed incision, Dr. Novak took his leave, slipping from the room without a word.
III
"What's up?"
Dr. Novak looked up in surprise as Dean closed the door to the dictation room behind him.
"I appreciate that you didn't just ask 'What's up, Doc,'" Dr. Novak said with a strained smile that didn't touch his eyes.
Dean shook his head. "You can't hide by being funny. What's eating you?"
Dr. Novak sighed. "You'll know sooner or later." He toyed with the pen in his hand for a moment. "I got a voicemail this morning. One of my patients had an SSI." Dr. Novak let his eyes drop to the pen. "She died from related complications last night."
Dean felt his jaw drop. His mind worked at double-pace to try and compose something to say, but the best it could present was "Shit."
"It was the case where we – where I – dropped the vein hook," Dr. Novak continued in a flat voice.
With a horrible sour twist, Dean felt his stomach drop. A surgical site infection death in a case where an instrument had dropped… "There's going to be an investigation."
Dr. Novak nodded. "Infection Control will be in contact with everyone." He swallowed. "I really hope documentation is up to scratch, because if we can't document that the instrument was properly sterilized after the fact…"
"It was," Dean said firmly. "And I saw the indicator. There's no way she got anything from that. It had to have been something else."
"Maybe." Dr. Novak reached up to run a hand over his face. "At any rate…that's why I'm out of sorts."
A shiver ran down Dean's spine as a revelation struck him. He could be wrong, but… He pulled a chair out from one of the desks, legs straddling the back of it as he rested his arms on the top of the backrest. "It's not your fault," he said.
The incredulous eyebrow that Dr. Novak raised confirmed Dean's suspicions. "Are you sure about that?" the surgeon asked archly.
"Absolutely." Dean swallowed. "I actually check indicators and filters. Every single thing you touched was sterile. I didn't let you use the skin blade on deep dissection. I even changed hypos on the local after I drew it up." He shook his head. "That case was as tight as we could possibly make it. It's not your fault."
"She was on my table," Dr. Novak insisted. "She got the infection because she was on my table."
"Doesn't make it your fault," Dean replied stubbornly. "Come on, Doc. You know this." He caught the surgeon's eye and held it. "If it's anyone's fault, it'll be mine, for contamination that I didn't catch."
"My table," Dr. Novak repeated.
"My instruments," Dean countered. "At least wait until the investigation is done to assign blame."
Slowly, Dr. Novak shut his eyes and then nodded. "I suppose that's fair."
"I mean it," Dean said as he rose from the chair. "Don't start beating yourself up again as soon as I leave. You don't deserve the kind of abuse you're capable of dishing out." He paused. "That sounded better in my head."
"Point taken nonetheless." Dr. Novak offered a small smile, much more genuine than the one he'd tried earlier. "I imagine I'll see you next week."
"Next week," Dean agreed.
IV
"Dean."
Dean looked up in surprise from unlocking his car. "Doc," he said in response. "Didn't realize it was next week already."
Dr. Novak shifted the shoulder strap of his satchel, swinging the car keys in his hand around a finger by the keyring. "No one else here would have done what you did today."
For the space of several heartbeats, Dean had to frantically try to remember what he'd done that had been out of the ordinary.
"I'm – not exactly popular here," Dr. Novak continued as Dean continued to draw up a blank, "and…I needed to hear it. Even if I didn't know it."
"Oh," Dean said as his mind lit upon what the surgeon was talking about. "That's why I did it."
One corner of Dr. Novak's mouth twisted in a shadow of a wry grin. "Because I needed to hear it, or because I didn't know I needed it?"
Dean found himself reflecting the same not-quite grin. "What you need, not what you ask for, right?"
That earned him an actual halfhearted chuckle, and the sound twisted into a tiny pleasurable knot in Dean's chest. "Right. I'll see you next week. And…thank you."
Dr. Novak's footsteps echoed in the cavern of the parking garage long after he'd walked out of sight.