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"I don't know what the fuck to do with him anymore Cas, so figure it out, because he's not doing so great!" Sam Winchester slams the door to the car after an honest discussion about his brother's condition. A condition that he is helpless to, distraught by. Apparently, his elder brother has hardly had a bite of food since leaving purgatory. Sam implies that only Cas can fix it, at this point. The angel heads toward the apartment.
—
Dean is sprawled out listlessly on the couch, cocooned by multiple blankets. Cas stands there for several seconds before Dean pulls his eyes away from whatever he is watching.
"Cas!" he gasps, his eyes meeting the angels’.
—-
Castiel tells him everything. He stands at a distance, remorseful. Insists that Dean couldn’t save him because he didn’t want to be saved. “I needed to do penance. After the things I did on earth and in heaven, I didn’t deserve to be out.”
“Yeah,” Dean replies, voice flat. He tags at the blankets a bit, drawing them in closer.
Castiel moves toward the seemingly fragile man and kneels in front of him, placing a hand on his forehead. "You're sick," he announces, his face contorted a bit.
"Not you too," Dean whines, making a half hearted attempt to pull away from the angel.
"You haven't been eating. At all." Castiel, with furrowed brows, runs his eyes up and down the man’s body. Sunken cheeks, pale, impossibly bony hands. Of course, he can’t make out what’s beneath the blanket yet but he knows.
Dean looks away and he frowns. "Yeah, well." He pauses, swallows, and gulps. "You know why."
Castiel's chest aches a little, and he frowns. Dean Winchester would always be beautiful to him, but for the first time ever, it was hard to look at the hunter.
"Don't look at me like that, Cas. I'm fine." He gulps, and retrieves the remote control to turn the volume up on the TV.
With some reluctance, Castiel takes a seat next to Dean, feeling stiff and awkward at first. He had an incredible urge to hold the hunter, to engulf him close to his chest and to never let go. Instead, he places his hand next to Dean’s. And then, after a few seconds, he moves his hand onto Dean’s. Dean doesn't pull off, and a minute later the angel scoots a little closer toward him, and soon after Castiel’s stiffness melts away, until the two beings are holding hands. They stay that way for hours.
----
"Let's get you to bed," Castiel directs after the second movie ends. The hunter hasn’t moved more than his hand since the two fell into companionable silence, and Castiel starts to get worried about him.
Dean looks at Cas, retrieves the remote, and turns the TV off. "Okay, dad." He slowly peels away his blanket cocoon, briefly pausing before removing it completely and revealing his skeletal form.
“Dean!” Cas gasps,
“Cas, I know. Okay? I know how it looks.” Dean stands up and crosses his arms over his abdomen before walking out of the living room and toward his bedroom.
Castiel follows Dean down the hall, and it’s clear from the way the man ambulates that he is not well. He is short of breath quickly, and appears to be in pain with the most basic movements. "Dean," the angel demands. "Are you okay?"
"I'm fine!" Dean exclaims with irritation. "Please, Cas. I need just one person to not think I'm pathetic."
The angel is sensitive to Dean’s desperation and complies with his request. He nods and sighs. “Of course.” Cas lingers just outside the bathroom while Dean completes his nightly routine. Through the halfway open door, Castiel can see the ordeal is exhausting to the hunter. He moves slowly, and needs to take a few seated breaks to recover.
"Don't look at me like that," Dean pants before placing a hand over his chest and taking a few deep breaths.
"Dean," the angel exclaims as he rushes over to the hunter. The hunter mutters something about not feeling well, and just needing to sleep as Castiel helps him to his bed. He seems to welcome the help, despite his weak verbal protests of I’m fine, I’m fine . Castiel gently tucks Dean into bed and, without a word, slips out of the room.
Two minutes later, he’s standing over Dean with a cold glass of orange juice in his hand. “Here.”
Dean turns his head away. “No! No, Cas. I can’t.”
"But you're ill. And your sugar is low.” Cas can tell.
"I can't," Dean speaks in a voice barely a whisper. "I can't, Cas."
The angel’s blood runs cold with the sound of Dean’s desperation and helplessness. Something is deeply, deeply wrong. He knows he won’t win this battle, so he holds it together enough to tell Dean, “we’ll talk about this in the morning,” and walks toward the door.
"Cas...." the man calls out, and his tone reminds Cas is a small child’s. "Can you stay here? Just for a few minutes?"
Castiel’s heart falls into his chest as he turns around. “Of course.” He spots a desk chair and drags it to Dean’s bedside where he sits. Dean rolls onto his side away from Cas, and it is silent for a few minutes before he rolls back toward Cas again and reaches out a hand. Castiel pauses a moment before placing his comparatively plump, warm hand upon Dean’s cold and bony, lifeless one.
“I'm sorry,” he declares before a pause. “I need you.”
A fretting Castiel places his free hand upon Dean’s head, gently stroking his blond-brown locks. Eventually, Dean is soothed into a deep sleep. Castiel remains bedside through and night and into the morning.
—
The next morning, Sam and Castiel have a discussion about Dean, and about what should be done about him. Sam insists that Dean use his angel powers to rid Dean of whatever he is going through, but Castiel explains that he is powerless to it. “It’s not supernatural. I can’t do anything. Don’t you think I’ve tired, Sam?”
There was talk about hospitalization, feeding tubes, force feeding, spells, witches, interventions. All the while, a listless Dean lays on the couch watching old movies, wrapped in several blankets.
As the days draw on, Dean begins declining more rapidly and seriously. He barely lets anything touch his lips; even water is limited by the hunter. Sam thinks this is extreme. He had learned about anorexia nervosa in college and read that most anorexics eat something , even if it’s only 500 calories. But Dean doesn’t eat, ever.
Within four days of Cas’s return, Dean reaches a point where he is too weak to leave his bed. His breathing is labored. Speaking is becoming difficult. Castiel remains at his bedside, holding his hand, caressing his hair, stroking his pencil-thin arm. Finally, though, the decision is made to take Dean to the hospital. Too weak to object in a significant way, Sam hoists his older brother up, places him in the back seat of the car where Castiel holds him, and drives.
—
The elder Winchester is admitted immediately upon arrival. Clearly malnourished and dehydrated, medical personnel waste no time hooking Dean up to an IV drip. Bradycardia, orthostatic hypotension, hypoglycemia, hypokalemia, low magnesium. Acute liver cell damage. Evidence of kidney damage. Dean is admitted to the ICU, doctors and nurses wide-eyed and in bewilderment that a previously healthy man could be in such a state.
“Please, Sammy, don’t let them do this to me,” Dean begs without his usual gusto. He is having trouble keeping his eyes open as it was, let alone speaking. “Cas? Is Cas here?”
“I’m right here, Dean,” the angel soothes, taking the hunter’s hand. “Shh, it’s going to be okay. You’re going to be okay. Just rest.”
—
Everything is a blur for Dean. He drifts in and out of consciousness, asks for his brother, asks for Castiel. Tossing, turning, pulling. He is placed on restraints due to the fact that he continually attempts to pull his NG tube and IV lines out. Screaming out during nightmares, hallucinating creatures that could have only been from hell or purgatory. By a psychiatrist, he was deemed not stable enough to make his own medical decision and so Sam was granted medical power of attorney temporarily.
After three days in the hospital, Dean was pumped full of enough electrolytes, fluids, and calories that he is no longer in very critical condition. He is moved out of the ICU and onto a general medical floor. He starts to become more lucid and oriented. And he wants the NG tube out.
“Get that psychologist or whoever she is in here. I don’t need Sam or anyone else making decisions for me,” Dean yells, pulling the nasal cannula out of his nose. “These things,” Dean says, gesturing to his IV and NG tube, “are coming out and I’m going home.”
Cas looks sullen with tears in his eyes. “Dean…”
“Please,” Cas. He throws his hands up. “Please… just say you're on my side.” he moves his hand to find Cas’. “I need to know that someone is on my fucking side.”
“I'm on your side, Dean. We're all on your side.” Cas shifts a bit in the chair he sat on beside Dean's bed. He lifts his right hand to caress Dean's fragile arm, as his left hand holds Dean's softly. “You are starving to death.”
“I feel sick, Cas. I need to go home. I can’t have anything inside of me right now. I feel like I’m going to burst. I need to be empty”
“Dean, you’re sick. You’re not in your right mind. Something must have happened to you while you were there,” Cas explains.
“It's what I want, Cas,” Dean explains without reluctance. “I want to go home.” After a pause, he continues. “I didn't eat for a year when I was in there, Cas. Now? I feel sick just looking at food, being hooked up to this thing. My body is rejecting it. Cas, when I first came earth side, I tried to eat and you know what? It tasted exactly like human flesh. I tried a few more times, and I couldn’t anymore. And I’m not doing it again.”
Cas frowns, and tightens his grip on the hunter just before Sam walks in with a hot coffee in hand. “Oh good, he’s awake.”
“And he’s getting out of here. Get that doctor in here Sam, or I’m taking these out myself and I’m serious,” Dean declares, pulling his hand away from Cas and crossing his arms around his chest.
“You’ve got to be kidding me, Dean,” Sam exclaims as he places his coffee on a bedside table. “You almost died - you still almost might die - and you want to play this game?”
Dean looks straight ahead, lips turned downward. “Get her now, Sam.”
—-
Hours later, after a psychiatric evaluation deemed Dean stable enough to make his own medical decisions once again, the three men are on their way out of the hospital. Dean is rolled out on a wheelchair by a dismayed Sam who can’t believe the experts considered Dean stable enough to make his own medical decisions .
“You guys chained me up to the bed for a week, and now I can’t even walk. Thanks for that,” Dean remarks as they reach the parking lot.
“You couldn’t walk when you came in here,” Sam retorts with an eyeroll. The angel and younger hunter help the man, weak as a newborn kitten, into the back seat and drive home.
—
Sam and Castiel assist Dean onto the couch and wrap him in a mound of blankets. Sam leaves a chocolate Ensure on the coffee table and instructs Castiel to get Dean to try some. Meanwhile, Sam said he’d be making calls about what to do next with Dean.
Castiel sighs in a recliner as an exhausted Dean makes a half hearted attempt to watch an old western movie. Castiel stands and reaches for the Ensure which doesn’t go unnoticed by the hunter, who subsequently closes his eyes and pretends to be asleep, until he actually is.
—
That night, and the nights after, Castiel sits at Dean’s bedside. It is the only way Dean can sleep anymore. “I need you,” he’d say. Day time is spent with Dean resting, quickly losing any sustenance and strength he had gained during the administration of electrolytes, fluids, and calories in the hospital. Castiel stays with him, pleads with him every few hours to try to eat, to try to drink. “I’m huge,” Dean says. “Can’t you see that?”
Sam busies himself in trying to solve whatever is happening to his brother. He calls in favors, casts spells, calls specialists. He also needs to keep supernatural beings away from his brother who may harm him in his weakened state, so his options are limited. He does quite a bit of traveling to ensure his brother remains safe. He is thankful for Castiel’s presence and help. Sam feels guilty about not being present for his brother more often, but his mere presence tends to set Dean off, and their meetings almost certainly end with a huge argument, which is not good for Dean right now.
Finally, on Dean’s fourth day back home from the hospital, he has a breakthrough. He, through tears in his eyes, tries the chocolate Ensure that his brother and the angel had begged and pleaded with him to try. It tastes burnt, like ash. Unpleasant. But it does not taste like human flesh. Dean has a second taste. And then he crawls back into his blankets and crosses his arms over his chest. “I’m so proud of you,” Castiel soothes as he caresses the hunter’s hair. Dean stays silent, despondent; an uncomfortable expression on his face as he feigns interest in whatever was on the TV.
—
Sam cries when Castiel tells him that Dean finally let calories pass his lips. He knows Dean needs much more, but for the first time since the ordeal started, Sam feels a little hope that maybe his brother will get better. And each day, things do get better. A week later Dean, still impossibly weak and listless, is consuming 2 bottles of Ensure plus a few pieces of fruit and vegetable.
The hunter whimpers in private to Castiel about how bloated he feels. About how he feels all of this is beyond his control and that he hates what he was doing, hates that he is consuming calories and needing sustenance. “It’s like I was chasing that high… that feeling of purity, of penance. I didn’t need anything when I was in there, Cas. I hate to need something.”
“We’re so proud of you,” Cas coos as he rubs small, soothing circles into Dean’s palm with his thumb. “You are not big. You are underweight, and you need to continue eating.”
—
It is an uphill battle for a year. When Dean becomes healthy enough to ambulate without assistance, he insists on going for a short walk with Cas or his brother after meals every day to ease the discomfort that food causes him. It’s compulsive, but at least he’s eating, Cas and Sam say. He has many setbacks: days where he refuses to eat or drink, consuming only foods deemed “safe,” lying about what he’s eaten, tears, nightmares, a few hospitalizations. He’s even forced himself to throw up on a few occasions due to the discomfort of eating; this terrifies Sam.
A year in, and Dean is no longer in the danger zone. He is still underweight by at least a few pounds, and Sam and Castiel figure he probably always will be now. But he is able to function. To leave the house. To enjoy life, just a little. Though he never lets himself enjoy it too much. He still had a tendency to search for that purity, that penance. It is Sam and especially Castiel who pulls him back to earth each time. He needs them.
Dean finally lets Castiel crawl into bed with him at night. He is still insecure about his body to an extreme degree, but he wants Castiel nearby. And Castiel’s constant reassurance that he isn’t fat, that he is beautiful, helps ease the insecurity. The angel finds the man’s prominent ribs, sharp hip bones, and bony arms frightening at times, but this is his love and he will do anything to make him feel safe and secure. On occasion, Dean still has vulnerable moments where he is too insecure to let Cas into bed with him. On those nights, Castiel brings the chair bedside.
“Would you hold my hand, Cas?” He asks. “I need you.”