Chapter Text
There is a saying that doctors make the worst patients. This is not because they cannot recognize their own symptoms or when to seek treatment. In fact, they are the best at self-diagnosing and can recognize their own symptoms instantly. The issue, then, is that they are too stubborn to accept that they need help. They wish to self-treat, their expertise inhibiting them from being vulnerable. Such a problem is especially accentuated when they are close friends with other doctors. Then, the struggle to relinquish control leads them to delay seeking help until their condition is severe. This was the dilemma Dennis Whitaker, a second-year resident at Pittsburgh Trauma Medical Center, faced.
As a doctor, Dennis Whitaker knew the risks of being raised on a farm. It was why he wanted to pursue rural medicine, after all. He'd read the articles that growing up on a livestock farm upped the blood cancer risk by 22%. Not to mention the various respiratory illnesses that came from long-term inhalation of grain and animal feeding. He knew the signs of these illnesses well and always knew when to ask for a patient's history in livestock farming. It wasn't often that he got such cases in the city of Pittsburgh, but Pennsylvania was still largely rural overall. Dennis liked treating these patients. Not because he was ever happy to see anyone sick, but he liked being able to treat what he knew. He was comfortable with these cases. By this logic, he should have known the risks in himself.
Broken Bow, Nebraska, was always a major hub for livestock farming. It was home to the second-largest producer of cattle in Nebraska, and the region was known for its beef operations. The Whitaker farm was no different. The Whitakers raised cattle and poultry, and Dennis especially loved spending time with the cows. He loved brushing them, sitting against them, and even cuddling them when they would lie down. His brothers would tease him for being so affectionate with the animals, but he wouldn't care. On days the poor things looked lonely, he would run outside and read to them. So what if he got teased? He loved them; his brothers didn't have to understand that. His father would warn him that those animals were bound to make him sick one of these days, but young Dennis would smile right back and tell him it was worth it. And, to him, it was. It was worth showing love to those whom the rest of his family deemed unworthy.
Unfortunately, it was bound to catch up with him one day. This was a truth that Dennis's partner, Doctor Michael "Robby" Robinavitch, seemed much more willing to accept. Robby didn't want Dennis to be sick, of course, and didn't think he was. But Robby was also a doctor who knew the risks of raising livestock and oversaw every one of those farmers' cases Dennis worked on. By every standard, Dennis was the epitome of health. He was young, active, strong, and thriving. But that did not stop Robby from worrying.
Which only made Dennis all the more eager to conceal any potential illness.
It started after a middle-aged farmer from Lancaster came in after being exposed to Bovine Leukemia Virus via drinking unpasteurized milk. Fortunately, the virus has never been documented as capable of transferring to humans, but exposure still has its risks. The virus had been detected in the breast epithelial tissue of humans, ultimately meaning it had an association with breast cancer. After assessing the woman's symptoms-localized pain, skin dimpling, and unexpected swelling-and ordering imaging, Doctor Whitaker made that diagnosis. Fortunately, they caught it early, and Whitaker was very optimistic about treatment. However, the whole case only worsened the Chief Attending's concern regarding farming.
"Doctor Whitaker, can I talk to you for a minute?" Robby asked, popping his head into North 12.
"Is everything okay?" the woman asked, glancing between the two doctors.
"Yes, everything's fine," Robby assured. "You're in very capable hands. I just need a second."
After quickly excusing himself, Whitaker stepped outside to join Robby.
"What's up?" he asked. He was shifting his weight, rocking back on his heels. Robby could see he was impatient to get back in there and finish working, ever so eager to be of service, yet Robby couldn't let this wait.
"You should take a blood test."
The rocking stopped.
"What?"
"Face it, you're at risk. How many livestock farmers come in as patients every week? If not for your peace of mind, then for mine. Please?"
Whitaker stared blankly for a moment, taken aback. "Um. Yeah? Yeah, okay. Sure. I'll think about it."
Visibly eased by Dennis's agreement, however uncertain, Robby patted the resident's shoulder.
"Good. Now, get back in there."
The truth was that Dennis knew he was at risk. Part of him always knew, even as a child. He knew from his father's warnings and, later, from his father's illness. He knew from the hundreds of farmers he treated. But all of this 'knowing' only made him more reluctant to seek out definitive answers. While Dennis was a doctor, he was still very much human. This human part of him was afraid of what a blood test would show. He was afraid that if he found out he was sick, then he would have to face it. He would have to face the symptoms, inevitable treatment, and whatever came after. But as long as he didn't know for sure, then he didn't have to face it. Safe to say, he was a huge fan of Schrödinger's Cat. As long as he did not have a diagnosis, he could be both sick and not sick.
But Robby requested a blood test. And Dennis was fairly sure he'd do anything if Robby asked.
Robby and Dennis had been dating for almost a year now. Robby ended up cutting his sabbatical short. After finding it in himself to come back, he couldn't stand to leave anything unsaid for any longer. When he came home and opened the door to find Dennis cooking and singing his heart out in his kitchen, he broke. He confessed everything. He confessed how Dennis had saved him during Pitt Fest, how Dennis's kindness motivated him to be a better man, and how he couldn't help falling in love with the resident. He knew there were issues with such a confession. Mainly, Dennis worked for him and was only half his age. Any relationship would have to go through HR, and it could be a risk to Dennis's career. However, Dennis didn't seem to care when he responded to Robby's confession by rushing into the older man's arms. Dennis, apparently, had been so worried that Robby wouldn't be coming back that he vowed to himself that if Robby did come back, he would be completely honest about his feelings. They'd been together ever since.
So, Dennis had Trinity take him to UPMC Presbyterian for blood work on their next day off. Doing it at PTMC would have allowed him to avoid fighting with his insurance, but on the off chance that something was wrong, he couldn't risk any of his friends knowing. Trinity was naturally the exception to this rule. She was his emergency contact and health proxy, so she would ultimately know everything about his condition. Beyond this, she was more than capable of wrestling anything out of him that she wanted. Keeping this in mind, Dennis figured it was easier to just bring her along.
"Nervous?" she asked, watching carefully as the nurse drew her friend's blood.
"Nope," he replied, popping the 'p.' "Just peachy."
Trinity snorted but let it go.
The unfortunate thing about blood tests (or any tests, really) is the waiting for results. After two days, Trinity got the real answer to her question as she watched her roommate pace back and forth across their living room.
"Come on," she groaned, sinking deeper into the sofa. "You're blocking my view of Glee."
"You watched it how many times now?" he retorted, but the sass was absent from his voice.
"Not nearly enough."
Nevertheless, she grabbed the remote and paused the show.
"Sit." When he opened his mouth to argue, she cut him off. "You're stressing me out. Sit down before I'm worried about my blood pressure."
Dennis hesitated but collapsed onto the sofa with a huff. Trinity immediately wrapped her arms around him: an affectionate act that she would later deny. As much as she refused to admit it aloud, she loved her Huckleberry, and it killed her to see him like this. When the two first became friends, she had a lot of work on her hands. Dennis Whitaker was just a shy, repressed farm boy with a bad haircut. It took so long to force him out of his shell and make him actually take care of those beautiful curls. Months passed before he was even close to being the confident man and doctor she saw before her today. Dennis was her success story, but one thing she could not soothe was his health anxiety.
Neither of them was sure how much time had passed before Dennis's phone rang. He jerked up, lunging for his phone.
"Hello?' ... "Yes, this is he." ... "Uh huh." ... "I understand. Thank you."
"And?" Trinity urged. "What'd they say?"
Dennis wordlessly tossed his phone onto the ground and stared at his friend.
For as long as Dennis could remember, he struggled with stamina. He could lift any weight with no trouble or dance the night away with Trinity, but the second he tried to run or climb a flight of stairs, he would immediately become winded. It was normal, though. He never jogged, so he just assumed he wasn't as athletic as he thought he was. Sometimes, that winded feeling would stick with him, even at rest. He also explained this away, believing it just took his body longer to settle down after physical exertion. Dennis used that same excuse to explain away the constant tightness in his chest and small wheezing sound when taking deep breaths. The cough just lingered after a nasty bit of influenza in the winter, but that didn't mean it was a symptom for anything else. Neither was the fact that he got the flu quite often and was sick with the common cold anytime the weather changed.
Poor immune system, he'd say.
His blood tests said otherwise.
The tests did not provide a diagnosis, so the doctor asked for him to come back in for a further assessment. Here is what the tests did say:
Dennis's blood contained an abnormally low oxygen count and excessive carbon dioxide count. As a result, his red blood cell count was elevated as his body struggled to compensate for the poor lung function. In short, his lungs were failing. This was not the common cold or poor stamina; something was wrong. The cat was out of the box, and Dennis Whitaker was officially deemed a sick man.
"What do they think it is?"
Dennis shrugged, "They're not sure. I need to go back for a spirometry and exam."
"Oh, Huck...What are you gonna tell Robby?"
"I'm not."
Trinity's head shot up, and she stared at him wildly.
"Maybe I didn't hear you right-"
"I'm not telling him."
"No, I heard you right," she confirmed. "What are you thinking?"
"We don't even know what this is. Maybe it's not even serious! There's no point worrying him over nothing."
"Dennis-"
"Trin," he cut her off, sighing. "I can't risk this interfering with work. He's still our boss."
"All the more reason to tell him, you fuckleberry!"
Dennis shook his head.
"I can't."
A selfish part of Dennis wanted nothing more than to tell Robby. He wanted to tell Robby everything, collapse in his arms, and let Robby tell him that everything was going to be okay. He wanted to be soothed. He wanted to be held, but it wasn't worth upsetting Robby. They had something great, and Robby was finally beginning to heal from the decades of neglect for his mental health. Dennis couldn't screw that all up now. He wouldn't. So, in a few days, when Robby asked Dennis if he heard anything, Dennis lied.
"Nope. Everything must be normal."
Robby frowned, "Even so, you'd think they'd let you know."
"Must be busy. I wouldn't worry about it."
"You sure?"
"Positive!"
Robby nodded, trusting his boyfriend's word.
"Okay," he agreed, leaning forward to give Dennis a kiss on the forehead. "I'm really glad. I'm sorry I made you go through that, but I needed to make sure you're okay."
"It's okay," Dennis promised. "Now we know."
He smiled at Robby the way he always did, but now, guilt clawed its way up his throat in the form of a nasty cough. Dennis coughed and coughed until he gagged.
He never lied to Robby. Ever. It was the most important rule they had for one another.
Robby’s eyes flick across Dennis’s face carefully.
"Jesus, Den. Drink some water."
Dennis nodded, eagerly taking the water glass Robby was offering him and guzzling it down.
"I'm fine," he told him, words escaping automatically.
Robby raised a brow but didn't comment beyond, "I never said you weren't."
"Good."
Robby did not try to tell Dennis he was sick. He didn't have to. Dennis's doctor did it for him when it came time for Dennis's diagnosis.
Chronic Obstructive Pulmonary Disease. Or COPD.
In other words, the walls and elastic fibers of the air sacs in his lungs were destroyed, trapping old air, and his bronchial tubes were inflamed and swollen, narrowing the airways and triggering his cough. Emphysema and chronic bronchitis.
There was no cure.