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sarahowritesostucky · 4 months

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📖 "Medically Necessitated" Ch 1

Rated: Explicit Pairing: Bucky x Steve Tags: a/b/o, age gap, past rape, rape recovery, trauma recovery, pregnancy, medical trauma, hurt/comfort, mentions of CSA, religious fundamentalism, first time, gender dysphoria, male omegas are intersex (peen & vagine) Summary: After a medical emergency brings him into the ER, Bucky escapes the religious cult he's been raised in. It's up to Steve, nurse practitioner and omega sex & repro specialist, to see him through a medically supervised heat.

1. Jori

Steve meets Bucky under less than ideal circumstances.

T.W. This fic contains occasional mentions of Steve's patients, who deal with issues of csa, sa, abortion, ptsd, and other traumas. Bucky is in the immediate aftermath of a rape at the story's start.

Steve hates sedating patients for procedures, but unfortunately in his line of work it’s often necessary. The only thing worse than when he has to sedate patients, is when he wishes he could sedate a patient, but for some medical reason he can’t. Like now.

“Shhh,” he soothes, petting over his patient’s leg when he feels her starting to tremble again. She’s laying back on the table, legs spread under the privacy blanket he’s given her. Steve settles his gloved hand in the crease where her thigh meets her hip, digs his thumb purposefully into the flesh of her lower belly from over the fabric of her pink hospital gown. There’s a tertiary gland in the low belly/upper mons that is the first of the omega sex glands to develop. And when stimulated properly, it can help to calm them down.

Unfortunately for Steve’s patient, hers won’t be fully developed for a few more years yet. He tries to get at it with his thumb anyway, hoping that if he can just graze it, it might help keep the girl calm until the procedure they’re doing is finished. He’s got her on the highest dosage of lorazepam allowed for a patient her age, but she’s still conscious and there’s nothing he can do for that other than comfort her verbally, using his alpha Voice that, in any other context, would be utterly inappropriate. “You’re doing so good,” he whispers.

Jori blinks her sleepy eyes up at him, another sluggish tear falling down her face. “Is it almost over, Mr. Steve?”

Steve takes a quick look at the machine’s readings, then forces a pained smile for her. “Yeah, Honey. Only a few minutes left. I’m so proud of you, you know that? You’re my best patient ever. Being so brave. Just a little longer here and then we’ll be finished."

They’re in the pediatric exam room, where the walls are painted in cheerful colors and the gynecological equipment is disguised to try and make it less intimidating. Steve likes his job as an omega sexual and reproductive healthcare practitioner, but there are some cases, and some elements, that he really, really wishes didn’t exist. Marjorie Goldberg and this exam room are two of them.

Seeding machines should not come with pediatric-sized attachments.

“Is she okay?” Mrs. Goldberg asks urgently, shooting up from her seat as soon as Steve steps out into the waiting area. Clint is sitting next to her, his OmCare badge clipped onto his jacket, and he stands when she does. Steve takes a deep breath and walks over.

“Marjorie is okay,” he tells her. “She shouldn’t need any more treatments after this one. She’ll need to be on medication for the foreseeable future, though. She needs to get into an intensive therapy program as soon as possible. We’re sending that information to her DCFS caseworker. I’m also recommending monthly checkups back here or at a licensed clinic for at least the next six months.”

“For more of this?!” Mrs. Goldberg takes an angry step forward.

“No. Just to check her levels and monitor her progress,” Steve says, tone clipped. “Nothing invasive, just blood tests and external ultrasounds to make sure everything’s okay.” His eyes flick to Clint, who is watching the woman like a hawk.

Clint is one of the OmegaCare social workers employed by the hospital. He’s there because the Goldbergs don’t currently have custody of their daughter, and it’s been a very … testy situation, with all parties involved.

Mrs. Goldberg is insisting on being as present as she’s legally allowed to be, not missing any appointments, lingering in the waiting room each time poor little Jori has to endure a treatment. She’s not allowed to see Marjory without supervision, and she isn't currently the one in charge of her daughter's medical care, but she's asserted her right to stay informed about it all, and since Steve is temporarily the senior N.P. on the pediatric omega GYN ward, that means it's his side she's a thorn in.

Mr. Goldberg is the reason the treatments have been necessary. He’s in prison now.

“You couldn’t even let me in there to hold her hand!” Mrs. Goldberg is saying, voice raised in anger.

Steve looks her dead in the face. He’s got little to no sympathy for this woman. “That’s not up to me, Mrs. Goldberg. You know that. DCFS is evaluating the nature of your relationship with your daug—”

“She needs me!” Mrs. Goldberg yells, outraged, though obviously on the verge of tears, too. “I’m her mother, for Christ’s sake!”

“And he was her father,” Steve bursts out, unable to contain himself anymore. “And we all know why I just had to be in there, therapeutically inseminating his seven year old daughter!”

Mrs. Goldberg stands there, red-faced and quietly crying. Steve feels near-instant regret hit him when Clint shoots him a what the fuck, man?! look from over the lady's shoulder. Steve swallows guiltily. That’s the kind of reaction that gets you administrative leave, if the client makes a big enough stink about it. By the sound of her pitiful crying though, Mrs. Goldberg is just feeling guilt and misery, hopefully not thinking about taking action against an NP who has just—very loudly and unprofessionally—yelled at her. Steve is supposed to be able to keep his shit together better than this. But then again, this isn’t really his wheelhouse.

He specializes in trauma cases, but the kids usually fall to his colleague, Dr. Connors. Steve is one of only a few staff who are qualified enough to cover most of Connors’ caseload while the man is out on maternity leave. Steve’s happy for the guy, sure—he’s just given birth to two healthy pups after a difficult pregnancy. But Steve’s starting to lose sleep (what little he gets to begin with, these days) to the nature of the work. He’s not cut out for the kids.

He clears his throat and mutters an apology to Mrs. Goldberg, looking at his clipboard rather than her wet face. “Marjorie’s still recovering from the sedation we gave her.” They’d tried for stronger drugs at first, aiming for full or at least twilight sedation, but the little girl had had such violent seizures that it was rendered impossible. “It’ll be another half hour or so until she’s ready to go back to her foster home.”

Mrs. Goldberg sniffles. “She’s alone now?”

“She’s with a nurse,” Steve says. He looks at Clint, nods, then turns to get away from the situation.

“Doctor Rogers!” the woman calls out, her voice all water-logged and choked.

Steve stops walking with a sigh. He doesn’t much bother with correcting people on the 'Doctor' thing anymore, finding it to be a waste of breath. “What?” he says curtly, not turning back around to face her.

“I didn’t know.” Her voice is pleading, tearful and urgent. Maybe she wants him to believe her or feel sorry for her or something. Maybe she just needs somebody to tell her that it’s not her fault. “I swear I never knew what he was doing to her. Not for sure. I swear.”

Steve’s hands tighten on his clipboard so hard that he feels it creak. “Right,” he grits out, forcing himself to continue walking away. “‘Not for sure’.”

Steve leans over the countertop of the nurse’s station and hands Sam a stack of charts. “Four and seven discharged. Five and six were admitted. Still waiting on the attending for eight.”

Sam nods, more bug-eyed than usual. He’s on his fifth coffee now. He takes the charts and starts putting them away. “Kay kay kay.”

“No more coffee,” Steve warns him, and Sam scowls.

“I’m fine.”

“Mmhm.” This is the tail end of the second shift for both of them. Sam’s a nurse on the om-psych ward, and given that Steve handles almost exclusively trauma cases for om-obgyn, he and Sam’s cases tend to intersect a lot. They both also draw the ire of their department managers pretty frequently, so they’re often sentenced to either clinic duty or shifts in the ER together. That’s how they became such good friends, and it’s where they are now.

“How was the shift on pediatrics?” Sam asks, though he sounds like he can already guess the answer. Steve’s been in a foul mood ever since he switched to his ER scrubs and clocked in.

“Awful,” he grunts. “I can’t keep doing the kids. It’s killing my soul. I’m going to my unit head tomorrow and telling her,” he decides. “She can’t force me to do it. I’ll tell HR it’s a mental health issue.”

Sam laughs. “Then they’ll send you my way. I’ll recommend shock therapy.”

“I’d take it over what I had to deal with today.” Steve gives him a brief recap of the Goldberg situation, and Sam loses all his humor.

“Shit, man.”

“Yeah.” Steve can’t say he isn’t really, really grateful to be alpha sometimes. Or at least grateful that he’s not omega. If anybody drew the short straw in life, it certainly seemed to be them. The fact that a grown man could rape his own daughter was bad enough, but then add to that the fact that because the girl was omega and her father alpha, she’d been forced into pre-pubertal heat too, her little body confused and trying to do what it thought it was supposed to do—to the detriment of her health in every way possible.

Steve sighs as he thinks about the abortion he’d had to perform on her. That kid was going to be on meds and in treatment centers for months, maybe years. Probably in therapy for the rest of her goddamn life. “I told them I’d be happy to testify at the guy’s trial,” he tells Sam. “In a medical capacity, if they needed it.”

Sam scoffs. “You are well spoken.”

“Very fucking eloquent.” Steve knows he needs to stop talking about this. It’s keeping him in a foul mood. He runs his hands through his hair. “Ugh, Sam. Distract me. Give me something to do.”

“Like what? Oh, hang on.” He leans over to the computer, clicking the mouse a few times as he navigates the screen. “Dispatch called in a code blue. Adolescent male, nonresponsive. They were doing chest compressions when the call came in.”

“When?”

“About ten minutes ago. So they should be here soon.”

Just as he says it, the doors to the ambulance bay bust open and several paramedics come wheeling in a gurney. Steve goes over to assess. The lead paramedic begins rattling off info to Steve as they move the gurney over to a bed: Adolescent male omega, presented with fever and respiratory distress. Pulse is thready, BP eighty over sixty.

The smell gets Steve right away, and an even stronger waft hits the air when they transfer over to the bed. The omega reeks of heat, but it’s sour and unhealthy smelling—unfulfilled, infected. Besides being inherently unpleasant, Steve’s body is responding to it, his dumb dick perking up like it thinks it can be a hero and help the situation. He tells the nurses to grab him blockers, and the new beta intern gets shoved in the direction of the supply cage.

Steve begins barking out orders. "Okay let’s get a line in him. I want a blood draw, full tox screen. Why isn’t he on oxygen yet? —Paxton! get the fuck off your phone. What the hell, man?”

“Sorry!" the intern says as she returns from her run to the supply cage, wringing her hands and just generally looking terrified of Steve’s ire. “We’re out of dermals.”

Steve ignores her, too busy rattling off IV meds and doses to the nurses. He'll have to wait until he can raid another cage for a transdermal patch to shut his dumb dick it up. He tells the intern to prep the crash cart, just to give her something to do. The boy on the stretcher looks to be in his late teens. He’s wearing jeans and a tee shirt that’s already been cut open. The nurses pull the scraps of it off him while Steve re-checks his vitals. When he shines his penlight in the kid’s eyes, he regains consciousness. He starts to struggle, afraid.

“Hey there,” Steve says, talking in his 'Nothing’s Wrong Here, Folks™️ voice to try and keep the kid from panicking. “I’m Steve, I’m an NP at Mercy General. You’re in the hospital. Can you tell me what you remember?”

“No family came with us,” the medic murmurs in Steve’s other ear. “Call came from a private residence. It was crowded but nobody wanted anything to do with us. They shoved him at us and told us to leave.”

Steve nods. That means it’s likely a drug situation. “What’s your name, Honey?” he asks the kid.

The kid blinks, still confused. “Bucky,” he says, “What happn’d?” He sounds bleary, like he might fade out of consciousness again.

Steve barks at one of the nurses to get him hooked up to the monitoring equipment. “That’s what we’re going to figure out,” he tells the kid kindly. “Bucky, can you remember if you took anything today? Any medicines or other substances?” He watches as the kid’s blown pupils flick around. The scent of frightened omega gets worse and Steve fights not to wrinkle his nose. One of the nurses relays the kid’s high temperature and pulse, his low blood pressure.

Two seconds later, he starts seizing. Steve holds his head steady while one of the nurses shoves a plastic guard between his teeth. They turn him on his side and the smell of urine hits Steve’s nose. As he’s holding the boy still, he puts his face near his neck and gets a better sense of his scent. What he smells makes his own heart rate tick up in alarm. The seizure passes and Steve tells the nurse to cut his remaining clothes off. Bucky’s barely conscious, emitting a low keening sound when Steve looks between his legs. “Fuck,” he curses.

There’s rampant infection, the fact that Steve can tell without even doing an exam is worse than alarming. He tells them to prep heavy duty antibiotics. “I need to do an internal,” he says. With the infection as horrible as it looks, there’s no way he’ll be able to touch the kid while he’s conscious. “Knock him out. And get a rape kit.”

They get him stabilized, on antibiotics and anti-seizure medication. Steve locates a blocker patch in one of the other supply cages to slap on himself before he heads in to do an internal exam on the unconscious omega. He finds impacted slick glands and prostate gland that are so enlarged and inflamed that Steve’s kind of amazed they haven’t ruptured. An ultrasound reveals an illegal IUD. Steve removes it. The boy’s hymen is obviously newly torn, and there are signs of recent tying. He's been raped by at least one alpha—violently, if the bruising is anything to go by. They swab what Steve would bet are foreign fluids from both his stomach and genitals. Steve meets with two cops and a social worker from OmCare, hands the rape kit over and tells them his findings. “Let me know if you contact any family,” he says.

So far, it seems like this boy has no one.

They admit him under “Bucky”, using his designation and admittance number (ꭥ-47202) in lieu of his unknown last name. Since he’s stabilized and since his medical problems seem to mostly be between his legs, he’s moved up to Om-obgyn Inpatient and officially put under Steve’s care. Steve is able to snag his department head and beg her to pull him from all pediatrics cases. She agrees, but makes the call that Bucky should remain on the adult wing. So he’s still Steve’s patient.

In his current state, Steve can’t do anybody much good for much longer. He’s nearing nineteen hours on shift, and even with the aid of several espressos, he doesn’t have much steam left in his body. He knows he could go home, but his next shift is scheduled for eight hours from then, and he really wants to be there when the kid wakes up. So rather than go home, he grabs an empty bed and crashes.

When he wakes, he checks the time on his phone and inhales deeply. At least he got a good six hours. He heads to the nurse’s station and gives the charts for their hall a lookover, then goes to the room where they’ve put the male omega from the night before: Bucky.

His eyes are closed when Steve walks in. Steve tilts his head, taking in the boy's features. He looks better now, more stable, less pale. And he smells better, which gives Steve a hint that the antibiotics are already helping. The notes on Bucky’s chart from the overnight nurse have him nodding in vague approval as he reads. “Okay,” he says quietly to himself. “Good.” Not good good, but much better compared to the state he’d been in last night.

When Steve looks up again, the boy is watching him.

Steve smiles gently. “Hey there. You’re awake.” He walks over to the bedside. The boy struggles to push himself up and Steve halts him, showing him how to instead use the controls on the bed rail to come up to sitting. “Don’t want to overexert yourself,” he says kindly. He pulls up a chair to the bedside and sits on it. “I’m Steve,” he says. He’s long avoided using his last name with patients because they always wind up calling him “Doctor Rogers,” and Steve isn’t an MD and it just gets awkward after awhile. “You’re in the hospital. You were brought into the ER late last night. This is the omega ob-gyn ward you’re in now, and I’m going to be your attending.”

“Attending?” the boy says, voice craggy and dry. He winces and puts a hand to his throat.

“It means I’ll be looking after you,” Steve clarifies. He gets up and goes to fill a cup of water.

“I’m Bucky,” the boy says. “You’re a doctor?”

Steve returns to his bedside and hands the cup over. Bucky takes it. “Small sips,” Steve warns. “I’m a nurse practitioner. In New York we can do just about everything the docs do. But like I said, you can feel free to call me Steve.”

Bucky nods, no affect to him. He seems almost resigned, Steve thinks. He hasn’t asked about any loved ones and Steve hasn’t missed that either. “What happened?” he asks.

“Well I was hoping you could tell me that,” Steve says, purposefully keeping his demeanor non-confrontational. “You’re sick. You have some infections going on. And you were in very bad shape when they brought you into the ER. You had a seizure.”

Bucky’s eyes widen. “I did?”

“Mmhm.” Steve leans forward a little and asks, “What do you remember happening yesterday, Bucky?”

This is where the omega goes still and clams up. He refuses to give an account of anything, saying that he has no memory of the previous day. Steve is trained in how to interact with assault and trauma survivors, but he doesn’t make any headway with the boy. Bucky clearly believes that being open and honest with strangers will put either him, someone he loves, or someone with authority over him, in trouble.

Steve backs off, hands him a room service menu so he can order something cool for his throat, then goes to page Sam.

When Sam comes out after spending almost an hour with the kid, Steve straightens up from where he’s been loitering at the nurse’s station. “What’d he say?”

Sam blows air through his lips. “It’s a doozy.” He tips his head down the hallway. “Walk with me. I’ll tell you over my next espresso.”

Turns out, Bucky has been living in an isolated religious sect that doesn’t believe in, among other things, male omegas’ reproductive rights. More precisely, they pretty much just don’t believe that male omegas should exist, think that they’re an ‘abomination unto the Lord’, or something like that. Steve looks up the Wikipedia page on their group, and is neither pleased nor particularly shocked at what he learns.

Short of murder, they espouse beliefs and practices that do everything possible to stop male O's from existing. They try to prevent nature from taking its course on the limited number of male O's born in their group, forcing them to live instead as regular beta males via a combination of drugs, surgeries, and social pressure. They call themselves the Children-of-God’s-Kingdom.

Steve’s heard of them before, but he’s never had anyone like that come through his ward. “Oh man,” he says, when Sam rattles off the things Bucky's told him. “So, a cult. You’re telling me he’s in a cult.”

“He doesn’t even know who his real parents are,” Sam says gravely. “They live communally. All the wacko parents sign custody of their kids over to their grand poobah.”

Steve scowls, feeling outrage for what’s been done to this poor kid in the name of religion. “Well they managed to almost kill him,” he snaps quietly, mindful of where they’re standing. “And it's almost a guarantee that he’s been sexually assaulted. We ran a rape kit last night.”

Sam doesn’t look surprised, just mad and caffeinated. Steve asks him if he got an age out of the boy, and Sam tells him regretfully, “Eighteen.”

“Fuck.” Steve shakes his head. Omegas don't reach their majority until nineteen. “We’ve gotta report it to social services before somebody from the cult shows up trying to claim him. Trust me: one look at his charts and OmCare will take custody.”

Sam nods. “He also said there’s an IUD inside him and hormonal suppressants implanted.”

“Yeah we got the IUD out. I’ll get the implant out today. Which arm?”

“You’d have to ask him.”

Steve nods tersely, wondering if the poor kid got to have any say over the things his so called ‘family’ did to his body over the years. Likely not. As a physician who is very well educated on the considerable risks, Steve has always heavily discouraged his omega patients from trying to use drugs and devices to suppress their natural cycles. But, much like many other unhealthy choices, birth control and suppressants aren’t technically illegal for omegas over the age of twenty one.

But Bucky is only eighteen, just now entering the ripest years of an omega’s reproductive life. Steve grits his teeth when he thinks of what further damage might’ve been done to this poor kid, had he remained in that cult for any longer. “I’m gonna go check in with him,” he says, taking a step in the direction of Bucky’s room.

Sam stops him with a touch to his arm to let him know, “He seems honest enough, but he’s anxious not to get anybody from his group in trouble. He wouldn’t name names. And you can bet he’s gonna be all kinds of warped about his designation, being raised like that. Tread carefully.”

Steve nods, angry. No doubt the kid’s been told his whole life how he’s an affront to God, has ‘unholy urges’, or some horrible shit like that. “Guess he’ll be up your way before long, then,” he tells Sam, before walking off.

Steve knocks lightly on the doorjamb to make his presence known. “Hey there.”

“Hi.” The omega is sitting propped up in the bed with an extra blanket and pillow now. He’s got water and a half-finished Italian ice cup on the bedside table. Steve notes the almost completely untouched breakfast platter and nods. Kid must be nauseous. He’s looking sheepishly up at Steve as he approaches. “You sent a shrink in.”

Steve pulls the chair back in to sit close to the bed like he had before. “That’s nurse Wilson,” he says. “And yeah, he came to try and get you to feel safer about talking.” The kid—Bucky—nods while looking down at his lap, and Steve asks, “Did it help?”

Bucky shrugs. “He said I don’t have to talk about anything if I don’t want to.”

Steve’s heart clenches as he remembers the rape kit they’d done on him, the torn hymen and the swollen — “That’s right, Honey,” he says. “You don’t.” He puts his hand on the bed, not touching him, just the thin hospital blanket next to his legs. “But I’m hoping you’ll tell me certain things, so that we can get you healthy again.”

Bucky looks very uncomfortable, but to his credit he seems to push through it. “Look, um, Steve?”

Steve nods.

“I heard the nurses talking. About my family.”

Steve straightens up. “Your family?” He’s hopeful he’ll be able to get information about the kid’s abusers, but Bucky disappoints him by saying,

“The ‘Children’ I mean. They’re my family.” He chews his lip and looks down at his knees. “Look, I know … I know it’s not normal, the way we live. I know other people are different, live differently.” Quietly, almost so quiet that Steve doesn’t hear it, he says, “People in the outside world don’t say bad things about us.”

“Who’s ‘us’?” Steve prods gently.

“Omegas,” Bucky whispers. “Boy omegas, anyway.”

Steve hates to see the self-loathing on the kid’s face, hating himself just for how nature made him. “Bucky,” he says carefully. “I want you to know that most people believe that male omegas are perfectly natural and normal. Both female and male omegas are beautiful and important.”

Bucky’s cheeks darken. He’s clearly uncomfortable talking about it. “I know. I’ve run away a couple times, spent time around … around normal people. I've watched tv shows.”

“That’s good, Honey.”

"Yeah. I —" Abruptly, Bucky’s face pales and his eyes get wide. Steve tenses. Bucky leans over and snatches the breakfast tray off the bedside table and gets it in front of his face just in time to barf all over the room service order of scrambled eggs and toast. Steve winces and gets up to help him. When it seems like he’s done retching, Steve takes care of the mess and returns with a couple of the hospital’s barf bags. “Here. Just in case.”

“Thanks. Ugh.” Bucky grimaces. “God. I feel so awful.”

“I know, Sweetheart.” Steve sits forward in his chair. “That’s because you’re sick. I need to ask you some questions to figure out what we’re gonna do to treat you and get you all better, okay?”

“... Okay.”

He tries to smile encouragingly. “Alright. I know it’s hard to talk about, but it’s important you answer honestly so I can help you, okay?” Again, Bucky nods, and Steve asks, “When did you have your first heat?”

Bucky looks mortified—beyond the usual discomfort of a teenager not wanting to talk about their body, or sex. He’s ashamed of himself, Steve realizes. But he manages to answer with a quiet, “Eleven.”

Male omegas tend to go into heat earlier than their female counterparts, their bodies needing more time in estrus to fully mature. Steve nods encouragingly, trying to show Bucky through his open expression that nothing about this should be shameful. “Okay, and how many heats would you say you’ve been able to cycle through naturally without birth control or suppressants?” Steve does some quick mental math: 7 years x 12 months … That’d be close to 84 heats, assuming he's always been regular with his —

“Oh never! Or, I mean ...” Bucky makes a face and corrects himself. “Not since the first one, anyway.” He looks miserably down at the blanket covering his legs, like he’s remembering something awful. “Just that first time,” he repeats quietly.

It’s a terrible answer, and Steve forces himself not to visibly react. He doesn’t want to scare the kid. He notes the information on the chart. “Okay. I removed your IUD last night. Do you know which arm they put your suppressant implant in?”

Bucky nods, pointing to his left bicep.

“We’re gonna take that out today. I’ll give you a local injection to numb everything. It won’t hurt.”

He nods, looking wary of the prospect. “So then I’ll … I’ll get my heats and stuff?”

Steve hums sympathetically and tries to reassure him. “It’ll be fine. You’ll feel a lot better, I promise.” Bucky doesn’t say anything, just keeps looking resigned and dejected. Steve hates it. He imagines the years the poor kid has spent hearing The Children’s vitriol, hearing despicable horror stories about pathetic, desperate, disgusting male omegas in heat, how it’s something to be avoided at all costs. Steve frowns and moves on to the unpleasant part. “So, one thing we did last night that you probably don’t remember, is we collected swabs of fluids and tissue. For evidence, in case somebody had hurt you.” He waits until he can see that Bucky gets what he’s saying. The poor boy’s eyes widen and his lips part and he gets very tense. Steve reaches out to grasp his hand, then adds, “I think somebody did hurt you, and I’d like it if you could tell me so that I can make them pay for what they did.”

Bucky shakes his head, tears breaking from the corners of his eyes. “No. No, I don't want to talk about this.”

Steve’s heart breaks, but he has to press the issue at least a little bit. “Honey, the thing is, this is important for me to know. Medically, it’s important for me to know, because you know what happens when an omega is suppressed for years and years and years, and then alpha semen gets inside their body?”

Bucky flinches hard at those words, but Steve holds fast. He gives Bucky’s hand a reassuring squeeze, leaning further forward and holding it in both of his large hands, enveloping it. “What happens,” he explains, trying to be gentle in how he says it, “is that it can trigger your body to try really, really hard to go into heat. And when your body can’t do that, that’s when you can start to get into really dangerous complications. Like having seizures and going into shock. Your organs can even start shutting down.” He instantly sees the terror in Bucky’s features and he hates it, wishes so badly that he didn’t have to be so honest with him. But federal legislation requires it. "That's why you had a seizure last night. It's why you're so sick."

Bucky’s lips are parted, not knowing what to say. “But I … I never … I didn’t know that?” He looks scared as his eyes flick around the room, always returning to Steve like a beacon. Vulnerably, he stutters, “Is ... is that happening to me? Organ failure?”

Steve knows he can’t lie to him, so he takes a deep breath and says, “I did conduct an internal exam and an ultrasound on you, when you were sedated last night.” He can see the humiliation in Bucky’s features as he realizes what this means. Steve presses on, “Many of your reproductive organs are inflamed or infected, from trying to make your body do what it’s supposed to do, but can’t.”

“Because of the suppressants,” Bucky murmurs.

“Yeah, Honey. Because of the suppressants.” Steve wishes so badly that he didn’t have to inform him, “There’s ... a chance that you could be unable to have children. In the future.”

The omega keens high in his throat, a noise that he has no control over and which Steve’s nature also has no control over how it instinctively responds to it.

One of Steve’s hands leaves Bucky and flies up to his own neck, where the expired sup patch is still adhesed to his skin. He grits his teeth, thinking that he most definitely needs a new one.

Steve is salaried higher for his usefulness as an alpha on this ward, but then again, he’s not usually dealing with eighteen year old boys who have no clue what independent sexual decision making is. “It’s okay,” he soothes him, voice swooping low and smooth. He starts up a deep, dominant rumble in his chest to help calm the boy. “We don’t know anything for sure yet, okay? You were very swollen when I looked at you. Your body needs a chance to rest and heal before we can know what we’re looking at, long term.” Steve can smell the intense distress of the omega at the possibility of no longer being fertile. Even if it’s something Bucky’s never considered before, it’s the boy’s innate nature to become defensive if such a thing is threatened.

“Is this all because of —” Bucky cuts himself off, clearly struggling. He won’t even meet Steve’s eyes as he forces himself to ask, “Is this happening because I had sex?”

Steve goes very still, his advocate training kicking into gear. “Did you have sex?” he asks gently. "Or did someone hurt you? Because it's not sex if you're not a willing participant. Then it's assault." Given what he knows about the cult Bucky’s been in, he finds it extremely unlikely that the boy would have had willing intercourse with a penetrative partner. Male omegas in that situation would be groomed to believe that that part of themselves was shameful and to be repressed at all costs.

In the bed, Bucky is looking tinier by the second, drawing into himself. He shakes his head frantically. “N-no. No. I said no.”

Steve watches him sadly. “Okay, Honey. Okay. Did somebody force themself on you?” Bucky starts to make that high keening sound again, the sound of an omega in intense distress, and Steve hurriedly adds, “You don’t have to tell me who it was. You don’t, I promise. Okay? But if somebody hurt you, you should blame them, not have to call it sex or feel bad that —”

“Mmn, mmmm mnn.” Bucky is shaking his head fast, face red and pained and looking like he wants to disappear into the cracks of the earth. “No,” he breathes, “Nno. I said no. They did it. The ... those guys. They did it.”

Steve's heart sinks all over again. More than one. He's dealt with cases of gang rape, but never with a patient so young. And never with a virgin. Fuck.

Bucky's scared eyes flick back to Steve’s face. “Oh god. Is that why I’m sick?” He cringes as if it’s the worst, most humiliating thing in the world. “Because they got their … their stuff inside me?”

Steve nods reluctantly, so sorry to have to tell him so. “It’s not your fault, Baby. It’s got nothing to do with you or how you feel about them. It’s just biology. Your body responds to it. It wouldn’t even be that strong normally, but after being suppressed for so many years, it’s almost like an allergic reaction.” Steve winces. “Your body’s overcompensating.” He can see how the poor boy’s about to burst into tears, so he gets up from the chair and sits on the side of the hospital bed, pulling Bucky’s hand and his whole lower arm against himself. His chest is emitting a low grade alpha rumble, but it’s only on the periphery of his notice. “Bucky,” he tells him tenderly, waiting until the boy looks up at him. “Hey, I’m sure there are so many things you’ve not been allowed to know about your body and how it works.” Bucky blushes hard but Steve presses on imploringly, “Most importantly that there is absolutely nothing to be ashamed of with your designation. It’s normal, it’s natural, it’s beautiful, and it’s yours.”

Bucky’s eyes spill over with more tears. “I wish I didn’t grow up there,” he whispers, and then he pitches himself forward at Steve’s body, crying, hanging onto the front of him and stuffing his face in his chest, against his lab coat and scrubs. “I hate them!” he gasps, voice choked with sadness. “I h-hate them!”

It takes everything in Steve to not say 'Me too'. Instead he just rubs the omega’s back and lets him cry against his body, telling him that everything is going to be alright now, everything is okay, he’s safe.

Because if Steve knows anything, it’s that he’ll kill to keep this kid away from the people who did this to him.

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