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About a minute after the orderly led Spike away from Xander and Troy, there was a clattering metallic crash from the direction of the exam rooms.

Troy looked at Xander, wincing. "Twenty bucks says that's Spike."

"Fuck. Let's go."

They found the room. Spike was flattened into a corner, hands pressed against the walls, eyes wide. The doctor, an Asian guy who didn't look much older than Xander himself, was back near the door, making with the soothing noises and cradling his right arm close to his chest. "It's okay, I'm not going to hurt you."

Troy went to the doctor and Xander went to Spike.

"Are you okay?" Xander heard Troy ask the doctor.

"I'm fine. Who are you?"

Xander, meanwhile, had carefully approached Spike. Spike's eyes were on the doctor and he was breathing fast and shallow. "Hey, Spike, it's okay. Nobody here is gonna hurt you." As soon as he got within arm's reach, Spike startled him by suddenly detaching himself from the wall and clinging to Xander. "Hey, okay, uh, yeah. I'm here."

"We're the ones who brought him in," Troy was meanwhile explaining to the doctor. "Sorry about the tray." A metal instrument tray and its contents were scattered on the floor -- that must have been the source of the noise. "I guess he's, um, nervous around strangers."

Spike seemed to be calming down as Xander rubbed his back and held him.

"Are you relatives?" the doctor asked.

"No," Xander said, at the same time as Troy's "Yes."

"We're not," Xander said more emphatically, glaring at Troy, even as he responded automatically to Spike's hiding his face against Xander's chest by lifting a hand to the back of his neck and petting his hair. "I just know him from, uh, my hometown." He knew what Troy would be thinking—as relatives they'd be more likely to be allowed to stay. But what Xander wanted was for Spike to become somebody else's problem, and the more connection this doctor thought they had with him, the less likely that was to happen.

"Well maybe you can help me fill in the chart a little?" the doctor said. "All the admitting nurse got was a first name—William?"

"Yeah, sorry, I don't know his last name," Xander said. "Oh, and for what it's worth, he actually goes by Spike."

The doctor made a note. "So you do talk, then?" he said to Spike.

"Um, no," Xander said. "Kinda not. At least, not since we found him."

"Found him?"

"Last night, at a soup kitchen."

Spike had started coughing again. Xander hoped nothing gross was ending up on his shirt.

"Can you tell me anything about his mental illness?" the doctor asked.

Xander shook his head. "When I knew him before, he wasn't like this."

"But you said he was sick before," Troy reminded him. "In Sunnydale."

The doctor looked up sharply. "Sunnydale? He's a survivor?"

"They both are," Troy clarified, despite Xander's quelling glare.

The doctor—Dr. Chen, by his name badge, which Xander could see now—made a sympathetic noise. "Sorry to hear it."

Through all this, Spike was still coughing.

"I need to do a physical exam on him," Dr. Chen said. "He had a panic reaction last time I tried. He seems calmer in your presence, uh—"

"Xander," Troy supplied his name.

"Do you think you could get him up on the examining bed?"

Spike climbed up on the bed willingly when Xander brought him to the edge. Xander held his hand, feeling a bit strange about his role, while Dr. Chen pushed up Spike's shirt and pressed his stethoscope against Spike's chest.

"Take a deep breath in," the doctor said. Spike just stared at the opposite wall. The doctor looked at Xander. "Maybe he'll do it for you?"

"Hey Spike, you've gotta help us out here. Deep breath, okay?" No reaction. Xander shrugged. "Sorry."

Dr. Chen frowned. "Does he understand what we're saying?"

"We think so," Troy said, and explained quickly what had happened last night in the car.

Dr. Chen listened to the story with a serious expression. "Has he shown any other sign of wanting to harm himself? Are these scratches self-inflicted?" He indicated Spike's face.

"He was having a nightmare," Troy said. "We think. He might not've known he was doing it."

"Okay, I want to continue the physical exam, but I'm going to refer Spike for a psychiatric evaluation," Dr. Chen said. Xander felt an immediate and profound sense of relief—somebody else was going to deal with this. "He should be able to get an appointment within three weeks." There went the relief. Shit.

"Three weeks?"

"Sooner if he could pay," Dr. Chen said. "Sorry." He sounded like he meant it, like he was sorry, and frustrated with the system. "I'd like to take your blood pressure now," he said to Spike, who continued to do nothing.

Dr. Chen pushed up Spike's sleeve and hesitated a moment before reaching for the blood pressure cuff. There were some weird little bruises and scabs on the inside of Spike's arm. A shivery feeling crept up Xander's neck as he guessed: vampire bites?

"Shit," Xander heard Troy say quietly, but he wasn't sure what he was thinking.

"Can you tell me anything about his drug use?" Dr. Chen asked.

"No," Troy said. "We didn't know. We didn't see his arms last night."

Oh. Not vampire bites. Xander felt a little dumb. Failings of a Sunnydale education. "Those are track marks?" he asked, just to be sure. To be sure that they were sure.

"Injection marks. Yes." Dr. Chen let the blood pressure cuff deflate, and reached for Spike's other sleeve. Spike seemed to have gone away—he was staring blankly in the general direction of the opposite wall. His other arm, his left, didn't have any of the marks on it.

"He's left-handed," Xander mentioned, not sure why he even knew that.

"It doesn't look like he's been injecting on a regular basis," Dr. Chen said. "He might not experience withdrawal." He shrugged, and took out a digital thermometer. "Or, he might be having them right now. I guess he's not going to tell us."

They were at the hospital for a very long time. As long as Xander stayed close, Spike stayed calm and passive through all the poking, prodding and tests, but he descended fast into panic when they were separated. Even the x-ray tech ended up getting Xander to stay with Spike, giving him a lead apron of his own.

Then there was the waiting. Spike ended up on a gurney, somehow, in another exam room, curled up asleep with one hand tucked tight in Xander's. Troy sat next to Xander, reading aloud from Cosmo.

"Want to know the ten sexiest things you can do with a silk necktie?"

Dr. Chen closed the door behind him. "You know, I was wondering."

Troy shrugged. "The list tops off at light bondage. I could do better than this."

Xander kicked his ankle. "Can we talk about that later?" He turned to the doctor. "How's Spike?"

"He has tuberculosis."

Xander wasn't exactly surprised. He'd seen some TB cases in the clinic in Cameroon. The coughing-up-blood was a thing he remembered.

Troy looked a little shocked, though. "That's—God, that sucks. Is he gonna be okay?"

"We have antibiotics to treat it. But it's very, very important that he follow the treatment regimen exactly, all the way through. Otherwise the disease builds up a resistance to the drug." Dr. Chen looked at Spike with obvious concern. "It's clear that he's in no condition, psychologically, to take charge of his own treatment."

Xander didn't like where this seemed to be heading. "So admit him."

Dr. Chen shook his head. "He's not sick enough for MediCal to pay for in-patient treatment. He'd qualify for a psychiatric bed, but they're full. There'd be a two-week wait, at least."

"What do you mean full?" Xander said. "The whole city?"

Dr. Chen gave a tight shrug. "Demand is high, funding is low."

"So, we'll do it," Troy said.

Xander kinda wanted to kill him. Or kiss him. Saving the world, one broken creature at a time.

"I was hoping you'd say that. I'd like to make you—Xander—his temporary legal guardian, and have you sign a document promising to complete the antibiotic treatment. I'll have a social worker visit you sometime in the next couple of days."

And that was how Spike became, officially, Xander's problem.

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