A/N: I'm updating both my fics at once! Kind of crazy as they are quite different in many ways. Anyway, the next couple chapters of this one are going to be heavy on the medical side of things. Apologize in advance if you don't like details of things, but I want this story to be thorough; these early chapters are all spent in the hospital. My adult life has been dedicated to medicine so I'm way more comfortable in this setting than some of you may like. Just bear with me and we'll soon be in to happier days. Though "soon" is open to interpretation. Hahahaha.

Castle was shattered. He couldn't think, couldn't move. Couldn't look at this caricature of Kate, couldn't look away. Her eyes were sunken deep into her head, hair a rat's nest that looked like it hadn't been washed in days. She was wearing one of his old t-shirts and a pair of shorts. Both were damp with the same bilious fluid that covered the bed and the floor. She looked like she'd lost 20 pounds; he could see deep indentations between her ribs in the areas where the t-shirt was melded to her chest. There was absolutely no indication from her that she was aware of them, had heard them screaming or felt his hands frantic to wake her up. Her chest made a deep rattling sound every time she had an agonal respiration. She was alive, but would not be for much longer. Behind him Alexis had regained her composure, especially upon seeing her Dad fall apart. She'd dialed 911, was told they had already been dispatched. She went to open the door for the EMS crew after first grabbing some towels to sop up some of the mess on the floor.

A lifetime later Castle heard some voices behind him. Male voices. Confused he turned slightly from his vigil by their bed and saw some paramedics entering the room with a gurney. Their faces were composed, neutral masks until they caught sight of Kate; they couldn't hide their shock when they saw how sick she was. Castle was unceremoniously shoved aside as the two men tried to attend to Kate. He didn't mind; he knew he couldn't help her. He watched as they worked quickly. They placed an oxygen mask over her face, placed her on monitors. He listened as they called out numbers, not understanding everything.

"Heart rate 140. Thready pulses. Blood pressure 80 over palp. Sat 97% on non rebreather."

One of the medics was looking at her skin. He pinched it and it tented easily in his fingers.

"She's too dry for an IV. I think we're gonna need to put in an I/O."

The other ran out of the room. Turning to Castle and Alexis, the other said "Are you her family?"

"I'm her fiancé and this is my daughter."

"Does she have any medical conditions? Do you know what's been happening with her?"

"I was out of town. She's completely healthy normally, in great shape. She told me she had caught the stomach flu last week, but I had no idea how sick she was. I couldn't get her to answer the phone yesterday so flew back this morning to check on her."

"She's extremely dehydrated and in shock. Normally we'd place an IV and start fluids but her veins are so dry there's no place to put one. We're going to place a needle in her femur and start running fluids into her that way. As soon as we get that started we'll be loading her in the bus and taking her to the nearest hospital. She's very sick sir. She needs immediate attention."

"Can I ride with her?"

"Yes, but just one of you can come."

Castle paused. He wanted to be with her more than anything, but he couldn't leave Alexis alone in a strange place. Just then the other paramedic came back in carrying what looked like a drill. An unfamiliar woman followed him.

"Oh my God. Kate!" she said. Castle stood numbly as the medics drilled a needle into Kate's upper thigh and taped it in place. They seemed satisfied with its placement and started stringing a bag of saline to run into it.

"Are you Rick Castle?" she was speaking to him.

"Yes" was all he could manage, not really caring who else was there. His whole focus was Kate.

"I'm Abby Murray. I heard you screaming over the phone so I called 911. I came as quickly as I could. What happened?"

"She was sick; I don't know" he mumbled "She won't wake up."

"Sir, we're going to load her on the gurney now. Are you coming with us or not?" the paramedic interrupted.

"My daughter….I want to come but I can't leave my daughter."

"Dad, I'll be fine. You need to be with Kate."

Abby spoke up next. "You go with her and I'll bring your daughter in my car. Which hospital will you be going to?"

The paramedics had moved Kate to the gurney, strapped her in with blankets covering her everywhere but her face and were hurrying down the stairs. They told Abby where to go and loaded the gurney in the back of the waiting ambulance. Rick was told to sit next to the medic in the back. He found her hand under some blankets and tried not to think how light and bony it felt. She still hadn't responded to any stimuli. They burst out of the neighborhood, sirens blaring and he braced himself as the frantic movement threatened to unbalance him. He kept stroking her hand as the medic next to him radioed the Emergency Room that was their destination.

Jerking to a stop, Rick was startled when the doors of the ambulance flew open. He was urged out of the way and watched helplessly as the medics and some of the ER personnel quickly unloaded the gurney and rushed her inside. Not knowing what else to do, he trailed behind unwilling to let her out of his sight.

In the trauma room, the medics were quickly recounting how they'd found Kate to the waiting medical team. Rick stood just inside the doorway, watching as the attending physician quickly assessed the situation. One of the nurses approached him.

"Are you her husband?"

"Not yet. She's my fiancée."

"Ok, you can stay in the room; just try to stay out of the way. As soon as they've stabilized her they'll need to ask you some questions."

He could see they were struggling to get an IV in any of her peripheral veins. He shorts and shirt had been cut off and her tremendous weight loss was very apparent. The attending physician beckoned him in a bit closer. She was medium in height and build with a confident air that made Rick like her immediately. He could see she knew what she was doing and ran the trauma team with a practiced air. He relaxed a smidgeon; Kate seemed to be in good hands.

"I'm Dr. Collins. I heard you say you're her fiancé? Do you know what happened?"

"Not really. She's a new federal agent and has spent the last five and half weeks training for her new position. I went out of town on business, so we've just been able to talk on the phone. She's been really tired. A few days ago she started vomiting; she told me she had the stomach flu. I haven't heard from her since Friday. When I couldn't reach her, I got worried. So, I flew in this morning and found her on the bed like this. It looked like she'd been puking for days; the bed and the floor were a mess." He felt like he had diarrhea of the mouth, couldn't stop talking. Anything to help them save Kate.

"Any previous medical conditions?"

"She was shot in the chest; you can see the bullet wound in the front and the surgical scar on her side. That was two years ago, she's had a clean bill of health from her cardiologist."

One of the nurses interrupted. "No luck on the IV Dr. Collins."

The physician turned back to Castle. "Mr…"

"I'm Rick. Rick Castle."

"Mr. Castle, your fiancée.."

"Kate" he broke in, eager to supply information.

"Yes, Kate. She is extremely dehydrated. The paramedics put a needle into her thigh bone so we could start rehydrating her, but she needs more. Now, I know you're her fiancée; however in the eyes of the law you are not able to consent for procedures. Does she have any family we could contact? Parents, siblings?"

He was devastated. He'd forgotten that their relationship wasn't formal enough for him to be able to give consents and have physicians talk to him about meaningful topics, namely Kate. "Her father is in New York. I'll try and call him."

"Ok. In the meantime, she is critical enough that we are going to move forward with whatever procedures we think she needs. In an emergency, if two physicians agree it is necessary we can do whatever we think is required to save a life. This is one of those times. We are going to do a cut down on one of her big veins to insert a central line. Then we can start rehydrating her and trying to figure out what is going on. Do you understand?"

Castle nodded numbly. Whatever they needed to do was fine with him as long as Kate got better.

"We're also going to intubate her and put her on a ventilator to assist her breathing; she is probably so acidotic from the dehydration that she is struggling to breathe. Once this is all done we'll be able to get some blood sent to the lab to figure out what is going on. You need to find her father so he can give consent for you to get information; otherwise we won't be able to tell you the details of what we find."

Castle nodded again. He knew about the privacy laws that hospitals and physicians operated under. It seemed stupid since Kate was closer to him than to any other living being, but they weren't married yet and that was all it took to alienate him from her in the eyes of the hospital. He started trying to find Jim Beckett while absently watching the team as they worked to save Kate.

A few hours later found him sitting next to her bed in the ICU, stroking her hand as he listened to the electronic reassurance of her heartbeat sound through the room thanks to the monitors. The ventilator whooshed 14 times a minute. He'd counted it multiple times. One more minute she was still with him, hadn't completely given up. He hadn't been able to get hold of Jim at all. He'd left dozens of panicked messages without response and finally had recruited his mother to go to Jim's apartment and see what she could find out from the neighbors. She hadn't called back yet.

Alexis and Agent Murray had arrived shortly after Kate had been intubated and had the central line placed in her neck. They'd stayed until it was time to move Kate to the ICU. Abby had again volunteered to take Alexis to a nearby hotel; he was grateful to her for all her help; they'd never met and yet she had been nothing but helpful and concerned. It restored his faith in humanity a bit that someone who was a total stranger to him could be so kind.

The doctors were very worried about Kate. He wasn't allowed details, but they had told him she was critically dehydrated. They were working to replace the fluids she'd lost, but they had to go slowly. Apparently she could suffer brain damage if they tried to correct everything too fast. She wasn't sedated at all, but still hadn't moved, hadn't tried to fight the breathing tube in her throat. They'd reassured him that this was expected given the degree of dehydration; as she improved she would wake up. He prayed fervently that moment would come soon, though he was warned it could take days and she may have suffered neurologic damage anyway. He prayed about that too. He'd been scared about losing her many times; they'd faced death together so often after all. This seemed so much worse; she'd been alone and had suffered so profoundly. He vowed he'd never leave her for more than a few days again.

His phone ringing broke his reverie as he clutched her right hand like a life ring. It was his mother, finally.

"Did you find him?"

"No darling, he's not here."

Castle's gut clenched again. It was killing him not to know anything substantial.

"Richard, I knocked on some neighbor's doors. I found a delightful little man across the hall who says Jim left for his cabin on Friday and was planning to be up there for most of the week. Do you know where it is?"

He didn't. Had never been up there, didn't know anyone who had besides Kate and Jim.

"No Mother. Does the neighbor know?"

"I'm afraid not kiddo. How is Katherine?"

"Unchanged. She's still not moving" his voice broke, tears threatening. It was all so overwhelming, and sometimes a boy just needed his mother.

"Now Richard, you know as well as I do that Katherine Beckett is as tough as they come. She's going to be fine Richard. You need to stay strong and keep saying she'll be fine."

"She's so still, so unlike Beckett. I don't know what I'll do if…" he couldn't finish.

"Richard, I'm leaving Jim's place now. I'm catching the next shuttle tonight. I'll rent a car, so don't worry about getting me. That way we'll have a car for moving around."

Castle wanted to protest, but stopped. He needed her here to help keep him strong and she would be indispensable for Alexis; he knew he couldn't do much to reassure his baby girl when he was falling apart.

The next person he thought to call was Lanie. She probably didn't know the cabin's address either, but she might know who he could call to find out. He was preparing to leave a voice mail when she didn't answer right away. When she suddenly picked up it startled him; she was breathless like she'd been running.

"Castle!" she gasped. "Why are you calling me on a Sunday? Is everything ok? You bored on your book tour and wanted to talk some sass?" She was teasing, but he couldn't process most of the conversation.

"Sorry to bother you Lanie" he started. Paused. Tried to be calm and in control. Utterly failed.

"Castle, it's no bother. Are you ok? What's wrong?" Her voice had lost it's playfulness and she was suddenly very serious.

He thought he heard a voice in the background, felt a little guilty for interrupting whatever she was doing but then glanced at Kate's unmoving body and whatever guilt and control he'd had evaporated. Lanie loved her too; her best female friend, her sister. He didn't need to pretend with her.

"Lanie" it came out with half a sob. He heard her suck in air on the other end, knowing just with this one word something was terribly wrong. "It's Kate. I found her…she's really bad. We called 911, now she's in the ICU."

"Oh my God Castle. What's wrong?"

"I don't know; they can't tell me, but I'm not sure they know yet either. She was apparently throwing up for days, she's really dehydrated." He paused again, body shaking now with sobs. "Lanie, she's on a ventilator and she doesn't move. She doesn't do anything when I touch her or talk to her. They had to cut into her to put in a central line. Oh God Lanie, what am I going to do?" He could hear her moving, whispering to someone in the background. Suddenly she was back with him.

"I'm coming down as soon as I can get a flight."

"You don't need to do that Lanie."

"Don't you tell me what I need to do Richard Castle. She's my best friend, I'm coming down."

"Ok. My mom's coming too; maybe you guys could come together." He was proud he'd remembered that simple detail. He was trying to hold it together.

"I'll check with her Castle. What about her Dad?"

He'd almost forgotten why he'd called in the first place. "I can't reach him at all. The hospital needs her next of kin, so I've been trying since we got here. Mother went to his apartment and a neighbor said he'd gone to his cabin. Do you have any idea where it is?"

"No sweetie, I'm afraid not."

He sighed. It had been a long shot. "Do you think Ryan or Espo might know?"

She hesitated for a minute; he thought she might not have heard him. Then he heard her ask the question to whoever she was with. Confused, Rick waited for a minute, not sure what was going on. A second later, he heard Espo's voice on the phone and understood. The tiny ribbon of guilt that he'd felt earlier started to rise again, but any regrets were erased when Javi spoke.

"Bro, I know where the cabin is. I'm leaving now, it takes a couple hours. As soon as I find him we'll call you so don't turn off your phone, ok? Take care of her Castle."

"I will. And thank you Javier."

"Hey man, we all love her too. Just hang in there." Then he was gone, one of her guardian angels on a mission to find her father for him. For the first time since he'd found her, he relaxed a tiny bit. She had so many people in her life that loved her; surely together they could move mountains.