A/N – I'm still on a roll with this story. I'm having fun with it at the expense of my other stories but I'll try and get an update up for the other 2 this weekend.
Thanks so much for the reviews on the last chapter. I guess if I want reviews I just need to write a massive cliff hanger. I'll make a mental note of that. ;-) Please continue to let me know what you think. I appreciate any feedback I can get.
Thanks so much to GCatsPJs and Junkiecat for their help and to MickeyBoggs for proofing.
Enjoy reading and don't forget to review.
Disclaimer – I don't own Bones!
Chapter 12
Brennan's cell phone vibrated again but she couldn't bring herself to answer it. She couldn't talk to him yet. She was afraid, shaken to her core. This could not be happening, not to her. She was a vegetarian, had a BMI of 20, and had never smoked a cigarette. Sure, she had handled her share of cancer causing chemicals during her studies but she always took the necessary precautions. It was irrational since she knew that these things just occurred, that the mitotic division of cells sometimes went awry, but it wasn't supposed to happen to her. She sighed as the phone vibrated for a third time. The tears were still pouring down her cheeks. She knew it was probably the wrong approach, but she composed another simple text message. 'I don't have all the answers. Just come, please?' She knew it probably came across as more insecure than she intended, but she couldn't control her spiraling emotions at the moment.
Booth frantically dialed her number. She wouldn't answer and it terrified him. The scenarios that ran through his head were awful. 'Why is she even at the hospital?' he thought to himself. 'She just has Parker's strep throat,' he told himself over and over, willing it to be true. He had received her text message just as he had finished informing Katie Byler's mother that her daughter's remains had been located. He was just waiting with her to make sure she was alright until her other daughter arrived. When he opened the text, everything changed. He quickly excused himself and hopped in the SUV. Thankfully, he knew that Brennan's doctor's office was attached to Georgetown. Otherwise, he would have no idea which hospital to go to. He knew that that was an indication of her distress. She was a detail oriented person and rarely left out specifics.
Finally, after the third attempt to get her to answer her cell phone, he got her very simple text. The fear and insecurity of his partner was abundantly clear. She was scared. Something scared her and that scared him. He flipped on his siren. This was clearly the definition of an emergency.
He used one hand to compose a reply. 'R U OK? On my way. What floor?'
Despite his typical calm nature, it took him a few seconds to successfully hit the send button due to his shaky fingers. He hoped that maybe she'd call him back or at least give him a little more information. He got a response but it didn't really tell him anything. '6th floor,'was all it said. She didn't tell him she was fine like she would normally do. Her response was too simple and too scary.
He studied the simple phrase now displayed on his phone. '6th floor, 6th floor,' he thought to himself. He couldn't think of a time when he had been on the 6th floor. When the information finally clicked and that simple sign he saw one time flashed in his head, he felt like he was hit by a very large anvil. "That's oncology," he said aloud. "No, no, no," he fussed and suddenly he hoped that she found a murder victim or something at the hospital. He pressed his foot down toward the floor board. Speed limits and protocols were no longer important. All that mattered now was his Bones.
She didn't know why she was still holding the plain, white, now wrinkled paper that displayed her whole blood count results. She read over it over and over again. She knew it wouldn't change the results but something inside her hoped that if she took a deep breath and maybe blinked that her platelet count would increase and her white blood cell count would decrease. She could have dealt with the low iron levels. Anemia was easy enough to control but this, this might be too much for her to handle.
The day before, she was stomping through the murky swamp water and today she was seated in a wheelchair being wheeled across the skywalk from her doctor's office to a triage room on the hematology and oncology floor at Georgetown University Hospital. She had insisted that she could walk but was told that she would not be allowed since her platelet count was dangerously low and any fall or bump could cause serious problems.
She was wheeled into a very small room where she was asked to change into a hospital gown and instructed to climb onto the hospital bed. She was cold, alone, and scared. 'This cannot be happening,' she thought as she rested her head back against the bed. She knew she only had a few minutes to collect her thoughts before either a nurse or a certain FBI Agent came into her room.
Booth could actually hear his dress shoes squeal as he came to a halt at the nurses' station of the oncology floor at the hospital. He would have never dreamed he would need to come to this floor, at least not for another 30 years. Young, healthy people like his partner, his girlfriend didn't get cancer. He sighed and ran his hands through his hair. She'd tell him not to jump to conclusions that he didn't have all the information. Maybe it wasn't cancer. He could hope, right?
"May I help you?" the young desk clerk asked him and he was pretty sure she was checking him out as she waited on his response. Most of the time if he caught someone looking he'd flirt but not now. His thoughts were on one thing or one person.
"Ummm, yeah," his voice was not calm and cool like it would normally be. "I. . . Temperance Brennan?" he forced out.
The young receptionist simply nodded and typed a few things on the computer. "She's back in our triage area," she informed him. "If you'll wait just a second, I'll have her nurse come down to take you back. You can have a seat."
'Have a seat? She wants me to have a seat,' he thought to himself. There was no way in hell he could sit down when something was wrong with his partner. 'Doesn't she realize she works on the CANCER floor of a hospital?' He shook his head to clear his thoughts and stepped back from the desk. There wasn't a whole lot of room for pacing, but he managed for find about 5 feet of clear carpeted area he could pace as if he were a tiger behind the glass at the zoo.
It was just a few minutes before Booth noticed a tall, slender nurse come to the desk. The receptionist tipped her head in Booth's direction and the nurse approached. "Are you Agent Booth?" she asked.
He nodded. Pain and fear were etched into his features. If Brennan could have seen the look at that very moment, she would have quickly recognized that she had only seen that look a few other times, namely when he told her about his past as a sniper and when he told her about his father.
The nurse could see the fear. She had done this many times before and hated it every time. "I'm Elizabeth but most patients and families just call me Liz. I'm the charge nurse on day shift. I'll take you back if you are ready."
Booth seemed to have lost the capacity to form words. He just gave her another nod and followed as she led him down what seemed like an endless corridor. The hall itself disturbed Booth in the way the lab disturbed him, the way he had described to Gordon Gordon almost three years before. The hall was too pristine, too clean. He knew that this corridor housed patients suffering through some of the most painful, most debilitating disorders known to man. It wasn't right that there were pictures of beautiful mountains, rivers, and streams hanging at even intervals on the wall. The entire thing just wasn't fair.
They stopped just in front of a door. It was closed and only about ten or so feet from yet another nurses' station. "I . . . I just need a second," he said. He couldn't go in the room scared. He couldn't let her see him on the verge of tears.
"Take your time," Liz said. "I'll give you two a few minutes before I come in to get a few orders going for her." She then stepped toward the desk where she flipped open a file folder.
He took a deep breath and turned to face the heavy wooden door. He let his head tip forward and rest for just a second. 'Please, God,' he prayed silently. 'Just let her be okay. She's way too special for me to lose. Please?' He prayed on a regular basis but he was pretty sure that simple prayer was the most desperate and the most heartfelt one he had ever prayed. He lifted his head and took a breath before taking the handle and entering the room.
After a few minutes of being lost in her thoughts, Brennan slipped into a light sleep. The fever, the exhaustion, and emotional stress finally overtook her active thoughts. She knew she needed to think, to get her resolve back but she was numb at the moment, most likely from emotional shock even though she'd deny it if someone mentioned it.
Booth slipped into the room quietly and drank in the sight in front of him. At first glance, nothing had changed. She was simply sleeping. He could tell from the look on her face that she wasn't sleeping peacefully. He knew the look. It was there when she found her mother and when she fell asleep after Zack's admission. It was usually something he could help with by bringing Thai in the middle of the night of letting her break into his good scotch.
When he backed up a bit and looked at the big picture, however, he knew everything had changed. She was in the hospital not because of an accident or suspect. This one was her own body betraying her. No Pad Thai at midnight could fix this one. He didn't know all the details or even any details about what was going on but he knew it wasn't going to be an easy road. He took a deep breath and suddenly her eyes popped open.
"Hi," Brennan said. Her voice had weakened since that morning. She couldn't seem to get rid of the lump in her throat.
He sat down on the bed and took her hand. He didn't say anything. He just pulled her hand to his lips and kissed it. He then put her hand down and wrapped her up in a hug.
"I. . . I should have connected all my symptoms," Brennan mumbled into his shoulder. "Maybe. . . " she couldn't get the words out and the tears simply began to fall.
Booth just held her and placed the occasional kiss in her hair while she cried. The tears streamed down his cheek for a few minutes as well but this wasn't about him. It was about her.
After a few more minutes, her breathing evened out so he pulled back slightly. "I need you to tell me what all this means?" he pleaded. He needed answers. He needed to know what they were facing. Hopefully, it would be better than what he was imagining during the drive over.
She nodded and pulled out the crumpled sheet of paper and handed it to him. She attempted to wipe her soaked eyes with the back of hand. Booth took the paper but before looking at it he pulled a few tissues from the box and handed it to her. "Thanks," she said with a cough.
He grimaced as she coughed. He didn't like it one bit but at least maybe they could give her something for that. He focused his attention to the paper she had handed him. He looked at the numbers and could understand most of them. It was titled Whole Blood Analysis and had the usual patient information. He double checked the name just to make sure it was hers and that there hadn't been a mix up. It was hers. There was no doubt about that.
He looked at the remaining numbers and columns. There were so many numbers on the paper that he immediately became confused. He finally noticed that the far column was listed as a 'Normal Range' column. He checked her numbers against what was in the last column. First, the platelet number jumped out at him. Normal was listed as 150 – 450 with some long numbers after it. Her number was only 25. He was pretty sure that wasn't a very good thing. He continued to glance over the numbers and noticed that her white blood cell number was way above the normal range. He looked on to the bottom of the paper and he saw a note flagged by asterisks and written in bold. 'Blasts Clearly Evident in Peripheral Blood Smear,' it read.
He'd seen enough so he refolded the paper and handed it back to her. "I don't. . . I don't know what this means," he looked at her with confused eyes.
She closed her eyes and leaned her head back against the bed. She couldn't look at him and manage to explain it at the same time without breaking. "Those cell counts are indicative of one of the forms of acute leukemia. I . . . I most likely have cancer," she forced out.
Neither of them had time to say or do anything. There was a sharp knock on the door followed by the entrance of the nurse from earlier, Liz.
"I can come back," she said. It was obvious that they were having a moment.
Brennan cleared her throat. "No," she protested. "It's alright. We can talk shortly and I would really like to get this process started." She told the truth, she really did want to get the process started but she was also anxious for some relief to her symptoms so she could think clearly and figure out how to fight her own body's betrayal.
"Alright then," she said. "I'm going to get you started on some fluids and a broad spectrum antibiotic that will help with your respiratory symptoms. Your strep test was negative but there's a little bit of a crackle there. We'll keep a check on that but hopefully the antibiotics will get rid of it quickly," Liz explained. "Dr. Patel has talked with our head of oncology, Dr. Maxwell Brooks and he has agreed to take you as a patient. He's on his way up."
The nurse was efficient in getting Brennan's IV placed in her left forearm instead of at her elbow or on the back of her hand. This placement would provide Brennan with the least disruption the use of her hand.
"Do you need anything for pain?" Liz asked as she checked Brennan's vitals. Brennan just shook her head. She wanted to wait and see if the IV fluids helped before she took anything that would inhibit her neuronal processes. "Let me get your temperature," she said as she put a cover on the thermometer. It was just a few seconds before it beeped and she checked the display. "101.2," she announced. "That's better than at the doctor. Hopefully the fluids will help get it down a little more. I'll check it again soon." She recorded some information on the computer station in the room and then looked at Booth and Brennan. "Do you guys need anything?" she asked.
The both shook their heads. "Alright, if you need anything just buzz. I'll be back in with Dr. Brooks in a few minutes," Liz stated compassionately before leaving the partners alone.
The tension in the air was very thick. It was a different kind of tension than what they were used to. It wasn't sexual tension; it was worry.
"We're going to be alright, Bones," Booth broke the silence. "We're going to be together for 40 or 50 more years."
A tear trailed down her cheek. "You can't know that, Booth," she said.
"Bones, I have faith. I know you don't believe like I believe but you believe in science and you believe in me," he held her hand in his own as he spoke. "Just have faith that the things you do believe in will get you through this. We don't even know what it is yet," he reasoned.
She just nodded and rested her head back on the back of the bed. Her head was throbbing and she could feel the pain radiating down her neck and back. "I'll try, Booth," she said as she reached up and massaged her trapezius muscles slightly in effort to relieve some of the ache.
"Here," Booth said as he stood up. "Slide forward and let me help some."
She did as instructed and tried her best to relax while waiting on the doctor.
"We are going to get you started by giving you a couple of units of whole blood and sending you down for a CT scan," Dr. Brooks explained. "I need to get a full picture of what we are looking at."
The doctor had been with them for just over ten minutes and was getting straight to business. Brennan could really appreciate that. "When will we have a more definitive diagnosis?" she asked.
"I really need to get you in for a bone marrow aspiration and biopsy but that'll have to wait until we get your platelets up before I can do that. After this transfusion, we'll do a clotting test and if you are clotting well enough, we'll take you back for the test tonight," the tall, lanky doctor explained. "I'm fairly certain we are looking at the M3 form of AML," he was about to explain when Booth interrupted.
"What's that?" the FBI Agent asked as if he was daring the doctor not to answer.
"Acute Promyelocytic Leukemia, your platelet levels are so low that I suspect APL," he explained. "From the looks of your white count and spleen, it is pretty advanced, but we're going to hit this hard ASAP." His tone was confident. "I'll know for sure tonight if there are actually blasts in your bone marrow and if that is confirmed we'll start you on ATRA immediately. I won't know for sure if it's APL for 48 hours or so but if we don't get your platelet count under control you are at an extremely high risk for hemorrhage."
"What's a blast?" Booth asked. He recalled seeing that written in bold on that lab report.
The doctor should have seen that one coming. It was one of the most common questions he got from new patients and their family members. "Blasts are immature blood cells. Normally, the blast cells differentiate into the different types of blood cells. With some forms of leukemia, the blasts stop developing and are present in the person's blood. The person's blood counts and immune systems suffer," his explanation was very simple but it did the job of explaining the significance. He only wished he didn't have to give the lesson quite so often. "With APL, this leads to extremely low platelet counts. That's why we anticipate Temperance has that particular form of leukemia," he explained. "If we're wrong and it turns out to be a different form, the ATRA will not hurt her but it could be very dangerous for you to go another day without it."
Brennan just nodded and Booth let out a pained sigh. He didn't like any of this.
"I know this is all a lot to take in but I can assure you that I'm the best in my field and I will do everything I can to get this under control as quickly as possible," he said as he patted Brennan on the leg. He then addressed Liz. "Go ahead and order two units from the blood bank and put a stat on it. As soon as that's infusing, let's get her down for a chest X-Ray, CT scan, and go ahead and start her on the antiemetic protocol," he dictated to the nurse who quickly stepped out to make the necessary calls to the various departments. "Dr. Brennan, I need you to understand that this isn't going to be easy. Good days are going to be few and far between for the next few weeks," he then directed his attention toward Booth. "She's going to need a lot of support."
Booth just nodded and took her hand again as a sign of support. He really appreciated this doctor's possessive attitude toward his patient.
"Good," Dr. Brooks said. "Temperance, let us know if you hurt or if something doesn't feel right. As soon as we get a confirmation of blasts in the marrow, we'll get you into a more comfortable suite."
The doctor exited and Booth looked at his girlfriend. "Suite?" he questioned.
"Georgetown has one of the most patient centered oncology departments in the country. About six months ago they finished a remodel which included several inpatient suites to provide long term patients with a more comfortable environment," she explained. She knew that if leukemia was confirmed that she'd be looking at four to six weeks inpatient at the minimum. "I made a donation and attended the ribbon cutting," she finished. The irony of the situation almost made her laugh.
"Ummm," he didn't really want to broach the subject, but it had to be done. "Bones, what do you want to do about calling everyone? Do you want to wait?"
Another round of tears leaked down her cheek. "I would imagine it would be unfair not to contact them," she said with a sigh. "I probably need Angela to go by and pick up a few things for me. This gown is not comfortable and I'm cold," she said. She hated sounding pitiful but she couldn't really help it.
"You want me to call them?" he asked as he took the blanket from the foot of the bed and covered her with it, positioned himself beside her, and pulled her in to his side as he spoke. "I can do it when they take you for tests."
Brennan simply nodded and allowed herself to drift off again but this time sleep was more restful with his arms around her.
To be continued . . .
Another Note - I just wanted to say that I know the topic I'm addressing in this story is sensitive and please know that I am doing my best to keep it medically accurate and realistic. I lost a parent to cancer at a young age so I know what it can do to a person and their family. I mean no disrespect at all.
