Actions Have Consequences or Rewards.
by Castlefan6
Authors Note: This is Totally AU; Beckett has found a new love, Castle is hiding a deadly secret, Takes place after the punch to the stomach in Headhunters.
Taking Literary License to fill in the blanks.
I don't own Castle; I use the characters for amusement purposes only, except the ones I create.
Also, we take liberties with the timeline from Canon and use events to make this a more believable fiction, thanks.
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Chapter 2
Castle's Loft
Two Hours Later
Rick awoke to a sickening smell, he must have barfed into the dishpan, he set it in the sink, rinsed it out, and then poured a gallon of bleach in the disposal, and the dishpan. Now he could smell bleach, not alcohol or other stomach recycled contents. He had a meeting with Gina at 11:00 AM, so he showered, and brushed his teeth three times, using mouth wash each time to get the awful taste out of his mouth.
He decided to forego the pain relievers, they weren't doing anything for him anyway, so he sipped on some room-temperature tea, with honey. It got the bitterness from his teeth and gave him some strength to get showered and dressed. He was in the cab on the way to his meeting, on time for a change, when his cell phone rang.
"Castle," he answered,
"Rick, I'm glad I caught you before you left, I'm sorry but it's me that is going to have to cancel last minute today, something has come up that requires a board meeting, off-site, I'm very sorry. At least I caught you at home" she tried to smile in her voice until she heard him say,
"Pull over Cabbie, change in addresses, keep the meter running and I'll take care of your tip"
"Oh my God the first time you were going to be on time for our meeting in I don't know when, and I have to cancel, I'm so very sorry. I heard they were really desperate last night trying to locate you and Kate, so maybe you should stop by the precinct." She said, jokingly,
No need to tell her anything he thought, "That's a good idea, Gina, enjoy your board meeting, let me know when you want to re-schedule." As he disconnected the line and gave the cabbie the new address for the 12th precinct. Perhaps he could mend some fences, he knew Espo would be pissed, but the one person he really had to pull out his acting skills for was Beckett.
When they arrived, he tipped the cabbie three times what he normally would, at least someone would be happy with the change of plans. He made his way up the stairs to the lobby, waved at the Desk, and then proceeded to take the elevator to the fifth floor, homicide.
Kate never looked when the elevator dinged, figuring that he was going to blow the case off until she heard his voice greeting LT and a few of the other detectives. She received her first surprise when he arrived empty-handed, no coffee, for either of them and gingerly sat down in his seat.
"Did you forget something Castle, where's my coffee?" Kate asked, a little sharper than she intended,
"The instructions for the machine are still on the side, if you want one, I think a detective with your skills is capable of figuring out 5 steps to a cup of coffee, Beckett," he said, through gritted teeth, she could tell he was in pain, but she attributed that to the hangover she was sure he had.
"OK, I'm sorry I asked, it's just that you always bring me a coffee when you come into the precinct, what changed?" Kate pushed the matter,
"I wasn't coming to the precinct until Gina called to cancel our meeting at the last minute, I thought Espo sounded like he needed help, so I thought I would stop by. I was only a few blocks from here," he replied,
"I'll have Espo bring you up to speed, I have to get back to preparing for trial. I got called out last night only because Roz wasn't available. Hey Espo, you want to brief Castle on what we got on the murder last night?" She yelled,
Espo and Ryan appeared, neither looking happy, as they briefed Rick on what they had found on the scene.
"They cut his fingerprints off, and knocked out all of his teeth? God, we have to hope that Lanie can pull something from DNA or this dude may wind up a John Doe forever" Rick said, again grimacing through his teeth,
Ryan's phone rang, "he muttered, you sure, what was that address again, how recent? OK get a SWAT team over there, Esposito, Castle, and I will be there in ten minutes, don't breach unless he tries to leave."
"Lanie got a hit on the DNA for the victim's brother, the dude has a rap sheet a mile long, so he's got to know something about who killed his brother, why, and why they didn't want us to ID the body," Ryan said,
They both noticed the pain on Rick's face as he attempted to stand,
"You okay, Castle?" Kev asked, looking back to see if he was following him yet.
"Hm? Oh, yeah," he said, standing up slowly. His face turned very pale, then sweat popped out on his forehead.
Kevin thought he might have imagined it, but he seemed to be moving stiffly, and he thought he saw him clutch his stomach for a second. Brushing it off, he headed out, behind Javi, going through the mental checklist of things that had to be done before they breached the home. The warrant had been issued, so the big hurdle was over, now they had to be sure everyone stayed safe.
Castle chose to ride with Kevin and managed to get himself into the car without screaming in pain. They had just reached about halfway to midtown, though, when Castle suddenly demanded that he stop the car. Kevin looked over, radioed Javi they needed to stop, and pulled over.
"Are you serious right now?" Ryan asked, incredulous. "For what?"
"Just stop the car," he repeated. "Right here."
The Irishman sighed impatiently but did as he said, hoping an explanation was forthcoming. There was. He had hardly opened the door and climbed out when he started vomiting. The light went on in Ryan's mind, and he rolled his eyes at him.
"Castle, you really should quit binge drinking on weekdays," she said. "Most people consider that unhealthy."
"Thanks for the health tip, but I didn't drink half of what I normally do," he said before heaving again. "I think I'm dying," he added.
"Oh, man up, Castle," said Ryan condescendingly. He thought back to when Castle had been bitten by the nutjob with porphyria and become convinced that he was doomed to become a vampire. Surely this was no different. "Shake it off and let's go. Or would you like me to call your mother?"
Espo pulled up behind them in time to see Castle heaving the second round, except this time he went to investigate as Ryan continued to talk to him
"Kevin, this isn't funny!" Castle insisted.
Ryan noticed how white his knuckles were as he held her side mirror in a death grip. "From where I'm sitting, it's pretty funny, but it won't be when you have to pay the damages for breaking off my mirror."
"Kev, I'm serious!" Castle snapped.
There was a tone in his voice, wholly unlike his usual mischievous self, which made Ryan reconsider and reluctantly got out of the car to see what he was so distressed about, meeting Javi midway.
Javi was speaking low, "Kev, get him to the hospital, there's a ton of blood, he's not barfing food, it's blood" just as Kevin noticed and exclaimed, "Castle, that's a lot of blood," he breathed.
"Uh-huh," said Castle, holding even tighter to the mirror.
"What happened?" Ryan asked, trying to remember if Castle had ever mentioned anything, a bleeding ulcer perhaps...
"I'm not sure, but..." he let go of the mirror and pulled up his shirt, revealing a cluster of nasty bruises on his abdomen.
"Oh God," said Ryan, remembering the scuffle from the days before with Slaughter, they had laughed at the time, but now that Rick was hurt, it wasn't so funny. "How long has this been going on?"
"The bruises, or...?"
Esposito nodded towards the bloodstains on the sidewalk.
"Just now," said Castle. "I've had a stomachache all day, but I thought it was just something I ate... I guess not."
The adrenaline had kicked in, and Ryan decided it was time for action. "Come on," he said. "we're taking you to the hospital."
This had the effect of scaring Castle even more. "What? You're not serious?"
"Shut up and get in the car!" said Ryan, already restarting the engine and handing Rick a barf container if he needed to throw up again.
Castle was quite uncharacteristically quiet on the way to the hospital, and for most of the ride, he was doubled over as if in pain which, Ryan figured, he probably was. He eyed him nervously whenever they stopped at a traffic light, and tried not to think about how much blood he had already thrown up. His color was very pale, and the sweating was really scaring Kevin to death.
It wasn't that the sight of blood bothered the young detective, hell he was a cop and after the site he had just seen a few days ago, he could look at anything. What was really upsetting him was when he saw one of their own losing far too much blood, and not being able to stop it. He couldn't place a tourniquet on internal bleeding, knowing that he only had a fixed amount of time to get him to the hospital.
"Ryan?" Castle said quietly, a few blocks from the hospital.
He was about to ask him what, but the color of his face answered his question, and he pulled over to the slow lane, flinching slightly when Castle got sick again.
"Are you okay?" he asked. He didn't answer, he didn't dare stop, not knowing how much time on the clock had already been run out. "Rick, use the barf bag, I have got to get you to Presbyterian hospital so they can take care of you."
Rick heaved into the bag, then wiped his mouth with the back of his hand, then frowned, looking at the blood that was smeared across the back of his hand when he wiped his mouth, and the puddle of it dripping down the barf bag.
Ryan reached under his seat for his stash of antibacterial wipes that he caught hell for using, and handed a few to Rick, as he barreled through the streets, lights, and siren going. "We're almost there," he said.
Once they arrived at the hospital, Ryan killed the siren but left the lights flashing and rushed the two doctors pushing the cart out to retrieve Rick. "This is a cop, you understand, He's one of my partners, so move your asses, the fucking paperwork will be filled out later." Kevin was screaming.
Rick was rushed back to the trauma bay as Javi and Kevin tried to fill in the information they could, realizing quickly only one person knew him well enough to answer the questions being asked, Ryan, called Kate on her cell.
"Who is Detective Kate Beckett?" the lady from behind the desk asked, as Javi was talking to her,
"She's his primary partner, Why? What do you need?" Ryan yelled,
She's his ICE contact and has his medical POA, (Power of Attorney) so she will have to authorize his treatment, before"
Javi handed his phone with Kate on the other end to the lady, "Listen, this is Detective Kate Beckett, I'm en route to the hospital now, his daughter and mother are out of town, treat my partner, or he will sue you for everything you have. His medical card reads Richard Rogers, he also has the second card behind that that reads Richard Castle, the man who donated the funds to build the pediatric ward, Mr. Rogers Neighborhood. Now do you still have a problem"
Kate heard an "Oh my God, I'm so sorry, He's headed to the VIP wing, once he's out of surgery"
"Surgery? Rick is having surgery? I'm on my way, and he better be taken care of when I get there" she hung up, the lady behind the desk visibly shaken handed Javi his phone back,
Beckett arrived in time to see him shortly before he was wheeled back into the operating room and sent the boys on to the takedown. The medical staff had determined the source of the bleed to be from a traumatic blow to the liver, causing one or more veins to burst, and bleed into his stomach cavity.
His stomach had shown the bruises of Slaughter's punch, and from the looks of it, there had been more than one thrown and landed. She was shown to the VIP waiting room, to await the news of Rick's surgery, and made herself a cup of tea when she arrived. After drinking about half, she realized it had been a while since she had used the ladies' room.
Safely locked behind a stall door for privacy, she covered her face with her hands and breathed deeply, willing her tears not to fall. He'll be fine, she told herself. The harder part to reconcile was why she cared so much, and why did she feel guilty about her activities with Paul. She was totally out of her element here with the medical jargon, she needed someone to make it all make sense to her.
She splashed cold water on her face, and now having mostly regained her composure, she returned to the VIP area and waited. She had absolutely nothing to do, she had fled the precinct without as much as telling Gates what was going on, she had called her once Rick was taken back to the surgical suites.
The only thing she had with her was her purse, which contained her police notebook, her cellphone, and her backup pistol. She tried to keep her mind occupied with the details of the case she was prepping for, but thoughts of Rick in surgery and her fucking Paul, almost made her throw up.
Everything seemed to remind her of some other moment with Castle, which brought her back to the very real danger he was in. She thought how much she would miss having him around the precinct if he ever decided to leave her, or worse be taken from her. She would never admit it, but she dreaded the day he decided, for whatever reason, to leave.
She had very intentionally avoided thinking about this scenario, and convinced herself foolishly that it simply wouldn't happen, she wouldn't allow it to happen. She held her phone in her hand, playing with the keys with her fingers just to keep her busy doing something, how many times had he waited like this for her to call, hell he was in surgery, he wasn't calling. That thought was ridiculous, as many of her thoughts were now. She needed to talk to someone who could help make sense of all of this, finally, her brain fog cleared and she dialed a familiar number,
"Hi, Beckett, what can I do for you?" Lanie's warm voice answered after several rings.
"Hi, Lanie. Can we talk for a minute?"
"I was about to start an autopsy, but if you need me to check something, I'm sure John Doe the Third won't mind waiting a few more minutes, he doesn't have any place to go"
"Thanks, Lanes, make him wait, PLEASE?" Beckett cut her off.
"Okay, Girl, what's going on? You sound awfully upset, what's going on, or what happened?"
Beckett hesitated. "It's Castle," she said, fighting back tears that once again had pooled in her eyes, threatening to fall at any second.
"What about Writer Boy, and from what I hear, why do you care, you got yourself a hotshot ADA?" Lanie asked. "Is he working your last nerve again? Girl, I know he can be a handful, but you need to loosen up once in a while, you know how Castle is!"
Beckett found herself on the verge of tears again. "No, nothing like that Lanie. I'm at Presbyterian Hospital with him. He's in surgery." She got out, willing the tears not to fall,
"Surgery? Rick's in surgery? For what and how serious is it, Kate?" Lanie repeated. "What the hell happened?"
Beckett explained how Castle had suddenly started vomiting blood, and how she suspected it had started when he had taken punches from Slaughter two days ago, when he had asked for her help, pleading mea culpa for his actions. Lanie listened patiently.
"So?" Beckett asked. "What do you think?"
"Kate, you know I work with the dead, with that said, any doctor would tell you that it's hard to say without taking a look at him," said Lanie. "The boys definitely did the right thing taking him to the hospital."
"Yeah," said Beckett. She had known that much. "You think he'll be, okay, I mean Lanie we haven't worked things out yet, he has to be Ok, tell me he will?"
"Kate, modern medicine can pull some amazing stunts," said Lanie. "Don't worry too much, it's not helping him, or you sweetie. Think of it this way, at least if you have a panic attack, you're already in the hospital. In fact, you're both in the best place possible for either of you"
Beckett couldn't help but smile a little. She knew Lanie's comment was only half sarcastic, and that she was keenly aware of her hatred and fear of hospitals. Thanks, Lanie," she said.
"Anytime. You know I got your back. You let me know how things go, okay? Tell writer boy to hurry up and get better, he still owes me. I'm glad you called."
"Okay. Thanks, Lanes, you know I will." She breathed, feeling much better than she had,
Beckett ended the call and placed the phone back in her purse, now she returned to staring at the group of three pastel floral paintings across the hall. She had studied them so much that she was positive she could be able to accurately describe every detail of every one of the paintings to their sketch artist if she were asked. The clock kept ticking, the only sound in the room she was in, seconds turned into minutes, minutes into hours, it seemed like days, but in reality, it was three and a half hours later. Finally, a cute blonde nurse wearing purple scrubs approached her from the end of the hallway. "Miss Beckett?" she asked.
Beckett looked up, nodding acknowledgment of her name, "That's me, how is he?" she asked,
"He's coming out of surgery now. The anesthesia will take a while longer to wear off, but he's going to be fine. You can come to see him now for a few minutes, once he's out of recovery and in his room, you can spend as much time as you wish with him, unless he has a setback."
Beckett sighed a long breath of relief, mumbling "Thank God" running her hand through her hair and leaning back into the chair. "Thank you," she said as she gathered her purse, and stood,
"Follow me please," said the nurse.
She walked into the recovery room, she didn't see him at first, but then her eyes noticed his hair, he looked so much smaller. She walked over to his bed, leaned down, and kissed his forehead,
"You Jackass, you scared the hell out of me. I don't know what I would do if anything happened to you." She said softly, as she brushed the hair from his eyes. She held his hand until they made her return to the VIP waiting room, and she was so relieved she actually fell asleep.
About three hours later the same nurse returned with a large coffee, and a muffin, "You better eat something Detective, he's just about ready to see his first visitor, and you need to be awake." She smiled,
"Thanks so very much, I appreciate this," she said softly,
"It was my pleasure, I don't know what your relationship to Mr. Castle is, but he's loved by all of the nurses and staff here. There's nothing we wouldn't do for him, he's so loving and giving, you'd never know that he was one of the rich guys people talk about. He's special to us, and if you have his Medical POA, you must be special to him as well." Carrie, the nurse's name tag had come into view, said as Kate fought back tears,
She waited for her to drink her coffee, and asked, "Are you, ready Detective?"
"I'm ready Carrie, and please call me Kate, I can't thank the staff enough for your kindness,"
"You're more than welcome, now Mr. Castle may still be a little groggy, but his room is right around this corner, just hit the passcode of 4747 to enter the wing, his room is the first door on the right." As she pushed the numbers, the doors swung open, and two minutes later, she tiptoed into Rick's room, pulled the chair close to the bed, and held his hand.
A little while later, Castle finally opened his eyes, bright blue and twinkling, in spite of the fog of the anesthesia.
"Kate? What are you doing here, I thought you were on a special assignment? Ryan and Espo brought me in, but I don't know much more than feeling a lot of pain and throwing up a lot of blood." he said, trying to force a small smile.
"Yeah, I guess it seems they needed your Medical POA, which is me, to sign the forms, even though you donated the money for the new pediatric wing, you know rules are rules," said Beckett quietly while staring down at the floor as she found herself suddenly unable to look at him.
"Detective Beckett, did they tell you what happened, why I was barfing blood and hurting so much?" He asked as she thought, Oh God she was back to Detective Beckett,
"Our friend Slaughter is going up to the board on charges for that going away punch he threw at you, I saw it, Rick, it was a sucker punch. He caused some blood vessels supplying blood to your liver to be crushed, they repaired it in surgery." Kate said,
"I didn't think you saw that or that you even cared if you did. Things haven't been good between us, so thanks for coming down, I think I'll be OK now" he said, trying to dismiss her, even moments after waking from major surgery.
"Rick, we need to talk, not now, but if you think I'm leaving without finding out some answers as to what the hell happened between us, you're nuts. I'm here until they kick me out," she said, a little more forcibly, but still very guilty,
Just then a knock upon Rick's door, and a doctor with surgical scrubs on, stuck his head in,
"Mr. Castle, I'm Doctor Poulos, I repaired the trauma damage to your liver in surgery but we have some additional news we need to discuss."
"Do you want me to step out of the room?" Kate asked Rick, looking him straight in the eye,
"No, since you're the Medical POA you should hear this, so how bad is it doctor?" Rick asked,
"Do you want the lousy news or the really lousy news first?" Doctor Poulos asked,
"Let's work our way up shall we, so save the big news until we discuss the smaller one, please," Rick said, he was shocked when he felt his hand being engulfed with Kates, holding on tight. She just looked at him, trying to get him to look her in the eyes, after a quick glance he turned his eyes back on the doctor.
"OK Rick, the bad news is that your bloodwork came back positive for von Willebrand Disease, it's a disease that inhibits the blood to clot as it should naturally. There are three types of the disease, VWD, for short, unfortunately, you have Type 3. It's rare in fact it's the rarest type of all people with VWD, Only 3% of people with VWD have Type 3.
"This is the most severe form of VWD, in which a person has very little or no VWF, the natural clotting agent in our blood, and low levels of the required protein, to help you clot, naturally. Your chances for bleeding out are very high, even with something as simple as a tooth extraction UNLESS it's known before and we build your system up before the procedure is done." Doctor Poulos said,
"You mean he could have bled to death from a simple tooth extraction, and no one knew it before now?" Kate asked,
"It's very rare, and Rick's case would probably have gone undetected if he hadn't required so much blood, plus the severe bruises around his stomach area. We were fortunate one of our residents is a hematologist major and spotted the signs. He alerted our blood lab who intervened with the proper clotting drugs to allow me to complete the surgery. To answer your question Detective, yes, he could have, and he almost did bleed out today, until we discovered, and took the steps to intervene." Doctor Poulos said,
"Well, I'm finally in the top percentile of something, so, what do we do about it Doc? Is there a cure, or treatments, anything I can do?" Rick asked, trying to joke, but almost as rattled as Kate was, her hand began to sweat, and she was holding on so tightly.
"We are placing you on a regiment known as Factor Replacement Therapy, which involves weekly injections of medications known as Recombinant VWF and medicines high in content of VWF and factor VIII, the proteins your body is missing. Some medications you should learn about are, Humate P, Wilate, Alphanate, or Koate DVI, all are used to treat people with more severe forms of VWD. Each of them come with their own side effects, so you will need to work with your doctors to see which drug or drugs work best with the least amount of ill effects. I won't kid you, they're all going to make you sick.
"These medicines are injected into a vein in the arm to replace the missing factor in the blood, we hope in time to re-engineer the blood chemistry so you can reduce or remove therapy, but we're a long way from there. We also need to monitor so that we don't put you in the higher risk category for blood clots, that could lead to a stroke, or worse."
"Wow, and that was the good news, right Doctor? If I understand this, my blood doesn't clot so I have to take injections that are at the least going to make me ill, and worst-case scenario cause a blood clot that could kill me or leave me with the aftermath of a stroke, and that's your good news? I can hardly wait to hear the bad news," Rick asked trying to lighten the atmosphere,
"I'm afraid so, Rick. Are you ready for the really sucky news now?" He asked.
"Go ahead Doc, make my day" Rick tried to joke,
"I'm afraid, that we have biopsied, and found your left kidney to have Renal Cell Carcinoma (RCC). It is the most common type of kidney cancer in adults. RCC usually starts in the lining of tiny tubes in the kidney called renal tubules." The doctor looked at Rick, studying his face, to see if he should continue, but he was stoic, not showing any emotion whatsoever,
"The tendency of RCC is that it often stays in the kidney, but it can spread to other parts of the body, most often the bones, lungs, or brain. We discovered yours fairly early, I'm not the oncologist, but based on my experience, I would rate the tumor as stage 2 with stage one being the mildest, and stage four the most severe. I'm sure they will be scheduling PET and CT scans to ensure cancer hasn't spread." Doctor Poulos said and stopped waiting for questions, from either Rick or Kate. Both were stunned, it was all Kate could do to keep her tears in check.
"Take a moment Rick, it's not like the old days, or even just a few years ago. We've come a long way in treating cancer, and in your case, your right kidney is perfectly healthy and functioning well. Many people live productive active lives with only one kidney, but before we get to there, there are medications and treatments for this.
"OK, remind me not to ask you for any suckier news Doc, you sure know how to deliver. " Rick said,
"Rick, what I'm saying now is the GENERAL process, we'll get you lined up with an Oncologist and a Nephrologist who will coordinate your treatments with me and your family Doctor, Doctor Peter Williams.
"Surgery is the most common treatment for kidney cancer, most people with early-stage cancer (stages 1, 2, and 3) can be cured with surgery. Even in surgical procedures, there are options. These are the ones you need to discuss with the Nephrologist, and weigh the pros and cons with your family to reach a decision.
"In a partial nephrectomy, the tumor or the part of the kidney with the tumor is removed to leave behind as much of the kidney as possible
"In a radical nephrectomy, the entire kidney is removed. If needed, the surrounding tissues and lymph nodes may also be removed. We even give options to the types of surgery that is best for each patient, depending again on your conditions.
"The Open type of course causes the most trauma to the body and requires the most recovery time. The other two types, Laparoscopic, and Robotic are minimally invasive, leaving you with a shorter recovery time, and less trauma, again discuss these with your specialists and family."
"Rick, Kate, do you have any questions for me now?" Doctor Poulos asked,
Ricked was so shell shocked, he was silent,
"Doctor, how long do you need to keep him hospitalized this time, and can he incorporate some of his specialist visits while he is already here?" Kate asked this time her other hand had joined her first in holding his huge hand between hers,
"I'd like to keep him here about a week, depending on how some of the testing goes, and of course he can start with the specialists, in fact, we encourage it." He smiled, a weak smile,
"I'll give you some time," call me with any questions as he placed two of his business cards down on the nightstand next to the bed"
"Thank you doctor" Rick managed to say, before turning towards the wall, Kate wouldn't release his hand so he gave up trying to pull loose, and let her hold it in silence,
TBC
