For the Dead Travel Fast
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Castle paced the room for lack of anything better to do with his nervous energy. Kate was asleep, stabilized with a massive infusion; he had given blood the old-fashioned way, and lots of it, but they had a whole process of frozen bags of plasma and stuff for her. Fibrinogens? No idea what that was but they said it was good for her.
He didn't love that he was so in the dark, but it seemed like they all were. Her blood was suspect. Harris was in the lab with it now, trying to figure out the problem.
A rap on the door startled him so badly that he nearly stumbled over his bare feet turning to check. "Oh Walt."
"Rick, I came as soon as I heard she'd taken a turn," Walt said, coming straight for him. There was an awkward hand clasp that perhaps was really Castle clutching too hard, but Walt didn't say anything about it. "How's she doing?"
"She's asleep. She looks like death warmed over, but they had to do a dialysis treatment. They nearly replaced half her own blood."
Walt's look of surprise made Castle feel like shit. But Walt only nodded as if they did that all the time.
Castle was sure they didn't. "Have you seen Tessa?"
"She's making rounds on the rehab side. She sent me over here to check on you both."
He winced, ran a hand down his face. He was so damn tired. He'd been certain if they would just let him drink from her—or her from him—that would fix it. But Dr Harris and Michaela both had balked at the suggestion, telling him further research was needed, further study. They didn't know why she'd spontaneously bled from that gunshot wound.
Walt waited with him in the room, and his presence forced Castle to find a chair and sit, rather than pacing like a caged lion. And when he had sat down beside Kate's bed, all of his weariness and phase-change had hit him fast, a ton of bricks, and he was drooping in moments.
He was heavy-eyed and struggling against sleep when the door opened. He jerked to his feet and again was made aware of his disheveled state, the bare feet, the plaid pajama pants that hung loose from his hips, the t-shirt with a stain of her blood at his collar.
Dr Harris was in the doorway, she had a team with her. "We need a CT scan of her abdomen," she said, hands folded before her like she thought she needed to explain to him like a child. "It's a series of x-rays which will provide a cross-sectional—"
"Yes, I know, that's fine. Please." He stood; the team was already coming around to unhook her from the heart monitor, the blood pressure finger-cuff. "Is she asleep or have you knocked her out?"
"We didn't give her a sedative, no." Harris was flipping through her chart now, signing off on something, handing it to an orderly or tech who slung it under his arm and moved out. The team had worked so fast, Castle wasn't even sure what they'd done, but they were already wheeling her out. "But we replaced quite a lot of blood volume in a short time, and I guarantee her body has decided to keep her under to repair the damage."
"Do you know why she was bleeding?"
Dr Harris hesitated but finally gave him the benefit of her full concentration, and an explanation. "I have a couple of guesses. I don't like guessing, but here's what I've found. For some reason, in the blood we drew samples of, there is some general breakdown of the phospholipids. Phospholipids create structure in cell membranes, so if they've dissolved, your cell structure begins to dissolve—"
"Spontaneous bleeds."
"Maybe," she said, frowning. "I don't know that for sure. I've sent images of our slides to my sister; I want her opinion on the matter. But in the meantime, my other guess: I'm getting a CT and seeing what kind of damage was done when she was shot."
"Oh," he said, throat closing up at the idea. Of course getting shot three times in the chest wasn't going to just magically go away. Of course she'd have damage, seen or unseen, didn't matter—it couldn't have possibly been healed in the scant space of a few hours on their kitchen floor. "She bled a guy to replace what she'd lost."
Dr Harris nodded. "That's not my primary concern. The lichen in her marrow was already present, ready to colonize the new blood, and likely that fresh supply was something she'd needed for a while, to jumpstart true growth. No. I'm worried about bullet fragments."
He felt himself go pale.
Walt reached out and gripped his arm, put a bracing hand at his back as the floor tilted under his feet. "Bullet fragments," he rasped. Silver bullets were a legendary killer for werewolves, right? Not vampires. But the garlic really did work so maybe—
"I did some research and called a few of our local Peacemakers. Most pistol bullets are made of a lead-antimony alloy—"
"Encased in a soft brass or copper-plated soft steel jacket. Yes. I know. And machine-gun or rifle bullets have a harder jacket, usually of steel or a copper-nickel alloy. Not silver."
"Silver?" she said, shook her head. "I'm talking lead toxicity, lead poisoning."
"Oh," he mumbled.
"As such, it could have been the trigger for something known as DIC, disseminated intravascular coagulopathy."
"What is that?"
"Basically, she's burning through coagulant ingredients making all these unhelpful clots due to some kind of underlying abnormality—no idea what, no, don't ask—that's what the CT is for. It could be activated by inflammation—or something bigger. We don't know yet. But because all the coagulant ingredients are gone, she can't make clots, and so she starts bleeding."
"From wounds that should be closed?"
"From anywhere, really. Gums, IV ports, anyplace not sealed up."
He winced.
"So I'd like to see if there are bullet fragments which could be causing inflammation or even toxicity in the blood. Vampire toxicity."
Vampire toxicity sounded far more serious than it should have, since it included the word vampire. But his blood ran ice cold because the vampire of the thing was still this looming terrible unknown.
"Hey," she said, evidently seeing it on his face. "We gave her cryo infusions, which is like super concentrated plasma. All the good stuff; she's stable for now. We'll do the CT scan and see where we are."
"Okay." Because what else could he say?
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