Jump 8
Kate had just capped the dry erase marker when her phone buzzed from the pocket of her jeans.
When she tugged it out, she was confused to see Rick's ID on the screen. His mother's appointment wasn't due to start until, well, she guessed it should be about to start now, so there couldn't be news.
She excused herself from the boys, hard at work scouring financials and phone records on the victim they had been called on just before dawn. She answered as she ducked into the break room.
"Hey. What's going on?"
"Nothing. We're just sitting in Dr. Leigh's office waiting for her to come in. I just… I had an idea. Do you have a few minutes? Or are you in the middle of an interview?"
He was nervous. She knew it by the terseness in his voice.
"No, I've got a little time. We're waiting for family to come in. What's up?"
She heard a beep in her ear and pulled her phone away to see the Face Time alert blinking.
Huh. She smiled to herself before clicking "accept."
Holding her phone up in front of her and pulling the door closed, she waited for his face to appear.
"We thought maybe this way you could be here, too."
Something warm spilled in her chest, overflowed again.
"Is it okay… I mean did you check with your doctor to make sure she doesn't mind?"
She heard Martha in the background before a dizzying camera spin revealed her slightly drawn but smiling face.
"Of course. Richard thought of it when we got here, and her nurse said patients do it all the time. But dear, if you need to go, don't even hesitate. I understand—you have a new case, I hear. The first few hours must be very important."
"I do, and they are, but so is this. I'll stay on as long as I can."
She needed to sit down; all of Rick's camera work was going to make her nauseated if she stayed standing.
"So I was telling Mother—"
And then they were interrupted by the click of a door opening. A bright, smooth voice filled the room, but somehow didn't overpower.
"I'm so sorry to have made you wait. Hello Martha. I would say it's good to see you again, but I had hoped our first meeting at your biopsy would be our last. How are you?"
More spinning. Geez Castle. She sank into the couch as a brunette in a crisp white coat with a stethoscope around her neck shook Martha's hand and reached over to Rick.
"About as well as can be expected, I think. Dr. Leigh, I would like to introduce you to my son, Richard Castle, and my daughter-in-law, Kate Beckett."
Whoa. Um. Yeah. Fast-forwarding a bit. She tried not to let any of the shock roiling with fear in her gut show on her face.
The doctor, of course, seemed unfazed, shook Rick's hand, flashed a smile at her over the iPhone.
What was the proper etiquette for meeting a doctor on Face Time? A wave would have to do.
Dr. Leigh returned it as she sat, leaning forward toward Martha to begin.
"I know I was brief on the phone last night. I'm sorry for that. I just wanted to have you face to face to discuss this, and I always want you to have the people you care about here to hear everything with you and be able to ask questions."
Maybe it was her detective instinct, but she liked this woman already.
Castle kept the phone's camera focused on the doctor, angled from near his shoulder.
Kate grabbed a notepad and pen from the nearby end table and started taking notes. She blocked in at the top of the page: "Dr. Leigh, 11/6/2012."
"So the pathologist saw what is called ductal carcinoma in situ, or DCIS. That means there are cancer cells present, but they are all contained inside one of the ducts in your breast. It hasn't spread, based on what we have seen so far. And with this kind of cancer, it is very unlikely that it will ever spread."
Kate immediately cued in to the DCIS acronym. It was one of many she had come upon in her research, and she had hoped the night before that this was Martha had been describing.
"Now don't take this the wrong way, I would never wish a breast cancer diagnosis on anyone, but if I had to pick a kind to have, this is the one I would pick."
The doctor wasn't smiling, wasn't trying to make light of anything, but compassion just shone through her big brown eyes. Kate knew this woman was in the fight with them, and that she meant to win every bit as much as Martha did.
"You have lots of options. The best news is that the vast majority of women simply have the mass removed and then follow up with either radiation or Tamoxifen or a combination of the two."
Kate added the treatment options under her first bullet point, "DCIS."
"So no chemotherapy?"
Dr. Leigh turned to Castle at his interruption.
"No. Not in the traditional sense, though some would call Tamoxifen a sort of chemotherapy. The platinum-based agents or monoclonal antibodies are not needed to treat this kind of cancer."
Martha had been uncharacteristically quiet, and Kate thought she might know why.
"Dr. Leigh, I just want to clarify something. When you say 'have the mass removed,' you mean a lumpectomy, not a mastectomy, correct?"
Kate remembered from her reading that it wasn't uncommon to remove only the tumor even in more serious breast cancers, but Kate wasn't sure Martha had done as much studying up as she had.
The doctor's apologetic eyes immediately focused on Kate's image on the phone.
"Oh, yes, I'm sorry that I wasn't clear. The studies have all shown that removing the mass alone leads to just as good survival as removing the entire breast. It's called Breast Conserving Surgery, or BCS. There is a slight chance of recurrence of the tumor, but in that case, it's almost always the same DCIS rather than a more serious type. And radiation therapy to the breast after surgery does an excellent job of preventing recurrence."
It was tough to judge Martha's reaction, since Kate was limited in her field of view by the angle of the phone, pointed directly at Dr. Leigh. But she heard Rick let out a breath. The doctor turned back to her patient and continued.
"Something else good that we learned from the biopsy is that your tumor is estrogen receptor positive. That means we have the option to use the drug Tamoxifen to kill any cancer cells that might after surgery."
Kate quickly jotted down "ER+."
Kate was startled by a soft tap on the window of the break room, but she wasn't surprised to see Esposito pointing toward a woman and teenage boy stepping off the elevator.
Dr. Leigh was discussing side effects and percentages when she cued back into the discussion. She hated to interrupt, but she didn't want to disappear without an explanation. At the doctor's next pause, she interjected.
"Excuse me—I'm so sorry to interrupt, but I'm going to have to step away."
Dr. Leigh's eyes slanted to her, and rather than annoyance, Kate recognized gratitude.
"Thank you so much for joining in. I'm glad to have met you, Ms. Beckett, and if you have questions later, don't hesitate to e-mail me or call. I'll make sure they have all my contact information when they leave."
Wow. Between Dr. Burke and her own gynecologist and the surgical team from last summer, she had an admittedly limited exposure to doctors. But this woman, with such a positive way about her despite working in a field that must be dark and sad at times, Kate was floored. Leigh had even remembered her name after one mention, despite the fact it wasn't Martha or Rick's last name.
She liked her. She liked her a lot. Enough that she truly missed being able to shake her hand at that moment.
"Thank you, Dr. Leigh. I really appreciate your letting me be part of this."
Castle turned the phone around, let her see Martha, who had a legitimate smile on her face.
"Kate, darling, go fight crime. I'm sure Dr. Leigh has all sorts of information that I can bring home for you to help me look through tonight."
"I'm sorry I have to go."
Her view turned again, this time to Castle.
His look nearly took her breath away.
It was the smile. The one she saw directed at Alexis, mostly. The crinkle at the corner of his eyes. The little upturn at the corners of his mouth. He was proud of her. He was proud that she had taken the time to do this for him, for his mother. She could tell he hadn't been sure she would.
And all of that sank deep—took up residence somewhere to be called upon later.
"I love you."
The blush swept over her cheeks, and she was suddenly glad he was the only one who could see her.
He was saying it with people in the room—a stranger even. He was saying it aloud, despite the fact that it was pouring out his eyes without a single word. How could she not say it back to him?
"Love you, too. See you tonight."
She clicked off and held a hand up over her eyes, tried to center herself. But then she realized she wasn't actually off balance. If anything, she was steadier than she had been in days. When she stood and stepped out to face the wife and son of their latest victim, she felt lighter.
Nothing would ever make this part easy, but meeting people like Dr. Leigh—people who put their patients first, got involved, cared—it boosted her flagging strength to keep going for the hardest parts of her own job. It gave her the courage to know that it did matter, how much she invested. It did matter that she fought so hard for these families. And it made her so glad to know that there were still other people in this world who would fight just as hard for hers.
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