Ok, so here it is. I know it took forever, and I apologize for circumstances beyond my control. It was very difficult for me to write. I am posting from vacation on my child's netbook with no Word to help me, so mistakes are mine. I am completely indebted to IMW for her assistance. Thank you, Thank you, Thank you.
Dr. Geoff Ballard was at the recovery room nurse's station writing up notes on his most recent patient when he was paged to the ER. Really, what was it about the holidays that made people so accident prone?
As he exited the elevator an intern intercepted him. "Car accident. A police cruiser hit a civilian car in a car chase. We have both the cops and the other driver."
"Who needs me?" He was a neurosurgeon, and not all trauma patients have brain injuries.
"All patients have proper pupillary responses, but the civvie has yet to wake up. She s in trauma 2."
As Geoff walked into Trauma 2, all of the blood drained from his face. Kate.
"I thought you said she was a civilian. She's a cop." Geoff rushed to her side. "Do we have films yet? How long has she been out?"
"She was not in the patrol car, she was in a Prius. Are you sure she's a cop?" The intern stated.
"Films are developing now. We were hoping to avoid a CAT or MRI. We have booked an OR and are waiting on your go ahead." The nurse joined in the conversation.
He was checking out her other injuries. There was a nasty cut and bump on the head. They still had the collar on her. She had a protruding compound fracture of her left humerus. Thank God she's a righty. "Are there any other injuries?"
Dr. Swindle, the other attending, was across from him. "She has some serious bruising on her right side, like she turned to shield herself from the impact. I think the steering column and the airbag probably caused it. The films should tell us if her ribs are broken. You know her?"
"Yeah." Geoff said solemnly. "She's my girlfriend's sister. Name is Kate Beckett. Someone get Avery Moore on the phone for me."
Geoff focused his attention solely on Kate. "Kate? Kate, can you hear me?" As he asked her these questions he shone his penlight in her eyes.
Suddenly, Kate's eyes sprang open and her back was arching. "Is she seizing?" The intern said loudly.
"No, she's waking up." Geoff got in her face and tried to calm her. "Kate, it's me Geoff. Do you know where you are?"
Letting out a painful moan, Kate's only response was "Hurts."
"I know. Listen to me. Do you know your name?"
"Kate Beckett." She groaned, and then she held her breath.
"Breathe Kate. Do you know where you are?"
She whimpered, "Hospital."
"Do you remember what happened?" Geoff knew that this was a long shot even without a brain injury, but he asked anyway.
"No." Her eyes moved around a little and came back to his. "Shot?"
"No, you were in a car accident."
"Your side? Your arm or your side?"
"Both." Her breathing became shallow. "Side really hurts."
"Dr Ballard?" A nurse came in. "We have Avery Moore on the phone." The new relationship between Geoff and Avery was big news in the hospital.
"Kate, I m going to talk to Avery. I'll be right back."
"Avery." Kate groaned. "She'll worry."
He smiled at her. "It's what big sisters do."
He walked into the hall leaving the intern and the nurse to tend to Kate and prep her for surgery.
"Hey, babe. I'll have to say you sure know how to pick 'em. Dinner was a doozy. Can't wait until you get here and I can tell you about it. I saved you a plate--"
"Avery, stop. Kate is here."
"Kate came to you? I mean she was upset, but why would she come to you?"
"The ambulance brought her here Avery. Kate was in a car accident."
"Oh my God. Is she...?"
"She's hurt pretty bad, but she's awake and talking. She's being prepped for surgery now. I don't think you can get here before they take her up."
He took a deep breath. Their family had been through so much. "Are your dad and your brother and sister still there?"
"Yes, we'll be there as soon as we can, Geoff. We'll leave the kids with Justin. What happened?"
"All I know is there was a police chase, and the cruiser hit her car."
He heard Maggie in the background saying, "What's wrong?"
"Avery, you need to call Rick, he should be here. She may need some blood, Avery. They are typing now."
"OK, Andrew is O negative, but he's been out of the country. Maggie and I are both A positive like Kate."
"Have them page me when you get here. I may be--"
"Dr. Ballard, we need you!" The nurse stuck her head out of the door.
"I gotta go!" As he was running into the room he called for Dr. Swindle. "What happened?"
The intern answered, "I'm not sure. She was mumbling something about a castle and going home. I turn around and she's trying to push herself up on her right arm. Then she vagaled."
The doctors were looking her over, when Geoff palpated her abdomen and found it rigid. "We have to get her up to surgery. And squeeze that saline. We need blood. She's bleeding out."
Geoff and the nurse expedited the gurney to the elevator and up to the surgical floor where the trauma surgeon was waiting. As they were intubating her, Geoff was in the process of scrubbing in. He was not going to let her die.
Castle's phone was ringing when he walked through the door. It had taken them twice as long to get home, due to a detour they had to take. They were never able to figure out exactly what happened, but his best guess was an accident or maybe a fire. He was in a terrible mood. All he wanted to do was go see Kate and make sure she was okay.
He picked up the phone, expecting it to be Kate. "Castle."
"Rick, it's Avery." He heard her voice shaking on the other end, but he figured it was nerves about what had happened over dinner.
"Avery, hi. I was just about to head over to Kate's to talk to her--"
"Rick, she's at Presbyterian."
"What? Where?" Presbyterian? The hospital? No that can't be right. Why would she be?
"Presbyterian hospital. She was in an accident on her way home. Geoff just called me."
"Avery, an accident? Are you sure?" His heart seemed to drop into his stomach. He realized that he had sat down when he looked up at his daughter and mother. That explains why all of his calls went straight to voicemail. "Is she... is she okay?" He couldn't say alive. He knew she was. She was so much a part of him now; he would have felt it if she died.
"Geoff was in the ER with her. He said that she was hurt pretty bad, but that she was awake and talking. They were taking her to surgery though."
"Hurt? Hurt where? Why does she need surgery?" He felt light-headed. He wanted to throw up, but he knew he had to be strong for her. He remembered the last time she went into surgery, at least then he knew what was going on. His body started to tremble uncontrollably.
"I don't know. He had to go before he could tell me. We are on our way to the hospital now."
"I'll meet you there."
He stood hanging up the phone. "Kate was in an accident." Realization hit. "Oh, God. She was probably in that accident that had us held up in traffic! Oh, God!" His resolve was crumbling. "I have to get to the hospital."
"I'm coming with you." Alexis stood next to him.
"Alexis, no. You aren't spending your Thanksgiving--"
"Sitting at home, waiting for news, paralyzed with fear of losing my friend. No, you're right. I'm not going to spend my Thanksgiving doing that."
"Okay." Castle had no energy to argue with his "wise beyond her years" daughter. He looked to his mother. "Are you coming too?"
"I'll stay here dear, and make some calls. Call me when you know anything." Rick nodded and headed for the door.
"What's going on? She's in surgery? Did you get to see her?" Rick Castle raced into the surgery waiting room with Alexis on his heels looking as troubled as her father. He moved quickly towards Avery who was pacing the floor, chewing on her thumbnail. He had never seen her so worried before. The rest of the Beckett clan was seated in a corner of the room, whispering among themselves. Alexis, seeing Johanna sitting off by herself, decided to join the girl.
Rick was visibly upset, and Avery was trying to come up with calming words and still tell him the truth.
"Geoff is in there with them--"
"She has a brain injury?" Oh God, not again.
'No. At least not severe. They're keeping an eye on that."
"Then why is Geoff...?"
"He's a trauma surgeon. He's really just assisting. It appears that she turned on impact and the steering column combined with the air bag broke some ribs and lacerated her liver. The bleeding was contained in the peritoneal cavity until she moved in the ER and..." Avery searched for words, but nothing but the straight truth came to her. "It looks like a rib punctured the peritoneum and she bled into the abdominal cavity."
"So, what s the...? What do they think...? I mean..." Rick couldn't complete his questions. He wanted to know her odds, but then again he didn't. He sat in the padded chair and held his head in his hands. At that moment, Jim Beckett approached them.
"We're going downstairs to the blood bank." Jim motioned to Andrew and Maggie. "Call us if you hear anything, okay?"
"Yeah, Dad, I will," Avery smiled slightly, "I'll go give blood when you get back."
After they were out of earshot, Rick asked, "She's getting blood?"
"Yeah." Avery said nothing else. She replayed the scene with Emma bleeding out. Trying to squeeze blood into her, but unable to keep up. Sliding in it. She shuddered at the similarities, but took comfort in the fact that Emma was okay now. She couldn't have any more children though. Ironic. Kate and Maggie argue about the surrogacy; Kate gets mad and leaves. She gets into a car accident. That was as far as Avery let it go. She couldn't lose anyone else. Her sanity was at stake.
The second hand on the waiting room clock seemed to shout out each passing second in the quiet room. Each minute passed agonizingly slow. Avery and Rick sat side by side, taking comfort in the presence of each other, and feeling no pressure to break the silence.
"Don't you leave me, Kate. I just can't take it. Fight. Fight, baby." Castle's voice was low but potent, as if trying to reach Kate's soul through the walls. Avery could hear the heartbreak in his voice.
She didn't know why, but she had to see her sister. Leaving a startled Castle in the waiting room, Avery forced her way through the halls, dodging interns and nurses, running as fast as she could and still feeling like her feet were trapped in dreamlike quicksand. She burst into the scrub room and froze at the sight in front of her. It looked like a massacre had occurred in the OR. The amount of blood on the floor was overwhelming, and there was more being suctioned out. So really it shouldn't have been a surprise to hear the audio that went with the visual. Avery recognized the faint monotone declaring Kate's heart had stopped beating.
She threw on a mask and cap and flew into the OR.
"Avery! Get out!" Geoff bellowed at her. He was in Kate's side looking for the second bleeder.
The other surgeon in the room was shouting orders to the staff. They were pumping oxygen into her lungs, squeezing blood into her as fast as they could. A nurse was standing on a stool doing chest compressions.
Ignoring her boyfriend's order and the fact that he had his hands inside her sister's chest, Avery found herself at Kate s head. Her eyes were taped shut and she was intubated, which she expected. "Don't you die on me." Avery echoed Castle's sentiments from the waiting room.
"Do you hear me, Katie? Fight. Fight for your life. So you can watch your nieces and nephews grow up. So you and Rick Castle can get married and spend a lifetime bickering at each other." Avery had a lump in her throat and her eyes stung from the tears, "I know it's hard, but you have to fight. Fight to stay with me." The tears started to fall, "I can't lose you too." She whimpered almost inaudibly.
Geoff was ignoring Avery at the head of the table. He could hear the tone of her voice. He knew she was upset, but if he was going to save Kate, he couldn't afford the luxury of quieting her lament. "Found it." The bleeder. It was a big one, but with the already substantial blood loss and the artificial pumping, it was easy to fix. It took two more units of blood and God only knew how many more chest compressions until her heart finally started beating on its own, allowing the attendants of the operating room to take a deep breath.
The pulse of the room changed dramatically, as the ortho surgeon fixed her arm and the rest of the damage was repaired. Leaving the others to close the wounds, Avery followed Geoff out of the OR into the scrub room. As soon as the door closed behind her, he turned on her.
"If you ever do that again, I'll throw you out of the OR myself." Geoff growled at her.
"What?" She was taken aback by his outburst.
"That little stunt you pulled in there. I swear, Avery, when I say 'Get out of my OR' I mean it."
"I needed to see her."
"You were being selfish."
"Selfish? How so? My wanting her not to die was completely selfish?"
"Of course not Avery. No one wants her to die. And I know you ve lost people and I know losing her would be the final straw. Which is why I m so angry at you right now." He took a deep breath. "You came in there and I was immediately distracted. Your sister has flatlined on the table, I am looking for the bleeder and you rush in. It took everything I had not to stop what I was doing and go to you. I needed you to leave. I told you to leave and you ignored me. Your distraction could have cost Kate her life."
"I need to go tell Rick and the rest of your family how it went." He stepped past her.
He was trying to think positive thoughts. He was trying to imagine her opening her eyes and smiling at him. Castle never meant to scare Avery with his words. Really he wasn't even sure she heard him. But the longer she was gone the more worried he became.
After Avery bolted from the room, Alexis and Johanna sat close to him and joined in his silent vigil. He vaguely remembered overhearing a conversation with his mother and another with Justin. Maggie, Andrew and Jim returned, and also queried as to Avery's whereabouts. Castle's shrug echoed Johanna's "I don't know. She just ran out."
A short time later, Ryan and Esposito entered, he thought they may have asked him questions; he might have even answered, but he didn't know what he said.
Later, Castle was aware of movement in his peripheral vision and looked up to see Avery Moore and Geoff Ballard walking towards him in the "hospital blue" scrubs. Avery's wardrobe change was not lost on rushed to them. Her siblings and father were not far behind him.
"Avery, Geoff, what happened? How is Kate?"
"I'm sorry I left you like that. I can't explain it. I just had to go see. I got there right when her heart stopped." Avery saw the devastation in Castle's eyes and quickly gave them the good news. "They got her back. She just lost so much blood--"
"Avery." Geoff stopped her and then addressed the group. Even though he had been pretty well covered in the operating room, there was still some of Kate s blood on the lower part of his scrub pants. Castle again fought the urge to vomit. "Kate suffered pretty severe injuries in the crash. She has six broken ribs, front and back. The ribs lacerated her liver, which caused the majority of the internal bleeding. We were able to repair the bleeding, but not before she lost a significant amount of blood. The blood loss did result in cardiac arrest, but we were able to start CPR immediately and her heart is performing fine now. She is still getting transfusions. She also had a compound fracture of the left humerus." Geoff pointed to his upper left arm for clarification. "That has been repaired, and ortho will advise on the prognosis of the arm."
"Kate's condition is still serious, and I will admit her to intensive care from the recovery room, but after twenty-four hours I hope to move her to the floor."
Castle came forward, hand extended. "Thank you, Geoff, for everything." The rest of the group joined in Castle's appreciation.
Geoff nodded, but Castle could see fear in his eyes. "I think she's out of the woods, we'll just have to see how she is when she wakes up."
Geoff started to leave when Avery put her hand on his arm. "Geoff, please..."
"I have to go dictate my notes on the surgery. She'll be waking up soon. You can go see her, but they don't like more than one person at a time back there." His eyes remained on Avery as he spoke to the entire group. Then he left the room.
Avery was distraught. Geoff had never talked to her like that before. She could see his point, but at the time all she could think about was Katie.
"Do you think I could go see her?" Castle asked. Avery fielded the question, but she had a feeling he directed it toward the entire family.
"Well, since you were the last thing on her mind before she passed out, I think that s only fair." Avery recalled the story Geoff told her upon her arrival.
"What are you talking about?"
"The intern said right before she passed out she was talking about a castle and going home. I think she was talking about you."
He chuckled, anxiously following Avery to the recovery room. "She's going to look bad, just warning you."
Avery's warning was not enough. Kate's face was extremely pale, her eyes sunken with deep purple rings and some of her hair was matted to her head with blood. A hospital gown covered her, but her left arm was wrapped up to the shoulder. "Oh, God. Kate."
"A compound fracture is when the bone protrudes through the skin. They repaired the damage and pinned the bones, but they there's still quite a bit of swelling." She watched as Castle moved to Kate's right side. He lifted the gown and saw the bandaging over the badly bruised area. He glanced at the bags of fluid hanging by her bed. "They're giving her blood and antibiotics. Really, I know she looks bad, but she's going to be fine."
His jaw clenched as he gently slid his hand into hers. "An accident. A fucking car accident."
"I'll leave you with her. When she wakes up she'll need some pain meds. Let the nurses know."
Avery left them alone and Castle collapsed into the chair by her bed. All of the emotions he had been keeping in check pushed to the surface with every audible beat of her heart. His head rested on her bed and he wept.