I surfaced slowly, as though from a great depth. First I became aware of my heart beating and my chest rising and falling, then of the sound of a monitor echoing the beats. I listened for a while not thinking or feeling, just drifting in a semi-conscious state.
Next I became aware of a murmuring of voices in the background. Not loud enough to understand, but just enough to pull me closer towards the surface.
After a time, the voices became silent and I heard the scrape of something being dragged nearer, followed by a heavy sigh. Then silence.
Time passed. I had to know. Who was there? Was I being watched? I sent the right signals to my eyelids and after a struggle they opened and I blinked.
I turned my head towards the watcher and that started the flood of memories.
Wilson.
He'd come round to my place to check on me and … events after that blurred together in my mind. Pain, sickness, hands and faces, pushing and pulling me; questions and tests, noise and lights. And fear.
The fear came back to me in a rush and I must have made a sound because Wilson looked up and started towards me.
"Hey," he said quietly, "you back with us?"
I tried to respond but my mouth was dry and no sound came out. I cleared my throat but the best I could manage was a croak. Wilson spooned some ice chips into my mouth and I let them melt and slide down my throat.
"Thanks." Better that time.
"How're you feeling?" Wilson asked casually, although I could see the worry in his eyes.
"Okay." I thought about it, "Woolly", I clarified.
"Any pain?"
"No," I realised with relief. Wilson started checking tubes and monitors, purposefully avoiding eye contact. "What happened?" I rasped. Wilson paused in his ministrations.
"What do you remember?"
What do I remember? I thought back to … Wednesday, and realised I didn't know what day it was. I suppressed the panic which was beginning to take over and thought back carefully…
---
Wednesday
When I woke that morning my first thought was hung over, and I barely made it to the bathroom to clasp the toilet bowl before emptying the contents of my stomach. Then I remembered - I hadn't been drinking last night.
Damn clinic! Was my next thought. I'd spent the last two days treating a vicious stomach bug that had people puking all over the waiting room, the corridors, the exam rooms and finally on me.
I resigned myself to a day of vomiting and called in sick. Cuddy wasn't there so I left a suitably pathetic sounding message and crawled back to bed.
The next few hours were miserable. I was hot one minute and shivering the next; I couldn't keep anything in my stomach for more than five minutes and unfortunately, that included Vicodin.
The need for pain meds was becoming urgent. My leg had been giving me more trouble over the last couple of weeks and I was finding that Vicodin was barely keeping it in check. To miss a dose was bound to cause problems and by now it had been over six hours since a pill had stayed down.
I was also feeling restless and recognised the psychological effect of withdrawal kicking in already. I got up slowly and headed for the living room so I could distract myself with the TV. I detoured to the kitchen to pick up an icepack and another bottle of water, and then collapsed into the left-hand corner of the couch. I piled up some pillows for my leg and hauled it up painfully, placing the ice-pack over the top of my thigh.
My heart was thumping noisily in my ears and I felt exhausted from the effort. I lay my head back and concentrated on controlling the jumping in my stomach.
Time passed slowly. I began to drift in and out of a restless sleep, my dreams mingling with the sound of the TV in the background. I think the phone rang once or twice, but wouldn't swear to it.
Some years later, there was a knock at the door. I roused myself to croak. "If you've got a key, come in, if you haven't, go away." The effort left me breathless and dizzy. The door opened.
"House? Cuddy said you were sick, she sent me round to check if you were playing hookey." Wilson wandered round to the end of the couch and studied me. "God, you look like crap", he remarked as he shed his coat and rolled his sleeves up. I shut my eyes and took some deep breaths.
"I support euthanasia y'know", I mumbled to show that I was still there.
I felt his cool hand on my forehead and another clasped my wrist. I tried to shrug him off but I couldn't raise the energy. Wilson had seen me at my worst and he was the only one who could see through my bluffs. I didn't try to raise my shields but accepted the inevitable.
Wilson was perched on the edge of the coffee table, his warm brown eyes beneath a brow furrowed in concern. I braced myself for a lecture.
"You've got a fever, you're dehydrated and tachycardic", he said with a look of exasperation. "You should have called me."
Well, he wasn't yelling at me. I must really look pathetic if he was trying to be gentle. The doctor in me realised I needed some help but the sick side of me didn't want to move, didn't want to be poked and prodded. Didn't want to go back to hospital.
Wilson rubbed his hands over his face and sighed loudly. I tried pushing myself into a sitting position but gasped as pain shot through my leg and up through my hip. Wilson moved forward and grasped my upper arms to help. I sat tense and panting, both hands clasped tight around my leg.
I should have realised then that something was wrong. Normally, rubbing my leg brought some relief, managed to distract the mangled nerves into calming down. But it wasn't helping; in fact it was making things worse. My leg felt tender and sore to the touch but in my exhausted state I overlooked it, just put it down to the general malaise.
Wilson propped me up in the corner and started to reason with me.
"Look, a quick trip to the ER, get some fluids in you, a dose of Compazine and some pain meds and you'll be home before midnight."
He was right of course. The dehydration on its own was causing the nausea by now… and I really needed some pain meds. Perhaps if I could get some sleep … I might feel better by morning.
Eventually I grunted assent and started to get myself together to move. Wilson grabbed my sneakers and slipped them on for me, just tucking the laces in at the side. He got my overcoat from the closet and put his own coat back on. Then he stood by the couch, waiting for me to make the first move.
I grabbed my cane from the floor with my left hand and looked to James for support on the right. He moved in quickly and on a painful grunt I got up.
My vision blurred as my blood pressure dropped and the bedroom seemed infinitely more inviting than a trip to the ER, but James steered me carefully to the front door where I leaned briefly while he threaded my arms into my coat.
There was a real danger of me passing out at that point. My breath was coming in short, shallow gasps, my head was swimming and the whole of my right side was throbbing in time with my rapid pulse.
"Wilson…" I gasped. He took one look at my face and slung my right arm over his shoulder.
"It's okay, I've got you." Clutching me around my waist he more or less dragged me to his car and somehow bundled me into the back seat. I remember my leg being jostled and letting out a strangled yell, but I don't recall the journey to the hospital.
I was vaguely aware of someone calling my name, then hands pulling and lifting until I was laying on a gurney. My stomach chose that moment to reclaim my attention by clenching up painfully, causing me to retch miserably.
"Roll him!" I heard and instantly felt hands turning me to the left. They needn't have bothered – all I managed to produce was a spit's worth of bile.
Eventually we reached an exam room and I was transferred to a narrow bed.
The attending introduced himself, "Ah, House! Thought you'd seen enough of the ER." He smiled broadly. "It's Myers, you probably don't remember me from the last time you were here…" I tuned him out and looked around for Wilson. Our eyes met and he read the plea in my expression. Get him away from me! Wilson started filling him in on the details whilst two nurses helped me to get into a gown. I felt a pinch in the back of my hand as the IV was set up and the usual monitors were attached to me.
Myers turned back to me and started an examination. "Soon sort you out House," he smiled encouragingly, "Looks like you caught the bug that's going round. Half my staff have been off this week, it's been hell in here…" I let him get on with it and concentrated on breathing evenly and not puking. When he reached my leg he pulled back the gown and raised his eyebrows. "Is this normal for you?" he asked, looking down with concern. I struggled to raise my head from the bed and Wilson came over to support me.
My leg is ugly. I usually avoid looking at it at all. I didn't want to see it now but I saw the expression on Myers' face. When I followed his gaze I saw the problem. The crater that was my thigh was swollen and red. I reached out with my hand and felt the heat from it. I shook my head, confused. How had that happened? When had it happened? I didn't remember any bumps or bruises … I shook my head and collapsed back down to the pillow.
Myers turned to his staff and started giving orders. "CBC, CRP, blood culture, and we'll get an x-ray of that leg to see what's going on. Start him on Compazine, Demerol and open up the fluids," he finished.
He loomed into my field of view again, "Take a nap House and I'll see you later." He patted my shoulder and left.
After a time I was left alone with Wilson who had pulled up a chair. "Home by midnight then?" I asked wearily. He had the decency to look apologetic, but then shrugged.
"You're better off here anyway." A silence fell between us and I felt the Demerol haze soothing me to sleep.
I was woken up briefly when the portable x-ray was brought in, and again when a nurse wanted a urine sample. Wilson had vanished somewhere along the line but I was pretty sure he wasn't too far away. Anyway, I was too drowsy to bother much.
The next time I woke I felt uneasy, the pain was building again, I still felt nauseous and I was shivering. I reached out and pulled the thin blanket around my shoulders. Wilson was back and was dozing uncomfortably in the chair beside me, an empty coffee cup still clutched in his hands.
There was a tap on the door and Myers came in, startling Wilson awake. "Sorry," he said, although he didn't look it. Wilson stood up, stretched and rubbed the back of his neck to get the crick out. I lay there hoping they would ignore me, but Myers sat in Wilson's vacated chair and looked at me seriously.
"We've had some results back," he started. "Your white count's through the roof so we're going to put you on broad spectrum antibiotics until we get something back from the cultures. We'll give you something to help get that fever down, and I think we can top up the Demerol too." He studied the file for a moment. "The x-rays were inconclusive but I'm still worried about your leg." Another pause and I held my breath not quite seeing where this was going. "I want to admit you for more tests."
"No!" I responded instantly. I really didn't want anyone mucking about with my leg, not after last time. "Just dose me up and let me go home." I sounded desperate even to my own ears. "I probably just banged my leg this morning…" I trailed off seeing the disbelieving look in Wilson's eyes.
But Wilson understood my fear. "What tests are you planning?" he asked reasonably, glancing at me.
"Well, given his history we need to check for a clot, so a CT and angio for starters -"
"How about you do the CT first and then decide? You don't need to admit him for that." Good ol' Jimmy was using his puppy dog eyes. Myers thought for a moment then agreed.
I sighed in relief and thanked him. I just wanted to get home to bed.
A nurse came back in and fiddled around with the IVs for a moment and I soon felt another hit of Demerol. This time I was too agitated to let it soothe me back to sleep and I fidgeted in the narrow bed until it was time to go down for the CT.
The transfer to the gurney overrode the Demerol and left me feeling wiped out and shaky. As I was being rolled out of the exam room I looked over to Wilson expectantly.
"Want me to come?" he raised his eyebrows and I nodded briefly.
The scan seemed to take for ever as I concentrated on not shivering and breathing slowly. Wilson left the mic' on in the viewing room but my brain was too slow to follow what they were saying.
Back to the ER and hooked up to the IVs again I started to dwell on the possible outcomes. Another clot, more muscle death, loss of function, maybe the leg would have to go … and yet it didn't feel like last time. Sure the pain was there, but it was different, no paresthesia, no numbness. My fevered brain struggled to make sense of it.
Soon enough Wilson and Myers returned and Wilson gave me an encouraging smile as Myers started talking.
"Well, looks like it's not a clotting problem…" I let out a long shaky breath. I hadn't realised how scared I'd been.
"…but, there is some swelling that may be restricting blood flow. You need to be admitted for further tests," he finished firmly.
Wilson looked as though he was going to step in again, but I nodded my head in agreement and shut my eyes to any further conversation. I wasn't going to risk it this time.
Myers and Wilson started talking quietly together and I heard James thanking him then sitting down again.
I opened my eyes. "What time is it?" I asked. Wilson glanced at his watch.
"Nearly 1 a.m." he replied.
"You'd better go home," I said quietly, "guess I won't be needing a lift tonight."
"Ah, no," he replied in disbelief. "I'm not going anywhere." He sighed and looked uncomfortable. "Look, you're going to be okay. I'll let Cuddy know what's going on and you're going to get the best treatment." Not like last time, hung in the air between us.
"Thanks," I whispered before letting the pull of the Demerol take me away again.
I lost track of time after that. I was moved to a room, fresh gown, another exam, more bloods, IVs changed.
The orthopaedic consultant arrived soon after. I'd met Dr Jensen before she joined the staff at PPTH. She'd written a couple of interesting articles on CRPS which I'd argued with her on, but she'd put up a good defence. She quickly ran through the tests she wanted. I concentrated as best I could until she'd finished. Wilson asked a couple of questions but I'd heard enough.
"So you're thinking compartment syndrome." I stated. She nodded. That wasn't good. Pressure around the nerves and blood vessels could cause permanent damage. On the other hand, it had been caught early on…
"If you're ready we can do the tests now," she said, "the sooner the better."
"Okay. Go ahead."
She called a nurse in and drew the blanket off my right leg and proceeded to take it through a range of motions. I was soon panting and sweating, my hands bunched tight in the bedclothes. Each movement sent a flare of pain through my body, gradually building until I thought I couldn't take anymore. Dr Jensen carefully placed my leg back on the mattress and stopped to look at me.
"I'm sorry I had to put you through that," she said, a slight shake in her voice. "Just one more test then I'll get you some pain meds and you can sleep." A nurse appeared with a blood pressure cuff and Jensen prepared a needle attached to a pressure gauge. She swabbed an area on my thigh then quickly bent my leg at the knee. I let out a yell but she'd already inserted the needle and she held my leg firmly.
Finally she straightened out my leg and covered it up again. "Okay, we're done," she said. "I'll order IV morphine so you can get some rest. I'll be round first thing in the morning to discuss the results."
Wilson came over and wiped my face with a cool cloth. He was pale and looked tense and worried.
To be honest, I really didn't care right then - my whole body was screaming at me. The nurse seemed to be moving in slow motion but eventually the morphine was running and I slid away.
When I awoke, I was aware that some time had passed. There was daylight creeping through the windows that stung my eyes. My head was pounding and I was shivering uncontrollably. I looked around for Wilson but he wasn't in the room. I thought vaguely that perhaps I should call someone, but when I tried to form words all I could hear was whimpers. It didn't occur to me to use the call button. After a while I felt the sunlight was burning me so I tried to roll over. Somehow I must have pulled of some leads because soon after a monitor started its shrill alarm and feet came running into the room.
People started asking me questions but I didn't understand and I certainly couldn't answer. My blankets were pulled off and I struggled feebly as something cold was placed under my arms and over my body. I felt the bed moving and the overhead lights blurred into a continuous stripe. I shut my eyes…and…that's it. I don't remember anything else.
---
I looked at Wilson questioningly.
"You spiked a fever – 105.8. They took you up to the ICU." His eyes flicked around guiltily. "I went up to my office at around 3am for a nap. You were sleeping peacefully when I left." He was obviously trying to justify abandoning me to himself. I didn't blame him though.
"What day is it?"
"Friday," he looked at his watch, "two-thirty."
I'd lost a whole day and a half and I was still so tired. Something didn't quite add up. Wilson was looking uncomfortable, nervous.
"What?" I prompted.
"I had to authorise surgery."
The penny dropped. I noticed for the first time that I wasn't in a room but in recovery. That also explained the heavy feeling numbing my brain and limbs – the after-affects of the anaesthetic still coursing through my system.
"Yeah. Fasciotomy, I know," I replied understanding the need to release the pressure in my leg before it could damage the nerves. Wilson looked confused.
"No, the compartment syndrome tests were negative," he explained, hesitantly. Now it was my turn to look confused.
"When your fever spiked Jensen realised it wasn't related to the stomach bug. She went ahead and did a needle aspiration and the lab confirmed osteomyelitis." Wilson paused while I digested that information.
Osteomyelitis. The third year text flashed past my eyes …depending on the degree of bone infection… it may become necessary to amputate. No!
"Oh God! Wilson, what have you done?" I struggled, trying to sit up so I could see my leg – or lack of leg. The room spun and blood thundered in my ears as suddenly Stacy stood before me.
"Honey, I love your leg as much as you do …"
"You're not cutting it off … it's my leg, it's my life."
"It's just a damned leg … now let them cut it off …"
The deja-vu had me in its grip and the crushing weight of what had happened took my breath away. I felt the room fading, voices echoing distantly as I sank once more.
---
The next time I woke the memories were there, crisp and clear, taunting me. I didn't want to open my eyes – if I opened them the facts would be cemented in place. If I kept my eyes closed perhaps I would drift off to sleep again where my body was whole and healthy.
Eventually the monitor betrayed me, its insistent beeping increasing with the pace of my thoughts.
"House? You awake?"
Wilson. He had some nerve.
"You took it." The words didn't come out as blunt and accusing as I had planned but they were there anyway.
"What?" A hint of panic in his voice. His cool hand was feeling my forehead but I twisted away angrily.
"You took my leg!"
"What? No! No, you're going to be okay."
My eyes flew open on hearing Wilson's denial. I raised my head from the pillow and saw the shape of my legs under the blanket. Two legs. I tried to sit up but Wilson stopped my feeble efforts with one hand on my shoulder.
"Don't try to move, you've got a drain in your leg." His words sounded flat and distant. He reached for the bed controls with his free hand and soon my head and shoulders were raised slightly. I reached forward to my right thigh.
"I can't feel anything," I said more quietly now. My brain was working furiously to fill in the blanks.
"They gave you a spinal block for the surgery," he reassured me, "it should be wearing off soon. You need to let us know if the pain escalates so we can top it up."
He correctly interpreted my frown.
"The surgeon removed a chunk of infected bone from your femur. You've got a plate and some pins to support it now. An abscess had formed but they cleaned it up and left a drain. You'll need to keep that in for a week or so and you'll be on antibiotics for at least a month."
The adrenaline rush of the last few minutes was leaving me weak and drained. Wilson's hand remained on my shoulder. "You're going to be fine," he stressed.
Minutes passed in tense silence. He was still hiding something from me.
"You didn't know how bad it was going to be before the surgery," I stated matter-of-factly." He dropped his gaze to the floor and started fidgeting with the bed-clothes. Eventually he turned away and started pacing to the window.
"I … I wouldn't authorize amputation," he said finally, guiltily. "Even if there was no other course of action. I told them to just clean it up and close until you could make the decision." He turned round and looked beseechingly at me.
The cogs were clicking into place now. "The infection could have killed me before I ever woke up," I said slowly.
"I know, I know!" he looked distraught. "I'm sorry," he blurted coming close and snatching up my hand.
I looked at his dishevelled appearance, his red-rimmed eyes and the slump of his shoulders. He'd done what Stacy couldn't and it was tearing him up.
"You did the right thing," I said quietly. "Thank you." His mouth opened and closed a few times, silently. Our eyes met and I was conscious of his warm hand enfolding mine and the over-brightness of his eyes. I pulled away, giving him time to collect himself.
"Is it still Friday?" I asked, clearing my throat which was unaccountably tight.
"Yeah." He looked expectantly at me.
"That means I haven't eaten in nearly three days," I said sitting up straighter. "The least you can do, since you were going to let me die, is go fetch me some food."
Wilson blustered impressively but he couldn't hide the grin as he turned to the door.
"And none of that crappy Jell-O!" I yelled after him.
