More Than Just A Headache
Wilson turned and glanced at his friend sitting in the passenger seat beside him; drawn, pale, and exhausted. It was clear that he hadn't slept in days… could he be suffering from some kind of post-traumatic stress disorder resulting from Kutner's death? Or was this really a Vicodin overdose? As House had said, he'd been popping the pills for years, almost as long as Wilson had known him… it made no sense – and yet it was the only reasonable, plausible explanation… so what had changed?
Then something else presented itself to Wilson – another, previously unexplored possibility suddenly occurred to him. It was a stretch of all logical possibility, but even so it was still possible… and it made sense.
"House how has your head been since the accident?" He asked. "Any headaches, dizziness, short-term memory loss… ever walk into a room and then forget why you were there?"
"I'd have told you!" House muttered.
"No you wouldn't." Wilson frowned, eyebrows raised as he glanced over at his friend and contemplated this new possibility – before turning his eyes back towards the road directly ahead of them, as he waited for his friend's response.
House shook his head with this. "No." He sighed. "No. Nothing."
"How about the leg?" Wilson enquired. "Any more pain than usual?"
"Apparently that's to be expected." House responded, craning his head stiffly to look at his best friend now as his hand immediately reached to gently grasp at his aching thigh. "When you're involved in a bus accident, it does have the slightly annoying tendency of managing to exacerbate the already intolerable pain of an already damaged limb."
"And I suppose more pain equals more pills." Wilson nodded in sudden understanding.
"Well of course." House snapped. "I can't function if I'm in too much pain too even wipe my own ass… but I don't see what my leg has to do with any of this… my leg is defected … my brain's fine…"
"Yes…but what if you're brain hasn't recovered quite as much as you think it has?" Wilson asked, pulling the car into the side of the road at the first available opportunity in order to better engage with his friend. "Swollen or scarred brain tissue would produce pain…" He explained. "Pain which you wouldn't necessarily be feeling if you were so dosed up on Vicodin to counteract the pain in your leg…"
He watched as House's brow suddenly furrowed in thought and vague realisation, deep crevices appearing where soft lines had previously traced a path across his forehead.
"…and, if the inflammation occurred in the right place, swelling could produce hallucinations." Wilson concluded. "Any pain you experienced during this time could still be genuine, maybe the result of a series of minor seizures… you'd wake up exhausted, but you wouldn't question that because in your mind you hadn't slept anyway… it all fits House." He explained. "The sleeping pills…the insulin induced coma, they worked briefly because they allowed time for the inflammation in your brain to reduce… but once you woke up, started to walk, talk, diagnose again, taxing the already injured tissue caused the swelling to continue, and the hallucinations to return."
House sighed.
"An MRI could confirm for us one way or the other." Wilson suggested, observing House as he shifted restlessly in his seat, in evident discomfort. "When did you last take any Vicodin?" He asked.
"Couple of hour's maybe" House mumbled, as he nestled his head further back into the soft leather headrest. "Not since… Ow!" He suddenly cried out as Wilson suddenly reached around and lightly palpated the area of his skull where he knew the fracture to have been. "What did you do that for?" House asked.
"Just proving a theory." Wilson explained.
"That hurt!" House complained.
"I learned from the best." He responded, before throwing the car back into gear, and carefully pulling back out into the city's busy early evening traffic. House noticed that they were now travelling significantly faster than they'd previously been when Wilson had initially picked him up, watching in bewilderment as Wilson turned the car around and started heading in the opposite direction.
"Where are we going?" House asked.
"The hospital." Wilson replied simply, definitively – although not unkindly with this however. "This is serious House, if I'm right…You need to get an MRI."
House simply sighed, too tired to ague. He settled himself back into the comfortable recline of Wilson's front passenger seat, closing his eyes, and for the first time in days drifted off into a somewhat troubled state of sleep…
….
"MRI shows some residual inflammation around the area of the brain controlling sensory awareness… your ability to see, to hear, to smell…" Wilson explained. "There's also some evidence of minor scarring and swelling around the area of the temporal bone, impinging short-term memory." He concluded, showing House the results of the scans from where he currently lay upon the hard mattress of his hospital bed.
"How bad is it?" House asked, although he already realised the answer as he cast a critical eye over the slides which Wilson had just handed him.
"It's bad…" Wilson nodded. "Although very unlikely to be permanent…"
House nodded despondently, before meeting his friend's concerned gaze…and then averting his eyes again.
"I'll get you admitted." Wilson explained. "We'll order some more tests and start you on a course of anti-inflammatory drugs until we can pin point exactly what's causing the inflammation." He smiled encouragingly.
He watched as House grimaced at this.
"Relax House, its good news." Wilson tried to reassure his friend, "You're not losing your mind, it's not the Vicodin, its treatable."
"Yeah, treatable, but not necessarily curable." House sighed.
"House, you've suffered a serious brain injury." Wilson explained. "Perhaps it was just too much to expect that you had made a full recovery in such a short a space of time as you appeared to have done… let's just take it one day at a time, hey?"
"Yeah…they said that about the leg." House muttered cynically.
"That was different." Wilson spoke gently to his friend now, lowering his tone somewhat and raising his eyebrows in a silent attempt to reprimand his pessimism… he wasn't going to let House just give up before he'd even given the treatment a chance. "Removing dead muscle from an otherwise useless limb is not the same as reducing the inflammation around an injured brain. A few weeks rest, and the right course of drugs, and there's nothing to suggest that you couldn't make a full and complete recovery, with no recurring complications, or symptoms!"
House groaned, his head sinking further back into the soft recesses of the pillow as the effects of his last dose of Vicodin gradually began to wear off, and the pain which had until now gone unnoticed – the one crucial clue to revealing the true underlying cause of House's condition – began to make itself painfully known. "A few weeks?" He sighed in obvious frustration.
"You need to rest!" Wilson ordered. "That's what got you in this position in the first place…"
"I can rest at home…" House interrupted him. "I can rest in my office… I can rest in the doctor's lounge…"
"You're staying here!" Wilson ordered him. "Even if I have to sedate you…and believe me House, give me reason to and I'll do it… and no cases, you're team will be thoroughly briefed… you're not even to contemplate getting out of bed without your doctors permission! Understand?" He asked.
"And who's my doctor?" House asked hopefully.
"Me and Cuddy will be sharing the biggest proportion of your case." Wilson explained. "Foreman and Chase have agreed to assist… that way there'll always be somebody here to keep an eye on you."
"You? But you're an oncologist." House retorted; some of his usual sarcasm and a hint of dramatic irony returning into his unusually strained tone of voice – although Wilson could tell that his friend's heart wasn't really behind the sentiment of ill-grace striven for…
"Special case." Wilson smiled – doing his best to appear reassuring.
"What about my leg?" House asked, gently rubbing the injured limb. "I'm sure I don't have to tell you, but all this time in bed doesn't exactly sit well with the 'use promotes muscle tone, muscle tone reduces pain' theory you've seemed so eager to drum into me at every available opportunity over the past few years."
"You'll be on a course of gentle physiotherapy to exercise the leg." Wilson explained. "You'll be closely monitored, any changes; loss of muscle tone, increased pain or weakness will be immediately reported to either myself or Cuddy. Everything's in hand." He reassured him, before asking, "How is the leg?" As he observed House grimace and his grip on the wounded thigh intensify – fingers turning white as he buried them even deeper into the throbbing tissue of the damaged limb.
"It doesn't hurt unless I move it." He winced.
Wilson nodded. "I'll order you some extra pain meds, and a compress," He nodded, noting something down on the chart at the end of House's bed as he spoke – before adding, "and something to help you sleep…I'm on first night watch duty." He grinned. "So I'll be back soon."
"You draw the short straw?" House asked.
"It was my call." Wilson shrugged, as he turned to leave. "What can I say?"
With this Wilson turned to go, but before leaving turned back to face his friend. "I know you'd never say anything, but I didn't think you'd want to be left alone tonight." He smiled reassuringly.
"I'm alright." House nodded.
"It's going to be ok you know."
"I know." House smiled meekly… and as Wilson finally left, House pulled the blankets tightly around him, before rolling over onto his side and settling down to rest.
"Thank you." He sighed once he was sure that Wilson had finally left the room.
A while later he heard Wilson return but didn't stir, in too much pain and far too exhausted to move – he felt the welcome relief as the drugs Wilson injected into his IV started to take effect on his exhausted system; their warming property numbing his pain and allowing sleep to finally lull him into welcome oblivion... 'perhaps things were going to be alright after all' he considered as – for the first time in days – he finally started to relax, and drifted into a dream free, Amber free, pain free sleep.