Author's Note: As you might guess from the title alone, this is an AU version for the ending of Season 4. I shouldn't be writing this, as I am currently working on another story that is only two chapters away from being completed. But ever since this plot occurred to me, I have been unable to ignore it. It has constantly disturbed my waking and sleeping hours, pushing its way into by consciousness, refusing to go away and demanding to be put down on paper. It will stand alone for now, although I do have bits and pieces for a complete continuation simmering away in my brain. If and when they finally coalesce into a full story, there will be additional chapters.

Usual disclaimer: House, the show, and House, the character, are the creations of the brilliant David Shore and belong to him et al. I am merely writing this for entertainment purposes, with no monetary gain to myself, and absolutely no copyright infringement is intended.

Amber's Head

House was an ass.

Hardly an original thought, she knew. Actually, she had known even before she met him that he was an ass. No, she corrected herself, she couldn't have known that, of course, but she was certainly well aware of his reputation long before she had ever met him.

He was reputed to be brilliant, egotistical and annoyingly unpredictable.

Since Amber Volakis knew that she was also fairly brilliant, she supposed that others would have thought she was an egotist as well. But on top of that she was also ruthlessly ambitious, a quality which she had to admit was not shared by Dr. Gregory House. He could be ruthless, without question, whenever he had score to settle or he wanted something badly enough, and he also took fierce pride in knowing that he was best in his field. But he truthfully did not seem to need the acknowledgement and accolades for which Amber clearly hungered. He did not need, as she did, the respect of others.

It was to fulfill that need for respect and acclaim that she had applied for a fellowship with him in the first place. And why she had continued to tenaciously cling on to the chance as the other, lesser candidates were winnowed out. During that time, she had sometimes admired House, and sometimes despised him, but even in those moments when she was in complete awe of his abilities, she had always known that he was still an ass.

She just hadn't realized that, given enough alcohol, he could also be a snarling, loutish pig. Not that she had expected, given his misanthropic nature, that he would be a jolly drunk. But if it hadn't been for James, she certainly would not have followed him onto the bus to give him his damned cane. Being insulted, groped (she was sure there had been nothing 'accidental' about the brush of his hand over her ass when he stumbled against her) and forced to pay his bar bill was bad enough. Now she was stuck on the bus with him, determined to see him safely home. After which, she was going to have to ride the bus back to the bar to pick up her car.

Oh, well, she thought, trying to stifle another sneeze, James was certainly going to owe her big time when she got back to their apartment.

She glanced back at House, sitting across the aisle from her. He was staring fixedly over her shoulder, with a very strange expression on his face.

Great, she thought, maybe he's about to puke.

The next moment there was an ear-splitting crash, and the force of a tremendous impact sent her flying. The bus spun and rotated wildly, her body continuing to be tossed into the air as it lurched erratically. She was only vaguely aware of the pain as she hit and bounced off the seats and the sides of the vehicle; it was the fear that was worse at the moment. As the bus tilted once more, time slowed to a hideous crawl. Reaching out, pleading for help, she felt someone grasp her hand. She looked up and saw House, barely hanging onto the side of the bus himself, trying desperately to hold onto her. But then her fingers slipped away from his, and she knew she was about to hit another hard, unyielding object, and that she was helpless to stop the chain of events that were inexorably unfolding before her eyes.

Then there had been a brief period of merciful unconsciousness.

She awoke, to the sound of people crying and moaning. The universe seemed to have compressed into a single dark, smoky, pain-filled room, and when she tried to move an agonizing jolt ran through her body, beginning somewhere in her right leg.

She looked down and could not suppress her own cry of despair as she saw the jagged metal sticking up through her thigh, knowing even before she had turned to head to look at the other side that her leg was skewered, her slim, muscular limb transformed into a bizarre shish kebob.

And she was cold, much too cold.

It must have hit an artery. I'm losing blood. I'm dying.

There was another sound now. A soft, almost scraping sound.

It was House. He was crawling towards her through the shattered glass and metal, his eyes still bleary from drink and yet focused on her thigh.

As he neared her, she could still smell the stink of alcohol on his breath as he reached up to tug on her scarf.

"I need to tie this around you."

She could see that it was taking all his powers of concentration to wind it around her leg and tie it into a knot. She was going to tell him that it was much too loose, that it wouldn't stop the precious blood from pumping out of her body. But then he drew back and cinched it taut, sending another wave of pain through her.

Now it was so tight that it hurt, and she knew that was good. But-

"I'm cold."

"Stay with me. Just stay with me."

She closed her eyes.

I don't want to die. I don't want to die.

* * * * * * * * * * * * * * *

"Amber?"

James. James was calling her. From someplace far away. But she wanted to sleep. She needed to sleep. Just for a little while longer.

"Amber? Sweetheart, please wake up!"

Poor James. He sounded so worried. She really had to try.

It seemed to take forever, but she finally managed to open her eyes. The familiar sights, sounds and smells of a hospital room surrounded her. But she was seeing, hearing and smelling them from a different angle. From a hospital bed.

"Amber?"

She tried opening her lips to speak, but her mouth was horribly dry and her tongue wouldn't move the way she wanted it to.

"Sweetheart, can you hear me?"

I can, I just can't figure out where you are.

"Squeeze my hand."

Which hand?

She knew that she was in a lot of pain. Or, rather, that she would have been in a lot of pain except for the fact that they must be pumping her full of drugs. Funny, it didn't really take away the pain, it just dulled it. It was like being wrapped in cotton. Like being wrapped in a cocoon of narcotics, she thought, as her eyes focused on a spot on the wall.

"Amber?"

There he was. Following her eyes, he had finally moved into her line of sight.

"Honey, can you hear me?"

She tried to nod and then saw that he was holding her right hand. With a great deal of effort, she concentrated and managed to make her fingers squeeze gently against his own.

"Oh, thank god, thank god," he said, bending down and starting to cry as he leaned over and kissed her.

She continued to squeeze his hand as he put his other arm around her and held her tight. After a moment he turned back to her and kissed her again, his tears sliding off of his cheeks and dripping against her lips.

She felt her tongue slip out and taste the saltiness of his tears, the motion allowing her to moisten her mouth slightly.

"How bad is it?" she asked, her voice barely audible.

He drew back slightly and used his right hand to wipe away his tears, keeping his left hand tightly encircling hers.

"You've had a lot of surgeries in a short time," he told her, nodding. "But you're going to be okay."

"How long have I been in the hospital?"

"Over a week," he said.

"Did they-"

She stopped and squinted, trying to remember, trying to will her other body parts to move, but finding that she was still too heavily sedated to direct her thoughts.

"Did they have to amputate my leg?" she asked, hearing her voice shake with fear.

"No, no," he assured her, bending down and kissing her forehead. "You had a bad laceration, but they were able to repair it."

"House tied my scarf around it," she said.

"Yeah," he said, bringing her hand to his lips and kissing it.

"He saved my life."

"I also saved your leg!" answered another familiar voice. "It's kind of a bitch to be crippled, you know."

Great. Even now he had to be there, trying to come between her and James and ruin their relationship.

"How do you feel?" James asked, ignoring House as he continued to look down into her face.

"I hurt all over," she admitted, as she felt the effects of the drug rapidly subsiding as she continued to regain consciousness.

"I can only imagine," he said, his large, expressive brown eyes gazing at her sympathetically.

"What other injuries do I have?" she asked.

He took in a deep breath before replying. "You were pretty banged up from the accident. Do you remember-?"

"The bus. I was on the bus," she said, nodding her head. "But what-"

"A garbage truck ran into it," he explained. "Your seat was right at the point of impact."

"Did I break anything?"

"No," he said, shaking his head. "But you had massive contusions on both of your kidneys."

In response to her raised eyebrows, he continued, "It was bad enough to send you into renal failure-temporarily," he added, hurriedly.

"But, anyway," he said, squeezing her hand again, "you're going to be okay, and we can wait until later to tell you the rest. Do you need more pain medication?"

She nodded.

Yes, but I also need answers.

"Okay," he said, rising from the bed. "I'll get the nurse in here to give you something."

"No, wait!" she pleaded, clinging onto his hand.

"What is it?" he asked, sitting back down.

"My kidneys failed," she murmured, starting to breathe in and out rapidly. "No, no, that's bad," she said. "That's bad, because...because..."

"Because you had just self-medicated yourself with amantadine," said House.

Now she could see him as well as hear him, peering over James' shoulder.

"I thought you were too drunk to notice," she said.

"What?" asked James, looking at her in confusion.

"The amantadine," she murmured.

"You remember taking that?" he asked.

"Yeah," she said, nodding her head.

"Pretty stupid drug, you know," said House, rolling his eyes. "I really think it does bupkis for relieving flu symptoms. On the other hand, it does a really great job at frying all of your internal organs. If you're unlucky enough to go into renal failure first, that is."

"I took amantadine, and then my kidneys failed," she said, feeling her eyes beginning to tear up. "I'm going to die."

"No, no you're not," said James, bending over her and brushing her hair back from her face. "Shh, shh, it's going to be okay."

"They put me on dialysis?" she asked.

"No, they didn't," he said, shaking his head.

"Dialysis doesn't filter out amantadine," House informed her, sounding annoyed. "God, I thought you were way smarter than that, it's a good thing I kicked you off of my team."

"So, my kidneys started working again by themselves? And cleared out the amantadine?"

"No," said James, hesitating again. "You got a transplant," he finally admitted, after a moment.

"I got a kidney transplant?" she asked, sounding both relieved and shocked. "How did I get cleared for a transplant so quick?"

He looked away and licked his lips before replying. "Honey, you were critical. Since dialysis wouldn't clear the amantadine, you were going to go into multi-organ failure if we didn't get you a functioning kidney."

"Did Cuddy pull strings?" she asked, in amazement.

She was sure the Dean had never liked her. On the other hand, she seemed awfully fond of James. Maybe she had done it for him rather than her.

"No. There was a directed donation, and since you're type AB..."

Well, yeah, that helped. Although it was the rarest blood type, it was also the universal recipient, so she could receive a kidney from anyone.

"But you couldn't have done it!" she protested. "You had glomerulonephritis when you were in college."

James was now looking down at her hand, avoiding her eyes. Avoiding telling her something.

"Guess which altruistic AB donor gave you a kidney?" prompted House.

She looked at her former boss for a moment and then glanced back at James, who was still refusing to look at her.

"Did House donate a kidney to me?" she asked.

"Bingo!" hooted House, holding his cane aloft. "Ding, ding, ding! Give that lady a fellowship. She got the answer with only a few hints and without even using a whiteboard!"

James was looking into her face now, his eyes blinking rapidly with surprise.

"How did you know?"

"He's type AB," she murmured, as the memories came flooding back to her. "That case with the magician who had lupus. House made us give him the rest of that unit of blood, because he was type AB. But-"

She stopped and cried out in pain as her head began to throb.

"Ow," she cried, feeling fresh tears spring from her eyes as battled the pain.

"What is it?" James asked, rising to his feet again. "Do you need something for pain?"

"Yes, please," she whispered. "My head is killing me."

"Gee," she said, raising her hand to her temple and trying to make a joke, "you would think there would be enough residual Vicodin in that kidney to keep me numb for a lifetime."

House laughed out loud at the comment but, to her surprise, James didn't even crack a smile.

"I'll be right back," he promised, moving quickly out of the room.

She waited until he was out in the hallway to turn back towards House.

"You're looking fairly well, considering you just donated a kidney," she remarked.

"Actually, I'm a lot sicker than you know," he replied, twirling his cane as he smiled at her.

"But you're-"

She stopped and looked away as James and a nurse entered the room. The nurse was carrying a syringe and, after a brief glance up at her monitor to check her vitals, she threw Amber a smile before reaching over to inject the medication into her IV line.

"Good to see you finally awake," she said, as she pressed down the plunger. "You have a lot of people waiting to visit you, but I told them you were going to need some rest first."

In less than a minute, the medication began to work and started to feel some relief from the pain.

"Is that helping?" the nurse asked, as she bent down and raised the sheet to check on her dressings.

"Yes, thank you," murmured Amber, as James sat back down on the bed beside her.

"Good," said the nurse, making some quick notes on her chart.

Bending down, she looked at the catheter bag and nodded in satisfaction.

"It looks like that new kidney is continuing to work fine," she said.

Leaning over to the side, Amber could see that she was putting out urine at a consistent rate.

"Better than I would have imagined," she said, turning to look at House.

But he had disappeared, and realized that he must have left the room while she was busy concentrating on the nurse.

"Be sure to call me if you need anything else, Dr. Volakis," the nurse said, as she exited the room.

"I will," she said, turning towards James and smiling. "You're staying, right?" she asked, as she held out her hand.

"Absolutely," he assured her, squeezing her hand, "I am staying right here for as long as you need me. But you should lie down and try to get a little rest," he advised.

"Just don't try that everlasting rest. It's not all it's cracked up to be."

"What?" she said, turning to the other side of the bed as she heard House's voice again.

"Amber," said James, looking at her quizzically and then turning his head to see what she was staring at. "Something the matter?"

She looked back at James and then very slowly turned her head back to look at House. She watched as the older doctor bent down and brought his hand within inches of James' face before snapping his fingers.

There was absolutely no response. James didn't even blink.

"C'mon, Cutthroat Bitch," House said, as he straightened back up, "put the pieces together. Even with a critically ill patient, what's the chance of getting a kidney immediately? Unless there's a nice donor lying in the next hospital bed? With organs that are just dying to be donated?"

"Honey, are you cold?" James said, looking concerned as she began to shiver.

"Just a little," she said, hugging her arms around her. "Do you think you could get me another blanket?"

"We better get Chase in here," he said, rising to his feet. "I'm afraid you might be septic."

"Wait!" she shouted. "I have to ask you something first."

"But-"

"James, please!" she yelled, sounding frantic.

"Amber...honey, what is it?"

She looked around the room, searching for House, but he had once more disappeared.

"What happened to House?" she demanded.

He hesitated for a long moment.

"He...was at a bar and got drunk and tried calling me. You went to go pick him up and for some reason he decided to take the bus home instead. He was in the accident with you-I thought you remembered."

"How badly was he hurt?"

James took in a deep breath and stared down at the floor again before slowly raising his eyes back to her face.

"He...had a concussion," he said, finally. "We're not really sure how bad it was initially, because he wouldn't let anyone examine him. And then he did...something..that widened the skull fracture."

She stared at him, looking horrified but obviously demanding that he continue.

"It led to a massive brain bleed," James said, his voice barely audible.

Amber nodded and closed her eyes for a moment.

"James," she said, opening her eyes again, "was House alive when he donated his kidney to me?"

As Cuddy had just recently told him, there were times when he felt obligated to tell someone the full, brutal truth.

"No," he answered, his voice husky and blinking back tears in his eyes as he spoke, "he was brain dead."