When House broke the surface of consciousness early the next morning, he was gazing into the unshaven armpits of an ICU nurse in a sleeveless uniform as she hung a fresh bag of plasma on his IV tree. His memories of the day before were such a rummage sale of the real and the vividly imagined that he wasn't completely sure if he was awake or even alive. If he had died from the gunshot wounds, however, lush axillary growth was not a vision of heaven he was prepared to accept, and he willed himself back to oblivion.
A few hours later he opened his eyes again, this time to see Cuddy looming over his bed, arms crossed, a look of extreme vexation on her face. Another unpleasant vision. He opened his mouth to tell her so, then remembered the malfunction in his voice box. Lately it was just one nightmare after another, he thought.
"I am not happy about this," Cuddy began. Then she delivered an astonishing speech, the main thrust of which was that he was going to be allowed to try the ketamine coma. The speech was full of footnotes, conditions, and caveats, but the upshot was that the game was on. The only thing that could have made him happier would be running the experiment himself on someone else.
"Are you listening? House?" Cuddy waved a hand in his peripheral vision. "There will be no misunderstandings or surprises this time. Let's get everything on the table right up front."
The procedure itself was straightforward. He would be given ketamine in sufficient doses to keep him sedated for five days. To reduce the anxiety resulting from the confusion and hallucinations that often accompany the drug, it would be administered with another anesthetic, a benzodiazepine called Versed. He would be intubated, and his bodily other functions would be performed by catheters and IV tubes. His progress and vital signs would be monitored in four-hour shifts by his team, Wilson, and Cuddy. His parents, who were expected momentarily, would be allowed to visit as much as they liked, but no one else would be allowed into his room. The cover story was that he wanted to be spared undue media attention as a result of the shooting.
Cuddy made it clear that she still had reservations about this venture, not least of which was House's general level of fitness. Urquhart had been surprisingly upbeat after the surgery. "I half-expected to find the bullet had ricocheted right off his liver, with all the drinking and pilling this guy does," he confided, "but it was in pretty good shape considering it probably gets about 6,000 megs of acetaminophen a day. His heart and lungs are good, he's got the stomach of a 30-year-old: He's actually pretty healthy." Even so, Cuddy had an instinctive feeling that trauma followed by prolonged chemically-induced unconsciousness was not a prudent recovery protocol.
Her other reservation had to do with the ultimate efficacy of the procedure. Most of the world first became familiar with ketamine when it entered the club scene of the 1990s as a recreational substance with street names like Special K. It quickly developed a reputation as an accessory to date rape and overall your-brain-on-drugs bad news, acquiring an aura of danger that became both a selling point and a warning—this is serious stuff.
In fact, ketamine has been around for about 30 years as an anesthetic, amnesiac, and pain reliever, with an excellent safety record for both adult and pediatric patients. Not that it is completely benign: ketamine works by depressing the cerebral cortex, but it activates the limbic system, a complex of nerves and networks in the brain that controls basic emotions such as fear, pleasure, and anger, and patients emerging from a ketamine coma have been known to experience fits of irrational terror or rage and even strike out at those around them. Oddly, children are less likely to experience outsized emotions than adults.
Ketamine also appears to be particularly effective against the so-called "wind up" phenomena, in which pain is magnified and prolonged well beyond normal and is resistant to opioids and neuropathic agents. The role it plays in this process is not well understood, but the fact that it works at all at least half the time has raised the hopes of hundreds of thousands of chronic pain sufferers.
And therein lay Cuddy's deepest reservation. House was a man of soaring highs and crushing lows. She'd already had ample opportunity to watch him deal with disappointment after his expectations had been raised. In her experience, this usually led to a period of black depression and a noticeable uptick in self-destructive behavior. Now he was putting all his bets on an unproven, unapproved therapy. What if it didn't work? Or worse, what if it worked for awhile, then stopped?
If this were any other patient, Cuddy would have insisted on extensive psychological counseling before and after the procedure. She said as much to House, who answered with such a broad grimace of amusement and disbelief that a chorus of suppressed snickers rose behind her. She was going to have to cede this particular battle, but she knew that going in.
"Okay, one last thing," Cuddy said. "You need to appoint a new medical proxy. Now. No proxy, no coma. Do you want to think about it for a little while?"
House shook his head and scanned the group standing behind her. He pointed and mouthed:
"Chase."
-0-
The room emptied out quickly after that. Cuddy strode away to get a hospital lawyer and a laptop for House. Chase, looking gobsmacked, went to fetch his iBook. Foreman and Cameron drifted away to get coffee. Wilson was about to follow suit, but House caught his eye and gestured for him to stay.
"My parents," he mouthed.
"They'll be here right after lunch," Wilson assured him.
"Hotel?"
"What?"
House scowled and tried again, forming the words with exaggerated care. "Where are they staying?"
"Oh. Cuddy offered them a hotel room, but your dad says they'll stay at your place."
House winced.
"Don't worry about the mess. I got my cleaning service to go in and muck it out this morning. They'll firebomb the bathroom and kitchen, put clean sheets on the bed—it'll be fine."
House closed his eyes in something like despair. Wilson took pity and decided not to toy with him.
"Foreman and I went there last night," he said. "We found your works and brought them here. Unless you have any other secrets lying around your apartment, there shouldn't be any nasty surprises for Mom and Dad."
Eyes still closed, House nodded bleakly.
"You know, House, your problem isn't really pain, and it's not really drug addiction," Wilson said gently. "Your problem is the one four-letter word you refuse to use: 'Help'."
-0-
Cameron forebade herself to dwell on the possible reasons why House had chosen Chase instead of her as his proxy. Instead, she dwelled on why he passed over Foreman.
"I can see choosing Wilson, or Cuddy," she said. "They've known him the longest. But if he wanted to choose one of us, why not you? He loves you!"
"You mean, 'Why not me?'," Foreman said mildly, pressing the call button for the elevator.
"I don't mean that at all! I understand why he didn't choose me. Our relationship is weird enough as it is! But he never sees Chase without making fun of him. Why would he put his life in the hands of someone he doesn't respect, instead of someone like you, who he does respect?"
The elevator arrived, and they stepped inside.
"Maybe he thinks I'm still messed up from the biopsy," said Foreman, pressing the button for their floor. "Maybe he doesn't like me this week. Maybe it's another House mindfuck. Maybe he mentally flipped a coin and it came up Chase."
"Aren't you curious?" she persisted.
Foreman shrugged. "Yeah. I just don't see any point in chewing over it. Even if you could get an answer out of him, you could never be sure he was telling you the truth. Maybe he doesn't even know himself."
Cameron crossed her arms and grumbled quietly.
"Maybe we're overlooking the most obvious explanation," Foreman added.
"What's that?"
"Chase is the intensivist. We're really flying blind here: no qualified anesthesiologist, no respiratory therapist, no cardiologist, no experience with the procedure, almost no literature to guide us. Maybe he's worried the whole thing will go south." Foreman was silent a moment, then added, "And if it does, maybe he thinks Chase is the one who's most likely to pull the plug for him."
For the first time, Cameron grasped the enormity of what they were about to do.
"This really is insane, isn't it?" she whispered.
Foreman laughed. "Around here, 'insane' is the starting point," he said.
-0-
When they arrived at the Diagnostics Department a few minutes later, they found Chase standing outside the crime scene tape arguing with a cop. On the floor just inside the tape was a heap of laptops, printouts, and the cage with Steve McQueen inside—everything they had abandoned in the OB-GYN lounge the night before.
Having a plan of action had put heart in the team, pushing Alfred Hunnicut to the backs of their minds and making them suddenly capable of facing the shadowy corners of their dark, empty apartments. After a surprisingly good sleep, they met in the cafeteria the next morning to brainstorm strategies for reversing her decision. Instead, they had barely settled at a table when Wilson summoned them to Cuddy's office to hear about her change of heart. From there they went straight to House. In the meantime, the disgruntled obstetricians and gynecologists of Princeton Plainsborough Teaching Hospital hauled their belongings to their rightful department and left them there just before the police arrived to continue their investigation. The detectives were already annoyed because the items had been taken out of the room the night before. They were not inclined to permit further tampering.
Looking at the remnants of the mess they'd left in the lounge, Foreman only felt irritation—sure, they'd been inconsiderate, but under the circumstances, couldn't the other doctors show some leniency? Then his eye fell on Steve McQueen, huddled apprehensively in a far corner of his cage, and felt a sharp pang of guilt.
"It don't matter that it'll just take you a minute," the cop was saying to Chase. "I can't let you take anything out of here. Nothing. I'm sorry, Doc, but those are my orders."
Foreman looked hopefully at Cameron. Cameron took a step back, folded her arms, and looked at Foreman. He sighed and turned to the cop.
"I know it's important to leave the scene exactly the way it was," he said gently. "But Dr. Chase works in the intensive care unit for babies. Lotta sick babies in there, man. Some of them are dying."
The cop's face visibly softened. Foreman noticed and pressed his advantage.
"All his notes are in his laptop. We already messed up by moving our things around once. Would it really hurt the investigation to let Dr. Chase duck in for a second and get his computer? It could mean a lot to those babies."
The cop glanced around. The detectives were in House's office, huddled around his desk and not paying attention to the confab in the hall. "Get in and get out," the cop growled, lifting the tape so Chase could duck under.
"I'll just get this guy out of your way," Foreman added, deftly lifting the cage and a sack of rat food over the tape. "He wasn't here yesterday anyway." And before the cop could protest, the team had fled down the hall.
"That was good," Cameron remarked, "but next time remember to bat your eyelashes. We could've all gotten our laptops."
"You can really lay it on thick when you want to," said Chase. "The part about the babies was inspired."
"You have worked in NICU. There are a lot of sick babies in there. All your notes are in your laptop. Was there one word of untruth in anything I said?" The cage was starting to feel uncomfortably heavy. Foreman halted and switched hands. A thought struck him: "Where are we going, anyway?"
"I thought you knew," said Cameron. It occured to her that there was no place in the entire hospital complex where they could set up camp until the police finished searching their offices.
"Chase has a place to go," Foreman said accusingly. "He gets to hang out with the boss."
"Yeah," Chase said. "It's a dream assignment."
"You don't sound too happy about it," Cameron remarked.
"I'm not. It's just another chance to fuck up in front of House." The elevator arrived and he stepped inside.
"Chase," said Foreman softly. The Australian looked up at him hopefully. Foreman reached forward and gently pressed the handle of the rat's cage into his hand. "Take this with you."
Chase's shoulders drooped and he rolled his eyes upward. At that moment he looked like nothing so much as a medieval painting of an early Christian martyr—perhaps Saint Stephen, beautiful and uncomplaining in his agony.
But Foreman and Cameron were both raised as Protestants, and the resemblance escaped them completely. Instead, they headed to the Grab n Go for another coffee, agreeing along the way that Chase would always be House's whipping boy if he didn't grow a backbone and stand up to him once in awhile.
-0-
Greg House was a polyglot and a polymath, a board-certified doctor with two specialties and a Ph.D., a talented musician, and a quick study when it came to subjects that really interested him—a criterion that, alas, typing did not meet. Nor did he employ the two-finger, hunt and peck approach: he preferred to hammer on all the keys with all of his fingers at once, usually swearing ferociously at the results, and usually giving up almost as soon as he started.
He and Chase were now negotiating the details of the coma procedure and the preferred course of action for assorted contingencies via Instant Messenger—or, rather, House was furiously keyboarding and Chase was haltingly decoding the results. Given two people with reasonably good typing skills, IM was well-suited to the task, since it produces a text log of the conversation. As it was, Chase had hours of editing ahead of him.
watt is tth ep;an if i codfe? House asked.
"What is the plan if you code? We resuscitate, right? Unless...is this one of the No Heroic Measures things?" House was already typing a response. "I can't keep them all straight," Chase pleaded.
f yore havng that mccuch troubel folowng me, i'l aks mr, golsdmthj tobe myy porxy, wrote House. Mr. Goldsmith was an elderly gentleman who had been in a persistent vegetative state for almost three years. House had adopted Mr. Goldsmith as a kind of oracle, and his room as an unofficial TV lounge.
waht i ment was how aarre yu gong to kepe alid on tihs if yu hava to cal for bacjkup?
"We have a short list of doctors we think will help us out without reporting us," said Chase.
hersh isnt on tha tlist i hoep. hes a biggre tattletael than yyu.
Chase made a note to take Dr. Hersh off the list. "Next time I hire a hitman, I'm gonna spring for the silver bullets," he muttered.
wnot wwrrk, House typed back. It;ll; jst maek m e mad
Chase was trying to decipher this riposte when House sent another message:
Dont yu watn to knwo why i piked you?
"If I asked, would you tell me the truth?"
House grinned and fumbled a reply: i waantd somone woh was sstill afraaid of gomg to hell.
Chase snorted. "After two years with you, who's afraid of hell?"
House laughed soundlessly. Then he glanced out the window, and his shoulders sagged. Chase followed his gaze and saw that Cuddy was approaching, followed closely by an elderly couple who were peered anxiously into each room as they passed it.
yore in lcuk, House typed, his mouth grim. ist a house faimly reunio n.