Chapter 14
Cuddy and Wilson settled into the hard, unforgiving chairs on either side of House's bed in the ICU. Cuddy held House's limp, lifeless hand, staring into his slack face, desperate for a trace of his usual animation, for a lewd comment or sarcastic barb to fly from his lips at their concern. She was not rewarded; instead she was lulled by the dim lighting, the soothing regular sound of his heart monitor, the too regular, almost eerie whoosh of the ventilator forcing oxygen into his battered but healing lungs.
Thoughts raced through Cuddy's head trying to determine her boyfriend's chances of a full recovery. His ribs would heal, his lung injuries would take a little longer but barring complications, they should heal well too. She, and the other Doctors were concerned about how House's previous severe skull fracture could affect his head injury, they would have to wait until he woke up to determine that one. Some blood was present in his urine, indicating at least some damage to his left kidney, but tests had revealed that the damage was minimal and it should heal on its own without the need for dialysis. That just left the leg.
It had barely pinked up since the surgery to reset the bone, repair the artery and restore blood flow, the foot was cool and pulses were still depressed. Cuddy was not naïve; she knew that the chances of saving the limb after such a long time without any blood flow were low. Even after the infarction there was an adequate blood supply to the lower limb, only the thigh muscles were compromised. Despite this she still held onto a slim hope that he would be ok, that his leg would be ok, she couldn't imagine any other scenario.
Some time later Cuddy's phone began trilling, calling her attention back to the hospital, her hospital. She excused herself from the bedside and walked into the brightened hallway, blinking at the dazzling light. Trying for a professional veneer, and almost succeeding she listened to her assistant ramble about the ER, OR and ICUs overstretched resources and tired staff. She approved an order to bring in agency staff and send home all non-urgent cases and cancel elective procedures. Then she made arrangements for herself and Wilson to take a leave of absence. HR had already been informed of House's injuries and the fact that he would be off work for an indeterminate amount of time. She also rang the insurance company to ensure that House was fully covered. When she finished her admin tasks she also allowed herself a phone call home, checking on Rachel and talking to her about her day. When she finally hung up she felt exhausted despite the early hour.
When she re-entered the darkened room Wilson had scooted his chair forwards and was talking softly to House, telling him an amusing story from the clinic that he knew his friend couldn't hear. Smiling faintly despite the situation Cuddy slipped into the chair and listened to the story.
The rest of the day crawled by slowly, the quiet interrupted only by nurses entering discreetly to check his vitals, his incisions and the condition of his leg. The wounds in his head and chest had started the slow healing process but the leg looked livid, his temperature had been tracking the whole afternoon and the thin sheen of sweat had now progressed, his cheap hospital gown and sheets were now damp, his hair plastered to his head; he was shivering slightly. A cooling blanket had been ordered and covered his motionless form. Despite all of this the main concern for everyone involved was the continued poor state of his leg.
Alarmed at the decline in his condition Cuddy insisted on a consult with his Doctors. Half an hour later Cuddy and Wilson reluctantly left House's bedside and were showed to a small meeting room. The bland room looked remarkably like that found in any hospital. Medical posters giving advice about the importance of properly washing your hands, exercise and being vigilant about spotting disease appeared at random intervals around the unremarkable beige walls. Low, comfortable beige chairs lined the room, an equally low table held a tissue box and empty, unused plastic cups. A water cooler in the corner bubbled.
Looking around the room Cuddy identified Dr Ramirez , the ICU Doctor who stopped by briefly during rounds, Nurse Smith, the ICU Nurse in charge of House's care and Dr Williams the Surgeon in charge during the surgery.
After the brief introductions Williams was the first to speak, "As you are aware the surgery on Dr House went smoothly. We were able to repair the damage done to the lung and were able to re-inflate it without any issues. We were able to re-set the leg and repair the arterial damage and restore blood flow to the leg. Post-op examinations, of the leg however, have not been as positive as we would like." He looked grave, about to continue.
Here Cuddy jumped in, unable to hold her tongue any more. "That is down to your OR. House was left lying on a gurney in your ER for hours while his leg was slowly dying. He only got a spot because he almost bled out. If you saw him straight away his leg would be healing right now." Everyone shifted uncomfortably, they knew that she was right.
Red faced, Williams jumped in to defend his department. "I'm sorry Dr House had to wait for so long, but we were inundated by patients who were more critical."
"His lung was shredded, he wasn't breathing and a tourniquet was stopping him from bleeding out! How much more critical could they have been?" This time it was Wilson's turn to jump in to defend his friend. He was rewarded with silence from the man in front of him.
To prevent further embarrassment from his colleague Ramirez took over, "Dr House's latest labs showed that his leg was the cause of the infection." Cuddy nodded impatiently, she knew this already, biting back the scathing comment desperate for release she listened as he continued. "We are presently unable to identify the strain of infection… He's becoming septic. The prescribed broad spectrum antibiotics don't seem to be working well enough to combat the sepsis. We are running tests to determine which targeted antibiotics will work best." He paused letting the information sink in, before continuing. "His organs were starting to show the strain. They are becoming deprived of oxygen and essential nutrients. He sats are dropping and liver and kidney panels showed decreased function. I've prescribed vasopressors to improve blood pressure." At this Cuddy began to feel light headed, her breathing quickened. "I know that you refused amputation during the surgery, but I think it's time you reconsidered."
"No!" She practically shouted, exasperated. She was beginning to know how House felt during the infarction when everyone tried to force him to relent and let them take his leg. It was a much easier decision to make when you were the one wearing the white coat, but from the other side the decision weighed much more heavily. House was the only person who advocated keeping his leg, even Stacy and Wilson agreed amputation was the best course of action, leaving him feeling cornered, feeling alone. He had wanted to tough it out, to wait for the toxins released into his system to be filtered out by his kidneys, but that choice was eventually taken from him, by Stacy and herself; leaving him in chronic pain, and alone.
During the crane collapse House had again fought strongly against everyone to save a leg, that of his patient Hanna. He went as far as to say that he actually knew the worth of a leg. He had fought for so long to save his leg that Cuddy couldn't just give up at the first, or even the second sign of trouble, she needed to give him time to fight this. "You need to give him time. Get him on the right antibiotics, order dialysis to support the kidneys if he needs it, up his oxygen. Give the medicine time to work, and wait to see if the leg improves. We can talk about it again later if there's still a problem."
Everyone else in the room looked at her incredulously, including Wilson. They were all concerned about the stress that was being placed on his already weakened system. She had considered this and had given them a course of treatment. As far as she was concerned the discussion was over. Cuddy stood up and picked her way passed the legs to the door. She had left House for long enough.