Disclaimer – We do not own House M.D. It all belongs to David Shore and Fox.
~Chapter 19~
Cuddy's lost gaze kept focusing somewhere far past House despite his attempts to call her. She was in a state of shock knowing the gravity of the situation. House kept telling himself to sit and wait for the ambulance but he felt as if he needed to be standing; he needed to be ready. For what, he had no idea but he just couldn't get himself to sit. When the paramedics arrived, ten minutes later, the reality hit them both. Cuddy gasped for air almost falling into an anxiety attack snapping House out of his state of helplessness and back into motion. He was by her side in two quick, painful steps.
"Cuddy, look at me! Please, look at me!" He demanded more urgently now, shaking her shoulders. When she finally focused her eyes on him, House said "I need you to stay alert, to control your breathing. Can you do that for me?"
When she did not respond, he repeated more gently, "Lisa, can you do that for me?"
Cuddy weakly nodded as she tried to get up on her own, but failed. Two pairs of strong hands, gently wrapped around her waist, helped her onto the ambulance stretcher. In that moment he hated being a cripple, he hated being an invalid, both physical and emotional one. House firmly ordered focusing his gaze on the paramedic, who was standing by Cuddy's head,
"Put her in sitting position and give her oxygen." He motioned with his cane towards the headrest, "and be very careful with her right arm."
House finally added refraining from insults and bullying of those in lower rank than he had. He couldn't have her getting upset over that now; he was a jerk but he knew his limits. With a lifeless expression on his face he followed the paramedics out of his apartment.
House stayed with Cuddy in a painful, kneeling position while she was oblivious to what was going on around her. She felt him holding her hand, from time to time, and moving the wet curls away from her forehead but she was sure she was hallucinating. It must have been a product of her imagination. The roads went by almost as if in slow motion, yet they arrived to the PPTH quickly. If adrenalin could be produced artificially, it would be one hell-of-a-drug, House thought to himself as he finally released all the built-up air from his lungs and slowly stepped out of the ambulance.
Finally in the ER, House felt on his own territory where everything made sense and where he was no longer helpless. Looking at his watch he realized that the night shift was still in and that it was too early to call his team. Without further stalling he turned around and almost politely asked the closest nurse,
"Get me someone who's trained in PICC removal and wake up Dr. Richardson, tell her it's about Dr. Cuddy. Go!"
Limping around the medical station, House picked up a bag of saline, a syringe and a set of hypodermic needles. The night shifts tended to be short-staffed so he had to administer the IV drip and draw blood samples himself. He approached Cuddy's left side and carefully sat on her bed. He gently raised her arm into his lap and looked at her eyes, making sure that she was responsive to the procedure.
In silence, he drew the blood samples and attached a saline drip to her left arm when the head cardiology nurse walked in, followed by two other nurses. House instantly recognized the woman who inserted Cuddy's catheter a week ago and quickly said,
"Make sure that the tip of the catheter is placed in a sterile container and sent to the lab for C and S evaluation," then he turned to the other two nurses and ordered, handing her the plastic tubes "You, take these samples to the lab and you," he turned his head sharply towards the other girl "…get me the mobile ultrasound in here, now!"
The nurse diligently worked on removing the peripherally inserted central catheter, following House's instructions with military precision. House approached Cuddy's bed again and with a small tug on her shirt softly spoke,
"Your job is to stay alert and prevent panic. Mine is to take care of you, OK?" If he wanted to calm her down, he had to calm himself first and by emphasizing his role in this whole ordeal he was finally able to focus on what he had to do; thinking about his shortcomings and where he royally screwed up in the last four months wasn't helping either of them.
"OK." She barely whispered, closing her eyes. If anything, she was aware of her own breathing now; but more than that she was thankfully aware of his presence in her life.
"Now, rest! I am gonna go run some tests." House announced as quickly as he walked out, hating himself for leaving her.
Well before 9:00am the entire team was in House's conference room, prepared for a differential. Everyone was holding identical medical files, along with their coffee mugs, and none of them were pleased with what they had seen.
House approached the white board and slowly wrote, his heart sinking deeper and deeper with each letter.
Multiple clots, neck to elbow
Venous thrombosis
Pulmonary embolism?
"No prolonged signs of swelling, no infection," House looked at the chart before continuing "The ultrasound can't show us if any of the clots broke off and are travelling to her heart or lungs, she hasn't lost consciousness and breathes on her own," he recited before asking a question he knew answer to "How do we find a clot without using x-ray?"
"We can't," Thirteen said, briefly pausing to look at everyone "but we can give her blood thinners to prevent the clots reaching her heart or lungs. Heparin injections, which dissolve blood clots, have less risk of fetal damage." House looked back with indifference, silently asking for more ideas.
"How about Lovenox?" Kutner asked carefully "It doesn't get passed onto the baby but dissolves clots with the same success rate. However, it does require hospitalization and subcutaneous injections into her stomach, every day for the next five months." Everyone looked at each other in silent agreement, objectively failing to find a flaw in Kutner's suggestion.
"Fine." House said with a small shriek, as a visual of poking Cuddy's belly with a needle and leaving nasty bruises appeared before his eyes "Go run the aPTT, PT, platelet count, and D-dimer again. Repeat the bleeding-time test before putting her on Lovenox." He monotonously pointed to the glass door with the medical file he was holding suggesting to them to leave, instantly.
House walked over to the coffee machine as his team hurriedly exited the conference room. He just remembered that he hadn't slept the night before. A strong coffee was in order. For the next three minutes he stared into emptiness, his stomach violently knotting in trepidation.
When he finally sat down, pressing his forehead against his sweaty palms, he felt more alone and miserable than ever before. By reflex, his fingers fished for the cell phone in his pocket and absentmindedly dialed the only person who could have brought some reason into all of this. Wilson.
When he heard Wilson pick up on the other side, House quickly asked bringing the coffee mug to his lips,
"Where are you?"
"Just getting out of the airport. Why?" Wilson replied with unhidden curiosity
"It's Cuddy." House plainly said flaring a red signal in Wilson's head. When there was no excitement in House's voice, for whatever reason, it meant something was seriously wrong.
"What do you mean it's Cuddy? House, what happened?"
"Her PICC clotted up and she has extensive venous thrombosis." When House heard Wilson exhale violently on the other side, he added "It's my fault."
"Wait. No. It's not your fault. It could have happened to anyone." Wilson desperately tried to reason with him but felt that guilt had already started corroding that abrasive armor of his. Maybe for the better, he thought to himself.
"Yes, it could have happened to anyone but it didn't. It happened to me. It happened to her. Everything else seemed more important than looking after her."
"House, what are you trying to say?"
"We had a fight. She rejected me." He painfully exhaled the last three words.
"You told her?" Wilson asked with a great deal of interest
"No."
"How could she reject you if you haven't told her? Wait, don't tell me. You tried to get into her pants, didn't you?"Wilson stated in a ridiculously screechy voice
"It wasn't like that." House tried to defend himself but in vain. He himself didn't believe that.
"Oh God, House. You are an idiot!" Wilson screamed from the other side
"I know. What should I do?" House nervously fidgeted in his chair, desperately needing Wilson to come to his rescue.
"It isn't about sex, it's about being with a man that is ready to grow up, House and take the relationship to the next level. When it comes to children, women draw their claws out and no matter what they say they need that contract, that whole shabang!" Wilson offered a life-lesson soliloquy knowing full well that House was paying close attention on the other side.
"In English, Wilson. I don't do yenta." He added mockingly, rolling his eyes.
"She wants it all House, and remember, there will always be someone else out there that will promise her the world if you aren't ready or willing to give it to her."
"Point taken, Dr. Phil," House offered Wilson one of those rare moments of admitting that his best friend was right. Without giving him a chance to gloat, he quickly asked "When are you coming in?"
"An hour or so. Why? Is she gonna be OK?" Wilson asked not hiding his concern.
"I don't know," House said brokenly wishing he had a more definitive answer to offer to his friend "We have to wait and see if the blood thinners work." Like never before, House put all his bets and hopes on a tiny, liquid chemical compound, hoping it would work.
"House, go talk to her, please. Tell her that she is not alone in this and that you are there for her. She could use your support, now more than ever."Wilson pleaded him on an intelligent level, sneakily pushing the emotional button.
House suddenly felt a fierce resolve knowing it was the courage he needed. Wilson poured it into his system like a skilled mechanic changing the oil in a car. He mumbled something incoherent into Wilson's ear and hung up, determinately getting up from his chair.
"As Marcus Aurelius said, and thou wilt give thyself relief, if thou doest every act of thy life as if it were the last." House exuberantly announced to himself as he grabbed his cane. "Or in simple Rolling Stones terms - show time!"
