Info on NJ DWI laws is from the internet. Drunk drivers, by the way, are a pet peeve of mine, couldn't help working it into a story. I have not encountered ANY state's DWI laws that I think are anywhere close to sufficient, and then, of course, there is plea bargaining, which for some charges ought not to be allowed. Nobody is forced to drink and drive. Get a taxi. I read once about some small country years ago where the penalty for DWI was losing your license for life on your first offense, and on your second offense (obviously without license), you go to prison for 10 years, and will actually serve those years, too. Guess what? They hardly had any problem with drunk drivers there.
PSA over. Enjoy, if that's the right word for it, chapter 25. We are getting close to what I consider the climax of this story and the top of the big hill (no, we weren't to the big hill yet. These were just preparatory hills).
(H/C)
House, Wilson, and the neonatologist stood in the scan room, studying the films. "Grade II at the moment. We'll keep a close eye on it," the neonatologist stated. "If it goes up to Grade III, we'll have to place a shunt." He looked from the films to House. "This happens in over 50% of very premature babies; it's a very common complication. I'm sorry, but hopefully it won't expand past Grade II."
House flinched at the words I'm sorry, but his eyes were riveted to the scans. He had feared this from the time of delivery. The ventricles are the cavities in the brain that store CSF, but in very premature babies, the blood vessels adjacent to them are still developing and fragile. Even more concerning, up until about 35 weeks gestation, the germinal matrix, an area of the brain controlling fetal development, is full of blood vessels and activity, and it lies directly below the ventricles. The germinal matrix has completely disappeared by the 8th month of pregnancy, but in a baby ripped from the mother's protected environment while it was still present and active, any fluctuation in blood pressure, even one ironically caused by the ventilator that is busy saving another part of the infant's anatomy, can cause rupture.
The outcome was determined by the grade of hemorrhage. Grade I, or mild, had excellent long-term prognosis. Grade II, moderate, was more serious than grade I, but it was Grade III and IV that so often led to raised ICP, hydrocephalus, and long-term brain damage and functional defects. With Grade IV, the chance of brain damage was nearly 100%.
House closed his eyes, and Wilson, next to him, eyed him with concern. House still looked pale and tired, even though he'd gotten over nine hours of sleep last night. Of course, being dragged out of sound sleep to go visit Cuddy, whose spiking fever was being kept at bay with a cooling blanket while the assault of antibiotics was intensified, and then to come get results of the scan on his daughter was enough to stress out anybody. Wilson noted House leaning on his cane more than usual and reminded himself to provide breakfast as soon as he thought he had a chance of forcing House to eat it. He needed the anti-inflammatories.
"Other than the IVH," the neonatologist continued, "she's been continuing problems with sudden desaturations, but we're managing those with the respirator. We have her on surfactant to try to accelerate development of the lungs. Also, I noted the music."
House opened his eyes. "You don't suppose that made her bleed?"
"No, of course not. In a 25-week gestation, it's very hard to prevent a bleed. I was going to say, her vitals were a bit more stable last night on the record after that, and several of the nearby babies responded also. We might put in a request for a sound system down in the NICU on the next budget."
Wilson gave a weak smile. "I think Cuddy will probably be favorably inclined toward NICU budget requests now."
"When she gets back to work, whatever month that is," House snapped. He turned abruptly and walked out of the scan room, and the neonatologist looked after him with unmistakable sympathy.
"He didn't mean to snap at you; he's just stressed out at the moment," Wilson apologized.
"Believe me, I understand. I'd be on edge myself. This is rare, you know. Most premature babies I work with are the result of some physiological problem in the pregnancy, not the result of stupidity."
"Damn driver." Wilson eyed the scans. "Honestly, what do you think her chances are?"
Wilson wasn't family, but House had just told the doctor a short while ago to go ahead and speak openly in front of him. "For survival, a little over 50%," the neonatologist said. "For functionality, there are too many variables, including if this bleed worsens. If it stays steady and we have only the routine complications from here on, she could be fine or with only minimal deficits. Her response to any one of those routine complications would have an impact on the result."
Wilson shook his head. "Routine complications . . . and I thought I had a rough specialty."
"I've got pictures, actually," the neonatologist said. "Pictures parents send me of babies who were my patients for months, and they are now going to school, playing soccer. I'm sure you've got updates from patients years ago, too. There are lots of success stories."
True, Wilson thought. Also true that the parents whose kid is now dead or with a functional IQ a fifth of theirs aren't likely to send you updates for your former patient file. He sighed. "I'd better go find House." He didn't think his duties in keeping an eye on his friend would wind up much less today than yesterday.
(H/C)
On the way to Cuddy's room, House stopped at the nurse's station as he saw the two uniformed police officers there. "Dr. House, these officers want to talk to you," the nurse called.
House glanced toward Cuddy's room. "Is she the same?"
"No change yet."
With a sigh, House turned to face the police. "Dr. House? I'm Officer Morrison. I realize this is a bad time, but we just need a statement about the accident."
"Is he in jail?"
"The other driver? He made bail."
House clenched his fist on his cane until the fingers turned white. "You mean that irresponsible bastard just walked out and returned to his life? I wish my family had that option."
Morrison looked sympathetic. "There has to be a trial. I understand your anger, but we have to follow due process. And the statement we get from you is a very important part of convicting him at that trial. We'll also need a statement from your wife when she's up to it."
"Well, considering that right now, she has a fever of 103.8 and is only semiconscious and not coherent, I think you'll have to postpone that."
"Please, Dr. House, can you give us just a short statement yourself?" They had the attention of the whole nurse's station and anybody else within earshot at this point. "Is there somewhere we could discuss this more privately?"
House turned and stalked off at an annoyed limp, not even answering. The two police followed him to the small waiting area for family and friends. "Now, in your own words, what happened? Remember, this helps to convict him."
House fought down fury. "I had stopped at a red light. The light changed, and I started across. He entered the cross street from the bar halfway down the block and floored it, accelerating up into the intersection and running the red light. I tried to dodge, and he swerved the same way and hit us. That knocked the car across into the light post on the far corner of the intersection. Bottom line: I had green; he had red. I was sober; he couldn't even walk straight. Open and shut enough for you?"
A hand on his elbow made him jump, and he realized that Wilson had come up unnoticed behind him. House took a deep breath. "What was his BAL?"
"It was 0.21."
Wilson shook his head in disbelief. "And the bartender kept serving him?"
"Apparently, they had cut him off. He said he had a ride outside."
"What will he get?" House asked. "At the trial, what's the penalty for DWI?"
"It's his second offense, so if he's convicted, he'll get a fine of between $500 and $1000, 30 days community service . . ."
"30 days? And $500? You have got to be kidding me."
"He also has to serve at least 48 hours in jail."
"48 hours?" Wilson chimed in, his own blood pressure rising.
"And he loses his license for 2 years."
"Meaning he still gets his full life back, oh minus the $500 to $1000, sooner than we will be sure that my daughter, assuming she lives that long, will have no permanent disabilities of any kind in long-term functioning."
Morrison shook her head. "I'm sorry." House flinched. "You can, of course, file a civil case."
"We will," House vowed. "Not that it will make up for it, but I don't want this moron to even be able to afford to OWN a car when we're done with him." He started to turn away and was frozen in his tracks by her next words.
"And as for the driver's claim of assault . . ."
"WHAT?"
"He filed a complaint of assault. He says you hit him."
"Yes, I hit him, and the next time I see him, I'll hit harder."
Wilson tugged at House's arm. "House, maybe you'd better . . . "
House snarled at him, jerking his arm away, not even noticing that it was the one with the dressing.
Morrison quickly intervened. "After the driver was told that the two teens who stopped after the accident had made a statement on your behalf at the station, he withdrew the charge. I'm sure it would have been thrown out anyway, given the extenuating circumstances."
"So I don't have to worry about an assault charge. Thank you, you have just made my day SO much better. His withdrawing that just fixes everything, doesn't it?" House whipped around and stalked off.
Wilson opened his mouth to apologize, then closed it, deciding House had nothing to apologize for. "You'll let him know when the driver's trial is?" he asked.
Morrison nodded. "I'm sorry," she said again.
(H/C)
House spent the rest of the morning sitting by Cuddy's bedside, wiping her face with a cool cloth, watching her fight the infection that no doubt had entered her system with the damage to her colon. Wilson had brought in breakfast and made House take his morning meds, but the food tasted like sawdust in his mouth. The oncologist left after that, never going too far but giving House some symbolic space. House sat there for the next few hours trying to cool Cuddy down and remembering that they should have been spending this morning, before the parents arrived, discussing names. No, they should have been spending this morning at home and not in the damned hospital.
It was late morning when her fever finally began to fall, responding to the cooling measures and the new, stronger antibiotics. Cultures were still pending, but they were hitting her with high-powered coverage for all the likely suspects, and their efforts were starting to make a difference. House finally sat back in the chair, flexing stiff fingers, realizing that Cuddy had fallen into sleep. Good. She needed the rest.
He felt like he needed more himself. Last night, even dreamless, didn't seem to have touched the exhaustion in him at all, and his whole body felt heavy.
Wilson entered softly. "Hey, her temp is falling."
House nodded. "She's asleep." He stood up stiffly. "Going to make a pit stop and then go visit Rachel. I haven't seen her yet today with everything else. Will you stay here a little while?"
"Sure," the oncologist replied. After House came back, he'd go get them both lunch.
House limped into Pediatrics, wanting to test Jensen's theory but feeling like that night wasn't a great one to test it on. He had slept like a rock, no dreams at all, but he still didn't feel close to rested. Rachel was in the toy room, playing with an aide. She heard him and turned around, stretching her arms up from the floor and giving a happy laugh when she saw him.
The yellow cast almost seemed to expand off her right arm, seeming larger than she was, and House felt his pulse, breathing, and blood pressure skyrocket. His stomach twisted. All the memories crowded around the corners of his mind, pressing in, threatening to smother him. "Back in a minute, kid," he told her as he turned quickly around. A few strides down the hall, he ducked into the first bathroom and barely made it to the toilet before he vomited.
Five minutes and some deep breathing and cold water to the face later, he left the bathroom. Taking a deep breath, he turned back toward Pediatrics and forced himself to enter the room, to go across and talk to her, to smile and act normal, to push the visit as long as he could before he was forced to leave because he was afraid he was about to pass out. He left with a promise to send Wilson down later to bring Rachel up to Cuddy's room for a family visit when the parents arrived.
The anger at the drunk driver had almost been displaced for the moment by anger at himself.