Chapter 28
"On Days When Bad News is the Only News There Is …"
Tuesday morning brought with it a breath of normality. Maybe too much … like when you take in a gulp of oxygen that almost gags you …
A local delivery service arrived with a large grocery order at 8:00 a.m. I paid the guy and went about putting everything away. I went into Greg's room about 8:30 and he was awake and watching for my entrance. He had snark to spread and a few profound proclamations to make.
He felt well enough to complain about the oxygen, ("When are you gonna let me get rid of this?"); the aerosols, ("I feel like I'm drowning in sea water!"); and the scheduled chest X Ray, ("Why do I still need this?")
I listened to the griping with clenched teeth, even though I was very relieved to hear him come back at me with some of the old spark. I even agreed to lower the 02 to two liters.
But even that only shut him up until the young technician from the radiology service arrived.
He tilted his head and looked her up and down before asking again: "Why do we need a chest X Ray? We know it's pneumonia. Couldn't we skip the unnecessary dose of radiation?"
When the tech tried to explain that the exposure was minimal, I jumped in quickly to explain to her that House was a physician. She rolled her eyes in a long-suffering manner, and I knew she had probably been over this route many times before. She didn't say anything further, much to her credit, but I heard her mutter under her breath about "doctors being the absolute worst!"
I leaned down beside her shoulder and whispered in return: "I assure you, Gregory House is the worst of the worst!"
Judging from the startled look in her eyes, the technician had recognized the name. She finished her work, packed up hastily, and left. From the bed, Greg threw me a satisfied smirk that told me I'd saved the kid from his biting tongue just in time. I answered the smug remark with only a wink. He wrinkled his nose in disdain.
I helped him to the bathroom, and then wheeled him out to the couch shortly after that. Assisted him getting settled. He ate a good lunch that I whipped up quickly from the fresh stash of staples, and leaned back to catch up with the soaps on TV. Shortly thereafter, he dropped off to sleep. I cleaned up the lunch dishes and returned everything to the kitchen to keep from disturbing him.
Since we'd talked about his recurring nightmare, he seemed to have lost all resistance to going to sleep. The naps he'd been denying himself during the day were quickly becoming a part of his renewed routine. I decided that it was a good thing … something that would help speed up his recovery.
When I walked in from the kitchen again and glanced across at him, something was different. I stared, and froze in my tracks. House's face was contorted, his teeth clenched, and a line of perspiration was beading on his upper lip. I saw him pull that left leg up toward his chest, but before I could gather my senses to take it all in, his eyes flew open again and both hands were on the thigh.
I hurried to him, but by then he was awake, eyes refocusing, hands relaxing, and he straightened the leg, looking disoriented and puzzled. He glanced around the room and then at me.
"What was that?" I asked, sitting on the edge of the couch near his feet.
"Not sure …" he ventured. "Guess I was dreaming that my leg hurt. But when I woke up, it was fine. Weird!" He struggled to a sitting position and I watched him rub experimentally at his leg. "Doesn't hurt at all …" His puzzlement was deepening. Mine too.
"Do you remember what you were dreaming about when it started?" I asked. I reached out to touch the thigh muscle, but it seemed fine.
He thought about my question for a moment, then shook his head. "No idea." His expression changed gradually to a mischievous, teasing look. "I got it! I've been grieving the loss of the pain so much that my subconscious decided to make me feel better by letting me dream about it. Too cool!"
I wasn't amused. I had witnessed the agony that had twisted his features for those long moments. "No! I was watching when you woke up. You were hurting … it was real!"
"Oh relax! Maybe I hit my leg on the couch or something …"
My worry turned to exasperation, and I couldn't have helped the eye roll even if I'd wanted to. "Yeah … those soft cushions can be murder! Gotta be real careful around 'em. Y'know, everything I've ever read says pain incorporated into dreams is actual pain that's disrupting your REM sleep. You're certain you're okay?"
The look on his face turned patronizing. "Let me get this straight … you're upset because I'm not having a problem. You're concerned that I'm not currently in pain? Sorry that I'm … unhh … comfortable. If it'll make you feel better, I'll try to arrange for an abscessed tooth or something …"
He'd got me again, and I had to laugh out loud, just as he'd expected. "You're right; it's ridiculous to worry that you're not in pain. But that was … strange."
He shrugged. His part in this nonsense (to him) conversation was over. He turned his attention back to the TV.
Half an hour later, I came to fear that the odd occurrence might have been a harbinger. As I came back to the living room with a full bag of TPN, I saw him rubbing angrily at the left leg again, and this time he was definitely awake.
He looked up at me with luminous, pain-laced blue eyes. "Hurts for real this time." There was a smile of chagrin on his face. "Happy now?" But the weak attempt at humor died on his lips when he saw the fear and concern I knew was etched on my face. So he looked away and decided to tell the truth, I guess, because his voice was breathless with pain. "Gonna be a bad one …"
I wondered if that particular remark was a back-door method of asking for the morphine to be administered before the spasm could get out of control. "Should I … ?" But before I could finish the question, he nodded sharply.
I moved toward him, discarding the TPN bag on the lid of the piano. He'd need to shift himself to a lot more comfortable position on the couch than he was in right then, in order to ride this one out.
"Don't touch me!" He warned, grinding the words through clenched teeth. He curled himself more protectively over the leg, teetering near the edge of the couch. "Just get it!"
I knew this was going to be the worst one yet, and I returned as quickly as possible with the morphine … a double dose. This wasn't the time to depress his already compromised respiratory effort. It was also not the time to be casting a judgmental eye on his degree of pain, so I made sure I was prepared either way.
He'd already reached the point where all ten fingers were white and rigid and digging deeply into the muscle. His eyes were tightly closed. He was trying very hard to control his breathing, but I could hear it rasping out of him in anguished gasps.
I knew he would hear anything I said only peripherally, but I tried to speak calmly anyway. "I'm pushing the med now, House. It'll begin to ease up soon." I mumbled all the comforting nonsense that came to mind, just in an attempt to help him stay focused. I watched his ashen face closely and continued to administer the dose.
"You're doing okay with the breathing," I told him. "Keep it up. I've got about 3mg in now. Should be hitting the spasm. Breathe! I'm right here with you. Relax your hands and let the meds work. Go with it. Breathe!"
Obediently, he pulled in a breath, and I saw his hands begin to release from the leg. His eyes were still closed tightly, but the pain lines in his face were beginning to soften. He took a few more deep breaths before he was finally able to relax further. "Okay … it's bearable. Wasn't as bad as I thought." He opened his eyes and looked up at me. "Thanks …"
Not as bad as you thought? Bearable??? Oh God, House … you can't live like this! It's just not fair, and we've got to find out what it is. Got to fix it!
I tried to imbue my voice with a lot more confidence than I felt when I answered him. "We should get the test results back today. We'll know what it is. We'll take care of it. Promise. Just … hang in there a little while longer."
Bless him, he smiled at me, but it was overlaid with a sadness I could hardly stand. "Shouldn't make promises you can't keep," he said weakly, and I could feel, rather than see, the residual fatigue and after-image of pain the hard spasm had left within him. The discouragement in his voice tugged at my heart, and I found it very difficult to look him in the eyes. I grasped his shoulders and lifted him to an easier position against the pillows; kind of a stopgap to keep from talking and keep him from hearing the catch I knew would be in my voice.
He shouldered further into the pillows, not moving his legs, but dragging them as he shifted his body backward. It was agonizing to watch. He was taking no chances of further pain. I covered his legs with the blanket and sat down beside him again. He was exhausted.
He was looking directly at me when he spoke again. "Been thinking. There's been no improvement. If it were an injury, it would be getting better by now. If the tests don't show anything, I … I want you to do a biopsy."
"No! We'll figure it out! That won't be necessary. House … I …"
"Be objective!" He stated, flatly and harshly. "If I were any other patient, what would be your next move?"
"But you're not any other …" I heard my voice trailing off, and I remember how I lowered my head shamefully, and pinched at the bridge of my nose as he continued to look at me appraisingly.
Ten seconds of absolute silence hung between us, but in no way did it resemble the snark-filled mute conversations we often enjoyed together. "A muscle biopsy," I finally said. "We'll have to wait about ten days because of the EMG. That'll give me time to find someone to do the procedure …"
"No! I said I want you to do it." I saw the plea in his eyes that he couldn't voice, and that I simply could not turn down.
"Okay … I'll do it. Maybe … maybe it won't come to that. We still have ten days for this to resolve." But I didn't bother trying to instill a false hope in my voice. I wouldn't insult his intelligence that way.
It was quiet between us the rest of the day. He stayed on the couch, weary and resigned. He picked at his dinner, and I did nothing to try to cajole him to eat anything more. We stared at the TV, but neither of us could have told anyone what was on. It was only a means of distraction, and both our thoughts were somewhere else entirely.
Lisa Cuddy got there somewhere around 6:30 p.m., and I pulled her into the kitchen to update her. She was shocked and saddened by House's request, but she understood why I had agreed to it. Her hand on my shoulder was a consolation I'd needed badly.
"I'll take care of him this evening," she told me, "and get him settled down for the night. Try not to worry too much. Maybe I'm overly optimistic, but ten days is a long time. Something might still change."
I accepted her offer with gratitude, and her general optimism didn't hurt either. Since the initial shock had worn off, I was daring to hope again for a less drastic answer.
When the courier arrived that night, Cuddy was just leaving his bedroom. She was smiling as she walked down the hall in my direction. She said she'd let House remove the oxygen an hour earlier, and he maintained his sats at 95 on his own. He'd managed a good cough effort after the aerosol treatment. She said he beat the daylights out of her in a game of gin, and then went to sleep like a good boy. I laughed, and that's when we heard the knock on the door.
The courier handed me the envelope with the test results and I took it optimistically. I sat down on the couch, opened the envelope and scanned the contents.
"NO!"
Cuddy heard me and started toward me as I tore frantically through the rest of the pages. I knew she was about to ask me what was going on, but I could feel the heat and the denial rising like bubbles in my blood. I dropped everything on the coffee table. Part of them scattered onto the floor as I escaped into the kitchen with my hands over my face, shaking my head and repeating over and over: "No! Oh no! It can't be … No!"
Cuddy was silent behind me, and I knew she was bent down, gathering up the scattered papers. It got deathly quiet, then the sound of cautious footsteps slowly followed me into the kitchen. I felt her pause in the doorway and stare at me, speechless. Her face was white. Slack.
Eyes misting until the numbers on the front ran together, I dialed the phone …
Oooo0oooO
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