PART II

Ch. 4

Wilson shifted in his chair, trying to find a more uncomfortable position.

If he was uncomfortable, he reasoned, he might stay awake more easily. He studied House's unconscious face from the new angle. Ironically, House actually looked better than he had in the ER. Some of the gauntness was gone from his features, but it was not the result of any real weight gain but rather of fluid retention caused by the kidney failure. And despite that, he still looked drawn and sick.

Many people's personalities assert themselves even when they are asleep: Wilson remembered particularly his second wife's face, which in sleep bore a pinched, resentful expression she managed to suppress when she was awake. His first wife, when asleep, looked even more childlike and confused than when she was awake. But House…his features might be called handsome, and they were especially so when smoothed out as he lay on his back in the bed; but in repose his face was wiped clean of all the personality that animated it to such an extraordinary degree when House was awake. He didn't really look like House. He looked like any sleeping man. An empty vessel.

But as Wilson watched, House's face changed. The change was so subtle as to be almost imperceptible. It certainly would not have been obvious to anyone not schooled to notice such things. His eyebrows moved a fraction of an inch higher, and a small furrow appeared between them. Oncologists—and anyone involved in pain management-- are taught to read the faces of patients who are unable to communicate. Wilson instantly recognized the subtle change that had come over House's face as a classic sign of pain. He cursed himself for a fool and pushed the call button for a nurse.

It took forever for the nurse to respond. What, was she walking through molasses?

"What orders has Dr. Chase left for pain meds?" Wilson asked the moment the laggard appeared in the doorway. The nurse, who was actually a little out of breath from hurrying, consulted the patient file in her hand and wondered, not for the first time, who had kidnapped the mild-mannered Dr. Wilson the nurses all knew and loved and left this short-tempered wretch in his place.

"Nothing," she said. "There are no orders."

"That's just insane," said Wilson. "Page Dr. Chase for me." He remembered at the very last instant to add "please," but the nurse was gone by then.

*****

It was Cameron who finally brought him a cup of coffee. Probably it was an excuse for her to check on House as much as anything, but Wilson took the Styrofoam cup gratefully.

"How is he?" she asked, her glance skittering from the monitors back to the bed. "He looks…really bad."

Wilson had already closed the blinds to the room, and now he stifled an urge to pull the sheets up over House, to keep curious eyes off his semi-naked form, which was laid out on the bed, tubes and wires stuck to it like some sort of insect specimen pinned to a wall that doctors, nurses, orderlies, med students, and virtually anyone seemed to feel they had a right to examine, poke, prick, measure, or just plain ogle. True, being in the ICU by definition meant an uninterrupted stream of intruders—someone was always needing a specimen of this bodily fluid or to regulate that med. But House, he'd come to realize as he witnessed the comings and goings, must occupy some sort of strange niche in the hospital's collective unconscious. An unusual number of staff had found an excuse of some sort to come into his room, just to look, as if they needed to see with their own eyes that the legendary doctor, the indomitable, irascible force of nature that was Dr. House, had been reduced to the frail figure in the bed hovering between life and death.

Coffee was Cameron's excuse. But for that cup of coffee Wilson was deeply grateful, since everyone else in the damned hospital seemed to have decided, like some sort of communal barkeep, to shut him off.

"He is pretty bad. Still unconscious. And just had another seizure."

"What's the diagnosis?"

"You name it, he's got it:"

"But he'll recover, right? I mean, he's…House." She shrugged, unable to come up with a better explanation for why he couldn't die. All part of the legend, Wilson realized. But he was still amazed at her naivete. Or were they all guilty of a similarly naïve assumption?

"Sadly, that doesn't count for much when you're fighting off infection and your lungs and kidneys don't work. Turns out you can't simply browbeat electrolytes and bacteria into doing your bidding."

The coffee was the poor, thin stuff they brewed in the cafeteria—what House referred to as pee pee de chat—but Wilson pulled the lid off the cup and drank it down in three long swigs.

Cameron tore her gaze away from the unconscious House and widened her eyes as she watched Wilson finish the coffee.

"Thanks," he murmured, wiping the back of his mouth with a hand.

"I could just get an IV started, pump it straight into your jugular," she suggested.

"But then I'd miss out on the delicious taste part," he said with a rueful half smile.

"Cuddy says you're going for the world no-sleep record. She's a little worried about you."

"Never trust that woman to bring you coffee," said Wilson vehemently. "I think she dosed the last one with Ambien. It took three No Doze to stay awake after that." He stifled a yawn and then suddenly looked closely at Cameron. "You didn't put anything in this one, did you? Cameron?"

"No! I promise! There's nothing in there."

Cameron was such a lousy liar. "Not even…caffeine, right?" said Wilson. "This is decaf." He threw the cup in the trash with disgust, and reached for a phone, but at that moment Chase entered the room with the charge nurse.

"He's not on any pain meds? What were you thinking? "demanded Wilson, without preamable.

Doctors were widely known to make the worst patients, but no one ever pointed out that even worse than a doctor-as-a-patient was a doctor-as-a-friend-or-relative of a patient. Wilson should long ago have been hauled off and drugged and tied to a bed somewhere. His ragged mind had clearly forgotten his earlier conversation with Chase over painkillers. A sense of pity for Wilson's position allowed Chase to forebear bringing up that earlier conversation now, but he couldn't keep the note of irritation out of his voice

"I was thinking that it would be better if I didn't kill the patient."

"He's in pain," said Wilson, gesturing at House. "He needs something."

Chase looked closely at House's face. The furrow had deepened, a new one had appeared above his eyebrows, and tiny lines were visible at the corners of his eyes. It was clear that House was hurting. He shook his head.

"I'm sorry. There's nothing I can give him that won't make his condition worse. Morphine and all the opiates, hydrocodone--they all depress the respiratory drive. And the others, all the NSAADs, stress the kidneys or the liver. He can't afford that right now. Even aspirin is too risky. And given the choice between killing him and leaving him in pain for a few more days, I chose not to kill him."

Chase's logic was irrefutable but that didn't mean Wilson had to like it. "What's she doing now?" he asked as the nurse begin setting up some equipment. The need to know every detail, every facet of what was happening to House had become an obsession. This time he was going to keep things under control.

"We're going to prep him for dialysis. Start a sub-clavian line."

The relief showed in Wilson's face. Dialysis was House's last, best hope, both for survival, and for recovering some kidney function. But it wasn't easy to slot someone into the full dialysis schedule. "That's great," he said. "When's it happening?"

"We're prepping him now, just in case," Chase said. But he shook his head. "They don't have an official opening until tomorrow night."

"That's not acceptable," said Wilson, struggling to keep his voice calm. "He could be dead by then."

"You know that we've only got one dialysis center, and he's too critical to be moved to another hospital. We have no alternative."

"House wouldn't accept that as an answer," said Wilson. "He'd find a way to jump the queue if it was his patient."

"Look, Dr. Wilson, I've already gotten Dr. Cuddy to move him up the list in front of four other patients. But everyone else on the list is just as critical as he is."

Wilson glared at Chase, but once again he couldn't argue with his logic. He rubbed the back of his neck tiredly and nodded . "All right then. We'll just have to keep him alive until tomorrow."

Chase looked at him, at the nearly purple circles under his eyes, his unkempt hair. And you seem to think you can do that by sheer force of will, he thought. He exchanged looks with Cameron. She was clearly thinking the same thing.

"If you got a little sleep," she said gently to Wilson, "you'd be in better shape when he wakes up. And staying here with him will not, by itself, keep him alive."

Wilson didn't even look at her. "You don't know that," he said. What he wanted to add, but couldn't find the words to explain, was that it wasn't so much his presence—his conscious, awake presence--that would keep House alive, but his absence that might let him die. House would simply be unable to die under his watchful eye. He couldn't explain that, so he settled for something more rational. "The next 48 hours are critical," he told them both. "He needs someone to monitor his meds and his vitals twenty-four/seven. You said so yourself, Chase."

Technically Wilson was right. With a patient in House's condition, it was going to be a constant, continual struggle to keep one step ahead of the changes in his body. All his electrolytes needed constant monitoring: too little or too much potassium or sodium could kill him. Keeping his blood pressure in normal range required a complete pharmacy full of carefully monitored drugs.

"Dr. Wilson," Chase explained patiently, "there are machines to do that. And the nurses are in here constantly checking on him."

"That's great. And I'll be here, too. Just in case."

In that case, thought Chase, you might as well make yourself useful. "The fact that he's registering pain means he's slowly regaining consciousness," he pointed out. "Maybe you could try to wake him up enough for us to do a neuro exam. He might respond better to your voice."

"Fine," said Wilson. "Lend me your penlight." And he moved to the front of House's bed and shook him gently by the shoulder.