Chapter 54
Later that evening, the team tried to wean down the propofol, but once again Issy became agitated when asked to open her eyes. Chase left her at Ramsay sedation level four and told House that they would try again tomorrow. She had been at level five after surgery, so it was an improvement, but not enough of one for House's liking.
Wilson took dinner matters into his own hands again, ordering Chinese food delivery. Sizzling shrimp, Hunan beef and pork lo mein were on the menu tonight. Issy's I-pod was on an Eric Clapton shuffle and House occasionally waved an aromatic piece of food under Issy's nose.
"She's at a lower level of sedation tonight. Sounds and smells will get through better and I want her brain stimulated."
Wilson nodded, although privately disagreeing with House on this matter. Ramsay level four was still fairly high and exactly how much stimuli was getting through to Issy's sedated brain was up for question. However, it wasn't worth an argument with House, so Wilson kept his opinions to himself.
He left around nine, promising to return with breakfast again tomorrow. House flipped around the channels for a while, finally turning the TV off. He stared at Issy for a few minutes as if he could will her to wake up. An idea came to him and he limped over to her IV. He made a slight downward adjustment to the propofol and watched the monitors. After five minutes, there was no change. He lowered it again and waited. This time she was at the same dose that she had been at earlier when she had gotten agitated. He didn't request anything from her, just watched the monitors. Sure enough, after a few minutes at this dosage, her heart rate started increasing. It was not enough of an increase to set off the alarms, but it was significant in House's eyes. He had a theory.
Ringing the nurse and requesting some morphine, he waited until she had brought the syringe and left the room again before testing out his theory. He gave Issy the shot of morphine and then watched the monitors. After five minutes, her heart rate was back to normal. House grinned; his theory was correct. Issy was agitated because she was in pain. Now that the morphine had soothed her pain, he quietly requested for her to open her eyes.
"It's Greg, Issy. You're safe now. Open your eyes for me, baby. Open your eyes for Greg."
He felt such a thrill as her eyelids fluttered. Finally she managed to open her eyes, but her gaze was unfocused.
"Can you see me, baby? It's Greg. I'm right here with you. You're safe now."
It seemed like her eyes were trying to track to the sound of his voice, but then her eyelids fluttered close again.
"Good job, Issy. Can you wiggle your toes for me?"
He glanced down at her feet and saw the movement under the blanket. Smiling, he took her hand and asked her to squeeze it. The resulting grip was very weak, but she had responded to his command.
"Once more, Issy. Open your eyes for me. Open your eyes for Greg."
Her eyelids fluttered and then finally opened.
"That's my girl. Can you see me? Can you see my face? Blink your eyes if you can see me."
Issy's eyes simply closed again, but House wasn't disappointed. With the help of some morphine, he had weaned her down to Ramsay level three tonight. Tomorrow, he felt certain that he could get her off the propofol. She just needed some morphine for the pain and perhaps some Ativan for the agitation. It wasn't easy waking up again after being in a drug-induced coma for a while, something that he knew from first-hand experience.
House made an adjustment to the monitor so if her heart rate went up during the night due to pain, the alarm would sound and wake him up. He put the I-Pod on a nice relaxing shuffle and climbed into the recliner. Grasping her hand through the bedrails, he muttered: "Tomorrow, baby. You'll wake up tomorrow."
With that thought in his mind, and Jackson Browne singing softly on the I-Pod, House fell into a deep sleep.
+++ HOUSE MD +++ HOUSE MD ++++
The monitor had awakened House only once during the night, but another shot of morphine had settled Issy down again. Considering her extensive injuries, it was not surprising that she was in a great deal of pain. The heavy sedation had kept the pain at bay, but once they had started weaning the propofol, her body began reacting to the pain.
When the team arrived on Saturday morning, House explained what he had done. They were surprised at Issy's response, but armed with the new knowledge they prepared to start the weaning process again. This time House gave Issy 2 mg of morphine to take the edge off of her pain first and then they started the taper. By the time the drip rate had been cut in half, Issy was staring to blink and fidget.
Foreman said: "I think she is coming around."
House gripped her small hand in his, his thumb gently stroking the back of her hand. For once, not caring what Wilson or the ducklings heard, House said: "Issy, wake up. It's Greg. You're safe now. You're at PPTH. Open your eyes for me, Issy."
It sounded like Greg's voice, but it couldn't be. He couldn't be here. She was at that abandoned motel with that evil man. The memory of his rage washed over her like a tidal wave. He had ripped her clothes off with that big knife and tried to rape her. When his erection failed, his anger hit epic proportions and he started beating her with a broomstick. She curled up into a little ball, trying to protect her head from his blows. Then he had forced her legs apart, the pain exploded deep in her belly and she mercifully remembered no more.
Then she was back in Akron on the street where she had grown up. Her Daddy had been there and she had wanted to go with him, but he wouldn't let her. He told her to go back, but what was there to go back to? Then Issy heard voices calling her name. One voice sounded like Greg's but that couldn't be. Greg had not been in that awful motel room and he certainly hadn't been in Akron.
The pain was back. It crashed over her like a wave. She tried to moan, but suddenly she realized that there was something over her mouth and in her throat. She tried to take a breath, but couldn't do so. Panic swept through her body and she struggled to free her arms to rid herself of the thing that was in her throat. But her left arm was weighed down with a heaviness that she couldn't fight and someone was holding her right hand in a firm grip. She was trapped! She was going to suffocate! He was going to kill her!
"Issy, it's Greg. Open your eyes, Issy. You're safe now. You're at PPTH. Don't struggle; you're intubated and the machine is breathing for you. Open your eyes and you'll see where you are. You're in the hospital. You're safe now. Open your eyes, baby, please."
That last 'please' was said on such a desperate note. Issy had never heard such a tone come out of Greg's mouth before. It sounded like his voice, but it couldn't be him. Could it? Hoping against hope that he really was there, she slowly opened her eyes.
Her blue irises were the most beautiful sight that he had ever seen. Despite the presence of the other doctors, House smiled at her. "Hey, welcome back."
She stared at him as if he were an aberration. If he were really here, why was there something in her throat, suffocating her? Surely if Greg were here, he would pull it out so that she could breathe. She must be dreaming his presence the same way that she had dreamed about her Daddy.
Issy wrenched her hand out of his grasp and brought it to her mouth. A hard plastic covering was there, but before she could pull it out, her hand was grabbed again.
"Easy, baby. You're intubated. It won't feel very good if you pull that tube out yourself. And you really won't like it if we have to put it back in. Just relax and let the machine breathe for you."
Another voice piped in: "House, she's agitated. We need to sedate her again before she does herself an injury."
That voice. She knew that voice. That was Foreman, the fellow that Greg had been forced to rehire. Her eyes followed the sound of the voice and sure enough, there he was. Next to him was Dr. Taub the one who had stitched her up when Mancini had hurt her. He gave her a weak smile and a wave.
A voice with an Aussie accent spoke up: "Remember me?"
Issy's eyes tracked to the sound, but she knew immediately whom that voice belonged to. It was Dr. Chase, the surgeon with the lovely hair and sexy accent. She looked into his face and he smiled, making him look even more handsome than he usually did. There was something about him that made her want to smile back, but she couldn't with that plastic thing in her mouth.
A gentle voice said: "I'm here too."
Issy looked into the soft brown eyes that belong to Greg's best friend. He seemed genuinely happy to see her. If Wilson were here, perhaps that man really was Greg.
She turned her head to look at him. It was the same intense blue eyes that she had been staring into for months. She could see the little scar on his nose. He had told her how he got it, but at the moment she couldn't remember the story. His scruff was a little longer than usual, but it did really look like him. She pulled her hand free once again and touched his cheek. He covered her hand with his own and pressed her palm to his lips.
His words came out as a whisper: "Mon trésor."
Issy's eyes widened: she remembered those words. She had called him that back in New York. It really was Greg!
Tears pooled in her eyes and leaked out, running down the sides of her face. After a gentle caress of his cheek, she lowered her hand and fisted the front of his shirt.
"Ow, ow, hey, you got some chest hairs there. Can you ease up a bit?"
Issy fisted his shirt even tighter than before. This time, House laughed and leaned closer to her. "I'm not going anywhere. I promise. Wilson will have to bring me a urinal when it's time to tinkle."
He planted a kiss on her forehead and Issy managed to get a whiff of his manly scent. Since he hadn't had a chance to shower yet, his body odor was stronger than usual, but Issy didn't care. The scent told her that this was not a dream. Greg was really here with her. She was safe again. Exhausted, she closed her eyes and fell into a deep, dreamless sleep.
+++ HOUSE MD +++ HOUSE MD +++
Issy was confused when she first woke up. It took her a moment to remember where she was and why there was a tube down her throat. Then it came to her. She had been kidnapped and injured by the girls' father. Now she was back at PPTH, intubated and being monitored in ICU. What kind of injuries had she sustained that necessitated this type of medical intervention?
She glanced around the room; all the other doctors had left. Only Greg remained and he was lying on his left side in a nearby recliner, his hand reaching through the bedrails to hold onto hers. He let out a soft snore; the sound was comforting and she wanted to smile, but the mouthpiece prevented it.
"I'm not going anywhere. I promise. Wilson will have to bring me a urinal when it's time to tinkle."
The urinal might not be necessary, but he was true to his word. He had not left her alone and for that she was profoundly grateful.
The throbbing pain that she remembered from earlier today was still there. She remembered getting hit with the broomstick so the pain in her arm and side was understandable, but why did she have such an ache in her belly and why did the skin on her chest feel so uncomfortably tight?
Issy became aware of music playing and she glanced around for the source, smiling inwardly when she saw her I-Pod set up on the bedside table. Josh Ritter was singing 'Good Man' and Issy wanted to chuckle at the irony of it. Most people thought of Dr. Gregory House as an uncaring misanthrope, but Issy knew that the sleeping man holding her hand had another side, a side that he rarely let people see. She had been lucky enough to be privy to that part of his personality. He had been good to her, so good that she didn't want things to end between them.
She gently stroked the back of his hand with her thumb. That slight movement caused him to wake with a start. He glanced around bleary-eyed for a moment, until his eyes found hers. His smile was wide and genuine and Issy would have given anything to be able to smile back.
His eyes shone as he whispered: "There's my girl."
House eased himself first to a seated position, and then he struggled to his feet. Limping the few steps to the head of the bed, he cupped her face between his big hands and leaned down to kiss her forehead. "Don't ever get kidnapped again. I don't think my old heart could take it."
Tears formed in Issy's eyes and leaked out, running down the side of her face. She could hear the worry behind his gruff tone and was touched by his concern. It just made her love him even more.
He planted another lingering kiss on her forehead and wiped away her tears with his thumbs. "It's nice to see your blue eyes again. I'm trying to behave and let Chase play attending physician, but I'd like to get you off the vent as soon as possible. Believe it or not, I can't wait to hear your voice again."
Issy tapped the mouthpiece and mimicking pulling the tube out.
"You want the tube out too, huh?"
Issy nodded.
With a smirk, he said: "Let me page your attending and see what we can do."
House paged both Chase and Wilson. Even though it was Saturday, and Chase was technically off duty, he was fully expecting the call from House and arrived in ICU in a short period of time.
He greeted Issy with a big grin. "Hey, Issy. Looking good. You seem much more awake and alert this time. What's going on?"
Issy tapped the mouthpiece.
Chase nodded in understanding. "You want the tube out?"
A nod was Issy's answer.
"Let's check you out first and see how you're doing."
Wilson arrived just as Chase was getting started. The two older doctors watched carefully while Chase examined Issy.
When he was finished, Chase expressed his belief that Issy seemed well enough to try to wean off the vent. It was decided that they would stop the machine and let her breathe on her own through the tube for an hour. If she handled that well, they would pull the tube and put her on oxygen via nasal cannula.
Chase explained: "You still won't be able to talk with the tube in your throat, but hopefully after an hour, we'll be able to pull that too."
He turned the vent off and they watched as she started breathing on her own.
Chase held the stethoscope to her chest. "Try to take a few deep breaths for me."
Issy tried, but the pain in her side increased when she tried to take a deep inhalation. She pointed to that area and looked at Chase.
"Yes, it's going to hurt for a while, but you'll need to take deep inhalations every hour to help prevent pneumonia from setting in. If you hold a pillow against the broken ribs, that will help to stabilize them when you take deep breaths."
Broken ribs? What the hell? She gave Chase a questioning look.
Chase frowned: "You do know that you have three broken ribs, right?"
Issy slowly shook her head and shot House a questioning look. He gripped her right hand and said softly: "You haven't been awake very long. Haven't had time to tell you everything yet. Let's take it slow, alright?"
House shot a meaningful glance at Chase as he spoke the last sentence.
Chase picked up on House's message and started off gently: "You have three broken ribs. They will heal on their own, but they'll be sore for a while. It will hurt when you take deep inhalations, but you need to do it to prevent pneumonia from setting in. Both of the bones in your forearm are broken. Dr. Lane reduced them and he put on a splint because you had a lot of swelling. In a couple of days when the swelling goes down, he'll cast it."
Issy nodded.
OK. So she had a broken arm and ribs. That was not unexpected considering that the bastard had beaten her with a broomstick. But what about her belly and why did her skin feel so tight on her chest? What else had happened to her?
Issy pointed to her belly and for a split second, she thought she saw a flash of pain in House's eyes. The look disappeared quickly and House grabbed her hand.
"Hey, I didn't tell you about the girls."
Issy's eyes widened and she shook her head, trying to silently encourage him to go on.
House had hoped that this news would be a good distraction from telling her about the rest of her injuries. He really wanted her to absorb only a little bit at a time.
"I met them, the girls and their mother. They were here yesterday and they want to see you."
Issy had so many questions and was completely frustrated by her inability to talk. She pulled her hand out of House's grip and signed the letters 'OK'.
Wilson was the one to recognize what she was doing. "Hey, are you signing? Do you know how to sign?"
Issy responded by signing 'A, B, C'.
Wilson got the message: "A, B, C? You know the alphabet?"
Issy made a fist and bobbed it up and down.
"So you signed 'OK'. You want to know if the girls are OK?"
Issy's fist nodded yes again.
Chase picked up the recitation. "Maddie had a urethral tear. That was the cause of the bleeding and the painful urination. I repaired it and she's going to be just fine."
House went on: "Their mother is here with them and they all want to see you. Abby is afraid that you are mad at her."
Issy's eyes widened as she signed: "WHY."
Wilson translated her question. House shrugged: "She seems to think that this is all her fault. If she hadn't brought her sister to the ER, her dad would not have kidnapped you and you wouldn't have gotten injured."
Tears leaked out of Issy's eyes as she shook her head back and forth. Her fingers signed: "NO, NO."
House went on: "I told her that it wasn't her fault, that she is only a child and she can't shoulder the responsibility that belongs to the adult, but I think she needs to hear it from you."
A panicked look crossed Issy's face and she frantically signed to Wilson. "DAD."
Wilson answered: "Their dad is dead. The police shot him when they rescued you. Do you remember any of that?"
Issy shook her head, her mind reeling with everything that she had been told. Her arm and ribs were broken, but she had other injuries that they had not told her about yet. Why hadn't they told her everything? The evil man was dead and the girls were safe. That was good news, but why didn't she remember what had happened? Time seemed to have stopped at a certain point of the attack. He pushed her legs apart and then there was horrible pain. What had he done to her? On top of all of that, Abby thought everything that had happened was her fault. Issy needed to see her ASAP and tell her the truth. It had never been her fault; it had always been her dad's.
Issy signed: "NEED TO SEE ABBY."
House stroked her hair away from her face. "I know you do. Her mom is supposed to call me later so that I can tell her if you are up for a visit. You'll want to be extubated so that you can talk to her. Let's see how your O2 sats do so that we'll know if we can extubate you today or not."
Issy sank back into the pillow, tears leaking from her eyes once more.
House asked: "Issy, are you in pain?"
She nodded.
"Let me get you some morphine. Pain causes you to take shallow breaths and that will lower your O2 sats. It's already fallen to 95. Let's get your pain under control so we can get you extubated."
Wilson rushed out to get a syringe of morphine. When he returned, House promptly shot 2 mg into her IV line. "This should help. Just relax. We'll be right here."
Issy tried to fight the effects of the morphine, but in the end, her eyes closed as she dozed off from the medication.
The three doctors watched the monitor. The relaxing effect of the morphine allowed Issy to take deeper breaths and her O2 sats slowly crept back up to 97.
Chase said: "We'll see how she is when she wakes up, but if she stays here, I think we can extubate her. When are you going to tell her about the rest of her injuries?"
House shrugged and glanced away: "You're her attending; shouldn't you be the one to make that decision?"
