"What happened?" House limped into the room, a frown creasing his forehead.
Both Cameron and Foreman looked up, their faces sharing the strain of concern.
"Respiratory depression. I had to intubate him." Foreman fell silent.
House moved further into the room, his probing eyes taking in the form of Robert Chase; his body motionless but for the steady rise and fall of his chest, each movement accompanied by the mechanical hiss of a ventilator.
"Symptoms?"
"He's been complaining of headache for a couple of days." Cameron spoke quietly, her gaze averted. Whilst her face was hidden her voice was awash with suppressed guilt.
"He said he was ill, and I ignored him."
"Let's save the self-recrimination for later, shall we?"
Cameron glanced up quickly before averting her eyes once again. The brief moment had been long enough, however, for House to see them shining with tears.
"So what causes respiratory depression?"
Neither Foreman nor Cameron answered for a moment, their usual quick-fire responses impeded by the unexpectedness of the situation they now found themselves in.
"Anaphylaxes? Maybe an allergic response to an antigen?" Cameron offered the suggestion tentatively.
"Check Chase's file for any known allergies."
"There was no significant swelling when I intubated, the throat was maybe a little red, but otherwise clear."
"Check the level of serum tryptase in his blood anyway."
"Asthma?"
"No history"
"Could be adult onset."
"See if there's a history, look at the immediate family."
"How about Guillain-Barre? Respiratory depression could have been brought on by posterior tongue displacement secondary to loss of muscular tone."
"Possibly. Was there a gag reflex when you intubated?" House directed the question at Foreman.
"I don't know, it all happened so quickly."
House was obviously displeased by this response, but said nothing.
"Well we can't test for Guillain-Barre without a spinal tap, and going by the limited information we have – " he shot a look at Foreman " – we don't know if that's necessary. Considering that treatment for GB is merely supplementary let's leave that one for now."
"How about Botulism?"
"Do we know if there was any vomiting or diarrhoea?"
Foreman shook his head, Cameron shrugged.
"Diplopia? Blurred vision?"
Silence.
House sighed.
"Get a blood smear, look for botulinium toxin."
"The smear will take a while. If it is botulism he could be dead before the results are in."
Foreman interjected, frowning.
"We can't treat it unless we're sure. The anti-toxin itself is potentially lethal."
"Give him 40mg of guanidine hydrochloride."
Cameron nodded.
"What else?"
"Atelectasis?"
"Caused by what?"
"Bronchogenic tumour?"
"Not supported by the symptoms." House shook his head, rejecting the idea.
"We might not know all the symptoms."
"So what do we know?" House barked. "We've spent every day of the last week with him, for God sake! What symptoms do we know?"
Foreman ran a hand across his face.
"He had a cold."
"A cold"
"He was sneezing, flushed."
House looked expectantly at first Foreman, then Cameron.
"That's it?"
Cameron dropped her gaze.
"That's all we know?"
House sighed.
"Start with a plain chest x-ray, no contrast. See if anything shows up. Get a chem. panel, CBC, haematocrit, and coagulation factors… and an ABG."
Their tasks delegated, the group disbanded, leaving the unconscious Chase lifeless behind them.
…………………………
"Chase?"
Chase blinked against the light, trying to focus his blurry vision.
"Chase, can you hear me?"
The voice was familiar; a comforting presence in an alien situation.
"Chase?"
He forced his eyes to remain open, and slowly the concerned face of Cameron came into focus. The room was familiar yet different, white and sterile, a hospital room but from an angle he was unaccustomed to. A faint hissing sound hummed amongst a regular cadence of beeps.
Chase tried to speak but found that he couldn't. Something was blocking his throat, and he panicked, clutching at his mouth to remove the obstruction.
"No. Chase, no." A restraining hand grasped his own. "You have a tube in your throat to help you breathe; you have to leave it there, ok?"
Chase gagged, panic still gripping him.
"Just take a slow breath. Slow and easy, that's it."
Chase followed the instructions and found his fear calming. Turning his gaze to Cameron, he looked at her imploringly, trying to ask the question that he could not vocalize.
"You collapsed, do you remember?"
Chase shook his head gently, trying to think, trying to remember. What had happened?
With effort he raised his hand, trying to signify that he wanted to write.
Dizzy. Sick. Headache.
The words were scrawled untidily across the paper and the effort left Chase drained.
Cameron read the words, digesting them slowly. As an aid to diagnosis they meant very little, corresponding to an unknown number of conditions.
"We're running some tests." Cameron glanced at Chase, then back at the scrawled words. She knew her words were inadequate, but didn't know what else to say.
The sudden rapid increase in the rhythm the heart monitor displayed caught Cameron's attention, and she shifted her gaze up at once. The once regular pattern was now skewed abnormally, and Chase's clear blue eyes were glazed.
"Chase?" Cameron forced her knuckles into the flesh just below his collar bone, but Chase failed to respond.
"Chase?"
"What is it?" Foreman strode into the room, his brow creased as he scrutinized the heart monitor.
"He's in v.fib, we need to shock him."
Cameron and Foreman moved at once into action, their movements perfectly coordinated as they pulled the crash cart into position.
"Charge to two-hundred… Clear"
The shock of electricity jolted through Chase's body, causing him to jerk sharply.
Their activity suspended, Foreman and Cameron turned as one to study the heart tracing. A flat line glared back at them, unashamedly declaring its finality.
"Again!"
Once more a jolt of electricity shook Chase's body.
A small noise signified the return of a normal heart rhythm, and Cameron looked up, her hands still clasping the defibrillator paddles as she watched the green line progress across the monitor.
"Normal sinus rhythm." Foreman spoke unnecessarily, almost as if to confirm the finding to himself.
Breathing heavily Cameron stepped back from the bed.
"What is this?"