CHAPTER TWENTY-ONE: Blip

Seven hours. It's been seven hours since House went under, and everything seems to be stable. Wilson has slept, soundly, for two of those hours, and according to Cuddy, the time had been uneventful. In the hour Wilson's been awake, House has been holding his own. But now, his heart rate's creeping up and his O2 sats are falling again.

Wilson stands over him, frowning. A thorough assessment had told him only that House's respiratory rate is climbing, heart rate's just a bit fast. And his breathing is becoming shallow. He's in pain, Wilson realizes. He's mournfully awed that House's pain can break through all the layers of sedation. "Now ya see, House, you're like the boy who cried 'wolf.' If you hadn't made the Vicodin look positively…recreational…I'd have picked up on all this a helluva lot sooner." Oh, that's good, Wilson. Let's blame it on House when he can't even fight back. He increases the rate on the morphine to 45mg and glues his eyes to the respiratory monitor.

When there's no improvement after ten minutes—actually, his respiratory rate is increasing, and the sat has fallen another point—Wilson ups the morphine to 50mg and waits. He's so tense he's actually forgetting to breathe properly himself. He forces himself to take several deep breaths, and then reassesses the situation.

He's still got his stethoscope to House's chest when it happens. The O2 sat alarm begins a steady, ominous screech. And House's respirations, which had been hovering at 22, drop to 5 per minute. Wilson tears his eyes away from House; sat's down to 87. "Damn! C'mon, House, let's not do this."

He reaches for the ambu bag, tears it out of its sterile wrap, dumps it on the bed. He briefly considers the syringe of Narcan and decides not to get drastic yet—the Narcan would reverse the problem immediately, and House would awaken screaming in agony and withdrawal, and all the careful work of the last hours would be undone.

He quickly drops the rate on the drip back to 45mg, and picks up the ambu. House's respirations are about 4 per minute now, but his heart rate's still within normal limits, so Wilson has a little time to straighten this out. He pulls the pillow from beneath House's head, tilts his head back slightly, and seals the mask to House's mouth and nose.

As Wilson squeezes the bag rhythmically, his eyes go from House's face, to the sat monitor, to the cardiac monitor. When the O2 sat hits 94, the steady alarm suddenly ceases. The only sounds in the room now are the steady whoosh-gasp of the ambu bag and Wilson's own strained breathing.

The automatic BP cuff inflates, and Wilson sees that the blood pressure and heart rate remain stable. Once the O2 sat hits 96, he cautiously removes the ambu bag from House's face and sets the O2 flow rate on the nasal cannula up to 5 liters. House is breathing 10 a minute now, on his own. He appears deeply unconscious, comatose. Wilson attempts to rouse him, but hard pressure on his nailbeds, even pinching the web of skin between his fingers, yields nothing—not even an increase in heart rate.

Wilson closes his eyes and offers House a silent apology for what he's about to do. He balls his hand into a fist and presses his knuckles, hard, into the center of House's chest. He's always considered the sternal rub barbaric, has used it only twice in his career. After the second time, he'd sworn to himself he'd never do it again.

After 30 seconds of steady, increasing pressure, House responds with a low moan, a slight jerk of his head. Then his hand comes up, weakly, to try to brush away the source of the agony. Wilson breathes again.

He unties the gown and looks at House's chest. Already, there's a large bruise rising on his sternum. He reties the gown and gently places the pillow under House's head. Wilson's fighting the lump that's rising in his own chest, but finally he has no choice; he sinks down into the chair and lets the silent tears escape.

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When Cuddy enters the room twenty minutes later, Wilson is composed again. He'd called her and told her about the incident, said she didn't need to come down, but she's worried about both of them. She squeezes Wilson's arm, examines his face. He's not happy, but he seems calm, back in control, so she heads over to House. He appears comfortable, and the monitors tell her that his vitals are all within normal limits.

Wilson joins her at the bedside. Wordlessly, he lowers the blanket to House's waist, undoes the tie on the gown, and reveals to her what he'd had to do to his friend. Cuddy looks at the spreading bruise and chuckles softly, sadly. She gives Wilson a small smile.

"You're gonna catch hell for that," she says.

Wilson attempts to smile back, fails miserably. "I know. But I don't think even House can make me feel worse than I already do." He shakes his head, reaches out to touch the bruise gently, then reties the gown. "The only good news here is that he came out of level 4 pretty quickly once I put the drip down to 45mg. And he's been stable since then." He sighs. "I told you there'd be blips, but I guess I was hoping I'd be wrong."

"Listen, you got through it—you both got through it. He'll be okay. He is okay. You did what you had to do; you need to let it go. We've got sixteen more hours of this. What would House say if he saw you feeling this way?"

Wilson considers. "He'd say, 'Jimmy, you couldn't have just threatened to take away my GameBoy? That would've gotten my attention a whole lot quicker, and with a lot less physical damage—to me, anyway.' And then I'd duck—quickly."

This time, they're both able to laugh, and their laughter is so full that House stirs briefly in his sleep, and turns his head away from the noise.