Chapter 5

Changes – Part 1

15 April

Cuddy's heart rate hovers around 90bpm, not great considering she's asleep, but the ECG stays steady. BP is 90/60. As I hang another bag of Ringer's lactate, the door slides open behind me.

"You've been here for three days solid," Wilson says. "You should let the nurses do their job."

"Nurses will screw something up." My legs wobble, heavy eyelids blurring for a moment. I shake if off. Getting as many doses in her as possible while keeping her BP up, her heart rate down, and avoiding fluid overload is a balancing act. One I'd rather not trust to anyone else. "I have to do this myself."

She stirs, half rolls onto her side.

"At least go to your office, try to sleep for a few hours. I'll stay with her."

I squint at him, then at the wall clock. It's 9:30. Gave her the morning dose an hour and a half ago. The next one isn't until 4PM. There's a stab at my leg, a spike in the ambient pain level. Time for another pill.

"Wilson's right," Cuddy murmurs.

I freeze with the bottle in my hand. She was more aware than I thought.

"Get some rest."

I glance at her, then Wilson a final time. "Fine."

A rattling sounds in the periphery of consciousness. A latch clicks. I wake up. The dim surroundings of Wilson's office, curtains drawn, return to focus. I roll my neck across the sofa arm, glance at the door. Someone must have peeked in a moment ago, probably expecting Wilson and finding me asleep on his couch, instead.

It's a little after eleven o'clock. Still tired. I roll onto my side, eyelids drifting closed. The blackness swallows me again, extinguishes the sting of waking reality. Only to grip me with a sense of impending doom.

Her voice lashes like a whip, hissing into clarity."Why keep deluding yourself?" Amber blinks through the amorphous void, in front, on my left, on my right, condescending smile, a blade searching for a weak point. "You know how this is going to end."

"This is getting really boring." I tap my cane at the non-existent floor to a cavernous echo. "The whole intruding my dreams and wrecking what little sleep I can manage with your tired banter."

"Keep pretending you don't care." She blows at my ear. "Keep pretending Cuddy has a chance."

I force a yawn, hand in front of my mouth, ignoring her static warps from one side to the other.

"You're not a first year med student," she says. "You know damn well interleukin-2 has a poor response rate in cancers with her cell type. A cure is a fairy tale. Something I'd expect from a child who still believes in Santa Claus. Not someone with your logical mind."

She phases through me. "Wilson knows. He'd be a pretty poor member of his field if he didn't. And you know he's not. He's just humouring you."

Her eyes are inches from mine again. "Painting stripes on a horse doesn't make a zebra. She's not a special case just because you want her to be."

She materialises below me, a pane of glass. Perfect. I slam my cane into it. A spiderweb forms in the surface. Her eyes keep taunting.

"Why don't you try something more interesting?" I bash again.

"Okay." She smirks, exploding into shards, blowing me backwards, blasting my eardrums with the reverberating shatter.

I lurch awake, plant my feet on the floor, steady myself. Maybe coffee is a better idea.

Cameron, Chase, and Thirteen sit around the conference room table, studying a case file. "Thought you were taking some time off," Cameron says.

"What, a man can't come into his own office for coffee?" I limp past them to the counter.

"Sure what you need right now is coffee and not sleep?" Chase squints.

"Yup." I fill the machine.

"Ask what they're working on." An annoying whisper swims into my ear. "Go on."

My hand freezes at the coffee machine button. A knot catches in my throat, seems to sink to my stomach. My eyes close reflexively. I'm not dreaming. That means...

"Are you okay?" Cameron's voice bombards me from behind.

"Great question." I flip a sarcastic glance back at her. Chase and Thirteen look at her and then at each other. Yeah, we all know Cameron never learns.

"You said to try something different." Amber. Just her voice. She's not in the room. I want to snap at her that this isn't creative. It's just as worn out as her other attempts. But obviously I can't. More importantly, it wouldn't be rational.

The pot bubbles.

"Head CT and LP showed nothing," Chase says to the others. "Spinal MRIs and EMG were clean."

"You need to focus on Cuddy," Amber says. "But what you really want is to hide in this case, go on like nothing's changed."

Don't need her telling me that.

"Neuro-otological pathology could have caused loss of balance."

"Calorics were normal."

I can't stop myself. "Who's the patient?"

"Refrigerator mechanic, no family, in and out of work," Chase says. "Just won $42 million in the state lottery."

"Nice." I pull my lips into my mouth for a moment, then turn to grab a mug. "Too bad it won't make any difference once it's all blown on cocaine, hookers, and super cars."

"Hm. I dunno." Chase reclines his chair on its back legs. "He might not screw it up. That kind of money, he could turn his life around."

"But we know differently, don't we?" comes Amber.

"Miserable stays miserable." I put the mug under the coffee maker and watch it trickle for a bit. "Happy doesn't buy lottery tickets in the first place."

Thirteen locks her hands together, elbows on the table. "Our level of happiness is set," she says. "It's in our DNA. No cash payout's gonna change that."

"Wow." I take the mug, press it to my lip. Too hot. "It's like there's two of me."

Surprisingly, Cameron doesn't bother arguing."It's likely that years of exposure to toxic chemicals could have damaged his brain."

"Possible." A soft blow sends ripples through the coffee. "But the sudden disease may have come from his sudden millions. Could be buying something, collecting something stupid and contaminated—ceramics, precious metals—which gave him atherosclerosis of his carotid arteries."

A sip is tolerable now. "If I were you, I'd search his home."

"That would be fun, wouldn't it?" Amber muses. "Chance to get out and away from it all, play detective."

I ignore her. "So, has Thirteen told you why she was gone?"

"Good idea," Amber says. "Stir up some drama with the team."

Thirteen sends a look, half concern, half annoyance.

Chase glances at her, then me. "Erm... no."

She crosses her arms, posturing defensively.

I take a longer sip. "Too bad."

I hook my cane on the bed rail and go to hang the fresh bag of IL-2 on the crowded IV stand. Arlene's legs are in the way.

"You'll have to move."

She pats Cuddy's hand and turns to me with a glare. "Shouldn't a nurse be doing this?" She lifts up, scuffs her chair back, creating a small gap.

"Not my speciality, but I think I can manage." I squeeze in and slide the bag on. "Much more than can be said when you decide to cook."

"I don't think I like you handling my daughter's treatment."

"Mom," Cuddy scolds. "I'm an adult."

Arlene glances at her dismissively before returning her sour gaze to me.

"Really? Not confident in my ability to swap IV bags and monitor vitals?" I adjust the drip. "Pretty sure they covered that at some point in med school."

Her eyes narrow. "Did they also cover going behind your patient's back at every chance?"

I slide out from the gap and grab my cane from the bed railing. "Oh, right. I never did apologise properly for saving your life. Sorry about that."

Cuddy groans. "Would you two stop?"

"I'm just a little concerned," Arlene says, ignoring her exasperated daughter. "You're not exactly the most mobile member of staff." Her eyes cut to my leg.

"Just how much running do you think I need to do in here?"

"Seriously. Stop it. Both of you." Cuddy grips the railing and pulls herself up. "You're not helping."

"Sorry," Arlene blurts stiffly. "I just don't understand why someone else can't do this."

My hand slides over the smooth hook of my cane. I bite my tongue to keep from lashing.

"If you don't want to be here, go home, Mom."

"I just got here." Arlene brushes her slacks, indignant. "I'm not letting anyone force me away."

"Then you'll have to get along." Cuddy stares hard at her, then me.

Great. I need another oxy. Arlene scrunches her brows as I pull out the bottle and pry off the cap. Her mouth starts to open, then her eyes roll to Cuddy and she stops herself.

"Hm. You sure that's for your leg?" Amber's voice slashes through my brain. "Just keep popping them like candy. That'll solve everything."

My fingers tighten around my cane. This is worse than Arlene.

"You'll be back in Mayfield before you know it. Clawing the bed, thrashing around all night, unable to shut me out."

More like I'll just be bored out of my mind.

Clacking shoes echo from behind. "Mommy!" Rachel runs in, trailed by Julia at a normal pace.

"She kept asking to see you." Julia steps up beside me.

"Oh, I really didn't want..." Cuddy pauses, chapped lips sticking together.

Rachel pounces at the bed, IV cords tangling around her legs. I catch her and lift her free, set her beside Cuddy, who hugs her weakly.

"Sorry to leave her on you." Cuddy reaches towards her sister.

"It's okay." Julia takes her hand. "One more's not a big deal. Rachel's having a good time at our place."

Rachel cocks her head towards her aunt. "Am not."

"Rachel." Cuddy sweeps her bangs. "That's not polite."

Julia smiles. "She sounds like her grandma."

Arlene pulls a stick of gum from her purse, unaffected.

"I wanna play click-click with House." Rachel juts her chin towards me.

My feet slide me back a step.

"Click-click?" Cuddy's finger stops moving along Rachel's forehead as she turns to me.

"Oh no." Amber is like a stabbing headache. "Wouldn't want her to find out you were training her little girl like a dog, would you?"

"Oh, it's nothing," I say to Cuddy. "Some game she made up."

"Go ahead. Ignore me." Amber's voice gets louder. "You won't be able to for long."

16 April

There's another sharp flick at my ear. My heavy eyelids shoot open and I lurch forwards in the chair by Cuddy's bed. Must have fallen asleep for a few minutes. Amber won't let me have more than that.

She looms over me, smirking. "How long do you think you can keep this up?"

"How long can you?" I ask, low, to avoid waking Cuddy who writhes every so often, sweat beading on her forehead.

"Nice retort." Amber leans in close, hand on the back of my chair. "You're already losing your mind. You can't even see it." Her breath tickles my neck, as real as the stiff arm rests digging into my elbows, the drip of the IV, or the flock of pigeons fluttering by the window.

Cuddy stirs, digging a reddened place on her arm. "I'm still itching," she murmurs with half-closed eyes.

Bilirubin levels are fine. It's not her liver this time. Probably cytokine mediated irritation of peripheral nerves. "I'll get you some gabapentin." I use my cane to tap the button to call a nurse.

Her eyes widen and fix on me. "You said that before."

My arm freezes, cane still extended. No, I didn't. I draw it back slowly. "I think I'd remember."

"See?" Amber smiles again. "Day four of high-dose IL-2 and Cuddy is more lucid than you are."

I want to snap at her. Some sort of logical riposte that will prove she's wrong. I can't. And not only because Cuddy is staring at me. My mind can't form an argument. It's the lack of sleep. That's all.

"He had a focal seizure. It's neurological, but not toxic inhalation or metal poisoning." The words come into focus before I realise who's speaking them or that I'm standing in front of the conference room table.

"Neurological Lyme's Disease would explain the seizures... and the paralysis," Cameron says slowly, clearly paying more mind to scrutinising me.

Are we talking about lottery guy? Obviously I can't ask that.

"Wondering why you're here, aren't you?" Amber pushes a breath at the back of my neck, pricking up the little hairs. As if I could forget her for a second.

Chase sets down his mug to hurl me a similar look of scepticism. Coffee? What time is it? "Er... antibody titers were negative for Lyme's Disease," he says.

"Postural hypotension," Thirteen offers with an arched brow. "Could have reduced the blood supply to his brain."

"Is something smeared all over my face?" I limp a step forwards, a sense of action to substitute for a concrete goal.

They exchange glances.

"No? Then stop staring like there is."

"He'd be a miserable wretch," Amber whispers in my ear. My lips move without my telling them to, repeating her words. "He'd be a miserable wretch."

Cameron straightens her shoulders against the chair back. "Actually, the prognosis is—"

"Oh, I'm sorry." I cut her off. My fingers squeeze my cane handle, a metaphor for wringing out the intent under the fog. It wasn't Amber's idea first. I know what I'm thinking. She's not telling me anything new. I can always take a jab at a patient."No, I just meant his life is gonna unravel."

"Are you sure about that?" Amber comes around to my side. "Hey, maybe you're really talking about yourself."

"It's not postural hypotension." Chase faces Thirteen. "He's not orthostatic." He turns to the pen on the glass below him, gives it a click without lifting it, then looks at me. "Yeah, his life could unravel, or maybe not. He's not going after material things."

Amber brushes against me on her way by, provoking an instinctual shudder. She stops in front of the window, peering for a moment before flicking a backward glance. "Nice way to divert your broken mind from all the things that really matter."

My jaw clenches, cane wobbling from front to back. I let her turn to a blur against the overcast sky on the opposite side of the glass, the team sharpening into focus."Too bad," I say. "He might actually get those."

"He's looking for the love of his life." Cameron pouts her lips. "That's something."

Thirteen arches towards the table. "And she'll never live up to the memory. The thrill of finding her will wear off and he won't even be able to dream about being happy."

"Interesting. Down on the patient's romance because your own lifespan is shorter than dinner and a movie?"

"You're the one who said miserable stays miserable. You keep saying it. Several times a day." She pushes her hair behind her ear as her gaze turns to where Amber stands at the window. "I love being back, having every theory you and I share used as proof of my own personal damage."

Amber flicks the blinds away and lets them smack against the window frame. Flap.

Thirteen doesn't react. Because it's not real. It's not really moving.

Flap.

I clench my eyes shut.

Flap.

"Are you okay?" Cameron asks.

"Headache." Fixing on the table again, I try to ignore the moving blur in the periphery.

Flap.

"Anyway, more importantly," Thirteen redirects. "A quest for his lost love doesn't mean he's not been sleeping around. Could be Herpes encephalitis. Would explain the neurological symptoms."

"No, he doesn't seem the type to do that," Cameron argues. "He's really committed to finding Jennifer."

Flap.

I pound my cane to the carpet. "Wow." And again, in time to the annoying blinds smacking. "Already know the name of the lost love."

Questioning returns to the eyes of the team, flicking between my face and my cane.

I grind the tip into the carpet, along with the urge to stomp it louder. "As fun as it would be to watch you two fight about this for the rest of the day, we've gotta move on. EEG to confirm. IV acyclovir to treat."

The flapping stops. "Is that safe?"

And the hazy blob transforms into a gloating Amber once more as the team push out their chairs. They hesitate a moment, then disperse around me without another word.

"Calling for treatments in your condition, I mean." Amber strides across to me.

The conference room door swings closed. "Do you even know what's going on?"

The footsteps become distant in the hall.

"Of course I do," I answer before considering it.

Images return in piecemeal. Hanging another bag of IL-2. It was time. But what were Cuddy's vitals? The digits on the monitors are a contiguous smudge in my memory. It's Amber's fault. She prodded me constantly. Couldn't ignore her. I had to say something back. But I couldn't. Not with Cuddy tossing and turning, and complaining.

A hard swallow gulps down.

"You remember, don't you?" Her lips twist to the side in a smirk.

No. Not entirely. What did I give her? Why did I leave her and come here?

I lurch myself to motion, out and down the hall as fast as my limp will allow.

The unmistakable staccato beeps flood my ears as I round the corner. I push my numbed leg faster and faster, rocking with jagged motions.

Through the glass, the code team surround Cuddy's bed, pumping a bag-valve-mask over her face, compressing her chest, charging the defibrillator paddles.

"Go ahead. Get in their way." Amber's voice causes me to freeze at the door. "That'll definitely clean up your mess."

"You did this."

"No. You did. I'm not real, remember?"

It's stupid, infantile, vulnerable, but I can't stop it from tearing through me and bursting from my throat. "Shut up!" The force leaves me shaking, cane wobbling.

Her lips form a line, a brief resignation. Then the twinkle of malice flares in her eyes again. They're fixing on something over my shoulder. Someone.

Wilson. He blinks in quick succession, mouth half-open in the stage of searching for the right words. "Who... who were you talking to just now?" he asks after a moment.

I turn back to the glass, back to the figures flurrying around Cuddy's body, all hands pulling away, paddles going down. A jolt. Back to chest compressions. One. Two. Three. I lose count. His gaze is like a 12 gauge needle in my neck.

"Really?" I whip around. "That's what you care about right now?"

"All right, then." He crosses his arms, eyes flicking between the crisis in the other room and me. "What the hell happened here?"

A few breaths pour out of me.

Arms tangle, one set maintaining chest compressions, another guiding the endotracheal tube in, another charging the paddles a second time.

"Pushed too hard."

He squints, surveying the space around us. "That's all?"

"What else do you need?" I can't stop a sideways glance to Amber, silent in her self-satisfaction before I look in the room again. "It's done. Nothing can change that."

The ECG shows normal rhythm. She's plugged to a ventilator. The team step back, heaving sighs and glistening with perspiration. It's over.

"It doesn't matter how it happened." I turn to Wilson. "I can't do this any more."

His brows quirk up. He didn't think I'd admit it. I'm not that stupid. Something needs to change.