Chapter 21
House sat with his leg up on the desk. Dr. Adukalil sat across from him. Both men looked up when Cameron entered. "How's he doing?" House asked.
"Temperature is about the same. The morphine kicked in. His dad and girlfriend are back. No change yet in his vitals. Dr. Adukalil, Charlie's dad was wondering how long it would take for the bacteriophage to work. Do you have any estimate?"
Adukalil shrugged. "I really don't know. It took several hours in the primates. Some of the bacteria appeared to respond quickly, perhaps within a few minutes. Others took days. The way these bacteria are mutating, it's hard to say. I would expect to see improvement in two or three hours."
"Thanks. I'll let him know."
"Why don't I come down and talk to the family?" Dr. Adukalil suggested. "I'm afraid I did not say two words to his brother when I was in there before. I was too interested in the treatment."
House grumbled, "Talking to families is way overrated. Cameron, why don't you, Chase and Foreman take turns checking on the patient. Draw blood every half hour. Do a CBC so we can monitor the bleeding. Mike, how often do you want blood?"
"Every half hour is good. That way I can keep an eye on the antibodies. I will do cultures, too, but the antibodies will give us better information more quickly."
"All right, little minion. Off you go. And be ready to pack him full of platelets, and have some units of whole blood on hold for him. He might keep bleeding even after the bacteriophage start working."
The nurses and doctors had left, and now Alan, Don, Amita, Larry and Agent O'Connell were the only ones left with Charlie. Agent O'Connell sat in his chair and went back to reading his book, but the others were reluctant to leave Charlie's side. Don brought over two chairs, and offered one to his father and the other to Amita. Amita sat and took Charlie's limp left hand in her hand. He didn't even stir.
Alan murmured his thanks to Don and sat, gently brushing Charlie's hair with his fingertips. "What happened today, Don?" He asked softly.
"We were talking. I was kidding him about Dr. Cameron liking him."
"What?" Amita said, glaring at Don.
"Oh, she smiled at him, and I was kidding him. Don't worry. It was nothing. But afterwards, he looked tired and he closed his eyes, so I figured he was just going to go back to sleep. Then he started rubbing his stomach, and he looked like he was in pain. He said he thought he was going to be sick. Then he threw up, and it looked like it was all blood. He was curled up, holding his stomach. But you know what he did? As bad as he was feeling, he tried to cheer me up."
"That sounds like Charlie," Alan said as he smiled down at his younger son.
"You want to hear something crazy, Dad?"
"What's that, Donnie?"
"I'm glad this didn't happen while he was working on something for me. That's selfish, isn't it?"
"No, Donnie, it's perfectly natural. You don't want to be the cause of your brother's pain. There's nothing wrong with that."
"That's good," Don said, "Now I guess my next issue is wanting to do grave bodily harm to whoever was the cause of Charlie's pain."
Alan chuckled. "As the great philosopher, Mr. T. said, 'I pity the fool.'"
"I hate to interrupt," Larry said, "but, Don, are you proposing to find out who gave Charlie anthrax?"
"Colby says they know who did it: Ali Abu-Hassan's son, Mohammed," Don said.
"But you're not certain?" Larry asked.
"Well, Charlie didn't think Mohammed would do it. He said Mohammed was embracing the modernization of Iraq."
Amita said, "Could he have been faking it? Pretending to support the new government so he wouldn't arouse suspicion?"
"He could," Don said. "When Charlie wakes up, I'd like to talk to him more about it." Don glanced over at Agent O'Connell. "Don't worry, I won't discuss any secret stuff with him. And, anyway, it's a little out of my jurisdiction."
Larry shook his head, "No, Don, I don't believe that anything involving your family is outside of your jurisdiction."
Amita gasped. "Charlie? He just squeezed my hand."
Charlie turned toward the sound of her voice, "Amita?" he murmured.
"Welcome back," Amita said, touching Charlie's cheek. "How are you feeling?"
"Mmmkay. Sleepy."
"Are you in any pain? We can call the nurse."
"Nope. No pain." He opened his eyes, and appeared to be focusing someplace over Amita's left shoulder. He suddenly giggled.
"What?" Alan asked. "Charlie, what's so funny?"
"The horses, and the little soldiers riding them," Charlie said, chuckling. "They're funny."
"Where?" Don said, trying to follow Charlie's gaze.
"Over there. On the window sill." Charlie pointed toward the blank wall behind Amita. "They're silly."
"I think we'd better call the nurse," Don said, pressing the call button.
"No!" Charlie shook his head and tried to sit up. "She'll scare them all away."
Alan held Charlie down. "No, Son, we won't let her scare them away. Just relax."
The nurse entered quietly. "Well, it looks like our patient is waking up."
Charlie put his finger to his lips. "Shhhh. Don't scare the horses."
The nurse leaned toward him and whispered. "I won't. How are you feeling?"
"Okey dokey," Charlie said, grinning. "I like the horses."
"Okay. Why don't I take your vitals while I'm here. I'll be quiet so I don't scare the horses."
Charlie nodded and made a soft shushing sound as he fell back asleep.
The nurse whispered, "Don't worry. That was from the morphine. It's not uncommon to have hallucinations under morphine."
"That's a relief," Don said. "I was afraid he was going nuts."
The nurse took Charlie's temperature and made note of the readings on the machines that were monitoring his condition. "Good news," she whispered, "his temperature is going down."
"Thank you," Alan whispered.
"No problem," the nurse said, smiling. "Don't hesitate to call us if you have any questions about what's going on, okay? I'm sure this is all strange for you."
"You got that right," Don said. "Horses."
The nurse laughed. "You should hear some of the things my patients have seen."
Dr. Cameron entered the room and said, "How's he doing?"
The nurse looked up, smiling, "Fever's down, BP is staying the same. And he was awake for a minute or two."
"Any pain?"
"No. He was seeing little horses with soldiers riding them," the nurse said. "But he said there was no pain."
"That's good. House wants us to take blood and vitals every half hour," Cameron said, tying a rubber tourniquet around Charlie's arm, just above the elbow. She pulled a Vacutainer and a spare tube from her pocket and put them on the table. She pressed on the veins in the crook of Charlie's elbow, then, finding a satisfactory vein, she popped the cover off the needle and pushed it gently into the vein. After she filled the two tubes, covered the puncture with gauze and disposed of the needle, she said, "Oh, Mr. Eppes, I almost forgot. I checked with Dr. Adukalil, and he said he'd expect to see results in two or three hours. It varies a lot, so don't be discouraged if it takes longer."
"That's good to hear," Alan said, "And it sounds like he's getting better already."
"This is encouraging," Cameron said. "His temperature going down and his blood pressure staying the same are both good signs." She held up the vials, "And we're going to check these for red and white blood cells and platelets. That'll tell us the progress of the infection and the internal bleeding. Dr. Adukakil will check for antibodies. That'll tell us if the body is fighting the bacteria."
"And you're doing this every half hour?" Amita asked.
"Yes," Cameron said, "We have platelets and whole blood on hand in case we need them. Dr. Hosue believes the bleeding might continue for a while even after the bacteriophage begin to work. And when we can, we'll start cutting back on the morphine."
Don snickered, "But won't that scare the silly horses away?"
Cameron laughed, "Ah, with Charlie, the morphine makes him see horses, right? I had a patient who saw topless nurses riding wolverines."
"Hmm," Larry said, "I wonder what triggers the hallucinations. But even more interesting would be why one person sees horses and another sees wolverines."
"Well," Alan said, "Charlie is studying the math of the brain. Maybe he can come up with an algorithm to answer your questions, Larry."