Title: The Devil's In the Details
House, Wilson, CuddySummary: The Devil's In the Details
again centers around the House-Wilson-Cuddy bond. The story has a lot of introspection, especially for House and Wilson. The plot (such as it is....) centers around House's undiagnosed left
leg pain. This is the third and final book of the Devil
trilogy, which began with The Devil, You Say,
and continued with Battling the Demons.
The previous chapters can be found by clicking
And here are the chapters for this evening:
CHAPTER NINETEEN: Trials
Throughout the spasm, Wilson sits on the edge of the couch, doing what he can with soothing words. And when that no longer seems enough, he places his hands above the knotted muscle and looks to House for permission. House nods at him, and Wilson firmly works the muscle until he sees House’s face relax, his breathing even out again. And so the pain in House’s left leg eases without the need for morphine, and that makes House and Wilson happy; they both feel as if they’ve somehow won a battle, in a war whose rules are yet unknown to them.
The rest of the day passes quietly. Cuddy senses that something important’s happened in her absence, and that it was good. But she doesn’t question either man; she knows only that both seem more comfortable with one another, that Wilson seems relieved, that House is less distant.
After a quiet dinner, she draws blood for the evening labs; she’ll drop it off at Princeton General on her way home. House has had no further problems with the left thigh since this morning, and Wilson isn’t as weary, as close to the edge, as he’s been the past several days. Cuddy feels comfortable leaving them. When she bids them good night, they scarcely pause in the heated discussion they’re having about tonight’s television schedule. Both voices are good-natured, though, and she can tell they’re having fun.
Several hours later, Wilson’s getting House’s meds and TPN ready for the night. He’s got an ear out for House, who’s in the shower, and he’s thinking that it’s been a good evening; gonna be a good night.
A few minutes later, House is settled in bed, and Wilson’s preparing to hook up his total parenteral nutrition. He checks the insertion site for the PICC line, and looks up at House. “How long has this been red?”
“I dunno. Cuddy did the dressing change yesterday; she didn’t say anything about it.” House studies the site. “Maybe it’s just from the hot water. Doesn’t look too bad to me.”
“We’ll just keep an eye on it. Let me know if it starts to hurt, or if the erythema spreads, okay?” Wilson makes a mental note to run a blood culture in the morning.
“Will do. Hey, weighed myself, up ten pounds now! Five more, I’ll only be tethered to this thing at night.” He glances sidelong at Wilson.
Wilson grins at him. “Good try. I seem to recall that math was never your strong suit, and this one involves double digits, so I’ll help ya out here. Ten plus five equals fifteen. We’re going for twenty.” Wilson’s grin grows wider. “That would be ten plus ten,” he adds helpfully.
“Yeah, I knew that. Just doin’ a little check to see if that lorazepam’s affecting your memory. Or your math skills.”
“No such luck. All it’s affecting is my ability to put up with you. And speaking of pills, here ya go,” Wilson says as he hands House the Zofran and hydrocodone.
“And speaking of lorazepam,” House says, “you taken it yet tonight?”
Wilson feels a quick flash of defensiveness. I’m a big boy; I can see to my own dosing schedule. Before he can say the words aloud, though, he realizes that maybe it’s good for House to be concerned about someone other than himself; maybe it’s even good to let House issue a medical order or two. So, instead of the sharp retort, he answers, “Not yet; I’ll get to it.”
“Why don’t you ‘get to it’ now?” House asks. “We’ll have a regular pill poppin’ party,” he says, indicating the Zofran and the super-Vic still in his hand. “Go get it; I’ll wait ‘til you get back. We can toast ‘better living through chemistry’ together.”
Wilson laughs, nods, and goes to get the little white pill that’s helping him hold it all together. When he returns, he asks, “’Better living through chemistry.’ Very amusing.Original line?”
House shakes his head, “No, commercial slogan. Before your time, kid.” House rolls his eyes like a weary old man; Wilson can tell that he’s in a good mood. “But it was funny then, too. So, uh….” He indicates the pill that Wilson’s still holding, as he takes his own medication.
Because he knows that House expects it, Wilson makes a face at him before putting the pill in his mouth. After he swallows it, House regards him with satisfaction, and it dawns on Wilson that House might actually miss caring for others. Maybe it isn’t all about the puzzle for him; maybe some of it, a little of it, could be the pleasure of help-- nah, this is House. But just in case….
“Hey, could you do me a favor and take a look at my wrist? Lemme know if it’s okay to get rid of this bandage now?” He sees House’s eyes light up as he reaches for Wilson’s wrist. Well, I’ll be damned! He actually does get some fulfillment from the caring. Learn something new every day.
House removes the elastic bandage, checks for swelling, manipulates the wrist gently. “That hurt?” he asks, and Wilson shakes his head. “Should be okay without the Ace. I’ll check it again in the morning,” House says. Then he turns the wrist over, and regards the fading thumbprint-shaped bruise for a while before releasing Wilson’s hand. You never said a word when I did that, Jimmy. Must’ve hurt like hell, and you just stood there. Almost like you deserved it. Wish you’d quit beating yourself up for what came before. And now you’re even feeling guilty in your sleep….
As if Wilson’s read his mind, he says hesitantly to House, “Think I’m ready to tell you the rest of that nightmare now. Wanna hear it?”
“Sure; I love bedtime stories,” House says. Then he sees the serious, almost fearful expression on Wilson’s face. “Sure you’re ready?” he asks, almost kindly.
Wilson nods tersely, but he doesn’t begin speaking right away, and House is beginning to wish he’d told Wilson he was too tired, or something.
Once Wilson does start to talk, though, he appears driven—as if he must get through the horrific story, as if survival depends on it. But whose survival? House wonders as he listens.
“And then, you brought the pestle down on your left thigh. You did it again and again, until there was… nothing left.” Wilson’s voice is faint; his eyes are focused on the awful mental images. House wants to stop him, wants to find a way to chase the nightmare from his friend’s mind. But all he can do is listen.
“I wanted to help you. I tried to help you. I couldn’t. I couldn’t even get to you… and then, when I did….” Wilson closes his eyes briefly; when he resumes speaking, his voice is almost inaudible, and House has to strain to hear the next words. “The muscle was gone; it was dead…. And you laughed.” Wilson shakes his head, as if to clear the memory away, and then he looks at House with eyes that hold an unformed plea, and the vestiges of Wilson’s helplessness.
“Doesn’t take a shrink to analyze that,” House says softly. “Look at me, Jimmy. And listen to me.” House waits until he’s certain that Wilson has come far enough out of the awful story that he’s focused fully on House, in the here and now.
“I am not suicidal; I told you that a week ago, and it’s the truth. Told you I’m not going anywhere ‘til you’ve been raised properly.” House stops speaking a moment, and smiles. “And I’m revising the estimate of how long that’s gonna take upwards every day. I’ll be around to make your life hell for a good long time yet.”
Wilson smiles at that, but the plea is still in his eyes.
House continues, “And you’re doing a good job. The best. Should’ve told you sooner. Should’ve told you better. But I’m telling you now, and I want you to believe it. Dragged you to Hell with me, and you’ve stood guard the whole way. ‘Whatever it takes,’ you told me, and that’s what you’ve done. What you’re doing. So do me another favor, all right?”
House waits for Wilson to nod at him, and he sees that the plea is gone from Wilson’s eyes, sees that he’s answered Wilson’s unspoken question. “It’s a really big favor, but I know you won’t let me down; I want you to get outta here before I get all mushy on ya, okay? And get some sleep. Wait—that’s two favors. You’re right; my math is lousy. Try to handle it.” He shoots Wilson a mock glare.
Wilson is shaking his head and smiling as he shuts out the light. He waits until he’s almost out of the room before he says softly, “Thanks, House.” He closes the door quietly.
CHAPTER TWENTY: Trying
In the morning, the insertion site on House’s PICC line remains inflamed, but it doesn’t seem to be any worse. Wilson draws extra blood from the port for a culture anyway.
Both men have slept well. Cuddy was right; the Ativan hadn’t interfered with Wilson’s ability to hear his watch alarm during the night. He’d been able to check on House, and then return to sleep quickly. And it’s made a difference; he feels more like himself this morning, and far less anxious than he’s been. He doesn’t even hesitate to take the 0.5mg dose that Cuddy had decreed necessary during the day.
House’s night had passed without incident, so he, too, is in good spirits. Wilson wonders about the left leg, though; House doesn’t even ask for his cane when it’s time to go to the living room. When Wilson questions it, House says simply, “After yesterday, figured the chair might be safer for a while.”
Once House is settled on the couch, he uses his doctor voice to say to Wilson, “Let me see that wrist now.” The tone of the statement drives home to Wilson the importance of allowing House to take control whenever possible.
Good to see him get satisfaction out of contributing, Wilson thinks as House meticulously examines his wrist. It’s not only not hurting him to worry about me a little, I really think it lets him feel better about his own situation. Gotta remember that.
“You’re okay to go without the bandage for now,” House tells him. “I don’t want that wrist stiffening up on you. But if it starts to swell again, let me know right away; I’ll take another look at it.”
Matching House’s serious tone, Wilson thanks House, and assures him that he’ll alert him immediately if there’s any change in the wrist. House nods with satisfaction, evidently happy with his patient’s compliance.
Wilson decides that the timing might be good for that talk on self-perception that Dick seems to think is so important. So after breakfast, when House reaches for the TV remote, Wilson stops him.
“Hey, can we talk a few minutes?” Wilson asks him.
“Haven’t we been doing a lot of that lately?” House responds. “Doesn’t a little mindless TV sound like more fun?”
“A lot more fun,” Wilson admits. “But this is important… or so they tell me.”
“Cuddy and Dickinson,” Wilson responds—and now House looks interested. “It’s about the breakthrough pain; the loss of it, I mean. According to Dick, any major life change like that can cause a period of… uh… grieving, and--” Wilson isn’t really surprised when he’s interrupted. “House, would you stop laughing? This is serious.”
House does stop laughing, at least long enough to ask, “Now who the hell would be upset at losing pain?” He considers his own question, and then answers it aloud while Wilson’s eyebrows climb to his hairline.
“Well, maybe a masochist might be upset, but then he’d be in pain ‘cuz he’d lost his pain, so he’s technically still in pain, so there’s really no loss of pain at all, so it’s all good. Which is bad. Or maybe not… if, by definition, you’re a sadist, ‘cuz then that would mean… well, I’m not really sure what that would mean, but it’s something to think about.”
Wilson waits patiently until House has curbed most of his amusement before he continues. “What I’m trying to say is, it’s not the loss of the pain, so much as a change in how people perceive themselves, when something that’s defined their existence is gone.”
“I don’t define myself by my pain,” House responds—and immediately the discussion he’d had with Wilson in his nightmare comes rushing back to him. He shakes his head, trying to clear the memory, as Wilson looks on, concerned.
“What’s the matter?” Wilson asks.
“That dream… the bad one. You told me that the only way I could come to terms with the disability was to redefine everything else, so that the leg, the pain, meant nothing. You wouldn’t believe me when I….” House’s voice trails off. He reaches over and picks up the remote, turns on the television. “I don’t wanna talk about this anymore. You’ve done your duty; you’ve discussed it with me. I get it.” House already has his eyes glued to an infomercial.
Now that Wilson’s finally having this conversation, though, he wants to finish it out. “House.” He waits. “House, please.” Finally, House looks at him. “The concern is that if people don’t come to terms with the changes, it could lead to problems.” Wilson’s been careful to keep the conversation general, careful to say ‘people’ instead of ‘you’; he suspects that House wouldn’t respond well if he made this specific to House’s state of mind.
But now he’s thinking that generalizing it may have been a mistake. So he takes a deep breath, and approaches it again. “Look, it’s like this. You had to live with the breakthrough pain for such a long time, and not only were you dealing with it… alone… uh, you were having to try to convince us it was real. That’s a raw deal. Makes sense that since you had to devote so much energy to getting us to believe you, after while the pain might begin to define who you are, how you feel.”
“It didn’t,” House says shortly, and turns up the volume on the television to indicate the conversation’s closed.
“I agree with you,” Wilson says. House is surprised; he mutes the TV, and actually looks at Wilson.
“You agree with me, yet you insist on discussing this?” he asks.
“I told Dick that you were handling the loss of the extra pain just fine, that I didn’t feel this talk was necessary. And you had only two days of being back to status quo on the leg. So there’s not even been much of a change so far, has there?”
“Not that I can see,” House says. “Tell your shrink that his concern’s misplaced. Tell him I can deal with it—if I ever get the chance to find out what it’s like.” He indicates the left leg with an expression approaching disgust.
“I’ll do that,” Wilson says. “But I need to know what I can do to help you come to terms with all this, and--”
House’s voice is unexpectedly gentle, almost amused, when he interrupts. “Stop already! That’s how you can help. Told you there’s not a problem; stop trying to cause one, okay? In case you haven’t noticed, all you’ve been doing for, what, eleven days, is ‘helping’.”
House quirks his mouth into a half-smile. “And now, in true Jimmy Wilson fashion, we’re moving smoothly from ‘helping’ right into ‘overcompensating.’ So quit it. That’s an order.”
Wilson’s smile is chagrined, and he nods at House. “Yeah. Okay. Sor--” He cuts off the apology, and laughs at himself. “You’re right. So I’ll just shut up now.”
House picks up the television remote. “That’s the first sensible thing you’ve said this morning,” he observes. “So shut up already; almost time for SpongeBob. It’s a good one, too; he and Patrick both get to sing!”
“Now I’m the one in pain,” Wilson mutters darkly. But he feels good; now he can tell Cuddy and Dick that he and House have had the vital conversation, and he’d been right—no problem at all.
CHAPTER TWENTY-ONE: Questions
At lunchtime, House picks at his meal. All Wilson’s attempts at conversation are met with monosyllabic answers. When Wilson questions his increasingly listless behavior, House says he feels all right, claims to be enjoying the taco salad he’d asked for but hasn’t touched. He denies nausea, but something just isn’t right.
As the afternoon progresses, House’s mood becomes apathetic. And when Cuddy comes by after work with a new video game, House’s eyes brighten briefly, but he just thanks her and sets it aside. Cuddy then produces a get-well card for Wilson from the team, and it raises no sarcastic crack out of House. Wilson decides then that something’s up, and it can’t be good.
Cuddy senses that something’s wrong, too, and tries to make House laugh by telling him about Cameron’s reaction to Wilson’s supposed ‘flu. “The first thing she said was, ‘Oh, poor House; he’ll probably get it too. Wouldn’t it be safer to just admit Dr. Wilson?’ And then, of course, Chase pointed out that if you do get it, you’ll need someone to soothe your fevered brow. That cheered her up considerably!”
Wilson laughs; House forces a small smile, but there’s no humor in it— he doesn’t seem interested in the conversation. Cuddy looks a question at Wilson, who can only shrug back at her and shake his head. But there’s no question, to either of them, that even the small effort he’s putting forth is tiring House, so Cuddy cuts her visit short. “Let me know what’s going on with him,” she whispers to Wilson at the door; he assures her he will, as soon as he knows.
After seeing Cuddy out, Wilson goes to sit beside House. “Leg bothering you? Either of them?” he asks.
“No. Just lazy today, I guess. Matter of fact, I think I’d like to catch a nap,” House says.
“Wait a second. Lemme just get a quick set of vitals, okay?” Wilson’s concern is growing; House looks flushed, and his eyes are almost glassy. Wilson reaches for his wrist to get a pulse, and is surprised at how warm the skin is. He turns the arm to see if the erythema at the PICC site has worsened, and is relieved to see that the site is actually clear again. But House’s pulse is slightly elevated. “Gonna get the thermometer; be right back,” Wilson says. While he’s in the bedroom, he also grabs a stethoscope and the pulse oximeter.
As Wilson approaches the couch, he notes that House’s respiratory rate is too rapid, and the effort’s somewhat shallow. He hands House the thermometer. House rolls his eyes, but puts it in his mouth. When it signals, he doesn’t even glance at the reading, just hands it back to Wilson.
“You’ve got a fever. Just 100.8, but enough to make you feel under the weather. Can ya sit up a little? I wanna get a good listen to your lungs.”
Wilson listens closely to the breath sounds. They’re clear, but he thinks they might be slightly diminished on the right. He’s not reassured when the pulse ox result is only 92 percent. He frowns down at House, who’s already lain back and closed his eyes. “I’m not gonna medicate for the temp right now,” he says. “I’d like to watch it a little while.”
House flings an arm over his eyes and nods, clearly disinterested. “Just let me get some rest; I’ll be fine,” he mumbles.
“Okay; here if you need me,” Wilson tells him quietly as he settles himself in the chair with a medical journal he knows he’s too distracted to read. What now? If it’s not the PICC site, could be pneumonia. He’s not been moving around much on his own, especially since the wheelchair. With the larger doses of hydrocodone, his cough reflex is even more suppressed. And as rundown as he is….
Wilson looks over at House, who’s already fallen asleep. He looks better than he did a week ago, and the weight gain’s starting to show. But he still appears too frail to Wilson’s discerning eye. If his temp goes up, or the pulse ox goes down, not gonna wait on the blood cultures. I’ll start a broad spectrum antibiotic tonight. Pneumonia right now could kill him.
Wilson watches House for several more minutes; he’s sleeping soundly now, but his respiratory rate hasn’t slowed, and the effort is still too shallow. Finally, Wilson sighs and opens the journal, trying to keep his eyes on the words, and off of the worrisome human puzzle across the room.
When an hour has passed, Wilson rises from the chair and goes to stand over House. It’s 6:30pm, time to check his temp again. “House, wake up; dinner time.” House shifts position, and turns over so that his back is to Wilson.
“Go ‘way. Not hungry,” he says.
Wilson puts a hand on one thin shoulder, and his lips purse with worry. He draws his hand back and reaches for the thermometer. “You’re burning up. C’mon, I need to get a temp.”
House grumbles, but reaches blearily for the thermometer Wilson’s holding out, and puts it in his mouth. When it beeps, Wilson takes it out. “Almost one-oh-two,” he tells House. “I’m gonna go order a few doses of ceftriaxone from the hospice pharmacy, have ‘em deliver it tonight. And I’m gonna get you some ibuprofen. Don’t go back to sleep now; you need to take it.”
“Uh-huh,” House mumbles, unimpressed.
“I mean it,” Wilson says. “Stay awake a few minutes. Looks like you might have a touch of pneumonia brewing. I need you to take the ibuprofen, and then we’ll get you back to bed. You’re gonna eat some soup, at least; not putting that super-Vic into an empty stomach. You didn’t eat lunch. House, are you listening to me?”
House doesn’t open his eyes, but he actually smiles as he responds. “If I repeat it all back to you, will you go the hell away and let me sleep?”
Wilson can’t help smiling, too; nice to know that House isn’t too ill to give him a hard time. “If you can repeat it all back to me, then you already know the answer to that. So sit up and stop being difficult, or I’ll be forced to throw your GameBoy through the TV screen. Then, you won’t be able to play your new game—which, Cuddy tells me, has fifty-eight levels. Naked girls on level 58. You also won’t be able to watch TV. So we’ll have plenty of time to talk, get in touch with our feelings. All that really fun stuff.”
House’s grin widens, and he opens his eyes. “You really know how to hit a guy where it hurts,” he says, as he struggles to a sitting position.
“Yeah. I lie awake at night, just thinking of ever-more-inventive ways to torture you,” Wilson says dryly. “Glad you liked that one; it’s my own personal favorite.” He heads off to the kitchen to get the Motrin as he allows House’s laughter to ease his own anxiety.
CHAPTER TWENTY-TWO: Breathe
The first thing Wilson does when he gets to the kitchen is to place a call to the pharmacy to order the ceftriaxone; he requests a stat delivery. The sooner they get it started, the better. He also orders three days’ worth of albuterol aerosols and a nebulizer; House’s lack of mobility and the effects of the hydrocodone on his cough reflex have to be countered somehow.
Then Wilson calls Cuddy. He tells her he’s virtually certain that House has pneumonia, and he gives her his plan of treatment. She insists on a chest x-ray for confirmation, and Wilson concedes it’s not a bad idea. Cuddy promises to set up a visit by mobile radiology in the morning.
When Wilson returns to the living room, House has propped himself up on the pillows. He’s awake, but he looks miserable. Wilson hands him the ibuprofen, then picks up the pulse oximeter. After House has swallowed the pills, Wilson hands him the oximeter. House attaches it to his finger and holds his hand up for Wilson to read the number.
“You must not have it positioned right,” Wilson tells him as he takes House’s hand and positions the monitor himself. He gets the same reading, 90 percent. Wilson picks up his stethoscope. “Sit forward and take some deep breaths.”
There’s no real change in House’s breath sounds; his lungs are still clear, but now Wilson is certain that the air exchange is diminished in the right lower lobes—and even the deep breaths haven’t changed the pulse ox reading. “Let’s get you into the bedroom,” Wilson says calmly as he positions the wheelchair by the couch.
House is able to transfer himself to the chair, but it’s clear that this minimal physical effort is difficult for him. He sits huddled in the chair, eyes glazed and unfocused, as Wilson disconnects the IV. “Feel like crap,” he says as Wilson pushes the chair to the bedroom. “It’s cold in here.” That’s when Wilson sees that House is shivering.
Once Wilson has him settled in bed, he takes another temperature. “Your fever’s spiking; almost 103 now, that explains the chills. Don’t need a chest x-ray to tell me it’s pneumonia. No wonder you feel like crap.” While Wilson’s speaking, he’s rolling the portable O2 setup to the bedside.
“What’s that for?” House grumbles.
“Oh, it’s just a little something I like to do when a patient’s O2 sat falls below life-sustaining levels,” Wilson answers lightly. “Humor me.”
“Ninety isn’t that bad,” House counters, shooting a dirty look in the direction of the oxygen setup.
“No, not bad at all—if you’re a lifelong asthmatic who chain-smokes,” Wilson retorts as he connects fresh tubing to the machine and sets the gauge for three liters. “We caught this early, and the antibiotics will be here soon; odds are you won’t need the O2 for long.”
Wilson tries to hand the nasal cannula to House, who patently ignores it. “A touch of pneumonia—not a big deal,” he tells Wilson.
“You’re absolutely right,” Wilson says agreeably. “And we’re gonna make certain it doesn’t become a big deal,” he continues pleasantly as he positions the nasal cannula in House’s nose. “To that end, I’ll start the antibiotics as soon as they arrive, and we’ll start aerosol treatments every six hours. Oh, and your boss has decreed that you’re getting a chest x-ray in the morning. We’re attacking this thing from all sides; it doesn’t stand a chance.”
Wilson is smiling and casual—and laughing inwardly. House is obviously frustrated that Wilson is refusing to engage in debate, and finally, he simply rolls his eyes and leans back against the pillows in an exaggerated gesture of defeat. “Could’ve won that if I felt a little better,” he says, in an undertone.
“I’m certain you would’ve,” Wilson says soothingly, trying not to smirk. “So I won’t hold the loss against you.”
“Big of you,” House mumbles. He’s started to shiver again. “Can I have another blanket? Or is freezing to death part of your overly-aggressive plan of attack? ‘Cuz I hear death cures a lot of things.”
“If you’ll stop whining, I’ll be happy to let ya know.” Wilson places the tympanic thermometer in House’s ear canal. “Sorry,” he says. “Still one-oh-two point eight. Let’s wait on the blanket until it’s below 102. In the meantime,” he continues, grabbing several pillows and placing them on House’s lap, “lean forward for me, gonna do a little CPT while we’re waiting on the aerosols.”
“Chest physiotherapy?” House asks with disgust. “Works great with pediatric patients and comatose adults. I don’t fit in either of those categories.”
Wilson decides to let that one slide—especially since House has already leaned obediently into the stack of pillows in front of him. Wilson cups his hands and starts the rhythmic percussion against House’s back that’s designed to loosen secretions in the lungs. He begins forcefully, but when he sees House wince he realizes quickly that the procedure’s uncomfortable for him; House is still so thin that Wilson feels as if he’s striking directly on bone. He’s glad that House can’t see the sadness on his face as he gentles his hands, and uses precisely the force he’d use with a pediatric patient. And when he finishes, Wilson doesn’t remove his hands; he flattens them out and carefully rubs the skeletal back, to take the sting out of the percussion—just as he’d do for a child.
Wilson feels the muscles relax under his hands, and smiles a bit when House takes a deep, shaky breath, letting go of the tension his frail body had created to defend itself against the blows.
Wilson continues the massage for a few extra minutes, to unobtrusively allow House to regain a bit of stamina before they have to repeat the procedure on his chest. Finally, he grasps House’s shoulders gently, and leans him back against the pillows at his head. House doesn’t open his eyes, and doesn’t attempt to reposition himself; he’s relaxed, and already breathing more easily, and appears content now to submit to the gentle ministrations.
Midway through the chest percussions, House begins to cough. Wilson gives him a handful of tissues, and keeps his hands on House’s shoulders as the coughing wracks his body. But Wilson isn’t surprised when House is unable to bring anything up; the cough effort he’s able to sustain is too weak to be effective.
“Sorry,” House whispers. “I know you need a sputum specimen. Was gonna try. Hurts.” He leans forward and begins to cough again, and this time Wilson wraps an arm around his back, and holds a pillow firmly against his chest, to lessen the discomfort.
Wilson had been prepared to remind him that it’s supposed to hurt, that even ‘a touch’ of pneumonia can mean a day or two of feeling awful. Instead, he waits for the coughing to end, and then he just says quietly, “We don’t need a specimen unless the antibiotics aren’t effective; don’t try so hard. It’s okay; I know. I know it hurts. I’m sorry. We’ve got the secretions moving, though; that’s what’s important.” And he decides to forego the remainder of the CPT.
When the medications arrive a little while later, Wilson draws blood for the labs first; he wants a complete blood count before starting the ceftriaxone, and he’s arranged for the courier to make an early pickup. Then he gives a loading dose of the antibiotic, but elects to wait a couple of hours on the aerosols. House’s fever is finally coming down, his O2 sats are approaching normal, and he’s fallen into an almost-comfortable sleep.
Wilson sits by the bedside for the next two hours, watching as House occasionally struggles for breath. Wilson adjusts the pillows to keep his head elevated, and twice removes House’s fingers from the nasal cannula when he attempts to take it off in his sleep. When the fever finally breaks, Wilson wipes the sweat from House’s face and slides a clean pillow under his head. Then he gently arranges the promised extra blanket over his legs and chest. House continues to sleep.
At 10:30pm, as Wilson’s preparing the aerosol treatment, House awakens on his own. He’s already feeling better, and he takes the nebulized aerosol without argument. When Wilson hands him his medications, he looks at the pills, and then at Wilson. “You already take yours?”
Wilson looks away from him. “Well… no. Figured I’d skip it tonight, uh… just in case.”
House nods. “I see.” Then, he sets his own medication down on the bedside table, deliberately reaches up and begins to remove his nasal cannula.
“Hey! What are you doing? It’s already past time for your meds. And we just got your sats back to normal range!”
“Past time for your med, too. And I figured I’d skip the O2 tonight, so you’d have something real to worry about while you stay awake. Just in case.”
The two men look at each other wordlessly. Wilson’s glaring at House, while House watches Wilson with something approaching amusement. Wilson’s the one to break eye contact. He shakes his head, rubs the back of his neck, sighs. “Fine. I’ll take it. Get the oxygen back on. Take the pills. I’ll be right back.”
When Wilson’s awakened by his alarm at 4:00am, he prepares the neb and enters House’s room quietly. House is sleeping peacefully. His temp’s under 100, his O2 sat is 95 percent—and he’s wearing the O2, as promised. Wilson decides to give the aerosol blow-by; he doesn’t want to wake House, so he holds the treatment by his mouth and nose until it’s gone. Then he carefully does a respiratory assessment, and he’s pleased that House’s respiratory status has remained stable. Okay, House, so I didn’t need to sit up and worry all night. Guess what? Happy to have been wrong.
Wilson gently adjusts a pillow that’s slipped down, and straightens the blankets that House had kicked away. Then he returns to the living room to lie on the couch, and falls easily back into a peaceful sleep himself.
Chapter Twenty-Three: RESULTS