Summary: Wilson is given an unexpected opportunity to prove his friendship to House. This story is my own attempt to make sense of the unsettling disruption of the House-Wilson dynamic in Season 3, so mention is made of many of the S3 plotlines and character development. House-Wilson-Cuddy angst, hurt/comfort, introspection--my usual gig. ;) x-posted
CHAPTER FIFTEEN: PAINFUL REALIZATION
When House awakens in the early afternoon, the strength of his voice startles Wilson. “How long we been here?” he demands, eyeing the IV poles around his bed.
Wilson looks at his watch. “About eighteen hours now, I guess. Why?”
“By my calculations, should’ve had two doses of vancomycin by now. Don’t see any.”
Wilson peers closely at House’s face. He seems lucid; he’s certainly coherent, but…. “Don’t you remember? Chase was here a while ago; we discussed it with him. Last vanc level was still too high; gotta hold off until it drops.”
House sits up in the bed. “No! Need the vanc; fightin’ MRSA here, remember? Seems like you’re the one with the memory problem. Now let’s get it in here; you people are morons. Even stuck in bed, I’m a better doctor than all of you put together; good thing I’m on the case!” House is becoming increasingly agitated; Wilson sees that he’s begun to perspire. And now his respiratory rate is not only too fast, his breathing’s become labored—he looks and sounds like he’s just run a few miles.
Wilson stands and walks to the head of the bed, waits until House looks at him. When he’s certain he has House’s attention, he tries again. “House, there’s nothing to worry about. The vanc level is still within therapeutic range. We’re having some problems with your kidneys; they aren’t excreting the drug. The good news with that is, the vanc’s still covering the infection. Do you understand?”
House explodes angrily, “I understand the MRSA’s not being treated! And I understand… I understand….” His voice trails off abruptly; his eyes dart around the room, and Wilson sees the beginnings of panic. When Wilson places a hand on his shoulder he frowns, and looks up at Wilson. “Why... are we... here?” His voice is low again, and strained; he’s pulling in air between words.
Wilson presses the call bell discreetly. “We’re here because your kidneys are shutting down. And you have an infection; we’re treating it, and everything’s fine,” he says soothingly. Pulse ox is down to 88%; respiratory rate’s over 40; looks like he’s starting to head towards respiratory arrest.
Judy enters the room. Never removing his eyes from House’s face, Wilson tells her calmly, “Page Dr. Chase. Stat. And get me two milligrams lorazepam IV.” She nods and hurries off.
“You’re lying to me! Thought I wouldn’t figure it out? Tricked me; forced me into rehab, tried to tell me I’ve got an infection. Kidneys are fine, I’m a nephrologist, I’d know! You can’t hold me here; haven’t done anything wrong. I’m outta here!” House stops shouting, but begins to try and get out of bed.
Chase and Judy arrive simultaneously, as Wilson struggles to restrain House. Chase takes the syringe from her hand and moves quickly to the bedside. “What happened?” he asks Wilson as he injects the sedative into the IV port.
Wilson’s got his hands clamped around House’s shoulders, and he’s still got his eyes locked with House’s. He waits until he feels the tense shoulders begin to relax, and sees House’s eyelids droop as the med takes effect. He lowers House gently back onto the pillows, then turns to Chase.
“He woke up, seemed okay at first. Then he got upset about the hold on the vancomycin, started yelling, and then he just… lost it. Suddenly didn’t have any recall of why he was here. Accused me of putting him in rehab.”
Wilson, eyes full of worry, is still watching House. Even unconscious, his breathing’s too rapid—and he’s working too hard for each breath. “He’s been tachypneic since admission; now his sats are falling. Need to get ‘im up to the unit, put him on a vent until his lungs clear.”
Chase shoots Wilson an odd look, then begins to examine House. Probably feels I’m overreacting; maybe I am, Wilson thinks.
Wilson waits silently, watching the monitors, while Chase does a thorough exam. Wilson’s puzzled; House’s heart rate and respiratory rate aren’t falling, despite the sedative.
“I agree with you about ICU,” Chase says when he completes his assessment. “But he doesn’t need a ventilator; he’s compensating well right now. We’ll get him on oxygen, continue to monitor his status.”
Wilson doesn’t agree, but there’s a more pressing concern at the moment. “The Ativan isn’t doing anything to settle down his vitals; what’s going on?”
Chase frowns. “Don’t know.”
Wilson’s still watching House, and suddenly it dawns on him. “Look at his leg!” House’s right leg is twitching beneath the blanket, and—even through the sedation—House is moving it continually, apparently trying for a more comfortable position. “Up his pain meds,” Wilson tells Chase. “That’ll help.”
Chase stares blankly at Wilson for a moment, checks a page in the chart, then speaks hesitantly. “He’s… uh… not on pain meds; we didn’t order anything. Wasn’t an acute concern, and….” Chase stops speaking as the anger builds in Wilson’s eyes.
Wilson turns to Judy. “I want 10mg Dilaudid IV in here now. And after you do that, you get Dr. Cuddy on the phone and tell her she has two minutes to get down here,” he bites out quietly, viciously. Then he wheels on Chase, and begins to shout.
“What the hell were you thinking? Were you thinking? House is right; he’s a better damned doctor unconscious than the rest of us on our best days! It’s no wonder—”
Cuddy had already been on her way to check on House; she comes swiftly into the room, a look of panic on her face. “What’s going on?”
Wilson turns to include her in his tirade. “Glad you could join us, Dr. Cuddy; you’ve made it just in time to watch your patient deal with not only MRSA and renal failure, but now untreated pain and the torture of withdrawal as well! You think his leg was just gonna conveniently take a vacation while you dealt with his other problems? You just forget that you’re treating not only a critically ill man, but also a chronic pain sufferer? He’s physically dependent on those meds you’ve been denying him for over eighteen hours—no wonder he thought I’d tricked him into rehab! And the dialysis would’ve removed any Vicodin he had in his system; isn’t quite as effective on the vanc, but it’s damned good at leeching out hydrocodone!”
Wilson pauses to take a breath; he’s got plenty more to say, but a quiet moan from the bed sends him swiftly to House’s side instead.
The combination of Wilson’s shouting, the untreated leg pain, and his building withdrawal symptoms are causing House enough distress that his growing restlessness is evident, despite the dose of lorazepam. Judy’s just returned with the Dilaudid, and Wilson yanks the syringe from her hand and begins to administer it while he talks softly to House.
Wilson’s running on caffeine and adrenalin, anger and stark fear. He looks at the faces around him, thinks, Screw it; gonna give him what he needs, and blocks it all out. The man who, moments before, had sounded like an angry dictator, is now a father crooning over a fretful newborn. His voice is soft, loving, soothing. “It’s okay now; you’ll feel better in a minute, I promise, buddy. It’s okay, I’m here. They didn’t know, but I’m fixing it now; it’s all right. Everything’s gonna be fine… just fine….”
He finishes administering the med, hands Judy the empty syringe and takes the basin of cool water she’s holding. He sets it on the bedside table, and wrings out a cloth. “Shhh; it’s okay now, promise,” he whispers as he gently wipes the sweat from House’s face. “Let go; you’re safe now. It’s all better, just let go and relax; I’m right here with you, and it’s all okay.” The room is full of people, but Wilson’s creating a safe, warm bubble for his agonized friend; they’re the only two here.
“I understand why you thought you were in rehab; you were trying to tell me you were in withdrawal—sorry I didn’t get it. Missed the clues, huh? That whole thing with your left hand… but you didn’t miss the clues. You never do, do you, not even when you’re sick….” Wilson’s gentle murmur and the medication are beginning to have an effect— House is still now; he’s ceased battling invisible monsters.
“We took care of it; it’s all gonna be fine. I’m here; you’re safe—it’s okay.” The same phrases, over and over and over. When the tears start spilling down the sides of House’s face, Wilson’s heart twists in his chest. As a doctor, he knows it’s simply the body's physiological reaction to the release of extreme stress or pain. He’s seen it hundreds of times. Chemo patients after a violent bout of vomiting, unconscious accident victims as the first pain meds hit, even dying patients as the body lets go, shuts down. Intellectually, Wilson knows that the phenomenon has nothing to do with crying, in the emotional sense. But still, it’s always bothered him. And now, it’s House.
“Shh, shh, shh, all better now, all better. You’re safe. I’m here….” He tenderly dries the tears, never once ceasing the soft words of protection, of comfort. Only when House’s heart rate has decreased and his breathing’s evened out, only when he’s finally fallen into something resembling a natural, comfortable sleep, does Wilson turn from the bed and acknowledge the others.
Cuddy looks stricken, but she meets his eyes and speaks calmly. “We were wrong. There are no excuses for what just happened. I’m sorry.”
Chase, pale and shaken, steps forward. “The oversight was unforgivable. I… there’s nothing to say.” He looks down at the floor.
Wilson glares at the two of them for a moment more, then takes a deep breath. “He’s not in pain now; that’s all that matters. Let’s get him up to the unit.”
As House’s bed is rolled to the elevators, it’s a quiet, subdued procession that accompanies him. And each one of them is silently asking forgiveness from the sleeping man—Wilson most of all.