CHAPTER SEVENTEEN: INTENSIVE CARING
The three fellows come running into House’s cubicle, and virtually screech to a stop. “What’s happening?” Chase demands.
“Fever’s shooting up—104.6 now,” Cuddy tells him.
Chase almost laughs with relief; he’d been afraid that the page was somehow related to House’s untreated pain, or to the withdrawal symptoms. Or worse—Wilson might’ve wanted to bring up the vent again. “So order an antipyretic,” he says. “Acetaminophen, ibuprofen.”
“Can’t do that. He’s scheduled for his first full dialysis session in a few minutes; that’s got to take priority. And that’ll remove the drugs from his system before they’ve even had a chance to start working.”
“Yeah,” Chase says thoughtfully. “Besides, acetaminophen’s not good for his liver, and ibuprofen is murder on compromised kidneys. Okay; let’s get him in an ice bath.”
“No!” Wilson, who’s been glowering at both Cuddy and Chase, speaks up for the first time. “I won’t allow you to put him through that! There are other options, maybe not as fast but just as effective. And he has more than enough circulation problems in the right leg without—”
Chase meets Wilson’s eyes. “It’s the preferred treatment for fever above 105. Anyway, he’s unconscious, so—”
“Am not,” interrupts a weak, raspy voice from the bed, and they all turn towards House, who’s eyeing his three fellows, standing in an anxious row before him. “You didn’t tell me it was Buy One, Get Two Free Day,” he says to Wilson.
“Sorry,” Wilson responds. “Didn’t even know those two were in the building.” He scowls at Cameron and Foreman.
“It’s okay.” House closes his eyes. “Cuts out the middle man. And you need to let the nice intensivist treat the intensive care patient. Just go back to being a helicopter….”
Everyone gathered around the bed shares a concerned look. “Helicopter?” Wilson asks tentatively.
“You know, that whole… hovering thing… you do so well.” House’s weak voice is growing fainter. “Chase is… good doctor….” He sighs, and returns to what Wilson hopes are pleasant dreams.
Now Wilson eyes Chase. “He doesn’t recall what just happened downstairs. Obviously.”
Chase looks down. “I know that. And… okay… his temp’s not 105 yet. So let’s put him on a convective airflow cooling blanket.” He looks to Wilson for approval.
Wilson nods. “That’ll work.”
They wait until House’s dialysis session is underway, then Wilson approaches the bed. “House; need to talk to you.” No response. “Hey, you awake in there?”
House doesn’t respond, and Wilson’s starting to get worried. When he places a hand on House’s arm and squeezes gently, House doesn’t open his eyes or respond verbally, but he does turn his head towards Wilson. Wilson doesn’t know how much’ll get through, but he speaks to House as if it’ll all be understood.
“We’ve gotta take care of your fever, House. Meds won’t work ‘cuz of the dialysis, so we’re gonna put you on a cooling blanket, see if that helps. Might be a little uncomfortable; you just let me know if it is.”
Wilson continues to speak to House as he’s turned and lifted by Chase and Foreman to allow Cuddy and Cameron to slide the thin blue blanket beneath him, and then he’s resettled comfortably. Throughout the procedure, House is generally nonresponsive. He does open his eyes once, looks around, spots Wilson smiling reassuringly, and goes back to sleep.
After an hour, Chase is pleased that House’s fever has come down a degree and a half, and no longer poses a neurological danger. Wilson is pleased that, apparently, the blanket isn’t adding to House’s discomfort, and that—while he’s still tachycardic—his heart rate has fallen to 116. Cuddy’s relieved that the crisis has been averted, but she isn’t surprised when Wilson indicates that he’d like to speak with her and Chase.
Leaving Cameron and Foreman with House, the other three step outside the cubicle. Wilson motions them further out into the hall, and Chase and Cuddy stand patiently before him, waiting for whatever it is he wants to tell them. Both understand that he’s exhausted and worried, and both understand that they’ve made a big mistake; they’re willing to let him have his say.
Wilson runs a hand over his eyes, rubs the back of his neck. When he begins to speak, they see the anger simmering in his eyes, but his voice is calm.
“What happened is inexcusable for any patient—but House? You know him, you know his medical history, you know how dependent he is on those pills.”
“We all know how dependent he is on the Vicodin,” Chase says defensively.
Wilson knows exactly what Chase is getting at. “I’m not blameless. Believe me, I probably feel worse about it than either of you. But I’m not his treating physician right now; I’m his friend. And I’m damned lucky he’s allowing me to be his support system. Otherwise, he’d be trying to get through this alone.”
Both Chase and Cuddy start to protest, and Wilson shakes his head. “Yeah, I know you’d try—but he wouldn’t allow it. You know House; he’d make a conscious decision to shut everyone out. Chase, you know that when a critically ill patient has no support, there’s rarely a good outcome. Frankly, I’m amazed, and grateful, that House has decided to let me in, help him through this. And that has to be my primary responsibility. I have to maintain the trust he’s placed in me. If I try to be his doctor as well—”
“You’re absolutely right,” Cuddy interrupts. “You’re doing the right thing. And you made a good point about how well we know House and his medical needs. Speaking for myself, though, I think that’s why it happened. I’m so familiar with his intimate relationship with those damned pills that I let it become just a part of who he is; I’d stopped thinking of it as an ongoing medical need. That’s not a defense—believe me, I don’t even want to defend my part in this. But it is a reason.”
Wilson nods. “No, it’s not a defense. But it’s understandable. I appreciate your honesty.” He and Cuddy smile at each other, both acknowledging that they’ll now move past this, personally and professionally.
Chase, however, isn’t ready to either explain or defend his own responsibility in what occurred. “It was a mistake. Mistakes happen,” he says almost sullenly.
Wilson’s eyes widen, and Cuddy says tersely, “That’s not good enough, Dr. Chase.”
Wilson puts a hand on Cuddy’s arm. “Would you mind excusing us? I’d like to speak with Chase privately.”
“Sure. I want to go check on House anyway.” Cuddy reenters the unit, leaving the two men alone.
“Chase, you do understand everything I’ve said, right?” Wilson is puzzled at Chase’s attitude; he senses resentment from the younger doctor.
“Oh, I understand it all right; I understand that House is gonna make me feel like crap, and you’re getting off scot-free!” Chase says. When Wilson, astonished at the outburst, just stares at him, Chase continues, “I don’t get this. All through the narcotics investigation, we protected him, lied for him, had our lives disrupted for him. Now I’m trying to save his life, and the one person who turned on him is lecturing me about trust!”
Wilson sighs and leans heavily against the wall. When he speaks, his voice is low, and strained. “I made the deal with Tritter because he verbally attacked Cuddy; he attacked you physically. And I didn’t know what either of you would do, how bad you might make things for him.”
He looks at Chase almost beseechingly. “I couldn’t allow him to go to prison over some stupid principle that made sense only to him. And he would’ve; I don’t doubt that for a minute. He has a moral code that… that… defies interpretation. And I should know; I’ve spent years trying to understand it. But he’ll stand by that code to the death. And that’s what prison would have meant for him, Chase. Death. I was working as hard to save his life then as you are now. I made mistakes then that I’m still paying for now. And House is paying for my mistakes. I take everything I did—and didn’t do—very seriously. I’m asking you to take the same responsibility.” Wilson leans his head back against the wall, closes his eyes.
Chase studies him thoughtfully for a minute. “Okay, I’ll take full responsibility for my oversight… if you’ll keep him from punching me out when he hears about it.”
Wilson opens his eyes to find Chase grinning at him. He grins back. “You’ve got it. Don’t forget, delirious or not, House called you a good doctor. That’s… no small thing, coming from him. Now, let’s go make sure he lives to give you grief for a few more years.”
Chase offers his hand; Wilson shakes it firmly. Then they walk together back into the ICU.