CHAPTER TWENTY-THREE: LAST WISHES
Wilson awakens because of a noise he’s not hearing. He’s been dozing lightly, anticipating the arrival of Cuddy and Chase. And—as horrible as the sound of House’s respirations have been—the rapid, rhythmic panting that Wilson’s been aware of, even in his own semi-conscious state, has reassured him that House is breathing.
But now, that awful rhythm is off; the sounds are being punctuated by long seconds of silence. Wilson, instantly awake, sits up and sees Chase and Cuddy in the corner of the room, speaking in low voices—he can’t make out what they’re saying, but Cuddy appears to be crying. Wilson can’t worry about Cuddy now, though; he needs to find out what’s going on with House. He rises and starts to the bedside.
“Dr. Wilson,” Chase calls to him softly, but Wilson ignores him; he’s seen that during the moments of silence, House’s chest isn’t moving. Wilson reaches for the emergency equipment.
“What the hell’s the matter with you two?” Wilson shouts. “He’s having periods of apnea! Why are you just standing there?” He’s just grabbed the ambu bag when Chase’s hand on his arm stops him.
“No,” Chase tells him; Wilson, uncomprehending, stares at him. “No,” Chase repeats. “Leave him alone.”
“What are you talking about?” Wilson tries to yank his arm back, but Chase holds it firmly.
“The Advance Directive; you can’t do that,” Chase says, indicating the ambu clutched in Wilson’s hand. “Come on, Dr. Wilson; you know that.” Chase’s voice is gentle, but his grip on Wilson’s arm remains strong. Then he sees the look on Wilson’s face; it’s equal parts panic and puzzlement. “He didn’t tell you; he said he’d talk to you,” Chase whispers.
Wilson’s mouth goes dry as he remembers House’s strained voice. …told Chase…. And he sees that odd combination of sadness and regret that House had had, just before he’d given in to sleep. “No. He didn’t tell me anything. And he would’ve. Now let go of me. We’ve got a patient in acute respiratory distress. If you’re not going to help him, I will.”
Chase looks helplessly at Cuddy, who moves to stand next to Wilson. “I… didn’t know anything about this either. But apparently when you and I were speaking, just after you arrived in the exam room, House was talking to Chase. He told Chase that he didn’t expect things to get… bad. But he also said that in the event of multiple organ failure he… didn’t want any intervention.”
“That’s not in his chart!” Wilson looks toward House; he’s not apneic right now, but his O2 sats are at 86%. Wilson hands the ambu bag to Chase, who releases his arm. Wilson glares at him defiantly and increases the oxygen flow to 30 liters.
Chase doesn’t comment about the oxygen. “He asked me not to make it part of his chart. He said he’d tell you himself.”
“He didn’t actually sign the Advance Directive,” Cuddy says. “But now we know what his wishes are; we have to respect them.”
Wilson resolutely pushes House’s whispered words, that last expression on his face, out of his mind. “All we have is Chase’s word on that. House would’ve told you; he’d have told me, if that’s what he really wanted!”
Chase looks as if Wilson has just slapped him. “And you think I’m lying to you?” he asks Wilson quietly.
“You’ve turned on House before, and yesterday you were pretty vocal in your resentment about everything that’s happened this past year; how do I know this isn’t part of some… agenda you have?”
This incredible question hangs in the air, as Chase and Cuddy stare at Wilson, their expressions moving slowly from shock to concern.
Wilson looks from one to the other, and realizes what he’s just asserted. “I’m… sorry, Chase; I don’t know where that came from. But you’ve got to understand—even if House did tell you he wanted no intervention, he changed his mind. He must’ve! There’s no way he’d keep something like that from me.” Yeah, like he told me about the brain cancer fiasco. Like I told him about the antidepressants. Like he let me know right away about the shoulder… and the prednisone. If we’d been any more closed off from each other these last few months, the guy could’ve moved to Maine and I wouldn’t have known about it ‘til I got a change of address card—if I got a change of address card.
“And what would you have said if he had told you?” Cuddy asks.
“I… don’t know,” Wilson admits. “But I do know that right now, he needs to be put on a vent. We can straighten the rest out later, when he’s better, stronger. When he can think for himself.”
Chase’s eyes widen. “Have you heard anything I said? House is going into multi-system organ failure. He knew it might happen, and he discussed it with me when he could think for himself. He told me what he wanted done. And what he didn’t.”
Wilson ignores Chase. House is having another apneic spell, and Wilson holds his own breath until House gasps and resumes breathing. Wilson turns to Cuddy. “Authorize the ventilator. Now.”
“I… can’t do that.” Cuddy’s eyes beg for Wilson’s understanding.
“Why not? You’re his proxy; what’s stopping you?”
“He is. I know what his wishes are; I can’t just… ignore that.”
Wilson narrows his eyes, looks hard at Cuddy. ”Your history says you can. You didn’t have a problem ignoring what he wanted after the infarction. What’s changed?”
Cuddy’s anger flares. “Everything’s changed! That decision was made to save his life. Now you’re asking me to prolong his death. And even if he did manage to recover, would I be doing him any favors? Going against his wishes last time cost him Stacy. He pushed her away, and he’s been pushing everyone else away ever since. If I overrode what he wants this time—and if he lived—you think he’d be happy about it? Grateful to me? No; he’d have a long, miserable recovery, all alone, and eventually he’d come back here even more bitter and distrustful than he is now.”
“He wouldn’t be all alone! I’m not Stacy; I won’t let him push me away. Yeah, we’ve had our problems, big problems. But—”
“Stop it!” Chase interrupts. “We shouldn’t even be having this discussion.” Chase lowers his voice. “House could go on like this for hours—days. I understand how difficult this is for you to watch, Dr. Wilson. And I think you’d be… well-advised… to think about leaving, at least for a little while. Give yourself a chance to… come to terms with his decision. His death.”
Wilson stares at Chase as if he’s lost his mind. “I’m not leaving this room. I made him a promise; I told him I’d see him through this, and that’s what I’m going to do. Because he will get through this.”
Chase shakes his head sadly. “I’m sorry; I can’t be a party to this. I won’t.” He turns to Cuddy. “I’ll be in the Diagnostics office. Call if you need me.” He looks at Wilson with a mixture of frustration and pity, then quietly leaves the room.