CHAPTER THIRTY-FOUR:  INTANGIBLE SIGNS

It’s been well over two hours since they’ve heard from Wilson.  The toll it’s taking on Cuddy, Foreman, and Chase is evident in the number of partially empty coffee cups scattered throughout House’s cubicle, and in the way none of the three will meet each other’s eyes anymore.  The toll it’s taking on House is even more obvious.  Now that the VRSA’s raged, unchecked, for several hours, his fever’s above 104, the tachycardia is worsening, and they’ve already had to increase the dosage of enalapril controlling his blood pressure.

And—despite the heavy sedation—Cuddy’s certain that House is somehow able to sense Wilson’s absence.  Wilson had taught her to watch for the subtle signs of increased leg pain, and she’s seen them twice now, and has had to medicate for them with the PCA.  But it’s more than that; there’s a restlessness in House that can’t be described, or explained, simply by listing his symptoms.  Even after the extra Dilaudid, his posture doesn’t relax, and he seems… generally unsettled.  Cuddy tries to speak to him the way Wilson would, but House’s response just isn’t the same.  His blood pressure is continuing to climb slowly; she tries again.

“It’s okay, House; Wilson’ll be back soon.  He’s gone to find something to help you, and when he gets back, he’ll explain everything.  But I’m here; I’m right here, and you’re safe.  And Foreman and Chase are here too; we’re all looking out for you.  I want you to relax, and trust us.  Your B/P’s going up; that’s not good for your kidneys.  So you need to just… have a little faith, okay?”  Cuddy’s attempting to keep her voice calm, soothing, assured, as she’s seen Wilson do.  But nothing changes, and finally she turns away from the bed, the worry stark in her eyes.

Chase and Foreman are studying the monitors, and their concern is growing.  “We could try some more diazepam,” Foreman says to Chase.  Cuddy overhears him.

“No!  He’s already sedated almost past the point of safety, and it isn’t doing any good.  Don’t you understand what the problem is?  House knows something’s up.  And… he knows Wilson isn’t here.”

Foreman makes a quiet scoffing noise; Cuddy ignores it, and turns to Chase.  “How many times have you watched an intubated preemie in NICU, an infant supposedly drugged into oblivion, respond with changes in vital signs as soon as the mother touches him, or speaks to him?  Is there a medical explanation for that?  Is there a medication that can reproduce that effect?”

Chase shakes his head and turns to Foreman.  “Dr. Cuddy may be right.  And if she is, it won’t matter what we give him, or how much.  We may just have to wait until Dr. Wilson gets back.”

Cuddy nods with satisfaction, but Foreman’s shaking his head.

“If Wilson doesn’t return soon, it’s not gonna matter what’s causing the jump in his vitals,” he says.  “I’m willing to give it fifteen more minutes; after that, we need to put aside all these ‘emotional effect’ theories, and start thinking like doctors again.”  Foreman’s tone is dubious, but it isn’t cruel, and Cuddy smiles almost pityingly at him.

“You’d be surprised,” she says, “what emotions can do to the body, how they can help or hinder recovery.”  She gazes at House.  “As a matter of fact, I’ve seen all those messy emotions make the only difference between recovery… and death.”

“Yeah, and I might buy all that if this were any other patient,” Foreman asserts.  “But this is House.  Emotions don’t mean a damned thing to him; he wouldn’t recognize an actual feeling if he tripped over it!”

Cuddy flares.  “And it’s just that attitude that’s put us—and him—where we are now!  Maybe some of it’s his own fault; you’re right, he’s quite… skillful at hiding his feelings.  But lately, we’ve taught him to hide not only his emotions but also his pain.  Negative conditioning.  As a neurologist, I’m sure you’re familiar with that.  Every time he came to one of us and tried to be honest, we gave him the emotional equivalent of an electrical shock.  So eventually… he quit trying.  And no one noticed.  Or if we did, it was only because we were relieved that he’d started… behaving himself.  And we reinforced it by ignoring him every time he slipped up and tried to complain.  Wilson’s correct—we were punishing him because the treatment failed.”

Foreman looks thoughtful.  “Maybe you’re right.  I’m not saying I buy everything you’ve said, but I’ll admit to not bothering to hide my impatience with his… antics.”

“And all that needs to change as he recovers,” Cuddy says adamantly.  “We all have to let him see that we respect him and his feelings.  That we take his pain seriously.  Oh, I’m not saying that we suddenly go all cuddly and concerned on him—that wouldn’t get us anywhere either!”  Cuddy smiles dryly at the notion.  “What I’m suggesting is that we react to him the same way we’d react to complaints from any patient—just give him the benefit of the doubt, that’s all.”

“You don’t think he’d take advantage of that?” Foreman asks her dubiously.

Cuddy gazes steadily at him.  “You don’t think it’s going to be a very, very long time before he trusts any of us enough to even think of coming to us—let alone lying to us?”

Foreman shrugs.  “I don’t know.  And if Wilson doesn’t get back here soon, with something concrete, the point’ll be moot.”  His eyes are trained on the bank of monitors, and the other two follow his gaze.

House’s heart rate is above 140; his blood pressure is 174/94.  And all three are very much aware that medically, they’re out of options.  Even Cuddy falls quiet and grim.

As House’s heart rate hits 150, Foreman moves to mute the shrill cardiac alarm that’s broken their desperate silence.  The three look helplessly at one another—and Wilson walks in.

He takes one look at their faces, and at the monitors, and marches straight to House’s bedside, motioning impatiently to them with his hand to cut off their barrage of questions as he begins to speak to House.

“I’m back, House—you need to settle down.  Stop scaring these people, and behave yourself.”  Wilson puts a hand on House’s arm.  “Yeah, I know that you live to torment Cuddy.”  Wilson glances up and sees Cuddy’s wide eyes, her apprehensive expression, then returns his gaze to House. 

“You’re doing a good job of it, too.  But it’s time to stop now.  I’m right here, and you’re safe.  And I’ve got your magic bullet.  I know that these three have questions, and so do you.  I’ll explain everything as soon as you get yourself under control—so pull it together right now, pal.”  Wilson’s words are firm, but his tone is warm and affectionate.

“Well… I’ll be damned,” Foreman says in a voice barely above a whisper.  Cuddy and Chase look away from House, to the monitors; Wilson doesn’t bother.

House’s heart rate is down to 124, and it’s still decreasing.  His blood pressure’s already fallen to 130/82.  Those are the things these physicians can understand, can quantify—they’re the things that put a quiet smile on Cuddy’s face, as she triumphantly regards the other two.  But it’s the intangibles, those variables they can’t even begin to measure, that change the silence in the room from desperation to… awe.  If they had to put a name to it, they’d be at a loss. 

But all of them know that—whatever word they might choose to qualify what they’ve just witnessed—it goes far deeper than any medical intervention ever could.  Apparently, House is aware of that too; his vital signs continue to stabilize. Even the vent sounds like it’s not having to work quite so hard.  Finally, Wilson’s satisfied that House is becalmed.  “Good job,” he tells House quietly.  Then, keeping his hand wrapped securely around House’s wrist, he turns, looks at the faces regarding him expectantly, and smiles.

Chapter Thirty-Five