Monday, March 14, 2005

11:57 PM

Sitting at the piano.

My hand was pronounced healed today. Woo hoo.

I tried playing a few scales tonight with both hands and it hurt my left hand like I don't know what -- not the fracture hurt, the stiff out-of-condition hurt. The fourth finger is the weakest anyway, and now... I'm going to have to take it slowly.

So that whole stupid bet left me unable to play the piano without premedicating myself. Rich, isn't it?

I'm so tired, I can't play anyway. My right hand is resting on the keys, but I'm not playing. I'm just sitting here, thinking.

The nurse came to roll me into the OR. James walked with me as far as the double doors. "Okay, Greg. See you on the other side. You're almost there."

I met his eyes, and the doors swung shut.

I saw the OR nurses laying out the supplies, pairs of bright eyes over their masks and under their caps. Another pair of eyes appeared and sat down next to me.

"Dr House? I'm Valerie. I'm the nurse anesthetist who'll be working on Dr Taylor's team today...." She ran through her list of questions, and then turned to the table behind her. She picked up a syringe and flushed the IV port on my right hand.

She picked up another syringe.

"Okay. You're going to go to sleep now...."

Even if I'd wanted to, I couldn't have told Eileen much about what came next because there's not much to tell and my memory of those days is still blurry.

My brain came back online in the recovery room. It took me a while to realize that I was awake and in an unfamiliar place, to remember -- with an unpleasant jolt -- where I was and what I was doing there. A nurse in scrubs and a puffy blue hair cap materialized, took my temperature, and gently started asking questions, satisfying herself that I did indeed know who I was, where I was, roughly what date it was, and why I was there. She filled me in on the time (late morning) and asked me for a pain rating. I had to stop and think. It was such a strange sensation to realize that I wasn't in pain anymore -- and then to realize that actually yes, my leg still hurt, but compared to what it had been before....

"Seven," I whispered.

"That much?"

"Better than twenty."

She walked over to my IV pole and started fiddling with something. I heard a high-pitched whirring and stretched to take a peek. The noise was coming from a locked pump.

"Morphine," she said. "I'm giving you a bolus. Let's see if we can get you down to a four or a three. How's your throat?"

"A little raw."

She brought me some ice chips and reminded me that I needed to lie flat. I took the first spoonful and waited. Nothing -- they were staying down. It felt wonderful.

She let me take another spoonful and then took the cup away. I tried to give her my most mournful puppy-dog-eyes look, but her heart was hardened. "Okay," she said, "I'm going to take another look at your foot now."

I remembered -- my foot? Apparently it was still attached. This was good news.

I braced myself as she took off the covers. It was cold, and the paresthesia was tingling, but only faintly -- nothing like it had been last night. I looked down at my foot. It was looking much more familiar, except for the X drawn on the top of my arch with a permanent marker.

"Wiggle your toes?"

I wiggled. And they moved. I fell back on the pillow in relief. She smiled. I felt the cool gel, then the Doppler probe on my foot -- and then heard the swish swish of my pulses.

"Sounds good, doesn't it? I can palpate them too. Here's something else that might sound good: you have a visitor. Dr Wilson's here, do you want me to show him back?"

I nodded. The nurse went over to the desk; in a moment I saw Wilson appearing at the door. They talked to each other for a moment, and then he was standing over my bed.

"Hey," he said.

"Hey," I croaked back.

"How're you feeling?"

I thought it over. "Like crap. But... upgraded crap."

He grinned. "Upgraded crap. I could see that." He pulled a chair over and sat down. "How's the pain?"


"Good. " He looked at his hands for a second. "Have you talked to Taylor yet?"

"Not yet. Hey, I could wiggle my toes, too."

"Congratulations," James said wryly. "Taylor should be in soon to fill you in. I, ah... I told him that if you asked him if you would be able to play the piano again, that he should go ahead and reintubate you."

My face fell. "But it's a legitimate question!"

"I thought I'd better let him know what he's in for. Professional courtesy and all that. Speaking of which, he can put a restraining order on Pasternak, if you want him to."

I rolled my eyes. "I'll just play dead like I always do."

"Dr Nussbaum's been by too. He asked me to tell you he'd like to come by a little later, after you've had some rest."

"How did he know?"

"Well, it's funny how this works, but emergent surgeries performed on faculty members are the kind of thing Medical Directors tend to find out about fairly quickly. I think he's ticked that nobody called him last night."

"Did you give him the papers?"

"I'll drop them by later. He wasn't coming by to ask for the papers, you know."

We sat in silence for a little while. I was passing over from the drugged dopiness of the anesthesia to the bug-eyed dopiness of sheer exhaustion. Wilson caught me looking longingly at the ice chips. He let me have a couple and then took the cup away again. Traitor. I had to content myself with sucking on the spoon.

He shifted in his chair again. "I called your mom."

I sighed. "How did she do?"

"I didn't tell her too much; I wanted to save it for when she got here. I need to get home for a little bit and crash. Your mom's coming in this afternoon, so I'll make sure she gets over here okay. If she doesn't want to stay at your place, she can stay at ours."

"Wilson..." I started to protest, and then I saw his face. "...Thanks."

"Dr House?"

It was Taylor, come to confirm what I'd already begun to piece together. He ran over what happened in surgery (two big clots and a little one in the femoral artery and one of its major branches); his impression (some tissue damage but thought they'd gotten in on time, skeletal muscle pretty resilient, optimistic); the plan (morphine drip and up to the floor.)

And suddenly, it was happening. The nurse handed me a spirometer and tucked my chart down by the foot of the bed, and we rolled out of the recovery room.

Wilson hung around while they got me settled into my new room and the nurses gave report. When the floor nurse came back in, he stood up, suppressing a yawn. "Okay, House, I'll see you later this afternoon. I've got my pager."

I managed a moderately evil smile. He gave me an oh-shut-up look as he walked out the door.

Things went well for a while. My leg hurt but it was bearable, thanks to the morphine drip. Lunch came around and the tray girl unveiled a spread of broth, jello, and italian ice. I knew better than to even take the lid off the broth, and the texture of the jello put me off, but the italian ice... bellissimo. My throat was still a little sore from the surgery and the ice felt so good. I finished with a chaser of ginger ale and clicked on the TV. Not much on besides the news and Mr Rogers. I left the news on and played with my spirometer for a little bit. A spirometer, for those of you not in the Secret Medical Club, is a gadget to encourage patients to take deep breaths after surgery to expand their lungs and help prevent pneumonia.

The spirometer set me to coughing, which is what it's supposed to do, but then a few leg tinglies wanted in on the action and I decided to work on a nap instead.

I don't know how long I slept, but I woke up with a start, shaking with cold. My right thigh hurt terribly, and the rest of me wasn't far behind.

My brain was barely functioning. It was a while before it occurred to me to hit the call button. I groped feebly in the linens before I finally found it, clipped to the side rail. It started to rattle and knock across the bed rails as I gripped it in my shaking hand. It hurt too much to lift my head to look at the thing, too much to even think of bringing my left hand over to push the button, so I clicked blindly with my right thumb. I changed the channel on the TV a couple of times before I finally got the call button.

The speaker clicked on. "May I help you?"

My head swam -- I couldn't get anything out.

"May I help you?" The voice sounded impatient.

"Help," I whispered.

The speaker clicked off. No! Don't leave me here! Frantically, I started clicking, clicking, clicking again.

I heard a voice at the door. "May I --" The voice broke off and shouted into the hallway. "I need some help in here, please!"

And suddenly I was surrounded by swarms of hands. Hands taking a pulse, hands offering a thermometer and offering it again. A blood pressure cuff, squeezing and then sighing as it deflated. The rip of the Velcro, and a new cuff that inflated with a buzz. The weight of blankets; a voice saying, "Run over to Onc and get some blankets from the warmer. Tell them it's for Dr House."

A voice saying, "Come on, stay with us. Are you having pain? How would you rate it?" That was too much thinking for me; the best I could manage was a whispered, "Everywhere." The tiny whirr of the morphine pump; a cobalt cloud as the drug hit my brain.

White coats fluttering. The rubbery pinch of a tourniquet on my left arm; tapping, and then slapping on my left hand; a stick as they drew more blood. A metallic taste in my mouth as they opened the IV fluids. Shivering even harder as the covers drew back; one pair of hands at my feet, another pair straightening the tubing from the catheter. An incredulous voice: "That's all?" Another voice -- Taylor's, perhaps. Shivering, shivering, and then the warmed blankets. I couldn't help sighing with relief, even as I trembled. More blankets. My mind floated again.

A voice: "We've got a room. Let's go." A jolt as someone unlocked the bed wheels. A voice at my side: "Dr House, we're taking you over to the ICU."

The bed started to roll. I closed my eyes -- the motion was too much -- well, that and I didn't want to see the looks of the people in the hallway.

I felt the bed turn the corner. Too much work to try to figure out where we were.

I opened my eyes as we rolled into the ICU room. Activity swirling around me. Too dull, too tired, too thickwitted to observe. Still trembling in my cocoon of blankets. Thermometers, BP cuff, pulse ox clip on the finger. Someone pulling down the blankets -- no -- I grunted in protest and gave a weak swat; a voice: "I'm sorry, Dr House, but we need to get your monitor on." Patches and electrodes on my chest, a stethoscope on my front and then my back. Someone looking at my feet again. Someone pulling up my gown and looking at my surgical incision. An oxygen cannula under my nose and behind my ears.

Finally the flurry was over and the nurses left to take report. I wasn't shaking as much, but my body ached all over from the strain. It finally occurred to me that I had a fever. I closed my eyes to shut out the lights and the equipment; the jungle of chrome and tubes and lights was overwhelming. The noise of the ICU seemed like it was coming from some far away place, some far away place where I was not.

A nurse came back in and started talking at me, asking those annoying do you know where you are? are you having pain? questions, trying to assess my mental status, I couldn't understand why he was bothering me, those questions didn't seem to have anything to do with me. I managed to summon my wits and come up with "Greg House.... Hospital.... September.... Leg. Hurts."

I floated in that stupor all afternoon, dozing occasionally. I hurt all over, especially my leg, but it wasn't too bad, especially if nobody touched me; the worst part was the fatigue. I was just tired, so tired. I was vaguely aware of the nurses who were passing in and out of the room, checking the IVs, checking my feet, checking my blood pressure, asking me questions I could sometimes answer, writing it all down. Once I woke and recognized Gelb, one of my old colleagues from Nephrology. Who told them I was here? It was nice of her, but she didn't need to come to visit. I was okay. I tried to tell her so, but it was too hard to put the sentence together; I gave up and let my head flop back down on the pillow.

Later -- minutes, hours later? -- I opened my eyes and saw Dr Nussbaum. I realized he'd been calling my name. I tried to tell him that Wilson had my papers but I couldn't get the words out, couldn't get the thoughts right, and he didn't seem interested, which vaguely worried me -- I really wanted to be on the committee, and I tried to tell him, but he told me to lie down, not to worry. I closed my eyes for what seemed like a minute and then he was gone. The light from the windows had changed -- it was getting late. Had I fallen asleep?

And then it was dusk, and a tray appeared, and I knew eating would involve lifting the cover off the tray and pulling the wrapper off the juice and doing something with straws and spoons, and it was just too much work to figure all that out, so I just ignored it and put my head back.




Someone was talking at me. How long had they been at it?

I opened my eyes again. The hospital room was half-lit. Through the drawn blinds, I could see it was dark outside.

Wilson. Wilson was talking to me. I looked around the room and found him standing beside the bed.

"Greg. How are you feeling?"

"Okay." My voice was thick and slow.

He produced a penlight and shone it in my eyes. I made an irritated noise and turned away. "Greg, please, just a minute, follow this for me." He moved the light back and forth; I followed it with my eyes, knowing he wouldn't leave me alone if I didn't.

He held out his hands. "Squeeze."

It took a minute for me to process his command, and another minute to send the instructions down to my hands. I concentrated as best I could, and was finally able to lift my hands up off the bed and grip his fingers.

"C'mon, Greg, squeeze."

I was squeezing, couldn't he see that? Perfectionist. I tightened my grip until I couldn't hold my hands up any more and had to let them fall down to the bed.

"Do you know where you are?"

I nodded.

"Greg. Where are we?"


He kept asking me questions but I'd had enough. "Tired," I managed to explain.

"Okay," he said, but he didn't look satisfied. "Greg, your mom's here."

Several vague thoughts swirled around -- what? she didn't need to come all this way, I'm fine; you didn't need to go to all this trouble; thank you for getting her here -- but none of them could make it through the molasses that was my brain in time to be spoken. All I could manage was something like "Um?"

He looked at me for a long minute, and then walked over to the door. "Mrs. House?"

And there was my mother. He pulled a chair over for her and she sat down by the bed.

"Gregory," she said, and gave me that affectionate, weary, what-am-I-going-to-do-with-you smile that I knew as well as my own face.

part four


Anonymous Anonymous said...

Really enjoying this - great detail - thanks

March 15, 2005 6:15 PM  
Blogger Sanlin said...

As mentioned, I'm still feeling a bit dopey myself, right now--and I don't have any quality drugs or recent anesthesia to blame it on. LOL ;-)

Glad to hear your hand is mended. :-) I hope you get full use of it back, again, ASAP. Or, "stat!" should I say? ;-) It tickles my fancy when you tickle the ivories... :-)

Waking up after anesthesia... always an odd sensation. I usually get a joke or two in before the "99... 98... 97..." *out like a light and then awake, again* "...hey, is it over?..." part. LOL Never a comfortable feeling--I like being 'tranqed' or having my movement restricted about as much as a tiger does... That is to say, not at all. LOL

Ahhh... It's amazing how *good* simple things like ice chips can be, in such situations, isn't it? :-)

And, here's good old James, again... and your Mom. Oh, what a busy child you must have been, Lo those many years ago... LOL Some things don't change that much. ;-)


March 17, 2005 2:36 PM  

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