ext_149751 (![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png)
doctorhouse-md.livejournal.com) wrote in ![[community profile]](https://www.dreamwidth.org/img/silk/identity/community.png)
cuddys_house2008-11-06 07:15 am
doctorhouse-md.livejournal.com) wrote in cuddys_house2008-11-06 07:15 am
Wednesday, 10th January, 2007
"Got a new case," Cameron announced, stepping into House's office. House looked up at her from his desk. "A pregnant woman, 36 weeks gestation," she continued. "Presented in clinic with band pain around the upper abdomen, epigastric pain, blurred vision, vomiting, malaise-"
"What smells like pre-eclampsia, sounds like pre-eclampsia and looks like pre-eclampsia?" House interrupted. "Oh, wait, I know this one. Pre-eclampsia."
Cameron stopped in front of his desk. "No hypertension, no proteinuria, no history of hypertension. First baby. No history of pre-eclampsia during this pregnancy, either. Onset of the symptoms occurred yesterday within an hour after eating lunch." She slapped the file down onto his desk.
"Pre-eclampsia can be asymptomatic."
"You call having symptoms 'asymptomatic'?"
"Prior to the onset and diagnosis of pre-eclampsia, yes," House retorted.
"It's not pre-eclampsia. Ran a blood panel. No antiphospholipid antibodies."
"HELLP syndrome."
"No evidence of hemolysis, either," Cameron replied.
"Ran a liver panel? Ran a test for thrombocytopenia?"
"Still waiting on the liver panel. Platelet count a little below normal but nothing substantial."
"A little below normal," House mimicked.
"As in not below percentile range."
"But almost."
Cameron shrugged.
House gave her a look. "You're boring me. Go away." He picked the file up and thrust it out at her. "Take this boring file with you."
"Is there something going on between you and Cuddy?"
At first, House didn't catch onto Cameron's question, not expecting such an abrupt change in conversation. But then he gave her another look; a carefully masked look of incredulity. "What has that got to do with anything?"
"There's a rumour going around."
"It's a hospital. Rumours spread like unquarantined disease."
Cameron ignored him. "There's a rumour that you and Cuddy are seeing each other. And that you're the father of her baby."
House dropped the file to the desk, inwardly panicking that Cameron was accurate but outwardly giving her a cynical, almost disparaging look. "For such a smart doctor, you're exceptionally gullible."
"Is it true?"
If House wasn't mistaken, the way Cameron was looking at him was almost... hopeful. Hopeful, maybe, that he'd say the rumours weren't true. Which made House realise: Cameron was far from over her stupid little crush on him that he took so much pleasure in mocking her for. In fact, he pulled his face into an expression of mock sympathy. "Would it break your soft, little heart if those rumours were true?"
Cameron shifted on the spot and held her arms stiffly at her side. "Are they?"
"Are you nuts? Why would I place a bet in Chase's pool, betting for Cuddy and me being together, if we were?"
"To confuse us?"
House snorted at Cameron. Damn her for being on the ball. Not that he'd let her know that. "Like I said: gullible." He picked the file up again and held it out to her. "Now go away."
Cameron seemed to sigh relief with the way her shoulders sagged, though still refused to accept the file. "She also started vomiting blood."
"Ew, gross," House replied impatiently. He waved the file at her insistently. "Could be a simple Mallory-Weiss syndrome. Or peptic ulcer. Might explain the epigastric pain."
"You don't think that's serious?"
"Serious, but not interesting."
"She's having a baby, House. She's 36 weeks. She's definitely in no state to deliver safely. Probably not naturally."
"Obstetrics. Not my department. Next floor down."
Cameron heaved an exasperated sigh. "Can't you at least take a look at her? Assess her? Make sure it's not something life-threatening before sending her to obstetrics? If she's in any serious medical danger, so is her baby. We can't afford to waste time if the baby's life is at stake."
House really wasn't interested in the case. He sat back in his chair, file still in his hand, and gave Cameron an assessing look. He didn't want to be wasting his time on a woman who probably had asymptomatic pre-eclampsia. But, he supposed, Cameron was right about the baby. If it was something life-threatening, then the baby's life was what mattered. He sighed and looked away, then reached for his cane.
"This better be worth my time," he said.
*
"So, Madeline," House greeted the woman, sliding the door closed as he read her name at the top of the file. "I'm Dr. House. Apparently, you're 36 weeks pregnant and have asymptomatic pre-eclampsia."
"What does that mean?" a male voice said from the other side of the room.
House looked across at the man. "Take it you're the daddy."
The man nodded, a worried expression on his face. "Patrick."
House stared at him for a moment, a sudden fleeting thought of imagining himself in Patrick's position. Of being the onlooker to Cuddy in a worrisome situation during her pregnancy. He quickly shook that from his mind. "Well, Patrick," he said, returning his attention to the file. "It means your wife is going to be okay. Just requires close supervision for the next few weeks. Maybe early delivery. That's nothing to be concerned about. She's within the safe range of delivery - almost all babies delivered at 36 weeks survive without complications."
A look of relief spread across Patrick's face. "So, she's going to be okay? The baby's going to be okay?"
"Yep," House replied boredly. "Means my job is done here." He looked at Madeline. "The nurse will fix you up with medication. Maybe schedule a c-section if absolutely necessary. If you've got questions, don't bother me with them." He faced away and started back to the door.
"Dr. House," Patrick said.
House ignored him because he was probably going to ask an inane question, and went to pull the door open.
"Dr. House!" Patrick called.
House looked over his shoulder at Patrick's panicked voice and his eyes landed on Madeline, who was jerking and twitching violently. Without hesitation, he limped quickly across to the bed, slapped the file on the dinner tray and reached for the emergency call button. He immediately then began turning Madeline onto her side.
"What's happening?" Patrick asked in a distressed voice.
"What's it look like, you idiot?" House snapped. "She's having a seizure." Two nurses burst into the room, one with a crash cart, and one of the nurses stripped away the bedsheet on top of Madeline that was getting tangled up in her legs. House suddenly stopped long enough to peer down at the bed, at the large brown liquid stain on the sheet below her. At that same moment, Chase rushed into the room, followed by Cameron and House looked over his shoulder at them, Madeline still fitting and the nurses holding Madeline on her side. Over on the other side of the bed, Patrick was staring at Madeline wide-eyed.
House nodded at him. "Someone do something about him. Get him out of here." Then he looked back to Chase and Cameron again. "New symptom: our patient's kidneys are failing."
*
"Eighty milligrams of creatinine per decilitre means acute renal failure," House announced to his team. "Baby needs to be delivered, stat. Mother needs to be put on dialysis. Chase, I want you to find out what the mother was doing, what she was eating, what medication she's on, if any. Aspirin, heparin, NSAIDs, whatever you can find. Foreman, I need you to organise an endoscopy, find out the cause of the haematemesis--"
"You want us to put her on dialysis and perform an endoscopy?" Foreman interrupted, sceptical. "The woman's in a coma."
"Good point," House agreed. "While you're at it, organise a bone marrow biopsy."
"What for?"
"For fun," House replied sarcastically. Then he explained, "Because in the last two hours, her platelet count has dropped significantly, and I want to find out the cause. Whether it's due to decreased production or peripheral destruction. Bone marrow biopsy is more accurate at this crucial point in time."
"We can't do all of these invasive tests, and put the mother through major abdominal surgery," Foreman argued. "Her body might not be able to cope with it."
"Do nothing and waste time, her body is going to be able to cope with it a lot less, seeing death is a symptom I'd prefer to avoid," House countered.
"I think we should focus on delivering the baby first," Chase said. "Maybe once the baby's out, her symptoms will be easier to manage and get under control."
"She might not live through the surgery," Cameron pointed out. "As Foreman said, she's in a coma."
"Baby's got to come out at some point," House said.
"You need consent from the father first, seeing the mother is incapable of of agreeing to informed consent."
"I'm on it," House replied to Cameron as he started towards the door.
"Why you?"
House stopped as he pushed the door open and looked back at his team. All of them were staring at him nonplussed. "You never want to be involved in talking to the patients or their family, unless they outright refuse to agree to informed consent," Chase observed, his brow arched curiously.
"Saving time," House explained. "Can't let you guys pussyfoot around. I have a more direct approach."
"Like bullying?" Foreman remarked dryly.
"Whatever works," House agreed, and he was out the door before his team could argue with him.
*
"What's happening to my wife?" Patrick asked.
House stood in front of Patrick outside the ICU, not looking directly at him or the tears damp on Patrick's cheeks. Instead, he was staring through the glass at Madeline, at her baby bump, the tubes coming out of her mouth and the drips she was attached to. She was just a woman he didn't care about beyond the fact that she was his patient, with a baby he didn't care about beyond the fact that he wanted to save it. "She has gone into acute kidney failure," House replied. "Means we have to operate to get the baby out before we can put her on dialysis."
He heard Patrick sniff, but still refused to look at him. "What about the- the bleeding? From her mouth? The bloody vomiting?"
"Still trying to identify the cause of that. What's most important right now is we get the baby out."
"Will Madeline die?"
House finally looked at him. He nodded. "There's a chance that might happen, yeah. There's a chance your baby might not survive, either."
He watched impassively as Patrick's face crumpled and a sob escaped from his lips. He turned away from House and gripped his head in his hands, staring at Madeline through the glass. Patrick getting emotional wasn't going to help. House needed an answer now. "I need your consent to do delivery the baby."
"No," Patrick sobbed, and House wasn't sure if Patrick was answering him or if he was simply voicing his fear of losing both his wife and child.
"Patrick," House said firmly, and Patrick shook his head and began to crouch down as though the emotional stress of potentially losing his loved ones was unbearable. House grabbed his arm and tugged him back to his feet. "Hey," he said.
"No," Patrick sobbed again.
"Hey." House tugged on his arm and made Patrick face him. Patrick responded by latching onto House's forearm. House searched his face until he managed to get the man's eye contact. "Come on, focus. I need you to give me consent to deliver the baby."
"I don't want Madeline to die."
"I know you don't, but that's what's going to happen if you don't let me deliver this baby. You could lose both Madeline and the baby if you don't let me do the surgery."
Patrick stared at House for a moment, then looked away in anguish, his face crumpling again, distraught. House felt Patrick's fingers digging into his forearm and felt Patrick's other hand clutching at his upper arm. Another sob escaped Patrick's mouth.
"Patrick," House said again, firmly but quietly as he gripped Patrick's arm a little tighter to get his attention. "Stay with me here. You need to make a decision now. Every second you spend weeping over what hasn't happened yet is time wasted and one second closer to your wife's death. Now, come on. Let me do the surgery. Might save your wife and your child."
"Might?"
"That's better than 'can't'."
Patrick stared at House and House stared right back at him, hanging on the man's response. At last, Patrick just nodded, his lips quivering, and House released Patrick's arm with a sigh of relief. He then nodded. "You're making the right choice," House told him. "It's the choice I'd make if I had to."
He stepped back, leaving Patrick standing on his own in the hallway, and quickly made his way down the hall to call for an OR and for a team of surgeons to scrub up for Madeline's surgery.
*
"Keep an eye on her vitals," House snapped at the attending standing beside him as he stared down at the c-section happening in front of him. It had turned out that the mother had been leaking amniotic fluid on top of everything else, which resulted in oligohydramnios. The baby's life was severely at stake. He handed the chief surgeon a gauze. The steady beep of the vital signs monitor was keeping House both reassured and on edge, mentally counting each heart beat while anxiously waiting for the surgeon to pull the baby out. He glanced up at the observation deck and saw Chase and Cuddy standing there, his eyes staying on Cuddy for a moment before he returned his attention to the surgery.
"Here it comes," the surgeon said, wedging a bluish, small head from within Madeline's womb. House held his hands out ready to catch the baby, looking across at the vital signs monitor in alarm as it began beeping frantically to announce Madeline's vitals were dropping. The surgery suddenly became filled with the commotion of nurses calling out at each other to stablise Madeline, paddles being drawn, the surgeon announcing, "Baby's out."
"Chord cut," another surgeon said, snipping the umbilical chord.
House caught the baby in his hands, a little girl, noticing that it wasn't breathing and had a blue colour to it. "No respiration," he called out and limped across to the paediatric table, placing the baby down carefully. He rubbed its chest, trying to stimulate it, muttering, "Come on, breathe."
He suctioned out the gunk from the baby's mouth. A team of nurses and a paediatrician gathered around him and House immediately started to apply CPR. "Lungs aren't opening up," he announced. A nurse administered mask ventilation while everyone else around him rushed to do what they could to save the baby's life. "Come on," House said to the baby, sounding more urgent. "Come on."
Behind him, the commotion was still going on, the surgeon demanding aid to cauterise and stitch while her vitals continued to plummet. "Apgar's zero," one of the nurses said.
"Keep trying," House snapped back at everyone. The baby was intubated while House continued to apply resuscitation, hanging on every second for the baby to take its first breath on its own. "Come on, breathe," he muttered again to the baby.
At the five minute mark, the same nurse announced again, "Apgar's still zero." House refused to listen. He felt a hand on his back a few minutes later, having tried for almost ten minutes to revive the baby, but ignored that, too. "House," the paediatrician said. "There's no point. I'm going to call it."
"What are you, stupid?" House barked back at the woman, giving her a fierce look.
"It's been almost ten minutes."
House shook his head and kept going. But a couple of minutes later, he slowed what he was doing, and then stopped. He stared down at the baby, lifeless and blue, unable to even explain the feeling that was weighing heavy and thick in his stomach.
"Time of death," he heard the paediatrician say, "17.41."
*
Patrick jumped to his feet the moment House stepped out of the elevator, still in his scrubs. He approached Patrick slowly while Patrick came rushing towards him with a look of frantic worry on his face. House could see Patrick had been crying for a long time, the way his eyes were red, how tired and drained he looked. "How is she?" he asked.
House stopped just in front of Patrick and tried his hardest to shake the numb feeling from him. This was stupid. This wasn't even his kid. Death happened all the time, neonatal ones, too. The baby had died, from what could be determined on the paediatric table, of maternal-related conditions, probably related to the mother's renal failure and the oligohydramnios. "Your wife is still in a coma," House replied. "So far, she's stable, though. But critical. I can't guarantee her life until we know she's pulled through this."
He couldn't work out if the sob Patrick gave was one of distress or relief. "What about our baby?"
"Your baby--" House stopped. He stared at Patrick and swallowed. He tried to think of a few different ways to say the man's baby was dead. He opened his mouth but nothing was coming to mind. He closed his mouth again and shook his head. "There was nothing we could do. I'm so sorry."
He watched Patrick's face go from bewilderment to raw shock and he felt wrong just walking away from him. So, he stayed standing where he was in the hallway, looking away while Patrick started to weep into his hands. But eventually, when Patrick sank onto the seat nearby, his face still covered with his hands, House took one last look at him and felt that same heaviness in his chest and stomach twist again, before he turned and walked away.
"What smells like pre-eclampsia, sounds like pre-eclampsia and looks like pre-eclampsia?" House interrupted. "Oh, wait, I know this one. Pre-eclampsia."
Cameron stopped in front of his desk. "No hypertension, no proteinuria, no history of hypertension. First baby. No history of pre-eclampsia during this pregnancy, either. Onset of the symptoms occurred yesterday within an hour after eating lunch." She slapped the file down onto his desk.
"Pre-eclampsia can be asymptomatic."
"You call having symptoms 'asymptomatic'?"
"Prior to the onset and diagnosis of pre-eclampsia, yes," House retorted.
"It's not pre-eclampsia. Ran a blood panel. No antiphospholipid antibodies."
"HELLP syndrome."
"No evidence of hemolysis, either," Cameron replied.
"Ran a liver panel? Ran a test for thrombocytopenia?"
"Still waiting on the liver panel. Platelet count a little below normal but nothing substantial."
"A little below normal," House mimicked.
"As in not below percentile range."
"But almost."
Cameron shrugged.
House gave her a look. "You're boring me. Go away." He picked the file up and thrust it out at her. "Take this boring file with you."
"Is there something going on between you and Cuddy?"
At first, House didn't catch onto Cameron's question, not expecting such an abrupt change in conversation. But then he gave her another look; a carefully masked look of incredulity. "What has that got to do with anything?"
"There's a rumour going around."
"It's a hospital. Rumours spread like unquarantined disease."
Cameron ignored him. "There's a rumour that you and Cuddy are seeing each other. And that you're the father of her baby."
House dropped the file to the desk, inwardly panicking that Cameron was accurate but outwardly giving her a cynical, almost disparaging look. "For such a smart doctor, you're exceptionally gullible."
"Is it true?"
If House wasn't mistaken, the way Cameron was looking at him was almost... hopeful. Hopeful, maybe, that he'd say the rumours weren't true. Which made House realise: Cameron was far from over her stupid little crush on him that he took so much pleasure in mocking her for. In fact, he pulled his face into an expression of mock sympathy. "Would it break your soft, little heart if those rumours were true?"
Cameron shifted on the spot and held her arms stiffly at her side. "Are they?"
"Are you nuts? Why would I place a bet in Chase's pool, betting for Cuddy and me being together, if we were?"
"To confuse us?"
House snorted at Cameron. Damn her for being on the ball. Not that he'd let her know that. "Like I said: gullible." He picked the file up again and held it out to her. "Now go away."
Cameron seemed to sigh relief with the way her shoulders sagged, though still refused to accept the file. "She also started vomiting blood."
"Ew, gross," House replied impatiently. He waved the file at her insistently. "Could be a simple Mallory-Weiss syndrome. Or peptic ulcer. Might explain the epigastric pain."
"You don't think that's serious?"
"Serious, but not interesting."
"She's having a baby, House. She's 36 weeks. She's definitely in no state to deliver safely. Probably not naturally."
"Obstetrics. Not my department. Next floor down."
Cameron heaved an exasperated sigh. "Can't you at least take a look at her? Assess her? Make sure it's not something life-threatening before sending her to obstetrics? If she's in any serious medical danger, so is her baby. We can't afford to waste time if the baby's life is at stake."
House really wasn't interested in the case. He sat back in his chair, file still in his hand, and gave Cameron an assessing look. He didn't want to be wasting his time on a woman who probably had asymptomatic pre-eclampsia. But, he supposed, Cameron was right about the baby. If it was something life-threatening, then the baby's life was what mattered. He sighed and looked away, then reached for his cane.
"This better be worth my time," he said.
"So, Madeline," House greeted the woman, sliding the door closed as he read her name at the top of the file. "I'm Dr. House. Apparently, you're 36 weeks pregnant and have asymptomatic pre-eclampsia."
"What does that mean?" a male voice said from the other side of the room.
House looked across at the man. "Take it you're the daddy."
The man nodded, a worried expression on his face. "Patrick."
House stared at him for a moment, a sudden fleeting thought of imagining himself in Patrick's position. Of being the onlooker to Cuddy in a worrisome situation during her pregnancy. He quickly shook that from his mind. "Well, Patrick," he said, returning his attention to the file. "It means your wife is going to be okay. Just requires close supervision for the next few weeks. Maybe early delivery. That's nothing to be concerned about. She's within the safe range of delivery - almost all babies delivered at 36 weeks survive without complications."
A look of relief spread across Patrick's face. "So, she's going to be okay? The baby's going to be okay?"
"Yep," House replied boredly. "Means my job is done here." He looked at Madeline. "The nurse will fix you up with medication. Maybe schedule a c-section if absolutely necessary. If you've got questions, don't bother me with them." He faced away and started back to the door.
"Dr. House," Patrick said.
House ignored him because he was probably going to ask an inane question, and went to pull the door open.
"Dr. House!" Patrick called.
House looked over his shoulder at Patrick's panicked voice and his eyes landed on Madeline, who was jerking and twitching violently. Without hesitation, he limped quickly across to the bed, slapped the file on the dinner tray and reached for the emergency call button. He immediately then began turning Madeline onto her side.
"What's happening?" Patrick asked in a distressed voice.
"What's it look like, you idiot?" House snapped. "She's having a seizure." Two nurses burst into the room, one with a crash cart, and one of the nurses stripped away the bedsheet on top of Madeline that was getting tangled up in her legs. House suddenly stopped long enough to peer down at the bed, at the large brown liquid stain on the sheet below her. At that same moment, Chase rushed into the room, followed by Cameron and House looked over his shoulder at them, Madeline still fitting and the nurses holding Madeline on her side. Over on the other side of the bed, Patrick was staring at Madeline wide-eyed.
House nodded at him. "Someone do something about him. Get him out of here." Then he looked back to Chase and Cameron again. "New symptom: our patient's kidneys are failing."
"Eighty milligrams of creatinine per decilitre means acute renal failure," House announced to his team. "Baby needs to be delivered, stat. Mother needs to be put on dialysis. Chase, I want you to find out what the mother was doing, what she was eating, what medication she's on, if any. Aspirin, heparin, NSAIDs, whatever you can find. Foreman, I need you to organise an endoscopy, find out the cause of the haematemesis--"
"You want us to put her on dialysis and perform an endoscopy?" Foreman interrupted, sceptical. "The woman's in a coma."
"Good point," House agreed. "While you're at it, organise a bone marrow biopsy."
"What for?"
"For fun," House replied sarcastically. Then he explained, "Because in the last two hours, her platelet count has dropped significantly, and I want to find out the cause. Whether it's due to decreased production or peripheral destruction. Bone marrow biopsy is more accurate at this crucial point in time."
"We can't do all of these invasive tests, and put the mother through major abdominal surgery," Foreman argued. "Her body might not be able to cope with it."
"Do nothing and waste time, her body is going to be able to cope with it a lot less, seeing death is a symptom I'd prefer to avoid," House countered.
"I think we should focus on delivering the baby first," Chase said. "Maybe once the baby's out, her symptoms will be easier to manage and get under control."
"She might not live through the surgery," Cameron pointed out. "As Foreman said, she's in a coma."
"Baby's got to come out at some point," House said.
"You need consent from the father first, seeing the mother is incapable of of agreeing to informed consent."
"I'm on it," House replied to Cameron as he started towards the door.
"Why you?"
House stopped as he pushed the door open and looked back at his team. All of them were staring at him nonplussed. "You never want to be involved in talking to the patients or their family, unless they outright refuse to agree to informed consent," Chase observed, his brow arched curiously.
"Saving time," House explained. "Can't let you guys pussyfoot around. I have a more direct approach."
"Like bullying?" Foreman remarked dryly.
"Whatever works," House agreed, and he was out the door before his team could argue with him.
"What's happening to my wife?" Patrick asked.
House stood in front of Patrick outside the ICU, not looking directly at him or the tears damp on Patrick's cheeks. Instead, he was staring through the glass at Madeline, at her baby bump, the tubes coming out of her mouth and the drips she was attached to. She was just a woman he didn't care about beyond the fact that she was his patient, with a baby he didn't care about beyond the fact that he wanted to save it. "She has gone into acute kidney failure," House replied. "Means we have to operate to get the baby out before we can put her on dialysis."
He heard Patrick sniff, but still refused to look at him. "What about the- the bleeding? From her mouth? The bloody vomiting?"
"Still trying to identify the cause of that. What's most important right now is we get the baby out."
"Will Madeline die?"
House finally looked at him. He nodded. "There's a chance that might happen, yeah. There's a chance your baby might not survive, either."
He watched impassively as Patrick's face crumpled and a sob escaped from his lips. He turned away from House and gripped his head in his hands, staring at Madeline through the glass. Patrick getting emotional wasn't going to help. House needed an answer now. "I need your consent to do delivery the baby."
"No," Patrick sobbed, and House wasn't sure if Patrick was answering him or if he was simply voicing his fear of losing both his wife and child.
"Patrick," House said firmly, and Patrick shook his head and began to crouch down as though the emotional stress of potentially losing his loved ones was unbearable. House grabbed his arm and tugged him back to his feet. "Hey," he said.
"No," Patrick sobbed again.
"Hey." House tugged on his arm and made Patrick face him. Patrick responded by latching onto House's forearm. House searched his face until he managed to get the man's eye contact. "Come on, focus. I need you to give me consent to deliver the baby."
"I don't want Madeline to die."
"I know you don't, but that's what's going to happen if you don't let me deliver this baby. You could lose both Madeline and the baby if you don't let me do the surgery."
Patrick stared at House for a moment, then looked away in anguish, his face crumpling again, distraught. House felt Patrick's fingers digging into his forearm and felt Patrick's other hand clutching at his upper arm. Another sob escaped Patrick's mouth.
"Patrick," House said again, firmly but quietly as he gripped Patrick's arm a little tighter to get his attention. "Stay with me here. You need to make a decision now. Every second you spend weeping over what hasn't happened yet is time wasted and one second closer to your wife's death. Now, come on. Let me do the surgery. Might save your wife and your child."
"Might?"
"That's better than 'can't'."
Patrick stared at House and House stared right back at him, hanging on the man's response. At last, Patrick just nodded, his lips quivering, and House released Patrick's arm with a sigh of relief. He then nodded. "You're making the right choice," House told him. "It's the choice I'd make if I had to."
He stepped back, leaving Patrick standing on his own in the hallway, and quickly made his way down the hall to call for an OR and for a team of surgeons to scrub up for Madeline's surgery.
"Keep an eye on her vitals," House snapped at the attending standing beside him as he stared down at the c-section happening in front of him. It had turned out that the mother had been leaking amniotic fluid on top of everything else, which resulted in oligohydramnios. The baby's life was severely at stake. He handed the chief surgeon a gauze. The steady beep of the vital signs monitor was keeping House both reassured and on edge, mentally counting each heart beat while anxiously waiting for the surgeon to pull the baby out. He glanced up at the observation deck and saw Chase and Cuddy standing there, his eyes staying on Cuddy for a moment before he returned his attention to the surgery.
"Here it comes," the surgeon said, wedging a bluish, small head from within Madeline's womb. House held his hands out ready to catch the baby, looking across at the vital signs monitor in alarm as it began beeping frantically to announce Madeline's vitals were dropping. The surgery suddenly became filled with the commotion of nurses calling out at each other to stablise Madeline, paddles being drawn, the surgeon announcing, "Baby's out."
"Chord cut," another surgeon said, snipping the umbilical chord.
House caught the baby in his hands, a little girl, noticing that it wasn't breathing and had a blue colour to it. "No respiration," he called out and limped across to the paediatric table, placing the baby down carefully. He rubbed its chest, trying to stimulate it, muttering, "Come on, breathe."
He suctioned out the gunk from the baby's mouth. A team of nurses and a paediatrician gathered around him and House immediately started to apply CPR. "Lungs aren't opening up," he announced. A nurse administered mask ventilation while everyone else around him rushed to do what they could to save the baby's life. "Come on," House said to the baby, sounding more urgent. "Come on."
Behind him, the commotion was still going on, the surgeon demanding aid to cauterise and stitch while her vitals continued to plummet. "Apgar's zero," one of the nurses said.
"Keep trying," House snapped back at everyone. The baby was intubated while House continued to apply resuscitation, hanging on every second for the baby to take its first breath on its own. "Come on, breathe," he muttered again to the baby.
At the five minute mark, the same nurse announced again, "Apgar's still zero." House refused to listen. He felt a hand on his back a few minutes later, having tried for almost ten minutes to revive the baby, but ignored that, too. "House," the paediatrician said. "There's no point. I'm going to call it."
"What are you, stupid?" House barked back at the woman, giving her a fierce look.
"It's been almost ten minutes."
House shook his head and kept going. But a couple of minutes later, he slowed what he was doing, and then stopped. He stared down at the baby, lifeless and blue, unable to even explain the feeling that was weighing heavy and thick in his stomach.
"Time of death," he heard the paediatrician say, "17.41."
Patrick jumped to his feet the moment House stepped out of the elevator, still in his scrubs. He approached Patrick slowly while Patrick came rushing towards him with a look of frantic worry on his face. House could see Patrick had been crying for a long time, the way his eyes were red, how tired and drained he looked. "How is she?" he asked.
House stopped just in front of Patrick and tried his hardest to shake the numb feeling from him. This was stupid. This wasn't even his kid. Death happened all the time, neonatal ones, too. The baby had died, from what could be determined on the paediatric table, of maternal-related conditions, probably related to the mother's renal failure and the oligohydramnios. "Your wife is still in a coma," House replied. "So far, she's stable, though. But critical. I can't guarantee her life until we know she's pulled through this."
He couldn't work out if the sob Patrick gave was one of distress or relief. "What about our baby?"
"Your baby--" House stopped. He stared at Patrick and swallowed. He tried to think of a few different ways to say the man's baby was dead. He opened his mouth but nothing was coming to mind. He closed his mouth again and shook his head. "There was nothing we could do. I'm so sorry."
He watched Patrick's face go from bewilderment to raw shock and he felt wrong just walking away from him. So, he stayed standing where he was in the hallway, looking away while Patrick started to weep into his hands. But eventually, when Patrick sank onto the seat nearby, his face still covered with his hands, House took one last look at him and felt that same heaviness in his chest and stomach twist again, before he turned and walked away.