Disclaimer: Not mine….obviously but I will kindly borrow them for the duration of his musing of mine.
Rating: Could change but K+ for now
Spoilers: Post No Reason (Season 2 Finale)
Summary: What happens pretty much directly after the final scene and why exactly House told Cameron to tell Cuddy about giving him Ketamine.
Reviews are always welcome.
Dr. Lisa Cuddy did not remember the corridor of the Emergency Room to be quite as long during previous visits as it was on that fateful morning.
Her shoes had an ankle strap.
It was an absurd thought to have at that particular moment but as she lengthened her stride in order to move more rapidly down the stark white hallway she was suddenly thankful for choosing the shoes - for she had enough to worry over without risking a torn tendon in her ankle.
"Where is he?" she asked the admitting desk, her eyes wide with urgency.
The 'he' she was referencing was easy enough to deduce and the woman quickly replied "They're prepping to take him to surgery right now. He's stable" she added, hoping to reassure the Dean that she wasn't going to lose one of her doctors.
Cuddy graced the woman with a grateful nod before once more taking off in the direction of the back of the ER. She saw his team first. They were helping the nurses transfer the patient's IV and heart monitor to a portable source in order to be able to move him upstairs. As they turned the gurney toward the elevators at the back of Emerge she caught a glimpse of him.
One glimpse was all she was given – all that she could take.
"What that hell happened!" Her voice rose in volume in an attempt to mask the frantic edge of her tone.
"First shot through and through to the right mid abdomen, likely impacted the liver second was through and through to the carotid artery." Foreman announced succinctly.
"The guy just walked into the office and shot him." Chase divulged, his pallor paling as he recalled the event from moments before. "Said he was a former patient or something."
"He's lost a lot of blood" Cameron spoke softly, her eyes downcast as they followed the path of the hospital bed into the elevator.
Cuddy shot Cameron a look of thinly veiled contempt for voicing her pessimistic observations. When word had reached her of the shooting and the sole victim she hadn't entertained the possibility that House wouldn't survive. He was shot in a hospital – her hospital – the only outcome she could foresee was his survival. Perhaps it was naiveté or perhaps it was self-preservation fueling that assured thought whatever her motivation, she would do everything in her power to ensure its reality.
"He said to tell you to give him Ketamine." Cameron spoke suddenly, breaking through the harried thoughts of her boss.
"What?" Cuddy shook her in order to focus her mind back on the woman next her.
"He regained consciousness momentarily when we were wheeling him into the ER; he said to tell you to have them give him Ketamine" Cameron reiterated. "Do you have any idea what he's talking about?" Her tone was undercut with a hint of jealously that even the dire situation could not dissolve.
Realization dawned in Cuddy's dark blue orbs and she took a deep breath as the information trickled through her neural pathways. Without a word Cuddy made a dash for the elevator that had taken House upstairs for surgery – three intrigued doctors doing their best to keep up with the slight woman's determined gait hot on her heels.
"Alright, where're we going?" Chase shot a worried glance toward Foreman at Cuddy's agitated state.
"Why would House specifically request Ketamine to put him out? This isn't a minor surgery he's having and unless he's looking forward to riding the magic carpet and having a conversation with God it doesn't make much sense; only House could think of getting high after getting shot. Ketamine's half life is only two and a half hours; they'd have to administer a dose high enough to comatose him in order to do the surgery." Foreman wondered aloud, not truly expecting an explanation from the administrator.
"The Ketamine would act on the pain receptors as an analgesic; if there's pain he wouldn't experience any of the psychotropic effects." Chase added.
"But it's still a glutamate inhibitor" Foreman pointed out. "The drug's activity in the prefrontal cortex mimics a severe schizophrenic episode; with the possible increase in circulation associated with Ketamine he could become disoriented and violent on the operating table and end up bleeding out."
The elevator dinged and opened on the forth floor; Cuddy was already squeezing between the heavy metal doors before they opened fully. She knew that the longer she had to mull over the information the less confident she would become at the order she was about to give the anesthesiologist.
"They just wheeled him into an OR." Wilson caught her, coming from the opposite direction, having bypassed the ER and gone directly to the OR floor.
"Who's the anesthesiologist?" Cuddy asked in a rush of an expelling breath.
"Carroll." Wilson's brow furrowed at the administrator's unusual state of distress. "What's going on?"
Cuddy picked up the phone at the nurses' station, calling into the OR. "It's Dr. Cuddy. I need to speak to Dr. Carroll right away" she paused as she listened to the other end. "I realize that; it's with regard to Dr. House's care." She hung up and shared a word with one of the nurses before turning her attention to the OR door swinging open.
"What's this all about Dr. Cuddy? We can't wait much longer to put House under; he's lost too much blood and might not remain stable." Dr. Carroll, a small and painfully thin balding man approached his boss and the four doctors standing at her back.
"Put him under with Ketamine." She ordered bluntly.
"The surgery will take too long. I can't use Ketamine. O.5mg will barely affect him; he'd wake up in the middle of the operation if he even lost total consciousness at all." Carroll huffed in exasperation, miffed at having someone tell him how to do his job despite that someone being his boss.
"That's why you have to give him 8mg." Cuddy announced resolutely drawing incredulous stares from all angles.
"That'll comatose him. There could be irreparable damage done to his hippocampus and prefrontal cortex." Carroll warned harshly.
"It's what he wants." Cuddy tossed back.
"Cuddy, he's unconscious. He can't want anything right now." Wilson interrupted.
"He told Cameron to tell me to give him Ketamine." She informed Wilson, setting her shoulders.
"He was out of his mind! More than usual!" Wilson argued. "He had just been shot!"
"He could end up never waking up from a dosage that high; it's over sixteen times the therapeutic dose." Dr. Carroll lowered his voice as though talking down a jumper off a ledge.
"Don't patronize me Carroll!" Cuddy sniped. "I have the same initials after my name that you do." She turned to Wilson once more. "House and I have talked about this; there are trials being done in Germany that show promise for pain management and the regeneration of damaged neural receptors."
"I'm sorry Dr. Cuddy. I can't administer the anesthetic without the patient's consent. We're talking about memory loss and thought distortion that could plague him the rest of his life." Carroll shook his head.
"You have my consent." An eerie calm overtook Cuddy as tension bled from her limbs, knowing that she had won this fight.
"You can't make a decision like that just because you run this hospital." Cameron argued hotly. "It's not your call to endanger someone's life because you want to make a name for yourself."
"It is my call. I hold Greg's medical proxy." Cuddy didn't notice the slip of House's first name from her lips or the further surprise from all those standing with her; instead she was focused on the nurse who was approaching them. "Here" she took a clipboard from the nurse and scribbled her name a few times "now you have consent to use the Ketamine." She handed Carroll the papers.
After glancing at them quickly he sighed, "I hope you know what you're doing." With resignation he turned and headed back into the operating room.
"What the hell was that all about?" Wilson voiced the question on everyone's mind.
"I'll be in my office. Would you please inform me when Dr. House gets out of surgery." Cuddy addressed the nurse at the OR station, making it clear that the query she posed was in fact an order. And with that she turned about headed back to her office nestled within the Clinic walls.
TBC - if you guys think I should – definitely have more.