"Peripheral aneurysm," groaned House, the pain so bad he was barely able to speak. "Threw a clot."

Wilson just stared at him.

"But that's really rare," he said. "And clots usually cause strokes."

"Do I look like someone who's had a stroke?" asked House impatiently.

Well, no. He certainly didn't.

"If it wasn't rare," he went on, "I'd have figured it out yesterday."

"Peripheral aneurysms usually present in the back of the thigh, not the front."

"Usually being the operative word."

While Wilson was struggling with this concept, House took charge.

"Get me an MRI. Now. I need to know what's going on in there."

Wilson made a call.

"The soonest we can get you in is five o'clock. Does that suit you?"

"Actually, none of this suits me. But it'll do."

Insisting on an MRI turned out to be smart—and Wilson was learning that smart was something House did very well.

As soon as they saw the results, they had the answer. House was right. It was an aneurysm. A clot backed up the blood flow, creating gangrene. His muscle cells were dying, which caused the pain, and leaked myoglobin, which was damaging his kidneys.

The next few hours were tense. Now that he had the answer, House dug in his metaphorical heels and stubbornly insisted that he control his treatment.

"Deal with the aneurysm and remove the clot. Do a bypass to restore blood flow."

For the first time in two days, Cuddy knew what to say.

"We should remove the leg."

"I like my leg. Do a bypass."

"Reperfusion. You'll be in pain."

"I'm already in pain. Deal with the aneurysm and remove the clot. Do a bypass to restore blood flow."

After a few more times back and forth, Cuddy gave in and ordered the surgery the way House had requested it.

As Cuddy predicted, the removal of the clot caused reperfusion, which increased House's pain, if such a thing were possible. It went from excruciating to intolerable.

The next morning was even worse.

"I can't stand seeing you like this," said Janet to House, when he took a breath after screaming for two solid minutes. When he wasn't screaming, he was vomiting, although there was nothing left to vomit. "If this was going to work, it would have happened by now."

"No… Let's wait… give it more time."

"This pain is going to kill you."

After a very long pause, House looked away from her. "I know," he said.

"Let them take your leg."

"I-I can't."

He couldn't bring himself to tell her why he couldn't let them cut off his leg, even though he knew it would stop the pain. In fact, he wasn't entirely sure why himself. The pain was so intense, it blocked the voices in his head, the ones that constantly judged him.

"See that cripple?" said his father. "Pathetic. Those guys who came back from `Nam missing a limb… what did they have to live for? Barely even human. They'd have been better off dead."

"Oh, look at that poor man," said his mother, inclining her head toward a filthy, one-legged man sitting on the corner, a battered fedora on the ground in front of him. Leaning against it was a piece of cardboard that read 'Help me.' An equally filthy dog panted nearby, a ragtag yellow kerchief around its neck. "I feel so sorry for people like that, don't you, Greg?"

He'd deal with the pain.

"I knew a guy once who was showered with napalm and never made a peep. Now that was a man."

Although House's logical mind never would have admitted it, a little part of his brain that he seldom accessed thought that maybe, somehow, he deserved the pain.

"I'm… disappointed in you. I just don't get you. You don't fit in. You're a bum. You spend years in medical school, and you throw it away to go play the drums? We had higher hopes for you, son."

But another little part of his brain had an idea.

"Call the doctor."

Janet ran into Cuddy and Wilson in the hall, headed toward House's room.

"He wants you to put him in a chemically induced coma to ride out the pain," she said.

Startled, Wilson simply looked at her. A coma?

"We can do that," replied Cuddy guardedly.

"Will it work?"

"It could. He could be right," she told Janet. "He could come out of this with almost full use of his leg… or he could be in pain for the rest of his life." She paused. "There is a third option—a middle ground between what we did and amputation."

"He's not big on middle ground," said Janet.

No, he's not, agreed Cuddy. Not the House I remember.

"You'll be asleep in about a minute," said Cuddy, removing the syringe from his IV.

"Thank you," he said weakly.

"You sure this will work?" asked Janet, leaning close to him.

"Sure it will," he replied, getting drowsy. He looked at her through heavy lids. "Hey… I love you."

"I love you, too."

She paused.

Then she whispered.

"I'm sorry."

As he responded, his eyes grew heavy and his voice drifted away.

"You don't have anything to be sorry for…"

As soon as he was out, Janet got up and walked over to Cuddy, standing at the foot of the bed.

"This middle ground. What is it? I'm his medical proxy, and I want to know what the options are."

"Cutting out the dead muscle," said Cuddy. "It's called debridement. There's still a chance of reperfusion, but it should allow him to keep the leg."

"How could you do that?" asked Wilson angrily. "How could you influence her to go against his wishes?"

"She needed to know there was another option."

"No, she didn't. She needed to support what he wanted."

"Yes, she did need to know. It's called informed consent, remember?"

"He's the one giving consent. And if there's anything I've figured out in the last few days, it's that House is informed."

"You know what this will mean, don't you?" asked Cuddy of Janet as House began to stir. "He may still have some pain, and he'll need a lot of support."

"I understand," said Janet. "I'll take responsibility for my decision."

Even if you leave him with chronic pain? wondered Wilson, standing nearby. How happy is he going to be about that?