Conclusion. Finally. Sorry it took so long. Comments are appreciated, in regards to this last chapter or the story as a whole. Forgive me in advance if the medical aspect of this isn't perfect. I researched some and improvised the rest.

A/N: I'm considering making an extended/alternate ending to this. If enough people request it, there could definitely be one more chapter. Thanks for reading!

If you want to refresh on any of the previous chapters here they are:

occlusion conclusion

The ambulance doors slam shut with Cuddy on the inside of them. She pulls rank with the paramedics, insisting on PPTH and using their presence as an excuse to withhold tears.

House is unconscious and, after they connect the leads, she sees his blood pressure's low. When she takes his hand, it's cold. The ambulance is speeding, but she knows it's going too slow. Right now she's hoping he did cheat, hoping this is a complication of some STD.

Right now she knows better.

And there's nobody in the ER to convince her otherwise. No Cameron with her blind blonde optimism, no Wilson defending the prospect of lechery. Nobody's standing except her and two doctors on her payroll whose names she barely remembers scrambling to keep the love of her life's heart beating.

After he is stabilized and the first wave of panic passes, when there's nothing to do but worry and wait for the first round of tests to come back, Cuddy goes to her office to recompose herself, smearing foundation under her eyes and across her face where tears and sweat etched the fear of imminent devastation.

Then she's in his office, the swing of the glass door slow and somber and uncertain as anything.

"We heard," starts Taub.

With her head bowed she offers, "The ER found ascites. We should test ––"

"He already did," Foreman interrupts. "Liver enzymes, creatinine, urea, LDH. He knew something was wrong."

"When?"

"Two days ago."

"Test again," Cuddy insists. "Do an ultrasound, and biopsy his liver."

The team get to their feet and rush out. This isn't the first time their boss has been a patient. It is the first time his boss has stood impatient, on the brink of breaking down and willing to beg if it would make him better.

jejune stars

An indeterminate nausea has persisted for the past week. Cuddy knows what it might mean, the same as she knows it might not mean anything. So she tries to concentrate on the catastrophes they've survived and not the odds they're against.

The memory of one morning comes to her in times like this. Ann Arbor. Not just the aftermath of daybreak but the night before when she struggled him out of his leather jacket, her knees weak, hands trembling. They came together co-conspirators stealing a chance. Even at the height of his egotism there remained a kind of ingenuous wonder in her presence. And she was naïve enough to believe it was just beginning.

Outside stars like candlelight flickered too dim and losing to dawn. He sprawled still and close. The cool bathed his eyes and slowed the flight of time, time that had crept so insidiously through their few weeks In the blink of an eye they'd met and danced and somehow made it here. House stared at the ceiling irresolute.

She heard him wake, felt him turn and watch her a while. Without effort she looked chaste and unsuspecting. He thought she was asleep. She breathed even, didn't even flinch when his fingers stroked a strand of hair away from her eyes, or when he lifted the sheet to sneak one last peek.

Finally he leaned to kiss her softly. He tried to hold onto the moment and was chilled by the innocence of the kiss, the flutter of her eyeslashes and the sight of her sleeping body silhouetted by the September sun rising.

He knew it was goodbye.

Never would she have thought one night could so vastly impact the rest of her life. Never should it have taken twenty years for him to make her his wife. All she had to do was open her eyes.

Cuddy let him go, not knowing she could have followed him, found him, resisted then the way she does now the fate that led them to this place.

Her office door opens quietly. A pallid Wilson stands straddling the doorway.

"It looks like Budd Chiari," he chokes, not meeting her eyes.

"What did the biopsy reveal?"

"Biopsy was nonspecific but ruled out cirrhosis and galactosemia and cancer. And with his tendency toward thrombosis––"

"He had a clot in his leg so now he has one in his liver."

"We're waiting for the results of the new tests but with ascites and hepotomegaly. It fits."

Cuddy nods, exhales for what feels like the first time in hours. She feels relieved and she knows she shouldn't.

"I'll let the team know."

"Possible causes of the Budd Chiari?" Foreman initiates the DDX.

"We're sure it's Budd Chiari?" Chase haggles,

"Wilson confirmed," Taub endorses.

"Genetic predisposition would point to protein in C deficiency, protein S deficiency or factor V Leiden mutation," he continues.

"Toxin's a possibility. Pyrrolizidine alkaloids: Borage, Boneset, Coltsfoot, Comfrey, Heliotrope," adds Chase.

"And since the odds of him being exposed to any of those is next to nothing, and the odds of him getting depressed and calling a hooker are close to guaranteed, we're probably looking at infection. STD, or fungus," Foreman interrupts.

"Genetic tests are going to take the longest so start with blood tests for toxin and likely infectious suspects," he finishes.

They stand and start toward pathology to run the labs, all three knowing the futility of finding the underlying cause.

magnetic north

House wakes up gradually. He sees her wide awake still at his side. He tries to turn toward her but the throb in his abdomen interrupts his movement.

"You did a biopsy," he deduces, wincing. "Did it tell you anything?"

She nods.

"It's Budd Chiari."

House huffs half incredulous.

"Another clot. History repeats itself."

"We started you on heparin and spironolactone. Your team did a retrograde angiography. They're trying to figure out what's causing it."

"Doesn't matter. Slow onset turned acute, fulminant. I'll be jaundice

soon and then––"

"I put you on the transplant list."

"They aren't going to let you waste a liver on me."

"Your best chance is a transjugular intrahepatic portosystemic shunt."

"TIPS is just a temporary fix. Diverting bloodflow is an end around the clot. It's going to reduce the swelling. But the damage; centrilobular necrosis, renal failure, ischemia..."

His voice trails off. She's looking too pale.

"The damage is done."

He wants to ask her what's really wrong. He's been here before, so has she's never looked this scared at his bedside. Something else is wrong. He wants to ask, or confirm but can only manage:

"What's my Child Pugh score?"

"Elevated."

"Why not tPA?

"A shunt is safer. They've just started treating Budd Chiari with tPA.

The risks of hemorrhage, the chances of it working ––"

"But it's only been hours. I'm still within the window where it might make a difference."

Cuddy closes her eyes, trying to assuage the sting of tears.

"You're right. It's not too late."

"Alteplase," he prescribes knowing it will either cure him or kill him.

The intolerable bareness of his hospital room bothers her only after they take him out. She orders flowers and starts toward her office but turns back around. She has to be with him, no matter what happens or how much it hurts. Still, she's half afraid to go in.

At the threshold she hesitates, closes her eyes. Then, stepping into an even colder more sterile room:

"House, you should know I'm––"

"Tell me after," he strains to say, the anesthesiologist hovering over him.

She bows her head. He can see regret.

"And if I get a hematoma at the puncture site in my groin, you're the only one allowed to remove it."

His eyes close a prolonged moment and open to meet hers. He's trying to smile and counting backwards and out before Cuddy can think of anything else to say.

The procedure bears no complications. After the arterial catheter's in, they start the alteplase at 1.83mg an hour. Complete thrombolysis before the anesthesia wears off. No transfusion was needed, a hematoma localized but didn't need evacuated.

Waiting for him to wake up isn't easy but she knows telling him will be the hardest part.

It took all the strength she had to draw the blood and order the test on herself. And knowing the results breaks her heart. The pain, the past, the accumulating weight on her heart.

Of course, he might already know. It would explain why he acquiesced to marriage, his logic of giving her the second half of what she wants. It would explain the scene from dinner last week.

Rachel was in bed. He'd watched her a few hours that night and Cuddy wasn't sure how he'd manage to cook a four course meal and get a toddler fed, bathed and into bed early but the prospect of home cooking å la House kept her from questioning it. She dropped her briefcase and looked over his shoulder until he relinquished the spoon and finally offered her a taste.

"Mmm."

"Save the moaning for after dinner. Table's set," he said slanting behind the hot stove.

"Go, sit."

As she made it to the dinner table, her shoes slid off and she sat confounded by how they'd become something resembling a real family. Even if he hadn't changed, he was trying. She struggled not to think how easily it could all fall apart.

The plate landed in front of her, the aroma alone enough to eclipse any pessimism, or realism about this relationship. She mumbled 'wow' with the first bite still in her mouth and a short while later another syllable. "Wine."

She started to stand but House volunteered.

"I'll get it."

He came back with a half full wine glass. After a few bites she took a sip.

"House! This is grape juice!"

"All wine is grape juice, when you think about it. Really old grape juice."

"Where's my Bordeaux?

"I drank it.," he lied. "Pairs great with onion rings."

Cuddy paused, incredulous. She doubted he was telling the truth but couldn't see then why it mattered.

He was grinning smugly despite all his effort to conceal the I know something you don't know gleam in his eyes. For almost three weeks he'd been swapping her coffee with decaf, sneaking folic acid in with her meals. Before they went to the shore she'd thought she lost her birth control. Really he was hiding them, and keeping her distracted enough to postpone a refill. He didn't think it would be that easy.

What he didn't know was she'd already stopped taking it two months before she broke it off with Lucas.

They finished eating and he did the dishes. She'd DVR'd his soaps and expected him to veg out in front of the TV while she curled up in her bed with budget reports. But he followed her.

There were few words, just him watching her undress––his blue eyes like searchlights following her, patient. He pulled her down to him and she felt it, the raw want for her he's always had that finally crossed the border into love.

Then there was only the weight of him on top of her, kissing his way up her inner thigh, dragging his cheekbone over her skin, leaving a damp trail of kisses up her stomach until he was finally, finally inside her.

It was an hour but it was over too quick. After he'd shuddered her name, when she knew his leg must have been killing him, Cuddy pressed her lips to his jaw and loosened her arms around his back.

"Don't," he whispered.

And that night she didn't let him go.

They made love again, leaving both their suspicions unspoken. Cuddy could never distinguish the difference between what was intuition about his motives and what was hope. All she knew was that they were each other's magnetic north. No matter how much they fought it, or were afraid, they couldn't throw the compass away. It was all leading to the same place.

The rhythm of EKG nearly lulls her to sleep.

"It worked," he says before she can drowse off at his bedside.

"You were right," Cuddy starts, still thinking of that night. "The tPA worked."

"House vs. clot, 2-0."

He reaches out for her hand. His is ice cold. Cuddy leans in and he pulls her down, his arms in a tight grateful clasp. She rests her head on his chest and they lie still a long quiet time.

When she hears his breath catch she sits up, sees his fists clenched. His legs are writhing and his back is arches. His vitals escalate. He's having a seizure.

Cuddy hollers for a nurse and goes to the other side of the bed to get a syringe and some ativan and after administering it into his IV, she sees his catheter bag full of blood.

The seizing stops.

"House," she says. He's unresponsive. She gets the nurse's flashlight and checks his pupils. They don't react. Her heart sinks.

He's slipped into a coma.

A complication of the renal failure, she knows and rushes out.

The tears have crested and the instant she draws the blinds in her office they stream down her face. She doesn't know what she's crying for more, the fact that she never told him or the feeling that she's failed him so far. If he'd listened to her about the shunt ––

Life and death shouldn't hinge on an if. So she calms herself and tries to think like House. She's looking at his chart, struggling to be objective and after a few composed minutes makes a connection.

They're the same blood type.

There's more to matching them than that, she knows. And even if she could donate one of her kidneys, it would mean terminating the pregnancy. With her head in her hands she considers the ultimate sacrifice. For most women it would be easy. For most women pregnancy is repeatable, not a saga she gave up on or a biological feat the father is still unaware of.

Cuddy needs a consult. She walks into Wilson's office, finding him staring at his desk and looking lost.

"His liver survived but his kidneys are compromised."

"I heard."

"I preemptively put him on the wrong transplant list."

"He's on the right one now?" Wilson asks, unnecessarily panicked.

"Yes. But dialysis isn't going to bring him out of a coma. I don't know how long––"

She stops pacing. "I could give him one of mine."

A beat. Wilson nods. "You could."

With his words it feels a little less like it's all unraveling.

"It might be his best chance," he tries as Cuddy starts out the door.

It might be his only chance.

Now she's got a judgment call to make, wager all or hold her breath and wait.

Doubtfully she stands outside House's room as his team gives him another transfusion. She knows what she has to do. She orders the tests, books an OR for tomorrow morning and starts to fill out the paperwork. In a few hours, no matter how much it hurts. What she has to do to make him wake, get him back.

Everything will change.