It started, as all episodes of House do, with a cold open. A literal cold open, both because it was freezing weather outside and because my partner caught a really nasty cold, or at least we thought it was at the time. They got this cold by sitting in a skip throwing building waste into a wheelbarrow so my mother could build a dragon in the gardens of a medieval monastery. My life is quite strange. This was mid-January, and while it doesn't snow much in Kent due to the sea air, it does get below freezing.

My partner was working hard, and - once out of the skip - was wheezing and sneezing and generally struggling. This is not an unusual state of affairs for them. They suffer from fibromyalgia, myalgic encephalopathy, asthma, and bursitis in both hips. When they were all but falling asleep in the pub over the road from the dragon building site, we wrote it off as a combination of exhaustion and cold. That cold, and the chesty cough it turned into, wouldn't go away. Neither would the breathlessness. After well over a week of their condition worsening, I dragged them kicking and screaming to A&E, on January the 22nd.

This concludes the prologue. Strap in, folks, it only gets more capital-M Medical from here.

After several tests and a whole lot of waiting around in the corridors of our chronically understaffed and underfunded local hospital, my partner was admitted to the RAT ward. This is ironic because we have many pet rats, and also because it stands for Rapid Assessment and Treatment. Once there, their condition was monitored at length, and found to be pretty bad. There was masses of fluid building up in their lungs, huge amounts of infection markers in their blood, and they were badly dehydrated. Worse, they were struggling to take in enough oxygen, so they were becoming delirious. On January the 26th, they were transferred to the ICU and placed under sedation. Basically they were in a medically-induced coma. The team thought it wouldn't be for long, and that we just needed time for the antibiotics and antivirals to work. This proved... half right. We did need time.

On February the 2nd, my partner was transferred to a much larger regional hospital with a newly-built Critical Care Unit. They were in a serious condition, but they were also the most stable, meaning that they were the easiest to move and so therefore were shipped out to make space. This was an hour and a half's drive away, and since I do not drive I was reliant on my parents to give me a lift there. I became extremely well-acquainted with the road signs on the way, including the fantastic one for the Godmersham & Crundale Village Hall, proof there'll always be an England.

I made the trip back and forth every day, and every day their condition worsened. There was always some new thing. The Critical Care doctors tried all sorts of things: stronger antiviral treatments; an intubated fluid drainer; even lying them on their front and basically squeezing the gloop out of their lungs like the world's largest and phlegmiest Capri-Sun. Nothing worked. I also had to point out that the ventilator mask they were using was pushing in their top lip piercing so hard that it had almost been shoved out the other side and into their mouth, whereupon it could have been aspirated. Which would have been... unhelpful.

Suddenly, a bounce back. On the 8th, the team brought my partner out of sedation. This was wonderful to see! Slight problem: they were still completely delirious. I have no idea what was going through their head at the time, but that was alright, because they didn't either. I had to try and calm them down, over and over, when they weren't able to get out of bed and walk home. The light fittings were snakes. The cabinets full of medical supplies were a corner shop. We had a pet otter, about which they were very worried. It was all very tough, but I thought we just had to push through it.

This is the part of the House episode where the patient has an unexpected massive downturn. Despite being on enough drugs to fell a racehorse, their condition wasn't improving. In fact, it was getting worse. On the 13th, they were conscious, and the next morning, the doctors told me they'd had to put them back under sedation. Yes, that was on Valentine's Day. It was not a fun time.

This was diagnosed as ARDS, or Acute Respiratory Distress Syndrome, a catch-all term meaning "the lungs have done a fucky wucky and we don't really know why". My partner's lungs were constantly filling with fluid, the fluid was becoming infected, and the infections were causing the lungs to fill with fluid. It was almost like their body's systems were being turned against the body itself. All we could do was try and make them as comfortable as we could, rubbing hand cream into their chapped and dried-out fingers as they were pumped full of drugs and painkillers.

Not only that, but their condition worsening meant further strengthening of the ventilation settings just to try and get their blood oxygen concentration to a decent level. Fighting through all the crud in their lungs meant shoving air in there way too hard and way too fast. It got to the point where they were breathing fifty times a minute. That kind of strain on the human lung is completely untenable. So, on the night of the 19th, I get a call I've been dreading ever since the start.

My partner is being transferred to St. Thomas's Hospital in London for ECMO treatment.

This is that part of an episode of House where someone tries a potentially-dangerous experimental medical procedure on a patient for whom nothing else has worked. ECMO stands for Extra-Corporeal Membrane Oxygenation, and it is a last-ditch treatment for when a patient's lungs are capital-F-U-K-T FUKT. A giant tube is run from the femoral vein that slurps mulberry-coloured deoxygenated blood out of the patient. The blood is then shoved through a kind of thin mesh that has oxygen pumped through it by a machine that looks like the bastard offspring of a microwave oven and the thing they use to inflate bouncy castles. The oxygenated, vividly-scarlet blood is then sent through a different tube back into the femoral vein on the patient's other leg. This means the lungs don't actually have to do all that much, and can start to regenerate and recover from damage without fear.

It's obviously risky to literally pipe out someone's blood and run it through a sieve. It's kill or cure. I had to give my consent. And on the 20th, they were shoved on an ambulance and taken to St. Thomas's Hospital in London. It's an excellent hospital, but more pertinently, it's one of only five hospitals in the entire country that offers ECMO treatment. Indeed, so new is ECMO as a medical treatment that the doctors in charge of the dedicated ECMO ward asked me if I would consent to my partner being part of a study to determine best practices for the technique's use, because they don't really know yet.

The specific area of interest was in how they wanted to exercise the lungs. Since the machine is essentially an artificial lung, my partner's actual lungs were left with nothing to do but recover. The doctors were unsure whether to keep them on a normal respiratory rate of 15 breaths per minute or to cut it down to two, making the lungs do absolutely minimal work and letting the machine take the strain. After several tests, they settled on the latter.

London is several hours by car or public transport. I opted for the latter on account of not wishing to inflict London traffic on anybody. It was expensive for someone on the kind of extremely minimal income that typifies the chronically disabled in my allegedly-enlightened nation, but I was able to manage thanks to financial help from friends and relations. And all that to hold one-sided conversations with my partner, who was under even deeper sedation than normal so as not to cause them harm from how invasive the treatment is.

They looked like a corpse in a bramble thicket. They were pallid, clammy to the touch, and still as standing water, surrounded by an incomprehensible tangle of wires and tubes. They were like this for nine days.

Each one felt like forever.

On the 24th, I had to consent to a tracheotomy, to take even more strain away from their lungs and allow the doctors to more efficiently remove the infected lung fluid. On the 27th, the doctors had to rush them into surgery to find and hopefully plug up a bleed in their bowel. On the 29th... on the 29th, the day I was losing hope the hardest, they were able to be decannulated. The inch-wide plastic tubes were removed from the giant veins in their legs, they were taken off the enormous dose of blood thinners necessary to make the machine work, and they were transferred to Intensive Care.

I'd had false hope before, but it stuck. ECMO was a last resort, an experimental treatment with a less than 80% survival rate, but it worked. My partner was able to be taken to a normal Intensive Care Unit and slowly, tortuously slowly, they healed. But we weren't done yet. Like any episode of House, the twist is about to come.

The bleed in my partner's bowel came back, along with pain palpable through a haze of fentanyl and a series of inconclusive CT scans. They needed keyhole surgery to find the bleed, but what the surgeons actually found was far worse: a full on perforation of the bowel in two places, both near each other and near the stomach. It took them six hours to fix, but at the end, they were left with a stoma - a temporary one, but still an open wound. What they'd had to do was cut out the perforated section and bring the resultant hole to the surface so that the bowel itself could heal.

While recovering from this immense procedure, the blood tests revealed something unusual even for an ICU patient whose body has, to slip into complex medical jargon for a moment, been put through the fucking wringer. Anti-Jo-1 is an antibody that attacks and attempts to destroy something called a tRNA synthetase. Normally, antibodies are fine. We like them. They do a good job of making you not dead. This is not one of those occasions. In addition to being difficult to detect, the target of Anti-Jo-1 is an important enzyme used in protein transfer.

This results in a chronic autoimmune condition called antisynthetase syndrome.

Antisynthetase syndrome, or (and I swear I'm not making this up) ASS, is an extremely rare disease, but one that fit my partner's symptoms to an almost textbook degree. It causes joint inflammation, muscle pain, myositis of the lungs, and interstitial lung disease. It even causes what's known as "mechanic's hands", wherein the skin on your palms and the sides of your fingers becomes... dry and cracked...

This is why I said we've been in an episode of House. My mother gives hand cream as presents to anyone even vaguely femme in her life, and we'd been rubbing it into my partner's hands for the entirety of their stay in hospital. In so doing, we had accidentally been hiding one of the symptoms of their eventual diagnosis. I cannot help but look at this and see outright fucking foreshadowing.

That diagnosis was during mid-April. My partner was not able to move at all upon coming out of their medically induced coma, and their muscles had atrophied so completely that it took prolonged physiotherapy for them to sit on the edge of their hospital bed. On the 5th of May, my partner was able to be discharged from hospital and came home to me, and we sat in our local pub to a chorus of well-wishes from everyone who knows and loves them.

Thank you for reading. Roll credits.

---
"She's old, she's lame, she's barren too, // "She's not worth feed or hay, // "But I'll give her this," - he blew smoke at me - // "She was something in her day." -- Garnet Rogers, Small Victory

FiMFiction.net: we might accept blatant porn involving the cast of My Little Pony but as God is my witness we have standards.

You can also tell it's an episode of House because it wasn't lupus. =]