Mayfield Psychiatric Hospital had requested all the facts: a complete set of House’s medical records, including any psych records. And anything else relevant. The faxed note was co-signed by House granting permission to disclose the private files. It was the “anything else relevant” that she’d had a terrible time with. Cuddy knew she should leave nothing out, medically or behaviorally, and it was one of the emotionally difficult tasks she’d ever had to do.

She had started with the facts. His medical records: the tome that now sat on her desk, four inches thick. From the infarction to the shooting. The Ketamine treatment. Rehab records from 2007. The overdose Christmas eve 2006; His near-electrocution less than a year later. She started paging through the massive file.

“Patient self-injected Demerol; discharged. Drug seeker. Flag file for future ref.”

“Patient presents second time. Admitted. Referred to L. Cuddy.”

“DDX: Femoral artery, caused by trauma to the right quad. See note.” Cuddy placed a post-it flag on the page. It was important for the docs at Mayfield to read this part. Very. She flipped to the attached note, written all those years ago in her own hand. “Initially misdiagnosed by ER staff after frustrated patient (a noted staff nephrologist) grabbed the syringe. Patient presented with a 10 pain rating. Explained that the ER doc was an ‘idiot.’ Apologized for the self-injection. Delay in final diagnosis led to extensive muscle cell death. Patient requested no further treatment than removal of the clot followed by high dose anti-coags, concerned about loss of his leg…” Cuddy flagged that page as well, pulling out a yellow lined legal pad. “Other relevant information,” she wrote neatly at the top of the page.

“Betrayal by the person closest to him contributing factor to his current physical disability. He has a hard time with trust. Do not know if that issue predates the debridement surgery,” she jotted.

She continued the narrative. “He abandoned traumatic injury psychotherapy after one session post-op, while continuing physical therapy six months. Regained very little motion or reduction of pain in right quad due to nerve damage and muscle loss. Frustration over pain issues and mobility caused him to withdraw, leading to the breakup of his long-term relationship with the woman who overrode his decision about the surgery. Withdrew further from associates, friends. Resigned his position on the PPTH staff in both subspecialties of nephrology and infectious diseases.

PPTH offered him a new position on clinical faculty, an endowed chair in diagnostics, which he declined. It was at that time, patient became careless about his appearance (but not his hygiene), lost weight and showed other signs of depression (in addition to the social withdrawal). After being fired from four other area hospitals within 6 months, he accepted the PPTH offer and joined the teaching and clinical staff of Princeton as part of an overall settlement for the leg. But he continued to withdraw from any sort of society, where he had been social and outgoing (if a little abrasive) before the infarction.

Cuddy stopped writing. There was too much, and she was too close to it. Wilson was too close to it. She remembered the time Wilson had set up that bet to prove to House he was an addict. A week off Vicodin. Done. And what had it proved, other than House’s physical dependence on the drug—and that being off it made him feel like shit? And that even strung out, he was the best diagnostician around. “I’ve done enough damage,” Wilson had admitted to her when it was all over and he had proven his point. Yeah. They were both too close. And both too guilty.

How many other times had they interfered? How many time should they have intervened but didn’t? How do you tell a psychiatrist that you’re guilty of practicing their specialty without a license? Cuddy closed the file copy. Should she have suspected something? Should Wilson? They both had known he was in pain. Deep pain. But were there signs that he was really about to go off the rails? Cuddy shivered, the image of House sitting on her sofa, frightened and lost. “How do I know you’re real?” he had asked so quietly.

The door opened, startling her. “I knocked…I heard you, but you didn’t… You OK?” Wilson noted her expression.

“Sorry. I was… Of course I’m not OK, probably doing as well as you.” Cuddy scrubbed her eyes, smearing her mascara.

“How was the wedding?”

“Beautiful ceremony. I’m happy for them both,” she replied sincerely. “I couldn’t stop thinking about him… The whole time, I… How could we not have seen…?” She was on the verge of tears again.

“We’ve been telling him for years, Cuddy. Did you know he’d seen a psychiatrist a few weeks ago—before Kutner…” She hadn’t known. “As far as I know, only once, but still… What are you doing?”

Trying to put together the Reader’s Digest version of House’s medical history. Cuddy pointed to the very thick file folder, rubber-banded together, on her desk. “He’s had a lot of blows lately. In the last year. Physical and emotional.”

“Like Amber’s death,” Wilson suggested somberly.

“Yes. He blew it off as if he felt no responsibility; carried no guilt. But I knew better. I should have…” Wilson cut her off; it was pointless, this sort of guilt.

“Did you note down the deep brain stimulation? The bus crash? That stunt last year with the knife in the socket?”

“He should never have done that procedure…” Cuddy regretted reminding Wilson of it. Of what he had asked of his best friend. “Not in his condition at the time. It was risky even under ideal circumstances. With a fractured skull, it was lunacy. You didn’t see him afterwards, Wilson. He was like death for days after. Even after he woke from the coma. He wouldn’t eat; wouldn’t talk. Just stared. I was terrified for him. Physically he was OK, but…”

“Let’s not play that game, Cuddy. Look, I know I made some mistakes. But it’s not my…not our fault. He won’t open up; he won’t listen to you…or me.” Wilson blew out a breath. “You should have seen him when we pulled up to Mayfield, Cuddy. I felt like I was taking him to prison. Condemning him to life in solitary. I hated…”

“It was his choice, Wilson.”

“He’s afraid.”

“So am I. Afraid for him. What if he can never practice medicine again?”

“Don’t go there.” Wilson closed his eyes remembering his conversation with House only weeks earlier about “mojo.”

“You’re afraid you’ll never practice medicine again,” he had told House.” And I’m terrified of what you’ll do if you can’t.” The conversation had haunted Wilson for the last week. “He has to be able to practice. Consult. Something,” he said to Cuddy, finally.

“On the other hand,” Wilson continued trying to lighten the mood. “Knowing House, he’ll be running the place before long,” Wilson said, changing gears away from the morbidity of their conversation. “Diagnosing physical ailments that fit better diagnostically than mental illness. He’ll drive them crazy.” Wilson laughed with a bit too much effort.

“His mother. You should call her; let her know.”

“I’m not exactly on her friends list right now.” Cuddy glanced at him quizzically. “It’s a long story.” Now there was a bombshell that been ticking away inside House for months. But he’d seemed to have handled it well. His father’s death; the confirmed knowledge that John House was not, in fact, his biological father. And that, in the final analysis, it didn’t really matter. House was his son, for better or for worse. At least he seemed have been dealing OK with it. With House, you never really knew…know, Wilson considered.

“It could be post-traumatic stress,” Wilson said randomly.

“What could?”

“House. Do you know he’s an abuse survivor.”

“His father?” Wilson nodded. “Why doesn’t that surprise me? He’ll never tell them, not directly anyway.” Cuddy thought back to all the times House managed to intervene in suspected abuse cases. His righteous indignation. That girl who was raped, too. “I don’t think we have the right to tell them…it’s not…”

“I think they’ll figure it out. That’s what they do… With his dad dying last fall, maybe that’s what helped to bring…what caused...”

“Like that was all… Maybe it was all too much for him. The crash, Amber, his dad, the hostage thing, even Rachel. And then Kutner.”

“You know he’s in love with you. I think he has been for awhile.” Cuddy nodded. She knew. “He feels a lot more than we’ve given him credit for, Cuddy. He just can’t express… He’s always been a lot more fragile than we think. And maybe the weight of this year…”

Cuddy sighed. “I need to call shipping. Get this Fedexed this afternoon. They’ll need his medical records. They’re part of the story. I’m going to call over there. Let them know this is on its way. Maybe…”

“…Maybe see if you can find out how he’s doing?”

“Yeah.”

“Have you talked to his team?”

“Next thing on my list. All they know is he’s out sick. At least all they know for sure. I’m sure they suspect something’s not quite right with him, but…”

“Let me know what I can do Cuddy.” She picked up the phone as Wilson walked aimlessly into the busy hospital clinic.