Take As Directed
SUMMARY: Hydrocodone is habit forming. Glimpses post infarction.
SEASON/SPOILERS: "Three Stories", sprinklings of the rest of season, so anything could be fair game.
AUTHOR'S NOTE: Yep, it's been done. Another House post infarction/pre series fic. But the muse felt inspired and I'm working off a theme here and trying to answer a couple of my own plot hole questions (i.e. how did Wilson, an oncologist, get to be House's prescribing doc?).
Hopefully there is an end in the near future, as this has already turned into a far bigger story than I'd first imagined, since I thought it would end after two pages.
DISCLAIMER: Not mine. Just borrowing.
I am not a doctor. Anything medical has been heavily researched (or questioned to death to my friend currently in medical school who thinks I'm odd, lol). All quotes about Vicodin should are taken directly from www dot drugs dot com slash vicodin dot html. The Internet is one awesome place, but feel free to drop me a line about any glaring errors and I'll fix 'em right up.
Hydrocodone is habit forming. It is possible become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if acetaminophen and hydrocodone is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose.
They were the words anyone could read off any Internet site, the words any good doctor would tell you. Good advice, followed by the majority of people that were handed Vicodin prescriptions following a painful injury or wisdom tooth removal.
Of course, the majority of the population wasn't in his position. Had his problem, and lucky enough for him, happened to be a doctor and know every disgusting little detail and the dry hard fact that unlike dental surgery, his pain wasn't going to disappear.
Bitterness was much easier to handle when wrapped around facts, especially facts that only he managed to see and only he managed to point out before his doctor blinked at him and said, "well, yes, that is a possibility and I assure you that we are exploring every option."
Bullshit. If they'd been exploring it, they would have seen it right away. If he hadn't been so out of it between the extreme pain maybe he'd seen it sooner.
He could blame his doctor for missing it, he could blame Stacy forever for going against his wishes without giving him so much as a warning. It was easy.
Much harder to blame himself.
Now he could blame the world on his physical pain, finger the bottle of Vicodin in his pocket and wish that if it couldn't manage to make him completely forget about his leg, it could make him completely forget about everything else.
Wallowing in self-pity could be so exhausting. Worse than the looks he got that first day he ventured out, crutches in tow, feeling like the whole world was staring. Stacy held his duffle bag and his prescriptions, as he managed, painfully, to make it to her car, trying to ignore the fact that she had to open the door for him so he wouldn't fall flat on his face.
The ride was silent. He'd spent a month at PPTH, doing inpatient therapy, mulling over what his life was about to – had already really – become.
Vicodin is used to relieve moderate-to-severe pain.
"I'm sorry," were the first words he'd heard when he woke up. They were soft and feminine and for a second he'd thought he'd imagined them. She'd said them before and he'd been confused. Why was she sorry? It was his decision, his leg, and while he knew it was stupid, knew it could and probably would kill him, he couldn't do what she asked.
So when he managed to open his eyes and look at her face, he saw the lines of intense worry. The small smile, but soft eyes, revealing more than her lawyer built exterior could ever show.
"Nothing to be sorry about," he mumbled again, wondering for a brief moment if he hadn't fallen asleep yet and that time and reality were playing some confusing trick on him. He licked his lips. They were dry and his brain was fuzzy.
She blinked and said nothing.
It was when his head managed to clear that he realized what had happened. He felt the bandages, felt the pain. The eyes said it all.
The eyes never lie.
Too bad people always do.
Wilson came. Took Stacy's chair as she headed out to get coffee. Wilson was wearing a suit jacket and his red striped tie, the one he always wore when he went to a conference. His shirt was wrinkled, looking like he'd slept in it. He was sans the lab coat he wore every time Greg saw him at PPTH and he found the image disturbing.
"No coat," he said, his voice sounding foreign to his ears.
"Yeah," Wilson answered.
He swallowed. "How much?"
Wilson let out a breath. "A lot."
He took in those two simple words and mulled them over. "Show me."
"Greg, Cuddy's coming in this after-"
He shook his head. "Don't want to hear it from her. I want to hear it from you."
Wilson was silent a moment. "Okay. I'll get some paper."
He didn't say a word as he watched Wilson sketch. He didn't blink at the amount. Wilson, for his part, let him be and didn't sugar coat the facts, presenting them exactly for what they were and what they meant.
It was no wonder that he was already being considered as oncology's next department head when Sanderson retired. Lots and lots of practice giving bad news.
Being good at giving bad news. An oxymoron of sorts, he thought distantly.
"Thank you," he managed to say when Wilson quieted, again finding it ironic that his friend was so good at presenting the facts, the bad news, that Greg felt he needed to thank him.
Wilson simply nodded his head and settled back into the chair.
"How was the conference?" he asked.
Wilson gave a short laugh. "God, Greg…" He shook his head. "Boring."
"They usually are." If he looked straight ahead, ignored the bandages, the pain, the beeping of the heart monitor, the guilt hidden in Stacy's eyes, he could maybe, just maybe, survive.
"Open bar at least?"
"Of course," he repeated. His leg was ignoring his plea to be ignored. Ha, another blast of irony. Was he doomed to suffer nothing but for the rest of his existence?
One hand crept up to the covers and he couldn't control the hiss that escaped his lips. Wilson was up and grabbing the control for his pain meds, pressing it into his hands.
He shook his head. "Don't need it."
Wilson pushed the button for him. "Don't need it or don't want it?"
The morphine filtered into his system and the pain settled into a steady throb. Still there, but, for the moment it was almost bearable.
"You didn't hesitate to ask for it before," Wilson said and he closed his eyes.
"You've been talking to Stacy."
He sat back down. "Maybe."
"She called you?"
"She was concerned."
"I'll bet." Concerned enough to go against his wishes. "What did you tell her?"
Wilson sighed. "I told her…"
He raised a hand. "No. I don't think I want to know."
"…to wait. Give it twenty-four hours."
He almost laughed. "No, you didn't. If you were here, you'd have told me I was being an idiot."
"No, I think you're turning me into you. I have something called a bedside manner. Nice little thing, you learn it at medical school, along with respecting the patient and all that jazz."
He fingered the control of the morphine pump. "You're not my doctor. You're my friend."
Wilson leaned back. "Yes, I am."
"You'd offer your medical opinion, sure, but you can't stop yourself from expressing your personal one."
"Yes, but --"
"I knew Stacy would call you." He knew it all along. Stacy wasn't completely stupid. She was frustrated. Sure, Cuddy had ripped the case out of her staffs' hands when she discovered the mistake and, while he'd heard that she was a good and respected physician, he, nor Stacy, really knew her. Cuddy would be honest, but didn't know him and how stubborn he was. That he didn't want to let go a leg, of a past life. She'd present facts and Stacy would be confused.
Didn't mean he still didn't blame her. Stacy, that is.
"You really tell her to wait?"
Wilson looked him straight in the eye. "Yes, I did. You're too stubborn to do otherwise. You could have remained stable."
This wasn't the whole story. "I'm sensing a but, here."
Wilson shifted in his chair. "You know, as well as I do, that you'd need the debridement done eventually. If you value your life, that is."
He swallowed. "Maybe. Maybe not. But it's still my choice, right?"
"My choice, right?"
"House, legally…" Wilson sighed. "There's no winning with you."
Again, he almost let out a laugh. "No, I guess not."
Stacy returned, coffee in hand, eyes still guilt-filled. He said no more on the subject. Not to Wilson, not to Stacy, not to Cuddy as she examined him and gave her own version of the facts, a similar remorseful expression in her own face.
He thought about his office and how he left his golf clubs leaning against the filing cabinets, next to the over following stack of charts he'd finished reviewing just before this whole mess started.
They weaned him off the morphine quickly and switched him to oral stuff. Waved little plastic cups bearing Vicodin in front of his face.
Avoid alcohol while taking Vicodin. Alcohol can increase drowsiness and dizziness caused by the medication, possibly resulting in unconsciousness and death. Also, acetaminophen can be damaging to the liver when taken with alcohol.
A week later, the pain was still awful and they were trying to taper off his Vicodin. Trying to move his stupid useless leg, talking about physical therapy and rehab.
Deep down inside, he knew the fact that pain hadn't subsided by now was a bad sign. The word "chronic" loomed on the horizon, despite the fact that no one would admit that was looking more and more likely. He started therapy. He let Stacy try and cheerlead, anything she needed to make those him stop seeing those eyes. The pain after therapy was so bad, they brought the Vicodin back, upping the dosage, letting him get to the maximum 40 mgs hydrocodone a day.
That was same script he finally left the hospital with as well. A temporary prescription, he was told. That much acetaminophen could damage his liver if he continued to take it long term. He could become addicted to the hydrocodone.
They also told him not to drink while on the medication, either, but the minute he got home, he asked Stacy to pour him a glass of scotch.
Her eyes widened.
"Greg, with the meds-"
"I just want one and I took my last pill hours ago. Christ, Stacy, it isn't going to kill me. I just…" he let his sentence trail and they stared at each other. For a moment, he thought she wouldn't back down. Not without a fight, anyway. It was one of things he loved about her. Her spunk, her fire, her way of not putting up with his crap and dishing out her own when she wanted to. She, in so many ways, was his equal.
He still loved her, really. Despite what she did, despite his deep down hatred of her deceit and her actions, he loved her.
He wasn't sure if would ever be enough, but for the present moment, it helped contain his resentment.
He should have known something was wrong when she said nothing, turned, and proceeded to pour. He took a sip and let her walk into the kitchen before he reached out for his Vicodin and downed one with another sip of Scotch.
The next time he attempted such a thing, however, was a different story.
He continued to go to therapy, but Stacy stopped taking him. He pretended not to notice that gradually, her side of the closet seemed to migrating to her mother's. Wilson picked him up and he'd struggle toward the door with the crutches – which despite all his effort in the world, he still couldn't master – and head toward his car.
He came home one evening to an empty house and an unsealed letter on the piano, "Greg" scrawled across it in a script he'd always remember.
He didn't open it, didn't read it.
He knew what it said.
They loved each other, but he couldn't forgive her, she couldn't move on, and they were both heading for a brick wall. The only difference was she could stop herself from the collision. His brakes had already been cut.
He'd downed two pills this time, not the prescribed one, and a tumbler of Scotch when Wilson came back in through the front door, looking for his keys.
He'd never thought he'd be sitting on his couch, a plastic bowl in his lap, while his best friend shoved a finger down his throat and proceeded to tell him what an idiot he was and that as a doctor he should know better.
Of course he should. Didn't mean that would stop him.
Wilson's marriage was on the rocks before the infarction happened, and James had already been spending his lunch hours with his divorce lawyer. As soon as the papers were signed, he spend that time at Greg's house and poured the Scotch down the drain, saying no more. At least until Greg was off Vicodin.
Off Vicodin. Oh yes, and on to some other wonder drug that could at least manage to make his leg pain just a manageable nuisance instead of a screaming bitch. They could sure as hell try. He'd let Wilson suggest a new pain regiment to him, to his doctors, would even forgo the Vicodin for a week, two weeks, a month. But they all failed in his eyes, and back to the Vicodin he went, each time welcoming it back like a long lost puppy.
He also bought more Scotch.
Take Vicodin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
Wilson tried; Wilson was a good friend. And Greg, for his part, wasn't suicidal. Not in the least. He could still hold his liquor and he wasn't a complete idiot. He didn't mix meds and alcohol, at least not in front of Wilson, and not nearly as often as Wilson first thought he might.
He was even contemplating working again, doing something to get mind working again. To see other people's pain and forget about his own. Solve medical mysteries like it was playing Clue – the who, what, where.
He didn't think about Stacy.
No, that was a lie. He did think about her, had a few wet dreams and a few nightmares, both ending with a throbbing leg and a hand grabbing the nightstand for his Vidodin.
One night, he rolled the bottle in his hand, reading the label, seeing the dosage, prescribing physician, his own name and address, and threw it across the room, the plastic exploding against the wall and sending pills all across the corners of his cluttered bedroom rug. There was nothing wrong with his arm or his aim, that was for sure.
The next morning, the pills were lost to the mess and he couldn't really bend down to look for them anyway. He found his crutches and limped to the living room and turned on the Price Is Right, and tried to ignore the pain creeping up on him.
When Wilson came to pick him up for physical therapy, he was in agony and every millimeter he moved sent shooting pain down his leg.
"What happened?" were the first words out of Wilson's mouth.
House managed to smile sheepishly. "Me and the pill bottle, well, we had a fight. I lost."
"You're going to have to be less cryptic or I'm taking you to the ER."
"Geez, James, no need to get all melodramatic. I got pissed, threw the bottle. Now my bedroom rug has been infested by Vicodin, and possibly dust mites, but hopefully they'll eat the Vicodin and die off."
"Or you could just do your laundry."
"What a concept. Now why didn't I think of that?" He rubbed at his thigh. "I'm out of refills; I need a new prescription. Cuddy won't give it to me without an exam."
"Funny thing, a doctor wanting to examine a patient before prescribing him medication."
Greg glared at him. "You, her, me, hell all of Princeton Plainsboro Teaching Hospital, knows what's wrong with me. Just write me the scrip and we'll drop by the pharmacy so I'm not driven to kill myself before PT."
"I'm an oncologist."
"Yeah, and? You did my last physical before this whole mess started. The insurance company didn't care. Besides you write for narcotics all the time."
Wilson shook his head. "All right. Just this one time. Next time you cough up the time and the fifteen dollar co-pay for the office visit." Wilson dug through his coat pockets where House knew he usually threw a prescription pad. He took it and a pen out and looked at him before scribbling.
"You can't take Vicodin forever, Greg. The acetaminophen will eventually kill your liver."
"Until someone can find something better, I can sure as hell try. So why don't you stop wasting your time and start telling me something I don't already know." He knew he was being curt, but his leg hurt so much he didn't care. Wilson handed him the prescription. "Thanks."
"Yeah," Wilson said, "Just this once."
End Part One.