Summary: My first fic! One-shot - but I might do a sequel – featuring a PotW, a frigid med student and some Chase/Cam. Ensemble cast.
Disclaimer: I like to play with other people's characters. It's my secret shame. I watch them on TV and then dream up my own fantasies. My point being, none of the PPTH staff are mine, except when I play with them in my head.
Author's Note: If you know anything about medicine, unlike me:
"See no evil, hear no evil, speak no evil."
And review no evil! But do review. Heh.
"Eight-letter word for boredom."
Thursday. Foreman, Chase and Cameron were slumped lazily around the diagnostics lounge, losing the will to live. Cases had been scarce for the past two weeks, but ten minutes ago, House had paged them all, requesting their presence in diagnostics. Hopefully, they'd soon have another project.
House ambled through the door carrying a bundle of files. They followed his progress towards the table; judging by today's stagger, House was not to be messed with. Irritability. Aggression. Annoyance. But even more so than usual. He tossed the bundle of files onto the table, and grimaced at his employees.
"The evil that is nepotism has bit me in the ass," he told them with a sigh. "Laura Cuddy, Cuddy being the watchword, is joining our team for the week."
"Why?" probed Cameron, looking confused and annoyed.
"Because God is seeking vengeance for forty years of one-sided haggling," House replied glumly, lowering his head into his hands
"Why diagnostics?" Chase asked. House looked up at him, a maniacal glint mixed with the incredulity that filled his blue eyes.
"Why, because that's Laura's worst area of medicine!" he told them, and the three groaned in annoyance. "She's a med student, and she's been having difficulty diagnosing illnesses. So Cuddy reattaches the old 'Dean of Medicine' strings and decides to make the diagnostic department dance like those ridiculous German puppets."
He shook his head and took a seat at the table, leafing through the files scattered upon the surface.
"When's she coming?" Foreman enquired, taking a sip of his coffee. "Shouldn't we wait for her?"
"I'm sure she'll scamper on up here once she's finished the catch-up convo with fun Aunt Lisa." House retrieved the sheet he was look for and took a deep breath. "Female, thirty-five, has had multiple facial and body reconstruction cosmetic surgeries, and has been having weird freak-out fits for about two months."
"Freak-out fits?" Cameron queried, her forehead moulding into a frown.
"Jerk-fits. Not exactly a twitch, but muscles contracting uncontrollably. She's got this wicked cool shoulder-shrugging action going on. Oh, and she's clinically depressed."
"You think they're linked?" Chase asked, leaning forward, intrigued.
"IMPO, not exactly."
"Impo?" Forman asked, perplexed.
"Uh, 'In My Professional Opinion'? God, Foreman, get a cyber-life. No, according to the shrink's report, she's all about self-hatred…" House trailed off as the sound of tapping filled the room. House's eyes narrowed, and Chase, Cameron and Foreman twisted around in their seats to find the source of the noise.
Standing meekly on the other side of the glass was a petite brunette, holding a clipboard tightly to her chest. Her hair was drawn back in a tight bun, and a pair of thick-framed glasses rested on the bridge of her nose. She had small, squinty eyes that teemed with raw, unfamiliar fear and thin, pursed lips. The tip of her nose was pointed and angular, as were her ears. Her elfin-like appearance seemed childish, and she was quivering with absolute terror at the prospect of meeting with House.
House gritted his teeth and stood up, beckoning her inside. Her eyes widened in panic, and she fumbled to make her way into the lounge. Chase, Foreman and Cameron stood up to greet her, and her eyes darted to each of them in alarm, before returning to House.
House sighed in resignation, and put out his hand. "You must be Dr. Cuddy. I'm Dr. House." Laura's knuckles were white as her fingers grasped tighter around her clipboard, hugging it close to her chest. She shook his hand before withdrawing quickly, and then turned to the others. "This is the rest of the team: Dr. Chase," she nodded at him without meeting his eyes, her arms still wrapped protectively around the clipboard, "Dr. Foreman," another dazed nod of recognition, "and Dr. Cameron." Laura looked up to see Cameron give her an encouraging smile. She blushed and quickly returned her gaze to the floor. "Take a seat, Dr. Cuddy. Can I call you Laura, to avoid confusion?" House asked, with forced pleasantness. Laura's cheeks burnt red again, and she looked back down at the ground. House grimaced. Chase glanced at Cameron and Foreman, his face threatening to break into a grin. Laura took a seat and they all sat down once more.
"So, as I was saying, clinically depressed thirty-five year old female who has had numerous cosmetic surgeries and…" House trailed away again, watching as Laura furiously scrawled down notes onto her clipboard. He shook his head and blinked exaggeratedly. "Um…" Foreman, Cameron and Chase were now all smiling amusedly as House struggled to focus. "She's… well, she's having writhing fits."
"It sounds like choreoathetosis, or myonclonus. A risky facial surgery procedure could have left her with brain damage," Foreman told them. Laura stopped writing for a moment, staring up at him.
"The neurologist in Atlanta ruled out dyskinesia. Foreman here is a neurologist also, Laura," House informed her quickly. She jumped at his addressing her and returned to writing furiously again. House rolled his eyes. "Other ideas?" he probed.
"Tourette's?" Cameron ventured. "Maybe it hasn't been diagnosed?"
"Couldn't have been missed," House replied.
"Fibrillation?" Chase suggested, his expression neutral once more.
"Nice. Go check her out." House handed Cameron her file. "Foreman, and you too, Laura, go do another neurological exam once they finish. Dyskinesia seems to fit."
Cameron and Chase had just reached the nurses' station and gotten their patient's details when they were intercepted by Cuddy.
"Dr. Cameron, Dr. Chase. You met my niece, Laura?" she enquired, her usual professional persona seemingly left aside.
Cameron responded first. "Um, yeah, she's lovely, and so, um… polite. I'm sure she'll make an excellent doctor."
Cuddy sighed sadly. "I'm not so sure. It's all she's ever wanted, since she was a child. And she's top of her class, grade-wise. You don't have to tell me she's too shy. It's a competitive business, I don't know if she has what it takes."
Cameron and Chase looked at each other, confused. Chase spoke up. "Dr. Cuddy, if that's how you feel, don't you think it'd be kinder to tell her that, instead of encouraging her?"
"Actually, the idea was to toughen her up. How's House reacting towards her?" Cuddy asked, hopefully.
"Impatiently," Chase replied with a grin, "she's making him really uncomfortable." Cameron nodded along with him.
"He hates silences."
Cuddy nodded. "Okay. I just want to see her stand up for herself. Defend herself. If she doesn't do that within a week, I'll start advising her against medicine." She swaggered away from them, and they walked on towards the patient's room.
"Ha," Chase remarked with a smirk. "You tried to ass-lick Cuddy, and she called you on it."
"That was not ass-licking," Cameron replied, laughing slightly, playfully indignant. "That was telling a white lie for someone else's benefit."
"Whatever, Cam," he muttered, grinning broadly, his eyes bright with mirth. "I wonder how Foreman's doing with her."
"I don't think I've ever met anyone that shy before," Cameron stated. "She blushed when I smiled at her."
"Maybe she fancies you," Chase said with a wry grin before they entered room 218. What he saw inside made his jaw drop.
Miss Karen DeLongpre was propped up on her bed, applying lipstick to her smooth, overly plump lips while looking into a hand-held mirror. Her face had been altered to a thin, chiselled form. Her skin was unlined and porcelain-like, her eyebrows were drawn in a smooth, flawless curve. Her nose was straight and elegant, and her cheekbones were high and phantom-like. The hospital gown she wore rested upon her enormous bosom, which protruded a long distance before her. She was completely made-up, with heavy eye make-up and deep red lips.
Cameron also did a double-take on seeing her, but quickly resumed her professional guise. "Ms. DeLongpre?" The woman looked up and smiled nervously at them, revealing a set of shockingly white teeth. "I'm Dr. Cameron and this is Dr. Chase, we're just gonna do a brief examination, if that's okay?"
Karen smiled. "Sure. What are you checking me for?"
"Fibrillation and fasciculation," Cameron told her, pulling down the covers of her bed.
"What parts of your body have been jerking?" Chase asked, putting his stethoscope earpieces into his ears. Karen hastily covered her legs with her gown.
"Shoulders, neck, elbows, my spine kinda twists and one of muscles in my cheek tries to smile." Chase gave her a smile at this, and placed the bell on her chest. After listening for a few seconds, he raised his eyebrows to Cameron.
"Just breath in and out as normally as you can. Try to fall into an easy pattern, okay?" She nodded to him, and he bent over her, listening again. After thirty seconds, he beckoned Cameron closer. Without warning, Karen's arm snapped upward and the back of her hand swung forward to meet with Chase's cheek.
Chase stepped backward, grimacing in pain as his right eye began to well up. "I'm so sorry," Karen began, immediately apologetic for her involuntary actions. "I can never tell when it's gonna happen –"
"Karen, it's fine," Chase reassured her with a slight laugh, his face screwed up in a frown as his eyes blinked rapidly, adjusting to the light of the room. "But, um… as I was about to say, your pulse is very irregular. Is there any heart problems you haven't told us about?"
"No. I've never had a problem before," she replied, looking confused and concerned. "Doctor, I've just painted my nails, and your eye…"
"Chase, your eye is bloodshot. And you're still blepharospasming," Cameron told him. Chase turned to look at her, squinting to see her. "C'mon, I'll clean it out for you." She grabbed his arm and led him out of the room.
Foreman and Laura watched as the elevator doors opened before striding inside. He had just scheduled an MRI for Ms. Karen DeLongpre, and decided that Cameron and Chase would be finished by now, so he could work his expertise on the new patient.
Silence. Foreman sighed. He'd been in similar situations before, where a patient or nurse wasn't very talkative. But he could always talk to them if he tried. Laura walked around surrounded by a force-field that screamed 'uncomfortable'. The silences were more than awkward. They were totally, completely excruciating in every possible way.
He was going to say something. Anything. He realised she hadn't actually spoken anything since she'd arrived in the diagnostics lounge. There – that was one reason why he should say anything at all that would be plausible for a response. Anything. Just say something, Eric, he told himself.
"What age are you, Laura?" The words tumbled out of him before he could process his decision. Not bad for a subconscious solution, he told himself proudly.
She looked up at him for a second, before looking back down. "Twenty-two."
Taken aback by the sound of her voice, he blurted out the first thing that came into his head to keep the conversation going. "You're very quiet for a twenty-two-year-old."
Foreman mentally scolded himself. Poor attempt, subconscious. He tried to recover from his last sentiment. Ask a question that isn't rhetorical.
"Did you always want to be a doctor?"
She nodded without looking at him. Foreman gritted his teeth. Ask her something she'll have a lot to say about.
"Are you enjoying med school?"
Laura nodded again. She's enjoying med school? Nobody enjoys med school!
"Nobody enjoys med school!"
Foreman silently cursed himself. She looked up, surprised. Again, Foreman tried to salvage the conversation. "I mean, at least I hated med school. You know, those… those thick medical volumes to memorize, constant crucial tests… what do you like about it?" Surely, the elevator would stop soon…
Laura shrugged. "Study." She kept her gaze on her feet. Foreman decided the med school subject had been entirely exploited. Time to change the subject.
"So what kind of doctor do you want to be?"
Of course she does – the type of doctor that requires the most extroversion. Would that he could express in words the irony that Laura, the extreme introvert, was in training to be a G.P. The girl had felt the need to abbreviate 'general practitioner' so as not to increase her outgoing conversation by thirty-three percent. The elevator dinged to solute their arrival at the second floor. Foreman closed his eyes in relief.
Cameron pulled Chase up to the diagnostics lounge. She flung him onto a chair and tipped his head over the back. "Do we have a pipette in one of these cupboards?" Cameron asked, rummaging through them with a frown, pulling out boxes of syringes and bandages.
"Try the one on the far right," Chase advised, his head still tilted upwards and his eyes closed. "A little cardboard tray, maybe on the top shelf."
"A literal case of the blind leading the blind," Cameron said, still searching through the boxes. Chase turned his head sideways to face her.
"Please never make jokes. Ever."
Cameron laughed and pulled out the battered brown cardboard box containing a selection of pipettes. Taking one out, she walked to the sink and filled it with pure, cooled water from the kettle. She grabbed a napkin and handed it to him. She grasped the sides of his head with her palms and positioned his head carefully. Chase brought the napkin to his ear in preparation for the run-off.
"Hold still," Cameron said in frustration, as she clambered over him. Chase pried his eyelids apart and Cameron secured them open with her thumb and index finger. "Okay… so what do you think about Karen?" She brought the pipette above his eye and began to squeeze the plastic.
"Hmmm… that heartbeat would worry me," Chase said as she poured a trickle of water into his eye. "It was ectopic, totally irregular. I don't see how it could be a fibrillation, unless, there's multiple nerve damage, including ventricular or aortic fibrillation."
"Maybe it was your hair," Cameron teased. "It makes my heart race sometimes." Chase grinned. She let the last of the water run out of the tubing and then dropped her hands to her side. "Or those beautiful, blue-green eyes, streaked with red."
"Whatever, Allison," Chase said with a wry smile. "At least my admirer is of the opposite sex." Cameron narrowed her eyes and shoved him playfully.
"Speaking of, we should probably go find Foreman and relieve him of Laura."
"She can't be any worse than you."
House sat on Wilson's examination bed, swinging his legs back and forth. "Yes," he replied evenly, "one would think. But you have to meet this girl. She is Cuddy's master-plan for my inevitable destruction. She'll be the end of me, Wilson."
Wilson looked up at him skeptically. "Come on, House. What's the worst she can do?"
"I'll snap at her! Then Cuddy will get all bossy – not the good kind – and she'll fire my sorry ass."
Wilson paced himself with a deep breath, looking heavenward. "House," he said, with all the patience he could muster, "just don't. Control yourself."
House looked at him, his blue eyes wide with exasperation. "I'm doing that. Deep breaths, counting to ten, thinking happy thoughts. But I don't know how long I can last without grabbing her stupid clipboard and shoving it up her –"
"House, could I have a word?"
Both of their heads snapped up, startled, towards the door. Cuddy stood in the frame; her arms folded, her face contorted in annoyance. House's face lit up.
"Sure you can," he told her, his expression pensive, "spelunking. Verb: to spelunk."
Cuddy shot him a dirty look. "Outside."
House hopped off the bed and followed Cuddy out the door. "Later, Jimmy."
"Gotta say, Cuddy, I adore your niece. She's real chatty."
Cuddy frowned at him. "You don't have to mock her," she told him. "I realise she's quiet, but –"
"Quiet?" House interrupted, "Why, the opposite!"
"House, I know how uncomfortable she's making you. The idea of putting her under you was to try and bring her out of her shell. I'm giving you my permission not to hold back on her. She needs to grow a pair." Cuddy marched off in the direction of her office, leaving House standing alone. He was completely befuddled. He shook his head and limped back up to diagnostics.
Foreman arrived back in the diagnostics lounge, with Laura in tow, to find Cameron and Chase conversing comfortably, awaiting his arrival. Laura loitered at the door as Foreman got himself a coffee, before awkwardly pulling up a chair alongside the other two.
"Did you guys check her out for dyskinesia?" Cameron asked Laura. Laura nodded mutely. Cameron, perplexed, looked to Foreman uncertainly.
"No obvious signs, but I scheduled her for an MRI anyway. You guys notice anything?"
"Ectopic heartbeat. Points to ventricular fibrillation," Chase informed him, stretching back in his chair while giving a yawn. Foreman looked at him curiously over the rim of his coffee.
"What happened to your eye, man?"
Cameron smirked. "The jerking patient backhanded him while he was checking her pulse. It was hilarious." Chase flashed her a dirty look, and then noticed Laura had looked up, and was staring unblinkingly at Cameron again. Laura noticed Chase watching her, and quickly blushed and turned away. House limped into the room, looked around at everyone, narrowing his eyes at the sight of Laura.
"What've we got, Minions?" he asked, staring around expectantly.
"Patient presented with ectopic heartbeat," Cameron told him, taking a sip of her water."
House raised his eyebrows. "That doesn't fit," he remarked, dissatisfied.
"It fits ventricular fibrillation, but cases of fibrillation are usually isolated," Chase commented, his eye still red and watery. House's gaze turned to him.
"What the hell happened to you?"
"Karen, the jerking patient, slapped me."
"Convenient. You sure it's not just your time of the month? It's okay to be emotional, you know," House sympathised. Laura's head popped up again, and she surveyed House curiously. House caught her gaze. "What? Don't look at me like that," he snapped.
Cameron, Foreman and Chase raised their eyebrows.
Laura's eyes welled up, and she turned her head back downwards to the clipboard. House rolled his eyes.
"Foreman, what'd you find?"
Foreman cleared his throat and spoke up. "No signs of brain damage, or interference in any way. But dyskinesia can be caused by drug use. Including metoclopramide."
House looked thoughtful. Cameron glanced at Foreman, intrigued. "So, you think they used it as an anaesthetic in surgery? Wouldn't the side-effects die down once the drug use was discontinued?"
Foreman considered this. "Not necessarily. It's not unheard of."
"But what about the irregular heart beat?"
"How irregular was it?" House asked.
"About average pace, but there was no significant pattern."
House moved over to Laura, grabbed her clipboard, and flicked back a few pages. He scanned a page, his eyes widening with glee, turned back a further five pages before tossing the clipboard to Chase. "I knew I'd told you she was depressed. Strong doses of anti-depressants would disturb the natural rhythm of the heart. It's choreoathetosis dyskinesia. Put her on tetrabenazine."
Chase awkwardly handed the clipboard back to Laura as House exited the room grinning broadly. "Sorry 'bout that," Chase apologized. She shook her head glumly, and then looked at him.
"Is he always such an… ass?"
Cameron, Foreman and Chase all stared at her for a minute. She began to blush under their fixed stare, until Cameron spoke up.
"Pretty much. You just have to be equally sharp with him," she advised, standing up. Laura nodded and stood up gracefully with the rest of them. Together, they walked out of the lounge and headed for Karen's room.
House barged straight into Wilson's office without knocking. Wilson was sitting at his desk, filling in a large stack of medical forms, and jumped slightly at the sudden interruption.
"The frigid is all about Foreman," he announced as he propelled himself excitedly onto the bed. "I scanned over the eight pages of notes she'd compiled since this morning, and found a little 'E.F.' surrounded by a heart in the margin of page five. Finally, something to work with!" House sighed contentedly and lay back on the bed.
"Okay, what?" Wilson asked, bemused. House grinned at him.
"'E.F.'? Eric Foreman? Jeez, Wilson, get with the programme," House scolded. "I burdened Foreman with her this morning, while he was doing a neurological report on a patient. And now she's got it bad for him." He smirked at the thought, and gave another sigh of satisfaction.
"So, what, you're gonna use it as leverage to get her to speak? That's emotional blackmail, House. It's fine for the Ducklings, but she's just a med student. And she's Cuddy's niece!"
House rolled his eyes and snorted in defiance.
"Whatever, Jimmy. You put the 'uncool' in oncology."
"There is no 'uncool' in oncology."
"No, but there is 'oncol', which is very similar." House nodded philosophically to himself. "Besides, Cuddy authorized the mental abuse, provided that she gets more ballsy." He shot Wilson a self-satisfied smirk.
"Cuddy told you to act, well… normal… towards her?"
"Yep," House nodded proudly. "She finally appreciated that the psychological torture I subject my employees to is for their own good after all. I feel…" House paused for effect, searching for an adequate description, "jubilant."
Wilson rolled his eyes and returned to his work.
Foreman, Chase and Cameron headed for Karen's room, with Laura lagging not far behind them. Dyskinesia was treatable, but if tetrabenazine didn't work, they'd have to try her with a number of different drugs before they could determine what suited her.
"How are we doing, Ms. DeLongpre?" Chase asked as he entered, pasting a cheery smile on his face. Karen looked up, her eyes red, and she blew her nose quickly before looking away.
"It's not a good day, Dr. Chase," she replied, glumly. "They're weaning me off my meds." Her mascara was smudged and running, as was her lipstick.
Chase nodded understandingly. Foreman and Laura stood at the door, looking on and Cameron went to check her chart. "We're almost sure that what you have is a form of dyskinesia," Chase informed her, "called choreoathetosis. But we're just going to do that MRI you were scheduled for, to make sure we haven't missed anything. Okay?"
Karen wasn't listening to him. Instead, she was staring directly at Laura, her eyes filling with growing anger. Laura was staring back at her, transfixed by the sight of Karen, with the swollen features and running dark eyes. "What're you looking at?" Karen demanded angrily, still sniffling quietly. Laura paled and blanched, quickly looking away. But Karen persisted, "You act like you've never seen a human being before –"
Cameron saw Laura gulp, and quickly interrupted. "Laura, maybe we should leave Ms. DeLongpre –"
"No, let her stay," Karen insisted, "She's – she's fascinated by my misery. God knows, someone should get enjoyment out of it."
Laura's eyes filled with tears again, and she turned and fled for the bathrooms. Cameron sighed and ran out after her, handing Chase her chart on the way out. Chase glanced at Foreman to see his reaction, and Foreman flashed him a look of warning. Chase turned back to Karen, who was panting angrily from her outburst.
"I'm so sorry about that, Ms. DeLongpre. Maybe you should take a moment to calm down. Dr. Foreman and I will be back in five minutes to take you up for your MRI." Karen allowed her head to fall back into the pillows and closed her eyes, before Chase and Foreman left the room.
Once out of earshot, Foreman emitted a low whistle. "Woman has quite a temper."
Chase nodded. "She's got a mean backhand, too." Foreman grinned, and they made their way over to a vending machine. Chase slid a few coins into the slot and selected a Mars bar. "So, Laura's nice," Chase commented with a sly grin.
Foreman rolled his eyes. "For fifteen minutes, she spoke three words. Three. And one was an abbreviation. Six syllables, Chase!" Chase laughed at his frustration, and ripped open the wrapper of his chocolate bar.
"Cameron and I met Cuddy earlier, she told us the idea of putting her under House was to get her to stand up for herself." He bit into the Mars bar and they took a seat on some waiting chairs. Foreman considered this little tidbit.
"It might be working. She called him an ass - on her first day. Not to his face, but to his employees. That takes guts."
Chase nodded. "Still, she was just staring at a patient. I know that's no ordinary patient, but she was actually gaping at her. I think she's into girls." Chase theorised. Foreman smirked at him.
"Why would you think that?"
Chase shrugged casually. "I'm insightful on these things. You saw how she blushed when she saw Cam smile at her. And I caught her staring at her earlier on."
"You do that all the time," Foreman retorted.
"My point exactly," Chase countered, "I think she's hot."
Foreman rolled his eyes. "Oh, we are not going back there," he pleaded, grinning at Chase.
Cameron chased Laura all the way to the restroom, where she entered on time to hear a cubicle door locking. She walked towards it.
"Laura, don't worry about it. That patient was coming down off drugs; withdrawal always makes them snappy," Cameron reassured her through the door. No reply. Cameron sighed and leaned against the door, listening to the uneasy sobbing. "You just have to toughen up."
Time to try a different approach, Cameron thought as she listened to the uncontrollable blubbing. "You know, I've suffered a lot worse abuse. Chase got sued once, and his patients usually love him. And he got dismissed from a case. And House… I don't know if your aunt has told you, but he provides the hospital legal staff with forty percent of their work per year. Last year, he was issued with a restraining order for breaking a DNR." Cameron could hear the snivelling begin to subside inside the cubicle. "Just because one patient snapped at you doesn't destroy your career forever. It happens to the best of us; you just have to get over it and move on." Cameron heard the sobbing cease and shifted her weight back to her feet. She turned as Laura unlocked the door, and gave her a brief smile. Laura rubbed her eyes childishly, and Cameron could conclude from the absence of smudging that she wasn't wearing any make-up.
"I'm going to talk to my aunt," she told Cameron, and she quickly rinsed her hands before walking briskly to the door. Cameron sighed at her innocence.
Cameron met with the boys and they walked back to Karen's room together.
"She's gone to talk to Cuddy," Cameron informed them, shaking her head absently. "You guys didn't take her for the MRI?"
"We decided to let her cool off," Foreman told her. "She had to erupt on someone; she's probably still spewing hot ash." Chase chuckled at the imagery, and Cameron smiled briefly. They proceeded to enter the room, where Karen was lying down.
"Ms. DeLongpre, are you nice and relaxed now?" Foreman asked as they entered. Karen shook her head, now panting even more than when they had left her. Chase frowned, and immediately crossed the room with his stethoscope, while Cameron pulled down the bed covers.
"She's shivering," Cameron noted, and Foreman began to taking her temperature. Cameron ran out of the room to find a nurse.
"Her heartbeat's completely irregular," remarked Chase, pulling the earpieces out of his ears.
"Fever, 103," Foreman told them, "Cold sweats. Withdrawal?"
Chase shook his head. "No, her heart's failing. We need echocardiography, as soon as possible," he told the nurse as Cameron returned. "Page House, and call the O.R. She needs heart surgery."
Foreman, Chase and Cameron rushed Karen up to cardiology, disputing their original diagnosis.
"Ventricular fibrillation still fits. You were right, Chase. I don't get how, but it fits," Foreman conceded. Chase looked across the gurney at him.
"It fits, but it's still as unlikely as before," Chase deduced. "Dr. Whelan," he greeted the cardiologist. They pushed Karen into his office, where the echocardiography equipment was laid out and ready.
"Dr. Chase. Cameron, Foreman. Why the emergency?" The man questioned, as he opened Karen's gown, pausing momentarily at the sight of her enormous breasts. He turned around and picked up a transducer, placing it just above her heart.
"Her heartbeat is getting more irregular. Whatever's causing it is progressing rapidly, she's gonna need surgery."
Karen began to cry uncontrollably, and Cameron immediately stepped closer to her. "Karen, don't you worry. You won't feel a thing."
Karen continued to wail loudly. "What's wrong with me? The surgery never works!" Cameron, concerned, picked up her hand and squeezed tightly.
"No, this surgery's going to make you better."
"That's what all of them were supposed to do," she whimpered. "None of them worked. Look at me." She started shifting restlessly, and Whelan started grumbling as he tried to attach more transducers to her chest.
Cameron, confused, pushed her shoulders down and looked into her eyes. "Karen, I think you're a beautiful woman, but you need to relax or we can't treat you."
The image appeared on the screen, a series of moving lines. Whelan paused, his index finger in his mouth as he studied the image before him. After a moment, he pointed to a structure composed of lines which was rapidly jumping. "The valves. They're losing function. What were the other symptoms?"
"Long-term symptoms were jerking muscles, and irregular heartbeat," Chase told him.
"Then earlier on, exertion from shouting led to shortness of breath, and high fever," Cameron explained.
"And chills," reminded Foreman.
"If excluding long-term symptoms, this is endocarditis," Whelan said, still following the progression of the echocardiogram.
"Brought on by the dental reconstruction she had done recently," Cameron concluded quietly, her eyes wide in epiphany.
"She needs emergency valve replacement; this is acute endocarditis. Extremely rare. Lets get her down to the O.R." Whelan advised, his hands clasping around the sides of the gurney and pulling it out the door."
Chase, as an intesivist, scrubbed in to assist in the procedure. Cameron and Foreman watched from the other side of the glass, anxiously monitoring the procedure. The valves would be first examined to determine whether or not it could be repaired.
Chase was tasked with keeping her awake, stimulating her with conversation to ensure she didn't drop off. The surgeon, McGough, was cutting a long incision into her chest.
"Do you have any family?" Chase asked her mildly, sticking to his brief of harmless small talk. She nodded slightly.
"Two parents in Virginia. A brother in Atlanta, and another in Nevada. And I have one son of my own. You?"
"Children?" Chase asked, baffled.
"No, family," Karen clarified.
"Both parents are dead now, they split up years ago. One younger brother. Two younger half-sisters in Australia."
"Australia? Aren't you British?"
"No," Chase replied, shortly.
"I've never been to Australia. Is it very hot?"
"Where do you come from?"
"What, in Australia? Aren't you British?"
Chase glanced nervously at the surgeon, before looking back to Karen. "No, I'm Australian."
"I've never been. Is it hot there?" Karen asked, her eyelids drooping. Alarmed, Chase tried to revive her attention.
"Karen, keep looking at me, is it cold in Atlanta? Karen…" It was no use. The ECG began to quicken, and McGough started barking orders at the assisting nurses, bustling around them. "What's going on?" he asked them, "she's just lost consciousness."
"She's bleeding out!" shouted McGough, frantically trying to control the gushing blood. "There's damage to the tricuspid and pulmonary. Get her on the pump oxygenator!"
"We haven't given her heparin," Chase pointed out. McGough ignored him and began connecting the cannulas to her arteries and veins. The ECG stopped abrubtly, as the nurses disconnected Karen's heart.
Cameron and Foreman watched through the window as McGough operated on Karen's heart. Chase looked on as the surgeon worked ruthlessly on the heart. Cameron knew time was not a luxury they had; without heparin, there was every possibility of a clot occurring.
Chase rarely agreed to assist in the O.R. He had often told Cameron of how he hated being so helpless – him not being qualified to do anything but assist. Unless a diagnostic case specifically requested his presence during surgery, he avoided having anything to do with the O.R. at all costs.
Indeed, Cameron could see the agitation in his face as he watched McGough mercilessly carve into Karen's heart.
"How glad are you 'you chose immunology as a speciality?" Foreman asked with a grimace. Cameron glanced at him before looking back into the theatre.
"Very. I suck at quick decisions," she remarked absently. "Plus, McGough's an arrogant jerk to his team." She watched as McGough's mouth formed a selection of indecent expletives in the direction of the assisting nurse, mute to the world on the other side of the O.R. window. She saw Chase's eyes narrow in dislike. You can take the boy out of the seminary, but you can't take the seminary out of the boy, she thought.
Maybe she should ask him out. They'd never actually gone on a proper date.
She needed a consult. "D'you think –"
"Is she twitching?" Foreman interrupted, his attention rapt on the form of Karen on the operating table. Cameron followed his fixed gaze, and studied Karen for a moment, frowning in concentration.
Sure enough, the EEG began displaying a different pattern of waves. "She's stroking," the neurologist decided, moving towards the microphone. "Cerebral Thrombosis. She's having a stroke," he told them, and they all ceased working immediately. Chase bowed his head sadly.
McGough sighed and shook his head, stepping away from the table.
Twenty minutes later, Chase, Cameron, and Foreman met back in the diagnostics lounge, joined once again by Laura. Still in shock after losing a case they'd thought was closed, the room was quiet. Cameron was staring glumly into space. Foreman had his head in his hand, his elbow propped up on the table, as he tried to find reason in Karen's sudden change of status.
"Endocarditis. It doesn't make sense. What was causing the dyskinesia?" Foreman asked of no one in particular. No one ventured a response. Chase stood up and made towards the coffee machine, sighing. Cameron grimaced and leaned back in her chair.
"Rheumatic fever could take the form of Syndenham's chorea."
Everyone looked over at Laura, surprised. Foreman's brow creased in confusion, as he processed what she was suggesting. Chase considered her implication, before turning to the others, his expression comprehending.
"Which made her susceptible to endocarditis," he finished for her. Laura nodded mutely.
"Wait, wait, wait. So she had rheumatic fever all along?" Cameron asked, her mind working furiously.
"Yes, slowly straining her heart valves. She could have had it for years without obvious symptoms," Chase explained.
"And it affected the nervous system, causing irregular jerking movements, and emotional upset. Which could be mistaken for depression," Foreman finished.
"So, recently she's having some dental reconstruction done, and was introduced to some endocarditis micro organisms," Cameron theorized, "which, being the acute form, occurred suddenly, causing chills, shallow breathing and high fever."
Chase nodded, then turned to Laura, amazed. "When did you figure rheumatic fever?" he questioned her.
"Endocarditis only affects hearts damaged by prior inflictions," she told him. "Jerking limbs…"
Chase nodded and smiled at her. She blushed and looked away. He glanced at Cameron who was smirking knowingly.
Chase walked with Cameron to her car, chatting easily as they strolled at a leisurely pace. He was, as always, the handsome, polite, chivalrous gentleman she had come to expect - decent and caring and so insightful. It was such a comforting presence. He could listen and advise in an unvaryingly pleasant demeanour, without feeling the need to divulge more personal information than deemed relevant.
Cameron clicked the little button on her car keys, and her car unlocked with a low whistle. She turned and leaned against the driver door, watching him as he stuffed his hands in his trouser pockets. She smiled at him, the picture of timidity.
"So, are you heading home for the night?" she asked him, just noticing the absence of his leather jacket.
"No, I can't," he told her wistfully, "I have to work the graveyard-shift in the ICU tonight." His face lit with faux-excitement, but Cameron continued to press the issue. He worked for House in diagnostics, and had no business in the ICU. Personally, she hated the place. It was too quiet, too traumatic.
"Why?" she asked him blankly.
Chase shook his head and shrugged absently. "I'm filling in for one of the other intensivists. You know Dr. Soya? Her father died, so she has to take some time off." He shrugged again. "Cuddy said she'd give me some extra time off for Christmas."
"Still, though, the night-shift?" Cameron persisted.
"I'm Australian. Right now, they're starting the morning-shift. And I don't need beauty sleep anyway," he told her, looking up at her with a cheeky grin.
"Whatever, wombat. I'm taking you out for breakfast first thing tomorrow."
"See, now I have something to look forward to."
He smiled at her for a minute, and she smiled back. It was so natural, and so familiar, and by instinct, she looked into his soft, aquamarine eyes and leaned forward, capturing his lips with hers. It was light, and innocent, and very comfortable. He pressed deeper into her warm mouth, and she felt his fingers brush over her hips and slip behind her back. Then, hearing a soft tug on the door handle, she found herself tightly confined between Chase's strong body and the now-open door. His lips slipped off hers, and she opened her eyes to find him looking down, grinning sheepishly. She smiled back. "Goodnight, Dr. Cameron," he told her, locking his amused eyes with hers. He stepped back and opened the door fully and she got inside her car, her smile never wavering.
"See you tomorrow," she said, and he pushed the car door closed with a smile before walking back towards the hospital.
Okay, so it's kinda sucky, but it's a first attempt! Please review, and criticize constructively! I'm young, so impart that knowledge of English literature I know y'all have!