Title: Love and Happiness
Rating: PG-13 for naughty f-words
Genre: Angst, House/Wilson - you decide whether you want pre-slash or just strong friendship
Summary: With Wilson critically injured and fighting for his life, House finds himself battling some very personal demons.
Disclaimer: I've got a job now, which means I'm finally making some money. Not enough to buy House, though. Or Wilson. It might be enough for Cameron, she's just so cheap... ;)
Beta: Neery, who kicked ass and actually managed to make me rewrite a scene, and TLI, who probably suffered the most for this fic. Not only did she straighten out my language mistakes (all the correct grammar's hers, all the wrong stuff is my fault because I was too stupid or stubborn to listen), but she also kick-started me a couple of times, endured my whining on MSN, emergency-beta'ed any scene I sent her, and was overall the most awesome beta a fanfic writer could ever wish for. THANK YOU BOTH YOU ROCK!!
AN: After getting so much wonderful feedback for my first House fic, I sat down and wrote this at close to light-speed, which is so totally not how I usually do the writing thing. My head is still spinning. Anyway, I hope it's any good. I tried to get the medicine right, or at least wrong with consistency, but if you're a doctor or a nurse or know your way around medicine for some other reason, you'll probably find holes big enough to fly a cargo plane through. I apologize in advance.
Feedback is a writer's chocolate! Well, this writer's chocolate, anyway. And I'm not on a diet, so feedback away:)
Everybody at Princeton-Plainsboro Teaching Hospital agreed that Dr. Gregory House was an out-of-control nutcase. People who had been working there long enough would be able to tell you that he had been even before his infarction, and that the disability had only added a slightly melodramatic touch to his outrageous personality. The reason he was still employed was for one thing the Dean's huge and admittedly justified trust in his abilities as a doctor and diagnostician, and for another the head of oncology, Dr. James Wilson. The reason Lisa Cuddy could convince the hospital administration board again and again not to take steps against Dr. House's reign of madness and terror was that every time House had threatened to go off the deep end and do something really inexcusable, Wilson had been there to grab his cane and make him stop. Cuddy had promised the board that she would make sure that this would never change.
But no matter how much power she had at her disposal as the Dean of Medicine, no matter how much ruthlessness and manipulative skills she possessed, there were things even Lisa Cuddy was powerless against. Simple things, really, like the fact that if provoked, people sometimes became violent. And that if someone had a knack for being in the wrong place at the wrong time, that someone might get caught in the crossfire.
Cuddy dropped her head between her shoulders and sighed, her eyes on the pale green sheets of the hospital bed in front of her. A part of her felt resentment at the fact that she was here alone, but she knew that the part was being unfair. House was upstairs in his office with the police, and Cuddy almost felt sympathy for the officer who had to deal with him right now. She just hoped they'd had the presence of mind of putting Mr. Frank in a different room. One blood stain on House's office carpet was enough.
She looked up at the steady pulsing light of the heart monitor and then dropped her gaze to the EEG. Delta- and T-waves, nothing above the eight-Hertz mark. Normal, for a patient in a barb coma.
Her pager went off, and she quickly turned it off, the high shrill sound seeming too loud in comparison to her subdued surroundings. She didn't have to look at the display to know who was demanding her presence. She sighed and patted the hand of the man who was lying in the hospital bed.
"Hang in there, James," she said quietly, then left and headed for the elevators.
"When you dealt with the patient's father before today, did you feel in any way threatened?"
House grabbed the handle of his cane a little tighter, thinking that anybody who thought he didn't have any self-control should see him right now. "I didn't deal with the father of the patient before today," he said, his voice oozing hostility. "I never even saw the man before today, and believe me, today it wasn't voluntarily."
The police officer who was asking the questions, a short, scrawny guy with a big red pimple between his eyebrows, consulted his notebook. "But you stated that you were the patient's attending ever since her hospitalization, which was over a week ago."
"You got that information from me," House said. "Which means you don't have to tell me. I already know."
Officer Pimple didn't react to the sarcasm. He was probably just too dumb to process the fact that House was mocking him. "You're saying you treated the patient for over a week and never spoke to the family?" he asked, frowning in what seemed to be utter confusion. House made a face at him.
"Duh. You're really smart. All those brains, I'm surprised you can even hold your head up straight."
Pimple lowered his notebook and gave House a scolding look that almost made House laugh. "There is no need to insult me, Dr. House," he said in a petulant tone. "No one is accusing you of anything."
They should. "No," House snapped. "You're just wasting my time with pointless question I already answered twice over."
Pimple sighed. "I'm sorry, Dr. House. We need your statement for the report."
"It's not going to change no matter how many times you ask. Can I go now?"
Pimple shook his head. "I need you to describe the incident one more time, please."
"If you want story-time, read your damn notebook," House said and began to limp towards the door. "I'm going to treat my patient."
"Dr. House!" Officer Pimple had raised his voice. "If you don't give your statement voluntarily, I will have to ask you to come down to the station with me."
House stopped, leaning on his cane. Silently, he counted to ten, and then again. Then he turned around.
"Anything you want, Officer," he said, and thought that this police officer was either very very brave, or even stupider than House had initially assumed. Usually, when he used this tone, people were quick to seek shelter, preferably far, far away from the Diagnostics office. Pimple barely flinched. House crossed the room and stood behind his desk, deliberately not sitting down.
"Well, then, listen closely, son," he said. "Uncle Greg will tell you a story. Once upon a time, there was a little girl, and she was very sick. Very, very sick. She was so sick, in fact, that... "
" ... we have to do the procedure!" House stared at Cuddy who was sitting in the chair behind her desk in her office, answering his stare with an equally intense glare.
"Oh, do we? Well, that's a shame, because we can't!" She grabbed the file that was lying in front of her on the table and waved it at him. "You can't do a laparoscopy on an unstable patient, House!"
"No, I agree I can't. That's what we have surgeons for."
Cuddy rolled her eyes and got to her feet, opening the file and holding it in one hand like a preacher reciting psalms during sermon. "She's admitted with a cough and back pain. You give her steroids for anemia. She gets worse. You give her immunosuppressants. She gets worse. You give her Interferon against a viral infection. She gets worse. You give her antidepressants for- God knows what you gave her that for-"
"I thought she had OSD," House said.
Cuddy didn't seem to deem that worth a comment, but only continued, " -, she gets worse! You push her to the brink of death, and everything you can come up with as a last-minute rescue is cutting her open? Not much of a rescue. It'd be easier just to stab her." She slammed the file down on the table, and House thought that if she glared at him any harder, her eyes would pop out.
"It's her only chance," he said. "She's got a pericystic tumor. If she doesn't get the surgery, her liver will explode."
"And if she does get the surgery, she'll code on the table!" Cuddy shook her head. "I can't allow it, House. Find another way."
House felt himself getting angrier and raised his voice. "There is no other way, Cuddy! In her condition radiation and chemo are both out of the question. Surgery is our only option!"
"House, the patient's in a coma! She coded twice in the last thirty-six hours! Even if I gave you permission to go ahead with the surgery, no anesthesiologist in their right minds would ever agree to..."
She continued to speak, but her voice was drowned out by angry voices approaching and the loud bang of the office door flying open. House turned around and found himself face to face with the anger-distorted features of a man roughly the size and build of the incredible Hulk. Somewhere behind the heaps of flesh and muscle he could catch a glimpse of James Wilson in his white doctor's coat, trailing the huge man and doing everything to make himself heard over the bellows of the angry giant.
"Mr. Franks, you need to-"
"Are you Dr. House?!"
Together with the aggressive question, the Hulk blew a whiff of stale too-much-coffee-and-cigarettes-breath into his face, and House pulled back, blinking.
"Yes," he said. "Nice to meet y-"
Before he could finish the sentence, he felt a hard push and found himself stumbling backwards against Cuddy's desk, his right leg sending a sharp bolt of pain to his brain as it gave out under him. He sat down hard on his ass and had to blink a couple of times to get his bearings. As his vision cleared, he was presented with the rather intimidating view of the incredible Hulk advancing on him.
"You incompetent, no-good piece of shit of a doctor!" Huge hands closed around his collar, and House was yanked to his feet, hearing and feeling his t-shirt rip. Stupid moron, I liked this shirt, he thought. He would have said it out loud, but was prevented by the hands that were closing around his throat, beginning to choke him. He reached up, attempting to loosen the maniac's grip, but he might as well have tried to rip an oak tree from the ground. His vision started to get blotchy, and panic began to increase simultaneously with the need to draw a breath.
Suddenly, there was commotion on the edge of his blurry vision. The hands let go of him, and he dropped to the floor, almost continuing to choke as he tried to breathe and cough and curse at the same time. He blinked frantically, trying to make out what was going on, and saw Wilson, holding - his cane? It sure looked like his cane - like a baseball bat. Then something blocked his view, and a second later, House realized it was the incredible Hulk, who had for some reason decided to turn on Wilson. There was a lot of shouting and the sound of things falling over and breaking, and then the door flew open once more, letting in two security guards who with a little help from their tasers stopped the Hulk's rampage short and made a sudden silence fall over the office.
Coughing and gasping, House began to pick himself up from the floor. He felt a hand settle on his arm, helping him up, and looked up to see Cuddy beside him, a shocked expression on her face.
"Are you okay, House?"
"I'm-" He coughed some more, wincing at the pain in his throat. "I'm fine." He looked over to the security guards who were squatting beside their kill. "What took you guys so long?" he asked.
The shorter one of the two looked up and squinted at him. "Maybe one of you should take a look at this," he said. "I'm no doctor, but this doesn't look so good."
Only then did House realize that the two guards weren't merely making sure that the incredibly maniacal Hulk didn't bounce back up and kill them all. There was another figure lying on the floor, half-obscured by the massive form of the fallen giant, wearing a white doctor's coat and not moving.
House pushed himself off Cuddy's desk and, ignoring the various aches and pains in his leg, back, neck and throat, quickly limped over to where Wilson was lying on the floor. As he got closer, an uneasy feeling spread in his stomach. Wilson was obviously unconscious, his eyes were closed, and-
House stopped in his tracks, steadying himself on the beefy shoulder of one of the security guards. "Cuddy, get an emergency team up here, stat."
Cuddy, who was right behind him, followed his eyes, and House heard her gasp. She hurried over to the desk and picked up her phone.
As he listened to her ordering an ER team to her office, House kept his eyes on his unconscious friend, involuntarily tightening his grip on the guard's shoulder as he looked at the puddle of blood around Wilson's head that was clotting the brown hair together and seeping into Cuddy's expensive carpet.
"Turns out that Wilson tried to stop the incredible Hulk from choking me to death by hitting him with my cane, which was a little like poking a gorilla with a stick. The gorilla shoved him into Cuddy's bookshelf and Wilson got his head cracked open, which leads us to the unpleasant situation we have on our hands now." House stopped to take a deep breath. "Can I go now, Officer?"
Officer Pimple was scribbling in his notebook, the tip of his tongue showing between his teeth. House waited for a few seconds, then produced a contemptuous snort and headed once more for the door. "I'm going," he said. "If you need anything else, I'll make sure you won't find me."
"Uh... yes, you can go," Pimple called after him. "Could you please send Dr. Cuddy in?"
House considered for a moment, but then dug his pager from his pocket and paged Cuddy to get herself to his office. Better to keep those idiots busy.
He took the elevator to the ground floor, and, while he was in the car, sent out a few more pages. On the ground floor, he went into the clinic and shouted across the room to make Brenda notice him.
She turned around. "What, House?"
"Which exam room is open?"
She pointed. "Two and three."
House limped to the closer one of the two. "Don't you dare send in any patients," he said. He knew that usually, he wouldn't stand a chance pulling this kind of authority crap on Brenda, of all people, but House counted on the light-speed hospital rumor mill having relayed the information of this afternoon's events to the clinic already. People were morons, even nurses, and even clinic dragons like Brenda. If she knew what had happened to Wilson, she'd probably cut him some slack and give him an empty exam room to brood in while his office was being usurped by the police.
House sat down on the examination table, leaned his cane against the wall and waited. It wasn't long before the door opened again to let in the three musketeers, all of them wearing the exact expression House had silently predicted they would. Foreman looked skeptical and all-business-and-awaiting-instructions. Cameron looked wide-eyed, and her perfect hairdo was still perfect, but not as much so as it had been this morning. Chase looked innocent and guileless and as brain-deprived as ever. Actually, he was the hardest to read of the three. Of course House would never tell him so.
"Who's with the patient?" he asked sharply, making them stop and throw each other guilty glances.
"She's in the ICU," Chase said finally. "There are more than enough people watching her."
House rolled his eyes. "You," he said and pointed at Chase, "go play intensivist. Page me if her status changes."
Chase did some eye-rolling of his own, but left without any more protests. He also was the best-trained of the three. House turned back to his two remaining minions. "What is her status?"
Cameron and Foreman exchanged a glance, then Cameron spoke up. "Is it true that Dr. Wilson was beat up by a patient?" she asked, and House almost shuddered at the caring concern that was dripping from her voice. He used the feeling to give his answer another sharp edge.
"Wrong answer," he said. "Tell me our patient's status, and-" He held up a finger to forestall Cameron who had already opened her mouth again. "-one word about Wilson before we're done with the treatment discussion, and you're fired."
She snapped her mouth shut and gave him her best outraged good-person glare. He ignored her and turned to Foremen. "Well? Patient status still some time this millennium?"
"She's still breathing on her own," Foreman said. "And no internal bleeding."
House fell silent and picked up his cane, beginning to bounce it up and down. "So no pericystic tumor," he said quietly. Damn. It had been a beautiful solution.
"No. Fortunately, you were wrong." Cameron had rejoined the conversation, using that special tone of hers that made every word sound like an insult. House began to wish he'd sent her to look after the patient.
He got to his feet and limped over to the cupboard where the band-aids and free med samples were stored. He patted his pockets and then produced a black marker from one of them.
"Initial symptoms," he announced, and scribbled "cough" and "back pain" on the improvised white board. Then he turned around. Cameron was looking at him with disapproval written all over her face.
"That's permanent marker, House," she said.
"And that's a really ugly combination of eye shadow and nail polish," he shot back. "What was next?"
"Rash," Foreman said and crossed his arms. "Then syncope episodes."
He listed those two, then added "anemia", "low white count" and "cardiac arrest", and finally squeezed "coma" in the remaining two inches at the bottom of the left cupboard door. Then he turned back around.
"Now, what did we treat her with?"
"Antibiotics and steroids," Cameron said. "Immunosuppressants. Interferon."
"And antidepressants," Foreman added.
House listed all of them on the right cupboard door, then took a step back and frowned. "Cameron, get me a few colored markers from the counter."
He could practically feel her glare between his shoulder blades, and turned around to bat his eyes at her. "Pretty please with an HIV ribbon on top?"
She stared at him for a few more seconds, then let out a sharp breath that made her nostrils flare and stalked out of the room, returning a moment later with a bunch of colored Eddings clutched in her hand. House took them from her with a mocking smile of thanks, then turned back to the cupboard.
"Now," he muttered, frowning. "What did we give her first?" He uncapped the red marker with a flick of his fingers and painted a big red circle around the word "steroids".
"Which of her later symptoms could have been caused by the steroids?" he asked.
"The skin rash," answered Foreman. "An allergic reaction. That's why we took her off the steroids and put her on the immunosuppressants."
House crossed out "rash" on the left cupboard door, then picked up the green marker and circled "immunosuppressants".
"Caused the low white count," said Cameron, and House was almost pleased to notice that the disapproval was disappearing from her voice. She was getting engrossed in the differential as well. He crossed out the low white count with a big green line. Then he took the blue marker and circled "Interferon", and proceeded to crossing out "cardiac arrest" and "coma". Then he stepped back.
"We did stop the Interferon, right?" he asked.
"Yeah," Foreman said. "Along with the antidepressants, right after she arrested for the first time."
House nodded. "Good. That leaves us with an anemic, comatose patient with a low white count on immunosuppressants and antibiotics." He frowned. "Any ideas?"
There was a stretch of silence before Cameron spoke up. "It could still be a tumor," she said. "Kidney, or large intestine."
House shook his head. "It's not a tumor."
"Could be ALL," Foreman suggested, and House snorted.
"Ever seen an ALL with normal lymphocytes?" he asked.
Foreman raised his eyebrows. "She's on immunosuppressants."
House rolled his eyes. "The dosage is much too low. Besides, all the immunosuppressants in the world don't make all those nasty blasts just go away."
Foreman shrugged and nodded. "Okay, so what is it?"
House didn't answer, but stared at the red-blue-green-black pattern on the cupboard doors, willing it to give up its secret to him. Anemia, syncope, he thought. Cough. Might just be a cough. Or not.
"Take her off the immunosuppressants," he said. He wasn't looking at her, but he could practically hear Cameron cross her arms.
"And what good is that going to do?" she asked.
House turned to look at her. "Oh, the sweet wittle immunologist is pissed because I said it's not an immune problem," he mocked. "Just take her off the meds. No matter what happens, it'll always tell us something."
"One of these days, you're going to do one experiment too many, and then you won't be able to save the day," Cameron said. House nodded.
"Yes. But until that happens, I'm still your boss, and you're gonna do what I say. Take her off the immunosuppressants." He limped towards the door and stopped at the sink, wetting a towel and tossing it to Cameron, who caught it in surprise. "Before you do, clean those cupboard doors," he said. "We wouldn't want to piss off the clinic staff, would we."
He didn't stay to see her expression change from surprise to exasperation, but left the exam room and the clinic and stood in the entrance hall to wait for one of the elevators to take him to the third floor.
House didn't like the ICU. He'd never liked it; even before the infarction he'd thought it was a place with too many medical staff and too little privacy. When he'd ended up here a little over five years ago, he'd been in too much pain to pay much attention to his surroundings, but the steady low bleeping of the heart monitors and the symphonic hissing of multiple ventilators had resounded in his dreams for years afterwards. The last time he'd been here, after the shooting, he'd done his very best to make the ICU staff's lives living hell, and had been transferred to the ward after no more than two days.
Needless to say that he was one of the least favorite doctors, if not people, of that particular department; a fact of which he was reminded when he let the ICU double doors swing shut behind him and immediately felt the eyes of the ICU nurses on shift on him. He met the glare of the hefty, middle-aged one who was sitting in front of one of the computers, and saw something like accusation accompanying the usual hostility. He gave her the best fake-sweet smile he could manage, and she turned away in disdain.
Having made sure that he wouldn't be bothered by anyone, he limped past several ICU booths and sought out the last one on the left. The curtains were half-drawn, and as he entered, he was relieved to see that there were no other visitors beside himself. He stepped up beside the bed and sat down on the green plastic visitor's chair. Only then did he raise his eyes to look at the occupant of the hospital bed.
It wasn't an open fracture, so there was no bandage around Wilson's head, except for the one band aid where the ventriculostomy device had been inserted. There was no hair, either; they'd obviously shaved it all off right in the ER. There was dark purple bruising down the right side of Wilson's face, and his right eye was swollen shut. Next to him on the IV stand hung a barbiturate-sodium solution and the evening dose of antibiotics, both tubes snaking down to the bed and under the collar of Wilson's green hospital gown to the CVC they'd put in. The most disturbing part of the picture, even more disturbing than the missing hair, was the ET tube in Wilson's mouth. It was held in place by a blue face mask and connected to the ventilator that stood next to the IV stand and was making its familiar, unsettling sound.
House let his eyes linger on the little he could make out of his friend's face and swallowed, trying to clamp down on the unpleasant feeling that was seeping up from his suddenly too tight chest to his throat. He blinked a couple of times and looked away, leaning forward onto his cane.
"You idiot," he said quietly. "You couldn't win a fight against an arthritis-afflicted osteoporosis grandma. What made you think you could take on Mr. Hyde?"
He stared into space for a couple of moments, then let out a dry laugh and leaned back in his chair. "Oh, right, I know," he said. "You thought with me being me, I certainly had one of those nifty sword-in-shaft canes, right? En garde!" He laughed again, then swallowed and lowered his eyes back to the floor. "Sorry to disappoint you."
The silence that followed seemed all the heavier to House because he knew exactly what Wilson would have answered, had he been conscious. He could almost hear the dry remark, could almost see the slightly raised eyebrows and the thin, quirky smile it would be accompanied by. Almost.
Instead, there was only the steady hiss-pause-hiss of the ventilator, and the other ICU sounds around him. Sounds he associated with pain and people dying that sent his imagination into overdrive, showing him things he had no desire to see.
With a jerky movement, House got to his feet and headed for the half-drawn curtain. When he stepped through them, however, he stopped short. Only two booths further down, he could see an all-too-familiar pony tail bouncing, Cameron looking as pristine and perfect as ever in her fancy white doctor's coat as she frowned down at the chart she was writing in.
Quickly, House took a step backwards and let the curtains close behind him, then limped over to draw them shut completely. He stood there for a moment, leaning on his cane. He just didn't want to talk to her right now. Who could blame him? She really was in an unbearable mood today.
He went back to the chair and sat down, then looked up. "Seems like you're not getting rid of me, after all," he said, then licked his lips. "That's the girl two booths down she's writing orders for, by the way. You know, the patient with the pericystic tumor. Only she doesn't have a tumor. You got that one wrong." He grinned at the man in the bed, then shrugged. "Yeah, okay, I got it wrong, too. But you agreed with me. Got all mushy-carey when you looked at the scan results." He sighed and began to bounce his cane up and down on the floor. "I'm taking her off immunosuppressants. Cameron went for my throat for that one."
She's right. It's stupid.
"It's the only thing I can do. Either that, or let her rot in a room together with coma guy from 216."
You've no idea what's wrong with her, do you?
House frowned. "I've got some ideas. And even if I don't, I'll figure it out eventually. There's a logical reason for her symptoms, and I'm going to find it." I always do, right? House looked at his friend, but of course Wilson couldn't answer. Probably couldn't even hear him.
House leaned back in the chair, still frowning and bouncing his cane off the floor. When he finally got up and left, Cameron was long gone.
It was long past midnight when House's pager went off, but House wasn't sleeping. He was sitting at his piano, absentmindedly staring into space and waiting for the Vicodin to kick in while his fingers ghosted over the keys without producing any sound.
Had he actually been playing, he probably wouldn't have heard the feeble whistling of the pager which was buried under a heap of clothing next door in his bedroom. As it was, though, even that low sound was clearly distinguishable in the three-am silence of his apartment. He didn't get up immediately, though, but stayed where he was until his fingers had struck the last silent notes of Dave Brubeck's Somewhere. Then he reached for his cane and limped next door to find some clothes. He didn't look at the page. He didn't care what this was about. Any reason to get out of his silent apartment was good enough for him.
When he arrived at the hospital, Foreman, Chase and Cameron were already waiting for him, all lined up and looking as if lack of sleep just didn't affect them. House hated them a little for that, but mostly, he didn't care; only limped past them into the entrance hall and stabbed his cane at the elevator button.
"So, what's going on that couldn't wait another six hours?" he asked.
Chase, who, judging from the way he didn't look quite as one hundred percent perky and sharp as his two colleagues, had been the one on call, came up next to him.
"Janet spiked a fever of over one-oh-three," he said.
House frowned. "The patient's name is Janet?" he asked. "What parents in their right minds would call a kid Janet? Let me guess, her father's name's Brad."
Foreman was the only one who got the joke, and judging from his look of long-suffering annoyance, he didn't appreciate it. Cameron and Chase just looked confused, and House waved his hand impatiently. "So, she spiked a fever, and what happened next?"
"We sent some blood cultures and a blood screen to the lab," Chase continued. "The screen came back with a white count of seven point five."
The elevator doors opened with a rattling sound, but House didn't step into the car. Instead, he turned to narrow his eyes at Chase. "Her white count went up thirty-five hundred units in half a night?" He held out his hand. "Let me see the lab."
Chase handed him the sheet of paper, and House frowned down at the numbers, then raised an eyebrow and stepped into the elevator. "Seems like some tired moronic doctor on call screwed up the blood draw," he said and held lab sheet out to his underlings, who had followed him into the elevator. Chase took it and nodded.
"That what I thought," he said. "That's why I drew the blood again." With a smirk, he produced another lab sheet.
House frowned at him, then snatched both labs from his fingers and began to examine them. The results were more or less identical; and they made sense, except for the white count. And Chase maybe wasn't a brilliant doctor, but he wasn't dumb enough to screw up two blood draws in a row. Slowly, House lowered the sheets.
"It's an infection," he muttered. "An infection after all."
The elevator arrived on the fourth floor, and House limped down the dark empty corridor towards his office; Chase, Cameron and Foreman trailing him.
"Maybe it's viral," Foreman suggested.
House shook his head and dug in his pocket for his keys. "No," he said while unlocking his office. "If it was viral, then the Interferon would have done something."
"It did put her in a coma," Chase remarked, and House rolled his eyes.
"It can't be bacterial," said Foreman. "She's on every antibiotic known to man."
"Yes, and her immune system is all screwed up," Cameron said. "She could very well have a bacterial infection."
House sat down behind his desk and picked up his fuzzy ball, beginning to throw it back an forth between his hands. "Of course it's bacterial," he said. "Anything else doesn't make any sense."
"Oh, and bacterial does." Defiantly, Foreman crossed his arms.
House ignored him, keeping his eyes on the ball as it flew back and forth between his right and his left hand. "Infection," he said to no one in particular, drawing out the word as if he were tasting it. "Infection and anemia. White blood cells and red blood cells." He caught the ball in his right hand and turned to look at Chase. "What's her platelets count?"
"Er..." Chase consulted the lab sheet he still held in his hand. "Normal," he said then. "Three hundred."
House frowned, then replaced the ball on its accustomed place. "Get a bone marrow sample," he said.
The three ducklings were silent, waiting for an explanation. When none came, Chase spoke up eventually. "A bone marrow sample. You think there's something wrong with her blood production?"
"No. I just think it would be fun to stab her with a really long needle, now that she's unconscious and can't tell on us."
"But you said it wasn't ALL, or any other kind of leukemia," Cameron protested, and House rolled his eyes.
"Yes I did, but that was before Chase told me that Mrs. Mysterious Disease doubled her white count in less than ten hours. Go and get the bone marrow sample before I do it myself."
"We can't," Foreman said. "We need parental consent, and her dad's in custody for assault. Social Services hasn't assigned a case worker yet."
House frowned. "Didn't I just say 'now that she's unconscious and won't tell on us'? It's the middle of the night, Foreman. This must be easier than your first car theft." He saw Cameron open her mouth and forestalled her protest by screwing up his face in a mocking grimace and whining in a high-pitched voice, "House, we can't do a bone marrow sample on a coma patient without parental consent, it's immoral!" He gave her an annoyed look. "It would be equally immoral to fail to diagnose a bone marrow condition in the girl just because her father has the instincts and conduct of an orangutan. Go and do the sample already."
They all stared at him for a few more moments; Cameron in outrage, Foreman in annoyed amusement and Chase in blank indifference, then they filed out of the room, leaving House with a profound sense of relief to be rid of them.
He sat there and stared at the blank desktop for a few moments. Then he reached for his cane and levered himself to his feet to go out on the balcony. The night was cold, but clear, and due to the late hour, there was only the occasional sound of a car passing on the nearby street. He walked to the edge of the balcony and leaned on the wall, gazing down at the deserted parking lot. Absentmindedly, he reached into his pocket and shook the last two Vicodin out of the pill bottle. Their white color seemed very bright against his dark surroundings.
He turned his head to look over to Wilson's office. It was as dark as everything else, and the shutters were half closed. The pitiable shrub growing in a pot in the far corner of Wilson's balcony looked even more pitiable than usual, slowly freezing to death in the cold of the October night.
House hesitated for a moment, then levered himself onto the dividing wall and swung his legs over to the other side. He walked over to the French door to Wilson's office, and found it locked. After a moment's consideration, he reached into his pocket, producing a paper clip, which he then bent out of shape the way he'd seen Foreman do it when he'd made him break into Cuddy's drawer. He began to poke around in the lock, shifting angles and frowning in concentration until he head a low clicking sound. A satisfied expression spread on his face as he pushed and the door opened without any resistance.
As he entered, he found that Wilson's office wasn't as dark as it had seemed from outside. It was illuminated by several tiny red, blue and green status lights on Wilson's printer, monitor and computer, which was giving off a low buzzing hum. It seemed like Wilson had left it on when he'd left his office yesterday morning, and with all that had been going on, no-one had remembered to switch it off.
House limped around the desk and lowered himself into Wilson's chair. It was one of those expensive, almost criminally comfortable office chairs. Leaning back in it, House could almost understand the many hours Wilson spent sitting here doing paperwork. He let his eyes wander over the room. It wasn't too often that he got to see it from this perspective. It did look different from this angle. Like this, the collection of useless, tacky junk Wilson had received as gifts and assembled on the shelves behind his desk was out of his field of vision, which was a definite improvement. He also had a good view of the paper compartment under the desktop, which held about four or five depressingly neat stacks of papers and files. Shifting his eyes a little, House noticed that the left upper desk drawer was open a little. He reached out, sliding a finger into the crack, and slowly pulled it open all the way.
Of course, it was still there. Volvo-driving, ties-by-weekday-sorting Jimmy didn't change a habit just because it might save him a whole carload of trouble if he did. House took the prescription block from the drawer and turned it in his hands. Then, coming to a decision, he put it on the desk and sat up. He needed a refill. Cuddy wouldn't be in for at least another five hours, two hours after the pharmacy guy got here. House would just have to make sure to copy Wilson's loopy signature - the only thing, actually, that was loopy about his friend's otherwise completely illegible handwriting.
He looked around the desk for a pen, shifting a few papers. In the process, he accidentally nudged the mouse, and with a chattering sound, the computer started up its hard drives and the monitor sprang to life. Blinded by the sudden brightness, House squinted at the screen and raised an eyebrow when he saw what was displayed there. It was the picture of three squirrels in an unambiguous position, with the flashy red capture of Fancy a Threesome?. Checking the taskbar at the bottom of the screen, House noted that he was looking at the display of an attachment of one of those chain emails that were one of the more annoying things the age of communication had brought with it. The other tabs were two unfinished medical reports, one browser window displaying the website of some hospice in South Jersey, and PPTH's patient charting program, OPAC.
House hesitated for a short moment, then pushed the prescription block and a few stacks of papers aside and pulled the keyboard closer. He usually didn't like using OPAC; it was a program custom-written for PPTH, and subsequently incredibly buggy, especially since they had tried to 'update' it a couple of months ago. Right now, however, it might prove useful for a change.
He logged on, clicked on the search option and typed 'Wilson, James' in the input area. After a few more seconds of rattling, the computer presented him with a list of two 'Wilson, James's. One had been born in 1921 and had been discharged from geriatrics three days ago. The other one had been born in 1969 and was listed as ICU patient. House pulled up the chart of the second one.
The electronic filing was kept very simple, probably because even today in the age of palm computers and cell phones with voice dial, there was still a lot of manual filing happening. Diagnosis, medication and general patient assessment were on the first tab page, labs and radiology on the next, EEG, EKG, and other specific test results on the next, AEDL assessment on the last. The only thing missing is a goddamn passport picture, House thought.
He frowned at the screen, his long fingers absentmindedly playing with a pen they'd found on the desk. The longer he looked at the file, the jerkier and more aggressive the movements of his fingers became.
Diagnoses: linear skull fracture, contusion, brain swelling, uncontrolled ICP. Treatment: IV antibiotics, IV nutrition, fluids. And of course the barbiturates. Lots of them.
House let his eyes wander further down to the notes made by the emergency team and the trauma surgeons. ...high initial blood loss... ...ICP levels not responsive to Mannitol... ...seizure prevented by administration of high-dosage Dilantin... ...possibility of diffuse axonal injury...
He dropped the pen. DAI? House thought, feeling the bottom of his stomach, which didn't seem as firm in place as usual anyway, drop a little further. The neurosurgeon didn't say anything about DAI.
Quickly, before images of Wilson the Permanent Coma Patient could form in his mind, he leafed through the rest of the file, looking over labs and radiology results and EEG curves, but nothing that he found held the prospect of brightening the chances.
It didn't look good for Jimmy Wilson. Not good at all.
House closed the filing program and sat staring at the monitor. There was a feeling gnawing at him, the feeling of do something, you're a fucking doctor, for God's sake. He got this feeling quite often; actually, he got it every time he ran into a roadblock during a differential and the patient's health was deteriorating. The only difference was that usually, there was something he could do. Let the ducklings run a ton of tests. Sit in his office and brood over the symptoms on the white board. Rant at the patients that it was their own damn stupidity that had gotten them sick.
With Wilson, well, being in a coma, he wouldn't hear him ranting, and the only other person House could have ranted at, actually would probably have done more than just rant at if allowed, was being held custody and out of his reach. There were no symptoms to brood over, because the diagnosis was pretty clear; a cracked skull was a cracked skull was a cracked skull. And as for the tests, well, Wilson wasn't even his patient. Besides, they wouldn't have done any good, anyway.
In the silent semi-darkness of Wilson's deserted office, House allowed himself a small sigh and ran a hand over his face. Then he closed all programs on Wilson's computer and told it to shut itself down. When the screen had flickered and gone black, House turned off the monitor, and the office got a little darker still as the blue status LED went out. House hesitated, then picked up the prescription block and put it back into the drawer, unused. He levered himself to his feet and went over to the small cupboard where he knew that Wilson kept the free samples he got from the pharmacy agents. After some rummaging around, he found a bottle of Dolacet 650 and pocketed it. He sent out a quick page to the three musketeers - it simply read "going home", he knew that if they still needed him, they'd catch him on his way out - then left Wilson's office, this time by the front door.
No one was waiting for him at the elevators, in the lobby or in the parking lot. Seemed like for once, the kids were able to entertain themselves without his help. The ride home was unpleasant; it was actually already too late in the year for bike riding, especially at night. He was freezing when he arrived at his apartment in Baker Street, and his numb fingers dropped the keys twice when he tried to let himself in. He carelessly tossed his coat on the couch and limped into the bedroom. When he stepped out of his pants, the pill bottle he'd taken from Wilson's office fell out of his pocket, and he had to retrieve it from under the bed.
Finally, he was lying in bed, his feet slowly warming under the thick blankets. He was dog-tired, but the persistent twinge in his leg promised that sleep wouldn't come easily. He dry-swallowed two of the Dolacet, wincing at the unfamiliar taste and shape, then hesitated and tossed back a third one. Maybe the hydrocodone would put him to sleep.
As an afterthought, he turned off the alarm clock which was set on nine am, deciding that if they needed him, they'd call him. Then he rolled onto his side and pulled the blankets up to his ears.
Still, it took him more than two hours to fall asleep.
The bone marrow sample had given them nothing but normal results. House sat behind his desk and held the lab sheet in one hand, frowning at it. The small numbers kept blurring before his eyes. He'd woken at nine thirty this morning, less than three hours after falling asleep, but the pain in his leg hadn't let him go back to sleep, even though he'd felt tired enough to sleep for another week - probably due to the pills he'd taken. Eventually, he'd made his way to work, because there was nothing else he could do to take his mind off the pain - he could have tried the morphine, but he was reluctant to shoot himself up with the hard stuff when he had a dying patient on his hands that might demand his attention at any time. Too many questions to answer if he refused to come in even if his patient was about to snuff it.
When he'd arrived at the hospital, though, he'd found out that neither his minions were in - their days as interns on thirty-six hour shifts were long gone, and they'd obviously decided that if their boss could go home and get some shut-eye, so could they - nor was the bone marrow analysis done yet. The annoyed early-shift person in the lab had told him to wait another hour, at least. He'd ranted at and insulted her, making sure that the first thing she would do when he was gone was run the tests, if only so he wouldn't come back a third time. Then he'd meandered aimlessly through the hospital's corridors, not realizing where exactly he was going until he'd stood in front of the ICU doors.
He hadn't stayed long, though. Wilson's condition was unchanged; due to the barbiturates, his ICP levels were in a more or less tolerable range, but his file had told House that the neurologists weren't exactly optimistic about what would happen if they took him off the meds. He'd still been lying in the same position as the day before, except that someone had stuffed a pillow under his ankles in order to keep him from rubbing open his heels. There wasn't any more life in his features than the last time House had seen him, and even though he'd tried, House hadn't been able to talk to him without being painfully aware of the fact that his friend simply wasn't giving any answers.
So he'd left, spending the rest of the time prowling the corridors in the near vicinity of the lab, until the lab person had come out of her den and shoved the lab sheet into his face, telling him to take it and get lost.
But there was nothing unusual about the results. No misshapen lymphocytes, no tumorous blast cells, absolutely nothing out of the ordinary.
He had to admit, bone marrow had been a long shot. Still, the damned test results didn't have to be that smug about it.
He held out his hand and let the sheet flutter onto the table, then leaned his head back and stared unseeingly at the ceiling, trying to coax the bits of information to rearrange itself in a way that made sense. Like a kaleidoscope, his mind shifted them around, every time creating a new pattern, but he couldn't come up with one that seemed likely, or even possible.
There has to be something there, he thought. There always is. Something-
His concentration was broken by the rattling of his office door being flung open with considerable force. He squeezed his eyes shut in anticipation of the inevitable noise of breaking glass. When it didn't come, he cracked one eye open and groaned as he saw who was standing before his desk.
"What do you want?" he asked.
The woman standing in his office was tall, seeming even taller due to the high-heeled shoes she was wearing. Everything about her desperately screamed elegance and high-class, from the color of her lipstick and her sleek black coat to the way she was clutching her purse in carefully manicured hands. Even the way the mascara had left dark smudges under her eyes seemed to speak of taste and refinement.
She drew in a breath that made her nostrils flare. "I've come to tell you what a complete and utter asshole you are," Julie Clemons, until recently Wilson, spat. House rolled his eyes.
"Can we cut the emotional crap and get to the part where I tell you to get out of my office, or do I have to break my New Year's Resolution and shoot you after all?" he asked, reaching for his cane.
"I knew it would end like this," she hissed, as if he hadn't just said anything. "First you try to control every aspect of his life. Then you ruin our marriage... and now you've finally managed to get him killed!"
House looked up at her, and decided that he was in no mood to fuck around. He wasn't having his peachiest day ever as it was. He grabbed his cane and stood straighter than he usually did, which brought his face a few centimeters above Julie's eye level. Then he narrowed his eyes.
"First of all," he said, his voice pure hostility, "I didn't ruin anyone's marriage. You managed to do that all by yourself by jumping in bed with the first number cruncher whose tie you approved of. Second, you lost any right you may have had to mess with Wilson's life the moment you signed those divorce papers. Third, no matter how much you might wish otherwise, Wilson's not dead yet. I don't give a crap about your reasons for being here, and if you don't get out right now-"
"You'll what?" Julie interrupted. "Trip me up with your cane? You," she continued, stepping closer to him, "are a horrible person, House. Me and James had our differences, but I still respect him as a person. You respect no-one. No matter what he did for you, how much time he spent with you, everything that he gave up for you, you just take and take and never give anything back. And now that he's dying, all you can do is sit here and wallow away in self pity all over again, and-"
Later, House couldn't quite tell what had urged him to raise his cane. He grabbed it by its shaft as if to strike, and he probably would have done it, if she hadn't ducked and flinched as violently as she did. Seeing her reaction, he caught himself at the last second.
"Get out," he said, pointing the cane at the door. "Now."
She stared at him for a few more seconds, then began to retreat towards the door. For a few moments, it looked like she were going to say something, then she only shook her head, turned and quickly left the office, leaving House standing beside his desk.
He didn't move, only flexed his fingers around the cane he was still holding by its shaft. Then he suddenly raised his hand and flung the cane across the office. It hit the bookshelf about halfway up, toppling over one of the vases which fell to the floor and shattered with an ugly crunching sound. It made House wince.
He kept his eyes closed for a moment, taking a couple of deep breaths. Slowly, the burning rage diminished a little, and he felt at least marginally in control again. He opened his eyes and grabbed his patient's file off the desk, then limped across the office to retrieve his cane, picking it up without looking too closely at the scattered shards of the green vase. It had been one of the few things he'd kept after moving out of his and Stacy's house five years ago.
On his way to Cuddy's office, he ignored the way people kept sidestepping through doors or busying themselves with papers and files when they noticed him approaching. He chased a trainee nurse out of the elevator and let it take him to the ground floor, then crossed the lobby, navigating around staff and clinic patients the way an aircraft carrier navigates around sailing boats.
Cuddy was alone in her office. He pushed the door open and tossed his file onto the one she was writing in. Cuddy looked up, and he met her eyes with a hard look.
"I'm done with this" he said. "I don't know what's wrong with her. Let someone else handle the case."
Cuddy only stared at him for a moment, then picked up the file and glanced at it. "We're talking about your coma girl?" she asked.
House turned around and limped towards the door. "Not mine anymore. I'm giving her up for adoption."
"House!" At her tone, House stopped, but didn't turn around. He heard a scraping of her chair, and knew she had gotten up. "You can't hand over patients just like that," she said. "Not without a diagnosis."
He turned around and saw that she'd come around her desk. He narrowed his eyes at her. "What part of 'I don't know what's wrong with her' did you not understand?" he asked. "I don't have a diagnosis. Either some other moron is going to come up with one, or she's going to die. Frankly, I don't give a fuck which."
She stared at him, then let out a laugh and shook her head. "That's not how it works, House," she said. "You come up with diagnoses for any case assigned to you, and I let you be as much of a bastard as you want to be. That's how it's always been, that's how it's gonna be this time."
House let out a derisive snort. "Sorry," he said. "Must've broken my magic wand." He waved his cane at her. "Repair's gonna take at least two weeks, come back after that."
They stared at each other for a few moments, then Cuddy shook her head. "You can't punish this girl for what her father did, House," she said in a calmer voice. "It's not fair, and it won't help Wilson. If he were here, he'd tell you so himself."
House pressed his lips together and said nothing for a moment. Then he raised his eyes. "Probably," he said. "But he's not, is he." He looked at her a little longer, then turned around and reached for the door handle.
This time he didn't stop. There was the muffled sound of high heels on carpet behind him, and then he felt a hand on his arm. He pulled away and turned around, opening his mouth to tell Cuddy to fuck off. But when he looked at her face, he closed his mouth again without speaking.
"Take the chart, House," Cuddy said, holding out the yellow-whitish folder. "Go find out what's wrong with her. Do your job."
It wasn't the words that made him take the chart from her. The words were standard Cuddy talk. There was something in her eyes, though, that made him reach out and snatch the folder out of her fingers.
Without another word, he turned his back on her and left.
"You tell me what's wrong with her!" House said, dropping the chart onto the nightstand in the ICU. Then he raised his eyebrows at the unconscious man in the bed. "Oh, right! You can't! Because this girl's moronic idiot of a father turned you into a maybe permanent vegetable!" He began to pace in the tiny space of the ICU booth; two steps towards the closed curtain, turn around, two steps to wards the nightstand. "Seems like we're in kind of a tight spot here," he continued. "Cuddy wants me to magic a diagnosis out of nowhere, but hey, seems like the magic's gone. A few more people are gonna die, and I'm out of a job, but if you think about it, in the great scheme of things, what does it really matter?"
Will you calm down, House?
House shut his mouth and stopped his pacing. He stood completely still with his head lowered, staring at the mottled gray of the floor's linoleum. His head was pounding, and his leg was giving him hell. Without looking up, he dug the Dolacet from his pocket and took two. He was getting used to the round shape of the new pills.
Using the handle of the cane, he pulled the visitors' chair closer and sat down. For quite some time, he didn't move, only stared unseeingly at the display of the ICP monitors. Then he looked up.
Every time he was here, it always surprised him to realize how much it hurt him to see his friend like this. It was a cliché, but it really did feel as if someone were twisting his insides, like someone had taken a part of him and run off with it, leaving him hurting and angry and completely unable to do anything about it. It had happened to him before, but House realized that this was worse, hurt worse than anything his leg had ever done to him. This wasn't just his leg. This was Wilson.
He leaned forward and covered his face with his hands. He knew that it was the middle of the day, and that at any moment, someone might come barging through the drawn curtains and find him like this. He couldn't stop himself, though. It hurt too much.
I don't think I can do this, Jimmy. He could hear the rush of blood in his ears. It almost drowned out the sounds of the monitors. I can't treat that girl as if her father hadn't done anything. It wasn't exactly what he'd meant, but he couldn't not think it. He needed the assurance that this was about the patient. Always about the patient.
He raised his head and looked at Wilson. Wilson, with no hair falling into his face, and no mischievous sparkle in his eyes. With an ET tube in his mouth and another tube in his head. With no witty or reproachful or dry or plain cynical answers to give. Without-
Quickly, House got to his feet, almost dropping his cane in the process. He took the patient's file from the nightstand, then looked at Wilson one more time.
I'm gonna do my job, he promised him silently. I will. But if you drop out on me, I'm gonna make sure you get the ugliest Donald Duck gravestone in the dingiest back corner of the cheapest graveyard I can find. I mean it.
House pushed open the door to the conference room. Chase, Foreman and Cameron were sitting around the table, all three of them flinching as the door flew open. House passed by them, snatching the coffee cup out of Chase's hand in the process, and hung his cane on the whiteboard. Then he took a sip from the cup and made a face.
"Ew," he said in disgust and limped over to the sink to dump the cup's contents. "You do know that too much sugar will turn you into a diabetic?"
"No it won't," said Foreman, sounding as if he couldn't care less. House poured himself a new cup of coffee and added just about the same amount of sugar as had been in the first one.
"It might," he said. He returned to the whiteboard and picked up the marker, then turned around to face his three underlings.
"I am sick of this case," he announced. The three young doctors lowered whatever they'd been looking at and raised their heads to stare at him. He ignored them, and continued, "Cuddy said I can't dump it, though. So, what we're going to do today, we're not going to leave this hospital either until we've figured out what's going on, or until the patient dies. I really don't care which, so in case anyone of you volunteers to help the patient along a bit, do it now so we can all go home."
They were still staring at him with wide eyes. Even Foreman had given up on his act of the tough, unshockable doctor. House raised his eyebrows at them. "No-one? Pity. Well, then let's get to work."
He grabbed the cloth and wiped out the jumbled up notes, then wrote "Annoying Coma Girl" at the top of the board and underlined the words. Then he turned around.
"Okay, let's do this differently this time," he said. "Scenario: Patient, fifteen years, female, comes to the clinic with unrelenting back pain and a cough. Chase, what d'you do?"
Chase shifted in his chair. "I ask whether she engaged in any straining activity and might have pulled a muscle," he said.
"Kid's the incarnation of a couch potato. Never does anything more straining than walk from the living room to the fridge and back." House pointed with the marker. "Cameron, your turn."
"I give her a thorough exam to cover all the usual reasons for back pain. If that doesn't lead to any results, I send in a blood draw and give her an X-ray."
House nodded. "X-ray comes back normal, blood tests show an elevated white count and slightly decreased erythrocytes. Patient is given steroids for intermittent anemia and develops a skin rash. What d'you think? Foreman?"
"I think it's an allergic reaction to the steroids," Foreman said, crossing his arms and displaying his best indulgent/impatient expression. House frowned at him and didn't say anything. After a while, Foreman began to fidget.
"Could be a new symptom, too," he said. House didn't answer, then turned around and wrote 'cough', 'back pain' and 'skin rash' on the whiteboard.
"Now," he continued. "Let's assume the doctors decided it was an allergy and took her off the steroids. They put her on antibiotics and immunosuppressants. What would that have done? Chase?"
"Antibiotics would have fought off bacterial infections, if there were any. Immunosuppressants would have decreased her white count."
"Making it impossible for us to tell whether the white count dropped after administration of the antibiotics," said House. He added "bacterial infection" to the list of symptoms.
"Skin rash goes away," he said then. "Kid starts to feel better. Then she suddenly develops a severe anemia with syncope episodes. Cameron?"
"Anemia could be caused by the immunosuppressants," she said. "Or it could be a new symptom."
House scribbled "anemia" under the last item of the list. Then he stepped back and frowned at the board, staring at it silently before grabbing a colored marker and circling the last three symptoms on the list. He stared for a few more moments, then slowly drew another circle around "back pain".
"House, what are you doing?" Cameron asked.
House didn't reply. Instead, he went over to his bookshelf and pulled out a copy of the Mount Sinai Journal of Medicine. He leafed to one of the articles and silently stared at the page for a few moments. Then he snapped it shut and grabbed his cane, dropping the journal onto the table as he passed it on his way to the door.
"Come on," he said to his minions. "Time to solve a case."
When the diagnostics team arrived in the ICU, House barked at one of the nurses to get him a portable ultrasound and led his ducklings straight to their patient's booth. While they waited for the ultrasound device, House pushed aside the blankets and spread transparent ultrasound gel on the patient's lower abdomen. His three fellows watched in concerted lack of understanding.
"You don't think she's pregnant, do you?" Cameron asked, and House rolled his eyes.
"Does she look like a girl who's having sex at fifteen to you?" he asked, and Cameron gave him a consternated glare, which he neither acknowledged or even noticed, as at that moment, the nurse showed up with the portable ultrasound. He put his cane aside to take the device from her and turned it on.
"Now, watch and learn," he said, and put the transducer onto the girl's belly. A black-and-white picture crystallized itself on the ultrasounds small screen. He looked at it and made a satisfied grunt, then turned it so the kids could take a look at it.
They stared at it for a few moments, then Foreman shook his head. "I'll be damned," he said.
"We'll all be damned for not seeing this sooner," House said and turned the ultrasound off.
Chase looked up. "But she didn't have a fever!" he said.
"In rare cases, Crohn's patients can stay without fever even if the disease has already progressed to higher stages," House said. "And as soon as we put her on immunosuppressants, any chance for a correct diagnosis was out the window, anyway. No way to diagnose an inflammation of the bowel if immunosuppressants are screwing with the labs." He reached for his cane. "Increase the antibiotics and start her on glucocorticoids. When the inflammation's gone, she'll probably wake up on her own. Then the internists can have her."
He didn't wait for the three to start executing his orders but pushed past them and passed through the curtains, quickly leaving the ICU. He had no reason to stay. His work was done.
Later that evening, House was standing in his kitchen, squinting and frowning in concentration as he tried to decipher the less-than-tidy handwriting on the small piece of paper he was holding in his hand. It was a hastily scribbled recipe for macadamia nut pancakes that Wilson had put down for him after he had declared the pancakes the best he'd ever had. At the time, House had snorted and made a sarcastic remark about ice ages in hell and him handling a frying pan, but he'd kept the recipe with the vague idea of giving it to his mother at some point, if only to throw her off track by making her think he'd actually taken up cooking.
He hadn't had the chance to give it to her yet, though, and so the recipe had still been hanging next to his notepad on the door of the fridge, held in place by Garfield the Incredibly Tacky Fridge Magnet, when he'd come into his kitchen about ten minutes ago, intending to get himself a beer and ending up picking up the recipe instead.
He remembered sitting on the couch in the living room, pretending to read a medical journal but actually watching Wilson making pancakes in the kitchen. He'd made it look very easy, moving around and mixing ingredients with the air of a man who didn't have to think about what he was doing to get it right. House had found himself feeling a little envious of that unconscious ease, which of course had caused him to mock Wilson even more than he usually would have done. Being who he was, Wilson hadn't let the scoffing bother him, but had only answered in the same manner and smiled at the compliment that he knew was hidden beneath.
House wasn't quite sure what had urged him to abandon the prospect of beer and silent brooding in the living room for a probably doomed attempt at doing what Wilson had had in mind when he'd noted down the recipe - making pancakes. The last time he'd cooked anything - not counting warming up canned chicken-and-noodle soup - he'd still been walking without a limp. And even then, it hadn't exactly turned out great.
Still, here he was with half of the recipe's ingredients laid out on the kitchen table in front of him, trying to figure out what the hell Wilson might have meant by 'sittaculk'. Or maybe 'sittaink'. Wilson's southpaw scrawl was almost illegible on the best of days, but he'd exceeded himself with this one. If House squinted and cocked his head, the word might have read 'settireek'.
After another moment, he dismissed it for later consideration and moved on to the next item, which probably was supposed to mean 'butter'. He limped over to the fridge to get it, and also grabbed the eggs that were listed two items further along. Then he opened one of the cupboards to get some vanilla extract and the half-empty bag of chopped macadamia nuts, dumping it all on the table next to the other ingredients.
For a moment, he just stood there, letting his eyes wander over the congregation of bags and bowls. He realized that most of those things - the flour, the baking powder, the vanilla and the nuts - were only in his kitchen because Wilson had put them there while he'd been staying with him. They had been sitting in the seldomly opened kitchen cupboards, untouched and forgotten about. They probably would have died and turned to dust in there if House hadn't been overcome by the strange urge to take them out and put them on the kitchen table.
What in the name of all saints am I doing here, anyway?
He stood there a few moments longer, then raised his cane and slowly, deliberately, dragged it across the tabletop. Flour, eggs, sugar, milk and macadamia nuts were pushed over the edge and spread on the floor, creating a squelching sound and a middle-sized white cloud of flour-dust on impact. House watched as the milk channeled itself in the cracks between the tiles, quickly building a network that originated from the big, squishy puddle of white goo next to the table. The macadamia interspersed the white with small brown dots, and the egg yolk created four bigger yellow spots. If he'd taken a picture of the whole thing, he was sure someone would have paid a lot of money to be allowed to hang a blown-up version of it above their couch in the living room.
He turned around and went over to the fridge to get himself a beer. When he was half-way on his way to the living room, the phone began to ring. He ignored it and dropped into the couch.
"I haff vays off makink you hank upp!" his own voice spoke up after the fifth ring. "Only a fool vill dare to speek after de-" The message ended, and there was the electronic beep of the answering machine. Then Foreman's voice came from the phone's speaker.
"House?" he asked. "Are you there? If you are, pick up. It's about Wilson."
Quickly, House reached out and switched the phone to hands-free mode. "What's going on?" he asked.
"House," Foreman said, "you might want to come to the hospital. They're taking Wilson off the barbiturates."
"What?" House felt something cold trying to claw its way up his throat. He swallowed and shook his head. "Why? It's way too early."
"He's having hypotensive episodes they can't control with propranolol anymore. Right now, the barbs are doing more harm than good." There was something in Foreman's voice that for House's liking sounded way too much like compassion. It made his stomach feel very light. So did Foreman's next words. "House, this doesn't necessarily mean that he'll- what I mean to say, he might come out of this and be okay."
"Sure," House said, his voice carrying a rough edge. "Or he might come out of this and grow a set of angel's wings."
"I'm on my way," House said, and hung up.
When House arrived at the hospital, darkness had already fallen. He parked his car and went inside. Brenda was on late shift, and met his eyes as he crossed the lobby. News had a way of passing the clinic counter as one of their first stops, and the nurse's gaze seemed softer than usual. It made House grit his teeth a little harder still.
He was waiting in front of the elevators, restlessly flexing his fingers on the cane's handle, when he heard the staccato of Cuddy's high heels approaching. He looked around.
"House," she said, her eyes widened the way they always were when she was upset. "I heard about Wilson."
He nodded and turned back. She stood beside him. House could sense that she was trying to find something both hopeful and not completely stupid to say, and decided that he really didn't want to hear it. He shifted a little.
"I solved the girl's case," he said. "Crohn's disease." The statement had the desired effect of distracting Cuddy. Now, however, from the corner of his eyes he could see her frowning at him, so he continued before she could say anything. "What happened to the father?"
"Last I heard, he's facing a lawsuit for battery," she said. The elevator doors opened, and they stepped inside. House pushed the button for the third floor.
"Battery, eh?" he said. "What will that get him? A slap on the wrist?"
Cuddy closed her eyes for a moment. "I don't know," she said and shook her head. "I guess it depends."
"Yeah." House's tone was bitter. "I'll be sure to let Wilson know that if he wants the guy to be locked away, he'll have to croak to prove his point." He saw Cuddy flinch, but didn't really care. A tight ball of emotions was sitting at the pit of his stomach, eating its way upwards. He had to keep a close eye on it if he wanted to keep it from erupting.
"He'll be okay, House," Cuddy said in a slightly husky voice.
"You don't know that." The elevator arrived on the third floor, and the doors rattled open. "Actually, you know he probably won't be." He started down the corridor, not caring when Cuddy didn't follow him immediately. She caught up with him about halfway down the corridor, and they entered the ICU together.
There was a small crowd standing at the curtain of Wilson's booth, consisting of the three musketeers and Dr. Lee Vang, one of the neurologists in charge of Wilson's case. Vang was writing in the chart with Foreman looking over his shoulder. Cameron was facing the bed with a worried frown contorting her features, and Chase stood a few steps further back, looking confused and unhappy.
House and Cuddy stepped up to them, and Vang looked up. "House," he said by way of greeting. House gave him a nod. The two of them weren't in any way friends - House couldn't think of any person beside Wilson he would call his friend - but Vang was a competent doctor and a tolerable human being in that way that he usually left House alone. One of the main reasons House hadn't taken Wilson's case out of the neurological department's hands to put Foreman on it was that Vang had been assigned to the case.
"We have taken him off the barbiturates," Vang said, handing him the chart. "The residual effects should wear off some time during the night. We'll monitor him closely to be able to treat rising ICP levels before they can do any damage."
House frowned at the chart, feeling a twinge beneath his chest as he saw the orders that had been noted down in the course of the afternoon. Point-five megs of atropine at four, another point-five half an hour later. One meg at five thirty. Standing orders on more propranolol than could possibly be good for a person. And now, discontinuation of the barbiturates.
He looked up at Vang. "Will he wake up, what do you think?"
Vang shook his head. "It's impossible to tell," he said. "The brain scan is useless as long as the barbs are still in his system. If he doesn't wake up, though..." He trailed off, and House didn't need him to finish the sentence. He knew what it would meant if Wilson didn't wake up despite being taken off the barbs. PPTH's boy wonder oncologist would join the jolly club of the vegetative state guys in the basement, the intercranial pressure having damaged his brain beyond hope or repair.
House nodded. "Thanks," he said without looking at the other doctor, then limped past Vang, Chase and Cameron to sit in the visitor's chair beside Wilson's bed. He took his cane in both hands and rested his chin on the handle. His eyes were on his friend's still face.
There was murmuring behind him, and Dr. Vang left after signing off on today's orders in the chart. Cuddy and the others crowded around the foot of the bed, and for a long while, there was silence, interrupted only by the sounds of the ventilator's artificial breathing. Then Cameron muttered something to Cuddy of which House only caught the word 'family'. Cuddy turned around, and she and Cameron walked away. After a short moment's hesitance, Chase trailed after them.
House looked up at Foreman, expecting him to leave as well. Foreman however didn't move, only continued to frown at the ICP monitor, his arms crossed. House raised his eyebrows. "Hey, Mr. Neurologist," he said. "You've seen the chart. What odds are you giving him?"
"Bad ones," Foreman said, then met House's eyes. "But you know that." He unfolded his arms and put them on the foot railing of the bed. "I'm sorry, House," he said in a quieter tone of voice. "I really am."
House opened his mouth to give a snarky remark, but for once, wit and sarcasm seemed to have bailed on him, leaving him defenseless. Foreman, however, didn't take advantage of it, but only turned away and left as well, his shoulders a little tauter than usual.
For a long time, House didn't move, only sitting there on his visitor's chair and staring blankly into nothingness. Then he shook his head a little and got to his feet. He walked over to the curtains and drew them shut, then went up to the bed and stood beside it, looking down at his friend. Slowly, he reached out and put his own left hand over Wilson's.
"Don't give up, Jimmy," he whispered, almost inaudibly. "Don't give up." He swallowed and frowned, then blinked a couple of times.
Don't leave me, he thought. Please.
House frowned at the conscientiously folded paper in his hand and absentmindedly shook his head. This wasn't right. The pointy end was supposed to go up.
He sat the almost-finished hatching paper crane next to the standing and the flying one on the nightstand and stared at the three origami figures, lost in thought. He'd had no trouble remembering how to make the normal crane, and the standing one was almost the same, with a very slight variation. He didn't seem to be able to get the wings of the hatching one right, though.
Never mind making a thousand of these, he thought and leaned back in the chair, feeling a sort of dry amusement at the thought of him walking up to the ICU night nurse and telling her he needed a few more spare consent forms, he had another nine hundred and ninety-seven cranes to make. Ninety-eight, actually. He didn't think hatching cranes with broken wings counted.
It was late. No, actually, it was early, very early on the next day. The overhead lights in the ICU were dark, and they would stay dark for at least another two hours. Around midnight, House had felt the exhaustion of stressful days and mostly sleepless nights catch up with him, but right now, he was wide awake again. Good old endorphines, they could be counted on at any time.
He wouldn't have fallen asleep, anyway, though. Every time his eyes had slipped shut, he'd immediately jerked them open again, seeking out the ICP monitor to make sure the levels were still in the tolerable range. Earlier in the night, around eleven pm, the amplitude of the bolt waveform had increased and P2 had shot up. Five minutes later, Vang had been there, looking dishevelled like any doctor did when woken up from restless napping in the on-call room, and had put down standing orders for IV Mannitol. Ever since, the waveform hadn't acted up again, but those five minutes of watching P2 trying to cut out her sister waves had been enough for House to dismiss any thoughts of nodding off at some point during the night.
Otherwise, the night had been surprisingly uneventful so far. Around nine, Wilson's parents had shown up, and House, feeling no urge to talk to them, had spent the one and a half hour of their visit stocking up his caffeine levels in his office. When he'd returned, the night nurse had been standing beside Wilson's bed, and House had shooed her out of the booth, telling her to leak her overcaring over some other dying patient. She hadn't returned since, except to hook up the Mannitol, which she had done without sparing him a glance.
About half an hour ago, House had begun to feel nervous. It had been more than enough time for the barbs to leave Wilson's system. His friend, however, still wasn't showing any signs of life. It had been going too easy until now, the ICP had been too easily controlled by the new meds. Maybe because there wasn't anything left that a high ICP could harm in any way. House didn't believe in optimism. In this case, however, the pessimistic prospect made his stomach want to turn and twist itself around.
To distract himself, he'd snatched a few consent forms from the nurse's desk and had started to make the origami birds. First, he'd been reluctant to make cranes, of all things, but it was the only thing he knew how to make by heart. Besides, he was quite sure Wilson of all people would have appreciated the irony.
Count on Japanese symbolism to depress the hell out of you at any time, he thought, staring at the flying crane that had the paragraph about the risks of intubation written across its left wing. He reached out and picked up the three paper figures, intending to dump them into the waste basket next to the bed, when a flicker on the EEG monitor caught his eye. He turned his attention to the readings, frowned, blinked and looked again. Then he quickly got to his feet and rang for the nurse.
"Wilson?" He stood beside the bed and bent forward to be able to clearly see his friend's face. "Jimmy, can you hear me?"
First, there was nothing at all, and House almost turned around to make sure he hadn't imagined the EEG perks in the alpha range. Then, however, Wilson's left hand twitched in a definite conscious movement, and House held his breath. "Come on, Jimmy," he urged. "Wake up. Open your eyes for me."
Wilson's hand moved some more, and then he began to move his head as well, trying to turn it to the side but prevented by the ET tube and the face mask. His eyelids fluttered, and slowly, very slowly, he opened his eyes.
House swallowed and licked his lips, his eyes fixed on his friend, who was looking at him, actually looking at him, the expression in his brown eyes glazed over and confused and pretty scared, but definitely the expression of a person who still had most or maybe even all control of his brain left. House conjured up a smile, and when he spoke, he couldn't have cared less that his voice didn't sound exactly steady, even though the night nurse had come through the curtains and was now standing at the foot of the bed, watching the whole scene and being smart enough to keep her mouth shut.
"Welcome back, Jimmy," House said. "It's about time."
Wilson blinked and raised his hand, sending it in the general direction of the ET tubing. House caught the fingers before they could get a hold of anything, though.
"Hold still," he said. "I'll take it out in a minute." He threw a glance at the respiration monitor and assured himself that Wilson was triggering the vent on each breath. Then he loosened the face mask's straps and grabbed a plastic syringe to deflate the cuff. He sought out Wilson's eyes again. "Exhale," he ordered, and pulled out the tube in one swift, steady move.
Wilson returned to the land of the independently breathing with a lot of coughing and gagging. House let him clasp his fingers around his own, waiting until his friend had gotten his breath back and signaling the nurse to hook up the oxygen mask.
Wilson closed his eyes for a moment, drawing deep, ragged breaths. Then he opened his mouth, managing a croaked word on the second try.
"House," he said.
"Right here, Jimmy," House said. "It's okay. Try not to talk too much."
Wilson blinked a couple of times, swallowed, and gave a few more feeble coughs. "What-" he asked.
"Long story," House said. "I'll tell you as soon as Dr. Vang here has given you a neuro exam."
Vang, who had obviously received a call from the night nurse, had appeared a few moments ago and was hovering behind House, pocket flashlight in hand. House took the oxygen mask from the nurse and put it over Wilson's mouth and nose, then stepped aside to give Vang access to the bed.
"Dr. Wilson," said Vang and switched on the flashlight. "I'm Dr. Lee Vang. This is going to be a little bright."
From where he stood, House couldn't see whether Wilson's pupils were contracting, so he watched Vang, and thought the man looked satisfied with what he was seeing. The doctor pocketed his flashlight and carefully pulled the oxygen mask away from Wilson's face. "Can you tell me your full name?"
This time, Wilson's voice decided to work on the first try, even though it still was little more than a croak. "James Evan Wilson."
"Good. Do you know your birthday?"
"Twenty-fifth of August." Wilson closed his eyes and drew in a breath. "Nineteen sixty-nine."
Vang nodded and put the mask back. "Very good, Dr. Wilson."
The neurologist stepped back from the bed and looked up, and only then did House realize just how much he had dreaded the outcome of this very first exam. Vang's optimistic expression triggered a feeling of such strong relief in him that for once, House was glad that he had the cane to lean on. He wasn't sure if he had been able to get a word out, so he was glad when Vang chose to speak up.
"The brain scan will tell us more in the morning," he said in a quiet tone. "But I think that we can pretty safely assume that Dr. Wilson here is one very lucky person."
House only nodded, and Vang picked up the chart, writing a few more orders and then handing it to the nurse to carry them out. House didn't pay them any more attention, but stepped up to the bed again, resting both hands on its edge and seeking out Wilson's face again.
Wilson had closed his eyes again, and for a moment it seemed as if he'd gone to sleep. Then, however, the long lashes fluttered open once more, and House met Wilson's gaze which seemed a little more focused this time. He saw him open his mouth beneath the plastic mask, and reached out to pull it away.
"What is it, Jimmy?" he asked.
Wilson blinked a few times. "What-" He cleared his throat. "What did you do about the girl?"
For a moment, House was confused. Then he realized what Wilson was talking about. Part of him wanted to laugh out loud, while the other part wondered why the hell this even surprised him. He shook his head. "You wake up from a fucking barb coma, and the first thing you ask is what happened to the patient?"
Wilson only looked at him, and House could see that one, he was holding his eyes open by sheer willpower, and two, for some twisted Wilson-reason this was really important to him. "She's fine," he said. "Crohn's disease. Woke up, was transferred to the ward, will be going home soonish."
This seemed to satisfy Wilson, because he let his eyes slip shut. House was just about to put the oxygen mask back in place when he saw Wilson's lips move and heard him whisper something. His hand froze for a second before completing the movement. Then House stepped back and slowly lowered himself back onto the chair. He stared at his friend for some time, then swallowed, hard.
"No, I didn't kill her," he said quietly. "But don't thank me."
After another two days of Mannitol treatment in the ICU, Wilson's ICP levels had balanced out and he was transferred to the Witherspoon Wing. With his room being only about fifty yards down the corridor from the diagnostics office, House could usually be found there in one of the visitor's armchairs with a stack of charts in front of him on the table and his PSP in his hands. After about a week, Cuddy had been able to make out a pattern of this happening even more often during the time of the afternoon when she was trying to find House to make him work his clinic hours. Still, she couldn't bring herself to make him leave Wilson's bedside, and she and the business part of her mind came to the silent agreement that she would make him pull double duty once Wilson was back on his feet.
Another two weeks after that, the circumstances had changed only in so far that now, when she came into Wilson's hospital room, she would usually find both of them at the small table, playing cards or sharing greasy take-out food or simply sitting there and insulting each other in the way they always did.
Four weeks after he had woken up from the coma, Wilson was released from the hospital and went on a three week stay in a neurologic rehabilitation center somewhere in West Virginia. Cuddy sensed that her time had come and pounced on House, demanding payback for the twenty days of freedom she had granted him. Being the slick bastard that he was, though, House found a way to weasel out of most of it, dumping the rest on his fellows and skipping the last of the three weeks completely by demanding his first real vacation - real vacation, as in 'not sick days' - ever since she had hired him. She was tempted to refuse, but something made her give in. That something might have been the strong hunch that House would be spending his week off in a motel near the Touro Rehabilitation Center for Head Trauma and Brain Injury in West Virginia.
Around that time word got through to her that the case of the state versus Mr. Elmond Franks had ended in an amend to second degree battery and a verdict of a fine of two hundred and fifty dollars plus fifty days of jail time on suspension and one hundred and eighty days on probation. Hearing those news, Cuddy was glad that House wasn't around so she wouldn't have to be the one to tell him that yes, a slap on the wrist was all he had gotten.
By the time her head of diagnostics came back to work, Cuddy had made the observation that the clinic was currently more frequented by patients than usual, which resulted in a battle of herself versus the business part of her mind, which now claimed that keeping House away from the clinic was the most economic thing to do. She won this one, if only barely, and the old routine of her prowling the corridors on House hunt re-established itself.
The day her head of oncology finally came back to work was the day of the first snow fall before Christmas. Those days always provided a special atmosphere, and this one was no exception. The welcome-back party the oncology department organized for their boss was one of the few hospital parties that would stay in Cuddy's fond memory for some time to come, and not only because it was the only hospital party ever where House didn't make an appearance just to steal cake and mock the party guests.
After that, things rapidly returned to the way they had always been. Complaints about House increased, due to the fact that he actually came into contact with patients again. The oncology department, which had suffered under the momentary loss of their most workaholic staff member, returned to its former glory. The corner table in the cafeteria, which had stayed untouched by everyone except ignorants and fools for the last two months, was again occupied almost every lunch by its two rightful owners. Cuddy wouldn't have needed Cameron storming into her office two days before Christmas, outraged and ranting about some hair-brained procedure House was planning to do and Wilson was going along with, to be assured of the fact that things were, in fact, back to normal. It was a nice touch, though.
House struck the last few chords of Silent Night and let his fingers rest on the keys, waiting until the last trace of the resonance had dissipated before he drew his hands back. The silence that followed was only interrupted by the rattling of the shutters that were being shaken by the winter storm this year's Christmas Eve had brought. That, and the deep, even breathing coming from the direction of the couch.
House didn't have to turn around to know that Wilson was sound asleep. About an hour ago, he had sat down in front of the piano and had begun to play his way through his repertoire of Christmas carols. Halfway through The First Noel he'd noticed that the shifting around had stopped, and in between White Christmas and Coventry he'd heard the first quiet snore. By now, Wilson was probably well into his first REM phase.
House glanced over his shoulder and almost smiled at the way Wilson was stretched out on the couch, one arm across his chest while the other one was wedged awkwardly between him and the backrest. It would be pins and needles all over when he woke up.
Resting his hands on the keys again, House turned back to the piano. Almost tentatively, he struck a few single notes, trying to recall the harmonies of an old song he'd once known. His right hand found a scaled theme that felt right, and his left hand followed almost instinctively, underlying the melody with a counterpointed shuffling baseline. After a while, it came back to him, and he picked up the pace a little, beginning to hum along.
House had never been a huge soul fan. At this moment, the song felt right, though, and as he went into the first chorus of Al Green's Love and Happiness, a thought crossed his mind that sometimes, on rare occasions, against all odds and anything life had ever taught him, things did work out the right way, after all.
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