Standard disclaimers apply, made for practice, not profit.
Please review, constructive criticism welcome.
Cuddy is startled to see House waiting at the hospital entrance. At seven in the morning on Monday. With a tried posture and pale, sunken face.
"House?" She calls out in concern, taking in his haggard appearance.
He looks up so slowly it appears a lame Hollywood effect, dark circles under blood shot eyes. "Knock-out pills." He holds out a hand, his usually demanding voice comes out strained. "Off counter stuff sucks."
Cuddy strides over, studious eyes connecting with glazed ones. "Booze doesn't qualify as…" Her words trickle off as House produces an opaque pill bottle from his blazer, holding it label-first in her face.
"Let's get you checked up." She takes him by the forearm and guides him in.
House makes no move to resist until his slow brain figures they're heading for the clinic and not the pharmacy. "Just gimme the damn pills." He groans.
"No." She stares him down. "No more blind prescriptions."
"I haven't slept in days!" House shouts, startling the scarce early morning staff off janitors and nurses.
"The sooner I finish the sooner you get to crash." Cuddy is adamant.
"Fine." He mutters, following her to exam one. Seated at the exam table he watches her retrieve a tourniquet, syringe and test tube. "It's not physical." He insists, rubbing one eye with the heel of his other hand, but doesn't stop her from rolling his sleeve up.
"You're warm." She notes, reaching for his forehead.
House pulls away. "Under one hundred and dropping." He groans. "I was also lethargic and without appetite. It's the flu shot you – OUCH!" He yelps at the needle prick.
"Vaccination is mandatory for all medical personnel." Cuddy shoots him a pointed look. "Pump."
Dark red flows into a test tube in time with the clenching of Greg's lanky fist. "I didn't get a bug in decades and than you give me one for prevention." He returns glare for glare.
"Insomnia could be hormonal." She seals the vial. "I'll test the thyroid and pituitary functions."
"Whatever." He mumbles. "Just get me something. Hell, club me over the head if you have to."
A faint grin steals it s way to her lips as she writes on a prescription pad. "Here." She offers a slip.
Snatching it without thanks, House lands off the exam table and hobbles away. Half way out, he looks over the shoulder. "When the results come back - don't wake me."
"Go." She urges him out. "Sleep."
The door of Wilson's office opens with a rumble of laughter as a young couple exits.
"We'll John, I hope never to see you again." The oncologist shakes his patient's hand.
"Same here doctor." Replies the other man through an exchange of smiles, before ushering his wife down the hall.
Watching the two amble away, Wilson feels his stomach rumble and churn. One glance at the wrist watch later, he is on the door of Greg's office, surprised by the totally closed blinds. With a rap on the glass, he steps in uninvited.
The white board stands out of place next to the diagnostician's desk, its badly wiped surface scrawled with three un-medical terms:
Glancing around the office, Wilson finds House awkwardly slumped in the corner recliner, chin on chest and eyes half-open.
"House!?" Wilson jumps to his side, taking his head for a better look. "House, look at me!"
Blue eyes drift slowly to the source of the sound, pupils wide. Wilson's own snap back and forth over the room, falling on an open bottle of tranquilizers one quarter empty. Turning the label, he reads the present date, eyes wide with shock.
"Shit!" He drops the bottle, pills rattling against a rushed beat of footsteps on carpet.
"Call code!" He hollers to the hall and races back just as fast, fingers on House's jugular.
"One. … Two. … Damn it!"
Nervous, Wilson licks his lips. "Talk to me, House, tell me where you are."
House lifts his head slowly, looks around. "Office."
"What office?" Wilson presses.
"Tired…" Greg mumbles, head drooping again.
"House, look up!"
The man obeys begrudgingly.
"Stay with me, you have to stay with me."
Office doors slam open to a three man team of medics pushing a gurney.
Wilson steps aside as they move House form the recliner. "Point one epi shot before his heart stops." He jogs behind them to the elevator.
Sleeve rolled up, an injection pen is emptied into Greg's shoulder, opposite arm brushing the thing off with glacial moves. Pressure gauge is wrapped around the forearm, portable pulse-ox added for good measure.
"What happened?" A medic asks.
"Sedative overdose." Wilson heaves.
On three, a dazed House slams into the hard mattress of the ER table, pairs of gloved hands moving over him, reducing shirt to shreds. Pig Latin rattles off with urgency as tubes wide and narrow are brought on scene.
"Nho." House groans against the one in his mouth, head rolled side to side to escape the offending object.
Strong hands grab him by the temples and hold the head still for the procedure but House starts choking, his slow arms vainly flailing to fight off the attack. The tube is pulled while orderlies pin his wrists to the table.
"Swallow." Commands a graying blackhead in her alto, guiding the tube back in through a mouth held open by force.
House jerks with a retching spasm, rancid ooze spewed out.
"Recovery Pose!" She commands, nurses helping to unbuckle one hand and roll him on the side. "Suction."
Gauze wipes the dribble from his face as he coughs the straying bits out, a different tube slurping up the mess.
"Get him active charcoal." The woman snaps her gloves off in frustration.
From outside ER, Cuddy and Wilson stare through half-open blinds.
Wilson sighs. "A few months ago I tried slipping antidepressants into his coffee." He admits to Cuddy's shock. "They worked." He adds regretfully. "Do you think he…?"
Cuddy shakes her head, to deny it and to fight the thought away. "I don't believe it." She crosses her arms defiantly. "Not now."
"Hormone panel showed his melatonin is negligible. The pineal gland isn't working. Sleep deprivation causes problems with higher thought processes, he could have just lost count of the pills."
Wilson's brow rises in an expression of interest. "That would explain it."
"Explain what?" She frowns at him.
"This." Wilson gestures to ER. "He's resisting treatment with enough sedatives in him to kill an elephant."
"We should do a head scan, look for structural abnormalities."
Wilson pinches the bridge of his nose, the faint light of computer screens illuminating his face as images stream in from the MRI. His eyes scan each row of dots as it appears, taking in the curving lines and bloby surfaces that are Greg's brain, slices coming in from the crown down.
"Found anything?" Cuddy's voice sounds from over his shoulder.
"Nothing so far." Wilson sighs an answer; eyes fixed on the screen but no longer focused. "No masses, lesions, gumma…"
"Shutting down for no reason."
"Looks…" The oncologist freezes, attention glued to the brain scan. "Wait a second." He scrolls through the last dozen pictures, eyes growing wide with shock as he notes the shrinking space between brain and skull. "Good God... the frontal cortex!"
Cuddy shakes her head, baffled. "This kind of swelling, he should be having a massive headache."
Beeping of the pulse-ox interrupts her, vitals display showing an increase in pulse and blood pressure.
"He is." Wilson pulls from the desk, racing to the scanner room. "Vicodin was masking it." He slams a large button.
House is slid out, strapped immobile and grimacing in pain.
"He needs a morphine shot or his brain 'll herniate."
Cuddy wheels over a gurney and grabs the stretcher under a writhing, moaning House. "COX inhibitor for inflammation and paracetamol for the fever."
"Are you trying to shoot his liver?" Wilson helps her move House, vainly rolling his head under the binds as if it could ease the growing pressure, fingers clutching at the hospital gown, groaning ever louder.
She glares icicles his way. "Got a better idea?"
"Aspirin for swelling, fever and clot prevention, which, given his history and the fact he'll be lying around a lot now, is not insignificant." He rolls the gurney out. "One mildly toxic drug beats three."
Tense and quivering, House whimpers, breathing coming in hiccups.
"What's the differential for brain swelling?" Cuddy calls the elevator.
"Scan showed no trauma." Wilson pushes House in and punches third floor. "Could be infection, overdose, poisoning…" He trails off as doors shut.
"James?" She sounds weary.
"Paraneoplastic syndrome." He mutters.
Cuddy's mouth opens slightly. "Cancer."
Blue eyes snap open, gasping against spiking pain.
She passes a hand through the black mane. "All right, we need to do complete blood works-"
He shakes his head. "Treatment before test."
"What?" She's befuddled.
"His practice." Wilson points at House as the doors ping open. "Give him everything but chemo." He speaks as they roll their friend to ICU. "If he doesn't get better we'll know its cancer. Morphine." He orders Brenda. "Now."
Undoing the binds, Lisa and James hoist House to a free bed, nurses quick to hook him up on IV and monitors, instantly screaming in alarm. Second later, a shot of opium floods Greg's system, vitals dropping.
"BP normal, pulse steady." Wilson reads the display. "He's in the clear."
"For now." Cuddy reminds. "Broad spectrum antibiotics, interferons, standard heavy metal chelation." She rattles off at a young blonde. "Have complete blood works done: tox screen, drug panel and cancer markers. We still need to know which of those worked, or your treatment will shoot his liver." Her looks is stern.
"I'll schedule a lymph node biopsy and torso X-ray." He adds. "Faster results."
Relaxed, House opens his eyes, a lost expression on his face.
"Greg?" She calls out loud and clear.
Dark brows knit confused. "Stacy?"
The lines of Cuddy's face slope. "No, House." Her voice softens. "It's me, Lisa Cuddy."
"Cuddy…" The word comes out stretched, an unfamiliar sound.
Lisa opens a shelf of vacutaniers and sterile needles, hiding a film of tears. A shaky, calming breath later she blinks a few times and faces the nurse. "Hold his arm still."
Rubber band rolled up one arm, a needle breaks into vein, House jerking his palm up against the hold in an attempt to shield the sensitive crook of elbow.
Cuddy notes his step down on the awareness scale while filling three vials of blood. "Get House to radiology and page Doctor Wilson."
Wilson raps the dean's office doors.
"Come in." Cuddy calls.
Entering into the stripes of orange light and gray shadow, Wilson raises his brows in a ' Which is it?' question.
She shrugs. "Nothing, anything. His fever is rising but his white blood cells are low. No cancer markers. Toxins in trace amounts, not enough to do damage. He's a walking pharmacy but that's nothing new. And his blood sugar is elevated."
"Diabetes?" He is baffled.
"His diet doesn't preclude it, but it wouldn't have this effect."
"How come the results are this quick?"
"I threatened to fire the lab if House died."
"A little motivation goes a long way." He sniggers.
Cuddy leans back into the chair, unamused, toying with her rubber band. "You?"
Wilson shakes his head. "I was just on the way to the lab, biopsy results are pending."
"Page me when you're done."
Cuddy walks in ICU, her shadow long and pale in the gloom of dusk. Approaching Greg's bed she takes him by the hand and forearm, stroking gently.
Eyes flutter open, aimed forward to the ceiling corner, unfocused. "Pain." House whispers in a distant voice.
"Does your leg hurt?"
House's eyes go wide at the last word. "Flame. Acid." Voice is thick with tension.
She frowns, decides to err on the side of caution. "I'm upping your morphine." Her thumb rolls the small gauge a notch.
"Clot." He continues, oblivious to her statement. "Poison."
Her throat clogs up. "We gave you aspirin." She reassures. "You can't clot."
"Fire. Drug." His voice is louder, urgent. "Bug."
Cuddy shakes her head, confused. "What do you mean?"
"It's evening, House." Lisa replies dejected.
"Light. Manta!" He shouts. "DOUG! CHARLES!!" Hollering dies with lack of breath.
Cuddy shuts her eyes, bites her lips together with a silent, huffed sigh. She clears her throat a bit and grasps his shoulder. "Calm down. Relax."
Vacant blue orbs drift shut. Lisa lets go of him and walks to the foot of the bed. Blanket tossed aside, she scrapes his bare sole with her pen and the foot curves away on reflex. Noting another step down, Cuddy replaces the covers.
"Willow." The mumbled word is a belated afterthought.
Cuddy leaves with a defeated posture.
The dean pirouettes on the tips of her stilettos to the sound of doors shushing open in the imaging room. Wilson enters with Greg's thick medical file clasped in both hands.
"Good news or bad news?" She asks.
"Both." He walks to a light screen and stuffs a film in the clamp. "Good news is that it isn't cancer: Biopsy showed no abnormal cells…" He flicks the light on, neons blinking to life. "All organs pristine. He's got cardiopulmonary systems of a twenty years younger man."
"Makes sense with all the pacing he does."
Wilson stands akimbo. "Bad news is we don't know what it its."
"Maybe we do." She does not sound relived.
Wislon squints. "What do you mean?"
"Hepatic encephalitis." He sighs resigned. "A decade of vicodin abuse."
She shakes her head. "Too early, the liver is not scarred, he's not even jaundiced."
"Is he getting better?" He glances her way.
Cuddy's head drops in defeat.
"Tests and treatment both disprove the alternatives."
"All the alternatives?" She insists.
"All we though of so far." Hands slap against his sides. "I'll test his liver functions, do a biopsy. You recall current treatments, get a pig and put him on an organ waiting list."
Her arms take hold of one another. "The transplant board will never allow it."
"Than we'll have to pull strings. Cash in favors." He shrugs.
Wilson paces the surgery halls in baby-blue ensemble of paper apron, face mask and skull cap. The taller surgeon stands at ready over the patient, but waits for the oncologist to enter, a wordless question in his lopsided brows.
House, covered head to toe with dark blue cloth, beard shaved and hair tucked under a half-transparent net, lies perfectly still and calm as if already anesthetized.
Seeking permission with just a look, Wilson is granted one with the surgeons slow, understanding nod.
"House?" Wilson calls out, voice slightly muffled from the mask. "Can you hear me?"
Hand in latex glove rubs hard at Greg's brow. A grunt is all the response Wilson gets, no attempt to move from the pain. His firm knuckle press into the center of lanky chest makes House gaze wide eyed for a moment, his gasp sharp.
"Shallow coma." The oncologist declares grimly, than nods his go-ahead. Pushing the OR doors open, he proceeds with removing the gloves, a gurney with a sedated animal wheeled past him.
At first light of the following day, a drained looking Cuddy finds an equally exhausted Wilson in the lab, hunched over a microscope.
"Fatty liver, first stage of failure." He answers the unspoken question. "You got him on the list?" He looks over the shoulder.
Her sad face is reply enough. "I've tried everything."
"Apparently not." He mumbles to himself.
"Yes, I did." She stomps over. "I even convinced them I'd have him in rehab and AA. Hell, I told them I'd get House a desk job, article review, medical research, diagnostic classes - anything without patient contact. I thought the no lawsuits concept would win them over. I'd even offered to get a considerate replacement like Chase to take over diagnostics, let the guy pick his own batch of fellows. They still refused."
Wilson turns around annoyed and miffed. "You'd stuff him in a nine to five job?"
"I'd spare him clinic duty." She counters.
Wilson rolls his eyes. "He'd die of boredom."
"In infectious disease research? Curing AIDS is such a drag." She snarks.
"You'd be making choices behind his back!" He insists.
"If it means having him live, yes!"
Fingers rubbing temples, Wilson ducks his head and shakes it sadly. "You haven't learned a thing."
Cuddy shoots him a murderous glare, looking away for a few moments before calming down again. "How is he?"
"Unresponsive." Wilson huffs.
"Than it doesn't matter - pig dialysis isn't working either. If it were his liver, it would be helping. Plus his enzymes are elevated." She holds out a readout.
Wilson looks genuinely dumbfolded. "With failing liver? And rising ammonia? That's impossible! " He snags the report from her hand.
"Apparently not." She watches his disbelief. "If only we had a brilliant diagnostician." her words are sadly bitter.
He fumbles with the paper. "I think it's time we made some calls."
TO BE CONTINUED