Four weeks later ...
The PI for the Virtual Iraq trials was not enchanted to meet Dr. Gregory House.
House's one consult at Cornell was months ago and had lasted only a week, but it was still spoken of in tones of awe and affront by the faculty, and Dr. Francille French had clearly been privy to those conversations. A tall, severly attractive middle-aged black woman and a no-nonsense researcher, she had been expecting Dr. Ramakrishnan and one patient, and she wasn't happy to see that House had tagged along.
Nevertheless, she led the trio from Princeton to her lab with considerable grace, giving them a quick history of the program as they went.
"The first virtual-reality exposure therapy I'm aware of was Virtual Vietnam, in the late 1990s," said Dr. French. "It was used to treat Vietnam vets with PTSD. They were are handful of hard-core cases; they'd been through 30 years of multiple interventions without responding to any of them. All of them showed significant improvement with this program. We started using virtual-reality exposure therapy at Cornell in the 1990s, to treat patients in our burn unit—most of them firefighters. Then, when 9-11 happened, we created a new version for people who had worked in the World Trade Center. Now the focus is on soldiers returning from Iraq. There will be significant demand: we're anticipating that one in five Iraq vets will require treatment for PTSD."
On hearing this, Deadman, who had been slumped in his wheelchair and almost mute since they'd picked him up at the Manhattan veterans hospital, sat up a little straighter and started taking an interest. This was his second session with the Virtual Iraq group. The first had been a prolonged interview, in which the therapist kindly but firmly led him to recall his experiences in the Middle East, from the smell of the marketplace to the sound of a car bomb exploding. He told Krish the whole thing sucked dead dick, but he kept his second appointment.
"Veterans represent a departure for us," Dr. French continued, as they entered the lab. "The firefighters and 9-11 patients experienced severe trauma, of course, but it was of relatively short duration, and the priority was survival. In a battleground situation, the patient experiences multiple stresses over a prolonged period, while playing a role in which he is expected to put aside concern for his personal safety in favor of goals set by faceless superiors."
It took some persuading to get Deadman to consent to the experiment. He didn't want to be separated from his family for two months. He wasn't a fan of psychotherapy in any format. He balked at the implication that he was suffering from mental illness. And, House suspected, he wanted to be free to off himself if the PTSD symptoms overwhelmed him again.
Everyone credited Deadman's final acquiescence to Krish, who kept talking to him in a warm rich voice about the program's good track record and the soldiers who had tried it and were living good lives again, able to get and keep jobs and enjoy their families. Krish wasn't so sure. As he remembered the scene, he was beginning to think it was a lost cause when House spoke up.
"Deadman. Don't be a douche," said House. "Give it a chance. If it works, great. If it doesn't, I'll help you try something else." It was an innocuous offer, but the two men exchanged a look that made Krishna very uneasy.
"What the fuck," Deadman said at last. "I gotta sit on my ass for 12 weeks anyway. Might as well play video games while I'm at it."
They entered the lab, and Deadman was wheeled away for a private interview with the therapist. House wandered around the room, poking at the equipment and asking obnoxious questions until Dr. French offered to let him try Virtual Iraq for himself.
She sat him in a chair that had been placed over a device that transmits the feel of sound waves, and helped him put on headphones and a helmet with 3-D video screens in place of the visor.
"The therapist controls the experience, making it more and less intense according to the patient's responses," said Dr. French. "You tell me how much stimulus you are up for, and I'll adjust the inputs accordingly."
"Gimme the works," said House.
He was assigned to the role of a soldier driving a Humvee. There was a soldier in the passenger seat and another in the back seat, and in the rearview mirror he could see the legs of the gunner who was manning the turret on the Humvee's roof. The animation was a disappointment; it was as good as any video game he'd ever played, but only that good. On the other hand, as soon as the scenario began the chair began to vibrate, and he could hear the sound of tires on pavement.
The Hummer rolled along a desert highway and entered a town. House was growing bored when a sniper appeared on an overpass and began firing. The gunner fired back. The smell of gunpowder filled his nostrils, setting off some primitive alarm in his nervous system. As the Humvee approached a marketplace the street filled with people, milling nervously and speaking rapid Arabic. A car bomb exploded, the concussion registering in his bones. An RPG fired at close range, and suddenly the gunner dropped into the back of the vehicle, the top of his body missing, blood spouting everywhere. The voices in the street were hysterical now; the odor of gunpowder grew stronger and mingled with the smell of burning rubber, hair, and flesh. And the guns kept firing ...
Dr. French shut down the show and helped him out of the helmet. House's face felt cold, and he drew deep breaths, trying to steady his heartbeat.
"That was overkill," Dr. French remarked in an off-hand way. "We'd never flood a patient with stimuli like that. But you get the idea."
House was regaining his composure. "Nice," he said. "When's it coming out for Wii?"
The therapist wheeled Deadman into the room and helped him into the chair. He put in the helmet and sat waiting. Krish and House watched from an observation room.
Flooded with stimuli, House thought. A therapist would be careful not to overdo it; a Shiite militiaman, not so much. Imagine being 18 again; a kid, really; and your first experience with the world outside your childhood home involved buddies getting blown apart. An environment where the veiled figures hurrying through the alley could be women trying to get home before curfew—or insurgents who would suddenly turn and fire.
The thought came, unbidden: his own father had been 18 when he joined up. And his first real-world experience outside of Blackshears, Georgia, took place in the rice paddies of Korea.
"I think you're ready to go up to the roof," the therapist was saying to Deadman, who was apparently experiencing a different scenario than House's.
"Hang on," said Deadman, a frantic note in his voice. "Just—lemme think—" Deep breath: "Okay. Go."
"And this is supposed to heal his psychic wounds?" asked Wilson, his voice rich with skepticism.
House shrugged. "If he thinks it does, it will."
"It's a weird concept," Wilson mused. "Reinact the worst stuff you ever lived through until you're cured."
"Maybe they'll come out with Virtual Marriage," said House. "Six months of weekly sessions, and at the end you grow a pair and ask someone out..."
"... said the guy who didn't ask anyone out for five years."
"I was waiting for the right girl."
"I keep thinking about your farewell luncheon," Wilson said, "and marveling that you resisted the urge to do something really stupid. By way of good-bye."
"I'm getting too old for that kind of crap."
"With age comes wisdom."
"Bullshit, Wilson. With age comes presbyopia, arthritis, and constipation. It gets harder to get in the mood when you have piles."
They rose and strolled to the elevator bank. As they waited, a thought struck Wilson.
"What if they could do a virtual reality game about your leg?" he asked. "What if it would shave some of the angst off the last ten years? Would you try it?"
House hesitated. He doubted he'd have the stomach to relive those months, no matter what the promised payoff. He put the thought aside.
"You know me, Wilson," he grinned. "I like to learn things the hard way."