Chapter 3 – Two by Two
Rain still drizzled from the overcast sky early the next morning.
Wilson handed House his own cup of coffee as he slid into the passenger seat of the car, sipping the hot liquid from the rim of his travel mug to stave off the chill.
"Thanks Honey," House said appreciatively, taking a long gulp.
"You're welcome, Baby Cakes," Wilson deflected, pulling into traffic. "By the way, I called ahead and arranged for Qaiser's RA to open the room."
House rolled his eyes. "Great. Now the kid's roommate will have had time to hide anything worth finding."
"I doubt it," Wilson replied, turning towards Princeton's main campus. "The roommate had a seven-thirty class."
"The last time I had a seven-thirty class, I slept with the TA for test notes," House bragged. "And slept through every class like a baby."
"So did I," Wilson said, watching House for a reaction.
"You slept with the TA?" House asked his eyes wide.
"No. But I did sleep through every class."
"Hah," House wasn't amused. "Testing the theory of learning through osmosis?"
"Something like that," Wilson said with a grin.
They travelled the next ten minutes in relative silence, coming to a stop just outside a towering gray brick building with gothic architecture.
"Here," House handed Wilson his handicapped placard. "Use this."
Wilson surveyed the parking situation and the raindrops and didn't hesitate. He took the spot nearest the entrance and hung the placard from the rear view mirror. They made for the door as fast as House's cane would travel.
Shaking the cold and wet from their coats and hair, they asked a passing student for directions to the elevator. After a quick ride, they stepped out onto the fourth floor looking left and right for the direction they should take.
"The RA is in 420," Wilson said, pointing left and down the hall. "Numbers are higher the other way."
House nodded and followed Wilson down the corridor.
"Why weren't dorms co-ed when we were in college?" House asked eyeing a redhead wrapped in short terrycloth robe.
"Didn't keep you from sleeping with the TA," Wilson responded, trying not to stare at the same redhead.
Shortly they found themselves outside room 420. Wilson knocked and a guy with a curly brown ponytail answered the door.
"Aaron Downing?" Wilson asked.
"That's me," was the answer. "You the doctor I spoke to on the phone earlier?"
"Yes," Wilson nodded. "I'm Doctor Wilson and this is Doctor House."
"Good to meet you," the RA said. "Let me grab the key." He disappeared a moment and returned with a large master key on a chain. "412 is this way," he said, squeezing past House and down the hall.
"Sorry if I woke you," Wilson made conversation as Aaron fiddled with the lock on their patient's door.
"No problem," he said calmly. "My first class doesn't start until ten on Fridays."
House grinned, a glint in his blue eyes. "Smart kid," House praised him.
Aaron smiled back and opened the door, gesturing for the two doctors to enter first.
Stepping inside, House did a quick inventory. Two beds, two built in closets with drawers, two desks and two chairs. The bedding on both twins was neutral; both desks had nondescript lamps and identical alarm clocks. The window had standard issue blinds framed by the one bright spot of color in the room; curtains, obviously home made, with intricate gold embroidery against orange and purple silk.
"Which bed is Qaiser's?" House asked the RA.
"That one," Aaron pointed to the one furthest from the window.
Wilson bent over and peaked under the bed. Not even a dust bunny. "I've never seen a dorm room this clean," he remarked.
"Yeah," Aaron seemed to take it as a symbol of pride that he had the neatest tenants in the hall.
House, meanwhile, searched through the closet for anything unusual. Jeans, polos, sweaters, sox, a plastic crate with a handle filled with basic hygiene supplies. "Do you know which bathroom Qaiser used?"
"Uh, nearest guy's facility is across the hall and down about three doors," Aaron speculated.
Wilson sat in front of Qaiser's laptop which lay idle on the small desk. An anthology of English literature, a trigonometry book, and a copy of the Koran sat beside it. He picked up the decorated book and held it up for House to see.
House took it from Wilson's hands. "How well do you know Qaiser and," he had no idea what the roommate's name was, "the other guy?"
"Sure," House conceded, moving to look through the other closet.
"They're clean, quiet, seem like nice guys," Aaron said. "Qaiser is some kind of architect or engineering major. Ahmed does biology, I think. They roomed together last semester too."
Wilson had managed to get into Qaiser's email account. "Mostly just emails to his parents," Wilson said. "Did they have many visitors?"
"Sometimes a few other kids from the Mosque, always guys, no girls," Aaron answered. "Maybe a study or lab partner."
"Anyone named Charlie?" Wilson asked, remembering the name from the previous evening.
Aaron shrugged. "They don't exactly sign in."
Wilson took that as a no.
House found nothing of interest in the roommate's closet either. "Any one have a problem with them being Muslim?" he asked, grasping at straws.
The RA laughed. "You're kidding right? Muslim, Hindu, Jew, Catholic," he listed. "You name it, we got it. No body seems to mind."
House sat on the edge of Qaiser's bed. Giving it a bounce, he noticed a thick piece of intricately woven cloth that had slipped between the bed and the wall. Reaching over, he retrieved a prayer rug. He began to scan the room for one that belonged to the roommate.
"Was Qaiser very religious?" House asked, poking around the room.
"Yeah, I think so," the RA said. "Ahmed is for sure. I was seriously surprised when I found out that Qaiser was in the hospital for alcohol poisoning. He didn't really seem like the Bickers type."
"House, what are you looking for?" Wilson asked, closing the laptop.
"Ahmed's prayer rug," House told him.
Aaron perked up. "He usually takes it with him Fridays."
House's phone began to ring. "Friday prayers?" he asked, grabbing for his phone.
"Yeah," Aaron nodded. "There's a flyer." He pointed towards the hallway and stepped outside the room to retrieve it.
House answered, putting the phone on speaker so Wilson could hear as well. "It takes you three hours to get an MRI of his chest?" he began the day's berating.
"And a good morning to you, too," came Taub's voice. "Is Wilson with you?"
"I'm here," he spoke up.
Taub continued. "Bone marrow biopsy came back negative for Multiple Myeloma."
"Wilson, you're 0 for 2," House said.
"The sputum culture is still growing but so far there doesn't appear to be enough bacteria in his lungs to diagnose pneumonia, aspirated or not," Taub reported. "Looks like Cameron's Clindomycin cleared it up pretty quickly."
"We should start him on broad spectrum antibiotics." It was Thirteen's turn to speak up.
"Right," House said sarcastically. "Because this guy's kidneys handled the first round so well."
"The chest MRI showed more fluid building in his lungs," Thirteen pleaded her case. "His morning labs show BUN and Creatine levels tanking fast. His kidneys may have another day but if the pressure keeps building in his lungs he'll die from congestive heart failure first."
House looked at Wilson, scratching his forehead. "Up his Lasix," he told them.
"Already did," they heard Taub answer. "We're also running tests for E. coli and Salmonella."
"He had some blood in his stool this morning," Thirteen elaborated.
House stared at his phone with contempt. "You think he came in with E. coli and took almost week to present?"
"We've been concentrating on his kidneys, House," Thirteen said. "We could have missed the symptoms."
"Yeah, yeah," House moved them along. "Hold on."
The RA had come back into the room holding a sheet of yellow copy paper.
"Does Qaiser eat in the dining hall here?" House asked him.
"Sure," Aaron answered. "I see him most nights."
"Any one around here sick to their stomach the last week?"
The kid thought a moment. "No. There was a twenty-four hour bug going around a couple of weeks ago, but I haven't heard of anyone with food poisoning."
"Thank you," House told him. He turned back to the phone. "Any of you guys sick?" he asked Taub and Thirteen. "We've all eaten the hospital's food. I'm not pooping blood. How about you Wilson?"
"No," Wilson answered as quickly as possible, giving the RA an apologetic smile.
"It can't hurt to check," Taub said, defeat edging into his voice.
"Fine," House told them. "Run it. Wilson and I will be in shortly." He picked up the phone and ended the call.
The RA stepped forward and handed the yellow flyer from the hall to Wilson.
"Friday prayers, Juma," he pointed to the announcement, "start at noon in the Student Center. Ahmed will be there. If you want to know anything about Qaiser and Bickers, he's the one you should talk to."
"Thanks," Wilson said, taking the flyer from him.
"Here," Aaron handed House a black and white photo from the student directory. "That's Ahmed. I think he goes early to help organize things."
House nodded and handed the photo to Wilson. "Thank you."
"Anything else I can help you guys with?" the RA asked, looking nervously at the clock.
"Just need to check out the bathroom," House said.
Aaron looked at House, confused and a bit concerned.
"For mold and stuff," House explained with a roll of the eyes.
Taub and Thirteen had crossed Wegener's and cancer off of the white board and added a circle and question mark around pneumonia. E. coli was now listed as a possible culprit.
"I see you've been playing with the markers again," House's sarcastic wit entered the room as loudly as he did, shrugging off his backpack and coat, his cane preceding each step with a muffled thud. He looked anxiously from his fellows, to the board, and back again.
"Huh," Wilson remarked as he strode in from his office next door. "If you cross something off the list, don't you need to add something to replace it? Unless he's cured." Wilson was being intentionally glib.
"Thank you," House nodded to Wilson. "We need more ideas." He stepped around the table, passing Taub on the way to the sink. He snatched the dry erase marker from his hand as he went by and Taub grimaced.
"So you didn't find anything in his dorm room?" Thirteen asked, looking more tired than she should after a night's rest. House wondered if she'd gone home at all.
"Unfortunately, no," Wilson said, disappointed at being disappointed.
House rinsed out a mug and poured in coffee. "No alcohol hidden in the back of the closet, no marijuana rolled up with the socks, not even a prescription from Daddy's medicine cabinet for sleeping pills."
Wilson took on a capricious tone. "House thought he might be on to something of the mold variety when we checked out the bathrooms. Alas, it was only crusty hair gel."
"Like I said," House continued, "we need new ideas."
"White count is elevated but not from aspiration pneumonia," Taub said. "What if it's viral?"
"The pneumonia?" House clarified. "Or whatever is causing his kidneys to fail? I'm cool with either one."
"The fluid in his lungs could be what's causing the kidney failure," Taub stated plainly. "The kid was outside in the cold and snow for hours. He could have easily caught viral pneumonia. The timeline fits."
"Except the kidneys went wacko before the lungs," House reminded him not so gently.
"Maybe not. Maybe we just noticed the kidneys first because that's what we were looking at for signs of damage from the alcohol poisoning," Thirteen reasoned.
House looked at them, mischief in his eyes. "You two have been working on this all morning, haven't you?"
There was silence for a moment and then Taub spoke. "You were the one who wanted more ideas."
"Fine," House said. "See if he'll give you another sputum sample."
"What about Fabry disease?" Wilson said somewhat reluctantly. "He's away from home, eating like a college kid eats. Maybe the fats finally got to him."
"Fabry disease usually doesn't take twenty years to present," Taub told him.
"No purple blemishes on the skin, either," Thirteen added. "But we could run a test for the genetic marker and check for cloudiness in corneas."
"Do it," House said, adding it to the list of possibilities.
"I know you think E. coli is a red herring," Thirteen proceeded lightly, "but what if it's related to Hemolytic Uremia? HUS or TTP would cause the blood to clot abnormally in the renal capillaries causing the kidney failure. E. coli or the pneumonia could have triggered either."
House nodded. "Anybody besides a computer look at his red blood cells recently?" He took the silence as a no. "Okay, then let's do that too. And check for muscle enzymes and elevated myoglobin in his blood while you're at it." He added Rhabdomyolysis to the board.
"He has been achier today," Thirteen said, knowing the two could be connected.
"One more thing," House said, lifting his eyes to survey them all. "I need two of you to intercept Qaiser's roommate-"
He was cut off by the clicking of two inch heels. House managed a groan before she could say his name.
It was Cuddy. Not loud, just mildly infuriated and absolutely demanding. He tried to hide a smile at the way she flushed.
"Dr. Cuddy," he said to her, pleasant enough.
She looked at the gathered crowd and pointed to his private office, stepping quickly through the adjoining door.
"What did you do?" Wilson whispered as House passed by him.
"I have no idea," he said, the curious feeling of being, for once, oblivious making its way through his body. It was an odd yet warm sensation that seemed to travel from his toes to his head quite quickly.
"Tell me you have a theory about this case," Cuddy insisted, barely waiting for the door to close behind House.
"Okay," House proceeded cautiously. "I have a theory about this case. Several, actually. We're whittling them down as we speak."
"Mr. and Mrs. Zaheer, along with the vice president of student affairs, were just in my office demanding to know why their son's condition continues to deteriorate further despite the medicines and technology at our disposal." Cuddy sounded like she had taken the last part from a direct quote.
"Because he's sick and we don't know why," House said, not masking conceit. "I don't know about you, but I find it hard to use those medicines and technologies to cure a patient when I haven't even diagnosed him yet."
"Hah!" she laughed. "Since when? You get an idea in your head and start treatment before you confirm the diagnosis all the time."
She was right, which House hated and instantly chose to defy.
"If you wanted me to act like I always have with this patient then you shouldn't have assigned Wilson to guard duty," he said, putting the focus back on her.
Cuddy glared at him. It was an excuse, blaming her, and she knew it. She simply doubted the merit of sticking up for herself. It wasn't worth the energy. Not now.
"Fine," Cuddy let him have the point. "But in the meantime, your patient's kidneys are failing, his lungs are filling with fluid, and his heart may be in danger from the pressure."
"Don't forget the bloody stool," House baited her.
"Probably nothing. Thirteen's chasing down E. coli, not that she'll find it."
Cuddy starred at him, hard. He could feel her eyes on him, filling with every emotion from confusion to anger to concern as they burrowed into him. It made him uneasy.
"The parents want him treated," Cuddy said, replacing her hot gaze with the cool stare of an administrator. "They want him put back on dialysis and they want him on antibiotics."
"No," House squealed, twisting his body in protest. "This isn't some garden variety bacteria that can be wiped out with an all inclusive drug! The only thing broad spectrum antibiotics will do is box in his kidneys more, causing them to fail more rapidly, giving me less time to figure out what's really killing their son."
"You don't think it's an infection?" Cuddy asked him, looking for a way to support his process while still protecting the patient.
"If the kid had aspiration pneumonia then the antibiotic Cameron gave him in the ER took care of it," House explained. "Which means, either he has viral pneumonia, which besides being one hell of a coincidence is also not treatable by antibiotics, or, the fluid in his lungs has nothing to do with an infection and is the result of something wrong with his body's processes. Also not treatable with antibiotics."
Cuddy stood firm. "I get it, House. I really do. But they don't want to watch their son suffer anymore. Remember, you got this case yesterday. They've been dealing with this since Sunday morning. I can do my best to talk them out of the antibiotics, but your patient goes back on dialysis now."
House pouted through his rage. "You let me have this case. After months of watching Foreman take the scenic route around every diagnosis I finally have a chance to do this again, the right way. Don't tie my hands!"
"You tied your own hands years ago!" she found herself shouting back at him. Cuddy heard the words come out like the maddening beat of the pulse at her neck. She sounded vengeful which took her by surprise. House too, it seemed. She didn't feel that way towards him. But that was the way the words came out, vindictive and without pity.
House's face fell as if from some great rooftop. His grip tightened around his cane while his shoulders fell limp. He looked anywhere but at her. He wasn't sure if he could hide whatever was behind his eyes; fear, pain, love. And he could smell the regret coming off her, her own mysterious remorse at words that had acted of their own accord, leaving her off balance. He could tell from the way she was squirming that she was fighting with her need to apologize, comfort and reassure him. He could also see that he wasn't the only one who may have grown more comfortable with themselves during his absence. She was also fighting to keep the authority that belonged to her and was doing a hell of job, something House had always wished she would embrace more.
He managed to meet her eyes. They were sad but firm.
"He goes back on dialysis," Cuddy instructed, no longer yelling or fighting.
House nodded. "I'll get Taub and Thirteen up there now," he told her, hoping his voice had some measure of comfort for her in it. He didn't want her to spend the rest of the day agonizing over him.
Cuddy thought she heard something in the way he acquiesced; something approaching tender. She thought House sounded more the way she often had before he'd been away, trying to balance strength and emotion in a neat package. It let her breathe easier as she backed out of the office. It also tugged at her heart, reminding her of the other instruction she had come to deliver.
"You have physical therapy at noon," she reminded him kindly.
"I know," he answered, not a trace of the smart ass in his voice. He even tried a weak smile which Cuddy lingered on.
He was thankful when she turned and left the room but the relief at being alone disappeared as quickly as it had come on when Wilson poked his head in from the next room.
"You okay?" Wilson asked him.
House took the deepest breath of his life.
"I think so," he said, almost upbeat. "Our patient is going back on dialysis."
Wilson nodded. "Yeah. We heard that," he said, and House had to laugh just a bit.
The elevator doors opened onto the ICU wing. Taub and Thirteen headed down one hallway while Wilson accompanied House down another. It was a shorter hallway with a waiting room at the end and both doctors wished they had been allowed to travel down the other hall when they saw what awaited them.
Mr. Zaheer was pacing the same ten foot area with a surprisingly rapid pace. His wife sat curled on the edge of a couch, hugging her knees to her chest. House's distaste for dealing with the family of patients was sweating from his every pore. And so he hung back and let Wilson take the first swing.
"Mr. and Mrs. Zaheer," Wilson's easy and calming nature was set to high, even for him.
Both parents stopped their anxious movements and stood directly before them with expectant looks.
"Doctor Wilson," Mrs. Zaheer seemed glad to see a familiar face.
Wilson had the good sense to speak before either parent could begin to question.
"This is Doctor House. He's in charge of your son's case," Wilson introduced them.
"Then please, Doctor House," Mr. Zaheer pleaded, "tell us what you are doing for our son."
House pushed his pride aside and spoke softly. "Right now my team is putting your son back on dialysis."
That produced a quick response from the parents who hugged one another in relief.
"The dialysis should help relieve the fluid in his lungs and the pressure on his heart. It should also give us more time to find out what's causing your son's kidneys to fail."
"I don't understand," Mr. Zaheer said. "Why can't you treat the pneumonia with antibiotics?"
House looked sideways at Wilson who took the hint.
"We're not convinced the fluid in your son's lungs is the result of pneumonia," Wilson tried his best to explain. "We tested some of the sputum that he coughed up and the amount and types of bacteria weren't consistent with the aspiration pneumonia he was being treated for earlier."
"You're saying the pneumonia isn't bacterial?" Mrs. Zaheer asked. "Is there some sort of anti-viral treatment you could try instead?"
Wilson looked at her a moment before answering. "We're looking into that now, but you should both know that your son may not have pneumonia at all."
They looked at House, hoping he could make sense of what was happening to their son.
He did his best. "Your son has pulmonary edema, basically a build up of fluid in his lungs. Since the antibiotics cleared the pneumonia that he came in with, it's much more likely that the fluid is a result of whatever is causing his kidney failure."
"Which is?" Mr. Zaheer demanded to know.
"I don't know that yet," House admitted, his answer pulling the rug out from under their feet. "We're still running tests for genetic diseases, blood conditions that could have been triggered by the pneumonia or the alcohol, looking for malformations in and around the kidneys." He couldn't think of anything else to tell them and so he stopped talking.
His silence didn't sit well.
"How long will all of this take?" Mrs. Zaheer looked to both House and Wilson for a definite answer.
"We can't be sure," Wilson told her. "But the dialysis should give us the time we need."
House had been watching as the parents grew closer to hysteria. At any moment it would take over, taking precious time away from treating their son. So when he heard Thirteen's voice calling out loudly from down the opposite hall and saw the rush at the nurses' station, it was a welcome reprieve.
"Excuse me," House shuffled quickly off towards the commotion, leaving Wilson with the distraught parents.
Approaching his patient's room, he confirmed what he'd thought Thirteen had yelled out; a code blue. The patient was in cardiac arrest.
"Epi is on board," one of the nurses announced.
"I need to tube him!" Thirteen insisted. "Push .7 of Vecuronium!"
"We need to relieve the pressure around his heart now," Taub said coolly.
House stepped inside, careful to stay out of the way.
"What the hell happened?" he demanded.
"We were hooking his central line up to the dialysis machine and he started to complain of chest pain," Thirteen informed him, preparing to intubate while the paralytic took affect.
Taub picked up where Thirteen left off. "His heart stopped seconds later. We're prepping for Perocardiocentisis now."
House noticed Wilson at the door, doing his best to block the parents from entering.
"I'm in," Thirteen said when she'd placed the ET tube. "Bag him."
"Hand me the Betadine," Taub said and went about generously spreading the disinfectant around the area where he would insert the needle into the sack around Qaiser's heart.
"What's happening?" Mrs. Zaheer cried out hysterically.
"Get them out of here!" House shouted back to Wilson or a nurse or whoever would do the job.
"Hand me the needle," Taub requested, hearing the parents cries disappear down the hall.
Thirteen retrieved a syringe from a nearby tray and handed it to Taub who was busy feeling for the spot in between the ribs that would allow him to puncture the sack around the patient's heart and drain the excess fluid putting pressure there. He located it quickly and stabbed through the skin, slowly feeling for the popping sensation that would let him know he had entered the pericardial sack that surrounded the heart.
"Got it," he announced a few seconds later, careful not to push further and nick the heart muscle. Slowly he pulled back on the syringe, the excess fluid rushing out of the sack.
The pressure on the heart muscle decreased and the monitor began to show signs of returning to a normal rhythm. As Taub drew further back on the syringe, the waves indicated Qaiser's heart beat had begun to stabilize.
Taub pulled back when the syringe was halfway filled and the heart was back in normal sinus rhythm. "Okay," he said, looking at Thirteen. "Let's not do that again."
The room began to clear as the code team collected the crash cart and finished hooking Qaiser up to both the ventilator and dialysis machines. Wilson returned, giving House a look that meant he would owe Wilson a rather large favor for dealing with the parents. But House wasn't interested in anything but the tell-tale sign of a deepening bruise spreading across the abdomen of his patient.
House stepped forward and pulled the hospital gown up on both sides. He waited until they had all had a chance to see what he had.
"New symptom," he announced, half in excitement and half in angst. "Liver failure."
They looked at each other. They looked at the patient's chart for something they had missed, something that would have tipped them off to the impending death of yet another vital organ. Then they looked at one another again.
"I didn't see any signs of jaundice when I looked at his corneas," Taub said. "No cloudiness either."
"Jaundice can be harder to see in people of middle-eastern descent," Thirteen said as she looked carefully at Qaiser's finger nails for yellowing.
"Liver function tests were normal this morning," Wilson said, reviewing lab results. He shook his head. "Now what?"
House looked away, his eye catching the time on the wall clock. It was eleven.
"Redraw the liver function panel and rush it," House ordered. "Grab me a few vials for the Fabry test, HUS and TTP, a viral load, and another to look for chewed up platelets. Do it fast and get them to me in the lab."
He began to walk away.
"Wait," Thirteen stopped him. "You're going to be in the lab?"
He nodded. "Until noon. Then I'll be in physical therapy. Cuddy's orders. You two," he paused and pointed at Wilson, "get Wilson to give you the name and photo of Qaiser's roommate and get down to the campus student center before Friday prayers at noon. Find him, interrogate him, then bring him here and really scare the hell out him. I need information."
"I'll go update the family," Wilson offered.
"Good," House thanked him.
Taub and Thirteen rushed to fill vials of blood as House and Wilson exited back down the hallway.
"Any more bright ideas?" Wilson asked before they parted, House for the relative safety of his lab and him towards the distraught parents.
Hitting the down button with the tip of his cane, House thought while he waited for the elevator to appear.
"Liver failure gives us new options to explore," he said matter-of-factly. "If you can find a way to make that sound like a positive step towards their son getting better, let me know."
Wilson watched House disappear into the elevator. He knew that the heavy load House challenged himself with when he took on a case was now fully setting in and it could trigger problems. He doubted that there would ever be a full regression back to the hallucinatory state that had prompted House's summer stay at Mayfair but there were other possibilities. Alcohol, drugs, stupid stunts that resulted in self-inflicted pain and misery.
And down the hall, he had two scared parents in a misery all their own.
One case of misery at a time, Wilson reminded himself and set off towards the waiting room.
Warm, soothing bubbles flowed over House's lower body as he soaked in the hydrotherapy whirlpool after forty minutes of physical therapy; forty minutes in which he had been concentrating on his patient's liver failure rather than his own mobility and strengthening exercises. The PT assistant had called him on it but no amount of pestering could chase away the dying patient he felt responsible for lying upstairs. He'd even tried to worm his way out of the tub, usually his favorite part of the weekly sessions. But he'd been convinced that he could brainstorm almost as well in the hydrotherapy pool as he could anywhere else and he'd have less pain later in the day if he complied.
And so he sat, in short swim trunks and an old gym tee shirt, considering the many roads between kidney and liver failure, when Cameron interrupted.
"If I'd known you were coming, I would have requested a tub for two," he said, willing her to leave him peace.
"I heard about the liver failure," Cameron said anyway.
"Yeah, looks like you're off the hook for causing the kidney failure," he reminded her.
She gave him a small and patronizing smile. "I never thought it was the Clindomycin."
"Good for you," House told her. "Still think he's not a drinker?"
She took her time before answering. "I don't know," she said with classic Cameron optimism, revealing that she did indeed still believe her former alcohol poisoning patient had his first experience with alcohol only a week ago.
"Taub and Thirteen should be back with some better answers any moment," he said, looking at the time. "I sent them after Qaiser's roommate. They should have had time to put the fear of God in to him by now." He paused a moment. "Sorry. The fear of Allah. I keep forgetting."
Cameron leaned against the wall, folding her arms, a look on her face that House had come to interpret as her way of reasoning silently through whatever was bothering her.
"Doesn't it seem odd to you?" she asked and House knew she had managed to find words for the thought that she hadn't yet settled. "I mean, how does a kid like Qaiser end up rushing one of the exclusive eating clubs at Princeton?"
"Peer pressure. He told Wilson he'd agreed to go along with a friend."
She shook her head. "But he could have signed up for a less exclusive club and avoided the alcohol and whatever hazing ritual they put him through. Exclusive eating clubs are for legacy students and socialites and children of the wealthy and powerful. Qaiser had a scholarship, no social standing, and a father who drives a delivery truck."
House thought about for a moment and he had to agree with Cameron. Something didn't quite fit. Of course, neither did Wilson, who as he finished his thought, also joined them in the small hydro room.
"Sorry," Wilson apologized, almost breathless. He marched quickly to the phone on wall and transferred a call, putting it on speaker. "Tell House what you told me," he said to whoever was at the other end of the line.
"We found Ahmed," Thirteen's voice announced through the phone.
"And?" House yelled back at her over the sound of the jets.
"Where are you?" she asked, obviously wondering what the background noise was.
House opened his mouth to answer then thought of an easier way. Reaching to the side, he shut off the bubbles abruptly. "That better?"
"Yes," Thirteen said, still waiting for an answer but giving up on ever receiving one. "We found Ahmed and he says that Qaiser has never had alcohol or done drugs when he was around. He confirmed what Qaiser said about going out for Bickers with a guy named Charlie. They were roommates Spring semester of their freshman year. Ahmed doesn't seem to like him much; he thinks Charlie uses Qaiser just to pass math classes. Also, Ahmed isn't sick and hasn't been all semester so we can probably rule out E. coli and Salmonella."
"What about Qaiser? Any recent illness or pre-existing conditions?" Cameron asked, putting Thirteen off her game for a brief moment.
"Uh, no. He says Qaiser was healthy when he saw him last Saturday morning. But House," the excitement in her voice was beginning to grow, "I think Charlie may have had something to do with the alcohol poisoning."
"Are you going to tell me why before the water gets cold?" House asked, knowing she wouldn't care that he was being cryptic.
"The lists we collected of the names of the Bickers," she continued. "The ones that Qaiser wasn't on? I had the one that guy Chad gave me yesterday and I showed it to Ahmed. It turns out that Charlie is on that list."
"Sounds like Charlie is using Qaiser for more than just passing math classes," Wilson muttered.
House turned the idea over in his head.
"His name is Charles Ellington, at least on the list of Bickers," she told them.
"Does Ahmed know where this sinister friend is?" House asked.
"Not exactly." This time it was Taub's voice that came over the speaker phone. They could hear Thirteen quietly conferring with someone in the background. "He does live in the same hall as Qaiser and Ahmed and, like she said, they were roommates their freshman year. Maybe Qaiser's RA can tell us what room he's in."
Wilson spoke up. "Don't bother. Call Cuddy and have her get the information from the registrar."
House eyed his friend suspiciously.
"What?" Wilson stared back. "You think I pulled the patient's dorm room and his RA's contact information out of a hat?"
House smiled approvingly.
"Apparently," Taub said, after conferring with Thirteen again, "Ahmed thinks this Charlie guy has a girlfriend. Someone named Sarah Mitchell."
Taub sounded confused over the importance that Thirteen had placed on the name. He would soon find more confusion when both Cameron and House said, almost simultaneously, "The girl who called 911."
"Huh," Wilson thought that over.
"Have Cuddy get her information too," House instructed. "I want you to go and find them and get them in here. Drag them if you have to."
Taub didn't need to be told anymore. "You got it."
The phone clicked and was left with a dial tone. Wilson silenced it.
"I suppose it's possible that they slipped him something at the party," Wilson considered, trying to make up a list of possible substances that could cause the patient's deterioration.
Cameron looked unconvinced. "The original tox screen was negative."
"But that's just for the usual stuff," House said, grabbing a towel off a nearby chair and slowly pulling himself up out of the tub. "Who knows what kind of wacky substances didn't show up on the toxicology report?"
"So now you're going with drugs or some other poisoning?" Wilson asked.
"I still think a systemic failure is more likely," Cameron put in her two cents.
"It is," House agreed drying himself as the water receded. "But since we're groping around in the dark for whatever abnormal puzzle piece is inside the patient's body trying to kill him, I figured we should also follow up on the very odd, very evident, and only connection to someone who can tell us how Qaiser got here in the first place."
House swung himself over the side of the whirlpool and dried his feet. Wilson handed him his cane and watched as House rose carefully to a standing position.
Looking at Wilson and then at Cameron, House made a decision. "We're going to need more hands. At least until Taub and Thirteen can get back here with our suspects."
Cameron was already frowning but House could sense the old thrill of chasing down the mystery getting to her.
"How about it, Cameron?" he asked her. "You started with this patient. Want to help see it through to the end?"
She looked longingly at him for a moment but shook her head. "I'm supposed to be in the Clinic," she said. "And then I've got another late shift in the ER."
"You must really want Valentines free," House stated the obvious.
"It's the entire weekend. Friday through Monday on a beach with plenty of sun and room service," she grinned evilly at House.
That was difficult to compete with, House thought.
"Fine, I'll do your clinic hours in exchange for you assisting on procedures and helping out in the lab until your shift starts," House agreed.
It startled both Wilson and Cameron, hearing House offer to take on someone else's clinic duty for any reason. But House saw the twinge of remorse behind Cameron's eyes; the little voice that was telling her that she was responsible for getting him involved in the first place. The guilt she would feel if House didn't succeed on a case she had asked permission for him to take was slowly eating at her.
"Fine, I'll do it," she agreed. "You can make up my four hours."
House nodded. "Good. I'll change and meet you in the lab."
"Right," Cameron said a bit nervously, but she eagerly headed out the door for the familiarity of the diagnostic's lab.
House caught Wilson looking at him suspiciously for ulterior motives.
"You do know you're doing two of those clinic hours," House informed Wilson, who could only nod and submit.
Cameron was sitting comfortably in what had been her usual spot in the diagnostic's lab when House and Wilson returned. Seeing her there with her white coat and glasses, peering through a microscope as if she were watching the first single celled organisms on Earth come together to create life, House almost felt nostalgic. House saw a small bit of Wilson did too.
"Find anything?" House asked her, striding into the lab as he'd always done, confident, pausing at a certain distance and leaning on his cane.
Cameron looked up and felt a certain sense of nostalgia as well. He'd changed into his standard jeans, tee-shirt, button up that needed ironing and blazer that needed cleaning and of course, the trainers on his feet. If Foreman or Chase had been there, she would have sworn that there had been a rip in the space-time continuum.
Bringing her self into the present, she reported on what little she'd learned in the twenty minutes or so she'd been there. "His platelets look fine; no shredding. There also doesn't appear to be any excess muscle enzymes in the blood work. The genetic test for Fabry isn't complete but I don't see any signs of excess lipids in any of the lab work that would point towards a fat storage problem."
House grinned. "This lab has missed you."
She rolled her eyes.
"Seriously," House said. "I don't think the centrifuge has been calibrated since you left."
"I'll get right on that," Cameron lied.
Wilson stared at the lab results of the stool sample. "Looks like we can rule out E. coli and Salmonella."
"Hey," House scolded them. "Don't be such downers. We've got a whole new toy to play with now."
"House, come on," Wilson came back at him. "What could possibly be wrong with this kid's liver that would have shown up in his kidneys and lungs first?"
"Alcohol," House answered without missing a beat.
"You think he's been sneaking shots in the ICU?" Wilson asked him.
"What about Qaiser's roommate?" Cameron added. "He said they didn't drink."
House looked in to her innocent, puppy dog eyes with disappointment. "How well did your college roommate really know you?"
He was glad when she admitted that it hadn't been as well she should have. Considering it was Cameron, House had been slightly afraid that the analogy would backfire into some heartening tale of female bonding.
"Okay," House started over. "Since we don't know for sure if this kid is secretly a lush, why don't we look and see if the liver shows any signs of scarring. If it does, we'll know that the liver likely caused the kidney failure."
"Cirrhosis can be caused by things other than alcohol," Wilson reminded him. "We should look for Hepatitis. I know vaccinations are required when students enroll, but he may have contracted it growing up in Pakistan and never known."
"Hep B and C would have likely shown up in the STD panel," House explained. "But Hep A is a possibility."
"I'll retest for all of them," Cameron offered. "And I'll recheck all his liver function panels since he was brought in. Maybe they'll give us some clue as to when the liver began to fail."
"Great," House said. "Come on, Wilson. Let's go look at a liver. I'll bring the popcorn."
Thirteen slipped her phone back in her pocket along with a missed call from Foreman. Cuddy had come through with the information she and Taub needed to find Charlie and his girlfriend; her personal life could wait.
They were standing in front of Sarah Mitchell's door, having struck out at finding Charlie at the residential hall. They found the previous days presidential welcome at the eating club that had listed Charles Ellington as a Bicker, less than inviting. Chad didn't know if the Charles on his list and the Charlie that Ahmed swore were the same person actually was. The only information they'd been able to uncover was that the Charles on the list did in fact have a girlfriend whose name was Sarah.
Frustrated, cold, and wet from the unceasing rain outside, Thirteen took over pounding on Sarah Mitchell's door. The polite tapping that Taub had tried obviously wasn't getting the job done.
A moment later, a skinny brunette with tattoos where her sweats didn't cover, answered the door.
"Sorry," the girl said, slipping two ear buds out. "I guess I must have been really rocking it."
Taub looked at Thirteen, his face happy with the excuse that had been given. Thirteen tried to take a breath and relax.
"Are you Sarah Mitchell?" Taub asked the girl who stood squarely in the doorway.
She eyed them suspiciously. "Who wants to know?"
Taub apologized and made the introductions. "We really need to speak to Sarah," he emphasized.
"Sorry," the tattooed girl shrugged. "She's out for the night."
"Then you're her roommate?" Thirteen said.
"Yeah. I'm Amy, Sarah's roommate."
"Do you have any idea where Sarah might be?" Taub asked Amy.
She was eyeing them suspiciously again and Thirteen was growing weary of the constant scrutiny. She was also done giving the speech about being doctors and not cops. It had taken them almost two hours between Charlie's oblivious roommate and the eating club president's stubborn denials to get to Sarah's doorstep. Time was running out and she was tired of being played. This is when Thirteen had the idea to play a little game of her own.
Pushing Taub a little off to the side, she leaned in closely to the roommate, Amy, and put on her best girl-to-girl game face.
"I'm really sorry," she started out, "but I need to find Sarah. See, she came to the Clinic the other day and somehow her test results were screwed up." She shoved Taub even further into the hallway. "And now my boss," she leaned her head towards Taub, "blames me."
Amy looked slightly terrified. "Is she okay?"
"She should be fine," Thirteen told the now concerned roommate. "I just have to find her and make sure she takes a couple of pills; her boyfriend, too. That's all."
Amy gave her a knowing look. "She's never careful," she said.
Thirteen pleaded softly. "Help me out?"
The girl nodded and spoke loudly enough for both Thirteen and Taub to hear. "She left almost two hours ago with her boyfriend, Charlie. They drive to her parents' place almost every Friday for dinner."
"Do you have an address?" Thirteen asked.
"No," Amy answered honestly. "But it's not hard to find. Just get on the interstate, drive until you've left civilization, and it's the first farm on the left."
Taub smiled at that. Thirteen muttered a thank you.
"Sorry to disturb you," Taub said as Thirteen returned to his side.
Amy stared smugly at Taub but gave Thirteen a grin of solidarity.
"Thank you," Thirteen returned the grin.
"Sure," Amy said and clicked the pen she had been holding. She gestured for Thirteen to give her her hand. She complied and Amy wrote down ten digits on the inside of her palm. "That's Sarah's cell."
Putting her ear buds back in, she waved and shut the door.
"What was that?" Taub asked when they were alone outside the door once again.
"I told her I was only trying to protect her roommate's sexual health," Thirteen replied innocently, trying the cell number she'd been given.
Taub nodded approvingly.
After several rings the phone buzzed loudly in her ear. "The customer you are trying to reach has left the coverage area. Please try your call again later."
"They must be in a no coverage zone," Thirteen informed Taub.
Taub whipped out his own phone. "I'll call Cuddy and have her get us a phone number for Sarah's parents. And better directions then a farm in the middle of nowhere."
Thirteen agreed and Taub dialed as they made their way back to her car. She took another look at her own phone's display and the missed call from Foreman. She sighed and decided it could wait.
Whenever House visited the nuclear medicine department he had the distinct feeling of being entombed. It was colder than the morgue, more sterile than an operating room, bleaker than the rainy sky outside, and held giant equipment that resembled coffins. It was also too quiet.
"I should have brought music," House said as he and Wilson positioned Qaiser on the gurney and equipment and screens around them.
"Yes," Wilson said thoughtfully. "What kind of music goes well with a HIDA scan, House?"
House thought. "Classical is out," he said as they slipped blue aprons over their bodies and necks. "Opera might work."
"I hate opera," their patient whispered. The breathing tube had been removed once he'd gained consciousness. "It's all about death."
"He has a point," Wilson acknowledged. "We need something more upbeat."
"I've got it," House announced, as if he'd just discovered the perfect wine for a gourmet meal. "We need the Who."
"Who?" Qaiser asked.
"Exactly," House nodded, knowing the kid had no idea of the pun he'd just made.
"Do you watch CSI?" Wilson asked him.
"Sure," Qaiser answered.
Wilson grinned. "The theme music to all of the CSI shows are actually songs taken from a band called The Who."
Qaiser's eyes lit up with sudden understanding.
"It's sad when great musicians are relegated to pop culture status," House told the teen. Then getting down the business he raised a syringe and made sure to catch his patient's eye.
"Okay," House began. "The last time you saw me with one of these I was taking stuff out." He let his eyes bug out, mimicking his maniacal performance from the kidney biopsy. "Fortunately for you, this time I will be putting stuff in."
"And it's radioactive stuff?" Qaiser looked uncertain.
Wilson took over. "It's safe. The fluid has a slight radioactive isotope that when injected will let us see all of the organs and blood vessels in your abdomen. We should be able to see anything that isn't working as it passes through."
"If it's so safe, why are you guys wearing lead aprons?" Qaiser asked.
House was quick with a comeback. "Are you kidding? These are the latest fashion in doctor couture. We had to send all the way to Paris to get these babies."
Wilson chuckled which calmed Qaiser.
"It might feel a little cold," Wilson said just before House bent to inject the tracer material. "It shouldn't do more than that. Just stay as still as you can."
He started to nod then stopped, remembering the instructions not to move.
When House had finished emptying the syringe into the IV, Wilson reached above the bed and lowered the imaging plate, adjusting the equipment on its arm so that the patient's torso was centered and in full view on the computer monitors. Then, like House, he pulled up a stool and sat, waiting patiently for pictures.
Huddled under the gas station overhang with his hands wrapped around a hot paper cup, Taub shivered and counted the numbers until the pump clicked and the tank was full. They had stopped just off the 206 for gas and coffee. With daylight fading fast and the rain coming down in buckets, it was slow going to reach Sarah's parents farm where they hoped to find Charlie and some concrete answers about their ailing patient.
Returning the pump to its cradle, Taub hastily reached for the car door and slid inside, leaving the damp chill outside. Thirteen had just finished a call and was eagerly sipping her own coffee.
"Still no answer," she told him, having tried several times now to reach Sarah, her parents, or Charlie.
"How's Foreman?" Taub asked her. He'd seen her constant glances at the phone, heard the way she deflected when House brought him up, and now watched as she squirmed at his question.
"He's fine," she said without expression. "It looks like his dad is coming home tomorrow."
"That's good," Taub said about the father. "What did he say when you told him House was in charge of a case?"
Thirteen turned the key in the ignition, adjusting the vents to warm her chilled body.
"I didn't tell him," Thirteen admitted, still void of emotion.
Taub absorbed the slight shock she delivered so smoothly.
"Why not?" His voice was strained.
"Because," she said with an amused look, "Foreman would have wanted to rush back, which he can't do. House has this under control. I didn't think he needed to be worried about being in two places at once when he's only really needed with his parents."
"Yes," he said, thinking she was right about Foreman wanting to come back and yet not convinced that was her only motive. "It's sweet of you to protect him like that."
She couldn't ignore the sarcasm in Taub's tone. She looked at him straight on. "What?" she asked. "Why do you care what I told Foreman?"
"Because now you're going to have to tell him when he gets back," he told her. "Unless you want him to hear it from someone else and wonder why you didn't mention it. Trust me when I say that will be the hard part."
She smirked. "This isn't infidelity. I work for House, not Foreman. It's not like I'm cheating on him just because he isn't here to supervise."
Taub was amused. "So a lie of omission is okay as long as your motives are pure?"
"You are the last person I need lecturing me about relationships," she said angrily, starting the engine and turning the windshield wipers and headlights on. "Just because you figured out how to make your marriage work doesn't mean you can fix everyone else."
Taub waited a minute for her to calm down. She was right, he thought as they made their way back onto the interstate. He hadn't set out to give relationship advice; he'd been concerned about what would happen when Foreman returned and Cuddy had to decide on a permanent team dynamic. He didn't do well with change and he'd barely adjusted to needing Foreman's approval. If House was back in charge again, that would mean another change to deal with, and how Foreman perceived that change had a great deal of influence on how well he would adjust.
"I'm sorry," he said after they'd driven several miles in silence. "It was a selfish question."
She relaxed her grip on the wheel, glancing sideways at him to gauge his sincerity.
After a few more silent miles she managed a question of her own. "How did you find out that Foreman was leaving?"
"An email from the airport on Wednesday night," Taub answered. "We all found out that way."
She took a deep breath and exhaled loudly. "Exactly. We all found out that way."
Taub raised an eyebrow. "Wait. You mean, he didn't tell you he was leaving himself? In person or a phone call?"
She drove on, shaking her head. "Nope. I got the same damn email that you and Cuddy and House and Cameron and who knows who else got."
"I understand wanting to avoid the meet-the-family stress, especially when one of them is in the hospital and the other has Alzheimer's," she acknowledged. "I just wish he would have trusted that I would know that."
Taub smiled softly at her. "He should have," he said, sounding almost wise.
Thirteen caught his small smile out of the corner of her eye. The tension began to melt with each passing mile.
"So," Taub said after passing two exits. "When do we get there?"
Cuddy studied House from the hall outside his office. He was busy at the computer, glasses on, looking intently between the screen, the images on the light board, and the patient's chart. The whiteboard had been wheeled in, now covered in symptoms, tests, and diagnoses that had been scratched out. His stubble had grown and darkened and the lines on his forehead were actively reshaping themselves as possibilities came and went.
Cuddy had missed watching him like this. She would often sneak upstairs after most of the staff had gone home and watch House in all his concentration and wrinkled attire as he poured over a case. She had managed for years to keep her innocent act of voyeurism hidden from him, knowing that if he knew that this was when she found herself most vulnerable to his charms, or lack there of, the spell might be broken.
After months of not having the opportunity to see him like this, Cuddy stood not only in awe of House and his talents but of herself and how much she'd missed watching him like this. She'd thought that if the day came again when she would have the opportunity to watch him hard at work that she wouldn't be capable of feeling the same way. And maybe it wasn't exactly the same but she did feel the vulnerability, the attraction, even the desire she knew she probably shouldn't even now.
Looking down at her watch, she decided to come out of hiding and risk entering his office.
House looked up as Cuddy gently pushed his office door open, taking off his glasses and focusing on her, the first distraction he'd allowed himself in hours.
"I thought you would have gone home by now," he said, looking into her eyes for a clue to her visit.
"You're my last stop before I head home," she told him, her voice thick with comfort. She leaned her briefcase against the yellow easy chair. "Where's Wilson?"
"Cafeteria," House answered.
They stared at one another for an anxious moment that neither cared to experience.
"I wanted to apologize for this afternoon," Cuddy said.
At the same instant, House was talking over her. "Sorry I was an ass earlier."
That led to another anxious moment before dissolving into mutual grins and unspoken acceptances.
"Is that the HIDA scan?" she asked after a moment.
House nodded and feeling brave, Cuddy crossed behind his desk to look at the computer screen. She hovered near enough to give him goose bumps.
He tried focusing his attention on anything but her. "Pancreas, spleen," he said, bringing up each series of images one at a time. "Nothing out of the ordinary. Good blood flow to the kidneys and gallbladder. The liver," he zoomed in on the organ, "is clean; virtually no cirrhosis. So I owe Cameron a hundred bucks."
Cuddy let out a knowing laugh. "Not to mention four hours in the Clinic."
House looked at the all-knowing smile on her lips and found it tempting.
Cuddy broke from his gaze and pointed to another view of the liver. "Bring that one up," she asked him and House complied. She was staring intently at the bile ducts that connected to the liver. "The ducts look slightly narrow."
House beamed with pride. "Excellent catch Doctor Cuddy. Not even Wilson picked up on that one the first time."
She smiled back but it quickly turned to a grimace. "He's young for Primary Sclorosing Colongitis," she said, taking another look at the scan in motion on the screen. "If he's got it, it's very early in its progression."
House nodded in agreement. "Ironic, isn't it? I go fishing for signs of alcoholism and find out that in about thirty years, he'll need a new liver, despite no alcoholism."
"At least we can get him on the donor list early," Cuddy tried to make light of the situation.
But House wasn't amused. "He won't be around long enough to need a new liver if I can't figure this damn thing out."
Cuddy straightened, watching House become angry with himself. She'd watched him do it on many cases over the years, retreating to somewhere away from anyone's reach, as if to avoid hurting them. And yet that was exactly what he accomplished each time.
But not this time, Cuddy made up her mind. She wasn't going to let any of them fall into the old, destructive patterns. She decided to grab him before he could get too far down the rabbit hole.
"Talk to me, House," she insisted, leaning against his desk and facing him with a sweet determination.
He appreciated the attempt, and the view, but he knew he didn't have the time. So he reached past her for his glasses, intent on continuing his search.
He was surprised when he felt her hand intercept his, pushing it and the glasses back to the desk. He looked up, startled at the stubborn face she wore.
"You don't get to avoid me, House," she said sternly. "Not when it comes to patients."
She waited for him to insult her, try and push her as far away from poking a hole in his emotions as possible. She waited for the anger and the hurt and the outrage. She waited but it never came.
He sat back in his chair without letting her hand lose its grip on his own. He was quiet, trying not to look at Cuddy, remembering all the ways he could hurt her and have his silent anger all to himself. He wouldn't, he knew, despite not knowing what he should do now.
Cuddy, looking into the well behind his blue eyes, knew he had no idea what to do or say. So she made the first move.
"This may surprise you," she began with a combination of authority and empathy, "but I'm actually capable of worrying about my daughter, the hospital, and you, all at the same time. And I haven't dropped a ball yet."
He looked longingly at her. "You shouldn't have to worry about me," he whispered.
"You don't get to decide that, House," she reminded him, holding on tighter to his hand.
Her gentle squeeze seemed to trigger a sudden explosion inside him and without even realizing it, House began to reveal things he never had before.
"You were right, earlier. I have lost my touch. A year ago I would have thrown every procedure, every medication, and every experimental treatment for whatever diagnosis popped into my head at this kid without thinking twice. And something would have worked, the kid would be fine, and I'd have my puzzle solved."
"Or he'd be dead," Cuddy interrupted. "The antibiotics could have killed him before his liver began to fail and you'd only solve this case at autopsy. House," she shifted so he couldn't look away from her. "You were just as passionate about not restarting the dialysis or antibiotics, and who knows? You may yet prove yourself right. God knows it's crazy, and you and crazy have a pretty good track record."
She stopped and reconsidered what she'd just said. Considering the kind of crazy he'd dealt with lately, perhaps she should have chosen her words more carefully.
House saw how uncomfortable she was, probably trying to think of a way to get off the crazy topic. It annoyed him that people couldn't or wouldn't use that word around him, that they winced and skirted around his break as if not talking about it would somehow make him forget it happened. That Cuddy did it seemed a personal affront.
"Stop," he told her. "Stop tip-toeing around me like I'm a china doll. It happened, Cuddy," he leaned into her, more forceful now. "I hallucinated. I went crazy. I went away and then I came back. Am I sane now? I don't know. Am I capable of being the same kind of doctor I was before all of this happened? Maybe not."
"Is that what you're worried about?" she practically screamed at him. And yet she wouldn't let go of his hand.
"Of course that's what I'm worried about!" he yelled back. "You've got Foreman babysitting me, then Wilson. I can't solve this damn case. And you won't look at me or let us be left alone together for more than a few minutes. I'm not the same and you don't feel the same!"
House expected her to cower but Cuddy only rallied.
"We are alone, you jackass!" she exclaimed. "And you are going to solve this case! You don't get to have your first crisis of faith – not in me or yourself. Not now."
She let House sit in silence for a minute to prove she wouldn't back down. And suddenly she was very aware of him staring at their hands, still locked together on the desk. Her knuckles were white from holding him so tightly. Her breath caught and she loosened her grip, afraid she might have actually hurt him. But as she let go, House caught her same hand and held it for a moment in his. He gently stroked it. Once, twice, then let it go.
"Thank you," he said humbly.
"Don't thank me yet," Cuddy said, allowing herself a small, private smile. "You still have a case to solve."
"And food to eat," Wilson entered, carrying a box from the cafeteria. "Have Taub and Thirteen checked in yet?"
"No," House answered, reaching greedily for what smelled like fries.
"It's been over two hours," Wilson said, sounding concerned.
Cuddy reached over House to grab one of his fries. "Give them some time," she said, narrowly avoiding getting her hand slapped back. "It takes a while to find a farmhouse in south Jersey in all this rain." She chewed and swallowed, looking out House's window at the sheets of rain that fell from the sky. "Which reminds me," she said, crossing back to where she had left her briefcase beside House's easy chair.
House realized almost immediately what she had in mind.
"Again?" he whined as she pulled the plastic bag with its urine cup from her bag.
She stood, smiling sympathetically. "Sorry House. But there's an emergency board meeting tomorrow afternoon."
"There is?" Wilson hadn't heard about it and he was on the board.
"Noon," Cuddy informed him. "We're meeting with the University president about what the hospital and the clinic can do to prevent alcohol abuse. And you know they'll grill me about House."
Wilson looked at him. "She's right."
House stood and took the cup from Cuddy. "You want to stop alcohol abuse? Stop having stupid board meetings," he said, completely serious.
Cuddy smiled at that.
"You need to watch?" House asked her, heading for the door and the bathroom down the hall.
"God, no," she winced. "Wilson can hang back at the door."
Wilson looked at her. "Seriously?"
House flashed a wicked smile. "I always wanted a pee buddy," he said sarcastically.
Wilson stood and followed House down the hall to the men's room. Leaning against an empty stall, he waited while House filled the specimen cup.
"I hope Taub and Thirteen are okay," he said absently.
House turned part way and said, "Dude. I'm trying to pee."
"Sorry," Wilson said. "It's just, if this rain keeps up, we'll have to build an ark."
House finished and took the cup with him to sink to wash his hands. "You get sea sick," House reminded Wilson.
"Yeah, but if the choice is between living in a boat with a bunch of animals and dying in a vengeful flood . . ."
Wilson stopped because House did. He'd stopped washing and was staring through the mirror.
"What?" Wilson prodded as House's eyes narrowed, finding some answer in between the words he'd said only in jest.
For an instant, time froze. And when it began again, House was headed out the bathroom door with a grin for Wilson and the urine cup in his hand.
Wilson followed him back to the office where Cuddy was waiting for the urine sample. But House only stepped in long enough to ask a question.
"You said farmhouse?" House said, covering Cuddy's face in confusion.
"Yes," she answered slowly, her hand stretched out for the cup. "Taub and Thirteen went to find this Charlie guy at his girlfriend's parents' place."
"Yeah, yeah," he hurried her along. "When you said farmhouse, did you mean a quaint little country cottage or did you mean an actual working farm?"
She felt his eyes drilling into her skull.
"Uh, a farm," she said, still waiting for him to give her the cup. But House turned quickly and continued down the hall, specimen still in hand. "House!"
Both Cuddy and Wilson tried to catch up to him but House seemed to be moving at lightening speed.
"What did you say?" Cuddy asked Wilson as they followed House towards the lab. Cuddy knew House often found sudden revelation in a case in casual conversation with him. She found it very helpful, if not a bit creepy.
"I have no idea," Wilson answered, remembering a similar exchange between himself and House just that morning over Cuddy.
Cameron was still in the lab when House burst in, wild-eyed and determined.
"There's no Hepati-"
"Where's the beer bottle?" House cut her off, searching the room for the bottle he'd brought back with him to test for drugs.
He scanned all the countertops, opened the cupboards, and finally began to search the trash.
Looking very confused and a little worried, Cameron got off of her stool and retrieved the amber bottle from beside the centrifuge.
"Is this what you're looking for?" she said, holding it up. "It was in my way."
House snatched it from her hand and set it down on the counter, twisting open the lid of the specimen cup.
"Do you need me to test that?" Cameron asked about the urine, assuming it belonged to the patient.
"Nope," House said, snapping on a glove and carefully holding the bottle in place as he poured the contents of the cup into the beer bottle.
"House, what are you doing?" Cuddy demanded an answer as he finished pouring.
He looked up at her, excitement dancing behind his eyes. "Testing our patient's sense of smell."
It was apparent from all of their faces that they hadn't yet caught up to him, so he continued on, pushing Cuddy and Wilson aside and making for the elevator.
"Don't worry," he turned and hit the up arrow. "I'll get you a new sample."
Cuddy stood frozen, mouth wide open.
The elevator arrived and Wilson managed to slip on with House just as the doors slid shut.
"House?" Wilson tried to catch his friend's gaze. "What's going on?"
There was no answer as House hit the button for the ICU wing.
"House, that bottle has chemical compounds all over it." Wilson's voice was strained. "You can't make him drink from it."
House turned to Wilson with disgust. "Ewww."
"Then what?" he pestered, exiting with House.
The two drew stares as House marched down the hallway with his cane in one hand and the beer bottle in the other. House smiled pleasantly at all who looked on, even raising the bottle in a cheer to the nurses outside their patient's room.
"Watch and be amazed as the Bible comes to life before your very eyes," House said to Wilson with just enough conviction to make Wilson consider that House had finally gone mad.
"Qaiser!" House called out to the kid on the gurney. "It seems I owe you an apology."
Qaiser shifted in his bed. "You saw I had no scarring on my liver. You believe me now, about not drinking."
"Yes," House nodded, approaching the bedside, hanging his cane from the bed rail. "Well, except for that one time. And I believe you when you say you'll never do it again."
A small crowd had begun to gather outside the door and Cuddy and Cameron had managed to push through and into the room.
"House!" Cameron called out.
"It's all right Doctor Cameron," Qaiser calmed her. "He believes me now, that I don't drink."
"Of course I do," House told them. "Tell me something," he said to Qaiser. "The one time you did drink, was the beer cold or warm?"
"It was cold in the beginning," Qaiser said, thinking back. "But it got warmer each time."
"This friend of yours, Charlie," House said, inching closer to the bed. "You ever tell him that charming little tale about your grandmother's goat? The one that almost made Doctor Hadley lose her cookies?"
Qaiser looked confused but answered him. "Yes. When he asked me to do Bickers with him. I told him about the smell."
House looked directly at Cuddy, Cameron and Wilson. "Qaiser thinks beer tastes like ass," he said, shocking them, "and he should know. His grandmother's goat used to sit on his face when he tried to milk it." He turned back to Qaiser and raised the beer bottle. "Is this what you were drinking that night?"
"House!" Cuddy protested.
"Yes, that's the beer," Qaiser said after a quick look at the logo on the bottle.
House shoved the bottle under the kid's nose.
"Ugh!" Qaiser tried to turn away but House let the bottle follow him.
"Take a good whiff, Qaiser," House instructed. "Is this what you were drinking?"
Reluctantly, Qaiser sniffed the substance in the bottle one more time. His face turned green.
"That's the stuff," he said, sure of himself. "Just like the goat's ass."
Wilson's phone rang and he fumbled to answer it. "It's Taub," he informed them.
"Wait," Cameron stepped between House and their patient. "Are you saying that Qaiser was drinking urine instead of beer?"
House feigned shock. "No! At least not actual human urine." He turned to Wilson. "Ask Taub what kind of animal Charlie tapped for his special brew."
Wilson asked, feeling stupid saying the words.
"Why would his friend have him drink urine?" Cuddy asked, mad as hell at House's stunt.
"Simple," House said nonchalantly. "To get into an exclusive eating club."
"But we pledged together," Qaiser insisted.
"No, you didn't," Cameron looked at him with sympathy. "Charlie was on the Bickers list but you weren't. They never had any intention of letting you into their eating club. I'm sorry."
Qaiser shook his head in disbelief.
"I'm still not sure where the urine comes in," Cuddy said, demanding more.
Wilson rejoined the conversation. "You were right, House. Taub and Thirteen pulled a confession from him. Charlie filled a thermos with urine from one of the horses at Sarah's parents' farm."
"You don't have to look so surprised," House told Wilson. "I am a diagnostic genius."
House felt eyes roll all around the room.
"It's Leptospirosis," House announced his diagnoses. "Don't worry, it's treatable," he mentioned off-hand to the nervous patient.
"I got this from drinking horse urine?" Qaiser questioned.
"Horse, sheep, hell, even a goat would have done," House answered. "But it's not likely you contracted it from actually swallowing the stuff. Your stomach acids, as whacked out as they were from the alcohol, which was the cold stuff by the way, probably would have taken care of it. You probably spilled it, rubbed it in your eye, got it on your hands before taking a piss."
"Why would Charlie do this?" Qaiser said, wheezing from the stress and the fluid still in his lungs.
"It was a hazing," Wilson explained calmly, having hung up with Taub. "The eating club agreed to let Charlie in if he could get you to drink alcohol. And when you agreed to that, they decided to up the stakes. Charlie had to get you to drink urine if he wanted in."
Wilson looked as pathetic as Charlie's justification. Qaiser looked betrayed. House was the only one who seemed pleased.
"We'll start you on Doxycline," House informed his sullen patient. "We'll have to keep you here to monitor any side effects but you should start feeling better in a few days."
"Thank you Doctor House," Qaiser whispered.
House nodded and retreated from the room with his beer bottle full of urine, leaving Cuddy, Cameron and Wilson to deal with the crushed boy king.
They'd all gravitated to the conference table in House's office; Wilson and Cuddy with questions, Cameron fresh from assuring the Zaheers that their son would recover, and Thirteen and Taub on speaker phone, making their way back to Princeton under dark but clear skies. Outside, the rain had turned to barely a drizzle. House smiled at the symmetry. It had been this way when he accepted the case and it had come full circle at the end.
"Why didn't the Clindomycin clear up the Leptospirosis?" Wilson asked the first question.
"Wrong antibiotic," Cameron answered him. "It made sense for the aspiration pneumonia but it wouldn't touch the Leptospirosis."
House nodded in agreement. "And it worked great for the pneumonia."
"We just didn't believe it," Thirteen said on her end. "We were so focused on the alcohol poisoning as the cause of the kidney failure."
"It seemed like the logical place to start," Wilson admitted. "Even if he'd had a genetic or systemic problem, the alcohol poisoning could have triggered any one of them."
House sighed looking at the white board. "We missed the symptoms," he said, disappointed in himself. "We dismissed the fever and white count as pneumonia, the headache, exhaustion and bloody stool as related to either the pneumonia or kidney failure."
"And when the pneumonia turned out to be pulmonary edema," Wilson began to fill in the gaps, "we went back to alcohol or defect."
"The liver failure didn't help either," Taub added. "I was convinced it was the alcohol when the liver began to go."
House leaned forward on his cane. "The liver should have been the nail in the coffin." He looked over the various diagnoses they'd considered. He cursed hindsight.
Cuddy saw the 'what-ifs' playing in House's mind. "There was no reason to think he'd been exposed to Leptospirosis," she pointed out. "He lives in a dorm in Jersey. No pets. Certainly no livestock."
House looked up at her. "No, no reason. Except that it fit the symptoms."
"I thought it had a pretty long incubation period," Cameron said, wondering if she was mistaken.
"Any where from a few days to a couple of weeks," House told her. "But when he went on dialysis, the bacteria got spread through his system even faster. We sped up the infection, which is probably why his kidneys began to fail when you took him off dialysis the first time."
Cuddy shot House a knowing smile. He had been right about the dialysis.
"What's his prognosis?" Wilson asked. "Does he need a new liver now or can he wait the thirty years for his bile ducts to fail?"
House found some amusement in that irony. "He can wait the thirty years. The liver should fine. And we'll know in a couple of hours if his kidneys can handle the antibiotics. If they hold up, most of the damage done should be reversible."
"Thank God," Cuddy sighed.
Taub came back on the line. "What I don't get is how you figured it out at the same time we did, from a hundred miles away."
House grinned at Wilson.
"Uh, that would be me, apparently," Wilson declared with some amusement. "The two of you had been out so long in the rain that I suggested we may need to build an ark. House took it from there, as only House can."
Cameron laughed along with Taub and Thirteen. Wilson sat embarrassed. Cuddy looked fondly on both Wilson and House. Things felt right again for the first time in a long time.
"I've got to get down to the ER," Cameron announced, looking at the time. "I'm already late."
"Thanks for your help in the lab," Wilson said to her.
She beamed. "You're welcome. It was good to be back, but just for the afternoon," she added quickly, looking directly at House.
"You say the nicest things," House told her with half a measure of sarcasm.
"We're going to hang up," they heard Thirteen say. "Taub needs another bathroom break."
"And you need more coffee," Taub insisted. "Or I'm driving the rest of the way back."
"I'm hanging up on you now," House told them, punching the disconnect button.
Cuddy stood with a content smile on her face. "I should get home, too," she said to House and Wilson.
"Aren't you forgetting something?" House waved the urine filled beer bottle at her.
"You still have that thing?" Wilson said, nose turned up.
Cuddy laughed playfully. "You know what. We'll skip it this one time."
"What will the board say?" House asked, trying to remember that laugh for later.
"You saved the kid's life, House. Yesterday's urine will have to do." She bent down for her briefcase. "Goodnight."
"See, that wasn't so bad," House said to Wilson when they were the only two left in the room.
"What, observing you on a case?" Wilson snickered.
"Come on. Admit it. You had fun."
Wilson looked at his best friend who seemed quite pleased with himself. "You had fun," Wilson told House. "I just came along for the ride."
"There wouldn't have been a ride without you," House said, thanking Wilson for agreeing to Cuddy's terms.
"You're welcome," Wilson answered him.
They sat silently for a moment before House's stomach began to growl.
"Chinese?" House suggested over his gurgling stomach.
"You're buying," Wilson informed him.
"Because that way you have no excuse for stealing my food," Wilson explained, turning out the lights as they left House's office.
"This is about the muffin, isn't it?"
"You want a blueberry muffin I'll get you a blueberry muffin."
Their voices trailed off as they made their way towards Wilson's office to retrieve his coat.
"And then you'll steal it and I'll have to eat whatever you pick out."
"I guess we're each buying our own muffins then."
"Yes, House. I guess we are."
One month and six cases later, House and Cuddy sat before his therapist waiting anxiously for what came next.
If you're curious, as several are, about what happens between House and Wilson or House and Cuddy in therapy, stay on the look out for a series of one shots I'm doing. It follows every character through the series, pausing at certain points as they seek help or reflect on events. After all, everyone needs a good therapist at some point! NORMAL IS OVERATED!