This is a crack!AU inspired by DreamsofSpike's "Dark Redux". Assuming I can keep it up, there's going to be one chapter per episode, based on the episode. Whee... Note: Now rated M because it begins to get graphic in chapter 4, 1.3, "Maternity". Apparently you can't rate individual chapters... but the story as a whole is still T. More or less.
Wilson waited till he heard the door open behind him, and the dot and shuffle of the cane. "29 year old female, first seizure one month ago, lost the ability to speak. Babbled like a baby. Present deterioration of mental status," Wilson said.
Cuddy looked up past Wilson and said, not to him, "I was expecting you here twenty minutes ago."
Wilson turned his head a little and studied the man by the door.
"That's odd, because I had no intention of being in your office 20 minutes ago." The man lifted his chin a little: his voice sounded almost indifferent, but all his body language held a fragile defiance, expecting to be broken.
"You think we have nothing to talk about?"
"No, just that I can't think of anything I could say that you'd be interested in."
"I have a case for him," Wilson said. He swung his attention back to Cuddy.
"He's behind on his clinic hours."
"He has three over-qualified doctors working for him, as of two days ago. Three. Do you know how many oncology fellows I have? Two."
"I am not behind on my clinic hours," the man interrupted.
"That's not what Nurse Previn tells me. You're doing double time till you catch up."
"See, I was right, I didn't have anything to say you would be interested in."
"Come over here," Cuddy said.
Wilson turned his head again to watch the man walk slowly across the room, the cane he was allowed gripped in one hand. He came up to the desk and turned his head to look at Wilson directly: a slow cold stare. He said nothing: there was nothing done that could be taken notice of. He stood three inches taller than Wilson, and a hard stare from him was intimidating at close range, however absurd Wilson felt that to be.
"The 29 year old female," Wilson said crisply.
"The one who can't talk?" Cuddy asked.
The man grimaced fleetingly, as if he might have made some comment but thought better of it.
"She's my cousin."
Cuddy looked faintly sympathetic. "And she wants a diagnosis?"
"Brain tumor," the man said. "She's going to die. Boring," he added flatly.
Wilson lifted his eyebrows and eyed the man. "No wonder you re such a renowned diagnostician. You don't need to actually know anything to figure out what's wrong."
The man looked back at him. "You're the oncologist; I'm just a lowly infectious disease guy."
Wilson laughed: he was genuinely amused. "Yes, just a simple country doctor. Brain tumors at her age are highly unlikely."
"She's 29. Whatever she's got is highly unlikely."
"Protein markers for the three most prevalent brain cancers came up negative." He glanced at Cuddy, who was eyeing Wilson with a certain loss of sympathy, but he handed the man the file when she said nothing. "No family history," he added.
"I thought your uncle died of cancer," Cuddy said.
"Other side," Wilson told her. He was still watching the man. "No environmental factors," he added helpfully.
"That you know of," the man said.
"And she s not responding to radiation treatment," Wilson capped it.
"None of which is even close to dispositive," the man said. He was looking through the file with some interest, though. "All it does is raise one question." He looked at Cuddy. "Doctor Wilson's cousin goes to an HMO?"
Cuddy shook her head at Wilson, looking mildly disapproving, if not exactly annoyed.
Wilson leaned on Cuddy's desk. "Come on! Why leave all the fun for the coroner? What's the point of putting together a team for diagnostics if you're not going to use them? You've got three overqualified doctors working for you, getting bored, while your prize asset is doing time in the clinic!"
The man shrugged. He looked at Cuddy. "Are you going to grab my cane now, stop me from leaving?"
"That would be juvenile," Cuddy said. She sounded quite even-tempered. "I can still have you whipped if you re not performing effectively."
"I'm here all the time."
"Your billings for this quarter aren't satisfactory."
"You ignore requests for consults."
"I call back. Mostly. Who complained?"
"You're weeks behind on your obligation to the clinic."
"I am not," the man said.
"You're allowed a certain amount of leeway, but you went over it." Cuddy was looking at Wilson, not at the man. "No MRIs, no imaging studies, no labs, and he also can t make long distance phone calls or photocopies."
"How many hours behind is he?" Wilson said, with resignation.
"I'm not!" The man had actually raised his voice: Wilson looked at him with some surprise, then at Cuddy. Cuddy shrugged a little, but she was still looking at Wilson.
"According to Nurse Previn, about four months."
"I show up! I do my job!" The man really was actually shouting. "If you're going to whip me at least have the guts to face me and tell me!"
"You're still yelling," Cuddy said. She was looking at the man now. Her voice held nothing but amused sarcasm. "Is your yelling designed to scare me? Because I'm not sure what I'm supposed to be scared of. More yelling? That's not scary. That you're going to hurt me?" Wilson was particularly impressed with the little contemptuous lilt on hurt me. "That's scary, but I'm pretty sure I can outrun you." She looked away, back at Wilson. "Do you have an offer to make, Doctor Wilson?"
"Sure," Wilson said. He was annoyed. "I'll walk Greg down to the Diagnostics department, and then I'll go do four hours extra clinic duty to help him start making up the time he's missed."
"Good for you," Cuddy said. She looked back down at her desk, and Wilson realised he'd been dismissed. He glanced at the man: "Come on," he said.
"You better love this cousin a whole lot," the man muttered, clutching the file to his side with one arm and following, dot and shuffle, with his cane.
Wilson ignored that. The man was notorious for spending time at the whipping post being disciplined for offenses that ranged from rudeness to insubordinate behaviour and back again. Wilson had been moved into the office next to the Diagnostics department only three weeks ago, but Wilson had already decided that the slave in charge of Diagnostics was too interesting to be whipped.
The big glass box of the Diagnostics office was a place Foreman hadn't yet spent much time: the first two days had been a rushed induction which included being walked from the department office to every other location in the building. Doctor House had a cubby-hole in back of the Diagnostics office, and seldom came out: this was the first time they'd run a DDX.
"And the big green thing in the middle of the bigger blue thing on a map is an island. I was hoping for something a bit more creative."
Foreman leaned back and eyed the man. He didn't like the situation, and he was surprised by the man's tone of voice. "Shouldn't we be speaking to the patient before we start diagnosing?"
"Is she a doctor?"
"Greg doesn t like dealing with patients," Doctor Cameron explained helpfully. "He's allowed to wear a polo neck, but he still doesn't like it."
"Isn't treating patients why we became doctors?"
"No," the man said. "Treating illnesses is why we became doctors, treating patients is what makes most doctors miserable." It was impossible to tell if he'd meant that has a joke.
"So you're trying to eliminate the humanity from the practice of medicine."
The man lifted his chin and looked Foreman down. He was, surprisingly, taller than Foreman: over the past three days whenever Foreman had met him, he'd been carrying himself hunched, giving the appearance of a much shorter man. Holding the case file seemed to have given him a fragile kind of confidence. "If you don t talk to them they can t lie to us, and we can t lie to them. Humanity is overrated. I don t think it's a tumor."
"First year of medical school," Foreman said, "If you hear hoof beats, you think 'horses' not 'zebras'."
The man's voice was actually sarcastic. "Are you in first year of medical school? No. First of all, there s nothing on the CAT scan. Second of all, if this is a horse then the kindly family doctor in Trenton makes the obvious diagnosis and it never gets near this office. Differential diagnosis, people: if it's not a tumor what are the suspects? Why couldn t she talk?"
"Aneurysm, stroke, or some other ischemic syndrome," the senior fellow said. He hadn't spoken before, and his only reaction to the man's newfound confidence and sarcasm was a small smile.
"Get her a contrast MRI." The man paused. "Check to make sure Doctor Wilson did his clinic hours, first."
"Creutzfeld-Jakob disease," Cameron said.
"Mad cow?" Chase said.
"Mad zebra," the man said. He sounded amused.
"Wernickie's encephalopathy?" Foreman offered.
"No," the man contradicted him calmly, "blood thiamine level was normal."
"Lab in Trenton could have screwed up the blood test. I assume it's a corollary if people lie, that people screw up."
"Re-draw the blood tests." The man glanced at the clock. "And get her scheduled for that contrast MRI as soon as Doctor Wilson's time is up. Let's find out what kind of zebra we're dealing with here. Doctor Cameron!"
She looked up at him, calmly, a little surprised.
"For the benefit of our new kid, what are the rules here?"
To Foreman's surprise, Cameron bit her lip and blushed. "I'm sorry. Doctor House."
Chase got up. "We'll explain on the way over to the patient, Doctor House."
Chase and Cameron flanked him out of the doorway: Foreman glanced back. The man wasn't wearing a polo-neck but a casual cotton shirt over a plain white t-shirt: the collar round his neck was immediately visible.
"He's owned by the hospital," Chase said.
"He's a slave." Foreman was still spluttering over it. "I saw him in the halls outside, I thought he was a janitor!"
"This hospital wrote a contract for him that says inside the Diagnostics Department, which is defined in the contract as the office, his room behind the office, and the balcony outside, he gets to behave just like any other doctor, and he is your boss," Chase said. "Cameron's slip up was calling him Greg in that room. You can call him Greg outside the room, though personally I prefer to run away, but inside Diagnostics he's Doctor House. He's Doctor House if you have to speak to him in front of the patients in the clinic too - he's supposed to do clinic duty four hours a day, unless he can claim press of other work, and he usually tries."
Cameron was still looking embarrassed.
Foreman glanced at her, and asked Chase "What happens then?"
"He gets whipped for it," Chase said cheerfully. "You definitely want to avoid that. He has the right to fire you."
They were wheeling the patient down the hall to the MRI, when the patient, looking dazed, asked "You aren t my doctor, are you, Dr. House?
"Thankfully no," Chase said. "I'm Doctor Chase."
"Doctor House is the head of diagnostic medicine," Cameron told the patient. "He s very busy, but he has taken a keen interest in your case."