UPDATED A/N (9 June, 2010): I want to explain the "slightly AU" warning that I put in my summary. It's because this story might not stick to canon in an OMGsh STRICT sense. I received a message from a reader (who will remain undisclosed) who told me of the fact that Chase has, in fact, dealt with patients' deaths before. Other things were included in the message. I made a few inferences, one of which was that Chase probably had not reacted as violently toward patient death in the cannon as he does in the story you're about to read. I had forgotten that he'd dealt with death in cannon because, quite frankly, I'd forgotten some of the earlier episodes; I haven't even seen season one since I was a sophomore or junior in high school, and that's nearly three or four years ago (if I count correctly). My memory's not brilliant. I'm assuming these cannon deaths were in the ICU. At least there, patients are in a room (the glass walls suck, I know), and a lot of the time they're on medicines to kill their pain. At least, that's what I've experienced when dealing with the ICU (in real life, of course). In this story (**SPOILER WARNING**), Chase holds a person's literal heart in his hands as the person dies. I don't know -what- could possibly prepare someone for that experience. And for a surgeon to have someone die on his table... that's something that no surgeon wants. I think it would bring on an onslaught of pain and thoughts that, all of a sudden, the surgeon is turned into a smaller person than he thought he was. I think a theological element would come into play, as well; I think he would almost have to recognise that God - or some Supreme Being higher than humans - exists because once he realises his own smallness, he can recognise the greatness of a power higher than humanity. I didn't bring theology into this to save myself a controversy. (**END SPOILER**) I'm done rationalising now. Just please don't send me flames. I can't handle them. And I mean that in all seriousness; it's a health thing. I have general anxiety disorder, and flames/added negativity (I verbally abuse myself on a daily basis as it is) only makes things worse. If you have negative opinions of my story, that's fine; I don't need to know them.
A/N: hello, again! I come bearing yet another House/Chase one-shot. In this, Chase is board-certified. I tried to make it as IC as possible, but the possibility of OOC-ness remains (of course).
I am not a medical student, nor will I ever be, so it took a bit of research to write this. Some things I all ready knew (I did take some medical classes in high school because I was under the delusion that I wanted to go to pharmacy school), but others had to be looked up. I hope you enjoy this!
Standard disclaimers, of course, though I do lay claims to Bennett, Antoinette, Andrews, and the rest of Chase's little crew. I may use them later on, actually. (I think Bennett's rather fun.)
"There is a balm in Gilead to make the wounded whole..."– African-American spiritual
Chase was sitting in the stairwell behind the surgeons' lounge, and his whole body was trembling. Tears and sweat were running down his face. Things like this just did not happen to him. They did not happen, damnit! Not to him. Not ever.
He could not believe this had happened. It was entirely his fault. One year into his certification with nothing happening, and suddenly something devastating occurs. He apparently wasn't meant to be certified. Whoever gave him that nearly perfect score on his exam was a downright idiot. He would never be a thoracic surgeon. The embroidered title on his lab coat was purely superficial; it had no substance.
Tremors attacked his hands as he reached into the pocket of his lab coat. He pulled out his mobile, flipped it open, and scrolled through his contact list. There was exactly one person he wanted to talk to right now, and he did not care if this one person was busy.
He felt bile and acid start to make their way up his throat as he pressed the "call" button once the name "Greg" was highlighted.
Things like this did not happen.
The mobile rang three times in his ear before House answered.
"I..." Chase started to interrupt, but his body began trembling again as sobs racked his body. "It's all my fault, damnit!" he cried out. "Shit like this does not happen to me!"
"Chase, what's going on?" House sounded worried. Chase could vaguely hear sounds of Kutner and Thirteen deliberating something in the background.
"The patient," Chase said, sounding thoroughly disgusted with himself. "He fucking died, Greg! Damnit!" Chase was now pacing up and down the stairwell landing, pulling harshly at his strawberry-blonde hair. Tears—the result of anger and self-deprecation and defeat—were still making their way down his face. "He died, and—" Chase whimpered—"I... on my table... I couldn't... God!" Chase cried with pain and indignation as he slid to the floor.
It started out as a normal day—"normal" meaning that Chase's pager did not wake the both of them up at four in the morning, as it was so often apt to do even when he was not on-call. House and Chase drove to work, and House dropped Chase off at the southern end of the hospital. House grabbed Chase's sleeve just as he was about to get out of the car. Chase turned towards House with a questioning look before his older lover leaned across the seat and kissed his forehead.
"Have fun cutting people open," House said.
Chase rolled his eyes. "Er... thanks. Have fun... diagnosing?"
House snorted. "Yeah, right. Kutner and the clan are just loads of fun."
"I actually don't mind my team much," Chase commented, surprising himself with this remark.
"I do," House said. "That nurse with the red, curly hair and that one resident—they're always..."
"Flirting with me?" Chase offered, smirking at House's obvious jealousy.
"In the more subtle of terms, yes."
Chase laughed. "You're jealous."
House rolled his eyes. "Not even."
"Are, too," Chase accused playfully. "You don't have to worry about them, though; it'd take a helluva lot more than them to make me turn on you."
House raised an eyebrow. "Oh? Should I be worried?"
"No. Besides, McGregor has this huge crush on Brewer, and I'm betting that she'll come to her senses soon and shift her attention from me to him. And Bennett... Well, I don't know. He does know I'm with someone, so at least that helps. Some."
"And he still flirts with you?"
"Apparently," Chase replied helplessly.
"He's an idiot."
"Oh, before I forget—I'm on-call tonight, so don't bother waiting up for me."
"If you're on-call, that's all the more reason to make use of the on-call rooms," House replied with a smirk, forgetting all about Brewer and Bennett.
Chase blushed. "I... er..." He smiled up at House bashfully, knowing exactly what the on-call rooms were used for—and it was never sleeping. Well, the actual sort, that is.
"The on-call rooms it is, then. Now leave. Kutner and the other children will be wondering where I am."
"All right, I'm going. 'Bye." Chase and House shared a chaste kiss before Chase exited the Corvette and made his way toward the hospital.
Chase headed to his office first to see what his schedule looked like for the morning. "OR four," he muttered to himself. "Right, then." He proceeded in making his way for the locker rooms to change into his scrubs before heading towards the OR.
Upon entering the prep room, Chase found Dr. Bennett looking at a less-than-promising EKG. Chase felt a slight sinking feeling in his stomach, but he shrugged it off. After all, if the patient's heart was perfect, the guy wouldn't be here. No need to worry; everything would be fine.
"What've we got?" Chase asked, walking up behind Bennett.
"Oh, hey, Dr. Chase," Bennett greeted, grinning suspiciously. Bennett never called Chase by his last name alone, like the rest of his crew did. No, Bennett always had to add the respectful "doctor" title to the front. It wasn't that Chase really cared, but he knew that Bennett had ulterior motives.
"Er... Hi," Chase replied awkwardly, blinking once. Bennett was still grinning. Chase felt like he was back at university. "Er... what've we got?" Chase asked again. This was slightly unnerving.
"Right," Bennett said, his grin leaving him, "60-year-old guy had a huge anterior wall MI this morning while out jogging. The hell's a 60-year-old doing jogging, huh? Anyway, so it happened, and the poor bastard collapsed. Paramedics did their thing and resuscitated him, but his EKG looks gritty," Bennett explained, turning from Chase to the EKG in question.
"Yeah," Chase replied, a bit distracted.
"He's hypertensive and on alpha blockers."
"This diagonal looks rather tight," Chase muttered disapprovingly, his brows knitting together, as he focused on a certain section of the EKG. "Who in hell cathed him?" He turned to look at Bennett.
Chase rolled his eyes. "Figures. You said he's on alpha blockers. Which ones?"
"Well, only one, actually. Plurals—bad habit of mine. He's on Cardura."
"You mean doxazosin?" Chase corrected in question form. Chase always preferred the proper name of medications to the brand name.
"Yeah. I mean yes. Yes, that's what I meant. Sorry."
"Who prescribed it?" The apology was irrelevant.
"I... I dunno. Does it—"
"Yes, it matters, and it sounds like something Ellis would do," Chase seethed. "Not on purpose, of course—just one of his usual 'mistakes.'"
"What's wrong with—"
"Increased risk of heart failure by twenty-five percent is what's wrong with it."
"Dr. Chase?" A soft voice came from behind him. He turned to see Antoinette Brewer, the perioperative nurse "with red, curly hair" as House had described her, standing in the doorway leading into the OR. "Oh, you're here, too, Dr. Bennett." In Chase's opinion, her voice sounded a bit disappointed at this observation. Bennett narrowed his eyes at her. Chase ignored him.
"Is the patient ready?" Chase asked, all ready in the process of putting on his mask. Bennett followed suit.
"Yes, sir. Dr. Grey started him on anaesthesia about ten seconds ago. He's asleep now, and all of his signs are good." She smiled softly at Chase.
"Very good, then. Let's proceed, shall we, Bennett?" Chase started walking toward the OR, Bennett following him obediently.
Inside the OR, the patient was surrounded by Chase's small crew of one surgeon, one resident, and two nurses. Dr. Grey, the anaesthesiologist, was there "just in case." Chase and Bennett walked over to the group, making it two surgeons and two residents. Chase didn't have to look up to know that he—along with the others—were being watched by a group of interns. It was funny, but even after a year of being board certified—and after five years of residency—he still got the slightest bit nervous at doing this in front of people.
"You'll do great, Dr. Chase," Bennett encouraged, smiling at Chase. "Forget about them."
"Thanks, Bennett," Chase replied appreciatively before turning to Antoinette. "Brewer, hand me my scalpel."
At first, the surgery seemed to be going somewhat well. Actually, it went perfectly fine all the way up until it was time to stitch the patient's chest up. Everyone was making small talk, even. Andrews stated that there was a bet going on to see how long Wilson and his new girlfriend lasted, and he was wondering if anyone wanted in on it. Bennett said to put him down for one hundred that they stay together for a month, and Madison Leonard said she'll put down fifty that they don't last more than two weeks. Andrews said that Madison was being a wimp for not putting down more money, but she promptly told him that she likes her money and doesn't waste half her salary on bets like the rest of the hospital. McGregor didn't put down anything but he did like Antoinette, and he did flirt with her. This caused him to be teased by Andrews.
"Why don't you just ask her out all ready?" Andrews teased. Antoinette blushed crimson and busied herself with sponging up blood. Chase wished he would go ahead and do it. He also wished that Antoinette would accept. That way she would stop flirting with him, and he'd just have to deal with Bennett.
"Fuck you, Andrews," McGregor muttered, pissed off that Andrews had embarrassed Antoinette in front of everyone.
"Now, now," Chase chastised, smirking, "don't use such harsh language. There are women in the room."
"Oh, shut up, Chase," Madison Leonard shot back, slapping Chase's arm with her hand that was not currently working on suturing the patient up.
"All right, we need to be serious. The retrograde on?"
"Retrograde on, chief," confirmed Grey, keeping his eye on the anaesthetic machine and the patient's vitals.
"Good. Come down to half-flow, then; give me just a bit of volume."
"Down to half-flow; here's your volume."
Chase looked over at the heart monitor, made sure it was still normal, and gave a nod at Madison to let her know she should finish stitching the patient up.
"Ready to come off?" Chase asked Grey.
"All right, then. Let's come off."
Chase kept his eye on the heart monitor. After Madison finished, she tied off the suture thread and snipped the excess.
"We're clamped and off bypass," the anaesthesiologist confirmed. Antoinette proceeded to sponge the area around the stitches.
"Dr. Chase!" someone shouted from the door. Chase looked up and shook the blonde fringe out of his eyes.
"Yeah? What is it?"
"Methodist's on line three! Some cardiologist about wanting a consult!"
Chase smiled to himself. "You lot can take it from here, yeah?" he asked, looking around at everyone. "I apparently have to give a consult to someone at Princeton Methodist."
"Sure thing," Bennett said. Chase mentally rolled his eyes. Bennett would go along with whatever he said.
"Bennett's right, chief," Andrews agreed, nodding. "We can take it." Chase felt better that a fellow surgeon—not just a resident—thought as much.
"All right. I'll just be down the hall if you need me. Yell or something."
And with that, Chase left.
It was ten seconds later that all hell broke loose. He was on the phone with a Dr. Irmhoff at the Methodist hospital when he heard McGregor yelling from the OR.
"Dr. Chase! Hurry!"
Chase ran through the doors like a whirlwind. "What's going—"
"V-tach!" McGregor shouted, trying his best to not sound anxious. "It just happened... out of nowhere! When you left, the heart monitor was fine!"
"Damnit!" Chase cursed loudly, immediately thinking of that damned Ellis and his damned doxazosin. "Okay, get the paddles."
"Got 'em," Madison said.
"Charge to twenty," Chase instructed.
Madison flipped a few switches. "Charging." She handed the paddles to Chase.
Chase pressed them to the patient's chest. "Clear!" he shouted as everyone stood out of the way of the electricity.
"Shit! No pressure!" Bennett exclaimed.
"Bennett, stay calm, damnit." Chase turned to the anaesthesiologist. "Did you give him Lidocaine?" Urgency was present in his voice.
"Shit, you did." Chase internally groaned. So the patient was probably going to have heart failure because of that idiot Ellis, and prior to that he was probably going to have a cardiac arrest because of Grey. "Okay, well, we'll just have to deal with this." Chase replaced the paddles. "Hit him again at thirty."
"No response," Antoinette said.
"Start compressions," Chase instructed. He noticed that everyone else was just staring at him. "I said start compressions! Damnit, are you all deaf or something?" Chase glared at all of them before starting the compressions himself.
"Dr. Chase, it's not working," Antoinette said in her soft voice. Right now, it was too damn soft and too damn soothing. Chase's nerves were thread-bare live wires that refused to be soothed.
"We're cutting him back open. How long to put him back under?"
"Ten seconds. But it'll take ten minutes to get the machine running," Grey announced, hurriedly flipping on switches.
"We don't have ten minutes!" Chase yelled, starting up compressions again. "Damnit! Nothing!"
"Dr. Chase..." It was Bennett trying to be soothing, but Chase would have none of it.
"Scalpel," Chase said curtly after five minutes of compressions with no response. Antoinette handed it to him, and he proceeded to cut the patient's chest open.
"Chase! The anaesthetic, it –"
"Yeah with the ten minutes," Chase interrupted impatiently. "You don't hear him screaming, do you? Someone hand me the internal paddles and charge 'em to twenty."
"This is negligence, Chase!" the anaesthesiologist exclaimed, taken aback. "You have to wait the ten minutes. The hell've you been doing–hanging around House?"
Chase stared Grey down. "I'm trying to save this poor sod's life, Goddamnit, Grey! You just try to tell me that's negligence!" He was shouting, and he could feel hot tears stinging the backs of his eyes.
"Here," Madison said, thrusting the paddles into Chase's hands.
"Nothing," Madison said as she anxiously watched the heart monitor.
"Try thirty, then!"
Madison did. "Still nothing!"
Chase removed the paddles and started massaging the patient's heart with his own hands. "Come on," Chase muttered. "Damnit... come on!"
"Chase, he's going..." Andrews this time.
"Oh, he's not going anywhere," Chase said with a very determined voice, looking Andrews straight in the eyes. Andrews didn't have the heart to argue back. Nobody did.
Chase had blood splattered all over the front of his plastic apron and all over his hands. He refused to quit massaging. This patient would not die, damnit. Not on his table.
"Dr. Chase, he's..."
"Bennett! Shut up!" Chase yelled, his voice breaking at the end. Chase used the bend in his elbow to wipe away a few stray tears that had fallen from his eyes. "Just shut the hell up!"
"He's dead, Chase," McGregor said flatly.
"Go to hell!" Chase shouted. "Go to sodding hell! I..."
"He's flat-lining," Madison reasoned. "McGregor's right. I... I'm sorry."
"He doesn't have a pulse," Antoinette confirmed, two of her fingers resting on his carotid artery.
"Shit!" Chase finally gave up. He looked down at the body on his table. "I killed him."
"Dr. Chase!" Bennett gasped. "No, you didn't. He died. People die in surgery a lot. You're not –"
"I sure as hell didn't do anything to help him live, did I?" Chase asked, his voice scalding.
"You tried," Antoinette emphasised.
"Hah. Fat lot of good trying does. Everybody tries."
After that, Chase walked out of the OR. And after that, he ran.
And now here he was, on the phone with House, having a complete meltdown. He refused to allow himself to have said meltdown until he was alone. He would not break down in front of the others. Getting mad at himself is one thing; breaking down is another. It would look horrendous.
"All right, I'm in my office now—none of the children can listen in. So you had a patient die?"
"I killed him, Greg. I killed him. I didn't do enough... I didn't... Oh, God, I killed someone!" Chase's pulse started racing, and he began breathing more shallowly.
"Robert, don't be stupid. You didn't 'kill' anybody. This person died. People—"
"I can't breathe!"
"Calm down. Right now. You've caused yourself to have a panic attack."
"Where are you?"
"Stairwell," Chase whimpered.
"Yeah, which stairwell, genius?"
"Behind the surgeons' lounge."
"I'm coming down there."
"D-don't... don't hang up," Chase pleaded. He was rocking himself back and forth.
And he didn't. He kept talking to Chase, trying to get him to calm down. Ten minutes later, he arrived at the stairwell and hung up. Chase was pacing on the landing when House entered.
"People die, Robert."
"Not on my table, they don't," Chase argued, sniffling. "I fail as a surgeon, Greg. That idiot who gave me a perfect score on my exam should quit his day job."
House snorted. "Anyone who grades exams for a living probably couldn't get jobs anywhere else, Robbie. We should feel sorry for them."
"Why?" Chase asked, looking up at House with red-rimmed eyes.
House knew he wasn't talking about why they should feel sorry for people who graded exams. He sighed. "C'mere." He was holding onto his cane with one hand, but he held his other arm out to Chase.
Chase wrapped his arms about House and buried his face into his older lover's chest. He wanted to disappear. He felt like all of his work—the residency, the hours spent studying—was for nothing. But more than that, he felt as though he had failed his patients. By letting one of them die, he was automatically saying that any of them could die on his table and it would be all right. Chase hated himself for it. He heaved a heavy sigh and hugged House tighter.
"My certificate, my licence, my degrees... Everything should be revoked." His voice was muffled by House's shirt, but he was heard just fine.
House held Chase close to him and caressed his back. "You're not negligent. Patients die, Robbie. It happens. It doesn't make you a bad doctor."
Chase turned his head so that the side of his face was resting against House's chest. "He had hypertension, and someone was writing him scripts for doxazosin."
"Whoever the 'someone' is, they're an idiot."
"He really is," Chase confirmed, sniffling. "At least, if it's who I think it is. Anyway, and then the anaesthesiologist gave him Lidocaine."
"So there were other factors that could have resulted in his death other than you allegedly not trying hard enough. The result of other idiots' negligence could've killed him."
"I thought it was negligence at first, too," Chase said. "But there's not really negligence in prescribing medicine. Or in giving anaesthesia."
"There is if the patient all ready had hypertension and other heart issues, and you still gave him a form of anaesthesia that has a cardiac arrest side-effect. And Cardura doesn't even have any business being on the market."
"You're a good surgeon, Robbie. During your residency, you did several surgeries on my patients. Or at least you assisted with them. And they all turned out just fine. You care about your patients. A lot of these bastards are just in it for the money."
"Do you care?" Chase asked softly. "About patients, I mean."
"I care," House answered, threading his fingers through Chase's hair. "I just distance myself."
"But why? You don't distance yourself from me."
House couldn't help but smile. He kissed the top of Chase's head and held him tighter. "Mmm, well, you're different."
"Well, good," Chase replied, smiling softly through his tears. "But how come you're always a bastard to patients?"
House sighed with resignation. "I'm gonna have to tell you the truth, aren't I?"
"Yep. I can see through lies. At least yours."
"You know me too well, wombat," House muttered. There was a pause. "Distancing myself keeps me from feeling copious amounts of pain if someone does die. You're better than me in this respect." What House didn't say was that he found Chase to be better than him in many respects.
"I'm not better than you," Chase protested, drawing away from his lover slightly in order to look him in the eyes. "We just deal with things differently."
"Yes. I'm the avoidant, plotting type."
Chase smiled softly. "What if I like the avoidant, plotting type?"
There was another pause of a few seconds. "I think this experience will be good for you."
"In what way?" Chase asked.
"It will allow you to be able to handle death in the future. Death of patients, I mean. It will make you stronger." House refrained from mentioning that this bit of information was given to him from a continuing medical education class on death and dying.
"Do you believe that?" Chase asked, an eyebrow raised.
"Well... No. Learned it in a CME class. I don't believe people get used to death. I believe it's something we experience a lot of—especially in this fun profession—but I don't think we can get used to it."
"Yeah. That's what I think. Classes are stupid; they never teach you about reality. Med school didn't prepare me for half of what I face." Chase sniffled. "School doesn't get you ready for when you hold someone's literal heart in your hands as they die."
"Med school should be sued for its inability to prepare people for reality."
This caused Chase to laugh a bit. "How can you always make me feel better? No matter what... I can be having the worst sodding day ever, and then you'll show up, and it's like... I dunno. You just have this tendency."
"I really have no idea. It's magic. By the way, can we exit this stairwell? Kutner and the other children probably have no idea what to do; I should probably get back."
"Oh, right. I think I'm scheduled for something important in probably—" Chase grabbed House's wrist and looked at his watch—"right now, anyway."
House laughed. "'Something important'? Any idea what that 'something important' might be?"
"Some sort of cardiac... something," Chase muttered, rubbing his hands over his face.
They started walking out of the stairwell, but before they exited, House grabbed Chase's wrist. "Hey, don't work yourself to death. I want you sane at the end of the day. So that means take care of yourself, got it?"
Chase smiled. "Yeah."
As Chase was walking back to his office to check his schedule, he did feel weary and as though he had just fought a losing battle against Death, but he also—somehow—felt as though he would be able to battle through the rest of the day and win. He doesn't have to wonder who takes care of the caretaker because at the end of the day, and even throughout it if necessary, he has a balm in Gilead.