On his way back to House's room, Wilson took his time walking down the patient hallway. During their last round of remodeling, Princeton General had not only converted a number of semi private rooms to private rooms, but on many floors, they removed the bright white lights and bright white paint in the patient hallways. The white paint had been replaced with soft flat pastels. Each floor featured a different base color. The bright lights in most of the hallways had been replaced with softer recessed lighting, intended to accent the base color. Some of the floors originally had beautiful carpeting in the hallways because some nincompoop in an office somewhere no doubt decided that carpeting would give it a homey touch. It is nigh impossible to roll wheel chairs and beds on carpeting; let alone the fact that dirt hides in carpet no matter how often you clean it, and therefore it tends to harbor germs. Not a good idea to have décor that harbors germs in a hospital. Much to the employees' glee, the carpeting was removed. Wilson had overheard some of the nurses joking that when the carpeting was removed, they had wanted to burn it in a bonfire in a remote area of the parking lot some day when the lot wasn't crowded. It was replaced with flooring that accented the new colors and was safer for patients.
Wilson needed to think, and he wanted to give House a little more private time as well; time to finish the doctor selection process. Wilson was accustomed to being teased about wanting to spend time with his "cancer kids" and he took that teasing in stride; he really did find solace in spending time with kids. He missed not having children of his own, and in his new life with House that wasn't likely to change. He and House could always adopt or use a surrogate, but House had enough to be concerned about now. Any discussion about children would have to wait awhile.
He'd always found children's attitude towards life in general and illness in particular to be so refreshing and so different from most adults'. In Wilson's experience, most adults, when faced with illness or disability, focused too much on what they could no longer do. This is normal and natural; adults have a lifetime of history and know what they're missing. On the other hand, children mostly had two things on their minds. They usually wanted to know what kind of presents they were going to get out of this and when they could go out and play; usually in that order. It didn't matter what kind of serious surgery they had, what kind of painful tests they had to endure, or that they might now have to use crutches or a wheel chair to get around. The first two things little kids usually wanted to know when they woke up after anesthesia or when they started treatment were "What kind of toys am I getting out of this?" and "When can I go out and play?"
Older kids were concerned more about when they could see their friends again or when they could go back to school.
Wilson's oncology practice included both children and adults, even though there were pediatric oncologists in Princeton whose practices were limited strictly to children with cancer. When faced with childhood cancer, parents had their choice of pediatric oncologists or an oncologist with a mixed practice consisting of adults and children. Wilson wanted children in his practice; parents and children liked him, and he liked them too.
He found himself on the elevator, going up to the pediatric floor. He had a ten year old patient there, a little girl with osteosarcoma and the primary tumor was in her right femur, just above her right knee. The tumor had just been identified and staged via biopsy, and chemotherapy had just begun. Radiation had been ordered, but not started yet. She had not had surgery yet because Wilson, her parents and the little girl's orthopedic surgeon were still discussing what kind of surgery would be best for her. She needed surgery; there was no way around it. Surgery to remove the tumor was of utmost importance. At issue was whether or not they should amputate. Wilson knew there were limb-sparing procedures that could result in the removal of the tumor without having to amputate her leg. The little girl's orthopedic surgeon was of the opinion that amputation now would result in a higher chance of cure, and less risk of recurrence of the cancer later on.
Wilson arrived at her room bearing a little teddy bear from the gift shop. The sight he saw when he rounded the corner into her room was arresting. This little girl who knew she had cancer and might soon be facing the amputation of her leg had a big smile on her face. Her parents were watching TV in the room with her. She was sitting in her mother's lap, squirming like any ten year old restrained in someone's lap, and playing with a new doll. "Dr. Wilson!" she shouted. "See what my mommy gave me?" She proudly displayed her new long-haired doll and all the hair ribbons and barrettes that came with the doll. She was braiding the doll's hair. "What color ribbon should I put on her? I want blue, but mommy's favorite color is red."
Smiling himself, Wilson said, "Why not use both? You could tie a blue ribbon at the top of her braid and a red ribbon at the bottom. I think that'd be cute!"
The little girl herself started losing her hair, but she didn't care about that and she didn't care about her leg. All she cared about was doing her doll's hair. Her mother had all she could do to hold on to the little girl because the little girl just wanted to run around and show everyone her new doll. Her leg made that difficult, but pain and disability didn't seem to hold her back at all.
"I swear, it's like she's had five cups of sugar today. I don't have this much energy, and I'm not sick!" her mother exclaimed with a smile.
"Mooommmm!" the little girl whined. "Let me down! I want to show Maggie!" Maggie apparently was another patient she'd made friends with. "Not know, sweetie. Let's let the medicine help your leg. Daddy and I need to talk to Dr. Wilson."
"Ok, but don't leave me alone."
Here's this girl facing life altering illness and surgery and she's bursting at the seams with a zest for life. House is not dying, he's down there ready to go home and his depression is not only holding him back, it's sapping the life out of him. What irony, Wilson thought.
Wilson really hadn't gone to see the little girl because he wanted to talk to mom and dad; he went to see the little girl to remind himself what life could be like for House if he would just let it. House didn't have to let this drag him down. Wilson wished he could take just a little of this girl's spirit, her zest for life, and inject it into House. The best he could do was let a little of it soak into him.
Wilson couldn't just leave without talking to her mom and dad, though. They went out to the private pediatric conference room and discussed the various surgical options available, including limb sparing surgery. The tumor was small enough that her leg could be saved; they could remove the tumor and a little of the surrounding healthy bone and replace it with a titanium prosthetic bone or something similar. That would need to be discussed with the orthopedic surgeon, of course. Wilson wanted to be sure the parents knew that option was available and that current theory was that amputation should be considered only if limb sparing surgery wasn't possible. As it turned out, the little girl's parents had really done their homework and were already pretty well convinced they wanted the limb sparing surgery. They wanted to be certain Wilson was on board with that decision as well. They didn't have much else to talk about other than that, so Wilson agreed he would call the orthopedic surgeon and set up one more pre op meeting with the girl's parents.
Wilson left the impromptu meeting with a happier heart. He was ready to go back down to House.
"So, you wallowed in misery with your cancer kids?" House greeted him as he walked back into the room.
"Nope, I got an injection of zest for life from a ten year old. Hope you found your new rehab doctor. You need to pack up before they charge you for another day."
House started aimlessly tossing things at his suitcase, without even bothering to get out of bed to go pack it properly. It was a petty thing to do and just another way of showing his frustration.
"You're going to pick that stuff up, you know," Wilson answered as things hit the floor randomly in the general direction of the suitcase.
"Cripple here. If you wait for me to get over there and pack it properly, we'll still be charged for another day. It would be faster if you packed it."
"It would be faster if you would go get the suitcase, bring it over to the bed and pack it properly. It's five feet from the bed, House. It has wheels and a pull handle. It's not heavy. I'm not going to pack your stuff for you, so you can either pack it yourself or lie here and wallow in self pity. It's up to you. I'm going to talk to Ruth and make sure everything's good to go. When I get back, you'd better be ready to go."
"I'm on crutches! How am I supposed to manage the crutches and the suitcase?" House complained.
"I don't care how you do it, but you'd better figure out something. You're not dying, House. You're not even sick anymore. I'm not asking you to drag the thing three miles through an airport. I'm telling you to move it five feet from the floor to the bed and pack it yourself. Everything that needs to be packed is already where you can reach it now, House, except for the stuff you just threw on the floor. Get the suitcase and pack it and I'll be back."
Wilson turned his back to House and walked out with a big grin.
From just outside the room, Wilson could hear House put on the call bell for the nurse.
"May I help you, Dr. House?" came the polite voice over the intercom.
"I need help packing my suitcase. They're letting me go home today."
A few minutes later, an aide House hadn't met yet arrived at House's room. "Way to go! I hear you're going home." The aide moved some chairs out of the way so House could get to the suitcase.
House glared at him. Unfazed, the aide said "I didn't think you'd want to have to navigate an obstacle course trying to get to your suitcase. Most people prefer to pack suitcases themselves. They want to make sure they don't leave anything behind and that their stuff doesn't get wrinkled, broken or stolen. I'll help with the suitcase after you pack it. Here are your crutches," he said as he handed the crutches to House.
House continued to glare at him, but it soon became apparent that the aide was not going to give in. House had several options; lie there and do nothing, which would result in the suitcase not getting packed, smack the aide with a crutch which would result in an arrest for assault and still not getting the suitcase packed, or give in and try to do it himself.
"Ok, but I don't want an audience. You can leave. Sorry I bothered you," House snapped.
"Call me when you're packed and I'll help with whatever else you need," the aide said professionally. The aide had been well trained in rehab. He knew that in the world of rehab, helping patients regain their own independence, to whatever degree that's possible, is the goal. Very often that involves doing whatever is necessary to enable the patient to do things for themselves. The aide remembered one of his instructors saying something like "They can't do it for themselves if you keep doing it for them."
He walked out of the room knowing he had just done a very good thing, even if House didn't see it that way. Out in the hallway, Wilson high fived him and gave a silent fist pump.
Back in the room, sitting on the bed with his feet on the floor, House studied how he was going to get to the suitcase, pull it back to his bed and pack it, all with two crutches under his armpits and an uncooperative leg. Thanks to a great pain management program with the fentanyl patch and oral ketorolac, pain wasn't really as much of an issue anymore. Thanks to his forced compliance with physical therapy while he was in the hospital, his upper body strength had become Superman-esque. His body wasn't really getting in the way of the process of packing his suitcase. His mind was.
Packing his suitcase meant it was time to go home. Packing his suitcase meant it was time to leave the safety of his hospital room and the comfort of knowing that your every little need would be met by someone else if need be. Packing his suitcase meant he had no other choice but to get used to life on his own with a disability. He'd seen others in the disability support group who didn't seem to have as much difficulty accepting their limitations as he did. Packing his suitcase and going home meant that the next time he had to pee in the middle of the night, he couldn't call a nurse to bring him a urinal. Yeah, he could make it to the bathroom on his own. And yeah, he could pack the damn suitcase on his own too. But it would be nice not to have to plan out ahead of time how he was going to get those tasks accomplished.
Faced with no other real choice, he shoved the crutches under his armpits and stood up. Thanks to all the good PT, he was no longer shaky with the crutches, but he still didn't trust himself bending over to pick up the suitcase or the stuff he'd just tossed on the floor. That would mean temporarily having to give up one crutch, something he wasn't sure was such a good idea.
Funny how long it took him to come up with an easy solution. This world renowned physician who never missed even the most obscure symptoms in others and could piece medical mysteries together in record time had to actually put some thought into this easy to resolve dilemma.
After several maddening, exasperating minutes, House felt like an idiot for not immediately realizing all he had to do was catch the suitcase with the tip of a crutch and pull it over. Same thing with the items he'd haphazardly tossed on the floor. From there it was even easier to flip the little items up onto his bed, also by using the tip of a crutch. The suitcase wasn't really a problem either because once he used the crutch to pull it over to his bed, it had a retractable handle and he could easily lift it up even from a seated position on his bed. He actually felt like a fool for two reasons; one, for not realizing any of this sooner, and two, for acting like such a helpless baby in front of Wilson when he actually could have packed the suitcase last night and saved time, trouble, and his dignity. Wilson was right. His attitude was holding him back.
He had been conditioned, through life with an abusive parent, to believe (among other things) that no matter how difficult the task, nothing he accomplished was ever really, truly good enough. So when faced with the many difficult tasks in rehabilitation, he'd mastered everything he'd been expected to do so far, but nothing ever felt really good enough. He was never satisfied with what he'd accomplished. Picking up discarded items and packing a small suitcase with a bad leg and two crutches was certainly possible, and yet not easy. Finishing those tasks independently should have left him with some sense of satisfaction, he realized; instead, all he felt was self-doubt and embarrassment because he'd made himself feel foolish and look foolish in front of Wilson. Now, Wilson would walk in to the room, find the suitcase packed, and think he'd won some kind of stupid victory. That was all House could focus on.
Meanwhile, Wilson made a quick trip down to the physical therapy department. Ruth was setting her area up for the patients she had scheduled that day. "Hi, do you have a few moments?" Wilson asked. "I see that you're busy, so maybe that was a stupid question," he qualified his question quickly.
"Nope, I'm not too busy. What can I help you with?" Ruth asked as she moved about her area, arranging items where she wanted them.
"Do you really think Greg is ready to go home?"
Ruth stopped and stood up to face Wilson. "Let's both find somewhere to sit a moment."
They both found comfortable chairs.
"He's met all of the discharge criteria so far, so yes, he's ready to go home."
"I'm not talking about criteria, or test results, or measurable data or anything like that. I'm talking about your gut feeling. Do you think he's ready to go home?" Wilson asked.
Ruth smiled. Wilson looked at her and realized there was something behind that smile; it was a "knowing" smile. It was the smile parents always flash when their teens tell them they don't know what it's like to be a teenager. Of course they do; their teens are never convinced of that, though.
"Let me hazard a guess," Ruth replied. "I think you're just as unsure of his readiness to go home as he is."
"You're not secretly a psychiatrist, are you?" Wilson laughed. "I have to admit, he may be ready to go home but that doesn't mean it's going to be easy. I was hoping you'd say, 'of course he's ready', and then I could get the satisfaction of volleying with you. You hit the ball back to me, though. Gotta give you credit for that."
"I made him a bet," Wilson continued. Ruth's ears perked up at that. "Yeah, you heard right. There's a thousand dollars on the line. Did you hear that Dr. Smith asked him to find a new physiatrist?"
"I'd heard that, yes. I'm actually surprised Greg didn't find a new one before now. Dr. Smith is great at what he does but he can be hard to get along with, especially when the patients have as much or more medical knowledge than he does," Ruth admitted.
"Well, the bet is that, once he finds a new physiatrist, he has to comply with everything the physiatrist prescribes for two months. He has to give me a copy of his outpatient PT schedule and he has to give me a copy of the physiatrist's prescribed therapy regimen. I win the thousand dollars if he fails to comply with even one part of the prescribed therapy. If he misses one appointment or one home prescribed therapy exercise and I find out about it, he's out a thousand dollars. If he does everything exactly as prescribed for two months, he's a thousand dollars richer at my expense."
Ruth laughed. "Now I have to give YOU credit. I never would have thought of that! Bribery, or maybe even extortion! Cool!"
"Yeah, well, I gotta play to our strengths. Listen, it's been great talking to you. I have to get back to him. You're going to see him one more time before he leaves today, right?" Wilson said hopefully.