Summary: When a panel is convened to review the facts of Gregory House's life, his fellows (past and present), colleagues, patients and friends are called to testify. Possible character death.
Six blind men came upon an elephant. "What is an elephant like?" they wondered, so each of them approached part of the elephant and touched it. The first blind man, who touched the elephant's leg, proclaimed, "An elephant is like a pillar." "No, it is like a rope," disagreed the second blind man, who had grabbed the elephant's tail. "You're both wrong. It is like a tree branch," said the third man, who touched the trunk, while the fourth blind man thought the ear felt like a hand fan. Blind man number five, who touched only the elephant's side, argued that it was like a wall, and number six insisted that the elephant's tusk was like a pipe. They began to argue, each insisting that the impression he had of the elephant described the entire beast. A passing wise man watched the scene with bemusement, finally taking pity on the arguing blind men, explaining to them that an elephant was all of those things... and more.
-Ancient East Indian fable
Day One, 9 a.m. - Monday
The atmosphere was somber, fluorescent lights casting a blue glow on the otherwise dark room, turning the faces of its inhabitants a sickly green. The stifling, humid New Jersey heat of August was only slightly modified by an air conditioner humming in the background.
Along one side of a long table sat three men and two women, papers, file folders stuffed to overflowing, notepads, pens and bottles of water placed next to each person. Opposite them, a lone chair was situated behind a smaller table, centered so that the person being questioned would sit directly across from the head of the panel, a stout, gray-haired man who sat at the middle of the long table. On the small table sat another bottle of cold water, condensation forming around its rim.
Diagonal to the long table was a second small table, upon which was placed a digital recorder operated by a heavyset, middle-aged female court stenographer wearing a slightly too tight moss green suit. At least, it appeared to be moss green under the fluorescent lighting. It might, in fact, have been pink.
Through the door came a slim, striking brunette, who walked slowly toward the panel and hesitantly seated herself on the lone chair. For the next couple of hours - in fact, for the next few days - most of the questions were asked by the gentleman appointed the head of the panel, although occasionally other panel members interjected if they had specific questions.
"State your name for the record."
"Dr. Remy Hadley."
"You were one of Dr. House's fellows, is that correct?"
"Yes, I was."
"Could you please describe what your fellowship consisted of?"
Thirteen found herself surprisingly nervous as she faced the panel, although she couldn't put her finger on exactly why. Perhaps it was because she was still debating about how forthcoming to be. Or perhaps because she was a little uncomfortable with the fairly recent emergence of more severe Huntington's symptoms.
On the surface, however, she seemed serene, appearing surprisingly at ease in the less-than-comfortable hard-backed chair, although a slight tremor of her hands became evident as she gestured while answering the questions put to her.
"Certainly. Whenever we got a new case, we would brainstorm possible diagnoses - what we called a DDX - and would treat according to what seemed to be the likeliest diagnosis. It was often a process - sometimes long, sometimes short - in which we would continue narrowing it down until we came up with the correct solution."
"What was Dr. House's role in all of this?"
"Dr. House would reject diagnoses that didn't match the symptoms, based on his extensive experience and knowledge, and would suggest possible solutions and treatment based on those symptoms. He rarely saw patients, because he felt that direct interaction with them might interfere with his ability to look at the situation objectively."
"Was there anyone on the team who most often came up with the correct diagnosis?"
"Absolutely. Dr. House himself usually solved the case. Occasionally, one of the rest of us - there were usually between three and five of us on the team - would come up with the solution, but usually it was Dr. House."
"I understand that Dr. House had an unusually high success rate. Is that correct?"
"Yes. During my tenure with him, Dr. House and his team correctly solved about 95 percent of the cases he took on."
"As we understand it, Dr. House was considered the last resort for many of these patients."
"Yes. Usually, our cases were ones that other doctors had given up on."
"So this success rate was especially impressive?"
"Yes. The Diagnostics Department at PPTH was the first of its kind in the world, and Dr. House's reputation was what made it so successful."
"As we understand it, part of that reputation came from what one might call his prickly personality. We understand that Dr. House could be obnoxious and that many people disliked him."
"Certainly, he could be obnoxious, and he was definitely disliked by some people - even by some who admired him and occasionally by those who genuinely liked him."
"Was this your experience with him? How would you describe him as a person?"
Thirteen pondered a moment before responding. "Well, he was sometimes abrasive, sarcastic, manipulative and, occasionally, downright mean. But I somehow felt that beneath the façade was a complicated, lonely man who was in a lot of pain, both physical and emotional."
"How would you describe Dr. House's managerial and teaching style?"
She looked pensive again. "I guess I would say that it was unorthodox, but effective. He encouraged us to - well, perhaps encouraged is too soft a word - he insisted that we look at each case objectively, stand up for what we believed in and put the patient's well-being ahead of everything else, including our personal lives. Because of working with him, I am definitely a better doctor and I'm almost certainly a stronger person."
"Would you say that Dr. House was an ethical man?"
"Depends on your definition of ethics. He would occasionally do things, or ask that we do things, that others in the medical profession might consider questionable, but it was in the service of finding the right answer and saving the patient's life. I would say that, in the course of his career, Dr. House developed his own standards and ethical beliefs and he held to those very dearly."
"We understand that Dr. House spent a lot of his time playing video games, avoiding clinic duty, watching television, and even playing pranks and mind games on other doctors. Would that be a fair assessment, and if so, do you have anything to say about that behavior?"
"Yes, that is fair, and I've actually given a lot of thought to this. I do believe that there are three reasons behind his behavior. First, as those who have studied creativity have noted in the literature, stepping away from a problem to do something mundane, such as watching a soap opera or playing a game, actually frees the brain to work subconsciously on the creative problem, leading to better solutions."
"You believe that finding the answer to these medical problems is primarily a creative endeavor?"
"Yes, I do. Of course, medical knowledge is involved, but the process of finding out what was causing an unusual set of symptoms is definitely creative."
"What do you believe the second reason would be?"
"I believe that, because of his superior intellect, Dr. House became bored easily, and those seemingly extracurricular activities actually kept him grounded. I'm not sure that most people saw it that way, however. I think many people around the hospital thought he was just lazy, but I would have to disagree."
"Why is that?"
"Because, when he thought no one was paying attention, Dr. House was constantly keeping up on the latest medical research, reading international and domestic medical journals published in a variety of languages and tracking unusual cases on the Internet. Of course, if questioned about it, he always claimed to be viewing porn. Sometimes, he actually was."
A low chuckle escaped the 40-ish, gray-haired woman on the far left of the panel. Thirteen's eyes flickered momentarily in her direction before returning to the face of the panel's chair.
"What would the third reason be?"
"Dr. House was in constant, intractable pain from a leg injury. Again, if you read the literature on the subject, chronic pain sufferers find that distractions enable them to function better."
"Talk to us about Dr. House's pain."
"What would you like to know?"
"How did it begin?"
"I wasn't around when it happened, so I only know about it second hand. You'd do better to talk to someone who was actually present."
"Who would that be?"
"Dr. Wilson, although I believe he was on his second honeymoon at the time, Dr. House's then-girlfriend, whom I never met, and, of course, Dr. Cuddy, who was the physician in charge of his case."
"Thanks, Dr. Hadley. We will follow up with them."
"Is there anything you would like to say about Dr. House's pain?"
"Hmmm… I'm sure you already know that he self-medicated with Vicodin… except for a couple of years after he was hospitalized at Mayfield Psychiatric. Then he was clean, although his pain levels - whether on Vicodin or not - were pretty extreme. We often saw him subconsciously rubbing his thigh, and sometimes he just had to get up and walk around to keep the pain at bay."
"Yes. I believe he got pretty desperate about the pain at times, and occasionally tried radical approaches to eliminate it."
"Could you give us an example of one of these radical approaches?"
"Well, during my tenure with him, probably the most radical - actually the two most radical - were when he tried quitting Vicodin and switching to methadone… and, of course, when he attempted self-surgery."
"Tell us about the methadone. I understand there have been excellent results with some pain patients."
"Dr. House didn't tell any of us that he had quit taking Vicodin or that he was on the methadone. The only reason we found out about it at all was that he stopped breathing one day in the office. Initially, the doctors present thought he was just asleep."
"Who was present at that time?"
"Drs. Wilson, Cuddy, Foreman and Kutner. I came into the office with some test results right after they resuscitated him."
"Did he find that the methadone helped him with his pain?"
"Apparently, it completely eliminated his pain. Immediately before we discovered what was going on, his limp had become less severe - turns out he was faking how bad the limp was altogether for a few days - and his mood brightened considerably. For a day or so, after we learned about the methadone, he didn't need to use his cane at all."
"You say he faked his limp. Do you have an explanation for that?"
"If I had to hazard a guess, I'd say that he was afraid the methadone wasn't going to work for him, and didn't want a lot of unnecessary questions about it until he was convinced that it was going to become a permanent treatment for him. Dr. House was a very private person."
"While he was on methadone, did he continue using Vicodin?"
"There is no way, medically, that he could have continued using Vicodin while he was also taking methadone. His transition off of Vicodin must have been pretty easy, because none of us noticed anything until he stopped breathing because of the methadone, so it certainly made me doubt whether he had actually been addicted, as some people have insisted."
"Was there a reason he didn't stay on the methadone?"
"I don't really know all the details… although the word around the department was that Dr. Cuddy insisted on controlling his methadone intake, which annoyed him to the point that he actually quit briefly."
"Was there a reason why Dr. Cuddy would have interfered with his medical treatment, which had been prescribed for him, as we understand it, by a doctor outside of Princeton-Plainsboro?"
"I wouldn't know about that. None of us knew who was prescribing for him. And I can't speak for Dr. Cuddy, although I will say that it seemed as if Dr. Cuddy and Dr. Wilson often interfered with Dr. House, both medically and personally."
"But then he came back to work. Do you know why he returned, after he felt strongly enough to resign his post?"
"Not really. Just that he did."
"What happened with the methadone?"
"He felt that its side effects - not the respiratory problems, but a general mental haziness - compromised his ability to do his job. So he went back on the Vicodin."
"Interesting. So would you say that he thought he functioned better in pain and on Vicodin than without pain but on methadone."
"Do you think that his ability to think clearly was more important to him than the elimination of his pain?"
"That would be my take on it. I think, though, that if he could have eliminated his pain and continued to work effectively, he would certainly have done it. I suspect that Dr. Wilson might disagree with that assessment."
"Why is that?"
"He seemed to believe that Dr. House preferred being in pain. Within my hearing, he often accused Dr. House of enjoying his misery."
"Yes. I disagree."
"It sounds as if you liked Dr. House, despite his abrasive nature."
"Sometimes I did."
"Why would that be? Why did you like him?"
"First of all, it was a privilege to work with a true medical genius like him. For me, that made up for a lot. Second, well, I owe him. Although he flaunted his flaws, he tended to hide his good deeds… and he did me a several good deeds during the time I knew him."
"Could you elaborate?"
Thirteen hesitated. Here it was. How much should she tell? Should she mention the way she had drugged House and then conducted several biopsies on him without his permission… or how he never seemed to hold that ethical lapse against her? Should she talk about how he kept her on, even after she had killed both Stark and his dog through her own negligence? She rejected those options, even though they did give her a greater appreciation, both for House's personality and for his extreme loyalty to those who worked for him.
"I-I, uh, well, I guess it's no secret that I have Huntington's Chorea. It was Dr. House who made me confront the likelihood that I had inherited it from my mother, and got me to face up to the consequences. When I didn't handle the prognosis well, he - in his own unique way - got me to reset my priorities. I probably wouldn't be alive today if he hadn't intervened."
"You said that he did you several good deeds. Were there any others?"
She considered mentioning how House had offered to euthanize her when the time came, but decided to avoid that piece of information if they would allow her to. "The other one is very personal, and I'd prefer to leave it that way." Thirteen remembered clearly the moment that House had turned to her in his car - the same car he later drove through Cuddy's dining room - and offered to kill her if her Huntington's situation worsened to the point where she just wanted out.
"Fine. Moving on. You also mentioned self-surgery. This sounds pretty radical."
"Dr. House was often pretty radical."
"Do you know the details of what happened when he performed surgery on himself?"
"Not all of them. All I know is that he had been experimenting with an untested drug that was supposed to re-grow damaged muscle. Instead, it caused tumors to grow in his injured thigh. As with the methadone, he chose to keep this information to himself. I guess he was embarrassed to admit that he had done something so extreme, even though he'd already mentioned what he was doing to me, so he tried to excise the tumors himself. At home, alone. In his bathtub."
Thirteen noticed that a couple of the panel members seemed startled by this information, even though it was obvious from their questions that they had already done their homework before the inquiry began.
"That is extreme, although it's not unheard of for physicians to occasionally attempt self-surgery. Did the surgery work? Did he remove the tumors?"
"As I understand it, he got a couple of them, but another surgeon at the hospital removed the others in his leg. But following what amounted to three surgeries - his own self-surgery and the follow-up surgery performed by Dr. Hourani, plus another when he developed complications - Dr. House checked himself out against medical advice - AMA - after a couple of days. I don't think Dr. House really trusted that the hospital would do right by him… not surprising, given his past experiences… which explains why he did his own surgery in the first place, and why he refused to recuperate at PPTH."
"Were there any other side effects of the untested drug?"
"I don't know, but I've always wondered whether there might have been additional tumors, other than the ones in his leg." The unsettling thought had circled around in her head, both at the time and then later on, as she tried to fit together the puzzle pieces of what had happened immediately thereafter.
"What makes you think that?"
"Nothing specific, but it was around this time that his emotional state became unstable… this was shortly before he drove his car into Dr. Cuddy's house. It was so out of character for him to be violent in that way… I couldn't help but wonder if there might have been additional tumors growing that affected him somehow. Or some other physical problem that had gone undiagnosed."
"But you never had the opportunity to diagnose him?"
"No, we did not. In fact, we never even discussed it as a group." This was something that had weighed on her; should they have addressed the issues going on? Should they have tried to apply his own methods to their boss?
"Were there any physical after-effects of the drug or the self-surgery?"
"He never said, of course, but I believe his pain levels increased. The area was so sensitive to begin with that I can't help but believe the tumors and the three surgeries must have aggravated what was already an incredibly painful area."
"Thank you, Dr. Hadley. Why don't we take a brief break, and we'll finish up our remaining few questions at 11 a.m.?"
Thirteen rose gingerly from the uncomfortable hard chair, standing a moment before she began to walk, trying to make it appear as if she was merely stretching out her limbs… when actually, she was testing herself to make sure she was able to move without losing her balance. As gracefully as she could, she made her way out the door, down the hall and into the ladies' room, where she splashed cold water on her face, and stretched a bit more.
The tremors had gotten noticeably worse lately, and she knew pretty soon things would get so bad that anyone who saw her would know something was wrong.