[AN: It's Monday in fic-land and probably the true beginning to House's journey back. Depending on how far along I get, I may post another chapter later in the week. For now, enjoy this and if you don't mind – tell me what you think.]
The next morning was a flurry of activity. David had an early meeting at the University, so was out the door by 6:30am to allow for the 40 minute drive in to the office. Phillip's football practice dropped from two-a-days to one practice per day since school would start on Wednesday, but because of the heat the coaches decided to practice early morning instead of the afternoon. He had to be there dressed and ready by 8am and Billy's well baby check was at 8:30. House walked in through the side door just as Phillip was bringing his equipment out of his room to take to Susan's car. He walked over to the coffee pot and poured himself a cup and watched Phillip walk out the front door. Susan walked in from the back where she had been getting Billy dressed and his diaper bag put together, "You're up early," she said. "How are you this morning? Did you sleep well?"
"Fine and no," House said taking a sip of his coffee. "How long are you going to be gone?"
"Probably until noon," Susan answered. House suddenly looked lost confirming Susan's suspicion that he didn't want to be alone, so Susan casually asked, "Would you like to come along? Though I have to warn you, it's likely to be boring."
"I'll come," House said. He walked out of the house and was back within a few minutes.
Soon Phillip was getting out of the car and heading to practice. Susan watched him run inside the gate before she pulled out of the parking lot and headed toward the doctor's office.
There were two other patients in the waiting room of the doctor's office when Susan arrived with House and Billy. Susan handed Billy to House and then went to the front desk to check in. House glanced around at the occupants and found a seat against the wall as far from the obviously ill woman as possible and held on to Billy who had spied a toy on the floor and was trying to get down. A little girl that House estimated to be just under three got up from the children's table where she'd been working on a puzzle, "What's your baby's name?" she asked.
"William," House replied not interested in explaining the complexity of uncles and nephews to a preschooler. "How come he here? He don't look sick."
"Neither do you, why are you here?" House asked.
"I come with mama; she sick," the little girl said as she pointed to her mother at the end of the row.
House glanced over at the mother who was obviously suffering from some sort of respiratory infection. The woman coughed and House immediately diagnosed her with pneumonia. He glanced over at the older woman across from her who House decided was in the early stages of congestive heart failure and grimaced.
"Sally, come back over here and leave the man alone," the mother said finishing her statement with another coughing fit which made House wonder where the lab was in this town or did everything have to be sent off somewhere else.
Sally started to move away, "You gots a pretty baby," she said before she went back to sit by her mother.
Susan finished checking in and came over to sit in the corner by House. Seeing that Billy was trying to reach one of the toys on the floor, Susan pulled out one of his toys from his diaper bag and handed it to him. "I see you don't play by the same rules here as you do at home," House said.
"Nope," Susan said. "Playing with toys off the floor at home is a little different than playing with toys off the floor where dozens of other sick kids have had their hands, snot, and who knows what other disgusting things. I'm sure the toys are washed fairly regularly but I'd just as soon not take a chance. Not yet anyway. He'll have plenty of opportunity to develop his immune system."
A woman walked in holding her three year old by the hand, House's eyebrows lifted in surprise, "You don't see that as often these days," he said.
Susan turned around, "hmm," she said. "No you don't."
"You've had them haven't you?" House asked.
"Yep," Susan said.
"Has he had the immunization yet?" House asked.
"Not that one," Susan said. "I don't think he gets varicella until twelve months."
"He may not need it," House said as the woman sat down between pneumonia lady and Susan. The little boy sat on the chair next to his mother and started scratching his arm.
"Quit scratching," his mother admonished and tried to pull his hand away from his arm. The little boy cried out in frustration and got up off of his chair and went to play with the toys scratching as he went.
"Most kids are immunized these days, where'd he pick up the chicken pox?" Susan asked.
"Yes, chicken pox. Where'd he get it?" House asked.
"We don't have any chickens," the lady said. "It's not chicken pox."
House rolled his eyes, "You're a moron. It's the chicken pox and he's extremely contagious. He shouldn't be here or anywhere for that matter."
"It's just a rash, but he won't quit scratching it. So I came to get a cream from the doctor," she said.
"It's chicken pox. Get him out of here and take him home," House said. He grabbed a piece of scrap paper from the side table next to him and wrote something. "Go to the pharmacy and pick up this lotion. It's over the counter, you don't need a prescription - but leave him at home with somebody when you go."
"What do you know, are you a doctor?" the lady asked indignantly.
"Actually, yeah - now get out of here before he infects the baby or the old lady," he ordered. "And don't give him any aspirin."
The old lady looked up toward House and then at the preschooler, "I had chicken pox years ago," she said. "I'll be okay."
"You're immune compromised, you could be re-infected. For that matter, you need to move away from Miss Pneumonia," House said.
Pneumonia lady looked over at House, "It's just bronchitis." She broke down coughing again and the old lady shifted seats closer to Susan.
The lady with chicken pox boy got up dragging her little boy along and went over to the receptionist counter to complain and pointed over at House. The receptionist looked over toward House and Susan and then glanced down at the little boy. Her eyes went wide and she quickly left her desk and ushered the woman with her little boy out of the waiting area and inside.
"Just two days and you're already causing a ruckus," Susan said quietly to House.
"It's what I do best," he said.
The nurse opened the door and called a woman's name. Pneumonia lady got up and walked in with her daughter following close behind.
The older lady looked over at House and Susan. House was still holding Billy in his lap while Billy was playing and mouthing the toy Susan had given him. She glanced back at Susan, "How old is your son?"
"Almost six months," Susan answered.
"Do you have any other children?" she asked.
"Two," Susan said.
"What about you, do you have any children?" she asked House.
"No," House said.
"That's too bad; you're obviously very good with them. Though not so good with adults," she said.
"Just not the stupid ones," House said.
"I'm curious," Susan said. "How do you know that the baby isn't his?"
"He has the same eyes as the both of you, but he doesn't favor either of you - and you two favor each other. Babies usually favor the father. He's your brother," she said nodding over to House, "but I'm fairly sure you only share one parent."
"I'm impressed," Susan said.
House narrowed his eyes to look at her more closely, "I know you," he said.
"No, we've never met. I would remember you," she said.
"I've seen you somewhere," House said.
"Medical conference possibly," the lady said referring back to his earlier conversation with chicken pox mom. "Before I retired I was a geneticist and spoke on a regular basis."
"What's your name?" House asked.
"Collins," she replied, "Margery Collins."
House lifted his eyebrows but didn't say any more. Susan hadn't heard of Margery Collins, but obviously the name was familiar to Greg. She decided to ask him about her later.
The nurse opened the door and called for William James. Susan got up from her chair and turned to House to get Billy, "Do you want to go in or wait here?"
"I'll wait here," he said.
Susan walked inside the exam room and the nurse shut the door behind her. She could hear the patient in the next room talking to the doctor. She'd have to keep that in mind in the future so that she didn't speak too loudly, "I know it's just bronchitis," the lady said, "but the man in the waiting room said I had pneumonia."
"OK, well I need to listen," the doctor said.
"I can't have pneumonia, because I can't afford to stay home from work," she said.
"If only all illnesses would stay away because of that reason," the doctor said sarcastically. "I won't know what it is until I can listen," the doctor repeated.
"But if I miss work, then I won't be able to make my rent," the lady said.
"You know, it's really hard to hear when you keep talking," he said with some exasperation to his voice. "Please be quiet for a moment."
"I'm already losing time at work by having to come in for this. Just give me an antibiotic and I'll go back to work," the lady said.
"Shut up!" the doctor said.
Susan smiled to herself, "I can only imagine what your uncle would say to the lady at this point," she said to Billy. Billy reached up to grab her nose, missed and grabbed her lips instead. He pulled and then laughed at her face when he moved her lips. Susan smiled causing him to lose grip and then reached and tugged lightly on his lower lip in response. Billy thought that was hilarious and found his mother's lip again. Susan pulled him closer and kissed his forehead, "So now you're moving to lips," she said. "You'll have the entire face figured out in no time."
"Well, he's right, you have pneumonia," the doctor said through the wall. "I'm writing you a note for two weeks off of work and two prescriptions you need to get filled today. We're going to try to treat this at home for a few days and if there is no improvement I'll have to send you over to Westland Memorial. I want you back here on Thursday. The nurse will be back in a moment to help you set all that up.
"But what about…?" the lady started before breaking downing yet another coughing fit. Susan heard the door open and close then some mumbling between the doctor and the nurse in the hall
Two minutes later the door to the exam room opened and the doctor walked in. He looked like he was in his early 50's, "You have a HIPPA violation," Susan said quietly.
"Oh?" he asked. "How's that?"
"You can hear quite well through this wall," she said pointing to the wall in question.
"We've only just opened this room today to see patients. I bought this practice six months ago and the previous doctor used this room for storage. I guess now I know why. I'll see to getting that issue fixed this afternoon. Do you want to change rooms? He asked.
"No, this is just a well-baby exam, so nothing remarkably confidential," Susan said.
The doctor reached for Billy and set him on the exam table keeping hold of him so he didn't fall off, "I haven't seen him yet, so I assume you've just moved here." He said.
"Almost two months ago," Susan confirmed. "He'd just had his 3 month exam when we moved." She pulled his medical records out of the diaper bag and put them on the exam table behind Billy. "He hasn't had any major issues; one ear infection. He's up to date on all his immunizations."
"He eats well," the doctor said as he tickled Billy's double chin, "is he on any solid food?" the doctor asked.
"Not yet," Susan answered.
"Well, go ahead - start with rice cereal diluted with your milk," the doctor said. "Give him a few weeks on that before you switch to oatmeal. Save wheat for last and then you can start with vegetables. I'll have the nurse give you a pamphlet that will outline how and when to introduce the new foods. I'd like you to continue nursing him for a while longer. It isn't absolutely necessary anymore as he's gotten all the antibodies he needs from you at this point, but I like to encourage my mother's to continue the practice for the first full year and then put them straight on whole milk. He'll taper off on his own as he starts to eat more solid food allowing you to gradually wean him." The doctor finished his exam, "He's perfectly healthy," he said handing Billy back to Susan. "He's a little heavy in the 75th percentile on weight and 60th in height but I'm not worried about it at this stage."
Susan nodded, "My daughter was pudgy as well when she was a baby."
"The nurse will be in shortly with his next round of immunizations and those pamphlets and we'll see him again at nine months," the doctor said. With that he left the room and went to his next patient. The nurse followed shortly with the immunizations and soon Susan was carrying a crying Billy out into the waiting room.
When she opened the door to the waiting room, the population had exploded. The office was now full of people. No wonder the doctor had seemed in such a hurry. She glanced over at Greg who was watching a young girl and picked up the scrap paper pad and started writing. He saw Susan walk into the waiting room and stood up. As he passed by the mother of the little girl, he handed her the piece of paper and said something to her. He met Susan and together they walked out of the office.
"What was that all about?" Susan asked when they got to the parking lot.
"She has more problems than her mother thinks she does," House said. "I suggested a test."
David returned to his office after the staff meeting and started working on his notes for lecture. At this university, he would still be responsible for teaching one class even though he was dean of arts and sciences. He didn't mind at all as he enjoyed teaching at this level. He would be responsible for one senior level course in his specialty. He looked at his roster; he only had five students enrolled. At least he'd be able to remember all their names. At PPTH Academic, his class sizes had been so large there was no way he could keep up with all of his students. Of course he had been relegated to teaching entry level chemistry where the enrollment was higher. The further up in level, the classes were the fewer students enrolled. He'd been a department head, but he'd had to leave the upper level classes to those with more seniority and tenure as his dean had insisted. David hoped the politics didn't play as large a role here. So far he hadn't gotten that impression.
His admin knocked on the door, "Dr. James, I just signed for a package for your wife."
"My wife?" David asked.
"That's what it says," she said handing it over.
Sure enough the package was addressed to Susan James % David James, PhD at Westland University. David set it on his desk without opening it, "I'll take it home this afternoon. Oh Diane, I almost forgot; would you please make copies of those three physics proposals I'm debating about? I'd like to take them home tonight as well."
"Sure," Diane replied and walked out of his office. David returned to his lecture notes.
The doctor was listening to the bowel sounds of the little girl, "The diarrhea hasn't subsided at all?"
"No," the mother replied. "I've started putting her back in diapers to keep from messing up all her clothes."
He looked at the patient's records left behind by the previous physician. Most of the ailments were fairly typical, ear infections, bronchitis, refusing to eat, but what was interesting was that she had been having issues with diarrhea since she was weaned. "What is she eating? Does she eat balanced meals?" the doctor asked. "How much sugar does she eat?"
"I'm not really sure," the mother said. "I'm so busy with the that the older two pretty much fend for themselves."
The doctor stared incomprehensibly at the mother, "Who would know what she is eating?" he asked.
"Her sister probably," the mother said.
"And, how old is her sister?" he asked.
"Five," the mother said.
"So, you have a five year old and a three year old taking care of themselves, while you take care of the baby," he confirmed.
"He takes a lot of attention being retarded and all," she said.
"Retarded," he repeated amazed that she was so blunt in her description. "Have you thought about getting a nanny?" he asked.
"Now, how am I supposed to afford a nanny on what I'm paid," she said. "I'm lucky to get enough money to buy groceries much less pay for a nanny."
The little girl moaned and turned to her side as a sickening aroma emitted from her body as her bowels evacuated uncontrollably. The doctor slipped on a pair of gloves and turned back to the child, "Sweetheart, I need to look at your bottom," he said as he unfastened the diaper. "Do you have a spare diaper with you?" The mother pulled a diaper out of the bag and handed it to the doctor. "Where are your other two children?" he asked.
"At home," she answered.
"Who's watching them?" he asked as he cleaned the little girl's bottom. She was covered in rash from the constant exposure to bowel.
"My daughter is taking care of the baby," she said.
"Your five year old is babysitting a developmentally disabled baby," the doctor clarified.
"Sure," she said. "She does really well with him."
"I want you to stay real still sweetheart. I'm going to get something out of the cabinet for your bottom," he said. He turned and reached into the cabinet for a cream for her rash and while he was there, he pushed a button that would call the nurse to the room. He turned around and started applying the cream. Before he was finished, the door opened and the nurse came inside, "Would you please call Shirley for me and let her know that we need to reschedule her appointment for this afternoon." He looked at his watch, "Tell her to be here in an hour."
The nurse looked a little confused, but she realized that there must be an issue with this particular patient because he was talking in code. Shirley was the local officer for child protective services. Her office wasn't in this town however, but in Westland, between the hospital and the University. It would take her nearly an hour to get here. "Sure," the nurse said and walked out the door.
The doctor put her diaper back on the little girl and lifted her to a sitting position. He removed his gloves and washed his hands and then proceeded with his examination. As he worked, his brow furrowed. Her abdomen was distended, but her other vitals were normal. "I need to do some testing and would like to keep her here this afternoon," he said. "I have a special room she can stay in and I'll have my assistant stay with her for the day."
Not surprisingly the mother didn't mind at all, "Ok," she said and started to walk out the door. She put her hand in her pocket to get her keys and felt the note inside. "Oh, that other doctor in the waiting room told me to give you this note," she said handing him the note and then was gone.
Other doctor? He thought to himself. This was his third patient this morning that had alluded to another doctor in the waiting room. He opened the note and read it; it simply said "add CRP". Well, he was going to do blood work anyway; he may as well add CRP to the list of tests. It wouldn't hurt, but he had to wonder who the guy was and what he was thinking. First on the agenda, pull the blood and call the hospital lab courier for a stat pickup. Then he would see to his other patients and start working on finding this mysterious waiting room doctor.